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X2019-0410 - Misc
X( 011-0410 6100 Newport C'enkr Or State of California—Health and Human Services Agency ��,n� rfi California Department of Public Health ! CDPI .� KAREN L. SMITH, MD, MPH GAVIN NEWSOM State Public Health Officer & Director Governor June 19, 2019 Jeffrey Haupt, DPM 400 Newport Center Drive Suite 706 Newport Beach, CA 92660 Dear Dr. Haupt: X-RAY FACILITY REGISTRATION NUMBER 71038 On June 3, 2019, we completed an inspection of your facilities and operations as they relate to radiation safety and compliance with the California Code of Regulations, and the California Health and Safety Code. At the time of our inspection no items of noncompliance were noted. We wish to thank you and your staff for your cooperation during this inspection. If you have any questions, you may reach me at (714) 524-5688 or emir.cruz@cdph.ca.gov Sincerely, Emir Cruz, Health Physicist Inspection, Compliance & Enforcement Radiologic Health Branch CDPH, Radiologic Health Branch, 500 S. Kraemer Blvd., #225, Brea, CA 92821 (714)-524-5681,(714)524-5682 FAX Internet Address: www.cdph.caxIov/rhb N 24�hAarrnP"� N00 Ne wpa,4 Center Air Balance Co., Inc. Test and Balance Analysis Report Architect: LPA Design Studios Engineer: Building Mechanical Systems Allied Mechanical Air systems, Inc. +rentor: 191568 Certification # Date: Ma 8 2019 qroved Bob Conbo I Las Vegas 294-1306 1255-7331 ! Fax: (702) Corporate neadgaarters 4721 E. Hunter Ave. Anaheim, CA 92807 mail�n amet'icanairbalanee.com Anaheim 693-9 Phone: (714) 693-3700 I Fax: (714) AABC National Performance Guaran Pursuant to the agreement between AABC Certified Testing g Balancing Agency and All systems shall be tested and balanced in accordance with the project plans and specifications and to the optimum performance capabilities of the equipment. Testing and balancing shall be done in accordance with the standards published by the Associated Air Balance Council. If the Agency listed above fails to comply with the specifications for any reason other than tProper theermination of business by the AABC agency or equipment malfunction or inadequacy which prevents personnel to alssistfthe membersAge Bcy tollperformgwork n a co d nce with and if warraed,provide Standards. The supervision will be provided at no additional cost to building owner. This Guaranty is valid for one year from the date of submission of a test and balance report, Provided the Agency is a current member of AABC, and may only be invoked in writing by the building owner, architect, or engineer of record. The Guaranty is limited to the terms and conditions as stated herein. Project Name Address Name of Engineer Engineering Firm Address 410 Goddard Irvine, CA Email Date 05/08/19 TBE # 92-01-03 By Robert A. Conbo AABC Certified TBE Allift Aq@� Associated Air Balance Council AABC National Headquarters 1518 K Street, N.W. Washington, D.C. 20005 Test and Balance Analysis Report Certification for Dr. Haupt 400 Newport Center Dr. Newport Beach, CA 92660 This is to certify that American Air Balance Co., Inc. has balanced the systems described herein to their optimum performance capabilities, unless otherwise noted in the project summary. The testing and balancing has been performed in accordance with the standard requirements and procedures of the Associated Air Balance Council and the results of these tests are herein recorded. Certification Number 191568 Date May 8, 2019 Approved Bob Conboy, Test and Balance Engineer Supervisor Managing Technician Joe Sieber Randy Borger Corporate Headquarters American Air Balance Co_ Inc.. phone: 714-693-3700 . t'ax: 714693-9509 . www. anbcco px.mu . mail o nabccoip.mu Associated Air Balance Council Annual Certificate ./lr/crJ=�u✓/a- Robert A. Conboy American Air Balance Co., Inc. fo r�cr,��rri/,aorz; rrf�rs� r�acr/'rartaorr�s: a� rr i 6,11 J �E'.i' l lE'Ll �.:1E',�3' CLf?lli CI LILC'E' 6,11f�'wC lelev, ac/zd'r // ru/a; r`:yulalrtrrrn; am/ lvfwz�vzn lwl C/ t✓zc> rmr>crczter�..%(rr" Oaka.c.-I 6axanti1 < fr crlrnrre raarr��r%i �i�// cardr razed /u fie, irrrt, /xJ/a/ r r/.er/u la/area <rr arcr/r°r zraxe au /ir /fte, ,rtaiz rrs r , ar e s/JiG/ r/rerG � /fie C G� ' arul a"s a rneJ/2lc:rr�I�c�.,'lmv�ercra/ecz! '�/C,�rxlzrzcc�rrrrraczl rrr/�,r� yti�aJ ,210-4111) t h r<e ili<rz/xo/z ru/nrI l 92-01-30 iJf, de Jfaurs% ararlclmwle �f / as;fr�r rrsirrira a,i<srrricatirriz: %rLi accr/icrrc is 0/1 ari wwaa/ ler',Sia- ezrurr rrrrl�ttir, << /�u a�tacJ,<sr 1,evv1 lliel twee alray: s aaea/; i/7l.3' 1kn{imaii j. Idnk, .President Raymond R. Berr, Executive Director Associated Air Balance Council leecov/y cert tr dial Randy R. Borger furw heel rrwell)tei<rreddfie rrwrrsrrlly' c" dol ll&1n ferlii y avu/ia/rrrcin/ aw air , -% (�A6' 6c r iu✓.7s & Malanee, ,mac/rac'cr'cria unci °die,'°.er ervhriora r�rr cor er✓lre/ wedlwlenice<yiirefr'All American Air Balance Co., Inc. 7u r. r,cyrsdi•aCrtar llal r w, 311-01-17 ir- ole 1,ecyelrei-ed algia'm tie lieainoe✓errrred.(. (r, Omen Ier%ecye'iecy: zTiscertfccrde al/*'( <Aerenc6ry,d'/20(9a/m/m!1'ele wl'learoerrr-nreirurzG/rrrsrJ. _.-..--- --- � -- 1k,li man f. Link, Presi'bw Raymond R. Bw, Fxandhv Dirador American Air Balance Co., Inc. The following instruments were used to successfully measure and set each device on this project. Instrument Manufacturer Model Serial # Calib. Date Air Data Multi Meter Shortridge ADM 860 M96497 06/11/18 Amp Volt Meter Fluke 333 91756563 11/20/18 Drill Dewalt DC72018V 330768 Flow Hood Shortridge 84000 Hydrodata Meter Shortridge HDM-250 W11223 04/04/19 Laptop Computer Dell Latitude E6410 687P1 M1 Laptop Computer Dell Latitude E6440 6W4RD12 Mobile Phone Apple iPhone 5 16gb 990002809197146 Pitot Tube Dwyer 48" 160-48 Tac Chronometer Jaquet 252 736136 07/10/18 Corporate Headquarters 4721 E. Hunter Ave. Las Vegas Anaheim, CA 92807 Anaheim Phare: (702) 255-7331 /Fax: (702) 294-1306 mail rr americannirbalmrce.com Phone: (714) 693-3700 / Fax: (714) 69PaW)1 Of 1 • ricaA ■aria�„(I #: Symbol for PSI or