Attachment 1.pdf

BeaconMedaes · 2101 Dover Road · Epsom, NH 03234

Life is in the details

2024 Medical Gas Testing and Evaluation Testing Completed : January 7, 2025

Report Date: January 8, 2025

White River Junction VA Medical Center 210 North Main Street White River Junction, VT 05009

Attachment 1

TABLE OF CONTENTS BY SECTION

Table of Contents Section Introduction

Purpose of Inspection and Evaluation ............................................................... 1.1

Methodology to Complete Inspection .............................................................. 1.2

Signature Page .................................................................................................. 1.3

Inventory of Medical Gas Components

Summary Maintenance Deficiencies

Summary Compliance Deficiencies

Summary General Comments

Newer Health Care Facility Code Recommendations

Master Alarm Testing Results

Oxygen Particulate Testing Results

Medical Air Moisture Testing Results

Alarm Testing Results

Zone Valve Testing Results

Outlet/Inlet Testing Results

Source Testing Results

Verification Reports Completed

Repairs Completed

Credentials

PURPOSE OF INSPECTION AND EVALUATION

The following inspection report is designed using the NFPA 99, 2012 edition code, which is the current Center for Medicare & Medicaid Services standard.

The purpose of an inspection and evaluation of a medical gas system is to determine if the system functions as designed, to suggest areas for improvement, and to note what could be upgraded to meet current NFPA 99 criteria so that patient/employee safety is always being maximized.

Your facility was inspected by representatives using all state-of-the-art testing equipment carrying all credentials necessary to properly inspect medical gas systems.

It is important to understand that the findings in this report may or may not be looked at as a patient or employee safety issue, but each item needs to be evaluated by hospital risk management personnel to determine if there are safety issues.

NFPA 99, 2012 EDITION PARAGRAPH 5.1.1.4 STATES THAT AN EXISTING SYSTEM

THAT IS NOT IN STRICT COMPLIANCE WITH THE PROVISIONS OF THIS CODE

SHALL BE PERMITTED TO BE CONTINUED IN USE AS LONG AS THE AUTHORITY

HAVING JURISDICTION HAS DETERMINED THAT SUCH USE DOES NOT

CONSTITUTE A DISTINCT HAZARD TO LIFE.

This report also may satisfy any preventative maintenance requirement from all regulatory agencies. Please note that our methodology constantly changes to meet any changes in NFPA and other regulatory requirements.

THIS REPORT REFLECTS THE DEFICIENCIES THAT WERE OBSERVED AT THE TIME

OF THE INSPECTION. OTHER DEFICIENCIES MAY ALSO EXIST THAT WERE NOT

OBSERVED DURING THIS INSPECTION.

METHODOLOGY TO COMPLETE INSPECTION

Medical Gas Sources – Medical air compressor, vacuum pumps, gas manifolds, and any other device used to deliver medical gases to patients.

1. Inventoried by location.

2. Leak checked and documented.

3. Recommendations to comply with NFPA 99, 2012 edition Health Care Facilities Code.

Master Alarm Panels – Alarm panels located at two separate locations throughout the facility. These panels monitor conditions directly from the medical gas sources.

2. Tested by removing existing pressure switches and other sensing devices to test the actuation points. No interruption of service is necessary if each device is mounted on code compliant demand fittings.

3. Verify proper points are being monitored at each panel.

4. Verify each panel is in the proper locations.

5. Verify proper labeling.

Area Alarm Panels – Alarm panels that are located throughout the facility that monitor medical gas pressures for the area only.

2. Tested by lowering pressure in each zone for each gas and documenting the alarm point.

3. Verify proper location.

4. Verify proper labeling.

Zone Valve Boxes – Accessible valves typically found in a corridor covered by a plastic window used mostly for emergency purposes.

2. Checked for leakage from packing, flange, and gauge port using oxygen safe leak detector.

3. Verify proper labeling.

4. Verify proper locations.

Medical Gas Outlets/Inlets – Connection points for each gas located mostly in patient areas. (Any outlets/inlets located in Airborne or Droplet precaution rooms will not be tested.)

1. Inventoried by location in each room or area inspected left to right and then top to bottom.

2. Complete an operational pressure test on each outlet and document pass/fail. (Test Parameters per NFPA 99, 2012 edition)

3. Check function of outlet/inlet and latching mechanism.

4. Check for leakage with equipment and without equipment attached.

5. Document connection type and outlet/inlet manufacturer.

Oxygen Particulate Analysis – Particulate is often found in existing medical gas systems due to improper installation methods that were used in the past.

1. Samples are taken on each floor in each building. (See particulate analysis section)

Medical Air Dewpoint Analysis – Moisture is removed from medical air systems at the source. Periodic Analysis of moisture throughout the facility is important to prevent contamination.

1. Samples are taken on each floor in each building. (See Medical Air Dewpoint Analysis Section)

2. A sample will be taken at the medical air source to compare building samples to.

Emergency Oxygen Supply Connection Box – This box is typically mounted on the outside of a facility to facilitate the back feeding of the oxygen system if there is an interruption in service.

2. Check existing location for proper compliance.

3. Check existing piping arrangement to insure proper order of components.

4. Check to make sure box is secured.

Reporting

1. All data was collected and broken down into (3) categories:

a. Items that are maintenance issues and need repair, adjustment, calibration, relabeling, or replacement. These items may or may not be an immediate patient safety issue but can be taken care of easily and without much coordination.

b. Design issues that do not meet NFPA 99, 2012 edition Health Care Facilities Code and need to be updated in the future. These items may or may not be patient safety issues but need to be addressed by hospital risk management personnel as soon as possible.

c. General comments that don’t fit in either category A and/or B.

SIGNATURE PAGE

SYSTEMS INSPECTED BY:

(ASSE 6005, 6020, 6030, and 6040 Certified)

Print Name: Lucas Bresaw

Signature:

REPORT REVIEWED BY:

(ASSE 6005, 6020, 6030, 6035, 6040 Certified & MGPHO Credentialed)

Print Name: Chris Mogee

REPORT REVIEWED BY HOSPITAL PERSONNEL:

Signature: Date:

SYSTEMS INSPECTED BY:

(ASSE 6010, 6020, and 6040 Certified)

Print Name: Nathan Jarvis

Department Floor Area

Alarm Zone

Valves Outlet/ Inlets

Outlet/Inlets Tested

Miscellaneous Data

Radiology 1 4 14 35 35 Pulmonary 1 0 2 6 6

Desk 90 2 1 3 12 12 Nuclear Medicine 2 1 3 6 6

Eye Clinic 3 0 2 9 8

Total Count:

(Building 1) 6 24 68 67 98% Tested

INVENTORY OF MEDICAL GAS COMPONENTS

VAMC White River Junction - Birches Building

Alarm Zone

Valves Outlet/ Inlets

Outlet/Inlets Tested

Miscellaneous Data

Psychiatric Unit G 1 2 6 4 Inpatient Ward G 1 3 42 40

1 West 1 1 3 58 57

ICU 1 1 3 100 96

Respiratory 1 0 3 N/A N/A Construction 2025 1 South 1 1 3 N/A N/A Construction 2025

