VA WCHCS Bldg 1 Oneline Report 23.pdf

Prepared by ALARMSpecialists, Inc

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 1 of 29

Date Tested Device Location No de Lo op De vice Status Comments Building 1, Floor 0 N 0 L 0 M 0

March 20, 2023 Pull Station MECHANICAL RM BLDG 1 BSMNT N 1 L 2 M 44 Pass March 20, 2023 Pull Station EXIT BY STAIR 1 BLDG 1 BSMNT N 1 L 2 M 27 Pass March 20, 2023 Pull Station EXIT BY STAIR 2 BLDG 1 BSMNT N 1 L 2 M 25 Pass March 20, 2023 Pull Station EXIT BY STAIR 3 BLDG 1 BSMNT N 1 L 2 M 46 Pass March 20, 2023 Pull Station STAIR 4 BLDG 1 BSMNT N 1 L 2 M 23 Pass March 20, 2023 Pull Station OP ELEV EQUIP RM BLDG 1 BSMNT N 1 L 2 M 61 Pass March 20, 2023 Pull Station EXIT BY STAIR 9 BLDG 1 BSMNT N 1 L 2 M 47 Pass March 20, 2023 Pull Station EXIT BY STAIR 8 BLDG 1 BSMNT N 1 L 2 M 48 Pass

Building 1, Floor 1 N 0 L 0 M 0 March 20, 2023 Pull Station MAIN EXIT EAST BLDG 1 FLR 1 N 1 L 2 M 4 Pass March 20, 2023 Pull Station CAFETERIA EXIT BLDG 1 FLR 1 N 1 L 2 M 33 Pass March 20, 2023 Pull Station MORGUE LOADING DOCK BLDG 1 FLR 1 N 1 L 2 M 60 Pass March 20, 2023 Pull Station STAIRWELL 1 EXIT BLDG 1 FLR 1 N 1 L 2 M 92 Pass March 20, 2023 Pull Station HALL BY STAIR 1 BLDG 1 FLR 1 N 1 L 2 M 93 Pass March 20, 2023 Pull Station BY LAUNDRY LOADING DOCK BLDG 1 FLR 1 N 1 L 2 M 56 Pass March 20, 2023 Pull Station STAIRWELL 3 EXIT BLDG 1 FLR 1 N 1 L 2 M 50 Pass March 20, 2023 Pull Station STAIRWELL 3 EXIT BLDG 1 FLR 1 N 1 L 2 M 51 Pass March 20, 2023 Pull Station STAIRWAY 4 EXIT BLDG 1 FLR 1 N 1 L 2 M 41 Pass March 20, 2023 Pull Station STAIRWELL 5 EXIT BLDG 1 FLR 1 N 1 L 2 M 94 Pass March 20, 2023 Pull Station STAIRWELL 2 EXIT BLDG 1 FLR 1 N 1 L 2 M 57 Pass March 20, 2023 Pull Station PHARMACY NORTH EXIT BLDG 1 FLR 1 N 1 L 2 M 58 Pass March 20, 2023 Pull Station STAIRWELL 6 EXIT BLDG 1 FLR 1 N 1 L 2 M 59 Pass March 20, 2023 Pull Station EXIT BY MAIL ROOM BLDG 1 FLR 1 N 1 L 2 M 32 Pass March 20, 2023 Pull Station EMERGENCY ELEC RM 1235 BLDG 1 FLR 1 N 1 L 2 M 43 Pass March 20, 2023 Pull Station EXIT BY STORAGE 1240 BLDG 1 FLR 1 N 1 L 2 M 35 Pass March 20, 2023 Pull Station STAIRWAY 4 EXIT BLDG 1 FLR 1 N 1 L 2 M 42 Pass March 20, 2023 Pull Station EMS 1242 BLDG 1 FLR 1 N 1 L 2 M 36 Pass March 20, 2023 Pull Station EXIT BY OFFICE 1610 BLDG 1 FLR 1 N 1 L 2 M 1 Pass March 20, 2023 Pull Station EXIT BY STAIR 9 BLDG 1 FLR 1 N 1 L 2 M 2 Pass March 20, 2023 Pull Station EXIT BY STAIR 8 BLDG 1 FLR 1 N 1 L 2 M 22 Pass

Building 1, Floor 2 N 0 L 0 M 0

EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

VA Hospital - WCHCS - Bldg 1 - Device List (Pulls) - March 23

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 2 of 29

Date Tested Device Location No de Lo op De vice Status Comments

EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

VA Hospital - WCHCS - Bldg 1 - Device List (Pulls) - March 23

March 20, 2023 Pull Station STAIRWELL 2 EXIT BLDG 1 FLR 2 N 1 L 3 M 41 Pass March 20, 2023 Pull Station STAIRWELL 3 EXIT BLDG 1 FLR 2 N 1 L 3 M 44 Pass March 20, 2023 Pull Station STAIRWELL 4 EXIT BLDG 1 FLR 2 N 1 L 3 M 33 Pass March 20, 2023 Pull Station STAIRWELL 6 EXIT BLDG 1 FLR 2 N 1 L 3 M 40 Pass March 20, 2023 Pull Station STAIRWELL 7 BLDG 1 FLR 2 N 1 L 3 M 1 Pass March 20, 2023 Pull Station STAIRWELL 1 EXIT BLDG 1 FLR 2 N 1 L 3 M 92 Pass March 20, 2023 Pull Station STAIRWELL 5 EXIT BLDG 1 FLR 2 N 1 L 3 M 93 Pass March 20, 2023 Pull Station STAIRWELL 9 BLDG 1 FLR 2 N 1 L 3 M 2 Pass March 20, 2023 Pull Station STAIRWELL 8 BLDG 1 FLR 2 N 1 L 3 M 3 Pass March 20, 2023 Pull Station DENTAL RECEPTION BLDG 1 FLR 2 N 1 L 3 M 17 Pass

Building 1, Floor 3 N 0 L 0 M 0 March 20, 2023 Pull Station Kitchen Entrance 3217 Bldg 1 Flr 3 N 1 L 4 M 125 Pass March 20, 2023 Pull Station STAIRWELL 1 EXIT BLDG 1 FLR 3 N 1 L 4 M 32 Pass March 20, 2023 Pull Station STAIRWELL 2 EXIT BLDG 1 FLR 3 N 1 L 4 M 17 Pass March 20, 2023 Pull Station STAIRWELL 3 EXIT BLDG 1 FLR 3 N 1 L 4 M 13 Pass March 20, 2023 Pull Station STAIRWELL 4 EXIT BLDG 1 FLR 3 N 1 L 4 M 2 Pass March 20, 2023 Pull Station STAIRWELL 5 EXIT BLDG 1 FLR 3 N 1 L 4 M 33 Pass March 20, 2023 Pull Station BY STAIRWELL #9 BLDG 1 FLR 3 N 1 L 4 M 62 Pass March 20, 2023 Pull Station STAIRWELL 6 EXIT BLDG 1 FLR 3 N 1 L 4 M 18 Pass March 20, 2023 Pull Station BY STAIRWELL #8 BLDG 1 FLR 3 N 1 L 4 M 63 Pass March 20, 2023 Pull Station ICU NURSE STATION BLDG 1 FLR 3 N 1 L 4 M 77 Pass March 20, 2023 Pull Station OFFICE 3023 BLDG 1 FLR 3 N 1 L 4 M 14 Pass March 20, 2023 Pull Station PRE OP NURSE STATION BLDG 1 FLR 3 N 1 L 4 M 78 Pass

Building 1, Floor 4 N 0 L 0 D 0 March 20, 2023 Pull Station STAIR 1 EXIT BLDG 1 FLR 4 N 1 L 5 M 22 Pass March 20, 2023 Pull Station STAIRWELL 2 EXIT BLDG 1 FLR 4 N 1 L 5 M 15 Pass March 20, 2023 Pull Station STAIRWELL 3 EXIT BLDG 1 FLR 4 N 1 L 5 M 12 Pass March 20, 2023 Pull Station STAIRWELL 5 EXIT BLDG 1 FLR 4 N 1 L 5 M 23 Pass March 20, 2023 Pull Station STAIRWELL 6 EXIT BLDG 1 FLR 4 N 1 L 5 M 16 Pass

Building 1, Floor 5 N 0 L 0 M 0 March 20, 2023 Pull Station STAIRWELL 1 EXIT BLDG 1 FLR 5 N 1 L 6 M 31 Pass March 20, 2023 Pull Station STAIRWELL 6 EXIT BLDG 1 FLR 5 N 1 L 6 M 148 Pass Nursing staff has key to cover.

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 3 of 29

Date Tested Device Location No de Lo op De vice Status Comments

EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

VA Hospital - WCHCS - Bldg 1 - Device List (Pulls) - March 23

March 20, 2023 Pull Station STAIRWELL 2 EXIT BLDG 1 FLR 5 N 1 L 6 M 149 Pass Nursing staff has key to cover.

