HomeMy WebLinkAboutUNDERGROUND TANK (2) BAKERSFIELD FIRE DEPARTMENT
H~ZARDOUS MATERIAL DIVISION
2130 G Street, Bakersfield, CA 93301
(805) 326-3979
APPLICATION TO OPERATE AN UNDERGROUND STORAGE'TANK
APPLICATION IS BEING SUBMITTED FOR THE FOLLOWING REASON:
~TO OPERATI~ A NEW PAC~T~ __~ T~ OWNERSHIP ~ OFP. RATi~ AN ~NG P~
pREVIOUS TANK OWNER (if applicable)
NAME X t / ~, PHONE
ADDRESS IN / /-~ '
NEW TANK OWNER
ADDRE S S ~ ~ % ~ u ,
TANK OPE~TOR (if different from owner)
N~E ~ ~ PHO~
ADDRESS
APPLICANTS N~E (if different from owner)
N~E ~ ~ PHO~
~DRESS
TANK LOCATION
FACILI~ N~E $.~o~%~ ~.~ ~D~SS ~15 ~. ~~,
PHONE ~ o$ - ~ ~ 5 - %000- OPE~TORS N~ ~ ' -
EMERGENCY CONTACT
ADDRESS %n " . ~ .
TANK INFO~TION
tank~ volume date installed substance stored previous substance
Do You Have a HAZARDOUS MATERIAL RESPONSE PLAN? ~ NO
Do You Have an OWNER - OPERATOR AGREEMENT? N/~ ~ NO
Have You Filled Out a HAZARDOUS MATERIAL BUSINESS PLAN? NO
date ' - name (print)
STAT~ OF CAUFORM&
STATE WATER RESOURCES CONTROL BOARD
UNDERGROUND STORAGE TANK PERMIT APPLICATION . FORM A
... COI/J~.ETE THIS FORM FOR EACH FAClUTY/SITE
' [ MARKONLY ~ 1 NEW PERMIT F-~l 3 RENEWAL PERMIT i---'} S CHANGE O~ INFORMAT#3N F--] 7 PERMANENTLY C;LOSED SITE
ONE ITEM [] 2 INTERIM PERMIT E~] 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE
I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED)
DBA OR FACILITY NAME ' NAME OF OPERATOR
ADDRESS NEAREST CROS~ STREET PARCEL I
CITY NAME I STATE I Z~P CODE SITE PHONE I WI'TH AREA CODE
TO INDICATE CORPORATION I~ INDIVIDUAL ~'~ PARTNERSHIP ~ 1.0CN.-~Y ~ COUHi'Y.AGENCY {~ STATE-AGENCY I---] FEDERAL~GEt~Y
~TI~CTS
TYPEOFGUSINESS ~ I GAS sTATION ~ 2DISTRIBUTOR I l--'l VIF~NOU~I.o~TAaKsA?s,TEIE. P.~
RESERVAT~3N I .~.
E~ 3 FARM [~] 4 PROCESSOR ~ 5 OTHERJ OR TRUST LANDS ~ O I C.,A D ~)'7/,~ ~ ~..
EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY) . optional
DAYS: NAME (LAST, FIR. ST) PHONE I WITH AREA CODE I DAYS: NAME (LAST. FIRST) PHONE · WITH AREA CODE
NIGHTS: NAME (LAST, FIRST) PHONE · WITH AREA COOEl NIGHTS: NAME (LA~T, FIRST) PHONE · WITH AREA COOE
Ih PROPERTY OWNER INFORMATION- (MUST BE COMPLETED)
NAME CARE OF AOORES~ INFORMATION
MAIL~NO OR STREET ADDRESS '/ ~' I~ v~,.~ [--"l. tNOIVtOUAL ~ LOCAL. AGENCY ~ STATE.&GE,NCY
~ CiTY NAME . STATE ( ZIP CODE } PHONE · WITH AREA CODE
,L TAN OW.ER NFORMA O.-(MUST BE COM. ETEm
NAME[ OF OWNER CARE OF AOORE~ [NFORMATK3N
MAILING OR STREEI: ADO"'~ES$ ,/ ~ 1~ indicate ~ {NgNVlDUN. [~ LOC/~.~gNCY ['~ STATE-AGENCY
CITY NAME STATE ZiP CO0~ PHONE · WITH AREA
IV, BOARD OF EQUAI~IZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 739-2582 if questions arise.
TY(TK) HQ [ ' .t'ol3lT[2lslct
V, LEGAL NOTIFICATION AND BILUNG ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked.
THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT
· I~"LCAI"~'SNAME<"mNTEO&S~C'~'q'"~C'~, ~ r~ t,, p,, I APPL,:Am's?rrLE I SATE
COUN,'TY # JURISDICTION # FACILITY #
THIS FORM MUST BE ACCOMPANIED BY AT LEAST (11 OR MORE PERMIT APPLICATION - FORM B, UNLESS THIS IS l CHANGE OF SITE INFORMATION ONLY.
FORM A (9-9O)
STATE WATER RESOURCES CONTROL BOARD
UNDERGROUND STORAGE TANK PERMIT APPLICATION . FORM B
.~':-' ' COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM.
MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE O; INFORMAT~)N [] 7 PERMANENTLY CLOSED ON SITE
ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 8 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED
I. TANK DESCRIPTION cO~PLE'm ALL ITEMS - SPECIFY iF UNKNOWN
C. DAm INSTALLED [M(:~DAY/YEAR) ~ ~J ~o'~, t ~) 2 ~o~ ~ 5
II. TANK CONTENTS IF A- I (S MARKED, COMPLETE ITEM C.
[] ! MOTOR VEHICLE FUEL [] 4 OIL B. C. [] TM REGULAR ~11.3 DIESEL [] B AVIATION GAS
A.
UNLEADED ~ 4 GASAHOL
~ 2 PETROLEUM [] 8O EMPTY ~' ' PRODUCT [] II, PREMIUM [] 7 METHANOL
UNLEADED ~ 5 JET FUEL
~ 3 CHEMICAL PRODUCT [] 95 UNKNOWN ~ 2 WASTE ~ 2 LEADED ~====~ 99 OTHER (DESCRIBE IN ITEM O. BELOW)
o. I A.,ISNOTMARK D.E,TERNAMEOFSU STANCESTOR D C.A.S.,:GB TG-3H-G
II1. TANK CONSTRUCTION MARKONE~TE~ONLY~NaOXESA. a.~NOC,.~,~0ALLT,~T~PPUES~NaOXOANOE
A. TYPEOF ~ ~OUBLE WALL ~ ~ 3 SINGLE WALL W~T~
~ =~ 95 UNKNOWN
SYSTEM ~ 2 S~NGLE WALL ~ ~ SECONDARY CCNTA:NMENT (VAULTE~TAN~ ~ ~ O~ER
~ BARESTEEL ~ 2 STAINLESS STEEL ~ 3 ~ERGLASS ~ ~ 4 STEELC~DW/FIBER~SSRE[NFORCEDPLAS~C
B. TANK : ~
MATERIAL ~ 5 CCNC~ETE ~ 6 PQL~NY~ ChLC~E ~ 7 AL~MtNU~ ~l g t~/. ME~ANOL ~MPATIBLE W/FRP
~ I RUBBER LINED ~ 2 ~KYO L',~ING ~ 3 ~PC~ LINING ~ 4 ~ENOL~ LINING
LINING ~ 5 GLA~ L[Nt~ ~ 6 ~NL[N~O ~5 ~NKNOWN ~ O~ER ~ ~.~ .
~ L;NING MAT~RIAL COMPATIBLE WITH 1~ ME~ANOL ? 'vES~ ~O_
D. C0RROS~N ~~ 1 ~LYE~YLENE WRAP ~ ~ 2 COATING
PRO~ION '~ 5 CATNQOICPR~TECT[QN ~ 91 NONE
E. SPILL AND OVERFILL SPILL CONTA~MENT iNSTALLED (YEAR) [~ ~ ~ OVERFILL PREVENTION EQUIPMENT [NST~LEO ~EAR) t~
IV. PIPING INFORMATION cmc~ A IF ABOVE GR~ND OR U IF UNOERG~UND.
~ SYSTEM~PE A~ SUCT~ A U 2 PRESSURE
8. CONSTRUCTION A U I SINGLE WALL A~ 2 ~BLE WALL A U 3 LINED TRENCH A U ~ UN~WN A U ~ O~ER
C. MATERIAL AND A U f ~RESTEEL A U 2 STAINLESS S~EL A U 3 ~LWINYL CHLORIOE(P~)A~4 FIBEr.S PIPE
CORROSION A U 5 ~UMINUM A U 6 CONCRETE ~ U 7 STEEL Wt~AT~ k U 8 1~ ~L ~MPATIBLEW/FRP
PROTE~ION ~U g ~LVANI~D S~EL ~ U I0 CATHODIC PROTECTION A U ~5 UNKNOWN A U ~ O~ER
D. LEAK D~E~N ~ 1 AUTOMATIC LiNE LEAK DETECTOR '.~ 2 L~NE T~HTNESS T~ST~NG ~ 3 ~NffOR~5~IAL ~ ~ O~ER
V. TANK LEAK DETECTION
~ 8 TANK TEST]~ ~ 7 INTERSTITIAL MONITORING,~ gl NCNE ~ 95 UN~WN ~ ~ O~ER
VI. TANK CLOSURE INFORMA~ON
THIS FORM HAS BEEN COMPL~D UNDER PENAL~ OF PERJURY. AND TO ~E 8EST OF ~ KNOWLEDGE, IS ~UE ANO CORRECT
APPLICANTS NAME . ~ ~ ~ ~ ~ ~ DA~
LOCAL AG~CY USE ONLY THE STA~E L~. NUMBER iS CO~ED
;oRu ~ ff.e~ THIS ~RM ~ST BE AC~IED BY l PER~ OPUCA~ON · FORM g UNLE$ l CURRE~ FORM l ~ BE~ R~D.
~7or: ~L~. ~'~ G~zoe: 577'c Last Stat~s/~.:
(:omomnY Co~e: Ol vendor: Crew: Frame: dmp: dG Acouis, {)ate: F01/0~/611
comments: ~e:~t 5cneoule:
Installed Date:
Contrmc: ~0:
~erv Contr. S/~a~e: 00/00/00
3toc~ {iNSN) ~am~facturer Par< Numoer 3tanHard Part ~ (EiA) dtv 2eouireo Descriotzon
~, EVE~'~ NREE ~E~S ~,E 5~TT~,:~ SAHPLE. ~E~FGGm ~TE~ TE~.T,
~%~ .~" BAKERSFIELD FIRE DEPARTMENT
~-.-?_~:W f I e 1 d CA 93301
'~%15 Chester Avenue (805) 326-3979
Third Floor %~ C~ ~. ~
APPLICATION TO PERFO~ A TIG~NESS TEST
/Hospital
FACiLiTySan Joaqu.in Community ADDRESS 2615 Eye Street, Bakersfield, C
PERMIT TO OPERATE ~ BT-0345
OPERATORS Nia2/E Same OWNERS NAME Same
NUMBER OF TANKS TO BE TESTED 1 IS PIPING GOING TO BE TESTEDYes
TANK~ VOLUME CONTENTS
1 3,000 Diesel
CONFIDENCE UST 417 Montclair Street
TANK TESTINGCOMPANY SERVICES, INC. ADDRESS Bakersfield, CA 93309-17
TEST METHOD AES System II (Overfill)
NAME OF TESTERDouglas M. Youn~ CERTIFICATION ~ 86116
STATE REGISTRATION % 9~-1076
DATE & TIME TEST IS TO BE CONDUCTED 2/19/97 ~ 10:00 a.m.
BY: ,
CONF~IDENCE UST SERVICES, INC.
( ~,~ ~;~) ~; )
PRECISION TANK & LINE TEST RESULTS SUMMARY
Invoice Address: Tank Location: W.0.#:
SAN JC!ACJ!UfN COt~,HO'.S!:'T, SAN JOAQdlN CO~'4.1-~O.'~PT. I.D. Number:
P.O. BOX 2615 2615 EYE STREi~T Techni~ian:D. YOLJNG
C~AKERSk-iELD, iZ'A 93.303 BAKERSFIELD, CA Tech. ~:86t 16 Van~:,~,i
Date: ~2-19-97 Time Start: 10:00 End: 12:30 County: KE
Facility Phone#: <805) 326-4140 Groundwate? Depth: 144"+ Blue Prints: i~i/'A
~ontact: ALE'!'hiA REGAl_ Date;Time system was filled: 6+ HObRS
Tank Fill/Vent Product Type Of Vapor Inches of Pump Tank
Tank Capacity Product Tank Vapor Lines Line Recovery Water/Tank Type Material
1 ~000 DIESEL PASS PASS PASS N/A 0~00" SUC!'. ~WS
4
Additional information: TEST TECW~iC~AN: DOUG YOU~iG O.T.T.L. ~99-1Q'7B
SITE LOG TIME
Se~ Up Equip: 10~00
Bled Product Lines: YES
Bled Vapor Lines: N/A
Bled Vent lines: YES
Bled Turbine: N/A
Bled Suction Pump:
Risers Installed: YES
a) T~is system and method mee~s or exceeds the criteria in USEPA 40CFR
part ~80, NFPA 3~9-87 and all applicable state and l~cal codes;
b) Any failure listed above may require further action, check with
ali regulatory agencies.
~pyright (c) 198~ by AES, Inc.
Ce~tifie~ Technician Signature : ~/~~~ Date ~ ~-~-~
............ 2?t~h STREET ' --' .... -- --'
!
/
Ti: 3~0 GAL, DIE SEL AL
"H" L
ST, E
/~ (::(~NFZDEN(:::E UST BERV II'ES, INC.
AEC/System l! Precision leak Test 8~'aph (OverFill)
Invoice No.: 2446 Date: 02/19/97 Time I 10:02:42.
Technician: DMY Tank: 1 Tank Diameter(in): 75
Volume(gal): 3000 Grade Level(in): 120 Product Level(in): 118
Water' Level On Tank(in): 0
Specific 8rarity: .87 Coefficient. Of Expansion: 0.0004435
Calibration Value(mi): 200 Channel.: 1
Level Segment From: 1 To 300 Temp Segment Froml 1 To 300
Change In Calibration Zone = 30 Calibration Unit(gal/unit) = 0.00176
Starting Temperature (F): 54. 109 Head Pressure(psi' (Btm)): 3. 71
Surface Area (sq. in): 35. ~ Temp. Change <F/h) : -0. 129
Level volume(gph): -0.21
Temp. volume(gph): -0. i7 Product Line<gph): SUCTION
Net change (gph) : -~. ~4
L:opyri~ht (c) 1S~,9 by AES, Ino.
** Not · s **
'::.¥41'4 JEIA[,~UiN COhtMUNiTY HOSPITAL , 2615 EYE STREE']" , BR~.ER~{FIELD, EA.
~'HIS IS A HIGH LEVEL TEST WITH A 200 ML. CALIBRATION ADDED F'RIOR TO THESE DA'FR.
~-;~ ~,:'~ODLiC'T L 1NE IS FLOODE/, AND INC:LU~>ED 1N THESE: K)A]"A.
POLICY / PROCEDURE
HAZARDOUS MATERIALS AND Number
Manual
~~ WASTE MANAGEMENT
0B/04/94
l~view Dam
Subject TABLE OF CONTENTS 05/04/94
¢~]~/i~/N/'rY 05 / 04/94
I 2
2000 MANAGEMENT POLICY
(JCAHO EC 1.2.3., EC 1.4.3)
2001 NOTEBOOK
(JCAHO EC 1.2.3.)
2002 STORAGE
(JCAHO EC 1.2.3)
2003 ORDERING AND RECEIVING
(JCAHO EC 1.2.3)
2004 RECEIVING MSDS
(JCAHO EC 1.2.3)
2005 HOW TO READ MSDS
(JCAHO EC 1.2.3.)
2006 SPILLS
(JCAHO EC 1.'2.3), EC 1.4.3.)
2007 RESPONSIBILITIES
(JCAHO EC 1.2.3)
2008 DEPARTMENT MANAGEMENT
(JCABO EC 1.2.3.)
2009 PLANT OPERATIONS DEPARTMENT
( JCAHO EC 1.2.3 )
2010 PHARMACEUTICAL
(JCAHO EC 1.2.3)
2011 MATERIAL MANAGEMENT
(JCAHO EC 1.2.3)
2012 DISPOSAL OF RADIOACTIVE MATERIALS
(JCAHO EC 1.2.3)
2013 CHEMICAL WASTE OFF-SITE DISPOSAL
(JCAHO EC 1.2.3)
POLICY /PROCEDURE
HAZ/~OUS MATERIALS AND Numar
Manual
WASTE ~A~NT
~ 05/04/94
Renew Dam
Su~jea T~LE OF CONTENTS 05/04/94
~~~ 05 / 04/94
2 2
2014 CHEHOTHE~Y WASTE ~AGE~NT
(JCAHO EC 1.2.3) ~AGE~NT PROG~
2015 WASTE GAS ~AGE~NT VROCEDURES
(JCAHO EC 1.2.3)
2016 TMININ6
(JCAHO 1.2.3 )
2017 NEW E~LOYEE CHEMIC~ ~NSERVICE S~ ~MO
(JACHO ~Cl. 2.3)
2018 CHEMIC~ T~INING RECORD
(~CAHO EC 1.2.3)
2019 HAZED CHEMIC~ C0~ICATION E~LOYEE T~INING
RECORD
(JCAHO EC 1.2.3)
2020 EMPLOYEE INJURY
(JCAHO EC 1.2.3)
2021 E~LOYEES RIGHT TO KNOW
(JCAHO EC 1.2.3)
2022 ~DIC~/BIO~Z~DOUS WASTE ~AGE~NT
(JCAHO EC 1.2.3)
2023 HAZ~DOUS CO~ICATION CHECKLIST
(JCAHO EC 1.2.3.)
2024 ~U~ EV~UATION
(JCAHO EC 1.2.3)
POLICY
M~a~ H~ZARDOUS RATERIALS AND Numar 2000
~~ WASTE MANAGEMENT ~v~ Da~
Su~ ~ew Da~
~~~ ~anagemen2 Policy 0s/04/94
C MUN
05/0 /9
POLICY:
This Hospital is in the business of providing healthcare services.
In order to conduct our business, we must use certain materials
that require specific precautions to be taken to protect our
employee's health. Therefore, it shall be the policy of this
Hospital to co~unicate any hazards associated with handling
hazardous materials to employees involved in those operations.
It will be the responsibility of management and supervisors to
ensure that the proper info~ation is obtained and disseminated to
the appropriate employees. It shall be the employee's
responsibility to follow safe practices as outlined in the Material
Safety Data Sheets or operating procedures.
We are not creating a new role or responsibility for any of our
employees. This Hazardous Co~unication Progr~ is intended to
supplement our no~al safety activities. Current safety policies
remain in effect.
The effectiveness of the Hazardous Co~unicating Progr~, as wi~h
our no~al Safety Progr~, depends upon the active support and
involvement of all personnel.
POLIC~ ~D PR~ED~ FOR ~AG~NT OF ~Z~OUS ~TERI~ ~
W~TE:
In accordance with requirements mandated by OS~, Safety Order
5194, JCAHO and other governing agencies, the following policy is
set forth for this Hospital.
P~POSE:
To recognize the potential threat that hazardous material and
wastes poses to human health and the enviro~ent. To establish,
implement, monitor and document evidence of an ongoing progr~for
the management of hazardous material and wastes, to ensure that
there is minimal risk to patients, personnel, visitors, and the
co,unity enviro~ent within the confines of.the hospital.
OB~CTI~S:
> To develop a system that addresses the identification of
hazardous material and wastes from the point of ent~ into the
hospital to the point of final disposal.
POLICY
M~u~ HAZARDOUS I~tTERZALS A_ND N~r 2000
~~ WASTE MANAGEMENT
W n~/n~/~
.T~JV~~fl~ Nanagement Pol£c~ 0~/0¢/9~
COMMUNITY
05/04/94
· To develop a system for managing hazardous material and wastes
safety after identification.
· To ensure policies and procedures related to various hazardous
material and wastes are reviewed, revised and approved
annually by the appropriate committee.
· To enhance adequate supervision of hospital personnel on
hazardous material and wastes.
DEFINITIONS:
· Chemical Hazardous Material - A substance which by reason
being explosive, flammable, poisonous, corrosive, oxidizing,
irritating or otherwise harmful is likely to cause internal or
external injury to humans or the environment.
· Infections Hazardous Material - Any material possessing a
significant potential for contagion or cross-infection.
· Radioactive Hazardous Material - Any material capable of
giving off radiant energy in the form of particles or rays
such as alpha, beta and gamma rays.
· Gaseous Hazardous Material - Any substance which may be
dispersed through the air and act as a poison, irritant or
asphyxiate.
> Physical Hazard - Sharps, pointed objects, pressurized
containers such as aerosol cans, gas bottles, etc.
SEMI-ANNUAL REVIEWS:
Semi-annual reviews shall be conducted by the Safety Committee with
each department to check management techniques of hazardous
materials for labeling, isolation, ventilation and possible
substitution of less hazardous agents.
POLICIES AND PROCEDUNES~LATING TO CHEMICAL ANDPHYSZCALHAZARDS:,
Policies and procedures relating to chemical and physical hazards
shall be reviewed by the Safety committee, and by the Infection
Control Committee for infections hazards on an annual basis.
Recommendations, conclusions and action of these committees are
POLICY
M~u~ H~Z~RDOUS ].~TERI~S AND Numar 2000
~~ WASTE MANAGEMENT
~fectiv¢
Su~e~ ~ew Da~
~~~iff Nanagemen~ Policy
C~MUN~
reported to the hospital wide Quality Assessment and
ImprovementProgr~ in the fo~ of Safety Co~ittee Reports on a
warterly basis to the Executive Co~ittee and the Governing Body.
T~INING:
Ail 9ersons required to handle hazardous chemicals or materials
will be 9rovided with a99rogriate orientation, equipment and on the
job training. Each department shall be responsible for training
each individual handling hazardous material and wastes prior to
perfo~ing any work assig~ents.
A master file of the training records will be kept in the users
department for emgloyees review and a copy will be kept in the
Nursing Staff Develogment Degartment.
~ELING=
Each department will be responsible for identifying and labeling
all hazardous materials and wastes within their department/are~.
Upon ordering these materials, the Department Director initiating
the order will info, Materials Management that hazardous materials
are being ordered. Materials Management shall develo9 guidelines
for receiving, identifying and delivering these materials to their
destination.
The Safety Co~ittee shall develop guidelines to safely check these
hazardous materials during each bimonthly Safety Co~ittee Meeting.
Ail drums, buckets, jugs, 9ails, or any other container containing
hazardous chemical substances will have a clear, complete,
conspicuous and durable label identifying the chemical used.
~TE~I~ S~ET~ DATA SHEETS=
A material safety data sheet is to be obtained for eve~ chemical
used in the hospital and identified as hazardous.
A master file of all material safety data sheets will be kegt in
theusers degartment for emgloyees review and a master file will be
kept in Materials Management and/or with the Safety Officer.
STOOGE ~ ~DLING:
POLICY
M~u~ H~ZARDOUS NATERIALS ~UND Nm~r 2000
~~ WASTE MANAGEMENT
Su~ Re6ew ~m
~~~I~ Management Policy 05/04/94
05/04/9&
4 6
> Hazardous chemical will be stored in appropriately labeled
containers maintained for this purpose.
> Regular inspections will be made of the storage site to ensure
that there are no leaking or spilled containers. If a spill
or leak is found, the following actions will be taken:
- Before attempting to clean up an hazardous chemical spill
or splash, know what the chemical is.
- Follow the directions according to the established
procedures for cleaning up that kind of chemical spill or
leak.
- Evacuate all personnel from the area.
- Extinguish all fl~es if there are any.
- Ensure adequate ventilation.
- If a fire occurs, set off the fire ala~.
- Wait by the spill area, well out of danger, until help
arrives. Avoid tracking through the spill.
- Obtain appropriate protective safety equipment.
- Complete a incident report on the spill or leak.
NOTE: Engineering Department and the Safety/Security Department
will be responsible for clean-up of massive spills or
leaks that will require additional personnel and
equipment. C~PI will be contacted to handle all massive
spills and all carcinogens (805) ~89-$648.
> Materials which ignite easily under no~al conditions
(fl~able) are considered fire hazards and will be stored in
a cool, dry, well ventilated storage space, away from areas of
fire hazard.
> Highly flyable materials will be kept in an area separate
from oxidizing agents (material susceptible to spontaneous
heating, explosives, etc.)
> The storage area for flyable will be supplied with fire
fighting equipment, either automatic or manual. There will be
"no smoking or striking matches" signs posted in and around
the storage area.
> Oxidizers will not be stored close to liquids of low flash
point
POLICY
Nm~r
M~u~ H~Z~'~DOUS MATERIALS ,M~D 2000
~~ WASTE MANAGEMENT
" ~fecfi~ ~
~~~IN Management Policy 0~!O4/94
COMMUNIll'
.0~/0¢/9~
> Acids and acid fume sensitive materials will be stored in a
cool, dry, well ventilated area, preferably wooden.
> Materials which are toxic as stored or which can decompose
into toxic components from contact with heat, moisture, acids
or acid fumes will be stored in a cool, well ventilated place
out of the direct rays of the sun. Incompatible toxic
materials will be isolated from each other.
> Corrosive materials will be stored in cool, well ventilated
area (above their freeze point), the containers will be
inspected at regular intervals to ensure they are labeled and
kept closed.
> Corrosives will be isolated from other material.
> Protective clothing and equipment will be available for use
when handling these materials.
DISPOSAL:
> Disposal of small amounts of liquid chemical wastes (60cc, 2-
oz.) may be disposed by diluting I part chemical to 100 parts
water and flushed down the sewer system. These amounts shall
be diluted and flushed down the sewer at varying times during
the day.
> In diluting chemicals for flushing down the sewer system,
always add the 1 part chemical to the 100 parts water. Never
add the water to the chemical container.
> Wear rubber gloves, fume mask, and/or other safety equipment
as required when preparing liquid chemicals for disposal.
> Small amounts of pathological waste containing hazardous
chemicals shall be placed into a red garbage disposal and
thoroughly ground while adding copious amounts of water and
flushed down the sewer.
> No empty drums, buckets, jugs, pails, or any other container
that has held toxic or corrosive materials will ever be reused
for anything.
$~0~0~
POLICY
M~,,u., I~Z~DOUS I~tTER~T.,S AND ~r 2000
~~ WASTE ~A~~
mf~ O.~ 05 / 04 / 94
subjm Management Policy ~ew Da~ 05/04/94
~~~ 05 / 04 / 94
~~~ Pa~e 6 °f6
The Safety Officer is responsible for assuring that proper
pe~its are obtained for disposal of all hazardous chemical
waste generated at the facility.
A certification of disposal will be obtained from the receiver
for all hazardous chemicals disposed off-site.
POLICY
M~u~ Numar
~~ HAZARDOUS MATERIAL AND 2001
WASTE ]~NAGF.~N~ mf~c~ Da~
Su~ Renew ~
.T~.~/JOA~,/IW Nobebook
COMMUN
1
POLICY=
Any department which stores or uses materials/products considered
a Hazardous," in terms of the chemicals contained in them, shall
have a MSDS (Material Safety Data Sheet).
PROCEDURE=
The notebook shall contain a copy of the MSDS on all materials in
that department which are classified as hazardous and on which the
manufacturer/distributor provides MSDS.
DEPARTMENT DIRECTOR RESPONSIBILITIES=
> The personnel of the department shall be oriented to the
Hazardous Materials Notebook.
> Orientation to the MSDS Notebook:
- Existence of the Notebook and contents.
- Where it is kept. (It is to be available to employees.)
- How to read and interpret a material safety data sheet.
(See Policy and Procedure on Reading and Interpreting
Material Safety Data Sheets.)
> All department use materials considered "Hazardous" and have
a MSDS Notebook in the department for reference.
POLICY
M~u~
~~ HAZARDOUS MATERIAL AND 2002
W WASTE MANAGEMENT
12/15/95
Su~
~qW~~W Storage
COMMUNITY
Ail hazardous materials are received into the department by
appropriate personnel and stored in a supply closet for chemicals
only. They are properly labeled with a description of the hazard
they represent. Since storage space may be limited, acid and
alkali products may be stored together, but they are suitably
separated.
Par levels have been established for these hazardous chemicals, and
purchases are made based upon these levels.
Storage areas are kept under lock and key until they are needed~
The storage areas for hazardous chemicals are cleaned and organized
as often as needed and inspected frequently.
Hazardous waste storage and processing areas will be free of
clutter and effectively separated from patient care, food
preparation and serving areas.
POLICY
M~u~ N~r
~~ HAZARDOUS MATERIAL AND 2003
~ WASTE MANAGEMENT mf~
5/4/94
Su~ ~cw Da~
¢O~WUN~ Ordering & Receiving
PWRPOSE:
To ensure that hazardous materials are ordered, received and
handled in a safe and expeditious manner.
POLICY:
> All hazardous materials which are regularly ordered and
stocked within the hospital are set up in the purchasing and
inventory system.
> It shall be the responsibility of the user department to
notify the Materiels Management Department that it is a
hazardous material they wish to order.
- User departments will be responsible for notifying
Materiels Management of any hazardous item, which has not
been denoted as such.
- User departments will be responsible for indicating
hazardous materials, which are ordered on Non-Stock
Requisitions, as such by writing it on the face of the
requisition.
> It shall be the responsibility of receiving personnel to
monitor the labeling and packaging of all materials which have
been denoted as hazardous on the purchase order.
- Any deficiencies shall be reported to the Safety Officer.
- The vendor/manufacturer shall be notified of any
deficiency and corrective action will be requested.
- Receiving personnel shall be responsible for obtaining
and affixing appropriate labeling when not provided by
the manufacturer.
> Materiels Management shall be responsible for obtaining
current Material Safety Data Sheets for requesting
departments.
> Inventory levels of all hazardous materials will be routinely
reviewed for appropriateness as a part of the overall
inventory manaqement proqram of the hospital.
POLICY
M~u~ Numar
,~m,~ HAZARDOUS I~TERI;J~;I~TD 2004
~ WASTE MANAGEMENT ~f~i~ m~
~ ~2/~5/95
Su~ R~w
C~U~ Receiving MSDS
POLICY:
When Materiels Management receives a MSDS on a new or existing
product used in the hospital, the following procedure is to be
followed:
PR~EDU~:
> The Director of Materiels Management or designee will dispense
a copy of the MSDS to:
- Ail departments using the product.
- The Master Hazardous Materials Notebooks:
* Safety Officer
> When the MSDS is received:
- The Department Director or designee places the copy in
the Hazardous Materials Notebook, located in the
department.
> In the MSDS Notebook (placed under the department using the
product)
> The Department Director will info~ personnel via verbal
notice or written memo regarding the new product and any
precaution/safety equipment required in using it.
POLICY
M~.~ HAZARDOUS MATER~AL AND Num~r 2005
~~ WASTE MANA~EMENT
W mfec~v¢ Da2 12/15/95
su~ HOW TO READ MSD$ ~cwD,~ 12/15/95
~q~/JO~OOl~/ The Right To Know .....
/~r~t ~s' I ~ 2
POLICY:
A ~aterial Safety Data ~heet gives you detailed info,marion on a
chemical and i~s hazards.
1. ~$D$ stands for ~aterial Safety Data Sheet.
2. ~ach department has an ~$D$ included in its Hazardous
Substance Policy file. Check with your Department ~ead
as to where it is located.
3. The ~$DA should cover 14 ma~or elements. If there is no
relevant or applicable information, it should be so
stated on the ~$D$. The mandatory items for inclusion
are:
a. Trade name (product identity, same as used on the
label).
b. Chemical and common name and CAS number of each'
hazardous ingredient.
c. The physical and chemical properties such as vapor
pressure, flashpoint and solubility of chemicals.
d. The physical hazards such as fire, explosion, and
dangerous chemical reactions.
e. The specific acute (short term) and chronic (long
term) health hazards, including the signs and
symptoms of illness and medical conditions (use
simple or lay terms) which may be aggravated by
exposure.
f. The potential routes of entry of the hazardous
substance(s) into the body.
g. The permissible exposure limits published and/or
recommended limits for the hazardous substance(s)
recommended limits for the hazardous substance(s)
[OS~A Permissible Exposure Limit (PEL and the
American Conference of Governmental Industrial
~ygienists (AGGI~) Threshold Limit Value (TLV)
listings] and any other limit recommended by the
manufacturer.
POLICY
M~u-, HAZARDOUS MATERIAL AND Numar 2005
WASTE MANAGEMENT
Effective D~ 12/15/95
Subj~ HOW TO READ MSDS Rcv~wDa~ 12/15/95
The Right To Know
Page 2 of 2
If the hazardous substance(s) is listed as a
carcinogen by National Toxicology Program (NTP),
the International Agency for Research on Cancer
(IARC) or the Occupational Safety and Health
Administration (OSHA).
