Health Facility Design Checklist Monograph · Health Facility Design Information Checklist 1...

Health Facility DesignInformation Checklist

HKS Inc.Joseph G. Sprague, FAIA, FACHA, FHFITodd Gritch, FAIA, FACHA, CBORon Gover, AIA, FACHAJohn Bienko, AIATina Duncan, AIA

Mazzetti + GBAWalter Vernon, PE

Smith Seckman ReidClay Seckman, PE, HFDP

TLC Engineering for Architecture Kim E. Shinn, PE, LEED Fellow

ASHE Monograph

HKS Inc.Dallas, TXJoseph G. Sprague, FAIA, FACHA, FHFITodd Gritch, FAIA, FACHA, CBORon Gover, AIA, FACHAJohn Bienko, AIATina Duncan, AIA

Mazzetti + GBASan Francisco, CAWalter Vernon, PEContributing Authors:James Ferris, PEJim Peterkin, PETaw North, PE

Smith Seckman ReidNashville,TNClay Seckman, PE, HFDPContributing Authors:Rick Wood, PETony Johnson, PE

TLC Engineering for ArchitectureBrentwood, TN Kim E. Shinn, PE, LEED FellowContributing Authors:Norm Brown, PE, LEED APArash Guity, PE, CEM, LEED APJill ConnellBrian Hageman, LEED APEric Sweet, PE, CxA, LEED AP

ASHE Monograph

Health Facility DesignInformation Checklist

ASHE Disclaimer

This document is provided by ASHE as a service to its members. The information provided maynot apply to a reader’s specific situation and is not a substitute for application of the reader’s ownindependent judgment or the advice of a competent professional. Neither ASHE nor any authormakes any guaranty or warranty as to the accuracy or completeness of any information containedin this document. ASHE and the authors disclaim liability for personal injury, property damage,or other damages of any kind, whether special, indirect, consequential, or compensatory, that mayresult directly or indirectly from use of or reliance on this document.

© 2017 ASHE

The American Society for Healthcare Engineering (ASHE)of the American Hospital Association155 North Wacker Drive, Suite 400

Chicago, IL 60606312-422-3800

[email protected]

ASHE members can download this monograph from the ASHE website under theResources tab. Paper copies can be purchased from www.ashestore.com.ASHE catalog #: 055575

vHealth Facility Design Information Checklist

Contents

Health Facility Design ChecklistIntroduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Part 1: Project InformationProject Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Project Directory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Part 2: Facility DevelopmentSite Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Planning and Zoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Fire Prevention, Detection, and Protection Systems . . . . . . . . . . . . . . . . . . . . 17

Part 3: Building SystemsHeating, Ventilation, and Air Conditioning Systems . . . . . . . . . . . . . . . . . . . . 23

Plumbing Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Natural Gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Domestic and Fire Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Plumbing Fixtures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Sanitary Sewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Storm Drainage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Bulk Medical Gases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

Part 4: AppendixSustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Additional Information and Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

vi ASHE Monograph

1Health Facility Design Information Checklist

Introduction

In July of 2016 the Centers for Medicare & Medicaid services (CMS) adopted the 2012 edition of NFPA 101: Life Safety Code®, replacing the 2000 edition. As the CMS is the primary federal agency setting health care standards, this adoption will significantly change the health care regulatory environment. This checklist was originally conceived and published in 2008. In the intervening years virtually every regulatory standard applicable to health care has been updated and revised, thus it is appropriate to update and revise the Health Facilities Design Information Checklist monograph.

Health care is one of the most intensely regulated fields of design. The maintenance and operations of health care facilities are subject to numerous federal, state, local, and accreditation agency regulations. This checklist provides a useful tool to gather data and answer fundamental questions associated with the architectural, mechanical, electrical, plumbing, technology, and fire protection requirements of new construction and major renovation projects. It contains a series of questions that prompt attention to critical issues that affect the issuance of a certificate of occupancy including site considerations, planning and zoning requirements, state and local codes, fire safety ordinances, natural gas supplies, domestic and fire water requirements, sanitary sewer facilities, and electrical power. This document should be coordinated with the owner’s overall project requirements in terms of project scope, purpose, and objectives.

One of the many uses of this checklist is to help lessen the possibility of overlooking essential zoning and code requirements that could impede the progress of a construction project or delay the review of plans and specifications by city, state, or local inspectors. The checklist also provides space for recording names of key individuals who will serve as technical resources throughout the project, including the state architect, fire marshal, health officials, inspectors, zoning authorities, and utility personnel.

This checklist contains items that may vary from one jurisdiction to another in application, interpretation, or basic requirement. While it would be impossible to provide a complete listing of all codes for all projects, the checklist should

2 ASHE Monograph

provide, in combination with other code documents, a comprehensive resource and reference for most construction projects and maintenance of most facilities. This document can serve as a resource in establishing clear lines of communication with the authorities having jurisdiction (AHJs). In some sense, owners could use this document to validate to what degree their project teams have done the necessary due diligence in code research and general project requirements to meet the project’s design and scope provisions for a successful outcome.

When the checklist is used appropriately at the beginning of the project, most misunderstandings and delays can be avoided by better planning and communication. This document and its appendix will provide a useful tool to the health care community to increase their understanding of the regulatory environment.


Part 1: Project Information

Project Summary

Date of Project Permit: _______________________________________________________

Project Name: _______________________________________________________________

Project Location: _____________________________________________________________

Client Representative: ________________________________________________________

Client Representative Phone Number: ___________________________________________

Report Prepared by: __________________________________________________________

Applicable Codes

Building Code: ______________________________________________________________

Plumbing Code: _____________________________________________________________

Mechanical Code: ____________________________________________________________

Energy Code: ________________________________________________________________

Accessibility Code(s): _________________________________________________________

Electrical Code: ______________________________________________________________

Fire Code: __________________________________________________________________

State or Local Amendments: ___________________________________________________

Life Safety Code: _____________________________________________________________

Sign Code: __________________________________________________________________

Department of Health Licensing:________________________________________________

Seismic Code: _______________________________________________________________

Building Insurance Standards: __________________________________________________

Other: _____________________________________________________________________

4 ASHE Monograph

Building Planning

Type of Construction: _________________________________________________________

New construction? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Existing construction? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

If existing, describe scope: _________________________________________________

_______________________________________________________________________

Occupancy Group(s): _________________________________________________________

Mixed occupancy: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Separated: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Seismic Category: ____________________________________________________________

Vibration Limitations? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

If yes, explain: ___________________________________________________________

Fully Sprinklered? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

High Rise? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

General Building Limitations

ITEM ALLOWED/REQUIRED ACTUAL/PROVIDED

Height of building

Number of stories

Max . single floor area

Total area of building

Penthouse and roof structure

Parking spaces STD: TTL: STD: TTL:

ACC: ACC:

Number of Stories (below grade): _______________________________________________

Future Vertical Expansion: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

If yes, number of additional stories:______________________________________________

Number of Beds: Existing _____________ New ______________ Total _________________

Additional Notes: ____________________________________________________________

___________________________________________________________________________


Project Directory

Owner

Name of Company/Firm: _____________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________

City, State, Zip Code: __________________________________________________________

Contact Name/Title/Position: _______________________________________________

Email: __________________________________________________________________

Phone: _________________________________________________________________

Architect


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Mechanical and Plumbing Engineer


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Electrical Engineer


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

6 ASHE Monograph

Information Technology


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Structural Engineer


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Civil Engineer


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Geotechnical Engineer


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________


Commissioning Agency


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Building Insurance


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Contractor


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Other


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

8 ASHE Monograph

Other


Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Authorities Having Jurisdiction

Accrediting Organization: ____________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

State Architect: _____________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

State Health: _______________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________


State Plumbing: ____________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

State Fire Marshal: __________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Local Fire Chief/Marshal: _____________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Local Fire Inspector: _________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

10 ASHE Monograph

Local Building Official: _______________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Building Inspector: __________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Building Plan Reviewer: ______________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Planning and Zoning Official: _________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________