Pounds per square inch A: Symbol for Delta - difference, net decrease or in crease A: Nameplate Amps AABC: Associated Air Balance Council ABS: Absolute AC or ACU: Air Conditioner or Air Conditioning Unit ACCU: Air -Cooled Condensing Unit ACGIH: American Conference of Governmental Hygienists ACH Air Changes Per Hour ACT: Actual ADP: Apparatus Dew Point AEE: Association of Energy Engineers AFE: Association of Facility Engineering AHU: Air Handling Unit AK: Free Area Factor ALT: Altitude AMB: Ambient AMP: Ampere ANSI: American National Standards Institute AP: Access Point A -Scale or Db(A): A filtering system which roughly matches the response characteristics CCW: of the human ear ASHRAE: American Society of Heating, Air Conditioning and Refrigeration CEG: Engineers ASTM: American Society for Testing and Materials ATM: Atmosphere AVG: Average B: Boiler BHP: Brake Horsepower BP: Boiling Point BSC: Building Systems Commissioning BTU: British Thermal Unit BTUH: British Thermal Units per Hour C: Celsius C to C: Center to Center CAV: Constant Air Volume or Continuous Air Volume CC: Cooling Coil CCW: Counter -Clockwise CD: Ceiling Diffuser CEG: Ceiling Exhaust Grille CER: Ceiling Exhaust Register CFM: Cubic Feet per Minute CH: Chiller Corporate Headquarters 4721 E. Hunter Ave. Las Vegas Anaheim, CA 92807 Anaheim Phone: (702) 255-7331 / Fax: (702) 294-1306 mail@aabecorp.com Phone: (714) 693-3700 / Fax: (714) 693-9509 Americal r�rQ�z! Air Balance Dill Qu CHW or CHWS: Chilled Water Supply CHWR: Chilled Water Return CM2 Square Centimeters CM/SEC Centometers per Second CMD: Count Mean Diameter CP Specific Heat: water = 1.0 BTU / Ib per OF air = 0.24 BTU / Ib per OF CP or P: Circulating Pump CPT: Capacity Performance Testing (Building Commissioning) CR: Ceiling Register CRR: Ceiling Return Register CT: Cooling Tower CU: Condensing Unit CUH: Cabinet Unit Heating CV: Specific Heat at Constant Volume CV: Valve Constant CW: Chilled Water CWR: Condenser Water Return CW or CWS: Condenser Water Supply DAT: Discharge Air Temperature Db: Decibel DB: Dry Bulb DC: Direct Current DD: Direct Drive Delta (A): Difference - net decrease or increase DIA: Diameter DNL: Data Not Listed DOP: Dioctyl Phthalate, an aerosol generated by blowing air through liquid Dioctyl Phthalate (mean particle diameter is between 0.2 and 0.4 microns) A P: Differential Pressure or Pressure Drop, net chan ge in Pressure DPT: Dew Point Temperature DsTD: Standard Air Density, equals 0.075 Ib / Cu. Ft. @ 29.92 in, Hg A T: Differential Temperature, net change in temperature EAT: Entering Air Temperature EC: Evaporative Cooler Economizer: Controls and componentry that allow an air handler to logically utilize outdoor air for cooling as opposed to the use of mechanical cooling EDC: Electric Duct Coil EDH: Electric Duct Heater EER: Energy Efficiency Ratio EF or E: Exhaust Fan EFF: Efficiency EG: Exhaust Grille EMCS: Energy Management Control System(s) Corporate Headquarters 4721 E. Hunter Ave. Las Vegas Anaheim, CA 92807 Anaheim Phone: (702) 255-7331 / Fax: (702) 294-1306 mail@aabccotp.com Phone: (714) 693-3700 / Fax: (714) 693-9509 American Air Balance Co., Inc. EMF: Electromotive Force EMS Energy Management System(s) ENT: Entering EP: Electro -Pneumatic Switches ER: Exhaust Register ESD: Electrostatic Discharge ESP: External Static Pressure EWT: Enterino Water Temperature °F: Degrees Fahrenheit F to F: Face to Face FAF: Forced Air Fan FCU: Fan Coil Unit FDA: Food and Drug Administration FG: Floor Grille FH: Fume Hood FIV: Field Installation Verification (Building Commissioning) FLA: Full Load Amperage FLTS: Filters FP: Freezing Point FPB: Fan Powered Box FPM: Feet Per Minute FPS: Feet Per Second FPT: Functional Performance Testing (Building Commissioning) FR: Floor Register FTU: Fan Terminal Unit G or g: Gravitational Constant GA: Gauge GC: General Contractor GPH: Gallons Per Hour GPM: Gallons Per Minute GR: Grain - measurement of actual moisture in an air sample, 7000 grains = one pound of water GSD: Geometric Standard Division H: Enthalpy H2O: Water HC: Heating Coil HD: Head pressure measured in inches or feet of water Heater O.L.: Thermal Overload protection for motors located at the motor starter NEPA: High Efficiency Particulate Arrestance HEPA Filter: High Efficiency Particulate Air Filter H9: Mercury HOA: Hand/Off/Auto switch HP: HorsePower HPS: High Pressure Steam Corporate Headquarters 4721 E. Hunter Ave. Las Vegas Anaheim, CA 92807 Anaheim Phone: (702) 255-7331 / Fax: (702) 294-1306 mail@aabccofp.com Phone: (714) 693-3700 / Fax: (714) 693-9509 .�.`■G. American as cois�Balance HPU: Heat Pump Unit HRC: Heat Recovery Coil or Heat Reclaim Coil HTHW: High Temperature Hot Water HV: Heating Ventilator HVAC: Heating, Ventilating & Air Conditioning HW: Hot Water HWR: Hot Water Return or Heating Water Return HWS: Hot Water Supply or Heating Water Supply HX: Heat exchanger Hydronic: Indicates the use or conveyance of liquid for thermal transfer Hz: Hertz 1. D.: Inside Diameter 1/0: Input / Output ID: Impeller Diameter (pump) IES: Institute of Environmental Sciences IV: Inlet Vanes K: Correction Factor KW: Kilowatts KWH: Kilowatt Hour LAT: Leaving Air Temperature L/S: Lter per Second LD: Linear Diffuser LF: Linear Foot LPS: Low Pressure Steam LPS: Liters Per Second LTD: Least Temperature Difference LTHW: Low Temperature Hot Water LV or LVG: Leaving LWG: Low Wall Grille LWR: Low Wall Register LWT: Leaving Water Temperature MAU or MUA: Make-up Air Unit or Make -Up Air MAX: Maximum MB: Mixing Box MBH: Mega BTU's per Hour MET: Mean Effective Temperature Micron: 1.0 x 10-6 meter Mil.: 2.54 x 10-5 meter MIN Minimum MM: Millimeters MM X MM: Millimeters by Millimeters MMD: Mass Mean Diameter MTD: Mean Temperature Difference MVD: Manual Volume Damper Corporate Headquarters 4721 E. Hunter Ave. Las Vegas Anaheim, CA 92807 Anaheim Phone: (702) 255-7331 / Fax: (702) 294-1306 mail@aabccorp.com Phone: (714) 693-3700 / Fax: (714) 693-9509 American Air Balance Co., Inc. MZ: MultiZone N/A: Not Applicable or Not Available NASA: National Aeronautics and Space Administration NC: Noise Criteria or Normally Closed NIC: Not in Contract N/L: Not Listed NM: Not Measured NO: Normally Open NPFC: Naval Publications and Forms Center NPSHA: Net Positive Suction Head Available NS: Not Specified NSF: National Sanitation Foundation NTIS: National Technical Information Service NTS: Not To Scale NVL: No Valid Location for Testing OB: Octave Band - a range of frequency where the highest frequency of the band is double the lowest frequency of the band. The band is usually specified by the center frequency. The preferred octave bands are designated by the following center frequencies: 31.5, 63, 125, 250, 500, 1000, 2000, 4000, 8000, 16000. OBD: Opposed Blade Damper 0. D.: Outside Diameter OAT: Outside Air Temperature OPT: Operational Performance Testing (Building Commissioning) O.S.A. or OA: Outside Air P. E.: Professional Engineer P: Circulating Pump Pa: Pascal - 1 Pascal = 6.894 x 10' psi PCT: Percent PD: Differential Pressure or Pressure Drop PE: Pneumatic Electric Switch PF: Power Factor PH: Phase(s) PHC: PreHeat Coi I PMP: Circulating Pump PNC: Preferred Noise Criterion Curves PPM: Parts Per Million PSI: Pounds per Square Inch PSIA: Pounds per Square Inch Absolute PSIG: Pounds per Square Inch Gauge PSL: Polystyrene Latex Spheres - used to generate an aerosol challenge medium where electronic & semi -conductor products are manufactured PWR: Power Corporate Headquarters 4721 E. Hunter Ave. Las Vegas Anaheim, CA 92807 Anaheim Phone: (702) 255-7331 / Fax: (702) 294-1306 mail@aabccorp.com Phone: (714) 693-3700 / Fax: (714) 693-9509 American "..:-MEN:- "iii".� Air Balance C w TON (Air Cond.): Equals 12,000 BTU per hour TP: Traverse Point or Test Point. TP (Motor): Thermal Protected (opens motor circiutry if rated amps are exceeded) TR: Thermal Resistance TSP: Total Static Pressure UH: Unit Heater ULPA Filter: Ultra Low Penetration Air Filter V: Volt or Voltage VA: Volt Atmossphere VAC: Vacuum VAV: Variable Air Volume VD: Volume Damper VEL: Velocity VFD: Variable Frequency Drive (electric motor speed controller) VP: Velocity Pressure W: Watts WB: Wet Bulb W.G.: Water Gage WT: Weight Z: Zone Zoning: The practice of dividing a building into small sections for heating and cooling control, selected so that one thermostat can be used to determine each section's heating & cooling requirements Las Vegas Phone: (702) 255-7331 / Fax: (702) 294-1306 Corporate Headquarters 4721 E. Hunter Ave. Anaheim, CA 92807 mail@aabccorp.com Anaheim Phone: (714) 693-3700 / Fax: (714) 693-9509 American Air Balance Co., Inc. Dr. Haupt Newport Beach, CA 92660 American Air Balance Co., Inc is a Testing and Balancing Agency that engages in testing, adjusting and balancing of air and water moving systems. American Air Balance Co., Inc. does not undertake the construction of HVAC systems, fans, ductwork, terminal boxes, dampers, air distribution or other components. Additionally, our firm does not undertake construction of other building systems, such as walls, doors, windows, lights, that may have a direct affect on the performance of the system(s) being tested. This report represents the optimal obtainable results given the limits of the installed system and the existing conditions at the time of certification. The data and information provided herein is factual, accurate and based upon the information provided in addition to the existing conditions of the building at the time the tests were conducted. Each system's component installation and design dictates limitations and test parameters. System specific procedures must be followed to duplicate the results listed herein. American Air Balance Co., Inc. employs the standards and procedures per the latest version of the AABC National Standards and Test and Balance Procedures, as applicable, unless otherwise dictated by the project specifications and/or project system specific requirements. Verification of the report contents must be carried out within 45 days of certification and shall be accomplished by our Field Technician, using the same instruments, under the same test conditions used to develop this report; otherwise this project warranty is null and void. Our office must receive requests for field verification in writing within 30 days of certification. American Air Balance Co., Inc. makes no representation or warranty that the systems and data contained herein will remain in the condition recorded beyond the date of certification. Adjustlnent(s), change(s) and/or tampering with component of the systems will affect the values listed herein. Changes, modifications and/or adjustment to the building structure, systems and/or sub systems, including but not limited to Architectural, Mechanical, Electrical, Plumbing, Building Automation Controls and Fire/Life Safety Alarm Systems will adversely affect the integrity of the systems and alter the data listed herein. Any such changes void American Air Balance Co., Inc.'s warranty and the AABC National Performance Guaranty. Proper building and HVAC system(s) maintenance must be followed to maintain efficient conditions. Improper system maintenance directly affects system performance. Las Vegas Phone: (702) 255-7331/ Fax: (702) 294-1306 Corporate Headquarters 4721 E. Hunter Ave. Anaheim, CA 92807 mail@americanairbalance.com Page I oft Anaheim Phone: (714) 693-3700 /Fax: (714) 693-9509 EMUL American Air Balance Co.. Inc. Explanation of "K" Value and Flow Hood Readings Air distribution was read with a Shortridge Flow Hood; Air Data Multi -Meter, model ADM -860, where possible, and where 1.0 is listed as the effective area, "K" in our report, unless otherwise noted. This flow hood is a direct reading instrument that compensates and corrects for hood backpressure, altitude, density and temperature when appropriate; therefore a 1.0 is listed as the effective area. The velocity listed in this report reflects the velocity through the flow hood and not the diffuser