Same Day 2 1 3 45 45 Surgical Services 2 2 20 48 48

PACU 2 1 3 90 81

Total Count:

(Building 31) 9 43 389 371 95% Tested

VAMC White River Junction - Granite Building

Alarm Zone

Valves Outlet/ Inlets

Outlet/Inlets Tested

Miscellaneous Data

Green Mountain Clinic 1 0 3 4 4

Emergency Room 1 1 3 24 24 Outpatient X-Ray 1 0 3 3 3 White Mountain

Clinic 2 0 3 3 3

Podiatry 3 1 3 12 12 Main line panel for entire 3rd floor Urology 3 0 3 6 6 Vascular 3 0 3 9 9

Neurology 3 0 3 6 6

ENT 3 0 3 3 3

Total Count:

(Building 39) 2 27 70 70 100% Tested

VAMC White River Junction - Mountains Building

Alarm Zone

Valves Outlet/ Inlets

Outlet/Inlets Tested

Miscellaneous Data

Total Count:

Birches Building 6 24 68 67

Total Count:

Granite Building 9 43 389 371

Total Count:

Mountains

Building 2 27 70 70

Master Alarm G 1 2 1

Total Count: 19 94 527 508 96% Tested

VAMC White River Junction - Total Inventory 2025

SUMMARY OF MAINTENANCE DEFICIENCIES

Master Alarms

Carbon Dioxide Manifold

1. During testing, the carbon high/low alarms initiated at 80 psig and 24 psig respectively, both need to be adjusted to fall within 20% of the operating pressure.

Vacuum Pump

1. During testing, the vacuum lag alarm would not initiate at the master alarm panel, only locally.

Birches Building

Radiology

1. MRI – 1st oxygen outlet leaks.

2. Bone Density – Oxygen outlet leaks.

3. X-Ray 1 – 1st oxygen outlet leaks.

Pulmonary

1. Stress/Echo – 1st oxygen outlet leaks.

Eye Clinic

1. Oxygen zone valve located right of Room 319 leaks at the left flange.

2. Room 318 – Oxygen outlet leaks.

Granite Building

1 West

1. Medical air zone valve located right of Room 119 leaks at the left flange.

2. Room 120 – Vacuum inlet has a low flow of 2.0 scfm.

3. Room 123:

a. 2nd oxygen outlet leaks 50 psig.

b. 2nd medical air outlet leaks from the back assembly.

4. Room 137 – Oxygen outlet leaks from the front and back assembly.

5. Room 139:

a. 1st oxygen outlet leaks from the back assembly.

b. 2nd medical air outlet leaks 50 psig.

6. Room 140 – 2nd oxygen outlet leaks.

7. Room 141:

a. 1st medical air outlet leaks from the back assembly.

b. 2nd oxygen outlet leaks from the front and back assembly.

8. Room 150 – Medical air outlet leaks 50 psig.

9. Room 152 – Oxygen outlet leaks from the back assembly.

ICU

1. ICU 1 – 2nd oxygen outlet leaks.

2. ICU 4 – 3rd oxygen outlet leaks.

3. ICU 5:

a. 1st medical air outlet leaks from the back assembly.

b. 2nd medical air outlet leaks.

4. ICU 6 – 4th vacuum inlet has a low flow of 1.75 scfm.

5. ICU 7 – 3rd oxygen outlet leaks.

Same Day

1. Room 232 – 2nd oxygen outlet leaks from the back assembly.

2. Room 233 – Oxygen outlet leaks.

3. Room 234 – Medical air outlet leaks from the back assembly.

4. Room 235 – Oxygen outlet leaks from the front and back assembly.

5. Room 237 – Oxygen outlet leaks from the back assembly.

6. Room 242:

a. 1st oxygen outlet leaks from the back assembly.

b. 1st medical air outlet leaks from the back assembly.

PACU

1. Oxygen zone valve located right of PACU Entrance leaks at the stem in the on and off positions.

2. PACU 2 – There is an audible leak coming from behind the headwall.

3. PACU 4 – 4th vacuum inlet leaks.

4. PACU 5 – 2nd oxygen outlet leaks.

5. PACU 6 – 1st oxygen outlet leaks.

6. PACU 7 – 2nd oxygen outlet leaks.

Sources

In-house Oxygen Components

1. Threaded check valve located on oxygen main line piping leaks on the house side.

1. Carbon Dioxide main line pressure needs to be adjusted to fall within the code compliant gauge pressure of 50-55 psig.

SUMMARY OF COMPLIANCE DEFICIENCIES

Master Alarms

1. There is currently only one master alarm panel provided for this facility.1

Birches Building

Radiology

1. Angio Room - There is no WAGD inlet installed in this area where nitrous oxide or halogenated anesthetic gas is intended to be administered. 2

2. Zone valves located inside CT Scan 2 area are installed behind a normally open or normally closed door. 3

Pulmonary

1. Pulmonary Function Room – Both vacuum inlets are not supplied through a zone valve. 4

Desk 90

1. Area alarm located inside Desk 90 on left does not have separate visual indicators for each condition monitored. 5

Nuclear Medicine

1. Area alarm panel located right of Spect CT was blocked by a supply cart that did not provide adequate opportunity for surveillance.6

Eye Clinic

1. Rooms 311, 312, and 313A – Medical air outlets in these rooms shall be identified as to the name or chemical symbol for the specific medical gas provided. 7

Granite Building

Psychiatric Unit

1. Area alarm panel located at the Nurses’ Station does not have separate visual indicators for each condition monitored. 8

1 West

1. Area alarm located at the Nurses’ Station does not have separate visual indicators for each condition monitored. 9

2. Rooms 145 – Medical air outlet in this rooms shall be identified as to the name or chemical symbol for the specific medical gas provided. 10

Same Day Surgery

1. Area alarm panel located inside Room 213:

a. Is installed in a locked room which does not provide adequate opportunity for surveillance. 11

b. Does not have separate visual indicators for each condition monitored. 12

2. Room 237 – Medical air outlet needs to be labeled, “Not in Service”. 13

Surgical Services

1. Area alarm panel located right of the OR Manifold Room needs to be relabled:

a. For Nitrogen, “OR’s 1 & 4. 14

b. For Carbon Dioxide, “OR’s 1-4”. 15

2. Operating Rooms 1-3 – There are no WAGD inlets installed in these areas where nitrous oxide or halogenated anesthetic gas is intended to be administered. 16

3. Vacuum/WAGD zone valve located left of OR 4 needs a compliant WAGD label added to the existing labeling. 17

PACU

1. Area alarm located at the nurse’s station is a non-compliant Black Ohio panel which does not distinguish between an increase or decrease of 20 percent of the normal operating line pressure and has a recall for a potential fire hazard. (See General Comments). 18

2. PACU 1-9 and Bay 287 – All outlets/inlets (except the last two vacuum inlets) in each of these bays, shall be identified as to the name or chemical symbol for the specific medical gas or vacuum provided. 19

Mountains Building

Emergency Room

1. Zone valves located left of ER Entrance in Hallway C-113 need to be relabeled, “Rooms 1, 2, 4, 5”. 20

Podiatry/Urology/etc.

