HomeMy WebLinkAbout3247 CAMINO DE LOS COCHES; 210; AS060095; Permit10/29/2020 AS060095 Permit Data
City of Carlsbad
Sprinkler Permit
Permit No: AS060095
Job Address:
3247 CAMINO DE LOS 1FZlO
COCHES
Status: ISSUED
Permit Type: SPRINK
Parcel No:
Lot#: 0
Reference No.:
Applied 5/16/2006
Approved: 5/18/2006
Issued: 5/18/2006
PC #: Inspector:
Project Title: MUDGETT/NEFF DENTAL#210 T.I. FIRE SPRINKLER PLAN CHECK &
INSPECTONS
Applicant: Owner:
VANGUARD FIRE PROTECTION
1604 LA MIRADA DR #105
SAN MARCOS CA
760-736-3060
Fees($) Add'I Fees ($) Total($) Balance($)
120 0 120 0
1/1
LOS COCHES DENTISTRY
CARLSBAD, CALIFORNIA
08/30/06
CertiFied Medical Testing 5594358827
DENTAL OXYGEN SYSTEM
(SOURCE EQUIPMENT)
LEVEL III SYSTEMS
p.3
The information presented below, evaluates the existing design and configuration of the Dental Gas Systems "Source
Equipment" relative to the latest recognized Edition of theNFPA99, (designated in "Bold Text") as well as the Code Edition
which initialized the Referenced Standard Requirement, (designated in "Italicized" text). THIS DATA IS PRESENTED .FOR
INFORMATION PURPOSES ONLY. No information provided herein shall imply that the existing equipment fails to meet
minimum standards.
Ref. NFPA 99, 1999, Par. 1-2.
"Construction and equipment requirements shall be applied only to new construction and new equipment, except as
modified in individual chapters. Only the altered, renovated, or modernized portion of an existing system or individual
component shall be required to meet installation and equipment requirements stated in this standard.''
MANUFACTURER: MODEL: NO.OFCYLS: LINE PRESSURE: STORE CAPACITY:
PORTER VANGUARD 2 50 PSIG. 251 CF
1. THE MANIFOLD MUST BE CONNECTED TO 2 BANKS OF CYLINDERS THAT AL TERNA TEL Y SUPPLY THE
PIPING SYSTEM. (NFPA 565, 1951, Sect. 2.lb) (NFPA 99, 1999, PAR. 4-3.l.1.7a)
2_ EACH BANK MUST HA VE A PRESSURE REGULA TOR AND CYUNDERS CONNECTED TO A
COMMON HEADER. (NFPA 565, 1951, Sect. 2-Jb) (NFPA 99, 1999, Par. 4-3.1.1.7a)
3. EACH BANK MUST CONTAIN A MINIMUM OF 2 CYLINDERS OR AT LEAST AND AVERAGE DAYS SUPPLY.
(NFPA 565, 1951, Sect. 2.lb) (NF'PA 99, 1999, Par. 4-3.1.1.7b)
4. THE SECONDARY BANK MUST AUTOMATICALLY OPERA TE TO SUPPLY THE SYSTEM WHEN THE
PRIMARY SUPPLY IS DEPLEATED. (NFPA 565, 1951, Sect. 2-lb) (NFPA 99, 1999, Par. 4-3.1.1.7a)
5. THE RESERVE IN USE PRESSURE SWITCH MUST BE CONNECTED TO THE MASTER ALARM PANEL. (NFPA
565, 1951, Sect. 2.lb) (NFPA 99, 1999, Par. 4-3.t.t.7a)
6. EACH PIGTAIL MUST HAVE CHECK VALVE. (NFPA 565, 1951, Sect. 2-1.C.2) (NFPA 99, 1999, Par. 4-3.1.1.Sb)
7. THE CYLINDERS MUST BE APPROPRIATELY RESTRAINED. (NFPA 99, 1987, Sect. 4-3.1.2.lc)
(NFPA 99, 1999, Par. 4-3.1.1.Sa)
8. ALL ELECTRIC FIXTURES MUST BE AT LEAST 5 FEET ABOVE FLOORLAVEL. (NFPA 56. 1951, Sect. 2-1.D.4)
(NFP A 99, 1999, Par. 4-3.1.l.2a4)
