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04-105202CITY OF L Federal Way February 10, 2005 Ramzi Haddad Pacificadd Services 3601 43r8 Avenue Court NE Tacoma, WA 98422 RE: Permit #04-105202-00.0-00-UP; ST FRANCIS HOSPITAL 34515 9th Avenue South, Federal Way Dear Mr. Haddad: CITY HALL 33325 8th Avenue South • PO Box 9718 Federal Way, WA 98063-9718 (253) 835-7000 www. cityoffederal wa y. com The City has completed an administrative review of the proposal to build a concrete pad to support a mobile PETSCAN trailer in a parking lot at the St. Francis Hospital located at 34515 9"' Avenue South, Federal Way. The Process I application is hereby approved based on the enclosed Findings for Site Plan Approval. This decision shall not waive compliance with future City of Federal Way codes, policies, and standards relating to this project site. The effective date of this decision is February 9, 2005. Pursuant to Federal Way City Code (FWCC) Section 22-355, any person who received notice of this administrative decision may appeal this decision in the form of a letter to the Federal Way Hearing Examiner by February 23, 2005. Because you are the only party of record, you can waive your right to appeal this decision, in which case it shall be effective immediately. The City must receive this waiver in writing. The total hourly Process I fee for this project is $58.50. This amount is subtracted from the $58.50 fee paid at the time of application. There are no additional land use review fees due. Sincerely, Ld Kathy McC ung Director of Community Development Services enc: Findings for File 04-105202 Approved Site Plan Parking Summary Email c: Isaac Conlen, Associate Planner 04-105202 Doc. LD. 30294 A�� CITY OF - -- FederalWay FINDINGS AND CONCLUSIONS FILE NO.04-105202-00-UP St. Francis PET Scan, 34515 91h Avenue South Federal Way, Washington FILE BACKGROUND The applicant proposes to install two small pads for a PETSCAN Mobile Trailer. The trailer will be brought to the site one day per week. FINDINGS 1) The subject property is zoned Office Park (OP). Pursuant to Federal Way City Code (FWCC) Section 22-831, "Hospitals" use is permitted in the OP zoning district. 2) The project is exempt from environmental review under the State Environmental Policy Act (SEPA). 3) The proposal has been reviewed for consistency with all applicable zoning regulations including FWCC Section 22-831 "Hospitals"; FWCC Article IV, "Nonconformance"; FWCC Article XVII, "Landscaping"; and Article XIX, "Community Design Guidelines." 4) Applicant indicates there will be no long-term noise associated with operation of the PETSCAN trailer. 5) The proposed facility will be located in the area of five existing parking stalls, which will be utilized one day per week. On the day of delivery, a number of other stalls will be blocked off to allow access for the delivery vehicle. This will occur early in the morning and these stalls shall be available for parking in time for the day shift. The applicant indicates that the short-term displacement of five parking stalls one day a week will not have a detrimental impact on hospital campus parking. Given a total of more than 873 parking spaces, five stalls represents less than one percent of the total supply. From a long-term perspective, the applicant indicates that the hospital has submitted an application to the City to construct another 547 parking stalls on the hospital campus. This will more than adequately address parking demand into the foreseeable future. The applicant indicates approval to begin construction of these stalls in June of this year. The completion date is unknown. 6) The hospital is located within a Wellhead Capture Zone 1. The applicant has submitted a Hazardous Materials Inventory Statement indicating that the proposed facility will not involve the use, storage, or transportation of any hazardous materials. 7) Pursuant to FWCC Section 22-354, and the forgoing findings, the proposal is found to be consistent with the Federal Way Comprehensive Plan, all applicable provisions of the FWCC; and with the public health, safety, and welfare. Feb. 9. 2005 2; 36PM No. 0180 P. 2 0EFA TM NT OF COMMUNM DEVELOPMENT SERviC.ES 33325 8 h Avenue South PO Box 9718 CITY OF Federal Way WA 98063-97I8 253-835-Fax -2609 Federal -Way ►n1,CIv05Cdcrk0wy,goni HAZARDOUS MATERIALS INVENTORY STATEMENT CRITICAL AQUIFER RECHARGE AND WELLHEAD PROTECTION AREAS I- WHY SHOULD THIS INVENTORY STATEMENT BE FILLED OUT? Critical Aquifer Recharge (CARAs) and Wellhead Protection Areas (WHPAs) are considered "critical areas" pursuant to Federal Way City Code (FWCC), Chapter 18, "Environmental Protection." This inventory statement must be filled out by the applicant or agent for any proposed activity listed in Section IT of this handout, and which are located within Wellhead Capture Zones 1, 5, and 10 as shown on the Critical Aquifer Recharge and Wellhead Protection Areas Maps. Please refer to the handout on Critical Aquifer Recharge and Wellhead .Protection Areas for a description of the review process. IT. .A.CTiviTIEs GOVERNED BY CARA AND WHPA REGULATIONS The inventory statement must be filled out for the following activities: • Construction of any residential structure, including single-family development • Construction of any barn or other agricultural structure • Construction of any office, school, commercial, recreational, service, or storage building ■ Construction of a parking lot of any size Other minor new construction (see WAC 197-11-800[21) ■ Additions or modifications to or replacement of any building or facility. (does not include tenant improvements) • Demolition of any structure ■ Any landfill or excavation ■ installation of underground tanks ■ Any division of land, including short plats • Change of use, which involves repair, remodeling, and maintenance activities • Dredging • Reconstruction/maintenance of groins and similar shoreline protection structures • Replacement of utility cables that must be buried under the surface of the bedlands + Repair/rebuilding of major dams, dikes, and reservoirs • Installation or construction of any utility, except for on -going operation and maintenance activities of public wells by public water providers ■ Personal wireless service facilities Feb. 9, 2005 2:36PM No, 0180 P. 3 Project Name ? lf'c,sr— Applicantr9 Project Locatio�� /d -lam - Tracking No_ III. TYPES AND QUANTITIES OR HAZARDOUS MATERIALS Please provide the approximate quantity of the types of hazardous materials or deleterious substances that will be stored, handled, treated, used, produced, recycled, or disposed of in Connection with the proposed activity. If no hazardous materials will be involved, please proceed to Section IV. MATERIAL LIQUID (gallons) SOLID (Poun (1) Acid or basic solutions or solids (2) Antifreeze or coolants (3) Bleaches, peroxides, detergents, surfactants, disinfectants, bactericides, algaecides (4) Brake, transmission, hydraulic fluids (5) Brine solutions (6) Corrosion or rust prevention solutions (7) Cutting fluids (8) Deicing materials (9) Dry cleaving or cleaning solvents (10) Electroplating or metal finishing solutions (11) Engraving or etching solutions (12) Explosives (13) Fertilizers (14) Food or anunal processing wastes (15) Formaldehyde (16)Fuels, additives, oils, greases (17) Glues, adhesives, or resins (18) Inks, printing, or photocopying chemicals (19) Laboratory chemicals, reagents or standards (20) Medical, hospital, pharmaceutical, dental, or veterinw-v Fluids or wastes (21) Metals (hazardous e.g. arsenic, copper, chromiurn, lead r►zerc ,silver etc. (22) Paints, pigments, dyes, stains, varnish, sealers. (23) Pesticides, herbicides or poisons (24) Plastic resins, plasticizers, or catalysts (25) Photo development chemicals (26) Radioactive sources (27) Refrigerants, cooling water (contact) (28) Sludges, still bottoms (29) Solvents, thinners, paint removers or strippers (30) Tanning (leather) chemicals (31) Transformer, capacitor oils/fluids, PCB's (32) Waste oil (33) Wood preservatives (34) List On -MR hazardous materials or deleterious substances on a se crate sheet. Bulletin #056 — November 24, 2004 Page 2 of 3 k;\Handouts\i la=dous Materials Inventory Statement Feb. 9. 