POLICY
M~u~ HAZARDOUS MATERIALS AND N~ 2006
~~ WASTE MANAGEMENT
W mf~ Da~ 01/07/91
Su~e~ SPILLS ~ew Da~ 11/20/90
~4~V~Ob442Ul~f The Right To Know
COMMUJViTY 12/15/9&
HCPSP/T~ P'g= 1 or 3
PURPOSE:
To ensure that departmental personnel are prepared to properly
respond to the spill of a hazardous material.
POLICY:
A list of all hazardous materials routinely received and
distributed by Materials Management will be available in the Safety
Office, along with MSDS on each item.
A "Spill Kit" containing the following items will be readily
available in specific departments:
Adsorbents Surgical Masks
Plastic Bags & Containers Head Covers
Nitrile Gloves Isolation Gowns
Goggles Impervious Shoe Covers
Wet-Vac
The "Spill Kit" will be routinely checked to see that all required
materials are present and in usable condition.
In the case of a spill, the MSDS for that material shall be quickly
obtained and proper procedure followed.
In general, the response shall be as follows:
MAJOR SPILL
Note:
A major spill has occurred under the following conditions: A
life threatening condition exists, the condition requires the
assistance of emergency personnel, and the condition requires
the immediate evacuation of all employees form the area or the
building, the spill involves quantities greater than 2.0
liters, the contents of the spilled material is unknown, the
spilled material is highly toxic, you feel physical symptoms
of exposure, highly toxic, biohazardous, radioactive or
flammable.
PROCEDURE:
.e Hold breath if possible and quickly determine what was
spilled.
POLICY
M~u~ HAZARDOUS MATERIALS AND Nm~r 2006
~~ WASTE MANAGEMENT
mr~g~ Da~ 01/07/91
S~ SPI~?.$ R~w ~ 11/20/90
~~~IN The Right To Know
COMMUNIT~ 12 / 1 S / 94
· Evacuate the personne~ in the area and c~ose a~l doors.
· ~otify people £n the ~m~ediate area, supervisor and
Safety Office~ D£al 700. ~epo~t the n~e of spiC,ed
chemical (if ~nown~ amount spilled and location. ~f
flam~able~ state that is a ~ammable liquid.
· Operator w£11 announce code
· Contact CAL9~ (80S) 589-5~48.
· Stand by the area of spi~l to direct Emergency ~esponse
personnel. ~f any specia~ hazard such as f~ammab±lity~
corrosiveness, toxic ~ume$, etc.~ e×£st~ notify emergency
personnel.
· ~e-enter area only after the spill has been el£minated.
~ minor spill is characterized by the confidence and the
capab±~it~ of unit personnel to clean up the spi~l without the
assistance o~ emergency personnel even thought the cleanup
procedure may require specialized ~nowled~e and specialized
equipment. ~ relatively small area is affected and only a
~elat£~ely small number of personnel may need to lea~e the
area unt£1 the spill is cleaned up.
· Put absorben~ from the spil~ kit on the material if ~he
material spilled is in ~i~uid form (and if this can be
done safely).
· Call in personne~ from En~ineer£ng Department and the
Safe~y
· ~a~e appropr£ate action to remove the hazard.
· Clean up the area.
· Additional information or assistance on minor spill
cleanup may be obtained from Safety Officer.
POLICY
M~u~l H~Z~V, DOUS I~tTERI'/kLS AND Numar 2006
~~ WASTE MANAGEMENT
(' ~ Effective Da~ 01/07/91
Subjm SPILLS Renew Da~ 11/20/90
..S,~V./O~42UIM The Right To Know
~UNITY 12/15/94
HO~FF~ P.gc 3 of 3
· Do not use respiratory protective equipment unless you
are trained in this safe use.
· Department personnel will be oriented and re-inserviced
_ annually in the use of the spill kit. evacuating the
area, and alerting emergency response personnel
PROCEDURE
EMPLOYEE RI~T TO KNOW/ N~r 2007
M~u~
HAZ COMM PROGRAM
Subjea
COMMUNITY
ALL DEPARTMENT DIRECTORS:
1. Director of Safety shall, as required, insure that the
orientation training program has been given and keep records
of the dates. Notice of employee rights will be located in
the Hazardous Material and Safety Management Manual and be
made available to all departments.
'2. Shall review area with supervisors to develop a composite list
of all chemicals currently being used and stored.
3. Shall submit chemical inventory list to the Hazardous
Communication Coordinator along with copies of all available
MSDS°s.
4. Shall review operations with supervisors to .determine jobs
which will require Hazard Communication Training.
5. Shall arrange for training of all involved employees in
coordination with hospital wide training program-.
6. Shall notify the Hazardous Communication Coordinator of any
change effecting hazardous materials being used.
7. Shall ensure up-to-date records being maintained on all
employees required to work with hazardous materials.
8. Shall report damaged containers or spills to the Hazardous
Communications Coordinator immediately.
MATERIALS MANAGEMENT:
1. Assist Department Directors in obtaining MSDS's on all
hazardous materials used in the hospital.
2. Shall ensure that supplies's samples include a MSDS for the
use of operating personnel in evaluating the product.
3. Shall identify supplies who fail to cooperate in providing
MSDS's and report this information to the appropriate person.
PROCEDURE
F_~PLO~E RI~' 'TO I~IOH/ Number 2007
IL%Z COI~I~ PROGI~
Subject
S4N JO~OUlN i2/i5/54
COMMUNITY
HOSPIT.4L ~ ~ o~ 2
4. Shall follow established safe practices for receiving
hazardous substances that include the following provisions:
a. ~ Ensure MSDS's are received with initial shipment of a
hazardous material.
b. Ensure labels are affixed to containers.
c. Store hazardous materials in designated locations.
d. Use prescribed personal protective equipment when
handling hazardous material.
POLICY / PROCEDURE
M~u~ [ Numar
~~ HAZARDOUS MATERIAL AND 2008
WASTE MANAGEMENT
W ~wD~ 05/04/94
Subj~
S,~VJO~OUffN ~e~ar~men~ ~anagemen~
COMMUNITY 05 / 04/94
HO~TrAL
i 2
0B3~C~V~S:
Develop a program that properly identifies hazardous materials and
addresses the handling, transport, storage and safe disposal of
these materials.
A hazardous materials is any material in use that its considered to
represent a threat to huma~ life or health. A hazardous waste is
a material no longer in use that represent such a threat. Once a
material is used, contaminated, or determined to be in e×cess of
the amount required, it is considered waste.
~ethods for handling each type of waste is outlined in the
following policies and procedures and monitored accordingly.
.CHEMICAL WASTE:
Chemical waste comes from a variety of sources within the hospital
including Dietetic Department/Service. It is usually collected at
the pint of use and segregated into containers intended for only
one kind of chemical waste. Waste from chemicals shall never be
mixed together because they can react together and cause serious
problems, such as explosions and/or deadly gas emission. The
following is a simple, generalized, step-by-step process that could
be used to handle and transport chemical waste:
· The componentsof each type of chemical waste are clearly
labeled.
· If the original label is unclear, damaged, or missing, or
if the container holds material that is different from
the original material, a new label shall be attached.
· The label clearly indicates that the material is
Hazardous Waste and lists the component and the strength
of the waste and type of hazard it represents, if the
type of hazard is not obvious.
· Labeled containers are removed from the area where they
are used as soon as possible after filing, to reduce the
hazards in the area.
POLICY / PROCEDURE
l~nu~! HAZARDOUS MATERIAL AND Number 2008
~~ WASTE MANAGEMENT
FJfecfive Da~
0~/04/94
Review Date
Subject
~~~[~ D~part;ment; Management; 05/01/94
2 2
· The chemical containers are picked up in sturdy carts and
transported in cardboard tote boxes.
· . Personnel who transport chemical wastes are trained to
deal with spills and leaks.
· Tote boxes are not over filled and the materials in a
tote box are chemically compatible.
.., POLICY
M~nu~ N~r
~~ HAZARDOUS MATERXAL AND 2009
W WASTE MANAGEMENT ~f~ DAm
5/4/94
S~ Renew ~
~%ZARDOUS C~E~ICALS
The followin9 hazardous chemicals are in use in the Plant,
Operations at San Joaquin Community Hospital:
Oxygen Acetylene
Propane Petroleum Oil
Paint/Paint Thinner Diesel Fuel
Cleaning Solvent Drain Opener
PRECAUTIONS IN HANDLING:
Fire or Explosion: May ignite combustibles (wood, paper, oil,
etc.). Mixture with fuels may explode.
Container may explode in heat or fire. Vapor
explosion hazard indoors, outdoors or in
sewers.
Health Hazards: Contact with liquid may cause frostbite.
Vapors may cause dizziness or suffocation.
Fire may produce irritation or poisonous
gases.
Fire: Small fires: Dry chemical or C02. Move container from fire
area if you.can do so without risk. Stay away
from ends of tanks. Cool containers that are.
exposed to flames with water from the side
until well after the fire is out.
Emergency Action: Keep unnecessary people away. Stay upwind;
keep out of low areas. Isolate hazard area
and deny entry. Wear self-contained breathing
apparatus and full protective clothing.
Isolate for 1/2 mile in all directions if tank
or tankcar is involved in fire.
Fire: Small fires: Dry chemical, C02, water spray or foam. Large
fires: Water spray, fog or foam. Move
container from fire area if you can do it
without risk. Stay away from ends of tanks.
Cool containers that are exposed to flames
with water from the side until well after fire
POLICY
M~u~
~~ HAZARDOUS MATERIAL AND 2009
WASTE MANAGEMENT
Su~e~ ~ew
~k4N~4~llll Plant Operations
C(~UNFFF Department
H AL
is out. For massive fire in cargo area, use
unmanned hose holder or monitor nozzles. If
this is impossible, withdraw from area and let
fire burn. Withdraw immediately in case of
rising sound from venting safety device or
discoloration of tank.
Spill or Leak: No flares, smoking or flames in hazard area.
Stop leak if you can do it without risk. Use
water spray to reduce vapors. Small spills:
Take up with sand, or other noncombustible
absorbent material, then flush area with
water. Large spills: Dike far ahead of spill
for later disposal.
FIRST AID
Move victim to fresh air; call emergency medical care. If not
breathing, give artificial respiration. If breathing is difficult,
give oxygen. In case of contact with material, immediately flush
skin or eyes with running water for at least 15 minutes. Remove
and isolate contaminated clothing and shoes.
OSHA REGULATIONS FOR HANDLING HAZARDOUS CHEMICALs
SEE OSHA GENERAL INDUSTRY SAFETY AND HEALTH STANDARDS (29CF1910)
OSHA 2260
PERSONAL PROTECTIVE EQUIPMENT [OSHA SUBPART 1):
(a) Application, Protective equipment, including personal
protective equipment for eyes, face .. extremities,
protective clothing, respiratory device~ ... shall be
provided, used, and maintained ... wherever it is necessary by
reason of hazards of processes or environment, chemical
hazards, radiological hazards ... in a manner capable of
causing injury ... through absorption, inhalation or physical
contact."
EYE AND FACE PROTECTION:
(a) "General. (1) Protective eye and face equipment shall be
POLICY
~~ HAZARDOUS MATERIAL AND 2009
WASTE MANAGEMENT mf~ m~
5/4/94
Su~ Renew Da~
~~~lN Plant Operations
¢~Z~UN~ Department
HOSi'IT
required where there is a reasonable probability of injury ...
In such cases, employers shall make conveniently available ...
No unprotected person shall knowingly be subjected to a
hazardous environmental condition." American National
Standard for Occupational and Education Eye and Face
Protection Z87.1-1968.
MEDICAL SERVICES AND FIRST AID (OSHA SUBPART K):
(c) "Where the eyes or body may be exposed to injurious
corrosive materials, suita~fJ facilities for quick drenching
or flushing of the eyes and body shall be provided within the
work area for immediate emergency use."
INFORMING CONTRACTORS:
It is the responsibility of San Joaquin Community Hospital to
provide contractors the following information:
1. Hazardous chemicals to which they may be exposed while on the
job site.
2. Precautions the personnel may take to lessen the Possibility
of exposure by usage of appropriate protective measures.
POLICY / PROCEDURE
~,~ H~ZARDOUS I~TERI~ff., AND 2010
WASTE MANAGEMENT
Pha~aceu~ical Depar~men~
C~UN~
Pha~acy Directors and personnel shall exercise extreme care when
handling hazardous materials and wastes.
PR~EDU~:
1. Expired drugs will be put in yellow containers, sealed, and
taken to hazardous waste site with a list of contents.
2. Ail drugs on fo~ulary are listed in the PDR (Physician Desk
Reference).
3. Ail cyto-toxic and/or experimental drugs shall be handled
with special precaution according to instructions from
manufacturer. Inserts and instructions are to be kept with
medications up to the time dispensed.
4. Ail waste from chemotherapy medications must be disposed of
as Hazardous Waste in yellow containers specified for such.
Red bags are for infectious wastes only.
POLICY / PROCEDURE
Manu~ ~ Nm~
'~'~ HAZARDOUS MATERIAL AND ~t~ D,~ 2011
( WASTEMANAGEMENT
Su~ ~cw Dab
&-~~W~ Materiels Managemen2 Dep2
... 1 1
POLICY=
The Materials Management Purchasing Department has the
responsibility for purchasing hazardous materials that are stored
in the departments. Listed below is a summary of the steps
involved in purchasing the needed materials:
PROCEDURE:
1. Mini-inventory of the materials is taken on the designated
day.
2. Items on hand as well as the items needed are recorded on the
Purchasing Request Form. Ail hazardous chemicals are
~ indicated by an asterisk on the Purchasing Request Form.
3. The quantity on hand is compared with the Min/Max levels. The
reorder quantities required are based upon these levels.
4. The form is then forwarded to Materials Management.
5. The Purchasing Department will generate a purchase order and
call the order in to the appropriate vendor.
6. When supplies are delivered, they are checked in according to
standard procedure, by the warehouse personnel. Materials
Management assures that a copy of most recent MSDS is
available.
7. Warehouse personnel delivers the order to the department.
8. Chemicals and other hazardous materials are stored in the
appropriate areas by department personnel.
POLICY / PROCEDURE
M~ud Nura~r
~~ P~Z~OUS I~TERZ]~L ~M~ID 2012
WASTE ~AG~NT ~f~ D~
~ 12/15/9~
R=~w Dsm
Su~
WgA~IN Disposal of
I 1
POLIC~=
Ail radioactive materials are disposed of in accordance with the
Nuclear Regulatory Comission regulations.
PROCEDU~S:
NOTE: WHEN ~DLING ~DIONUCLIDES, ~ RUBBER GLO~S.
1. Remove all expired radionuclides from the active storage area
to the radioactive decay vault.
2. Enter into the indicated log book the date of transfer, the
activity transferred, the volume transferred and initial the
e~try.
3. Place all radioactive waste materials; such as: used syringes,
needles, test tubes and other cont~inated items into
containers labeled for such waste.
i. Daily remove and seal the plastic bags which contain the
radioactive waste from the containers and place in the decay
vault.
5. Dispose of the radioactive waste materials in accordance with
the instructions given in the Nuclear Regulatory Co~ission
regulations.
6. Enter into the designated lo9 book details showing radioactive
materials disposed of, the date of disposal and the
radioactivity present at the time of disposal.
7. Perfo~ the final disposal of all radioactive materials in
accordance with the pres=ribed methods Oivtn by the Nuclear
aeoulato~ Comission regulations.
8. Enter into the designated lo9 book showin9 all disposals of
radioactive materials, date of disposal, radioactivity present
and the method used for disposal.
POLICY / PROCEDURE
M~u~ ~AZARDOUS MATERI&LS ~D Nm~r 2013
WASTE MANAGEMENT
~f~fi~Da~
S~ ~Hcw D~
.TugU~.J~t~(M,/IJ~/ CHF.~IC~%T.,W&STE OFF-SZ~E 12/15/94
12/15/94
1 1
OFF-SITE D~SPOSAL OF HAZARDOUS CHEmiCAL ~ASTE:
Hazardous chemical wastes requiring off-site recycling~
storage, treatment or disposal ~ill require an off-site,
California Department of Health Services approved contractor
for hauling and disposal.
B. All hazardous chemical waste leaving the hospital site will be
manifested (with the exception of recovered silver on-site,
lead-acid batteries, and possibly mercury and waste oil).
C. The manifests are to be completed by the off-site contractor
and filed in the Security office. The manifest will contain
the hospital's EPA generator ID number ( Section 66472).
D. All containers will meet U.S. DOT regulations and be packed
according to U.S. DOT regulations.
POLICY / PROCEDURE
M~u~ Numar
,~,~ EAZ/~DOUS F&TERI/~L AND 2014
WASTE
~f~fi~
~ 12 / 15 / 94
~4NJOAgIUlN CHEMOTHERAPY WASTE
COMMUN~ ~AG~NT
1
CHEMOTHE~Y WASTE ~AGE~NT
The chemotherapy waste management procedures described herein are
necessary to ensure that chemotherapy wastes generated with San
Joaquin Co,unity Hospital are properly identified, segregated,
contained, stored, transported, treated, and disposed of in
manner that will minimize health risk to patients, staff, visitors,
and co--unity.
I. CHEMOTHE~Y WASTE DEFINITION
Chemotherapy waste is defined as waste containing or
contaminated by chemotherapy agents. Chemotherapy wastes
include:
A. Excess concentrated antineoplastic agents
B. Excess prepared antineoplastic solutions
C. Misfo~ulated antineoplastic drug solutions
D. Antineoplastic cont~inated materials including:
* IV tubing
* needles, syringes
* vials, ~pules, bottles
* wipes, towels
* gloves, go~s
Right cytotoxic drugs are listed (u-listed) in their pure fo~
as hazardous chemical wastes once they have been deemed a
waste by the hospital. These drugs are cyclophosph~ide,
streptozocin, chlor~ucil, melphalan, uracil mustard,
chlornaphazin, mitomycin C, and daunomyuin. Currently Kern
County does not pe~it incineration of cytotoxic drugs.
Within the county cytotoxic drugs are'currently being disposed
of by BFI.
All cytotoxic drugs are ass~ed to exhibit carcinogenic,
teratogenic, reproductive, or mutagenic properties.
POLICY / PROCEDURE
M~ufl I~I~Z~I~DOUS M~TERI~ ~ID Numar 2014
~~ WASTE MANAGEMENT
mfecti~ Dam 12/15/94
S~ CHEMOTHERAPI WASTE Renew Dam 12/15/94
~4JVJOAOUlN MANAGEMENT
COMMUNITY
HOSPITAL ~ 2 ~ 5
Therefore discharge to the sanitary sewer is strongly discouraged.
[California's Proposition 65 law makes it illegal to discharge
agents into drinking water sources. California's Proposition
'Short List' currently includes cyclophosphamide, melphalan, and
chloram~ucil].
A. Chemotherapy waste will be properly contained and labeled
in the facility (e.g. ~ursing, Oncology, Pharmacy) ~here
it is generated.
1. Chemotherapy drug wastes that w£11 be disposed of
by off-site disposal must be collected in sturdy,
leak-proof containers that are appropriately
labeled.
2. Chemotherapy wastes (other than sharps) are to be
collected in sturdy, leak-p~oof conta&ners that are
appropriately labeled.
3. ~eedles, syringes, blades, and other small
contaminated sharps must be placed in properly
labeled, puncture-resistant containers prior to
disposal ±n the chemotherapy waste bags. These
boxes are not to be o~er filled and must be
properly closed to a~oid sp£11age of sharps waste
&nto the bag.
¢. Chemotherapy waste bags and the sharps d±sposal
bo×es must not be handled in any manner which might
cause them to break open, spill, or conta_mina~e the
handler.
5. Incidents £n~ol~ing spillage from chemotherapy
waste bags or sharps disposal bo×es, or &n~uries
resulting from their handling, must be reported to
the employee's supervisor and appropriate safety
personnel.
~. Transportat±on of chemotherapy wastes will ut£1ize
dedicated hazardous waste transporters that are
placarded, able to be secured and cleaned.
POLICY / PROCEDURE
M~u~ HAZ~qDOUS I~TERIAL ~ID N~ 20~4
~l,~ WASTE MANAGEMENT
mfc~i~ Da~ 12/15/94
Su~ CHEMOTHERAPY WASTE ~¢.D,~ 12/15/94
SAltl JOAOUIN MANAGEMENT
HOSPFr, Ag, ?~, 3 ~ 5
1. The frequency of daily chemotherapy waste
collection shall correspond to the quantities of
chemotherapy waste generated to avoid storage of
those wastes at the site of generation.
2. No chemotherapy waste will be collected if not
properly packaged and identified.
3. Chemotherapy waste containers are capped prior to
being transported by maintenance.
4. Once the transporters are full they are to be taken
to the hazardous waste storage area by the
Engineering Department.
5. Chemotherapy waste that is not transported is not
permitted to be discarded into the general waste
streams.
III. CHEMOTHERAPY WASTE HANDLING PROCEDURES FOR SPECIFIC
AREAS OR DEPARTMENTS
A. Pharmacy
1. Specific containers within Pharmacy are to be
established for the collection of chemotherapy
waste and must be properly labeled.
2. Chemotherapy wastes (including those generated by
Nursing) will be collected by Engineering and
transported to storage.
3. Excess concentrated (originaI container, EPA-'
listed) chemotherapy drug wastes are to be
segregated, packed and labeled for off-site
disposal.
4. Contaminated needles, syringes, blades, etc. will
be discarded in chemo waste containers.
POLICY / PROCEDURE
M~,a HAZARDOUS F~T~RIAL AND :N~r 2014
~~ WASTE MANAGEMENT
~ mf~ D~ I 1B/94
su~ CHEMOTHERAPY WASTE ~w m~ 12/1~/94
COMMUNITY
G. ~rs£ng (Onc°logy) "
1. Specific containers are provided for the
collection of chemotherapy waste.
4. Chemotherapy waste containers a~e not to be used
for the collection of no~al wastes.
~. Containers ~sed ~or the collection of che~otherap~
~astes must be color-coded chemotherapy waste
containers.. ?his is a responsibility of 9har~acy
2. ~he frequency of chemotherapy waste collection
shall co~respond to the ~uant±ties of chemotherapy
should include at least vinyl gloves when handling
the waste containers.
a) The waste in chemotherapy waste containers may
not be dumped or in any way be transferred
from one container to another.
b) Chemotherapy waste containers will be closed
securely prior to their removal from the
hospital to be transported to storage.
POLICY / PROCEDURE
M~u~l HAZARDOUS MATERIAL ~D Namb~r 20~4
~~ W~TE ~AG~NT
~f~ D.~ ~2/15/94
Sub~ CH~OTHE~PY WASTE ~,~ D.~ 12/15/94
W~~IN ~AG~NT
4. Incident Reporting:
a ) Any incident involving spillage of the
contents of a chemotherapy waste container
will be reported to the employee's supervisor,
safety personnel, and employee health.
b) Any injuries to personnel resulting from waste
"handling" procedures will be reported through
the hospital incident reporting system.
POLICY / PROCEDURE
M~.~ HAZARDOUS NATERIALS AND !Numar 2015
~~ WASTE MANAGEMENT
~fecti~ Da~
W Renew Dam
~ueIJ.lO. ei4:~,llN WASTE OAS ]O~I&OF.J~NT 12/15/94
C4~I~f UNg'I~ PROCEDURES
! 5
WASTE GASES MANAGEMENT PROCEDURES
The waste gases management procedures described herein are
necessary to ensure that waste gases generated or released are
properly handled, stored, contained or ventilated in a manner
that will minimize health risk to patients, staff, visitors,
and the community.
I. IDENTIFICATION OF GAS TYPE AND THEIR WASTES
Compressed gas is a gas of any form'which in a container
exhibits a pressure of 40 pounds per square inch (PSI,
absolute) or greater at 20 degrees C. Compressed gases can be
placed into one of four categories.
( A. Compressed gases are gases which are pressurized at the
temperature above their boiling point and are in a fully
gaseous state. Since the interior pressure of the
container generally reaches about 2000 psi at 20 degrees
C when the cylinder is fully charged, gases are normally
stored in cylinders of heavy-walled construction.
Examples of compressed gases of this type are oxygen,
nitrogen, and argon.
B. Liquified gases are gases which are liquified under high
pressure at a temperature above their boiling point.
Both liquid and gas are in a state of equilibrium in the
cylinder with the equilibrium remaining constant until
the liquid phase is exhausted. The interior pressure of
the cylinder depends on the type of gas and is normally
much lower than compressed gases. 'The amount of gas in
the cylinder can only be measured by weight. Examples of
liquified gases are propane, butane,.chlorine, and carbon
dioxide.
C. Dissolved gases are gases which are dissolved in another
chemical inside the cylinder since they are unstable when
compressed. As an example, acetylene is dissolved in
acetone to a pressure of about 400 psig (pounds per
square inch, gauge) at 20 degrees.
POLICY / PROCEDURE
m.~u~ HAZARDOUS MATERIALS AND Numar 2015
~~ WASTE MANAGEMENT
W ~f~ D.~ 12 / 15 / 94
Su~=~ WASTE GAS MANAGEMENT ~wDa~ 12/15/9&
~~~IN PROCEDURES
COMMUNITY ! 2 / 15 / 94
HOSPITAL P'ge 2 ~ 5
D. cr¥og~n~c l£qu£ds ~ocm by condensaC£on when g~ses w£~h
low boiling points ace compressed a~ ~e~pe~a~ures below
~heir boiling point. Examples o~ c~yogenic liquids
~orm£ng ~rom gases w£~h low bo£1£ng points are oxygen (-
183 degrees C), ni~cogen (-96 degrees C), and helium (-
269 degrees C).
Compressed gases ace hazardous because o~ h£gh pressure
(crea~£ng ~he possib£1£~ o~ explos£on ~rom ~he container o~
escaped gas) or
~he nature o~ ~he gas-(ign£~abil~y, ~oxici~, cocros£vi~, or
as anasphyx£an~). ~as~es gases ace de~£ned as gasses ~ha~ ace
~eleased ~hrough exp±ra~ion, escape, leeching, decompos±~±on,
or spillage as a resul~ o~ use or accident.
;Zo GENEP~L PROCEDURES
A. Each depar~me~ ~h~ uses compressed gases or gene~a~es
waste gas w£11 have spec£~£c pol£c£es and procedures ~ha~
conCa£n in~o~ma~£on regarding ~he sa~e handling, and
disposal o~ ~hesewas~es. These pol±c±es and procedures
shall be rev~ewed~ rev~sed~ and/or approved b~ ~he
En~£ronmen~al Health and Sa~e~y Committee annually.
Those departments no~mall~ us±n9 co~pressed gases ace:
1. Anes~hes£olog~ (e.g. Eh~ane, Forane)
2. Central Suppl~ (e.g. E~h~lene oxide - ~h±$ 9as ~s
regulated by 051~, spec~£~c procedures should
already be de~eloped)
3. En~nee~£n~ (e.g. Acetylene)
4. Resp£ra~or¥ Therap~ (e.g. oxygen)
5. Labora~or~ (e.g.Carbon D£oxide)
B. ~ll persons usin9 compressed gases mus~ be p~ovided wi~h
~he prope; ~raining and equipment.
C. The Hazardous ~a~er£als ~nd Was~e Coord£na~o~ £n
conjunct±on wi~h ~he Sa~e~ O~ice has au~ho;£~ ~o.
£ns~i~u~e emergenc~ procedures in ~he even~ o~ a m~o;
gas acciden~ or release.
POLICY / PROCEDURE
M~u~ HAZARDOUS I~TERIALS ~ND Nm~ 2015
~~ WASTE MANAGEMENT
~ mf~v~ Da~ 12 / 15 / 94
Su~ WASTE GAS MANAGEMENT R¢~¢w~ 12/15/94
~.~~JW PROCEDURES
¢~%f~%~WFFF' ! 2 / ! S / 94
HO~P/TAL ~'~ 3 of 5
D. Fire protection eqUipment will be available in all areas
where compressed gases may have the potential to cause a
fire or feed a fire.
E. The gas contents of any cartridge or cylinder must be
identified by reading the label. Cylinder content is not
identified by colored labels, except medical gases. Each
cylinder should be properly labeled.
F. The cylinder should be free of rust, damage or leaks. If
not, return to vendor.
III. STORAGE OF GAS CYLINDERS
Proper storage of gas cylinders is essential to minimize
accidental escape of cylinder contents.
A. Cylinder caps are to be kept on at all times except when
cylinder is in use.
B. All cylinders should be kept upright and strapped or
chained to the wall to prevent falling.
C. Flammable gas stored in the lab should not ordinarily
exceed two days' working needs. Storage areas must be
clearly posted, dry, well-vented, and temperatures should
be kept below 85 degree F.
D. If more than one type of gas is stored in the same area,
they should be grouped. Fuel gases (acetylene, propane)
should be kept separate from those supporting combustion
(oxygen, chlorine).
E. Keep all sources of ignition away from storage area.
IV. TRANSPORT OF CYLINDERS
A. Always use hand trucks for transport. Secure cylinder to
hand truck.
B. Cylinder caps are to remain on at all times when
transporting.
c. Avoid rough handling and hard blows to the tank.
POLICY / PROCEDUR~
M~u~ HAZARDOUS MATERIALS AND N~r 2015
~~ WASTE MANAGEMENT
W 12/15/94
$~e~ WASTE GAS MANAGEMENT R=~=wDa~ 12/15/94
~,4N JOA42UIN PROCEDURES
¢O~N~ 12/15/94
HO~P/TA/. P'~ 4 ~ 5
IV'. USE OF CYLINDERS
A. The user should be familiar with cylinder structure
(valves and fittings), labeling, nature of gas being
-used, and procedures for installing and removing
cylinders.
B. Do not use gas until the content of the cylinder is
identified.
C. If the cylinder is exposed to extreme temperatures, allow
it to come to room temperature slowly in ambient air.
D. Secure cylinder to a stable object with chain or belt.
E. Different gases use different regulator gauges, nipples,
and fittings. Do not use an adaptor to connect an
improper regulator onto a cylinder.
F. Use no oil on oxygen regulator valves and gauges.
G. Check for leaks with soapy water. Never use,a flame.
H. Hydrogen cylinders should be grounded to prevent static
electricity when the bottle is in use.
I. Do not use any cylinder below 30 psi or 'suck-back' may
occur. This is particularly important for acetylene.
J. Label empty cylinder and separate it from full cylinders.
K. Glass equipment should not be pressurized unless used
with special protective equipment.
VI. DISPOSAL OF WASTE GAS AND CYLINDERS
A. All gas scavengering systems should be vented to outside
air with sufficient escape velocity to prevent re-entry
into the building.
B. Ethylene oxide sterilizers and ventilation cabinets
should be properly vented or exhausted to meet OSHA
standards (29 CFR 1910.1047).
~ P()LICY / PROCEDURE
M,~,~ HAZARDOUS I~tTERIA.LS ~ N~ 2015
~~ WASTE ~AG~NT
~ Da~ 12/15/94
Su~i~ WASTE ~AS ~A~N~ ~D~ 12/15/9i
~ ~~IN PR~EDU~S
COM~~
C. ~h~lene oxide s~e~ilized i~ems should be
aerated acco~din9 ~o specific ~i~e ~equi~emen~s ~o
eliminate ~he h~za~ds ~o ~oxic
D. . ~mp~ d~sposab~e 9as ~o~les o~ cylinders should be
discharged ~i~hin ~he chemical ~e hood
discharge veloci~ ~o ~e outside ~o preven~ laye~in~ on
~he ~oo~ o~ ~e-en~ in~o ~he building. The~ discard
in~o ~ene:al ~as~e s~e~. ~his doe~ no~ appl~ ~o ~oxic
9as c~11nde~s. ~on-disposable cylinders vill
~o
vendo~ o~
POLICY / PROCEDURE
M~u~ HAZARDOUS NATERIALS AND N~r 2016
~~ WASTE MANAGEMENT
~ ~f¢~ti~ Da~ 12/15/94
S~t Renew Dam 12 / 15 / 9 4
¢O~MUWI71' Training
EMPLOYEE RESPONSIBILITIES:
1. Obey established safety rules.
2. Use personal protective equipment as required.
3. Inform your supervisor of=
A. Any symptoms of overexposure that may possibly be related
to hazardous chemicals.
B. Missing labels on containers.
C. Malfunctioning safety equipment.
D. Any damaged containers or. spills must be reported.
immediately.
TRAINING:
PURPOSE=
This procedure outlines the San Joaquin Community Hospital policy
for training personnel who are required to handle hazardous
chemicals.
SCOPE:
Training for personnel will include as a minimum, the following
areas:
1. The Hazard Communication/Right to Know Law.
2. Symptoms associated with overexposure to hazardous materials.
3. First Aid treatment.
4. How to read Material Safety Data Sheets.
5. Use of personal protective equipment. Location, availability,
type, use and limitations.
6. Standard operating procedures.
POLICY / PROCEDURE
M~u~ HAZARDOUS MATERIALS AND Numar 2016
~~ WASTE MANAGEMENT
W ~f~i~ Da~12/15/94
~6¢w Da~2/15/94
Su~
~ JOAOUIN
¢~MUN~F~ Training
HOSPITAl. P'g¢ 2 ~ 2
7. Hazards of chemicals to workers involved in non-routine tasks
such as in the cleaning, maintenance and repair or equ£pment.
