Title Page
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Site conducted
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Conducted on
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Prepared by
1 - Lobby - L2D-3
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Voltage
2 - Lobby - L2D-3
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Voltage
3 - Lobby - L2D-3
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Voltage
4 - Lobby - L2D-3
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Voltage
5 - Front Office - L2D-7
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Voltage
6 - Front Office - L2D-7
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Voltage
7 - Front Office - L2D-7
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Voltage
8 - Front Office - L2D-7
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Voltage
9 - Front Office - L2D-7
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Voltage
10 - Front Office - L2D-7
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Voltage
11 - Office Manager - L2D-1
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Voltage
12 - Office Manager - L2D-1
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Voltage
13 - Office Manager - EL2-14
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Voltage
14 - Office Manager - EL2-14
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Voltage
15 - Office Manager - EL2-14
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Voltage
16 - Pre-Op Hall - L2D-1
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Voltage
17 - Family Conference - L2D-33
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Voltage
18 - Family Conference - L2D-33
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Voltage
19 - Family Conference - L2D-33
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Voltage
20 - Family Conference - L2D-33
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Voltage
21 - Family Conference L2D-33
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Voltage
22 - Sink at Pre-Op - L2D-5
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Voltage
23 - Pre-Op - L2D-20
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Voltage
24 - Pre-Op - EL2-4
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Voltage
25 - Pre-Op - EL2-4
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Voltage
26 - Pre-Op - L2D-20
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Voltage
27 - Pre-Op - L2D-18
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Voltage
28 - Pre-Op - EL2-11
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Voltage
29 - Pre-Op - EL2-11
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Voltage
30 - Pre-Op - L2D-18
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Voltage
31 - Pre-Op - L2D-16
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Voltage
32 - Pre-Op - EL2-9
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Voltage
33 - Pre-Op - EL2-9
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Voltage
34 - Pre-Op - L2D-16
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Voltage
35 - Pre-Op - L2D-14
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Voltage
36 - Pre-Op - EL2-7
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Voltage
37 - Pre-Op - EL2-7
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Voltage
38 - Pre-Op - L2D-14
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Voltage
39 - Nurse Station Pre-Op - L2D-5
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Voltage
40 - Sink at Pre-Op - L2D-5
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Voltage
41 - Endo Lab - L2D-30
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Voltage
42 - Soiled Utility - L2D-29
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Voltage
43 - Soiled Utility - L2D-25
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Voltage
44 - Soiled Utility - L2D-27
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Voltage
45 - Soiled Utility - L2D-27
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Voltage
46 - Clean Utility - EL2-15
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Voltage
47 - Clean Utility - L2D-27
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Voltage
48 - Endo Lab - EL2-8
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Voltage
49 - Endo Lab - L2D-32
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Voltage
50 - Endo Lab - L2D-32
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Voltage
51 - Endo Lab - L2D-26
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Voltage
52 - Endo Lab - EL2-10
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Voltage
53 - Endo Lab - EL2-12
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Voltage
54 - Endo Lab - L2D-26
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Voltage
55 - Pre-Op L2D-5
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Voltage
56 - Recovery - L2D-37
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Voltage
57 - Restroom Recovery - L2D-31
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Voltage
58 - Recovery - EL2-17
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Voltage
59 - Recovery - L2D-36
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Voltage
60 - Recovery - EL2-36
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Voltage
61 - Recovery - L2D-37
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Voltage
62 - Recovery - EL2-13
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Voltage
63 - Recovery - LE2-6
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Voltage
64 - Recovery - EL2-13
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Voltage
65 - Recovery - L2D-43
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Voltage
66 - Recovery - EL2-15
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Voltage
67 - Recovery - L2D-45
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Voltage
68 - Recovery - EL2-19
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Voltage
69 - Recovery - EL2-18
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Voltage
70 - Recovery - L2D-43
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Voltage
71 - Recovery - EL2-17
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Voltage
72 - Recovery - L2D-47
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Voltage
73 - Recovery - EL2-19
