VA Hydrant Inspection Report_out of date.pdf

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Inspection Summary

Customer Information

Name VA Medical Center (1201 NW 16th Street)

Building Information

Name VA Medical Center - Utility Building

Address 1201 N.W 16th Street, Miami, Florida 33125-1393

Contact Information

Name Jose Orta

Role Operations Foreman

E-Mail jose.orta1@va.gov

Phone 7869614078

Account Information

Service Provider Johnson Controls North America

Office Address 10550 Commerce Parkway, Miramar FL 33025

Office Phone 954-431-3700

Office License 80542700012002

Inspector Name Nestor De Four

Inspector License

FP124-000174

Inspection Information

Start Date 09/21/2024

Date 09/21/2024

Inspection Type Joint Commission

Work Order# 57320056

Timezone GMT-04:00

Inspection Summary

The following Tests and Inspections have been covered in this inspection

EP 11 - Fire Pump Tested Under Full Flow (Annual) and/or Pump Supervisory Signals

General Inspection Notes

1. ANNUAL FIRE PUMPS INSPECTION

2. GREEN TAG - PUMP#2

3. UNABLE TO TEST -PUMP#1

GENERAL DEFICIENCIES

DESCRIPTION IMAGES

1- REPAIR / REPLACE DAMAGE FIRE PUMP-#1TRANSFER SWITCH & CONTROLLER

GENERAL DEFICIENCY IMAGES

APPENDIX 1

www.xaapbuildings.com

DEVICE DEFICIENCIES

TEST TO PERFORM LOCATION DESCRIPTION ADDRESS DEVICE MAKE MODEL BARCODE INSPECTOR / DATE IMAGES

EP11

Utility Building , 1st

Floor

IN PUMP ROOM

PUMP #1

9:M1-46 Fire Pump Run — — —

Nestor Roderick De Four

09/21/2024

FAILURE TYPE: Functional Failure FAILURE REASON: Did not operate Fire Pump.

EP11

Utility Building, 2nd

Floor Fire Pump#1 9:M1-47

Supervisory-Fire Pump Loss of

Power

Nestor Roderick De Four

09/21/2024

FAILURE TYPE: Functional Failure FAILURE REASON: Did not operate Fire Pump .

EP6,EP11

Utility Building , 2nd Floor 1000GPM PUMP#1 — Electric Fire Pumps — — —

Nestor Roderick De Four

09/21/2024

FAILURE TYPE: Functional Failure FAILURE REASON: UNABLE TO PERFORM ANNUAL FIRE PUMP INSPECTION FIRE PUMP CONTROLLER AND TRANSFER SWITCH NOT OPERATIONAL LOCKED & TAG SHUT BY OWNER.

RECOMMENDATIONS

Priority Created At Created By Updated At Updated By

MEDIUM 09/20/2024 Nestor Roderick De Four 09/20/2024 Nestor Roderick De Four

Description: 1- Address - AC duct above Controller for Pump#1 leaking water unto controller - Correct

INSPECTION RESULTS SUMMARY

CURRENT INSPECTION RESULTS PREVIOUS INSPECTION RESULTS

TEST PERFORMED DEVICE TYPE TOTAL PASSED FAILED CANNOT INSPECT % INSPECTED TOTAL

EP11 Electric Fire Pumps 2 1 1 0 100 2

EP11 Fire Pump Run 2 1 1 0 100 2

EP11 Supervisory-Fire Pump Loss of Power 2 1 1 0 100 2

TOTAL 6 3 3 0 100 6

FIRE PUMP TESTED UNDER FULL FLOW (ANNUAL) AND/OR PUMP SUPERVISORY SIGNALS

CUSTOMER NAME: VA Medical Center (1201 NW 16th Street)

