FY 2024 Annual Fire Alarm Bldg 45.pdf

X

McCulloh

Multiplex

Digital

Reverse Polarity

RF

Other:

Service Frequency

Weekly

Monthly

Quarterly

Semi-Annual

Annual

Other:

Date: October 9, 2023 Time: 8:00am

Service Organization

Name: Alexandria VA Fire Department

Address: 2495 Shreveport Hwy

Pineville, LA

ZIP Code 71360

Monitoring Company

Contact: Alexandria VA Fire Department

Telephone: 318-466-2718

Transmission Type

Tag Color: Green

Location

Customer: Building 45

Property: Alexandria VA Health Care System

Address: 2495 Shreveport Hwy

Pineville, LA 71360

Contact: Joel Miller Fire Chief

Telephone (318) 466-4313

Quantity Tested

Quantity Installed

Circuit Styles

Inspection and Test Report

Control Panel Manufacturer:

Number of Initiating Circuits:

Software Version Number:

Edwards (ETS) Model No.: Fire works System

Circuit Styles A & B Fiber

V4.0

Last Date System Had Any Service Performed:

Last Date Software or Configuration Was Change(

Alarm Initiating Device and Circuit Information

Device Type Manual Pull Station

Air Sampling Smoke Detector

Ionization Smoke Detector

Photoelectric Smoke Detector

Photoelectric Beam Detector

Ionization Air Duct Smoke Detector

Photoelectric Air Duct Smoke Detector

Fixed Temperature Heat Detector

Rate of Rise Heat Detector

Rate Compensated Heat Detector

Line Type Heat Detection Cable

Fire Sprinkler Waterflow Switch

Other:

Alarm Verification feature is DISABLED El ENABLED

Battery Type

Dry Cell

Nickel- Cadmium

X Sealed Lead Acid

Lead Acid

Other:

Alarm Notification Appliances and Circuit Information

Quantity Quantity Circuit Installed Tested Styles Device Type

Bells

Horns

Chimes

Speakers

Strobe Lights

144 144 Y Other: Combination Horn/Strobe

Number of Alarm Indicating Circuits: 6

Are Circuits Monitored for Integrity? X Yes No

Supervisory Signal Initiating Devices and Circuit Information

Quantity Quantity Circuit Installed Tested Styles Device Type

6 6 2 Tamper Switch

Building Temperature

Site Water Level

1 1 2 Fire Pump Power

1 1 2 Fire Pump Running

Fire Pump Auto Position

Fire Pump or Controller Trouble 6 6 2 Main Drain

4 4 Fire Department Connections 2 2 2 Transfer Switch/Control Relays

Generator Engine Running

Low Air Pressure

Air Duct Smoke Detector

Other:

Signaling Line Circuits

Quantity: 'I Circuit Style: 6

System Power Supplies a.Primary: Nominal Voltage 120 Amps 1

Overcurrent Protection: Type: Circuit Breaker

Amps 20

Location of Primary Supply Panelboard: Elec Closet Panel "LS-45-1"

Power Disconnect Location: Breaker #4 b.Secondary (Standby)

Sealed Lead Acid Storage Battery: Amp- Hour Rating: 8 AH Calculated capacity is Amp-Hours to operate the system for 24 Hours

Engine driven generator dedicated to the fire alarm system

Location of fuel storage:

c. Emergency or standby system used as a backup to primary power supply instead of using a secondary power supply:

Emergency system described in NFPA 70, Article 700

Legally required standby system described in NFPA 70, Article 701

Optional Standby System described in NFPA 70, Article 702, which also meets the performance requirements of Article 700 or 701

PRIOR TO ANY TESTING

NOTIFICATIONS ARE MADE:

