S02 Exhibit B - Agency Requirement - Westmoreland CBOC.pdf

Agency Specific Requirements (ASR) Cover Page and Clarifications

Summary: VA Pittsburgh Healthcare System (VAPHS) is initiating a lease for the Westmoreland Community Based Outpatient Clinic (CBOC). The following documents provide design criteria for this clinic. The Lease Design Narrative (LDN) and the associated Room Data Matrix (RDM), the Program for Design (PFD) and Project Content List (PCL) are specific to the clinic location included with this package. If a conflict arises between documents, this Agency Specific Requirement document supersedes all others, including the Lease. The ASR Package includes but is not limited to the following documents.

Document Name Exhibit #

Lease Design Narrative (LDN) and Room Data Matrix

B-1

B-2

B-3

Global Documents – For the VA CBOC Program:

1. Lease Design Narrative (LDN) - Exhibit B-1 The purpose of the LDN is to stand as the global document that consolidates the governing codes, standards, references and guidelines in a document that provides performance-based standards for a VA leased CBOC. The offeror must see the PFD for each project specific CBOC housing (i.e. program) requirement.

a. Design and documentation of the CBOC shall be in compliance with the requirements of the GSA Form L100 Global Lease.

The LDN covers construction materials and standards not fully addressed by the codes and standards within the GSA Form L100 Global Lease and the Facility Guidelines Institute (FGI)

Environmental Services

Water Quality Monitoring

b. The LDN includes multiple disciplines and sections and must be read in its entirety. It includes Narratives in the following areas:

i. Planning and Design Criteria ii.Site Civil & Landscape

iii. Architecture

iv. Interior Design

v. Structural

vi. Mechanical

vii. Plumbing

viii. Electrical

ix. Lighting Scope

x. Telecommunications

2. Environmental Services Statement Of Work- Exhibit B-2 The purpose of the Environmental Services Statement Of Work is to outline the expectations related to housekeeping and ensuring the facility is maintained according to VA standards.

3. Water Quality Monitoring- Exhibit B-3 The purpose of the Water Quality Monitoring exhibit is to outline the expectations related to testing, treating, and ensuring the water within the facility is maintained according to VA standards and is safe for all visitors, veterans, and staff.

ATTACHMENT B-1

LEASED CBOC DESIGN NARRATIVE

TABLE OF CONTENTS

1. INTRODUCTION

2. GENERAL REQUIREMENTS

3. PLANNING AND DESIGN CRITERIA

4. TECHNICAL NARRATIVE

4.1 This section has been omitted in its entirety.

4.2 Site Civil & Landscape

4.2.1 Pedestrian and Vehicle Access & Circulation

4.2.2 Parking

4.2.3 Site Grading

4.2.4 Storm Water Management

4.3 Architecture

4.3.1 General Criteria

4.3.2 Accommodations for Care of Patients of Size

4.3.3 Acoustics

4.3.4 Equipment/Accessories/Furnishings

4.3.5 Signage and Wayfinding

4.3.6 Critical Dimensions

4.3.7 Entry Canopies

4.3.8 Exterior Windows

4.3.9 Elevators

4.3.10 Slab Depressions

4.3.11 Interior Metal Fabrications

4.3.12 Millwork

4.3.13 Joint Sealant Systems

4.3.14 Doors and Frames

4.3.15 Hardware

4.3.16 Interior Glass Types

4.3.17 Gypsum Board Systems

4.3.18 Pharmacy Dispense/Consult Pass-through

4.3.19 Radiation Shielding

4.3.20 Radio Frequency Shielding and Magnetic Shielding

4.4 Interior Design

4.4.1 General Criteria

4.4.2 Acoustic Ceiling Tile

4.4.3 Ceramic Tile

4.4.4 Resilient Flooring and Base

4.4.5 Carpeting

4.4.6 Concrete Floor Treatment

TABLE OF CONTENTS

4.4.7 Fiberglass-Reinforced Panels

4.4.8 Painting

4.4.9 Wall Protection

4.4.10 Window Shades

4.4.11 Carpet Walk-Off Mat

4.4.12 Manufactured Wallcovering

4.4.13 Resinous Flooring and Base

4.4.14 Privacy Curtains / Screens

4.5 Structural

4.5.1 Seismic Design

4.6 This section has been omitted in its entirety.

4.7 Mechanical

4.7.1 References

4.7.2 HVAC Design Basis

4.7.3 Air Handling Units (AHUs)

4.7.4 Exhaust Systems

4.7.5 Cooling System

4.7.6 Hot Water Heating System

4.7.7 Humidification System

4.7.8 HVAC Piping Systems

4.7.9 Air Distribution and Duct Systems

4.7.10 HVAC Insulation Systems

4.7.11 Vibration Isolation

4.7.12 HVAC Sound Control

4.7.13 Testing, Adjusting and Balancing

4.7.14 Automatic Temperature Control Systems

4.7.15 Special Conditions

4.8 Plumbing

4.8.1 References

4.8.2 Plumbing Design Basis

4.8.3 Materials

4.8.4 Plumbing Insulation Systems

4.8.5 Medical Gases

4.8.6 Special Conditions

4.9 Electrical

4.9.1 Electrical Project Scope

4.10 Lighting Scope

4.10.1 Interior Lighting

4.10.2 Indoor Lighting Specifics

4.10.3 Exterior Lighting Specifics

4.10.4 Lighting Controls

4.10.5 Luminaires

4.10.6 LED Drivers

4.10.7 Lighting Control Panels

4.10.8 Occupancy and Vacancy Sensors

4.10.9 Dimmers

TABLE OF CONTENTS

4.11 Telecommunications

4.11.1 Scope of Work

4.11.2 Pathways

4.11.3 Spaces

4.11.4 Telecommunications Bonding and Grounding

4.11.5 Equipment Racks and Cabinets

4.11.6 Power Distribution Units and Uninterruptable Power Supplies

4.11.7 Telecommunications Infrastructure Plant

4.11.8 Systems Scope

5. APPENDIX

5.1. Room Data Matrix

5.2. Hardware Groups and Modifiers

Section 1 - Page 8

SECTION 1

INTRODUCTION

SECTION 1 - INTRODUCTION

1.1 The purpose of this Design Narrative is to consolidate the governing codes, standards, references, and guidelines in a document that provides performance-based standards for a VA leased CBOC.

1.2 The governing codes, standards, and references are based on a VA affiliated outpatient clinic classified as a Business occupancy. This document does not apply to occupancies classified as Ambulatory Health Care or Health Care.