March 20, 2023 Pull Station STAIRWELL 3 EXIT BLDG 1 FLR 5 N 1 L 6 M 1 Pass March 20, 2023 Pull Station STAIRWELL 5 EXIT BLDG 1 FLR 5 N 1 L 6 M 30 Pass March 20, 2023 Pull Station NURSE STATION 5031 BLDG 1 FLR 5 N 1 L 6 M 25 Pass

Building 1, Floor 6 N 0 L 0 M 0 March 20, 2023 Pull Station STAIRWELL 1 BLDG 1 FLR 6 N 1 L 7 M 1 Pass March 20, 2023 Pull Station STAIRWELL 3 EXIT BLDG 1 FLR 6 N 1 L 7 M 6 Pass

Building 1, Floor 7 N 0 L 0 M 0 March 20, 2023 Pull Station ELEV S4 EQUIP RM 4300 BLDG 1 FLR 4 N 1 L 5 M 6 Pass March 20, 2023 Pull Station PENTHOUSE MECH ROOM BLDG 1 FLR 7 N 1 L 8 M 9 Pass

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 4 of 29

Date Tested Device Location No de Lo op De vice Status Comments Building 1, Floor 0 N 0 L 0 M 0

March 21, 2023 Smoke Detector OP ELEV EQUIP RM BLDG 1 BSMNT N 1 L 2 D 66 Pass Building 1, Floor 1 N 0 L 0 M 0

March 21, 2023 Smoke Detector HALL BY OFFICE 1678A BLDG 1 FLR 1 N 1 L 2 D 8 Pass March 21, 2023 Smoke Detector ELEV P3 LOBBY BLDG 1 FLR 1 N 1 L 2 D 13 Pass March 21, 2023 Smoke Detector BY WAITING RM 1003 BLDG 1 FLR 1 N 1 L 2 D 14 Pass March 21, 2023 Smoke Detector EMERGENCY RM WAITING BLDG 1 FLR 1 N 1 L 2 D 15 Pass March 21, 2023 Smoke Detector RECEPTION LOBBY BLDG 1 FLR 1 N 1 L 2 D 17 Pass March 21, 2023 Smoke Detector DINING AREA BLDG 1 FLR 1 N 1 L 2 D 33 Pass March 21, 2023 Smoke Detector ELEV S3 LOBBY BLDG 1 FLR 1 N 1 L 2 D 52 Pass March 21, 2023 Smoke Detector PUBLIC ELEV LOBBY BLDG 1 FLR 1 N 1 L 2 D 54 Pass March 21, 2023 Smoke Detector HALL TO BLDG 20 BLDG 1 FLR 1 N 1 L 2 D 56 Pass March 21, 2023 Smoke Detector PHARMACY BLDG 1 FLR 1 N 1 L 2 D 57 Pass March 21, 2023 Smoke Detector PHARMACY BLDG 1 FLR 1 N 1 L 2 D 58 Pass March 21, 2023 Smoke Detector PHARMACY EXIT WEST BLDG 1 FLR 1 N 1 L 2 D 61 Pass March 21, 2023 Smoke Detector PHARMACY SHELFING BLDG 1 FLR 1 N 1 L 2 D 62 Pass March 21, 2023 Smoke Detector HALL BY STAIR 2 BLDG 1 FLR 1 N 1 L 2 D 59 Pass March 21, 2023 Smoke Detector PHARMACY BLDG 1 FLR 1 N 1 L 2 D 60 Pass March 21, 2023 Smoke Detector HALL BY OFFICE 2657A BLDG 1 FLR 2 N 1 L 3 D 18 Pass March 21, 2023 Smoke Detector HALL BY PHARMACY BLDG 1 FLR 1 N 1 L 2 D 51 Pass March 21, 2023 Smoke Detector PHARMACY BLDG 1 FLR 1 N 1 L 2 D 55 Pass March 21, 2023 Smoke Detector ELEV P2 SOUTH LOBBY BLDG 1 FLR 1 N 1 L 2 D 45 Pass March 21, 2023 Smoke Detector HALL BY MORGUE BLDG 1 FLR 1 N 1 L 2 D 53 Pass March 21, 2023 Smoke Detector BY MAINTENANCE 1214 BLDG 1 FLR 1 N 1 L 2 D 30 Pass March 21, 2023 Smoke Detector VENDING AREA BLDG 1 FLR 1 N 1 L 2 D 31 Pass March 21, 2023 Smoke Detector BY CANTEEN 1222 BLDG 1 FLR 1 N 1 L 2 D 32 Pass March 21, 2023 Smoke Detector ELEV S4 LOBBY BLDG 1 FLR 1 N 1 L 2 D 34 Pass March 21, 2023 Smoke Detector BY CANTEEN STORAGE BLDG 1 FLR 1 N 1 L 2 D 35 Pass March 21, 2023 Smoke Detector HALL BY OFFICE 1406 BLDG 1 FLR 1 N 1 L 2 D 70 Pass March 21, 2023 Smoke Detector HALL BY OFFICE 1411B BLDG 1 FLR 1 N 1 L 2 D 71 Pass March 21, 2023 Smoke Detector HALL BY OFFICE 1419 BLDG 1 FLR 1 N 1 L 2 D 72 Pass March 21, 2023 Smoke Detector HALL BY OFFICE 1423 BLDG 1 FLR 1 N 1 L 2 D 73 Pass March 21, 2023 Smoke Detector HALL BY ER-1 BLDG 1 FLR 1 N 1 L 2 D 1 Pass March 21, 2023 Smoke Detector HALL BY ER-3 BLDG 1 FLR 1 N 1 L 2 D 2 Pass March 21, 2023 Smoke Detector HALL BY EXAM RM 1625 BLDG 1 FLR 1 N 1 L 2 D 3 Pass March 21, 2023 Smoke Detector HALL BY EXAM RM 1638 BLDG 1 FLR 1 N 1 L 2 D 4 Pass March 21, 2023 Smoke Detector HALL BY EXAM RM 1646 BLDG 1 FLR 1 N 1 L 2 D 5 Pass March 21, 2023 Smoke Detector HALL BY EXAM RM 1652 BLDG 1 FLR 1 N 1 L 2 D 6 Pass March 21, 2023 Smoke Detector HALL BY OFFICE 1657 BLDG 1 FLR 1 N 1 L 2 D 18 Pass March 21, 2023 Smoke Detector ELEV S5 LOBBY BLDG 1 FLR 1 N 1 L 2 D 16 Pass

VA Hospital - WCHCS - Bldg 1 - Device List (Smokes) - March 23 EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 5 of 29

Date Tested Device Location No de Lo op De vice Status Comments

VA Hospital - WCHCS - Bldg 1 - Device List (Smokes) - March 23 EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

March 21, 2023 Smoke Detector RECEPTION LOBBY BLDG 1 FLR 1 N 1 L 2 D 21 Pass March 21, 2023 Smoke Detector HALL BY EXAM 1672 BLDG 1 FLR 1 N 1 L 2 D 19 Pass March 21, 2023 Smoke Detector HALL BY REST RM 1669 BLDG 1 FLR 1 N 1 L 2 D 20 Pass March 21, 2023 Smoke Detector HALL BY OFFICE 1649 BLDG 1 FLR 1 N 1 L 2 D 7 Pass March 21, 2023 Smoke Detector BY PROCEDURE 1685 BLDG 1 FLR 1 N 1 L 2 D 9 Pass March 21, 2023 Smoke Detector BY NURSE OFFICE 1692 BLDG 1 FLR 1 N 1 L 2 D 10 Pass March 21, 2023 Smoke Detector BY OFFICE 1703 BLDG 1 FLR 1 N 1 L 2 D 11 Pass March 21, 2023 Smoke Detector AM SURG WAITING 1703 BLDG 1 FLR 1 N 1 L 2 D 12 Pass March 20, 2023 Smoke Detector BY STAIRWELL 8 BLDG 1 FLR 2 N 1 L 3 D 19 Pass March 25, 2022 Building 1, Floor 2 N 0 L 0 M 0 March 20, 2023 Smoke Detector CT EQUIP RM 2610 BLDG 1 FLR 2 N 1 L 3 D 2 Pass March 20, 2023 Smoke Detector M HEALTH CHECK-IN 2650 BLDG 1 FLR 2 N 1 L 3 D 12 Pass March 20, 2023 Smoke Detector MENTAL HEALTH CHECK-IN 2665 BLDG 1 FLR 2 N 1 L 3 D 14 Pass March 20, 2023 Smoke Detector ELEV P3 LOBBY BLDG 1 FLR 2 N 1 L 3 D 26 Pass March 20, 2023 Smoke Detector STAIRWELL 7 BLDG 1 FLR 2 N 1 L 3 D 32 Pass March 20, 2023 Smoke Detector MENTAL HEALTH DESK BLDG 1 FLR 2 N 1 L 3 D 35 Pass March 20, 2023 Smoke Detector LAB ROOM 2217 BLDG 1 FLR 2 N 1 L 3 D 45 Pass March 20, 2023 Smoke Detector Elev P3 Hoistway Bldg 1 Flr 2 N 1 L 3 D 55 Pass March 20, 2023 Smoke Detector HALL BY ROOM 2013 BLDG 1 FLR 2 N 1 L 3 D 64 Pass March 20, 2023 Smoke Detector OFFICE 2016 BLDG 1 FLR 2 N 1 L 3 D 65 Pass March 20, 2023 Smoke Detector OFFICE 2016 BLDG 1 FLR 2 N 1 L 3 D 66 Pass March 20, 2023 Smoke Detector OFFICE 2016 BLDG 1 FLR 2 N 1 L 3 D 67 Pass March 20, 2023 Smoke Detector OFFICE 2016 BLDG 1 FLR 2 N 1 L 3 D 68 Pass March 20, 2023 Smoke Detector HALL BY ROOM 2006 BLDG 1 FLR 2 N 1 L 3 D 62 Pass March 20, 2023 Smoke Detector HALL BY ROOM 2008 BLDG 1 FLR 2 N 1 L 3 D 63 Pass March 20, 2023 Smoke Detector PATIENT WAITING 2207 BLDG 1 FLR 2 N 1 L 3 D 70 Pass March 20, 2023 Smoke Detector BLOOD BANK 2217(A) BLDG 1 FLR 2 N 1 L 3 D 49 Pass March 20, 2023 Smoke Detector LAB ROOM 2218 BLDG 1 FLR 2 N 1 L 3 D 48 Pass March 20, 2023 Smoke Detector HALL BY STORAGE 2222 BLDG 1 FLR 2 N 1 L 3 D 43 Pass March 20, 2023 Smoke Detector HALL BY ROOM 2234 BLDG 1 FLR 2 N 1 L 3 D 44 Pass March 20, 2023 Smoke Detector HALL BY ROOM 2229 BLDG 1 FLR 2 N 1 L 3 D 47 Pass March 20, 2023 Smoke Detector LAB ROOM 2217 BLDG 1 FLR 2 N 1 L 3 D 46 Pass March 20, 2023 Smoke Detector ELEV S4 LOBBY BLDG 1 FLR 2 N 1 L 3 D 42 Pass March 20, 2023 Smoke Detector RECEPTION 2402 BLDG 1 FLR 2 N 1 L 3 D 61 Pass March 20, 2023 Smoke Detector ELEVATOR P1/P2 LOBBY BLDG 1 FLR 2 N 1 L 3 D 69 Pass March 20, 2023 Smoke Detector ELEVATOR S3 LOBBY BLDG 1 FLR 2 N 1 L 3 D 72 Pass March 20, 2023 Smoke Detector SIMULATION LAB 2404 BLDG 1 FL 2 N 1 L 3 D 75 Pass March 20, 2023 Smoke Detector HALL BY STORAGE 2407 BLDG 1 FLR 2 N 1 L 3 D 80 Pass March 20, 2023 Smoke Detector HALL BY X-RAY 2415 BLDG 1 FLR 2 N 1 L 3 D 81 Pass March 20, 2023 Smoke Detector HALL BY X-RAY 2420 BLDG 1 FLR 2 N 1 L 3 D 82 Pass

