Page 50 - 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 3

Contractor n/a Facility Contact Darrell Huckaby
th
Area Served NICU 4924-4926 Floor/Bldg 4 Floor

Zone Valve Location for this Area Across hall from Soiled Equipment ZVB Manufacturer Beacon

FL Hosp. Tag # O2-000000311190 AIR-000000311191 VAC-000000311192
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Test Gauge O2 53 AIR 50 VAC 20
Pressure vs.
ZVB Gauge 54 50 22

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 4924 4924

Area Alarm Panel Location for this Area Across from Soiled Equipment Room

Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Beacon Total Alert Infinity ADV# 000000311193
GAUGE LOW HIGH TEST
GAS/VAC PSI ALARM ALARM VISUAL AUDIBLE SWITCH SENSOR COMMENTS PASS/FAIL
OXY 54 40 60 P P P SS PASS
AIR 50 40 60 P P P SS PASS
VAC 22 12 NA 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
“Medical Gas Pipeline Equipment Service, Sales & Verifications”
©Daniel Voight 2009