BUILDING NAME: VA Medical Center - Utility Building

BUILDING ADDRESS: 1201 N.W 16th Street, Miami, Florida 33125-1393

CONTACT NAME: Jose Orta

CONTACT E-MAIL: jose.orta1@va.gov

CONTACT ROLE: Operations Foreman

CONTACT PHONE: 7869614078

SERVICE PROVIDER: Johnson Controls North America

OFFICE ADDRESS: 10550 Commerce Parkway, Miramar FL 33025

OFFICE PHONE: 954-431-3700

OFFICE LICENSE: 80542700012002

INSPECTOR: Nestor De Four

INSPECTOR LICENSE: FP124-000174

INSPECTION START DATE: 09/21/2024

INSPECTION END DATE: 09/21/2024

WORK ORDER: 57320056

TIMEZONE: GMT-04:00

INSPECTION RESULTS SUMMARY

CURRENT INSPECTION RESULTS PREVIOUS INSPECTION RESULTS

DEVICE TYPE INVENTORY COUNT PASSED FAILED CANNOT INSPECT % INSPECTED INVENTORY COUNT

Electric Fire Pumps 2 1 1 0 100 2

Supervisory-Fire Pump Loss of Power 2 1 1 0 100 2

Fire Pump Run 2 1 1 0 100 2

DEVICE DEFICIENCIES

LOCATION DESCRIPTION ADDRESS DEVICE MAKE MODEL BARCODE DATE OF TEST TYPE IMAGES

Utility Building , 2nd Floor

1000GPM PUMP#1 — Electric Fire Pumps — — — 09/21/2024

FUNCTIONAL

FAILURE

DEFICIENCY

IMAGES APPENDIX

1.1

FAILURE REASON: UNABLE TO PERFORM ANNUAL FIRE PUMP INSPECTION FIRE PUMP CONTROLLER AND TRANSFER SWITCH NOT OPERATIONAL LOCKED & TAG SHUT BY OWNER.

Utility Building, 2nd Floor

Fire Pump#1 9:M1-47 Supervisory-Fire

Pump Loss of Power

— — — 09/21/2024

FUNCTIONAL

FAILURE

FAILURE REASON: Did not operate Fire Pump .

Utility Building , 1st Floor

IN PUMP ROOM

PUMP #1

9:M1-46 Fire Pump Run — — — 09/21/2024

FUNCTIONAL

FAILURE

FAILURE REASON: Did not operate Fire Pump.

RETIRED DEVICES

No retired devices in this inspection.

Element of Performance - EP-11

NFPA 25-2011: 8.3.3

Joint Commission Standard EC.02.03.05 Element of Performance 11 EP -1 a7e7677e-bcaf-4676-92ba-d73156e736ff | Fire Pump Tested Under Full Flow (Annual) and/or Pump Supervisory Signals | 09/21/2024

Customer: VA Medical Center (1201 NW 16th Street) | Building: VA Medical Center - Utility Building

Elements of Performance #11

Every 12 months the facility will test the Fire Pump Under Full Flow Condition. The completion date of the tests is documented.

Fire Pumps Under Full Flow

For additional guidance on performing the tests, see NFPA 25-2011: 8.3.3

Device Test Method

Fire Pumps Under Full Flow

An annual test of each pump assembly shall be conducted under minimum, rated, and peak flows of the fire pump by controlling the quantity of water discharged through approved test devices.

8.3.3.2 The pertinent visual observations, measurements, and adjustments specified in the following checklists shall be conducted annually while the pump is running and flowing water under the specified output condition:

1. At no-flow condition (churn) as follows:

• Check the circulation relief valve for operation to discharge water

• Check the pressure relief valve (if installed) for proper operation

2. At each flow condition:

• Record the electric motor voltage and current (all lines)

• Record the pump speed in rpm

• Record the simultaneous readings of pump suction and discharge pressures and pump discharge flow

3. For electric motor–driven pumps, the pump shall not be shut down until the pump has run for

10 minutes.