Electrical Inspector: _________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Mechanical Inspector: _______________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Plumbing Inspector: ________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

Other

Title: ______________________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: __________________________________________________________________

Phone: _________________________________________________________________

12 ASHE Monograph

Utilities

Gas Company

Name of Company: __________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: _________________________________________________________________

Phone: _________________________________________________________________

Water Company

Name of Company: __________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: _________________________________________________________________

Phone: _________________________________________________________________

Sanitary Sewer

Name of Company: __________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: _________________________________________________________________

Phone: _________________________________________________________________


Storm Sewer

Name of Company: __________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: _________________________________________________________________

Phone: _________________________________________________________________

Power Company

Name of Company: __________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: _________________________________________________________________

Phone: _________________________________________________________________

Telecommunications/Internet Provider

Name of Company: __________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: _________________________________________________________________

Phone: _________________________________________________________________

Other

Name of Company: __________________________________________________________

Phone: ____________________________________________________________________

Street Address: ______________________________________________________________



Email: _________________________________________________________________

Phone: _________________________________________________________________

14 ASHE Monograph

PART 2: FACILITY DEVELOPMENT

Site Considerations

1 . List the general soil strata depths in this area and provide a general description of each:

_______________________________________________________________________

_______________________________________________________________________

2 . Is there any expansive soil at this site or area? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

3 . What is the water level at this site? __________________________________________

4 . Is there any evidence of landfill at this site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

5 . What is the slope of the land across the site and building footprint? _______________

_______________________________________________________________________

6 . Is there any significant vegetation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, what type? ______________________________________________________

7 . Are any easements or right-of-ways associated with this site? . . . . . . . . . . . . Yes No

8 . Are there any mineral wellheads on this site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . In operation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

9 . What is the status of the mineral and water rights on this property? _______________

_______________________________________________________________________

10 . In high seismic areas (IBC categories D, E, F), are there site hazards

such as liquefaction, slope instability, or surface rupture? . . . . . . . . . . . . . . . . . Yes No

11 . Is the site located in an environmentally sensitive area

(wetlands, steep slopes, etc .)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, what type? ______________________________________________________

12 . What is the site class per latest approved edition of the International Building Code?

_______________________________________________________________________

13 . Is liquefaction considered a possibility for the soil types at this site? . . . . . . Yes No

14 . What is the general history of seismic activity at this site? ________________________

_______________________________________________________________________

_______________________________________________________________________

15 . What type of foundation elements are most common for buildings in the general area

of this site? _____________________________________________________________

_______________________________________________________________________


16 . Which soil strata is most suitable for support of major building column loads? _______

_______________________________________________________________________

_______________________________________________________________________

17 . Do the soils in the general area of this site exhibit properties that lead

to corrosion of buried ferrous elements, deterioration of below-grade

concrete, or other concerns? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, what concerns? __________________________________________________

18 . Are wetland mitigation offsets required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

19 . Would this site be considered “brownfield land”? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

20 . Are there any known below-grade contaminants at this site? . . . . . . . . . . . . Yes No

21 . Is there a Phase I Environmental Report for the site? . . . . . . . . . . . . . . . . . . . . . . Yes No

22 . Is any part of the site located in a flood plain? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, is there a 100-year floor map? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

23 . Has the run-off report been completed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, when was it completed? ___________________________________________

24 . Is the property on a wellfield or other environmentally sensitive area? . . . . Yes No

a . If yes, what type of sensitive area? ________________________________________

25 . What level of FAA-approved lighting is needed? _______________________________

16 ASHE Monograph

Planning and Zoning

1 . Is this site platted? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Is a survey available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Is the site platted within an incorporated city? . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . Is the site platted within an extraterritorial jurisdiction? . . . . . . . . . . . . . . Yes No

2 . How is the project site presently zoned? ______________________________________

a . How does it fit within the city master plan? ________________________________

3 . What is the zoning of the adjacent property? __________________________________

a . Are there any residential proximity issues? ________________________________

___________________________________________________________________

4 . Is a special use permit/re-zoning required for this proposed

building site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

5 . What are the setback requirements? ________________________________________

_______________________________________________________________________

6 . What is the height restriction? ______________________________________________

a . How is it determined? _________________________________________________

b . Are there any height restrictions or setbacks relative to proximity?_____________

___________________________________________________________________

7 . What is the floor-to-area ratio at this site? ____________________________________

8 . Is there a floodplain or flow located on this property? . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, is it platted? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

9 . Are there any wetlands on or near the property? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

10 . Are there any deed restrictions or restrictive covenants on this site? . . . . . . Yes No

11 . Are there any approach departure paths from nearby airports or helistops

applicable to this site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

12 . Are there any noise or odor concerns at this site? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

13 . Are there any historical environmental sensitivities? . . . . . . . . . . . . . . . . . . . . . . Yes No

14 . Are there any cemeteries nearby? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

15 . Is there a local design review process? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

16 . Are there any parking restrictions? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, explain ________________________________________________________

17 . Are there any loading restrictions? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, explain ________________________________________________________

18 . Are there any know hazards on or near the site; i .e ., railroad lines? . . . . . . . . Yes No

a . If yes, explain ________________________________________________________


Fire Prevention, Detection, and Protection Systems

Fire Resistance Rating Requirements

BUILDING ELEMENT RATING REQUIRED/HOUR

UL LISTING

Primary structural frame

Bearing walls

Nonbearing walls and partitions — Exterior

Nonbearing walls and partitions — Interior

Floor and associated secondary members

Roof and associated secondary members

1 . Is a fire lane required around building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

2 . How are the distances measured to the building from the fire lane? _______________

_______________________________________________________________________

3 . What is the fire truck access (width, radii, hammer head, etc .)? ____________________

_______________________________________________________________________

4 . Can the automatic fire alarm be connected to the local fire department? . . . Yes No

5 . Is a fire command center required in the building? . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Is direct access to the outside required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

6 . What type of fire alarm supervision is required/provided?

Remote station service

Proprietary station service

Central station service

Public fire alarm reporting system

7 . Where are fire alarm annunciators required for fire department use? _______________

_______________________________________________________________________

a . What type is required? LCD Graphic

8 . What are the requirements for elevator recall? _________________________________

_______________________________________________________________________

_______________________________________________________________________

18 ASHE Monograph

9 . Is an elevator lobby required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, will an alternate means be provided by:

Hoistway smoke and draft control door assembly? . . . . . . . . . . . . . . . . . . . Yes No

Pressurization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

10 . What color exit lights are required? Red Green

11 . Are fire alarm initiation circuits required to be class “A”? . . . . . . . . . . . . . . . . . . Yes No

12 . In what areas of the building is smoke detection required? _______________________

_______________________________________________________________________

_______________________________________________________________________

13 . Smoke detectors required in:

a . Corridors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b . Patient rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c . Sleeping rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d . Storage rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e . Mechanical rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f . Areas open to corridors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g . IT closets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h . Elevator lobbies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i . Elevator machine rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j . At fire/smoke doors magnetically held open . . . . . . . . . .

k . At doors into pressurized stair enclosure . . . . . . . . . . . . .

l . At each fire alarm control panel . . . . . . . . . . . . . . . . . . . . . .

m . Other: ______________________________________________________________

14 . Type of fire extinguishers required:

a . Corridors . . . . . . . . . . . . . . . . . . . . . . . . . .ABC . . . . . .Pres . water . . . . Other

b . Electrical rooms . . . . . . . . . . . . . . . . . . . .ABC . . . . . .CO2 . . . . . . . . . . . Other

c . Storage rooms . . . . . . . . . . . . . . . . . . . . .ABC . . . . . .Pres . water . . . . Other

d . Mechanical rooms . . . . . . . . . . . . . . . . . .ABC . . . . . .CO2 . . . . . . . . . . . Other

e . Kitchen hoods . . . . . . . . . . . . . . . . . . . . . .CO2 . . . . . . .H2O . . . . . . . . . . . Other

f . Operating rooms . . . . . . . . . . . . . . . . . . .CO2 . . . . . . .H2O . . . . . . . . . . . Other

g . MRI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ABC . . . . . . . . . . . . . . . . . . . . . . . Other

h . Laboratory . . . . . . . . . . . . . . . . . . . . . . . . .ABC . . . . . . . . . . . . . . . . . . . . . . . Other

