Page 76 - 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 3
Contractor n/a Facility Contact Darrell Huckaby

Area Served Observation Rooms MOD E & F Floor/Bldg 4 Floor Med Plaza
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Zone Valve Location for this Area Outside MOD E ZVB Manufacturer Medaes

FL Hosp. Tag # O2/MA-P-5CC-04-B-Z-W-20/ 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 23
Pressure vs.
ZVB Gauge 51 49 23

Valve Size ½” ½” 1”
Comments: All FL Hosp Tag #’s for this zone should end with 20 (Vac has wrong tag)

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 E Bed 23 Mod E Bed 23

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-Z20)
GAUGE LOW HIGH TEST
GAS/VAC PSI ALARM ALARM VISUAL AUDIBLE SWITCH SENSOR COMMENTS PASS/FAIL
OXY 51 40 60 P P P PS PASS
AIR 50 40 60 P P P PS PASS
VAC 23 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