9. THE STORAGE ENCLOSURE, DOOR, AND DOORFRAME MUST BE "ONE HOUR FIRE RA TED".
(NFP A 565, 1951 ~ Sect. 2-1 .D. 1) (NFPA 99, 1999, Par. 4-3.1.1.2a2)
10. THE STORAGE AREA MUST BE FREE OF COMBUSTIBLE MATERIALS.
(NFPA 99, 1987, Sect_ 4-3.1 _2_ 1 _H) (NFPA 99, 1999, Par_ 4-3.1.1.2a5)
11. NO STORAGE OF FLAMMABLE GASES IS ALLOWED IN AN OXIDIZER LOCATION. (NFPA 565, 1951, Sect. 2-
1.D.3) (NFPA 99, 1999, Par. 4-3.1.l.2allb)
12. THE AMBIENT TEMPERATURE IN THE STORAGE AREA MUST NOT EXCEED 130 DEGREES F. (NFPA 56F,
1973 Sect. 2262) (NFPA 99, 1999, Par. 4-3.1.1.laltg)
13. NO SOURCES OF HEAT OTHER THAN STEAM OR HOT WATER ARE PERMISSIBLE IN THE AREA OF THE
SYSTEM ENCLOSURE. (NFPA 56F, 1973, Sect. 2264) (NFPA 99, 1999, Par. 4-3.l.1.2allg)
Rug 3~ 06 11:37a CertiFied Medical Testing 5594358827 p.4
14. (A) IF SYSTEM IS MORE THAN THE MANIFOLD'S PRESSURE RELlhFS 1T SHALL BE VENTED TO THE
OUTSIDE OR MECHANICALLY VENTED TO INCLUDE THE PRESSURE RELIEF VAL VE VENTED TO THE
OUTSIDE. (NFPA 56F, 1973, Sect. 225) (NFPA 99, 1999, Par. 4-3.1.l.2b4}
(B) THE STORAGE AREA MUST BE PROVIDED WITH 72 SQ. IN. OF TOTAJ. FRRF. AREA. (NFPA 56F. 1973.
Sect. 231) (NFPA 99, 1999, Par. 4-3.1.1.2b4)
(C) IF THE DOOR OPENS ONTO AN EXIT ACCESS CORRIDOR THEN THE VENTS MUST HA VE FIRE
DAMPERS OF APPROPRIATE RATING. (NFPA 99, 1990, Sect. 4-3.1.2.3) (NFPA 99, 1999, Par. 4-3.1.1.2b4)
15. NO SOFT SOLDERED JOINTS ARE PERMISSIBLE ON THE PIPING SYSTEM. {NFPA 565, 1951, Sect. 4-lb) (NFPA
99, 1999,Par. 4-3.1.2.7)
16. FINAL LINE REGULATORS SHALL BE DUPLEXED. (NFPA 99, 1990, Sect. 4-3.1.8.7) (NFPA 99, 1999, Par. 4-
3.1.t.8g)
17. A MANUALLY OPERA TED SHUTOFF VAL VE SHALL BE INSTALLED UPSTREAM OF EACH PRESSURE
REGULATOR, AND A SHUTOFF VALVE OR A CHECK VALVE SHALL BE INSTALLED DOWNSTREAM.
