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X2021-2737 - Misc (3)
P2S Inc. T 562.497.2999 5000 East Spring Street, Ste 800 F 562.497.2990 Long Beach, CA USA 90815-5218 www.p2sinc.com Page | 1 Clearwater Senior Living Newport Beach – MEP Compliance Memorandum January 25, 2024 Attention: Roger Bernstein, Vice President of Construction, Oppidan cc: Douglas Pancake, Morgan Goei, Sean Carroll, Woodrow Otis From: Mikhail Fuks, Principal, P2S Inc. Project: Clearwater Senior Living Newport Beach Subject: MEP Final Compliance To all addressed above, The intent of this memo is to acknowledge construction completion and compliance with the project contract documents including drawings and specifications for the Mechanical, Electrical and Plumbing systems on the above noted Clearwater Newport Beach senior living project. The P2S Inc design team has previously completed a final observation walk and findings report for resolution by the installing general contractor, W.E. O’Neil (WEO). This week WEO has completed all relevant items on the original findings report and therefore P2S Inc finds the project complete in compliance. Thank you and please advise if any further information is required. Mikhail Fuks, PE, HFDP, DBIA Principal / Engineering Group Leader 33 Appendix E LANDSCAPE INSTALLATION CERTIFICATE OF COMPLETION I hereby certify that: (1) I am a professional appropriately licensed in the State of California to provide professional landscape design services. (2) The landscape project for the property located at (provide street address or parcel number(s)) was installed by me or under my supervision. (3) The landscaping for the identified property has been installed in substantial conformance with the approved Landscape Documentation Package and complies with the requirements of the City of Newport Beach Water Efficient Landscape Ordinance (Municipal Code Section 14.17) and the City of Newport Beach Standards for Implementation of the City of Newport Beach Water Efficient Landscape Ordinance for the efficient use of water in the landscape. (4) The following elements are attached hereto: a. Irrigation scheduling parameters used to set the controller; b. Landscape and irrigation maintenance schedule; c. Irrigation audit report; and d. Soil analysis report, if not submitted with Landscape Documentation Package, and documentation verifying implementation of the soil report recommendations. (5) The site installation complies with the following: a. The required irrigation system has been installed according to approved plans and specifications and if applicable, any prior approved irrigation system alternatives. _____ Yes ____ No b. Sprinklers comply with ASABE/ICC 802-2014 Landscape Irrigation Sprinkler & Emitter Standard. _____ Yes ____ No (6) The information I have provided in this Landscape Installation Certificate of Completion is true and correct and is hereby submitted in compliance with the City of Newport Beach Design Standards for Implementation of the City of Newport Beach Water Efficient Landscape Ordinance. Clearwater at Newport Oppidan Investment Company, Inc. 2382-2021 x x x Balanced 3-Story Senior Housing Tait & Associates, Inc.2/8/2024 Tait & Associates, INC. Jacob Vandervis C046301 701 N. Park Center Dr. Santa Ana, CA 92705 12528 1/10/2024 Approved Plans and Delta Revisions N/A x x ,-t#CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 | Newport Beach, CA 926588915 www.newportbeachca.gov | (949) 644-3200 [Voluntary] CONTRACTOR/PROPERTY OWNER SELF-CERTIFICATION DECLARATION FOR RESIDENTIAL PROPERTIES (Water Heater) Date 1t22t24 Permit # contractor's Name: AMPAM Parks Mechanical License No. 775747 4661gss.1 7036 S. Avalon Blvd. Carson, Ca.Phone # (requ ired )310-835-1532 Contracror's Erns;1. alfonso.toledo@ampam.com FAX #N/A lnstaller I certify that the installation is in compliance with applicable code requirements. I hereby affirm under penalty of perjury and under the laws of the State of California that I am licensed to perform plumbing work under provisions of Title i6, Article l3 of the Business and Professions Code, and my Class C-36 license is in full force and effect. I further affirm that I have reviewed and understand the requirements of the applicable 2019 California plumbing Code and Newport Beach Municipal Code and that the self-certiflcation report submitted by me will be based on the code requirements. This certification is for a WATER HEATER that is installed in the same location and is the same size and type. Seismic strapping and TPR line installed 2019 California Plumbing Code lnstaller's Pro e Owner (Requted) As the property owner of the project address noted above, I have read, understand and agree to participate in the System Self-Certification Program. lfurther understand that by participating in this program, the plumbing system wi not be inspected by a City of Newport Beach Building lnspector during construction or after installation unless requested. The Building Division may request and reserves the right to verify code compliance after the installation is complete. Propeiy Ownet's Signature Date Email This form must be completed and returned to the City of Newport Beach, Building Division, for a final approval of the plumbing permit. Please return this torm to the Building Division by mail orfax. Please mail to: Cityof Newport Beach Phone: (949) 7'18-1888 Community Development Departmenl Fax #: (949) 644-3250 Building Division P. O Box 1768 Newport Beach, CA 92658 Forms\Conlractor-Owner Sef Cert Declaration-Waletqealet O1l29l2A Project Address: 101 BayView Place, Newport Beach, Ca. 92660 The following is to be completed by the California licensed plumbing contractor participating in the City of Newport Beach Self-Certification Program when installing a water heater. Please type or print. Contractor's Mailing BILL CARR SURVEYS, INC. 755 Debra Lane, Anaheim CA 92805 (714) 978-3889 / Fax (714) 978-3890 www.billcarrsurveys.com April 17, 2023 rbowman@weoneil.com W.E. O’Neil 2100 Main Street, Suite 300 Irvine, CA 92614 Attn: Robert Bowman Ref: Clearwater at Newport 101 Bayview Place Newport Beach, CA 92660 RE: Building Height Verification Robert, On April 14, 2023, Bill Carr Surveys, Inc. performed a survey of the constructed building height at the above referenced project. Our survey found the elevation at the building’s highest point to be 102.00’ (the high point of the roof framing). Please note that the building was still under construction at the time of our survey. Please refer to our Building Height Verification exhibit, attached hereto and by this reference made a part hereof. Please call our office if you have any questions. Sincerely, Jeff C. Clark Jeff C. Clark, PLS 8671 CEO/Principal Land Surveyor Bill Carr Surveys, Inc. [Electronically signed 04/17/2023] A B C D E F G H I J K L M N O P 7 8 9 10 11 12 13 14 15 LICENSED LAND SURVEYOR PREPARED BY: (714) 978-3889 755 DEBRA LANE ANAHEIM, CA 92805 CARLETON AINROFILACFOE T A T S DNAL R O Y E V R U S LANOISSE EXP 12-31-23 CLARK No. 8671 FORP JEFF JEFF C. CLARK P.L.S. 8671 EXP. DATE: 12-31-2023 PRELIMINARY UNLESS SIGNED SENSOR LOCATION GAS MODEL MOUNTED WIRED AND TERMINATED SENSOR IN FAULT VISIBLE DAMAGE ZERO (0PPM)SPAN (200PPM)OCCUPIED HOURS (UNOCCUPIED HOURS) >15 PPM >25 PPM CO >50 PPM CO >100 PPM CO Comments CONTROL SPECIALIST DATE COMPLETED D1 GARAGE CO DT6 Yes Yes No No 0 PPM 200 PPM GEF-1 MIN SPEED GEF-1 MIN SPEED GEF-1 MED SPEED GEF-1 HIGH SPEED HORN/STROBE ON TESTED USING 200PPM CO TEST GAS JESUS SALOMON 11/21/2023 D2 GARAGE CO DT6 Yes Yes No No 0 PPM 200 PPM GEF-1 MIN SPEED GEF-1 MIN SPEED GEF-1 MED SPEED GEF-1 HIGH SPEED HORN/STROBE ON TESTED USING 200PPM CO TEST GAS JESUS SALOMON 11/21/2023 D3 GARAGE CO DT6 Yes Yes No No 0 PPM 200 PPM GEF-1 MIN SPEED GEF-1 MIN SPEED GEF-1 MED SPEED GEF-1 HIGH SPEED HORN/STROBE ON TESTED USING 200PPM CO TEST GAS JESUS SALOMON 11/21/2023 D4 GARAGE CO DT6 Yes Yes No No 0 PPM 200 PPM GEF-1 MIN SPEED GEF-1 MIN SPEED GEF-1 MED SPEED GEF-1 HIGH SPEED HORN/STROBE ON TESTED USING 200PPM CO TEST GAS JESUS SALOMON 11/21/2023 D5 GARAGE CO DT6 Yes Yes No No 0 PPM 200 PPM GEF-1 MIN SPEED GEF-1 MIN SPEED GEF-1 MED SPEED GEF-1 HIGH SPEED HORN/STROBE ON TESTED USING 200PPM CO TEST GAS JESUS SALOMON 11/21/2023 D6 GARAGE CO DT6 Yes Yes No No 0 PPM 200 PPM GEF-1 MIN SPEED GEF-1 MIN SPEED GEF-1 MED SPEED GEF-1 HIGH SPEED HORN/STROBE ON TESTED USING 200PPM CO TEST GAS JESUS SALOMON 11/21/2023 D7 GARAGE CO DT6 Yes Yes No No 0 PPM 200 PPM GEF-1 MIN SPEED GEF-1 MIN SPEED GEF-1 MED SPEED GEF-1 HIGH SPEED HORN/STROBE ON TESTED USING 200PPM CO TEST GAS JESUS SALOMON 11/21/2023 IF DGC6 CONTROLLER DETECTS A FAULT, GEF-1 SHALL RUN AT HIGH SPEED UNTIL FAULT IS CORRECTED. CLEARWATER NEWPORT, 101 Bayview Pl, Newport Beach SEQUENCECALIBRATION DURING OCCUPIED HOURS, GEF-1 SHALL RUN AT MINIMUM SPEED. DURING UNOCCUPIED HOURS, IF ANY SENSOR IS ABOVE 15 PPM, GEF-1 SHALL RUN AT MINIMUM SPEED. IF ANY SENSOR IS ABOVE 25 PPM, GEF-1 SHALL RUN AT MEDIUM SPEED. IF ANY SENSOR IS ABOVE 100 PPM, REMOTE HORN/STROBE AND CONTROLLER HORN ALARM SHALL SOUND. IF ANY SENSOR IS ABOVE 50 PPM, GEF-1 SHALL RUN AT HIGH SPEED. INSTALLATIONSENSOR 4442 Parkhurst St., Ste. A Jurupa Valey, CA 91752 (951) 332-4195 Fax (951)361-1581 December 20,2023 Project No. 4910.4804084.0000 Attn: Roger Bernstein Harbor Point CSL,LLC 5000 Birch Street, Suite 400 Newport Beach, CA 92660 Subject: Satisfactory Completion of Work Requiring Special Inspection Clearwater a Newport Beach 101 Bayview Place Newport, CA 92660 Shoring Permit X2021-2703 Building Permit X2022-0254 To the best of my knowledge, the work for which special inspection and concrete materials testing were requested as of this date and listed below have been completed for the structure elements listed in the subject building permits. REINFORCED CONCRETE INSPECTION & PT STRUCTURAL MASONRY FIELD WELDING Based on the work performed between May 16, 2022 and November 15, 2023 for which CTE/UES conducted special inspections, it is our opinion that the construction for the referenced project is in substantial conformance with the approved plans and specifications and the applicable workmanship provisions of the California Building Code. Respectfully, CONSTRUCTION TESTING & ENGINEERING, SOUTH, INC. dba UES Dharmesh Amin, MS, PE, GE Principal Engineer 101 BAYVIEW PLACE NEWPORT BEACH, CA 92660 10/31/2023 Maggie Carlson mclavijo@dci-engineers.com 949-892-4950 S6163 x All Inspection Reports 10/31/2023 x 10/31/2023 Clearwater at Newport Beach owner, LLC 400 Water St. Suite 200 Excelsior, MN 55331 & Basement Walls x x x Date Received:11/14/2023 WAL No.: 23110101 Date Reported:11/17/2023 Customer:Aqua Backflow & Chlorination Inc Address:1060 C Northgate Street, Riverside, CA 92507 Attention:Lacey Brown A750 Sample I.D.DW - Drinking Water - Grab Sample Sample Point AM PAM - 101 Bayview Place Newport Beach Sampled By:Josh Stewart Date Sampled:11/14/2023 Enclosed are the analytical reports for the sample received 11/14/2023 17:05 with the chain of custody present. The sample was received in iced condition at 5.8 deg C. The samples were analyzed in accordance with the chain of custody and meet all requirements unless flagged or written in the case narrative. This analytical report must be reproduced in its entirety. Thank you for the opportunity to be of service to your company. Please feel free to contact us if there are any questions regarding this report or if we can be of further service. Gregory P. Conti, Laboratory Director Industrial Wastewater · Hazardous Waste · Domestic Water · Stormwater Metal Finishing Solution Analysis And Process Control Analytical Report Date Received:11/14/2023 WAL No.: 23110101 Date Reported:11/17/2023 Customer:Aqua Backflow & Chlorination Inc Address:1060 C Northgate Street, Riverside, CA 92507 BP