15 . Describe required operation of range hood fire extinguishing system: _____________

_______________________________________________________________________

_______________________________________________________________________

16 . Are 1½-inch hoses required on a standpipe system? . . . . . . . . . . . . . . . . . . . . . . Yes No

17 . Where are the standpipes and 2½-inch valves to be located? _____________________

_______________________________________________________________________

_______________________________________________________________________


18 . What are the types and numbers of 2½-inch outlets required on the roof? __________

_______________________________________________________________________

_______________________________________________________________________

19 . Are backflow prevention devices required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

20 . Is a fire pump required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, does the fire pump have to be in a separate room? . . . . . . . . . . . . Yes No

b . If yes, what is the rating of room? ________________________________________

c . If yes, is it required to be directly accessible from outside? . . . . . . . . . . . Yes No

21 . Is the fire pump: Diesel Electric

22 . Is the fire pump sized by number of standpipes in that fire area? . . . . . . . . . . Yes No

23 . Should a redundant fire pump be provided? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

24 . How is fire pump to be fed electrically?

Directly from utility

On emergency power

Other requirements

25 . Are two connections to the public main required for a high rise? . . . . . . . . . Yes No

26 . How far is it from Siamese connection to the pumper hydrant? ___________________

27 . Is a second water supply required based on seismic zone? . . . . . . . . . . . . . . . . Yes No

28 . Is a post indicator valve (PIV) required outside? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Is an outside screw & yolk (OS&Y) inside acceptable? . . . . . . . . . . . . . . . . Yes No

29 . What spacing is required for fire hydrants? ___________________________________

30 . Is a fire loop required around the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

31 . What is the mounting height for floor zone control valves? _______________________

32 . Is the building required to have a sprinkler head in every room/space? . . . Yes No

a . Are there any exceptions permitted per the building code? . . . . . . . . . . Yes No

b . If yes, explain: _______________________________________________________

33 . Are sprinkler heads required in portable wardrobes

(not part of building structure) that extend to ceiling or bulkhead? . . . . . . . Yes No

a . If not, what is the maximum depth/size wardrobe? _________________________

34 . What type of zoning is required for sprinkler system?

Zone per 52,000 ft

Zone per floor

Zone per smoke compartment

35 . Are fire sprinklers required outside under canopies? . . . . . . . . . . . . . . . . . . . . . Yes No

a . Over dock areas? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

36 . Is it permissible for the sprinkler drawings to be developed by

the sprinkler contractor? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Is a registered professional engineer seal required? . . . . . . . . . . . . . . . . . . Yes No

20 ASHE Monograph

37 . Can sprinkler heads be used in:

a . Electrical equipment rooms? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b . Elevator equipment rooms? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c . Computer/data processing rooms? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d . Telecom equipment rooms? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

38 . Who will conduct capacity flow tests? ________________________________________

39 . Is smoke removal required for the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes: Natural Mechanical

40 . Is an engineered smoke control system required for the building? . . . . . . . . Yes No

41 . HVAC smoke control (non-high rise): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Air handling unit(s) in smoke compartment . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b . Entire building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c . Will shut down on activation of a:

i . Ceiling-mounted smoke/heat detector . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ii . Detector in supply and return at Nurse Call (NC) unit . . . . . . . . . . . . . . . .

iii . Manual pull station . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

iv . A/S flow switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d . Smoke dampers will close via:

i . Interlock with nurse call (NC) system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ii . Detector induct at damper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

42 . HVAC Smoke Control (high-rise): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Discuss the smoke control system: _______________________________________

___________________________________________________________________

___________________________________________________________________

b . A/C unit(s) in smoke compartment in alarm will:

i . Shut down . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ii . Keep running . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c . Pressure relationship of smoke compartment in alarm relative to:

i . Adjacent smoke compartment: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Neg Pos

ii . Floor above: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Neg Pos

iii . Floor below: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Neg Pos

d . Smoke control system activates on initiation of:

i . Ceiling detectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ii . Detectors at A/C unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

iii . Auto sprinklers in smoke compartment . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

iv . Manual pull station . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e . Ceiling detector at elevator? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

f . Will stair pressurization fans be required? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No


g . On alarm initiation of fire alarm system, the audio/visual alarms will sound:

i . On floor of incident and floor above and below . . . . . . . . . . . . . . . . . . . . .

ii . Throughout the building (general alarm) . . . . . . . . . . . . . . . . . . . . . . . . . . .

iii . Smoke compartment of incident only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

iv . Smoke compartment of incident and public spaces on floor

of incident, floor above and below . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

v . Other ______________________________________________________________

43 . Communications

a . Will a fireman’s communication system be required?

(Some departments use radios only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If required, locate:

1 . Telephone handsets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 . Telephone jacks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

a . In stairwells at entrance to each level . . . . . . . . . . . . . . . . . . . . . .

b . In corridor at entrance to stairwell on each level . . . . . . . . . . .

c . Elevator lobbies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d . Fire pump rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e . Other ___________________________________________________

b . Other emergency communications required? ______________________________

44 . Is there an atrium? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, describe smoke evacuation system: _________________________________

___________________________________________________________________

b . Smoke evacuation of atrium is activated by:

i . Detectors in atrium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ii . Duct detectors in A/C system serving atrium . . . . . . . . . . . . . . . . . . . . . . .

iii . Automatic sprinklers in atrium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

iv . Beam detectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

v . Other __________________________________________________________

c . Can auto doors into atrium be used to introduce fresh air? . . . . . . . . . . . Yes No

d . What is the agreed on location to introduce fresh air, i .e ., what does

floor level mean? _____________________________________________________

45 . Are there anesthetizing locations? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

46 . Are automatic sprinklers provided in the anesthetizing locations? . . . . . . . . Yes No

47 . HVAC systems serving anesthetizing locations shut down on:

a . Detector in anesthetizing location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b . Detector in A/C system serving anesthetizing location . . . . . . . . . . . . . . . . . . .

c . Detector in smoke compartment with anesthetizing location . . . . . . . . . . . .

d . Automatic sprinklers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22 ASHE Monograph

48 . Exhaust systems serving isolation room or fume hood locations shut down on:

a . Detector in location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b . Detector in A/C system serving location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c . Detector in smoke compartment with location . . . . . . . . . . . . . . . . . . . . . . . . . .

d . Automatic sprinklers serving location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

49 . Do stairways need compartmentalizing every few floors? . . . . . . . . . . . . . . . . Yes No

50 . Are automatic closers required on patient room corridor doors? . . . . . . . . . . Yes No

51 . Is a remote annunciator panel required on patient room corridor doors? . . Yes No


PART 3: BUILDING SYSTEMS

Heating, Ventilation, and Air Conditioning Systems

*Per the officials listed, combination fire and smoke dampers are required where ducts penetrate:

BLDG OFFICIAL

FIRE OFFICIAL

DEPT OF HEALTH

4 hour wall (when allowed)

4 hour fire barrier

3 hour wall (when allowed)

3 hour fire barrier

2 hour fire wall

2 hour fire/smoke barrier

2 hour fire barrier

1 hour fire barrier

1 hour fire barrier (using sheet metal duct)

1 hour fire partition


Smoke partition

Smoke resistive wall

Floor penetrations

Penthouse floor

Roof penetrations

1 hour fire and smoke wall

Main electrical switchgear room (normal and EP)

Other

Other

24 ASHE Monograph

*Per the officials listed, fire dampers are required where ducts penetrate the following incidental room type (review fire barrier penetration with sheet metal duct exception when reviewing with authorities having jurisdiction):

BLDG OFFICIAL

FIRE OFFICIAL

DEPT OF HEALTH

Soiled workrooms

Soiled hold rooms

Clean workrooms

Clean supply rooms

Paint shops

Trash collection rooms

Repair shops

Storage rooms under 100 s .f .