2005 2:36PM No, 0180 P, 4 Project Name Cam- `S'C,a,�. 7-? C �/t-- Aepuplicant �~C' Project Location �%S /S� 9 �G �'v. Tracking No. IV. FURTHER INFORMATION Provide the approximate quantity of fill and source of fill to be imported to the site. ofImoorted )Fill Source of Fill Check box #1 if you do not plan to store, handle, treat, use, produce, recycle, or dispose of any of the types and quantities of Hazardous material or deleterious substance listed in Section Ill. Check box(s) #2 through #5 (and fill in appropriate blanks) of the below table ifthey apply to your facility or activity. # 1 [vf The proposed development will not store, handle, treat, use, produce, recycle, or dispose of any of the types and quantities of hazardous materials or deleterious substances listed above. 42 [ ] Above ground storage tanks, having a capacity of gallons will be installed. #3 [ ] Construction vehicles will be refueled on site. Storage within wholesale and retail facilities of hazardous materials, or other deleterious #4 [ ] substances, will be for sale in original containers with a capacity of. gaIlons liquid or _pounds solid The presence of chcnnical substances on this parcel is/will be for "temporary" non -routine #5 [ ] maintenance or repair of the facility (such as paints and paint thinners) and are in i ndividuai containers with a capacity of__ gallons liquid or __,l)pt1n;l1 solid. Check any of the following items that currently exist or are proposed in connection with the development of the site. Stormwater infiltration system (e.g., french drain, dry well, stornnwater swale, etc.) Hydraulic lifts or elevator, chemical systems, or othermachinery that uses hazardous materials Cathodic protection wells Water wells, monitoring wells, resource protection wells, piezometets Leak detection devices, training for employees for use orhaTa dous materials, self-contained machinery. etc. SIGNATURE Signature -- v et"ar fe--N "F' Id 1 a Print Name Date ifyou have any questions ahot;t frllilig arrt this applicutlorr form, please call the Iieparhrretrt of Corrrmrrnity Develvpnient Services at 253-835-2$Il please Le advised that art application fora tlevelopnietit permit lackbig the required information will trot be accepted 8ullctin #056 —November 24, 2004 Ptlgc 3 of 3 k:\IIandouts�la�flrdous Materials inventory Statement I 1 I I Isaac Canlen -PET scan pad waiver - - Page 1 From: "Pennington, Steve (Tacoma)" <StevePennington@fhshealth.org> To: <isaac.conlen@cityoffederalway.com> Date: 2/14/2005 11:59:54 AM Subject: PET scan pad waiver 3'� 5 Hi Isaac. Please accept this e-mail from the Franciscan Health System -at St. Francis Hospital, as our notice to the City of Federal Way. That we waive our right of appeal to the public comments on the PET scan project, as there were no public comments received per our phone conversation and we do not need to retain our right to exercise any appeals. Please contact me if you have any questions, Thanks Steve Steve -Pennington Regional Construction Manager Franciscan Health System 1717 J Street Tacoma; WA 98405 253.426.6835 p 253.426.6075 f stevepennington@fhshealth.org CC: 'Bass, Ron (Tacoma)" <RonBass@fhshealth.org>, "Tracy Winter (E-mail)" <tracyw@sellen.com>, "Mike Ryberg (E-mail)" <miker@sellen.com>, "Ramzi Haddad (E-mail)" <Ramzi@ezcadd.com>, "Zygmunt, Chet (Federal Way)" <ChetZygmunt@fhshealth.org> Isaac Conlen - RE: PETSCAN Project` - _ _ Page 1 From: "Pennington, Steve (Tacoma)" <StevePennington@fhshealth.org> To: "Isaac Conlen" <Isaac.Conlen@cityoffederalway.com> Date: 2/9/2005 1:41:25 PM Subject: RE: PETSCAN Project Good morning Isaac, It was a pleasure to meet you also and we appreciate your support in the review of this project. St. Francis Hospital is leasing the PET scan trailer from a group called Alliance, whom supplies mobile trailers with diagnostic equipment to hospitals whom do not have the same fixed equipment. SFH has leased this service for the PET scan trailer for one day per week only, to be placed in the south area of the hospital per our submitted drawings. Alliance will be delivering the trailer for that one day per week, in the early morning hours before the start of the day shift work crowd. Dropping the trailer off and then after the one day on site, coming back in the early hours the next day to pick up the trailer. So what this facilitates, is doing a temporary blockage of parking in the strip of the designated area. After the trailer is dropped, the parking will be opened back up again to staff, with only 5 stalls being not available to staff for that one day, plus a couple of stalls in the designated physicians only parking area. For that one day per week, the loss of the 5 stalls in the parking area, displaced by the trailer and the two physician stalls, will not adversely affect the parking on the hospital campus. We do have a master parking plan that we have submitted to the City of Federal Way to add 547 new stalls to the campus. We are likely to have approval to construct these around June of this year, in a phased capital outlay to complete the project. So FHS has a plan for parking that we are proceeding with for the campus and the 5 stall loss for one day per week with not adversely affect our current parking status to facilitate our use of the mobile PET scan trailer. I will have the attached form that you sent me, faxed back over to you soon. Please contact me if you have any questions, Thanks Steve -----Original Message ----- From: Isaac Conlen [mailto:Isaac.Conlen@cityoffederalway.com] Sent: Tuesday, February 08, 2005 5:19 PM To: Pennington, Steve (Tacoma) Subject: PETSCAN Project Hi Steve, I enjoyed meeting you today. One thing I forgot to mention. We have a checklist relating to storage of hazardous materials, which must be filled out for uses in wellhead capture zones (in which the hospital is located). I've attached the checklist. Would you, or your staff, fill this out and fax it back? (253) 835-2609. I'm not familiar with the PETSCAN technology, but it seems like a probable non -issue. I'll look for your email on the parking tomorrow. Let me know if you have any questions. fsaac Connen - RE: PETSCAN ProI6ct _ Page_2 . GG: "Ramzi Haddad (E-mail)" <Ramzi@ezcadd.com>, "Zygmunt, Chet (Federal Way)" <ChetZygmunt@fhshealth.org>, "Toby Coenen (E-mail)" <tcoenen@dowl.com> CITY OF FEDERAL WAY DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES DEVELOPMENT REVIEW COMMITTEE TRANSMITTAL DATE: 1/13/05 TO: Will Appleton, Development Services Manager Scott Sproul, Plans Examiner Wes Hill, Lakehaven Utility District Greg Brozek, Federal Way Fire Department FROM: Isaac Conlen FOR DRC MTG. ON: No meeting necessary. Please provide comments by January 21. FILE NUMBER(s): 04-105202-00-UP RELATED FILE NOS.: None PROJECT NAME: PROJECT ADDRESS: ZONING DISTRICT: ST FRANCIS HOSPITAL 34515 9TH AVE S W4 PROJECT DESCRIPTION: Proposal to construct a concrete pad in existing parking lot to accomodate a PETscan trailer as needed, anticipated once a month. LAND USE PERMITS: Process I PROJECT CONTACT: PACIFICADD SERVICES RAMZI HADDAD 3601 43RD AVENUE COURT NE 2534681629 (Work) MATERIALS SUBMITTED: Site plans. 