FY 2024 Annual Fire Alarm Bldg 7.pdf

Inspection and Test Report

Date: October 2, 2023 Time: 8:00am

Location

Customer:

Tag Color: Green

Service Organization

Name:

Address:

ZIP Code

Alexandria VA Fire Department Building 7

2495 Shreveport Hwy Property: Alexandria VA Health Care System Pineville, LA Address: 2495 Shreveport Hwy

71360

Pineville, LA 71360

Contact: Joel Miller Fire Chief

Telephone: (318) 466-4313

Monitoring Company

Contact: Alexandria VA Fire Department

Telephone: 318-466-2718

Transmission Type

McCulloh

Multiplex

Service Frequency

Weekly

Monthly

7 Digital

Quarterly

Reverse Polarity

Semi-Annual

RF X Annual

Other:

Control Panel Manufacturer: Edwards (ETS) Model No.: NFW2-100

Number of Initiating Circuits: 2 (A & B) Circuit Styles A & B Fiber

Software Version Number: V4.0

Last Date System Had Any

Last Date Software or Configuration

Quantity Installed

Service Performed:

Was

Alarm

Quantity Tested

Change(

Initiating Device and Circuit Information

Circuit Styles Device Type

68 68 2 Manual Pull Station

0 0

Air Sampling Smoke Detector

Ionization Smoke Detector 317 317 2 Photoelectric Smoke Detector

Photoelectric Beam Detector

Ionization Air Duct Smoke Detector 91 91

Photoelectric Air Duct Smoke Detector

Fixed Temperature Heat Detector 18 18 2 Rate of Rise Heat Detector

Rate Compensated Heat Detector

Line Type Heat Detection Cable 31 31 2 Fire Sprinkler Waterflow Switch

Alarm Verification feature is DISABLED E ENABLED 0

Dry Cell

Nickel- Cadmium

Sealed Lead Acid

Lead Acid

Other:

Alarm Notification Appliances and Circuit Information

Quantity Quantity Circuit Installed Tested Styles Device Type

0 Bells

0 Horns

0 Chimes

0 Speakers

0 Strobe Lights

620 620 V Other: Combination Horn/Strobe

Number of Alarm Indicating

Are Circuits Monitored

Quantity Installed

Circuits: 6

Devices and Circuit Information

Device Type for Integrity? X Yes No

Supervisory Signal Initiating

Quantity Circuit Tested Styles

36 36 2 Tamper Switch

Building Temperature

Site Water Level

2 2 2 Fire Pump Power

1 1 2 Fire Pump Running

Fire Pump Auto Position

Fire Pump or Controller Trouble

1 1 2 Main Drain

4 4

Fire Department Connections

2 2 2 Transfer Switch/Control Relays

Generator Engine Running

Low Air Pressure

87 87 2 Air Duct Smoke Detector

Signaling Line Circuits

Quantity: 1 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: Rm gm 1

Power Disconnect Location: Panel E7BA # 24 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:

Battery Type

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

X

Yes No Who & Time

VA Fire Department 1332

Joel Miller Fire Chief x x -

SYSTEM TESTS AND INSPECTIONS

Visual Functional Comments x x x

See battery calc sheet for size requirements o x

N/A

N/A

El x x x

PRIOR TO ANY TESTING

NOTIFICATIONS ARE MADE:

Monitoring Company

Building Occupants

Building Management

Other

AHJ Notified of Any Impairments

TYPE

Control Panel

Interface Equipment

Lamp / LED's

Fuses

Primary Power Supply

Trouble Signals

Disconnect Switches

Ground Fault Monitoring

SECONDARY POWER

Battery Condition

Load Voltage

Discharge Test

Charger Test

Specific Gravity

TRANSIENT SUPPRESSORS

REMOTE ANNUNCIATORS

NOTIFICATION APPLIANCES

Audible

Visual

Speakers

Voice Clarity

INITIATING AND SUPERVISORY DEVICE TESTS AND INSPECTIONS

See attached initiating and supervisory device test report

Visual EMERGENCY COMMUNICATIONS EQUIPMENT Functional Comments

COMBINATION SYSTEMS Visual Device

Operation Simulated Operation

Time: 12:00 AM

THIS TESTING WAS PERFORMED IN ACCORDANCE WITH APPLICABLE NFPA STANDARDS

Name of Inspector: Date: 2-Oct-23

Signature:

Phone Set

Phone Jacks

Off-Hook Indicator

Amplifier(s)

Tone Generator(s)

Call-in Signal

System Performance

Fire Extinguisher Monitoring Device / System

Carbon Monoxide Detector / System

Other:

INTERFACE EQUIPMENT

SPECIAL HAZARD SYSTEMS

Special Procedures

Comments:

SUPERVISING STATION MONITORING Yes No Time Comments

Alarm Signal

Alarm Restoration

Trouble Signal X

Trouble Restoration

Supervisory Signal

Supervisory Restoration

NOTIFICATION THAT TESTING IS COMPLETE Yes No Who Time

Building Management X

Joel Miller Fire Chief

Monitoring Company X

Alexandria VA Fire Departmer

Building Occupants

Other

The following did not operate correctly:

System restored to normal operation: Date: 2-Oct-23 Time:

Name of Owner or presentative: Joel Miller Fire Chief

Signature:

Date: 2-Oct-23 Time: 12:00 AM

Date: October 2, 2023 City: Pineville

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

Amps X 24 Hours

Standby Amp-Hours

I

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

Alarm Amp-Hours i

1r

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 10/2/2023

Bldg 7 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

Note: The loads shown above were determined by use of a current meter using actual field conditions.

Battery life tests 10/2/2023

Batteries Main Panel Batteries

Left

Right disposition volts

Amps volts

Amps 8Ah 12.7

11Ah 12.64

12Ah Good

Facility Name Building 7 Type Of Equipment Inspected Su erviso Si.nals

Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory

Total Devices Tested

I 0/02/23

ANNUAL

Inspections Performed By Veterans Adminstation Fire Department (VAFD)

PrVr The Joint Commission

VA Fire Department

EC .02.03.05 EP 1

NFPA Standards NFPA 72, 2019 Ref NFPA 72, 2010

Joint Commision Environment Of Care Detail Report-

EC .02.03.05 EP 1

upervisory gnas

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

Time To Alarm

Notification 10/02/23

11A

Fire Pump House N2LI M22 AC Failure Tested Passed 5 Seconds

11A

Fire Pump House N2LI M 13 Pump Running Tested Passed 5 Seconds

I IA

Fire Pump House

Phase Reversal Tested Passed 5 Seconds 10/02/23 CT2 41 Cab 1 Generator Bldg. 40 4934841654 Smoke Tested Passed 5 Seconds

Type Of Equipment Inspected

Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection

Total Devices In Inventory

Total Devices Tested

Smoke Dow Ofs !'SD)

10/02/23

10/02/23

ANNUAL

.117

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, 2019

Ref NFPA 72, 2010

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

Date Tested Device Type Building

Smoke Floor

Detectors (PSD) Cust

Zone No.

Comments

Notes

Location Service

Performed Test

Result 10/02/23 PSI) 7 1st 0011-111 001K IN 0111/1C01. RI,CORDS 1020252

Tested Passed 10/02/23 PSI) 7 1st 0011 1 II SNIK 11,01.1.110 M111) I<LCORDS (02025.1

10/02/23 PSI) 7 1st 001<111 001K II01.1.11Y ('OS I)) R01 IS(Ki 1020251

10/02/23 PSI) 7 1st S011 111 001K 11.1.0 I 01110( 111101k014I'0 1020255

10/02/23 PSI) 7 1St SOCTII SNIK II/61.1.1S0' W 111(kAKR0011 1020256

10/02/23 'SD 7 1st SOt .111 0N1K 11,01.I. HY SOCIAI VORKLR 1020257

10/02/23 PSI) 7 151 sot :III SNIK HALL BY DIVIICIAN 110 1020258

10/02/23 PSI) 7 1st SOLTII '<MK 11.11.1.110 WA11101110M.' 1020259

10/02/23 PSI) 7 1s1 SOLI-II 001K 1011,01.1,110 1(01101 10/ 1020200

10/02/23 PSI) 7 1st 1501-111501K IN WAll INC( ROOM 100C 1020261

10/02/23 PSI) 7 1st '411 HI 001K 1301.1. BY C005111:1 AI0 (020262

10/02/23 PSI) 7 1st CIA I LI< SMK 11A1.1. BY RA1)100RAI >1115.1 1020261

10/02/23 PSI) 7 1st Sot -Ill 601K 1151.1. liY INTFRVILW 512 102(1264

10/02/23 PSI) 7 1st 8O1 I II 601K 1151.1.11Y WAll NO A01 1020210

10/02/23 I'S!) 7 1St SOLI II SNIK IN WA!! INC; ROOM AN 1112026,, 10/02/23 PSI) 7 1st Sol -1•1 I 501K IN \NAITING R0001 A0I 1020267

10/02/23 PSI) 7 1st 501 111 SNIK IN IN ('I 5(2 1020268

10/02/23 PSI) 7 1st 001-111611K 1151.1.11Y 1..0.111 R000(1108 1020269

10/02/23 PSI) 7 1St 001 ill `OAK 11,01.1.M- 111105131A0 1(16 1020270

10/02/23 PSI) 7 1st 1501 - 111 601K 11,61.1. (10 WAITING 101 1020271

'tested Passed 10/02/23 PSI) 7 1st SOLI'll 001K ((Al.!. SOCIAL WKR AI 7 (020212

10/02/23 PSI) 7 1st S01-111 601K (161.1. liY 141.0 11400.010 10202/.1

10/02/23 PSI) 7 1St 01(1 'I') 501K 11,61.1. BY WAIIING A111 1((20271

.kested Passed 10/02/23 PSI) 7 1St 00( . Ili 00IK IN IN111<V11.011 512 1020275

10/02/23 PSI) 7 151 soll II SMK 1161.1.110 '01.11'!' 1)1,11 1020276

10/02/23 PSI) 7 1st 001 111 SNIK 1151.1.11V PA I ILNT RH'. 102(1277

10/02/23 PSI) 7 1st 001 111 001K IN WAFIIN(.1 ROOM 518 1020278

Tested l'assed 10/02/23 PSI) 7 1st 1301:11I SNIK 11.01.1 .1(0 EXAM R0011,125 1020279