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 6 of 29

Date Tested Device Location No de Lo op De vice Status Comments

VA Hospital - WCHCS - Bldg 1 - Device List (Smokes) - March 23 EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

March 20, 2023 Smoke Detector HALL BY 2419A BLDG 1 FLR 2 N 1 L 3 D 83 Pass March 20, 2023 Smoke Detector HALL BY ELEC RM 2604 BLDG 1 FLR 2 N 1 L 3 D 33 Pass March 20, 2023 Smoke Detector ENTRY TO IMAGING BLDG 1 FLR 2 N 1 L 3 D 60 Pass March 20, 2023 Smoke Detector BY MED STORAGE 2607 BLDG 1 FLR 2 N 1 L 3 D 27 Pass March 20, 2023 Smoke Detector ELEV S5 LOBBY BLDG 1 FLR 2 N 1 L 3 D 4 Pass March 20, 2023 Smoke Detector HALL BY ELEC RM 2613 BLDG 1 FLR 2 N 1 L 3 D 3 Pass March 20, 2023 Smoke Detector CAT SCAN DRESS AREA BLDG 1 FLR 2 N 1 L 3 D 1 Pass March 20, 2023 Smoke Detector HALL BY EXAM RM 2625 BLDG 1 FLR 2 N 1 L 3 D 5 Pass March 20, 2023 Smoke Detector LAB BY BLOOD DRAW 2214 BLDG 1 FLR 2 N 1 L 3 D 50 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 2223 BLDG 1 FLR 2 N 1 L 3 D 51 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 2629 BLDG 1 FLR 2 N 1 L 3 D 6 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 2654 BLDG 1 FLR 2 N 1 L 3 D 16 Pass March 20, 2023 Smoke Detector HALL BY MECH RM 2637 BLDG 1 FLR 2 N 1 L 3 D 9 Pass March 20, 2023 Smoke Detector HALL BY WORKRM 2643 BLDG 1 FLR 2 N 1 L 3 D 11 Pass March 20, 2023 Smoke Detector MENTAL HEALTH HALL BLDG 1 FLR 2 N 1 L 3 D 15 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 2634 BLDG 1 FLR 2 N 1 L 3 D 8 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 2658 BLDG 1 FLR 2 N 1 L 3 D 17 Pass March 20, 2023 Smoke Detector Hall by 2667 ROI Bldg1 Flr 2 N 1 L 3 D 22 Pass Change message March 20, 2023 Smoke Detector HALL BY OFFICE 2675 BLDG 1 FLR 2 N 1 L 3 D 7 Pass March 20, 2023 Smoke Detector HALL BY RECORDS 2673 BLDG 1 FLR 2 N 1 L 3 D 13 Pass March 20, 2023 Smoke Detector BY MED STORAGE 2606 BLDG 1 FLR 2 N 1 L 3 D 25 Pass March 20, 2023 Smoke Detector BY DENTAL EXAM RM 2682 BLDG 1 FLR 2 N 1 L 3 D 24 Pass March 20, 2023 Smoke Detector HALL BY DENTAL OFFICE 2691 BLDG 1 FLR 2 N 1 L 3 D 23 Pass March 20, 2023 Smoke Detector BY DENTAL SURG 2696 BLDG 1 FLR 2 N 1 L 3 D 21 Pass March 20, 2023 Smoke Detector PACU-SOUTHEAST BLDG 1 FLR 3 N 1 L 4 D 62 Pass March 25, 2022 Building 1, Floor 3 N 0 L 0 M 0 March 20, 2023 Smoke Detector Elevator S4 Lobby Bldg 1 Flr 3 N 1 L 4 D 2 Pass March 20, 2023 Smoke Detector ELEVATOR P1/P2 LOBBY BLDG 1 FLR 3 N 1 L 4 D 11 Pass March 20, 2023 Smoke Detector BY ELECTRICAL RM 3015 BLDG 1 FLR 3 N 1 L 4 D 15 Pass March 20, 2023 Smoke Detector Elev S4 Hoistway Bldg 1 Flr 4 N 1 L 4 D 25 Pass March 20, 2023 Smoke Detector Clean Core - North Bldg 1 Flr 3 N 1 L 4 D 53 Pass March 20, 2023 Smoke Detector Top of S5 Houstway Bldg 1 Flr 3 N 1 L 4 D 86 Pass March 20, 2023 Smoke Detector Electrical Rm 3218 Bldg 1 Flr 3 N 1 L 4 D 95 Pass March 20, 2023 Smoke Detector ELEVATOR S3 LOBBY BLDG 1 FLR 3 N 1 L 4 D 6 Pass March 20, 2023 Smoke Detector HALL TO STAIR #8 BLDG 1 FLR 3 N 1 L 4 D 73 Pass March 20, 2023 Smoke Detector TOP OF STAIR 8 BLDG 1 FLR 3 N 1 L 4 D 74 Pass March 20, 2023 Smoke Detector STAIR 9 BLDG 1 FLR 3 N 1 L 4 D 47 Pass March 20, 2023 Smoke Detector PACU BY 3007 BLDG 1 FLR 3 N 1 L 4 D 61 Pass March 20, 2023 Smoke Detector By Patient Rm 3018 Bldg 1 Flr 3 N 1 L 4 D 17 Pass March 20, 2023 Smoke Detector BY CHECK IN 3417 BLDG 1 FLR 3 N 1 L 4 D 10 Pass

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 7 of 29

Date Tested Device Location No de Lo op De vice Status Comments

VA Hospital - WCHCS - Bldg 1 - Device List (Smokes) - March 23 EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