Attention:Lacey Brown Sample I.D.DW - Drinking Water - Grab Sample A750 Sample Point AM PAM - 101 Bayview Place Newport Beach Sampled By:Josh Stewart Date Analyzed:11/14/2023 Date Sampled:11/14/2023 Flag Location Total/Free Time Total E. coli Heterotrophic Chlorine Sampled Coliform Plate Count ppm MPN (field result) Colilert Colilert SimPlate (by customer) Unit 109 2.3 / 0.43 12:45 Absent Absent <2 Unit 304 0.13 / 0.02 12:55 Absent Absent 33 Note: The water sample reported under Lab # 23110101 conforms to an acceptable bacteriological sanitary quality for drinking water according to principles/procedures set forth by the State Water Resources Control Board (California Water Boards). Lacey@aquabnc.com;Audrey@aquabnc.com;josh@aquabnc.com CG Industrial Wastewater · Hazardous Waste · Domestic Water · Stormwater Metal Finishing Solution Analysis And Process Control Flag Definition 4C Parameter is composite result of four grab samples. 4F Parameter result of four grab samples analyzed in field. B Analyte was present in an associated method blank BB Dilution water blank exceeds 0.20 mg/L. BD Depletion <2 mg/L. BG Glucose-glutamic acid check falls outside limits. BT Test replicates show more than 30% difference between high and low values. Sample toxicity is possible. Best result was reported. C Result provided by client. C1 Continuing calibration standard was not within control limits. C2 Sample was received in improper container. D1 Duplicate was not within control limits. The sample concentration was less than ten times the reporting limit. D2 Duplicate was not within control limits due to non-homogeneous nature of sample. D3 Duplicate was not within control limits. DC Peaks in diesel range but chromatogram does not match that of diesel standard. E Estimated reported value exceeded calibrationEstimated reported value exceeded maximum range. ES Standard(s) used for calibration curve expired. Calibration curve verified with second source standard. F Field result. GA Parameter analyzed using grab sample at end of sampling period. I1 Possible interference. Reported value may be suspect. L The laboratory control sample (LCS) was out of control limits. The sample data was reported without further clarification. L1 LCS was not within control limits. The MS or MSD met LCS limits which validated the batch. M Analyte was reported at MDL. MDO Minimum DO is less than 1.0 mg/L. Result may be higher. MI Sample matrix interfered with proper analysis of anaylte. Results are semi-quantitative. MS Matrix spike was not within control limits due to possible matrix interference. MS1 Matrix spike was not within control limits due to possible matrix interference. LCS was acceptable. MS2 The analyte concentration in the sample exceeded the spike level by a factor of four or greater, spike recovery and limits do not apply NE Non-accredited result. Not to be used for regulatory and/or compliance purposes. OLA Parameter analyzed by Enthalpy Analytical, Inc. ELAP certification 1338. CSDLAC Lab ID 10105. A copy of their report is included. OLC Parameter analyzed by Eurofins Calscience. NELAP certification 03220CA. CSDLAC Lab ID 10109. A copy of their report is included. OLE Parameter analyzed by Enviro-Chem, Inc. ELAP certification 1555. CSDLAC Lab ID 10200. A copy of their report is included. OLW Parameter analyzed by Weck Laboratories, Inc. ELAP certification 1132. CSDLAC Lab ID 10143. A copy of their report is included. P1 Sample was received without proper preservation. RH Value is outside the calibration range. RI Sample was not received on ice or refrigerated. RLI RL raised due to matrix interference. RT Temperature of sample upon receipt was outside of acceptable range. RW Final reweighs greater than 0.5 mg or 4%. T1 The method specified temperature during analysis was out of acceptable limits. T2 The sample storage temperature was out of limits. TA Sample was analyzed past the holding time. TAR Sample was analyzed past the holding time. Parameter was resampled or reanalysis. TB Sample analysis was requested and analyzed past hold time. TF Final time read exceeded method specifications due to technical reasons. TL Sample was analyzed past the holding time due to late date received. TP Reanalysis was reported past hold time. The original analysis was within hold time, but not reportable. TR Sample was analyzed ASAP but was received and analyzed past the holding time. V1 Sample volume used for analysis less than required by method due to sample matrix. Industrial Wastewater · Hazardous Waste · Domestic Water · Stormwater Metal Finishing Solution Analysis And Process Control PowerGen Commissioning date 20.11.2023 Acceptance date 20.11.2023 Date of hand-over to end user 20.11.2023 Design & constr. No.: NAObject name CLEAR WATER Type of application End-user group Private Application group 3D - Short-time operation, fuel stop Name / Company Name of the street Zip Code City Country mtu-No. Distributor/Dealer COLLICUTT ENERGY 12349 HAWKINS ST, CA 90670 SANTA FE SPRIN USA 133702944 System manufacturer RRPS SOLUTION 100 Power Dr, MN 56001 MANKATO USA 133702944 End user name 101 Bayview Way, CA 92660 Newport Beach USA Operator COLLICUTT ENERGY 12349 HAWKINS ST, CA 90670 SANTA FE SPRI USA 133702944 Name Firma Service technician mechanical NAGGIE MINA COLLICUTT ENERGY Service technician electrical NAGGIE MINA COLLICUTT ENERGY Project manager mechanical JAMES HAN COLLICUTT ENERGY Project manager electrical.JAMES HAN COLLICUTT ENERGY Type Manufacturer Serial number Model mtu-Order Application Install. pos.Operat. hours Generator RRPS SOLUTION 95090504252 MTU 4R0113 DS200 133702944 Power generation not relevant 4.52 Engine JOHN DEEREW PE6068N025281 6068HFG85 133702944 Power generation not relevant 4.52 supplied Components: Comment The following documents have been added Dok.