VA LAACC_351 E Temple St_ANN ELEV_09-11-24_Redacted 7.pdf

Section I - Building Description:

CHARACTERISTICS

PRIMARY OCCUPANCY TYPE B - Business FIRE CONTROL ROOM: ☐YES ☒NO

SECONDARY OCCUPANCY TYPE I-2 ELEVATOR INFORMATION: CARS BANKS

TYPE OF BUSINESS CONDUCTED PASSENGER 4 1

☐ Apartment/Condo ☐ Museum

☐ Bar/Restaurant ☐ Parking Structure

☐ Church ☒ Office Space

☐ Schools ☐ Repair Garage

☐ Day Care ☐ Retail

☐ Detention Facility ☐ Skilled Nursing

☐ Group Home ☐ Telecommunications

☐ Hospital ☐ Theatre

☐ Hotel/Motel ☐ Warehouse

☒ Medical Office/Clinic ☒ Other: VETERANS

OUTPATIENT CLINIC

FREIGHT

PARKING 2 1

NUMBER OF STAIRWAYS: 5

FIRE PUMP(S): ☒YES ☐NO

LOCATION: P-2

EMERGENCY GENERATOR(S): ☒YES ☐NO

LOCATION: P-1

PARKING STRUCTURE:

☒ UNDERGROUND ☐ DETACHED ☒ ATTACHED

NUMBER OF LEVELS BELOW GROUND: 2

UNIQUE PROPERTY FEATURES: TYPES OF OCCUPANCIES BELOW GROUND:

FULLY SPRINKLERED OUTPATIENT VETERNAS CLINIC

WITH RISER AT SOUTH STAIR #5.

S-2, PARKING

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6259429

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Elevators: Group II & III - Initial Test

TRN 6259429 Printed Thu Sep 12 06:04:39 CDT 2024

The owner/owner(s) representative shall ensure that the appropriate permits have been secured prior to any repairs being performed.

A copy of this section shall accompany the F-340RT in all cases.

Section III - Findings: ☐SYSTEM DEFECTS FOUND ☒NO SYSTEM DEFECTS FOUND

GRAY AREAS SHALL BE FILLED OUT BY CERTIFIED TESTER PERFORMING RETEST

DEFECT # ITEM #

(SECTION IV) DESCRIPTION LOCATION RETEST

ONLY

INITIAL TEST PERFORMED BY

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: SIGNATURE:

10/31/2026

PHONE NUMBER OF TESTING AGENCY: TESTING AGENCY: STATE: ZIP:

RETEST DATE: RETEST PERFORMED BY

RE-TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: RE-TESTER'S SIGNATURE: PHONE NUMBER:

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6259429

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Elevators: Group II & III - Initial Test

All testing procedures below were performed in accordance with the Los Angeles Fire Department Chief's Regulation No. 4 requirements, applicable sections of the NFPA Standards and other approved publications.

ITEM # DESCRIPTION

SECTION II - SYSTEM DESCRIPTION: ANNUAL AUTOMATIC ELEVATORS: GROUP II &

III:

Elevator Manufacturer(s):

MCE

Model#(s):

VVMC / HMC-1000

A second three position switch is provided in the following location(s):

N/A

A second two position switch is provided in the following location(s):

N/A

Elevator Banks are designated as (e.g. Bank 1, 2 or 3):

SERVICE, PASSENGER, PARKING

Elevator Car Identification(s) are designated as (e.g. 1, 2,/P1, P2):

S1, S2, 1, 2, 3, 4, 5, 6

All elevators serve all floors:

No

Elevator has two separate entrances:

No

Elevator Banks are designated as:

Elevator Banks Bank # Floors: To:

Low-rise

PASSENGER #1, 2, 3,

4 1 5

Mid-rise

High-rise

Parking levels only PARKING #5 & 6 P2, P1 1

Non passenger (freight) SERVICE #S1 & S2 P2, P1 1-5

Elevator machine room(s) is located:

ROOF / P2 LEVEL

Elevator shunt trip is provided:

Yes

Smoke detector is located in the hoist way(s):

No

Elevator is connected to the building fire alarm system:

Yes

Elevator is connected to a supervising fire alarm system.