1.3 VA leased CBOC facilities are considered non-mission critical sites.

1.4 Each VA leased CBOC will be affiliated with a VA medical center but will not be physically located on the affiliated medical center campus. Affiliation with a VA medical center includes review and certification by the VA medical center accrediting organization, The Joint Commission (TJC).

Refer to Part 2 General Requirements for further code information.

1.5 The design of the VA leased CBOC is based on VA established criteria for layout of a clinic. The clinic layout is based on the Patient Aligned Care Team (PACT) space module which is described in Part 3 Planning and Design Criteria.

1.6 Acceptable VA leased CBOC locations may be within a new freestanding building or in a renovated space within an existing building. Only single story facilities are acceptable.

1.7 Commonly Used Acronyms and Definitions:

PCMH Patient Centered Medical Home A team based, comprehensive, coordinated patient care model (refer to PACT)

PACT Patient Aligned Care Team Provides service to veterans that is patient-centered with the right care at the right time by the right person. A typical “teamlet” serving a veteran consists of four caregivers: a Primary Care Provider – physician (MD), physician assistant (PA) or nurse practitioner (NP); a Registered Nurse (RN); a clinical staff assistant (LPN or Medical Assistant) and an administrative staff member (Clerk).

CBOC Community Based Outpatient Clinic A lease-based facility providing outpatient services that is physically separated but administratively attached to a VA Medical Center.

PFD Program for Design Net square feet (NSF) listing of all spaces and rooms that are to be included in a construction project.

VA Veterans Health Administration VISN Veterans Integrated Services Network

SECTION 2 – GENERAL REQUIREMENTS

2.1 General

2.1.1 The codes, standards, and references listed below indicate recommended or minimum performance requirements. Based on input from Owner representatives and recommendations from the architectural/engineering firm, minimum requirements or standards may be exceeded by site specific project design.

2.1.2 Compliance is required with applicable codes and standards throughout the process of design, construction, acceptance, and on-going maintenance of the CBOC facility.

2.1.3 Design and documentation of the CBOC shall be in compliance with the requirements of the GSA Form L100 Global Lease and codes, standards, and references listed below.

This Leased Design Narrative covers construction materials and standards not fully addressed by the codes, standards, and references below.

2.1.4 Use the most current edition at the date and time of the Phase 2 notification of shortlist for any codes, standards or references listed below.

2.2 Codes

2.2.1 All VA leased CBOC facilities are to conform to all applicable codes, which includes but is not limited to following:

2.2.1.1 National Fire Protection Association (NFPA) 101 Life Safety Code, NFPA 99

Health Care Facilities Code and all standard references therein, current edition.

Occupancy classification to be Chapter 38 New Business Occupancy.

2.2.1.2 NFPA 75 Standard for the Fire Protection of Information Technology, current edition, applicable where the CBOC contains a Data Center.

2.2.1.3 Architectural Barriers Act Accessibility Standards (ABAAS), current edition.

2.2.1.4 International Building Codes (IBC): New buildings for which VA began project planning after May 5, 2016 shall comply with IBC 2015 or later edition (within 2 years of release).

2.2.1.4.1 International Building Code

2.2.1.4.2 International Energy Code

2.2.1.4.3 International Mechanical Code

2.2.1.4.4 International Plumbing Code

2.2.1.5 State and local International Building Codes (IBC) amendments as required by the local Authority Having Jurisdiction (AHJ).

2.2.1.6 United States Pharamcopeial Convention (USP) Chapters <795>, <797>, and <800>.

2.3 Standards

2.3.1 All leased CBOC facilities are to conform to the following standards:

2.3.1.1 FGI Guidelines for the Design and Construction of Outpatient Facilities, current edition (referred to as FGI Guidelines herein).

2.3.1.2 The Joint Commission (TJC) accreditation standards apply to the facility under the affiliated VA medical center license. Building construction and on-going maintenance procedures shall meet TJC standards. Lessor shall provide and submit all documentation that is required for TJC requirements.

SECTION 2

GENERAL REQUIREMENTS

2.3.1.3 GSA Facility Security Level (FSL) shall be as outlined in Global Lease.

2.3.1.4 Sustainability standards shall be as outlined in Global Lease.

2.3.1.5 American Society of Heating, Refrigerating and Air-Conditioning Engineers

(ASHRAE) Standard 170, Ventilation of Health Care Facilities, current edition (referred to as ASHRAE 170 herein)

2.3.1.6 ASHRAE Standard 188, Legionellosis: Risk Management for Building Water Systems, current edition.

2.3.1.7 ASHRAE Standard 62.1, Ventilation for Acceptable Indoor Air Quality, current edition (referred to as ASHRAE 62.1 herein)

2.3.1.8 Sheet Metal and Air Conditioning Contractors National Association (SMACNA) Standard, HVAC Duct Construction Standards - Metal and Flexible.

2.3.1.9 USP General Chapter 797 Pharmaceutical Compounding – Sterile Preparations

2.3.1.10 USP General Chapter 800 Hazardous Drugs - Handling in Healthcare Settings

2.4 References

2.4.1 Documents provided for reference only, ASR package dictates directive. Following are guides, manuals, and other references developed by VA applicable to leased CBOC facilities:

2.4.1.1 VA Signage Design Manual PG 18-12

2.4.1.2 VA Enterprise Facility IT Support Infrastructure Standard, most current.

2.4.1.3 Building Prototypes, Community Based Outpatient Clinic https://www.cfm.va.gov/til/prototypes.asp#CBOC

2.4.1.4 PACT Space Module Design Guide

https://www.cfm.va.gov/til/dGuide/dgPACT.pdf

2.4.1.5 Space Planning Criteria PG 18-9

https://www.cfm.va.gov/til/space/spChapter265.pdf

2.4.1.6 Room Templates, Leased Community Based Outpatient Clinics https://www.cfm.va.gov/til/leasing.asp http://www.cfm.va.gov/til/prototypes.asp#CBOC http://www.cfm.va.gov/til/dGuide/dgPACT.pdf http://www.cfm.va.gov/til/space/spChapter265.pdf http://www.cfm.va.gov/til/leasing.asp

ATTACHMENT B-1 SECTION 11 PLANNING AND

DESIGN CRITERIA

SECTION 3 – PLANNING AND DESIGN CRITERIA

3.1 Background

In 2010 the VHA committed to the development of a patient-centered medical home model for enhanced outpatient primary care services to veterans. The result was a patient care delivery model and a set of planning and design standards.

