SCOPE OF WORK

According to current Standards and Code requirements. The purpose of this service is to document and help you effectively maintain or reduce human exposure to hazardous Indoor air pollutants while assuring proper workplace and engineering controls.

EnviroAnalysis, Inc. will set forth and perform a Safety Compliance Program for testing of identified chemicals used by personnel in various work sites. Attention will be made regarding specified OSHA and JCAHO control methods required for each workplace monitored. Upon completion of the inspection and review of all laboratory test analyses, a finalized report will be provided for your use. It will outline all test results as well as site findings and make any recommendations or provide remedial direction necessary to assure compliance.

The report received from EnviroAnalysis will be consistent with the hazardous material and utility system management plan requirements set forth in JCAHO Standards: EC.1.3, EC.2.3, EC.4.3 and EC.1.7, EC2.7.

ENVIRONMENTAL TESTING & SAFETY INSPECTION of WORKPLACE SITES with HAZARDOUS CHEMICALS:

Outlined below is the criteria utilized to perform the exposure assessment and safety inspection for each site:

General Control Measurements

Exposure Monitoring vs. Active Dosimetry.
Permissible Exposure Limits (PEL)
Short Term Exposure Limits (STEL)
Ceiling Limits

General Control Measurements

Site/Personnel Data
Sampling and Analysis Procedure
Test Sampling Data
Employee Notification

Specific Control Methods Assessment for:

Respirator Use
Type
Availability
Use

Protective Clothing & Equipment

Type
Availability
Use

Regulated Areas

Signs & Labels

Workplace Practices

Hygiene Facilities

Quick Drench/Spill Showers
Fresh Rinse Eye Washes

Room Ventilation Characteristics

Specific Design Criteria
Thermal Controls (Temperature & Relative Humidity)
Air Exchanges per Hour
Pressurization

Upon completion of the subject testing and site inspection(s), a detailed compliance report will be provided for your safety compliance program. This copy should be kept on file for 30 years to assure compliance with OSHA's administrative requirements.

TESTING and INSPECTION of CYTOTOXIC DRUG EXPOSURE in the WORKPLACE:

SAFETY MANAGEMENT of HAZARDOUS DRUGS in the WORKPLACE is tested according to current OSHA/NIH & JCAHO Standards and Code requirements.

The purpose of this service is to document and help you effectively maintain or reduce human exposure to hazardous drugs while assuring proper workplace and engineering controls.

EnviroAnalysis, Inc. will set forth and perform a Safety Compliance Program for testing of identified chemicals used by personnel in various work sites. Attention will be made regarding specified OSHA control methods required for each workplace monitored. Upon completion of the inspection and review of all laboratory test analyses, a finalized report will be provided for your use. It will outline all test results as well as site findings and make any recommendations or provide remedial direction necessary to assure compliance.

POTABLE DRINKING WATER CONTAMINANT TESTING:

Potable Drinking Water is monitored as per JCAHO Standard EC.1.7, EC2.7 - Utility Systems Management Plan

Possible human carcinogen and bacterium diseases are now being introduced into facilities through water utility systems from various sources. Principle contaminants are:

Lead & Heavy Metals
MTBE
Colineiform
Legionella
Infectious Bacteria

HAZARDOUS MATERIAL MANAGEMENT PROGRAM:

Policy for the Safe Use of Hazardous Materials and the Proper Management of Hazardous Waste

The program will be designed according to local, state and federal standards applicable to hazardous materials and waste. In addition, the program will fulfill management's plan/needs as per JCAHO Standard EC.1.3, EC.2.3, EC.4.3.

The program will include the following key components:

Master Hazardous Materials Manual and Chemical Hygiene Plan.
Schematic Diagrams of Facility Hazardous Chemical Sites.
Software Program for Internal Management Use & Records.
Training of Management Personnel Regarding Program Use.
Appropriate Monitoring of Hazardous Chemicals & Sites.
Periodic Site Visits & Counsel Updates to Assure Effectiveness

Specific program content which will be developed is attached for your review. Following the development is the implementation of plans. The implementation phase will include the determination of responsibilities within the overall program, the purchase of appropriate equipment (such as PPE, containers, etc.) And training of all appropriate management personnel.