(NFPA 99, 1999 4-3.1.1.8D)
18. ALL GAUGES MUST BE LABELED "USE NO OIL,,_ (NFPA 565, 1934, Sect. 14B) (NFPA 99, 1999, Par. 4-5.l.2.9B)
19. A PRESSURE RELIEF VALVE MUST BE PROVIDED DOWNSTREAM OF THE LINE REGULATOR. (NFPA 565,
1951, Sect. 2-1.C.5) (NFPA 99, 1999, Par. 4-3.l.1.8e)
20. THE PRESSURE RELIEF VAL VE MUST BE RA TED AT 50% ABOVE NORMAL LINE PRESSURE. (NFP A 565,
1951, Sect. 2-1.C.4) (NFPA 99, 1999, Par. 4-3.1.1.8e)
21. A SHUTOFF VAL VE MUST BE LOCATED DOWNSTREAM OF ALL MANIFOLD EQUIPMENT AND
IMMEDIATELY WITHTN THE STORAGE AREA. (NFPA 99. 1990. Sect. 4-4.1.2.2B)(NFPA 99,.1999, Par. 4-3.1.2.3a)
22. THE usOURCE" SHUTOFF VAL VE MUST BE LABELED ''SOURCE VAL Vff' FOR THE (SOURCE NAME). (NFPA
99, 1990, Sect. 4-4.1.2.2B) (NFPA 99, 1999, Par. 4-3.1.2.Ja)
23. A SHUTOFF VAL VE MUST BE PROVIDED IN THE MAIN LINE ACCESSIBLE FROM WITHIN THE BUILDING
SERVED AND OUTSIDE OF THE SOURCE ROOM, AND IT MUST BE ACCESSIBLE 24 HOURS A DAY. (NFPA
99, 1990, Sect. '1-'1.1.2.2B) (NFPA 99, 1999., Par_ 4-3_L2-3b)
24. A PRESSURE GAUGE MUST BE LOCATED DOWNSTREAM OF THE MAIN LINE SHUTOFF VALVE AND ABLE
TO BE VIEWED FROM A STANDING POSITION. (NFPA 56F, 1977, Sect. 341) (NFPA 99, 1999, Par. 4-3.1.2.2el)
25. A PRESSURE SWITCH FOR THE MAIN LINE MUST BE LOCATED DOWNSTREAM OF THE MAIN LINE
SHUTOFF VALVE. (NFPA 56F, 1977, Sect. 325) (NFPA 99, 1999, Par. 4-3.1.2.2e2)
26. A PRESSURE SWITCH FOR THE MAIN LINE MUST BE LOCATED DOWNSTREAM OF THE MAIN LINE
SHUTOFF VALVE. (NFPA 56F, 1977, Sect. 325) (NFPA 99, 1999, Par. 4-3.1.2.2e2)
Design or configuration varhrnces from the referenced stand~rd are represented hy "Highlight".
LEAKAGE NOTE: 0
COMMENTS:
Alig 31• 06 11:37a
LOS COCHES DENTISTRY
CARLSBAD, CALIFORNIA
08/30/06
CertiTied Medical Testing 5594358827
DENTAL NITROUS OXIDE SYSTEM
(SOURCE EQUIPMENT)
LEVEL III SYSTEMS
p.5
The information presented below, evaluates the existing design and configuration of the Dental Gas Systems "Source
Equipment" re]ative to the latest recognized Edition of the NFPA99, (designated in "Bold Text") as well as the Code Edition
which initialized the Referenced Standard Requirement, (designated in "Italicized'' text). THIS DATA IS PRESENTED FOR
INFORMATION PURPOSES ONLY. No information provided herein shall imply that the existing equipment fails to meet
minimum standards.
Ref. NFPA 99, 1999, Par. 1-2.
''Construction and equipment requirements shall be applied only to new construction and new equipment., except as
modified in individua] chapters. Only the altered, renovated, or modernized portion of an existing system or individual
component shall be required. to meet instauation and equipment requirements stated in this standard."7
MANUFACTURER: MODEL: NO.OFCYLS: LINE PRESSURE: STORE CAPACITY:
PORTER VANGUARD 2 50 PSIG. 488 CF.