3.2 PACT Guiding Principles

An operational and planning design guide was developed which identified key principles and objectives. Refer to PACT Space Module Design Guide under References Section 2.4.

3.3 Community Based Outpatient Clinics (CBOC) Planning Approach The development of the PACT Planning Module was complimented by the development of a Prototype for Standardized Design and Construction of Community Based Outpatient Clinics, completed in 2014. Utilizing the PACT Module as the building block, prototypes were developed for three types and sizes of outpatient facilities.

3.4 References

For further information on the CBOC standard operations and planning, refer to the VA guides referenced under Section 2.4.

ATTACHMENT B-1 E

SECTION 4

TECHNICAL NARRATIVE

4.1 Site Civil

4.1.1 Pedestrian and Vehicle Access & Circulation

4.1.1.1 Separation of service and visitor traffic is desired to improve site safety.

4.1.1.2 Minimum traffic lane width is 12-feet, and minimum sidewalk width is 4-feet.

Curves for traffic lanes and radii at intersections must be adequately sized to prevent vehicles from encroaching on an opposing lane of traffic.

4.1.1.3 An accessible route must be provided from the public right-of-way abutting the site to the accessible building entrance.

4.1.1.4 Emergency vehicle access and circulation must be provided as required by the local Fire Department as approved by the Fire Marshal. Minimum fire lane width is 20-feet unless approved otherwise.

4.1.1.5 Provide a service area with a loading dock designed to accommodate the truck size designated in the Global Lease.

4.1.1.6 Service area shall accommodate vehicles that pick-up trash and recycled materials. Locate service area away from public and patient areas.

4.1.1.7 Provide reflective traffic control signs as required for intersections, no parking lanes, and guidance of site traffic.

4.1.2 Parking

4.1.2.1 Parking lots with 90-degree stalls must have minimum parking stall dimensions of

9-feet by 18-feet, and a minimum drive aisle width of 24-feet. Angled parking must have one way drive aisles with the same stall sizes as 90-degree parking.

Angled parking drive aisle width must comply with a published design standard for a designated parking angle.

4.1.3 Site Grading

4.1.3.1 Minimum and maximum slopes criteria for site grading:

Location Minimum Slope Maximum Slope Entry Drive 1.0% 3.0% Circulation Road 0.5% 8.0% Parking Lot 1.3% 5.0% Concrete Curb & Gutter 0.5% 8.0% Sidewalk 0.5% 5.0% Patient Drop-Off Zone & ADA Parking 0.5% 2.0% Loading Dock 1.3% 3.0% Planted Areas 2.0%

4.1.3.2 Roads and walks should have a typical cross slope of 2%, unless adequate surface drainage is provided by other slope conditions.

4.1.4 Storm Water Management

4.1.4.1 Storm water management and drainage system design must comply with EISA

Section 438.

ATTACHMENT B-1 SECTION 4

TECHNICAL NARRATIVE

4.2 Architecture

4.2.1 General Criteria

4.2.1.1 Refer to Appendix: Room Data Matrix for Door, Hardware and Acoustic requirements listed by Room Type.

4.2.2 Accommodations for Care of Patients of Size

4.2.2.1 Refer to FGI Guidelines Outpatient Facilities for accommodations for care of patients of size. Minimum requirements are to provide access to the Procedure Room and Procedure Room Toilet in each PACT Module. Refer to Agency Specific Requirements (ASR) provided with the Global Lease for specific information on projected weight capacities for patients of size in population to be served.

4.2.3 Acoustics

4.2.3.1 Refer to FGI Guidelines Outpatient Facilities for acoustics requirements at enclosed rooms. Refer to the Room Data Matrix-Interior Construction for information on rooms not covered under FGI or rooms with special acoustics requirements. Constructed rooms shall be tested for compliance with acoustical requirements prior to occupancy of the facility.

4.2.4 Equipment/Accessories/Furnishings

4.2.4.1 Refer to CBOC Project Contents List and Room Template sheets provided with the

RLP for equipment, accessories, and furnishings descriptions and locations. Items to be provided and/or installed by Lessor are noted on the list. Provide partitions, partition backing, and above ceiling structural support as required for wall and/or ceiling mounted equipment, accessories, and furnishings. Provide required utility connections for scheduled equipment.

4.2.5 Signage and Wayfinding

4.2.5.1 Refer to VA Signage Design Guide in Section 2.4 for signage standards and requirements.

4.2.6 Critical Dimensions

4.2.6.1 Patient-use corridors are to be 6 foot minimum clear, typical.

4.2.6.2 Refer to Room Data Matrix – Interior Construction for required ceiling heights by room type.

4.2.7 Entry Canopies

4.2.7.1 Provide non-combustible canopies over the following locations:

4.2.7.1.1 Patient entry to clinic.

4.2.7.1.2 Receiving area/loading dock.

4.2.7.2 At patient entry, provide a covered patient drop-off zone with space for at least one full size passenger vehicle (19 feet long) and an accessible access aisle.

4.2.7.3 Verify clearance from grade to underside of canopy with typical emergency and transport vehicles.

4.2.8 Exterior Windows

4.2.8.1 Provide safety glazing at interior panes of exterior windows within Secure Holding

Rooms. Safety glazing shall be laminated glass 7/16 inches thick.

4.2.9 Elevators

4.2.9.1 Where elevators are provided in a leased facility, not less than one elevator car shall accommodate an ambulance stretcher of 24 inches by 84 inches in the horizontal open position and shall be identified by the international symbol for emergency medical services (star of life). The symbol shall be not less than 3 inches high placed inside on both sides of the hoistway door frame.

4.2.10 Slab Depressions

4.2.10.1 At new construction, provide slab depression as required to provide flush threshold installation at audiology booths, and other equipment requiring recessed installation as recommended by equipment manufacturer. At existing construction, provide ramp to meet ABAAS.

4.2.11 Interior Metal Fabrications

4.2.11.1 Metal Fabrications: Welding Qualifications per AWS D1 for procedures and personnel dependent on metal type selected.

4.2.11.1.1 AV equipment supports above ceilings.

4.2.11.1.2 Toilet partitions support system.

4.2.11.1.3 Miscellaneous brackets, backer plates, etc., for support ofmiscellaneous equipment, walls or ceilings.

4.2.11.2 Medical Equipment Support Systems: Provide above ceiling support at rooms with ceiling-hung exam lights, ceiling mounted patient lifts and other ceiling hung examination or diagnostic equipment.