4% CITY OF Federal Way MASTER LAND USE APPLICATION BUILDING DEFT, DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33530 First Way South PO Box 9718 Federal Way WA 98063-9718 253-661-4000; Fax 253-661-4129 + r t nffPrlPral�■ aTcom APPLICATION NO(S) U�2C� Date `A-7— b y Project Name �T• , � PrN �1 S I�-U S� 1 } 1-L� C �1 �C r•l T �] 'P12-oJ - 3t Property Address/Location Parcel Number(s) _ Project Description _ bar y D�l LC T *L ^ sC�rr, ,✓ cs�ii,'�v�j Type of Permit Required Annexation Binding Site Plan Boundary Line Adjustment Comp Plan/Rezone Land Surface Modification Lot Line Elimination Preapplication Conference Process I (Directors Approval) Process II (Site Plan Review) Process III (Project Approval) Process IV (Hearing Examiner's Decision) Process V (Quasi -Judicial Rezone) Process VI SEPA w/Project SEPA Only Shoreline: Variance/Conditional Use Short Subdivision Subdivision Variance: Commercial/Residential Required Information c,l Zoning Designation ® l? Comprehensive Plan Designation Value of Existing Improvements Value of Proposed Improvements 1; aA -Building Code ( )' Occupancy Type Construction Type Applicant Name: R4�wl-L,� Address: 6fJ l -A 6 fi e G !-�T' City/State: 1 A-4,�V" Zip: (4R~Z `L Phone: �-53 -- �— `'q a Fax:�w- Email: (e_ik Signature: Agent (if different than Applicant) Name: Address: City/State: Zip: Phone: Fax: Email: Signature: Owner Name: 1 �12A►`t�S �541 i►4�-- Address: �5.451 Sst7u'i�- City/State: -�:',3e Z AA_vJ A-`T Zip: 'I &LD v 3 $ 3 A 2- Phone: Fax: 2 Ty3 S�GvC %�L�✓/V�'il/�%bri1 Wg Email: Signature: Bulletin #003 - March 3, 2003 Page I of 1 k:\Handouts — Revised\Master Land Use Application PACIFICADD SERVICES P l a n n i n g . P r o g r a m m i n g . A r t b i t e r t n r a l Des i g n Project Management . P M CA D D a t a b a s e s C A D C o n s u 1[ i _n g 0-10� .w FRANCISCAN HEALTH SYSTEM ST. FRANCIS HOSPITAL PET SCAN PAD PROJECT PROJECT ATTACHMENT FUNCTIONAL PROGRAM STRUCTURAL COPUTATIONS MOBILE IMAGING SITE SPECIFICATIONS GUIDE Construction Bid Set Building Permit Set DOH CRS Set December 22, 2004 3601 43RD AVENUE CT. NE • TACOMA, WA 98422 PHONE (206)240-3377 . FAX: (253)943-1999 December 22, 2004 1 CATHOLIC HEALTH I INITIATIVES Franciscan Health System FUNCTIONAL PROGRAM PLAN The enclosed template is to enable accurate documentation of new programs being introduced prior to budgeting for incorporation into the master planning for the facilities and operations. Please complete this document in its entirety, (all questions that apply). • For use with all projects that are one million dollars or more in total costs. 1. Fill out page 3 of the Current Configuration and any additional information to fully describe your current operation. 2. Answer all the appropriate questions, such that the Proposed Configuration can be fully understood by the leadership team. 3. Acquire the appropriate signatures from the affiliated teams to acknowledge their support and understanding of the new program (page 11). 4. Route the document to the chief operating officer of the facility in which work is proposed, the service line vice president, and the vice president for guest Iservices and facilities. J 5. Send the completed document to the Vice President for Guest Services and Facilities. 6. When applying for capital funds for your project, attach the narrative to the completed Capital Acquisition Request. J- Page 1 of 8 December 22, 2004 CATHOLIC HEALTH INITIATIVES Franciscan Health System tunct opal Program Narrative (Ten P. late) Project: Mobile CT/PET Scanning _ Location: St. Francis Hospital Campus Current Confi uration (page 3) ■ Describe existing conditions, i.e. type of space, size, type of operation • Brief review of deficiencies as they exist today ' ■ Review of process that limits the financial/functional growth in the current configuration ■ Describe current volumes and mix of services provided Proposed Configurations (page 4-11) Provide a written narrative on the following pages that reflect the items below that support your proposed new program: • GOALS SUPPORT NEEDS: (A) New Program Description (A) Patient support needs (E) Storage (B) Objectives for next FY. (B) Linen and Supplies (F) Env. Serv. (C) Image (C) Technical (IS / Bio-med.) (G) Dietary (D) Security (H) Courier J • OPERATIONAL CRITERIA (A) Capacity and Scheduling (B) Staffing (C) Potential Revenue • FUNCTIONAL AND SPACE NEEDS (A) Technology and Care Delivery (B) Issues and Future Trends (C) Patient and Staff Flow (D) Minimum space requirement sq. ft. MARKETING: (A) To public (B) To Physicians (C) To Health Plan Groups (D) Market Share (E) Recruitment of Doctors / Nursing BUSINESS OPERATIONS: (A) Hours of operation (B) Community Relations (C) Cause and or effect • DESIGN CRITERIA TIME LINE: (A) Space Program (A) Critical Path projection (B) Special Equipment (C) Relationships / Adjacencies (D) Regulatory requirements • POTENTIAL FUNDING SOURCE'S Foundation Capital Other (circle) ■ ATTACH BUSINESS PLAN (if available) JPage 2 of 8 December 22, 2004 CURRENT CONIF'IGURATION Describe the quantity and type of rooms that you currently occupy. (The description below is of the SFH Outpatient Center - the mobile CT/PET scanner will be located adjacent to this area.) 117 - Waiting Room —patients would arrive here after being registered in Main Outpatient Admitting Tamper proof receptacles will be installed in the waiting area- the registration area is located on the ground floor of the hospital which is one floor above the Imaging Department. 116 — Reception — Initial paper work would begin from this area; staff would greet patients, answer phones, etc. 115 — Patient Toilet — Located by the x-ray room and close to the waiting area so that patients waiting can also use (ADA). 105 & 105A — Dressing roans — Changing rooms for patients going into x-ray room —Patients will leave their clothing in the dressing room and will be instructed to bring all of their valuables with them into the x-ray room. Clothing hooks will be installed. — Bulk clean linen will be maintained in the Clean Utility room. Staff will provide a clean set of gown, robe, etc to the patient as they are escorted to the dressing room. After the patient has completed their examination and has changed — staff will remove used gowns from the dressing room (fpatient did not drop into the dirty linen hamper). 106 — Radiology / Chest room — These rooms are digital chest/radiography room. This room will be utilized by high volume/short duration studies Images produced on "dry" laser film or are interpreted by radiologist from workstations Patients will enter fi•orn the patient zone, if they need to change their clothes they will use the dressing rooms 105 & 105A 107 — Control Booth — Control equipment for the x-ray room 103 — Ultrasound Room — Usedfor all types of ultrasound procedures (exception of invasive procedures which will be done in the main department). 