Storage rooms over 100 s .f .

Gift shops

Kitchens

Boiler and heater rooms

Laundries

Locker rooms

Housekeeping closets

Film file (open storage)

Film file (closed storage)

Medical records

Business offices

Mechanical (fan) room walls

If unit only services one floor

If unit only services two floors

Electrical panel rooms

Elevator equipment room

Laboratories

Other

Other


*Per the officials listed, smoke dampers are required where ducts penetrate:

BLDG OFFICIAL

FIRE OFFICIAL

DEPT OF HEALTH

2 hour fire wall


2 hour fire barrier

1 hour fire wall

1 hour fire/smoke wall

1 hour fire barrier

1 hour fire partition

Smoke partition

Smoke resistive wall

Floor

1 hour corridor wall

2 hour corridor wall

Horizontal exit

Other

Other

*Per the officials listed, smoke dampers are activated by:

BLDG OFFICIAL

FIRE OFFICIAL

DEPT OF HEALTH

Detectors 30’-0” o .c . in corridors

Detectors in Supply & Return ducts at A/C units

Detectors in smoke compartments

Detectors in duct near smoke dampers

Other

Other

*Note: Refer to Fire Prevention, Detection, and Protection Systems for control of HVAC systems during fire alarm Part 2: Facility Development .

26 ASHE Monograph

Per the officials listed:

BLDG OFFICIAL

FIRE OFFICIAL

DEPT OF HEALTH

It is permitted to undercut door for exhaust from:

Patient room to patient bath

Corridor to janitor closet or toilet

Maximum room size, if applicable

Smoke venting is required

Supply and return or exhaust is required in every room in building

There are local requirements regarding exhaust systems that cannot be combined into a common exhaust

Overflow condensate drain lines can be connected to the entering side of a sink tail piece with visible poly tubing or connected to a ceiling-mounted tell-tale drip above sink

The room-by-room air exchange rates and pressure relationships that are listed in the FGI Guidelines for the Design and Construction of Health Care Facilities are acceptable for minimum requirements

Several hazardous areas may be enclosed by a single 2 hour wall with fire dampers

Boilers are required to be in a separate room

Existing chillers and boilers located in the same room need to be separated

The occupied portion of the building can be located above a room with a boiler

A smoke proof tower is required

Separate smoke and fire damper assemblies are allowed where both are required at one wall face


General Note: Refer to Fire Prevention, Detection, and Protection Systems for additional HVAC requirements for smoke evacuation, smoke control, and fire alarm interface in Part 2: Facility Development .

1 . What is the prevailing wind direction? _______________________________________

a . Are the cooling towers located downwind away from building

air intakes and entrances? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Are the air handling unit intakes located upwind of exhaust

air terminations? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

2 . Prevailing wind affected by surrounding buildings or natural features? . . . Yes No

a . If yes, is a wind study provided? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

3 . For reliability and maintenance, what level of redundancy shall be provided for:

a . Chillers? ____________________________________________________________

b . Boilers? _____________________________________________________________

c . Air handling units? ___________________________________________________

d . Hazardous exhaust fans (hoods, aII)? ____________________________________

4 . Systems to be on emergency power:

a . Heating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b . Cooling (all or portion) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c . Heat recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d . Air handlers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e . Hazardous exhaust fans (AII, hoods) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f . General exhaust fans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5 . Beyond the requirements of the Facility Guidelines Institute, are there spaces with

special user requirements for:

a . Temperature (central processing, NICU, etc)? . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If yes, where? ____________________________________________________

b . Air changes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If yes, where? ____________________________________________________

c . Exhaust? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If yes, where? ____________________________________________________

d . Humidity? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If yes, where? ____________________________________________________

e . Filtration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If yes, where? ____________________________________________________

6 . Are there any unique limitations relative to the size of the equipment due to access to

the site, building, etc .? ____________________________________________________

7 . Are there boilers with gas or diesel burners? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Is an air quality operating permit required? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

28 ASHE Monograph

8 . Are the boilers provided with dual fuel burners? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

9 . Is on-site fuel oil storage provided for boilers? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, is fuel containment and monitoring system provided in:

Above-ground tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Underground tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10 . Is combustion air provided for boilers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Freeze protection considerations for boiler room (sprinklers, etc)? . . . . Yes No

11 . Are chillers physically separated from fuel burning boilers and

water heaters? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

12 . Is refrigeration machinery room emergency ventilation required? . . . . . . . . Yes No

a . If yes, refrigerant monitoring system provided? . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Remote equipment emergency shut-off provided? . . . . . . . . . . . . . . . . . . Yes No

c . Remote ventilation control provided? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

13 . Air handler outside air intakes:

a . At least 6 feet above grade? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . At least 3 feet above roof? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . At least 25 feet from exhaust discharges, plumbing vents, and

medical vacuum system discharge? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

14 . Hazardous exhaust system discharge termination at least 10 feet

above roof? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

15 . Exit stairway(s) required to be pressurized? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

16 . Horizontal exit passageway included in building? . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Ventilation system serving passageway is dedicated system? . . . . . . . . Yes No

17 . Elevator hoistway connects more than three floors? . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Hoistway pressurization provided? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . Elevator machine room conditioned and pressurized? . . . . . . . . . . . Yes No

b . Elevator lobbies provided with hoistway vent? . . . . . . . . . . . . . . . . . . . . . . Yes No

c . Hoistway openings with provided with protection? . . . . . . . . . . . . . . . . . . Yes No

18 . Uninterrupible power supply (UPS) unit provided? . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Battery type and capacity require special ventilation? . . . . . . . . . . . . . . . . Yes No

19 . Are there pharmaceutical compounding spaces conforming to

USP 797? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Dedicated exhaust for chemo prep? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Air change rates for ISO classification? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . Room pressure monitors? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

20 . Are there pharmaceutical compounding spaces conforming to

USP 800? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No


21 . Are there emergency generators installed in a building? . . . . . . . . . . . . . . . . . Yes No

a . Exhaust silencer and discharge installed? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Fuel storage tank and pump with required capacity? . . . . . . . . . . . . . . . . Yes No

c . Double wall containment pipe and leak detection system? . . . . . . . . . . Yes No

d . Fuel conditioning system? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

e . Fuel day tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

22 . Ventilation provided for enclosed and partially enclosed

parking garages? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Carbon monoxide and nitrogen dioxide detection system provided? Yes No

23 . Who reviews the plans for a building permit? __________________________________

24 . To whom must plans be submitted? _________________________________________

a . How many sets?______________________________________________________

25 . Plans should also be submitted to:

a . Electrical inspector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b . Plumbing inspector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c . Fire chief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d . Others _____________________________________________________________

26 . At what stage does the plan reviewer want to review drawings? __________________

_______________________________________________________________________

27 . Is action required back during design? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Is yes, what action? ___________________________________________________

b . Completed by (name)? ________________________________________________

c . Date completed by? __________________________________________________

30 ASHE Monograph

Plumbing Systems

Natural Gas

1 . Is gas available on a firm rate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, maximum amount available? ______________________________________

2 . Is gas available on interruptible rate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, maximum amount available _______________________________________

b . Duration of history of curtailment: ______days ______ months at one time to be off

3 . Required service to building: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . One Two Other

a . Firm gas for lab, etc .? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . One Two Other

b . Interruptible? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . One Two Other

c . Meter? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . One Two Other

4 . Approval to connect to gas for this project by: _________________________________

5 . Will there be a charge to bring gas to the site? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If so, what is the approximate cost? __________________________________________

6 . What pressure of gas is available? ___________________________________________

a . What is the minimum anticipated pressure? _______________________________

b . What is the maximum pressure acceptable to be routed through occupied space?