4. For diesel motor–driven pumps, the pump shall not be shut down until the pump has run for 30 minutes.

5. Fire Pump Supervisory Signals (Pump Running, and Pump Loss of Power)

Element of Performance - EP-11

NFPA 25-2011: 8.3.3

Joint Commission Standard EC.02.03.05 Element of Performance 11 EP -1 a7e7677e-bcaf-4676-92ba-d73156e736ff | Fire Pump Tested Under Full Flow (Annual) and/or Pump Supervisory Signals | 09/21/2024

GENERAL DATA

PUMP

LOCATION/

DESCRIPTION

BACKFLOW

PRESENT

WATER SUPPLY

TYPE

TANK SUPPLY TANK CAPACITY TANK HEIGHT

CONNECTION

SIZE

DATE OF PUMP

TEST

TIME OF PUMP

TEST

1000GPM

PUMP#1

Yes City City NA NA 8” 09/29/2023 9:30am

FIRE PUMP DATA

MFG SHAFT TYPE MODEL SERIAL NO. RATED GPM RATED PSI

CHURN / MAX

PRESSURE

150% PRESSURE

RATING

RATED RPM

Fairbanks Horizontal 1B22CF 1019779 1000 125psi 140 95psi 3560

FIRE PUMP DRIVER DATA JOCKEY PUMP DATA

MFG MODEL SERIAL NO.

RATED

VOLTS

HORSE

POWER

RATED

RPM

RATED

AMPS

PHASE CYCLES

OPER

VOLTS

SERVICE

FACTOR

MFG MODEL

SERIAL

NO.

Marathon 365TSTDS4025AT 300311180039 460 100 3550 240 3 60 460 1.15 Grundfos

546-EE

48085

1-391-90

FP CONTROLLER DATA JP CONTROLLER DATA

MFG MODEL SERIAL NO. FP START MFG MODEL SERIAL NO. JP START JP STOP

Eaton Cutler Hammer

F170-100D-LMR-

L1-X1

16B-8362 125 Eaton Cutler-

Hammer

FDJP-2D 16B-8362JP 160 195

Notes:

• Fire Pump#1 Images: DEVICE NOTES IMAGES APPENDIX 1.1

• Fire Pump Room Images: DEVICE NOTES IMAGES APPENDIX 1.1

Element of Performance - EP-11

NFPA 25-2011: 8.3.3

Joint Commission Standard EC.02.03.05 Element of Performance 11 EP -1 a7e7677e-bcaf-4676-92ba-d73156e736ff | Fire Pump Tested Under Full Flow (Annual) and/or Pump Supervisory Signals | 09/21/2024

Fire Pump Questions

No Quarterly questions were answered for this inspection.

No Semi-Annual questions were answered for this inspection.

Is there an External Means to View and Record the Amps and Voltage Readings? Yes

When was the Last Annual Pump Test? 09/29/2023

* Circuit Breakers Passed Trip Test No

* Pressure Switch Settings Inspected No

What Color Tag Was Left On This Fire Pump At The Completion Of This Inspection? Red

Element of Performance - EP-11

NFPA 25-2011: 8.3.3

Joint Commission Standard EC.02.03.05 Element of Performance 11 EP -1 a7e7677e-bcaf-4676-92ba-d73156e736ff | Fire Pump Tested Under Full Flow (Annual) and/or Pump Supervisory Signals | 09/21/2024

INSPECTION RESULTS SUMMARY

Inspection Results Fail

INSPECTION FAILURE REASONS

AMPS Within Rated Specs Amp Readings must not exceed Operating Amps times the Service Factor

Inspection Results Questions marked with * were answered No.

GENERAL DATA

PUMP

LOCATION/

DESCRIPTION

BACKFLOW

PRESENT

WATER SUPPLY

TYPE

TANK SUPPLY TANK CAPACITY TANK HEIGHT

CONNECTION

SIZE

DATE OF PUMP

TEST

TIME OF PUMP

TEST

1000GPM

PUMP#2

Yes City N/A NA NA 8 09/21/2024 9:40am

FIRE PUMP DATA

MFG SHAFT TYPE MODEL SERIAL NO. RATED GPM RATED PSI

CHURN / MAX

PRESSURE

150% PRESSURE

RATING

RATED RPM

Fairbanks Horizontal 1822CF 10-2006089 1000 125psi 140 95 3560

FIRE PUMP DRIVER DATA JOCKEY PUMP DATA

MFG MODEL

SERIAL

NO.

