Page 102 - Womens Pavilion

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

Facility Florida Hosp. Orlando – Women’s Center Inspector Gage Stephens
City/State Orlando, FL Date 11-28-17 Page 1 of 2

Contractor n/a Facility Contact Darrell Huckaby
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Area Served Lactation Support/Baby Hold. Nursery Floor/Bldg 7 Floor

Zone Valve Location for this Area Corridor wall across from Rm 7930 ZVB Manufacturer Beacon

FL Hosp. Tag # O2 000000222053 AIR 000000222055 VAC 000000222054
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Test Gauge O2 52 AIR 49 VAC 22
Pressure vs.
ZVB Gauge 52 48 22

Valve Size ½” ½” 1”
Comments:

Gas/Pipeline Purity Oxygen Med Air Comments
Hydrocarbons <1 PPM <1 PPM
Dew Point -44F 5F
Carbon Monoxide <1 PPM <1 PPM
Carbon Dioxide 0 PPM 120 PPM
Gas Concentration 99%O2 21.8(%O2)
Particulates None None

Odor/Discoloration None None
Test Location Baby Hold 2 Baby Hold 2

Area Alarm Panel Location for this Area Nurses station, across from Rm 7931

Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Beacon Total Alert 2 ADV# 000000222150
GAUGE LOW HIGH TEST
GAS/VAC PSI ALARM ALARM VISUAL AUDIBLE SWITCH SENSOR COMMENTS PASS/FAIL
OXY 52 40 60 P P P PS PASS
AIR 49 40 60 P P P PS PASS
VAC 20 12 NA P P P PS PASS
PS= Patient Side SS= Source Side NW= Not Working CNT= Could Not Test NA = Not Applicable NP = Not Present

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