Monitoring Company

Building Occupants

Building Management

Other

AHJ Notified of Any Impairments

Yes x x x

No Who & Time

VA Fire Department 0800

Joel Miller Fire Chief

SYSTEM TESTS AND INSPECTIONS

TYPE Visual Functional Comments

Control Panel

Interface Equipment

Lamp / LED's

Fuses

Primary Power Supply

Trouble Signals

Disconnect Switches

Ground Fault Monitoring x x x x

SECONDARY POWER

Battery Condition

Load Voltage

Discharge Test

Charger Test

Specific Gravity

El x x x

See battery calc sheet for size requirements

TRANSIENT SUPPRESSORS

REMOTE ANNUNCIATORS

NOTIFICATION APPLIANCES

Audible

Visual

Speakers

N/A

Voice Clarity

N/A

INITIATING AND SUPERVISORY DEVICE TESTS AND INSPECTIONS

See attached initiating and supervisory device test report

EMERGENCY COMMUNICATIONS EQUIPMENT Visual Functional Comments

Phone Set

Phone Jacks

Off-Hook Indicator

Amplifier(s)

Tone Generator(s)

Call-in Signal

System Performance

Device COMBINATION SYSTEMS Visual

Operation Simulated Operation

Fire Extinguisher Monitoring Device! System

Carbon Monoxide Detector / System

Other:

INTERFACE EQUIPMENT

SPECIAL HAZARD SYSTEMS

Special Procedures

Comments:

SUPERVISING STATION MONITORING

Alarm Signal

Alarm Restoration

Trouble Signal

Trouble Restoration

Supervisory Signal

Supervisory Restoration

NOTIFICATION THAT TESTING IS COMPLETE

Building Management

Monitoring Company Building Occupants

Other

No

No

Time Comments

Who

Joel Miller Fire Chief

Time

Alexandria VA Fire Departmer

The following did not operate correctly:

System restored to normal operation Date: 9-Oct-23 Time:

THIS TESTING WAS PERFORMED IN ACCORDANCE WITH APPLICABLE NFPA STANDARDS

Name of Inspector: Date: 9-Oct-23 Time:

Signature:

Name of Ow r Representative: Joel Miller Fire Chief Date: 9-Oct-23 Time:

Signature: _Q

Date: October 9, 2023 City: Pineville

Protected Property: Alexandria VA Health Care System Address: 2495 Shreveport Hwy State: Louisiana Zip 71360 t

Amps X 0.083 5 Minutes 24 4 (5/60)

Alarm Amp-Hours

Amps X 24 Hours

- Standby Amp-Hours

I

Secondary Standby Load

The Amount of Power that must be Supplied by the Batteries During Non- Alarm Conditions

Secondary Alarm Load

The Amount of Power that must be Supplied by the Batteries During Alarm Conditions

Battery Load Calculations 10/09/2023

Bldg 45 2495 Shreveport Hwy Pineville, LA 71360

Fire Detection

Total Secondary Load Compensation for Non-Linear Discharge Characteristics X 1.20

Total Ampere Hour Battery Supply Required -

Battery life tests 10/09/2023

Batteries Main Panel Batteries

Left

Right disposition volts

Amps volts

Amps 8Ah 12.6

11Ah 12.54

11Ah Good

EC .02.03.05 EP 3

Joint Commision Environment Of Care Detail Report-

Inspections Performed By Veterans Adminstation Fire Department (VAFD) iV The Joint Commission

Facility Name Building 45 Type Of Equipment Inspected Date Inspections Began Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory Total Devices Tested

Date Tested Device Type Building Floor

Pull stations

Location Cust

Zone No.