RATED

VOLTS

HORSE

POWER

RATED

RPM

RATED

AMPS

PHASE CYCLES

OPER

VOLTS

SERVICE

FACTOR

MFG MODEL

SERIAL

NO.

WEG 100360P3E365TS 10021734 460 100 3560 222 3 60 460 1.15 A96083214-20535051 NA

FP CONTROLLER DATA JP CONTROLLER DATA

MFG MODEL SERIAL NO. FP START MFG MODEL SERIAL NO. JP START JP STOP

Metron MP430-100-480C QA-10N45379-11

Notes:

• Fire Pump #2 Images: DEVICE NOTES IMAGES APPENDIX 1.2

Element of Performance - EP-11

NFPA 25-2011: 8.3.3

Joint Commission Standard EC.02.03.05 Element of Performance 11 EP -1 a7e7677e-bcaf-4676-92ba-d73156e736ff | Fire Pump Tested Under Full Flow (Annual) and/or Pump Supervisory Signals | 09/21/2024

Fire Pump Questions

No Quarterly questions were answered for this inspection.

No Semi-Annual questions were answered for this inspection.

Is there an External Means to View and Record the Amps and Voltage Readings? Yes

When was the Last Annual Pump Test? 09/22/2023

Have Calibrated Gauges Been Used? Yes

Calibration Date of Suction Gauge 05/14/2024

Calibration Date of Discharge Gauge 05/14/2024

Inspect Pump Bearing Lubrication Yes

Shaft End Play Acceptable Yes

Pump Coupling Alignment Acceptable Yes

Inspect Transmission Coupling, Gear Drive, And Mechanical Parts Yes

Circuit Breakers Passed Trip Test Yes

Emergency Manual Starting Operated Without Power Yes

Pressure Switch Settings Inspected Yes

During fire pump test at peak power output conditions (150%) was power failure simulated?

Yes

Upon power failure simulation, did switch transfer to alternate power source? Yes

While at peak output conditions (150%) under alternate power, record Discharge pressure 120

While at peak output conditions (150%) under alternate power, record Suction pressure 25

While at peak output conditions (150%) under alternate power, record RPM 3562

While at peak output conditions, under alternate power, what was the Amps on all 3 legs?

(AB - BC - AC)

134-136–147

While at peak output conditions, under alternate power, what was the Volts on all 3 legs?

(AB - BC - AC)

456-458-459

After ending simulation, did switch transfer back to normal power source? Yes

What Color Tag Was Left On This Fire Pump At The Completion Of This Inspection? Green

Element of Performance - EP-11

NFPA 25-2011: 8.3.3

Joint Commission Standard EC.02.03.05 Element of Performance 11 EP -1 a7e7677e-bcaf-4676-92ba-d73156e736ff | Fire Pump Tested Under Full Flow (Annual) and/or Pump Supervisory Signals | 09/21/2024

Annual Flow Test Results

REVOLUTIONS PER

MINUTE

DISCHARGE

PRESSURE

SUCTION

PRESSURE

NET PRESSURE STREAM NO. GPM %

VOLTAGE

L1 L2 L3

AMP READING

L1 L2 L3

3582 RPM 195 PSI 45 PSI 150 PSI 0 0 0 % 458 462 461 92 89 99

3566 RPM 155 PSI 35 PSI 120 PSI 3 1020 102 % 456 459 459 136 133 140

3562 RPM 120 PSI 25 PSI 95 PSI 3 1542 154 % 456 458 459 134 136 147

FLOW INFORMATION

Hose 100% (Orifice size / Manufacturer of Testing Device) 150% (Orifice size / Manufacturer of Testing Device)

