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Medical Gas System Component Inventory


           Facility   Select Specialty Hospital-Orlando       Inspector  Anthony Voight

          City/State  Edgewater, FL                           Date       12-12-17        Page       1 of 1
                                                (Source & Master Alarms)
            Medical Air System#                                                              Year of
                  Location           Manufacturer & Model #   System Size, HP & Voltage  Manufacturer     Serial#
                                                      Beacon
         Basement                           LPS-7D80-DAY-003      7.5 HP, Duplex Stack Scroll                 65448
          Medical Vacuum System#                                                             Year of
                  Location           Manufacturer & Model #   System Size, HP & Voltage  Manufacturer     Serial#
                                                 Beacon/Busch
         Basement                           LVS-5D-H  A120-DA  5HP, Duplex Stack Vertical Tank   6-09-2006   146474-1
            Master Alarm Panel #                                  Number of Signals          Year of
                  Location           Manufacturer & Model #           Monitored           Manufacturer    Serial#
                                                   Amico Alert
         Nurses Station                    GP-L-1LR-01-MA-001                         12
                                                   Amico Alert
         Admin Desk                        GP-L-1LR-01-MA-002                         12

                                                      (Area Alarms)

         Area Alarm Panel Location     Manufacturer & Model #                      Gas & Vacuum Monitored
         8601-8604 & 8605-8621                         Amico Alert GP-L-1LR-01-6G-003                   O2, AIR, VAC

                                                      (Inlet/Outlets)
                              st
        Outlet Type/Series Legend- 1  Digit=Manufacturer; A=Amico, B=Beacon/Medaes/Ohmeda/Ohio, C=Chemetron/Allied/NCG/Oxequip,
        O=Ohio/Squire, G= Gentec, H=Hill-Rom, T= Tri-tech
        2  Digit=Type; W=Wall, C=Console, G= Gas Block, H= Hose Drop/Ceiling
         nd
        3  Digit=Connection; O=Ohmeda, C=Chemetron, D=DISS, P=Puritan Bennett, X=Oxequip
         rd
         th
        4  Digit=Series; B=Series B, 1= Diamond 1, 3= Diamond 3/Gemini, 4=Series 400, 5=Series 500, H= Horizon Gas Block, I=Integris Gas Block
        D=Diamond Care
         th
        5 Digit= Manufactured Assembly; B= Boom/Pendant, C= Ceiling Column, F= Floor Pedestal, H= Headwall, I= ICU Column, P= Patient Console

         Medical Gas Outlet/Inlet                                                                    Wall/Ceiling/
         Location/Zone             Manufacturer & Model        O    A     V   N2O   N2   WAG  CO2  Column/Headwall
         8601-8604                                     CWC5    8     8    8
         8605-8621                                     HWCD    27   27   27

                                                     Total Outlet Count:
                                             Oxygen                        35
                                           Medical Air                     35
                                             Vacuum                        35
                                              Total:                      105





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