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Voltage
74 - Recovery - L2D-49
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Voltage
75 - Recovery - EL2-16
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Voltage
76 - Recovery - EL2-16
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Voltage
77 - Recovery - L2D-47
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Voltage
78 - Recovery - EL2-13
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Voltage
79 - Recovery - L2D-51
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Voltage
80 - Recovery - EL2-23
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Voltage
81 - Recovery - L2D-53
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Voltage
82 - Recovery - EL2-20
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Voltage
83 - Recovery - EL2-29
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Voltage
84 - Recovery - L2D-51
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Voltage
85 - Recovery - EL2-22
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Voltage
86 - Recovery - L2D-44
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Voltage
87 - Recovery - EL2-27
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Voltage
88 - Recovery - L2D-46
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Voltage
89 - Recovery - EL2-25
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Voltage
90 - Recovery - EL2-21
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Voltage
91 - Recovery - L2D-46
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Voltage
92 - Recovery - EL2-28
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Voltage
93 - Recovery - L2D-48
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Voltage
94 - Recovery - EL2-26
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Voltage
95 - Recovery - L2D-50
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Voltage
96 - Recovery - EL2-21
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Voltage
97 - Recovery - EL2-30
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Voltage
98 - Recovery - L2D-48
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Voltage
99 - Recovery - EL2-20
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Voltage
100 - Recovery - L2D-52
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Voltage
101 - Recovery - EL2-24
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Voltage
102 - Recovery - L2D-54
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Voltage
103 - Recovery - EL2-26
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Voltage
104 - Recovery - EL2-25
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Voltage
105 - Recovery - L2D-54
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Voltage
106 - Recovery - EL2-22
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Voltage
107 - Recovery - L2D-56
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Voltage
108 - Recovery - EL2B-5
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Voltage
109 - Recovery - L2D-57
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Voltage
110 - Recovery - EL2-31
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Voltage
111 - Recovery - EL2-20
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Voltage
112 - Recovery - L2D-55
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Voltage
113 - Recovery - EL2-27
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Voltage
114 - Recovery - L2D-59
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Voltage
115 - Recovery - EL2A-14
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Voltage
116 - Recovery - L2D-61
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Voltage
117 - Recovery - EL2A-7
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Voltage
118 - Recovery - EL2-41
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Voltage
119 - Recovery - L2D-56
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Voltage
120 - Fridge Recovery - EL2-33
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Voltage
121 - Ice Machine Recovery - EL2-35
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Voltage
122 - Nurse Station Recovery - EL2-34
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Voltage
123 - Nurse Station Recovery - EL2-45
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Voltage
124 - Recovery - EL2-43
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Voltage
125 - Recovery - EL2-43
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Voltage
126 - Fridge Recovery - EL2-45
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Voltage
127 - Recovery - EL2-47
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Voltage
128 - Recovery - L2D-31
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Voltage
129 - OR Hall - EL2-18
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Voltage
130 - OR #2 - EL2B-2
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Voltage
131 - OR #2 - EL2B-10
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Voltage
132 - OR #2 - EL2B-12
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Voltage
133 - OR #2 - EL2B-12
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Voltage
134 - OR #2 - EL2-41
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Voltage
135 - OR #2 - EL2A-10
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Voltage
136 - OR #2 - EL2B-4
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Voltage
137 - OR #2 - EL2A-4
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Voltage
138 - Sterile Supply - EL2-29
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Voltage
139 - Sterile Supply - EL2-28
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Voltage
140 - Sterile Supply - EL2A-5
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Voltage
141 - Sterile Supply - EL2-41
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Voltage
142 - OR #1 - EL2B-38
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Voltage
143 - OR #1 - EL2B-6
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Voltage
144 - OR #1 - EL2-31
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Voltage
145 - OR #1 - EL2A-2
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Voltage
146 - OR #1 - EL2A-6
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Voltage
147 - OR #1 - EL2-41
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Voltage
