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:. _ �� <br /> .�•'�N'���IIfG • Medical Gases � M11eAical Gas Line Veri(ications • Analgesia Equiryment <br /> �C C� 3G! 'OG� <br /> *** ;11EDICAL GAS LINE *** <br /> CGR7'IFICATE OF VERIFICATION <br /> 4 FGl3RUARY 2003 <br /> CONTRACTOR: DOC <br /> DATG AND TIME O� TL•S'1'ING: 23 JANUARY 2003 / 9:20 A.1�1. ���� � I <br /> _ 1 c�(('? ( I—� <br /> P.4CILITY NA�11�: PROVIDLNCL' HOSPIT'AL— ACII�IC CAT I� � , �`� � <br /> l <br /> ADDRESS: GVLRL'l'1', WA � FEB O 7 2003 <br /> AREA: NGW IIULK h1EDIGiL O\YGGN SYSTF�1 <br /> �ITY ..�F�PuE�vERE.L s. <br /> TflST1NG BY: B. LVAN h1c ALUSTL'R - NITROX 1T�C. E�g�nec�in9 <br /> OUR PIRT1 CC-Rl'IFILS TIIA'I' THL• Af30VL 1�AMED PrRSON IS PROPL"RLti' 7'RAIhED <br /> AND CBRTIPIGD TO PGRPOR�1 THB ACTIVII'ILS RBQUIRGD. AI�L TGST AND <br /> MGASURr�1GNT LQUII'1�4GN7' IS PROPLRLY CALI[3KATGD AND MAINTAINGD. <br /> AS A RLPRL'SL'Nl'ATIVG OP NI'I�ROX INC. THL'- A130VL• NA�1GD VL'RIFIBR HAS <br /> CONDUCTBD TI:SIING �WD VLRIPICATION OF THE �1FDICAL GAS I'IP1NG SYSTG�1 <br /> AND RBLATBD I:QUII'�11?Nl"I'O CLlil'll�l' TIiI: I�OLLO\1'ING ON ll1G DATE ABOVG. <br /> 1. PINDINGS: <br /> A. ALL VAL�'I�.S AItL PItOPIiRI_l' LOCATIiD, l'ACiGGD, A�'J I�UNCTIONING <br /> PROPGRLI'. <br /> 13. ALL ALAR�1 VrWGLS AND DGVICBS ARL PROPI:RLI' LOCATED AND <br /> TGS7'L'D SIGNrV_S I�UNC'I'ION AT PROPGR SGT POINTS. <br /> C. SUI'PLY GAS S1'ST'LA1S ARL PROPLRLY LOCATL'-D AND �VL'RG <br /> SLQUGNSI:D. <br /> D. ALL LQUIP�1I�NT AND Pll'"I'I\GS \VLRG :V'PROPKIA"II�LY PRL:CLI.iWED <br /> Olt CLrrWGIJ ON SITL.. <br /> 1:. .11,I. 13RA7.ING \VAS CONDUC'fGD 1N ACCORDAI�CG �Vll'II STANDARDS. <br /> PIiOV'Ll'bocl-2"s_p; P�; 1 of 3 <br /> 270G 164th Stree[ S.W., Lynnwood, WA. 98037 <br /> (425) 741•8807 � 1-SOOJ36-7047 • Pax: (425) 741-250U � <br /> � � �� �% <br /> (- <br />