Service Performed

Comments Notes

Test Result

10/09/23 PS 45 1st ci,NTit Pui l IN CI ASS 1 ,)9(' 61)21(12), Tested Passed 10/09/23 PS 45 1st sounliql,1 'VI Sl AIR 4 BY KM 194 6525127

10/09/23 PS 45 1st (T51 It I'll I. Al' MAIN LOBBY ENTRY 6525128

10/09/23 PS 45 1st CI AIR ('ll I Al' 11151N(1 1(10 EXIT (,(125129

10/09/23 PS 45 1st Noit-i i I i,1'1.1 1.xn Al' LOADING DOCK 6(12513(1

10/09/23 PS 45 1st NI )it-i ii I'll.] Al' S'I AIR 2 BY ItM 123 65251 II

10/09/23 PS 45 1st Nok Ili pui I. DiNING COI 'WI YARD 1,511 61125132

10/09/23 PS 45 1st ('I SIR I'll I. Al' NERSI t STATION 6025113

10/09/23 PS 45 1st (1t5 I R 111,1. Al' STAIR I BY KM IL) 6525134

10/09/23 PS 45 1st NO12111(,11.1, NI 1)1515(1 100 1,511 6(120144

10/09/23 PS 45 2nd 5(11L I II 1,1,11 Al. STAIR 2 BY AM 221 (65.2(11.;8

10/09/23 PS 45 2nd ( I 5. I It MIA, A I (('FAIR I NEAR 1.1.1A' 6025149

10/09/23 PS 45 2nd CIA i It I'l'1.1, Al 51:1151. STATION 6(125135

10/09/23 PS 45 2nd ciA'i iz 1,01.1. A"I Sl AIR t BY AM 237 6025151

10/09/23 PS 45 2nd SOU'l II I'll I Al STAIR 4 BY RM 292 6025152

10/09/23 PS 45 1st PUI.I. AI EXIT NEAR (('FAIR 1 (t020154

10/09/23 PS 45 Attic CI N'I EIt Kilt Al STAIRS 6525160

10/09/23 PS 45 1st pui I xi 51 'Ittil, S'I ATION 6100178

10/09/23 PS 45 1st iq 'IA. Al'EXFI BY 120051 1711 6020179

10/09/23 PS 45 2nd i'ui.i. NI NERSE STA1•105 602(11x(1

10/09/23 PS 45 2nd PEI.I.AF ST \IR t, BY RM 21111 6020181

10/09/23 PS 45 Attic I'll.I. IN PENTFIOUSIt 6(120182

VA Fire Department

EC .02.03.05 EP 3

NFPA Standards NFPA 72, 2021

OK Ref NFPA 72, 2010

Pull Stations

ANNUAL

10/09/23

Facility Name Building 45 Type Of Equipment Inspected Date Inspections Began Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory Total Devices Tested

Smoke Detectors (PSD) 10/09/23 10/13/23

ANNUAL

Inspections Performed By Veterans Adminstation Fire Department (VAFD) yr The Joint Commission

VA Fire Department

EC 02.03.05 EP 3

NFPA Standards NFPA 72, 2021 OK Ref NFPA 72, 2010

Joint Commision Environment Of Care Detail Report- EC .02.03.05 EP 3

Date Tested Device Type Building mo Floor e e ec ors .

Location cust Zone No.