8. Emergency procedures.
9. Storage practices.
10. Identify what and where hazardous chemicals are found in the
work area.
TRAINING PROGRAM:
To develop specific training for all hospital personnel, the
following guidelines should be used:
1. Identify any areas where an industrial hygiene or occupational
health evaluation may be needed.
2. Perform the training.
3. Document all personnel training.
4. Evaluate effectiveness of training.
5. Review training procedures periodically, especially prior to
performing non-routine tasks.
PROCEDURE
EMPLOYEE I~LTERIKLS AND ' N,m~r 2017
M~u~
~~ WASTE MANAGEMENT
~ ~W E~PLOYEE CHEMICAL
Su~ TRAINING SAMPLE MEMO
COMMUNITY
HOSPITAL
From: Safety Officer
A new employee , was recently added to your staff.
~n order to comply with OSSA's Employees Right ?o ~now Standards,
you must conduct an £nservice pertaining to the chemicals in your
area prior to the time that the employee is given a work assignment
in which he or she will be working with the chemicals(s). The
scope of the initial educational session must include at least the'
following:
· Znfo~mation about the hazard communication requ£rements;
specifically that employers are required to have hazard
communication training programs.
· ~den~ification of hazardous materials present in their
work place.
· Where the following information can be located:
o Written hazard evaluation procedures
o Written description of the .Hospital Hazard
Communication Program
0 Listing of the hazardous materials
0 Location of the Material Safety Data Sheets (MSDS)
· Methods by which the employees can detect the presence of
hazardous materials.
· Information on any specific measures that have been
implemented by the Hospital to protect the employee.
· Information on measures that the employees can take to
protect themselves from the health or physical hazards
associated with the materials.
· Information on how to read and interpret warning and
other information on the labels and Material Safety Date
Sheets (MSDS).
· How to obtain further information.
Please complete inservice within ten (10) days and return a copy to
Safety Officer. Give employee a copy and department manager retain
the original.
2018
CHEMICAL TRAINING RECORD
1. Instructor
2. Training Date
3. Chemical Substance
4. Attach Material Safety Data Sheet flVISDS) to Training Record
5. Chemical Use
6. Employee Training Provided on:
a. Employee responsibility to report any release or threatened release of a
hazardous material to:
YES __ Department Manager or Supervisor
YES. . . b. Name of persons within facility who are responsible to respond to an
incident.
( last Name First Name Business Phone Home Phone
. Mst Name First Name Busi~ness Phone' Home Phone
YES~ c. Information contained in Material Safety Data Sheets.
YES d. Warning Labels.
YES.~ e. Safe Work Practices.
YES f. Procedures to follow during a release or threatened release. (Discuss
possible release scenarios, where to meet fire department, possible
evacuation of building.)
YES.__ g. Use of emergency equipment and supplies (fire extinguishers, hose
reels, absorbent materials.)
.YES. ~ h. Use and location of personal protective equipment.
Z Employees Trained:
8. Employee Signature Work Area
PROCEDURE
M~u~ Nmnb~r
~~ HAZARDOUS MATERIAL AND 2019
WASTE MANAGEMENT '~¢ Da~
W ,,, 05/04/94
R~-vicw Da~
S~ Hazardous Chemical
~IJ~AOUIN
Employee Training Record ,,
COMMUNITY
HOSPITAl.
1 8
PURPOSE:
The purpose of this program is to ensure that the hazards of all
the hazardous chemicals used by each department at San Joaquin
Community Hospital are evaluated, and that information concerning
their hazards is transmitted to affected personnel within their
department. The information transmitted will include container
labeling and other forms of warning, Material Safety Data Sheets,
and personnel training about toxic substances used in San Joaquin
Community Hospital that could affect their health.
SCOPE:
Any chemical which is known to be present in the work place in such
a manner that personnel may be exposed under normal conditions of
use or in a foreseeable emergency.
DEFINITION:
"Hazardous Chemical" - means any chemical for which there is a
physical hazard or health hazard.
"Physical Hazard" - means a chemical for which there is a
scientifically valid evidence that it is a combustible liquid, a
compressed gas, explosive, flammable, an organic peroxide, an
oxidizer, pyrophoric, unstable (reactive) or water-reactive.
"Health Hazard" - means a chemical for which there is statistically
significant evidence based on at least one study conducted in
accordance with established scientific principles that acute or
chronic health affects may occur in exposed employees. The term
"health hazard" includes chemicals which are carcinogens, toxic or
highly toxic agents, reproductive toxic, irritants, corrosive,
sensitizers, heatotoxins, nephrotoxins, neurotoxins, agents which
act on the hematopoietic system, and agents which damage the lungs,
skin, or mucous membranes.
"Label" - means any written, printed or graphic material displayed'
or affixed to containers of hazardous materials.
PROCEDURE
M~ Nm~r
~~ HAZARDOUS MATERIAL AND 2019
WASTE MANAGEMENT
Sub~ Hazardous Chemical
CO~MUWFF~ Employee Training Record
"Material Safety Data Sheet (MSDS)" - means written or printed
material concerning a hazardous chemical which is prepared by the
manufacturer for each hazardous chemical they produce.
"Training" - means to make proficient with specialized instruction
and practice.
A list of hazardous chemicals used in this hospital and the
identity that is referenced on the appropriate Material Safety Data
Sheet will be posted in the Safety/Security office and ER.
If a "non-routine" task should develop no work will be accomplished
until the proper procedure and proper chemical to use is learned
and transmitted to affected personnel.
The method we will use to inform any contracted personnel working
in San Joaquin Community Hospital is to include appropriate
provisions in the written contract we make with each of them. We
will include written specifications such as when and where they
will do their work and what they are permitted -- or denied
permission -- to bring on hospital premises.
LABELS AND OTHER FORMS OF WARNING=
The chemical manufacturer, importer, or distributor shall ensure
that each container of hazardous chemicals leaving the work place
is labeled, tagged or marked with the following information=
1. Identity of hazardous chemical(s)~
2. Appropriate hazard warning~
3. Name and address of the chemical manufacturer, importer, or
other responsible party.
Department Directors and Supervisors shall ensure that each
container of hazardous chemicals in the department is labeled,
tagged and marked with the following information=
1. Identity of the hazardous chemical(s) contained therein~
2. Appropriate hazard warnings.
We are not required to label portable containers into which
hazardous chemicals are transferred from labeled containers, and
PROCEDURE
M~u~ Numar
~~ HAZARDOUS MATERIAL AND 2019
WASTE MANAGEMENT ~f~ve Dam
n,~. mt, 05/04/94
Sub~ Hazardous Chemical
SANJOAOUlN
Employee Training Record
~ 8
which are intended only for the immediate use of the personnel who
performs the transfer.
Personnel shall not remove or deface existing labels on incoming
containers of hazardous chemicals, unless the container is
immediately marked with the required information.
Department Director and Supervisors shall ensure that labels or
other forms of warnings are legible in English and predominate
second language of personnel if applicable, and prominently
displayed on the container, or readily available in the work area
throughout each work shift.
The information on the labels and the importance of proper labeling
and following the label direction will be transmitted to all
department personnel in in-services, and proper handling procedures
in our training program.
MATERIAL SAFETY DATA SHEET:
Chemical manufacturers and importers shall obtain or develop a
Material Safety Data Sheet for each hazardous chemical they produce
or import. .Employers shall have a Material Safety Data Sheet for
each hazardous chemical which they use.
Each Material Safety Data Sheet shall contain at least the
following information:
1. The identity used on the label and except as provided for on
trade secrets:
A. If the hazardous chemical is a single substance, its
chemical and common name(s);
B. If the hazardous chemical is a mixture which has been
tested as a whole to determine it's hazards, the chemical
and common name(s) of the ingredients which contribute to
these know hazards, and the common name(s) of the mixture
itself; or,
PROCEDURE
M~u~ Numar
~~ HAZARDOUS MATERIAL AND 2019
WASTE MANAGEMENT ~f~v~ ~
~ ~,m~ 05/04/94
su~ Hazardous Chemical
~~Q~2~IN Employee Training Record .,
4 8
C. If the hazardous chemical is a mixture which has not been
tested as a whole;
(1) The chemical and common name(s) of all ingredients
which have been determined to be health hazards,
and which compromise 1% or greater of the
composition; and,
(2) The chemical and common name(s) of all ingredients
which have been determined to present a physical
hazard when present in the mixture.
a. Physical and chemical characteristics of
the hazardous chemical (such as vapor
pressure, flash point).
b. The physical hazards of the hazardous
chemical, including the potential for
fire, explosion, and reactivity.
c. The health hazard of the hazardous
chemical, including signs and symptoms
of exposure, and any medical condition
which are generally recognized as being
aggravated by exposure to the chemical;
d. The primary route(s) of entry;
e. The OSHA permissible exposure limit,
ACHIH Threshold limit VALUE, any other
exposure limit used or recommended by
the chemical manufacturer, importer, or
employer preparing the Material Safety
Data Sheet, where available.
f. Whether the hazardous chemical is listed
in the National Toxicology Program (NTP)
Annual Report on Carcinogens (latest
edition) or has been found to be a
potential carcinogen in the
International Agency for Research on
Cancer (IRAC) Monographs (latest
edition), or by OSHA.
g. Any generally applicable precautions for
safe handling and use which are known to
the chemical manufacturer, importer, or
employer preparing the Material Safety
PROCEDURE
M~u~ Numar
~~ HAZARDOUS MATERIAL AND 2019
WASTE MANAGEMENT
~ew Date
Sub~e Hazardous Chemical
~4JU.IO,44~UIN
~)4gl~lug~ Employee Training Record
5 8
Data sheet, including appropriate
hygienic practices, protective measures
during repair and maintenance of
contaminated equipment, and procedures
for cleanup of spills and leaksl
h. Any generally applicable control
measures which are known to the chemical
manufacturer, importer, or employer
preparing the Material Safety Data
Sheet, such as appropriate engineering
controls, work practices, or personal
protective equipment~
i. Emergency and first aide procedures~
j. The date of preparation of the Material
Safety Data Sheet and the last change to
it~ and,
k. The name, address and telephone number
of the chemical manufacturer, importer,
employer, or other responsible party
preparing the Material Safety Data
Sheet, who can provide additional
information on the hazardous chemical
and appropriate emergency procedures if
necessary.
(3} If no relevant information is found for any given
category on the Material Safety Data Sheet, the
chemical manufacturer, importer, or employer
preparing the Material Safety Data Sheet shall
mark it to indicate such.
(4) Where Complex mixtures have similar hazards and
contents (i.e. the chemical ingredients are
essentially the same but the specific composition
varies from mixture to mixture), the chemical
manufacturer, importer, or employer may prepare on
Material Safety Data Sheet to apply to all of
these similar mixtures.
(5) The chemical manufacturer, importer, or employer
preparing the Material Safety Data Sheet shall
ensure that the information recorded accurately
PROCEDURE
M~u~ Numar
~~ HAZARDOUS MATERIAL AND 2019
WASTE MANAGEMENT ~'ex~ivc"Da~
05/04/94
Sub~ Hazardous Chemical
~~OUIM Employee Training Record
HOSI'ITAL
~ 8
reflects the scientific evidence used in making
the hazard determination. If the chemical
manufacturer, importer, or employer becomes newly
aware of any significant information regarding the
hazards of a chemical, or ways to protect against
the hazards, the new information shall be added to
the Material Safety Data Sheet within three
months. If the chemical is not currently being
produced or imported the chemical manufacturer or
importer shall add this information to the
Material Safety Data Sheet before the chemical is
introduced into the work place again.
(6) Chemical manufacturers or importers shall ensure
that distributors and manufacturing purchasers of
hazardous chemicals are provide~ an appropriate
Material Safety Data Sheet with their initial
shipment, and with the first shipment after a
Material Safety Data Sheet is updated. The
chemical manufacturer or importer shall provide
Material Safety' Data Sheets with the shipped
containers or send them to the manufacturing
purchaser prior to or at time of shipment. If the
Material Safety Data Sheet is not provided with
the shipment, the manufacturing purchaser shall
obtain one as soon as possible.
(7) Distributors shall ensure that Material Safety
Data Sheets, and updated information are provided
to other distributors, and manufacturing
purchasers of hazardous chemicals.
(8) The employer shall maintain copies of the required
Material Safety Data Sheets for each hazardous
chemical in the work place, and shall ensure that
they are readily accessible during each work shift
to personnel when they are in their work area(s).
(9) Material Safety Data Sheets may be kept in any
form, including operating procedures and may be
designed to cover groups of hazardous chemicals in
a work area where it may be more appropriate to
PROCEDURE
M~u~ Numar
,~,~ H~ZARDOUS /O, TERIAL AND 2019
WASTE MANAGEMENT ~fc~v¢ ~
05/04/94
~¢w Da~
s~c~ Hazardous Chemical
L~nployee Training Record
?
address the hazardous chemicals. However, the
employer shall ensure that in all cases the
required information is provided for each
hazardous chemical and is readily accessible
during each work shift to personnel when they are
in their work area(s).
The information on Material Safety Data Sheets and the importance
to the personnel regarding hazardous chemicals will be transmitted
to all department personnel through in-services and proper
procedures on the use of each chemical in our training program.
PERSONNEL INFORMATION AND TRAINING:
The OSHA Hazard Communication Standard requires the employers
provide personnel with information and training on hazardous
chemicals in their work area at the time of their
initialassignment, and whenever a new hazard is introduced into
their work area.
INFORMATION:
Personnel shall be informed of;
1. The requirements of the standard.
2. Any operations in their work area where hazardous chemicals are
present and;
3. The location and availability of the written hazard
communication program, including the required list(s) of
hazardous chemicals, and Material Safety Data Sheets required
by the standard.
TRAINING:
Personnel training shall include at least;
1. Methods and observations that may be used to detect the
· presence of release of a hazardous chemical in the work area
(such as monitoring devices, visual appearance or odor of
hazardous chemicals when being released etc.).
PROCEDURE
~~ K,%ZARDOUS MATERIAL AND 2019
WASTE MANAGEMENT mf~cavc ~
05/04/94
subjca Hazardous Chemical
S,4NJOA42[IIN Employee Training Record
COAf~tfUWI71'
8 8
2. The physical and health hazard of the chemical in the work
area.
3. The measures the personnel can take to protect themselves from
these hazards, including specific procedures the employer has
implemented to protect personnel from exposure to hazardous
chemicals, such as protective equipment to be used; and
4. The details of the hazard communication developed by the
employer including an explanation of the labeling system and
the Material Safety Data Sheet, and how personnel can obtain
and use the appropriate hazard information.
The personnel information and training program will include all of
the requirements of the standard.
POLICY / PROCEDURE
Manual Number
,~,~ HAZARDOUS I~TERI~ff..S ,M~D 2020
WASTE MANAGEMENT ~fc~ Dat~
~ 12/15/9&
~ R,vi~w Dam
Subject
gan. N JOAOUflV F_a~]oyee
COMMUiVlT~ I 1
POT.TOY:
In the event of an emFloyee being injured by one of the Froducts
listed in the deFa~tments Ba~ardous ~ater~als Notebook the
~ollow~ng ~ocedu~e should at all t~mes be ~ol~o~ed.
PR~EDU~:
The d~rector/charge Ferson should re,er to the notebook a~d locate
the aFF~oF~ate mate~al ~a~et~ data sheet.
t~eatment bring the aFF~oF~ate ~ate~al sa~et~ data sheet ~th the
emFlo~ee to The ~mFlo~ee Bealth ~r~e, ~e~genc~ DeFa~t~ent
~me~genc~ Care 9ro~der according to hospital ~o1~c~.
8a~et~ Znc~dent ~eFo~t ~ho~ld be ~led o~t
POLICY / PROCEDURE
M~ I~ZARDOUS I~TERI~ff.,S ND ~um~r 2021
~~ WASTE MANAGEMENT
~f~6~ Da~ ~2/~/9~
s~ Employees Righ~ To Kn~ ~ewm~
~~~$~ ~Z~OUS S~ST~CE
CO~UW~ ~C~NITION CO~ICATION
i 3
DEP~T~NT ORIENTATION~
A. Upon completion of Department orientation, the employee will
be able to =
1. Locate the department Hazardous Substance Policy file
(Hazardous Substance e Policy Sheets and MSDS's).
2. Identify specific hazardous substances, including
identifying characteristics, protective measurers,
emergency or spill measures, and disposal procedures.
3. Identify the hazards associated with non-routine duties.
B. Hazardous Substance Policy
1. The department file is located in each department.
(Each depar~ent 9tint or tyge exact location)-
C. Hazardous Substances
1. Review contents of the department hazardous substance
9olicy.
2. For each hazardous substance on the department inventory,
review~
a. Observation and detection methods.
b. Ail info~ation found on the Hazardous Substance
Policy Sheet.
D. Labeling
1. Label contains=
a. Identity
b. Warning (show a label).
c. Manufacturer address.
E. Non-routine Duties
1. The dangers of working with unf~iliar substances.
' POLICY / PROCEDURE
M~u~ H~ZARDOUS NATERL~LS AND N~r 2021
/ ,~~ WASTE MANAGEMENT
~ ~ ~t~ti~O~ 01/08/88
su~ Employees Righ~ To Kn~ ~e~D,~
~~~ ~Z~OUS S~ST~CE
C~UM~ ~C~NITION CO~I~TION
2 3
2. The importance of asking questions about hazards before
perfo~ing non-routine duties in your department.
3. The importance of relaying hazard info~ation to other
workers who are perfo~ing non-routine duties in your
department.
4. The occurrence of unlabeled pipes which may contain
hazardous material.
DEP~T~NT UPDATE:
A. Upon comgletion of Ugdate, the employee will be able to:
1. Locate MSDS manual.
2. Identify hazardous substances used in the department.
3. Identify new hazardous substances added.
B. Review
1. Hazard Co~unication: We have a written progr~ that
outlines how we will provide info~ation and control your
exposure to hazardous substances. This plan is available
for your review during your training and at the location
for reviewing during your work shift.
2. MSDS Notebooks: Review contents of the file.
a. Location;
b. Obse~ation and detection method for identified
hazardous substances.
c. All info~ation found on the Hazardous Substance
Policy Sheets.
3. New Hazardous Substances: For each new substance include:
a. Location:
b. Observation and detection method~ and
c. Ail info~ation-found on the MSDS Sheets.
POLICY / PROCEDURE
M~ HAZARDOUS MATERIALS AND ~r 2021
~~ WASTE MANAGEMENT
mfe~i~D.~ 12/15/94
$~ HAZARDOUS SUBSTANCE ~w D.~
.,T~UV JO~IW RECOGNITION COMMUNICATION
¢OMMUN~
HOSPITAL I ~ ~ ~ ~
4. Non-routine Duties: The dangers of working with
unfamiliar substances:
a. The importance of asking questions about hazards
before performing a non-routine task or working on
a non-routine area.
b. The importance of relaying hazard information to
other workers who are performing non-routine duties
in your department.
c. The occurrence of unlabeled pipes which may contain
hazardous material.
POLICY / PROCEDURE
M~u~ HAZARD MATERIAL AND Numar 2022
~~F WASTE MANAGEMENT
SuH~ MEDICAL/BIO-HAZARDOUS ~w D~
~AJV,IOA4~IIN WASTE MANAGEMENT
¢~gNrfl'
HOSPITAL ~'~ 1 ~ 7
The medical waste management procedures described herein are
necessary to ensure that the medical wastes generated within San
Joaquin Community Hospital are properly identified, segregated,
contained, stored, transported, treated, and disposed of in a
manner that will minimize health risk to patients, staff, visitors,
and community. The procedures described here are based on San
Joaquin Community Hospital utilizing the bio-Hazardous waste
containers pending removal by BFI for final disposal.
I. M~DICAL WASTE DEFINITION
Medical waste is defined as waste capable of producing an
infectious disease. This definition requires a consideration
of the factors necessary for induction of disease which
include dose, resistance of host, portal of entry, and
presence of a pathogen and virulence. Therefore, for a waste
to be infectious, it must contain pathogens with sufficient
virulence and quantity so that exposure to the waste by a
susceptible host could result in an infectious disease. Under
California Health and. Safety Code (25117.5a) medical wastes
include:
A. Laboratory wastes, including cultures of etiologic
agents, which pose a substantial threat to health due to
their volume and virulence.
B. Pathologic specimens, including human or animal tissues,
blood elements, excreta, and secretions which contain
etiologic agents, and attendant disposable fomites.
C. Surgical specimens, including human and animal parts and
tissues removed surgically or at autopsy which contain
etiologic agents, and attendant disposable fomites.
D. Equipment, instruments, utensils, and other disposable
materials which are visibility soiled with infectious
material, secretions,excretions, discharge, body fluids)
from patients suspected or diagnosed communicable
disease.
E. Human dialysis waste materials, including arterial lines
and dialyzate membranes.
F. Any other materials which, in the determination of the
facility infection control staff, presents a significant
POLICY / PROCEDURE
M~u~ I/~ZARD M~TERI~J~ AND Numar 2022
~~ WASTE MANAGEMENT
W mf~ Da~ 12/15/9&
Su~ MEDICAL/BIO'HAZARDOUs Renew ~
~.~.~~IN i WASTE MANAGEMENT ,,_
COMMUNITY
may be reasonably expected to be contaminated with,
etiologic agents. As used in this section, "etiologic
agent" means a type of microorganism, helminth, or virus
-which causes, or significantly contributes to the cause
of, increased morbidity or mortality of human beings.
II. PROCEDURES FOR THE HANDLING OF MEDICAL WASTE
A. General
1. Medical wastes shall be segregated from other
wastes at point of origin in the hospital.
2. Trash chutes are not to be used to transfer medical
waste between locations.
3. Medical waste bags and the sharps disposal boxes
must not be handled in any manner which might cause
them to break open, spill or contaminate the
handler.
4. Incidents involving spillage from medical waste
bags or sharps disposal boxes, or injuries
resulting from their handling, must be reported to
the employee's supervisor and appropriate safety
personnel or employee health.
B. Containment
1. Ail infectious sharps shall be contained in
leakproof, rigid, puncture-resistant containers
which can be secured to avoid loss of contents.
They shall be labeled with the words 'Medical
Waste' or with the international biohazard symbol
and the word 'Biohazard'.
2. All bags used for medical waste (except for sharps)
shall be red in color and meet the 165-gram dropped
dart impact resistance test. They shall be labeled
with the words "Medical Waste" or with the
international biohazard symbol and the word
"Biohazard". Red bags are never to be placed
anywhere other than in an approved container.
' POLICY / PROCEDURE
M~ HAZARD MATERIAL AND N~br'r 2022
~~ WASTE MANAGEMENT ,
~f~ Da~ 12/15/94
Su~ea MEDICAL/BIO-HAZARDOUS
SAN.IOAOUIN WASTE MANAGEMENT
¢OMMUN~
HOSP/TA/. ~&' 3 of 7
3. Medical wastes 'shal~ be contained in a small red
bag and shall be securely tied during storage,
handling or transport.
-4. Medical waste contained in disposable containers
shall be placed for storage or handling in
disposable or reusable pails, cartons, drums,
dumpsters, or portable bins. Containment must be
leakproof, have tight-fitting covers, and be kept
clean, in good repair and properly labeled. Upon
emptying they are to be thoroughly washed and
decontaminated if a spill has occurred.
5. Containment must be in a manner and location which
affords protection from animals, rain, wind, and
does not provide a breeding place or food resource
for insects or rodents.
C. Storage
1. Medical wastes must not be stored for more than 4
days above 32 degrees F.
2. For medical wastes stored at or below 32 degrees F,
storage is not permitted beyond 90 days without
specific written approval or without a hazardous
waste facility permit, for the waste producing
facility.
3. Medical wastes shall not be stored more than 96
hours off-site of waste producing facility without
written approval or without a hazardous waste
facility permit.
4. Storage areas shall be specially designated for
medical wastes and shall be secured and properly
placarded.
D. Transportation of medical wastes will utilize dedicated
medical waste transporters that are placarded (biohazard
symbol), able to be secured and cleaned. Chutes are not
to be used for transport from one area to another.
1. The frequency of daily medical waste collection
~ shall correspond to the quantities of medical waste
- generated to avoid storage of untreated medical
wastes at the site of generation.
[
POLICY / PROCEDURE
M~au~ HAZARD MATERIAL AND N~r 2022
~~ WASTE MANAGEMENT
W ~f~fi~Da= 12/15/94
Su~ MEDICAL/BIO-HAZARDOUS R¢~cwDa~
;~AItI~4:)UlN WASTE MANAGEMENT
COMMUNITY
HOSPITAL ?
3. Medical waste bags will be tied and color coded
with tape before collection by Housekeeping.
,. '4. The waste bags shall be removed from their
containers and placed directly into the
transporter. Avoid packing down.
5. Once the transporters are full, they are to be
directly taken to the designated storage
area.
E. Treatment and disposal of medical wastes is
currently being handled by BFI.
III. MEDICAL WASTE HANDLING PROCEDURES FOR SPECIFIC AREAS OR
DEPARTMENTS
A. Surgery
1. All medical waste materials generated from surgical
cases will be bagged by operating-room staff using
the designated medical waste bags.
2. Needles, syringes, blades, etc., will be discarded
into the sharps disposal container.
The container shall not be overfilled. It must be
properly identified and closed before discarding.
Lids shall be taped after closing.
3. Body tissue and fluids (in suction containers) will
be discarded into the sanitary sewer system if not
required to be sent for biopsy or further analysis.
4. The operating room staff .is responsible for
properly lining containers with the appropriate
waste bags. Also they will ensure they are
properly and adequately closed prior to removal
from the operating room. A single red bag shall be
used, tied, and color taped for coding just prior
to disposal.
POLICY / PROCEDURE
M~ua R~ZARD Y~TERI;LL AND ~r 2022
(, ,~~ WASTE :MANAG~NT mf~ ~ 12/15/94
~G~IN WASTE~AG~NT
5. Housekeeping ~ll t~an~po~ the medical ~aste
~he des~gna~ed s~o~age area.
B. 'Cl~n~cal Labo~a~o~e~
1. Specific containers ~h~n ~he labo~a~o'~ mu~ be
established fo~ ~he co~ec~on of med~ca~ waste and
mu~ be p~operly ~abeled.
2. Clinical spec~mens~ cul~u~e~ and o~he~ wa~e~
exhibiting a h~gh ~nfec~ou~ potential w~ll be
collected using a ~ed bag. Once f~lled~ ~he bags
~ co~ec~on by Housekeeping.
3. Needle~, syringes, b~ades, e~c., w~ be d~ca~dad
~n~o ~he sharps d~posa~ box. The box should
' be overf~lled I~ mu~ be p~ope~ly ~den~f~ed and
clo~ed before d~sca~d~ng. L~d~ sh~ be ~aped
~ 4. C~n~ca~ laboratory ~aff are responsible ~o~
~n~ng ~he wa~e containers w~h ~he
~ medical wa~e bags.
~. Waste f~om ~so~a~on ~oom~ w~ll be ~emoved when
necessary by
2. Sha~p~ d~po~al boxes should no~ be
They mu~ be properly ~den~f~ed and clo~ed p~o~
~o d~ca~d~ng. L~d~ sha~ be ~aped.
3. Ai~ waste containers mu~ be p~ope~ly ~den~f~ed
and l~ned ~f ~o be used fo~ med~ca~ waste
~n~ng the con~a~ne~ w~h ~he appropriate waste
bags.
4. Red,cai waste bags a~e no~ to be u~ed fo~ the
collection of general
D. Housekeeping
POLICY / PROCEDURE
M~u~ F~Z~RD ledk~RXA~ AND Numar 2022
~~ WASTE MANAGEMENT
12/15/9&
su~ MEDICAL/BIO-HAZARDOUS ~cw ~
~~~IM WASTE MANAGEMENT
COMMUNITY
HOSPITAL 6 ?
1. Transport carts or containers used for the
collection of medical wastes should be dedicated
for medical waste collections only.
-2. The frequency of daily medical waste collection
shall correspond to the quantities of medical waste
generated.
3. All waste bags shall be handled carefully at all
times.
a) The waste in medical waste bags may
not be dumped or in any way be
transferred from one bag to another.
b) Medical waste bags will be closed
securely prior to their removal from the
container.
c) The waste bags must be grasped and
lifted.by the top of the tied bagand
held away from the body to avoid
potential contamination to the handler.
d) The bags shall be removed from their on-
site container and placed directly into
the proper transport cart.
4. All sharps disposal boxes must be placed into an
medical waste bag prior to being transferred.
5. Medical waste bags may remain in the transfer carts
during storage.
6. Ail medical waste bags will be taken directly to
storage after collection. No untreated medical
waste is to be compacted.
7. Ail transfer carts must be cleaned and disinfected
daily. As an alternate, transfer carts may be
lined with a disposable plastic liner which is to
be replaced daily.
POLICY / PROCEDURE
M~ HAZi~RD F~TERI~L ]OlD ~r 2022
~~ WASTE MANAGEMENT
W ~f~ Da~ 12/~5/94
M~~IN WASTE~A~NT
CMMUN~
8. The dedicated decont~ination area will be kept
neat and orderly. The floors will be cleaned and
disinfected on a monthly basis. Walls will be
cleaned and disinfected when soiled.
E. Engineering
1. Engineering shall be assigned to treat and dispose
of medical waste materials.
2. Ail Engineering personnel shall be familiar with
the hazards posed by medical wastes, the procedures
for treatment and disposal, and equipment
operation.
3. Any accidents, injuries or exposures are to be
reported to the departmental supervisor, Safety
Office and Employee Health after medical treatment
has been obtained.
F. Incident Reporting
1. Any incident involving spillage of the contents of
an medical waste bag will be reported to the
employee's supervisor, the appropriate safety
personnel and Employee Health.
2. Any injuries to personnel resulting from waste
"handling" procedures will be reported through the
hospital incident reporting system.
2023
HAZARD COMMUNICATION CHECKLIST
Completed by: Date:
Received by committee:
HAZARD COMMUNICATION PROGRAM YES ,O ACTION TAKEN
1. The program is in writing. Our written Program provides the
2. Describes how hazards will be evaluated and described
(.employees may rely on the chemical manufacturer or importer)
3. Tests all hazardous materials in the workplace (employers
may rely on the chemical manufacturer or importer)
4. Describes our labeling system.
5. Provides a list of hazardous chemicals referenced on MSDS
for all hazardous materials used in the workplace.
6. Describes our employee education and training program.
7. Describes hazards on non-routine tasks.
8. Describes how hazards of non. labeled pipes will be
handled.
9. Ind~des procedures for informing the on-site contractors of
the hazardous substances in the workplace to which their
employees may be exposed.
10. Is available to employees, their designated representatives,
assistant secretary of labor for OSHA and director of NIOSH. ,
LIST OF HAZARDOUS MATERIALS IN THE WORKPLACE
Our list contains all hazardous chemicals, Including but
not limited to:
1. Raw materials.
2. Both isolated and non-isolated intermediates.
3. Final product.
4. Cleaning and maintenance chemicals.
5. Laboratory chemicals for which MSDS information has been
received.
6. Waste products not regulated under RCRA, but which are
hazardous under this standard.
7. Impurities and by products.
8. Waste treatment and products.
HAZARDOUS MATERIAL~ LABEUNG SYSTEM .. "
1. All products containing hazmtlous materials leaving the
workplace are labeled (applicable to chemical manufacturers,
distributors and importers one).,
2. Stationary containers are labeled.
2023
.-- HAZARD COMMUNICATION CHECKLIST
Completed by: Date:
.%
,~ 'committee:
HAZARDOUS MATERIALS LABELING SYSTEM YES NO ACTION TAKEN
3. Temporary contair{ers used between work shifts or by
different workers ara labeled,
4, ~ method has been established to ensure that our labels are
correct and up-to-date, ,
CONTENTS OF HAZARDOUS MATERIAL LABEL ·
Our labels contain:
1, A chemical name that coincides with name on MSDS,
2, The identify of hazards with words (in English), pictures or ..
sTmbols.
3, Hazards of immediate and direct consequences of
mishandlin~l are inciuded. ,
4. Information that does not conflict with DOT regulations.
5. Other OSHA standards if material is already regulated.
6. The name and address of a responsible party (or parties).
IN-PLANT LABELING SYSTEM
1. Containers are labeled with the identity of hazardous
chemicals and hazard warnings (unless hazard warning
materials are used). ,
2. Hazard warning materials for hazardous chemicals in
stationary process containers are readily accessible to the
employee in the workplace.
3. The labels on incoming containers have not been removed
or defaced unless immediately replaced with our own labels.
4. The hazards in pipelines are identified, although they do not
have to be labeled.
5. Our labels are legible and in English.
MATERIAL SAFETY DATA SHEETS
1. A MSDS is available for every hazardous chemical which an
employer used.
2. Our MSDSs are readily accessible to exposed employees in
the work area throuc~lhoUt each work shift.
PROCEDURES HAVE BEEN ESTABLISHED FOR:
1. Updating our MSDS's (or receiving updated copies from our
supplier). . ,
2. Taking appropriate action if a sl;'ipment is received without a
MSD$.
