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20120130165635441.pdfLetter of Transmittal January 30, 2012 Project Info: CRS# 60237493 Kruger Orthopaedics NFPA 101, 2000 Version ASC Relocation of ASC Key People: Assigned DOH Steve Pennington Reviewer: steve.pennington@doh.wa.gov Facility Kruger Clinic Orthopaedics, PLLC Administrator: Marilyn Degan 21600 Highway 99 Ste 130 Edmonds, WA 98026 (425) 774-2637 x. judy@krugerortho.com Architect / Architectural Werks Inc Engineer: Janet Monda 12020 113t' Ave NE, Ste 210 Kirkland, WA 98034 (425) 823-2244 x. janet@awerks.com Consultant: Pennon Construction Company Inc Mac Sele 5303 1" Ave S Ste 100 Seattle, WA 98108 (206) 418-0235 x. macs@pennonconstruction.com Contact: SME Inc of Seattle Dallas Anderson PE 828 Poplar PI S Seattle, WA 98144 (206) 788-3829 x. dallasa@smeincofseattle.com Copies To: ® Local AHJ: City of Edmonds ® Architect / Engineer: Architectural Werks Inc ® Consultant: Pennon Construction Company Inc ® Consultant: Bellevue Mechanical Inc ® Contact: SME Inc of Seattle ❑ Contact: N/A ® CRS File Washington State Department of nealth Construction Review Services 310 Israel Rd. SE Tumwater, WA 98501 PO Box 47852 Olympia, Washington 98504-7852 www.doh.wa.gov/crs tel. 360-236-2944 fax. 360-236-2901 Project 21401 72nd Ave W location: Edmonds, WA 98026 Suite 3A Local Permit #: Facility Contact: Same As Administrator X. Local AHJ: City of Edmonds Leif Bjorback (425)771-0220 x. Bjorback@ci.edmonds.wa.us Consultant: Bellevue Mechanical Inc Larry Boyer 1331 120' Ave NE Bellevue, WA 98005 (425) 679-5931 x. larry.boyer@bellevuemechanical.com Contact: N/A X. ❑ DOH Child Birth Center Licensing ❑ DOH Office of Accommodations & Res. Care Survey ® DOH Office of Investigations & Inspections ❑ DSHS, Div. Of Alcohol & Substance Abuse ❑ DSHS, Aging & Adult Services Admin. ® L&I, Bill Eckroth, Electrical Section ❑ L&I, John Harvey, Factory Assembled Structures Page 1 of 15 Plan Review Comments for Project #60237493 rvactittyyata certineate: Facility Name: Kruger Orthopaedics Site Address: 21401 72nd Ave W Edmonds, WA 98026 Estimated Date of Occupancy: 12/2012 Licensee UBI#: 601850391 Critical Access Facility: ❑ Yes ® No Occupancy B Construction 2-B Applicable Code: 2000 NFPA 101 Group: Type: a Number of Current: N/A Added: Removed: Total: >� Beds: y, Automatic Fire Sprinkler System: ® Yes ❑ No Type 13 dAutomatic Fire Alarm System: ® Yes ❑ No Compartmentation req'd: ®Yes ❑No Smoke Control System Provided: ❑ Yes ®No w Special Delayed Egress Control: ❑ Yes ®No Location: Certificate of Need Required: ❑ Yes ❑No CON Approval Granted: ❑ Yes [—]No CON Number: Number of units: Private occupancy: Two person occupancy: aBased on size of rooms used for sleeping Residents Z O Based on size of common rooms Residents H Maximum allowable licensable beds: Qualifies for Assisted Living Funding Program ❑ Yes ❑No Number of qualifying units: cWU This facility will be using general anethesia. The data above is based on the information presented to CRS. Any change in the facility or facility program that causes the above information to be incorrect is subject to review by CRS. Approval for construction is not approval for licensure. A copy of the facility data certificate will be sent to the licensing agency. Page 2 of 15 Plan Review Comments for Project #60237493 Project Status: Authorized toBegin Construction _ [t� �Ir A+ ('� �_.. This project is not approved for use or licensure. The construction documents have been reviewed and construction can begin, subject to construction permitting from the local building official. This project will not be approved until the comments labeled as "not approved" have been resolved by providing a written response to each of the comments. When referencing drawings or attached materials, provide sheet or page #, revision # and date as applicable. Additional comments may follow based on design team response and site inspections may be required to verify compliance. Please note the following: ® The stamped "Authorization to Begin Construction" drawings will be delivered to the Facility Administrator. These shall be kept available on site for inspection during construction and post occupancy