4.2.12 Millwork

4.2.12.1 Quality compliance to conform to Architectural Woodwork Institute (AWI) and

Woodwork Institute (WI) quality standards.

4.2.12.2 Wood Veneer Casework Construction: Combination of custom wood casework and countertops to conform to program and functional requirements. (Location: Lobby, Reception)

4.2.12.2.1 Construction: Flush overlay construction with concealed hinges. AWI custom grade.

4.2.12.2.2 Items

4.2.12.2.2.1 Base cabinets

4.2.12.2.2.2 Upper cabinets with sloped or straight fascia.

4.2.12.2.2.3 Upper cabinets, open shelves with sloped or straight fascia.

4.2.12.3 Plastic Laminate Casework Construction: Combination of custom plastic laminate casework and countertops to conform to program and functional requirements.

(Location: Typical).

4.2.12.3.1 Construction: Flush overlay construction with concealed hinges, AWI Custom Grade.

4.2.12.3.2 Cabinet Hardware:

4.2.12.3.2.1 Concealed hinges, all metal, 110 degree opening, self-closing.

4.3.12.3.2.2 Full extension drawer guides, 100 lbs. capacity.

4.3.12.3.2.3 Door and drawer pulls: 4” center to center wire pull, 5/16” diameter round, 1 ¼” projection, satin chrome.

4.2.12.4 Solid Surface Fabrications: Hard, solid, non-porous mineral-filled acrylic resin

(methyl methacrylate) material in color to be selected by designer. Thickness: 1/2” minimum.

4.2.12.4.1 Locations:

4.2.12.4.1.1 Transaction tops at nurse stations and reception desks.

4.2.12.4.1.2 All counters with sinks to have solid surface countertop with integral sink, and 4” high minimum integral coved side and backsplash.

4.2.12.4.1.3 All counters in patient treatment areas to have solid surface countertop with 4” high minimum integral coved side and backsplash.

4.2.13 Joint Sealant Systems

4.2.13.1 Joints at plumbing fixtures, ceramic tile to be mildew resistant silicone.

4.2.14 Doors and Frames

4.2.14.1 Refer to Room Data Matrix – Doors and Hardware in Appendix for door and hardware requirements by room type.

4.2.14.2 Refer to Room Data Matrix- Interior Construction for required door acoustical ratings as determined by required STC at walls. Refer also to Section 4.3.3 Acoustics.

4.2.14.3 Door Frames and Borrowed Lites: One-piece, fully welded flush faces, welded and ground smooth. Blunt stops with tight hairline joints.

4.2.14.4 Material: 16-gauge cold-rolled sheet steel, painted.

4.2.14.5 Hollow Metal Doors in Service Areas: 1-3/4 inch, 16-gauge hollow metal doors complying with SDI Type II, heavy duty style 2, flush doors with hourly rating indicated.

4.2.14.6 Wood Doors: Provide AWI rated and nonrated doors.

4.2.14.6.1 AWI PC-5ME: 1-3/4 inch flush wood doors with bonded core construction, Grade A, veneer to be plain-sliced.

4.2.14.7 Provide UL fire rated doors with mineral core and special laminated stiles for ratings indicated on Room Data Matrix.

4.2.14.8 Finish: Prefinished in compliance with AWI Section 1500.

4.2.14.9 Automatic Sliding Doors: Single Slide Automatic Sliding Door, Class 1 Clean Room

Certified, narrow stile, 84” wide w/ 35.3” nominal clear door opening, trackless, clear anodized finish, and touchless actuators.

4.2.14.9.1 Comply with BHMA Standard ANSI A156.10 (BHMA 1601), Power Operated Pedestrian Door Standard and UL Standard UL 325, Electric Door, Drapery, Gate, Louver and Window Operators and Systems.

4.2.14.9.2 Manufacturer's Qualifications: Provide units produced by firm with not less than 5 years successful experience in fabrication of automatic entrance doors of type required for this project.

4.2.14.9.3 Manufacturer shall be a Member of the American Association of Automatic Door Manufacturers (AAADM) with certified service technicians.

TECHNICAL NARRATIVE

4.2.14.9.4 Installer's Qualifications: Engage installer who is authorized representative of automatic entrance door manufacturer for both installation and maintenance of type of units required for this project.

4.2.14.9.5 Minimum Experience: Not less than 3 years’ experience in installation and service of automatic entrance doors of same manufacturer.

4.2.14.9.6 Maintenance Proximity: Not more than 4 hours normal travel timefrom Installer's place of business and project site.

4.2.14.9.7 Service Life: Provide automatic sliding doors capable of operating without failure of any component, for not less than 300,000 open and close cycles, with normal maintenance as defined in manufacturer's standard operating manual.

4.2.14.10 Access Panels:

4.3.14.10.1.1 Flush stainless steel at toilet areas.

4.3.14.10.1.2 Flush gypsum board surface with concealed hinges at public and office areas.

4.3.14.10.1.3 Fire rated steel at rated construction.

4.2.15 Hardware

4.2.15.1 General Notes

4.2.15.1.1 Fire rated openings to have closers and gaskets, as required by rating.

4.2.15.1.2 Corridors and building exits require approved exit hardware.

4.2.15.1.3 Provide extra heavy duty, Grade 1 hardware for all components.

4.2.15.2 Major components and finishes are as follows:

4.2.15.2.1 Hinges: Provide ball-bearing hinges of size, quantity, and duty level as recommended by manufacturer, unless specifically noted otherwise. Provide non-removable pins (NRP) for reverse bevel doors that lock. Hinges shall meet the requirements of ANSI/BHMA A156.1-06.

4.2.15.2.2 Electric Hinges/Electric Power Transfers: Provide electric hinge or mortise electric power transfer, as required by electric locking device(s). Provide sufficient number of concealed wires to accommodate electrified function of specified hardware. Locate at second hinge from bottom, and where used in conjunction with exit devices, locate hinge nearest to exit device. Provide mortar guard for each electrified hinge. Electric Hinges/Electric Power Transfers shall meet the requirements of ANSI/BHMA A156.1-06.

4.2.15.2.3 Flush Bolts/Coordinators: Provide automatic, semi-automatic (constant/self-latching), or manual flush bolts for inactive door of pairs for inactive door of pairs as indicated in the hardware group(s), and as required for metal or wood doors. Provide stop-mounted coordinator for labeled pairs with automatic flush bolts. Whenever bottom bolts are utilized, provide dustproof strike, as required for sill conditions. Provide top and bottom bolt configurations where required by opening conditions. Flush Bolts/Coordinators shall meet the requirements of ANSI/BHMA A156.3-08.