1. Area alarm panel located at Reception Desk 389 needs “Main Line Pressure” added to its labeling. 21

Oxygen Bulk Pad

1. The outdoor bulk cryogenic liquid system needs to be provided with a minimum of two entry/exits. 22

2. Does not have permanent guard posts installed around the bulk pad site. 23

3. Piping shall be protected against freezing, corrosion, and physical damage where it enters the ground. 24

In-house Oxygen Components

1. Oxygen check valve located on the main line piping inside Granite Building Loading Dock Room B-06 has threaded connections. 25

In-House Emergency Oxygen Manifold

1. Oxygen check valve located on the in-house emergency line inside Granite Building Loading Dock Room B-06 has threaded connections. 26

2. Manifold Room door does not have a minimum one-hour fire resistance rating label.27

Emergency Oxygen Supply Connection

1. Oxygen check valve located on the EOSC pipeline inside Building 31 Loading Dock B- 06 has threaded connections. 28

Nitrogen Manifold

1. Pressure relief vent line:

a. Is not installed with hard-drawn seamless copper in accordance with ASTM B

819 on the roof. 29

b. Has threaded connections on the roof. 30

c. Is painted on the roof. 31

1. Pressure relief vent line:

a. Is not installed with hard-drawn seamless copper in accordance with ASTM B 819 on the roof. 32

b. Has threaded connections on the roof. 33

c. Is painted on the roof. 34

Manifold Room (OR Suite)

1. The medical gas manifold room is being used for non-medical gas storage. 35

2. There are electrical devices that are unprotected or located below 5 feet from the floor and not protected from possible physical damage. 36

3. The manifold room needs to be secured with a lockable door or otherwise secured.37

Medical Air Compressor

1. Medical air intake is not located a minimum of 25 feet from ventilating system exhausts, fuel storage vents, combustion vents, plumbing vents, vacuum and WAGD discharges, or areas that can collect vehicular exhausts or other noxious fumes. 38

Vacuum/WAGD Pump

1. Some turns, offsets, and other changes in direction to the main line and exhaust piping are soft-soldered and not made with acceptable joining methods. 39

2. There is no true source valve installed on the vacuum pump. 40

1 NFPA 99, 2012 edition paragraph 5.1.9.2.1

2 NFPA 99, 2012 edition paragraph 5.1.5.16

3 NFPA 99, 2012 edition paragraph 5.1.4.8.5

4 NFPA 99, 2012 edition paragraph 5.1.4.8

5 NFPA 99, 2012 edition paragraph 5.1.9.1 (1)

6 NFPA 99, 2012 edition paragraph 5.1.9.3.1

7 NFPA 99, 2012 edition paragraph 5.1.11.3.1

8 NFPA 99, 2012 edition paragraph 5.1.9.1 (1)

9 NFPA 99, 2012 edition paragraph 5.1.9.1 (1)

10 NFPA 99, 2012 edition paragraph 5.1.11.3.1

11 NFPA 99, 2012 edition paragraph 5.1.9.3.1

12 NFPA 99, 2012 edition paragraph 5.1.9.1 (1)

13 NFPA 99, 2012 edition paragraph 5.1.11.3.1

14 NFPA 99, 2012 edition paragraph 5.1.9.1 (7)

15 NFPA 99, 2012 edition paragraph 5.1.9.1 (7)

16 NFPA 99, 2012 edition paragraph 5.1.5.16

17 NFPA 99, 2012 edition paragraph 5.1.4.8.8 and 5.1.11.2

18 NFPA 99, 2012 edition paragraph 5.1.9.1 (1)

19 NFPA 99, 2012 edition paragraph 5.1.11.3.1

20 NFPA 99, 2012 edition paragraph 5.1.4.8.8 and 5.1.11.2

21 NFPA 99, 2012 edition paragraph 5.1.9.1 (7)

22 NFPA 99, 2012 edition paragraph 5.1.3.3.2 (3)

23 NFPA 55, 2020 edition paragraph 4.11

24 NFPA 99, 2012 edition paragraph 5.1.10.11.2

25 NFPA 99, 2012 edition paragraph 5.1.4.11 (4)

26 NFPA 99, 2012 edition paragraph 5.1.4.11 (4)

27 NFPA 99, 2012 edition paragraph 5.1.3.3.2 (4)

28 NFPA 99, 2012 edition paragraph 5.1.4.11 (4)

29 NFPA 99, 2012 edition paragraph 5.1.10.1.4

30 NFPA 99, 2012 edition paragraph 5.1.10.10

31 NFPA 99, 2012 edition paragraph 5.1.11.1.3

32 NFPA 99, 2012 edition paragraph 5.1.10.1.4

33 NFPA 99, 2012 edition paragraph 5.1.10.10

34 NFPA 99, 2012 edition paragraph 5.1.11.1.3

35 NFPA 99, 2012 edition paragraph 5.1.3.2.3

36 NFPA 99, 2012 edition paragraph 5.1.3.3.2 (10)

37 NFPA 99, 2012 edition paragraph 5.1.3.3.2 (2)

38 NFPA 99, 2012 edition paragraph 5.1.3.6.3.12 (B)

39 NFPA 99, 2012 edition paragraph 5.1.10.3.1 and 5.1.10.4

40 NFPA 99, 2012 edition paragraph 5.1.4.4

SUMMARY OF GENERAL COMMENTS

1. The bulk oxygen signals are not tested during the annual medical gas inspection and evaluation. These signals are tested by your bulk oxygen supplier and should be reported with their annual preventative maintenance program. These signals include:

a. Oxygen main liquid level low.

b. Oxygen reserve in use.

c. Oxygen reserve liquid level low.

d. Oxygen reserve low.

2. The location of the emergency oxygen supply connection was inspected for compliance per NFPA 99. The future use of a temporary oxygen source will be inspected during a verification process, and the location of that oxygen source may not meet the requirements of NFPA 99 and/or NFPA 55.

3. The nitrous oxide outlet located on Column 2 in Operating Room 3 has been tied into the carbon dioxide system and is labeled “Not in Service”. It’s recommended that this outlet be cut and capped to avoid any potential patient safety issues.

4. During the push button testing of the area alarm panel located at the Surgical

Services Nurses’ Station, it didn’t appear to be functioning correctly in 2025. If this issue persists, it’s recommended that this panel be repaired or replaced.

5. Area alarm panel located at the PACU Nurses’ Station is a Black Ohio panel. These panels are currently under recall due to a fire hazard. Please see attached flyer for more information.

NEWER CODE RECOMMENDATIONS FOR HEALTHCARE FACILITIES

Effective July 5, 2016, Center for Medicare & Medicaid Services adopted NFPA 99, 2012 edition of the Health Care Facilities Code. The following chart shows the different changes that may affect your facility.

Any items listed below that are included in these future editions may become applicable upon when CMS and/or the state adopts newer editions of the NFPA 99 Health Care Facilities Code.