101— Patient toilet — Toilet for the ultrasound patient from room 103 (ADA) 102 — Patient toilet — Toilet for the ultrasound patient from room 099 (ADA) Storeroom —located of Support Zone (staff work area) storage of medical supplies. 099 — Ultrasound Room — Used, for all types of ultrasound procedures (exception of invasive procedures which will be done in the main department). 096 — CT Scan — Multislice (8) Lightspeed GE CT Scanner 093 & 094 — Dressing rooms, for the CT patient - Patients will leave their clothing in the dressing room and will be instructed to bring all of their valuables with them into the CT room. Clothing hooks will be installed. 095 — Alcove — Entrance area to CT scanner (Crash Cart will be parked here for possible emergent use) 097 — CT Control — Control room — will have several computers and view boxes for viewing films 109 —Clean Supply —This stock will be kept at par -level by the materials management staff. This room will be used.for the storage of clean utility items. 111 — Staff toilet - (ADA) 12 L — Patient toilet — For the CT and MRI patient (ADA) 112 —Soiled Storage — This roon will be used for the short-term storage of dirty utilities We would like to install a single sink rather than the usual double sink since we do send all dirty supplies to Central Stores for cleaning, there is not a need for cleaning supplies in the Diagnostic Imaging Department. - The environmental service will empty this room daily. A L-locker is located on thefar wall for housekeeping/bedpans. This area will also house the large garbage canister that is emptied throughout the day. 113 — Work Area — Staff work area, paper work, charging, processing, film copy, etc. 114 — Scheduling — Private areas for staff to do telephone scheduling of patients 118 — Consulting room — Room for private patient consult with radiologist. 119 & 120 — Patient Prep — This area is intended to hold patients for a short period before and after procedures, while waitingfor° transport back to their room. At each station the headivall will contain, air, oxygen and suction. Each area will have dimmed lights as well as exam bright lights 121 - Nurse Station — Area for^ the care taker to chart/observe the stretcher patient. 092 — Office Space 089 — MRI - 1.5 T short bore magnet, will be used mostly by the outpatient — however will occasionally be used by the house patient. 086 — Control Room — Controls for the MRI 088 — Equipment Room — Location for the equipment that runs the MRI 087 — Office — Radiology staff office 085 — Data Room — Houses the IT needs for the data receiving/ sending of the digital images Page 3 of 8 J December 22, 2004 Storage Room 083 & 084 — Dressing Rooms — Dressing area for the MRI patient, one is ADA — Lockers are provided in this area, unlike the other dressing rooms, since patients Cannot bring valuables (wallets„ watches, etc) into the MRI room. 1 2. What are your current hours of operations In the Main hospital department X-Ray is staffed 24/7 — In the Outpatient Center CT, Ultrasound, and X--Ray have M-F 0700 to 1800 regular hours of operation. Standby coverage for off hours and weekends is provided for from the Main x-ray department. MRI is available 10 hrs per day on M— F and % day on Saturday. (Standby coverage for MRI is available up until 2300 hrs. 3. What are the current staffing levels? _ All modalities are staffed for volume of patients seenlscheduled. Ancillary staff is fixed in order to provide 1 service for reception, scheduling, files, etc. 4. Describe the current patient volumes and patient mix. Estimated patient volume is about 40 — 50, 000 exams per year. These are made up of 25, 000 x-rays, 5, 000 ultrasounds, 12, 000 CTs, 1500 MRIs, and 2,100 Nuclear exams. Our mix of patient is approximately 60% - 70% outpatient. These figures are for both the Outpatient Center and the Main department within the hospital. The CT/PET patient will be 100% outpatients. 5. Briefly describe the current deficiencies that limit growth of services, efficiency of staff, or potential additional revenue. PET or CT/PET is not a service we currently offer at St. Francis Hospital. By providing this imaging service we can provide another diagnostic tool.for our patients. 7 6. Describe the geographic area served by the program and the physician support (i. e. Full time physicians on staff j and level of referrals). Federal Way area will be serviced by this imagingfacility — There are no physicians' on-stafffor the department. There is a contract in place in which board certified radiologists do all of the interpretations of the Diagnostic Imaging procedure, this will include the CT/PET procedures. 7. Describe the current licensing and any limitations that license has. The license fr•orn the Radiation Protection Division for the State of fVashingion that covers the main department in the hospital will also include this new area. We have amended our Nuclear Medicine license to include the agents needed for PET. GOALS 1. Describe your new proposed program: First and foremost is to all of the imaging modalities needed to service our patients. The location of the "pad" where the mobile CT/PET will be located will be adjacent to our outpatient imaging area. If needed, we have space adequate to care for patients post procedure. This holding area will have oxygen, air, and suction. Separate clean and dirty utility rooms are located centrally to the existing outpatient department. 2. What objectives toward the above goals do you hope to accomplish in the next year? To provide CT/PET service. 3. Is there an image related to the mission, professional or design that needs to be met to convey the plan that is being presented. An efficient, functional area for the staff who work there and a healing caring environment for the patients we serve. OPERATIONAL CRITERIA Page 4 of 8 December 22, 2004 1 1. Describe the potential growth capacity and how scheduling would be done to maximize the number of patients seen. Scheduling would be done by the Diag Imag schedulers. Training will be provided to the schedulers on the CTIPET procedures prior to the beginning of the service. 2. Describe how staffing would be configured to meet the new capacities and what would the staffing ratio be? 1 Technical staffing will be provided by the contracted mobile CTIPET service. They will be registered and have a current State of Washington certification license. Support staff will be provided by the existing staff in the Diagnostic Imaging Outpatient area, from registration, reception, escorting, etc. 3. Breakdown, in as much detail as possible, how much new revenue and expenses would be incurred with the expanded services. Expense to construct trailer pad — approx $75, 000 FUNCTIONAL AND SPACE NEEDS Describe the proposed technology that is involved and how it enhances or changes the methods of care delivery. Mobile PETICT will be latest technology available — this will be a contracted service from a Vendor. Equipment and technical staffing will be included in Contract — scheduling, reception; billing of patient will be borne by SFH Diagnostic Imaging department. Interpretations of the procedures will be done by board certified radiologists that are currently interpreting all of the other imaging procedures at St. Francis Hospital. l 2. Review how functional issues will be resolved in a new space and describe