4.2.15.2.4 Locks: Provide cylindrical locksets and latches unless noted otherwise in hardware groups, with functions specified in assigned hardware groups.

Locksets shall meet the requirements of ANSI/BHMA A156.13-1994, Operational Grade 1, and Security Grade 1. Provide cylinders, backsets and strikes as recommended by manufacturer. Electrified locking devices shall meet the requirements of ANSI/BHMA A156.25-07.

4.2.15.2.5 Exit Devices: Provide heavy-duty exit devices with functions specified in assigned hardware groups. Fire exit devices shall comply with applicable building codes and be mounted to comply with accessibility codes. Devices must be UL listed as fire exit panic. Provide lever trim, cylinder dogging, and cylinders as indicated and per manufacturer’s recommendation. Exit devices shall meet the requirements of ANSI/BHMA A156.3-08.

4.2.15.2.6 Cylinders and Keying: Key locks/cylinders in groups with new master key or grandmaster key system as directed by Owner. Provide three (3) keys per lock. Provide construction master keying. Cylinders shall meet the requirements of ANSI/BHMA A156.5-14.

4.2.15.2.7 Electric Strikes: Provide heavy duty commercial Grade 1 electric strikes.

Provide strikes designed for use with latch/lock type specified at each opening. Electric strikes shall be UL listed as Burglary-Resistant Electric Door Strikes and where required shall be UL listed as Electric Strikes for Fire Doors and Frames. Provide fail-secure (non fail-safe) type electric strikes, unless specified otherwise in hardware group. Provide power supply, transformer and rectifier for each strike as required, and verify voltage with Electrical Contractor. Provide spacer plates and accessories as required for installation. Electric Strikes shall meet the requirements of ANSI/BHMA A156.31-07.

4.2.15.2.8 Closers: Provide heavy-duty non-sized closers with heavy-duty closer arms, adjustable to meet maximum opening force requirements of ADA and CBC if in California. Provide drop plates brackets and adapters as recommended by manufacturer according to site conditions. Provide closers meeting the requirements of UBC 7-2 and UL 10C Positive Pressure Tests. Mount closers on room side of corridor doors and stair side of stairway doors.

Closers shall meet the requirements of ANSI A156.4

4.2.15.2.9 Electromagnetic and Electromechanical Release devices – Closer Holders:

Provide connection to fire alarm where required by code. Verify voltage with Electrical. Electromagnetic wall holders shall meet the requirements of ANSI A156.15-06

4.2.15.2.10 Kick Plates/Armor plates: Provide kick plates – 10” tall x 2” less than door width x .050” thick; and armor plates – 34” tall x 2” less than door width x .050” thick. (At pairs provide plates for both doors – 1” less than door width.)

Door Trim shall meet the requirements of ANSI/BHMA A156.6-05.

4.2.15.2.11 Push Plates/Pull Plates: Where specified in assigned hardware group, provide push plate – 6” x 16” x .050”, and pull plate – 4” x 16” x .050” plate with 3/4” round x 8” CTC pull. Door Trim shall meet the requirements of

ANSI/BHMA A156.6-05.

4.2.15.2.12 Stops: Provide stops as appropriate for opening/stop conditions, utilizing wall stops/bumpers, overhead stops, or stop arms on closers. Do not use floor stops unless specifically noted. Door Trim shall meet the requirements of

ANSI/BHMA A156.6-05.

4.2.15.2.13 Auxiliary Hardware shall meet the requirements of ANSI/BHMA A156.16-08.

4.2.15.2.14 Gasket: Where smoke gaskets are specified or required by fire rating, provide gasketing complying with UBC 7-2 AND UL-10C. Provide accessories, shims and fasteners as recommended by manufacturer.

Gaskets are to be installed in accordance with BHMA A156.22 regarding air leakage as tested per ASTM E 283.

4.2.15.2.15 Weather-seal: Provide threshold, sweep, and weather-strip at allexterior openings. Weather-seal shall meet the requirements of ANSI/BHMA A156.22-05. Thresholds shall meet the requirements of ANSI/BHMA A156.21-09.

4.2.15.2.16 Finishes: Provide US-26D (satin chrome) and associated finishes as applicable for particular products. Finishes shall meet the requirements of

ANSI/BHMA A156.18-06

4.2.15.2.17 Low Energy Automatic operators, ANSI A156.19 Heavy duty commercial grade. Provide complete with drop plates, bracket, or adapters for arms as required to suit details. Provide a terminal strip in an enclosed box near or above door that indicates connections for Security and Fire Alarm equipment and for electrified hardware items associated with proper door operation, as indicated by hardware group operational description. Refer to floor plans for type of actuation devices and bollards if required. Coordinate with Security Contractor for doors actuated by electronic access control system.

4.2.15.2.18 Electronic access control: Electronic access control system/device(s), power supplies (unless otherwise noted in hardware group) and monitoring/alarm(s) are provided with Security System. General Contractor to coordinate the provision and installation of the products. Refer to documents with Security Information for location(s) and type(s) of control(s). Connection by Electrical.

4.2.16 Interior Glass Types

4.3.16.1.1 Clear Float Glass (GL-1): 1/4-inch thickness; comply with ASTM C1036, Type I (transparent glass, flat), Class 1 (clear), Quality q3 (glazing select).

4.3.16.1.2 Clear Tempered Glass (GL-1T): 1/4-inch thickness; comply with ASTM

C1036, Type I (transparent glass, flat), Class 1 (clear), Quality q3 (glazing select), and further processed to comply with ASTM C1048, Kind FT (fully tempered).

4.2.17 Gypsum Board Systems

4.2.17.1 Gypsum Board: 5/8-inch thick, Type X, ASTM C 1396/C 1396M, typical.

4.2.17.2 High Impact Resistant Gypsum Board: 5/8-inch-thick, Type “X”, Fire Class A, abuse-resistant gypsum fiber interior panel with embedded fiberglass mesh in back of panel. Provide at loading dock areas and Secure Holding Rooms.

4.2.17.3 Tile Backer Board: Portland cement board, Type X as required, 5/8-inch thick.

4.2.17.4 Acoustical Insulation: ASTM C665, Type 1, semi-rigid mineral fiber un-faced blankets. Thickness: 2 or 3 inches as required by UL design requirements. For UL designs not requiring mineral wool insulation, use fiber-glass batt insulation, full thickness of stud.

4.2.17.5 Acoustical Sealant: Non-skinning, nondrying, non-staining sealant especially designed for sound control applications.

