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<br />t� WALL ASSEMBLY - THE 1 AND 2 HR FIRE RATED GYPSUM A STEEL PIPE - NOM 24 IN. DIAM (OR SMALLER) SCHEDULE 10 (OR HEAVIER) STEEL
<br />WALLBOARD/STUD WALL ASSEMBLY SHALL BE CONSTRUCTED OF THE PIPE.
<br />MATERIALS AND IN THE MANNER DESCRIBED IN THE INDIVIDUAL U300 OR C CONDUIT - NOM 6 IN. DIAM (OR SMALLER) STEEL CONDUIT OR NOM 4 IN DIAM (OR
<br />U400 SERIES WALL OR PARTITION DESIGNS IN THE URL FIRE RESISTANCE SMALLER) STEEL ELECTRICAL METALLIC TUBING
<br />UL SYSTEM NO. W-L-1001 DIRECTORY AND SHALL INCLUDE THE FOLLOWING CONSTRUCTION FILL VOID OR CAVITY MATERIAL - CAULK -MIN 5/8. 1-1/4,1-7/8 AND 2-1/2 IN.
<br />UL SYSTEM NO. C—AJ-1044 FOR BLOCK WALLS FEATURES: © THICKNESS OF CAULK FOR 1 AND 2 HR RATED ASSEMBLIES, RESPECTIVELY, APPLIED
<br />A STUDS - WALL FRAMING MAY CONSIST OF EITHER WOOD STUDS WITHIN ANNULUS, FLUSH WITH BOTH SURFACES OF WALL. MIN 1 /4 IN. DIAM BEAD OF
<br />(MAX 2 H FIRE RATED ASSEMBLIES) OR STEEL CHANNEL STUDS. CAULK APPLIED TO GYPSUM BOARD/PENETRANT INTERFACE AT POINT CONTACT
<br />(FORMERLY SYSTEM NO. 147) WOOD STUDS TO CONSIST OF NOM 2 BY 4 IN. LUMBER SPACED LOCATION ON BOTH SIDES OF WALL THE HOURLY F RATING OF THE FIRE STOP
<br />F RATINGS-1 AND 2 HR (SEE ITEMS 2 AND 3) 16 IN. OCD WITH NOM 2 BY 4 IN. LUMBER END PLATES AND SYSTEM IS DEPENDENT UPON THE HOURLY FIRE RATING OF THE WALL ASSEMBLY IN
<br />T RATINGS-0, 1 AND 2 HR (SEE ITEM 3) CROSS BRACES. STEEL STUDS TO BE MIN 3-5/8 IN. WIDE BY WHICH IT IS INSTALLED, AS SHOWN IN THE FOLLOWING TABLE. THE HOURLY T RATING
<br />L RATING AT AMBIENT -LESS THAN 1 CFM/SQ FT 1-3/8 IN. DEEP CHANNELS SPACED MAX 24 IN. OCD. OF THE FIRE STOP SYSTEM IS DEPENDENT UPON THE TYPE OR SIZE OF THE PIPE
<br />L RATING AT 400 F-LESS THAN 1 CFM/SQ FT B GYPSUM BOARD - NOM 1/2 OR 5/8 IN. THICK, 4 FT. WIDE WITH OR CONDUIT AND THE HOURLY FIRE RATING OF THE WALL ASSEMBLY IN WHICH IT IS
<br />INSTALLED, AS TABULATED BELOW:
<br />3 SQUARE OR TAPERED EDGES. THE GYPSUM WALLBOARD TYPE, MAX PIPE OR F RATING T RATING
<br />to
<br />/� /—O THICKNESS, NUMBER OF LAYERS, FASTENER TYPE AND SHEET CONDUIT DUMETER HR HR
<br />PROVIDE SEALANT ORIENTATION SHALL BE AS SPECIFIED IN THE INDIVIDUAL U300 OR 1 1 OR 2 0, 1 OR 2
<br />AND PENETRATION U400 SERIES DESIGN IN THE URL FIRE RESISTANCE DIRECTORY. MAX 4 1 OR 2 0
<br />PER URL DIAMETER OF OPENING IS 26 IN.
<br />APPROVED
<br />ASSEMBLY FOR Q
<br />THROUGH -PENETRANT - ONE METALLIC PIPE, CONDUIT OR
<br />WALL
<br />TUBING INSTALLED EITHER CONCENTRICALLY OR ECCENTRICALLY
<br />PENETRATIONS OF
<br />WITHIN THE FIRE STOP SYSTEM. THE ANNULAR SPACE BETWEEN
<br />FIRE RATED
<br />PIPE, CONDUIT OR TUBING AND PERIPHERY OF OPENING SHALL
<br />ASSEMBLIES
<br />BE MIN OF 0 IN. (POINT CONTACT) TO MAX 2 IN. PIPE, CONDUIT
<br />OR TUBING TO BE RIGIDLY SUPPORTED ON BOTH SIDES OF WALL
<br />ASSEMBLY. THE FOLLOWING TYPES AND SIZES OF METALLIC PIPES,
<br />CONDUITS OR TUBING MAY BE USED:
<br />THE CONTRACTOR SHALL SUBMIT THE ACTUAL URL DETAIL WITH THE PERM
<br />DRAWINGS
<br />THE URL DETAIL HAS BEEN MODIFIED FOR ELECTRICAL 1 AND 2 HOURS.