Item Description NFPA 99, 2015 edition

NFPA 99,

2018 edition

NFPA 99,

2021 edition

The outdoor central supply system, since it is greater than 18.6 m2 (200 ft2), needs to be provided with a minimum of two entry/exits.

5.1.3.3.2 (4)

The cryogenic fluid central supply system does not have an auxiliary source connection installed on the patient side of the source valve.

5.1.3.5.7 5.1.3.5.7 5.1.4.10

The auxiliary source connection valve does not have a removable plug or cap installed.

5.1.3.5.7.1 5.1.3.5.7.1 5.1.4.10.1

The auxiliary source connection valve is not secured in its normally closed position.

5.1.3.5.7.2 5.1.3.5.7.2 5.1.4.10.2

Vacuum exhaust is located less than 25 feet from any door, window, air intake, or other openings in buildings or places of public assembly.

5.1.3.7.6.2 (2) 5.1.3.7.7.2 (2) 5.1.3.7.7.2 (2)

WAGD exhaust is located less than 25 feet from any door, window, air intake, or other openings in buildings or places of public assembly.

5.1.3.8.5 and

5.1.3.7.6.2 (2)

5.1.3.8.5 and

5.1.3.7.7.2 (2)

5.1.3.8.5 and

5.1.3.7.7.2 (2)

There are no alarms installed at the master alarms allowing the temporary oxygen supply to be monitored while in use.

5.1.3.5.13.2 (8)

Medical air intake shall be labeled in accordance with 5.1.11.1 with any method that would distinguish it as a medical air intake.

5.1.3.6.3.11 (I)

Vacuum exhaust shall be labeled in accordance with 5.1.11.1 with any method that would distinguish it as a vacuum exhaust.

5.1.3.7.7.4

WAGD exhaust shall be labeled in accordance with 5.1.11.1 with any method that would distinguish it as a WAGD exhaust.

5.1.3.8.5 and 5.1.3.7.7.4

Specific source, service, and zone valves do not have threaded purge ports on the patient side and source side.

5.1.4.1.6 (8)

Since certain rooms have the station outlets/inlets installed in a down-facing position, the outlets/inlets need to be DISS connectors.

5.1.5.17 5.1.5.17

Specific zone valves throughout the facility need to be relabeled so that the label is not affixed to the removable cover and is visible from outside the zone valve box assembly.

5.1.11.2.7 5.1.11.2.7 5.1.11.2.8

The sleep lab outlets downstream of the flow control device needs to be labeled to include a warning not to use the outlet for ventilating patients.

5.1.11.3.1.1 5.1.11.3.1.1 5.1.11.3.1.1

Source equipment needs to be labeled with the emergency contact information for the department or individual responsible for maintaining the equipment.

5.1.11.5 (4) 5.1.11.5.1

Where vacuum systems are used to serve WAGD systems in accordance with 5.1.10.2.3.1, labeling for the medical surgical vacuum source shall indicate that it serves both systems.

5.1.11.5.2

When clinical spaces are converted to nonclinical spaces, medical gas inlets and outlets that are not accessible for maintenance and testing shall be either removed or decommissioned.

5.1.14.3.5

MASTER ALARM TESTING RESULTS

Boiler Plant

Signal Tested Result Pass/Fail

Signal Tested Result Pass/Fail

Oxygen High Pressure

61 psig Pass

Carbon Dioxide High Pressure

80 psig Fail

Oxygen Low Pressure

42 psig Pass

Carbon Dioxide Low Pressure

24 psig Fail

Oxygen Emergency

Reserve Low Pressure

41 psig

Carbon Dioxide Secondary in

Use

Pass

Oxygen Emergency

Reserve Secondary in

Use

Pass Medical Air High Pressure

53 psig Pass

Nitrogen High Pressure

210 psig Pass

Medical Air Low Pressure

41 psig

Nitrogen Low Pressure

140 psig Pass

Vacuum Low Pressure

-15” Hg Pass

Nitrogen Secondary in

Use

Pass Vacuum Lag Alarm

Fail No alarm

Surgical Services

Signal Tested Result Pass/Fail

Signal Tested Result Pass/Fail

Nitrogen Secondary in

Use

Pass Carbon Dioxide Secondary in

Use

Testing Completed January 7, 2025

OXYGEN PARTICULATE RESULTS

Date Sample Taken

Building, Department and

Room #

Pre Weight

(In Grams)

Sample Weight

(In Grams)

Comments Result Pass/Fail

1/7/2025 Mountains, Outpatient X-Ray, X-Ray Room

.0772g .0772g No Discoloration

Pass

1/7/2025 Granite, 1 West, Room 135

.0868g .0868g No Discoloration

Pass

1/7/2025 Birches, Desk 90, Room 239D

.0912g .0912g No Discoloration

Pass

1/7/2025 Birches, Eye Clinic, Room 312

.0798g .0798g No Discoloration

MEDICAL AIR MOISTURE TESTING RESULTS

Date Sample Taken

Building, Department and

Room #

Dew point Reading at

Air Compressor

Dew point Reading on each floor

Results Pass/Fail

Comments

1/7/2025 Mountains, Outpatient X-Ray, X-Ray Room

-23.7 °F -21.4 °F Pass

1/7/2025 Granite, 1 West, Room 135

-23.7 °F -21.4 °F Pass

1/7/2025 Birches, Desk 90, Room 239D

-23.7 °F -23.0 °F Pass

1/7/2025 Birches, Eye Clinic, Room 312

-23.7 °F +5.0 °F Pass

VAMC White River Junction Master Alarm Testing

Floor Monitors Department Location Labeled Pass/Fail Comment G All Sources Boiler Plant Control Desk Yes Fail No 2nd Master Panel

Nitrogen & Carbon Dioxide

Secondary in Use only Surgical Services Right of OR Manifold Room Yes Pass

Master Alarm Results Boiler Plant Panel

Sources Line Pressure High Pressure Low Pressure Secondary/Lag Oxygen 52 psig 61 psig 42 psig N/A

Oxygen Emergency Reserve 52 psig N/A 41 psig Pass Nitrogen 170 psig 210 psig 140 psig Pass

Carbon Dioxide 58 psig 80 psig 24 psig Pass Medical Air 52 psig 53 psig 41 psig N/A

Vacuum -19" Hg N/A -15" Hg Fail Would not alarm during push button test

Master Alarm Results Surgical Services Panel

Sources Secondary Nitrogen Pass Carbon Dioxide Pass

Area Alarm Testing

Floor Monitors Department Location Labeled Pass/Fail Comment 1 Fluoroscopy, Angio Radiology Inside Angio Suite Yes Pass 1 MRI Radiology Inside MRI Control Room Yes Pass

Inpatient Recovery, Bone Density, X-Ray 2, Ultrasound 1-2, X-Ray 1 Radiology Left of Room 120 Yes Pass 1 CT Scan 2 Radiology Inside CT Scan 2 area Yes Pass 2 239 C-E, 239 O Desk 90 Inside Desk 90 on left Yes Pass No separate visual indicators 2 Spect CT Nuclear Medicine Right of Spect CT Yes Pass Blocked by cart

Floor Monitors Department Location Labeled Pass/Fail Comment G G42, G44, G47 Psychiatric Unit Nurses' Station Yes Pass No separate visual indicators G G71, G78, G83-G86 Inpatient Ward Nurses' Station Yes Pass

120, 123, 135-141, 143, 145, 150, 152 1 West 1 West Nurse's Station Yes Pass No separate visual indicators 1 ICU 1-10 ICU Nurses' Station Yes Pass

102, 104, 106, 108, 109, 167, 169, 178, 179, 185, 189-193, 195, 196 1 South 1 South Nurses' Station Yes N/A Under construction 2025

2 212, 214, 232-235, 237, 239, 242 Same Day Inside Room 213 Yes Pass Alarm located inside locked room, No separate visual indicators

Main Line Pressure for Nitrogen and

Carbon Dioxide Surgical Services Right of OR Manifold

Room Yes Pass Push button only (rings during master testing) Relabel Nitrogen OR's 1 & 4, Carbon OR's 1-4.

