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BLD2022-0393 DOH CORRECTION NOTICEProject Comment Form June 29, 2022 Project Information: CRS# 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility Project Title: New ASC Project 21911 76th Ave W Location: Edmonds, WA 98026 Local Permit #: Washington State Deprtment of (Ia *Heal th Construction Review Services PO Box 47852 111 Israel Rd. SE. Tumwater, WA. 98501 www.doh.wa. og v/crs tel. 360-236-2944 fax.360-236-2321 Electronic Submittal. Plans will be delivered to: Name: Kent Gregory Email: kgregory@tgbarchitects.com Phone #: 425-599-4469 Key Contacts: Company Name Phone Email DOH Reviewer Matthew Canpbell 360-236-2954 matthew.campbell@doh.wa.gov Facility Contact: TGB Architects Kent Gregory 425-599-4469 kgregory@tgbarchitects.com Facility Admin.: Transform Weight Loss Josiah Billing 425-305-5182 jbilling@transformweightloss.com Arch./Eng.: TGB Architects Kent Gregory 425-599-4469 kgregory@tgbarchitects.com Other: Other: Other: Other: Local AHJ: City of Edmonds Leif Bjorback 425-771-0220 leif.bjorback@edmondswa.gov Addt'l Copies To: ® L&I Electrical Section ❑ L&I Factory Assembled Structures ❑ Local Electrical AHJ Project Status: -Authorized to Begin Construction - Comments are NOT APPROVED The Construction Documents have been reviewed and found acceptable. All plan review comments have not been approved. Construction can begin, subject to construction permitting from the local building official. See page two for important next steps. A2BC Preliminary Initial Issued All Licensing Approved Conference Plan Review Construction Comments Closeout Inspection to Use Completed Completed Begins Approved Completed Required Space Yes Yes Yes No No Yes ; No Page 1 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility To avoid delays it is important you follow these Next Steps: Respond to Comments: • Revise project documents to be compliant with applicable rules and the review comments attached to this form. • Respond, in writing, to the comments attached to this form. • Submit revised plans and responses to comments to the Construction Review Services. During Construction • Maintain a copy of the A2BC drawing set on the project site. • Submit any changes to the A2BC set to CRS for review and approval prior to executing the work. If you have any questions, please contact Construction Review Services (360) 236-2944. You can monitor project status and history at www.doh.wa.gov/crs. Page 2 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility Project Details (for internal use only) Occupancy Type Construction Type Fed Code: IBC: B IBC: IBC: IBC: 2-13 IBC: IBC: Building Code: 2018 IBC NFPA 101: NFPA 101: NFPA 101: Licensing Code: FGI 2006 Number of Beds Added: n/a Removed: n/a CON Required? ❑ Yes ® No CON Approved ❑ Yes ❑ No Req'd Provided Type/category Are Hospital inpatients seen at this location? ❑ Yes ® No Automatic Fire Sprinkler System: No Yes 13 Are planned residents/patients incapable of self preservation? ® Yes ❑ No Automatic Fire Alarm System: Yes Yes If yes, how many? <4 Emergency Power System: Yes Yes Type 1 EES Is sedation provided? ® Yes ❑ No If yes, max. planned level? Medical Gas System: Yes Yes Category 1 General Anesthesia Smoke Compartmentation: No No Is space Medicare certified? ❑ Yes ® No Building Department contacted? No Estimated construction completion: New ASF not seeking reivew for CMS certification (licensed and certified ambulatory surgery facility (2007-2017) W license permitted to lapse) Services provided: Upper Endoscopies as part of the pre -surgical screening as well as post- O surgical if indicated, Laparoscopic Gastric Sleeve procedures and hiatal hernia repair. Z Certificate of Need not required: DOR #22-10 WElectrical distribution reviewed under L&I EPR# 2-55847. Required alterations include: adding load bank and temp portable gen set connections, creating an equipmem branch of the EES, recircuiting of 8 receptacles in the OR to provide a minimum of 12 receptacles served by the normal power branch of the EES, recircuiting of lights in the OR to the critical branch of the EES, conducting a coordination study, . For Assisted Living Facilities Only Total Sleeping rooms Minimum required area of day rooms/areas Total Approved beds A Total area provided in day rooms/areas Total Contract beds W C4 O O F w F O z