neck or face. General Procedures — All Projects Duct traverse readings were provided where possible and a sufficient length of straight duct was installed. Readings were not provided when one or more of the following conditions existed: • Insufficient lengths of straight duct were installed. • We were unable to obtain accurate readings. • Inadequate access to the ductwork. Scope of Work American Air Balance Co., Inc. has been requested to provide a Test and Balance for the above referenced project. This work is inclusive of: • Certification of Air Moving Systems. Project Specific Comments This section of our report is used to describe project special conditions, system observations and/or operational comments. At times, as applicable, items that remain outstanding and/or values that are not with the allowable project tolerances are footnoted on each individual test sheet will also be listed herein. American Air Balance Co., Inc. has noted the following upon conclusion of the Test and Balance of this project: General Notes • All testing was performed under normal operating conditions. • We were directed by Glen Rivas of Allied Mechanical to not obtain the actual outside air total for the fan serving our scope of work area. Las Vegas Phone: (702) 255-7331 / Fax: (702) 294-1306 Corporate Headquarters 4721 E. Hunter Ave. Anaheim, CA 92807 mail@americanairbalance.com americanairbalance.com Pap 2 of 2 Anaheim Phone: (714) 693-3700 / Fax: (714) 693-9509 _ American Air Balance Co., Ltc. ■ . •• TABLE OF CONTENTS (E) SUPPLY - Air Distribution Schedule ..................... (E)EXHAUST- Air Distribution Schedule ......... _......_ Corporate Healerquehers 4721 E. Hunter Ave Lae Vegas Anaheim CA 82807 Anaheim .., Phone'. (702)25573311 Fax (702)294-1306 mail@amencanairbeance.com Phone. (714)693-37001 Fax: (714)693-9509 cmuuu¢mrn -: American Air Balance Co., Inc. Air Distribution Schedule PROJECT Dr. Haupt, Newport Beach DESCRIPTION (E)SUPPLY Room No. Terminal No. Terminal Size K Req. VEL Req. CFM Actual VEL Actual CFM EXAM 3 1 8 X 8 1.000 175 175 160 160 EXAM 4 2 8 X 8 1.000 175 175 165 165 EXAM 2 3 8 X 8 1.000 175 175 160 160 EXAM 1 4 8 X 8 1.000 175 175 165 165 ADMIN. 5 8 X 8 1.000 150 150 135 135 X-RAY 6 10 X 10 1.000 200 200 185 185 DR. OFFICE 7 10 X 10 1.000 250 250 225 225 WAITING R. 8 12 X 12 1.000 300 300 310 310 RECEPTION 9 10 X 10 1.000 200 200 185 185 HALLWAY 10 8 X 8 1.000 150 150 145 145 HALLWAY 11 8 X 8 1.000 150 150 150 150 TOILET 12 6 X 6 1.000 50 50 55 55 Totals: 2150 2040 Corporate Heaierquarters 4721 E. Hunter Ave AM� Las Vegas Anaheim, CA 92807 Anaheim .�waa Phone (702)25&73311 Fax: (702)294-1305 mail@amancanairoalance.wm Phone: (714)69345700/Fax '.(714)693-9509 c.,aoa Lknh' 1 American Air Balance Co., Inc. Air Distribution Schedule PROJECT Dr. Haupt, Newport Beach DESCREIPTION EXHAUST Room No. Terminal No. Terminal Size K Req. VEL Req. I CFM Actual VEL Actual CFM STORAGE 1 6 X 6 1.000 75 75 80 80 TOILET 2 8 X 8 1.000 100 100 110 110 Totals: 175 190 Corporate Heaierquarters 4721 E. Hunter Ave Q Las Vegas Anaheim, CA 92607 Anahehn �Asc Phone'. (702)2557331 / Fax: (702)294-1306 ma @amenwrowbalance.mm Phone. (714)69337001 Fax: (714)693-9509 c.au..l 11-, . 2 FIELD TECHNICIAN'S DECLARATION STATEMENT • I certify under penalty of perjury, under thelewsof the Stateof California theinformation provided on thisform iStrUeand Correct. • I am the pawn who performed the acceptance requirements verification reported on this Certficateof Acceptaince(Field Techniclai), • I certify that the construction/instal lation identified on this form complieswith the acceptance requirements indicated in the plansand spedfrcations approved by theenforcement agency, and oonformsto the appl iceble acceptance requirementsand proceduresspecifled in Reference Nonresidential Appendix NAT • I haveconfinned that the Installation Certificate(s) for theconstruction/installation identified on thisform has been completed aid is posted or made adalablewith the building permit(s) issued for the build n9. RESPONSIBLE PERSON'S DECLARATION STATEMENT • I certify under penalty of perjury, under the lavvsof the Staterof CaUfornlak that I an the Field Technician, or the Field Technician isacting on my behalf as my enployeeor my agent and I hate reviewed the information provided on thisform. • I am alicensed Contractor, architect, or engineer, who iseligible under Division 3 of theSusinew end Professions Coft in theapplicaue classification, to take responsibility for the scope of work specified on this document and attest to the declarations in thisstatenent (responsible person). • I certify that the information provided on thisform substantiates that the construction/instailation identified an this form compl !as with the acceptance requirements indicated in the plans and specificationsapproved by the enforcement agency, and conforms to the applicable aoceptwm requirements and procedures specified in Reference Nonresidential Appendix NAT • I have confirmed that the I ristallation Certificate(s) for the oDirstruction/i nstailation identified on this form has been completed aid is posted or made availablewith the building permit(s) issued for the building. • I will ensurethat acompleted, signed copy of thisCertificateof Acceptanceshall be posted, ormade evalablewiththe building permit(s) Issued for the building, and made evailabletotheenforoanentagency for ail applicable inspections. I understand that a signed copy of this Certificateof Acceptance Is required to be i nduded with the documentation the builder providesto the build rig owner at occupancy. CorName: na A.