~ 3. Getting new and updated MSDS's to employees handling
materials.
'- 2023
~'- .... HAZARD COMMUNICATION CHECKLIST
Completed by: Date:
Received committee:
PROCEDURES HAVE BEEN ESTABLISHED FOR: YEs NO ACTION TAKEN
4. Advising employees of any changes in MSDS.
5.' 'Documentation of efforts to obtain MSDS from supplier
(recommended practice but not raquire~.
HAZARDS OF NON-ROUTINE TAsKs
Procedures have been established assessing the .
hazards of non-routine tasks as follows:
1. All non-routine tasks involving the use of exposure to
hazardous materials are identified.
2. The hazards involved in the performance of non-murine
tasks are described in wrifin~l.
3. A MSDS is prepared or obtained for the hazardous materials · ·
involved in these non-routine tasks. '.
4. A labeling system or written operating procedure has been
established to identify the hazardous substances and their
hazards involved in non-routine tasks.
5. Special training has been established for the performance of
non-murine tasks, includin~l written operafin~l procedure.
-~ EMPLOYEE EDUCATION AND TRAINING
Procedures have been established to inform
, , employees of:
1. Covers all manufacturing, quality control, plant service and
R & D employees who may be exposed to hazardous materials.
2. Requirements of the Hazard Communication Standard.
, 3. Operations where hazardous materials are present.
4. Location and availability of written hazard communication
program including the hazardous chemical list and material
safe~ data sheets· ,
PROCEDURES FOR TRAINING EMPLOYEES
INCLUDE:
1. Information about physical and health hazards of chemicals
in work area.
2. Detecting the presence of hazardous materials - monitoring
procedures odors, visibilib/, etc. ,
3. Proper use and selection of personal protective, equipment. ....
4. Emergency procedures in the event of accidental exposure
to hazardous materials, including ~mergency phone numbers
and the location of eye washes and safe~ showers. , , ,
(~.~ 5. How to determine hazards by reading a label.
6. The location of MSDS's and the procedure for reviewing
th~m nndl~r nhtainir~n n ~nnv
2023
HAZARD COMMUNICATION CHECKLIST
Completed by: Date:
Received committee:
PROCEDURES FOR TRAINING EMPLOYEES
.. INCLUDE: YES HO ACTION TAKEN
£
7. How to obtain the correct MSDS for the hazardous
substance used by the employee such as use of the trade
name as a key identifier.
8. How the MSDS is updated or the PrOcedure for obtaining
updated copies from the chemical manufacturer, importer or
distributor.
9. The significance to the employees of each section of
information on the MSDS, how to read it and what it means.
10. The measures employees can take to protect themselves
from chemical exposure. (Examples include eye washes, face
shields, respirators etc.)
11. Training which is done prior to the handling of the
hazardous chemical, including employees who may only
temporarily do this work.
12. Updated training is considered when the employee has
transferred iobs or departments.
13. Update training is considered when significant changes in
chemicals or operations have occurred.
2024
ANNUAL EVALUATION OF THE EFFECTIVENESS OF THE HAZARDOUS
MATERIALS AND WASTE MANAGEMENT PROGRAM
Please list the hazardous materials in use in the
currently
Hospital:
2024
Are there material safety data sheets for each product? n YES [3 NO If .not, please explain:
Are there MSDS's posted in both the areas of storage AND the areas of use? n YES [3 NO
If not, please explain:
Is an MSDS initiated at the time of entry into the Hospital and completed when the product is either
disposed of or consumed? [3 YES n NO If not, please explain:
Does the Safety Committee consistently track the entry and exit of all hazardous materials in use in
the Hospital: [] YES [3 NO If not, please explain:
Are staff who use the hazardous materials trained in appropriate use? a YES n NO
If not, please explain:
Are all hazardous materials stored in accordance with applicable law and regulation? [3 YES [3 NO
If not, please explain:
Have there been any user, errors/accidents over the course of the past year?.. = YES a NO '
If yes, please explain, and inolude aofions taken to prevent recurreno~:
2024
Were the actions taken effective in preventing recurrence? r3 YES = NO.
If not, what future actions are planned?
--
Have problems been identified in the handling/disposal of hazardous wastes? [] YES [] NO
If so, please explain, and include actions taken to resolve the problems:
Were the actions taken effective in resolving the problem? [] YES ~ NO
If not, what was the final resolution?
Are policies and procedures for the handling/storage/disposal of hazardous wastes consistently
( followed? n YES [] NO If not, please explain, and include actions taken to ensure compliance?
Were the actions taken effective? a YES a NO
· If not, what future actions are planned to ensure compliance?
Does the Infection Control Committee have consistent input into the management of hazardous
wastes? · n YES c. NO If not, please explain:
2024
Are staff who are exposed to hazardous wastes trained in appropriate handling/disposal?
r, YES ~ NO If not, please explain: '
Please rate the overall effectiveness of the Hazardous Materials/Waste Management Program:
n Poor n Fair r3 Good n Excellent
Explain your answer:
What areas would you like to see focused on by the Hazardous Materials/Waste Management
Program in the upcoming year?
Please send copy of Hazardous Material Incident Reports to Safety Committee for review.
Report completed by:
Date
SAN JDAOUIN COMMUNITY HOSPITAL Page:
Type NO: PA PERFORMANCE ASSURANCE Location: 0 R EOUIP AREA' Oept: 8460 EN6 NO Issue Date: ['I0/04/%!
Control #: OEO0003 Property: GENO012 Client: SJCH WO Issue Ti~e: [13:02:57l
M~gr: Caterpillar PM Guide: 4003 Last Status/MC: UP////C1
Model: 3306 Schedule Code~ W 'Descript: GENERATOR Last NO ): 41613
Serial: 66046111 Schedule Pri: I Categor): F EHERGENCY GENERATOR AND S¥STEHS Warranty Veto: (O0/O0iOOi
Colpany Code: Ol Vendor: Crew: Trade: Emp: ENO Acquis. Date: [00/00/00}
Notes/Specs: Last Performed: I09/2gi%)
Comments: Next Schedule: [10/06/%1
Installed Date: [00/00/00)
Contract PO:
Type Contract Work: [ ]
Serv Contr, S/Date: 00/00/00
Serv Contr. E/Date: 00/00/00
Stock ~(NSN) Manufacturer Part Number Standard Part # (EIA) Qty RequirPd Description [~pe
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.~. TO 1i A.~,
I. ('~') 'THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP PO~T~ON.~' ' ' WHILE
PERFORMING THE PRE-lEST CHECKS AS OUTLINED BELOW. FHiS WiLL PREVENT THE UNIT FROM AUTO~ATICALLY
~,TARTINO WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. (~F CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
~ND COMPONENTS.. REMOVE OR REPAIR AS NEEDED.
3. (~HECk V-BELTS FOR WEAR, .BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEOED,
4. (~ CHECk COOLANT LEVEL IN RADIAIOR ANO ADO AS ~EEDED.
~. · (~CK ENGINE OIL LEVEL ANO AO0 AS NEEOEO.
6. (~CHECk BATTERIES~ WATER LEVEL ANO AD~ AS NEEOE~,
Z. ~ECk BATTERY CONNECTIONS FO~ CORROSION AND TIGHTNESS.
B, (~ CHEC~ BATTERY CHARGER PONE, S, ITCH ,UST BE 1N "ON" POGITION
9. (~CK BATTER~ CHARGER..Cp6 8.C. ?~OLTAG~ ~ . ~ AND D.C. AMPERAGE
JO,. ~INE/~.TER::~,~TER,Sq~TCH,HUS:~,:~.~~ "ON" ~OS~ION, ,
11.' [~ERIFY HEATER IS WORKING; :," '.~'~
12. ~)~ECk DAY TAN~ PUMP SWIICH. SWIlCH ~UST BE IN 'ON" ~OSITION.
13, (~Ck GENERA[OR VOL)AGE REGULATOR SWIiCH ~UST BE IN "ON" POSITION.
14. ~C~ECk ENTIRE UNIt FOR ANY FUEL OIL~ ENGINE OIL~ OR COOLANT LEAk~,
15 ~LOG ENGINE RUNNING )I~E METER REAVING BEFORE TEST.
iSA. /'LOG ENGINE RUNNING lIME HETE~ R~AOING AFTE~ TES~,_~. ......
158. ~. tOTAL RUNNING lIME.. ~/~
lb. ~HECk FUEL OIL LEVEL. LOG READING BEFORE TES~,
16A. ~CHECK FUEL OIL LEVEL. LOG REA~IN6 AFTER TEST.
168.~ ........... TOTAL FUEL OIL CONSUME,,
17. (~P TEST AUTO ~WITCH ON THE GENERATOR CONTROL PANEL HUST BE SWITCHED TO AUTO POSITION.
lB. ~ 60 TO THE AUTOHATIC TRANSFER~ SNITCH LOCATED IN THE EQUIPHENT AREA FOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST 'POSITION AND'HOLD,FOR 15 SECONOS. GENERATOR SHOULD START AND IRANSFER SWITCH
?.,'., ?. ,:" '.TRANSFER THE '~OAD WIT~'IN~-I~6 S~C~DS'J'.~.;"~'~, '
~0, .(~VERIFY THE TRANSFER SWJ¥CH' HAS T~ANSFER~ED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
~'" 'CONTACTED LIGHTj .?,?,,m~.,/ ?, ? ~? .
2~'~CK UNIT FOR ANY UNUSUAL ~NOI~E,:AND~R VIBRATION. .
22. (~K UNIT EXHAUST FQR ExC~.S.S?E',.~pO~,).NG' . ~."
uNXT FOR OZC :.MAFER.,.:'OR E HAU ) EAKS. '
24; ~AF.TER ~0 )INUTEs ~,RUNNING.,TI~E, CH~K ANOn6. .~ '~.' ..
~ :'CHECk AND tO6 OIL PRESSURE~ · .~'~, ~:
~. CHECk AND ;~'06 ~OOLANT ~ENPEHATU~E,~ , _/.~ .....
~. CHECK AND LO6 FUEL PRESSURE, ' '~ '
25, (~ECk ANO LOG VOLTAGE:
~,~.,,--'~ype WOt PA PERFORMANCE ASSURANCE Location: O H E~UIP AREA Dept: 8460 CNG WO Issue Date:
Control ~: ~B0000] ProperU:gEN0012 Client: SJCH WO Issue Time: [13:51:27]
Mfgr: Caterpillar PM Guide: 4003 Last Status/MC: UPIIIICl
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO #: 41613
Serial: 66D46111 Schedule Pri: ! Category: F EMEEGE~CY GENERATOR AND SYSTEMS Warranty Date: [00)00/00]
Company Code: 01 Vendor: Crew: Trade: gmp: ENO Acguis. Date: [00/00/00]
Notes/Specs: Last Performed: [I0/06/96]
Comaents: Next Schedule: [10/13/96]
Installed Date: [00/00/00]
Contract PO:
Type Contract Work: [
aery Contr. S/Date: 00/00/00
aery Contr. E/Date: 00/00/00
Stock #(NSN) Manufacturer Part Number Standard Part # (EIA) Qty Required Oescription Type
NOTE: TESTING OF B-~ GENERATOR MUST BE PEEFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M, TO 11 A,M.
1, (,,-~/~E STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW, THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
.~ARTING WHILE YOU ARE PERFORMING YOUE PEg-TEST CRECKS,
2, (%.},'CRECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
/AND COMPONENTS, REMOVE OR REPAIR AS NEEDED.
3, (,,?qHECK V-BELTS FOR WEAR, BROKEN OR LOOSE, REPAIR OR TIGHTEN AS NEEDED,
4, (,'~?~HECK COOLANT L~EL tN RADIATOR AND ADD AS NEEDED,
5, ~ CHECK ENGINE OIL L~EL AND ADD AS NEZDED,
6. (~ECK BATTE~iEB' WATE~ LEVEL AND ADD AB
7. (~CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
12. (ff~HECK DAY TANK POMP SWITCH. SWITCH MOST BE IN 'ON' POSITION,
13, ( ~HECK GENERATOR VOLTAGE REGULATOR SWITCH MOST BE IN "ON" POSITIOL
14. ~C~K ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLAN~ LEAKS.
15 (~G ENGINE RUNNING TIRE METER READING BEFORE TEST. ~{}.~
1SA. LOG ENGINE RUNNIN~ TIME METER READING AFTER TEST. I~_
1SE. / .... <~. ..... =, , , TOTAL RUNNING TIME.
16. (~CHECK FUEL OIL LEVEL, LOG READING BEFORE TEST. _~~
16A. CHECK FUEL OIL LEVEL. LOG READING, AFTER TEST,
17, (~OP TEST AUtO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWlTCSED TO AU~O~.P,O$!~}~.~.
~NSFER THE LOAD WITHIN 10 SECONDS,
19. (~ TIME GENERATOR TOOK TO START ,' ........ . ~~ '
20 (~ERIFY YHg TRANSFER SWITCH US TRANSFERRED AND YRE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
24. (~ AFTER 20 MINUTES OF RUNNINg' TIME, CHE'dK AND ~OU. ,. "
· ' A, CHECK:AND LO~ OIL PRESSURE,. ',.:" . Not~ ..
~: '-CHECK AND LOS'COOLANT. TEMPERATURE,:
'.': ',::::::i:?:.:':' ' -:De WO: PA PERFOEHAKg ASSURANCE' :"" Location: 0 H E{2UiP AREA Sept: 8460 lNG WO Zssue Date:
...... '::::::" 3ontrol t: OEO000] '
;~::~.~?~j;.. ; Mf~r: Cate~pilIar PM Guide: ~00~ Last Status/rc: UP////CI
. Model: 3308 Sch~dul~ Code~'~ Oescript: GENERATOR Last ~0 {:
?" Serial: 6~D46111 Schedul~ PrE: 1 Cate~orF: F EMERGENC~ GENERATOR AND SYSTEMS Warranty Date: [00/00/002
Company Code: O1 Vendor: Crew: Trade: gmp: E~8 Ac~is. Date: [00/00/002
Not~s/Specs:
Comments: Last Performed: [10/13/96]
Inst~lled Date:
Contract PO:
Type Contract ~or~: [
Serf Contr, S/UHt~: 00/08/00
Stock {(~s~) Manufacturer Part Nunber Standard Part { (EIA) ~t~ Required D~scription
NOTE: TESTIN$ OF B-{ GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M, TO 1t A,R,
t. ( STOP EST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PA}tEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRZ-TEHT CHECKS AS OUTLINED BRLO~, THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
~RTIN~ WHILE YOU ARE PERFORMING ~O~R PRR-TZHT CHZCKS,
....... FOR~N OBJECT'H, LO0~ OR BROK~ ~iTTiN~
2, (f CHECK ENGINE RADIATOR AND GENERATOR AR~A FOR DEBriS AND -.~ . .. . ....
~ CORPONENTS. REMOVE OR REPAIR AS NERDED,
3, {~ CJ3CK V-BELTS FOR ~EAR, BROKEN OR LOOSE. REPAIR OR T!~TEN AS NEZDED,
5. < ~HECK EN~i~R OIL LEVEL A}ID ADD AS
6, (~SECK BATTER!ZS' ~ATER LEVEL AND AUD AS
7, (~H~CK--' BATTERT CON~ECT!ONS FOR CORROSION AND
I0.. (/E~HINE WATER HEATER SWITCH MUST SE IN "~R"
It, {~ERIFY HEATER IS WORKINH, '
"' 13. (,~HECK ~ENERATOR VOLTAGE REGULATOR SW!~CH RUS~ BE IN "ON" POH!T!ON. /~ ~ ~--/~/~
14.' (~CHECK ENTI"E U":Y FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS, --
15 {~.Og ENGINE RUNNIN8 TIME METER READINU BEFORE TEST, ~ ~__
q,. '~"~. 1SA, LOG ENSINE RUNNING TIME 'METER READING AFTEH TEST. . .~
i6. (~HECK FUEL OIL LEVEL. LOG REtDIN8 BEFORE TEST, '~~
I6A. CHECK FUEL OIL LEVEL, LO8 READINH AFTER TEST, ~ . '
lib ............ TOTAL FUEL OIL CONSHMED. - ~/
!7, (~OP TEST AUTO SWIZCH ON THE HENERATOR CONTROL PANE~{-HWITCHED TO AUTO POSITION.
.18. (~0 TO THE AUTOMATIC TRANSFER S~!TCH LOCATED IN THE EOUIPMENT AREA FOR BUILD!NH 4, TURN THE TRARSFER
SWITCH TO THZ TEST POSITION AND HOLD FOR 15 SECONDS. 8ENERATOR SHOULD START AND TRANSFER SW!TCR
.'2:~ :-:,,3.', ' .20'?(~VERIFY THE TRANSFER SWITCH HAH TRANSFERRED AND THE G ATOM HAS TAKEN T~E LOAD BY OBSERVING THE LOAD :' ';~"'
:.'::':..:::t?::'.:, ....e ~0: ~A PERFORMANCE ASSURANCE.;:. Loc]rich: 0 H E~Ui? AREA ~e~t: BI60 E~G WO Issu~ htr:
:!.:.:.it':ii!???.,' Control #: OE00003 Property: GEN0012 Cii~nt: SJCH WO Issue Time: .[I3:40:08]
ifi.:ii!.ii~i~.i:.' Mfgr: Caterpillar PM ~uide: 4003 Last Status/FC: UP/~//C!
Model: 3306 Schedule Code~"~ Descript: GENERATOR Last WO I: : 41613
.!.. Serial: 66D46111 Schedule Pri: 1 Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date:
Company Code: 01 Vendor Crew: Trade: Emp: ENG acquis. Date: [00/00/00]
Notes/Specs: Last Performed: [10/13/96]
Comments: Next Schedule: [10/20/96]
Installed Date:
Contract PO:
Type CoRtract Work: [
Serv Contr. S/Date: 00/00/00
Serv Contr, E/Date: 00/00/00
Stock #(NSN) Manufacturer Part Number Standard Part # (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M, TO 11 A,M,
t, ( STOP EST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW, THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
jE.T-ARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS,
2. (')',CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKE~ FiTTiNG GUARDS
~ COMPO,~N~. RE~.vVE OR REPAIR AS
3, (Q C~ECK V-BELTS FOR WEAR, BROKEN OR LOOSE, REPAIR OR TIGHTEH AS ~EEDED,
5. (?'~HECK ENGINE OIL LEVEL AND ADD AS NEEDED,
6, (~HECK BATTERIES' WATER LEVEL AND ADD AS NEEDED,
7, (.'!',,~HECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS2
S. ( ,'?~;HECK BATTERY CHARGER POWER SWITCH MUST BE iN "ON" PO~iTION
10..(,qv'ENGINR WATER HEATEH SWITC~ MUST HE IN "~-~SITION, '
13 (,~CHECK GENERATOR VOLTAGE REGULATOR SW~T~.. ~UST BE IN POSITION.
14, (~CHECK ENTIRE UNIT FaR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAZS, ~ /~ ~
~' I5 (~OG ENUINE RUNNING TIME RETER READINU BEFORE TEST, ~__
-%. JLA, LOG ENHINE RUNNING TIME METER READING AFTER TEST. ~ ' . .
'.>~? iLB ................. TOTAL RUNNING TIME. ~- - -
, 16, (~HECK FUEL OIL LEVEL. LOG RE[DING BEFORE TEST. ' ~
SWITCH TO TH~ TEST POStTIONAND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SW!TC~
.... ' , .~:.~ANSF~" THE LOAD W~THIN 1o SECONDS,
"+~- "20'~VE~IFY THE'TRANSFER SWITCH BAS TRANSFERRED AND TBE G ~TOR BAS T~KEN TBE LOAD BY OBSERVING THE LO~D
Type SO: PA PREFereNCE ASSU~NCE o ASEA Dept: 8460 ENO we Issue Date:
Hf~r: Cato~pilla~ PH ~uide: 4003 Last Status/~C:
Hodol: 3306 Schedule Code: W Dflcript: 6Sll~TOl Last WO l:
Sar/al: 66D45111 Schedule Pti: 1 Category: F INSRGENCY GHWE~AYO~ AND 8YSTEHS Warranty Date: [00/00/00]
Company Code: 0i Vendor: Crew: Trade: Sap: ERG Ac~is. Date: [00/00/00]
Rotes/Specs: Last Perfogmed: [10/20/96]
Comments: Hoxt Schedule: [10/27/9~]
~nstaHed Date: [00/00/00]
Contrac~
Typo Con,racK Work:
Serv Contr. S/Da~e: 00/00/00
Serv Contr. E/Date: 00/00/00
S~ock J(NSN) Hanufacturer Par~ Number S~andard Par~ f (SEA) fl~ Red,red Description Type
NOTE: TESTING OF B-% GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
I. { ) THE STOP TKST AUTOMATIC SWITCH ON THE GSNEMAYOR*S CONTROL PANEL MUST HE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT PROM AUTOMATICALLY
STARTING WHILE YOU ASS PERFORMING YOUR PBS-TEST CHECKS.
2. ( ) CHECK ENGINE RADIATOR AND GHERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKER FITTING GUARDS
AND COMPONHYS. REMOVE OS REPAIR AS NEEDED.
3. { CHECK V-BELTS POE WEAR, BROKEN OR LOOSE, REPAIR OS TIGHTEN AS NEEDED.
4, { CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. { CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
H. ( CHECK MAYYSRIES' WATER LEVEL AND ADO AS NEEDED'
7. ( CHECK BATTERY CONNECTIONS FOE CORROSION AND TIGHTNESS.
B. { CHECK BATTERY CMARGES POWER SWITCH MUST BE IN 'ON* POSITION
9. ( CHECK RATYHY CliARGBS LOG D.C. VOLTAGR T~-x~ AND D,C. AMPERAGE
10. ( ENGINE WATH UATH.SWITCH MUST BE I! 'OR* POSITION.
Ii. ( VERIFY HEATER IS WORKING.
12. { CHECK DAY TANK ~UMP HWIYCH. SWITCH MUST NS I! "ON" POSITION.
; 13.{ CNSCK GENERATOR VOLTAGE RBGULATOE SWITCH MUST BI IN "ON" POSITION.
14.{ CHECK NNTIH UNIT FOR ANY FUEL OIL, SNGIH OIL, OH CO0,LAIT LEAKS.
i5 ( LoG ENGINE S IMG TIME METES HEADI NSFONN
1SA. LOG ENGINE RUNNING TINS NSTER READING AFTER
15B .......... i'.. '.. 2 TOTAL RUNNING TINS.
16. ( ) CHECK FUEL OIL L~VEL.' LOG READIES BEFORE TEST.
1GA. CHECK FUEL OIL LEVEL. LOG READING AFTER TEST..
168 ..... · ....... TOTAL FUEL OIL CONSUMED.
17. ( ) STOP TEST AUTO ~]TCH ON THE GNNSHA~ON CONTROL PANEL MUST NS SWITCHED YO AUTO POSITION.
18. { ) C-O TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EflUIPNSNT AREA FOE BUILDING 4. TURN TEK TRANSFER
SWITCH Ye THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER' THE LOAD WITHIN 10 SECONDS..
I9. ( ) LOG TINS GHHEAYOS YOUR Ye START ...' ......
20. ( ) VERIFY THE TMANSFNS SWITCH MAS TRANSFERRED ARD TBS GENERATOR HAS TAKER TNS LOAD BY ORSBRVING THE LOAD
"21. { )CHECK UNIT FOR AIy,UNuSUALNOISE AND/OS YIBUTION, · '.
"22. () cHEcK ONLY, EKHibST',..FO! EICESSTVi"SKOKIN~?."/ ,,, :. ?,-- ,
23..( J CHECK UNIT FOR OIL,:'WAYH/OH EIRAUST. LHAKS.
'24. (.)AFTER 20 MINUTES OF.RUlfl{IN6 TIME, CHECK AMD/Id[,{~
.. B. CHECK AND'LOG COOLANT, !8NPHAYU~E.. ~
C..CHiCK. AND ~OG.PUEL. PSESSUHE. ,::/,,'";', ~'
~.' 25. ( ) CHECK AlU LOG VOLTAGE: .' ..,. , ..
SAN JOAQUIN COMMUNITY HOSPITAL Page:
Type MO: PA PEHFORMANCE ASSURANCE Location: 0 H ROUIP AREA Uept: 8460 ENO WO Issue Date: [11/01/96]
Control I: OEO0003 Property: GEM0012 Client: SJCR WU Issue Time: [12:54:25]
Mfgr: Caterpillar PM Guide: 4003 Last Status/FC: UPI/l/C1
Model: ~106 Schedule Code: W Descript: GENERATOR Last MO l: 41613
Serial: 65D46111 Schedule Pti: ! Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date:
Company Code: O1 Vendor: Crew: Trade: Nmp: NNG Acquis.' Date: .[00/00/00]
Notes/Specs: Last Performed: [10/27/96]
Comments: Next Schedule:
Installed Date: [00/00/00]
Contract PO:
Type Contract Work: [ ]
Serv Contr, S/Date: 00/00/00
Serv Contr. E/Date: 00/00/00
Stock I(NSN) Manufacturer Part Number Standard Part ! (RIA) flty Required Description Type
NOTE: TESTING OF' B-4 GENERATOR MUST BE PESFOHMED ON SUNDAYS BETWEEN TNB HOURS OF 10 A.M. TO 11 A.M.
1, ( ] THE STOP TEST AUTOMATIC SWITCH ON TNB GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PgE-TEST CHECKS AS OUTLINED BELO¥. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
Z. ( ) CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3 (,,),'CHECK V-BELTS FOR WEAN, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS HERDED.
4 (~CHRCK COOLANT LRVHL IN RADIATOH AND ADD AS MENDED.
5 (WCBECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6 (,'~CHRCE BATTERIES* WATER LRVNL AND ADD AS NEEDED..
? (~'CHRCE BATTERY CONNECTIONS FOE CORROSION AND TIGHTNESS.
8 (,4"CHECK BATTERY CHARGER POWER SWITCH MUST BE IN *ON" POSITION
9 (~ CHECK BATTERY CHARGER LOG D.C. VOLTAGE ~ AND D.C. AMPERAGE
10 .(,)'ENGINE WAYSH NMATNR SWIYC{..M.V~Y.,BE IN *ON" .POSITION.
1I (,,~ VERIFY HEATER IS WONKING.
12 { ,.)-CHECK DAY TANK PUMP SWITCH. SWITCH MUST SE IN eON" POSITION.
13. (,~'CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON*POSITION,
14. {,~ CHECK ENYINB UNIT FOR ANY FUEL OIL, EN6INN OIL, OH'COOLANT LEAKS. ..."'
· 1~ (4'.LOG ENGINE RUNNING. TIME METER READING BEFORE TEST. 1i4~ -'
lEA. LOG ENGINE HUMMING TIME METNH RNADING AYYEB TEST,:.~.J.~.=_2-__
'IS.,:.'{~CB8CK FUEL OIL LEVEL. LOG BERING BEFORE TEST. .'...~5/& :
1GA. CHECK FUEL OIL LEVEL. LOG'READING AFTER TEST. 'j&~
15B ............. TOTAL FUEL OIL CONS~D.
i7. (~ STOP TEST AUTO SWITCH ON THE GENEMAYOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. (~ GO TO THE AUTO'TIC TRANSFER SWITCH LOCATED IN THE K~UIPMENY AREA FOR BUILDIN~ 4. TURN THE TRANSFER
SWITCH YO THE TEST ~SIYION AND HOLD FOR 15 S~CONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
~t:'.'.'TRANSFER THE LOAD WITHIN 10 SECO~S. :
/.~9.{~ LOG TIME GENERATOR TOOK TO START .: .... :/'.... ~.
'~ 20. (~VERIFY THE Y~NHFER SWITCH BAS TRANSFERRED AND THE GENERATOR ~S TAKEN THE LOAD BY OBSERVING THE' LOAD
SAR JOAQUIN COMMUNITY HOSPITAL ~ /~-~//~l~"~r/,_// Page:
Type WU: PA PERFORMANCE ASSUNANCE Location: O S EQUIP AEEA Dept: 8460 ENG WU Issue Date: [11/08/96]
Control #: 0E00003 Property: GEN0012 Client:
MCi
WO
Time:
[12:39:3t]
Mfgr: Caterpillar PM Guide: 4003 Last S~atus/FC:
Model: 3306 Schedule Code: # Descript: GEllRATOR i:~ Last WO t: ¢1613
Serial: 66D46111 Schedule Pti: 1 Category: F EMERGENCY GENERATON AND SYSTEMS . Warranty Date: [00/00/00]
Company Code: 01 Vendor: Crew: Trade: Emp: ENG Acquis. Date: [00/00/00]
Notes/Specs: Last Performed: [11/03/96]
Comments: Next Schedule: [11/10/96]
Installed Date: [00/00/00]
· .Contract PO:
?~pe Contract Work: [
Serv Contr. S/Date: 00/00/00
Serv Contr. E/Date: 00/00/00
........................................................................................... ~ .............................
Stock #(NSN) Manufacturer Part Number Standard Part ! (EIA) Qty Required Description Type
....................................................................................................................
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS Of 10 A.M. TO II A.M.
1. ( ) THE STOP TEST AUTOMATIC SWITCH ON THE. GENESATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
.PERFOEMINH THE PEN-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
'STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. ( ) CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OH REPAIR AS NEEDED.
3, ( CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIOHTEN AS NEEDED.
4. ( CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. ( CSECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. ( CHECK BATTERIES' WATER LEVEL AND ADD AS NEEDED.
'/. { CHECK BATTERY CONNECTIONS FOR CORROSION AND
8. ( CHECK BATTERY C~RSER POWER HWIYCH MUST BE IN "ON" POHITION
9. ( CHECK BA~YE{Y CHARGER LOH D.C. VOLTAGE ~ AND D.C. AMPERAHE
10.,( ENGINE WATER BEA~{~.SWIYCR MUS~ BE IN 'ON" POSITION.
11. ( VERIFY HEATER IS WORKING. '
12. ( CHECK DAY TANK PUMP SWITCH. SWITCH MUHY BE IN "ON" POSITION.
13. ( CHECK GENERATOR VOLTAGE REHULATOR SWITCH MUST BE IN "ON" POHIYION.
li. ( CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
1SA. LOG ENGINE RUNNIN~ YIMi METER READIN8 AFTER TEST. l~.
15B ............. ~'... TOTAL RUNNING TIME,
16. ( ) CHECK FUEL OIL ~EVEL. LO8 READING BEFORE TEST. dT.
16A. CHECK FUEL OIL LEVEL. LOG READING AFTER TEST. _4~.
liB. ' TOTAL FUEL OIL CONIUMED.
17. ( } STOP TEST AUTO SWITCH ON THE ~ENERAYOR CON~ROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. ( ) HO TO THE AUTO'TIC YRANSF. ER SWITCH LOCATED IN YiN E~UIPMENY AREA FOR BUILDING 4. TURN THE TRANSFER
SWITCH YO THE TEST POSITION AND HOLD FOR 15 SECONDS. ~ENERATOR SHOULD START AND TRANSFER HWIYCH
~RANSFER THE LO~ WITHIN 10 SECONDS.
. 20..{) VERIFY THE T~ANSFER SWITC~ HAS.YRANSFENRED AND THE ~NERATOR ~AH TAKEN THE LOAD BY .OB~E~VIN~ THE LO~
-/ CONTACTED. LI~HY.'~' '.:< ? ~: '..'." ',., ';.
':=:-2i.'{ ) CHECK UNIT FOR ~Y ,~iUAL NOISE ~NDIOR Vi*BRA~ION.
'""22. ,(.) CH~CK 'UNIT ~X~UHT.'IOR ~RXC~HSlV~ SMOKING.' '
::'23. { ) CHECK' UNIT'FOR Oi'~.[~wiT~R,"OR EXHAUdT~LEAKH2
24. ('} AFTER 20 MINUTES' OF".{~iitN8,~IME,/:;'CBECK AND LOG.
~ Mfgr: Cat~rpi!lar PM Guide: 4003 5ast Status/FC:
Company Cod~: Oi V~dor. Cr~w: Tra~: Emp: EN,, Acquis =,~, .
Tnstal1~d
~o~.z ~!NSNt Ra~ufactuT~r Pa~t Nu~ba~ ~"'-d~-~ ' ~
~. . ............................ ~-- . .......... n~l;~m~ OR ~:~:~t'~ ..
~a (/~R~CK ENTYRE ~N!T FOR ANY ~UEL OIL, ENGINE OIL, OR COOLANT L~AKS.
!SB, ~. ............. TOTAL RUNNING T!~E, /
t~s ............ TOTA~ FUtL OiL CONSU,~U. .~-
~ XST A~i~O SwXC~ ON ~,~ ~,~TOR CONTROL PA~[-i~i~-S,!TCH~U" ~- TO AUtO POSitiON.
~, (~~ a~R~TO~ ~00~ To S~ ......... ___~ .....