4.2.17.6 Framing Systems

4.2.17.6.1 Metal Studs and Furring: ASTM C645 and meeting or exceeding flexural strength, allowable bending moment, and screw pull-out of a standard 33 mil thick stud.

4.2.18 Pharmacy Pass-throughs

4.2.18.1 Provide secure transaction drawer/pass through cabinet and window withamplified speak thru at Pharmacy Dispense/Consult windows.

4.2.18.2 Provide stainless steel, type 304, #4 finish, pass-through cabinet with mechanical interlock doors with clear tempered safety glass windows to comply with USP 800 clean air requirements at Pharmacy pass-through windows.

4.2.19 Radiation Shielding

4.2.19.1 For Radiology X-Ray Rooms, obtain a radiation shielding report from the VA’s physicist with recommendations based on radiology equipment.

4.2.19.2 Comply with requirements of the National Council on Radiation Protection and

Measurement (NCRP) Report #49.

4.2.19.3 Provide lead lining of gypsum wall board, wood doors and hardware, hollow metal frames, and lead glass view window.

4.2.19.4 Lead sheet to be FS QQ-L-201, Grade C, thickness as required by physicist report but not less than 1/16 inch.

4.2.19.5 Shield walls to an elevation of 7 feet minimum.

4.3 Interior Design

4.3.1 General Criteria

4.3.1.1 Refer to Appendix: Room Data Matrix – Interior Construction for finish requirements listed by room type.

4.3.1.2 Refer to sustainability guidelines as required by the GSA Form L100 Global Lease for additional product requirements for all interior finishes.

4.3.1.3 Provide finishes with flame spread and fire and smoke development to meet all applicable codes.

4.3.2 Acoustic Ceiling Tile

4.3.2.1 AT-1: Acoustical ceiling tile, standard size to be 24”x24”x 1”, fine textured, non-fissured, humidity resistant, sag-resistant, mold-resistant, thermal resistant, minimum 35 CAC and .75 NRC., high light reflectance and with recycled content and low emitting VOC. Suspension system: 9/16” or 15/16” with or without gasketed grid.

4.3.2.1.1 Location: Typical, unless otherwise noted.

4.3.2.2 AT-SP: Acoustical, scrubbable ceiling tile, standard size to be 24”x24”x 1”, with vinyl-laminated or sealed face and sealed edges, humidity-resistant, thermal resistant, impact resistant, water repellent, high light reflectance, minimum .55 NRC and .35 CAC. with recycled content. Suspension system: 9/16” or 15’16” with or without gasketed grid.

4.3.2.2.1 Location: Procedure rooms, utility rooms, kitchens and/or food service areas.

4.3.2.3 Rooms with exposed ceilings: IT support rooms including Main Computer Room, Telecommunication Room, and Entrance Facility Room to have exposed ceilings.

4.3.3 Ceramic Tile

4.3.3.1 Porcelain Tile (PT), Quarry Tile (QT) Ceramic Tile (CT): Provide tile that complies with ANSI A137.1 for types, compositions and other characteristics indicated.

4.3.3.2 Tile-setting system: ANSI A108.02. Provide complete tile-setting system consisting of materials by a single manufacturer and ANSI standards referenced by TCA installations methods specified in tile installation schedules and other requirements specified.

4.3.3.3 Waterproofing and Crack Isolation: Provide products and systems that comply with ANSI A118.12 for crack isolation and ANSI A118.10 for waterproofing, and as recommended by the membrane manufacturer for the application indicated. Include reinforcement and accessories recommended by manufacturer.

4.3.3.4 At above grade floor slabs, provide membrane waterproofing under floor finish in rooms/areas with floor drains. Extend waterproofing under entire area which slopes to the floor drain or which is subject to surface water; carry membrane up abutting vertical surfaces 3 inches minimum.

4.3.4 Resilient Flooring and Base

4.3.4.1 Resilient Flooring (RF) (RFT) (RSF) (WSF)

Slip Resistance of Flooring Materials: Provide materials with SCOF Dry Static Coefficient of Friction (SCOF) 0.5 or greater when tested in accordance with ASTM D2047.

4.3.4.2 Resilient flooring shall not require any additional finish coatings or stripping of finishes.

4.3.4.3 Resilient Floor Tile (RFT): Minimum size to be 12” x 12” by 0.098” (2.5mm) thick.

Wear layer to be 0.020” minimum. To conform to ASTM F 1066 - Standard Specification for Vinyl Composition Floor Tile. PVC and phthalate free or complies with REACH requirements.

4.3.4.4 Welded Seam Sheet Flooring (WSF): Commercial grade, ASTM F1913, homogeneous, sheet flooring with minimum wear layer of 0.079 inch and overall thickness of 0.05 inch with heat or chemical welded seams. PVC and phthalate free or complies with REACH requirements. Integral base where noted on Room Finish Schedule.

4.3.4.5 Resilient Sheet Flooring (RSF): Commercial grade, ASTM F1303, heterogeneous, PVC and phthalate free or complies with REACH requirements, sheet flooring with minimum wear layer of .020” and overall thickness of 05”. With or without heat or chemical welded seams.

4.3.4.6 Rubber Flooring (RF): Commercial grade, ASTM F1859, vulcanized rubber sheet or tile flooring with minimum overall thickness of 2.0mm for new construction and 3.0 mm for existing, renovated spaces, Pharmacy or Therapy gyms. With or without heat or chemical welded seams. PVC and phthalate free or complies with REACH requirements.

4.3.4.6.1 Resilient Base (RB): 1/8-inch thick, 4” high minimum base, to meet ASTM F1861. Material to be vinyl (phthalate free) or rubber. Location: Coved at resilient flooring, where integral base is not used, and straight at carpeting.

4.3.5 Carpeting

4.3.5.1 Carpet Tiles (CPT): Commercial grade, ASTM E84, 6,6 nylon with recycled content, loop pile, with PVC free backing. Minimum carpet density of 6.0.

4.3.5.1.1 Adhesive: Low VOC type recommended by carpet manufacturer.

4.3.5.1.2 Edge Strips: Vinyl tee edge cover with extruded aluminum carpet edge guard stripping, color as selected from manufacturer's standard colors, with concealed teeth to grip carpet from below.

4.3.6 Concrete Floor Treatment

4.3.6.1 Concrete Sealer (CS): 30 percent clear, non-yellowing, waterborne, membrane-forming curing and sealing compound: ASTM C1315, Type 1, Class A, minimum 30 percent total solids. Comply with ACI 301.