�� �( I . /-3 all R n mr's,QJa p. R p`iePersnisSionature LicenseC-10 Ifv�ACA1�� q � Datate.grinneeip Pbsitio t paty (Title): Occupant Sensor, Manual Da li htin Control, and Automatic Time Switch Control Intent: Li htsareturned off when not needed per Section 119(d)& 131(d). Construction Inspection 1 1 nstrumentation to pertorm test i nd udes, but not I i mited to: a Hand-held amperage and voltage mater b. Power mater continued on next page 2008 Nonresidential Acceptance Forms August 1009 Nt)JJro* J,<<eV'A— �0- QT 30015- W q CERTIFICATE OF ACCEPTANCE LTG -2A Lighting Control Acceptance Document (Page 2 of 3 Dp--»Pr.,,m 1Audre r der?o System NaMe or I ntification ag: t, �i u cn is Light meter System to tion or Area Served: SU 9 e # 70q. C 2 Occupancy Sensor Construction Inspection Occupancy sensor has been located to minimize false signals ❑ Light meter ❑ Ultrasonic occupancy sensors do not emit audible sound (119a) 5 feet from source 3 Manual Daylighting Controls Construction Inspection ❑ 1If dimming ballasts are specified for light fixtures within the daylit area, make sure they meet all the Standards requirements, including "reduced flickeroperation" for manual dimming controls stems Automatic Time Switch Controls Construction Inspection 4 a. Automatic time switch control is programmed for (check all): Weekdays Weekend ❑ Holidays b. Document for the owner automatic time switch programming (check all): Weekdays settings 1F Weekend settings ❑ Holidays settings Set-up settings ❑ Preference program setting Verify the correct time and date is properly set in the time switch Ll Verify the battery is installed and energized 16 Override time limit is no more than 2 hours ip Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 119 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices A. Select Acceptance Test (Indicate lighting control systems Names/Designations by the applicable tests below) (M I Occupancy Sensor aA rQ d iM 5 ❑ 2 Manual Daylighting Controls 3 Automatic Time Switch Controls B. Equipment Testing Requirements Applicable Lighting Check and verify those items applicable to selected system: Control Systems Occupancy Sensor - Step 1: Simulate an unoccupied condition 1 2 3 a' Lights controlled by occupancy sensors turn off within a maximum of 30 minutes from start of an unoccupied condition per Standard Section 119(d) V/ N � J Y / N Y / N b The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation /� / N v Y / N Y / N c. Signal sensitivity is adequate to achieve desired control N Y / N Y / N Occupant Sensor - Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly N Y / N Y / N b Lights controlled by occupancy sensors turn on when Immediately upon an occupied condition OR this requirement is mutuallyexclusive with Ste 2.c. / N Y / N Y / N c. Sensor indicates space is "occupied" and lights tum on manually N I Y / N Y / N continued on next page 2008 Nonresidential Acceptance Forms August 2009 Control or Occupant Sensor - Step 3: System returned to initial operating conditions Y / N Y / N Y / N Occupant Sensor - Step 4 - Sensor is also a multi -Level Occupant. Sensor used to qualify for a Power Adjustment Factor in Section 146(a)2D of the Standards. If yes, then `a,' `b,'Y and `c' must also be es. N Y / N Y / N a' The first stage activates between 30 to 70% of the lighting either manually or automatically. Y N Y / N Y / N b. A reasonably uniform level of illuminance is achieved by dimming of all lamps or luminaires; or by switching alternate lamps in luminaires, alternate luminaires, or alternate rows of luminaires. / N Y / N Y / N C. After the first stage occurs, manual switches have been provided to activate the alternate set of lights, activate 100% of the lighting power, and manually deactivate all of the lights. oY N Y / N Y / N Manual Daylighting Controls - Step 1: Manual switching control a. At least 50% of lighting power in daylit areas is separately controlled from other lights / N I Y / N Y / N b. I The amount of light delivered to the space is uniformly reduced I Y / N I Y / N Y / N Manual Daylighting Controls - Step 2: System returned to initial operating conditions (VIN I Y / N Y / N Automatic Time Switch Controls - Step 1: Simulate occupied condition a. I All lights can be turned on and off by their respective area control switch / N Y / N Y / N b. Verify Verify the switch only operates lighting in the ceiling -height partitioned area in which switch is located / N Y / N Y / N Automatic Time Switch Controls - Step 2: Simulate unoccupied condition a. All non-exempt lighting tum off per Section 131(d)1 / N Y / N Y / N b. Manual override switch allows only the lights in the selected ceiling height partitioned space where the override switch is located, to turn on or remain on until the next/�Y scheduled shut off occurs kPI N Y / N Y / N c. All non-exempt lighting turns off / N Y / N Y / N Automatic Time Switch Controls - Step 3: System returned to initial operating conditions Y N Y / N Y / N Note. Shaded areas do not apply for particular test procedure C. PASS / FAIL Evaluation (check one): ❑ PASS: All applicable Construction n responses are complete and all applicable Equipment Testing Requirements res onse; are ositivi ty-X's) ❑ FAIL: Any applicable Construction Inspection responses are incomplete OR there is one or more negative (N - no) responses in any applicable Equipment Testing Requirements section. Provide explanation below. Use and attach additional pagesifnecess 2008 Nonresidential Acceptance Forms August 2009 CERTIFICATE OF COMPLIANCE (Page 1 of 4) LTG-1C Prof ctName: Date: 5-9-19 Project Address: 160 n l _ \ otf -7l Climate Zone: Building CFA : Unconditioned Floor Area: General Information Building Type: Nonresidential [I High-Rise Residential ® Hotel/Motel Relocatable Public Schools Schools Conditioned Spaces Q Unconditioned Spaces Phase of Construction: El New Construction Addition ® Alteration Method of Compliance: E] Complete Building Area Category Tailored Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. Name: W` ` Signature: Company: y A �W 1"\ qtr ✓ �V ej Date / Address: �5 Iwo l If applicable: CEA# CEPE # C, /S e/ Ce — u Ph q 67Q I — 3—M 6 O -1 Principal Lighting Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting design. • This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with Title 24, Pages 1 and 6 of the California Code of Regulations. • The design