Page 3 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility Preliminary Comments: Q 0 U Preliminary Conference-7/2/21 Steve Lickar Josiah Billing Kent Gregory Matthew Campbell Transform Weight loss - Transform Weight loss - TGBA - Department of Health T1 Contact General John Hilger, john.hilgergdoh.wa.gov or (360-236-2929). • With general questions regarding ambulatory surgeries licensed under Chapter 246-330 WAC, and, • Specifically, regarding the process for re -licensing / restoring the license for this facility. T2 There are four supporting programs within the Department of Health which support state licensed ambulatory surgery facilities. These are: • Certificate of Need o Contact FSLCONkdoh.wa.gov (360) 236-2955 • Facility Licensing o Contact Crissa Hanson Crissa.HansonADOH.WA.GOV at (360) 236-4985 • Construction Review o Application information: CRS(kdoh.wa.goy and (360) 236-2944 o Plan review: Matthew Campbell matthew.campbellkdoh.wa.gov at (360) 236-2954 • Facility Licensing Survey o Contact Rosie Tillotson: rosie.tillotson(c-r�,doh.wa.gov and (360) 236-4681 T3 Basis of review: building construction, life safety, and means of egress. • Alterations must meet the applicable provisions of the International Existing Building Code (IEBC) and referenced codes and standards as adopted and amended by the state building code council and the City of Edmonds. o State amendments to the IBC and IEBC Chapter 51-50 WAC: o Scope of work to be determined T4 Basis of review: building systems supporting surgical services: Page 4 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility The existing medical gas and vacuum, electrical, and mechanical HVAC systems are vested in the original review and approval for the stated services and methods (types of surgieries and types and levels of anesthetization). These systems must be reviewed to the current design and construction requirements appropriate to any the planned services, procedures, delivery of care and/or anesthetization methods and any altered, renovated, or modernized portions of these systems must meet the applicalbe provisions of the respective codes and standards: 0 2018 Uniform PlumbingCode ode (iapmo.org) with reference to NFPA 99: 2015 as adopted and amended under Chapter 51-56 WAC: o The NEC (NFPA 70) with reference to NFPA 99: 2018 as adoped and amended by WA State L&I Electrical Laws, Rules & Policies (wa.gov) and o The 2018 International Mechanical Code (IMC) with reference to the 2017 Edition of ASHRAE 170 for the ventilation of ambulatory surgery faclities. Recommend third party inspection / certification of the medical gas and vacuum systems to identify any elements not in strict compliance with 2015 NFPA 99 to identify any conditions of the design, installation, or maintenance which may present a distinct hazard to life. Recommend similar inspection of the essential electrical system to the requirements of the 2020 NEC by a consulting engineer. 2018 NFPA 99: 6.1.3 identifies electrical system requirements for new and existing health care facilities. T5 Basis of review: design and operational licensing requirements: • All facilties must meet the minimum health and safety requirements for the licensing, operation, maintenance, and construction of WAC 246-330 (Chapter 246-330 WAC:) including, • Alterations, including changes to the physical environment, additions, functional change, or modification to the facility must meet the provisions of the 2006 Guidelines for the Design and Construction of Hospital and Outpatient Facilities (FGI) Facility Guidelines logo v2 (fg_iguidelineLgrgrj, T6 Include a life safety plan in any documents provided for review. Ensure the facility's fire safety plan is current and maintained on site. IFC Chapter 43.3 T7 Recommend review FGI Section 1.2 Environment of Care regarding requirements for the functional program. Ensure patient, staff and material circulation patterns support operational infection prevention and design supports this effort by clearly identifying semi -restricted and restricted areas. T8 Operating rooms in which general anesthesia is administered and post -anesthesia recovery areas are designated as Category 1 areas and require: o A Category 1 piped medical gas and vacuum system ■ Generally including provision for waste anesthesia gas disposal, and o A Type 1 essential electrical