Yes

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: PHONE NUMBER OF TESTING AGENCY:

10/31/2026

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6259429

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Elevators: Group II & III - Initial Test

ITEM # DESCRIPTION

Elevator is connected to a stand-alone "elevator recall control and supervisory control unit"

No

All elevators shall only be operated by a Qualified, Certified Conveyance Mechanic as required by the Californa Labor Code.

Mechanic's Name: Lic.# Company Name: Contact Number:

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: PHONE NUMBER OF TESTING AGENCY:

10/31/2026

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6259429

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Elevators: Group II & III - Initial Test

All testing procedures below were performed in accordance with the Los Angeles Fire Department Chief's Regulation No. 4 requirements, applicable sections of the NFPA Standards and other approved publications.

ITEM # DESCRIPTION

SECTION IV - TESTING PROCEDURES: ANNUAL AUTOMATIC ELEVATORS:

GROUP II & III

PASS FAIL N/A

1.1 Fire Department dispatch, supervising station, & building occupants notified prior to the start of the test.

Yes

2.0 GENERAL INSPECTION/TEST PASS FAIL N/A

2.1 Total number of elevators on the property:

2.1A Total number of elevators tested: ☒ ☐ 8.0

2.2 A three position key operated switch is located on the main recall floor in the area of the elevators served. ☒ ☐ ☐

2.3 A three position key operated switch is labeled "ON, "OFF" and "BYPASS" (in that order - Group II) and the key is bezel is legible. ☐ ☐ ☒

2.4 The three position key operated switch is labeled "BYPASS", "OFF" and "ON." (In that order - Group III) and the key bezel is legible. ☒ ☐ ☐

2.5 A second three position key operated switch is provided in the (room/area). ☐ ☐ ☒

2.6 A second two position key operated switch is provided in the (room/area). ☐ ☐ ☒

2.7 Key is not removable in the "BYPASS" position. ☒ ☐ ☐

2.8 Key is removable on in the "ON" and "OF" positions at the DMFS. ☒ ☐ ☐

2.9 If two "three position recall key switches" are provided one does not override the other. ☐ ☐ ☒

2.10 If two recall switches are provided, elevators are recalled if only one recall switch is in the placed in the "ON" position. ☐ ☐ ☒

2.11 If two recall switches are provided, elevators only return to normal operation when both switches are in the "OFF" position. ☐ ☐ ☒

2.12 Bypass position restored the elevator to normal service regardless of smoke detector status. ☒ ☐ ☐

2.13 Additional two position switch does not override smoke detector at the designated level. (G-III) ☐ ☐ ☒

3.0 PHASE 1 - FIRE RECALL AUTOMATIC OPERATION PASS FAIL N/A

3.1 Manual recall - All elevators controlled by three position recall switch returned non-stop to the main floor, doors open, and remained open. ☒ ☐ ☐

3.2 Automatic recall - All elevators were recalled by the activation of an automatic sensing device and returned non-stop to the main floor, doors open, and remained open.

3.3 Doors on elevators with two entrances on the designated level opened at the lobby where the "three position switch" is located. (G-III) ☐ ☐ ☒

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: PHONE NUMBER OF TESTING AGENCY:

HANLON, JEFFREY R4419 10/31/2026 (714) 550-4416

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6259429

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Elevators: Group II & III - Initial Test

3.4 Elevator traveling away from the main floor reversed at the next available floor without the doors opening. ☒ ☐ ☐

3.5 Elevator traveling toward the main floor continued nonstop to the designated level. ☒ ☐ ☐

3.6 A moving elevator in car "door open button" is inoperative without delay. ☒ ☐ ☐

3.7 Audible and visual signal system activated (when provided). ☒ ☐ ☐

3.8 Audible, visual, and signal system activated on phase I & remains activated until car is at the designated level. (G-III) ☒ ☐ ☐