148 - OR #1 - EL2A-8
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Voltage
149 - OR #1 - EL2-24
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Voltage
150 - OR #1 - EL2B-14
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Voltage
151 - Nurse Station OR - L2D-60
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Voltage
152 - Nurse Station OR - L2D-60
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Voltage
153 - Nurse Station OR - L2D-60
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Voltage
154 - Janitor's Closet OR Hall - L2D-64
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Voltage
155 - Janitor's Closet Pre-Op - L2D-29
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Voltage
156 - Storage - L2D-62
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Voltage
157 - Storage - L2D-62
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Voltage
158 - Storage - L2D-64
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Voltage
159 - Storage - L2D-62
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Voltage
160 - Hall at Storage - L2D-64
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Voltage
161 - Back Hall - L2D-71
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Voltage
162 - Back Hall
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Voltage
163 - Back Hall - L2D-71
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Voltage
164 - OR Hall - L2D-33
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Voltage
165 - Decontamination - L2D-67
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Voltage
166 - Decontamination - L2D-67
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Voltage
167 - Decontamination - L2D-67
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Voltage
168 - Clean Makeup - L2D-35
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Voltage
169 - Clean Holding - L2D-15
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Voltage
170 - Clean Makeup - L2D-33
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Voltage
171 - Clean Makeup - L2D-35
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Voltage
172 - Clean Makeup - L2D-35
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Voltage
173 - Hall at Clean Holding - L2D-33
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Voltage
174 - Anesthesia - L2D-4
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Voltage
175 - Anesthesia - L2D-2
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Voltage
176 - Anesthesia - L2D-6
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Voltage
177 - Anesthesia - L2D-31
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Voltage
178 - Small Break Room - L2D-5
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Voltage
179 - Small Break Room - L2D-5
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Voltage
180 - Small Break Room - L2D-5
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Voltage
181 - Small Break Room - L2D-5
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Voltage
182 - Small Break Room - L2D-5
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Voltage
183 - Men's Dressing Room - L2D-17
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Voltage
184 - Men's Dressing Room - L2D-17
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Voltage
185 - Receiving - L2D-5
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Voltage
186 - Receiving - L2D-5
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Voltage
187 - Receiving - L2D-5
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Voltage
188 - Receiving - L2D-5
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Voltage
189 - Ladies Dressing Room - L2D-7
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Voltage
190 - Ladies Dressing Room - L2D-7
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Voltage
191 - Receiving Hall - L2D-5
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Voltage
192 - Receiving Hall - L2D-5
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Voltage
193 - Med Gas Room
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Voltage
194 - Soiled Holding - L2D-5
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Voltage
195 - Data
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Voltage
196 - Data
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Voltage
197 - Data
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Voltage
198 - Elec Room - EL2-2
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Voltage
199 - TV Break Room - L2D-71
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Voltage
200 - Storage at Break Room - L2D-70
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Voltage
201 - Storage at Break Room - L2D-68
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Voltage
202 - Storage at Break Room - L2D-68
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Voltage
203 - Break Room - L2D-69
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Voltage
204 - Break Room Fridge - L2D-67
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Voltage
205 - Break Room - L2D-69
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Voltage
206 - Break Room - L2D-71
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Voltage
207 - Break Room - L2D-71
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Voltage
208 - Break Room - L2D-69
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Voltage
209 - Endo Lab - L2D-30
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Voltage
210 - OR Hall - L2D-58
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Voltage
211 - Data
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Voltage
212 - Storage Break Room - L2D-68
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Voltage
213 - Clean Makeup - L2D-35
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Voltage
214 - Recovery - L2D-34
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Voltage
215 - Endo Lab - EL2-8
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Voltage
216 - Storage - L2D-62
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Voltage
217- Clean Makeup-
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Voltage
SIGNATURE
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I certify the completion of this inspection
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Please sign to verify completion