the new configuration. Are there future trends that would drive the space size or configuration differently that what are currently recognized? Outpatients will arrive at the main entrance of the hospital where they will be registered (admitted) by Patient Access for their outpatient CTIPET procedure. From there they will be escorted to the Diagnostic Imaging Reception & Waiting Room. The CTIPET patient will be received by Diagnostic Imaging reception and will use the departments' outpatient waiting room. The receptionist will notify the CTIPET technologist of the patients' arrival. The technologist will greet the patient and escort them to the CTIPET mobile, the route is from the reception room, outside along a garden walk to the mobile unit. Golf umbrellas will be available if needed. Sidewalkfrom om the doorway to the trailer will be kept free of debris, snow, ice, etc. by facility staff. Access to the trailer is either through a set of stairs and doorway or with a "lift ". Patients will enter via the stairs; unsteady patients may use the lift. After the completion of the exam the patient will be escorted back along the same route to the Main Lobby of the hospital or the Diagnostic Imaging waiting room. If needed the CTIPET patient will use the toilet located next to the Diag Img Waiting Room. Prior to the { CTIPET procedure the patient will be instructed to use the patient toilet. If the toilet is needed while the J patient is at the CTIPET Mobile they will be escorted back to the Diag ling Waiting Room. Disposable bedpan & urinals are available on the Mobile if they are need at the trailer. The Janitor Closet that will be utilized for the Mobile will be the one that is located in the Diagnostic Imaging Outpatient Department. The housekeeping on the trailer will be done by the technical staff. If the patient needs any immediate intervention while they are in the CTIPET room, the FHS Standard of Operation for the a code will be followed NO Conscious Sedation will be performed on any of the CTIPET patients — All patients are Outpatients ONLY. If the need arises the Patient holding within the Diag ling Outpatient area is equipped with suction and oxygen. A Crash Cart is also available in that area. j Page 5 of 8 �I December 22, 2004 How would the staff work flow and patient flow become more efficient in a revised plan? Outpatients- process begins with patient arrival from admitting to the outpatient imaging patient reception area. The patients are then greeted. A phone call is placed to the respective modality to alert them ofpatients' arrival. From this waiting area, the patient will be escorted to the mobile PET/CT trailer. Images produced by the equipment are sent to an Imaging Workstation (with specific PET/CT software) where the radiologist interprets the study if needed images will put on a CD or filmed. The patient is then escorted back to main lobby. The radiologist dictates into a digital dictation system, which is then transcribed by either in-house or outside transcription services. Once transcribed the radiologist then "verifies" that the report. Once verified the report is automatically.faxed to the ordering physician and printed in HIM and radiology,file room. Imaging records are stored locally for short term -kept off site for long term storage. 4. List the spaces (rooms) that would be required on a new plan and what the minimal square footage would be for each (# of offices, # of exams and how big etc.). See architectural drawing DESIGN CRITERIA 1 i. Do you have a space program that describes what would happen in each of the rooms? If no, then 1 describe the full circle of events fi-om when a patient or process starts till they are released from your service area. Below is the fistkg o the Lunction I use a each arealroom that would be used b , the PETICT patient. 1 NOTE ALL patients _are OUTPATIENTS 117 - Waiting Room — patients would arrive here after being registered in Main Outpatient Admitting Tamper proof receptacles will be installed in the waiting area- the registration area is located on the ground floor of the hospital which is one floor above the Imaging Department. 116 — Reception — Initial paper work would begin from this area; staff N ould greet patients, answer phones, etc. 115 — Patient Toilet — Located by the x-ray room and close to the waiting area so that patients waiting can also use (ADA). 102 — Patient toilet — One of several toilets located in this area that can be used by the PETICT patient. (ADA) 12 L — Patient toilet — For the CT and MRI patient — Can also be used by the PETICT patient — this toilet is closest facility to the doorway leading out to the mobile PETICT scanner. (ADA) 119 & 120 — Patient Prep — This area is intended to hold patients for a short period before and after procedures, while waiting for transport back to their room. At each station the headwall will contain, air, oxygen and suction. Each area will have dimmed lights as well as exam bright lights. This area can also be used for the PETICT patient who may need to lay down for a bit. NOTE: PETICT patients are NOT given any conscious sedation 1 121 - Nurse Station — Area, for^ the care taker to char•tlobserve the stretcher patient. I 2. What types of special equipment are going to be required to support the operations within your proposed plan? NIA Has Clinical Engineering reviewed / recommended the above equipment? Yes ❑ No ❑ 3. What other services feed into, or flows out from your service that should be considered in the location of l your service to provide optimal patient flow and to maximize your staffs time. i Facilities — Have been actively involved in the planning Security — Notice of when the mobile trailer will be on -site Admitting IT — Have been actively involved in the planning 4. Review any regulatory deficiencies that would be corrected and any that need to be considered in the redesign of your space. Page 6 of 8 December 22, 2004 I _N/A SUPPORT NEEDS 1. When a patient leaves your area, do they need transportation, a waiting area, and a way to get medications? NA 2. Review of the linen and supplies, quantities needed and how they are routed, stored and re -stocked. Delivery points will be assigned (this will be from supply within the Outpatient Imaging area) — amounts willflex with volumes 3. What type of technical support will be needed from Information Systems and Clinical Engineering? Both IT and Clinical Engineering have been represented in the planning and design of the space. 