Page 70 - Med Plaza and Cancer Center

ZONE VALVE/ AREA ALARM / OUTLET PERFORMANCE/GAS CONCENTRATION AND PURITY INSPECTION DOCUMENT

Facility Florida Hospital Orlando-Med Plaza Inspector Joseph Voight
City/State Orlando, FL Date 11-17-17 Page 1 of 5
Contractor n/a Facility Contact Darrell Huckaby

Area Served Observation Rooms 31-36 & MOD A-D Floor/Bldg 4 Floor Med Plaza
th

Zone Valve Location for this Area Outside MOD A ZVB Manufacturer Medaes

FL Hosp. Tag # O2/MA/VA-P-5CC-04-B-Z-W-22
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Test Gauge O2 52 AIR 50 VAC -25
Pressure vs.
ZVB Gauge 51 50 -25

Valve Size ¾” ¾” 2”
Comments:

Gas/Pipeline Purity Oxygen Medical Air Comments
Hydrocarbons <1 PPM <1 PPM
Dew Point -46 23
Carbon Monoxide <1 PPM <1 PPM
Carbon Dioxide <1 PPM 370 PPM
Gas Concentration 99.9%O2 21.0%O2
Particulates <1 <1

Odor/Discoloration None None
Test Location Mod A Bed 4 Mod A Bed 4

Area Alarm Panel Location for this Area Nurse Station

Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Medaes (GP-L-5CC-04-3G-Z22)
GAUGE LOW HIGH TEST
GAS/VAC PSI ALARM ALARM VISUAL AUDIBLE SWITCH SENSOR COMMENTS PASS/FAIL
OXY 49 40 60 P P P PS PASS
AIR 50 40 60 P P P PS PASS
VAC 24 12 - P P P PS PASS
PS= Patient Side SS= Source Side NW= Not Working CNT= Could Not Test NA = Not Applicable NP = Not Present

Corporate Office ∙ 4518 Clements Rd. Lakeland Florida 33811 Phone: 863-646-7555 ∙ Fax 863-646-2999
“Medical Gas Pipeline Equipment Service, Sales & Verifications”
©Daniel Voight 2009