Main Line pressure for

OR 1-4 Surgical Services Main Nurses' Station Yes N/A Push button only, (General Comment about push button test)

2 PACU PACU Nurses' Station Yes Pass Black Ohio

Floor Monitors Department Location Labeled Pass/Fail Comment 1 Rooms 1, 2, 4, 5 Emergency Room Inside Room 148 Yes Pass

Main Line pressure for 310, 311, 329, 336, 337, 351, 352, 360 Podiatry/Urology/

Vascular/Neurology/ENT Reception Desk 389 Yes Pass Push button only, Add "Main Line Pressure" to labeling

Zone Valve Testing

Floor Department Controls Gases Location Labeled Ports Notes 1 Radiology Fluoroscopy, Angio Oxygen Inside Angio Suite Yes No 1 Radiology Angio Medical Air Inside Angio Suite Yes No 1 Radiology Fluoroscopy, Angio Vacuum Inside Angio Suite Yes No 1 Radiology MRI Oxygen Inside MRI control room Yes No 1 Radiology MRI Medical Air Inside MRI control room Yes No 1 Radiology MRI Vacuum Inside MRI control room Yes No

1 Radiology

Inpatient Recovery, Bone Density, X-Ray 2, Ultrasound

1-2, X-Ray 1 Oxygen Left of 120 Yes No

1 Radiology

Inpatient Recovery, Bone Density, X-Ray 2, Ultrasound

1-2, X-Ray 1 Vacuum Left of 120 Yes No 1 Radiology CT Scan 1 Oxygen Across from CT Scan Yes No 1 Radiology CT Scan 1 Vacuum Across from CT Scan Yes No 1 Radiology CT Scan 1 Medical Air Across from CT Scan Yes No 1 Radiology CT Scan 2 Oxygen Inside CT Scan 2 area Yes Yes Behind door 1 Radiology CT Scan 2 Medical Air Inside CT Scan 2 area Yes Yes Behind door 1 Radiology CT Scan 2 Vacuum/WAGD Inside CT Scan 2 area Yes Yes Behind door 1 Pulmonary Stress/Echo Oxygen Across from Room 151 Yes No 1 Pulmonary Stress/Echo Vacuum Across from Room 151 Yes No 2 Desk 90 239 C-E, 239 O Oxygen Inside Desk 90 on left Yes No 2 Desk 90 239 C-E, 239 O Medical Air Inside Desk 90 on left Yes No 2 Desk 90 239 C-E, 239 O Vacuum Inside Desk 90 on left Yes No 2 Nuclear Medicine Spect CT Oxygen Right of Spect CT Yes Yes 2 Nuclear Medicine Spect CT Medical Air Right of Spect CT Yes Yes 2 Nuclear Medicine Spect CT Vacuum Right of Spect CT Yes Yes 3 Eye Clinic 311, 312, 313A Medical Air Right of Room 319 Yes No 3 Eye Clinic 311, 312, 313, 316, 318, 319 Oxygen Right of Room 319 Yes No Leaks at left flange

Floor Department Controls Gases Location Labeled Ports Notes G Psychiatric Unit G42, G44, G47 Oxygen Nurse's Station Yes No G Psychiatric Unit G42, G44, G47 Vacuum Nurse's Station Yes No G Inpatient Ward G71, G78, G83-G86 Oxygen Left of G76 Yes No G Inpatient Ward G71, G78, G83-G86 Medical Air Left of G76 Yes No G Inpatient Ward G71, G78, G83-G86 Vacuum Left of G76 Yes No

1 1 West 120, 123, 135-141, 143, 145, 150, 152 Medical Air Right of Room 119 Yes No Leaks at left flange

1 1 West 120, 123, 135-141, 143, 145, 150, 152 Oxygen Right of Room 119 Yes No

1 1 West 120, 123, 135-141, 143, 145, 150, 152 Vacuum Right of Room 119 Yes No 1 ICU ICU 1-10 Oxygen Outside ICU on right Yes Yes 1 ICU ICU 1-10 Medical Air Outside ICU on right Yes Yes 1 ICU ICU 1-10 Vacuum Outside ICU on right Yes Yes 1 Respiratory 174, 175 Medical Air Left of Room 176 Yes No Under construction 2025 1 Respiratory 174, 175 Vacuum Left of Room 176 Yes No Under construction 2025 1 Respiratory 174, 175 Oxygen Right of Room 176 Yes No Under construction 2025

1 1 South

102, 104, 106, 108, 109, 167, 169, 178, 179, 185, 189-193, 195, 196 Vacuum Right of Room 181 Yes No Under construction 2025

1 1 South

102, 104, 106, 108, 109, 167, 169, 178, 179, 185, 189-193, 195, 196 Oxygen Right of Room 181 Yes No Under construction 2025

1 1 South

102, 104, 106, 108, 109, 167, 169, 178, 179, 185, 189-193, 195, 196 Medical Air Right of Room 181 Yes No Under construction 2025

2 Same Day 212, 214, 232-235, 237, 239, 242 Oxygen Across from GI Procedure

Room entrance Yes No

2 Same Day 232-235, 239, 242 Medical Air Across from GI Procedure

Room entrance Yes No

2 Same Day 212, 214, 232-235, 237, 239, 242 Vacuum Across from GI Procedure

Room entrance Yes No 2 Surgical Services Operating Room 1 Oxygen Left of OR 1 (core) Yes No 2 Surgical Services Operating Room 1 Carbon Dioxide Left of OR 1 (core) Yes No 2 Surgical Services Operating Room 1 Medical Air Left of OR 1 (core) Yes No 2 Surgical Services Operating Room 1 Vacuum Left of OR 1 (core) Yes No 2 Surgical Services Operating Room 1 Nitrogen Right of OR 1 (core) Yes No