March 20, 2023 Smoke Detector Hall by Rm 3025 Bldg 1 Flr 3 N 1 L 4 D 14 Pass March 20, 2023 Smoke Detector Hall by Storage 3209 Bldg 1 Flr 3 N 1 L 4 D 13 Pass March 20, 2023 Smoke Detector BY PATIENT RM 3017 BLDG 1 FLR 3 N 1 L 4 D 16 Pass March 20, 2023 Smoke Detector HALL BY 3215 WASH RM BLDG 1 FLR 3 N 1 L 4 D 1 Pass March 20, 2023 Smoke Detector Hall by Stair 3250 Bldg 1 Flr 3 N 1 L 4 D 12 Pass March 20, 2023 Smoke Detector HALL BY PATIENT RM 3402 BLDG 1 FLR 3 N 1 L 4 D 30 Pass March 20, 2023 Smoke Detector ICU CORRIDOR BY RM 3404 BLDG 1 FLR 3 N 1 L 4 D 41 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 3405 BLDG 1 FLR 3 N 1 L 4 D 40 Pass March 20, 2023 Smoke Detector BY PATIENT RM 3410 N 1 L 4 D 32 Pass March 20, 2023 Smoke Detector OR #1 RM 3640 BLDG 1 FLR 3 N 1 L 4 D 57 Pass March 20, 2023 Smoke Detector HALL BY ROOM 3409 BLDG 1 FLR 3 N 1 L 4 D 33 Pass March 20, 2023 Smoke Detector BY IT ROOM 3432 BLDG 1 FLR 3 N 1 L 4 D 31 Pass March 20, 2023 Smoke Detector CENTER CORR BY PACU 3602 BLDG 1 FLR 3 N 1 L 4 D 59 Pass March 20, 2023 Smoke Detector PACU-SOUTH BLDG 1 FLR 3 N 1 L 4 D 60 Pass March 20, 2023 Smoke Detector S5 ELEVATOR LOBBY BLDG 1 FLR 3 N 1 L 4 D 56 Pass March 20, 2023 Smoke Detector ELECTRICAL RM 3608 BLDG 1 FLR 3 N 1 L 4 D 65 Pass March 20, 2023 Smoke Detector BY PACU NURSE STAT BLDG 1 FLR 3 N 1 L 4 D 64 Pass March 20, 2023 Smoke Detector PACU-NORTHEAST BLDG 1 FLR 3 N 1 L 4 D 63 Pass March 20, 2023 Smoke Detector ICU STAFF RR HALL BLDG 1 FLR 3 N 1 L 4 D 87 Pass March 20, 2023 Smoke Detector ICU CORR BY 3623 BLDG 1 FLR 3 N 1 L 4 D 42 Pass March 20, 2023 Smoke Detector ICU CORRIDOR BY 3626 BLDG 1 FLR 3 N 1 L 4 D 43 Pass March 20, 2023 Smoke Detector CORR BY MECH RM 3627 BLDG 1 FLR 3 N 1 L 4 D 45 Pass March 20, 2023 Smoke Detector HALL TO STAIR #9 BLDG 1 FLR 3 N 1 L 4 D 48 Pass March 20, 2023 Smoke Detector Hall by OR #1 3640 Bldg 1 Flr 3 N 1 L 4 D 49 Pass March 20, 2023 Smoke Detector Corridor by Office 3633 Bldg 1 Flr 3 N 1 L 4 D 50 Pass March 20, 2023 Smoke Detector BY HOUSEKEEPING 3634 BLDG 1 FLR 3 N 1 L 4 D 51 Pass March 20, 2023 Smoke Detector CORRIDOR BY RM 3636 BLDG 1 FLR 3 N 1 L 4 D 52 Pass March 20, 2023 Smoke Detector CLEAN CORE-CENTER BLDG 1 FLR 3 N 1 L 4 D 54 Pass March 20, 2023 Smoke Detector Hall by OR #2 3641 Bldg 1 Flr 3 N 1 L 4 D 46 Pass March 20, 2023 Smoke Detector OR #2 RM 3641 BLDG 1 FLR 3 N 1 L 4 D 58 Pass March 20, 2023 Smoke Detector E CORRIDOR BY OR#3 RM 3642 BLDG 1 FLR 3 N 1 L 4 D 68 Pass March 20, 2023 Smoke Detector CYSTO RM 3643 BLDG 1 FLR 3 N 1 L 4 D 88 Pass March 20, 2023 Smoke Detector OR #3 RM 3642 BLDG 1 FLR 3 N 1 L 4 D 89 Pass March 20, 2023 Smoke Detector SPS LOUNGE 3661 BLDG 1 FLR 3 N 1 L 4 D 83 Pass March 20, 2023 Smoke Detector E CORRIDOR BY OR #4 RM 3643 BLDG 1 FLR 3 N 1 L 4 D 67 Pass March 20, 2023 Smoke Detector HALL BY 3617 BLDG 1 FLR 3 N 1 L 4 D 44 Pass March 20, 2023 Smoke Detector CLEAN CORE-SOUTH BLDG 1 FLR 3 N 1 L 4 D 55 Pass March 20, 2023 Smoke Detector CORRIDOR 3669 BLDG 1 FLR 3 N 1 L 4 D 71 Pass March 20, 2023 Smoke Detector CORRIDOR BY RM 3653 BLDG 1 FLR 3 N 1 L 4 D 66 Pass March 20, 2023 Smoke Detector SPS DECONTAMINATE SOUTH BLDG 1 FLR 3 N 1 L 4 D 81 Pass

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 8 of 29

Date Tested Device Location No de Lo op De vice Status Comments

VA Hospital - WCHCS - Bldg 1 - Device List (Smokes) - March 23 EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

March 20, 2023 Smoke Detector SPS DECONTAMINATE SOUTH BLDG 1 FLR 3 N 1 L 4 D 82 Pass March 20, 2023 Smoke Detector SPS EQUIP STORE 3663 BLDG 1 FLR 3 N 1 L 4 D 90 Pass March 20, 2023 Smoke Detector SPS STERILE STORE 3664 BLDG 1 FLR 3 N 1 L 4 D 91 Pass March 20, 2023 Smoke Detector SPS INSTRUMENT CLEAN RM 3661A BLDG 1 FLR 3 N 1 L 4 D 78 Pass March 20, 2023 Smoke Detector SPS INSTRUMENT CLEAN RM 3661A BLDG 1 FLR 3 N 1 L 4 D 77 Pass March 20, 2023 Smoke Detector HALL TO EAST MECH RM BLDG 1 FLR 3 N 1 L 4 D 72 Pass March 20, 2023 Smoke Detector HALL BY 3671B BLDG 1 FLR 3 N 1 L 4 D 70 Pass Change message March 20, 2023 Smoke Detector E CORRIDOR BY RM 3672 BLDG 1 FLR 3 N 1 L 4 D 69 Pass March 21, 2022 Building 1, Floor 4 N 0 L 0 D 0 March 20, 2023 Smoke Detector TOP OF STAIR 4 BLDG 1 FLR 4 N 1 L 5 D 35 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 4001 BLDG 1 FLR 4 N 1 L 5 D 4 Pass March 20, 2023 Smoke Detector HALL BY CHAPEL BLDG 1 FLR 4 N 1 L 5 D 1 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 4010 BLDG 1 FLR 4 N 1 L 5 D 5 Pass March 20, 2023 Smoke Detector MOD SLEEP ROOM 4012 BLDG 1 FLR 4 N 1 L 5 D 91 Pass March 20, 2023 Smoke Detector Hall by 4016 Bldg 1 Flr 4 N 1 L 5 D 6 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 4021 BLDG 1 FLR 4 N 1 L 5 D 7 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 4028 BLDG 1 FLR 4 N 1 L 5 D 8 Pass March 20, 2023 Smoke Detector ELEV S3 LOBBY BLDG 1 FLR 4 N 1 L 5 D 3 Pass March 20, 2023 Smoke Detector PUBLIC ELEV LOBBY BLDG 1 FLR 4 N 1 L 5 D 25 Pass March 20, 2023 Smoke Detector HALL BY DECON 4204 BLDG 1 FLR 4 N 1 L 5 D 2 Pass March 20, 2023 Smoke Detector HALL BY 4404 BLDG 1 FLR 4 N 1 L 5 D 20 Pass March 20, 2023 Smoke Detector Hall by 4413 Bldg 1 Flr 4 N 1 L 5 D 21 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 4407 BLDG 1 FLR 4 N 1 L 5 D 22 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 4419 BLDG 1 FLR 4 N 1 L 5 D 23 Pass March 21, 2022 Building 1, Floor 5 N 0 L 0 M 0 March 20, 2023 Smoke Detector TOP OF STAIRWELL 2 BLDG 1 FLR 5 N 1 L 6 D 25 Pass March 20, 2023 Smoke Detector Patient Rm 5410 Bldg 1 Flr 5 N 1 L 6 D 30 Pass Change message March 20, 2023 Smoke Detector Secure Entry, 5P bldg 1 flr 5 N 1 L 6 D 34 Pass March 20, 2023 Smoke Detector TOP OF STAIR 5 BLDG 1 FLR 5 N 1 L 6 D 24 Pass March 20, 2023 Smoke Detector STAIRWELL 6 BLDG 1 FLR 5 N 1 L 6 D 23 Pass Get from 4th floor March 20, 2023 Smoke Detector HALL BY ROOM 5017 BLDG 1 FLR 5 N 1 L 6 D 22 Pass March 20, 2023 Smoke Detector HALL BY ROOM 5013 BLDG 1 FLR 5 N 1 L 6 D 21 Pass March 20, 2023 Smoke Detector BY NURSE STA. 5031 BLDG 1 FLR 5 N 1 L 6 D 35 Pass March 20, 2023 Smoke Detector HALL BY ROOM 5431 BLDG 1 FLR 5 N 1 L 6 D 40 Pass March 20, 2023 Smoke Detector HALL BY ROOM 5414 BLDG 1 FLR 5 N 1 L 6 D 41 Pass March 20, 2023 Smoke Detector HALL BY ROOM 5416 BLDG 1 FLR 5 N 1 L 6 D 42 Pass March 20, 2023 Smoke Detector HALL BY ROOM 5033 BLDG 1 FLR 5 N 1 L 6 D 20 Pass March 20, 2023 Smoke Detector DAY ROOM 5033 BLDG 1 FLR 5 N 1 L 6 D 26 Pass March 20, 2023 Smoke Detector NURSE STA. 5031 BLDG 1 FLR 5 N 1 L 6 D 4 Pass March 20, 2023 Smoke Detector HALL BY OFFICE 5424 BLDG 1 FLR 5 N 1 L 6 D 2 Pass