1. THE MANIFOLD MUST BE CONNECTED TO 2 DANKS or CYLINDERS THAT AL TERNA TEL Y SUPPLY THE
PIPING SYSTEM. (NFPA 565, 1951, Sect. 2. lb) (NFPA 99, 1999, PAR. 4-3.l.1.7a)
2. EACH BANK MUST HA VE A PRESSURE REGULA TOR AND CYLINDERS CONNECTED TO A
COMMON HEADER. (NFPA 565, 1951, Sect. 2-lb) (NFPA 99, 1999, Par. 4-3.1.l.7a)
3. EACH BANK MUST CONTAIN A MINIMUM OF 2 CYLINDERS OR AT LEAST AND AVERAGE DAYS SUPPLY.
(NFPA 565, 1951, Sect. 2.lb) (NFPA 99, 1999, Par. 4-3.t.l.7b)
4. THE SECONDARY BANK MUST AUTO MA TICALL Y OPERA TE TO SUPPLY THE SYSTEM WHEN THE
PRIMARY SUPPLY IS DEPLEATED. (NFPA 565. 1951 . Sect. 2-lh) (NFPA 99, 1999, Par. 4-3.1.1.7a)
5. THE RESERVE IN USE PRESSURE SWITCH MUST BE CONNECTED TO THE MASTER ALARM PANEL. (NFPA
565, 1951, Sect. 2.Ib) {NFPA 99, 1999, Par. 4-3.1.1.7a)
6. EACH PIGTAIL MUST HAVE CHECK VALVE. (NFPA 565, 1951, Sect. 2-1.C.2) (NFPA 99, 1999, Par. 4-3.l.1.5b)
7. THE CYLINDERS MUST BE APPROPRIATELY RESTRAINED. (NFPA 99, 1987, Sect. 4-3.1.2.lc)
(NFPA 99, 1999, Par. 4-3.1.1.8a)
8. ALL ELECTRIC FIXTURES MUST BE AT LEAST 5 FEET ABOVE FLOOR LAVEL. (NFPA 56, 1951, Sect. 2-1.0.4)
(NFPA 99, 1999, Par. 4-3.l.1.2a4)
9. THE STORAGE ENCLOSURE, DOOR, AND DOORFRAME MUST BE "ONE HOUR FIRE RATED".
(NFPA 565:, 1951, Sect. 2-1.D.1) (NFPA 99, 1999, Par. 4-3.1.1.202)
10. THE STORAGE AREA MUST BE FREE OF COMBUSTIBLE MATERIALS.
(NFPA 99, 1987, Sect. 4-3.1.2.1.H) (NFPA 99, 1999, Par. 4-3.1.l.2a5)
11. NO STORAGE OF FLAMMABLE GASES IS ALLOWED IN AN OXIDIZER LOCATION. (NFPA 565, 1951, Sect. 2-
1.D.3) (NFPA 99, 1999, Par. 4-3.l.1.2allb)
12. THE AMBIENT TEMPERA TORE TN THE STORAGE AREA MUST NOT EXCEED 130 DEGREES F. (NFPA 56F,
1973 Sect. 2262) (NFPA 99, 1999, Par. 4-3.1.1.2a11g)
13. NO SOURCES OF REA T OTHER THAN STEAM OR HOT WATER ARE PERMISSIBLE IN THE AREA OF THE
SYSTEM ENCLOSURE. (NFPA 56F, 1973, Sect. 2264) (NFPA 99, 1999, Par. 4-3.1.1.lallg)
Aug 3r OS ll:37a CertiFied Medical Testing 5594358827 p.S
14. (A) IF SYSTEM IS MORE THAN THE MANIFOLD'S PRESSURE RELIEFS IT SHALL BE VENTED TO THE
OUTSIDE OR MECHANICALLY VENTED TO INCLUDE THE PRESSURE RELIEF VALVE VENTED TO THE
OUTSIDE. (NFPA 56F, 1973: Sect. 225) (NFPA 99, 1999, Par. 4-3.t.1.2b4)
(D) TIIE STORAGE AREA MUST BE PROVIDED WITH 72 SQ. IN. OF TOTAL FREE AREA. (NFPA S6F, 1973,
Sect. 231) (NFPA 99, 1999, Par. 4-3.1.1.2b4)
(C) IF THE DOOR OPENS ONTO AN EXIT ACCESS CORRIDOR THEN THE VENTS MUST HAVE FIRE
DAMPERS OF APPROPRIATE RATING. (NFPA 99, 1990, Sect. 4-3.1.2.3) (NFPA 99, 1999, Par. 4-3.1.1.2b4)