Floor Department Controls Gases Location Labeled Ports Notes 2 Surgical Services Operating Room 1 Carbon Dioxide Right of OR 1 (core) Yes No Not in Service 2 Surgical Services Operating Room 2 Oxygen Left of OR 2 (core) Yes No 2 Surgical Services Operating Room 2 Carbon Dioxide Left of OR 2 (core) Yes No 2 Surgical Services Operating Room 2 Medical Air Left of OR 2 (core) Yes No 2 Surgical Services Operating Room 2 Vacuum Left of OR 2 (core) Yes No 2 Surgical Services Operating Room 3 Oxygen Right of OR 3 (core) Yes No 2 Surgical Services Operating Room 3 Carbon Dioxide Right of OR 3 (core) Yes No 2 Surgical Services Operating Room 3 Medical Air Right of OR 3 (core) Yes No 2 Surgical Services Operating Room 3 Vacuum Right of OR 3 (core) Yes No 2 Surgical Services Operating Room 4 Oxygen Left of OR 4 Yes Yes 2 Surgical Services Operating Room 4 Medical Air Left of OR 4 Yes Yes 2 Surgical Services Operating Room 4 N/A Left of OR 4 Yes Yes 2 Surgical Services Operating Room 4 Nitrogen Left of OR 4 Yes Yes 2 Surgical Services Operating Room 4 Carbon Dioxide Left of OR 4 Yes Yes 2 Surgical Services Operating Room 4 Vacuum/WAGD Left of OR 4 Yes Yes Add WAGD label 2 PACU PACU Oxygen Right of PACU Entrance Yes No Leaks at stem in on and off position 2 PACU PACU Medical Air Right of PACU Entrance Yes No 2 PACU PACU Vacuum Right of PACU Entrance Yes No

Floor Department Controls Gases Location Labeled Ports Notes 1 Green Mountain Clinic 115 Oxygen Right of Room 100 F Yes No 1 Green Mountain Clinic 115 Medical Air Right of Room 100 F Yes No 1 Green Mountain Clinic 115 Vacuum Right of Room 100 F Yes No

1 Emergency Room Rooms 1, 2, 4, 5 Medical Air Left of ER Entrance in Hallway

C-113 Yes Yes Relabel Rooms 1,2,4,5

1 Emergency Room Rooms 1, 2, 4, 5 Oxygen Left of ER Entrance in Hallway

C-113 Yes Yes Relabel Rooms 1,2,4,5

1 Emergency Room Rooms 1, 2, 4, 5 Vacuum Left of ER Entrance in Hallway

C-113 Yes Yes Relabel Rooms 1,2,4,5 1 Outpatient X-Ray X-Ray Room Oxygen Across from X-Ray Room Yes No 1 Outpatient X-Ray X-Ray Room Medical Air Across from X-Ray Room Yes No 1 Outpatient X-Ray X-Ray Room Vacuum Across from X-Ray Room Yes No 2 White Mountain Clinic 203 Oxygen Right of Room 203 Yes No 2 White Mountain Clinic 203 Medical Air Right of Room 203 Yes No 2 White Mountain Clinic 203 Vacuum Right of Room 203 Yes No 3 Podiatry 310-311 Oxygen Left of 311 Yes No 3 Podiatry 310-311 Medical Air Left of 311 Yes No 3 Podiatry 310-311 Vacuum Left of 311 Yes No 3 Urology 329 Oxygen Right of 329 Yes No 3 Urology 329 Medical Air Right of 329 Yes No 3 Urology 329 Vacuum Right of 329 Yes No 3 Vascular 336-337 Vacuum Across from 336 Yes No 3 Vascular 336-337 Medical Air Across from 336 Yes No 3 Vascular 336-337 Oxygen Across from 336 Yes No 3 Neurology 351-352 Oxygen Left of 352 Yes No 3 Neurology 351-352 Medical Air Left of 352 Yes No 3 Neurology 351-352 Vacuum Left of 352 Yes No 3 ENT 360 Oxygen Across from 357 Yes No 3 ENT 360 Medical Air Across from 357 Yes No 3 ENT 360 Vacuum Across from 357 Yes No

Outlets/Inlet Testing

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Radiology 1 Fluoroscopy (1A-100) DISS - Gemini Vacuum Pass

Oxygen Pass Radiology 1 Angio (1A-102) DISS - Gemini Oxygen Pass Anesthesia machine in room

Medical Air Pass Vacuum Pass Oxygen Pass

Medical Air Pass Vacuum Pass

Radiology 1 MRI (1A-103) DISS - Gemini Vacuum Pass Medical Air Pass

Oxygen Fail Leaks Vacuum Pass

Medical Air Pass Oxygen Pass

Radiology 1 Inpatient Recovery (118) DISS - Gemini Vacuum Pass Oxygen Pass

Radiology 1 Bone Density (119) DISS - Gemini Vacuum Pass Oxygen Fail Leaks

Radiology 1 X-Ray 2 (122) DISS - Gemini Vacuum Pass Oxygen Pass

Radiology 1 Ultrasound 1 (123) DISS - Gemini Vacuum Pass Oxygen Pass

Radiology 1 Ultrasound 2 (124) DISS - Gemini Vacuum Pass Oxygen Pass

Radiology 1 X-Ray 1 (136) DISS - Gemini Vacuum Pass Oxygen Fail Leaks Vacuum Pass Oxygen Pass

Radiology 1 CT Scan 1 (142B) DISS - Gemini Oxygen Pass Medical Air Pass

Vacuum Pass Radiology 1 CT Scan 2 (149) DISS - Powerex WAGD Pass

Vacuum Pass Medical Air Pass

Oxygen Pass Pulmonary 1 Stress/Echo (157) DISS - Console Oxygen Fail Leaks

Vacuum Pass

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes DISS - Gemini Vacuum Pass

Vacuum Pass Pulmonary 1 Pulmonary Function (158) DISS - Gemini Vacuum Pass Not piped through a zone valve

Vacuum Pass Not piped through a zone valve Desk 90 2 239C DISS - Gemini Oxygen Pass

Medical Air Pass Vacuum Pass

Desk 90 2 239D DISS - Gemini Oxygen Pass Medical Air Pass

Vacuum Pass Desk 90 2 239E DISS - Gemini Oxygen Pass

Medical Air Pass Vacuum Pass

Desk 90 2 239O DISS - Gemini Oxygen Pass Medical Air Pass

Vacuum Pass Nuclear Medicine 2 Spect CT (244A) DISS - Powerex Oxygen Pass

Oxygen Pass Vacuum Pass Vacuum Pass

Medical Air Pass Medical Air Pass

Eye Clinic 3 311 DISS - Ohio 1 Vacuum N/A Not in Service Oxygen Pass

Medical Air Pass Wrong gas label Eye Clinic 3 312 DISS - Ohio 1 Vacuum N/A Not in Service

Oxygen Pass Medical Air Pass Wrong gas label

Eye Clinic 3 313 DISS - Ohio 1 Vacuum N/A Not in Service Oxygen Pass

Eye Clinic 3 313A DISS - Ohio 1 Medical Air Pass Wrong gas label Eye Clinic 3 316 DISS - Ohio 1 Vacuum N/A Not in Service

Oxygen N/A Blocked by desk Medical Air N/A Not in Service

Eye Clinic 3 318 DISS - Ohio 1 Oxygen Fail Leaks Medical Air N/A Not in Service

Eye Clinic 3 318B DISS - Ohio 1 Medical Air N/A Not in Service

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Eye Clinic 3 319 DISS - Ohio 1 Vacuum N/A Not in Service