-Nr. as attached Commissioning Report Start-up Check List Installation Report Diesel Generator Set Gas-System Form A: Engine Generator Set Request for Start-Up Form B: Engine Generator Set Installation and Commissioning Commissioning-/Acceptance protocol Gen Drive print form send as mail 5.58 % B R I S T O L S T R E E T S B A Y V I E W P L A C E F.H. NEW BUILDING PROPOSED 3-STORY BUILDING FIRST FLOOR FF=59.00 GARAGE FF=47.00 PAD=45.00 PROPOSED COURTYARD CL B R I S T O L S T R E E T CL B A Y V I E W P L A C E CO X CO X EX. BLDG.EX. BLDG. EX. BLDG. EX. BLDG. CL B R I S T O L S T R E E T CL B A Y V I E W P L A C E B B A A D D C C E E F F BRISTOL STREET F.H. CO X CO X PRECISE GRADING NOTES STORM DRAIN NOTES LEGEND GRADING GENERAL NOTES BRISTOL STREET DRAWING NUMBER 6/ 5 / 2 0 1 9 1 0 : 4 7 A M * B I M c l o u d : S E R V E R - B I M c l o u d B a s i c f o r A R C H I C A D 2 2 / 1 5 0 2 5 . 0 0 M o d e l UNAUTHORIZED CHANGES & USES:ENGINEERS NOTE TO CONTRACTOR:UNDERGROUND SERVICE ALERT TWO WORKING DAYS BEFORE YOU DIG Call: TOLL FREE 1-800-422-4133 KNOW WHAT'S BELOW. CALL BEFORE YOU DIG. 70 1 N . P a r k c e n t e r D r i v e Sa n t a A n a , C A 9 2 7 0 5 p: 7 1 4 / 5 6 0 / 8 2 0 0 f : 7 1 4 / 5 6 0 / 8 2 1 1 ww w . t a i t . c o m Si n c e 1 9 6 4 Lo s A n g e l e s On t a r i o Sa c r a m e n t o Sa n D i e g o Sa n F r a n c i s c o Bo i s e Da l l a s De n v e r Ph o e n i x Po r t l a n d 70 1 N . P a r k c e n t e r D r i v e Sa n t a A n a , C A 9 2 7 0 5 p: 7 1 4 / 5 6 0 / 8 2 0 0 f : 7 1 4 / 5 6 0 / 8 2 1 1 ww w . t a i t . c o m Si n c e 1 9 6 4 Lo s A n g e l e s On t a r i o Sa c r a m e n t o Sa n D i e g o Sa n F r a n c i s c o Bo i s e Da l l a s De n v e r Ph o e n i x Po r t l a n d DRAWING DESCRIPTION 15025.00PROJECT: DRAWN BY:MT CHECKED BY:JV CAD FILE NAME: DATE OF ISSUE:2022-11-29 FO U N D A T I O N & U N D E R G R O U N D U T I L I T I E S CL E A R W A T E R A T N E W P O R T B E A C H OP P I D A N I N V E S T M E N T C O M P A N Y 10 1 B A Y V I E W P L A C E , N E W P O R T B E A C H , C A L I F O R N I A 9 2 6 6 0 4TH SUBMITTAL 2022-07-203 DELTA REVISION 2022-10-124 DELTA REVISION 2022-11-304 DELTA REVISION 2023-02-015 DELTA REVISION 2023-03-155 DELTA REVISION 2023-05-166 N C-3 PRECISE GRADING PLAN DETAIL "C" DETAIL "A" DETAIL "D" DETAIL "B" GENERAL NOTE TO CONTRACTOR DETAIL "E" 6 CL B A Y V I E W P L A C E 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 MILD REINFORCING PLAN NOTES: A B C D E F G H I J K L M N O P Q R S LICENSED LAND SURVEYOR PREPARED BY: (714) 978-3889 755 DEBRA LANE ANAHEIM, CA 92805 CARLETON AINROFILACFOE T A T S DNAL R O Y E V R U S LANOISSE EXP 12-31-23 CLARK No. 8671 FORP JEFF JEFF C. CLARK P.L.S. 8671 EXP. DATE: 12-31-2023 PRELIMINARY UNLESS SIGNED UP 11 11 7 7 9 9 3 3 8 8 3 3 BA 1 1 C E M O S 2 2 5 5 4 4 10 10 PHN QFJLKDG RI 6 6 B A Y V I E W P L A C E LICENSED LAND SURVEYOR PREPARED BY: (714) 978-3889 755 DEBRA LANE ANAHEIM, CA 92805 CARLETON AINROFILACFOE T A T S DNAL R O Y E V R U S LANOISSE EXP 12-31-23 CLARK No. 8671 FORP JEFF Jeff C. Clark JEFF C. CLARK P.L.S. 8671 EXP. DATE: 12-31-2023 (ELECTRONICALLY SIGNED 8/08/2022) Form B - Engine Generator Set Installation and Commissioning Instructions This report must be completed and signed by an certified commissioning technician in order to accomplish all requirements of the Limited Warranty. This report includes the physical installation checkups and commissioning procedures for all control versions, as well as open and enclosed generator sets. Applicant Contact Details Distributor/Company: Name: Telephone: Email: Project Details Project Name: Project Number: Site Address: Start Up and Commissioning Start Date: Start Up and Commissioning Completion Date: Engine Generator Set Nameplate Model Number: Serial Number: Rating: Hz:kW: kVA:Volts: Phase:Amps: Engine Model Number: Serial Number: Power:RPM: Fuel Type: Diesel NG LP Vapor Liquid LP Other Generator Manufacturer: Model Number: Serial Number: AVR Type: kVA:Hz: Voltage:Current: Phase Rotation: Breaker (Yes No) Manufacturer: Model Number: Serial Number: Voltage: Current: Poles: ATS (Yes No) Manufacturer: Model Number: Serial Number: Voltage:Current: Poles: Controller Manufacturer: Model Number: Serial Number: Firmware Version: Note: If this form does not appear with fillable fields, navigate to Edit > Preferences > Documents > PDF/A View Mode. In the View documents in PDF/A mode drop-down list, select Never. Click OK. Rolls-Royce Group www.mtu-solutions.com Form B - Engine Generator Set Installation and Commissioning 2 General Application: Load test type on site: Building load Grid parallel Load test not possible because: Engine Generator Set Application Installed in building Containerized Enclosed Yes No N/A Prestart Safety Checks/Environmental Check Commissioning performed by an certified commissioning technician Personal protection equipment is available and functional Access only for authorized personnel Emergency escape routes are unobstructed (no loose materials, parts, or tools) and labeled Danger spots are indicated (e.g. trip hazards, beams, pipes) Control panel/engine area is unobstructed All warning plates and instruction labels are properly in place Genset room is free of debris, dirt, dust, loose materials, parts, and tools Air ducts are free and clean Engine generator set is leveled; mounting bolts secure Shipping blocks are removed For two bearing generators, check for proper alignment Heat protection covers are installed Engine Generator Set Room (Equipment) Yes No N/A Battery powered emergency light is installed Fire extinguishers are in place First aid kit is in place Oil resistant floor coating Spill containment system in place Fire extinguishing system Water CO2 Chemical None Engine Room Requirements (Open Power Units) Yes No N/A Engine room is located as close as practical to the main consumer Space for maintenance is left around the engine generator set Battery powered back up lights available Engine Generator Set Room Ventilation