system, ■ Powered by a Type 10, Class X, Level 1 classified generator meeting the requirements of NFPA 99: 6.4, NFPA 110, NFPA 70 o A mechanical ventilation which maintains room ventilation and pressurization upon loss of electrical power. ■ Reference ASHRAE 170: 6.1 and 8.4.1, and FGI 3.1-7.2.3 Page 5 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility ■ Requirement for OR's only T9 Recommend creating a dedicated patient changing area. FGI 3.7-2.7 T10 Review general requirements of FGI: • Chapter 1.6 Common (building) Requirements • Chapter 3.7 Outpatient Surgical Facilities o Sections 1 through 5 of Chapter 3.1: Common requirements for (all) Outpatient Facilities Recommend line by line review of Chapter 3.7 to identify elements and adjacencies specific to outpatient surgical facilities then line by line review of common requirements for all outpatient facilities. Tl l Note retroactive provisions of the International Fire Code, Uniform Plumbing Code, National Electrical Code and NFPA 99 for medical gas supply and distribution, electrical wiring and protection for patient care areas, and essential electrical systems. Preliminary comments based on material received 2/3/22 and 2/28/22 and conference 2/28/22: Robert Cronk, Leo Maya, Nicole Olaes, Kent Gregory, Matthew Campbell T12 Status: Certificate of Need (CN): Application to, and evaluation by, the DOH Certificate of Need (CN) program under DOR22-10 identifies the services to be provided at this location to include bariatric, endoscopic, and laparoscopic surgeries and procedures. The functional program identifies endoscopic, laparoscopic, and the full scope of aesthetic cosmetic plastic surgery procedures. Revise application to CN or functional program for consistency. Revisions to the functional program / scope of services expected. T13 Revise the functional program to identify the procedures and level(s) of sedation planned for Minor Procedure room / Endoscopy procedure room 110 and revise architectural design as appropriate to the intended use. The room shown does not meet the requirements for a Class A procedure room or an endoscopy procedure room or provide additional space to accommodate conscious sedation. FGI 3.7- 2.3.1.1 and FGI 3.9-2.3.1.1 Revisions to the functional program /scope of services expected. Surgical services provided in the OR only. Evaluate Room I10 for PACUfunction. T14 Provide an overall licensing narrative and architectural plan to show how the facility design and operations address the requirements of FGI 3.1, 3.7, 3.8, and 3.9, as applicable to the services offered. These include, but are not limited to: Examination room(s) or equivalent areas for thorough patient pre -procedure examination Recovery areas: o Requirements determined by the level of sedation Support areas for surgical services, including o Nurse / control station in observation of the operatory o Scrub facilities o Drug distribution facilities with a refrigerator and handwash sink Page 6 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility o Soiled workroom with a clinical sink or equivalent flushing -type fixture, a work counter, a handwashing station, and waste receptacle(s), appropriate to the facility program o Sterilization facilities ■ Including a soiled workroom (may be same as above) and a physically separate clean/assembly workroom with a handwashing station and equipment for terminal sterilization of instruments o Fluid waste disposal facilities o Storage for clean and sterile supplies o Soiled holding for items processed off -site o Equipment supply and storage o Housekeeping room • Support areas for surgical staff o Staff clothing changing areas o Staff shower • Support areas for patients o Changing areas, including lockers, toilet facilities, and clothing changing areas, space for administration of medication, and provisions for securing patients' belongings • General support areas for outpatient facilities, including o A general housekeeping room o Equipment rooms for building system components o Waste collection facilities • And administrative and public areas including: o Reception o Waiting room and supporting toilet facilities o Access to a public telephone o Provisions for drinking water o Wheelchair storage o Interview areas o Individual office(s) o Provisions for medical records and clerical supplies These elements are