20 (~ERIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE HENERATOR HAS '
COLA~ED
2!, (~ECK HN!I FOR ANY UNUSUAL NOISE AND/OR VIBRATION,
22. (~ECK UNIT EXHAUST FOR EXCESSIVE SMOklN8,
23, (~HECK U~T FOR OIL, ~ATER, OR EZHAUST LEAKS,
,~ , .- 32'~5~
Mfgr: Caterpi!.ar ?~Guide ~003 Last StatusiFC:
¢o~trac~ PO:
Serv Contr, S/Date: 00/00/00
.........................................................................................................................
Y,~? ARE P3RFO~Ri~ YOUR PR=-%~=
~ ~a D '~ 'm , ~ · ., .
~ ~C~?C~ COOLA~;~ ~?!L ~ ~AD]A?O) A~D ADD A~
~4. -~ .... ~ ~L~ .... )J=T =~RAJ~ ~,n~,J ....U~L 0~=. OR COOLANT LEAKS
tLA~ LOG ENG[NZ RUNNing TiMR RETER READiN6 AFTER TEST. /7, 7
!58 ................
............ ; m __~___~'
iSA,CHECK FURL OiL [~wf, LOG RRADIN6 ~T{~
!8. {~ ~O .TO T~E AUTOmATiC T~ANSFER SW!TC~ LOCATED iN T~E EQUTP~RN~ AREA WOR BU=~D=~,~ ~.
SW~TC~ ~O ~ ~S~ POST,TON AND ~OLD FO~ 15 SECONDS, GRN~A~O~ S~OULD ~aP~ AND ~RANS~W~
~3'. (~ERIFY THE TRANSFER S~!TCH HAS TRANSFERRED AJD ~HE 6ENERATOR HAS TAEEN THE=,~.~'n'" BY OB~,RRV.N~= ' ' * 'u~ .... LOAD
~O~TACTED LIGHT,
~ ~ f m f T mT
21, f¢~H~CK ~NI~ FOR AN? UNUSUA= NOISE ANU/OR
22. xc ss vz
'" A. C"~C~ AND LOG 0I~ PRESSURE, '
-?;.47';.-~ ~-': ~ '¢~, ~;,= :?~';:~;;~;b: ':3b'-'. ;:'~:~-7~~ :i~E~,:.~,
25, : :i~g;~. ~.;:: :q6 VnLT~6F~ , ...
Type WOt PA ~ERFOHMANCR ASSUHANCE Location: O H E~UIP AEHA Dept: 8t60 ENO WO Issue Date: [12/27!96]
Control l: ogo0003 PropertF: GENO012 Client: SJCH WO Issue Time: [11:i6:17]
Mfqr: Caterpillar PM Guide: {003 Last Status/gC: UP////C1
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO {: {1613
Serial: 66D46111 Schedule Pri: 1 Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: [O0/O0/OO]
Company Code: 0I Vendor: Crew: Trade: Emp: ENG Acqui$. Date: [00/00/00]
Notes/Specs: Last Performed: [12/22/96]
Comments: 'Next Schedule: [I2/29/96]
Installed Date: [00/00/00]
Contract PO:
Type Contract Work: [ ]
Serv Contr. S/Date: 00/00/00
Serv Contr. E/Date: 00/00/00
Stock t(NSN) Manufacturer Part Nuaher Standard Part ! (EIA) ~ty Required Description Type
NOTE: TESTING OF H-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF lO A.M. YO 11 A.M.
/
I. (~%/YHE STOP TEST AUTOMATIC SWITCH ON THE ~ENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PE/~FOEMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
r ~'~ARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS
-
2. {L,~'.CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTIN~ ~UARDS
/~D COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3 (~4'~,MECK V-BELTS FOR WEAR, BROKEN OR LOOSE, REPAIR OR TIGHTEN AS NEEDED.
~'4/,~J~[CK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
.6"T'.,~3~'~CK ENGINE OIL LEVEL AND ADD AS NEEDED.
6 ?/C~J~CK BATTERIES' WATER LEVEL AND ADD AS NEEDED.
7 !~"~',C~H~CK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8 (L-KC,~ECK BATTERY CHARGER POWER SWITCH MUST BE IN 'ON" POSITION
10. { ¥~INE WATER HEATER SWITCH MUST BE IN "ON' POSITION.
11. i','J~'~ERIFY HEATER IS WORKINU.
I2..{..?~RECK DAY TANK PUMP SWITCH. SWITCH MUST BE IN "ON' POSITION.
13. (.Z,?"~ECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON" POSITION,
14. (c,~"CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
15 ( LOG ENGINE RUNNING TIME METER READING BEFORE TEST.
I§A. LOG ENGINE RUNNING TIME METER READING AFTER TEST.
ISB ................ TOTAL RUNNING TIME.
16. CHECK FUEL OIL LEVEL. LOG HEADING BEFORE TEST.
16A. CHECK FUEL OIL LEVEL. L0H READING AFTER TREY,
16B.' ........... TOTAL FUEL OIL CONSUMED.
17. ( STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BR SWITCHED TO AUTO POSITION.
18. ( GO YO TEE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EOUIPMENT AREA FOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 1S SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN i0 SECONDS.
19. ) LOG TIME GENERATOR TOOK TO START .........
20. } VERIFY THE TRANSFER SWITCH BAS TRANSFERRED AND YBE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
CONTACTED LIGHT.
21. ) CHECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRATION,
22. ) CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. ) CHECK UNIT FOR OIL, WATER, OR EEHAUST LEAKS.
24. .) AFTER 20 MINUTES OF RUNNING TIME, CHECK AND LO8. A. CHECK AND LOG OIL PRESSURE.
B. CHECK AND LOG COOLANT TRMPNRATURE.
C. CHECK AND LOG FUEL PRESSURE.
25. } CHECK AND LOG VOLTAGE:
.........................................................................................................................
Control l: 0E00003 Property: ~EN0012 Client: SJqH WO Issue lime: [15:25:15]
Mfgr: Caterpillar ?M Guide: 4003 Last Status/FC: UP!I/ICl
Model: 330~ Schedule Co~e: W Oescript: GENERATOR Last WO
Serial: 66D46111 Schedule Pti: ! Category: F EMERGERCY GENERATOR AND SYSTEMS Warranty Date: [00/00/00]
Notes/Sgecs: Last Performe~:
Comments: Nezt ScheQule:
Installed Dat~ [00/00/00]
?~pe Contract Work: [ ]
Serv Contr. B/Date: 0o/oo/oo
~erv Contr. E/Date: oo/oo/oo
Stoc~ I(NSN) Manufacturer Part Nu~ber Sta~fard Part I (EIA) Otv Required Description Ty~e
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THC HOURS OF 10 A.M. TO 1! A.M.
1. IHE STOP ~ES~ AUTO,TIC SWITCH ON THE GENERA?OE'S CONTROL PANEL MUST BE SET AY STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUYOMATICA3LY
STARTING NHILE YOU ARE PERFORMING YOUR ~RE-~EST CHECKS.
2. CHECK ENGINE RADIATOR AND ~ENERAYOR AR~ FOR DEBRIS AND FOREIGN OBJECTS, ~OOSE OR BROKEN FITYINU 8UARDS
AND COMPONENTS. REMOVE OR REPAIR AH NEEDED.
3. ( CHECK V-BELTS FOR WEAR. BROKEN OR LOOSE. REPAIR OR YIHHYEN AH NEEDED.
4. { CHECK COOLAHT LEVEL IN RADIATOR AND ADD AH NEEDED.
5. ( CHECK ENUINE OIL LEVEL AND ADD AS NEEDED.
6. ( CHECK BATTERIES' WA~ER LEVEL AND ADD ~ NEEDED.
7. ( CHECK BATTERY CONNECTIONS FOR CORR08~ AND
8. ( CHECK BATTERY C~RgER POWER HWITCH M{HY BE IN "ON" POHIYION
9. ( CHECK BATTERY CHAR~ER LO~ U.C.-VOLYA~E ~ AND D,C. ~PERA~E
lO, ( EN~INE WAYE~ BEAYEi SWITCH MUST BE IN "ON" POSITION.
11. { VERIFY BEATER IH WORKINg.
12. { CHECK DAY YANK PUMP SWITCH. SWITCH MUS~ BE IN 'ON"
13. /. CHECK GENERATOR VOLYAHE ~E~{LA~OR 8WITCH MUHY BE IN 'ON"
14. {, CHECK ENTIRE UNI~ FOR ANY FUEL OIL, ENGINE 0I~, OR COOLANT LEAKS.
15 ( ~OH ENGINE RUNNINU TIME METER RE~IN~ SEFORE ~HY. ~.~_
lEA. LO8 ENHINE RUNNINU TIME METER READIN8 AFYg{ TEST. ~ I, ~
16. { CHECK FUEL OIL LEVEL. LO~ RE~IN~ BEFORE TEST. ~
I6A. CHECK FUEL OIL LEVEL. LO8 RKADIN~ AFY{R YKHY.
I~B ............ ~O~AL FUEL OIL CONSUMED. , ~
17. { STOP ~EST AUTO SWITCH ON THE ~ENERAIV~ CONTROL PANEL MUST BN SWITCHED ~0 AUtO POSITION.
18. ( ~0 YO ~RE AUTO~IC Y~NSFER SWITCH ~OCAYED IN YRE R~UIPMENY AREA FOR BUILDIN~ 4. YUaN THE TRANHFER
SWITCH YO THE YESY POSITION AND BOLD FOR 15 SECONDS. 8ENERA~O~ HHOULD START AND Y~NSFRR SWITCH
~RANSFER }RE LOAD WITHIN 10 HECUIDS.
19. ( ) LO~ TIME ~ENEUYOR TOOK YO START. ........
20. ( ) VERIFY THE YWANSFER SWIYCH ~S Y{ANSFERRED A~ ~HE ~ENRUYOR ~ TAKEN THE LO~ NY OBHERVIN~ YU LO~
2,. CBRCKUNITFORANYUNOSUALNOIHRAND/ORVIBRAYION.
22. CH~CK UNI~ EXHAUST FOR EXCESSIVE SMOKING. ,.
24. AFT,, 20 MINUTES OF RUNNING TIM'. CHECK ARD 'O~A. CHECK AND LO, OIL PRESSURE. ' ~ '
B. CHECK AND LO~ COOLANT TEMPERATURE,
C. CHECK AND LOg FUEL
ZS. CHECK AND LO~ VOLTAGE:
.........................................................................................................................
......................................................................................................................
i9, (~ FiAlE ~E~ER?O~ fOO~:. TO STAAT ......... fO ~ '
..... TUC
C. CHEC:( ~f.16 LO~ F'OEL CF;ESSURE.
25, ~ ,~Egk A~'~[~ LOG
Type ~0: PA PERFORMANCE ASSURANCE Location: 0 H EQUIP AREA Dept: 8460 ENG WO Issue Date: [01/10/97]
Control {: ~EO0003 Property: GENO012 Client: SJCH WO Issue Time: [15:32:42i
Mfgr: Caterpillar PM Guide: 4003 Last Status/FC: UP////C1
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO #: 41613
SeYial: 66D46111 Schedule Pti: 1 Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: [00/00/00]
Company Code: O1 V~ndor= Crew: Trade< Emp: ENG Acguis, Date: [00/00/00]
Notes/Specs: Last Performed: [01/05/97]
Comments: Next Schedule: [01/12/973
Installed Date: [00/00/00]
Contract PO:
Type Contract Work: [ ]
S~rv Contr. S/Date: 00/00/00
Serv Contr, E/Date: 00/00/00
Stock #(NSN) Manufacturer Part Number Standard Part { (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SU}DAYS BETWEEN THE HOURS OF i0
1, )L~E STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELO'4, THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS,
2, ,.~HECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS~ LOOSE OR BROKEN FITTING GUARDS
.. AND~COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3, ~,?"CHE~K V-BELTS FOR WEAR: BROKEN OR LOOSE, REPAIR OR TIGHTEN AS NEEDED,
~'~CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED,
5, ~J/CHECK ENGINE OIL LEVEL AND ADD AS NEEDED,
6, .L~CHECK BATTERIES' '~ATER LEVEL AND ADD AS NEEDED,
7, (~C~HECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
3, (~HECK BATTERY CHARGER POWER SWITCH MUST B_I~IN..~3~" POSITION'
9, (/.~/.C~CK BATTERY CHARGER LOG D,C. VOLTAGE ./~-__~<~___ AND D,C, AMPERAGE~. ........
10, {- ,/.~ 'EN~G-}NE WATER HEATER SWITCH MUST BE IN "ON" POSITION,
Il, ,~.~r~,RIFY HEATER IS WORKING.
12, ~-C~}~CK DAY TANK PUMP SWITCH, SWITCH MUST BE IN "ON" POSITION,
13, ~'~HECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON" POSITION,
14, {~,)~ dHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS,
15 { ) LOG ENGINE RUNNING TIME METER READING BEFORE TEST. . - =
ISA.LOG ENGINE RUNNING TIME METER READING AFTER TEST, _~---~_~__
tSB ................ TOTAL RUNNING TIME,
16, ~HECK FUEL OIL LEVEL. LOG READING BEFORE TEST, ~_~
16A, CHECK FUEL OIL LEVEL, LOG READING AFTER TEST, ~.~2~___-<~,~
16B ............ TOTAL FUEL OIL CONSUMED,
1S, ( 0 AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENT AREA FOR BUILDING 4, TURN THE TRANSFER
· SWlTC...0 THE TEST POSITION AND HOLD FOR 15 SECONDS, GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN lO SECONDS, --~'--..~"~ _.__d~.~.<.~.._____-
19~ {/) LOG TIME GENERATOR TOOK TO START
20, ((-r~1i_ERIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
~-"~n' CONTACTED LIGHT,
2I. /}.~C. HECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRATION.
22, "T CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING,
ECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS,
~2"~. CHECK AND LOG OIL PRESSURE,' __ }3. CHECK AND LOG COOLANT TEMPERATURE. _ .....
C~ ~C~HECK AND LOG FUEL PRESSURE, ___ .-~'
25.,/...~..~ AND LOG VOLTAGE: ~/
Type WO: PA PERFORMANCE ASSURANCE Location: 0 H EQUIP AREA Dept: 8460 ENG WO Issue Date: [01/17/97]
Control #: OEO0003 Proper[y: GENO012 Client: SJCH WO Issue Time: [13:19:29]
Mfgr: Caterpillar PM Guide: 4003 Last Status/FC: UP////C1
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO #: 41613
Serial: 66D46tll Schedu!e Pri: I Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: [00/00/00]
Company Code: O1 Vendor: Crew: Trade: Emp: ENG Acquis.
Notes/Specs: Last Performed: [01/12/97!
Comments: Next Schedule: [01/19/972
Installed Date: [O0/O0/OOi
Contract PO:
Tzpe Contract Work: [ ]
Herr Contr, S/Date: 00/00/00
S~rv Contr. E/Date: 00/00/00
Stock {(NSN) Manufacturer Part Number Standard Part # (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEENTHE HOURS OF !0 A,M, TO !! A,M,
~. ( ~ THE STOP TEST A~OMA~iC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING '"
~Hn PRE-TEST CHECKS AS OUTLINED BELOW, THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS,
2, (W CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS, REMOVE OR REPAIR AS NEEDED,
3. ~ CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4~ .~CHECK COOLANT LEVEL iN RADIATOR AND ADD AS NEEDED,
5, ,~ CHECK ENGINE OIL LEVEL AND ADD AS NEEDED,
6, v) CHECK BATTERIES' WATER LEVEL ANN ADD AS NEEDED.
7, ,.~', CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS,
H, ~CHECK BATTERY CHARGER POWER SWITCH MUST BE IN "ON" POSITION
9, .~CHECK BATTERY CHARGER LOG D,C, VOLTAGE ____~z~3_ ..... AND D.C. AMPERAGE
lO, ~ENGINE WATER HEATER SWITCH MUST BE IN "ON" POSITION,
!i, , ~VERIFY HEATER IS WORKING,
12. .~, CHECK DAY TANK PUMP SWITCH, SWITCH MUST BE tN "ON' POSiTiON.
13. (~2"CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON" POSITION,
14, {~ CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE O!L~ OR COOLANT LEAKS,
15 (~ LOG ENGINE RUNNING TIME METER READING BEFORE TEST. ~3.
1SA, LOG ENGINE RUNNING TIME METER READING AFTER TEST. _~.
15B ................ TOTAL RUNNING TIME.
!6, (~ CHECK FUEL OiL LEVEL, LOG READING BEFORE TEST. _~_~_Y_~_
!GA, CHECK FUEL OIL LEVEL. LOG READING AFTER TEST, __~5__~_
tGB ............ TOTAL FUEL OIL CONSUMED. ___~Jf__
17, (~ STOP TEST AUTO SWITCH ON THE 6ENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION,
t8. (~GO TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENT AREA FOR BUILDING 4, TURN THE TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS, GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS.
19. (~ LOG TIME GENERATOR TOOK TO START ......... 5 ~-~.
20. (~ VERIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
CONTACTED LIGHT.
21, !~CNECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRATION,
22, (<?'CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING,
23. !< CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
24, ( ) AFTER 20 MINUTES OF RUNNING TIME, CHECK AND LOG, A. CHECK AND LOG OIL PRESSURE.
8, CHECK AND LOG COOLANT TEMPERATURE. __.__~z~__
C. CHECK AND LOG FUEL PRESSURE, ~,~'~
25. { f CHECK AND LOG VOLTAGE:
on,,ol ~: 0E00003 Property: ~=~uuz2 C!ie~t: SJCH WO fssue Time: [14:29:347
Mfqr: Caterpillar PM Guide: 4003 Lasc S~atus/FC: UPI/IICI
Model: 3306 Schedule Code: w Descrip[: GENERATOR Last WO #! 41613
Comp4ny Code: O! Vendor: Crew: Trade: Emp: ENG Ac~uis. Dat~: [00/00/00!
No[~s/Specs: Last Performed: [01/19/97!
Comments: N~×t Schedule:
Installed Dat~:
Contract PO:
Typ~ Contract WorR:
Serv Cont._, ~/Dat~'~, ., 00/00/00,
S~rv Contr, E/Dat~: 00/00/00
.........................................................................................................................
....................................................................................................................
~ ~N~ OF B-z GENERATOR MUST BE PEWFOWM~n ON SIJNDAYS BETWEEN m~E HOURS O~ !0 A,~ TO 1~ ~,N
'~' .... ~N:RO,, PANEL ,~UST BE .~ ~? .~OP POSITION WU!LE
STARTIN~ W~iL, E YOU ARE ~ORMING YOUR PRE-TZST
6. CHECK BATTERIES' WATER LEVEL AND ADD AS ~EED~D,
............ ' ~ ~ ...
7 CH~CK 8ATe~V CONNECTIONS FOR ~ORRuS~O~
9. CH.C~ 8ATTAR? CHARGER LOG D C. VO[.TAG~ __~_~___ AMD ~.C, AMPRRAgZ ~ .....
!i ~ r~ ....... I .
~. V,R~Y HE~?~R :S WORKING.
CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE !~ 'ON' POSiTiON,
14, CHECK ZNTIRZ UNiT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
15 LOG ENGINE RUNNING TIME METER READING BEFORE tEST~ ~.l
!SB ................ TOTAL RUNNING TIME.
!6. ~ CHECK FUZL OIL LZVEL. LOG READING BEFORE TEST. ___&4 ....
16A. CHECR FUEL OiL LEVEL. LOG READING AFTER TEST. _
!6B ............ ZOTAL FUEL OIL CONSUMED. _ .... ~_~_
%7. { STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO D
{ m mT~ " .....
18. ( GO TO THE ALOMA~=~ TRANSFmR SWTTCH LOCATED IH THE EgU!PMENT AREA FOR BUILDING 4 TOR~ TRE ~RANSFZR
SWITCH TO THE TEST POSITION AND HOLD FOR !5 SECONDS, GENERATOR ~HOULD START AND TRANSFER
TRANSFER THE LOAD WITHIN 10
!9. LOG TI~E GENERATOR TOOK TO START ......... _~_~
20, ~ERIFY THR TRANSFER SWITCH HAS TRANSFRR~ED AND THE GENERATOR ~AS TAKEN THE LOAD BY OBSERVING T~E LOAD
CONTACTED LIGHT.
21, CHECK UNIT FOR ANY UNUSUAL NOISE ARD/OR VIBRATiO~,
22. CHECK UNIT EXHAUST FOR EXCESSIVE SMOKINg.
'23, CHECK U~!T FOR OIL, ~ATER, OR EXHAUST LEAKS,
B. CHECK AND LOG COOLANT YEMPERATURE.
C, CHECK AND LOG FUEL PRESSURE. _ ........
25. CHECK AND LOG VOLTAGE:
~.~ WO [~ ~: [I~'~:''''~
Contract
.........................................................................................................................
....................................................................................................................
~!.,:~: :~:::,,.. .... .:~:~;~:,,~ ................................... . j,,,.~ ............. ~ ....
~f~;5 'SATYR HEATER S'~i'YC~
~_, C~EC~ FUEL OiL L~VRL, LOG
~l~gR T~g LO!D W!T~!~ !0 SECONDS,
, ~P, , '2~,
25 ~CHECK A,~D LO~ VOLTAOg, -
THE LOAD WiTHiN lO SECONDS.
./ Page: 5
· Type WO: PA PERFORMANCE ASSURANCE Location: 0 B EQUIP AREA Dept: 8460 ENG WO Issue Date: [03/07/97]
Co~trol ;: OEO0003 Property: GENO012 Client: SJCH WO Issue Time: [I3:46:40]
Nf~r: Caterpillar PM Guide: 4003 Last Status/PC:UPI~/~C1
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO l: 41613
Serial: 66D46111 Schedule Pti: 1 Category: F glfllIGENCY GE~A~UR AND SYST~ Warranty Date: [0o/oo/oo1
company code: Oi vendor: cre,: Trade: g~p: ENG icquis. Date: [00/00/00]
Notes/Specs: Last ?erfomod:[03102191]
Comments: Next Schedule:[03/09t97]
Imall~d DaCe: [00/00/00]
Contract PO:
Re Contract ~rk: [
Serv Contr. S/Date: 00/00/00
Serv Contr. E/Date:
Stock #(NSN) Kanufacturer Part Number Standard Fart # (EIA) QCy Required Description fy~e
.............................................................................................................
ND~E: ~STING OF B-4 ~ENERATOR MUST BE PERFORMED ON SUNDAYS BEN~EN ~E HOURS OF 10 A.M. TO 11 A.M.
1, { THE STOP YESY AUTOMATIC SWITCH ON THE GENEHAYOR'S CONTROL PANEL MUST BE SET AY STOP POSITION WHILE
PERFORMIN~ THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT YRE UNIY FROM AUTOMATICALLY
SYARYIN~ WHILE YOU ARE PERFORMIN~ YOUR PRE-TEST CHECKS.
? ( CHECK EN8INE RADIATOR AND HENERAYOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING ~UARDS
AND COMPONENTS. REMOVE OR REPAIR AH NEEDED.
3. ( CHECK V-BELTS FOR WEAL BROKEN OR LOOSE. R~PAIR OR YIHHYEN AS NEEDED.
4. ( CHECK CO0~T LEVEL IN RADIATOR AND ADD AS NEEDED.
5. ( CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. ( CHECK BATTERIES' WATER LEVEL AND ADD AS NEEDED.
7. ( CHECK BAYYENY CONNECY!ONS FOR CORROSION AND TIGHTNESS.
8. ( CHECK HAYYERY CHARGER POWER SWITCH MUST BE IN "ON" POSITION
9. ( CHECK BATTERY CHANGER LOG D.C. VOLTAGE ,4'5' AND D.C. AMPERAGE
I0.( EN~I~E WATER HEATER SWITCH MUST BE IN "ON" POSITION.
11,( VERIFY HEATER tS WORKING.
12.( CHECK DAY TANK PUMP SWIYUN, SWITCH MUST BE IN "ON~ POSITION,
13,( CHECK GENERAYUR VOLYAGE REGULATOR SWITCH MUSY BE IN "ON" POSITION.
I4.( CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENgINE OIL, OR COOLANT LEAKS.
15 { LOG ENGINE RUNNI~ TIME METER READIN~ BEFORE TEST. 2~. ~
1SA. LOG ENGINE RUNNING TIME MEYER READING AFTER TESt,
15B ................ YOYAL RUNNIN6 YIn.
I6. ( CHECK FUEL OIL LEVEL. LO{~ READING BEFORE YERY. ~q, 2~
16A. CHECK FUEL OIL LEVEL. LOG READIN~ AFTER TEST. Z~-
I6B ............ YOYAL FUEL OIL CONSUMED.
17. ( STOP YES~ AUTO SWITCH ON YHE GENERATOR CONTROL PANEL MUST BE SWITCHED YO AUTO POSIYIUN,
18. ( GO ~0 YRE AUTO'TIC YRANSFER SWITCH LOCATED IN YHE EQUIPMENT AREA FOR BUILDING 4, TURN YHE YRAI{SFER
SWITCH YO THE YESY POSITION AND HOLD FOR 15 SECUNDH. 6ENEHAYOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS.
19. ( LOG YIHE GENERATOR TOOK YO START ......... ~
20. ( VERIFY THE YRADSPER SWITCH HAS TRANSFERRED AND ~ GENERATOR HAS TAKEN Y]{E LOAD BY OBSERVIN~ THE LOAD
CONTACTED LIGHT.
21. { CHECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRAYIUN.
22. { CHECK UNIt EXHAUST FOR EXCESSIVE SMOKING.
23. ( CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS,
24. ( AFTER 20 MINUTES OF RUNNING YIHE, CHECK AND LOG,
A. CHECK AND LOG OIL PRESSURE.
B. CHECK AND LOG COOL'NY ~ENPERAYUHE,
C. CHECK AND LOG FUEL PRESSURE.
25. ( CHECK AND LOG VOLTAGE:
T.~.e WO: PA PERFOR~CE ~S~ARCE Location: 0 H EQUIP AREA Dept: 8460 ENG WO Issue Date: [03/14/97]
Control ;: OEOODO3 Property: GENOOI2 Client: SJCH ~0 Issue Time: [14:45:49]
Mfgr: Caterpillar PM Guide: 4003 Last Status!FC:~////C1
Model: ~306 Schedule Code: ~ ~escript: GENEH~DR ~st ~0 ~: 41613
Serial: 66D46111 Schedule PrE: 1 Category: F EMERGENCY G~ERATOE AR8 SYSTEMS ~arr~ty Bate: [00/00[00]
Comp~F C~e: Ol Vendor: Crew: Trade: ~p: ~G kc~is, Date:
Notes!S~ecs: Last PerformS: [03/09/97]
Co~ents: ~ext Sch~ule:
In~tall~ Date: [00/00/00]
Contract PO:
Type Contract ~ork: [ ]
SPry ~ntr. S/Date:
Serv Contr. UDate: OO/O0/O0
.......................................................................................................................
Stock ~(NSN) M~ufacturer Part N~er Standard Part ~ (MIA} Qty R~ired Description ~e
...................................................................................................................
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BE~EEN %'HE HOURS OF 10 A.M. TO 11 A,M.
1. (~HE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AY STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING ~HILR YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2..{-"!'CHECK ENHINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS: LOOSE OR BROKEN FITTING GUARDS
AND CO ONENTS. ,E, OV OR RE AIR
z. !..} CHECk< V-ZELTS AR, SHOKEN OR LOOSE. REP R OR U NEEUEB.
7. { -FCHECK BATTERY CONNECTIONS FOR CORROSION ~D
8. ~HECK BAYY~Y C~G~ ~W~ SWITCH MUST BE IN "ON" POSITION
9. (-~ ~HECK BATTERY CHASER LOS D.C. VOLYASE ~ ~D D.C, ~UAGE _ ~ _
10, ~GINE WATER HEATER S~IYCH ~SY BE IN "ON" ~SIYION,
11, {~IFY HEAY~ IS
12. ~RECK DAY Y~ P~ SWITCH, SWITCH MUST BE IN "ON"
13. ~CHECK 8~ERAYOR VOLTAGE R~U~R SWITCH ~SY BE IN "ON" ~SIYION.
14. (~K ~YIRE ~IY ~R ~ ~L OIL, ~8INE OIL, OR ~0~ LEDS.
15 ~GINE RU~INH YI~ ~ RUDIN~ BEFORE TEST.
1HA. ~"~G ENGINE R~IN~ TIME ~Y~ R~BING AFTER TEST.
15B. ~ ............... TOTAL R~NING YIn.
16. (~UCK FUEL OIL LEVEL. ~U REDINU BEFORE TEST,
16A./CHECK FUEL OIL LUEL. LOG READING AFTER VEST.
16B. ~' DYAL NEL OIL CONH~ED.
17. ~P YESY AU9 SWITCH ON NE 8~ADR CONNOL P~EL ~SY BE SWITCHED ~ A~ POSITION.
18. {~'YO Y~ AUTO,TIC ~SF~ SWITCH RCAYD IN ~E EQUIP~ UEA FOR BUILDIN~ 4. NRN Y~ N~SFER
S~IYCH N THE ~SY POSITION ~U ROLB FOR 15 SECONDS· 8EN~YOR SHOULD SY~Y ~D ~HFER SWITCH
YR~SFU YU ZU WITHIN I0 SECONDS·
CONYAC~D LIGHT.
Z1, (~HE~ ~IY FOR ~ ~USU~ NOISE UU/OR VIBRATION.
22. (~CK ~IY 'U~USY FOR ~CESSIVE SMOKING,
23. ~) CHECK UNIT FOR OIL, WAYU. OR ~HAUSY LE~S. ,
24. ~HR 20 Mt~S OF RUNNING YIn. CUCK ~D
C. CHECK ~D LOG FUEL PRESSURE.
25. (~ECK ~D ~G VOLTAGE
SAN ~"~ ~,,,~,v
.... ~ .......... ~, HOSPITAL /~ Pa~e: 5
Type WO: PA PERFORMANCE ASSURANCE Location: 0 H EQUIP AREA Dept: 8460 ENG iO Issue Date: [03/21/97]
Control #: OEO0003 Property: GENO0!2 Client: SJCH WO Issue Time: [13:32:5I]
Mfgr: Caterpillar PM Guide: 4003 Last Status/FC:UP////C1
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO {: 41613
Serial: 66D46111 Schedule Pti: 1 Category: F EMERGENCY GENERATOR AND SYSTEMSWarranty Date: [00/00/00]
Company Code: O1 Vendor: Crew: Trade: Emp: ERG Ac~is. Date: [00/00/00]
Notes/Specs: Last Performed:[03/16/97]
Comments: Next Schedule: [03/23/973
Installed Date:[00/00/00]
Contract PO:
Type Contract Work: [ ]
Serv Contr. S/Date: 00/00/00
Serv Contr, E/Date: 00/00/00
.........................................................................................................................
Stock #(NSN) Manufacturer Part Number Standard Part # (EIAI Qty Re~ired Description Type
....................................................................................................................
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M, TO 11 A,M,
I. {~L'!rHE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION ~ILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS ~
~:,~= PREVENT THE UNIT FROR AUTOMATICALLY
. ./~TARYiNG WHILE YOU .~.RE PERFORMING YOUR PRE-T. EST CHECKS,
, T ~ ~ ~ , T
2 ~ CHECK ENG,N~ RADIATOR AND GENERATOR AREA ~OR DEBRI. AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS, REMOVE OR REPAIR AS NEEDED,
3, (4"'~HECK V-BELTS FOR {EAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
~.., ~'C~H~uK COOLANT LEVEL :N RADIATOR AND ADD AS NEEDED,
5. i~ECK ENGINE OiL LEVEL AND ADD AS NEEDED,
6. !.'..~/~'~HECK BATTERIES' r~ATER LEVEL AND ADD AS NEEDED.
?, / '..~HECK. BATTERY ~ONNEC~:ONS'' FOR CORROSION AND TIGHTNESS,
8. / '.~ECK'/BATTERY C~RGER PO~ER SWITCH MUST BE II{ "ON" POSITION
9. (~ECK BATTERY CHARGER LOG D.C, VO.TAGE ~$ AND D.C. AMPERAGE
I0.(~ ENGINE ~ATER HEATER SWITCH MUST BE IN ~ON" POSITION,
II,( ,~'E~FY HEATER IS WORKING,
12 ! .?C~HECK DAY TANK PUMP SWITCH. SWITCH MUST BE IN "ON" POSITION,
13.( '~'~CK GENERATOR VOLTAGE REGULATuR SW:~CH MUSt BE IN ~N
t4.i'"-.~CK ENTIRE UNIT FOR ANY F~EL OIL: ENGI,','E OIL: OR COOLANT LEAKS,
!5 ( ,~?~OG ENGINE RUNNING TIME METER READING BEFORE TEST, ~/,
~0~ ENGINE RUNNING TIME METER READING AFTER TEST. ,~,t,
!SB ................ TOTAL RUNNING TIME,
16, (~4/~ECK FUEL OIL LEVEL, ~G READING BEFORE TEST. ~-_~
1GA,~ ' CHECK FUEL OIL LEAL, LOG READING AFTER TEST,
16B ............ TOTAL FUEL OIL CONSUMED. ~-~
!?, ( .~.r-, STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL ,.~ST BE SWITCHED TO AUTO POSITION.