Hose 1 13/4” / Hose Nozzle 13/4” / Hose Nozzle

Hose 2 13/4” / Hose Nozzle 13/4” / Hose Nozzle

Hose 3 13/4” / Hose Nozzle 13/4” / Hose Nozzle

Hose 4 — —

Hose 5 — —

Hose 6 — —

Hose 7 — —

Hose 8 — —

Hose 9 — —

Hose 10 — —

Hose 11 —

Hose 12 —

Hose 13 —

Hose 14 —

Hose 15 —

INSPECTION RESULTS SUMMARY

Fire Pump Operating Within Rated Specs Pass

AMPS Within Rated Specs Pass

VOLTS Within Rated Specs Pass

Inspection Results Pass

MOST DEMANDING SPRK. SYSTEM INFORMATION

Most demanding system

GPM

PSI

Element of Performance - EP-11

NFPA 25-2011: 8.3.3

Joint Commission Standard EC.02.03.05 Element of Performance 11 EP -1 a7e7677e-bcaf-4676-92ba-d73156e736ff | Fire Pump Tested Under Full Flow (Annual) and/or Pump Supervisory Signals | 09/21/2024

Fire Pump Performance Test

0 200 400 600 800 1,000 1,200 1,400 1,600

Flow - GPM

Pr es su re

PS

I

Discharge Suction Rated Curve Net Pressure Sprinkler Demand

Element of Performance - EP-11

NFPA 25-2011: 8.3.3

Joint Commission Standard EC.02.03.05 Element of Performance 11 EP -1 a7e7677e-bcaf-4676-92ba-d73156e736ff | Fire Pump Tested Under Full Flow (Annual) and/or Pump Supervisory Signals | 09/21/2024

SUPERVISORY-FIRE PUMP LOSS OF POWER

# LOCATION DESCRIPTION ADDRESS DEVICE TYPE BARCODE INSPECTOR DATE OF TEST RESULT

Utility Building, 2nd

Floor Fire Pump#1 9:M1-47

Supervisory-Fire Pump Loss of Power

Nestor Roderick De

Four 09/21/2024 Failed

Reason for failure: (Functional Failure) Did not operate Fire Pump .

Utility Building, 2nd

Floor Fire Pump#2 9:M1-44

Supervisory-Fire Pump Loss of Power

Nestor Roderick De

Four 09/21/2024 Passed

FIRE PUMP RUN

# LOCATION DESCRIPTION ADDRESS DEVICE TYPE BARCODE INSPECTOR DATE OF TEST RESULT

Utility Building , 1st

Floor IN PUMP ROOM Fire

Pump #2 9:M1-43 Fire Pump Run —

Nestor Roderick De Four

09/21/2024 Passed

Utility Building , 1st

Floor

IN PUMP ROOM

PUMP #1

9:M1-46 Fire Pump Run —

Nestor Roderick De Four

09/21/2024 Failed

Reason for failure: (Functional Failure) Did not operate Fire Pump.

Inspector Signature

Inspector Name Nestor De Four Date 09/21/2024

Signature of the

Operations Fot

Printed name of the Operations

Fot Jose Orta Date 09/21/2024

Element of Performance - EP-11

NFPA 25-2011: 8.3.3

Joint Commission Standard EC.02.03.05 Element of Performance 11 EP -1 a7e7677e-bcaf-4676-92ba-d73156e736ff | Fire Pump Tested Under Full Flow (Annual) and/or Pump Supervisory Signals | 09/21/2024