___________________________________________________________________

7 . Is a copy of the rate structure available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

8 . What is the BTU content of gas? _____________________________________________

9 . Who installs and pays for a high-pressure line? ________________________________

10 . Who sets the meter? ______________________________________________________

Is there a cost associated with this? __________________________________________

11 . Is a concrete pad or gravel required for meter? _________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

12 . Provide the required distance from meter to:

a . Building ____________________________________________________________

b . Louver _____________________________________________________________

c . Door _______________________________________________________________

d . Window ____________________________________________________________

e . Fuel tank ___________________________________________________________

Below ground ___________________________________________________

f . Oxygen park ________________________________________________________

g . Transformers ________________________________________________________


13 . Is a seismic gas shutoff valve required on the gas main? . . . . . . . . . . . . . . . . . . Yes No

14 . Is a high-flow shutdown device required on the gas main? . . . . . . . . . . . . . . . Yes No

15 . Is a special pipe joint required for building settlement where gas line

enters the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

16 . Are natural gas building riser diagrams required? . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Isometrics Flat

b . Full Partial

17 . What potential exists for negotiation of wellhead gas contract delivery? ____________

_______________________________________________________________________

18 . Is action required back during design? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Site plan locating building and gas meter? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Estimated gas demand in cubic ft/hr cubic ft/day ? . . . . . . . . . . . . . . . . . . Yes No

c . Application(s) required for providing new utility services to the

project site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If yes, describe: ___________________________________________________

d . Other ______________________________________________________________

19 . Completed by (name)? ____________________________________________________

20 . Date completed by? ______________________________________________________

32 ASHE Monograph

Domestic and Fire Water

1 . Location and size of the water main: _________________________________________

2 . Static pressure ____________ Residual pressure ____________ at ____________ GPM

3 . Total hardness in CaCo3 __________________ PPM/17 .1 = _________________ GPG

4 . Approval to connect this project to city water by: ______________________________

5 . Will there be a charge to bring water to this site? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

6 . Is it acceptable to have unmetered water on the property? . . . . . . . . . . . . . . . Yes No

a . City to own line? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Easement required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Size: _______________________________________________________________

c . May the meter be outside the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

7 . What is the water tap fee? _________________________________________________

8 . Is copy of area map on water available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

9 . Type and size of city water meter: ___________________________________________

10 . Is a special pipe joint required where the water line enters the building to allow for

building settlement, site settlement, etc .? ____________________________________

11 . City water entrance:

a . What is required?_____________________________________________________

b . Tapping sleeve & valve ________________________________________________

Who is responsible for this? ____________________________________________

Who pays? __________________________________________________________

City water meter:

a . Who pays for meter? __________________________________________________

b . Who sets meter? _____________________________________________________

c . Who pays to set meter? ________________________________________________

d . Can owner provide means to self-meter water usage? . . . . . . . . . . . . . . . Yes No

e . Who sizes the city water meter? _________________________________________

f . Location of water intake service backflow prevention device to be located:

Outside . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Inside . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g . Is redundancy provided for backflow prevention device? . . . . . . . . . . . . Yes No

h . Is reduced pressure backflow preventer required for backflow

prevention device? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . Are double check valve assemblies acceptable means of backflow prevention for

connections to ice machines and coffee makers? . . . . . . . . . . . . . . . . . . . . Yes No

j . Are air gaps on supply lines acceptable for connections to

ice machines and coffee makers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No


12 . Fire entrance — what is required? ___________________________________________

a . Meter ______________________________________________________________

b . Detector check ______________________________________________________

c . Reduced pressure backflow preventer (RPBP) ___________ of tapping sleeve

___________ and valve___________

d . Double check ________________________________________________________

e . Post indicator valve (PIV) ______________________________________________

f . Air gap (if on-site water tank) ___________________________________________

13 . What is required at connection to the city main? _______________________________

14 . Depth required for loop ___________________________________________________

15 . Type pipe required for loop ________________________________________________

16 . Pressure test required for loop ______________________________________________

17 . Can water not going to sewer be metered to avoid sewer charge? . . . . . . . . Yes No

18 . What are the fire line setbacks from structures or utilities? _______________________

19 . Are domestic water building riser diagrams required? . . . . . . . . . . . . . . . . . . . . Yes No

a . Isometrics Flat

b . Full Partial

20 . Are fire water building riser diagrams required? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Isometrics Flat

b . Full Partial

21 . If emergency fire water storage is required on-site:

a . What is the tank capacity required per NFPA? ______________________________

b . Are the tank openings (overflow pipe, tank vent) secured from

public access and provided with minimum 24-mesh? . . . . . . . . . . . . . . . . Yes No

c . Are hatches secured from public access? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

22 . If emergency domestic water storage is provided on-site:

a . Storage tank useable capacity provided __________________________________

b . Is there a provision to fill the tank via trucked-in water? . . . . . . . . . . . . . . Yes No

c . Are the tank openings (overflow pipe, tank vent) secured from

public access and provided with minimum 24-mesh? . . . . . . . . . . . . . . . . Yes No

d . Is the tank provided with AWWA-certified lining suitable for

potable water? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

e . Is there a provision to bypass tank for maintenance without

building service interruption? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

34 ASHE Monograph

23 . Confirm the following estimated quantity and quality of process is

adequate to meet landscaping needs without potable water use in

accordance with project agreements with municipality or LEED:

a . HVAC condensate: ____________________________________________________

b . Reverse osmosis (RO) system rejected water: ______________________________

c . Rainwater: __________________________________________________________

d . Other: ______________________________________________________________

24 . Confirm with municipality amount of annual rainfall expected to be

diverted to rainwater capture system: ________________________________________

25 . Is action required back to city? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Site plan showing entry to the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Approximate meter location? __________________________________________

c . Estimated water demand 6 pm __________________ GPD ___________________

d . Estimated fire water use 6 pm ___________________ GPD ___________________

e . Application(s) required for providing new utility services to

the project site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If yes, describe: ___________________________________________________

f . Other ______________________________________________________________




Plumbing Fixtures

1 . Food service plumbing (confirm with health department):

a . Is floor is required to slope toward drain? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Is floor required to be flat, regardless of area drain location? . . . . . . . . . Yes No

c . Is exposed piping required to be chrome-plated for cleaning? . . . . . . . Yes No

d . Are floor sinks for indirect waste piping required to be:

i . Flush with floor?

ii . Raised rim?

e . Is documentation required to illustrate adequate capacity and

temperature for domestic hot water to kitchens? . . . . . . . . . . . . . . . . . . . . Yes No

f . Natural gas loads for kitchen equipment submitted to utility? . . . . . . . Yes No

2 . Plumbing fixtures:

a . Are non-aerating flow controls provided on faucets? . . . . . . . . . . . . . . . . Yes No

b . Do fixture flow rates comply with AHJ requirements? . . . . . . . . . . . . . . . Yes No

c . Hazardous chemical handling areas:

i . Are sinks provided with a countertop berm or other protection

to prevent chemical spills from entering the sewer system? . . . . . Yes No

ii . Are emergency eyewashes and/or showers provided within

10 seconds travel time for staff handling hazardous chemicals? . . Yes No



36 ASHE Monograph

Sanitary Sewer

1 . Location, size, and invert elevation of sewer ___________________________________

2 . Is approval needed to connect this project to city sewer system? . . . . . . . . . Yes No

a . If yes, is approval needed for where to connect? . . . . . . . . . . . . . . . . . . . . . Yes No

b . Who needs to provide approval? ________________________________________

3 . Is a special pipe joint required where the sewer lines exit the building

to allow for building settlement, site settlement, etc? . . . . . . . . . . . . . . . . . . . . Yes No

4 . Will there be a charge to bring sewer to site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

5 . What is the sewer tap fee? _________________________________________________

6 . Is a copy of the area map on sewers available? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

7 . Is a comminutor required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

If yes, where? ____________________________________________________________

8 . What is the minimum size of connection to the city sewer? ______________________

9 . Is a lift station required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

