R_Boom Hose Inspections_2026_VA Charleston_4.pdf
PDF 255 KB Posted
- Attached to
- J065--FY26: REPAIR MEDICAL GAS LEAK
- Solicitation number
- 36C24726Q0868
About this file
This is a testing report documenting flexible connection testing and boom/retractable hose inspections performed at Ralph H. Johnson VA Medical Center in Charleston, South Carolina on June 3, 2026.
The testing was conducted by Evergreen Medical Services (EMS) in compliance with NFPA 99 5.1.14.2.3.1(A) standards, which require nonstationary booms and articulating assemblies utilizing flexible connectors to be tested for leaks every 18 months or as determined by facility risk assessment. Lead Technician Kevin (credential 6040) and technician Tanner Moore (ASSE 6030 credential 12454599) performed the inspections using oxygen-safe leak detectant, ultrasonic leak detectors, borescope cameras, and proprietary disassembly tools. Testing encompassed 69 separate boom and retractable hose assemblies across multiple facility areas including GI endoscopy suites (4 procedure rooms), catheterization lab, and 6 operating rooms. All assemblies passed inspection with 100% pass rate. The report notes that all hoses must comply with NFPA 99 2024 labeling requirements including CGA color designation, gas identification, non-standard pressure notation where applicable, and recommended replacement dates. Several outlet/inlet connections were found to have leaks during testing and were repaired at the time of service, with the next inspection date scheduled for June 3, 2026. Assembly manufacturers included Amico and Beacon models across oxygen, medical air, vacuum, nitrogen, and nitrous oxide systems.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C24726Q0868_4.docx | DOCX document | |
| 36C24726Q0868_3.pdf | ||
| PXL_20260526_124554514_2.jpg | JPG image | |
| 36C24726Q0868_2.docx | DOCX document | |
| PXL_20260526_124939323_3.jpg | JPG image | |
| PXL_20260526_124550763_1.jpg | JPG image | |
| R_SYS_2026_VA Charleston_6.pdf | ||
| R_PM_2026_VA Charleston_5.pdf |
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Text version
Page 1 FLEXIBLE CONNECTION TESTING McDowell
Marion, NC
2/22/2025
Facility: Contact:
City, ST: Title:
Date(s) of Testing: Email:
Phone:
Technician(s):
Contact Information
Technician(s) Performing Service
Some rooms such as ICU rooms may not be readily available for testing of the flexible connectors. Coordination from the staff and department contracting the testing will be required to hold rooms for testing and may incur additional charges for return trips.
Rooms may require terminal cleaning upon completion of testing prior to returning the space back to patient care. Dust and debris may be inside the ancilary space above the ceiling where the flexible connections are hooked to the distribution piping as well as inside the assemblies themselves. EMS
Technicians will make every attempt to clean up after testing however, the facility should evaluate if further cleaning is required.
Hoses will be inspected for leaks at both points of connection above ceiling and inside the assemlby at the back of the outlets/inlets.
Inspection of the hoses at pivot points and locations that would cause the hose to possibly rub or wear against the inside of the assembly will be done by removing end caps or other coverings for visual examination.
NFPA 99 2024 requires that all hoses used for flexible connections inside manufactured assemblies be labeled with the CGA color designation, the name or chemical symbol of the gas per table 5.1.11, the non standard pressure if applicable, and the recommended replacement date based on the date of manufacture. Any new hoses or replacement hoses must meet these criteria.
Credential and #:Tanner Moore ASSE 6030 - 12454599
Oxygen safe leak detectant and/or ultrasonic leak detector, Borescope camera as needed, Proprietary tools required to disassemble booms.(803)621-6104
Testing is performed as outlined and required by NFPA 99 5.1.14.2.3.1(A) - Nonstationary booms and articulating assemblies, other than headwalls utilizing flexible connectors, shall be tested for leaks, per manufacturer's recommendations, every 18 months or at a duration as determined by a risk assessment performed by the facilities governing body in conjuction with the RFA.