Oxygen Pass Medical Air N/A Not in Service

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Psychiatric Unit G G42 DISS - Series B Vacuum N/A Covid

Oxygen N/A Covid Psychiatric Unit G G44 DISS - Series B Oxygen Pass

Vacuum Pass Psychiatric Unit G G47 DISS - Series B Vacuum Pass

Oxygen Pass Inpatient Ward G G71 DISS - Series B Vacuum Pass

Medical Air Pass Oxygen Pass

Inpatient Ward G G78 DISS - Series B Vacuum Pass Medical Air Pass

Oxygen Pass Inpatient Ward G G83 DISS - Series B Vacuum Pass No door label

Medical Air Pass Oxygen Pass Vacuum Pass

Medical Air Pass Oxygen Pass Oxygen Pass

Medical Air Pass Vacuum Pass

Inpatient Ward G G84 DISS - Series B Vacuum Pass Medical Air Pass

Oxygen Pass Oxygen Pass

Medical Air Pass Vacuum Pass Oxygen Pass

Medical Air Pass Vacuum Pass

Inpatient Ward G G85 DISS - Series B Vacuum N/A In use Medical Air Pass

Oxygen N/A In use Vacuum Pass

Medical Air Pass

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Medical Air Pass

Vacuum Pass Inpatient Ward G G86 DISS - Series B Vacuum Pass

Medical Air Pass Oxygen Pass Oxygen Pass

Medical Air Pass Vacuum Pass Oxygen Pass

Medical Air Pass Vacuum Pass

1 West 1 120 DISS - Headwall Oxygen Pass Medical Air Pass

Vacuum Fail Low flow 2.0 1 West 1 123 DISS - Headwall Oxygen Pass

Medical Air Pass Vacuum Pass Oxygen Fail Leaks 50 psig

Medical Air Fail Leaks from back assembly Vacuum Pass

1 West 1 135 DISS - Headwall Oxygen Pass Medical Air Pass

Vacuum Pass 1 West 1 136 DISS - Headwall Oxygen Pass

Medical Air Pass Vacuum Pass

1 West 1 137 DISS - Headwall Oxygen Fail Leaks from front and back assembly Medical Air Pass

Vacuum Pass 1 West 1 138 DISS - Headwall Oxygen Pass

Medical Air Pass Vacuum Pass Oxygen Pass

Medical Air Pass Vacuum Pass

1 West 1 139 DISS - Headwall Oxygen Fail Leaks from back assembly Medical Air Pass

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Vacuum Pass Oxygen Pass

Medical Air Fail Leaks 50 psig Vacuum Pass

1 West 1 140 DISS - Headwall Oxygen Pass Medical Air Pass

Vacuum Pass Oxygen Fail Leaks

Medical Air Pass Vacuum Pass

1 West 1 141 DISS - Headwall Oxygen Pass Medical Air Fail Leaks from back assembly

Vacuum Pass Oxygen Fail Leaks from front and back assembly

Medical Air Pass Vacuum Pass

1 West 1 143 DISS - Headwall Oxygen N/A In use Medical Air Pass

Vacuum Pass Oxygen Pass

Medical Air Pass Vacuum Pass

1 West 1 145 DISS - Ohio 1 Oxygen Pass Medical Air Pass Wrong color gas label

Vacuum Pass Vacuum Pass

1 West 1 150 DISS - Headwall Oxygen Pass Medical Air Fail Leaks 50 psig

Vacuum Pass 1 West 1 152 DISS - Headwall Oxygen Fail Leaks from back assembly

Medical Air Pass Vacuum Pass

ICU 1 ICU 1 (160 C) DISS - Console Vacuum Pass Vacuum Pass

Medical Air Pass

Oxygen Fail Leaks

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Oxygen Pass Oxygen Pass

Medical Air Pass Vacuum Pass Vacuum Pass

ICU 1 ICU 2 (160 D) DISS - Console Vacuum Pass Vacuum Pass

Medical Air Pass Oxygen Pass Oxygen Pass Oxygen Pass Oxygen Pass

Medical Air Pass Vacuum Pass Vacuum Pass

ICU 1 ICU 3 (160 E) DISS - Console Vacuum Pass Vacuum N/A In use

Medical Air Pass Oxygen N/A In use Oxygen Pass Oxygen Pass Oxygen Pass

Medical Air Pass Vacuum Pass Vacuum N/A In use

ICU 1 ICU 4 (160 F) DISS - Console Vacuum Pass Vacuum Pass

Medical Air Pass Oxygen Pass Oxygen Pass Oxygen Fail Leaks Oxygen Pass

Medical Air Pass Vacuum Pass Vacuum Pass

ICU 1 ICU 5 (160 M) DISS - Console Vacuum Pass

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Medical Air Fail Leaks from back assembly

Oxygen Pass Oxygen Pass Oxygen Pass Oxygen Pass

Medical Air Fail Leaks Vacuum Pass Vacuum Pass

ICU 1 ICU 6 (160 J) DISS - Console Vacuum Pass Vacuum Pass

Medical Air Pass Oxygen Pass Oxygen Pass Oxygen Pass Oxygen Pass

Medical Air Pass Vacuum Pass Vacuum Fail Low flow 1.75

ICU 1 ICU 7 (160 K) DISS - Console Vacuum Pass Vacuum Pass

Medical Air Pass Oxygen N/A In use Oxygen Pass Oxygen Fail Leaks Oxygen Pass

Medical Air Pass Vacuum Pass Vacuum Pass

ICU 1 ICU 8 (157) DISS - Console Vacuum Pass Vacuum Pass

Medical Air Pass Oxygen Pass Oxygen Pass Oxygen Pass Oxygen Pass

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Vacuum Pass

ICU 1 ICU 9 (158) DISS - Console Vacuum Pass Vacuum Pass

Medical Air Pass Oxygen Pass Oxygen Pass Oxygen Pass Oxygen Pass

Medical Air Pass Vacuum Pass Vacuum Pass

ICU 1 ICU 10 (159) DISS - Console Vacuum Pass Vacuum Pass

Medical Air Pass Oxygen Pass Oxygen Pass Oxygen Pass Oxygen Pass

Medical Air Pass Vacuum Pass Vacuum Pass

Respiratory 1 174 DISS - Ohio 1 Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

Respiratory 1 175 DISS - Ohio 1 Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025 Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025 Oxygen N/A Under construction 2025

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

1 South 1 102 DISS - Headwall Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 1 South 1 104 DISS - Headwall Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

1 South 1 106 DISS - Headwall Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 1 South 1 108 DISS - Headwall Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

1 South 1 109 DISS - Headwall Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 1 South 1 167 DISS - Headwall Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025 Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

1 South 1 169 DISS - Headwall Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 1 South 1 178 DISS - Headwall Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

1 South 1 179 DISS - Headwall Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 1 South 1 185 DISS - Headwall Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Vacuum N/A Under construction 2025

1 South 1 189 DISS - Headwall Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 1 South 1 190 DISS - Headwall Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

1 South 1 191 DISS - Headwall Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 1 South 1 192 DISS - Headwall Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025 Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