Test

10/09/23 PSD 45 1st SOL; HI SMK OVER FIRE PANEL 602000 I

10/09/23 PSD 45 1st SOUTH SMK IN CORR BY ROOM 185 6020002

10/09/23 PSD 45 1st CENTER SMK IN CORR BY OFFICE 178 6020003

10/09/23 PSD 45 1st sourti SMK IN CORR BY ROOM 187 6020004

10/09/23 PSD 45 1st SOUTH SMK IN CORR BY ROOM 191 6020005

10/09/23 PSD 45 1st SOUTH SMK IN ( ORR BY ROOM 193 60200(10

10/09/23 PSD 45 1st CENTER SMK IN i 'ORE NEAR RN1 197 60211007

10/09/23 PSD 45 1st (T. TER SMK IN 1.1.1 VATOR LOBBY S 6020008

10/09/23 PSD 45 1st IT\ l'ER SMK IN ENTRANCE FOYER 6020009

10/09/23 PSD 45 1st clATER SNIK IN ELEVATOR LOBBY N 6020010

10/09/23 PSD 45 1st CENTER SNIK IN CORR NEAR STAIR I 602001 1

10/09/23 PSD 45 1st NoRTI I SMK SERV CORR BY KITCHEN 6020(112

10/09/23 PSD 45 1st NORTI1SMK SLRN, CORR 131" LINEN 107 6020013

10/09/23 PSD 45 1st NORTH SMK IN CORR 1,1 ROOM 1[2 6020014

10/09/23 PSD 45 1st NORTH SMK IN CORR BY ROOM 104 6020015

10/09/23 PSD 45 1st NORTH SMK IN CORR BY ROOM 105 6020016

10/09/23 PSD 45 1st NORTH SMK IN CORR BY ROOM 116 6020017

10/09/23 PSD 45 1st NORTH SMK IN DINING 117 6020018

10/09/23 PSD 45 1st NORTH SMK IN CORR BY ROOM 120 1,1)20019

10/09/23 PSD 45 1st NORTH SMK IN CORR BY ROOM 121 6020020

10/09/23 PSD 45 1st II :N•1 ER SMK IN CORR BY ROOM 127 6020021

10/09/23 PSD 45 1st 'I•1\ I ER SMK IN CORR BY ROOM 130 020022

10/09/23 PSD 45 1st 1 I• \ Ilk SMK IN CORR BY ROOM 133 6020023

10/09/23 PSD 45 1st 11 VI 1)12 SMK IN CORR BY ROOM 137 6020024

10/09/23 PSD 45 1st ('I Ni SMK IN CORR BY ROOM 181 6020031

10/09/23 PSD 45 2nd NORTH SMK IN CORR BY ROOM 221 6020032

10/09/23 PSD 45 2nd NORTH SMK IN CORR BY ROOM 218 6020033

10/09/23 PSD 45 2nd NORTH SNIK IN CORR BY ROOM 214 6020034

10/09/23 PSD 45 2nd NORTH SMK IN CORR BY ROOM 2111 6020035

10/09/23 PSD 45 2nd NORTH SMK IN CORR BY ROOM 205 6020036

10/09/23 PSD 45 2nd . NORTH SMK IN CORR BY ROOM 203 6(12(1037 •

10/09/23 PSD 45 2nd • NORTH SMK IN RE(' '1•1111RAPY NORTH 6020038

10/09/23 PSD 45 2nd NORTH SMK IN RTC TIIERAPY SOUTH 6020039

10/09/23 PSD 45 2nd Ii NI SMK IN DINING 299 NORTH 6020040

10/09/23 PSD 45 2nd 1 i NI IA SN1K IN DINING 299 CENTER 6020041

10/09/23 PSD 45 2nd CENTER SNIK IN DINING 299 SOUTH 6020042

10/09/23 PSD 45 2nd CENTER SNIK IN ELEVATOR LOBBY N 6020043

10/09/23 PSD 45 2nd CENTER SMK IN ELEVATOR I OBBY S (1)20044

10/09/23 PSD 45 2nd CENTER SMK IN CORR BY 1007I 274 6020045

10/09/23 PSD 45 2nd SOUTH SMK IN CORR M ROOM 282 6020046

10/09/23 PSD 45 2nd CENTER SMK IN CORR BY ROOM 225 6020047 r The Joint Commission NFPA Standards NFPA 72, 2021

OK Ref NFPA 72, 2010

Joint Commision Environment Of Care Detail Report- EC .02.03.05 EP 3

Facility Name Building 45 Type Of Equipment Inspected Date Inspections Began Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory Total Devices Tested

Date Tested Device Type Building

W

Floor

IP

mlin as

Location

Cust Zone No.