survey. ® Any changes/deviations (incl. change orders or addenda) from the approved documents must be submitted to the Department for review and approval. ® Beginning construction prior to resolving the attached comments will constitute facility acknowledgement that you are proceeding at your own risk. ® Please include your CRS number on all communications to Construction Review Services. PROJECT CLOSE-OUT REQUIREMENTS You must notify the department when construction is complete by completing the following steps: ✓ Verify that you have resolved all of the comments on this form and have submitted any revisions ✓ Complete the Online Notification of Construction Completed at: .wlitin tati rlolPr. � g .... 1......... _. . ✓ Email or fax the assigned reviewer (see page 1) a copy of the approval from the local building department (final permit approval or certificate of occupancy); and ✓ Email or fax the assigned reviewer a floor plan showing the scope of work. You will be recommended to Licensing, when you have completed these items. You can monitor project status at ww� v.doli.wa.gov/crs. Page 3 of 15 Plan Review Comments for Project #60237493 Technical Assistance (TA) Comments 0 s U TA — July I I'll, 2011 Attendees: Steve Pennington (tve ta,�x���wicr>Ge,�➢� w o.t;�) - Department of Health Marilyn Degan -Premier Orthopedics Janet Monda — Architectural Werks Mac Sele — Pennon Construction Design and Construction team The preceding are preliminary comments provided as information and for use preparing the construction documents. These preliminary comments may be revised during subsequent submissions/conferences. Additional preliminary comments may be made during subsequent submissions. Items Received: Sketch T1 Contact Certificate of Need at (360) 236-2955 to confirm what actions are needed with the relocation of your Ambulatory Surgery facility. LIFE SAFETY: T2 The main entry stair is a communicating space that the life safety code will look at more restrictively and will require a separation of the floors environmentally with a smoke barrier separation on the third floor in a fully sprinklered building. The doors on the third floor leading into the vestibule will need relytes in order for the public to ascertain whether there is an risk in using this exit way in the event of a fire. T3 The wall separating the ASF from the clinic will need to be a fire partition as noted in the Washington state amendments to the International building codes in Chapter 422. T4 The wall around the medical gas storage/manifold room on the 1st floor level of the parking garage will be required to have a one hour fire barrier surrounding it. T5 The number 5 gauss line will have to be contained within the MRI area, so that it does not affect ASF patients or the public using the exit access corridors. T6 Doors must swing in the path of egress where there are 50 or more occupants using the allowance of 100 square feet per person. Page 4 of 15 Plan Review Comments for Project #60237493 Architectural: T7 Drugs must be stored in a secured location, including refrigerated medications. T8 Patient toilets rooms must have doors that prevent entrapment. T9 Rooms that a clean or dirty with required pressure relationships should be provided with door closers to ensure that the pressure relationship is always maintained. T10 Public corridors are required to be a minimum of 5 feet wide except where stretchers are moved and then an 8 foot wide corridor is required. Tl l A washable drop ceiling is permitted in the surgery corridor as long as it is clipped or gaskets or uses a ceiling the that is a minimum of one pound in weight per square foot and sits flat in the ceiling grid. T12 Clearances for the PACU stations are 5 feet between gurneys and 4 feet off of a wall. T13 Patient restrooms supporting the PACU would need a means for disposing of fluid waste, a spray wand would be acceptable. T14 A clinical flush sink is required for the decontamination room. T15 The soiled utility room could be used as a soiled holding space for the Neptune unit docking station, soiled linen storage and infectious waste storage. T16 The billing office being open to the corridor is of a concern if