3.9 All car and corridor buttons rendered are inoperative. ☒ ☐ ☐

3.10 Door re-opening devices sensitive to products of combustion became inoperable. ☒ ☐ ☐

3.11 Elevator standing at a landing, in car "door open button" is inoperative as soon as the car moves away from the landing. (G-III) ☒ ☐ ☐

3.12 With the elevator stopped at a landing the emergency stop switch was rendered inoperable as soon as the doors closed and proceeded to the main floor. ☒ ☐ ☐

3.13 Elevators in "designated attendant" operation shall have immediate audio/visual and shall return nonstop to the designated level after a delay of 15-60 seconds. (G-

III)

3.14 Elevator standing at a floor other than the main floor (with doors open) and in car stop switch in the run position, closed the doors w/o delay & proceeded to the main floor. (G-III)

3.15 Call registered lights and direction lanterns extinguished and remain inoperative. ☒ ☐ ☐

3.16 Car position indicators (where provided) remained in service. (G-III) ☒ ☐ ☐

3.17 Hall position indicators (where provided) were extinguished and remained inoperative (except at the designated level and central control system). (G-III) ☒ ☐ ☐

3.18 Smoke detector activated on the main floor caused the elevator to proceed to the alternate recall level. ☒ ☐ ☐

3.19 Lobby smoke detector activated on the designated main floor, both phase I recall switches when provided are turned to the "ON" position, the elevator returns to the main floor from the alternate floor.

4.0 PHASE II - FIREFIGHTER IN CAR EMERGENCY OPERATION PASS FAIL N/A

4.1 The two position in car key/fire switch labeled "OFF" "ON" and is located in or adjacent to the operating panel in each car. ☐ ☐ ☒

4.2 A three position in-car key/fire switch "OFF' "HOLD" "ON" (in that order) and is located in the operating panel of each car. (G-III) ☒ ☐ ☐

4.3 The "three position in-car key/fire switch" rotates clockwise from "OFF" to "HOLD" to "ON." (G-III) ☒ ☐ ☐

4.4 The key is removable only in the "OFF" position of the two position switch. ☐ ☐ ☒

4.5 The key is removable in each position "OFF" "HOLD" "ON" and the operation/function does not change until the car is at a landing with the doors open in the normal position. (G-III)

4.6 In car switch is effective only when a main floor recall switch is in the on position, or a sensing device has been activated and the car has returned to the main floor.

4.7 The "ON" position places the elevator in "Emergency Service." ☒ ☐ ☐

4.8 The elevator can only be operated from within the car. ☒ ☐ ☐

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: PHONE NUMBER OF TESTING AGENCY:

10/31/2026

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6259429

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Elevators: Group II & III - Initial Test

4.9 Elevator does not respond to elevator corridor calls/corridor call buttons are inoperative. ☒ ☐ ☐

4.10 Directional lanterns remained inoperative. (G-III) ☒ ☐ ☐

4.11 Car position indicators remain in service. (G-III) ☒ ☐ ☐

4.12 Hall position indicators remain inoperative except at the designated level and central station. (G-III) ☒ ☐ ☐

4.13 Doors are closed by continuous pressure on the "Door Close Button" or by pressing the "Car Call Button" ☒ ☐ ☐

4.14 Doors are closed by continuous pressure on the "Door Close Button." (G-III) ☒ ☐ ☐

4.15 Releasing the "Close Door Button" prior to full door closure of the doors causes them to reopen. ☒ ☐ ☐

4.16 Doors are opened by continuous pressure on "Door Open Button." ☒ ☐ ☐

4.17 Open doors automatically re-close when pressure on "Door Open Button" is released prior to the doors reaching the fully opened position. ☒ ☐ ☐

4.18 The "In Car Stop Switch" remains operative. (G-II & G-III) ☒ ☐ ☐

4.19 All door re-opening devices are rendered inoperative. (G-III) ☒ ☐ ☐

4.20 The desired floor is selected by momentary pressure on the call button. ☒ ☐ ☐

4.21 The "Call Cancel Button" cancels registered calls. A traveling car stops at or before the next landing. (G-III) ☒ ☐ ☐

4.22 Arrival at the first floor selected cancels the cal for any other calls selected. ☒ ☐ ☐

4.23 When Phase II switch is in the "HOLD" position, the elevator stays in phase II, the car remains at the landing with the doors open, and the "Close Door Buttons" become inoperable.