15. NO SOFT SOLDERED JOINTS ARE PERMISSIBLE ON THE PIPING SYSTEM. (NFPA 565, 1951, Sect. 4-1 b) (NFPA
99, 1999, Par. 4-3.1.2.7)
16. FINAL LINE REGULATORS,SHALL BE DUPLEXED. (NFPA 99, 1990, Sect. 4-3.1.8.7) (NFPA 99, 1999, Par. 4-
3.1.1.8g)
17. A MANUALLY OPERA TED SHUTOFF VAL VE SHALL BE INSTALLED UPSTREAM OF EACH PRESSURE
REGULATOR, AND A SHUTOFF VAL VE OR A CHECK VAL VE SHALL BE INSTALLED DOWNSTREAM.
(NFPA 99, 1999 4-3.1.1.8D)
18. ALL GAUGES MUST BE LABELED "USE NO OIL''. (NFPA 565, 1934, Sect. 14B) (NFPA 99, 1999, Par. 4-5.t.2.9B)
I 9. A PRESS URE RELIEF VAL VE MUST BE PROVmEn OOWNSTREAM OF THE LINE REGULATOR. (NFPA 565.
1951, Sect. 2-1.C.5) (NFPA 99, 1999, Par. 4-3.1.1.Se)
20. THE PRESSURE RELIEF VAL VE MUST BE RA TED AT 50% ABOVE NORMAL LINE PRESSURE. (NFPA 565,
1951, Sect. 2-1.C.4) (NFPA 99, 1999, Par. 4-3.1.1.Se)
21. A SHUTOFF VALVE MUST BE LOCATED DOWNSTREAM OF ALL MANIFOLD EQUIPMENT AND
IMMEDIATELY WITHIN THE STORAGE AREA. (NFPA 99, 1990, Sect. 4-4.l.2.2B) (NFPA 99, 1999, Psu. 4-3.1.2.3a)
22. THE "SOURCE" SHUTOFF VAL VE MUST BE LABELED "SOURCE VAL VE" FOR THE (SOURCE NAME). {NFP A
99. 1990, Sect. 4-4.12.2B) (NFPA 99, 1999, Par. 4-3.t.2.3a)
23. A SHUTOFF VALVE MUST BE PROVIDED IN THE MAIN LINE ACCESSIBLE FROM WITHIN THE BUILDING
SERVED AND OUTSIDE OF THE SOURCE ROOM, AND IT MUST BE ACCESSIBLE 24 HOURS A DAY. (NFPA
99, 1990, Sect. 4-4.1.2.2B) (NFPA 99, 1999, Par. 4-3.t.2.JIJ)
24. A PRESSURE GAUGE MUST BE LOCATED DOWNSTREAM OF THE MAIN LINE SHUTOFF VALVE AND ABLE
TO BE VIEWED FROM A STANDTNG POSTTTON. (NFPA 56F, 1977. Sect. 341) (NFPA 99!' 1999!' Par. 4-3.1.2.2el)
25. A PRESSURE SWITCH FOR THE MAIN LINE MUST BE LOCATED DOWNSTREAM OF THE MAIN LINE
SHUTOFF VALVE. (NFPA 56F, 1977, Sect. 325) (NFPA 99, 1999, Par. 4-3.I.2.2e2)
26. A PRESSURE SWITCH FOR THE MAIN LINE MUST BE LOCATED DOWNSTREAM OF THE MAIN LINE
SHUTOFF VAL VE. (NFPA 56F, 1977, Sect. 325) (NFPA 99, 1999, Par. 4-3.1.2.2e2)
Design or configuration variances from the referenced. standard are represtnted by "Hlgltlighl0 •
LEAKAGE NOTE: 0
COMMENTS:
Aug 3 :t 06 11:37a
LOS COCHES DENTISTRY
CARLSBAD, CALIFORNIA
08/30/06
Certified Medical Testing 5594358827
DENT AL OXYGEN SYSTEM
(STATION OUTLETS)
p.7
THE SYSTEM COMPONENTS DESIGNATED BELOW HA VE BEEN TESTED FOR FUNCTION AL CAPACITY PER
NFPA 99, 1999 CRITERIA. EXCEPT AS NOTED IN THE COLUMN MARKED (FAIL), ALL COMPONENTS
DESCRIBED HEREIN ARE CERTIFIED AS OPTIMALLY FUNCTIONAL.