Yes No N/A Intake and exhaust opening properly sized and louvers installed Flexible duct section installed Radiator duct properly sized to louver Proper air flow direction past alternator and then the engine Engine room inlet air filter in place Weather/animal guard is fitted to intake and outlet Self Contained Engine Generator Set Ventilation Yes No N/A Engine generator set intake positioned away from obstruction to airflow Radiator discharge positioned away from prevailing winds Sufficient clearance around self contained engine generator set for airflow Air Inlet and Outlet Yes No N/A Air ducts are clean and clear Ducts are installed properly Weather protection guards are installed Silencers are installed properly Louvers open and close automatically Manual operation of louvers is possible Structure air flows are correct (no thermal short circuit) Unrestricted airflow over the engine Yes No N/A Cooling System Cooling system is free of leakages Pipelines and connections undamaged Radiator fan(s) are clear and clean Venting pipes have gradient toward expansion tank Overflow is free and spillage is avoided System is filled to proper level Filling cap is freely accessible Coolant preheater is functional Coolant type and concentration as specified in manual: 3B Prime 3E PPSE* ____________ Load bank None 3D Standby Rolls-Royce Group www.mtu-solutions.com Form B - Engine Generator Set Installation and Commissioning 3 Frame Mounted Radiator Yes No N/A Check belt tension and alignment Radiator clean and free from obstruction Radiator air outlet connected to outlet duct Check for possibility of hot air recirculation Engine generator set vent pipes routed upward toward radiator expansion tank Pipelines secure and undamaged Overflow clear and routed to avoid spillage Remote Mounted Cooling System Yes No N/A Pipelines cleaned and painted Device(s) aligned and fixed properly Pipelines fixed properly Expansion tank is of adequate size Pipelines isolated from generator set vibration Static head pressure is within system capability Auxiliary power supply is installed correctly Potential equalization is installed properly Fan rotational direction correct Overflow clear and routed to avoid spillage Engine generator set vent pipes routed upward toward radiator expansion tank Avoid air locks in pipelines air bleed valves provided All proper electrical connections made Heat Exchanger and Cooling Tower Yes No N/A Pipelines cleaned and painted Device(s) aligned and fixed properly Pipelines fixed properly Expansion tank is of adequate size Pipelines isolated from generator set vibration Vent valves installed Static head pressure is within system capability Secondary circuit pump direction is accurate Secondary circuit pump is functional Potential equalization is functioning properly Overflow lines are clear and routed to avoid spillage Engine generator set vent pipes routed upward toward expansion tank Air bleed valves installed Cooling tower make up supply is complete Auxiliary power supply to fans is correctly installed All proper electrical connections made Yes No N/A Yes No N/A Mounting/Foundation Engine generator set is installed on proper mounts Static deflection area of mounts not blocked by components Surface is level Support structure is adequate to support engine generator set weight Engine generator set is supported at each mounting location Lube Oil System Engine is filled with oil to proper level No oil leaks present Flexible lines installed in make up lube oil system Oil type as specified in manual (record type): Starting System Yes No N/A Battery and cables are free from damage Battery and cables installed, mounted, and wired properly Batteries filled up to appropriate level Idle charging voltage min. 27.6 VDC for 24 V system or 13.7 VDC for 12 V system Battery charger properly installed and wired Battery is located near starter with shortest cable run as possible Diesel Fuel System Yes No N/A Fuel system is free of leakages Flexible lines installed at engine Pipeline size adequate to system Pipelines and connections undamaged Flow and return lines connected correctly Fuel lines free of tension, scuffing, or kinks Potential equalization is installed properly Adequate room is left for fuel tank inspections Confirm proper rotation of auxiliary electric fuel lift pump Tank is not overfilled Tank is not in the vicinity of exhaust or other heat sources For electric fan driven fuel coolers: Fuel cooler plumbed and wired correctly Rolls-Royce Group www.mtu-solutions.com Form B - Engine Generator Set Installation and Commissioning 4 Diesel Fuel System (continued) Yes No N/A Fuel returns to fuel tank without restriction, proper sized pipe Fuel prefilter installed before engine inlet Electronic day tank pump used from main storage to day tank Day tank controls/pumps installed Fuel transfer pump connected to emergency power Level indicator used for checking tank contents Leak sensors are in place All proper control and sensor connections are made Spill containment procedure in place per code Diesel Fuel System (Main Storage Tank) Yes No N/A Isolating valves correctly positioned Transfer pump and controls operational Pipeline/tank heating system operational Fuel level monitoring system operational Check for leaks Day Tank Yes No N/A Tank is fixed properly and mounted to substructure Tank vent line is plumbed to safe area Tank filling line is of adequate size All unused fittings are plugged Mechanical fuel level indicator installed Electrical fuel level indicator installed and tested Fuel level switches installed and adjusted System pump(s) connected to emergency power Potential equalization is installed properly System pump(s) installed correctly (flow direction) Refill function checked Leakage sensor in place Adequate space available for inspections Isolating and solenoid valves checked Tank filled Check for leaks Fire valves present Gas