4.3.7 Fiberglass-Reinforced Panels

4.3.7.1 Fiberglass-reinforced panels (FRP): Gelcoat-finished, glass-fiber reinforced plastic panels complying with ASTM D 5319. Fire-Rating per ASTM E 84: Class A. Nominal thickness: 0.09 inch.

4.3.8 Painting

4.3.8.1 Interior painting: Paint (P) and Epoxy Paint (EP): Paint surfaces with primer and two finish coats that are compatible with one another as demonstrated by manufacturer or field experience, unless otherwise indicated

4.3.8.2 Materials: Use Low VOC, low odor latex top coats where indicated.

4.4.8.2.1.1 Paint the following items and surfaces:

4.4.8.2.1.2 Ceilings: Flat latex.

4.4.8.2.1.3 Walls - gypsum wallboard: Satin latex.

4.4.8.2.1.4 Walls - concrete block: Semi-gloss latex with block filler.

4.4.8.2.1.5 Hollow metal doors and frames: Semi-gloss latex over alkyd primer.

4.4.8.2.1.6 Exposed structure above: Latex dryfallout.

4.4.8.2.1.7 Exposed structure above: No finish.

4.3.9 Wall Protection

4.3.9.1 Rigid Wall Covering (RWC): Nominal thickness .060 inch, high-impact, PVC-free, standard texture, chemical and stain resistant, with vertical, inside and outside trims.

To comply with ASTM E84, ASTM F476 and ASTM D543.

4.3.9.3 Corner Guard – Stainless Steel (CG-SS): Surface mounted stainless steel, 3-1/2” wing size, full height, 16 gauge in Kitchen and/or Standard Grade, #4 satin finish.

4.3.9.3.1 Location: Provide at all outside exposed corners in in public, patient, and cart food service areas, loading dock area and back corridor and heavy use equipment storage areas.

4.3.10 Window Shades

4.3.10.1 Roller Window Shades

4.3.10.1.1 Manually operated window shade, chain driven, vertical roll-up, stainless steel bead chain with hold down clips, extruded aluminum rollers, and bottom slats. Aluminum headbox with endcaps and fascia with powder coat finish.

Light gap reduction channels available for black out shades. PVC-free shades, Flame-Resistance Ratings: NFPA 701. Comply with WCMA A

100.1. Window treatments should not compromise patient safety.

4.4.10.1.1.1 Locations:

4.4.10.1.1.1.1 Semi-Transparent to be typical, unless otherwise noted. 4.4.10.1.1.1.2 Black-out at conference rooms, tele-medicine rooms, logistics rooms, clean supply rooms, and medication rooms, if located on exterior walls

4.3.11 Carpet Walk-Off Mat

Modular Carpet Walk Off Mat (MAT) Textured loop modular tile, solution dyed nylon with recycled content and soil/stain protection, minimum 5/32” gauge, 6500 density, 8,5 stiches per inch and 27-36 oz/yd face weight. Non-woven primary backing. Secondary backing to be high performance, thermoplastic polymer with fiberglass reinforcing layer and not less than 19% recycled content. Secondary backing to be 100% recyclable at the end of its useful life.

4.3.11.1.1 Locations: Vestibules, extend into reception/lobby space as required to provide 20’-0” minimum of walk-off length.

4.3.12 Manufactured Wallcovering

4.3.12.1 Prefinished wood veneer wall covering, PVC-free vinyl wallcovering, textile wallcovering, and synthetic textile wallcovering (VWC).

4.3.12.1.1 Wall materials to comply with applicable codes and rated for commercial use.

4.3.12.1.2 Wood products to be certified as FSC pure or certified according to standards of Programme for the Endorsement of Forest Certification.

4.3.12.1.3 Vinyl, textile and synthetic textile wallcovering products to be provided from same production run and meet Type II standards.

4.3.12.1.4 Digital wallcovering to use high resolution digital image printing on a Type II substrate with abrasion resistant and stain resistant top coat finishes.

4.3.12.1.5 Adhesives to be water based low VOC, commercial heavy-duty and clear.

Use breathable primers prior to installation of wallcovering. Materials to be mildew-resistant and non-staining to wallcovering. Do not install over existing wallcovering.

4.3.12.1.5.1 Locations: Not to exceed 30% of wall space in reception and/or lobby spaces, install on interior walls only; paint only on exterior walls.

4.3.13 Resinous Flooring and Base

4.3.13.1 (RES) Methyl Methacrylate or MMA, Acrylic Resin System by BASF Corporation.

4.3.13.1.1 Materials: MasterTop 1851 SRS CF Methyl Methacrylate (MMA) Acrylic Resin System, MasterTop SRS 41P Primer/Sealer, MasterTop 1817 SRS PC Polymer Concrete, MasterTop SRS 61BC Self-Leveling Topping, MasterTop SRS 71TC Colorless Topcoat Resin, BASF Color Flake Blend.

4.3.13.1.2 Acceptable alternative manufacturers: Key Resin, Flowcrete, and Tennant.

4.4.13.1.2.1 Locations: Hazardous waste storage

4.3.14 Privacy Curtains / Screens

4.3.14.1 Privacy Curtains / Screens – In extenuating conditions, disposable or linen privacy curtains, portable screens, integrated blinds in glass, or other similar systems must be considered. If, due to specific existing conditions or operational requirements, it is not possible to provide a visually private patient changing area, the facility must establish a policy to ensure patient privacy while changing.

4.3.14.1.1 Examination, procedure, and treatment rooms - provide privacy curtains/screens to encompass adequate space for the healthcare provider to perform examination unencumbered by the curtain and provide a visually private patient changing area that allows the provider to remain in the room.

4.3.14.1.2 Exception: Patient care rooms where a patient does not have potential for exposure of breast or genital areas.

4.3.14.1.3 Lessor responsible for either laundering/disinfecting linen or changing disposable exam room privacy curtains every 3 months (or when alerted by CBOC staff that specific curtains are visibly soiled)

4.4 Structural

4.4.1 Seismic Design

4.4.1.1 In seismic regions, new clinic buildings must be designed for appropriate lateral seismic forces. New buildings for which VA began project planning after May 5, 2016 shall comply with IBC 2015 or later edition (within 2 years of release). The structural engineer will determine the Seismic Design Category (SDC) based on the risk category for the building and soil site classification. For existing buildings that are remodeled and have not been designed for current seismic codes, the structural engineer will need to evaluate if the modifications are changing the buildings gravity or lateral system. The structural engineer will need to evaluate if seismic evaluation and retrofit requirements apply according to ICSSC RP current edition, Standards of Seismic Safety for Existing Federally Owned and Leased buildings.

