Page 86 - 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
th
Area Served Baby Holding Nursery Floor/Bldg 6 Floor

Zone Valve Location for this Area Corridor wall across from Rm 6930 ZVB Manufacturer Beacon

FL Hosp. Tag # O2 000000222035 AIR 000000222037 VAC 000000222036
Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Test Gauge O2 52 AIR 49 VAC 21
Pressure vs.
ZVB Gauge 53 47 21

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
Baby Baby
Test Location Holding1 Holding1

Area Alarm Panel Location for this Area Nurses station across from Rm 6931

Location IAW NFPA 99 Pass Labeled Pass Gauges Pass Leak Test Pass
Area Alarm Panel Manufacture Data Beacon Total Alert 2 ADV#000000222146
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 48 40 60 P P P PS PASS
VAC 21 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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