Page 20 - Womens Pavilion

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

Facility Florida Hosp. Orlando – Women’s Center Inspector Anthony Voight
City/State Orlando, FL Date 11-29-17 Page 1 of 2

Contractor n/a Facility Contact Darrell Huckaby
rd
Area Served C-Section 1 Floor/Bldg 3 Floor

Zone Valve Location for this Area Corridor wall outside of C-Section 1 ZVB Manufacturer Beacon

FL Hosp. Tag # O2 000000222009 AIR 000000222012 VAC 000000222011 N2O 000000222013
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Test Gauge O2 52 AIR 48 VAC 21 N2O 54
Pressure vs.
ZVB Gauge 54 48 21 55

Valve Size ¾” ½” 1 ¼” ½”
Comments:

Gas/Pipeline Purity Oxygen Med Air N2O Comments
Hydrocarbons <1 PPM <1 PPM <1 PPM
Dew Point -44F 5F -40F
Carbon Monoxide <1 PPM <1 PPM <1 PPM
Carbon Dioxide 0 PPM 120 PPM 0 PPM
Gas Concentration 99%O2 21.8(%O2) 99.9%N2O
Particulates None None None

Odor/Discoloration None None None
Test Location C-Sect 1 C-Sect 1 C-Sect 1

Area Alarm Panel Location for this Area Nurses station across from C-Section 1

Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Beacon Total Alert 2 ADV# 000000222142
GAUGE LOW HIGH TEST
GAS/VAC PSI ALARM ALARM VISUAL AUDIBLE SWITCH SENSOR COMMENTS PASS/FAIL
OXY 52 40 60 P P P SS PASS
AIR 48 40 60 P P P SS PASS
VAC 21 12 NA P P P SS PASS
N2O 52 40 60 P P P SS 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
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©Daniel Voight 2009