Comments Notes

Service Performed

Test

10/09/23 PSD 45 2nd cENTER SMK IN LORE 131' ROOM 229 6020048

10/09/23 PSD 45 2nd CENTER SNIK IN ('UN It BY ROOM 233 6020049

10/09/23 PSD 45 2nd CENTER SMK IN CORR BY ROOM 237 6020650

10/09/23 PSD 45 2nd SOUTH SMK IN CORR BY ROOM 285 602065 I

10/09/23 PSD 45 2nd SOUTH SMK IN CORR BY ROOM 2115 6020052

10/09/23 PSD 45 2nd SOUTH SMK IN CORR BY ROOM 292 6020051

10/09/23 PSD 45 Attic CEN'l FR SNIK IN ELEA' EQUIP 171 6020058

10/09/23 PSD 45 1st SAIK IN CORRIDOR 101 61120069

10/09/23 PSD 45 1st S1 IK IN CORR 10r- ROOM 142 61120070

10/09/23 PSD 45 1st SMK IN SOILED UTILITY 141 6020071

10/09/23 PSD 45 2nd SMK BACK OF ELEC RM 267 6020072

10/09/23 PSD 45 1st SM IN IN STORAGE RNI I-16 6020073

10/09/23 PSD 45 1st 5N1K IN CLEAN UTILITY 147 6020074

10/09/23 PSD 45 1st SMK IN ('01:1:. BY ROOM 148 6020075

10/09/23 PSD 45 1st SMK IN CORR BY ROOM 151 6020076

10/09/23 PSD 45 1st SMK IN CORR BY ROOM 156 6020077

10/09/23 PSD 45 1st SNIK IN CORR BY ROOM 160 6020078

10/09/23 PSD 45 1st SMK IN CORR BY ROOM 164 6020079

10/09/23 PSD 45 1st SMK IN CORR BY ROOM 17/I 6020081

10/09/23 PSD 45 2nd SNIK IN CORR BY R( )0NA 240 6020083

10/09/23 PSD 45 2nd SMK IN SOILED ETII [IN 239 6020084

10/09/23 PSD 45 2nd SMK IN CoRR BY ROOM 244 6020085

10/09/23 PSD 45 2nd 6711,: IN STORAGE ItM 244 6020086

10/09/23 PSD 45 2nd sMK IN CLEAN I ill .1'1'Y 245 6020057

10/09/23 PSD 45 2nd SAlli IN CORR BY ROOM 248 6026688

10/09/23 PSD 45 2nd SMK IN SPD SUPPLY 1<71 249 6010089

10/09/23 PSD 45 2nd SNIK IN CORR BY ROOM 249 602(8)90

10/09/23 PSD 45 2nd SMK IN CORR (17 ROOM 254 6020091

10/09/23 PSD 45 2nd SMK IN CORR BY ROON I 258 6020092

10/09/23 PSD 45 2nd SMK IN CORR BY ROOM 262 6020093

10/09/23 PSD 45 2nd SNIK IN FILE STORAGE 266 6026094

10/09/23 PSD 45 2nd SAIK IN CORR In' ROOM 268 6020095

10/09/23 PSD 45 2nd 673K FRONT OF El AT' RM 267 6020096

10/09/23 PSD 45 1st SMK IN FILES ROOM 168 6020098

10/09/23 PSD 45 1st S611; IN CORR BY ROOM Ell 6020099

10/09/23 PSD 45 1st Sol IIII SMK IN IRM ROOm 180 6020106

EC 02 03 05 EP 3 Smoke Detectors (PSD)

ANNUAL

10/13/23

Type Of Equipment Inspected Duct Detectors (DSD)

EC .02.03.05 EP 3 & 19

Date Inspections Began Date Inspections Ended

P The Joint Commission

Frequency/Type of Inspection ANNUAL

NFPA Standards NFPA 72, 2021 Total Devices In Inventory 18

NFPA 72, 2010

Total Devices Tested 18

Joint Comm ision Environment Of Care Detail Report-

EC .02.03.05 EP 3 & 19

Date Tested

Device Type Building

Duct Floor

Detectors (DSD)