10/02/23 PSI) 7 1st 001-111 001K IN W.1111011 4O1)01 101 1020280

10/02/23 PSI) 7 1st SOLIII 501K 11.01..111r 1.0A111:0011 52-I 102(e)) I

10/02/23 I'S!) 7 1st 501111 00111 ((Al . I. BY 1%0 0.01 14011,01 .131 1020282

10/02/23 I'S!) 7 1St SOI "III 611K 10 WORK SI A FION .122 102(1283

10/02/23 PSI) 7 1st Sot '01 SMK IIALI ((010)0 40001 A36 1020281

10/02/23 PSI) 7 1St 00T111 SMK ((Al.!. 1(0 FX,1111:0011 A40 1020285

10/02/23 PSI) 7 1st SOCHI `OAK HALL ItY 0TAIRWA1 1020286

10/02/23 PSI) 7 15t 1.\11.1: 501K 11.11.1. WA! IINC 1<11 103 1020287

10/02/23 PSI) 7 151 (TN l'i..k SMK IN WORKROOM 102 1020288

10/02/23 PSI) 7 15t ('(.0! (K SMK 1151.1.110 MITT IN), 119 (112070')

10/02/23 PSI) 7 1st M.01112 SNIK 11,11.1.11Y WAITINti WI (020290

10/02/23 PSI) 7 1st c ..0 ILI< 014K 11/011.1 0 OR ELIA( 11)11(10 102(1291

10/02/23 PSI) 7 1st ('('0 11,11 SVIK 0.14.1,11.0A-10111.011(10 1020292

10/02/23 PSI) 7 1St CI •:\,1 kl: 001K I1A1.1 liY rITRASOr NI) 122. 102029,i

10/02/23 PSI) 7 1St ('1,01 1,11 5611.,: HALL B y 00.1 LAB ( 27 1020294

10/02/23 PSI) 7 1st CL 0 I I A< 1501K 1151 I. 1t0' NI 'CIA All 0(003 102(1295

10/02/23 PSI) 7 1st CIATI.11 SNIK HALL BY NLCI.LAR 0-1011(.1 1020296

Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection

Total Devices In Inventory

Total Devices Tested

Smoke Detectors (PSI))

10/02/23

1(1/02/23

ANNUAL

Inspections Performed By Veterans Adminstation Fire Department (VAFD)

VV' The Joint Commission

VA Fire Department

EC .02.03.05 EP 3

NFPA Standards NFPA 72, 2019

Ref NFPA 72, 2010

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

Date Tested Device Type Building

M o e e ec ors •

Floor Location ..

Cost Zone No.

Performed

Test

10/02/23 PSI) 7 1st 'EN I ER 551K II/11,1.11Y DARK1LOOAIS 1020207

'rested Passed 10/02/23 PSI) 7 1st l'I.N11.1: NAIK IN 1.11.111.11,1.1L00A1 102(1100

10/02/23 PSD 7 1st '1 \TER SAIK 1111,1 BY 1.11.511.11,1!1:11 1020300

10/02/23 PSI) 7 1st Cl!NIFIL SAIK IN IA1.11 !!!! I! ROOAI (02(010

10/02/23 PSI) 7 1st (' 'NTH: NAB)) I1A1.1, )D! R1'110'1E11 I OR 102(602

10/02/23 PSI) 7 1st ('I N ILI: SAUK IN VILWING ROOM (5)) 102(60)

10/02/23 PSI) 7 1st ( IA.)11: s 11K II Mi, BY HA OROSCOPI! 1021601

10/02/23 PSI) 7 1st '1!'N'11,IL S 1 1K 11/0.1 1..1.05'1.01(B) 100 1020305

10/02/23 PSI) 7 1st (1,711)1< SAUK 1111.1, BY I5IAGIN()(111)!1! 102030o

10/02/23 PSI) 7 1st (' A11.1: SAIK 11AI I.1\11(IIN( I SFA'10.1 IL) 102(I307

10/02/23 PSI) 7 1st TN!' IL DI ( -111A1.1.BY 5ILI••1 ING I I!! 0)201)1), 10/02/23 PSI) 7 1st ('L\ '1< 551K SI 10,1(T, Id,INA 1 It 1.0BBY 1(12(1)00

10/02/23 I'S!) 7 1st sot • I ii Dt. c 1 11111. BY INI 1,1:All AN .112 1020$10

10/02/23 PSI) 7 1st CIATI!1:. 511K 31I.IL5R1.1.1.1,VAIRI,OBM' 1020111

10/02/23 PSI) 7 1st CIATFIL SNIK 15 11.1.1,' LOBBY WO 11)2(50.1

10/02/23 PSI) 7 1st NOR'! II SNIK 11,11.1.11Y 01.11C1, 17.1 10203(3

10/02/23 PSI) 7 1st CIATIT: SAIK IN !RAI I:0011 1.51 1020315

10/02/23 PSI) 7 1st 11 N II It SAIK IN 1111.1.171 1020310

10/02/23 PSI) 7 1st LI N11.1: S11K 11.11.1, liY 01+1(1.175 (020317

10/02/23 PSI) 7 1st \Di: III 3)11K IN W,\)') IS)) 121! 102008

10/02/23 PSI) 7 1st 501<1)1 51IK IN 11A1.1 BY 11)1111. 1ING 1020319

10/02/23 PSI) 7 1st NORTIISAIK IN 1111.1, liA 001(1. 18.) 1(12))320

10/02/23 PSI) 7 1st NOR! II SNIK IN 11,111. BY 1.INI.N. 189 1020321

10/02/23 PSI) 7 151 SO) 01511K IN I1L11 IL0011 IS).) 1020.(22

10/02/23 PSI) 7 1st 501:111 55IK IN ‘A',1111NO 185 HI 1021).12(

10/02/23 PSI) 7 1st NOR I II SAIK IN W11115(1 185 le 102032,1

'Tested Passed 10/02/23 PSI) 7 1st \Oki]) NNIK IN 11111. BY PAIIEN1 1!1) 10211325

10/02/23 PSI) 7 1st NOR I II 31511!: IN 11A1.1. BY l'11. 11!711 (.,1) 1021026

10/02/23 PSI) 7 1st 51)1<1(1 SAIK IN 01,1.1 131 LAS! I:0051 (021627

10/02/23 PSI) 7 1st 50121.11 ',MK IN 1111,1. BY OF1•1( .1 IS.; 1)120328

10/02/23 PSI) 7 1st \of: (H 511K IN 11.11.1,B1 (1.1.1(1! 1020320

10/02/23 PSI) 7 1st NO1011 551K IN 1111,1, BY 0)3')) 'I, 179 1020330

10/02/23 PSI) 7 1st Nol: I It 551K IN \VAITINII 1805 1020331

10/02/23 PSI) 7 1St N01:111 S1IK IN 11A1 ,I, BY ILLSIDFNI 1020132

10/02/23 PSI) 7 1st NOR!!! SNIK IN I IA) I. BY 1..7,1,5I ISM) W20),( I

10/02/23 PSI) 7 1st \OR III NAIR IN 11111. BY SPEC l'01.1 102(031

'rested l'assed 10/02/23 PSI) 7 1st 51(k)')) SNIK 1111,1.10! St 1P1.5 180I) 1(120335

10/02/23 PSI) 7 1st ri..N ill: 551K IN 11,5).) (() K.N1)1013)(iY 1020310

10/02/23 PSI) 7 151 ',OLIN 551K 1111.1,1IY INSVIL.1.N('l, 112 (1).21)1

10/02/23 PSI) 7 1st (INTI.R SNIK I1A1.1, BY SI °RAGE 11,91.1 1(120(71

10/02/23 PSI) 7 1st Sol I'll' SAIK IN 111.1)1('AITLIA1)1LDS 1020.73

10/02/23 PSI) 7 1st (TN HAL SMK IN 1.1.11 ARR . R51 11,10 101003)!

10/02/23 PSD 7 1st ('1.510k 'OAK 11A1.). 10(,11,5' 1.010)1147 1010010

10/02/23 PSI) 7 1st LI 511 R SMK IN W1ITIN(i II',) ID!' 1,1.1!A 10)111)1, 10/02/23 PSI) 7 1st (1 . \ 11..R sVIK IN GAN! la ( 'DNA )<01,k\1 1010069

Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection

Total Devices In Inventory

Total Devices Tested

Smoke Detectors (PSI))

10/02/23

10/02/23

ANNUAL

Inspections Performed By Veterans Adminstation Fire Department (VAFD)

The Joint Commission

VA Fire Department

EC .02.03.05 EP 3

NFPA Standards NFPA 72, 2019

Ref NFPA 72, 2010

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

Date Tested Device Type Building Floor make Detectors (PD) Location

Cust Zone No.