AIR QUALITY SITE ANALYSIS:

EnviroAnalysis will perform appropriate testing of the following air parameters:

Respirable Particulates

Volatile Organic Compounds (VOC)

Carbon Dioxide

Biological Contaminants

Mold & Spores
Bacteria/Fungus

Room Air Flow Patterns

INSPECTION & TESTING of ISOLATION ROOMS:

SAFETY MANAGEMENT of the ISOLATION ROOMS in the Workplace testing is performed as compliant with current ASHRAE, OSHA, NFPA, & JCAHO Standards and requirements.

EnviroAnalysis, Inc. will set forth and perform a Safety Compliance Program for Inspecting the Room Ventilation Systems for Isolation Rooms. The purpose of this service is to help you effectively reduce human exposure to hazardous Indoor Air pollutants and assure proper engineering controls.

The finalized report received from EnviroAnalysis will be consistent with medical equipment and utility system management set forth in JCAHO Standards: EC.1.6, EC.2.6, & EC.1.7, EC.2.7.

DOMESTIC WATER PROGRAM for LEGIONELLAE CONTROL

EnviroAnalysis will set forth and perform each test as identified in the following schedule. Upon completion of the test schedule and review of all test analyses, a finalized report will be provided. It will be provided either electronically or paper format for your use. All test results as well as site findings and recommendations will be made to assure preventive control.

The overall management plan applies to target sampling for supporting the due diligence efforts incorporated into the facility's Preventive Measure Plan as recommended by the Center Fro Disease Control and Prevention.

The report information received will also be consistent with the management plan requirements set forth in JCAHO Standard EC.1.7, EC.2.7.

NOISE LEVELS MEASUREMENT

The purpose of testing is to provide test data on community noise levels. Further tests of octave band analysis is also offered which enables detailed analysis of uncomfortable noise sources so that appropriate engineering controls can be implemented.

WORKPLACE/TOXICOLOGY ASSESSMENT

EnviroAnalysis, Inc. will provide an on-site inspection and audit of the subject company's processes and work site.

The assessment will be performed and authenticated by a Certified Industrial Hygienist. Service will include the site-assessment, all travel and a certified summary report - outlining our findings and recommendations per applicable federal, state and local codes and regulations.

VENTILATION SYSTEMS

EnviroAnalysis, Inc. will set forth and perform a Safety Compliance Program for Inspecting the systems for Room Ventilation Systems. The purpose of this service is to help you effectively reduce human exposure to hazardous air pollutants and assure proper engineering controls. The finalized report received from EnviroAnalysis will be consistent with medical equipment and utility system management set forth in JCAHO Standards: EC.1.6, EC.2.6 & EC.1.7, EC.2.7. An outline of specific test and inspection strategies will be forwarded for your records.

ANESTHETIC GAS DELIVERY & REMOVAL SYSTEMS in the O.R.

Anesthetic Gas Delivery Systems in the Workplace are tested according to current Codes and Standards requirements. A typical Anesthetic Gas Delivery and Removal System is comprised of four major components - defined as follows:

High Pressure Anesthetic Gas Delivery System
Low Pressure Anesthetic Gas Delivery System
Waste Anesthetic Gas Disposal (WAGD) System
Room Ventilation System

Outlined below is the criteria utilized to perform the Anesthetic Gas Delivery and Removal System 'PM' Inspection.

