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NemoursPediatricsDeptford WS 18JAN21 Flipbook PDF

NemoursPediatricsDeptford WS 18JAN21


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Source Preventative Maintenance Report

Nemours Dupont Pediatrics - Deptford 1280 Almonesson Road Deptford, NJ 08096

PERFORMED BY SERVICE DATE TECHNICIAN PROCESSED BY

Major Medical Hospital Services, Inc. January 18, 2021 Ontay Anderson Robyn Rumbos

Scope of Work Performed Major Medical Hospital Services, Inc. has evaluated the medical source equipment system on the date indicated in this report and it meets the manufacturers and hospital guidelines in accordance NFPA, JACHO, Maintenance report. The preventive maintenance & testing has been performed in accordance with the most recent guidelines available and all recommendations may not require immediate compliance. The hospital is urged to repair or replace any items that are labeled for repair if not done at the time of service, as soon as possible. Information recorded during this preventative maintenance and included in this report represents our findings on the indicated evaluation date(s) only. Source equipment monitoring will be performed periodically by the trained professionals of MMHSI and results will be presented in an electronic report. This report will be prepared following the survey and will include a summary of the results, along with recommendations for actions needed to comply with the standards noted. Corrective Actions No corrective actions were needed at this time.

Recommendations Medical Vacuum: Recommend changing vacuum inlet filters, check valves, oil and cabinet filters

Future Considerations This will be a statement regarding the overall state of the equipement and will include any recommendations for projected needs or system replacements. No future considerations are needed at this time.

2

Medical Vacuum Maintenance Record Facility: Address: Floor: System Mfg: System S/N: Date of Service:

Nemours Dupont Pediatrics - Deptford 1280 Almonesson Road, Deptford, NJ 08096 Ground Location: Powerex Model: (H)12/09/15 5868108-332 Service Area: Monday, January 18, 2021 Visit Type:

Ambient Temperature Minimum Run Time Disconnect Rating Pipe Inlet Size Comments: Inspected = OK Wire Condition OK Strainers N/A Auto Drains N/A Safety Valves N/A Grease Motors N/A Set Points Cut In Cut Out

Lead 24 26

86°F 10 Min 9.0A 1 1/2"

System Size System Voltage Primary Fuse Pipe Outlet Size

Cleaned = CL Indicator Lights Gauges Check Valves Intake Elements Alternation PS2 N/A N/A

PS3 N/A N/A

Manufacturer Model Number Serial Number Hours Condition Drive Bearing Carrier Bearing

Pump 1 Busch MM1142BV23 U15400040 18673 OK 123°F 176°F

Pump Time

Minutes Seconds 10 0

Horse Power Drive Bearing Carrier Bearing Voltage A/B Voltage B/C Voltage A/C Amperage T1 Amperage T2 Amperage T3

Drive Motor 1 6.4 103°F 104°F 498 498 491 5.4A 6.6A 6.1A

Duplex 460 KLDR5A 1 1/2 to 4'

Not Applicable = NA OK Drive Belts OK Couplings OK Control Valves FN Drip Leg OK Bearings

Pump Room CVPD0504B4P1 Entire Facility Preventative Maintenance Pump Type System Amperage Secondary Fuse Misc.

Claw Pump 17.0A FLM7A N/A

Follow-up = FN Replaced = RP N/A Safety Guards OK OK Water Control Valve N/A N/A Water Temp. In N/A CL Water Temp. Out N/A OK Local Alarms Tested N/A

Lag 15 17

Lag in Use Lag is not currently in use

Pump 2 Busch MM1142BV23 U154400044 18685 OK 92°F 170°F Minutes 10

Seconds 0

Drive Motor 2 6.4 102°F 95°F 498 498 491 5.4A 6.6A 6.0A

Pump 3 N/A N/A N/A N/A N/A N/A N/A Minutes N/A

Seconds N/A

Drive Motor 3 N/A N/A N/A N/A N/A N/A N/A N/A N/A

Pump 4 N/A N/A N/A N/A N/A N/A N/A Minutes N/A

Drive Motor 4 N/A N/A N/A N/A N/A N/A N/A N/A N/A

Recommend changing vacuum inlet filters, check valves, oil and cabinet filters during next PM.

3

Seconds N/A