they have any substantial amount of fuel load from files above that of a normal hazard level for a business occupancy. Mechanical: T17 A level one medical gas system is required, with a duplex vacuum pump and redundant oxygen supplied from a fully piped manifold gas systems. T18 Only two vacuum outlets per operating room will be required to be piped in, as the Neptune unit will satisfy the requirement of the third vacuum outlet. T19 A medical gas zone valve is required outside of each operating room and one for the recovery room is also required outside of the outlets environment. Page 5 of 15 Plan Review Comments for Project #60237493 Q 0 0 U T20 Inferred controls for the scrub sink and faucet is acceptable as long as the faucet is a gooseneck. Handle controls for hand -washing can be either wing handles or single lever. T21 A hot water re -circulating loop must be provided for the domestic hot water. T22 A fully ducted supply and return air system is required for the ASF. T23 Insulation of ducting should be exterior mounted to allow cleaning of ducting. T24 Low wall returns on the opposite walls and as far apart as possible shall be installed in the operating rooms. Laminar, non aspirating diffusers shall be used on the supply air. T25 Air exchanges in the operating rooms shall not exceed 20 ACH. Any amount over the 20 ACH would need to be reviewed and supported by an ICRA, studies and consistent with recommendations from ASHRAE, CDC, NIH. T26 Back flow protection for the building and any equipment connected to the domestic water system will be required. Electrical: T27 An emergency power generator systems shall be provided meeting NFPA 110 and NFPA 99. T28 Security of the generator and fuel tank shall be provided. T29 A remote generator enunciator shall be provided at a nurse station where it can be monitored during business hours. T30 The branches of emergency power shall be provided, consisting of the Life safety branch, critical power branch and a equipment branch. The associate devices shall be placed on those branches as permitted by code. T31 All outlets shall be hospital grade. T32 Medical gas area alarms shall be provided for the PACU and the operating rooms. T33 Lighting in the operating rooms shall have lens and gaskets. T34 All patient bed locations shall be served from two sources of power. Page 6 of 15 Plan Review Comments for Project #60237493 Q C O O U T35 Provide exit signs that clearly delineate the required exit pathways. T36 Provide exit access pathway lighting. T37 Surgery suites will need a code blue emergency call button. Intake conference 11115111: T38 How will the generator be fueled when there is no access within the property of the owner? WAC 246-330-510 T39 How are the .5 guass lines for the MRI contained away from public area's. T40 Structural engineering buy off on overhead booms for lights or service must be provided. T41 Freeze protection in exterior stair must be provide for wet sprinkler systems per NFPA 13 T42 Revise life safety plan to show travel distances to the two require exit stairs that meet NFPA 101. T43 Smoke venting for anesthetizing locations to be provided per NFPA 99 Chapter 5. T45 The life safety branch of the emergency power system shall provide power to exit sign, exit access pathway lighting and services required to be on the life safety branch per NFPA 99 Chapter 3-4. Page 7 of 15 Plan Review Comments for Project #60237493 Kruger Orthopaedics NFPA 101, 2000 Version ASC Relocation of ASC Plan Review Comments: � b Q General: El Two complete plans and specifications for the fire alarm system installation or modification shall be submitted for review and approval prior to system installation. The department reserves the right to defer plan review and inspections to the local authority having jurisdiction (AHJ). Plans and specifications shall include, but not be limited to, a floor plan; location of all alarm -initiating and alarm -signaling devices; alarm -control and trouble -signaling equipment; annunciation; power connection; battery calculations; conductor type and sizes; voltage drop calculations; name, address, and phone number of the agency receiving off -premises transmission of