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 9 of 29

Date Tested Device Location No de Lo op De vice Status Comments

VA Hospital - WCHCS - Bldg 1 - Device List (Smokes) - March 23 EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

March 20, 2023 Smoke Detector HALL BY RM 5002 BLDG 1 FLR 5 N 1 L 6 D 3 Pass March 20, 2023 Smoke Detector Hall by 5203 Bldg 1 Flr 5 N 1 L 6 D 8 Pass March 20, 2023 Smoke Detector OFFICE RM 5205 BLDG 1 FLR 5 N 1 L 6 D 7 Pass March 20, 2023 Smoke Detector HALL BY NURSE STATION 5215 BLDG 1 FLR 5 N 1 L 6 D 6 Pass March 20, 2023 Smoke Detector SERV ELEV LOBBY BLDG 1 FLR 5 N 1 L 6 D 5 Pass March 20, 2023 Smoke Detector PUBLIC ELEV LOBBY BLDG 1 FLR 5 N 1 L 6 D 9 Pass March 20, 2023 Smoke Detector HALL BY RM 5419 BLDG 1 FLR 5 N 1 L 6 D 1 Pass March 21, 2022 Building 1, Floor 6 N 0 L 0 M 0 March 20, 2023 Smoke Detector SERV ELEV LOBBY BLDG 1 FLR 6 N 1 L 7 D 4 Pass March 20, 2023 Smoke Detector Storage Rm 6208 Bldg 1 Flr 3 N 1 L 7 D 9 Pass March 20, 2023 Smoke Detector PUBLIC ELEV LOBBY BLDG 1 FLR 6 N 1 L 7 D 14 Pass March 20, 2023 Smoke Detector HOISTWAY ELEV P2 BLDG 1 FLR 6 N 1 L 7 D 22 Pass Did NOT activate FFH relay March 20, 2023 Smoke Detector Electric Room 6210 Bldg 1 Flr 6 N 1 L 7 D 30 Pass March 20, 2023 Smoke Detector ELEVATOR S3 HOISTWAY N 1 L 7 D 105 Pass Did NOT activate FFH relay March 20, 2023 Smoke Detector STAIRWELL 1 BLDG 1 FLR 6 N 1 L 7 D 1 Pass March 20, 2023 Smoke Detector Hall by IT Closet 6406 Bldg 1 Flr 6 N 1 L 7 D 5 Pass March 20, 2023 Smoke Detector STAIRWELL 3 BLDG 1 FLR 6 N 1 L 7 D 7 Pass March 20, 2023 Smoke Detector EAST HALL BY RM 6009 BLDG 1 FLR 6 N 1 L 7 D 15 Pass March 20, 2023 Smoke Detector HALL BY ROOM 6401 BLDG 1 FLR 6 N 1 L 7 D 3 Pass March 20, 2023 Smoke Detector HALL BY ROOM 6404 BLDG 1 FLR 6 N 1 L 7 D 2 Pass March 20, 2023 Smoke Detector HALL BY STAIR 3 BLDG 1 FLR 6 N 1 L 7 D 8 Pass March 21, 2022 Building 1, Floor 7 N 0 L 0 M 0 March 20, 2023 Smoke Detector PENTHOUSE MECH ROOM BLDG 1 FLR 7 N 1 L 8 D 1 Pass March 20, 2023 Smoke Detector Stair 4 Electric Rm 4300 Bldg 1 Flr 3 N 1 L 5 D 12 Pass March 20, 2023 Smoke Detector ELEV S4 EQUIP RM 4300 BLDG 1 FLR 4 N 1 L 5 D 33 Pass March 20, 2023 Smoke Detector PENTHS ELEV EQUIP BLDG 1 FLR 7 N 1 L 8 D 5 Pass March 20, 2023 Smoke Detector PENTHS ELEV EQUIP BLDG 1 FLR 7 N 1 L 8 D 10 Pass March 20, 2023 Smoke Detector PENTHS ELEV EQUIP BLDG 1 FLR 7 N 1 L 8 D 55 Pass March 20, 2023 Smoke Detector PENTHS ELEV EQUIP BLDG 1 FLR 7 N 1 L 8 D 55 Pass Needs device label

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 10 of 29

Date Tested Device Location No de Lo op De vice Status Comments Building 1, Floor 0 N 0 L 0 M 0

March 23, 2023 Heat Detector OP ELEV EQUIP RM BLDG 1 BSMNT N 1 L 2 D 67 Pass Building 1, Floor 2 N 0 L 0 M 0

March 22, 2023 Heat Detector SHOP AREA RM 2013 BLDG 1 FLR 2 N 1 L 3 D 40 Pass Building 1, Floor 3 N 0 L 0 M 0

March 22, 2023 Heat Detector Kitchen SW Bldg 1 Flr 3 N 1 L 4 D 4 Pass March 22, 2023 Heat Detector Kitchen by Freezer Bldg 1 Flr 3 N 1 L 4 D 98 Pass

Building 1, Floor 7 N 0 L 0 M 0 March 23, 2023 Heat Detector ELEV EQUIP RM 4300 BLDG 1 FLR 4 N 1 L 5 D 31 Pass March 24, 2023 Heat Detector ELEV S4 EQUIP ROOM BLDG 1 FLR 4 N 1 L 5 D 90 Pass March 25, 2023 Heat Detector PENTHS ELEV EQUIP BLDG 1 FLR 7 N 1 L 8 D 2 Pass March 26, 2023 Heat Detector PENTHS ELEV EQUIP BLDG 1 FLR 7 N 1 L 8 D 3 Pass March 27, 2023 Heat Detector PENTHS ELEV EQUIP BLDG 1 FLR 7 N 1 L 8 D 4 Pass

VA Hospital - WCHCS - Bldg 1 - Device List (Heats) - March 23 EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 11 of 29

Date Tested DEVICE LOCATION No de Lo op De vice SHUTDOWN STATUS COMMENTS Building 1, Floor 1 N 0 L 0 M 0

March 22, 2023 Duct Detector AHU-3 SUPPLY BLDG 1 FLR 1 N 1 L 2 D 22 Pass Pass March 22, 2023 Duct Detector AHU-3 RETURN BLDG 1 FLR 1 N 1 L 2 D 23 Pass Pass March 22, 2023 Duct Detector AHU-9 SUPPLY BLDG 1 FLR 1 N 1 L 2 D 83 Pass Pass March 22, 2023 Duct Detector AHU-28 SUPPLY BLDG 1 FLR 1 N 1 L 2 D 37 Pass Pass RTS in Rm 1220 March 22, 2023 Duct Detector AHU-28 RETURN BLDG 1 FLR 1 N 1 L 2 D 38 Pass Pass RTS in Rm 1220 March 22, 2023 Duct Detector EMERGENCY DEPT 1622 AHU-4 SUPPLY BLDG 1 FLR 1 N 1 L 2 D 24 No Access No Access March 22, 2023 Duct Detector AHU-1 RETURN BLDG 1 FLR 1 N 1 L 2 D 25 Pass Pass Change message March 22, 2023 Duct Detector AHU-1 SUPPLY BLDG 1 FLR 1 N 1 L 2 D 26 Pass Pass Change message March 22, 2023 Duct Detector AHU 2 SUPPLY BLDG 1 FLR 1 N 1 L 2 D 40 Pass Pass March 22, 2023 Duct Detector AHU 2 RETURN BLDG 1 FLR 1 N 1 L 2 D 41 Pass Pass

Building 1, Floor 2 N 0 L 0 M 0 March 22, 2023 Duct Detector AHU-12 SUPPLY BLDG 1 FLR 2 N 1 L 3 D 29 Pass Pass March 22, 2023 Duct Detector AHU-12 RETURN BLDG 1 FLR 2 N 1 L 3 D 30 Pass Pass March 22, 2023 Duct Detector AHU-7 RETURN BLDG 1 FLR 2 N 1 L 3 D 91 Pass Pass March 22, 2023 Duct Detector AHU-7 SUPPLY BLDG 1 FLR 2 N 1 L 3 D 92 Pass Pass March 22, 2023 Duct Detector AHU-5 SUPPLY BLDG 1 FLR 2 N 1 L 3 D 84 Pass Pass March 22, 2023 Duct Detector AHU-4 RETURN BLDG 1 FLR 2 N 1 L 3 D 85 Pass Pass March 22, 2023 Duct Detector AHU-5 RETURN BLDG 1 FLR 2 N 1 L 3 D 86 Pass Pass March 22, 2023 Duct Detector AHU 8 SUPPLY BLDG 1 FLR 2 N 1 L 3 D 90 Pass Pass March 22, 2023 Duct Detector AHU 6 RETURN BLDG 1 FLR 2 N 1 L 3 D 87 Pass Pass March 22, 2023 Duct Detector AHU 6 SUPPLY BLDG 1 FLR 2 N 1 L 3 D 88 Pass Pass March 22, 2023 Duct Detector AHU 8 RETURN BLDG 1 FLR 2 N 1 L 3 D 89 Pass Pass

Building 1, Floor 3 N 0 L 0 M 0 March 22, 2023 Duct Detector AHU 13 SUPPLY BLDG 1 FLR 3 N 1 L 4 M 40 Pass Pass Good shutdown March 22, 2023 Duct Detector AHU 13 SUPPLY BLDG 1 FLR 3 N 1 L 4 M 41 Pass Pass Good shutdown March 22, 2023 Duct Detector AHU 13 RETURN BLDG 1 FLR 3 N 1 L 4 M 42 Pass Pass Good shutdown March 22, 2023 Duct Detector AHU 13 RETURN BLDG 1 FLR 3 N 1 L 4 M 43 No Access No Access Temp filter unit blocking access. Cannot be moved per HVAC tech.