ILOCATION
2:<Jb FLOOR
ROOMl
2
3
4
5
6
NO. OF OUTLETS FLOW RATE ( LPM) FAIL
220
220
220
220
220
220
DENT AL NITROUS OXIDE SYSTEM
(STATION OUTLETS)
COMMENTS
THE SYSTEM COMPONENTS DESIGNATED BELOW HA VE BEEN TESTED FOR FUNCTIONAL CAPACITY PER
NFPA 99, 1999 CRITERIA. EXCEPT AS NOTED IN THE COLUMN MARKED (FAIL), ALL COMPONENTS
DESCRIBED HEREIN ARE CERTIFIED AS OPTIMALLY FUNCTIONAL.
ILOCATI.ON NO. OF OUTLETS FLOW RATE (LPM) FAIL COMMENTS
2N6 FLOOR
ROOM I 1 220
2 l 220
3 220
4 220
5 220
6 220
Aug 3 1• 0 6 1 1 : 3 8 a
LOS COCHES DENTISTRY
CARLSBAD, CALIF ORN IA
08/30/06
Certiried Medical Testing 5594358827
MEDICAL OXYGEN SYSTEM
(WARNING ALARM SYSTEM)
p.8
THE SYSTEM COMPONENTS DESIGNATED BELOW HA VE BEEN TESTED FOR FUNCTIONAL CAPACITY PER NFPA 99, 1999
CRITERIA. EXCEPT AS NOTED IN THE COLUMN MARKED (FAIL). ALL COMPONENTS DESCRIBED HEREIN ARE
CERTIFIED AS OPTIMALLY FUNCTIONAL.
♦ ALP ( ABNORMAL LINE PRESSURE
♦ LPL ( LINE PRESSURE LOW )
♦ LPH ( LINE PRESSURE HIGH )
♦ RIU ( RESERVE IN USE )
MASTER ALARM PANELS:
♦ LLL ( LIQUID LEVEL LOW)
♦ RLL ( RESERVE LIQUID LEVEL LOW )
+ RPL ( RESERVE PRESSURE WW)
SIGNAL REQUIREMENTS: Almormal Li11e Pre."i.mre OR line Pres.rmre Lnw & Line Pre.r..mre High; Re.-.en.•e in U\'t!i Liquid leJ1el low:
Re.'ierve Pressure Low
LOCATION VIS. AUD. ALP LPL LPH RIU LLL RLL RJ>L FAIL COMMENTS
IND. IND.
CLEAN ROOM Y Y X X X
Aug 31 .. 06 11:38a
LOS COCHES DENTISTRY
CARLSBAD, CALIFORNIA
08/30/06
CertiTied Medical Testing 5594358827
MEDICAL NITROUS OXIDE SYSTEM
( WARNING ALARM SYSTEM)
p.9
THE SYSTEM COMPONENTS DESIGN A TED BELOW HA VE BEEN TESTED FOR FUNCTIONAL CAPACITY PER NFP A 99, 1999
CRITERIA. EXCEPT AS NOTED IN THE COLUMN MARKED (FAIL). ALL COMPONENTS DESCRIBED HEREIN ARE
CERTIFIED AS OPTIMALLY FUNCTIONAL.