drawn generally from Sections 3.7 and 3.8 for surgical facilities and the broader requirements of Section 3.1 which apply to all outpatient facilities. Section 3.1-5 provides design and construction standards for outpatient facilities in addition to the those of the building code. T15 Provide information to demonstrate the mechanical HVAC system meets the general requirements of FGI 3.1-7.2 and ASHRAE 170 Parts 6 and 7. T16 Revise design and/or relocate the med gas zone valve box serving the open pre / post -operative recovery bays such that a wall intervenes between the valve and outlets/inlets it controls and the valve is not located in the room with the station outlets/inlets that is controls. UPC 1311.6 T17 Provide engineered evaluation of existing conditions, and construction documents for proposed alterations to the mechanical HVAC and electrical systems towards the design of a single FGI Class C / Category 1 operatory. T 18 Provide information to demonstrate circuiting, identification, number of receptacles, and grounding of the electrical system for the Category 1 operating room and post -anesthesia recovery areas meet the Page 7 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility requirements of NEC 517.19, 517.31 and 517.63. Specify (re)testing and acceptance of the essential electrical system to the requirements of NEC 700 and NFPA 110 MMIM Comments made during this preliminary conference, both oral and written, represent guidance provided by the Department of Health, Construction Review Services, for your facility to meet the applicable licensing requirements for this project. These comments are provided as information and for use in preparing the construction documents. They may be revised and/or additional preliminary comments may be made during subsequent submissions. These preliminary comments should not be considered as an exemption or alternate from the requirements of any federal, state or local authority who may have jurisdiction and they do not guarantee compliance or approval by these authorities. In the event of conflicts between other jurisdictions and these comments, please contact this office immediately. Supplemental Notes based on review of select original construction documents: 02003 Edition IRC wIWAC Amendments 012003 Edition IBC WFWAC An"d n"" 102003 nkwrAI Am 02003 Ed U- IMC w(WAC AmeArnnddrent (02003 Edition ffGC SAC Amendments ®2003Edttton ,,�nmsr11-13 2003 UPC IAPMO UPC (2003): Uniform Plumbing Code: International Association of Plumbing and Mechanical Officials : Free Download, Borrow, and Streaming : Internet Archive with reference to standard 2002 NFPA 99 and 2002 NFPA 99C Page 8 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility Plan Review Comments: Q b o � z 1 xp l Provide as -built installation drawings, as available, and the most recent copy of the inspection and testing record for the building fire alarm system. NFPA 72: 14.6 Find attached Fire Alarm As-builts & 2019 Annual Guardian Fire alarm & sprinkler report. 2 xi Provide the most recent documentation of inspection and testing of the building fire sprinkler system to the requirements of NFPA 25. NFPA 13: 27 Find attached sprinkler deficiency report dated 12/10/21 (Mastgech LLC WSPRK 12.10.2021) Find attached Correction quote dated (3/16/22) (Mastgech LLC SPK Deficiency Quote 03.16.2022) 3 x❑ Provide a copy of the written plan for the protection of all persons in the event of fire, for their evacuation to areas of refuge, and for their evacuation from the building when necessary. IFC 401, 403.3.1 through 403.3 and 404 through 406, and WAC 246-330-230(2)(d) and (3) Find attached Fire Evacuation Policy dated 6/11/22 4 x❑ Provide/confirm illumination of the means of egress during loss of normal power to the two required exits from the building. (lighting within Lobby not shown) IBC 1008.3 / IFC 1104.5 See sheet E3.1 indicting photometrics of exist path. Exit signs are indicated. Exist lighting is owered by battery packs. 