Ralph H. Johnson VA Medical Center
Charleston, SC
6/3/2026
David Gatlin
Facility Information Equipment
Lead Technician
Kevin
Testing performed by EMS
Copyright Evergreen Medical Services, Inc. © 2025
Page 2 BOOMS & RETRACTABLE HOSES
Marion, NC
2/22/2025
Position
C eiling
C onnections
O utlet C onnection
H ose C ondition
3B GI Suite
(Endoscopy) 321 (GI Proc.
1) O₂ BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 321 (GI Proc.
1) Med Air
BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 321 (GI Proc.
1) Vac BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 321 (GI Proc.
1) O₂ BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 321 (GI Proc.
1) Med Air
BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 321 (GI Proc.
1) Vac BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 322 (GI Proc.
2) O₂ BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 322 (GI Proc.
2) Med Air
BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 322 (GI Proc.
2) Vac BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
Leaking Outlet/Inlet Connection - Repaired at time of testing
3B GI Suite
(Endoscopy) 322 (GI Proc.
2) O₂ BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 322 (GI Proc.
2) Med Air
BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
Test/Inspection D ate
Joint/DISS Leak Detection & Safe Working Condition
R ecom m endation(s) or
C om m ents
R oom
# (O utlets Listed Top to
Bottom
Left to Right & Front of Room to Back)
System
Boom or Retractable C olum n
A rea or Zone
A ssem bly M anufacturer
PA
SS/FA
IL
Lead Technician
Kevin
Page 3 BOOMS & RETRACTABLE HOSES
Marion, NC
2/22/2025
Position
C eiling
C onnections
O utlet C onnection
H ose C ondition
Test/Inspection D ate
Joint/DISS Leak Detection & Safe Working Condition
R ecom m endation(s) or
C om m ents
R oom
# (O utlets Listed Top to
Bottom
Left to Right & Front of Room to Back)
System
Boom or Retractable C olum n
A rea or Zone
A ssem bly M anufacturer
PA
SS/FA
IL
3B GI Suite
(Endoscopy) 322 (GI Proc.
2) Vac BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 325 (GI Proc.
3) O₂ BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 325 (GI Proc.
3) Med Air
BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 325 (GI Proc.
3) Vac BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 325 (GI Proc.
3) O₂ BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 325 (GI Proc.
3) Med Air
BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 325 (GI Proc.
3) Vac BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 326 (GI Proc.
4) O₂ BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 326 (GI Proc.
4) Med Air
BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 326 (GI Proc.
4) Vac BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 326 (GI Proc.
4) O₂ BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
3B GI Suite
(Endoscopy) 326 (GI Proc.
4) Med Air
BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
Lead Technician
Kevin
Page 4 BOOMS & RETRACTABLE HOSES
Marion, NC
2/22/2025
Position
C eiling
C onnections
O utlet C onnection
H ose C ondition
Test/Inspection D ate
Joint/DISS Leak Detection & Safe Working Condition
R ecom m endation(s) or
C om m ents
R oom
# (O utlets Listed Top to
Bottom
Left to Right & Front of Room to Back)
System
Boom or Retractable C olum n
A rea or Zone
A ssem bly M anufacturer
PA
SS/FA
IL
3B GI Suite
(Endoscopy) 326 (GI Proc.