4. What type of storage is needed for supplies, films, records and their respective volumes? Where needed — this has been incorporated into the planning. No storage anticipated 5. How often do you need environmental services support and are there any limitations to the hours in which they work. N/A 6. Will dietary need to support your functions and how would it occur or change? N/A 7. Please describe your courier or lab services if needed? No change from main hospital 8. Are there any security concerns with the operations? Discussed program with Security MARKETING 1. How will the program be marketed to the following groups? Physician Reps will inform physician community during their regular office visits. Contracted Vendor will also do separate marketing to physicians. `1 2. What does the new program represent in the area market share and its potential capture additional market 1 share? Initial estimates demonstrate 4-5 exams per week would be ordered. _} 3. Is there a current recruitment of physicians and/or nursing involved in the new business plan? l N/A BUSINESS OPERATIONS 1. What are your anticipated hours of operation to meet your business goals? Initially the mobile service will be provide one day per week — 0700 — 1700 hrs J2. Are there community groups that are supporting the growth or presence of this service in their community? N/A 3. Does the new or expanded program cause or affect other department work loads or bed capacities in a manner that they need expansion? Page 7 of 8 December 22, 2004 N/A TIME LINE Please describe any critical path time frames you are trying to achieve in order to meet a plan, regulatory deadline or financial obligation? Go -live with the service by 312005 SIGNATURES PHONE Department Manager Regional Director DI (253) 426-6285 Physician Representative Service Line Vice President Director of Clinical Engineering (253) 428-8350 COO. of affected Facility Vice President, Guest Services and Facilities (253) 779-6322 Construction Manager (253) 591-6835 Information Systems (253) 552-4179 Foundation Director (253) 627-4100 Please attach any additional information needed. This format is intended to begin the documentation and may need to have categories added, to fully explain the operational issues that are being conveyed and should be added as necessary. Page 8 of 8 ABKJ # 04129.00 Structural Computations for the: SAINT FRANCIS HOSPITAL P.E. T. SCAN PAD FOUNDATION DESIGN Federal Way, Washington EXPIRES :.r-;F6 December 20, 2004 Submitted To: PACIFICADD SERVICES 360143rd Avenue Ct. NE Tacoma, WA 98422 Tel: (253)-468-1629 Fax: (253)-943-1999 By: Andersen Bjornstad Kane Jacobs, Inc. 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Consulting Civil and Structural Engineers SEATTLE, WASHINGTON ABKI@abkj.com PROJECT:.5r, /5Q11/,1C1J JOB # 0 -fl L 9,0 D DATE 2— /tea V 10 SUBJECT: Pe7- %PAfl BY: fl S, '—�S HEET # CGJEC/c V ISTl2i,g(f raq G O ADD �!x'�p [/Y�r t✓ D � /C jF" SLIfe It--"Afl ; o �� ►rvA Y Sy/ j/be vl/ Z/ 0 0 0 0, SS) O, 757(Z) .36 3 3 1< < CPrPo�/ _ /b a I�orc L PI-AA-J C oevc�e&rt!5- SS ��hr�sr�s UT /7/, 8 k—/ > z, -7 A.SJU/✓IE SLR /-litJ C1�ICK� %y1/E'� � _ 42t7o8 c 0 9 A/2a PJr' fl UI o, /✓a7 C/2 Z100041� 21 0o o # 92000 r 2/DYdF <ra)f2 of LI J 8. S/ O."ISr 0,75I TA�itN J VE:WJ Zlo�s�/ 10 /o� L ON Gv /T1iOrn��4l, Z 16 0o —Zk p 10 IbSOD6 //v CleenJ E art,+& 771161zAle J S 7, / 8 " /!rt,� SO 0 0 FS i ALLIANCE IMAGING, INC. SITE SPECIFICATION GUIDE For MAGNETIC ETIC RESONANCE IMAGING LITHOTRIPSY 72. snow ,. Y Via_ raft Copyright 0 2000 Alliance Imaging, Inc. I J J Alliance Imaging SITE SPECIFICATION GUIDE TABLE OF CONTENTS Section Title 1.0 Nominal Site Planning Schedule 2.0 Magnetic Field Area 2.0 Parking Pad 3.0 Fencing 4.0 Signage 5.0 Electrical 6.0 Telephone 7.0 Water and Drain 8.0 Storage Space 9.0 Tunnels and Safety 11.0 Repositioning Guidelines 12.0 Patient Delivery 13.0 Advertising Signage 14.0 Codes and Regulations 15.0 Electrical Specifications 16.0 Wye Power Distribution Layout Using Existing Hospital Power Distribution Transformer 17.0 Wye Power Distribution Layout Using Dedicated Hospital Power Distribution Transformer 18.0 Example "A" WYE Power Supply Configuration 19.0 Example "B" WYE Power Supply Configuration 20.0 Wye Power Hospital Receptacle & Van Plug Configuration 21.0 Wye Power Hospital Receptacle Wiring Configuration 22.0 Practical Turning Radius for Tractor Trailer 23.0 Pad Specs 2 Alliance Imaging MOBILE IMAGING SERVICES 1.0 Nominal Site Planning Schedule Site planning for your Alliance magnetic resonance service is somewhat more critical than for other transportable services due to the unique aspects of the super conducting magnet. On the other hand, site planning and execution are much simpler for mobile service than for a fixed site magnetic resonance installation. The following schedule outlines the steps required for the qualifying, planning, constructing, inspection and approval processes for a typical site. Review of site. Visit of a site planning specialist to your proposed site to evaluate the site for system and safety suitability. Prints of the proposed area will be required, especially in the instance when the site sits over old construction, utility and service lines, or tunnels. Alliance confirms suitability of site and, if applicable, identifies specific problem areas. Site plan drawing is prepared by Alliance Site planning specialist. Hospital prepares working drawings for site preparation (including patient area protection if desired) and forwards them to Alliance for approval. Special materials may be ordered at this point. Plans are approved. Contracts let and construction begins. Timing includes two week contingency. Completion of site and approval by Alliance. Imaging services begin. *Note: Actual construction times are dependent upon availability of local contractors and availability of utility service. 3 2.0 Magnetic Field Area (Only for MRi systems 2.1 General The magnetic field emanating from the super conducting magnet is three dimensional and falls off with distance from the magnetic isocenter. Site planning must take into consideration the location of all ferrous objects in the vicinity of the site during the initial site planning visit. It is particularly important to know of buried metallic masses. 2.2 Location of Existing Buried Ferrous Masses In order to determine a suitable location for the trailer, Alliance and/or the van OEM must have copies of all prints and drawings of the proposed area. Of particular attention are those showing old construction, utility lines, and tunnels. The client must assume responsibility for unknown buried objects which may adversely affect system performance. In the absence of drawings, you may be able to identify someone who can supply reliable information about the proposed site's history. 2.3 Location of Site Proximate to Hospital Eg_uipment The magnetic field may effect the operation of certain kinds of equipment. The proposed location of the trailer must consider the effect of the field on nearby equipment. With shielded magnets, the 5 gauss line is contained within the trailer wall. This containment has greatly reduced most problems with equipment located near the mobile MRI. 2.4 Safety A field stronger than 5 gauss may adversely effect people with pacemakers, intracranial ferromagnetic aneurysm clips, recent surgery, neuro-stimulators, biostimulators and ferromagnetic objects in the eye. These people are to be excluded from entering the site. Because ferromagnetic tools and equipment can become dangerous flying objects near the magnet, they are to be excluded from the site unless explicitly approved by Alliance and/or van OEM staff. 3.0 Parking Pad 3.1 Purpose The parking pad provides a level surface on which the ferromagnetic trailer axle assembly can be precisely repositioned relative to the magnet whenever the trailer is moved. This ensures magnetic field homogeneity and thereby, image quality. A single pad is strongly suggested for regions that are prone to frost. This information is provided under (3.2). If a site exists conforming to the pad specifications below, then pad construction is not required. 