♦ ALP ( ABNORMAL LINE PRESSURE ♦ LLL ( LIQUID LEVEL WW)
♦ LPL ( LINE PRESSURE LOW) ♦ RLL ( RESERVE LIQUID LEVEL LOW )
♦ LPH ( LINE PRESSURE HIGH) ♦ RPL ( RESERVE PRESSURE LOW)
♦ RIO ( RESERVE IN USE )
MASTER ALARM PANELS:
SIGNAL REQUIREMENTS: Ah,wrmal Lille Pre.'t~mre OR line Pre.,.sure low & Lilte Pressure High: Resen1e in U.\·e
LOCATION VIS. AUD. ALP LPL LPH RIU LLL RLL RPL FAIL COMMENTS
IND. IND.
CLEAN ROOM y y X X X
A"ug 31-06 11: 38a Cert if' i ed Medi ca 1 Testing 5594358827 p. 10
LOS COCHES DENTISTRY
CARLSBAD, CALIFORNIA
08/30/06
DEW POINT TESTING
DEW POINT LEVELS WERE ESTABLISHED BY OBTAINING A SAMPLE DIRECTLY FROM THE NITROGEN
C.YLINDRR HTrT.17.F.n TO PRESSURIZE THE SYSTEM AND COMPARING TO SAMPLES OBTAINED FROM THE
MOST REMOTE OUTLET IN EACH WNE OF EACH PIPING SYSTEM.
DEW POINT RECORDING
SYSTEM SOURCE GAS PIPING SYSTEM VARIANCE
OXYGEN 10 DEG. F. 10 DEG. F. 0DEG. F.
NITROUS OXIDE 10 DEG. F. 10 DEG. F. 0DEG.F.
CONCLUSION: ALL TEST RESULTS REFLECT VARTANCE LEVELS WITHIN THE PARAMETERS SETFORTH
BY THE NFPA 99 CRfTERIA.
MAXIMUM ALLOWABLE VARIANCE TABLE
Dt:w Pui11t 5 DEG. C. @ SO PSJG.
~ug 3f OS 11:38a Certiried Medical Testing 5594358827
LOS COCHES DENTISTRY
CARLSBAD, CALIFORNIA
08/30/06
DENTAL GAS SYSTEM
Fl,OWTF.ST
OPERATIONAL PRESSURE TEST
p. 11
THE SYSTEM COMPONENTS DESIGNED BELOW HA VE BEEN FUNCTION-TESTED PER NFPA 99, 1999 CRITERIA.
EXCEPT AS NOTED IN THE COLUMN MARKED <FAil>, ALL COMPONENTS DESCRIBED HEREIN ARE CERTIFIED AS
OPTIMALLY FUNCTIONAL. FLOW TEST CRITERIA-NFPA 99, 1996 SECT. 4-5.1.3.3; OPERATIONAL PRESSURE TEST
CRITERIA-NFPA 99, 1996 SECT. 4-5.1.3.8.
SPECIFIC AREA PRESSURE DROP W/ N2 PRESSURE DROP W/ S GAS
OXYGEN <2 PSIG NIA
NITROUS OXIDE <2 PSIG NIA
MAXIMUM ALLOWABLE DROP TABLE
PRESSURE DROP < = 5 PSIG
VACUUM SYSTEM MUST BE CAPABLE OF MAlNTAINlNG PRESSURE OF 12 inHG WHILE
EVACUATING 3 SCFM AT AN ADJACENT STATION INLET }
Aug 31 -□6 11:38a CertiFied Medical Testing 5594358827 p. 12
LOS COCHES DENTISTRY
CARLSBAD, CALIFORNIA
08/30/06
PARTICULATE TESTING
PARTICULATE FILTER
SYSTEM FILTER NUMBER FLOW TIME WEIGHT PASS/FAIL
OXYGEN LINE 1 +200 LPM 5 minutes <l P~ss
NITROUS OXIDE LINE 2 +200 LPM 5 minutes < I Pass
CONCLUSION: All Filter Samples were taken from the piping systems listed above with Hi Flow Rates
(greater than 2001pm). They were in place for 5 minutes. There was no particulate matter
or debris noted.