CUSt

Comments Notes

Service Performed

Test

10/10/23 DSD 45 1st souni AIR' DUCA 01X1011.1,1 07.7 6020025

10/10/23 DSD 45 1st ('INTER ..( I IU DUCT 1)1,1' ('ORE 10 I 0 6020026

10/10/23 DSD 45 1st sou11 I AM, DWI- I)1:1 OFFI( I 17t( 6020021

10/10/23 DSD 45 2nd ciA lut ;dui DL,cy im:r coRR BI 27; 60200/5

10/10/23 DSD 45 2nd Sot III NI II. 1.11 , 21 DE! OFFHT ,,,,, 611211110, 10/10/23 DSD 45 Attic ( I,VI FR A111.2 Dt.:("1 DLIT( loR 6020059

10/10/23 DSD 45 Attic ( I.N.I11: AIR 2 DU( 'I. III . 'I I .1. 1111: 60211060

10/10/23 DSD 45 Attic ( I-N•I F.I: (III..; ()CFI DI. ILC I oR 60.00e, I

10/10/23 DSD 45 Attic (1:\ 1 ki: \ iit. 1 01.c1. 1)1.10-111R hi '1,, ),,..

10/10/23 DSD 45 Attic ( i...vi r1( AIR I 01.1. I III III 11(11 r,10117..i

10/10/23 DSD 45 2nd •,ol, II i /111.. 111,1 I DI I I (111,1.I .,,, , N 0 ,2.001,1

10/10/23 DSD 45 Attic ClAili Ill MC( T Drill AuR 1 'NI

10/10/23 DSD 45 Attic (I .N I Id: Alit I I)k, c r.1)1.1 I.( roll 1,1).7VP,:i

10/10/23 DSD 45 2nd AUL 7 111,1 l• DIA BRI.,(1.RNI.,, ) ,)02010,, 10/10/23 DSD 45 2nd At It N III (' I DIA IN DAVI:01171 (A)2010 i

10/10/23 DSD 45 2nd (I it.•:.< DIA •I DI% I 710 711' ..-I /4320102

10/10/23 DSD 45 Attic Li Nil I: Alit , it 1A,("I 1)1.11.C101: 00,161

10/10/23 DSD 45 Attic ( i• N'i IA( (III Is DI ( F DI. I I.( 101: (,i12011,:

Type Of Equipment Inspected Supervisory Signals

EC 02.03.05 EP 1

Date Inspections Began 10/09/23

Date Inspections Ended

Frequency/Type of Inspection

The Joint Commission

ANNUAL NFPA Standards NFPA 72. 2021 Total Devices In Inventory 3

Ref NFPA 72. 2010 Total Devices Tested 3

Joint Commision Environment Of Care Detail Report- EC .02.03.05 EP 1

Time To

Date Tested Device Type Building Floor Location Zone No. Notes Performed Result

Alarm Notificatio n

10/11/23

Fire Pump Room

AC Failure Tested Passed 5 Seconds

Pump Running Tested Passed 5 Seconds

Phase Reversal Tested Passed 5 Seconds

EC .02.03.05 EP 3 Joint Comm ision Environment Of Care Detail Report-

Date Tested Device Type Building Floor Location Cust

Zone No.

Comments

Notes Service

Performed Test

10/12/23 CR 45

10/12/12 CR 45

EC .02,03.05 EP 3

10/09/13 10/13/23

ANNUAL NFPA Standards NFPA 72, 2021 2 OK Ref NFPA 72, 2010

Facility Name Building 45 Type Of Equipment Inspected Control Relays Date Inspections Began Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory Total Devices Tested

V The Joint Commission

Date Inspections Began Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory Total Devices Tested

Strobes/ Speaker Strobes 10/09/23 10/13/23

ANNUAL

Inspections Performed By Veterans Adminstation Fire Department (VAFD)

V The Joint Commission

VA Fire Department

EC .02.03,05 EP 3

NFPA Standards NFPA 72, 2021 LA Ref NFPA 72, 2010

Joint Commision Environment Of Care Detail Report- EC .02.03.05 EP 3 roses Floor pea or rose