Terms And Conditions

1. Limitation of Liability; Limitations Of Remedy. It is understood and agreed by the Customer that Company is not an insurer and that insurance coverage, if any, shall be obtained by the Customer and that amounts payable to Company hereunder are based upon the value of the services and the scope of liability set forth in this agreement and are unrelated to the value of the Customer's property and the property of others located on the premises. Customer agrees to look exclusively to the Customer's insurer to recover for injuries or damage in the event of any loss or injury and that Customer releases and waives all right of recovery against Company arising by way of subrogation. Company makes no guaranty or Warranty, including any implied warranty of merchantability or fitness for a particular purpose that equipment or services supplied by Company will detect or avert occurrences or the consequences there from that the equipment or service was designed to detect or avert.<br />It is impractical and extremely difficult to fix the actual damages, if any, which may proximately result from failure on the part of Company to perform any of its obligations under this agreement. Accordingly, Customer agrees that, Company shall be exempt from liability for any loss, damage or injury arising directly or indirectly from occurrences, or the consequences therefrom, which the equipment or service was designed to detect or avert. Should Company be found liable for any loss, damage or injury arising from a failure of the equipment or service in any respect, Company's liability shall be limited to an amount equal to the agreement price (as increased by the price for any additional work) or where the time and material payment term is selected, Customer's time and material payments to Company. Where this agreement covers multiple sites, liability shall be limited to the amount of the payments allocable to the site where the incident occurred. Such sum shall be complete and exclusive. If Customer desires Company to assume greater liability, the parties shall amend this agreement by attaching a rider setting forth the amount of additional liability and the additional amount payable by the Customer for the assumption by Company of such greater liability, provided however that such rider shall in no way be interpreted to hold Company as an insurer. IN NO EVENT SHALL COMPANY BE LIABLE FOR ANY DAMAGE, LOSS, INJURY, OR ANY OTHER CLAIM ARISING FROM ANY SERVICING, ALTERATIONS, MODIFICATIONS, CHANGES, OR MOVEMENTS OF THE COVERED SYSTEM(S) OR ANY OF ITS COMPONENT PARTS BY THE CUSTOMER OR ANY THIRD PARTY. COMPANY SHALL NOT BE LIABLE FOR INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES OF ANY KIND, INCLUDING BUT NOT LIMITED TO DAMAGES ARISING FROM THE USE, LOSS OF THE USE, PERFORMANCE, OR FAILURE OF THE COVERED SYSTEM(S) TO PERFORM. The limitations of liability set forth in this agreement shall inure to the benefit of all parents, subsidiaries and affiliates of Company, whether direct or indirect, Company's employees, agents, officers and directors.

2. Limited Warranty. COMPANY WARRANTS THAT ITS WORKMANSHIP AND MATERIAL FURNISHED UNDER THIS AGREEMENT WILL BE FREE FROM DEFECTS FOR A PERIOD OF NINETY

(90) DAYS FROM THE DATE OF FURNISHING. Where Company provides product or equipment of others, Company will warrant the product or equipment only to the extent warranted by such third party. EXCEPT AS EXPRESSLY SET FORTH HEREIN, COMPANY DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE WITH RESPECT TO THE SERVICES PERFORMED OR THE PRODUCTS, SYSTEMS OR EQUIPMENT, IF ANY, SUPPORTED HEREUNDER. COMPANY MAKES NO WARRANTY OR REPRESENTATION, AND UNDERTAKES NO OBLIGATION TO ENSURE BY THE SERVICES PERFORMED UNDER THIS AGREEMENT, THAT COMPANY'S PRODUCTS OR THE SYSTEMS OR EQUIPMENT OF THE CUSTOMER WILL CORRECTLY HANDLE THE PROCESSING OF CALENDAR DATES BEFORE OR

AFTER DECEMBER 31, 1999.

3. Indemnity. Customer agrees to indemnify, hold harmless and defend Company against any and all losses, damages, costs, including expert fees and costs, and expenses including reasonable defense costs, arising from any and all third party claims for personal injury, death, property damage or economic loss, including specifically any damages resulting from the exposure of workers to Hazardous Conditions whether or not Customer pre-notifies Company of the existence of said hazardous conditions, arising in any way from any act or omission of Customer or Company relating in any way to this agreement, including but not limited to the Services under this agreement, whether such claims are based upon contract, warranty, tort (including but not limited to active or passive negligence), strict liability or otherwise. Company reserves the right to select counsel to represent it in any such action.