March 22, 2023 Duct Detector Kitchen RTU Supply AHU 14 N 1 L 4 D 7 Unable to Locate Unable to locate March 22, 2023 Duct Detector Kitchen RTU Return AHU 14 N 1 L 4 D 8 Unable to Locate Unable to locate March 22, 2023 Duct Detector AHU 22 RETURN BLDG 1 FLR 3 N 1 L 4 D 84 Pass Pass After 1530 or last OR Case March 22, 2023 Duct Detector AHU 22 SUPPLY BLDG 1 FLR 3 N 1 L 4 D 85 Pass Pass After 1530 or last OR Case March 22, 2023 Duct Detector AHU 24 RETURN BLDG 1 FLR 3 N 1 L 4 D 75 Pass Pass March 22, 2023 Duct Detector AHU 24 SUPPLY BLDG 1 FLR 3 N 1 L 4 D 76 Pass Pass March 22, 2023 Duct Detector AHU 23 RETURN BLDG 1 FLR 3 N 1 L 4 D 79 Pass Pass March 22, 2023 Duct Detector AHU 23 SUPPLY BLDG 1 FLR 3 N 1 L 4 D 80 Pass Pass

AHU relay Elev P3 Smoke Damper Bldg 1 Flr 2 N 1 L 3 M 35 Pass Move Icon to Hoistway on Onyx. Shown on N001 Screen 1 Building 1, Floor 4 N 0 L 0 D 0

March 22, 2023 Duct Detector AHU-15 SUPPLY BLDG 1 FLR 4 N 1 L 5 D 10 Pass Pass March 22, 2023 Duct Detector AHU-15 RETURN BLDG 1 FLR 4 N 1 L 5 D 11 Pass Pass

Building 1, Floor 6 N 0 L 0 M 0 March 22, 2023 Duct Detector AHU-16 SUPPLY BLDG 1 FLR 6 N 1 L 7 D 17 Pass Pass March 22, 2023 Duct Detector AHU-16 SUPPLY BLDG 1 FLR 6 N 1 L 7 D 19 Pass Pass Fan shutdown with L7M20

EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

EC.02.03.05 EP 19 Every 12 months, the hospital tests automatic smoke-detection shutdown devices for air-handling equipment. The results and completion dates are documented.

VA WCHCS - Bldg 1- DUCT DETECTION - MARCH 23

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 12 of 29

Date Tested DEVICE LOCATION No de Lo op De vice SHUTDOWN STATUS COMMENTS

EC.02.03.05 EP 3 Every 12 months, the hospital tests duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors on the inventory. The results and completion dates are documented.

EC.02.03.05 EP 19 Every 12 months, the hospital tests automatic smoke-detection shutdown devices for air-handling equipment. The results and completion dates are documented.

VA WCHCS - Bldg 1- DUCT DETECTION - MARCH 23

March 22, 2023 Duct Detector AHU-16 RETURN BLDG 1 FLR 6 N 1 L 7 D 18 Fail Pass Damper control L7M7. Relay failed to activate with L7D18. Damper actuated when relay manually activated

AHU relay HOISTWAY S3 DAMPER BLDG 1 FLR 6 N 1 L 7 M 105 Pass Building 1, Floor 7 N 0 L 0 M 0

March 22, 2023 Duct Detector AHU-17 SUPPY BLDG 1 FLR 7 N 1 L 8 D 6 Pass Pass March 22, 2023 Duct Detector AHU-17 RETURN BLDG 1 FLR 7 N 1 L 8 D 7 Pass Pass Test switch inop (RTS 151)

AHU relay ELEVATOR P1/P2 DAMPER N 1 L 8 M 22 Pass Move Icon to Hoistway on Onyx. Shown on N001 Screen 1 AHU relay ELEV S4 DAMPER BLDG 1 FLR 4 N 1 L 5 M 8 Pass Move Icon to Hoistway on Onyx. Shown on N001 Screen 1

Building 1, Floor 3 N 0 L 0 M 0 March 22, 2023 AHU relay OR #2-RM 3641 VAV N 1 L 4 M 82 Pass March 22, 2023 AHU relay OR #1 RM 3640 VAV N 1 L 4 M 84 Pass March 22, 2023 AHU relay OR #3 RM 3642 VAV N 1 L 4 M 89 Pass March 22, 2023 AHU relay OR #4 VAV N 1 L 4 M 91 Pass

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 13 of 29

Date Tested DEVICE LOCATION STATUS COMMENTS Building 1, Floor 0 N 0 L 0 M 0

March 20, 2023 Water Flow Switch MAIN WATERFLOW BLDG 1 BSMNT N 1 L 2 M 45 Pass 55 Sec March 20, 2023 Water Flow Switch BLDG 34 WATERFLOW STAIR 1 BLDG 1

BSMNT N 1 L 2 M 24 Pass 34 Sec March 20, 2023 Water Flow Switch WATERFLOW STAIR 2 BLDG 20 BSMNT N 1 L 2 M 26 Pass 21 Sec

Building 1, Floor 1 N 0 L 0 M 0

March 20, 2023 Water Flow Switch PUMP HOUSE WATERFLOW FIRE PUMP BLDG

1 FLR 1 FLOW N 1 L 1 M 53 Pass 34 Sec

March 20, 2023 Water Flow Switch STAIR 1 WATERFLOW BLDG 1 FLR 1 N 1 L 2 M 91 Pass 37 Sec March 20, 2023 Water Flow Switch WATERFLOW STAIR 2 BLDG 1 FLR 1 N 1 L 2 M 54 Pass 39 Sec March 20, 2023 Water Flow Switch WATERFLOW STAIR 8 BLDG 1 FLR 1 N 1 L 2 M 16 Pass 34 Sec March 20, 2023 Water Flow Switch WATERFLOW STAIR 9 BLDG 1 FLR 1 N 1 L 2 M 14 Pass 27 Sec March 20, 2023 Water Flow Switch MAIN FLOW RM 1633 BLDG 1 FLR 1 N 1 L 2 M 11 Pass 42 Sec

Building 1, Floor 2 N 0 L 0 M 0 March 20, 2023 Water Flow Switch STAIR 2 WATERFLOW BLDG 1 FLR 2 N 1 L 3 M 42 Pass 37 Sec March 20, 2023 Water Flow Switch STAIR 1 WATERFLOW BLDG 1 FLR 2 N 1 L 3 M 90 Pass 40 Sec. Repaired and retested 3/22/23 March 20, 2023 Water Flow Switch WATERFLOW STAIR 3 BLDG 1 FLR 1 N 1 L 2 M 64 Pass 43 Sec March 20, 2023 Water Flow Switch STAIR 4 WATERFLOW BLDG 1 FLR 1 N 1 L 2 M 39 Pass 38 Sec March 20, 2023 Water Flow Switch STAIR 4 WATERFLOW BLDG 1 FLR 2 N 1 L 3 M 30 Pass 37 Sec. Leaks badly pipe needs replaced March 20, 2023 Water Flow Switch STAIR 8 WATERFLOW BLDG 1 FLR 2 N 1 L 3 M 9 Pass 34 Sec March 20, 2023 Water Flow Switch STAIR 9 WATERFLOW BLDG 1 FLR 2 N 1 L 3 M 7 Pass 36 Sec

Building 1, Floor 3 N 0 L 0 M 0 March 20, 2023 Water Flow Switch STAIR 2 WATERFLOW BLDG 1 FLR 3 N 1 L 4 M 16 Pass 32 Sec March 20, 2023 Water Flow Switch STAIR 3 WATERFLOW BLDG 1 FLR 2 N 1 L 3 M 46 Pass 42 Sec March 20, 2023 Water Flow Switch WATERFLOW STAIR 4 BLDG 1 FLR 4 N 1 L 5 M 36 Pass 32 Sec March 20, 2023 Water Flow Switch STAIR 8 WATERFLOW BLDG 1 FLR 3 N 1 L 4 M 54 Pass 48 Sec March 20, 2023 Water Flow Switch STAIR 9 WATERFLOW BLDG 1 FLR 3 N 1 L 4 M 51 Pass 87 Sec

Building 1, Floor 4 N 0 L 0 D 0 March 20, 2023 Water Flow Switch STAIR 1 WATERFLOW BLDG 1 FLR 3 N 1 L 4 M 30 Pass 37 Sec March 20, 2023 Water Flow Switch STAIR 3 WATERFLOW BLDG 1 FLR 3 N 1 L 4 M 12 Pass 35 Sec March 20, 2023 Water Flow Switch STAIR 4 WATERFLOW BLDG 1 FLR 3 N 1 L 4 M 4 Pass 32 Sec

Building 1, Floor 5 N 0 L 0 M 0

March 20, 2023 Water Flow Switch WATERFLOW IN CEILING FEEDS 5P BLDG 1

FLR 5 N 1 L 6 M 22 Not in service Confirmed by VA Safety

March 20, 2023 Water Flow Switch STAIR 1 WATERFLOW BLDG 1 FLR 4 N 1 L 5 M 20 Pass 30 Sec March 20, 2023 Water Flow Switch STAIR 3 WATERFLOW BLDG 1 FLR 4 N 1 L 5 M 11 Pass 45 Sec March 20, 2023 Water Flow Switch STAIR 2 WATERFLOW BLDG 1 FLR 4 N 1 L 5 M 14 Pass 24 Sec

Building 1, Floor 6 N 0 L 0 M 0 March 20, 2023 Water Flow Switch STAIR 1 FLOW 5TH FL BLDG 1 FLR 6 N 1 L 7 M 3 Pass 40 Sec March 20, 2023 Water Flow Switch WATERFLOW STAIR 2 (5P) BLDG 1 FLR 5 N 1 L 6 M 23 Pass 44 Sec March 20, 2023 Water Flow Switch STAIR 3 FLOW 6TH FL BLDG 1 FLR 6 N 1 L 7 M 2 Pass 45 Sec

VA WCHCS - Bldg 1- Sprinkler (Flow) - March 23 EC.02.03.05 EP 2 Every 6 months, the hospital tests vane-type and pressure-type water flow devices and valve tamper switches on the inventory. The results and completion dates are documented.