alarm; and the manufacturer, model numbers, and listing information for all equipment, devices, and materials. Incomplete plans and specifications will be returned without review. Plans and specifications may be submitted separately from construction documents during the construction of the project. For small renovation projects in which devices are only to be relocated or very few devices are to be added, provide two plans that shows the relocation of devices which may be submitted for review in lieu of the above requirements. This information can be included on the electrical or architectural plans. Verify with Department staff to determine if the scope of your project meets this criteria. Section 907.1, International Fire Code Approved 1/30/11— based on a pull stations also being located at stairwell # 2 door on level 3 and a pull station being located at the front entry door to the ASF per red lined drawings FA1.3 2 ❑x Two sets of sprinkler system working plans shall be submitted for review and approval before any equipment is installed or remodeled. The department reserves the right to defer plan review and inspections to the local authority having jurisdiction (AHJ). Deviation from approved plans will require permission. Plans and specifications, including hydraulic calculations, that are incomplete or are not stamped by a Washin Loon State Licensed Fire Sprinkler Contractor, will be returned without review. Plans and specifications may be submitted separately from construction documents during the construction of the project. For small renovation projects in which heads are only to be relocated, a plan that shows the relocation of devices can be submitted for review in lieu of the above requirements. Section 903.1, International Fire Code (A)Note: Sprinkler heads in the operating rooms are required to be the clean room concealed type to meet the monolithic ceiling finish requirements of the 2006 FGI. Page 8 of 15 Plan Review Comments for Project # 60237493 Kruger Orthopaedics NFPA 101, 2000 Version ASC Relocation of ASC Approved 11/5/11— Based on cut sheets provided that meet the above requirement. (B)Provide fire sprinkler protection in the stairwells to meet the minimum of one at the top of the stair shaft and under the first landing above the bottom of shaft per NFPA 13 5-13.3 (reference sheet 4 of 4 of Patriots drawing) Approved 11/5/11— Based on cut sheets provided and response that the heads will be provided. Contact the Certificate of need program with the Department of Health at (360) 236-2955 to process the change of location for your Licensed Ambulatory surgery facility. Response: Judy Wood has contacted DOH staffper SP recommendation. It was suggested to re -contact and begin in 2 months. 4 ❑x Provide in the functional program per 2006 FGI 1.2-2.1 the following: (a)What types of procedure will be performed at the new site. (b)Where are medications stored and secured. This would also include securing of refrigerated medications. (c)Is the ice machine conveniently located for emergency use for patient in hypothermia? (d)How/ where are laundry services provided? Approved 1/30/11— based on comment response and updated functional program. El How will continued access be provided to the emergency power generator for fuel re -supply with no direct access from on -the -property is provided? WAC 246-330-510 (reference sheet A-101) Approved 1/30/11— based on response that a fuel fill line will be added where the fuel truck can fill the generator tank from the front of the building. 6 0 Provide steel bollard protection from vehicle damage to the generator and fuel tank from the neighboring parking lots per International Fire Code 3404.4.6 Locate these bollards no less than four feet on center per IFC Section 312. Approved 1/30/11— based on drawings that show the bollards installed. 7 IHI Provide an exterior door or access next to the storage room on the east wall of the first floor to provide easy access to the generator for maintenance and testing purposes per NFPA 110 Chapter 6. (reference sheet A -I I I grid line H2/3) Page 9 of 15 Plan Review Comments for Project # 60237493 Kruger Orthopaedics NFPA 101, 2000 Version ASC Relocation of ASC Approved 1/30/11— based on a new door out of the storage room that accesses the generator. 