Location

Date Tested Device Type Building

Notes Service

Performed Test

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING STAIRWELL 6020186

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING OUTSIDE RM. 168 6020187

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING RM. 169 6020188

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING RM. 164 6020189

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING OUTSIDE RM. 161 6020190

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING RM. 158 6020191

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING RM. 158 6020192

10/09/23 SO/SV 45 .1ST BLD 45 FL1 SOUTH WING RM. 155 6020193

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING RM. 154 6020194

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING NURSE STATION 6020195

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING RM. 153 6020196

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING RM. 152 6020197

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING OUTSIDE RM. 151 6020198

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING RM. 150 6020199

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING RM 49 6020200

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING OUTSIDE RM. 145 6020201

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING EXIT CORRIDOR 6020202

10/09/23 SO/SV 45 1ST BLD 45 FL1 SOUTH WING EXIT CORRIDOR HALLWAY 6020203

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING OUTSIDE RM. 138 6020204

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING RM. 164 6020205

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING RM. 120 6020206

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING RM. 126 6020207

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING RM. 126 6020208

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING RM. 130 6020209

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING RM. 172 6020210

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING RM. 173 6020211

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING OUTSIDE RM. 173 6020212

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING OUTSIDE RM. 100E 6020213

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING RM. 100 6020214

10/09/23 SO/SV 45 1ST BLD 45 FL1 CENTER WING RM. 101A 6020215

EC .02.03,05 EP 3

10/09/23 10/13/23

ANNUAL NFPA Standards NFPA 72, 2021 6 OK Ref NFPA 72, 2010

Facility Name Building 45 Type Of Equipment Inspected Tamper Switches Date Inspections Began Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory Total Devices Tested

V The Joint Commission

Joint Comm ision Environment Of Care Detail Report- EC .02.03.05 EP 3

Date Tested Device Type Building Floor Location

Performed Test

10/12/23 TS 45 1st ...,(II III I A \ II, IN sroR,vii Is. 6020136

10/12/23 TS 45 1st 1,01'ill I AMP IN STORAtil . 10.1 60.201;S

10/12/23 TS 45 1st Vil'Ill IAMP IN O'S \III II CM 6020142

10/12/23 TS 45 Outside PIV 10 [SNIPER NIODU1. L IN CM I-1 s.1 6020145

10/12/23 TS 45 2nd SOUTH TAMP IN CORP. BY I lit ' 279 6020159

10/12/23 TS 45 Attic CENTER TAMPER SWI'l L11 6020173

Passed

Failed

Date Inspections Began Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory Total Devices Tested

Flow Switches 10/09/23 10/13/23

ANNUAL

VA Fire Department

EC .02,03.05 EP 3

NFPA Standards NFPA 72, 2021 OK Ref NFPA 72, 2010

Inspections Performed By Veterans Adminstation Fire Department (VAFD)

V r The Joint Commission

Joint Commision Environment Of Care Detail Report- EC .02.03.05 EP 3

Date Tested Device Type Building Floor

Notes

Service

Performed

Test

10/12/23 WI, 45 1st 501,11111,i INsIoli\til Si1 (,(120 0';

10/12/23 WF 45 1st SOLI I 1 1.1 tA,\ IN SIOR. Vil 110 602(1137

10/12/23 WI' 45 2nd SOUTH FLOW IN COW( BY OFF 260 r,o2iii:so

Tested Failed

10/12/23 WI' 45 Attic CENTER WATERFLOW (,(12()171

Heat Detectors

10/13/23

ANNUAL

VA Fire Department

EC 02 03 05 EP 3

Facility Name Building 45 Type Of Equipment Inspected Date Inspections Began Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory Total Devices Tested

Inspections Performed By Veterans Adminstation Fire Department (VAFD)