Fuel System (Americas Only) Yes No N/A Dedicated gas supply line of proper size and material Check for gas filter/screen Check gas solenoid valve operation Check supply lines for leaks Check manual shut off valve operation Solenoid valves correctly positioned Regulator set to correct pressure Gas leak detection equipment operational Shut off devices operational Specified gas pressure is available at fuel inlet Exhaust System Yes No N/A Piping is installed and secured properly Flexible connectors installed at engine exhaust outlet Flexible connectors installed correctly Exhaust line condensate trap with drain installed Silencer is installed and secure Exhaust thimble installed per local codes Exhaust system below back pressure limit Exhaust piping diameter properly sized for length of run No diameter reductions downstream on exhaust pipes All exhaust system weight is properly supported Proper pipe wall thickness is maintained Exhaust lines are properly insulated Exhaust installed with a downward pitch to outlet Exhaust line protected from natural elements (rain cap installed) Exhaust gas prevented from re entry to building Hot parts safety decals/guards are present Fire Alarm/Suppression System Yes No N/A Fire alarm/suppression system present Engine Management System (Engine Governor) Yes No N/A Engine Control Unit box is free of damage Engine Control Unit box is securely mounted to engine Electrical connections securely fastened Grounding Yes No N/A Engine and generator are properly grounded Electrical and Control System Yes No N/A Remote wiring connected correctly Cables free of tension, scuffing, or kinks All connections clean and secure Bus bar phase sequence, voltage, and frequency checked Control cables routed in separate conduits from phase leads Engine generator set controls energized and functional Software version of engine generator set controller recorded All LEDs on panel illuminate when LED test is pressed Emergency stop control operational Test certificates available for all cables Utility service breaker capacity verified Small power and lighting circuits operational Rolls-Royce Group www.mtu-solutions.com Form B - Engine Generator Set Installation and Commissioning 5 Switchgear/Transfer Switch Yes No N/A Cables installed to correct torque specification Phase cables to switchgear/transfer switch are correctly sized and clearly identified Switchgear protection settings checked All other connections are clean and secure Generator Circuit Breaker Yes No N/A ON/OFF function Auxiliary contact Adjust over current protection Adjust the trip unit Phase rotation checked Preparation for Running Checks Follow appropriate lockout/tagout procedure Running Checks Yes No N/A Engine generator set engine control switch in the RUN position. Start engine and verify whether there is sufficient oil pressure Allow engine to run for five minutes Check coolant level, add as necessary, and reinstall cap Allow engine to run for at least 20 minutes and check engine operating temperature Check the battery charger for proper operation If the speed is unstable, adjust to specifications Adjust the AC output voltage to match the utility voltage using the voltage adjusting control Check for oil, coolant, and exhaust leaks/recirculation Check temperature on city water cooled models and adjust the thermostatic valve as necessary Engine generator set engine control switch in the OFF position Permission must be obtained from the building authority before transfer switch test is performed Test transfer switch Record the current phase for the three phase systems A B C Running Checks (continued) Yes No N/A Set the engine generator set exerciser with load to the customers required exercise period Verify that all options on the transfer switch are adjusted and functional to the customers requirements Record transfer switch delay settings: TDES (Time Delay to Engine Start) sec. TDNE (Time Delay Normal to Emergency) sec. TDN (Time Delay to Normal) min. TDEC (Time Delay Engine Cooldown) min. Mains Failure Test Number of start trials: Duration between mains failure and generator circuit breaker (GCB) closed (until emergency power source supplies load) sec. Yes No N/A Dyn. Frequency drift within limit of ISO 8528 5 Static voltage drift during operation within limit of ISO 8528 5 Static frequency drift during operation within limit of ISO 8528 5 Rolls-Royce Group www.mtu-solutions.com Form B - Engine Generator Set Installation and Commissioning 6 Running Checks (record on chart) Unless otherwise specified by local or state regulations, run the engine generator set at full expected system load in excess of 30% of the nameplate rating). Record data at 15 minute intervals. Shutdowns Yes No N/A Emergency stop (also external) Overfrequency/overspeed Underfrequency Overvoltage Undervoltage Oil pressure Lo Lo Engine temperature Hi Hi Check and verify any additional protective devices and list: Additional Comments/Notes: Rolls-Royce Group www.mtu-solutions.com Form B - Engine Generator Set Installation and Commissioning 7 Customer Acknowledgement (Literature and Instructions) Verify that the customer has the appropriate engine/engine generator set and transfer switch (if provided ). Instruct the customer in the operation and maintenance of the power system. I, ,received instructions on Please print name of person receiving instructions. Date Signature To be filled out by the commissioning technician only. Completed by (signature): Print Name: Company: Date: Note: Completion of this checklist does not relieve the installer of contract obligations. To be filled out by the customer/client. This signature acknowledges acceptance of unit and that all information on the start up is correct. The owner representative signature acknowledges review and understanding of this Form B Engine Generator Set Installation and Commissioning. Witnessed by (signature): Print