10 . Is a grease interceptor located: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Inside Outside

a . Is a grease trap required at dumpster? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Any sizing criteria for grease trap? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . Sampling well required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

11 . Are oil/water interceptors required for hydraulic elevator pit drainage? . . . Yes No

a . Is it acceptable to provide oil minder controls on sump pump

in lieu of oil/water interceptor? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Discharge piping to sanitary or storm? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . Discharge piping through exterior wall at grade? . . . . . . . . . . . . . . . . . . . Yes No

12 . Drainage discharge from traction elevator pit routed? . . . . . . . . . . . . . . . . . . . Yes No

a . Sanitary Storm

b . Discharge piped through exterior wall at grade? . . . . . . . . . . . . . . . . . . . . Yes No

13 . Minimum slope ___________ Maximum slope _________ of outside/inside sewer pipe

14 . Type pipe: (outside)

a . Cast iron: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . PVC: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . Clay: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

d . Concrete: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

15 . May the following drain into the sanitary sewer?

a . Dishwasher—140°: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Boiler blowdown: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . Drain at dumpster: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

16 . Is there a city standard for manholes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

17 . Are profiles required for sewer on the property? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

18 . Maximum distance between 8-inch sewer pipe manholes _______________________


19 . Does the AHJ allow ”plastic” type (Orion for instance) for acid waste,

reverse osmosis water, deionized water, etc ., and does it have

to be fire wrapped? _______________________________________________________

20 . What are the requirements for decontamination tank at ER, such as

size and construction of tank? ______________________________________________

21 . Does the AHJ allow connection of decontamination tank drain or

overflow drain to municipal sewer system? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

22 . Fuel oil storage restrictions:

a . Can PVC/DWV schedule 40 pipe be used:

i . For waste and vent pipe inside the building? . . . . . . . . . . . . . . . . . . . . Yes No

If acceptable, will piping be required to be fire wrapped? . . . Yes No

ii . Above ceiling? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

iii . Below slab? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . What are the requirements for drainage from helidecks and

containment of fire extinguishing foam? . . . . . . . . . . . . . . . . . . . . . . Storm Sanitary

c . What are requirements for drainage of transformer vaults? . . . . .Storm Sanitary

23 . Define floor drain requirements for “staff” and “public” restrooms . _________________

_______________________________________________________________________

24 . May fire protection test water be sent to sanitary sewer? . . . . . . . . . . . . . . . . . Yes No

25 . Has municipality approved fire test flow rates/volumes for

sanitary sewer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

26 . Are sanitary sewer building riser diagrams required? . . . . . . . . . . . . . . . . . . . . . Yes No

a . Isometric Flat

b . Full Partial

27 . What are requirements for drainage or parking structures?

a . Storm Sanitary

b . Oil/water interceptor required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . Size criteria? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No


a . Site plan locating building and point sewer leaves property? . . . . . . . . . Yes No

b . Invert elevations of sewer at property line? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . Estimated sewer load gallons per day (GPD) _______________________________

d . Application(s) required for providing new utility services to

the project site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If yes, describe: ___________________________________________________

e . Other ______________________________________________________________



38 ASHE Monograph

Storm Drainage

1 . Location, size, and invert elevation of storm drain: ______________________________

2 . Is approval needed to connect this project to city storm system? . . . . . . . . . Yes No

a . If yes, is approval needed for where to connect? . . . . . . . . . . . . . . . . . . . . . Yes No

b . Who needs to provide approval? ________________________________________

3 . Is a special pipe joint required where the sewer lines exit the building

to allow for building settlement, site settlement, etc? . . . . . . . . . . . . . . . . . . . . Yes No

4 . Does AHJ require filtration of storm water prior to discharging to

drainage system? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

5 . Will there be a charge to bring storm drainage to site? . . . . . . . . . . . . . . . . . . . Yes No

6 . What is the drainage tap fee? _______________________________________________

7 . Is a copy of the area map on storm utility available? . . . . . . . . . . . . . . . . . . . . . . Yes No

8 . What is the minimum size of connection to the city storm system? ________________

9 . Is a lift station required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

10 . May HVAC condensate drainage be routed to storm drain? . . . . . . . . . . . . . . . Yes No

11 . May fire protection test water be sent to storm drain? . . . . . . . . . . . . . . . . . . . . Yes No

12 . Has municipality approved fire test flow rates/volumes for storm drain? . . . Yes No

13 . Minimum slope _____________ Maximum slope _____________ of outside storm pipe

14 . Type pipe: (outside)

a . Cast iron: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . PVC: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . Clay: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

d . Concrete: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

15 . Is there a city standard for manholes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

16 . Are profiles required for drainage on the property? . . . . . . . . . . . . . . . . . . . . . . Yes No

17 . What is the maximum distance between 8-inch drainage pipe manholes? __________

_______________________________________________________________________

18 . Storm pipe restrictions:

a . Can PVC/DWV schedule 40 pipe be used:

i . For storm piping inside the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

ii . Above ceiling? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

iii . Below slab? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

iv . Storm? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

v . Sanitary? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

19 . What are requirements for drainage of transformer vaults? . . . . . . . Storm Sanitary

20 . Are storm building riser diagrams required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Isometrics Flat

b . Full Partial

21 . Detention sizing _________________________________________________________


22 . Water quality treatment sizing ______________________________________________

23 . Impacts to site development _______________________________________________

24 . What are the required site capacities vs . allowable capacity? _____________________

25 . What are the cooling tower blowdown and makeup water metering requirements?

_______________________________________________________________________

26 . What are the requirements for drainage of parking structures? ___________________

_______________________________________________________________________

a . Storm Sanitary

b . Oil/water interceptor required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . Provide size criteria . _______________________________________________

27 . Is it acceptable to pipe overflow roof drainage system to bubbler basins

on grade in lieu of piping through exterior wall to discharge

above grade? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Will bubbler basins require secondary means of drainage? . . . . . . . . . . . Yes No


a . Site plan locating building and point drainage leaves property? . . . . . . Yes No

b . Invert elevations of drainage at property line? . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . Application(s) required for providing new utility services to the

project site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If yes, describe: ___________________________________________________

d . Other ______________________________________________________________



40 ASHE Monograph

Bulk Medical Gases

1 . Confirm minimum clearances from medical oxygen bulk storage to:

a . Non-ambulatory patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b . Sewer inlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c . Property lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d . Stored fuel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e . Schools and places of public assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f . Nearest opening in wall or other structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g . Parked vehicles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h . Other: ______________________________________________________________

2 . Is truck access to medical gas bulk storage acceptable to supplier? . . . . . . . Yes No

3 . Is emergency oxygen supply connection provided to exterior of building

accessible to supply vehicles? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

4 . Are emergency reserves provided for each medical gas system? . . . . . . . . . . Yes No

5 . Is medical vacuum producer separate from waste anesthesia gas disposal

source (WAGD)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

6 . Is the medical vacuum producer also serving WAGD sized and

constructed of materials suitable for both systems? . . . . . . . . . . . . . . . . . . . . . . Yes No




Electrical

1 . Are two feeds available from separate substations to the site? . . . . . . . . . . . . Yes No

2 . If yes, is an automatic transfer available or manual only? _________________________

a . What is the estimated cost? ____________________________________________

3 . What is the power company’s reclose scheme? ________________________________

4 . Will there be a charge to bring power to the site? . . . . . . . . . . . . . . . . . . . . . . . . Yes No

5 . Is a primary service available from the utility of the property?

(for campus-style developments) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

6 . Is the utility service from the substation routed overhead or underground?