4 3.2 Dimensions A single pad 42' x 10' is preferred. For unimproved sites, there must be a 6' apron around the pad site. Asphalt may be used for this. The apron must extend out 13' from the pad in the area of the patient lift on the curb side of the unit. Pad design is determined by local soil conditions and loading. Loading on the smaller front pad is 23,000 pounds (nominal). Loading on the larger, rear pad is 39,500 pounds (nominal). The rear third of the rear pad may take the full 39,500 pounds when the trailer is on the support stands. Good soil conditions usually call for a reinforced pad thickness of 12". Actual pad design to be determined by your local architectural resource. 3.3 Alternate Dimensions Two concrete pads: one for the front trailer stabilizers, one for the rear stabilizers, support stands, and wheels. The front pad is 8'-0" x 10'-0". The rear pad is 20' x 10'. These are minimum dimensions. For unimproved sites, there must be a 6' apron around the pad site. Asphalt may be used for this. The apron must extend out 13' from the pad in the area of the patient lift on the curb side of the unit. Pad design is determined by local soil conditions and loading. Loading on the smaller front pad is 23,000 pounds (nominal). Loading on the larger, rear pad is 39,500 pounds (nominal). The rear third of the rear pad may take the full 39,500 pounds when the trailer is on the support stands. Good soil conditions usually call for a reinforced pad thickness of 12". Actual pad design to be determined by your local architectural resource. Alliance Imaging may help with variations and alternatives to formal pad construction 3.4 Reinforcement No reinforcement or non -ferromagnetic reinforcement is required. We recommend the use of "FIBERMESH" for reinforcement. FIBERMESH is available from Hill Brothers, (818) 333-2251, (408) 263-3131 or (619) 233-7171, or other locations throughout the country. 3.5 Slope and Grade Pad levelness should not exceed one eighth inch in ten feet in any direction over the pad (front and rear) area or the system performance may be affected. Note that the service area must be flat near the rear of the rear pad. This is for delivery of the cryogen containers required to replenish the magnet. Pads must generally conform to surrounding grade to provide easy access to pad and proper operation of patient lift. If a combination of front and rear pads is used, the difference in elevation should not exceed four inches. 5 3.6 Unit Access There must be access available sufficient for the tractor -trailer combination (turning radius of 50 feet). Please see Section # 24, Page # 20. The road to the pad must be capable of supporting the tractor trailer load. There must be no overhead obstructions. Trailer height is 13' - 6". 4.0 Fencing (Only required for unshielded MRI s stems 4.1 Should a client use an unshielded MRI, Alliance Imaging will provide information regarding fencing and safety requirements. 5.0 Si na a For MR] and PET systems) 5.1 Purpose MRI systems: To warn people and protect them and the system from adverse effects due to interaction with the unifs magnetic field. PET systems: To warn people and protect them and the system from adverse effects due to interaction with Radioactive Materials. 5.2 Specifications Signs, language and symbols meeting FDA requirements and system operating requirements will be made available by Alliance. Please notify Alliance if your location requires signage in Spanish. 6.0 Electrical 6.1 Specifications Requirements are 480 volts A.C., 3-phase, WYE, 150-200 amp service. The five -wire receptacle (neutral and ground) is a Russellstoll weatherhead #DF2504FRAB supplied by Russellstoll division of Midland Ross, (201) 992-8400, Livingston, N.J. Installation to conform to local codes. We recommend weather protection. A disconnect switch must be located near the receptacle. Normal time for delivery is eight weeks from Russellstoll, but Advanced Systems (909)949-9944 usually has them in stock. We have arranged for a discount price for our clients. Power should be supplied from a single source (clean, stable, ample power is required). Power variation must be limited to: Maximum Allowable Daily Line Voltage Variations: 456 to 504 Frequency: 60HZ and ±.5% {Regulation of 4% maximum at 60 KVA } KVA: KVA varies from 75 KVA to 150 KVA depending on system. PHASE BALANCE: Phase balance of + or - 2% maximum phase -to -phase line voltage difference from lowest phase. Transient Surges : Transient Voltage Surges must not exceed ±10% nor exceed five cyclic duration and not occur more than 10 times per hour Ground Conductor : An insulated copper ground conductor sized in accordance with national, state and local codes but not less than #1/0 AWG shall be installed between the facility vault and the Russellstoll receptacle. This ground shall not have a resistance of more than 2 ohms- 0 Special Ground Notes: The Mobile MR Imaging Unit MUST have an earth driven ground rod within five (5) feet of the hospital power receptacle. A grounding cable of a minimum of four (4) GA MUST be connected between grounding rod and grounding pin of hospital receptacle. Cable to be kept as short as possible, and MUST NOT exceed eight (8) feet in length under any circumstances. A separate grounding conductor must still be run with the phase conductors to the source of power from the grounding pin of the hospital power receptacle in accordance with NEC. Article 250-23. Shore power service should be located on the trailer road side of the pad area approximately 10 feet from the side of the pad and approximately 10 feet to the rear of the front pad (two pads), and mid point(single pad). Special Note: The bottom of the Russellstoll receptacle should be at least 3 feet from the ground. 7.0 Telephone 7.1 Purpose Three lines required, one dedicated for remote system diagnostics and repair, the other to make and receive telephone calls and facilitate the scheduling and moving of patients and third, modem line. 7.2 Specifications for Each of Two Telephone Lines Hubble Cable Set - Cat. No. PH-6599 50 feet, 3-conductor, No. 16 AWG SJTO Yellow vinyl cord Hubble Junction Box - Cat. PH 6619 Hubble Plug - Cat. No. PH-6597 7.3 PET systems Require local Area Network hookup for Image Data transfer Include one of the following: a) Twisted pair connection b) CAT-5 cabling c) Fiber optic wire 8.0 Water and Drain 8.1 General There are no toilet facilities on the trailer. When applicable, water is required for the system humidifier. 8.2 Specifications Access to outdoor water faucet bib. Consideration may be required in humid areas for drainage of water run-off from air conditioners. 9.0 Storage Space ( Only applies to units without shield cooler.) 9.1 Should storage space be required, Alliance Imaging will advise regarding helium dewar storage. 7 10.0 Tunnels and Safety 10.1 Specifications Because the magnetic field may penetrate the ground, safety dictates that tunnels underlying the site closer than the 5 gauss line should not be used during presence of the trailer and should be signed. 11.0 Repositioning Guidelines 11.1 Purpose Painted guidelines are used for repositioning the unit when it returns to the pad. 12.0 Patient Delivery 12.1 General The route from the hospital holding area and the mobile MRI unit should be examined for ease of access for transportation (i.e., levelness) and protection during inclement weather. 12.2 Specifications A covered walkway and/or a suitable vehicle may be required and is the responsibility of the client. 