Test

10/02/23 PSI) 7 1st ( TN 1 Lk 7711S IN 1.1.I.VAIOR 1011117 14/ 10100/0

10/02/23 PSI) 7 1st ('1.711.1< 7 717 IN 1101 R.00 71 11110 10100(1/

10/02/23 PSI) 7 2nd Sol HI SNIK IN 7(7171. WORK 131,1 2 10100(11

10/02/23 lS1) 7 2nd 701 HI 77IK I\ 70(17). WORK 131..1 I (0-10002

10/02/23 PSI) 7 2nd 701 ' I II 771K IN 1171.1 0 1' 10 /OM 2 10 1(3101/13

10/02/23 PSI) 7 2nd SHE I II 77)7 IN II. \11.117 I00071 2.15 10-1000.1

10/02/23 PSI) 7 2nd sot' ili 771K IN 1171.I. RV 107 171 244 11310005

10/02/23 PSI) 7 2nd 701:111 57IK IN M1:71 SI A1107 231 1040001(

10/02/23 PSI) 7 2nd sot . III sm liAl I Hy Nt Rs}, sl A ..11 10.10007

10/02/23 PSI) 7 2nd 701 111 'OAK IN 11711. BY ROONI 227 10-10001(

10/02/23 PSI) 7 2nd sot HI 571K IN 1171.1. BY R0071 22.1 1(3)0009

10/02/23 PSI.) 7 2nd 701 HI 591K IN 1111.1.10/ R0071 212 (040(110

10/02/23 PSI) 7 2nd sot III SMK IN 11.11.1.1tst R0011 211 1010011

10/02/23 'SI) 7 2nd (TN I Lk 7N1K IN 1171.1 RV 1 ()VIP STOR 1(140012

10/02/23 'SI) 7 2nd (TN 11.1t 77)7 1.71.1.1)')1 1.79111.1' ROOM 1(H))))).)

10/02/23 PSI) 7 2nd ( 1N 111: 7\17 IN 1111.1. BY 01.11(1. 0) 1010011

10/02/23 PSI) 7 2nd ('1,71 1.1< 711K IN 1.1.1,VA I OR I .01011 147 040015

10/02/23 PSI) 7 2nd ci .N11.1t 791K IN 0711, kV' 0111(1. .2:il 1040011(

10/02/23 PSI.) 7 2nd CliN 11.12 77/1K 11,71.1 It')' CORR '111F72AP7 10.10)07

10/02/23 PSI) 7 2nd rI .N 1 TR S711K IN 1111.1tAPY WA)! INH 1<11 1040017

10/02/23 PSI) 7 2nd ('IN 11It 791K 1'11).77'71, 1111,7711 1171.1. 1000019

10/02/23 PSD 7 2nd (TN') 11: 7N1K (IT)') P7110:1.11. 111111.11'1' 1040020

10/02/23 PSI.) 7 2nd CP 7.11It ISNIK 1171 1 HY It( 7 )71 24), 1040021

10/02/23 PSI) 7 2nd (1 7)11.771K 11711. I (/1.1 I 711:1.010)1 1040022

10/02/23 PSI) 7 2nd 1 lis. I LP 7\1K IN 11,71.1.0V 11717701<7(11, 11310024

10/02/23 PSI) 7 2nd CIA I PR SMIS IN 11 1. VA I 0It 1.011117 200 10401125

10/02/23 PSI) 7 2nd (TN 11.1t 7911S IN 71.10/ III 1 7,7) 1< 1.01307 1(4002), 10/02/23 lS1) 7 2nd CliN'I FP 7.717 ltl' CHNI•likliNCli I:71 .10011 101002/

10/02/23 I'S!) 7 2nd CIA I Lk 771K IN 1171.1 117 110171KPIN(I 104(1(27

10/02/23 PSI) 7 2nd ( liN1 TR SV1K HATT 117 I Pli,7I 7I7T 1<007) 104(1020

10/02/23 PSI) 7 2nd \HI< (117711K IN 11,71.1.1)7' I0i.S1 ROOMS 1010010

10/02/23 PSI) 7 2nd 'Sok III 7717 IN 11,711.11')' RFS' I100717 1010031

10/02/23 PSI) 7 2nd NOK1117717 IS 11,71.1. BY S'1.111LWAY 1040012

10/02/23 PSI) 7 2nd No1:10 7911: IN 1171110( 01+71 271 10-1003.1

10/02/23 PSI) 7 2nd 701:111 77IK 1111.1 11) 1.7771 ROO \1 273 0310011

10/02/23 PSI) 7 2nd NOR'))) 571K 11,71). 117'1..7771 I:0071 275 11140035

10/02/23 PSI) 7 2nd NOP III SNIK IN WA11 IN) I ROOM 282 1(1400 V, 10/02/23 PSI) 7 2nd SOR'I'l I 791K (171.1 117 17711170 It \1272 000037

10/02/23 PSI) 7 2nd NORTH 791K 1171.1. kV 711<7'!' 7111107. 1((40037

10/02/23 PSI) 7 2nd N) 7<14) 791K 11,71 I. BY li.X AN! 111107! 2(16 10100.14

10/02/23 PSI) 7 2nd NOR HI 711K 11111.11Y 17,171 70011 277 0140040

10/02/23 PSI) 7 2nd sot I'll ItVIK IN 11711. BY ROO 71 217 11710041

10/02/23 PSI) 7 2nd (TN 11 It SMK 117).1 II') ('01tIt 1111.1t711' 10107312

10/02/23 PSI) 7 2nd 1)7') I'll 7717 IN IltNI 111 11)71 2714 10-10071(

'rested l'assed 10/02/23 PSI) 7 3rd (1,71111 5717 IN IRM I:001134o 1020001

Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection

Total Devices In Inventory

Total Devices Tested

Smoke Detectors (PS1)1

10/02/23

10/02/23

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, 2019

Ref NFPA 72, 2010

Date Tested Device Type

Joint

Building

Commision

Floor

Environment Of Care Detail Report- EC .02.03.05 s

Detectors .s ke ( p D)

Cust

Location Zone No.

EP 3

Test

10/02/23 PSI) 7 3rd (.'L \ I ) 0 SNIK IN 110/11:00M 3511 1020002

10/02/23 PSI) 7 3rd soli II SA1K IN 1151.1. 10' 1.01000S 102(054

10/02/23 PSI) 7 3rd M)1. -111 5540 IN 11501.1)5 IMN'I Al. LAR 1020055

10/02/23 PSD 7 3rd 501 'III 5510 IN 1151.1.10r IWIPI. Intl \ 0 10210150

10/02/23 PSI) 7 3rd 5111 'III 5.510 11511 BY WAII ING 051330 1020057

10/02/23 PSI) 7 3rd SOCHI 5510 IN WAIVING 051 435 1020050

10/02/23 PSI) 7 3rd sot I II 5510 IN 11.11.1.145 STAIRS 1020050

10/02/23 PSI) 7 3rd 500011 SNIK IN 11A1.1.10' S'FAIRS 1020061

10/02/23 PSI) 7 3rd SOI. '1115M0 IN 11A1.1.10( XRAY .(00 1020002

10/02/23 PSI) 7 3rd 501 III 5510 IN XR.11' .130 1021x)(41

10/02/23 PSI) 7 3rd 501 III 5510 IN HALL 10 DVIIN 125 102(1(101

10/02/23 PSI) 7 3rd 50101 5510 IN 11501.111 10051 315 1020005

10/02/23 PSI) 7 3rd 500 I 11 SA10 IN 11501.115 (1)1(151 .1(1, I()2))1(1,), 10/02/23 PSD 7 3rd SOL 01 5 \It< 112,1.1.05 1. 01-.A I MINI ill 1020001

10/02/23 PSI) 7 3rd 501 111 5540 (IA! .1 BY IRLAI'MLNI 15 102(0105

10/02/23 PSI) 7 3rd Sol 'I II 5510 IN 11.51 I. 111' 1)11N1 .10.110 1020009

10/02/23 PSI) 7 3rd 501-1•115511: IN 11A1.1 Ii5 0I•1•IC1. .111 102007(1

10/02/23 PSI) 7 3rd r 'INFFR 5510 IN 11,11.1.10 01+1C1 300 1020071

10/02/23 PSI) 7 3rd (Th.N•1[1: SAIK IN 1151.1.10' 014.1C0 .105 1020072

10/02/23 PSI) 7 3rd CIND.R NMI: IN I1A1.1 BY II IV I 01110 1020073

10/02/23 PSI) 7 3rd (21,N11 .0 5510 IN Pl. DISPIASING 102(0174

10/02/23 PSI) 7 3rd CI •N RR 5140 10\11 RV LOCKIII: 1: \ I 350 (020075

10/02/23 PSI) 7 3rd CI.NILR 5\10 IN IIAI.I. BY S1 AIRS SO 10201176

10/02/23 PSI) 7 3rd Cl..N•II..0 5510 IN IL 1 1.1.10. C1'100061' 102(11)77

10/02/23 l'SD 7 3rd CIATIA: 5\1K IN 1051.1.10' 1111111 .I1(11 1020075

10/02/23 3S1) 7 3rd CIA'(I'll 5510 1\11.11.1 10' \1.11N LAB. 1020070

10/02/23 PSI) 7 3rd CIA11:0 5510 IN 1151.1.10' 1.01(10 .145 102005(1

10/02/23 PSI) 7 3rd (T.N ( 00 S\10 IN 1151.0 HY 54.5105 502 1020001

10/02/23 PSI) 7 3rd CI. N Hit SYR 1151.1. BY 5•11,011.11ATION 102(1(102

"tested Passed 10/02/23 I'S!) 7 3rd CIA ILI< 5.010 IN 4.1.1.0,5101: 1.111051 3.15 102005.1