_______________________________________________________________________

7 . Is service from a vault acceptable? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Dry vault (above ground) or wet vault (below grade)? _______________________

b . Who furnishes? (If owner, obtain power company’s vault standard

and specifications) ___________________________________________________

8 . Is service through a pad-mounted transformer acceptable? . . . . . . . . . . . . . . Yes No

9 . Who furnishes the pad-mounted transformer? _________________________________

10 . If service is through a pad-mounted transformer, does the power

company limit the maximum number of secondary conduits? . . . . . . . . . . . . Yes No

11 . Does the power company have standard maximum available transformer

sizes they stock and will they furnish? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, what sizes are available? __________________________________________

b . Is 480/277 volt service available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

i . If no, what voltage is available? _____________________________________

12 . Who pours the pad for the transformer? ______________________________________

(If it is the owner, obtain the power company’s standard pad detail .)

13 . Are there any clearance restrictions (from walls, doors, and so forth) on locating the

transformer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, what are they? __________________________________________________

14 . Is conduit necessary for primary conductors? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, who furnishes? _________________________________________________

(If owner furnishes primary conduit, obtain power company’s standard detail

for underground conduit .)

b . Are spare conduits required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

15 . Who furnishes and installs the primary conductors? ____________________________

(If owner, obtain power company’s specifications .)

Who installs and terminates these conductors? ________________________________

16 . Who furnishes the secondary conductors? ____________________________________

Who installs and terminates these conductors? ________________________________

42 ASHE Monograph

17 . Does the power company limit the maximum conductors per phase on the secondary?

_______________________________________________________________________

18 . Who furnishes the metering? _______________________________________________

19 . Is a primary metered service available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . Where is the meter to be located? _______________________________________

b . Is any metering conduit required? _______________________________________

c . Is telephone line required at the meter? __________________________________

20 . In the case of multi-tenant buildings, is it permissible to meter each

tenant separately? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

21 . Does the utility require hot or cold sequence metering?

(hot sequence indicates the meter before any disconnecting means,

cold sequence has a disconnect prior to the meter) . . . . . . . . . . . . . . . . . . . . . . Yes No

22 . Can a copy of applicable rate schedules be obtained? . . . . . . . . . . . . . . . . . . . . Yes No

a . What type of load sharing programs are available for the owner’s consideration?

___________________________________________________________________

b . Does the generator have to be tier I? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

c . What is the proposed cost paybacks of such a program? _____________________

23 . Who is the phone company/internet provider/satellite/cable incumbent

local exchange carrier (ILEC) in this area? _____________________________________

24 . What action is required back to the power company site plan showing

building and transformer location? __________________________________________

a . Estimated connected or added load _____________________________________

b . Firms requesting service _______________________________________________

25 . Are any easements or right-of-way legal documents needed to bring

the new service to the project site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

26 . Is the site subject to flooding (refer to Part 2 — Facility Development —

Site Considerations)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, then locate switchgear and emergency generation equipment

above flood plain .

27 . Define the sequence of operation with respect to the emergency generator

power system . ___________________________________________________________

28 . Are closed transition transfer switches permitted (closed transition switches

synchronize and parallel the standby generator[s] with the electric system for

approximately 100 milliseconds when transferring)? ____________________________

29 . What are the minimum hours of emergency generator run time without refueling?

_______________________________________________________________________

30 . Is emergency electrical distribution equipment required to be in

a separate room? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No


31 . Are diversified electrical loads accepted for:

a . Emergency generator _________________________________________________

b . Wiring, panels, etc . ___________________________________________________

32 . Is UPS required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, what equipment is connected to it? ________________________________

33 . Besides loads mandated by codes to be connected to an emergency

generator system (alternate power source), what optional loads need to be

picked up by the generator system? _________________________________________

34 . Is the emergency generator system to provide full back-up power

to the facility? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

35 . What is the maximum sound level permitted for emergency generator? ____________

36 . What EPA emission tier requirements must the generator meet? __________________

a . If there are multiple emergency generators are they to be

paralleled? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

b . Is N+1 required for the emergency generator system? . . . . . . . . . . . . . . . Yes No

37 . Is electrical switchboard required to be in a separate room? . . . . . . . . . . . . . . Yes No

38 . Fire pump:

a . How is electricity supplied to pump?

i . Served directly from utility transformer ahead of main breaker

for building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ii . Served from main switchboard ahead of main breaker . . . . . . . . . . . . . .

b . Is the fire pump required to be on emergency power? . . . . . . . . . . . . . . . Yes No

c . What special requirements are not in the latest addition

of the NEC 695? ______________________________________________________

Questions for electrical plan reviewer/inspector:

1 . Is plan review required for electrical permit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, who conducts the reviews? _______________________________________

2 . Do any special codes apply (energy codes and so forth)? . . . . . . . . . . . . . . . . . Yes No

a . If yes, what are they? __________________________________________________

3 . Are there local requirements on outside lighting levels, shielding, heights,

and so forth? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

a . If yes, please explain further . ___________________________________________

4 . Is natural gas a suitable source for dual fuel source emergency generator

system in this jurisdiction? _________________________________________________

5 . Will overcurrent protection coordination studies be allowed as a deferred

submittal after contractor and equipment selection? ___________________________

6 . Does the EPA air permit need to be revised or updated? _________________________

7 . What equipment needs to be connected to emergency power? ___________________

8 . What equipment needs to be on UPS? _______________________________________

44 ASHE Monograph

PART 4: APPENDIX

Sustainability

1. Generala. Applicable energy code (CalGreen, ASHRAE 90.1, IECC, etc.)b. Applicable green code (CalGreen, ASHRAE 189.1, etc.)c. Advanced Energy Design Guide (AEDG)

2. Architecturala. Space program

i. Locate staff offices and breakrooms on exterior walls for access to daylight and views

ii. Allocate and locate separate spaces for areas of respite and connection to nature for(1) Staff(2) Inpatients(3) Visitors

b. Windowsi. Prescriptive maximum allowable window-to-wall ratioii. Prescriptive maximum window assembly thermal parameters (U

value and solar heat gain coefficient)c. Opaque envelope

i. Roof(1) High solar reflective index (cool roof ) to minimize heat island

effects and rooftop operating temperatures for roof mounted HVAC equipment and outside air intakes

(2) Prescriptive maximum U value of roof assemblies(3) Evaluate use of green roof for both storm water abatement

(trade-off for artificial site impoundment or detention) and energy use and peak HVAC load reduction

ii. Walls(1) Prescriptive maximum U value of wall assemblies (including

spandrel panels)


iii. Floors(1) Prescriptive maximum U value of floor assemblies (both slab

on grade as well as floors exposed to semi-conditioned and unconditioned space)

iv. Commissioning(1) Consider envelope commissioning in compliance with

ASHRAE Guideline 0–2005 and the National Institute of Building Sciences (NIBS) Guideline 3–2012

v. Materials (1) Avoid use of materials with

(a) Volatile organic compounds (VOCs) including added formaldehydes

(b) Persistent, bioaccumulative, and toxic chemicals(2) Preferential use of materials

(a) Rapidly renewable or carbon sequestering(b) Post-consumer recycled content(c) Closed cycle reusable and recyclable(d) Low embodied energy(e) Locally sourced or manufactured (LEED v.4 is within 100

miles)(f ) Environmental Product Declaration®(g) Material transparency

3. Mechanicala. General. Avoid oversizing equipment. Provide for additional capacity

and redundancy through the use of multiples of parallel or staged equipment trains

b. Refrigerants. Avoid the use ozone depleting and global warming potential refrigerants

c. Minimize the use of reheat throughi. Variable air volume control where allowed, including unoccupied

setbacksii. Expanded temperature control range and deadbands, including

unoccupied setbackiii. Resetting supply air and water temperatures at part loadiv. Heat recoveryv. Decoupling heating/cooling from ventilation through the use of

heat recovery chillers or heat pumpsvi. Consider using natural and mixed-mode ventilation for non-

clinical spaces where appropriate based on climate and program

46 ASHE Monograph

d. Provide separate process paths for the control of i. Ventilation air and humidity ii. Sensible space temperature

e. Use variable frequency drives on fan and pump motors 1 hp and largeri. For energy consumption report and record to the building

automation system variable frequency drive kWhf. For air delivery systems that operate more than 8,000 hours annually,

size coil rows and face velocities and filter banks so that the sum of all systems fans’ (supply, return, and exhaust) motor nameplate power does not exceed 0.0009 kW/system supply CFM

g. Select cooling tower approach and range to minimize fan sizeh. Use separate cooling loops for low temperature applications so that

central plant water temperatures are not lowered to meet these applications’ needsi. Avoid the use of air-cooled refrigeration equipment that rejects

heat into conditioned spaces. Use either remote air-cooled condensers or water-cooled equipment

j. Use displacement ventilation for high ceiling and multiple-story spacesk. HVAC Controls

i. Use supply air temperature (SAT) reset for variable air volume systems

ii. Use static pressure reset for supply fans on variable air volume systems

iii. Include chilled water temperature reset controls iv. System metering for energy consumption: Install permanent

water flow meters that report and record to the building automation system flow rates and associated MBH for applicable building systems including steam, steam condensate, chilled water supply, process chilled water supply, condenser water flow, heat recovery water supply, and hydronic heating water supply.