features represented on this Certificate of Compliance are consistent with the information provided to document this design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name: ,n, Signature: Company: P e' Address: L cense # W70 City/ tte/7rp. ,-a Ce 30 Date: Lighting Mandatory Measures Indicate location on building plans of Mandatory Measures Note Block: LIGHTING COMPLIANCE FORMS & WORKSHEETS (check box if worksheet is included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, please refer to the Nonresidential Manual ublished by the California Energy Commission. LTG-1C Pages 1 through 4 Certificate of Compliance. All Pages required on plans for all submittals. LTG-2C Lighting Controls Credit Worksheet LTG-3C Indoor Lighting Power Allowance 0 LTG-4C Pages 1 through 4 Tailored Method Worksheet 0 LTG-5C Pages I and 2 Line Voltage Track Lighting Worksheet 2008 Nonresidential Compliance Forms July 2010 CERTIFICATE OF COMPLIANCE (Page 2 of 4) LTG -1C INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Project Name: �/ LQ0 ;Ali A7b� Date: _ Installation rtificate, LTG -I- ST (Retain a copy and verify form is completed and signed.) EN Field Inspector Certificates of Acceptance, LTG -2A and LTG -3A (Retain a copy and verify form is completed and signed.) © Field Inspector A separate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces Installed Lighting Power listed on this Lighting Schedule is only for: R1 CONDITIONED SPACE © UNCONDITIONED SPACE The actual indoor lighting power listed below includes all installed permanent and portable lighting systems in accordance with §146(a) ® Only for offices: Up to the first 0.2 watts per square foot ofportable lighting shall not be required to be included in the calculation of actual indoor lighting power density in accordance with the Exception to §146(a). All portable lighting in excess of 0.2 watts per s :tare oot is totaled below. Luminaire Schedule (Type, Lamps, Ballasts Installed Watts A B C I D E F G A `o fi Z ^ How wattage was Field determined Ins ectorZ w °' CEC According 0 Complete Luminaire Description c �_ Default to (i.e, 3 lamp fluorescent troffer, 4 from §130 w w F32T8, one dimmable electronic ballast NA8 d or e :h L l V MussedaI 6t S eDr 1 F71 L El El INSTALLED WATTS PAGE TOTAL: Building total number of pages l a— Installed Watts Building Total I 041 (Sum of all pages) L Enter into LTG -1 C Pae 4 of 4 1. Wattage shall be determined according to Section 130(d and e). Wattage shall be rating of light fixture, not rating of bulb. 2. LfFail then describe on Page 2 o theIns ection Checklist Form and take appropriate action to correct. Verify buildin plans i necessar . 2008 Nonresidential Compliance Forms July 2010 CERTIFICATE OF COMPLIANCE (Page 3 of 4) LTG -1C Prci N e• qoo YV to T re� 4 � l Dater 8 -1 INDOOR LIG TING SCHEDULE add FIELD INSPECTION ENERGY CHECKLIST Fill in controls for all spaces: a) area controls, b) multi-level controls, c) manual daylighting controls for daylit areas > 250JT automatic daylighting controls for daylit areas > 2,500 ft', d) shut-off controls, e) display lighting controls, q tailored lighting controls -general lighting controlled separately from display, ornamental and display case lighting and g) demand responsive automatic controls or retail stores > 50, 000 , in accordance with Section 131. MANDATORY LIGHTING CONTROLS - FIELD INSPECTION ENERGY CHECKLIST Field Inspector Type / Description Number of Units Location in Building Pass Fail W O tG 5R kcoSU-4e- .fit 70� a El I L,eA OCc 5eww-5Sew-5 uck 70R a El C] _ El 0 O 0 M 11 El El El E3 El Field Inspector's Notes or Discrepancies: 2008 Nonresidential Compliance Forms July 2010 CERTIFICATE OF COMPLIANCE (Page 4 of ll) LTG -1C Pro ect Name: kW 4 Ce v CT Date: s-8-1 Conditioned m1d Unconditioned sp a Lighting must not be combined for compliance Indoor Lighting Power for Conditioned Spaces Indoor Lighting Power for Unconditioned Spaces Installed Lighting' (from Conditioned LTG -1C Pae 2) Watts Installed Lighting from Unconditioned LTG -1C Page 2 Watts q 1 Lighting Control Credit Conditioned Spaces from LTG -2C Lighting Control Credit Unconditioned Spaces from LTG -2C Adjusted Installed Lighting Power _ Adjusted Installed Lighting Power _ Complies if Installed <_ Allowed = Complies if Installed <_ Allowed Y Allowed Lighting Power1 Conditioned Spaces from LTG -3C O { _ l t Allowed Lighting Power Unconditioned S aces from LTG -3C Required Acceptance Tests Designer: This form is to be used by the designer and attached to the plans. Listed below is the acceptance test for the Lighting system, LTG -2A and LTG -3A. The designer is required to check the acceptance tests and list all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. If all the lighting system or control ofa certain type requires a test, list the different lighting and the number ofsystems. The NA Section in the Appendix of the Nonresidential Reference Appendices Manual describes the test. Since this farm will be part of the plans, completion of this section will allow the responsible party to budget for the scope ofivork appropriately. Forms can be grouped by type of Laminaire controlled Enforcement Agency: Systems Acceptance. Before Occupancy Permit is granted for a newly constructed building or space or when ever new lighting system with controls is installed in the building or space shall be certified as meeting the Acceptance Requirements. The LTG -2A and LTG -3A forms are not considered a complete form and are not to be accepted by the enforcement agency unless the boxes are checked and/or filled and signed. In addition, a Certificate of Acceptance forms shall be submitted to the enforcement agency that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of§10-103(b) of Title 24 Part 6. The field inspector must receive the properly filled out and signed forms before the building can receive final occupancy. A copy of the LTG -2A and LTG -3A for each di event lighting luminaire control(s) must be provided to