1 South 1 193 DISS - Headwall Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

1 South 1 195 DISS - Headwall Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

1 South 1 196 DISS - Headwall Oxygen N/A Under construction 2025 Medical Air N/A Under construction 2025

Vacuum N/A Under construction 2025 Oxygen N/A Under construction 2025

Medical Air N/A Under construction 2025 Vacuum N/A Under construction 2025

Same Day 2 Procedure Room 1

(212) DISS - Series B Vacuum Pass

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Oxygen Pass Vacuum Pass Vacuum Pass Vacuum Pass

Same Day 2 Procedure Room 2

(214) DISS - Series B Vacuum Pass Oxygen Pass Oxygen Pass Vacuum Pass Vacuum Pass Vacuum Pass

Same Day 2 232 DISS - Headwall Oxygen Pass Medical Air Pass

Vacuum Pass Oxygen Fail Leaks from back assembly

Medical Air Pass Vacuum Pass Oxygen Pass

Medical Air Pass Vacuum Pass

Same Day 2 233 DISS - Headwall Oxygen Fail Leaks Medical Air Pass

Vacuum Pass Same Day 2 234 DISS - Headwall Oxygen Pass

Medical Air Fail Leaks from front and back assembly Vacuum Pass

Same Day 2 235 DISS - Headwall Oxygen Fail Leaks from front and back assembly Medical Air Pass

Vacuum Pass Same Day 2 237 DISS - Headwall Oxygen Fail Leaks from back assembly

Medical Air N/A Needs to be labeled, "Not in Service" Vacuum Pass

Same Day 2 239 DISS - Headwall Oxygen Pass Medical Air Pass

Vacuum Pass

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Vacuum Pass

Same Day 2 242 DISS - Headwall Oxygen Fail Leaks from back assembly Medical Air Fail Leaks from back assembly

Vacuum Pass Oxygen Pass

Medical Air Pass Vacuum Pass

Surgical Services 2 Operating Room 1 DISS Nitrogen Pass Boom, Panel (Berchtold), No WAGD in Room DISS - Series B Vacuum Pass DISS - Series B Vacuum Pass DISS - Series B Carbon Dioxide Pass

DISS Vacuum Pass Column DISS Vacuum Pass DISS Nitrous Oxide N/A Not in service DISS Vacuum Pass DISS Medical Air Pass DISS Oxygen Pass

Surgical Services 2 Operating Room 2 DISS - Series B Carbon Dioxide Pass Ceiling, No WAGD in Room DISS - Series B Carbon Dioxide Pass

DISS Vacuum Pass Column 1 DISS Medical Air Pass DISS Oxygen Pass DISS Vacuum Pass DISS Vacuum Pass DISS Nitrous Oxide N/A Not in service DISS Nitrous Oxide N/A Column 2, Not in service DISS Vacuum Pass DISS Vacuum Pass DISS Oxygen Pass DISS Medical Air Pass DISS Vacuum Pass

Surgical Services 2 Operating Room 3 DISS - Series B Carbon Dioxide Pass Ceiling, No WAGD in Room DISS Vacuum Pass Column 1 DISS Vacuum Pass DISS Nitrous Oxide N/A Not in service DISS Vacuum Pass DISS Medical Air Pass

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes DISS Oxygen Pass DISS Oxygen Pass Column 2 DISS Medical Air Pass DISS Vacuum Pass DISS Nitrous Oxide Fail Nitrous specific outlet, CO2 piped to it, Labeled "NIS" DISS Vacuum Pass DISS Vacuum Pass

Surgical Services 2 Operating Room 4 DISS - Series B Oxygen Pass Boom 1 DISS - Series B Oxygen Pass DISS - Series B Medical Air Pass DISS - Series B Medical Air Pass DISS - Series B Vacuum Pass DISS - Series B Vacuum Pass DISS - Series B WAGD Pass DISS - Series B Vacuum Pass Boom 2

DISS Nitrogen Pass Panel (Basco) DISS Nitrogen Pass (Same panel)

DISS - Series B Vacuum Pass DISS - Series B Nitrogen Pass DISS - Series B Carbon Dioxide Pass DISS - Series B Medical Air Pass DISS - Series B Medical Air Pass

PACU 2 PACU 1 (298) DISS - Console Oxygen Pass No gas specific label Medical Air Pass No gas specific label Medical Air Pass No gas specific label

Oxygen Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass Vacuum Pass

PACU 2 PACU 2 (295) DISS - Console Oxygen Pass Audible leak in headwall, No gas specific label Medical Air Pass No gas specific label Medical Air Pass No gas specific label

Oxygen Pass No gas specific label Vacuum Pass No gas specific label

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Vacuum Pass No gas specific label Vacuum Pass Vacuum Pass

PACU 2 PACU 3 (290) DISS - Console Oxygen Pass No gas specific label Medical Air Pass No gas specific label Medical Air Pass No gas specific label

Oxygen Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass Vacuum Pass

PACU 2 PACU 4 (289) DISS - Console Oxygen Pass No gas specific label Medical Air Pass No gas specific label Medical Air Pass No gas specific label

Oxygen Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Fail Leaks Vacuum Pass

PACU 2 PACU 5 (288) DISS - Console Oxygen Pass No gas specific label Medical Air Pass No gas specific label Medical Air Pass No gas specific label

Oxygen Fail Leaks, No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass Vacuum Pass

PACU 2 287 DISS - Console Oxygen Pass No gas specific label Medical Air Pass No gas specific label Medical Air Pass No gas specific label

Oxygen Pass No gas specific label Vacuum Pass No gas specific label

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Vacuum Pass Vacuum Pass

PACU 2 PACU 6 (286) DISS - Console Oxygen Fail Leaks, No gas specific label Medical Air Pass No gas specific label Medical Air Pass No gas specific label

Oxygen Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass Vacuum Pass

PACU 2 PACU 7 (285) DISS - Console Oxygen Pass No gas specific label Medical Air Pass No gas specific label Medical Air Pass No gas specific label

Oxygen Fail Leaks, No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass Vacuum Pass

PACU 2 PACU 8 (284) DISS - Console Oxygen N/A Asked not to test by staff, No gas specific label Medical Air N/A Asked not to test by staff, No gas specific label Medical Air N/A Asked not to test by staff, No gas specific label

Oxygen N/A Asked not to test by staff, No gas specific label Vacuum N/A Asked not to test by staff, No gas specific label Vacuum N/A Asked not to test by staff, No gas specific label Vacuum N/A Asked not to test by staff, No gas specific label Vacuum N/A Asked not to test by staff Vacuum N/A Asked not to test by staff

PACU 2 PACU 9 (283) DISS - Console Oxygen Pass No gas specific label Medical Air Pass No gas specific label Medical Air Pass No gas specific label

Oxygen Pass No gas specific label Vacuum Pass No gas specific label Vacuum Pass No gas specific label

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes

Department Floor Room # Outlet Type Outlet/Inlet Pass/Fail Notes Green Mountain Clinic 1 115 DISS - Gemini Vacuum Pass

Medical Air Pass Vacuum…