Au~ 3( OS 11:39a Certif'ied Medical Testin~ 559435882?
LOS COCHES DENTISTRY
CARLSBAD, CALIFORNIA
08/30/06
HYDROCARBON ANALYSIS
p. 13
THE MEDICAL GAS PIPING "ZONES" DESCRIBED BELOW CONSTITUTE ALL ZONES IN THE SUBJECT SYSTEM EACH
ZONE WAS TESTED AT THE MOST REMOTE OUTLET FOR HYDROCARBONS AS METHANE AND HALOGEN A TED
HYDROCARBONS.
TOTAL HYDROCARBONS AS METHANE
ZONE SOURCE GAS PIPING SYSTEM VARIANCE
OXYGEN 1.0128 PPM 1.1469 PPM 0.1341 PPM
NITROUS OXIDE 1.0128 PPM 0.9667 PPM -0.0461 PPM
TOTAL HALOGENATED HYDROCARBONS
ZONE SOURCE GAS PIPING SYSTEM VARIANCE
OXYGEN OPPM 0 PPM OPPM
NITROUS OXIDE 0 PPM OPPM OPPM
CONCLUSION: ALL TEST RESULTS REFLECT VARIANCE LEVELS WITHIN THE PARAMETERS SETFORTH
BY THE NFPA 99 CRlTERJA.
MAXIMUM ALLOWABLE VARIANCE TABLE
TOTAL HYDROCARBONS AS METHANE 1 PPM
HA LOG ENA TED HYDROCARBONS 2 PPM
I
!
j
FILE C Y
~ug 3t 06 11:36a CertiFied Medical Testing 5594358827 p.2
/tStYoooq'o
CERTIFIED 377 W. FALLBIWO~, STE. 208
MEDICAL FRr~SNO, CALIFORNIA 93711
TESTING (800) 243-5427 I Fax 559--435-8827·
A Division of Rio;l: Sol11tinns. I .ttl
To: ATTN: MR. JACK TERRY
JACK TERRY CONSTRUCTION
1812 PREMIER STREET
F ALLBROOK, CA 92028
PROJECT: FINAL CERTIFICATION
Subsequent to the Remodel Construction involving the Dental Oxygen and Nitrous Oxide systems-Construction Certification
Testing of the Dental Gas System OR PORTION THEREOF have been affected at the herein referenced facility. Testing procedures
utilized, conform with and are capable of detenninin funct· · h meet the minimum requirement set forth in NFPA 99
1999, CGA, and JCAHO requirements_~nt:l~Tf-"rommendations. With the exception o · ms so designated in the attached data
sheets,THEDENTALG GSYSTEMDESCRIBEDHERETNAT-32. 1./7 C~MIIUO O.
LOS COCHES DENTISTRY .::t:f 1.10
Complies with pipe gas systems Level III as per NFPA99, 1999 SEC. 4-5.1.1.1-SEC. 4.5.5.9
M DICALGAS
RESULTS
Oxygen
Nitrous Oxide
DATE: 08/30/06
GAS PRESSURE TEST FLOW TEST
RESULTS CONCENTRATION RESULTS
>99%
>99%
50 psig.
50 psig.
ROLAND W. LAMER
EXECUTIVE DIRECTOR
TCl000I-60
TEMP.TEST
RESULTS
76° F
76° F
FILE C Y