the owner of the buildingiror their records. Luminaires Controlled LTG -2A and 3A b y E = c E ui ment Requiring TestingDescription Z o c Location Controls and Sensors and Automatic Daylighting Controls Acceptance ePty t i c cwE 0 El— EJ Nonresidential Compliance Forms July 2010 LIGHTING CONTROLS CREDIT WORKSHEET (Pae 1 of 2) LTG-2C Pro6' tNI : 1(00 iv Date:6S'8,/ POWER ADJUS MENT FACTOR (PAF) FOR NON-DAYLIGHT CONTROLS Separate PAF Worksheet Must Be Filled Outfor Conditioned and Unconditioned Spaces. Control Credits listed oil this schedule are only for: CONDITIONED SPACES UNCONDITIONED SPACES A B C D E F G Room # Zone ID Areas WaO�t� Lighting Control Description OIC Plan Reference Room Area lir) Watts of Control Lighting Power Adjustments Facto? Control Credit Watts E x F) eSA o Cc Cie L4 r CC S ewSd c- ' © CZ 2 So c` r C nC D r Q'1NK Du ge'4 R1,1 oPLW So Re J60 L"Mk DCC Seta Sdrr, i Orc Sem So PAGE TOTAL Note: Conditioned and Unconditioned Spaces Shall Be Separately Totaled Number of Pages of LTG-2C Page I of 2 Building total of non-daylight control credit watts for all pages of LTG-2C Page 1 of 2 Enter building total of all daylight controls credit watts from LTG-2C Page 2 of 2 BUILDING TOTAL OF ALL CONTROL CREDIT WATTS (FOR BOTH NON-DAYLIGHT AND DAYLIGHT CONTROL CREDITS) Enter in LTG-1C Page 4: Lighting Control Credit as appropriate for CONDITIONED or UNCONDITIONED Spaces I. Description shall be consistent with Type of Control defined in Table 146-C 2. Power Adjustment Factor taken from Table 146-C August 2009 login LE—Miciim iwlmism 91 M �H d L x 0 Z as � aa, s s M N o � w N m N A Op C � 6 O ate' �N a° O Lyi� t � p N n t o e s g ° n f1 ro ro t%' o N N 1 M M i N N t login LE—Miciim iwlmism 91 M �H d L x 0 Z ALLOW. out �a,cu opaces, manor Lighting Power Allowances listed on is pane are only for: CONDITIONED spaces t"1 Primary Watts II Wattage Per fl? llowanr Total WATTS and Quantity of Special Design Smaller of I each Primnr 1711 rlfl A.e„ .,.-.._ _ 1 u1ALS—Enter into Area Category Method— (table PartAabove) n Additional watts available only when allowed according to the footnotes on bottom of Table 146-F for chandelier or sconce; craft, assembly or manufacturing specialized task work; precision commercial/ industrial work; or lab specialized task work. Special luminaires are light fixtures described in the Table 146-F Footnotes that are subject to an additional wattage owance. ---- — -moi. krugc t oI 4)11LOW -i The indoor lighting power allowance using the Tailored Method of compliance shall be determined using the LTG -4C set of forms. A separate set of LTG -4C fom , <h�n i,P auva 2008 Nonresidential Compliance Forms August Xzola oN►o 400 Newporl Cen{er lar 1/30/2019 Page 1 Therapy Physics, Inc. Dr Haupt 19.xlsm Summary 562-317-0650 Radiation Protection Shielding Design Facility: Dr. Jeffrey Haupt Address: 400 Newport Center Drive, Newport Beach, CA 92660 Contact: Barajas, Maritza <mbarajas@Ipadesignstudios.com> Signature: Room ID: X -Ray Date: January 30, 2019 Physicist: Calculation Method: NCRP 147 Michael Masiar, M.S., DABR Installation Type: Radiographic Certified Radiological Physicist Therapy Physics Inc. Patients / Week: 120 2501 Cherry Ave.,Ste. 270, Signal Hill, CA 90755 562-317-0650, FAX: 562-317-0661 e-mail: Mike@TherapyPhysics.com Barrier Requirements Summary Existing Recommended Shielded Structural Additional P/T Air Kerma Protected Location Material Barrier (mGy/wk) (mGy/wk) Admin 1.25 in gypsum 2 / 64ths inch lead 0.02 0.0164 Storage 1.25 in gypsum 0.0 in n/a 0.4 0.3983 Adjacent Tenant 2 / 64ths inch lead 0.02 0.0048 Above 2.0 in concrete 0.02 0.0072 Below 2.0 in concrete 0.02 0.0052 Hall/Door 2 / 64ths inch lead 0.1 0.0055 1/30/2019 Page 1 Therapy Physics, Inc. Dr Haupt 19.xlsm Summary 562-317-0650 Comments and Recommendations 1. This is a shielding report for a X -Ray room to be installed in multi -story building. As long as ceiling and floor decks contain at least 2 inches concrete, no additional shielding is required for the floor or ceiling of this room. Installer is responsible for verification of concrete in ceiling/floor. 2. All additional lead shielding in the walls will be added to a height of 7 feet (84 inches) to comply with requirements of CA Code of Regulations. 3. All shielding requirements are based on NCRP Report #147 (2005): "Structural Shielding Design and Evaluation for Medical Use of X -Rays" Calculations for each barrier are made using the computer software program based on data and assumptions are from NCRP Report # 147. 4. The additional shielding recommendations are designed to meet Radiation Protection Standards as defined by 10 CFR20. Any future changes in either equipment, workload or room design will necessitate a re-evaluation of these shielding requirements. 5. The following assumptions were used in the shielding calculations: Workload: Avg workload from NCRP 147 = 120 patients/week maximum 6. All junction boxes and other penetrations in lead lined walls must be lined with equivalent thickness of lead with overlapping lead edges. (No gaps in lead lining) 7. For lead thickness's of 1/32 inch or less, the steel door frames do not need lead lining. 