5 x❑ Provide/confirm exit signage from the proposed ambulatory surgery facility to the two required exits from the building. IBC 1013 / IFC 1104.1 See Sheet T2.14B indicating exit signage and travel path for (2) exit pathways. (TWL Architectural Drawing 042022 rev 071422) _ 6 x❑ Provide a site plan/revise T1.10 to show the path from the ASF exit discharge to the staging location of emergency transportation. IBC 1028, FGI 1.3-2.1, and WAC 246-330-230 See sheet A1.00 Site Plan 7 x❑ Provide/confirm the facility has a written and signed transfer agreement with one or more local hospitals that has been approved by the facility's medical staff. WAC 246-330-225(1)(b) Transfer Agreement with Evergreen Medical Center pending. Both Surgeons presently admitting privileges at Evergreen Medical Center. x❑ Provide, and identify on plan(s), at least one exam room, ensuring both visual and acoustical privacy, for examination and testing of patients prior to surgery. This room must have a handwash-station and may be used for patient changing, treatment, consultation, interviews, and similar functions. FGI 3.7-2.2, 3.1-2.1.1, and 3.1-2.1.3 See Sheet T2.14B, Minor Procedure S130 used for exam and testing. (TWL Architectural Drawing 042022 rev 071422) 9 x❑ Provide, and identify on plan(s), drug distribution station equipped with a work counter, sink, refrigerator, and locked storage for biologicals and drugs. FGI 3.1-2.1.7.2 See Sheet T2.14B drug distribution station at North end of Nurse Station S138 with required refrigerator S03, Locked Storage S10, and work counter. Sink S-1 located at south side of Nurse station. TWL Architectural Drawing 042022 rev 071422) 10 p Provide, and identify on plan(s), wheelchair storage 3.1-2.1.7.6 See Sheet T2.14B, Waiting S 100 for Wheelchair storage. (TWL Architectural Drawing 042022 rev 071422) Page 9 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility 11 g Provide/confirm door hardware selection for Patient Toilet Rooms S 140 and S 141 will permit staff emergency access. FGI 3.7-5.2.1.4 Doors at Patient Toilets S 141 & S 146 have exterior key access to privacy lock. See attached Patient Toilet Door photo. 12 p Provide access to public telephone(s) and provisions for drinking water in the waiting area of the proposed facility. FGI 3.1-4.1.3 See Sheet T1.10 and Public Drinking Fountain Photo for access to drinking water. Public Phones have not been provided in Public Building in this century 13 p Provide drawings to demonstrate the OR has at least 2 oxygen and 3 vacuum station outlets. FGI 3.7-6.1, 3.1-7.1, and Table 3.1-2 See Plumbing Sheet P2.2 indicating location of required outlets. 14 p Provide design/construction drawings, prepared by the engineer of record, or equivalent information, such as drawings and certification report (certified to 2005 NFPA 99 or a more restrictive later code), for the medical gas and vacuum systems to demonstrate these systems meet the requirements for 2005 NFPA 99 Category 1 systems supporting surgical procedures under general anesthesia and post anesthesia recovery / critical care areas. 2005 NFPA 99 Chapter 5 (FGI 3.1-7.1.4.1) New work and alterations, such as relocation of med gas zone valve box to provide a wall intervening between the valve and station outlets served shown sheet P2.1, must meet current 2018 UPC Chapter 13 (with reference to 2015 NFPA 99) as indicated sheet P1.1. Material provided for review does not include information about the `infrastructure of the medical gas and vacuum system to permit complete review of the Category 1 system with WAGD provided by the medical surgical vacuum. System elements include: • Source • Central supply location, quantity, and construction (NFPA 99: 5 and 11) o Plans indicate vacuum pump in the manifold room ■ Co -location not permitted 2005 NFPA 99: 5.1.3.3.1 • Permitted locations o As -built approved documents show medical surgical vacuum serving the Decontamination instrument processing room. Not permitted 99: 5.1.3.5.2 • Source regulators and relief valves • Local signals • Headers • Manifolds • Medical surgical vacuum systems o Source o Location o Equipment o Distribution ■ As -built drawings appears to serve non -patient care instrument processing room. This is not permitted in the 1999 NFPA 99 or the 2012 NFPA 99; cannot locate language in the 2005 Edition. o Valves ■ As -built drawings indicate the vacuum system is supplied through zone valves as required 2005 NFPA 99: 5.1.4 o Alarms Page 10 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility o Power o Exhaust • WAGD • Alarms o Double check mix of nurse call and med gas alarms 2016 CMS survey indicated that this information was not provided / maintained 5/12/22 Conference: Design team plans to engage third party certifier to evaluate and identify elements not compliant to 2005 NFPA 99 or more restrictive edition of the code. See attached report from third party certification firm showing specific defects and see Plumbing Sheets P2.0, P2.1, and P2.2 for resolution to all defects cited. Please note that while N2O defects are cited, there will not be an N2O manifold being installed and the N2O lines will be capped for future. 