4. Plumbinga. Use site recovered water for cooling tower makeupb. Use cooling tower water makeup systems and treatment that

maximize cycles of concentrationc. Avoid the use of potable water for cooling in any non-emergency

application (sterilizer and washer drains, MRI, lab, ice machines, etc.). Use closed loop cooling systems.

d. Reuse laundry rinse water for applicable and appropriate non-potable use


e. For water metering, where practical install permanent water meters that report and record to the building automation system for irrigation, cooling tower makeup, domestic hot water makeup, boiler makeup, pools and therapy suites, purified water systems, closed loop hydronic system makeup, and/or dietary department

f. Use low-flow fixturesg. Use rainwater collection where possible for non-potable useh. Use EPA WaterSense® labeled products for toilets, urinals, private

lavatory faucets, and shower heads5. Electrical

a. Poweri. Use high efficiency transformersii. Meter electrical energy consumption and report to the building

automation system for the following(1) Indoor lighting(2) Exterior lighting(3) Vertical transportation systems(4) HVAC equipment(5) Medical and vacuum equipment(6) Data and IT (MDF and IDF) rooms

iii. Consider continuous monitoring and commissioning systems b. Lighting

i. Provide occupancy or timed control of lighting to either shut off or reduce to 10 percent of lighting energy consumption when spaces are unoccupied

ii. Provide daylight harvesting in non-clinical daylight spacesiii. Minimize lighting power density to no more than 75 percent of

the maximum allowed by codeiv. Minimize exterior lighting trespassv. Use LED lighting where possiblevi. Provide lighting controls for individually occupied spaces

(1) 5.2.6.1. Staff(2) 5.2.6.2. Inpatient

48 ASHE Monograph

Technology

1. Service Entrancea. Identify the closest point of presence for the telecommunications

service providersb. Identify the location on the site for the telecommunication services

connection pointsc. Who provides the conduits to the connection points? d. What are the service providers’ requirements for service entrance

conduits and the entrance facility room demarcation point?e. Are there at least two telecommunication service entrances to the

building, separated by 20 feet?f. Are conduits for future buildings coordinated with the site plan and

entrance facility rooms?g. Determine the bandwidth needed to support the facilityh. Determine the number of analog lines needed to support the facilityi. Include services for data, voice, and television

2. Structured Cabling Systema. Backbone cabling to support minimum of 10 GbE (gigabite Ethernet)b. Horizontal cabling to support minimum of 1 GbE; 10 GbE is preferredc. Elevator phones connections providedd. Telecommunication rooms per NFPA-99 and FGI Guidelinese. Grounding and bonding providedf. Is low-voltage wiring above ceiling required to be in conduit?

3. End User Devicesa. Staff computers—account for PCs with dual monitorsb. Staff phones—VOIP or digitalc. Patient room phones—VOIP or digitald. Red emergency phone locations e. Multifunction devices (copy, scan, fax, email); coordinate with

architectural design for space to include clearances for service and maintenance

f. Specialty printers; provide connections and space for label printers, flatbed scanners, and other ancillary devices


4. Data Centersa. Server requirements to determine number of cabinets, power,

and coolingb. Storage requirements to determine number of cabinets, power,

and cooling

c. Cooling systems: Plan for N+1 redundancy, connect to emergency power

d. Power systems: Plan for N+1 redundancy, maintenance bypass, emergency power

e. Fire protection systems: Fire protection fluid systems (non-water)f. Evaluate cold aisle containment systems for feasibilityg. Growth: plan for 100 percent growth of data center space per

TIA-1179 (Healthcare Facility Telecommunications Infrastructure Standard) by planning soft space next to data center. Plan for growth in mechanical and electrical systems

5. Wireless Systemsa. Determine wireless access point devicesb. Determine if the wireless system is for data only or for voice

communicationsc. Provide (2) CAT6A cables per wireless access pointd. Provide a wireless heat map survey using an industry accepted

simulation/modeling software

6. Distributed Antenna System (DAS)a. Will the DAS be for public safety systems only or for cellular carriers?b. Provide additional space for DAS equipment

7. Special Systemsa. Real time locating services: determine the location technology to be

used (RFID, ultrasound, and wireless) b. Wireless clinical communications requires robust wireless systemc. Patient entertainment/education

i. Integrate with EMR?ii. Integrate with dietary?iii. Educational content? By whom?iv. Movie subscription provided? v. Integrate with hospital apps?

50 ASHE Monograph

d. Telemedicine: determine technology and locationse. Registration: biometric scanners, label printers, kiosks, mobile

registration cartsf. Time in attendance: coordinate locationsg. Alarm management middleware for integration of nurse call, EMR,

lab, pharmacy, RTLS systems (real time located services)h. Dictation i. Synchronized clocks: determine locations and type of clocks

(GPS, network)

8. Security Systemsa. Access control

i. Identify access control credential technology (smart card, proximity)ii. Identify locations for access control doorsiii. Coordinate access control wiring and devices with door

hardware designiv. Coordinate power, fire alarm interfaces, and life safety provisions

(delayed egress)v. Special considerations:

(1) Labor and delivery(2) Psychiatric(3) Pediatrics(4) Emergency lockdown sequences (active shooter,

decontamination, etc.)(5) High rise stairwell access(6) Automatic doors

vi. Provide a credentialing station with camera and backdropvii. Coordinate server requirements with IT

b. CCTVi. Identify locations for CCTV cameras ii. Determine the proper pixels per foot for the desired level of

recognitioniii. Determine the field of view of each cameraiv. Coordinate with the reflected ceiling planv. Special considerations

(1) License plate recognition(2) Low light conditions(3) Motion activation

vi. Determine the required number of days of video storage


vii. Determine monitoring locationsviii. Coordinate network storage and server requirements with ITix. Coordinate site camera locations with landscaping plansx. Determine requirements for integration with other systems

(1) Access control system(2) Duress alarm system(3) Smartphone apps

c. Intercomi. Determine locations and desired functionii. Network-based intercom allows flexibilityiii. Can function be achieved through VOIP phone system?

d. Duressi. Emergency department, nurses stationsii. Integrate with security systems

9. Paging Systemsa. Design to limit noise pollution in patient areasb. Is a separate building-wide paging system required for emergency

announcements?

10. Television Systemsa. Listed for health care useb. Coordinate blocking c. Specify mount with TVd. Coordinate control with nurse call or other patient devices

11. Audio Visual Systemsa. Paging b. Background musicc. OR integrationd. Surgical suite intercom

12. Emergency Radio Systemsa. Determine which frequencies are required to be supported b. Coordinate antenna locationsc. Coordinate structural supports for antennasd. Provide weatherproof penetrations for antenna cablese. Determine radio station locations (emergency department, incident

command center, security)

52 ASHE Monograph

Additional Information and Notes

Below are codes and standards referenced in this checklist that may also be useful to the user:

FGI Guidelines for Design and Construction of Health Care Facilitieswww.fgiguidelines.org

Green Building Councilwww.usgbc.org

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