18, ! .r'?'~GO TO THE AUTO.TIC TRANSFER SWITCH LOCATED IN ~E EQUIPMENT AREA FOR BUILDING 4, T~H THE TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SI4ITCH
TRANSFER THE LOAD WITHIN 10 SECONDS,
19. {.')~3~OG TIME GENERATOR TOOR TO START ......... q'
20. ,Z~'. VERIFY THE TRANSFER SNITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
CONTACTED LIGHT.
21, {?T'/CHECR UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRATION.
22, ~ CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. (,.,*?CHECK UNIT FOR OIL, WATER,, OR EXHAUST LEAKS,
24. !.,~r'. AFTER 20 RINUTEH OF R~NING TIME, CHECK AND LOG. A. CHECK AND LOG OIL PRESSURE.
B, CHECK AND LOG COOLANT YEMPERA~RE. ~tLo __
~.~ CHECK AND LOG FUEL PRESSURE. L~/._F/'4~[,,
25, ( ..,']"~HECK AND LOG VOLTAGE:
qpe WO: P~E~O~A~CE ASSURANCE 5oc~o~: 0 ~ ~Q~IP ARE~ ' .*' 8460 ~N~ ' ·
Control #: ffEO000] Property: GENOOt2 Client: SJCH WO Issue Time: [!4:47:29]
Mfgr: Caterpillar PM Guid~: 4003 Last Status/FC: UP////C!
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO #: 41613
Serial: 66046111 Schedule Pri: ! Category: F EMERGENCY GENERATOR AND SYSTEMSWarrmty Date: [00/00/001
Compan? Cod~: O1 Vsndor: Craw: Trade: Emp: ENG Acq~is, Date: [00/00/00]
Notes/Specs: Last Performed:[03/23/97t
Co~enta: Next Sch~ule:
Installed Date: [00/00/00]
Contract PO:
Type Contract Work: [
S~rv Contr. S/Date: 00/00/00
S~rv Contr, E/Date: 00/00/00
.........................................................................................................................
Stock ~INSN% Manufacturer cart Numb6r Stm~dard Part ~ (E!Ai ~ '
. , .._ . . =ti EeTnred Description
....................................................................................................................
NOTE; TZST!NG OF B-4 GENERATCR MUST BE PERFORMED ON SUNDAYS BETWEZN THE HOURS OF 10 A,M, TO !! LR.
I. (~"'T,iE S'COP TEST AUTO.TIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT HTOP POSITION (4RILE
PERFORMING THE PRE-TSST CHECKS AS OUTLINED BELOW, THiS ~ILL PREV~T THE UN!f FROM AUTOMATICALLY
~RTiNG ~HiLE YOU ARZ PERFORMIN~ YOUR PRE-TEST CHECKS.
(< CHECK ENGINE RADIATOR tND OE~E~.ATOR AREA FOR UEBRIH ~ND FOREiG~ OBJECTS, LOOSE OR BRCKE~ FIY~ING ~UARDH
. ~ CO~ON~?S, REMOVE OR REPAIR AS NEEDED
3, {~CHECK V-BE.TS FOR ~EAR, BROKEN OR LOOSE, ~AIR
[~ECK COCLAN? LEVEL iN RADIATOR AND ADD AH NEEDED.
5, ( ~CK EN6IUE OIL LEVEL A~D ADD AS U~EDED,
6, , ~CRECK BATT~!ES' ~ATE~ LEVEL kND ADD AS NEEDED,
!!, (<~FY HEATER !S ~ORKiNO,
12, ~.CK DAY TANK PUN~ SWITCH, Hw!YCH MUST BE iH ~ON"
13, {-~ECK HE~ERATOR VOLTAUE REGULATOR SWITCH MUST BE !N ~ON" POSITION.
(~CK ENY!RE OMI? FOR ~{Y FUEL OIL, ENGINE OIL, OR COOLANT LE~S,
1)A,' LOG ENGINE RU~NING TiME METER READtNn AFTER ?EST.
!5B, ~ ............. ?OTA~ RUNN~NH TIME, _
!6, {~HECK FUEL OIL LEVEL. ~G READING BEFORE TEST. _~
!uA, ~HECK FUEL OIL LEVEL. ~OO READINO AFTER TEST,
16B ............ TOTAL FUEL OIL CONS~ED, _~
17~ (~8P TEST AUTO SWITCH ON THE ~ENERAYOR CONTROL PANE~SWIYCRED
18. ~-~ YO THE AUtO.TIC ~ANSFER SWITCH LOCATED IN THE EOUIPME]Y AREA FCR n,,[n,.~ {. TURN THE YRANHF]R
S~IYCH YO THE YESY POSITION AND HOLD FOR 15 SECONDS. OENERA~R SHOULD S~kRY AND ~RANSFER S~ITCH
~ANSFZR YRE LOAD WITHIN lO SECONDS,
19. (~G TIME GENERATOR Y?OK ~ START .........
20. ~) VERIFY THE ~ANSFER D~ITCH ~S TRANSFERRED ~ND Y~ GENERATOR HAS Y~EN Y~ LOAD BY OBSERVING IHS LOAD
~C ' =ED
2!, (~ UNIT FOR ANY ~NUSUAL NOISE AND/OR VIBRATION,
23. (~K~"~ UNIT FOR OIL, WATER, OR EKHAUST LEAKS.
2~, (~FYER 20 MINUTES OF RUNNI{G YIREt CHECK AND
~. CHECR AND LOU OIL PREH$URE.
B, CHECK AND ~G COOLANT TEMPERATURE.
C. ~HECK A~D LOG FUEL PRESSURE. A'~ ~
25. ~CK ANU LOG VOLTAGE:
'' Co~e: W Deacript: ~NzRAtOR Last WO #:
aer~aA: 66~46~ Schedule Pti: ! Category: F EM~RGVNCV ~5,1=RA%R A,N,9 SYSTEMS Warranty Oate: [00/00/001
Company Code: Ol Vendor: Crew: Trade: Emp: ENG Ac~is, Date:
Comments: ~ext ,che~uze: [01!06/971
:00,,,~00!
Con[tact
~p~ Contract Wor~,
Serv Contr, S/Date: 00/00/00
S~rv Contr, E/Date: 00/00/00
19. ~?i~.R '~'ic~~'n~ TOOK TO START
20 ...... ..... ?~Z ~'t~, ..... S~!fCH H..~'~ ?RA~RR~ ~D ?~i ~=:,=,~,;,, HAS ~ti~,, ~i_.. LO!g B~ OBS[R'/i~G ?H~ LO!D
23. ~ZCK r,,.,, FOR OYL. ~.TE~. OR EIRAUS? LEAKS.
~ER ~u M:~4U~=D ,~. R~NN=NG L~E, ~HECK AND
,.'~,'" ,~,.=~,~,~c,, !~g LOg ~E,'" ' P~ESSUH. ______
25.(~HECK AND DG VOLYAUR:
Type WO: PA PERFORIg, NCE ASSURANCE Location: 0 H EQUIP A~R Dept: 8460 ~G WO I~sue Bate: [04/25/97]
Control I: OEO0003 Property: GENO012 Client: SJCH W Issue Yi~e: [14:20:01]
Mfgr: Caterpillar PM Huide: 4003 Last Stat~/FC: ~////PA
~el: 3306 Sch~ule Code: W Descript: GENERATOR Last ~0 {: 57379
Serial: 66D46111 Sch~ule Pti: 1 Category: F ~8EN~ ~EN~YOR ~D SYSTEMS Warr~ty Date: [00/00/00]
Company Code: O1 V~ndor: Crew: Trade: Emp: END Ac~is. Date: [00/00/00]
Notes/S~c~: Last PerformS: [04/20/~7]
Co~ents: Next Schedule: [04/27/97]
Install~ Date: [00/00/00]
Contract PO:
YDe Contract Work: [ ]
Serv ~ntr. S/Date: 08/00/00
Serv Contr, E/Date: 00/00/00
....................................................................................................................
Stock {(NSN) M~ufactur~r Part N~er St~dard Part { (EIA) Qty R~ir~ Description Yy~e
.................................................................................................................
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BEYWEER THE HOURS OF i0 A.M. YO 11 A.M.
/
1. ("~'YHE STOP TEST AUTO,TiC SWITCH ON YRE GENERATOR'S CONSOL PANEL MUST BE SET AY STOP POSIYIUN WHILE
PERFORMING YI{E PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PR~/ENY THE UNIT FROM AU~ORTICALLY
{/HYARYING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
= /~CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
i/&ND COMPONENTS. R~O~ OR REPAIR AS NEEDED.
3. ('?.~CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR YIGHTEN A$ NEEDED.
4. i~/CHECK !OOLANT LEVEL IN RADIATOR AND ADO AS NEEDED,
5. (~j/cHECK ~NGINE OIL LEVEL AND ADD AS NEEDED.
~. ( Q/~ECK BATTERIES' WATER LEVEL AND ADD AS NEEDED.
7. (.d/~HECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. (~HECK BATTERY CF~RGER POWER SWITCH MUST BE ~ "ON~ POSITION
9. {Q/~ECK BATTERY CHARGER LOG D.C. VOLTAGE ~,-~ AND D.C. AMPERAHE /~.
10. ( .~RNGINE WATER HEATER SWITCH MUST BE IN '~N4 POHi~oN.
il. ( ~ERI~ HEATER IS WORKING.
12. ('~CHECK DAY TA~ P~ SWITCH SWITCH ~SY BE IN "ON" POSITION.
13. </.CHECK ~ENE]h%YOR VOLYA8E REGULATOR SWITCH MUST BE IN 'ON' POSITION,
14. (~CBECK EI{YIRR UNIT FOR AlP[ FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
15 (~LOG ENGINE RUNNING TIME MEY~ READING BEFORE TEST.
I~A. LOG ~INE RUNI{ING TIME METER READING AFTER TEST.
15B ................. TOTAL RUNNIN~ TIME.
16. (?/CHECK FUEL OIL L~EL. LO~ R~DING BEFORE YERY.
16A, CHECK FUEL OIL LUEL, LOG READING AFTER TEST,
16B ............. TOTAL FUEL OIL CONSUMED.
17..~'~,}TOp YESY AUTO SWITCH ON THE 8ENERAYOR CONTROL PANEL MUST BE SWITCHED YO AUTO POSITION,
18. i %~/C,0 TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN YRE ~UIPMFd{Y ARB FOR BUILDING 4, TURN Y~ TRANSFER
SWITCH YO THE TEST POSITION AND BOLD FOR 15 SECONDS. ~ENEPJ{YOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WIT]WIN 10 SECONDS,
19..{,3~'LOG TIME GENERATOR TOOK YO START .........
20. {/VERIFY THE TRANSFER SWITCH HAS ~ANSFEI{RED AND THE G]H{ERANR ~ TAKEN Y~ LOAD BY OBSFJNIN~ THE LOAD
/CONTACTED LIG~.
21. ~)~CHECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRTION,
22. (~CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. (~.CHRCK UNIT FOR OIL, WA~R, OR EXHAUST LEAKS.
24. (~AFYER 20 MtNUYES OF RUNNING TIME, CHECK AND LOG.
A. CHECK AND LOG OIL P~ERSURE. ~
~.B.CHECK AND LOG COOLANT YEMPERAY~E.
/C. CHECK AND LOG FU~ PRESSURE, '
25. ~/)CHECK AND LO~ VOLTAGE:
SAN JOAQUIN CO~UNITY HOSPITAL
Type WO: PA PERFORMANCE ASSURANCE Loca[lon: 0 H EQUIP AREA Depc: 8460 ENG WO Issue Date: [05/02/97]
Controi {: OEO~O03 ?ropert~: GENO0i2 Client: SJCH WO Issue Time: [13:56:581
Mfgr: Caterpillar PM Guide: 4003 Last Status/FC:UP////PA
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO #: 57379
Serial: 66046111 Schedule Pti: 1 Category: F ENERGENCY GENERATOR AND SYSTEMSWarranty Date: [00/00/00]
Company Code: O1 Vendor: Crew: Trade: Emp: ENG Acquis. Date: [00/00/00]
Notes/Specs: Last Performed:[04/27/97]
Comments~ Next Schedule: [05/04/97]
installed Date:[00/00/00]
Contract PO:
Type Contract Work: [ ]
Serv Contr. S/Date: 00/00/00
Serv Contr. E/Date: 00/00/00
Stock #(NSN) Manufacturer Part Number Standard Part { (EIA) Qty Rewired Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BENEEN THE HOURS OF 10 A.M. TO 11 ~.M.
1. ..W~'~HE STOP TEST A~OML,C" "SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS ~iLL PREVENT THE UNIT FROM AUTOMATICALLY
H/T~R~iNG ~BILE YOU ~E PERFORMING YOHR PRE-TEST CHECKS.
~. ('<CHECK ENGINE RADIATOR &ND GENERATOR AREA FOR DEBRIS AND FOREIHN OBJECTS., LOOSE OR BROKEN F~Y~N~ GUARDS
. ~ COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. ~'7 CHECK V-BELTS FOR ~EAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. j,~/CHECK COOLANT LEVEL iN RADIATOR ~ND ADD AS NEEDED.
5. (<~"~j~CK ENGinE OiL LEVEL ~U ADU AS
6. ~Ch~CK~'~ BATTERIES' ~AYZR LEVEL AND ADD AS NEEDED.
7, {~ZCR BATTERY CONNECTIONS FOR CORROSION AND ~IGHTNESS,
t0. (~.~NGiNE WATER HEATER S{IYCH MUST BE IN "ON" PosiTION.
I!. ?<~IFY HEATER IS
!2. {~ECK DAY TANK PU~ SWITCH. SWITCH MUST BE IN "ON" POSITION.
i3. ~HECR HENERAYOR VOLYAHE REHULAYOR SWITCH MUST BE iN "ON" POSIT!ON.
14. (~ECK ENTIRE UNIT FOR ~Y FUEL OIL, ~HINE OiL, OR COOL,NY LE~S,
!SB. ~'~ ............... TOTAL RUNNIN~ TIME. ,
16. {~'CRECK FUEL OIL LEVEL. LOG RRDI~8 BEFORE lEST. ~'/ '
19. (-'?~OG TIME HENERAYOR TOOK YO START .........
20. ( ?"VERIFY THE YR~SFER S~IYCH HAS ~HFE~ED AND Y~ GENRAYOR ~S TAKEN Y~ ~AD BY. OBS~VINH THE ~AD
~UNYACYED LIGHT.
2I. (..?CHECK UNIT FOR ANY UNUSUAL NOISE ~U/OR VIBRATION.
22. ()' ~HECK UNIT ~UUSY FOR UCESSI~ SMOKINg.
23. (.~-UNIY FOR OIL, WATER. OR EXHAUSY~LE~S.
24.
A. ~HECR ~D LOG OIL PRESSURE. ~~ '
25. ~ CHECK ~D ~ VOLTAGE:
,~A~ JOAQUIN COH~UN!TY HOSPITAL ~1 Page= 5
~'., Type' WO: PA PERFORMANCE ASSURANCE Locations O H EQUIP A~EA Dept~ 8460 EMG WO Issue Date~ 05/16/97
Control #= 0E00003 Property~ GEN0012 Client= SJCH WO Issue Time~ 14=13~$2
~ Mfgr~ CaterDillar PM Guide= 4003 Last Status/MC= UP////PA
Model= 3306 Schedule Code~ W Descript= GEN~RATOE Last WO ~ 57379
Seriml~ 66D46111 Schedule Pri~ Catsgory~ F EMERGENCY GENERATOR AND SYSTEMS Warranty Date= 00/00/00
Company Code= 01 Vendor~ Crew= Trades ~mp= ENG Acq~s. Date= 00/00/00
Notes/Specs~ Last Performed= 05/11/97
C~ents= JCN#~ Next Schedule= 0S/28/97
Installed Date: 00/00/00
Contract PO=
· ype Contract Work=
Serv Contr. S/Date=
Serv Contr. E/Date=
Stock ~(NSN) Manufacturer Part Number Standard Part ~ (EIA) Qty Required Description Type
NOT~ TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BET~BN THE HOURS OF 10 A.M. TO 11 A.M.
1. (,~)THE STOP TEST AUTOMATIC SWITCH ON THE GHNERATOR,S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU AR~ PERFORMING YOUR PHE-TEST CHECKS.
2. (~HECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS~ LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. HEMOV~ OR REPAIR AS NEEDED.
3. (~8EcK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAI~ OR TIGHTEN AS NEEDED.
4. (~C~CK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. (~fCHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. (//~HECK BATTERIES, WATER LEVEL AND ADD AS NEEDED.
7. (/~HECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
,. ~ ~HECK BA~R~ CMARGE~ ~0~ D.C. VO~T~GE ~--~ ~ D.C.
( )~NG:NE W~T~R HER~R SWITCa MUS: BE IN 'ON' POSITION.
12. (~R DRY TRN~ PUMP SWITCh. SWITCH MUST HE IN 'ON' POSITION.
13. (~CHECK GENERATOR VOLTAGE HEGULATOR SWITCH MUST BE IN ~ON~ POSITION.
15 (~ ENGINE RUNNING TIME METER READING SEFOR~ TEST. ~
15A. LOG ENGINE RUNNING TINE METER R~ADINGAFTER TEST.
158 ................ TOTAL RUNNING TIME.
16. (~HECK FU~L OIL LEV~L. LOG P~EADING B~FORETEST.
16A. CHECK FUEL OIL LEVEL. LOG HEADING APTERTEST.
16B ............ TOTAL FU~L OIL CONSUMED.
17. ( ~TOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. (])~WGOTOTHEAUTOMATICTRANSFER SWITCH LOCATED IN THE BQUIPHENTAR~AFOE BUILDING 4. TURN THETRANSFEE
SWITCa TO TNB TEST POSITION AND HOLD FOR 15 SECONDS. GEN~BATOR SHOULD START AND T~ANSFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS.
20. ( ~RIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING TNB LOAD
CONTACTED LIGHT.
(~)~cHECK UNIT FOR ~ ~S~AL NOISE ~/OR VIBRATION.
22. (L/~CK UNIT BXBAUST FOE EXCESSIVE SMOKING.
~ EXHAUST LEAKS.
23. ( UNIT FOR OIL, WATER, OR
A. CHECK AND LOG OIL PReSSURe.
B. CHECK AND LO~ COOLm~NT TEMPERATURE.
c. cHEc~ ~ =~ P~L PHEHE~.
SAN JOAQUIN COMMUNITY HOSPITAL 91 . Page=
~pe WOt PA pERfORMANCE ASSURANCE Location= 0 H EQUIP A~EA Dept= 8460 ENG WO Issue DateJ ~/09/97
Control #= 0E00003 Property= GEN0012 Client= SJCN WO Issue Times
Mfgr= Cater~iller PM Guide~ 4003 Last Status/MC: UP////PA
Ms,el: 3306 Schedule Codel W Deecr£pt= GENERATOR Laet WO ~z 57379
Serial= &6D45111 Schedule Pti= Category= F EMERGENCY GENERATOR AND SYSTEMS Warranty Date= 00/00/00
Company Code; 0! Vendor= Crew; Trade= Emp= ENG /~/L~. Acquis. Date= 00/00/00
Notes/Ssecs= Last Performed= 05/04/97
Comments= JCN~; Next Schedules 05/11/97
Installed Date= 00/00/00
Contract
Type Contract Work=
Serv Contr. S/Date=
Serv Contr. E/Dates
Stock ~(NSN) Manufacturer Pert Number Standard Part ~ (EIA) Qty Required Description Type
....................................................................................................................
TESTING OP B-4 GE~RATOR MUST BE PERFORMI~D ON SUNDAYS BETWEEN THI~ BO~RS OF 10 A.M. TO 11 A.M.
1. (~THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
TARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. (~ CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
COMPONENTS. NEMOVE OR REPAIR AS NEEDED.
3. (.W~C~K V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. (.~C.~CK COOLANT LEVEL IN ~ADIATOR AND ADD AS NEEDED.
5. (~ CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. (~ECK BATTERIES' WATER LEV~LANDADD AS NEEDED.
?. (~CK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. (~ C~HECK BATTERY CHARGER PONER SWITCH MUST BE IN 'ON~ POSITION
10. (~ ENGINE WATER HEATER SWITCH MUST BE IN 'ON' POSITION.
11. {~Y HEATER IS WORKING.
12. (~,~ CH~K DAY TANK PUMP SWITCH. SWITCH MUST BE IN "ON' POSITION.
13. {~CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN 'ON' POSITION.
14. (~CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
15A. LOG ENGINE RUNNING TINE METER READING ~t/~TER TEST.
1~. (~CHECK PUEL OIL LEVEL. LOG READING BEFORE TE~T;' '
16A. CHECK FUEL OIL LEVEL. LOG READING AFTER TEST.
16B ........... TOTAL FUEL OIL CONSUMED.
17. { P TEST AUTO SWITCH ON THE GENERATOR CONT~0L PANE~MUST BE SWITCHED TO AUTO POSITION.
18. ( ~Go TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN 'THE..EQUIPMENT A~EA FOR BUILDING 4. TUP/q THE T~ANSFE~
SWITC~ TO THE TEST POSITION AND BOLD FOR 1~ SECONDS. GENERATOR SHOULD START AND T~ANSFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS.
19. (%TIMI~ GENE~ATORTOOK TO START ......... .~RA
20. (~ VERIFY THE T~ANSFER SWITCH HAS T~ANSFE~RED AND THE GE TOR ~A$ TAKEN THE LOAD BY OSSERVING THE LOAD
CONTACTED LIGHT. .'%
21. {~CHECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIB~TION.
2~. (~HECK UNIT EXHAUST FOR EXCESSIVE
SMOKIN$.
~3. ( ~ CHECK UNIT FOR OIL, WATER~ OR EXHAUST LEAKS.'
24. {-~AFTER 20 MINUTES OF RUNNING TIME~ CHECK ANDLOG.
A. CHECK AND LOG OIL PRESSURE.
c. cHE~ ~ ~ ~UNL PREsS~. /Vn~
2s. C..~HECK ~ ~ VOL~AGE~
SAN JOAQUIN COMMUNITY HOSPITAL
T~pe WOt PA PERFORMANCE ASSURANCE Location= O H EQUIP AREA Deptz 8460 ENG WO Issue Date= 05/23/97
Control #= 0E000~3 Property= GEN0012 Client: SJCH
az~,?~,.~.~:~.~'~&~ ~ PM Guide: 4003
W~.~,~:c*..:.* ..... Last Statue/MC= UP////PA
Mo~el: 3306 Schedule Codez W Desoript: GENERATOR Last WO #: 57379
Serial= 66D46111 Schedule Pti: Catego~: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company code= 01 Vendor= Crew= Trade= Bmp= ENG ~ Acquie. Date= 00/00/00
Notes/Specs= Last Performed: 05/18/97
Comments: JCN~= Next Schedule: 05/25/97
Installed Date: 00/00/00
Contract PO~
Type Contract Work=
Serv Contr. S/Date=
Serv Contr. E/Date:
.........................................................................................................................
Stock #(NSN) Manufacturer Pa~ Number Standard Pa~ # (EIA) Qty Required Description Type
....................................................................................................................
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
1. (~ THE STOP TEST AUTOMATIC SWITCH ON TRE GENERATOR,S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. ( w~ CHECK ENGIHE RADIATOR AND GENERATOR AR~A FOR DEBRIS AND FOREIGN OBJECTS~ LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. (~ CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. (~ CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. (~ CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. (~ CHECK BATTERIES' WATER LEVEL AND ADD AS N~EDED.
7. (~ CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. (F9 CHECK BATTERY CHARGER POWER SWITCH MUST BE IN "ON' POSITION
9. (~ CHECK BAT~'ERY CHARGER LOG D.C. VOLTAGE ~ AND D.C. AMPERAGE
10. (W9 ENGIN~ WATER HEATER SWITCH MUST BE IN "ON" POSITION.
11. (~ VERIFY HEATER IS WOP. KING.
12. (~ CHECK DAY TANK PUMP SWITCH. SWITCH MUST BE IN "ON' POSITION.
13. ( ~ CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON" POSITION.
14. (~ CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
15 (~ LOG ENGINE RUNNING TIME METER READING BEFORE TEST. ~.~
lIB ................ TOTAL RUNNING TIME. I .I
16. ( ~CHECK FU~L OIL LEVEL. LO(~ RFJtDING BEFORE TEST. ~"
16A. CHECK FUEL OIL LB"JNL. LOG READING AFTER TEST. '~ ~/~
16B ............ TOTAL FUFJu OIL CONSUMED.
17. ( ~ STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. ( ~ GO TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENT AREA FOR BUILDING 4. TURN THE TRANSFE~
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS.
19. (,4 LOG TIME GENERATOR TOOK TO START ......... ~'
20. (~ VERIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN TH~ LOAD BY OBSERVING THE LOAD
CONTACTED LIGHT.
21. (~ CHECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRATION.
22. ( ,~' CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. (~ CHECK U~NIT FOR OIL, WATER, OR EXHAUST LEAKS.
24. ( ~ AFTER 20 MINUTES OF RUNNING TINE, CHECK AND LOG.
a. cHEcK AND LO~ OIL PRESSU~.
B. cHEcK ~ ~ CooL~rr TE~ERATUR~. /~'.g' ~
c. CHECK m~D ~ FU'~ PRESSU'RE.
25. (~ CHECK AND LOG VOLTAGEz
ente,.~: ~: 0N0<.}:? Pr~.?e:ty: ,;EN00r'. Client' SJCH W0 Issue Time: 15:56:35
~f~¢: ,htee~i!!ar P~ Guide' 4003 bas~ St. at. us/~C: IJP////PA
:feri~!: ~6D4~Ill $cbedu!e Di: CateMory: F EMERGENCY GENERATOR fiND SYSTEMS Warranty Date: 00/00/00
........... ~a~. ~p: ]~G iegui~. D~te: 0</00/00
Instilled Date:
T~pe Cou~ra~
.........................................................................................................................
Stock ~{~'SN~ Manufacturer Part ~umber Standard ~art S {~!~} QW Required Description Type
....................................................................................................................
PE~F,)RMiNi] THE PRE-Ti'ST CHECKS AS OUTLINED BELOW. THiS WiLL PREVENT THE [INIT FROM 4UTJMAT!CALL¥
2. ,:~) CHECK ENGINE RADIATOR AND GENERATOR AREA FOR HBRiS !ND NREi']N OBJNTS. LOOSE OR BROKEN FITTING
lO. ,: ~ENGiNE ~iTER HEATER SWiNH ~UST BE iN '0~" NSiTiO~.
!l. {~ ~RiFY HE!T~R [S
12. {~ CHECK DAY TANK PUMP SWiNH. 3W!TCH ~l]$l BE !~ "0~" POSiTiON.
t3. ,: ~CHECK GENiE!MR VOLT~GE REGULAD)R SWITCH MUST BE !~ "ON" DSiNON.
I~ :~OG ENGINE RUNNIN~ TIME METER READIN~ BEFORE TEST. ~.v
!Sa. ................ TOTg RUNNING TIME.
i6. ~3HECE FI]EL OIL LEVEL. LOG READING BEFORE TEST. ~
!SB, TO~A5 FUEL OIL CONSUMED.
iV. /~}T6P'T~S~ iU~O'g~l~Cd O~ THE GENERATOR C0,TROL PANEL ~UST BE SWiTCHD TO AUTO
18. {w O) ?0 THE i[:TOMANC TRANSFER SWITCH LOCATED tN THE E~U!PMENT AREA FOR BUILDING 4. T:}RN THE
SWITCH TO IHE TEST POSITION AND HOLD FOR 15 SECONDS. GZNERADR SHOULD START AND TRANSFER SWITCH
:~N~F:R THE LORP WITHIN 10 SECONDS.
!9, <~: T!~.E GENE~tTOR TOOK TO STINT ......... +~ ~
~CON~tCIED LIGHT.
21. { ,: ?ICE UNIT FOR iN: UNUSUAL NOISE iND./OR Vi~RANON.
2'2. {~ ',HICK UNIT EXHtLiS? FOR EXCESS!YE SMOKING.
~. (~ CHICK ~i: FOR OIL. W!IER~ OR EXH!UST
i. OHECK ANit LOG OIL PRESSURE.
B. CHECi !ND LOG COOLANT liMPER!TURK, l{O
/C. CHECK 4ND LOG ~u,~ P~SsU~,.
SAN JOAQUIN COMMUNITY HOSPITAL #! Page= 5
Type WO~ PA PERFORRANCH ASSURANCE Location: 0 H ~QUIP AR~A Dept~ 8460 ENG WO Issue Date= 06/06/97
C~ntrol #= 0E000~3 Property= GEN0012 client~ SJCH WO Issue Time=
Mfgr: Cete~£11ar PM Guide= 4003 Last Status/MC~
Model= 3306 Schedule Code= W Descript= GENERATOR Last WO 9= 57379
Serial= 66D46111 Schedule Pti= Category= F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company Codez 01 Vendor= Crew; Trade; ~mp= ENG Acquis. Date= 00/00/00
Notes/Specs= ~_~ Last Performed= 06/01/97
Comments= JCN~= Next Schedule= 06/08/97
Installed Date= 00/00/00
Contract POi
Type Contract Work=
Sero Contr. S/Date=
Sero Contr. E/Date:
Stock 9(NSN) Manufacturer Pert Number Standard Part # (HIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
1. (~) THE STOP T~ST AUTOMATIC SWITCH ON THE GBHERATOR,S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORRING THE PP.E-TEST C~ECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU AR~ PERFORMING YOU~ PR~-TEST CHECKS.
2. ~ CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTSv LOOSE OR SROKEN FITTING GUARDS
AND COMPONENTS. REMOV~ OR NEPAIR AS NESDED.
(~ CHECK V-BELTS FOR WEAR, SROKEN OR LOOSE. HEPAIR OR TIGHteN AS NEEDED.
4. (~) CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
§. (~ CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. ~CHECK BATTERIES, WATER LEVEL AND ADD AS NEEDED.
7. (~ CHECK BATTERY CONNECTIONS FOR COR/~OSION AND TIGHTNESS.
8. (~ CHECK BATTERY CHARGE~ POWER SWITC~ MUST BH IN 'ON' POSITION
10. (~) ENGINE WATER HEATER SWITCH MUST BE IN 'ON' POSITION.
11. (~) VERIFY HEATER IS WORKING.
12. {~/ CHECK DAY TANK PUMP SWITCH. SWITCH MUST BE IN 'ON' POSITION.
13. ~9 CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN 'ON' POSITION.
14. (~CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
?
1SA.
~B ............ TOTAL ~U~L oil CONSUHEO. ¥~
~?. ( ~STOP TEST ~o SWITCH ON TNE G~RATOR COFmOL P~r~L MUST SE SWitCHED TO ~o POSITION.
~S. (~-~O TO THE aUTO.TIC TR~mS~'ER SWITCH rmCATED IN TNE E~UIP~ET mu~a ~o~ BUIrmINU 4. TURM THE
SWITCH TO THE ~ST POSITION AND HOL~ POR ~ SE¢O~S. GEHERATOR SBO~rU~ START ~D ~SPE~ SWITC~
Tm~mSP~R THE LOAD WITETN ~0 S~.CONDS.'k~
~. (/f' LO~ TIMZ GEWHRATOR TOOK TO START ......... ' _~
20. (,'~' VERI~ TNE TIn, ms,ER SWITCH ~ TtU~SF~m'U~D A~D T~m ~NERATOR SaS TAKEN THE LOaD SY OSSERVING THE roAD
CONTACTED LIGI~T.
21. (~HECK UNIT FOR AS¥ UNUSUAL NORSE AN~/OR VIBRATION.
~2. ~') C~CK Ut~T BXBAUST FOR EXCESSIVE S~OEING.
23.-- ~ CHECK UNIT FOR OIL~ WATE~ Ol~ EXHAUST LEAKS.
24. ~'AFTER 20 MINUTES OF RUNNING TINE, CS~CKAND~OG. ~.
A. CHECK AND LOG OIL PRESSURe-.
C. CHECK AND LOG FUEL PRESSURE.
25. ( ) CHECK AND LOG VOLTAGE~
SAN JOAQUIN CO,UNITY HOSPITAL ..... '~ ~'#1h~ ,' Page:
T~e WO: PA PERFORMANCE A~SURANCE Location: O H EQUIP AREA Dept: 8460 ENG WO Issue D&te: 06/13/97
Control #: 0E00~03 Property: GEN0012 Client: SJCH WO Issue Time: 13=24=03
Mfgr= Caterpillar PM Guide: 4003 Last Status/MC= UPll/1PA
Model: 3306 Schedule Code: W Descript= GENERATOR Last WO ~= 57379
Serial= 66D46111 Schedule Pti: Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company code: 01 Vendor: C~ew: Trade: Emp: ENG Acc/~is. D&te: 00/00/00
Notes/Specs: ~ Last Performed= 06/08/97
Comments: JCN#: ~ Next Schedule= 06/15/97
Installed Date: 00/00/00
Contract
Type Contract Work=
Serv Contr. S/Date:
Serv Contr. E/Date:
Stock ~(NSN) Manufacturer Part Number Standard Part ~ (EIA) Oty Required Description ~ype
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE SOU~S OF 10 A.M. TO 11 A.M.