4) Vac BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
25 AA223 Cath 2 O₂ BOOM Amico ✓ ✓ ✓ PASS 6/3/2026 26 AA223 Cath 2 O₂ BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
27 AA223 Cath 2
WAG
D BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
28 AA223 Cath 2 Med Air
BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
29 AA223 Cath 2 Med Air
BOOM Amico ✓ ✓ ✓ PASS 6/3/2026
30 AA223 Cath 2 Vac BOOM Amico ✓ ✓ ✓ PASS 6/3/2026 31 AA223 Cath 2 Vac BOOM Amico ✓ ✓ ✓ PASS 6/3/2026 32 Surgery A239 (OR 1) N₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 33 Surgery A239 (OR 1) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 34 Surgery A239 (OR 1) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 35 Surgery A238 (OR 2) N₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 36 Surgery A238 (OR 2) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 37 Surgery A238 (OR 2) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 38 Surgery A234 (OR 3) O₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 39 Surgery A234 (OR 3) O₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
40 Surgery A234 (OR 3) Med Air
BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
Lead Technician
Kevin
Page 5 BOOMS & RETRACTABLE HOSES
Marion, NC
2/22/2025
Position
C eiling
C onnections
O utlet C onnection
H ose C ondition
Test/Inspection D ate
Joint/DISS Leak Detection & Safe Working Condition
R ecom m endation(s) or
C om m ents
R oom
# (O utlets Listed Top to
Bottom
Left to Right & Front of Room to Back)
System
Boom or Retractable C olum n
A rea or Zone
A ssem bly M anufacturer
PA
SS/FA
IL
41 Surgery A234 (OR 3)
WAG
D BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
Leaking Outlet/Inlet Connection - Repaired at time of testing
42 Surgery A234 (OR 3) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 Leaking Outlet/Inlet Connection -
Repaired at time of testing
43 Surgery A234 (OR 3) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 Leaking Outlet/Inlet Connection -
Repaired at time of testing
44 Surgery A234 (OR 3) N₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 45 Surgery A234 (OR 3) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 46 Surgery A234 (OR 3) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 47 Surgery A234 (OR 3) O₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 48 Surgery A234 (OR 3) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 49 Surgery A234 (OR 3) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 50 Surgery A234 (OR 3) N₂O BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
51 Surgery A234 (OR 3) Med Air
BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
52 Surgery A234 (OR 3)
WAG
D BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
53 Surgery A234 (OR 3) O₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 54 Surgery A235 (OR 4) N₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
Lead Technician
Kevin
Page 6 BOOMS & RETRACTABLE HOSES
Marion, NC
2/22/2025
Position
C eiling
C onnections
O utlet C onnection
H ose C ondition
Test/Inspection D ate
Joint/DISS Leak Detection & Safe Working Condition
R ecom m endation(s) or
C om m ents
R oom
# (O utlets Listed Top to
Bottom
Left to Right & Front of Room to Back)
System
Boom or Retractable C olum n
A rea or Zone
A ssem bly M anufacturer
PA
SS/FA
IL
55 Surgery A235 (OR 4) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 Leaking Outlet/Inlet Connection -
Repaired at time of testing
56 Surgery A235 (OR 4) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
57 Surgery A236A (OR 5) N₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
58 Surgery A236A (OR 5) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 Leaking Outlet/Inlet Connection -
Repaired at time of testing
59 Surgery A236A (OR 5) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
60 Surgery A236A (OR 5) O₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
61 Surgery A236A (OR 5) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
62 Surgery A236A (OR 5) O₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
63 Surgery A236A (OR 5) Med Air
BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
64 Surgery A236A (OR 5) N₂O BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
65 Surgery A236A (OR 5)
WAG
D BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
Lead Technician
Kevin
Page 7 BOOMS & RETRACTABLE HOSES
Marion, NC
2/22/2025
Position
C eiling
C onnections
O utlet C onnection
H ose C ondition
Test/Inspection D ate
Joint/DISS Leak Detection & Safe Working Condition
R ecom m endation(s) or
C om m ents
R oom
# (O utlets Listed Top to
Bottom
Left to Right & Front of Room to Back)
System
Boom or Retractable C olum n
A rea or Zone
A ssem bly M anufacturer
PA
SS/FA
IL
66 Surgery A236A (OR 5) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
67 Surgery C205 (OR 6) N₂ BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 68 Surgery C205 (OR 6) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026 69 Surgery C205 (OR 6) Vac BOOM Beacon ✓ ✓ ✓ PASS 6/3/2026
Lead Technician
Kevin
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