Page 110 - Womens Pavilion
P. 110

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 4

           Contractor  n/a                                    Facility Contact   Darrell Huckaby
                                                                           th
          Area Served   Patient Rooms 7917-7928               Floor/Bldg   7  Floor

           Zone Valve Location for this Area   Corridor wall across from Rm 7919   ZVB Manufacturer   Beacon

          FL Hosp. Tag #       O2 000000222047 AIR 000000222049 VAC 000000222048
          Location IAW NFPA 99   Pass          Labeled    Pass      Gauges   Pass       Leak Test   Pass
           Test Gauge   O2    52   AIR    49   VAC    20
           Pressure vs.
           ZVB Gauge          51          51          20

          Valve Size       ¾”          ¾”         1 ½”
          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              7919           7919

         Area Alarm Panel Location for this Area         Nurses station, back wall, across from Rm 7922

         Location IAW NFPA 99       Pass                 Labeled    Pass   Gauges     Pass     Leak Test   Pass
         Area Alarm Panel Manufacture Data         Beacon Total Alert 2 ADV# 000000222148
                     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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