10/02/23 PSI) 7 3rd CIATI.It 55I0 IN SI..0VR1,1.1.1tVIA)11117 1020054

10/02/23 PSI) 7 3rd (TN ))i ,: 5510 (N NI) I) 01.00101. 10113)01,0 1020055

10/02/23 PSI) 7 3rd ( .1!Ni FR 51.1K IIA1.1.111 STORA01..(1,2 10211050

10/02/23 PSI) 7 3rd 1'I.N4111: 5010 IN 111' WAITING 1:0054 102(1057

10/02/23 PSI) 7 3rd ciATER 5\101151.1 BY )')(NI' 051 .11,3 10210155

10/02/23 PSI) 7 3rd l'I,NI1:0 SNIK 11.101. BY 1C1 WAITING 1020050

10/02/23 PSI) 7 3rd NORTI I 5510 11,01.1. BY 1X1' 01.:SP ('.501 1(120090

10/02/23 PSI) 7 3rd NOR') 115,510 5110 IN 11A1.1. BY 1ikl 110( 0)51 1020001

10/02/23 PSI) 7 3rd NORTII 5510 IN NURSI7S 5. 0.11.10\ 1020004

10/02/23 PSD 7 3rd NoR•fl I 5541: IN 1151.1.13Y N0051, STA 102000.1

10/02/23 l'SD 7 3rd N1W I II 5 \1K IN 11,51 I. BY 101011 .I70 (020(55

10/02/23 PSI) 7 3rd NOR HI SW. IN 1111.1. BY 001151 351 I0200Q6

10/02/23 PSI) 7 3rd N) III 5\10 IN 11,514.10' 00011.152 1020(107

10/02/23 PSI) 7 3rd NOR III 5510 1\11.501.115 111,2,11 NURS4 1020005

10/02/23 PSI) 7 3rd NOR I'll SVIK IN !ILA') NI 051..01.1101. 1020099

Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection

Total Devices In Inventory

Total Devices Tested

Smoke Detectors (PSI))

10/02/2

10/02/23

ANNUAL

.117

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

VA Fire Department

EC .02.03.05 EP 3

NFPA Standards NFPA 72, 2019

Ref NFPA 72, 2010

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

Date Tested Device Type Building

Smoke Floor

Detectors (PS

Cust

Zone No.

Performed

Test

10/02/23 PSI) 7 3rd NORI I I 5511< IN 1.0C1<1'R, ROOM 1020100

10/02/23 PSI) 7 3rd N0R1 II SNIK IN DIR1 Y l 111.111' 1020101

10/02/23 I'S!) 7 3rd NOR I II SNIK IN S !ORAL& 3,/l, 1020102

10/02/23 'SD 7 3rd NOR I II SNIK IN 011.013 Al. St l'P011.5 102010.I

10/02/23 PSI) 7 3rd NOR I II SVIK IN; R0051.'0.41(1 )020104

10/02/23 PSI) 7 3rd N) 3)03) II SAIK IN 1)13) Iv) 1020 04, 10/02/23 'SI) 7 3rd N) 133)1) 51.11< IN R0051 39.11 I02010t)

10/02/23 PSI) 7 3rd N) 11<))) SNIK IN ROOVI .1941) 1020107

10/02/23 I'S!) 7 3rd NOR I 11 S01K IN 1:00013o.R' I02010)1

10/02/23 PSI) 7 3rd NoR I II 501K IN Rot /1.1 30.11) 1020109

10/02/23 PSI) 7 3rd NOR) II SNIK IN 14011 RV ROOM 475 1020110

10/02/23 PSI) 7 3rd NO)) I)) SAIK I\ I1A1.1 BY I OCKI RS 1020111

10/02/23 PSI) 7 3rd CI. N 11 1: SMK IN PASS 11.1.0.; 1.0111tY 1020112

10/02/23 PSI) 7 3rd (IN) OR SMK IN 11,01.1.110 III:0 ASS) 1020114

10/02/23 I'S!) 7 3rd ('IN)) <011 CI Slit') I.) IN 1.1E0 1.040tY 10201 I

10/02/23 PSI) 7 3rd (1,7,.11 R in 31 Au 1 II.) is ict • wAITING 10201111

10/02/23 I'S!) 7 3rd NOR II) 5011< IN R0001491/0 102011 I

10/02/23 PSI) 7 3rd NOR I II 50I1< IN ISO) oA I ION .:Qi 1020115

10/02/23 'SI) 7 3rd N °IT) I I SAIK. IN IS) )!.0,VI ION 19 1 1020119

10/02/23 'SD 7 3rd SOT I II soIk IN ITO( . 1 RIC ROOM 1012 1)120120

10/02/23 PSI) 7 3rd Sot I)) SAIK IN I1A1.1 BY ROCI,PrION 1020121

10/02/23 PSD 7 4th CON HA) SAIK 11,01.1.111. 1 7,11.010/I 513)1< 10.1025I

10/02/23 PSD 7 4th 1T.N.111t SA1K IN 1101.0I7,0 ARLA A .1), 1040252

10/02/23 PSD 7 4th (T.S.) TR 001K 11A1 1. HY 00'0041.\ I OCKI.RS 10.1024

10/02/23 PS!) 7 4th (IN) FR SAIK IN 11AI 1 IiY 141<. 100 1010254

10/02/23 PSI) 7 4th CON I4N SVIK IN HAIL 110 0.1‹. 451 10102i:, 10/02/23 I'S!) 7 4th CIA IT.R SMK 11;011.110 5O.0 I 1 .011 02 101)125), 10/02/23 PSI) 7 4th CONIIR SNIK 11.01.1.1)Y ANOSIII Wol<KR01 1040257

10/02/23 PSI) 7 4th CONTFR SMK 1.N ELLCIRIC 1<0001 ISIs 1040258

10/02/23 I'S!) 7 4th CF.N It 1<554K 11A1.1. BY OR 11101111)1C OR 110112/')

10/02/23 PSI) 7 4th CI .N I OR SVIK OA. 1,1.1 0,0310< 1.01111V 1040260

10/02/23 PSI) 7 4th CONTI]: 55.11< IN 11;01.1. liY ONDOSCOPY 1040261

10/02/23 PSI) 7 4th (IN) II) SAM 11,01.1.11Y 5COP1. SI OR M& 104025.2

10/02/23 PSI) 7 4th CI .NIOR SVIK IN 4.1.1A/A FOR 1.00110 K W102),.)

10/02/23 PSI) 7 4th CI.N14.1: SNIK I IA1 I BY OH 01,3)1) 1<3.01< 104020

10/02/23 PSI) 7 4th CON I OR s0IK 1111.1,11Y 1.I.1.0 1.0111.10,1 10.1021,t, 10/02/23 PSI) 7 4th 1I.0 VOR SMK IN I.).) ('0(1)30)0,0)30,1/ ROOM 4017 10-152ot

10/02/23 PSD 7 4th 11..N11.1:501K IN IIA1.1 BY 1)141' 410 t0-10205

10/02/23 PSI) 7 4th NoR III SNIK IN 11251.1. lil' 1 NAM 10440o) 10402o9

10/02/23 PSD 7 4th NOR'Ill VA/1K IN 14011.111 CI I..RKS 471 10.15270

10/02/23 PSI) 7 4th N0RIIISNIK IN WM11'0).101472 1040271

10/02/23 PSI) 7 4th NO)) 01 SAIK 14011.10 WADING 47 2 1040272

10/02/23 I'S!) 7 4th NoRIII 50I1< IN HALL BY 0411C4. 187 01027)

10/02/23 PSD 7 4th NOR))) 001)',IN 11.011.1t1 1111 ICI .190 104024t

10/02/23 PSD 7 4th NOR DI 57'!)', IN 11,011 00 LASI R 1 , 2 1)052/0

Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection

Total Devices In Inventory

Total Devices Tested

Smoke I ktectors (PSI))

10/02/23

10/02/23

ANNIVkl, 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, 2019

Ref NFPA 72, 2010

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

Date Tested Device Type Building

Smoke Floor

Detectors (PSD) Location

Cust

Zone No.

Test

10/02/23 PSI) 7 4th N01:111 SNIK IN WA!) (NI, HNI DIA I 10.10271, 10/02/23 PSI) 7 4th NI/Iall SNIK IN WAITING WM UFA 2 1011127/

10/02/23 PSI) 7 4th N(9:111NNIK IIAI.1.111•111-.ARING LAB 1118075

10/02/23 PSI) 7 4th \tilt i II NNIK IN IIA1.1 kV ()HR.) .15.1 15,1111N

10/02/23 PSD 7 4th :saat'i II SN1IN IN HAI I. Ill 1111 I(I. 17, IiI.11178), 10/02/23 PSI) 7 4th \mill SMK HAI.) 118 IltAILNG lifr(MIS IIII8.281

10/02/23 PSI) 7 4th 1'). NT1.5 SSIIS HALT BY VAS 1.13'11.1b i 1010252

10/02/23 'Si) 7 4th (1..N111: 881K IN II1I.1 ItY SLI:k Hi V 111-1518i

10/02/23 PSD 7 4th p).0,254

10/02/23 PSI) 7 4th CI.NItl: SNIK IN SLItV LI IV,',! It I,) 1)111's 1(14(12,55

10/02/23 'SI) 7 4th 01.N11.1t 8815 IN ILM 1.101 OR; (WI ICI 10.0)25), 10/02/23 PSD 7 4th CI.N• IV:It SNIls IN l'ANS 'I 'VA) )t .11)1)5's III 111287

10/02/23 PSI) 7 4th 1 TN I lit SMK IN IIII.I. IS) 1111101 (i • I 0-1ii2XS

10/02/23 PSI) 7 4th 11 NO .1< 5/AK IN IA),). 15 III I-ICI. •IiiIIA 15I1,25', 10/02/23 PSI) 7 4th (IN'!) It NMI: IN IlAt I BY 'III',' lulii2,B, 10/02/23 PSI) 7 4th (1.'s I) .I< 8/AK IN IIII.TICIAN •I I1$ 1(1.105..ii