V r The Joint Commission NFPA Standards NFPA 72, 2021

OK Ref NFPA 72, 2010

Joint Commision Environment Of Care Detail Report- EC .02.03.05 EP 3

Date Tested Device Type Building Floor

- elk - ink amok

C . C I LI ors

Notes Service

Performed Test

10/12/23 RR 45 1st NORTI I I ikAT IN KITCHEN SOUTH 6020020

10/12/23 RR 45 1st III I I ILA r IN KrICHEN NORTH 1 6020029

10/12/23 RR 45 1st NORI'll I lEAT IN Ni WHEN NORTH 2 6020030

10/12/23 RR 45 Attic CENTER HEAT IN ELEV EQUIP RM 6020057

10/12/23 RR 45 Attic CENTER HEAT IN ELEV EQUIP RM 6020065

10/12/23 RR 45 2nd EXPANSION HEAT IN HAC 246 6020097

10/12/23 RR 45 2nd A14117 DUCT DET IN PENTHOUSE 6020103

10/12/23 RR 45 Attic CENTER AHUI DUCT DETECTOR 6020104

10/12/23 RR 45 Attic CENTER AHU1 DUCT DETECTOR 6020105

Passed

Failed

Monitoring CO

NFPA Standards LA Ref

VA Fire Department

EC .02.03.05 EP 5

Alex. VA Fire Department

NFPA 72, 2021

NFPA 72, 2010

Emer Svc Notification

Facility Name Building 45 Type Of Equipment Inspected Date Inspections Began Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory Total Devices Tested

V The Joint Commission

ANNUAL

10/09/23 10/13/23

EC .02.03.05 EP 5

Emer Svc Not

Time Notification Received

Service Preformed

Time Tested

Test Results

Floor Notes Date Tested Device Type Building Location Zone No.

10/13/23 Dial FACP 800 45 Seconds Tested Passed 45 1st

Date Inspections Began Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory Total Devices Tested

Main Drain Tests 10/09/23 10/13/23

ANNUAL

Inspections Performed By Veterans Adminstation Fire Department (VAFD)

V The Joint Commission NFPA Standards LA Ref

VA Fire Department

EC .02.03.05 EP 9

NFPA 72, 2021

NFPA 72, 2010

Joint Commision Environment Of Care Detail Report- EC .02.03.05 EP 9

Static Pressure

Residual Return Time to Pressure Statis Presure

Date Tested Device Type Building

Riser or Control Valve & Type Location Performed Result

10/13/23 MD 45 Control North End (Attic) 145 135 35 seconds Tested Passed 10/13/23 MD 45 Control South End (Attic) 145 140 45 Seconds Tested Passed 10/13/23 MD 45 Control North End (2nd Floor) 150 140 50 Seconds Tested Passed 10/13/23 MD 45 Control South End (2nd Floor) 150 140 52 Seconds Tested Passed 10/13/23 MD 45 Control North End (1st Floor) 150 140 35 Seconds Tested Passed 10/13/23 MD 45 Control South End (1st Floor) 145 140 40 Seconds Tested Passed

Type Of Equipment Inspected Fire Dept Connections

Inspections VA Fire Departmt

Company Performing BOG/EP Ref. # EC .02.03.05 EP

Date Inspections Began Date Inspections Ended

P The Joint Commission

Frequency/Type of Inspection ANNUAL

NFPA Standards TJC Ref NFPA 25, 2020, Total Devices In Inventory 4

LA Ref NFPA 25 2009 Tt Total Devices Tested 4

EC .02.03.05 EP 10

Date Tested Device Type

FDC Is Visible

Accessible

Couplings-Swivels Are Not Damaged And Rotate Smoothly

Plugs & Caps Are In Place And

Undamaged Location

Gaskets In Place And In

Good Condition ID Signs In Place

Check Valve

Not Leaking

Auto Drain Valve In Place

& Operating Properly

10/13/23 FDC Yes Yes Yes

Yes Yes Yes Yes