8 0 Provide a detail for the concrete service pad and seismic restraint for the emergency power generator and how clear service access will be provided per the manufacturer around the unit. WAC 246-330-505 (reference sheet C2) Approved 1/30/11— based on drawings section that shows the concrete pad and seismic notes for anchoring. 9 0 Note: On fire rated doors that are designated to have door protection, the maximum height of an non -listed applied panel is 16 inches above the bottom of door per NFPA 80 2-4.5 unless the door comes as an approved assembly with the door protection. Revise specifications per the above. (reference note # 7 on sheet A9.1) Approved 1115111— Based on comment response and modification of the door schedule to meet the above requirement on fire rated doors. 10 ❑x Provide door closers on the following doors to maintain the required pressure relationships per Table 2.1-2 of the 2006 FGI: A307A, A313A, A313A, A315A, A302A, A325A, A324A and A324A (reference sheet A2.1,A9.1 &A9.1B) Approved 1/30/11— based on sheets A9.1B that added the door closers. 11 0 Provide verification that the .5 gauss line for the MRI is contained away from public areas per 2006 FGI 2.1-5.5.5.8 (2) in the Lobby/Latte area. (reference sheet A2.4) Approved 1115111— Based on sheet A2.6 dated 11/30/11 that shows the .5 gauss lined contained. 12 0 Provide a structural engineered sign off on the support systems for the surgical lighting system per WAC 246-330-505 (reference sheet A6.3 section # 11) Approved 11/5/11— Based on sheet S8.02 that provides an engineered support system. 13 0 Provide details showing how the vertical and horizontal joints in the hygienic wall covering wainscot in the operating rooms will be joined to form a monolithic finish per 2006 FGI 3.7-5.2.2.4 (3) (reference sheet A9.2 and A6.1) Page 10 of 15 Plan Review Comments for Project # 60237493 Kruger Orthopaedics NFPA 101, 2000 Version ASC Relocation of ASC Not Approved 1/30/11— The vertical weld joint is acceptable, but the "J" mold top start edge trim is not acceptable, as it does not form a good seal against the wall protection. A solid surface trim piece or just a caulked top of wall protection to the wall is acceptable. Provide alternate top trim detail. 14 0 Provide a stamped and signed plumbing drawing by the engineer of record per WAC 246-330-505 Approved 1/30/11— based on signed plumbing drawings received. Life Safety: 15 ❑x Provide a 45 minute rated fire door to the medical gas storage room that is one hour rated per NFPA 101 Chapter 8.2.3.2.3.1 (2) (reference sheet A-119 and A-111) Approved 1/30/11— based on comment response that added the door rating. 16 0 Provide a two hour fire barrier with a 90 minute rated fire door around the elevator equipment room per the International Building Code Section 3006.4 (reference sheet A-111) Approved 1/30/11— based on drawing that shows the 2 hour rating. 17 ❑x Provide a one hour fire barrier around the Electrical service room on the first floor and a second exit meeting NFPA 70 f Article 110.26 (C) (2) for rooms with over 1200 amps of service and equipment over 6 feet wide. Approved 1/30/11— based on the one hour rating being provided and no second door being required as they are providing twice the work area per the exception. 18 0 Provide an updated life safety plan for the 3rd floor showing the two required exits per NFPA 101 Chapter 20 separate from the atrium exit that has been separated by a one hour smoke barrier. WAC 246-330-505 Approved 11/5/11— Based on comment response that made the two exit stair enclosures # 2 and #3 the two required exits for the ASF. 19 El Change the swing of door # A331B to swing in the path of travel to access the second NFPA exit stair # 3 per NFPA 101 Chapter 7.2.1.4.2 Approved 11/5/11— Based on comment response and sheet A2.1 that changed the door swing in the path of egress. Page 11 of 15 Plan Review Comments for Project # 60237493 Kruger Orthopaedics NFPA 101, 2000 Version ASC Relocation of ASC 20 0 Verify or provide the rating of the 31d floor door and wall assembly that door # 300A is part of