10/02/23 PSI) 7 4th mil.'i II SVIK IN HALL II) IMONI.!Iti 11110)2

10/02/23 PSI) 7 4th soi'I II SNIK IN IIA).) NY IMI1V1-11: 15-111, ,M

10/02/23 PSD 7 4th 8)11:111 SMK IN HALL 111. NI'lt.SL N FA 111,1029.1

10/02/23 PSI) 7 4th slit -ill SNIK IN IA)) II',' 1((11)M •Ill, IIKII120

10/02/23 PSI) 7 4th NOI ill NNIK IN NI •I<SI ',NIA HON 111.1112,s, 10/02/23 PSI) 7 4th 8))) .) II 8/AK IN 1111.).))', KrICIIIA 11,11,2,r7

10/02/23 PSI) 7 4th 811) [II N.NIK IN 1111.1.1t7 I ()I.N.G1 1.15 10•4112,)K

10/02/23 PSI) 7 4th 8)1)1!) 88(5 IIII.I Il's IIAY NI It!)! n 110119, 10/02/23 I'SD 7 4th 81)) 'I II SMK IN HAI]. II) It0()\141-1 Ii1.1u ;55

10/02/23 PSI) 7 4th 1 i \I) It 8/AK IN 11.V1.1. 10 0.1:.1.1 .1 V 1010102

10/02/23 PSI) 7 4th 1INI111: 8515 IN 11,511. I) 't 1.NASI 10440 1010338

10/02/23 PSI) 7 4th 111NTIA: SVIK 13.11.1,13Y 0.1‹.1.0(51.1:5 1040339

10/02/23 PSI) 7 4th SoTIII 5815 IN (IA) I. BY 13007,1 12.1 1040340

10/02/23 PSI) 7 4th (IN Ili: 'CM/S 11)51.1 II) WAIIING 10110S 1010341

10/02/23 PSI) 7 4th ('IN) 'It SNII): IN 11:.N11:00‘14VIS 10.1034.4

10/02/23 PSI) 7 4th 1' ...\ r111: SNIK IN 11)811 BY RI',) '1051 11).101.1S

10/02/23 PSI) 7 4th 1' •.N11.13 8815 OP 11(..A1 . 81101' BY I..111'V 1010317

10/02/23 PSI) 7 ATTIC ( ..VI It SNIIS 1 OP 04 ('Alt) I'.! I'',' SIIIT 1010263

10/02/23 PSI) 7 ATTIC 'I.N I I'It III,V1 P,\titi 4.1.4A'.VI ()It III 014031.1

10/02/23 PSI) 7 ATTIC 'TM It SVIIVP,\ SS 1.1.1A' 1.0'111 101 10.103 I), 10/02/23 PSI) 7 ATTIC 'TN'llt S\11SPASSI.I.TV I.))) API KM 1040)17

10/02/23 PSI) 7 ATTIC ITN llt 8N11;111.1t. FITA 1.0 119 1:,51 1040321

10/02/23 PSI) 7 ATTIC ('I.N'l It SNIK I'! 1,5,', 10k 11)1' 01. SI lAl. I 1040342

10/02/23 PSI) 7 lism•r S(1L III SNIK 11,51.1.11Y LINIA CHIT I.. 1020004

't'ested Passed 10/02/23 PSI) 7 II58T1' MA 1 It SVIK HALL lil' \10ItiTTI 1020005

10/02/23 PSI) 7 IISMT sot III tiN/iii 11,51.1. BY Al -101'SY 1020006

10/02/23 PSI) 7 liSr.)/IT Soli II SNIK ..\14()V1, 111131. PANI..1 1020007

10/02/23 PSI) 7 'ism sOt 'I II NV11: 1111.1, 131' SW11('I1( il...112 1020008

10/02/23 PSI) 7 lism.r LI.NT1.13 SVIKIIA1.1.1.1's I'liX 01+1(1 1020009

Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection

Total Devices In Inventory

Total Devices Tested

Smoke Detectors (PSI))

10/02/23

10/02/23

ANNUAL

3)7

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

VA Fire Department

EC .02.03.05 EP 3

NFPA Standards NFPA 72, 2019

Ref NFPA 72, 2010

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

Date Tested Device Type Building

Smoke etec ors Floor Location

Cust Zone No.

Service Performed

Test

10/02/23 'SI) 7 Bsmi ('I N11 RSMKIIM.I. BY S1 ORA(11,4 1020010

10/02/23 I'S!) 7 liSMT ('I \ 111: SMK1I2s1,I. It \ MA1\1.013131 1020011

10/02/23 PSI) 7 l(SMT CI N Ill: SMKIIA1.1.131 111(LAK ROOM 1020012

10/02/23 PSI) 7 liSMT (15.1.1,R S).11:11A1.1.13Y 10) Mil. 1020013

10/02/23 PSI) 7 BSMT (.1.\ 111: SVIK)\ FILVAIOR I 011119 18 1020014

10/02/23 PSI) 7 BSMT CI N11.1( SVIK(IALL BY I ILA/ 101313Y 18 1020015

10/02/23 PSI) 7 13SMT (TN1) R S9IKI1A1.1. BY (1111.). 01+1(1. 1020019

10/02/23 PSI) 7 Bsm.r yr\ 1.1,k SMKIIA1.1.111 SPI/1111 K STOR 1020017

10/02/23 PSI) 7 Bsm'r CLN ILI( SMKIIALL BY SON'S LO('KFR 1020019

10/02/23 PSI) 7 usmr cysil k SMK11 91.1.I15 WOMI.NSIAK:K1.1: 1(12(1019

10/02/23 PS!) 7 Bsfyrr r(.\ 11.1( SMKIIA1.1.1(1 W SIAIRWI..I.I. W20020

10/02/23 PSI) 7 Bsmr crs. I Lk 5 \IKW1,51'11.1..CIRIC RN) 29 1020021

10/02/23 'SI) 7 Bsm-r i 'IA 11.1: SNIKWLS I 1.1.1.C1 BR ' KM 25 1020022

10/02/23 I'S!) 7 liSMT

102002:1

10/02/23 PSI) 7 MM.!' ('I-N I'll: S\IKIN 1..1.1.VVIOR LOBBY t 1020024

10/02/23 PS!) 7 BSMT ('IN '('I) SNIKIN 11.1.1.1:00MS LND 1020025

10/02/23 PSI) 7 Bsm-r ('I,', Ilk ))NIKIN 11.1.1.1(0091 MIDDI 1 1020026

10/02/23 PSI) 7 liSMT (TNIII) SNIK1N I -.1.0 ROOM BY 1/001: 1020027

10/02/23 PSI) 7 liSMT ( 1 NTLR SNIKSLI2V 1..1.1..VA101( 1 OBBY 1020028

10/02/23 'SI) 7 BSMT (1 N111( SNIKIIAI I. BY ASS r (1)11..I. 30 1020029

10/02/23 PSI) 7 liSMT (1. \ILI) SMK(IALL BY L(NIPt Ill( ROOM 1020031

10/02/23 PSI) 7 IISMT NOR))) 991K 1(71.1. 131 ('LLAN !ANL\ 1020032

10/02/23 PSI) 7 115911' MB:11150K IN ROOM 44 1020033

10/02/23 PSI) 7 Bsm-r \own! SMK IN CORI: Al ROOM .44 1020034

10/02/23 I'S!) 7 liSMT NO)) Ill SNIK 11.51.1.1.):11 Al SI AIRWAY 102(1035

10/02/23 PSI) 7 IiSMT NORIIISVIK 11AI I. BY ( .0Y1111 TR 101 IS 1020037

10/02/23 PSI) 7 Bsm-r NOR I II SMK I IA).). BY NNIS 1 OCKLI:S 1020038

10/02/23 PSD 7 IiSMT NoRII1SNIK (IA).). BY .V11.(1 I 1.3,11 ('SIN)I (02111))')

10/02/23 PSI) 7 ItSMT NOR III SNIK I IALL BY STAIRWITI. 1(12(1122

10/02/23 PSI) 7 BSMT S01:111 SNIK IN VILDICALRIVORDS 1020251

10/02/23 I'S!) 7 BSMT SO! ('ll SVIK IN 911.1)1CAL ILLCORDS 102017(1

10/02/23 PSI) 7 BSMT 501 I'll SMF: 511..(1 I RN) 9111) RI.CORDS 1020111

10/02/23 PSD 7 BSMT CI \,11.1: SMKRM ,12 ON (111.1N(11: 11110071

10/02/23 PSI) 7 BSMT CI \ ITI< 5 \1KRM 12 ON (1,11,ING I. (19 (1721

10/02/23 PSI) 7 BSMT ' ('IN 11..R SMKRM Is ON (TILING R 10.10071

10/02/23 !'St) 7 BSMT CI NI I')) 5 \1KRM 45 ON (TILING I. (0100 ;1

10/02/23 PSI) 7 BSMT It,',) 'k SNIKRNI .I5 ABOVE CHIANG I. 1010078

10/02/23 PSI) 7 BSMT ('IN))!) 5NI18101 45 ON CLIIING ( 1010079

10/02/23 PSI) 7 BSMT ('LX I))) SMKI:).1 AS ABOVI., CHIANG R 101(1077

10/02/23 PSI) 7 BSMT (IN I I..R SN,IKI:NI -12 '51(1)90 (TILING I, 101007X

10/02/23 PSI) 7 BSMT I'LN10( SMKI(N( 12 ABOVI..('LILIN(11( 1040(09

10/02/23 PSD 7 BSMT CIA I Id) SMKRM .12 IN ( '1 OSI.:1 1040090

10/02/23 PSI) 7 BSMT t'l \ 1ER SVIKI:M 12 III) OW CI 091.1 1.1. 1040081

10/02/23 PSI) 7 BSMT I '1 I \ 3 TR 5MK10/1 12 111..1 OW '1.001<1)1 1010082

10/02/23 PSI) 7 BSMT (1.\ II')) SMKR)/1 12 111100 11(101<1. 10.40091 _

ANNUAL

10/02/2.3

Facility Name Building 7 Type Of Equipment Inspected

Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection Total Devices In Inventory

Total Devices Tested

Smoke Deiectol's (PSI))

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, 2019

EC .02.03.05 EP 3

Smoke Detectors (PSD)

Date Tested Device Type Buildin• Floor Location Cust

Zone No.