8. Equivalent thicknesses of lead for existing walls and floors is assumed to be as follows: 2 #/sq ft lead = 0.79 mm = 1/32 inch 1/30/2019 Page 2 Therapy Physics, Inc. Dr Haupt 19.xlsm Comments 562-317-0650 Protected Location: Admin Design Goal (P) (mGy/wk): 0.02 Occupancy (T): 1 Barrier Type: Secondary Wall P/T (mGy/wk): 0.020 Primary or Secondary: Secondary Use Factor: N/A Workload Distribution: All Barriers Number of Patients / Week: 120 Scatter Direction: Side Use Table / Bucky Preshielding? Existing Structural Material: Rad Tube Secondary in Leakage Scatter Leakage Scatter Distance to Protected Location: 3.9 ft 3.9 ft Unshielded Air Kerma (mGy/wk): 4.50E-02 2.89E+00 Structural Material Transmission: 6.45E-01 6.45E-01 Remaining Air Kerma (mGy/wk): 2.90E-02 1.86E+00 Transmission Model: Secondary Secondary Preshielding Credit: N/A Rec + Preshield Transmission: 8.66E-03 8.66E-03 Shielded Air Kerma (mGy/wk): 0.0003 0.0161 Existing Structural Material: 1.25 in Material: Gypsum Additional Barrier Required: 0.74 mm Material: Lead Recommended Additional Barrier: 0.79 mm Material: Lead ( 2 / 64ths inch ) 1/30/2019 Dr Haupt 19.xlsm Shielded Air Kerma (mGy/wk): 0.0164 Page 3 1 Therapy Physics, Inc. 562-317-0650 0 Protected Location: Storage Design Goal (P) (mGy/wk): 0.02 Occupancy (T): 0.05 Barrier Type: Secondary Wall P/T (mGy/wk): 0.400 Primary or Secondary: Secondary Use Factor: N/A Workload Distribution: All Barriers Number of Patients/ Week: 120 Scatter Direction: Side Use Table / Bucky Preshielding? : N/A Rad Tube Secondary Leakage Scatter Leakage Scatter Distance to Protected Location: 8.5 ft 8.5 ft Unshielded Air Kerma (mGy/wk): 9.48E-03 6.08E-01 Structural Material Transmission: 6.45E-01 6.45E-01 Remaining Air Kerma (mGy/wk): 6.11 E-03 3.92E-01 Transmission Model: Secondary Secondary Preshielding Credit: N/A Rec + Preshield Transmission: 1.00E+00 1.00E+00 Shielded Air Kerma (mGy/wk): 0.0061 0.3922 Existing Structural Material: 1.25 in Material: Gypsum Additional Barrier Required: 0.00 in Material: N/A Recommended Additional Barrier: 0.00 in Material: N/A Shielded Air Kerma (mGy/wk): 0.3983 1/30/2019 Page 4 Therapy Physics, Inc. Dr Haupt 19.xlsm 2 562-317-0650 Protected Location: Adjacent Tenant Design Goal (P) (mGy/wk): 0.02 Occupancy (T): 1 Barrier Type: Secondary Wall PR (mGy/wk): 0.020 Primary or Secondary: Secondary Use Factor: N/A Workload Distribution: All Barriers Number of Patients / Week: 120 Scatter Direction: Side Use Table / Bucky Preshielding? : 8.45E-03 Rad Tube Secondary Shielded Air Kerma (mGy/wk): 0.0048 1/30/2019 Page 5 Thera Dr Haupt 19.xlsm 3 Leakage Scatter Leakage Scatter Distance to Protected Location: 9.0 ft 9.0 ft Unshielded Air Kerma (mGy/wk): 8.45E-03 5.42E-01 Structural Material Transmission: 1.00E+00 1.00E+00 Remaining Air Kerma (mGy/wk): 8.45E-03 5.42E-01 Transmission Model: Secondary Secondary Preshielding Credit: N/A Rec + Preshield Transmission: 8.66E-03 8.66E-03 Shielded Air Kerma (mGy/wk): 0.0001 0.0047 Existing Structural Material: Material: Gypsum Additional Barrier Required: 0.42 mm Material: Lead Recommended Additional Barrier: 0.79 mm Material: Lead ( 2 / 64ths inch ) Shielded Air Kerma (mGy/wk): 0.0048 1/30/2019 Page 5 Thera Dr Haupt 19.xlsm 3 Protected Location: Above Design Goal (P) (mGy/wk): 0.02 Occupancy (T): 1 Barrier Type: Ceiling P/T (mGy/wk): 0.020 Primary or Secondary: Secondary Use Factor: N/A Workload Distribution: All Barriers Number of Patients/ Week: 120 Scatter Direction: Fwd/Back Use Table / Bucky Preshielding? : 4.75E-03 Over -Table Rad Tube Shielded Air Kerma (mGy/wk): 0.0072 1/30/2019 Page 6 Therapy Physics, Inc. Dr Haupt 19.xlsm 4 562-317-0650 Leakage Scatter Leakage Scatter Distance to Protected Location: 12.0 ft 12.0 ft Unshielded Air Kerma (mGy/wk): 4.75E-03 4.31E-01 Other Material Transmission: 1.00E+00 1.00E+00 Remaining Air Kerma (mGy/wk): 4.75E-03 4.31E-01 Transmission Model: Secondary Secondary Preshielding Credit: N/A Existing Material Tranmission: 1.67E-02 1.67E-02 Shielded Air Kerma (mGy/wk): 0.0001 0.0072 Other Existing Material: Material: Gypsum Structual Material Required: 1.28 in Material: Concrete Existing Structural Materal: 2.00 in Material: Concrete Shielded Air Kerma (mGy/wk): 0.0072 1/30/2019 Page 6 Therapy Physics, Inc. Dr Haupt 19.xlsm 4 562-317-0650 0 Protected Location: Below Design Goal (P) (mGy/wk): 0.02 Occupancy (T): 1 Barrier Type: Secondary Floor PIT (mGy/wk): 0.020 Primary or Secondary: Secondary Use Factor: N/A Workload Distribution: All Barriers Number of Patients / Week: 120 Scatter Direction: Side Use Table / Bucky Preshielding? Shielded Air Kerma (mGy/wk): 0.0052 1/30/2019 Page 7 Therapy Physics, Inc. Dr Haupt 19.xlsm 5 562-317-0650 Floor away from table Leakage Scatter Leakage Scatter Distance to Protected Location: 12.0 ft 12.0 ft Unshielded Air Kerma (mGy/wk): 4.75E-03 3.05E-01 Other Material Transmission: 1.00E+00 1.00E+00 Remaining Air Kerma (mGy/wk): 4.75E-03 3.05E-01 Transmission Model: Secondary Secondary Preshielding Credit: N/A Existing Material Tranmission: 1.67E-02 1.67E-02 Shielded Air Kerma (mGy/wk): 0.0001 0.0051 Other Existing Material: Material: Gypsum Structual Material Required: 1.07 in Material: Concrete Existing Structural Materal: 2.00 in Material: Concrete Shielded Air Kerma (mGy/wk): 0.0052 1/30/2019 Page 7 Therapy Physics, Inc. Dr Haupt 19.xlsm 5 562-317-0650 Protected Location: Hall/Door Design Goal (P) (mGy/wk): 0.02 Barrier Type: Secondary Wall Primary or Secondary: Secondary Use Factor: N/A Workload Distribution: All Barriers Number of Patients/ Week: 120 Scatter Direction: Side Use Table / Bucky Preshielding? Occupancy (T): 0.2 PIT(mGy/wk): 0.100 Existing Structural Material: Material: Gypsum Additional Barrier Required: 0.16 mm Material: Lead Recommended Additional Barrier: 0.79 mm Material: Lead Shielded Air Kerma (mGy/wk): 0.0055 ( 2 / 64ths inch ) 1/30/2019 Page 8 Therapy Physics, Inc. Dr Haupt 19.xlsm 6 562-317-0650 Rad Tube Secondary Leakage Scatter Leakage Scatter Distance to Protected Location: 8.4 ft 8.4 ft Unshielded Air Kerma (mGy/wk): 9.70E-03 6.22E-01 Structural Material Transmission: 1.00E+00 1.00E+00 Remaining Air Kerma (mGy/wk): 9.70E-03 6.22E-01 Transmission Model: Secondary Secondary Preshielding Credit: N/A Rec + Preshield Transmission: 8.66E-03 8.66E-03 Shielded Air Kerma (mGy/wk): 0.0001 0.0054 Existing Structural Material: Material: Gypsum Additional Barrier Required: 0.16 mm Material: Lead Recommended Additional Barrier: 0.79 mm Material: Lead Shielded Air Kerma (mGy/wk): 0.0055 ( 2 / 64ths inch ) 1/30/2019 Page 8 Therapy Physics, Inc. Dr Haupt 19.xlsm 6 562-317-0650 o o Il'SV/90 1 J - -- - - I o m z v � I' `ice Ig o lap uj , #O.Z Vl£ I L o � <V _ -17M o I� X l _ L4'SVR4 N ti —� o L L'SH191 0 ! — ill n JI- F— — cr cr Q U.- Z! 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