Name: Company: Location: Date: Submitter Name:Eric Wilber (e.wilber.s505398@otiselevator.net) Date Sent on Device:Nov 21, 2023 10:59:20 AM PST Date Received on Server:Nov 22, 2023 5:11:43 AM PST Reference Number:20231122-18343803465 Location:101 Bayview Pl, Newport Beach, CA 92660, USA Nov 21, 2023 10:58:40 AM PST [ View Map ] FORM LANGUAGE / LANGUE DU FORMULAIRE Language Which Language would you like the form in / Dans quelle langue voulez-vous le formulaire? English GENERAL Section 1 CommonSection Region 109 - Western Region Subregion 193 - Western - Southwest GBO 430 - Anaheim - GBO Office Name SAN - Anaheim District - SAN Jobsite Name Clearwater Newport Beach Project #F7ND3822 Contract #F7N1Z275 Date Nov 21, 2023 Does the customer require you to fill out their paper Final Acceptance? No © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 1 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T QUESTIONS Ladies and/or Gentlemen: We have examined the Elevator furnished and completed by you in (building name or street address) 101 Bayview PLC. Building in the city of Newport Beach The elevator appears to be satisfactory and in accordance with your contract and we hereby accept it. Note: Elevator Cab (enclosure) and Hoistway Entrances have been thoroughly inspected and found satisfactory. KEY ACKNOWLEDGMENT The following keys, necessary for the proper operation of the above named elevator, have been turned over to me along with complete instructions on the operations of the elevator. Please list type/quantity of each key given to customer: Utb(2) light Ute(1) stop switch Utf(3) fire service Bgm30(2) cabinet key Number of Emergency Door Key(s) (Under Glass) 0 Number of Hoistway Unlocking Device(s)0 Elevator Pads No © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 2 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T Other Photos OtherPhotos_1.jpg SIGN OFF OTIS SERVICE EQUIPMENT Any counters, meters, tools, remote monitoring devices, or communication devices which we may use or install under this Contract remain our property, solely for the use of Otis employees. Such service equipment is not considered a part of the Units. You grant us the right to store or install such service equipment in your building and to electrically connect it to the Units. You will restrict access to the service equipment to authorized Otis personnel. You agree to keep the software resident in the service equipment in confidence as a trade secret for Otis. You will not permit others to use, access, examine, copy, disclose or disassemble the service equipment or the software resident in the service equipment for any purpose whatsoever. If the service is terminated for any reason, we will be given access to your premises to remove the equipment, including the resident software, at our expense. CUSTOMER - PLEASE NOTE THE FOLLOWING: The New Installation Service (N.I.S. #1234567 will begin immediately and will continue for 12 months. The warranty period will begin immediately and will continue for 12 © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 3 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T months. Should any problem develop in the operation of this elevator, please call Otis Elevator Company at 1-800-233-6847. (Operator will request the name and address of the building, and the elevator number--should there be more than one elevator in the building.) Customer Approval Signature Method Approval signature on iPad now Respectfully submitted, OTIS ELEVATOR COMPANY By: Eric Wilber Approved for Otis Elevator Company by: Date of Signature Nov 21, 2023 Name of Customer/Owner Matt Hefel Authorized representative of Customer/Owner Date of Signature Nov 21, 2023 Title Superintendent Customer's Email mhefel@weoneil.com Additional Email Addresses:diane.acosta@otis.com © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 4 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T Submitter Name:Eric Wilber (e.wilber.s505398@otiselevator.net) Date Sent on Device:Nov 21, 2023 10:59:46 AM PST Date Received on Server:Nov 22, 2023 5:11:36 AM PST Reference Number:20231122-18343803464 Location:101 Bayview Pl, Newport Beach, CA 92660, USA Nov 21, 2023 10:58:40 AM PST [ View Map ] FORM LANGUAGE / LANGUE DU FORMULAIRE Language Which Language would you like the form in / Dans quelle langue voulez-vous le formulaire? English GENERAL Section 1 CommonSection Region 109 - Western Region Subregion 193 - Western - Southwest GBO 430 - Anaheim - GBO Office Name SAN - Anaheim District - SAN Jobsite Name Clearwater Newport Beach Project #F7ND3822 Contract #F7N1Z276 Date Nov 21, 2023 Does the customer require you to fill out their paper Final Acceptance? No © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 1 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T QUESTIONS Ladies and/or Gentlemen: We have examined the Elevator furnished and completed by you in (building name or street address) 101 Bayview PLC. Building in the city of Newport Beach The elevator appears to be satisfactory and in accordance with your contract and we hereby accept it. Note: Elevator Cab (enclosure) and Hoistway Entrances have been thoroughly inspected and found satisfactory. KEY ACKNOWLEDGMENT The following keys, necessary for the proper operation of the above named elevator, have been turned over to me along with complete instructions on the operations of the elevator. Please list type/quantity of each key given to customer: Uta(2) fan and independent Utb(1) light switch Ute(1) stop switch Utf(3) fire service Number of Emergency Door Key(s) (Under Glass) 0 Number of Hoistway Unlocking Device(s)0 Elevator Pads No © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 2 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T Other Photos OtherPhotos_1.jpg SIGN OFF OTIS SERVICE EQUIPMENT Any counters, meters, tools, remote monitoring devices, or communication devices which