Note 2: Mechanical water-flow devices (including, but not limited to, water motor gongs) should be tested quarterly. The results and completion dates are documented.

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 14 of 29

Date Tested DEVICE LOCATION STATUS COMMENTS

VA WCHCS - Bldg 1- Sprinkler (Flow) - March 23 EC.02.03.05 EP 2 Every 6 months, the hospital tests vane-type and pressure-type water flow devices and valve tamper switches on the inventory. The results and completion dates are documented.

Note 2: Mechanical water-flow devices (including, but not limited to, water motor gongs) should be tested quarterly. The results and completion dates are documented.

March 20, 2023 Water Flow Switch W FLOW STAIR 3 FLR 7 BLDG 1 FLR 7 N 1 L 7 M 13 Pass 31 sec March 20, 2023 Water Flow Switch STAIR 3 FLOW 5TH FL BLDG 1 FLR 6 N 1 L 7 M 15 Pass 38 Sec

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 15 of 29

Date Tested DEVICE LOCATION STATUS COMMENTS Building 1, Floor 0 N 0 L 0 M 0

March 20, 2023 Tamper Switch MECH RM TAMPER INLET BLDG 1 BSMNT N 1 L 2 M 126 Pass 2 Turns March 20, 2023 Tamper Switch MECH RM TAMPER OUTLET BLDG 1 BSMNT N 1 L 2 M 127 Pass 2 Turns March 20, 2023 Tamper Switch STANDPIPE STAIR 1 BLDG 1 BSMNT N 1 L 2 M 106 Pass 2 Turns March 20, 2023 Tamper Switch BLDG 34 TAMPER STAIR 1 BLDG 1 BSMNT N 1 L 2 M 28 Pass 1 Turn March 20, 2023 Tamper Switch STANDPIPE STAIR 1 BLDG 1 BSMNT N 1 L 2 M 104 Pass 2 Turns Change message March 20, 2023 Tamper Switch TAMPER STAIR 2 BLDG 1 BSMNT N 1 L 2 M 29 Pass 2 Turns March 20, 2023 Tamper Switch TAMPER STAIR 4 BLDG 1 BSMNT N 1 L 2 M 107 Pass 1 Turn

Building 1, Floor 1 N 0 L 0 M 0 March 20, 2023 Tamper Switch BYPASS DISCHARGE FIRE PUMP BLDG 1 FLR 1 TAMPER N 1 L 1 M 50 Pass 1 Turn March 20, 2023 Tamper Switch PUMP HOUSE TAMPER FIRE PUMP BLDG 1 FLR 1 TAMPER N 1 L 1 M 51 Pass 2 Turns March 20, 2023 Tamper Switch JOCKEY PUMP DISCHARGE FIRE PUMP BLDG 1 FLR 1 TAMPER N 1 L 1 M 52 Pass 1 Turn March 20, 2023 Tamper Switch PUMP ISOLATION OUTLET FIRE PUMP BLDG 1 FLR 1 TAMPER N 1 L 1 M 54 Pass 1 Turn March 20, 2023 Tamper Switch FLOW METER ISOLATION FIRE PUMP BLDG 1 FLR 1 TAMPER N 1 L 1 M 55 Pass End of run. Normally Closed Valve March 20, 2023 Tamper Switch TEST HEADER FIRE PUMP BLDG 1 FLR 1 TAMPER N 1 L 1 M 57 Pass Normally Closed Valve March 20, 2023 Tamper Switch INLET BYPASS FIRE PUMP BLDG 1 TAMPER N 1 L 1 M 58 Pass 1 Turn March 20, 2023 Tamper Switch JOCKEY ISOLATION INLET FIRE PUMP BLDG 1 FLR 1 TAMPER N 1 L 1 M 59 Pass 1 Turn March 20, 2023 Tamper Switch MAIN OS&Y VALVE FIRE PUMP BLDG 1 FLR 1 TAMPER N 1 L 1 M 60 Pass March 20, 2023 Tamper Switch PIV TAMPER BLDG 1 FLR 1 N 1 L 2 M 8 Pass 3 Turns March 20, 2023 Tamper Switch STAIR 1 TAMPER BLDG 1 FLR 1 N 1 L 2 M 90 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 4 TAMPER BLDG 1 FLR 1 N 1 L 2 M 40 Pass 1 Turn March 20, 2023 Tamper Switch TAMPER STAIR 8 BLDG 1 FLR 1 N 1 L 2 M 17 Pass 1 Turn March 20, 2023 Tamper Switch TAMPER STAIR 9 BLDG 1 FLR 1 N 1 L 2 M 15 Pass 1 Turn March 20, 2023 Tamper Switch BACKFLOW #2 TAMPER BLDG 1 FLR 1 N 1 L 2 M 9 Pass 1 Turn March 20, 2023 Tamper Switch BACKFLOW #1 TAMPER BLDG 1 FLR 1 N 1 L 2 M 10 Pass 1 Turn March 20, 2023 Tamper Switch TAMPER STAIR 8 STANDPIPE BLDG 1 FLR 1 N 1 L 2 M 12 Pass 1 Turn March 20, 2023 Tamper Switch TAMPER STAIR 9 STANDPIPE BLDG 1 FLR 1 N 1 L 2 M 13 Pass March 20, 2023 Tamper Switch TAMPER RM 1635 BLDG 1 FLR 1 N 1 L 2 M 96 Pass 2 Turns

Building 1, Floor 2 N 0 L 0 M 0 March 20, 2023 Tamper Switch STAIR 9 TAMPER BLDG 1 FLR 2 N 1 L 3 M 8 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 2 TAMPER BLDG 1 FLR 2 N 1 L 3 M 43 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 1 TAMPER BLDG 1 FLR 2 N 1 L 3 M 91 Pass 1 Turn March 20, 2023 Tamper Switch TAMPER STAIR 3 BLDG 1 FLR 1 N 1 L 2 M 65 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 4 TAMPER BLDG 1 FLR 2 N 1 L 3 M 31 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 8 TAMPER BLDG 1 FLR 2 N 1 L 3 M 10 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 9 TAMPER VALVE BLDG 1 FLR 3 N 1 L 4 M 50 Pass 1 Turn

Building 1, Floor 3 N 0 L 0 M 0 March 20, 2023 Tamper Switch TAMPER STAIR 2 BLDG 1 FLR 1 N 1 L 2 M 55 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 2 TAMPER BLDG 1 FLR 3 N 1 L 4 M 15 Pass 1 Turn March 20, 2023 Tamper Switch TAMPER STAIR 4 BLDG 1 FLR 4 N 1 L 5 M 37 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 3 TAMPER BLDG 1 FLR 2 N 1 L 3 M 45 Pass March 20, 2023 Tamper Switch STAIR 4 TAMPER BLDG 1 FLR 3 N 1 L 4 M 3 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 8 TAMPER VALVE BLDG 1 FLR 3 N 1 L 4 M 53 Pass 1 Turn

Building 1, Floor 4 N 0 L 0 D 0 March 20, 2023 Tamper Switch STAIR 1 TAMPER BLDG 1 FLR 3 N 1 L 4 M 31 Pass 2 Turns

VA WCHCS - Bldg 1- Sprinkler (Tamper) - March 23 EC.02.03.05 EP 2 Every 6 months, the hospital tests vane-type and pressure-type water flow devices and valve tamper switches on the inventory. The results and completion dates are documented.

Note 2: Mechanical water-flow devices (including, but not limited to, water motor gongs) should be tested quarterly. The results and completion dates are documented.

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 16 of 29

Date Tested DEVICE LOCATION STATUS COMMENTS

VA WCHCS - Bldg 1- Sprinkler (Tamper) - March 23 EC.02.03.05 EP 2 Every 6 months, the hospital tests vane-type and pressure-type water flow devices and valve tamper switches on the inventory. The results and completion dates are documented.

Note 2: Mechanical water-flow devices (including, but not limited to, water motor gongs) should be tested quarterly. The results and completion dates are documented.

