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3.8.2 Hurricane and Major Flood Areas. An off-site steam supply is an acceptable alternate to an on-
site boiler plant.
3.9 Central Oxygen Services
3.9.1 Earthquake Areas. Design, fabricate, and install bulk oxygen supply and storage facilities,
procured on a supply contract basis for the medical center, to resist seismic forces and prevent
dislocation and overturning of the liquid oxygen storage tank, standby reserve liquid oxygen tank, or
standby reserve liquid oxygen cylinders. Provide four days of liquid oxygen storage in the reserve tank
or cylinders. Design the outside oxygen supply line from the bulk storage facility to the hospital's central
oxygen system to minimize disruption from earthquakes and to facilitate repairs.
3.9.2 Hurricane and Major Flood Areas. No special requirements above that indicated in VA design
manuals.
4. EMERGENCY SITE ACCESS FACILITIES
4.1 Design. Base the design of these emergency facilities on the medical center continuing in operation
at full bed capacity or the ambulatory care building remaining in operation for a 4-day period
immediately following a disaster. Within that 4-day period, it is reasonably expected that unless an
epicenter was very near the site (which would cause relocation of patients and staff), any disrupted site
access facilities would be either repaired or alternate sources of supply and access facilities would be
established.
4.2 Ground Transportation
4.2.1 General. Preferably, provide public access to the VA premises by two or more off-site public
roads. Provide at least two separate on-site entrance roads to the VA facility above the 100-year flood
plain, preferably each connecting to a different off-site public access road. Design the on-site roads that
are essential for continuing the operation of the medical or ambulatory care center to minimize
obstructions from fallen trees, building debris, landslides and other dislocations caused by disasters.
4.2.2 Earthquake Areas. Design on-site bridges, overpasses, retaining walls, culverts, and other road
structures, which conduct essential traffic, to comply with local seismic code requirements.
4.2.3 Hurricane and Major Flood Areas. No special requirements above that required in VA design
manuals or indicated in paragraph 4.2.1.
4.3 Air Transportation. Provide a safe and reliable on-site space for ready access of emergency
helicopters on a parking area, road, or lawn. Provide an appropriate access for transporting patients
and supplies both ways between the helicopters and hospital or ambulatory care building.
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