4. Hazardous Materials. Customer represents that, except to the extent that Company has been given written notice of the following hazards prior to the execution of this agreement, to the best of Customer's knowledge there is no:

a. "permit confined space," as defined by OSHA, or space in which work must be performed that, because of its construction, location, contents or work activity therein, accumulation of a hazardous gas, vapour, dust or fume or the creation of a risk of infectious disease

b. need for air monitoring, respiratory protection, or other medical risk

c. asbestos, asbestos-containing material, formaldehyde or other potentially toxic or otherwise hazardous material contained in or on the surface of the floors, walls, ceilings, insulation or other structural components of the area of any building

d. All of the above are hereinafter referred to as "Hazardous Conditions". Company shall have the right to rely on the representations listed above. If hazardous conditions are encountered by Company during the course of Company's work, the discovery of such conditions shall constitute an event beyond Company's control and Company shall have no obligation to further perform in the area where the hazardous conditions exist until the area has been made safe by Customer as certified in writing by an independent testing agency, and Customer shall pay disruption expenses and re-mobilization expenses as determined by Company. This agreement does not provide for the cost of capture, containment or disposal of any hazardous waste materials, or hazardous materials, encountered in any of the Covered System(s) and/or during performance of the Services. Said materials shall at all times remain the responsibility and property of Customer. Company shall not be responsible for the testing, removal or disposal of such hazardous materials.

5. Equipment Disconnections. This represents Company's notice to you that the system(s)/device(s) listed on the face of this agreement as temporarily or permanently disconnected are no longer in service and, thus, cannot detect, perform and/or report

6. General. Unless otherwise specified, work shall be performed during company's regular business hours,, exclusive of Saturdays, Sundays and Company holidays. All work is subject to review and rebilling in accordance with the terms and conditions of Customer's agreement/contract with Company, if one is in effect. Company shall not be responsible for failure to render services due to causes beyond its control, including but not limited to material shortages, work stoppages, fires, civil disobedience or unrest, severe weather, fire or any other cause beyond the control of Company. Customer is aware that the Limitation of Liability and other provisions set forth in any existing agreement/contract, if one is in effect, or set forth above, apply to services performed and materials supplied. The terms of this agreement shall govern notwithstanding any inconsistent or additional terms and conditions in any purchase order or other document submitted by Customer.

Joint Commission Report | Date: 09/21/2024 Page 10 of 14

GENERAL DEFICIENCY IMAGES APPENDIX

1- REPAIR / REPLACE DAMAGE FIRE PUMP-#1TRANSFER SWITCH & CONTROLLER

GENERAL DEFICIENCY IMAGES

APPENDIX 1

Joint Commission Report | Date: 09/21/2024 Page 11 of 14

DEFICIENCY IMAGE APPENDICES

EP11:

LOCATION DESCRIPTION DEVICE BARCODE TYPE IMAGES

Utility Building , 2nd Floor 1000GPM PUMP#1 Electric Fire Pumps — FUNCTIONAL FAILURE DEFICIENCY IMAGES APPENDIX 1.1

FAILURE REASON: UNABLE TO PERFORM ANNUAL FIRE PUMP INSPECTION FIRE PUMP CONTROLLER AND TRANSFER SWITCH NOT OPERATIONAL LOCKED & TAG SHUT BY OWNER.

Joint Commission Report | Date: 09/21/2024 Page 12 of 14

DEVICE NOTE IMAGE APPENDICES

EP11

LOCATION DESCRIPTION DEVICE BARCODE IMAGES

Utility Building , 2nd Floor 1000GPM PUMP#1 Electric Fire Pumps — DEVICE NOTES IMAGES APPENDIX 1.1

Notes:

• Fire Pump#1

• Fire Pump Room

Joint Commission Report | Date: 09/21/2024 Page 13 of 14

EP11

Utility Building , 2nd Floor 1000GPM PUMP#2 Electric Fire Pumps — DEVICE NOTES IMAGES APPENDIX 1.2

Notes:

• Fire Pump #2

Joint Commission Report | Date: 09/21/2024 Page 14 of 14