High Pressure Delivery System

All Room Anesthetic Gases
Distribution Outlets
Appropriate Labeling

Color Code
Line Pressure
Outlets
Cross Connections

System Leakage

Lines
Connectors/Fittings
Machine Cylinders

Low Pressure Delivery System - All Room Anesthesia Machines

Machine Identification (Model & Serial Number, Service Date)
Machine Leakage, Total Leak Pressure
Component Scavenging Hookup (Ventilator, CO₂ Monitor
Vaporizer Flow Rate Verification, All Halogens

Waste Anesthetic Gas Disposal System - All Room Systems

Distribution Inlets (Appropriate Labeling, Vacuum/Evacuation, Color Code)
Vacuum & Flow Rate (Inlets, Cross-connection)
System Leakage (Lines, Connectors/Fittings, Scavenging Device

Room Ventilation System - All Room HVAC Systems

Thermal Controls (Temperature, Relative Humidity)
Design Controls (Supply Velocity, Exhaust Flow Rate)
Design Characteristics (Air Exchanges/Hour, Pressurization)

The purpose of this service is to help effectively reduce human exposure to hazardous Indoor Air Quality pollutants and assure proper engineering controls.

The finalized report received from EnviroAnalysis will be consistent with medical equipment and utility system management set forth in JCAHO Standards: EC.1.6, EC.2.6 & EC.1.7, EC2.7.

PREVENTIVE MAINTENANCE TESTING and INSPECTION ANESTHETIC GAS DELIVERY & REMOVAL SYSTEMS

Refers to the 'Positive Verification of the Anesthetic Gas Delivery and Removal Systems compliance status to 'Code' in terms of design and operational capability as defined in publications of the National Institute of Occupational Safety and Health [DHHS (NIOSH) 94-100], National Fire Protection Association [NFPA 99-2002], and American Society of Heating, Refrigerating and Air-Conditioning Engineers [ASHRAE Standard 62-2003] and/or may have been applicable at the time of construction or installation of specific systems thereof.

WASTEWATER SAMPLING & ANALYSIS

Samples of effluent wastewater discharge will be drawn and completed at the specified compliance sampling sites. The events will fulfill the sampling criteria for each quarter in accordance with the requirements of your City Permit.

Test samples will be gathered utilizing proper field techniques, equipment procedures, and preservatives. The Collected sample will be dispensed properly into containers with applicable preservatives, chilled and transferred to the test laboratory. Site sampling procedures are in accordance with EPA under Title 40, U.S. Code of Federal Regulations Part 403 and 'Standard Methods for the examination of Water and Wastewater' by the American Public Health Association.

Test sample methods will be applicable to EPA as per Title 40, U.S. Code of Federal Regulations Part 136 and amendments thereto. The Laboratory Results and Chain of Custody Report for the events will be enclosed for your records and distribution needs.

PIPED MEDICAL GAS

MEDICAL OXYGEN SYSTEM

Inspect Oxygen supply system for proper design, installation, identification, and function.

Inspect bulk site location.

NFPA 50 Standards

Enclosure/Location

Fire Safety Considerations

Inspect manifold source supply location.

Enclosure/Location

Capacity/Capability

Equipment Compliance

Test Oxygen system for concentration and gaseous purity at each outlet.

Test Oxygen for particulate contamination at least once in each zone.

Test with 0.45 micron filter device

Test each Oxygen outlet for proper function, identification, adaptation and mechanical

integrity.

Identify leaking/malfunctioning outlets

Identify outlets delivering substandard pressure/flow rate

Test each zone for maximum available flow.

Test each critical care outlet for maximum available flow.

Test outlet flow rate and pressure drop with high demand at adjacent outlets

Check for crossed lines.

MEDICAL SURGICAL VACUUM SYSTEM

Inspect Vacuum source equipment for proper design, installation, and function.

Sizing and Capacity

Inspect Vacuum exhaust.

Location-away from fresh air intakes

Environmental Considerations

Test inches (of mercury) of Vacuum at source and at each zone.

Test each Vacuum inlet for maximum available flow rate SCFM.

Test pressure at each inlet in all critical care areas.

Test for flow rate and pressure drop with high volume demand on adjacent inlets

Test each Vacuum inlet for proper function, identification, adaptation, and mechanical integrity.

Identify leaking/malfunctioning Inlets.

Identify Inlets delivering substandard vacuum/flow rate

Check for crossed lines.

MEDICAL AIR SYSTEM

Inspect Medical Air source supply for design, installation, location, and identification.