4.24 Car stays in phase II until it is returned to the recall floor, doors open, and the fire switch is turned to off. (G-II) ☒ ☐ ☐

4.25 Car stays in the phase II when the main floor switch is turned to "OFF" while the "in car" fire switch is in the "ON" position. (G-II) ☒ ☐ ☐

4.26 When the elevator is in the phase II and not at the designated level, and phase I is activated, and then the phase II switch is turned to the OFF position, the doors close automatically & revert to phase I upon full door closure, door open button remains operatvie. (G-III)

4.27 When the elevator is not at the designated level, and the phase I is in the effect and the phase II switch is turned to the OFF position, doors closed automatically, but reopened when the switch is turned to "HOLD" or "ON" prior to full door closure. (G-III)

4.28 Elevator can be removed from phase II when the car is returned to the designated level, doors open, and the fire switch is turned to the "OFF" position. ☒ ☐ ☐

5.0 IN CAR COMMUNICATIONS PASS FAIL N/A

5.1 Two-way communication provided inside the car. ☒ ☐ ☐

5.2 Two-way communication is connected to 24-hour emergency assistance center

(offsite). ☒ ☐ ☐

5.3 Two-way communication is connected to 24-hour emergency assistance location

(onsite). ☐ ☐ ☒

5.4 Two-way communication equipment transmitted the correct, address, (i.e. building address, street, city, and elevator identification number). ☒ ☐ ☐

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: PHONE NUMBER OF TESTING AGENCY:

10/31/2026

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6259429

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Elevators: Group II & III - Initial Test

5.5 Only emergency assistance personnel are able to terminate two-way communication. ☒ ☐ ☐

5.6 The audible "Emergency Signal Device" is operable from the emergency stop switch.

(G-II) ☐ ☐ ☒

5.7 The audible "Emergency Signal Device" is operable from an "Alarm Switch" marked

"Alarm" and illuminates when activated. (G-III) ☒ ☐ ☐

6.0 DEVICES ACTIVATED PASS FAIL N/A

6.1 Elevator lobby smoke detector/fire detection device. ☒ ☐ ☐

6.2 Elevator machine room smoke detector/fire detection device. ☒ ☐ ☐

6.3 Elevator hoist-way smoke detector/fire detection device. ☐ ☐ ☒

6.4 Other fire detection device(s) used for elevator recall. (Specify) ☐ ☐ ☒

AREAS/DEVICES/APPLIANCES NOT ACCESSIBLE FOR TESTING

A minimum of 90% of testing is required. If less than 90% testing is conducted do not submit this report.

Description:

END OF REPORT

ALL FINDINGS INDICATING “FAIL” ARE LISTED IN SECTION III (YELLOW SECTION) AND HAVE BEEN POPULATED WITH THE ITEM

DESCRIPTION, NUMBER AND LOCATION.

THE RESULTS ARE ACCURATELY LISTED AND THE EQUIPMENT IS FULLY OPERABLE EXCEPT AS NOTED. YOU ARE A CERTIFIED REGULATION NO. 4 TESTER WITH A VALID CERTIFICATION OR HAVE BEEN AUTHORIZED TO SUBMIT THE INFORMATION ON BEHALF

OF A CERTIFIED CHIEFS REGULATION NO. 4 TESTER.

I ACCEPT

☒Yes

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: PHONE NUMBER OF TESTING AGENCY:

10/31/2026

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6259429

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Elevators: Group II & III - Initial Test