15 © Provide the City of Edmonds permit number for proposed alterations to the medical gas and vacuum system. WAC 246-320-510 and UPC 104.3.1 City of Edmonds Permit Number 2022-0392. Note: the City of Edmonds will not allow work on medical gas and vacuum system until proposed alternation are specifically approved by DOH. 16 x❑ Revise panel schedule E1.3 to remove OR, Crash Cart, and Server Room receptacles from the Life Safety branch of the essential electrical system. See E1.3 clouded revisions 17 p Provide design/construction drawings, prepared by the engineer of record, or equivalent information to demonstrate the essential electrical system is served by a Type 1 generator set: • Which can restore power in 10 seconds or less (Type 10) • With adequate on -site fuel supply as required by the services provided consistent with facility emergency plans (Class X), with • Level 1 safety indicators and shutdown features (reference NFPA 110 Table 5.6.5.2) • And a battery powered, remote alarm annunciator located to be readily observed by personnel at a regular workstation with visible signals and audible alarms as required by 1999 NFPA 99: 3-41.1.15 (as referenced 2002 NFPA 70 / NEC) Engineering narrative states the specified/installed gen set meets NFPA 110 for a Type 10, Class X (18.9-hour run-time) with remote annunciator. Provide documentation of start up, and function testing to document performance to the standard endorsed by the engineer of record. Response to this item is deferred. Start up and testing of this existing Cummins Gen Set is waiting for a replacement part. No ETA has been defined. Once installed the systems will the load tested, followed by a performance report. 18 p Revise drawings to document or revise design to provide a mechanical HVAC system serving the OR and PACU with: • Individual temperature control (only in the OR), • An air conditions system capable of maintaining temperatures between 68-73°F and humidity between 30-60%, • Ventilation providing at least 3 outside and 15 total air changes per hour (only OR), • Supply air with a MERV 8 first filter upstream of conditioning equipment, and Page 11 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility • MERV 14 final filtration downstream of any fans or blowers with gaskets and seals to provide a positive seal against air leakage, and with a manometer installed to permit access for field testing. o Identify location of final filter FGI 3.1-7.2.3.1, Table 2.1-2, and 3.1-7.2.6 See Mechanical Sheets M2.1 and M2.2 for identification of all requirements. 19 xp Provide a plan of the area submitted for review for licensure showing the mechanical HVAC supply, return, and exhaust elements for areas listed in FGI Table 2.1-2, and a table presenting the room name, the supply, return, and/or exhaust CFM air total and outdoor air changes, pressure relationship to adjacent spaces, and design temperature and humidity, for these spaces to permit review to the requirement of FGI Table 2.1-2. FGI 3.7-6.2.1 and 3.1-7.2.2.2 See Sheet M-1.1 for addition of the Air Balance Schedule, showing all pressure balance relationships 20 p Revise equipment plan to identify local exhaust for steam/moisture producing equipment in instrument processing (or other) areas or show equipment on the mechanical ventilation plan. (Autoclave and Steris System in Substerile S 145, Washer / Disinfector in Decontam S 142 Endo Processor in Soiled S129) FGI 3.7-6.2.1 and 3.1-7.2.2.2(4) Autoclave has no steam emitting capability, and as such no vent is provided. The Washer/Disinfector currently has a 4" vent in place as noted on plans (see M2.2) 21 p Clarify whether there is a plenum return element in Substerile S 145. Identify all areas with plenum return elements within the proposed ASC. All return air ventilation in patient care areas must be ducted. FGI 3.1-7.2.5 All plenum return elements in patient and back of house areas have been converted to ducted return. See mechanical floor plan sheet M2.2 for layout. 