March 20, 2023 Tamper Switch STAIR 2 TAMPER BLDG 1 FLR 4 N 1 L 5 M 13 Pass 1 Turn March 20, 2023 Tamper Switch STAIRWELL 3 TAMPER BLDG 1 FLR 3 N 1 L 4 M 11 Pass 1 Turn

Building 1, Floor 5 N 0 L 0 M 0 March 20, 2023 Tamper Switch STAIR 2 TAMPER BLDG 1 FLR 5 N 1 L 6 M 20 Pass 1 Turn March 20, 2023 Tamper Switch TAMPER IN CEILING BLDG 1 FLR 5 N 1 L 6 M 21 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 1 TAMPER BLDG 1 FLR 4 N 1 L 5 M 21 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 3 TAMPER BLDG 1 FLR 4 N 1 L 5 M 10 Pass 1 Turn

Building 1, Floor 6 N 0 L 0 M 0 March 20, 2023 Tamper Switch STAIR 1 TMPR 5TH FL BLDG 1 FLR 6 N 1 L 7 M 5 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 3 TMPR 6TH FL BLDG 1 FLR 6 N 1 L 7 M 4 Pass 1 Turn March 20, 2023 Tamper Switch PNTHS TMPR 6TH FLR BLDG 1 FLR 6 N 1 L 7 M 14 Pass 1 Turn March 20, 2023 Tamper Switch STAIR 3 TMPR 5TH FL BLDG 1 FLR 6 N 1 L 7 M 16 Pass 1 Turn

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 17 of 29

Date Tested Device Floor Room # / Corridor Location / Description No de Lo op Device Label Status Comments Building 1, Floor 0 N 0 L 0 M 0

March 23, 2023 Speaker/Strobe Stair 2 Building 1 N 1 x 2 x x 49798781 Pass March 23, 2023 Speaker/Strobe Stair 4 Building 1 N 1 x 2 x x 49798379 Pass March 23, 2023 Speaker/Strobe Stair 7 Elevator Equip Rm Building 1 N 1 x 2 x x 49798552 Pass

Building 1, Floor 1 N 0 L 0 M 0

March 23, 2023 Speaker/Strobe exit in canteen/by serving line Building 1 N 1 L 2 x x 49797503 Pass March 23, 2023 Speaker/Strobe Pharmacy by Vault Building 1 N 1 x x x x 49797518 Pass March 23, 2023 Speaker/Strobe Kitchen line Building 1 N 1 x x x x 49797561 Pass March 23, 2023 Speaker/Strobe Main Entry Mech Rm Building 1 N 1 x x x x 49797563 Pass March 23, 2023 Speaker/Strobe Medical Clinics Area Building 1 N 1 x x x x 49797651 Pass March 23, 2023 Speaker/Strobe By Info Desk Building 1 N 1 x x x x 49797652 Pass March 23, 2023 Speaker/Strobe Restroom By ER Entrance Building 1 N 1 x x x x 49799101 Pass March 23, 2023 Speaker/Strobe Canteen Building 1 N 1 x x x x 49797581 Pass March 23, 2023 Speaker/Strobe by main elevators Building 1 N 1 x x x x 49797602 Pass March 23, 2023 Strobe Moruge Exit Building 1 N 1 x x x x 49797606 Pass March 23, 2023 Strobe Waiting Area By Pharmacy Building 1 N 1 x x x x 49797607 Pass March 23, 2023 Speaker/Strobe By Stair 1 Building 1 N 1 x x x x 49797589 Pass March 23, 2023 Speaker/Strobe By Stair 2 Building 1 N 1 x x x x 49797520 Pass March 23, 2023 Speaker/Strobe By Stair 3 Building 1 N 1 x x x x 49797596 Pass March 23, 2023 Speaker/Strobe By Stair 5 Building 1 N 1 x x x x 49797590 Pass March 23, 2023 Speaker/Strobe By ER Rm 5 Building 1 N 1 x x x x 49797683 Pass March 23, 2023 Strobe Across From ER 5 Building 1 N 1 x x x x 49797682 Pass March 23, 2023 Speaker/Strobe By Stair 9 Building 1 N 1 x x x x 49799109 Pass March 23, 2023 Speaker/Strobe by room 1004/pharmacy counseling Building 1 N 1 x x x x 49797512 Pass March 23, 2023 Speaker/Strobe Pharmacy by 1010 Building 1 N 1 x x x x 49797517 Pass March 23, 2023 Strobe Rm 1012 Building 1 N 1 x x x x 49797565 Pass March 23, 2023 Speaker/Strobe Pharmacy by 1021 Building 1 N 1 x x x x 49797567 Pass March 23, 2023 Speaker/Strobe in men's room 1216 Building 1 N 1 x x x x 49797597 Pass March 23, 2023 Speaker/Strobe by men's room 1216 Building 1 N 1 x x x x 49797598 Pass March 23, 2023 Speaker/Strobe By Rm 1218 Building 1 N 1 x x x x 49797599 Pass March 23, 2023 Strobe Restroom Across From 1218 Building 1 N 1 x x x x 49797506 Pass March 23, 2023 Strobe Restroom Across From 1218 Building 1 N 1 x x x x 49797522 Pass

VA WCHCS - Bldg 1- Audibles - Device List - March 23

EC.02.03.05 EP 4 Every 12 months, the hospital tests visual and audible fire alarms, including speakers and door-releasing devices on the inventory. The results and completion dates are documented.

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 18 of 29

Date Tested Device Floor Room # / Corridor Location / Description No de Lo op Device Label Status Comments

VA WCHCS - Bldg 1- Audibles - Device List - March 23

EC.02.03.05 EP 4 Every 12 months, the hospital tests visual and audible fire alarms, including speakers and door-releasing devices on the inventory. The results and completion dates are documented.

March 23, 2023 Speaker/Strobe By Rm 1234 Building 1 N 1 x x x x 49797698 Pass March 23, 2023 Strobe By Rm 1235 Generator rm Building 1 N 1 x x x x 49799118 Pass March 23, 2023 Speaker/Strobe Rm 1237 Building 1 N 1 x x x x 49797700 Pass March 23, 2023 Speaker/Strobe By Rm 1237 Building 1 N 1 x x x x 49797702 Pass March 23, 2023 Speaker/Strobe in women's room 1254 Building 1 N 1 x x x x 49797508 Pass March 23, 2023 Speaker/Strobe in women's room 1254 Building 1 N 1 x x x x 49797509 Pass March 23, 2023 Speaker/Strobe By Rm 1401 Building 1 N 1 x x x x 49797608 Pass March 23, 2023 Speaker/Strobe By Rm 1601 Building 1 N 1 x x x x 49797691 Pass March 23, 2023 Speaker/Strobe By Rm 1603 Building 1 N 1 x x x x 49797694 Pass March 23, 2023 Speaker/Strobe Across On 1608 Building 1 N 1 x x x x 49797693 Pass March 23, 2023 Speaker/Strobe By Rm 16236 Building 1 N 1 x x x x 49797629 Pass March 23, 2023 Strobe Restroom 1625 Building 1 N 1 x x x x 49798494 Pass March 23, 2023 Speaker/Strobe By Rm 1627 Building 1 N 1 x x x x 49797626 Pass March 23, 2023 Speaker/Strobe Rm 1633 Building 1 N 1 x x x x 49797690 Pass March 23, 2023 Speaker/Strobe Mech Rm 1635 Building 1 N 1 x x x x 49798861 Pass March 23, 2023 Strobe Rm 1636 Building 1 N 1 x x x x 49797631 Pass March 23, 2023 Strobe Rm 1637 Building 1 N 1 x x x x 49797632 Pass March 23, 2023 Speaker/Strobe By Rm 1645 Building 1 N 1 x x x x 49797625 Pass March 23, 2023 Speaker/Strobe By Rm 1648 Building 1 N 1 x x x x 49797618 Pass March 23, 2023 Speaker/Strobe By Rm 1652 Building 1 N 1 x x x x 49797619 Pass March 23, 2023 Speaker/Strobe By Rm 1658 Building 1 N 1 x x x x 49797620 Pass March 23, 2023 Strobe Rm 1668 Building 1 N 1 x x x x 49797640 Pass March 23, 2023 Strobe Rm 1669 Building 1 N 1 x x x x 49797637 Pass March 23, 2023 Speaker/Strobe By Rm 1673 Building 1 N 1 x x x x 49797617 Pass March 23, 2023 Speaker/Strobe By Rm 1678 Building 1 N 1 x x x x 49797646 Pass March 23, 2023 Speaker/Strobe By Rm 1679 Building 1 N 1 x x x x 49797645 Pass March 23, 2023 Strobe Rm 1687 Building 1 N 1 x x x x 49797564 Pass March 23, 2023 Speaker/Strobe By Rm 1688 Stair 8 Building 1 N 1 x x x x 49797642 Pass March 23, 2023 Speaker/Strobe Rm 1689 Building 1 N 1 x x x x 49797641 Pass March 23, 2023 Speaker/Strobe By Rm 1696 Building 1 N 1 x x x x 49797649 Pass March 23, 2023 Speaker/Strobe By Rm 1707 Waiting Area Building 1 N 1 x x x x 49797650 Pass

Building 1, Floor 2 N 0 L 0 M 0

6786 S Revere Pkwy Suite 110 Centennial CO 80112 Phone: 303 986-5900 Fax: 866 974-9299 Page 19 of 29

Date Tested Device Floor Room # / Corridor Location / Description No de Lo op Device Label Status…