1. ( ) T~E STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PRA~ENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. ( ) CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS~ LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. CHECK BATteRIES' WATER LEVEL AND ADD AS NEEDED.
7. CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. CHECK BATTERY CHARGER POWER SWITCH MUST BE IN 'ON' POSITION
9. CHECK BATTERY CHARGER LOG D.C. VOLTAG~ ~ AND D.C. AMP~-KAGE
10. ENGINE WATER KEATE~ SWITCH MUST BE IN 'ON' POSITION.
11. %'ERIFY HEATER IS WOR~KING.
12. CHECK DAY TANK PUMP SWITCH. SWITCH MUST BE IN 'ON' POSITION.
13. CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN 'ON' POSITION.
14. CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT L~AKS.
15 LOG ENGINE RUNNING TINE ~'=R READING BEFORE TEST. ~O, ~
15A. LOG HNGINE RUNNING TIME METER READING ~R TEST.
ls~ ................ TO=AL R~IN~ TIME. ~ ~
16. ( ) CHECK FUEL OZ5 LEVEL. LOG RI~ADING BEFORE TEST. 7.2
FUEL OIL LEVEL. LOG READING AFTER TEST. 7~, ~
16A.
CHECK
16B ............ TOT~J~ FUEL OIL CONSUMED. , .~, ~
17. ( ) STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. ( ) GO TO THE AUTOHATIC TRANSFE~ SWITCH LOCATED IN THE EQUIPMENT AREA FOR BUILDING 4. TURN THE TRANSFE~
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATO~ SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS.
20. ( ) VERZF~ THE ~SFER SWITCH SiS Z~,~SFEH~ZD AND THE GENERATOR HAS T~EN THE ~.OAD BY O~SERVIN~ THE
CONT&CTED LIGSZ.
~l. ( ) CHECK UEZT ZUR ~ UNDSUAL NOZSE ~m/O~ VISRATION.
22. ( ) CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. ( ) CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
24. ( ) AFTER 20 MINOTES OF RUNNING TINE, CHECK AND LOG.
A. CHECK AND LOG OIL PRESSURe. O K
B. CHECK AND LOG COOLANT TEMPERATURE. ~ ~ O
C. CHECK AND LOG FUEL PRESSURE.
25. ( ) CHECK AND LOG VOLTAGE~
S~ JOAQUiN COMMUNITY HOSPITAL ~I 4' ~ 7 > Page: 5
Type WO: PA PEP~O~ANCE ASSURANCE Location: O H EQUIP AREA Dept: 8460 ENG W0 Issue Date: 06/20/97
Control ~: 0E0000~% Property: GEN0012 Client: SJCH WO Issue Time: 15:35:24
Mfgr: ~e~Z~r PM Guide: 4003 Last Status/MC: UP////PA
Model: 3306 Schedule code: W Descri~t: GENERATOR Last WO #: 57379
Serial: 66D46111 Schedule Pri: Category: F EMERGENCY GENERATORAND SYSTEMS Warranty Date: 00/00/00
Company Code: 0~ Vendor: Crew: Tra~e: ~p: ENG .--~--~__ ~¢~is. D~e: 00/o0/00
Notes/Specs: Last Performed: 06/15/97
Comments: JCN#: Next Schedule: 06/22/97
Installed Date: 00/00/00
Contract PO:
Type Contract Work:
Serv Contr. S/Date:
Serv Contr. E/Date:
........................................................................... T .............................................
Stock $(NSN) Manufacturer Part Number Standard Part # (E!A) Qty Required Description Type
....................................................................................................................
NOTE: T~STING OF B-4 GENERATOR MUST BE PEP~FO~D ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
1. ~ THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PP.E-TEST CHECKS AS OUTLINED BELOW. THiS WILL PREVENT TEE- UNIT FROM AUTOMATICALLY
STARTING W~ILE YOU AR~ PER~O.%MING YOUR PR~-TEST CHECKS.
2. ~ CHECK ENGINE P~%DIATORAND GENERATOR AREA FOR DEB&IS AND FO.~IGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS HEEDED.
3. ~ CHECK V-BELTS FOR NE.~, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. ~ CHECK COOLA~T LEVEL IN RADIATOR ~D ADD AS NEEDED.
5. ~ CHECK ENGINE OIL LE~L AND ADD AS NEEDED.
6. ~ CHECK ~ATTERIES' WATER LEVEL AND ADD AS NEEDED.
7. ~CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. ./~ CHECK BATTERY CHARGER POWER SWITCH MUST BE IN "ON" POSITION
9. ~ CHECK BAT'SERY CHARGER LOG D.C. VOLTAGE ~ ~ND D.C. AMPERAGE ~
10. /ENGINE WATER HEATER SWITCH MUST BE IN "ON' POSITION.
11. ~VERIFY HEATER IS WORKING.
12. ~ C~ECK DAY TANK PUM~ SWITCH. SWITCH MUST BE IN "ON" POSITION.
13. ~/CHECK GE.~RATOR VOLTAGE P~EGULATOR SWITCH MUST BE IN 'ON" POSITION.
14. /CHECK ENTIP~E UNIT FOR ~Y FU~L OIL, ENGINE OIL, OR COOLANT LEAKS.
15 ~/LOG ENGINE RUNNING TIM]~ METER READING BEFORE TEST. ~
15A. LOG ENGINE RUNNING TIME METER HEADING AFTER TEST. ~(.
15B ................ TOTAL RUNNING TIME. ~
16. ~]~'CHECK FUEL OIL LEVEL. L(X~ P. EADING BEFORE TEST. 7~/~'
16A. C~ECK ~UEL OIL LEVEL. LOG READING AFTER TEST. ~. _ ~'--~
16B ............ TOTAL FUEL OIL CONSUMED. ~/~
17. ) STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
I~. ~GO TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENT AR~A FOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRA/~SFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS. ~.'d~
19. (WLOG TIME GENERATO~ TOOK TO ST~T ......... 4~/--'
20. (~VERIFY TEE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
CONTACTED LIGNT.
21. (~/CHECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRATION.
22. (~CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. ('~ CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
24. ('/) AFTER 20 MINUTES OF RUNNING TIME, CHECK AND LOG.
A. CHECK AND LOG OIL PRESSURE. ~/~/~4~t-
B. CHECK AND LOG COOLANT TEMPERATUP~E. ~ ~
C. CHECK AND LOG FUEL PP. ESSUPS2. A/~
25. ( ~ CHECK AND LOG VOLTAGE:
Ty~pe WO: PA PERFORMANCE ASSURANCE Location: 0 H ~UIP AREA Dept: 8460 ENG ~K) Issue Date: 06/27/~7
Control #: 0E00003 Property: GEN0012 client: SJCH WO Issue Time: 11:23:08
Mfgr: Caterpillar PM Guide: 4003 Last Status/We: UP////PA
Model: 3306 Schedule Cods: W Descript: GENERATOR Last NO 9: 5?3?$
Serial: 66D46111 Schedule Pr/: Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company Cods: 01 Vendor: Crew: Trade: Emp: ENG Acquis. Date: 00/00/00
Notes/Specs:
Last Performed: 06/22/97
Comments: JCN#: ~__~ Next schedule: 06/29/97
Installed Date: 00/00/00
Contract PO:
Type Contract Work:
Serv Contr. S/Date:
Serv Contr. E/Date:
Stock ~(NSN) Manufacturer Part Number Standard Part 9 (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO I1 A.M.
1. ( ) THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR,S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. ( ) CHECK ENGINE RADIATOR AND GENTfRATORAREAFOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR RE~AIR AS NEEDED.
3. ( ) CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. ( ) CHECK COOLANT LEVEL IN RADIATORANDADDAS NEEDED.
5. ( ) CHECK ENGINE OILLEVEL AND ADD AS NEEDED.
6. ( ) CHECK BATTERIES, WATER LEVEL AND ADDAS NEEDED.
7. ( ) CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. ( ) CHECK BATTERY CHARGER POWER SWITCH MUST BE IN "ON- POSITION
9. ( ) CHECK BATTERY CHARGER LOG D.C. VOLTAGE ~ AND D.C. AMPERAGE
I0. ( ) ENGI~ WATER HEATER SWITCHHT;ST BE IN "ON" POSITION.
11. ( ) VERIFY HEATER IS WORKING.
12. ( ) CHECK DAY TANK PUMP SWITCH. SWITCH MUST SE IN "ON" POSITION.
13. ( ) CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON" POSITION.
14. ( ) CHECK ENTINE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
15 ( ) LOG ENGINE RUNNING TIME METER READING BEFORE TEST. ~ 3
15A. LOG ENGINE RUNNING TIME METER READING AFTER TEST. &[~ .~
15B ................ TOTAL RUNNING TIME. i ~
16. ( ) CHECK FUEL OIL LEVEL. LOG READING BEFORE TEST.
16A. CHECK FUEL OIL LEVEL. LO~ READING AFTER TEST. ~,~
16B ............ TOTAL FUEL OIL CONSUMED. , .~
17. ( ) STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. ( ) GO TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN TEE ~QUIPMENTAREA FOR BUILDIN~ 4. TURN THE TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
T~SFER TNELO,~n WITHIN ~o sEco~r~s.
zo. ~ ~ VE~IF~ THE T~SFER SWITCH HAS T~SFERRE~ ~ THE GENERATOR HAS TX~N THE ~ B~ O~SERVI~G THE
CONTACTED LIGHT.
2l. ( ) CHECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRATION.
22. ( ) CHECK UNIT EXHAUST FOR EXCESSIVE SMOKINO.
2~. ( ) CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
Z4. ( ) AFTER 20 MINUTES OF RUNNING TIME, CHECK ANDI~gG.
A. 'CHECKAND LOG OIL PRESSURE.
B. CmECEAND LO~ COOLANT TK~PEaATUa~. ~ ~
C. CHECK AND LOG FUEL PRESSURE.
25. ( ) CHECK AND LOG VOLTAGE:
~^N JO^Q~Ji~ COMMUNITY HOSPITAL U/'3/' hge:
~ypeWO: PA PERFORMANCE ASSURANCE Location: 0 H EQUIP AREA Dept: 8!60.ENO {0 Issue Date:
Coa'trol {: OEO0003 Property: GENOO[2 Client: SJCH {0 issue Time: [17:37:111
Mfg~{~J~i.}j!J...l PM Guide: sO03 Last Status/MC: II/I
Model: 3306 Schedu!e Code: W .Descript: GENERATOR Last WO S: 0
Serial: 6fiD¢6lll Schedute Pri: 2 Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: [00/00/001
CompanyCsde: Ol Vendor: Crew: Trade: Emp: ENG Acquis. Date:. [00/00/00
Notes/Specs ~ Last Performed:
Comments: Next Schedule: .[!0/29/95
Inscatted Date: [00/00/00
Contract PO:
Tgpe Contract Work: [
SPry Contr. S/Date: 00/00/00
SPry Contr. E/Bate: 00/00/00
Stock t(NSN) Manufacturer Part Number Standard Part i (EIA) qtyRequiredDescription Type
NOTE: TESTING OF B-! GENERATOR MUST BE PERFORMED ON SUNDAYS gETWEEN THE HOURS OF 10 A.M, TO It A.~.
l. (;,J"THE StOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSItiON WHILE
PERFORMING THE PRE-TEST tHEtiS AS OOTnlNED BELOW. tHIS WiLL PREVENT THE UNIT FROM AUTOMAT!CAtLY
/STARTING'~HILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. (~")CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BRO[EN FITtiNG GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS ~EEDED.
3. {~CHECK V-BELTS FOR WEAR, BRO[EN OR LOOSE, REPAIR OR TIGHTEN AS NEEDEB.
4. (d ~HECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5, (~ ,,NH'ELK ENGINE OIL LEVEL AND ADD AS NEEDED.
fi. (/ ~HEC[ BATTERIES' WATER LEVEL AND ADD AS NEEDED.
7. (/ ~HECK BATTERY CONNECTIONS FORCORROSION AND TIGHTNESS.
8. ~CHECKBATTERYCHAROERPOWER SWlTCHMUST BE~;ON' POSITION
9, !~ ,CHECg BATTERY CHARGER LOG D.C. VOLTAGE __,GL---~,~ AND ~.C. AMPERAGE
lO.(,,"],,ENGINEWATERHEATERSWlTCHMUSTBE TN'ON" POSITION.
l'l. (~ ~VERIFY HEATER IS WORKING,
12. (~.CHECK DAY TANK PUMP SWITCH'. SWITCH MUST BE iN "ON" POSITION.
13. ~ ./~.ECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN 'ON" POSITION.
14, ~ CHECK ENTIRE· UNIT FOR ANY FUEL OIL, ENGINE OiL, OR COOLANT L~AKS.
15 J/ J~]~ENGINE'RUNN!NG TIME METER READING BEFORE TEST, ~_~'~'~'__
I B. /.', .,... ..... .,. TOTAL'RUNNinG T,ME.
16, ("')~JtECK FUEL OIL LEVEL. LOD READING BEFORE TEST, ~=__
16A,""~CJ. ECK FUEL OIL LEVEL. LOP'READING AFTER TEST.
16B. ~ ~-.....' ..... TOTAL FUEL OIL CONSUMED. I ~ ·
17. (....F'~[~-~.yJ~P-TEST AUTO SWITCH ON THE GENERATOR CONTROL PANE~-{UST'BE SWITCHED TO AUTO POSITION.
18. (,,~'J'~jl3.~TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENT AREA FOR BUiLDiNG 4. TURN tHE TRANSFER
/~TO THE TEST POSitiON AND HOLD FOR 15 SECONDS. OENERATOR SHOULD START ~ TRANSFER SWITCH
~NSFER THE LOAD WITHIN 10 SECONDS. ~ ~~.,,,A.
19. {,'"'} L~31I~TIME GENERATOR TOOK TO' START ......... _~ ~ - "' ~
20.,,J,,4~"VE~Y THE TRANSFER SWITCH HAS. TRANSFERRED. AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
138'NTACTED LIGHT,
21. (,";~UN[T FOR ANY UNUSUAL NOISE AND/OR VIBRATION. . '
22..!,-')'~,~UNIT EXHAUST FOR EXCESSIVE SMOKING. '
23, {-~'/~t3,{fECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
24. {""~FTER 20 MINUTES OF RUNNINO TINE, CHECK AN~ pG.
· CHECK LoG OiL PRESSURE.
AND [OG OOLANT TE, ERATURE. 7/
FUEL RESS RE.
25. {{,,?CHECK AND LOG VOLTAGE:
Type WO= PA P~RFORMANCE ASSURANC~ Loc~on~ O ~ ~gUIP ~ Dep~] ~460 ~O Iesue Dtke* 07/~1/97
Control ~ 0E00003 Property~ GEN0012 Client~ SJC~ WO I~sue T~e~ 13~04~09
Mf~r~ Cate~ill~r PM Guid~ 4003 ~st S~mtus/MC~ ~////PA
M~elz 3306 Schedule C~e: W Descriptz GENE~R Last WO ~z 57379
Serial= 66D46111 Schedule Pri~ Ca~ego~ F E~RGENCY GE~R ~ SYS~ Warranty Datez 00/00/00
Company C~e~ 01 Vendor: Crew~ Trade~ ~pz ENG Acrid. Date: 00/00/00
Notes/specs:
~, ~ ~er~o~, 07/0~/~7
Co~ents: JCNg: Next Schedule= 07/13/97
Installed Date: 00/00/00
Contract POt
~pe Contract Work~
ge~Contr. S/Dmte~
Se~ Contr. E/Date:
........................................................................................ . ................................
Stock ~(NSN) Manufacturer Pa~ Nu~er Standard Part ~ (EIA) Qty Re~ired Description
....................................................................................................................
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
1. ~ TH~ STOP T~ST AUTOMATIC SWITCH ON THE GENERATOR,S CONTROL PANEL MUST BE SET AT STOP POSITION WHIL~
PERFORMING THE PP.E-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
2. / STARTING WHILE YOU AR~ PERFORMING YOUR PP.E-TEST CHECKS.
(/) CHECK ENGINE ~d%DIATOR AND GENERATOR AREA FOR DEBRIS AND FO~d~IGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. (r) CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. NEPAIR OR TIGHTEN AS NEEDED.
4. {~(~/ CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. f/) CHECK ENGIN~ OIL LEVEL AND ADD AS NEEDED.
6. (JCHECK BATTERIES' WATER LEVEL AND ADD AS NEEDED.
7. ~CHECK BATTERY CONNECTIONS FOR CORROSION ARD TIGHTNESS.
8. (~ CHECK BATTERY CHARGER POWER SWITCH MUST BE IN "ON" POSITION
9. CHECK BATTERY CHARGER LOG D.C. VOLTAGE ~ AND D.C. AMPERAGE
10..~ ENGIN~ WATER HEATER SWITCH MUST BE IN 'ON" POSITION.
11. (_~ VERIFY HEATER IS WORIqING.
12. (?)CHECK DAY TANK PUMP SWITCH. SWITCH MUST BE IN "ON" POSITION.
13. (~ CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN 'ON' POSITION.
14. (~ CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COO..L.ANT LEAKS.
~ss ............ TC~= FUEL oil CONS~.O.
~0. ~Lv V~R~F~ THE ~HEE~ swiTCH ~ ~sv~.HEzo ANo THE ~TO~ SAS T~N TNB LOAD S~ OSSERVI~G
CONTACTED LIGHT.
23. ~) C~CK UNIT FOR OIL, WATERw OR EXHAUST LEAKS.
24' (~) AFTER 20 MINUTEs OF RUNNING TIM~" CHECK ~'
A. CNECK AND LO~ OIL PRESSrun.
25o (~ ~t~CK ~D ~ VOLTAGE:
SAN JOAQUIN COMMUNITY HOSPITAL / $1 Page: 5
T~pe WO: PA PERFOP~%NCE ASSURANCE ~.Q3Location: O H EQUIP AREA Dept: 8460 ENG WO Issue Date: 07/18/97
· Control #: 0E00003 Av~ Property: GIN0012 Client: SJCH WO Issue Time: 13:47:12
Mfgr: Caterpillar ~l I ' PM Guide: 4003 Last Status/MC: UP/II/PA
Model: 3306 Schedule Co~e: W Descript: GENERATOR Last WO $: 57379
Serial: 66D46111 Schedule Pti: Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company Code: 01 Vendor: Crew: Trade: Imp: E~G Acquis. Date: 00/00/00
Notes/Specs: ~ Las~ Performed: 07/13/97
Comments: JCN#: Next Schedule: 07/20/97
Installed Date: 00/00/00
Contract PO:
Type Contract Work:
Serv Contr. S/Date:
Serv Contr. E/Date:
Stock #(NSN) Manufacturer Part Number Standard Part # (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PEP~FORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
1. (~,.THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR,S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PER~OR24ING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PP~EVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU AR~ PERFORMING YOUR PRE-TEST CHECKS.
2. (~CK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS~ LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. ( ~HECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. (/~CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. (~/.-~H~CK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. ('rCHECK BA~n~RIES, WATER LEVEL ~ ~OD AS NEEDED.
7. ( ~/CHECK BATTERY CON~CTIONS FOR COPaOSION ANO TIG~n.'~SS.
8. ( ~CHECK BATTERY CHARGER POWER SWITCH MUST BE I~'ON* POSITION
10. ~ ENGINE WATER HEATER SWITCH MUST BE IN "ON* POSITION.
11. ~ VERIFY HEATER IS WORKING.
12. CHECK DAY TANK PUMP SWITCH. SWITCH MUST BE IN "ON" POSITION.
13. ~CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN *ON" POSITION.
14. ~CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL~ OR COOLANT LEAKS.
~B ................ TOTAL R~ING TINE.
16B ............ TOTAL FUEL OIL CONSUMED.
17. (~STOP TEST AUTO SWITCH ON T~tE GENERATOR CONTROL PANEL MUST BE SWITCMED TO AUTO PO~TION.
18. ( ~/GO TO T~rS AUTOMATIC TRANSFER SWITC~ LOCATED IN TXtE EQUIPMENT AR~A FOR BUILDIN~ 4. TUrN T~ TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SEOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS.
20. (r)/V~RIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
CONTACTED LIGHT.
21. (~C~ECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRATION.
22. ( ~CNECK UNIT EXHAUST FOR EXCESSiVE SMOKING.
23 ( ~/~HECK UNIT FOR OIL~ WATER, OR EXHAUST LEAKS.
A. CHECK AND LOG OIL PRESSURE. ·
./CHECK AND LOG FUEL PRESSUP~E.
25. ( ) CHECK AND LOG VOLTAGE:
T'/~a,~. 'WO: PA -'~.'~FO.~J,£dNCE ASSUP~q~¥CB Location: 0 H EQUIP .~R~ Depr: 8450 E.VG WO Issue Data: 07/25/97
Control ~: OEOOOD3 Property: GENO012 Cl~ant: SJCH WO Issue Time: 14:09:26
Mfgr: Caterpillar PM Guide: 4003 Last Status?fO:
~,zodel: 3306 Schedule Code: W Descript: GENERATOR Last WO ~: 57379
Serial: 56D46I!! Schedule Pti: Category: F EMERGENCY GENERATOR .~¥D SYSTE~.6S Warranty Date: 00/00/00
Company Code: Ol Vendor: Crew: Trade: Emp:~.G[. Acquis. Date: 00/00/00
Note$/S~ecs: /0~ Last Performed.~ 07/20/97
Co~..ents: JC~'~: Next Scheduie: 07/27/97
Installed Date: 00/00/00
Contract PO:
Type Contract Work:
Serv Contr. S,/D~e:
S~rv Contr. E/Dace:
Stock # [.~S.¥) '~' ~ '= ~+ Part . gy~e
~.a..u~a~.urer Numbez Standard Part ~ (EiA} Qty Required DescriPtion
NOTE: TESTING OF B-4 GENEF=~TOR .~dUST BE PERFOR~¥ED ON SUNDAYS BETWEEN TH~ HOURS ON 10 A.M. TO ll A.M.
i. ~ THE STOP TEST AUTOI~-ATiC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE'
PERFOPJ4i.¥G THE PRE-TEST CHECKS AS OUTLINED BELOW. THiS WiLL PREVENT TEE UNiT ?ROM AUTO.~TiCALLY
ST.a_RTiNG Wi¥iLE YOU .~RE $ERFOB...i'A~ _~5R PRE-TEST CHECKS.
2. /CHECK ENGINE R-=SiATOR .~VD GENER.~TOR ARF~4 FOR DEBRIS .a=VD FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GJi-%kES
Z~D CO;.:~O;%~NTS. REMOVE OR REPAIR AS ,VENDED.
3. /~ CHECK V-BELTS FOR W~R, BROKEN OR LOOSE. RESAIR OR ~ =
.i$.:.TEJ AS NEEDED.
4. /C~.ECX COOL,VT LE%'~L IN PJ~BiATOR .a-¥D .~DD AS NEEDED.
~ CHECK ENGINE OiL LEVEL ~¥~ .ADD AS NEEDED.
6. ~ CH.?CB~ 5ATTE~IES, WATER LEVEL .~¥D ~D AS ~EEDED.
7. (~ CHECK BATTERY CO~%LYECTiONS FOR CORROSION .~VD TIGHTNESS.
8. (/ CHECK BATTERY C,~L~GER POWER SWITCH MUST BE iN "ON" 3GSITiON
9. (A~CHECK BATTERY CY_A_RGER LOG D.C. VOLTAGE ~ _~D D.C. AIdPERAGE
20. ( ~ Ei~;'GiNE '~iATER H~--ATER ~,.iTCH MUST BE iN "ON" POSiTiON.
21. ~' /VERIFY H~ATER iS WORBriNG.
12. (~ Ci~ECH DAY T.%LVif PUB¢P SWITCH. SWITCH MUST BE IN "ON" POSITION.
13. (/) CH%'CK GE2,~.~.¢TGk V'DLTA~E REGULAr"OR SW~T~A~ ~u MUST BE IN "ON" POSITION.
24. ~ ,/ CHECK EN~.RE UNIT FOR ~¢Y F5~L OiL, ENGINE OIL, OR CO0i~¥T L~JfS.
15 (~) LOG ENGINE RUNNING Ti~ METER .~-~DING BEFORE TEST. ~ ~, /
1SA. LOG ENGi~'E RUNBiiNG TiME METER RE~ING AFTER TEST. ~. ~
25B ................ TOT.~_L RUNNING TI.~¢E.
! ~. (~ CHECK FUEL OiL LEVEL. LOG READING BEFORE TEST. '~/ Y~
! ~A. CHECK FUEL OiL LEVEL. LOG READING AFTER TEST. ? !
!SB ............ TOTAL FUEL OiL CONSUMED. ~ ..
17. { ~ STOP TEST AUTO SWITCH ON Tide GENE.RATOR CONTROL _~.~VHL MUST BE SWITCHED TO AUTO POSITION.
! 8. (~ GO TD THE AUTO~.TiC T.%~-¥SFER SWITCJ~ LOCATED IN THE EQUIPMENT ~-Rm--.~ FOR BUiLD?_Vg 4, TURN THE
SWITCH TO THE TEST PO3ITiON A~'~D ?.OLD FOR 15 SECO.%~S. GENE.~TOR SHOULD ST.~RT i~VD T.r~%NSFER SWITCH
TRA~SFER THE LOAD WITHIN I0 SECONDS.
79. ( ~ LOG TiME GENERATOR TOOK TO S~:~RT .........
20. (~ VERIFY THE TP.~VSFER SWITCH HAS TP~¥SFERRED AND THE GENERATOR HAS TAJfEN THE LO;~ BY OBSERVING THE
CONTACTED LIGi~.T.
21 . (/) CHECK UNIT FOR .~Y UNUSUAL NOISE A~VD/OR VIBRATION.
22. ( ~ CHECK UNIT EX.~,AUST FOR EXCESSIVE SMOKING.
23. {~/ CHECK UNIT FOR OiL, WATER, OR EXPiAUST LEAifS.
24. ('/~ Az-TER20 MINUTES OF RUNNING TIME, CHECK A~¥D LOG.
A. ' CH~CX 3LYD LOG OiL PRESSURE.
B. CHECif A~VD LOG CCOLA~T TEM2ERATURE. /~0 e
C. CHECK mVD LOG ~UEL PRESSURE.
25. ( ~CHECK Ai~D LOG VOLTAGE:
5.< Guide: 4003 Last Status/MC:
Code: i~~ SescripT: GSNE~&TCA Last WO %: 57579
. ~.S-k..:~ ;;arranty D!ta.
Z>.=~ Performed: 07/27/97
JS~; ~ · ~7ext Sci~ a,~ u i e: 0 J ,' 03 / 9 7
Ca.ztract ~0:
Type Contract
Serv Contr.
TESTING C£ ~-~ SE~¥ER-~T£i~ 5£UST SZ -~SRFOR.¥ZD CJ.I E'J2;£_-_YS SET?,~EE}; THE ?.OU-~S CF !~ A.&'. ?0 Il A.16.
5irZSL..i_;'.3 T?'Z =.,,Z-TiST C.¥EZXS .:E 3:TLZL,fSD =SLOW. Z.%'ZS UiLL 3REUEZCC TXZ ~UCiZ Z~CL.f AUCOL.LiZZC.~Zh~
7. ' Z~ECL< 2.LTTZFL' CZ~.rt:'Z~_Z22,~S Z,SA ~SRFCz~'G~i ~..';D TZGN'Z?ESS.
j .ZJz'ZCS: SACPZRL' :7:~l~gZA LES D.C. ?'SZT. k~E
2S. ,' ~ CEECZ GZk,,?L~TOR VLLT.~L'C .~iGUL, LOR SiiiTCH ~¥UST SS /3; "05? ~OSiTiO:V.
:' , CXECK Z'2,[TZRE UOiZZ gSA -~'~' FUEL Oil, ZNGi&~ OZZ, OR CCOL~'iT LEAXS,
25~.. LOG ZNGiZ~E .',-JZ4t~,!i}iG TiZ4E Zc~TER
1SS ................
l ~.%. 3:~ECX FUEL GEL ZZ%"EZ . LOG RE~Zi,iG
2S3 ............ TG Zk-~
l ~. ~ CC TC gl~Z AUDGi,L::TiC g.~,iSFER S;'LiCCM LOCATED i>i THE EGUiPJ':~NT ~ZA FC'Z 3JL'LDi}~ 4. ~C,%~2~ 255i~ TZ~'L}ISFER
927ZZ'C,~ TC ?/:Z' TEST ~SSiTiON AND HOLD FOZ~ 15 SECO>iDS, gEnghiS"OR SHOULD ST~T A~?S 2L~Z~SFZ~ SPiTCX
2}. ( ZOO TiZYZ SE:¥E.~TGR T~X ?0 START .........
20. ( ';Z~iFY THE TF~kZSFER $~ZITCH Y~S T~NSFERRED ,~qD T;~E GEi'I~TOR Y~S 2Z~S{ZN TEE LOAD BY OBS.ZLVZZ';'J 'iZYE LOAD
21. ( CHZC:< UNiT FOR ANY U.VUSD~ ~CDISZ ~D/OR ViP~TiON.
22. ( C=~Z'CX UNiT Z'X>Z%UST FSR EX,gESSiUIE
23. ( CE~CX DiVZi FO_': O!:, k~kTER, OR
A. CEZCX A},~D EGG Oil PRESSURE.
C. CHECJC ~-~-D LOG FC~L PRESSURE.
~pe WO# PA PERFORMANCE ASsuRANCE Location: 0 H EQUIPAREA Dept: 8460 ENG WO/eeue Date: 08/08/97
Control #: OEOOO~$ Property: GENO012 Client: SJCH WOIssue Time: 14:55:$0
Mfgr: Caterpillar PM Guide: 4005 Last Status/MC: UP/II/PA
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO ~: 57379
Serial: 66D46111 Schedule Pti: Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company Code: Ol Vendor: Crew: Trade: Emp: ENG Acquis. Date: 00/00/00
Notes/Specs: Last Performed: 08/03/97
Comments: JCN#: Next Schedule: 08/10/97
Installed Date: 00/00/00
Contract ~0:
Type Contract Work:
Serv Contr. S/Date:
Serv Contr. E/Date:
Stock #(NSN) Manufacturer Part Number Standard Part ~ (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS EETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
1. (")THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST SE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
y ARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. (,') CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BRONEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. (~CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. ( /~/HECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. ( ~HECK ENGINE OIL LEVEL AND ADD AS N~EDED.
6. (~CHECK BATTERIES, WATER LEVEL AND ADD AS NEEDED.
7. ( ~CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
9. ( ~CHECK BATTERY CHARGER LO~ D.C. VOLTAGE A~D D.C. AI4~ERAGE
15B. ~'~ ..... ~ ......... TOTAL RUNNING
~s. ('T CSECK r~L orr. L~. LO~ ~ING BEFO~ rEST.--
,*B. f ........... TOT= FUNL OIL CONS O.
17. ( ~/STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. (/~ GO TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE ~UIPMENT ASEA FOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST POSITION A2CD HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN 20 SECONDS.
19. (~' LOG TIME GENERATOR TOOK TO START .........
20. ( ~VERIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
CONTACTED LIGHT.
21. ( ~ CHECK UNIT FOR ANY UNUSUAL NOISE AI~D/OR VIBRATION.
22. (/)_CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
A. CHECK AND LOG OIL PRESSURE. ~/ ~
S. CHECK ~ LOG COOLANT TFJ4~EBATURE.
C/~HECK AND LOG FUNL
PRESSURE.
25. (~ CHECK AND LOG VOLTAGE:
Ty~e WO: PA PERFORMANCE ASSURANCE Location: 0 H EQUIP A~EA Dept: 8460 ENG 9;0 Issue Date: 08/15/97
Control #: 0E000~3 Property: GENO012 Client: SJCH WO Issue Time: 14:17:48
Mfgr: Caterpillar PM Guide: 4003 Last Status/MC: UP////PA
Model: 3306 Schedule Code: W Deecript: GENERATOR Last WO 9: 57379
Serial: 66D46111 Schedule PTi: Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company Code: O1 Vendor: Crew: Trade: Emp: ENG Acquis. Date: 00/00/00
Notes/Specs: ~ Last Performed: 08/10/97
Comments: JCN#: Next Schedule: 08/17/97
Installed Date: 00/00/00
Contract PO:
Type Contract Work:
Serv Contr. S/Date:
Serv Contr. E/Date:
Stock #(NSN) Manufacturer Part Number Standard Part # (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
I. ( ) THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR,S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. ( ) CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. ( ) CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. { ) CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. ( ) CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. ( ) CHECK RATTERIES' WATER LEVEL AND ADD AS NEEDED.
?. ( ) CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. ( ) CHECK BATTERY CHARGER POWER SWITCH MIJST BE IN "ON" POSITION
/0
9. ~~CNECKBATTER~' C~U~GER ~:~ D.C. VOLTA~ Z'~ ~ O.C. ~'~ERAGE
lO.~~ENGINE WATER H~TER SWITCH "~ST ~E IN 'ON" POSITION.
