Attachment 5 671-18-106 ICRA - FOUO _Signed.pdf

This is an Infection Prevention and Control Construction/Renovation/Maintenance Permit issued for a water softener replacement project at an external site work location. The permit, managed by Project Manager Maria Hernandez, covers work from the project start date through a completion date of 08/31/2026, with permit expiration on 08/31/2026.

The project is classified as Activity Category D with a Low Overall Patient Risk Category and Level III Infection Prevention and Control Precautions. Level III control measures are in effect and include all requirements from Levels I and II plus additional enhanced protocols. These measures mandate the construction and completion of critical barriers meeting NFPA 241 requirements that extend to the ceiling or ceiling tile level, all plastic or hard barrier construction activities completed to prevent dust release, sealing of all penetrations in containment barriers using approved materials, and maintenance of 0.1 inches water gauge negative pressurization of the entire workspace using HEPA exhaust air systems. The exhaust must be directed outdoors at least 25 feet from entrances, air intakes, and windows, with continuous operation 24/7 for the project duration. A differential pressure sensing device must be installed and monitored on the exterior work containment to continuously monitor and document negative pressurization. Additional requirements include installation of a final barrier with anteroom for pressure control, worker clothing and PPE removal protocols, shoe covers or cleaning methods, and daily cleaning of surroundings using damp mopping or HEPA vacuuming. The permit has been digitally signed by both the Project Manager and Infection Preventionist Marceau Doze-Guillory.