Page 5 - Select Specialty

MEDICAL GAS MASTER ALARM INSPECTION DOCUMENT

Facility Select Specialty Hospital-Orlando Inspector Anthony Voight Page 1 of 1

Contractor/ Facility Contact Darrell Huckaby Date 12-12-17
Alarm Location #1 Nurses station Manufacturer & Model# Amico Alert GP-L-ILR-01-MA-001

Alarm Location #2 Admin Desk Manufacturer & Model# Amico Alert GP-L-1LR-01-MA-002

VISUAL AUDIBLE TEST SWITCH
ALARM CONDITION SET POINT #1 #2 #1 #2 #1 #2 COMMENTS
O2 LINE PRESSURE HIGH 60PSI P P P P P P
O2 LINE PRESSURE LOW 40PSI P P P P P P
O2 SECONDARY IN USE 80PSI P P P P P P
O2 MAIN LIQUID LEVEL LOW P P P P P P
O2 RESERVE IN USE 65PSI P P P P P P
O2 RESERVE PRESSURE LOW P P P P P P
MED AIR LINE PRESSURE HIGH 60PSI P P P P P P
MED AIR LINE PRESSURE LOW 40PSI P P P P P P
MED AIR DEW POINT HIGH P P P P P P
MED AIR SYSTEM MALFUNCTION P P P P P P
MED VAC LAG ALARM 18 P P P P P P
MED VAC LINE PRESSURE LOW 12 P P P P P P

Main Line Pressure & Vacuum Switch Locations OAV-by equipment

IS MASTER ALARM INSTALLED IN A LOCATION TO ENSURE CONTINUOUS OBSERVATION Pass
IS AN ADDITIONAL PANEL INSTALLED IN THE PRINCIPLE WORKING AREA OF THE MAINTENANCE DEPARTMENT Pass
IS THE ALARM ELECTRICAL SOURCE ON EMERGENCY POWER Pass

CODE DEFICIENCIES NOTED:

Corporate Office ∙ 4518 Clements Rd. Lakeland Florida 33811 Phone: 863-646-7555 ∙ Fax 863-646-2999
“Medical Gas Pipeline Equipment Service, Sales, Verifications & Training”
www.medgaspro.org