Comments

Notes Service

Performed Test

10/02/23 PSI)

BSMT ( N'l k SMKi: .15 ill k 1010054 tested Passed 10/02/23 PSI) 7 BSMT Ii NI k 3N1Kk 1 .15 (II 31\l' 11.005 I. 1040085

Tesied Passed

Date Inspections Began Date Inspections Ended

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

Duel Deteciors (1)01)) lo/o2/2t

10/02/2t

ANNUAI.

Inspections Performed By Veterans Adminstation Fire Department (VAFD)

V The Joint Commission

VA Fire Department

EC .02.03.05 EP 3 & 19

NFPA Standards NFPA 72. 2019

NFPA 72, 2010

Joint Commision Environment Of Care Detail Report- EC .02.03.05 EP 3 & 19

0 , Date Tested Device Type Building Floor Location Cust

Zone No.

Comments

Notes Service

Performed Test

10/02/23 1)0))

1 st 01 1/ III HI 010 01010 Sk((11101/ 1111) 1401, 0 tested Passol

10/02/23 1)51) / INI NI,1 I It I'll I N010 IIAI I. It) N1 1<01. NI A 11/21/ /19

10/02/23 I 101 1 7 i s, \CA 1111 /1 ( 1 0010 10)11 It) I\ II RVII kV R'211 ('Ill

Vested Passed

10/02/23 I(S)) 7 it, ND) 151)/I I 0 VI 0 IN Oil)',!', 1 1 A IIDN 11//1/ 1.11 lested Passed

10/02/23 DSO

1„, 0( /1 III 1/1 0 1 00)0 10 NII IP. III I( 1\1 Aot1 ,,,, I i L:

1 eSied I ...led

10/02/23 1)51) 7 Is/ NI/1 III In 01 SO)), IN 01,011(1111 1,211tat

1,11111 Passed

10/02/23 1)01) 1 I, ',l II III In CI 0\1100110 I( (II) 011/11/01 I 1020 1(.1

.1 astad Passed

10/02/23 1)51) t,t NI/0111ln ( 1 SNIII IN lA 1IIIN(/ \DI 1112.114-10

1 asied Passed

10/02/23 1)51)

1u 0(11 HI (try, ss,its IN IN i Lim w Al2,0 Ili!! 11.16

1.(1)1 l'aNSell

10/02/23 Dtil / 7 1st 0Di 1111/1 01 5.0)0 IN \II NN RI 0116 a/\.1 11/21/I1!

lasted Passed

10/02/23 1/01) 7 Is ND( 111111 01 N \II. IN WI /MI N's (<(.0/ RNI 10..nit.o., 10/02/23 1/51/ 1 hi std'Itlid 1 i sNiis IN (0'111101, lot 11/2/i PSI rested Passed

10/02/23 1)51) 7 151 NM 1111)1 1'1 SM Is 10 I'll \ RNIA01' it/2/11S1

1,5),:,) Passed

10/02/23 USD 7 1st 01.011.1I Id 010\10 IN ( I 01 1 AMR sl I!', 111.211,01

Eesied Passed

10/02/23 1)01) 7 1,1 NM 1 11 1 /1 .1 I 0 \Hs IN I 111101. Itpi 11,21110 4

11csied Passed

10/02/23 Dtil ) 7 Is (1 \ILK II0('I .01(0 IN !A t\ sdk111)01 I 10 1112t) ii:, lesied Passed

10/02/23 1)01) 7 Is ( 1011 1)1)1(1)01K 11/01 I 1(1' 0111.110.1 /101 11)211101, Eesled Passed

10/02/23 DS1)

Is) 1.1.0 11 II In 01N NI0 11 01.1 1 I )11.11/11/1(11,1' 11/21/is/

10/02/23 Dtil)

IS 01 0 11 II IA 1 '1 00110 101/11RA II, 111215ss

111,1 Passed

10/02/23 1)01) 7 1st 010.11 II III C10\11010 0111( 1 Ito 111211 (''I

10/02/23 1)01) 7 1st ci.01 I II DI 0111/011.115 101DII I I<1)1D1 1/121/1011

10/02/23 Otil) 7 Is) I 1 Nil II In 01INDIllt I lit/ 11211'),)

10/02/23 555 1 Is) ( .1A 11 0 1 )1 •1 ' /10 , I./ ,R,...., / ,/ . 1,,,,,), I I/21, Ib2

1\asied Passed

10/02/23 MI) 7 Is 01 011,0 111 ( i IN HALL tu kAintn III,) 1 1) i

TesIcti Passed

10/02/23 leip

Is) CI 011 5111 CI I1A1.1. IsY 1. 0,00! 1:1)(101 I I 1 11/./11)/ts lus)ed Passed

10/02/23 Dtil) 7 I ( I.\ II I< 1 ,I'CI IN I NANI 1<c)t 1 \I I ; I it 11/21/•ii,/, 10/02/23 Dtil ) 7 1,1 (1.0 11 l< 1 11 ) 15011', N,11.C11 I« IIIN1 I \II , 11121140 leNtell Passed

10/02/23 1)01) 7 i s/ l 1 NI1.1) In 1 1 IIAI 1 Itl 011(1( 01,1 It/t 11/21/1/1

1 estad Passed

10/02/23 Dtil) 7 IS 01/1 I 11 111 01 \\II , IN 01 I lc I. A2// III:// i ,,...

1,5,:,! Passed

10/02/23 Dtil)

1st St/0111M ( 1 IN N1 1'1 110 (0)11< 1001 11/1A III-Riot/ losed Passed

10/02/23 MD 7 I hi Oil) 1 11 I 11 ('I 1/5 01 1'1.1:VIM/II II0111/1.0 11/.011164

10/02/23 MD

Is ( 1.011.k In 01(\ III \ la Hilt\ 1)1 i1, 111111,S lestad Passed

10/02/23 MI/ 7 2/11.1 (I 011 II I/1 010010 WI 1.110. 1(0(0 01(11) It/.1111123

1 tasted Passed

10/02/23 1151) 7 2nd 0) /1 1 11 1 11 CI ,(11) ioi \II 1 'I I ell 2 Mit/ ///0///II lestecl P.N.1

10/02/23 MD 7 21111 01/1 11114 ( I Alll'I 0111 11 (112\110 11/41/1/11

10/02/23 1)01) 7 211,1 0(11 111111 ( I \IR 1/11 011111 HI 2 \1111 1,11,1,1'

lesed Passed

10/02/23 1)01) 7 2nd I I 0(1.1<1)1 ci 0111 1 , 001,1. i\ lot 211p 10-it/t/0t

1.11,1 l' Cll

10/02/23 MD 7 2ntl I 1.0 11.1I (11) 1 \Ill 11 ., RI I IN RN' 2.0/ PI-PA/1 ,'

10/02/23 1)01) 7 2nd 01 N II II S401 01(1 I i• ',LI' IN I1N1 .2,/ , lo.8/1/.10

10/02/23 1151) 7 2nd c'l N I IA< in't I 0)111 1 1.1 IN I<N121D lo•loo is

Tested Passad

10/02/23 1101) / 2,,,I CI.NI IA< III CI 0111 I(/\ IN \II CIII<VI 2NI, 1,/.11/oso tesied Passed

10/02/23 1(111)

Intl 11 011 I< 1/11 1A1101t, IN \11.0111INI 201, It/lia/s1

10/02/23 MD 7 21/t1 L10111:1/1 01 Alll Hat I 0 VII( II I<N12010 II/I1/152

10/02/23 1)01)

2nd ( I.011 It 1 11 ( I AIR 1/1.110 N11( 111:01 INI/s 11141115' lesed Passed

10/02/23 Dtil) 7 Intl CI OIL II 11t ( 1 ,0111•/115 IN VII.) 11 10.1 25.10 ii141/t/6-1

10/02/23 1)01) 7 2nd 01 \II I< 1,1 1. i '01111101 I\ 1:1 11.111 Slul< 1/11/111,-)

10/02/23 DS)) 7 2ild 1 'I.\ 1 1 l< III c I AI It Illi IN \ !ECU I< \ I :MIN 1/1400-It/ l'ested PUNSell

10/02/23 1)01) 7 211,1 CI NI 1 (< 1)1 c / A111 II! !,\ 111)1.'S1.1.:1'1\l/ 111.11)//i/

1,,),:)! Passed

10/02/23 11511

2nd CI.N Hi< ,,010 11.011 Isl I 1.I.0'A I l< 1111/10 0141100

10/02/23 Dtil) 7 211,1 CI 0111: DI CI AIR 11 (10 III 1101) NI l /l< II/PAPP/

10/02/23 DID 7 2.111.1 01. N II l< 1,1 CI (III 11) 10 III 11,011 51(11) iti.ltsatt/

'lasted Passed

10/02/23 DSD

2nd ( I 011 II tat • \III 11.110 1:1'11/011 01111< 11141101/1 lest,:,) Passed

Inspections Performed By Veterans Adminstation Fire Department (VAFD)

VA Fire Department

Type Of Equipment Inspected 1 hici 1 le1:00,47, (DM))

EC .02.03.05 EP 3 & 19

Date Inspections Began

Date Inspections Ended

10/02/21 The Joint Commission

0)/112/21

Frequency/Type of Inspection ANNUM

NFPA Standards NFPA 72, 2019

Total Devices In Inventory SI

NFPA 72, 2010

Total Devices Tested

Joint Commision Environment Of Care Detail Report- EC .02.03.05 EP 3 & 19 uc e ec oars cust

Test

Result Date Tested Device Type Building Floor Location Zone No.