to form a smoke barrier to provide the communicating space separation per NFPA 101 Chapter 8.2.5.5 Approved 1115111— Based on comment response that these doors are in a one hour rated fire/smoke barrier wall. 21 ❑x Boiler room/mechanical room on roof that has direct access into stair well # 3, which cannot have direct access to that stairwell per NFPA 101 Chapter 7.1.3.2.1 (d) and the International building code Section 1022.3 Approved 1/30/11— based on the door being eliminated from the stair well. Mechanical: 22 ❑x Modify the following pressure relationships per Table 2.1-2 of the 2006 FGI: (A)Room A324 sub sterile is required to be positive. Approved 1/30/11— based on this room being adjusted to a positive pressure relationship, but less positive than the operating rooms. 23 ❑x How is smoke venting provided for anesthetizing locations per NFPA 99 Chapter 5-4.1.2 Approved 1/30/11— based on comment response of sequencing. 24 El How is humidity addressed for the operating rooms? WAC 246-330-505 Not Approved 1/30/11— DOH will not require built in humidity, but CRS does need to know what the policy and procedure is, if the humidity is out of the acceptable standard ranges and how the facility would know if there were out of range. 25 ❑x How are pressure relationship maintained during off hours and weekends? WAC 246-320-505 Approved 1/30/11— based on the AHU's running 24/7 per comment response. 26 ❑x Provide the locations and rating for the pre and final filters for the ambulatory surgery facility meeting Table 3.1-1 of the 2006 FGI. (Found the Hepa filters in the supply diffusers of the operating rooms, but could not find the filtering for the rest of the unit. Approved 1/30/11— based on sheet M0.02 and notes #1213 on heat recovery schedule. Page 12 of 15 Plan Review Comments for Project # 60237493 Kruger Orthopaedics NFPA 101, 2000 Version ASC Relocation of ASC Electrical: 27 0 Provide a shared medical gas alarm for the operating rooms located in the same corridor per NFPA 99 Chapter 4-3.1.2.2 (c) (reference elevations on sheet A7.2) The recovery area is required to have one of its own. Approved 1130111— based on sheet E2.313 that added the area alarm panel. 28 El Provide sprinkler freeze protection in stair wells # 2 & #3 per NFPA 13 5-14.3.3 (reference sheet M2.01) Approved 1/30/11— based on a dry sprinkler head being used in the stairwells. 29 El Provide a physical separation between the normal power distribution and the emergency distribution transfer switches on the first floor electrical room to prevent essential power interruption by a failure in the normal distribution per NFPA 70 Article 517.35 (C) (note this could be a hard wall partition of the room into two areas) Approved 1/30/11— based on wing walls being provided to form a separation. 30 ❑x Recommend that the ice machine in room # A304 be placed on the critical branch of emergency power as it will supply the ice for patients in hypothermic shock and without power the ice would not be dispensed from the machine. Approved 1/30/11— based on both the freezer and ice machine being provided with critical emergency power. 31 El Atrium door hold open circuits NL1-3 need to drop out on fire alarm as this is a rated fire barrier. Are these hold open devices on a relay with the fire alarm? WAC 246-330-505 (reference sheet E2.3A) Approved 1/30/11— based on comment response that the hold opens are controlled by the fire alarm control panel that drops them upon building alarm. 32 0 Provide two sources of outlet power in operating rooms # A320, # A319 and # A318 per NFPA 70 article 517.19(A) that requires both normal and emergency power. (reference sheet E2.3B) Approved 1/30/11— based on sheet E2.313 that added the normal power sources in addition to the critical power. 33 El Provide manual pull stations at the entrance to star well # 2 & #3 and at the exit/entrance to the ASF per 1999 NFPA 72 2-8.2.2 and 2006 FGI 3.7-6.4.1 (reference sheet FA1.3) Page 13 of 15 Plan Review Comments for Project # 60237493 Kruger Orthopaedics NFPA 101, 2000 Version ASC Relocation of ASC Approved 1/30/11— based on comment response and red lined FA drawing. 