TECHNICAL NARRATIVE

4.5 Mechanical

4.5.1 References

4.5.1.1 The following publications shall be referenced for applicable systems calculations and design information.

4.5.1.1.1 ASHRAE Handbooks.

4.5.1.1.2 ASPE Handbooks.

4.5.2 HVAC Design Basis

4.5.2.1 Indoor design conditions:

4.5.2.1.1 Health care function design conditions shall be in compliance with the requirements of the FGI Guidelines and ASHRAE Standard 170, with the Appendix 5.1 Room Data Matrix taking precedence and/or indicating required space design conditions when the FGI Guidelines do not fully address a space or room type.

4.5.2.1.2 General Office and Non-Patient Space Design Conditions:

4.7.2.1.2.1 Summer: 75 degrees F and 60 percent RH. 4.7.2.1.2.2 Winter: 70 degrees F.

4.5.2.1.3 Imaging Equipment Space Design Conditions - Unless equipment manufacturer requirements state otherwise, the space design conditions shall be:

4.5.2.1.3.1 Summer: 72 degrees F and 50 percent RH.

4.5.2.1.3.2 Winter: 72 degrees F and 30 percent RH.

4.5.2.1.4 Data Centers/Computer Rooms:

4.5.2.1.4.1 Space and equipment configuration shall maintain an average rack-face inlet temperature range of 72°F to 81°F.

4.5.2.1.4.2 For humidity levels, comply with recommendations in ASHRAE 2012a -

Thermal Guidelines for Data Processing Environments.

4.5.2.1.5 Basic MEP Equipment Room Design Conditions:

4.7.2.1.5.1 Heating: 70 degrees F.

4.7.2.1.5.2 Cooling: 80 degrees F.

4.5.2.1.6 Loading Docks:

4.5.2.1.6.1 The space shall be maintained at a minimum of 60 degrees F and shall have provisions to limit the intrusion airborne particulate and insects through dock door openings.

4.5.2.2 Outdoor design conditions:

4.5.2.2.1 ASHRAE 99.6% (winter) and 0.4% (summer) conditions associated with the site-specific location.

4.5.2.3 Outside Air Ventilation:

4.5.2.3.1 Patient Care Spaces: Per FGI Guidelines/ASHRAE 170.

4.5.2.3.2 General Office and Non-Patient Spaces: Per ASHRAE 62.1

4.5.3 Air Handling Units (AHUs)

4.5.3.1 Air handling units shall consist of, but not be limited to, the following:

4.7.3.1.1.1 The units shall be constructed of double wall, insulated metal panels with an overall U-value and necessary features to meet/exceed energy code (and prevent condensation based on the site specific outdoor design conditions).

4.7.3.1.1.2 Incorporate supply, return and outdoor air flow measuring stations for proper control feedback and insure minimum ventilation needs.

4.7.3.1.1.3 For AHU’s that are in excess of 15,000 cfm, SA/RA Array fans (minimum 2 fans per system) with backdraft isolation dampers shall be employed.

4.7.3.1.1.4 VSD controllers for fan array systems shall be provided in quantities that will provide no less than a 50% loss of nominal fan capacity if a single VSD were to fail.

4.5.3.2 For overall building capacity needs greater than 30,000 cfm, multiple AHUs shall be provided.

4.5.3.3 For building programs that have a Data Center/Computer Room, it shall be conditioned by dedicated air conditioning systems able to operate and maintain design conditions 24 hrs per day, 7 days per week. Cooling capacity of AC units shall be determined based upon room equipment specifications.

4.5.3.4 For building programs that have a Production Kitchen/Food Preparation, a dedicated air handling unit shall be provided capable of serving theconditioning and ventilation needs of the Kitchen space, including capability for a high percentage of outside air (up to 100%) to accommodate the make-up air needs of the space.

4.5.4 Exhaust Systems

4.5.4.1 Provide exhaust fans to provide general exhaust for toilet rooms, janitor’s closets, soiled utility rooms and similar spaces.

4.5.4.2 Dedicated exhaust fans shall be provided for Pharmacy, Laboratory, Kitchen/Cafeteria areas, and similar specialized spaces.

4.5.4.3 Telephone equipment rooms, electrical equipment rooms, data communication rooms and similar spaces requiring low density load cooling (and not occupied, no ventilation requirements) may be cooled with transfer fans if required airflow rates do not exceed 3 cfm per square foot.

4.5.5 Cooling System

4.5.5.1 If cooling is provided by chilled water, it shall be generated by water chillers providing at least 50% redundancy. Chillers shall employ multiple, independent refrigerant circuits, and shall have capacity control provisions to achieve at least 4 to 1 turndown. Design chilled water temperatures shall be based on 42°F supply with at least a 14°F difference in temperature for chilled water return.

4.5.5.2 The pumping system for the chilled water supply shall consist of variable speed pumps providing variable primary flow, arranged in a headered approach, and sized to provide at least 50% redundancy. Variable speed pumps shall each have a variable speed drive controller.

4.5.5.3 DX systems:

4.5.5.3.1 AHUs packaged with DX cooling sections shall have

compressors/condensing units with direct drive scroll or screw compressors, all-aluminum microchannel condenser coils, and direct drive TEFC condenser fans. Units shall employ multiple, independent refrigerant circuits, and shall have capacity control provisions to achieve at least 4 to 1 turndown.

4.5.5.3.2 Provide spring isolated mounting curbs for vibration attenuation, if applicable.

4.5.5.4 Provide unit supported screen wall panels (final color and design scheme TBD), if roof supported structural screen wall elements are not incorporated.

4.5.5.5 VRF systems shall not be considered for VA CBOC projects due to various concerns such as inappropriate system type for healthcare facility applications due to higher amounts of fresh air requirement as well as safety risk to building occupants due to use of high refrigerant volumes and associated potential leaks.

4.5.6 Hot Water Heating System

4.5.6.1 If heating is provided by boilers, hot water heating shall be generated by direct vent, sealed combustion, high efficiency (93% or better), condensing type boilers providing at least 50% redundancy.

4.5.6.2 The heating water system distribution shall be a variable/primary pumping system. The pumping system will consist of variable speed pumps providing variable primary flow and provide at least 50% redundancy. Variable speed pumps shall each have a variable speed drive controller.

4.5.7 Humidification System

4.5.7.1 If needed, centralized humidification shall be provided with self-contained natural gas…