Comments

10/02/23 DOD / 2.1 ('I \ ii It i)k ('I.)))) 1 14 151 01 511 •1 101 Itilttitha

I ested Passed

10/02/23 1)01) 7 3rd i. I NUR 1)1 5 1 01111, u) I • 011(110\4 (510 10.10t1 to

<57)57) Passed 10/02/23 MD 7 11(1 ( 1\1101)1 ( 170111 11)117' \IL( 1) 1/0) iVts 10200475

1 tested Passed 10/02/23 MD I 1.1 i i Si 1 I< 10 5 1 AIR II 1 IS \ I Ole At ,I i 111 0)200 !,) rested 15)e51

10/02/23 1)51) 7 1151 CI • II l< 10 CI AIR 111 l• I I I \ It/15151 102001,0

1 ested Passed 10/02/23 1)01) 7 101 cl 5111)10( 1 I) tto 7)0 I\ l \\ 0111N((l<51 IlHi/

I ested l'ast,e51 10/02/23 1)/1) 7 thl CI N11.1)10 ( I 511 1 I I 1 I• NII IPA( it i(11 1020002 rested Pas•eil 10/02/23 1/S1)

110 (').7'H.)< I ll ( 1 \IR I 1,1 15 ( ( 1N1 551 is, 115400, tested Pas•ed

10/02/23 1)01) 7 00 0101 III 10 CI 'OAK ISO) OH .511 1090 10.211(5/

lest.! Passed 10/02/23 1)01) 7 4th (INIII<I)1( I \III 11.4M(Ilivi(). i ,110i.1

1,,,.:,1 1.,,,,e(1 10/02/23 HSI) 7 4)11 Cl N11.510 CIAIII 11117, HO 01111<5 1040t0it

10/02/23 MI) 7 4th 1 I • H l< HI 5 1 5111 1 14 I • HI) 01 PR) 104 1) 101

Jested Passed 10/02/23 1)1(11 7 4)5 <.7,11.))))))1 0111 I 4 1 • 151(1):•( 11 ID(11) li)II,All:, 10/02/23 MD 7 4111 ( I 5)1.1<)))) 1,711) Ill IN 11 0( 401,0 10111,116

1 ,7)5,) PaNNell 10/02/23 1)01) 7 4th 715H l< Hi 5 , 0111 114 1•1170) 4 1 Ittattill7 le•ted Passed 10/02/23 1151) 1 4th ( i \11 OH) ('I II( 114 IN 11,51111<514,41) 1.1.1)1)1)0

1 tested Passed 10/02/23 1)51) 1 4111 (1 N)ll<1.1( 1 OH)11.1)5 0 011110A 40114 10-111q1', I ested l5)NN.1 10/02/23 MD 7 4th ( 1 N1) I< 10 ( 'AIR 1 1 IS likH•CII 11)(115 1011/40)

T I l5),C1.1 10/02/23 MI) 7 41h ( I 51) 1)10 ( t 0111 11,11\1 N 501 004 1(,), 10511)51)

I tested Passed 10/02/23 11511 7 401 (1 • ii i<l)t ( 1 \Ill 11.1)7' 000 I I ( 11 4),4 111-10±12

!tested Passed 10/02/23 1)51) 7 4<0 l 1 N II 51)1 ( I 0111 11 1 151 001111< \I 1(11 10411117

IL:sled Passed 10/02/23 MI) 7 4111 CI NH 11 1, \II\ IN II 01 I 151 I 501,1 l< \ I PH 11141,105

I est.! Passed 10/02/23 1)01)

-WI ( I N 11 I: ',51011'\11 05' (11: 11)( Ki It\ 115411;i9

I ested P ed

10/02/23 MD

4111 mit HI ',Mk 15 11701 1 111 10 )0 \I 12 1 10 twat)

I CNiell Passed 10/02/23 1)01) 7 4111 (i \111:•,\IK 1101 1 151 \\AI I PM( 1<51411, 1041,5H

I tested Pa•sed 10/02/23 1)01) 7 4t1) 5 I • H k \ \II. 15 11071 10)(701 15175 0110,"

Jested Passed 10/02/23 1)01) 7 415 ( I 7,11 I< 15510 IN 11701 1 140 RI (1101 14,1 0110 1 Is

<57)5,) l'assed 10/02/23 Dtil) 7 401 1') .511/00)0 ()PI I( AI 1,11()I' 01 111 ,7' 1011H17

[tested Passed 10/02/23 1)01) 7 Al I k 5)11(1111)11 1 \\If\ 51)7) 0111 11 1 /111W)

I este(' Passed 10/02/23 1151) 7 Al II)' ( I N II I< 10 (*I 5\)0 All) 11 1 1114 0 51.

15,0,1 l ions,) 10/02/23 MI) 7 Al I'll.' 100 H11)1 ( I 1501070111 II , 1)11011),, 'I ()sled Passed 10/02/23 DM) 7 Al II(' 5HI:11110 ( 1 \\II , \II( I Alll I lh I04011,1

15,1,1 Passed 10/02/23 1/011 7 All IC Sill H11)1 (' I 05)0,5)1)' II I I ll !() t21, I csIcti PJ,Cll 10/02/23 MD 7 ATTIC 1 1 \ II< \ \ 10 I It 0 \HA< MP( )1 5)1 51 I Itl.1,1.{.;

I esled Passed 10/02/23 1)01) 7 Al IIC 1(75 HI Hi) 10010 I'll 51:510( 1 010 lit to i4(

I ,o5,,) Pas•ed 10/02/23 MD 7 ATTIC , ill iiii, t( 1 0510 i,1001(.01\( y Am 111111)41, 1 cstcd Passe51 10/02/23 1)01) / 05511 timio/iriN\11. ,,LIININt)ll 0 I , 11 ,21,11.11

I estcd P.osed 10/02/23 1551) 7 1i15151 I ( 1 • H< HI ( 1 \\Its l<1 IR\ 15 1111 I( I • 11121)1.15

1,1.1 l'assed 10/02/23 1)51) 7 110511' • HI( I 11 HI) 10540 11 11,0 IN MI.( 11 l<01 10200 1 , Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection

Total Devices In Inventory

Total Devices Tested

Pull Stations

10/02/23

10/02/23

ANNIVAI.

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

VA Fire Department

EC .02.03.05 EP 3

NFPA Standards NFPA 72, 2019

Ref NFPA 72, 2010

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

Date Tested Device Type Building Floor Location Cust

Zone No.

Comments

Notes Service

Performed Test

10/02/23 PS 7 1st 501 I II ('I IL. (NIL liY 5111) kla 'OROS 11(21(10, 10/02/23 PS 7 1st SO1'111 l't LI. It) SPIRAL SI .511.1.651. 11/20377

10/02/23 PS 7 1st 501. 111 P1'1.1. SI NI RSE'S SI Al ION 1020.178

10/02/23 PS 7 1st Mil III PI 1.1..51 VLS11111.1.1 102037')

10/02/23 PS 7 1st SOt I'll I'll I. I16' P01.1(I. 1)1..11 1020380

10/02/23 PS 7 1st sot • II I 1.1. It IN pi jAkmAcy 11120 181

10/02/23 PS 7 1st SOI. I 11 Pt II 1..1irl ISY (1 SION11,14. SIR',' 1020.0(2

10/02/23 PS 7 1st (IN Flit l't 1.1.1\ WORKROONI 102 111211.1S.1

10/02/23 PS 7 1st ('IX 11•1S I'll I 11A1.1. IL) NI ('I [All 511.1) 10211:84

10/02/23 PS 7 1st CFNII.IS It 1.1.1N NI. 11.1 All \111/1CINI., 10211385

10/02/23 PS 7 1st (IN (1.1< l'Il I .,VI 55151 SI AIR0(F.1.1 1020.186

10/02/23 I'S 7 1st 1'10(11,1t ('t I.1.1 \ RA1)1OGRAPIIY !MIA 102038/

10/02/23 PS 7 1st CIA IIR PI 1.1,1\ 1.1.LOROSCOPI('11A1.1. 1020.189

10/02/23 PS 7 1st NORTH I'l I[(X11 115 P.A11EN't III 1020392

1 0/02/2 3 l'S 7 1st NOR III p111 ',xi] By \\. Al l'IN(i isos 1020393

10/02/23 PS 7 1st CI. \ II I: l't 1.1.1 \ 1.11. \ A FOR 1.(111115 14? 1040161

10/02/23 PS 7 1st ('I \ 11.,R Pt (.1 IN l ;ANTI< 1' CONTROL 651 10.111165

10/02/23 PS 7 2nd SOF 111 19 1.1 MI.CIIANICA1.11.,N1 110154 1020394

10/02/23 PS 7 2nd sot 1111,11,1,1.AD 01 11,511 tir 651 22 .1 10:10126

10/02/23 PS 7 2nd SOl 1 II Pt 1.1 . SI SIN HAIL lil' 5 l', \ IRW AY 10.10127

10/02/23 I'S 7 2nd S01-111 I'l 1,1.1151.1 'I ()MI .( 111251 2\15 1040121i

10/02/23 PS 7 2nd (1, \ II.R Pt .1 I. \ 1 \VLSI SI .A112 \V[1.1. Ni 1040129

10/02/23 PS 7 2nd CI.V11..k l't I I IN N,11.(11 R1 A 1)/1 2 N11; 1040110

10/02/23 I'S 7 2nd CIA 11.11 Pt :I, .1\ LII. VAI(W 1.0131n 247 1040131

10/02/23 I'S 7 2nd I 'I N 1.1.. t l't I I IN 1,011111' 200 10401 12

10/02/23 PS 7 2nd NL)RLII II II SI SI AIR111.1.1. SI 10401.1:

10/02/23 PS 7 2nd NOR 111 1'1'1.1.11AI 1 AL. I.-NAM ISOONI 2h 1040134

10/02/23 PS 7 ltd \ (*Ill I'l 1.1.11 11.1. SI 1 \\I 1<010(1 291 10401 15

10/02/23 PS 7 2nd SOI.' I'll Pt 1 I. .511.1'11A \ I( 'Al I'll 2N410 1040185

10/02/23 PS 7 3rd ('('NI FR P 1.1.IN Ill'It()11101,1)(11 1020136

10/02/23 PS 7 3rd CIA I FR PH. AN MI I 'I 1, \ NICAL RAI 1).15 10201,17

10/02/23 PS 7 3rd l'I NTH: P1 1.1.IN MAIN I.ABA.1.061 1020138

10/02/23 PS 7 lid (IN MR Pt' 1.1N II/51.1 Al' S FAIRS 102 1020139

10/02/23 I'S 7 .ird NOR III PIT .1\ 11 A1.1. A 1 SI AIRS Sii l 10201.10

10/02/23 PS 7 3rd (IN!! IS P1 I IA\ I IA1.1. SI' SI AIRS S#I 102016;

10/02/23 I'S 7 ltd NOR I'll Pt 1.1.1N 11A1.1 VI 1<00\1 182 10201 /1

10/02/23 I'S 7 ird S(11. I 11 I'll I. IN I IA1.1. Al SI AllSW.\Y 1(12(1172

10/02/23 PS 7 4th ('I NIFIS 1'1 1.1.1N 11,51 1.1(1' 11 .12. ,1!)1 1040.06

10/02/23 I'S 7 4th (IA I FR Pt 1.1.1\ 1151.1.11Y () R. (11 .611< 1040 177

10/02/23 I'S 7 .1111 ( .I.N.1 FR Pt '1.1.IN 11.51.1. 10 0.1:. 1.1)1111Y 111403711

10/02/23 PS 7 4t1t CFA IIIIS Pt 1.1.IN ILIA 'OVIASY 1040379

10/02/23 PS 7 4th NOR1 11 Pt :1.I IN \VAR (NI; 10/1 1/2 1010380

10/02/23 PS 7 4th Null I'll I'll I. IN 1:1'1. I.ANI; !Mid WA) 11710381

10/02/23 I'S 7 4111 NOR 111 PIA 1.1\ 111,,\RI\G HALLWAY 1010382

10/02/23 I'S 7 4th CI \ILI 11.1.1.IN 11,51.1.111 NIAIN 1.01111Y ((0018,1

Date Inspections Began

Date Inspections Ended

Frequency/Type of Inspection

Total Devices In Inventory

Total Devices Tested

Pull Stations

10/02/23

10/02/23

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, 2019 Ref NFPA 72, 2010

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

Date Tested Device Type Building Floor

Pull Stations Cust

Zone No.

Performed Test

10/02/23 I'S 7 4th 301 HI 01 1.1 IN 11A1 I BY S I AIIL3VA1 1040 I/S:s

10/02/23 PS 7 4th 301 111 11 1 1 IN 11A1.1. liY !!I1\1 .I25 101038o

10/02/23 PS 7 401 Sl)( III 1'1 II IN 103131 CF.\ 1FIL ' ((((0.01!

10/02/23 PS 7 4th CI N 1 I..R 01.1.1.111 O.R ll I \ A I OIL ILFAR 1040013

10/02/23 I'S 7 •Iih CI N 11.IL I'l 1.1.1N 0 IL BY LOCKIALS 104039 i

10/02/23 PS 7 4th Ci.N11..lt I'll I IN OR III 1 OCKF.ILS I010'((

10/02/23 PS 7 Kill(' 501 I II 1'1 1.1.311 1lIANIC.11. PI \ 11101 SI 10103So

10/02/23 I'S 7 AT II(' SO1 111 11 1 1,0 IL 1.1.1 \ It N110/1 SI 1010390

10/02/23 PS 7 Aril(' \.( Wt II 11. 1 I \Ill 1 IANICA1 l'IN 11101 SI 10,10392

10/02/23 I'S 7 ATTIC mihiIII'l I I 311.(11ANICAl. 01 N11101 SI 10.10 192

10/02/23 PS 7 AfFICI (1.N I R I'l 1 1.3111 11\ \ICA! 01.N 101 SI 10404l0

10/02/23 PS 7 Al TIC (1.N1 IL I'll I C \RI 11.1 \ II \ 11101.S1 10111120

10/02/23 I'S 7 BILMT

1020129

10/02/23 PS 7 FISIAT ifi.N i I: Pt 1 I IN NII !LIU S I °RAG! i 0210(1)1

10/02/23 PS 7 1357,41 (1 N I IL I'(l1.1\ II/31.1.11Y 1.01 NI)!. 20 1020131

10/02/23 PS 7 135311 \ 01: I 11 l't I I BY 11,31 1 LIL 3 1(0031 :, (1 10201 12

10/02/23 I'S 7 'ism"' No14.1 II pi. 11 1..xi 1 (HI 0.11)1NC DOCK (1)2)1!.)!

10/02/23 PS 7 1157,11 501 III I'll I 111 1 1 1..C1. 53311(111;19\1: 1020 04-1

10/02/23 I'S 7 iismT \000I pt I 1 IN 11,311 BY SIAIILWII I 1(121(1(5

10/02/23 I'S 7 1137,11 " NI!! 1,1 i (IN \ IAIN 1 .001(5 1020131

10/02/23 I'S 7 MM.!' I iNH: Pl 1 1 BY 1 R.3511 IL0ON1 102018,1

10/02/23 I'S 7 115341 501 111 01 1 1 IN V11.1)1( 31.10L 'OROS 1020419

10/02/23 PS 7 51114 -145341' (IN III! iii IAA] 51 A rks,A, A \ 10101s I

"rested Passed

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

The Joint Commission

Date Tested Device Type Building Floor Location Cust

Zone No.

Comments

Notes Service

Performed Test

10/02/23 CR 7 3RI) STAIRS N2L2IYI3it

10/02/23 CR 7 SUB liMT ELEV. ALT N3L2M-I I

Type Of Equipment Inspected

Date Inspections Began

Date Inspections Ended

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

VA Fire Department

EC .02.03.05 LP 3

NFPA Standards NFPA 72, 2019 Ref NFPA 72, 2010

Control Relays

I 0/02/23

I 0/02/23

Strobes/ Speaker Si robes

101(12/21

ANNUAL

Facility Name Building 7 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)

P r

V The Joint Commission

VA Fire Department

EC .02.03.05 EP 3

NFPA Standards NFPA 72, 2019

Date Tested Device Type Building

Floor

Speaker Strobes Location

Cust Zone No.

Test

10/02/23 SO/SV 7 SB BLD 7 SUB BASEMENT STAIRWELL 010501

10/02/23 SO/SV 7 SB BLD 7 SUB BASEMENT STAIRWELL 010502

10/02/23 SO/SV 7 SB BLD 7 SUB BASEMENT NORTHEND 010503

10/02/23 SO/SV 7 SB BLD 7 SUB BASEMENT WEST END 010504

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 15 (MEDICAL RECORDS) 010505

10/02/23 SO/SV 7 BM BLD 7 BASEMENT OUTSIDE RM. 14 010506

10/02/23 SO/SV 7 BM BLD 7 BASEMENT NEAR SMK 2004 (00507

10/02/23 SO/SV 7 BM BLD 7 BASEMENT SOUTH NEAR PULL STATION 010508

10/02/23 SO/SV 7 BM BLD 7 BASEMENT SOUTH STAIRWWELL (00509

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 12 (ELECTRICAL SWICTHGEAR) (1105010

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM 11D (MORGUE) 0105011

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 110 (MORGUE) 0105012

10/02/23 SO/SV 7 BM BLD 7 BASEMENT OUTSIDE SOUTH STAIRWELL 0105013

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 11C 0105(114

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 11 0105015

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 10 0105016

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 11A 0015017

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 58 01050I11

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 5B 0105019

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 6 1005020

10/02/23 SO/SV 7 BM BLD 7 BASEMENT OUTSIDE RM. 6 0105021

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 5A 01061)22

10/02/23 SO/SV 7 BM BLD 7 BASEMENT OUTSIDE RM. 4 01051123

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 5 0105024

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 5 0105025

10/02/23 SO/SV 7 BM BLD 7 BASEMENT LOBBY 1 0105026

10/02/23 SO/SV 7 BM BLD 7 BASEMENT OUTSIDE RM. EMS 0105027

10/02/23 SO/SV 7 BM BLD 7 BASEMENT CENTER HALLWAY BATHROOM 0105028

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 19A 0105029

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 1A (1105030

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 1C 0105031

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 1B 0105032

10/02/23 SO/SV 7 BM BLD 7 BASEMENT OUTSIDE STAIRWELL 0105033

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM.20 0105034

10/02/23 SO/SV 7 BM BLD 7 BASEMENT OUTSIDE RM. 20 (1105035

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 21 0105036

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM.21 0105037

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 37 0105038

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 37 0105039

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 36 0105040

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 36 01(15041

10/02/23 SO/SV 7 BM BLD 7 BASEMENT RM. 35 (005042

Strobes/ Speaker Strobes

10/02/21

ANNUAL

Facility Name Building 7

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…