34 0 Provide a ground wire that is the same size of the conductor in anesthetizing locations per NFPA 99 Chapter 3-3.2.1.2 (5)(b) Approved 1/30/11— based on sheet E2.313 typical that shows the ground wire size. 35 El What is the run time on the emergency power generator at full load with the fuel supply allowance provided? WAC 246-330-505 Approved 1/30/11— based on comment response that a 12 hour run time will be provided. Plumbing: 36 El The faucet for the following hand washing stations must be a gooseneck with either wrist blades or single lever controls per 2006 FGI 1.6-2.1.3.1: ➢Faucet for sink # P2A convert to gooseneck device Approved 1/30/11— based on cut sheet received and comment response that the faucet type above will be provided. 37 E Provide a bed pan spray wand on any two of the recovery room patient toilets to facilitate disposal of fluid waste in the recover area per 2006 FGI 3.7-2.5.6 (2) Approved 1/30/11— based on sheet P05 and comment response that added the bed pan washers to two patient restrooms. 38 ❑x Provide reduced pressure back flow devices to each sterilizer, the instrument washer and for the Neptune docking bay hot and cold water connections per 2006 FGI 3.1-7.1.2.3 (3)(a) (reference sheet P05) Not Approved 1/30/11— Provide cut sheets on the Neptune docking station that verifies that it has no water connections. Typical ones submitted all had water connections in order to flush out the Neptune mobile unit. 39 0 Provide a service isolation valve on the oxygen, Vacuum, nitrous oxide medical gas lines on the horizontal branch lines as they come off of the vertical riser on the third floor per NFPA 99 Chapter 4-3.1.2.3 (e) (reference sheet P05) Recommend that the compressed air branch line also receive a service isolation valve. Approved 1/30/11— based on comment response and sheet P05 that added the isolation valves. Page 14 of 15 Plan Review Comments for Project # 60237493 Kruger Orthopaedics NFPA 101, 2000 Version ASC Relocation of ASC 40 ❑x The zone valve for the medical gas outlets in the recovery area cannot be located in the same environment as the outlets per NFPA 99 Chapter 4-3.1.2.3 (d). But there is no other location to locate it behind a door/wall where it is accessible in the egress route. Recommend that the location for the zone valve remain, but that a cross corridor door be added west of the ante room to form a separate environment. Not Approved 1/30/11— The zone valve needs to be environmentally separated from the outlets, so that a fire fighter or staff do not have to go into the area of fire involvement by an oxygen fed fire to shut the gas off. Provide alternate location. 41 ❑x Note: The third required vacuum outlet is credited to the use of the Neptune units in each of the operating rooms. 42 ❑x Provide a detail showing the air gap to the drain for the ice machine drain hose of a minimum 1" per International plumbing code Chapter 801.2 Approved 1/30/11— based on sheet P06 that shows the air gap. 43 0 Provide a one line drawing off all the medical gas manifold systems showing source valves, check valves, relief valve, and redundancy switch over device, gauges, master alarm switch etc meet NFPA 99 Chapter 4-3 and figure 4-3.1.1.6 of the 1999 version. Not Approved 1/30/11— Provide the source valve location, check valves from tanks and relief valve piping routing from them. 44 ❑x Specifications on sheet P10 part 4.14 A speaks to using dental surgical vacuum. This system is not a level 3 dental system and must meet all the requirements of a level 1 medical gas system per NFPA 99 Chapter 4-3. Approved 1/30/11— based on sheet P10 update showing a level 1 system. Compliance with the comments above provided by the Department of Health, Construction Review Services, are necessary for this facility to meet the requirements of the applicable licensing regulations found in the Washington State Administrative Code and associated references. These comments do not relieve the facility from the responsibility to meet the requirements of any other applicable federal, state or local regulations. In the event of conflicts between other jurisdictions and these written comments, the most stringent shall apply. Page 15 of 15 Plan Review Comments for Project # 60237493