13.0 Advertising Si na e 13.1 General Many of our clients take advantage of the presence of the mobile MRI unit by advertising the service with a suitable sign. 13.2 Specifications A simple, brief explanation of the use of MRI and your name as provider can be most effective. 14.0 Codes and Regulations 14.1 General Local building codes and operating regulations vary greatly from site to site and it is the responsibility of the client to insure that the site and service conform to local and state regulations. N 15.0 ELECTRICAL SPECIFICATIONS FOR VARIOUS MOBILE UNITS 1.5 HORIZON 480 VOLTS 3 PHASE 5 WIRE WYE 125 KVA 150 AMPS 1.0 HORIZON 480 VOLTS 3 PHASE 5 WIRE WYE 125 KVA 150 AMPS 1.5 G.E. SIGNA 480 VOLTS 3 PHASE 5 WIRE WYE 75 KVA 150 AMS 1.0 G.E. 480 VOLTS 3 PHASE 5 WIRE WYE 85 KVA 100 AMPS 0.5 G.E. SIGNA 480 VOLTS 3 PHASE 5 WIRE WYE 85 KVA 100 AMPS 0.5 G.E. MAX 480 VOLTS 3 PHASE 5 WIRE WYE 85 KVA 125 AMPS PICKER 0.5 480 VOLTS 3 PHASE 5 WIRE WYE 85 KVA 125 AMPS PICKER 1.0 480 VOLTS 3 PHASE 5 WIRE WYE 150 KVA 150 AMPS TOSHIBA .35 480 VOLTS 3 PHASE 5 WIRE WYE 125 KVA 150 AMPS PHILIPS 1.0 480 VOLTS 3 PHASE 5 WIRE WYE 112.5 KVA 150 AMPS PHILIPS 1.5 480 VOLTS 3 PHASE 5 WIRE WYE 112.5 KVA 150 AMPS SIEMENS 1.0 480 VOLTS 3 PHASE 5 WIRE WYE 125 KVA 150 AMPS SIEMENS 1.5 480 VOLTS 3 PHASE 5 WIRE WYE 150 KVA 150 AMPS HITACHI 7000 480 VOLTS 3 PHASE 5 WIRE WYE 85 KVA 100 AMPS DORMER HM3 480 VOLTS 3 PHASE 5 WIRE WYE 112.5 KVA 100 AMPS DORNIER HM4 480 VOLTS 3 PHASE 5 WIRE WYE 112.5 KVA 100 AMPS DORNIER MFL 480 VOLTS 3 PHASE 5 WIRE WYE 112.5 KVA 100 AMPS 5000 SIEMENS PET 480 VOLTS 3 PHASE 5 WIRE WYE 125 KVA 150 AMPS ECAT GE PET 480 VOLTS 3 PHASE 5 WIRE WYE 125 KVA 150 AMPS I ADVANTAGE jj CT GE 9800 480 VOLTS 3 PHASE 5 WIRE WYE 125 KVA 150 AMPS CT GE FXI/MXI 480 VOLTS 3 PHASE 5 WIRE WYE 125 KVA 150 AMPS CT GE Pro-Spd 480 VOLTS 3 PHASE 5 WIRE WYE 125 KVA 150 AMPS NOTE: All new sites should be three phase, five wire, clockwise rotation WYE configuration power. Regardless of the fact that the equipment will work on the WYE or delta configuration. Alliance Imaging, Inc. policy shall be that all new contract locations will be 3 PHASE, 5 WIRE, WYE POWERCONFIGURED. _1 9 Existing Transformer Power Distribution Panel "�k OTHER LEADS R W1 Wye Power Distribution Layout Using Existing Hospital Power Distribution Transformer NOTE*** 125 Kva MINIMUM Dedicated power must be available for this circuit! 150 AMP Fused Switch Box NOTE*** #4 Gauge (Minimum) Earth Driven Ground Rod 2 Ohms or Less 10 shore power. Recegtack Mobile Scanner T'r ai[er Shore Fo,wer V[rfg Cable Additional Earth Ground Wye Power Distribution Layout Using Dedicated Hospital Power Distribution Transformer Hospital or Pole Mounted 125 Kva Transforn`� n 150 AMP Fused Switch Box NOTE"' #4 Gauge (Minimum) Earth Driven Ground Rod 2 Ohms or Less NOTE*** 125KvaMinimum Dedicated power must be available for this circuit! Hospital Share Power Peceptade 11 Trailer Shore Pole e r Plug Cable Mobile Scanner ,additional Earth Ground WYE POWER - EXAMPLE POWER SUPPLY CONFIGURATION EXAMPLE "A" 480 VOLT WYE OR STAR TRANSFORMER WITH CASE TO EARTH GROUND. PHASE "A" = RED, PHASE "B" = ORANGE PHASE "C" = BLACK G R 0 U"N'D G Pt E F'IN Fuse 0, PHASE A Fuse ;7) c) PHASE B Fuse -PHASE C X-2 12 1 1511 AMP SLO-BLO FUSED DISCONNECT EA izT i WYE POWER — EXAMPLE POWER SUPPLY CONFIGURATION EXAMPLE "Boy 480 VOLT EXISTING POWER DISTRIBUTION PANEL, RATED AT 150 AMPS. An W PHASE A (RED) PHASE B (ORANGE) PHASE C (BLACK) �il C BAT? EQuw-m'LN�I- (-;RaulvL'l P uo N"kirtkallim) GR, ENJ 2 OHMS OR LESS TO EARTH GROUND! 13 I I M_/I.i ['T71!sL, _!(i COTiF F°c_Ji R/-'iTt�_%� RUSSELLSTOLL RECEPTACLE PIN IDENTIFICATION (DF2504FRAB) MOUNTED AT HOSPITAL CORD PHASE A -- - 1 PHASE B PHASE C 3 E'QUtPMEF,lT G ROUND— G, MIIOIMUM GAUGE 4 4 GAUGE EARTH DRIVEN GROUND ROD (2 Ohms or Less) 14 RUSSELLSTOLE PLUG (DS2504MP) PROVIDED ON VAN POWER m boo r ORANGE BLACK — WHITE HOSPiTAi R1 CEP'i ACLE GROUNDING THRU PIN & SLEEVE CONNECTION. ALSO HOUSING OF THE PLUG and RECEPTACLE. I I, f 1 1 1 c'I..I' 1'l1 IttiCi COt: i�.' TIc7; (EZti i; PIEASE B (ORANGE) ALEEzN"E''v•E NOTC'EE Ev:C'E h3.'bV.ELITE PLUG AS FMBLY ALECNINII NT NOTCI€ RUSSELLSTOLL I Il RECEPTACLE Iy MODEL # DF2504FRAB �j 7 PHASE C (BLACK) [NSTALLED' AT 140SPITAL - Y A EIOV E? GROUND LEVEL 0 1 WEATHER TIGHT DOOR i Cf;IITE01\1: Re eptacic Shelf must fre grounded acvaciing to arti6e 250 of the Cti'atla«al Eiectrical Code 15 8 Ft 90 Deg I'Atn of P'ef ; G ."i :i'' OVERIUNG T'l ONE ISTWO VEJ."E Six INCHES PATEi OF REGFI'i FRONT 4J 27' 28' 25' f 23' 22' 25' ` 45 Deg 45 Deg 180 Deg. - i { Fifty (50'- 0") feet minimum practical turning i radius to center point of right front wheel.-- A minimum "A" dimension of ninety two inches I (92") is required from rearmost protection to centerline of tandem suspension. This provides l swing clearance for the generator set which is l mounted on the front of the trailer. i 8 Ft. i E PATH OF LEFT REAR SIDE HOSPF'I'At. tS RESPONSIBLE 3-0 E RSt'RETHE.-4CCESS ROUTE IS CLI,AR OF OBSTRUCTIONS WHEN THETRAEF,ER tS SCIFEF}L-111 i ,I RRIPE OR DEFART E:! 16 l I I 1 I J i i --____ --_-________y__. i PC L UO a I ado 00 � I r i ---------------- l '1 r 1, J .onstruction Review Services Home P^ -e Page 1 of 1 Faciiites and Services Ucens!n9 CONSTRUCTION REVIEW l,r -e I t h SERVICES You are here: DO_H Home » H_SQA » FSL » CRS Search I EmPPoyrees - - Construction Review Facility Name : ALLIANCE IMAGING, 1 Services (CRS) INC. - MOBILE PET UNIT #8437 . CRS Home Access I,i►A A,.Wash ington )("Iflem! Suea,3wwrmart'vAh, I i Facility City : CORVALLIS Facility ID : 011583 Facility Status : PENDING Facility Type : MOBILE UNITS Project Name : ALLIANCE IMAGING, INC. - MOBILE PET UN1 #8437 Project ID : 007097 Project Start Date : 0612012003 Project Status( ' A;�l=RCS Project Close Date : 0711812003 Submission Sul: mtssl,On Sobmtssio n Final Submlgss, :at7'IF:SSIG S G.eceivied srn�er 'r�.t� W (D Tareer Dpre Q !rems SLtb4-riSsi0'9 SU13MIssiOn Received '_status action W Re%'4eW C;omplese 001 6/19/2003 7/17/2003 MANFEE,SPEC CLOSED APPROVED 7/14/2003 Project Status iD : AFIPROV:_ 1 Page 1 of 1 Search again Please note - The data presented on this website may be up to 48 hours old. Approval of an individual submission does not constitute full approval of the project. An individual submission can receive approval, but there may still I>e additional information needed from the facility in order for CRS to provide full approval of the project. It may be a violation of the rules to begin construction before approval has been given by CRS. Projects without a submission review completed date have not completed the plan review process and may not be occupied. To report errors �ound in the data presented on this site contact (360)-236-2944 or email us at dohfslcrs@doh.wa.gov. DOH- Home I Access Washington I Privacy Notice I Disclai_m_e_r/CoP.yfi_ght_Info_rmation ,Washington State Department of Health Construction Review Services P.O. Box 47852 Olympia, WA 98504-7852 Phone:(360) 236-2944 JFax: (360) 236-2901 Driving Directions Last Update : 03/12/2004 11:22 AM Sr-- -1 inquires about DOH and its programs to the Health Consumer Assi_sta.nce_Office CL nents or questions regarding this web site? Send mail to the Su.hsite..Develop_er. Use of this project status directory for commercial purposes is strictly prohibited (Chapter 42.17 Revised Code of Washington). J 11/3/2004 http://www3.doh.wa.gov/hsga/fsl/crs/step4-project-profile.asp?pid=7097