Sizing and Capacity

Secondary/Reserve Source

Inspect Medical Air Intake.

Location

Fresh air Criteria

Inspect dryers, filters, regulators, and pressure relief valves.

Dryer Capacity versus Demand

Regulator Location

Correct Pressures

Test Medical Air system gaseous purity (Oxygen Concentration, Gaseous Hydrocarbons, Liquid Hydrocarbons, Carbon Monoxide, Carbon Dioxide, etc.).

Tested at Source Air Intake

Tested at Source Supply downstream of filters, dryers, regulators

Tested at Outlet farthest from Source Supply

Test Medical Air for particulate contamination at least once in each zone.

Test with 0.45 micron filter device

Test source and each zone for dew point.

Test Medical Air system for temperature.

Test Medical Air system for pressure at supply and each zone.

Test each Medical Air outlet for proper function, identification, adaptation, and mechanical integrity.

Identify leaking/malfunctioning outlets

Identify outlets delivering substandard pressure/flow rate

Test each zone for maximum available flow.

Test each critical care outlet for maximum available flow.

Test outlet flow rate and pressure drop with high demand at adjacent outlets

Check for crossed lines.

NITROUS OXIDE SYSTEM

Inspect Nitrous Oxide supply system.

Enclosure/Location

Capacity/Capability

Equipment Compliance

Safety Measures

Test Nitrous Oxide system for concentration.

Test Nitrous Oxide system for particulate contamination.

Test with 0.45 micron filter device

Test Nitrous Oxide system for pressure at supply and at each zone.

Test each Nitrous Oxide outlet for proper function, identification, adaptation, and mechanical integrity.

Identify leaking/malfunctioning outlets

Identify outlets delivering substandard pressure/flow rate

Test Nitrous Oxide zone shut-off valves for proper function, identification, and mechanical integrity.

Test each Nitrous Oxide outlet for maximum available flow.

Test Nitrous Oxide system components for leakage.

Check for crossed lines.

NITROGEN SYSTEM

Inspect Nitrogen supply system for proper

Enclosure/Location

Capacity/Capability

Equipment Compliance

Test Nitrogen system for particulate contamination.

Test with 0.45 micron filter device

Test Nitrogen system for pressure at supply and at each zone.

Test Nitrogen system outlets for proper function, identification, adaptation, and mechanical integrity.

Identify leaking/malfunctioning outlets

Identify outlets delivering substandard pressure/flow rate

Test Nitrogen zone shutoff valves for proper function, identification, and mechanical integrity.

Check Nitrogen pipeline for proper identification labeling.

Gas and Line Pressure

Test each zone for maximum available flow.

Check for crossed lines.

SERVICE TERMS:

Normal turn-around time for analyses is TEN working days from laboratory receipt of samples or upon completion of on-site monitoring. "RUSH" results carry a 50% to 200% surcharge added to the regular fee. Our laboratories require advance notice for "RUSH" service. Special handling pricing available upon request.

* Copies of internal laboratory QC data or test documents will incorporate an additional administrative fee of $50.00 per sample tested.

* Necessary supplies (filters, tubes, passive monitors, solutions, etc) are provided free of charge when EnviroAnalysis receives resultant samples for analysis. Lost, damaged, or non-returned supplies will be invoiced after 60 days unless EnviroAnalysis is notified.

* Fees can be negotiated for larger quantities (on a guaranteed basis) of any one type of analysis, often result in substantial savings.

* If necessary, shipping containers and return mailing labels will be provided. Containers not returned will be invoiced at replacement cost.

* Data changes and retrievals are charged at $45.00 per order.

* Standard reporting is done with one printed original, one copy and an electronic file for e-mail. Additional hard copies will be billed at $50.00 per copy.

* Prices are subject to change without notice.

* Normal terms are DUE UPON RECEIPT

* The total fee for the services provided by EnviroAnalysis will be based on the rates quoted herein plus amounts equal to all applicable federal, state, or local fees or sales, use, service, or other taxes (other than taxes based on EnviroAnalysis' net income).