22 p Revise HVAC design such that fresh air intakes serving the proposed ASC are located at least 25' from exhaust outlets of ventilating systems, combustion equipment stacks, medical - surgical vacuum systems, plumbing vents. FGI 3.7-6.2.1 and 3.1-7.2.5.4(1) See new mechanical sheet M2.3 for roof plan showing fresh air intake extension to meet 25' requirement 23 p Provide/confirm copper tubing for supply connections to the ice machine. FGI 1.6-2.1.3.4 Plans call out for copper tubing to be used for ice machine supply. See note on P2.2. 24 p Provide information to demonstrate or otherwise confirm equipment shown T2.14B: Autoclave and Steris System in Substerile S 145, Washer / Disinfector in Decontam S 142, Endo Processor in Soiled S 129, Icemaker in Clean Supply S 137, and any other equipment with direction connection to the building water supply or fixtures with threaded outlets, have backflow prevention devices or internal air gaps and indirect drains consistent with UPC Chapter 6 and 8 and FGI 3.1-7.1.2.2(3) See plumbing floor plan sheet P2.2 for addition of vacuum breakers where needed, and adjustments to indirect waste as required to meet code. See Clean Supply, Decontamination, and Substerile for notes 25 p Confirm/provide general handwashing stations used by clinical staff have hands -free faucet fixtures with single -lever or wrist blade handles of at least 4". FGI 1.6-2.1.3.2 All handwashing stations meet code with proper 4" wrist blades. Page 12 of 13 Plan Review Comments for Project 61189204 76th Professional Commons Chapter 246-330 WAC Ambulatory Surgery Facility 26 x❑ Provide/confirm the scrub sink is trimmed with foot, knee, or ultrasonic controls. FGI 3.1-7.1.3.2 Existing scrub sink is equipped with foot controls. 27 p Provide signed stamps on construction documents typically. WAC 246-320-505 All attached correction drawings are stamped and signed. 28 p Provide third party med gas verification report for the medical gas and vacuum system. 1999 NFPA 99: 4-3.4.1.3 and UPC 1318.0 See attached 2022 Annual Medical Gas Inspection — Transform Weight Loss Edmonds. mein 30 31 x❑ Provide a final HVAC testing and balance report which includes reference drawings used by the evaluator to demonstrate system performance and pressure differentials consistent with the engineered design and applicable requirements. FGI 1.5-4, ASHRAE 170: 8, and IMC 304. See attached 2022 Annual Medical Gas Inspection report. Project close out: A (virtual) final inspection will be required at substantial completion. Contact plan reviewer to discuss survey / inspection during construction to reduce the opportunity for issues at final construction inspection and licensing survey. WAC 246-320-505 Drawings M1.1, MD2.1, M2.1, M3.1, P1.1, and P2.1 revision date 5/16/22 received 5/16/22. Revise drawings to cloud or otherwise identify revisions and provide written responses to the `not approved' comments in this form. . Changes have been clouded on the plans, but because new sheets have been added, we have also attempted to point to the change in the written comments above. Changes to the approved (A2BQ documents must be submitted to DOH/CRS with revisions clouded or otherwise clearly identified to ensure review. Discrepancies between the approved drawings and construction may delay licensure. Respond, in writing, to the comments attached to this form. Additional comments may follow based on receipt of revised construction documents and design team response. Compliance with the comments above provided by the Department of Health, Construction Review Services, are necessary for this facility to meet the cited requirements of the applicable licensing regulations found in the Washington State Administrative Code and associated references. These comments, authorization to begin construction or final project approval do not relieve the facility from the responsibility to meet the requirements of any applicable federal, state or local regulations. In the event of conflicts between other jurisdictions and these written comments, the most stringent shall apply. The building owner or operator is ultimately responsible for safety and insuring the building is in compliance with all applicable laws. Page 13 of 13 Plan Review Comments for Project 61189204