we may use or install under this Contract remain our property, solely for the use of Otis employees. Such service equipment is not considered a part of the Units. You grant us the right to store or install such service equipment in your building and to electrically connect it to the Units. You will restrict access to the service equipment to authorized Otis personnel. You agree to keep the software resident in the service equipment in confidence as a trade secret for Otis. You will not permit others to use, access, examine, copy, disclose or disassemble the service equipment or the software resident in the service equipment for any purpose whatsoever. If the service is terminated for any reason, we will be given access to your premises to remove the equipment, including the resident software, at our expense. CUSTOMER - PLEASE NOTE THE FOLLOWING: The New Installation Service (N.I.S. #1234567 will begin immediately and will continue for 12 months. The warranty period will begin immediately and will continue for 12 © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 3 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T months. Should any problem develop in the operation of this elevator, please call Otis Elevator Company at 1-800-233-6847. (Operator will request the name and address of the building, and the elevator number--should there be more than one elevator in the building.) Customer Approval Signature Method Approval signature on iPad now Respectfully submitted, OTIS ELEVATOR COMPANY By: Eric Wilber Approved for Otis Elevator Company by: Date of Signature Nov 21, 2023 Name of Customer/Owner Matt Hefel Authorized representative of Customer/Owner Date of Signature Nov 21, 2023 Title Superintendent Customer's Email mhefel@weoneil.com Additional Email Addresses:diane.acosta@otis.com © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 4 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T Submitter Name:Eric Wilber (e.wilber.s505398@otiselevator.net) Date Sent on Device:Nov 21, 2023 11:00:32 AM PST Date Received on Server:Nov 22, 2023 5:11:39 AM PST Reference Number:20231122-18343803467 Location:101 Bayview Pl, Newport Beach, CA 92660, USA Nov 21, 2023 10:58:40 AM PST [ View Map ] FORM LANGUAGE / LANGUE DU FORMULAIRE Language Which Language would you like the form in / Dans quelle langue voulez-vous le formulaire? English GENERAL Section 1 CommonSection Region 109 - Western Region Subregion 193 - Western - Southwest GBO 430 - Anaheim - GBO Office Name SAN - Anaheim District - SAN Jobsite Name Clearwater Newport Beach Project #F7ND3822 Contract #F7N1Z277 Date Nov 21, 2023 Does the customer require you to fill out their paper Final Acceptance? No © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 1 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T QUESTIONS Ladies and/or Gentlemen: We have examined the Elevator furnished and completed by you in (building name or street address) 101 Bayview PLC. Building in the city of Newport Beach The elevator appears to be satisfactory and in accordance with your contract and we hereby accept it. Note: Elevator Cab (enclosure) and Hoistway Entrances have been thoroughly inspected and found satisfactory. KEY ACKNOWLEDGMENT The following keys, necessary for the proper operation of the above named elevator, have been turned over to me along with complete instructions on the operations of the elevator. Please list type/quantity of each key given to customer: Uta(2) fan and independent Utb(1)light Ute(1) stop switch Utf(3) fire service Number of Emergency Door Key(s) (Under Glass) 0 Number of Hoistway Unlocking Device(s)0 Elevator Pads No © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 2 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T Other Photos OtherPhotos_1.jpg SIGN OFF OTIS SERVICE EQUIPMENT Any counters, meters, tools, remote monitoring devices, or communication devices which we may use or install under this Contract remain our property, solely for the use of Otis employees. Such service equipment is not considered a part of the Units. You grant us the right to store or install such service equipment in your building and to electrically connect it to the Units. You will restrict access to the service equipment to authorized Otis personnel. You agree to keep the software resident in the service equipment in confidence as a trade secret for Otis. You will not permit others to use, access, examine, copy, disclose or disassemble the service equipment or the software resident in the service equipment for any purpose whatsoever. If the service is terminated for any reason, we will be given access to your premises to remove the equipment, including the resident software, at our expense. CUSTOMER - PLEASE NOTE THE FOLLOWING: The New Installation Service (N.I.S. #1234567 will begin immediately and will continue for 12 months. The warranty period will begin immediately and will continue for 12 © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 3 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T months. Should any problem develop in the operation of this elevator, please call Otis Elevator Company at 1-800-233-6847. (Operator will request the name and address of the building, and the elevator number--should there be more than one elevator in the building.) Customer Approval Signature Method Approval signature on iPad now Respectfully submitted, OTIS ELEVATOR COMPANY By: Eric Wilber Approved for Otis Elevator Company by: Date of Signature Nov 21, 2023 Name of Customer/Owner Matt Hefel Authorized representative of Customer/Owner Date of Signature Nov 21, 2023 Title Superintendent Customer's Email mhefel@weoneil.com Additional Email Addresses:diane.acosta@otis.com © OTIS ELEVATOR COMPANY, 2011 All Rights Reserved LiNX Form MNT-ADD (04/01/12) Contract #: DBCFContractNumber Page 4 of 4 EL E V A T O R F I N A L A C C E P T A N C E F O R M NE W E Q U I P M E N T