1~. ~ ~ CHECK ~A~ T~K P~ SWITCH. SWITCH ~ST SE IH "ON" POSITION.
13. ~ ~ cHECK GENE~TOR VOLT~GE REG~'n~TOR SWITCN ~ST BE IN "ON" POSITION.
14. ( ) CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LF2~.KS.
15A. ~OG ENGINE Rrn~VING rz~n¢ METER RF-~IN~ X~TER TEST.
i5B ................ TOTAL RUNNING TIME.
1~. ~ ~ CHECK SUSL OIL LevEL. ~ R~mING BEFO~ ~EST.
l~X. CHECK FUEL Oil. C~VZr~. ~G RS~U~IN~ ~TE~ TEST.
~S ............ TOT~ F~L OIL CONS~SD.
17. [ ) STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PAN-EL MUST BE SWITCHED TO AUTO POSITION.
18. ( ) GO TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENT AREA FOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN IO SECONDS.
CONTACTED LIGHT.
21. ( ) CHECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRATION.
22. ( ) CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. ( ) CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
24. ( ) AFTER 20 MINUTES OF RUNNING TIME, CHECK AND LOG.
A. CHECK mm ~ OIL P~SS~E.
~. CHECK ~ ~ C~n~T T~ERAT~. ~0
25. { ) CHECK AND LOG VOLTAGE:
SAN JOAQUIN COMMUNITY HOSPITAI~ Page: 7
T~e WO: PA PERFORMANCE ASSURANCE Location: 0 H EQUIP AREA Dept: 8460 ENG WO Issue Date: 08/22/97
Control ~: OSO0003 Property: GENO012 Client: SJCH WO Issue Time: 14:53:59
Mfgr: Caterpillar PM Guide: 4003 Last Status/MC: UP//lIPA
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO #: 57379
Serial: 66D46111 Schedule Pti: Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company Code: O1 Vendor: Crew: Trade: Emp: ENG Acquis. Date: 00/00/00
Notes/Specs:
~ Last Performed: 08/17/97
Comments: JCN#: Next Schedule: 08/24/97
Installed Date: 00/00/00
Contract PO:
Type Contract Work:
Serv Contr. S/Date:
Serv Contr. E/Date:
Stock #(NSN) Manufacturer Part Number Standard Part ~ (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO Il A.M.
I. ( ) THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR,S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU AREPERFORMING YOUR PRE-TEST CHECKS.
2. ( ) CHECK ENGINE RADIATOR ~ GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. ( ) CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. ( ) CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. ( ) CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. ( ) CHECK BATTERIES' WATER LEVEL AND ADD AS NEEDED.
7. ( ) CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. ( ) CHECK ~ATTERY CHARGER POWER SWITCH MUST BE IN "ON" POSITION
10. ( ) ENGINE WATER HEATER SWITCH MUST BE IN "ON" POSITION.
11. ( ) VERIFY HEATER IS WORKING.
12. { ) CHECK DAY T2ITK PUM~ SWITCH. SWITCH MUST BE IN "ON" POSITION.
13. ( ) CHECK GEbiERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON" POSITION.
14. ( ) CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT~AKS.
15A. LOG ENGINE RUNNING TIME METER READING AFTER TEST.
15B ................ TOTAL RUNNING TIME.
16. { ) CHECK FUEL OIL LEVEL. LOG READING BEFORE TEST.
16A. CHECK FUEL OIL LEVEL. LOG READING AFTER TEST.
16B ............ TOTAL FUEL OIL CONSUMED.
17. ( ) STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. ( ) GO TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENT AREA FOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
19. ( ) LOG TIME GENERATOR TOOK TO START .........
20. ( ) VERIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
CONTACTED LIGHT.
21. { ) CHECK UNIT FORANY UNUSUAL NOISE AND/OR VIBRATION.
22. ( ) CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. { ) CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
24. { ) AFTER 20 MINUTES OF RUNNING TIME, CHECK AND~G./
B. c EcK LOG coo,. '1
C. CHECK ~ LOG FUEL PRESSURE.
25. ( ) CHECK AND LOG VOLTAGE:
Type WO: PA PERFORMANCE ASSURANCE Location: 0 H EQUIP AREA DeDt: 8460 ENG WO Issue Date: 08/29/97
co~trol #: OEO0003 Property: GENO012 Client: SJCH WO Issue Time: 13:59:40
Mfgr: Caterpillar PM Guide: 4003 Last Status/MC: UP////PA
Model: 3306 Schedule code: W Descript: GENERATOR Last WO #: 57379
Serial: 66D46111 Schedule Pti: Category; F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company Code: O1 Vendor: Crew: Trade: Emp: ENG ~ Acquis. Date: 00/00/00
Notes/Specs: Lest Performed: 08/24/97
Comments: JCN~: Next Schedule: 08/31/97
Installed Date: 00/00/00
Contract PO:
Type Contract Work:
ServContr. S/Date:
Serv Contr. E/Date:
Stock #{NSN) Manufacturer Part Number Standard Part # (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
1. (~ THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR,S CONTROL P~VEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. (~ CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
A,VD COMPONENTS. RE~4OVE OR REPAIR AS NEEDED.
3. (/CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. (~ CHECK COOLANT LEVEL IN RADIATORANDADDASNEEDED.
5. (~CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. (~ CHECK BATTERIES, WATER LEVEL AND ADD AS NEEDED.
7. {~CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. {~ CHECK BATTERY CHARGER POWER SWITCH MUST BE IN "ON" POSITION
9. (~CHECKBATTERY CHARGER LOG D.C. VOLTAGE
10. (~ENGINE WATER HEATER SWITCH MUST BE IN "ON" POSITION.
11. {~ VERIFY HEATER IS WORKING.
12. (~CHECK DAY TANK PU~fP SWITCH. SWITCH MUST BE IN "ON" POSITION.
13. (/CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON" POSITION.
14. (~'CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
15 ( ~LOG ENGINE RUNNING TIldE METER READING BEFORE TEST.
15A. LOG ENGINE RUNNING TIME METER READING AFTER TEST.
~B ................ TOT~ RUNNING TI~. !
16. (~ CHECK FUEL OIL LEVEL. LOG READING BEFORE TEST. ~0
16A. CHECK FUEL OIL LEVEL. LOG READING AFTER TEST.
16B ............ TOTAL FUEL OIL CONSUMED. '~/~
17. (~STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. ( ~GO TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENTAREA FOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST POSITIONAND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS.
19. (W LOG TIME GENERATOR TOOK TO START ......... ~.
20. (~k'VERIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
CONTACTED LIGHT.
21. (~CHECK UNIT FOR ANY UNUSUAL NOISEA~D/OR VIBRATION.
23. ~/CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
A. cssc× mD ~OG OIL P~ssuRs.
B. CHECK aND Z~ COOLANT TE~EaaTUEE.
C. CHECK AND LOG FUEL PRESSURE.
25. ) CHECK AND LOG VOLTAGE:
Type WO: PA PERFORMANCE ASSURANCE Location: 0 H EQuIP AREA Dept: 8460 ENG WO Issue Date: 09/05/97
C~ntrol #: OEO0003 Property: GENO012 Client: SJCH WO Issue Time: 13:52:45
Mfgr: Caterpillar PM Guide: 4003 Last Status/MC: UP~Il~PA
Model: 3306 Schedule Code: W Deacript: GENERATOR Last WO #: 57379
Serial: 66D46111 Schedule Pti: Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company Code: Ol Vendor: Crew: Trade: Emp: ENG~ Acquis. Date: 00/00/00
Notes/Specs: Last Performed: 08/$1/97
Comments: JCN#: Next Schedule: 09/07/97
Installed Date: 00/00/00
Contract PO=
Type Contract Work=
Serv Contr. S/Date:
Serv Contr. E/Date:
Stock #(NSN) Manufacturer Part Number Standard Part # (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MIST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF I0 A.M. TO 11 A.M.
1. ( ) THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. [ ) CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. { ) CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. ( ) CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. ( ½ CHECK ENGINE OIL LEVEL A~DA~D AS NEEDED.
6. ( ) CHECK BATTERIES, WATER LEVEL AND ADD AS NEEDED.
7. [ ) CHECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. ( ) CHECK BATTERY CHARGER POWER SWITCH M~ST BE IN "ON" POSITION
9. ( ) CH~CK BATTERY CHARGER LOG D.C. VOLTAGE ~ AND D.C. AMPERAGE
10. { ) ENGINE WATER HEATER SWITCH MUST BE IN "ON" POSITION.
11. ( ) VERIFY HEATER IS WORKING.
12. ( ) CHECK DAY T2LVK PUM~ SWITCH. SWITCH MUST BE IN "ON" POSITION.
13. ( ) CHECK GENERATOR VOLTAGE REGULATOR SWITCH F~JST BE IN "ON" POSITION.
14. { ) CHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
7
15 ( } LOG ENGINE RUNNING TI~EMETER READING BEFORE TEST. ~,
15A. LOG ENGINE RUNNING TIHE METER READING AFTER TEST. ~.
15B ................ TOTA~ RUNNING TIME.
~. ~ ~ csscs FUEL OIL LSVE~. LOG ~ADING BEFORE TEST.
16A. CHECK FUEL OIL LEVEL. LOG READING AFTER TEST.
16B ............ TOTAL FUEL OIL CONSUMED.
17. ( ) STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. ( ) GO TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENTAREAFOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS.
19. ( ) LOG TIME GENERATOR TOOK TO START .........
20. ( ) VERIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR ;{AS TAlfEN THE I2DAD BY OBSERVING THE LOAD
CONTACTED LIGHT.
21. ( ) CHECK UNIT FORANYUNUSUAL NOISE AND/OR VIBRATION.
22. ( ) CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. ( ) CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
24. ( ) A~TER 20 MINUTES OF RUNNING TIME, CHECK AND LOG.
A. 'CHECK~V~ LO~ OIL P~SSS~S.
s. CHECK ~ LOG COOr~VT TElERATe. ~
C. CHECK AND LOG FUEL PRESSURE.
25. ( ) CHECK AND LOG VOLTAGE:
Type HO: PA PERFORMANCE ASSURA=VCE Location: 0 H EQUIP AREA Dept: 8460 ENG WO Issue Date: 09/12/97
~ C~trol #: OEO0003 Property: GENO012 Client: SJCH WO Issue Time: 14:45:59
·
Mfgr: Caterpillar PM Guide: 4003 Last Status/MC: U~////PA
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO #: 57379
Seri'al: 66D46111 Schedule Pti: Category: F EMERGENCY GENERATOR AI~D SYSTEMS Warranty Da=e: 00/00/00
Company Code: Ot Vendor: Crew: Trade: Emp: ENG Acquis. Date: 00/00/00
Notes/Specs: ~m ~ Last Performed: 09/07/97
Co,T~ents: JCN#: "~ Next Schedule: 09/14/97
Installed Date: 00/00/00
Contract PO:
Type Contract Work:
Serv Contr. S/Date:
Serv Contr. E/Date:
Stock #(NSN) Manufacturer Part Number Standard Part # (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORmeD ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO i1 A.M.
1. (~THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL MUST BE SET AT STOP POSITION ~HiLE
PERFOPJ4ING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFOPJ4ING YOUR PRE-TEST CHECKS.
2. (~ECK ENGINE RADIATOR AND GENERATOR A~EA FOR DEBRIS A~VD FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. { ~'~ECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. (w~C~Ci{ COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
7. (/)CHECX BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. (.~'~HECK BATTER? CI~RGER POWER SWITCH MUST BE IN "ON" POSITION
!0. (~,'~NGINE WATER HEATER SWITCH MUST BE IN "ON" POSITION.
!1. (~,~,'~ERi'FY H~TER IS WORKING.
12. {'~'~HECK DAY TANK PUMP SWITCH. SWITCHMUST BE IN "ON" POSITION.
13 . (~"~ECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON" POSITION.
! 4. ( ~CK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
15 (~w/~G ENGINE RUNNING TIldE METER RF-~OING BEFORE TEST.
iSA. LOG ENGINE RUNNING TIME METER READING AFTER TEST.
16. (~ CHECK FUEL OIL LEVEL. LOG READING BEFORE TEST.
i~A. CHECK F~L OIL LEVEL. ~OG RE~ING ~TER TEST.
~S ............ ~OT~ S~-SL OIL coNs~D.
17. ( P TEST AUTO SWITCH ON THE GENERATOR CONTROL pANEL MUST BE SWITCHED TO AUTO POSITION.
18. (~GO TO THE AUTOMATIC TR3L~SFER SWITCH LOCATED IN THE EQUIPMENT ARF~A FOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST !AGSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOA~ WITHIN 10 SECONDS.
19. {~'~OG TIME GENERATOR TOOK TO START
20. (~/'%~RIFY THE TRA~¥SFER SWITCH HAS TRi~"??ERRED AND THE GENERATOR HAS TAKEN THE LOAi) BY OBSERVING THE LOAD
CONTACTED LIGHT.
21. /)CHEC~ UNIT FOR ANY UNT]SUAL NOISE AND/OR VIBRATION.
22. {~,~ECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. ('~HECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
24. {~/~FTER 20 MINUTES OF RUNNING TIME, CHECK AND LOG.
A. .CHECK ~D LOG OIL P~SSURE.
c. cHEcK ~VD LOG F~L PRESSURE.
25. [%,~"CHECK AND LOG VOLTAGE:
SAN JOAQUIN COMMUNITY HOSPITAL #1 J'~ { , ' Page: 13
Type WO: PA PERFORMANCE ASSURANCE Location: 0 H EQUIP A~EA Dept: 8460 ENG WO Issue Date: 09/19/97
~ ~ntrol #: OEO0003 Property: GENO012 Client: SJCH WO Issue Time: 15:10:05
· Mfgr: Caterpillar PM Guide: 4003 Last Status/MC: UP//~~PA
Model: 3306 Schedule Code: W Descript: GENERATOR Last WO #: 57379
Serial: 66D46111 Schedule Pti: Category: F EMERGENCY GEN2~RATORAND SYSTEMS Warranty Date: 00/00/00
Company Code: O1 Vendor: Crew: Trade: Emp: ENG~ Acquis. Date: 00/00/00
Notes/Specs: Last Performed: 09/14/97
Comments: JCN#: Next Schedule: 09/21/97
Installed Date: 00/00/00
Contract PO:
Type Contract Work:
Serv Contr. S/Date:
Serv Contr. E/Date:
Stock #(NSN) Manufacturer Part Number Standard Part # (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE i~ERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
1. {~ THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR'S CONTROL PANEL NIIST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
STARTING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. {X CHECK ENGINE RADIATOR AND GENERATOR AREA FOR DEBRIS AkID FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUA_qDS
AND COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. (,/} CHECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. {4 CHECK COOLANT LEVEL IN R3LDIATOR AND ADD AS NEEDED.
5. (J) CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. (4 CHECK BATTERIES' WATER LEVEL A~D ADD AS NEEDED.
7. (~ CHECK BATTERY CONNECTIONS FOR CORROSION AI~D TIGHTNESS.
8. ( ~ CHECK BATTERY CHARGER POWER SWITCH MUST B.E~ "ON" POSITION
~. { ~ CHECK BATTERY CHARGER LOG D.C. VOLTAGE AND D.C. AMPERAGE
10. (/) ENGINE WATER HEATER SWITCH MIIST BE IN "ON" POSITION.
12. ( ~ VERIFY HEATER IS WORKING.
12. (~ CHECK DAY TANK PUMP SWITCH. SWITCH MUST BE IN "ON" POSITION.
13. (~CHECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON" POSITION.
14. {/~ gHECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR COOLANT LEAKS.
15B. / ............... TOTAI~ RUNNING TIME.
16. (~ CHECK FUEL OIL LEVEL. LOG READING BEFORE TEST. 7 0 '
~B. J ........... TOT~ FUEL oI: CONSUMED.
17. (~STOP TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. ( ~/~ TO THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENT AREA FOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN I0 SECONDS.
19. (~'LOG TIME GENERATOR TOOK TO START
20. ( ~VERIFY THE TRANSFER SWITCH HAS TRANSFERRED AIVD THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
CONTACTED LIGHT.
21. (~CHECK UNIT FOR ANY UNUSUAL NOISE AND/OR VIBRATION.
22. (~/CHEcK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. ( /CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
24. (,~AFTER 20 MINUTES OF RUNNING TIME, CHECK
A. CHECK ~ LOG OIL PRESSURE.
B. CHECK ~ LOG COOLANT TEMPEEATURE.
C. CHECK AI~D LOG FUEL PRESSURE.
25. { ) CHECK A=VD LOG VOLTAGE:
Ty~e WO: PA PERFORMANCE ASSURANCE Location: 0 H ~QUIP AREA Dept: 8460 ENG ~ Issue Date: 09/26/97
Control~ ~: 0E00003 ProDerty: GENO012 Client: SJCH ~ Issue Time: 13:04:29
~f~: Caterpillar PM Guide: 4003 Last Status/MC: ~////PA
ModeL: 3306 Schedule Code: W Descript: GE~R Last ~ ~: 57379
Serial: 66D46211 Schedule Pti: Catego~: F ~RGENCY GE~R~ SYST~S Warranty Date: 00/00/00
C~pany Code: O1 Vendor: Crew: Trade: ~p: ~G ~ Acquis. Date: 00/00/00
Notes/Specs: Last Perfo~ed: 09/21/97
Co~ents: JCN~: Next Schedule: 09/28/97
Installed Date: 00/00/00
Contract ~:
~e Contract Work:
Se~ Contr. S/Date:
Serv Contr. E/Date:
.........................................................................................................................
Stock ~(NSN} Manufacturer Pa~ Nu~er Standard Part ~ (EIA) Qty Required Description ~e
....................................................................................................................
NOTE: TESTING OF B-4 GE1FERATOR MUST BE PERFORMED ON SUNDAYS BETWEEN THE HOURS OF 10 A.M. TO 11 A.M.
1 . [ ~ STOP TEST AUTOMATIC SWITCH ON THE GENERATOR,S CONTROL PANEL MUST BE SET AT STOP POSITION WHILE
PERFORMING THE PRE-TEST CHECKS AS OUTLINED BELOW. THIS WILL PREVENT THE UNIT FROM AUTOMATICALLY
/~TING WHILE YOU ARE PERFORMING YOUR PRE-TEST CHECKS.
2. (t~ CHECK ENGINE RADIATOR AND GENERATOR A~EA FOR DEBRIS AND FOREIGN OBJECTS, LOOSE OR BROKEN FITTING GUARDS
COMPONENTS. REMOVE OR REPAIR AS NEEDED.
3. (~)yECK V-BELTS FOR WEAR, BROKEN OR LOOSE. REPAIR OR TIGHTEN AS NEEDED.
4. { ~ CHECK COOLANT LEVEL IN RADIATOR AND ADD AS NEEDED.
5. { ~/CHECK ENGINE OIL LEVEL AND ADD AS NEEDED.
6. (!/HECK BATTERIES, WATER LEVEL AND ADD AS NEEDED.
7. {~HECK BATTERY CONNECTIONS FOR CORROSION AND TIGHTNESS.
8. (~)~HECK BATTERY CHARGER POWER SWITCH MUST BE IN "ON" POSITION
t/ ~ " , AND D.C. AMPERAGE
9. {~)~H~ECK BATTERY CHARGER LOG D.C. VOLTAGE ~
12 (~ CHECK DAY TANK POT~P SWITCH. SWITCH MUST BE IN "ON" POSITION.
13. (%)/HECK GENERATOR VOLTAGE REGULATOR SWITCH MUST BE IN "ON" POSITION.
14. (~}~ECK ENTIRE UNIT FOR ANY FUEL OIL, ENGINE OIL, OR CO0~.AA~T_
1SA. LOG ENGINE RUNNING TIME METER READING AFTER TEST. _~,/ ~
16B ............ TOTAL FUEL OIL OONSUMED.
17. ( ~P TEST AUTO SWITCH ON THE GENERATOR CONTROL PANEL MUST BE SWITCHED TO AUTO POSITION.
18. (~ THE AUTOMATIC TRANSFER SWITCH LOCATED IN THE EQUIPMENT AREA FOR BUILDING 4. TURN THE TRANSFER
SWITCH TO THE TEST POSITION AND HOLD FOR 15 SECONDS. GENERATOR SHOULD START AND TRANSFER SWITCH
TRANSFER THE LOAD WITHIN 10 SECONDS.
20. ( ~VERIFY THE TRANSFER SWITCH HAS TRANSFERRED AND THE GENERATOR HAS TAKEN THE LOAD BY OBSERVING THE LOAD
)CONTACTED LIGHT.
21. ( CHECK UNIT FOR ANY UNI/SUAL NOISE AND/OR VIBRATION.
22. { ~CHECK UNIT EXHAUST FOR EXCESSIVE SMOKING.
23. (~ CHECK UNIT FOR OIL, WATER, OR EXHAUST LEAKS.
24. (~ AFTER 20 MINUTES OF RUNNING TIME, CHECK ANDAy
A. CHECK AIVD LOG OIL PRESSURE. ;_/
C;% CHECK AND LOG FUEL
25. ( ~CHECK AND LOG VOLTAGe:
S~¥ JOAQUIN COMMUNITY HOSPITAL #1 ~ Page: 13
Type ;;0: PA PERFORMANCE ASSURANCE Location: 0 H EQUIP AREA Dept: 8460 ENG WO Issue Date: 10/03/97
g,~trol #: OEO0003 Property: GENO012 Client: SJCH WO Issue Time: 10:12:40
~g _ Caterpillar PM Guide: 4003 Last status/MC: UP~l//mA
el: 3306 schedule Code: W Descript: GENERATOR Last WO #: 5737~
Serial: 66D46ill Schedule Pti: Category: F EMERGENCY GENERATOR AND SYSTEMS Warranty Date: 00/00/00
Company Code: 01 Vendor: Crew: Trade: Emp: ENG ~
Acquis .
Date:
00/00/00
Notes/Specs: Last Performed: 09/28/97
Comments: JCN~: Next Schedule: 10/05/97
Installed Date: 00/00/00
Contract BO:
Type Contract Work:
Serv Contr. S/Date=
Serv Contr. E/Date:
Stock #(NSN) Manufacturer Part Number Standard Part # (EIA) Qty Required Description Type
NOTE: TESTING OF B-4 GENERATOR MUST BE PERFORMED ON SUN]DAYS BETWEEN THE HOURS OF 10 A.M. TO ll A.M.
1. ~THE STOP TEST AUTOMATIC SWITCH ON THE GENERATOR,S CONTROL PAIVEL MUST BE SET AT STOP i~OSITION WHILE
PERFOP~ING THE PRE-TEST CHECKS AS O~LI~D BELOW. THIS WILL PR~ENT THE ~IT FROM AU~TIC~LY
TING WHILE YOU ~ PER~ING YO~ PRE-TEST CHECKS.
2. ~ CHECK ENGINE ~IA~R ~D GENE~R ~ ~R DEBRIS ~ ~REIGN OB~CTS, L~SE OR BROK~N FITTING GU~DS
~D CO~NTS. REMO~ OR REPAIR AS NEEDED.
3. ( ~CK V-BELTS FOR W~, BROKEN OR ~SE. R~PAIR OR TIGHTEN AS ~EDED.
4. (~ECX 3~T L~EL IN ~IA~R ~D ~D AS NEEDED.~ /
5. {, /~ECK ENGi~ OIL L~EL ~ ~D AS ~EDED.
7. {~ CHECK ~TTERY CONNECTIONS FOR CORROSION ~D TIGHTNESS.
8. ~ ~/CK ~TTERY C~GER ~R SWITCH MUST BE IN "ON" ~SITION
12. ~/CHECK DAY T~ PU~ SWITCH. SWITCH ~ST BE IN -ON" ~SITION.
13. (/~ECK GE~R VOLTAGE ~G~R SWITCH ~ST BE IN "ON" ~SITION.
15A. LOG ENGINE RULING TI~ ~TER R~ING ~TER TEST.
16A. CHECK F~L OIL L~L. ~G ~ING ~TER TEST.
I6B._ / ........... TOT= FUEL OIL CONS~D.
17. ~) S~P TEST AU~ SWITCH ON THE GENE~R CONTROL P~EL ~ST S~ SWITCHED ~ AU~ ~SITION.
~//.T~SFER THE L~ WITHIN 10 SECO~S.
19. (//LOG TIME GENE~TOR ~K ~ ST~T .........
20. ( ) ~ERIFY THE T~SFER SWITCH ~S T~SFERRED ~D THE GE~R
~ ~ONTACT~D LIGHT.
21. ~)~CK UNIT FOR ~Y ~SU~ NOISE ~/OR VIB~TION.
22. (.~ CHECK UNIT EX~UST ~R EXCESSI~ SMOKING.
25. (~ CHECK ~D LOG VOLTAGE:
N0¥ 0 7 1995
IBEX Precision Tank Test O['i~h"l~.'l-~ii~.l~
BROCK~AY'S TANK TESTING Bakersfield, CA. USA (805) 324-1062
Performed for: San Joaquin Hospital
Test Location: 2615 Eye St.
Bakersfield, CA
Test Identification : SJHosp-1
Test Date : 11-05-1995
Start Data Collection : 09:47:42
Ending Test Period : 11:52:18
Time Filled for Test : 24 hrs
---- Tank Data ---
TANK ID. :Generator CONTENTS :Diesel
Volume :15000 Diameter :125
Depth Bury :36 Product level :133
Groundwater :> 15 FT Pump Type :Suction
Tank Type :2 W.FG. Water in Tank :0
Test Fluid :Diesel Vapor Recovery :N/A
** Test Report
Average Rate of Change is based on 243 Data Points
Standard Deviation .............. 0059 Gallons
- Volume change of Tank Contents -
Net Volume * ( 60 min/Test Time)
-.0237 Gal. * ( 60/ 61.32 min.) = -.0231 Gph.
- Volume change due to Temperature -
Avg. Temp. * Volume * Coef. of Expn. * (60 min./ Test Time)
-.0035 Deg. F * 15000 Gal. * 0.00044 * 60/ 61.32 = -.0224 Gph.
Net change = Level Volume - Temperature Volume
NET CHANGE . . . --.0007 GPH.
Based on the Information provided and the Data Collected
This Tank & Flooded Lines Test has ...... PASSED
Certified Tester : Robert Brockman # 92-125]~~
This Test complies with U.S.EPA and NFPA requirements.
No other warrantees are expressed or implied.
RECEIVED
Ans'd ....
WO SJFIo~p ......... Te~I~, : -,0;~4 (;~h,lank N~, 1
P~oduc t D~ ese I,
Test Date 11-05-1995
0 ---""--.." .... '--"'-,'"'-'"",,,,--""'"-',',,,,,,,~nn~ Length (Hi n, ) 61.3
~1 P~ecision ,illl~
Te~p, P~eci's on
. 5 9al. .......... .
, a5 ' ............ Level - -, Oa31 (;ph, NET CHAXiiE = _,
.25 ~al .~:~- ............................ - ....... ....----- -----~.
, ~5~et Chan~e Gal, ~ // '"'
/
~ Liqui~ Level 133
· ~. ~ouna Wate~ ~ /
., , 5 ga~ ~?~'ioai Scale 1= ,Oi ~al, 6!,3 Hi~, "-...._.__ _---'"'"'"
INSPECTION RECORD
POST CARD AT JOBSITE
INSTRuCTIoNS: Please call for' an inspector onI~..when
~tth the' sase number a~e ready, They.~lll run In 'C°nSecitfVe:';.~de}.?beg. l;nn~
~lth number 1, ~0 NOT cove~ ~ork for any "nusbered gtoUp-':~nt.l'l?~a'ii~?l'te~s..1'
that group are signed off by the Permitting Authority, P~'i'i °~tng'
tnstrutions ~ill reduce the musher of requl~ed Inspection visits 'an~ therefor.
prevent assesssent of additional fees, :': .....
- T~S · s,c~r~ - .' .
~S~CT~O~ DA~ ~CTO~
~ac~rlli or Tank(s} ,, ,~ ....
/ Spark Test Certification
~ [qathodip Protection of ~a~isi~ ........
- PIPING SYSTEN -
~ioini & Race.ay ./ColleCtion Sump
Corrosion Protec!ion of Ptplng~ Joints, Fi, il PIpe[~-~ ~/ ~ '-:' ..
Electrical Isolation of Piping .Prom Ta~(s) ~-~ ~~- -~'-~:- '.':~,. -,,,
Cath6dic Protection SFstem-Plplng
. ~ :: ~.., .: . . . .....~;..::: ~'.~.(.~.~?,::~:~:~'~...
· . ,~.. . ~,,,.. ..' ,
,,,~
BSSR, INC.
BAKERSFIELD SERVICE STATION REPAIR
6630 ROSEDALE HIGHWAY, Il B
BAKERSFIELD, CA 93308 ) WORK ORDER #
(aos) s~-2Tr~ (aSSR)
FAX (8O,5) 588-2786
TO: ~'~Lx ~.~ ~1 LOCATION STORE # DATE ORDERED ARRIVAL TIME
WORK ORDERED aY P,O. # T'ECHN~C~AN DATE coUPLETEO ' ' '
Finish (money) '" FiniSh (gallons)' Calibration: Fast Slow
Totallzer ..... Checked
Readings Sta~ (money) sta~ (gallons) Adjusted Fast Slow
To
'Pt~uct Return to Storage (gallons) T0talizer Sealed [ Meter sealed
~ Yes ~ No[ ~ Yes ~ No
' Finish (money) ..... Finis~ (gallons)' Calibration: Fast Slow
Totallzer , , Checked . ,
Readings Staff (mOney) ' ' 'S{a~ (gallons) Adjusted Fast SJ~W" '
~ To
Product Return to Storage (gallons) Totalize~ Sealed I Meter Sealed
~ Yes ~ NoI ~ Yes ~ No
Finish (money) Finish (gallons} ' C~libration: F~s{ ' '[ ~1o~
Totalizer Checked
Sta~ (money) Sta~ ~g~llons) Adjusted Fast Slow
Readings
To
Product ' ' Return t0 StoCage'(gall0ns) T°talizer Sealed ~ Meter"Sealed
~ Yes C No ~ Yes ~ No
' ' Finish (money) ' [Finish (gallons) Cali~at'i~n: Fast Slow
Totalizer ........... Choked . ,
Readings Sta~ (money) [Sta~ ~gallons) Adjusted F~st ~low
To
Pr~uct ~Return to Storage {gallon~) Total~z~r Sealed ] Meter' Sealed ' '
,, , ~ Yes ~ No ,, ,[ ~ Yes ~ No
' ~ ~ ~ ~ ] r ~ O ~ ~O = / ' ~O R I CRAVEL ' 'T'0T~L H'R~. RATE AMouNT.'
~'~AN+i~] I I ' I ' ' PARTS NEEDED I I PRICE AMouNT
TOTAL ~BOR
TOTAL MATERIAL
TOTAL MIL~GE
TOTAL T~
TOTAL
. REBY AC NOW EmE T.E SAT S * O. COa. ET,ON THE ..OVE WO. .
S, NATU.E Thank You
~, '~.,~ BAKERSFIELD SERVICE STATION REPAIR
~.[ :-~.,~' 6"0 ROSED*LE HIGHWAY, ~ B
BAKERS~ELD, CA 9~ WORK O~DER
(~) ~-2~ (BSSR) .~,-~ /
Finish (money) ,.. Finish (gallons) Calibratiom Fast · Slow
Totalizer Checked
Readings Sta~ (money) Sta, (gallons) Adjusted Fast Slow
Product Return to Storage (gallons) Totalizer Sealed { Meter Sealed
: Yes : No~ ~ Yes : No
Finish (money) Finish (gallons) Calibration: Fast Slow
Totalizer Checked
Readings Start (money) Start (gallons) Adjusted Fast Slow
Product Return to Storage (gallons) Totalizer Sealed ~ Meter Sealed
~ Yes ~ No~ ~ Yes ~ No
Finish (money) Finish (gallons) Calibration: Fast ~ Slow
Totalizer ~ ~ Checked
Rea~g~.~,~. )~(Sta~ lmoney~ ~~ !~ Sta~ (gallons) ToAdjusted Fast 'Slow
~roduct ~oturn to Stora~o (~aflons) lotalizor Soalod [ Mol~r
~ish tmqney) ~ ~ Finish (gallons) Calibration: Fast Slow
Totalizer'
Read~g~ Sta~ ~o~ey) . Sta~ (gallons) .~:. -?T'~- Adj~'~ ~ast Stow
~ ~~ ~ ~ Return to Storage (gallons) Totalizer Sealed I Meter Sealed
-- ~ ~'~ ~ " ~ Yes_ ~ No ~ Yes ~ No
REP( RTED PROBLEM:
DESCRIPTION OF WORK: * ,
~~ ~ - I ~ LABOR TRAVEL TOTAL HRS. RATE AMOUNT
QU~NTI~ ED ~'~ PRICE "". AMOUNT~' ::.
I HEREBY AC~O~ED~THE~ATISFACTORY COMPLETION OF THE ABOVE WORK. - ~}