<br />PLUMBING PIPING AND 3 AND 4 HR REFERENCES ARE NOT SHOWN. THE
<br />DETAIL ALSO APPLIES FOR SPECIFIC 2 HOUR AND 4 HOUR LOCATIONS
<br />a CONDUIT FIRE STOP PENETRATION
<br />earn FOR 1 HR STUD WALL
<br />KS
<br />URL SYSTEM NO. W-L-3145 0
<br />CABLES - AGGREGATE CROSS -SECTIONAL AREA OF CABLES IN SPLIT SLEEVE TO BE MIN 8 PERCENT TO MAX
<br />F RATING -- 1 AND 2 HR ITEM SEE 1
<br />( )
<br />48 PERCENT OF THE AGGREGATE CROSS -SECTIONAL AREA OF THE SPLIT SLEEVE. CABLES TO BE RIGIDLY
<br />SUPPORTED ON BOTH SIDES OF WALL ASSEMBLY. ANY COMBINATION OF THE FOLLOWING TYPES AND SIZES
<br />PROVIDE SEALANT AND T RATING -- 1 /4 AND 1 /2 HR (SEE ITEM 1)
<br />OF CABLES MAY BE USED:
<br />CONDUIT FILL PER URL 3 1 A
<br />A MAX 200 PAIR NO. 24 AWG (OR SMALLER) COPPER CONDUCTOR CABLE WITH POLYVINYL CHLORIDE (PVC)
<br />APPROVED ASSEMBLY PROVIDE SEALANT AND
<br />JACKETING AND INSULATION.
<br />PENETRATION PER URL
<br />FOR BUNDLED CABLES THRU APPROVED ASSEMBLY
<br />B MAX 1/C, 750 KCMIL POWER CABLE WITH COPPER CONDUCTORS AND CROSS -LINKED POLYETHYLENE
<br />FIRE RATED ASSEMBLIES
<br />(XLPE) JACKETING.
<br />FOR WALL PENETRATIONS
<br />C MAX 3/C NO. 2/0 AWG (OR SMALLER) ALUMINUM OR COPPER CONDUCTOR SERVICE ENTRANCE CABLE
<br />OF FIRE RATED ASSEMBLIES
<br />WITH PVC INSULATION AND JACKET.
<br />D MAX 3/C NO. 8 AWG (OR SMALLER) NONMETALLIC SHEATHED (ROMEX) CABLE WITH COPPER CONDUCTORS,
<br />PVC INSULATION AND JACKET.
<br />CONDUIT STUB
<br />E MAX 7/C NO. 12 AWG (OR SMALLER) MULTICONDUCTOR POWER AND CONTROL CABLES WITH XLPE OR PVC
<br />INSULATION AND XLPE OR PVC JACKET.
<br />F MAX RG59/U (OR SMALLER) COAXIAL CABLE WITH FLUORINATED ETHYLENE INSULATION AND JACKETING.
<br />G MAX 62.5/48 FIBER OPTIC CABLE WITH PVC INSULATION AND JACKETING.
<br />CABLE SYSTEMS PROVIDE SEALANT AND
<br />2 CONDUIT FILL PER URL
<br />H MAX 4 PAIR NO. 24 AWG (OR SMALLER) COPPER CONDUCTOR CATEGORY 5 WITH HYLAR INSULATION AND
<br />�B APPROVED ASSEMBLY
<br />JACKET.
<br />FOR BUNDLED CABLES THRU
<br />ARE STOP SYSTEM -THE FIRE STOP SYSTEM SHALL CONSIST OF THE FOLLOWING:
<br />oil FIRE RATED ASSEMBLIES
<br />A FIRE STOP DEVICE -THREADED STEEL SLEEVE HALVES INCORPORATING SPLIT NUTS AND SPLIT WASHERS
<br />SIZED TO FIT THE SPECIFIC DIAM OF THE OPENING. DEVICE SHALL BE INSTALLED AROUND CABLES IN
<br />Q WALL ASSEMBLY -THE 1 OR 2 HR FIRE -RATED GYPSUM BOARD/STUD WALL ASSEMBLY SHALL BE CONSTRUCTED
<br />ACCORDANCE WITH THE ACCOMPANYING INSTALLATION INSTRUCTIONS. DEVICE PROVIDED IN NOM 1, 2 AND 4
<br />OF THE MATERIALS AND IN THE MANNER DESCRIBED IN THE INDIVIDUAL U300, U400 OR V400 SERIES WALL AND
<br />IN. (25, 51 AND 102 MM) SIZES. MAX DIAM OF OPENING IN WALL FOR 1, 2 AND 4 IN. (25, 51 AND 102
<br />PARTITION DESIGNS IN THE URL FIRE RESISTANCE DIRECTORY AND SHALL INCLUDE THE FOLLOWING CONSTRUCTION
<br />MM) SIZE DEVICES ARE 1-1/4, 2-7/16 AND 4-1/2 IN. (32, 62 AND 114 MM) RESPECTIVELY.
<br />FEATURES:
<br />B FILL, VOID OR CAVITY MATERIAL - PUTTY - MIN 1 IN. THICKNESS OF FILL MATERIAL APPLIED WITHIN THE
<br />A STUDS - WALL FRAMING SHALL CONSIST OF EITHER WOOD STUDS OR STEEL CHANNEL STUDS. WOOD STUDS TO
<br />CONDUIT FLUSH WITH BOTH ENDS.
<br />CONSIST OF NOM 2 BY 4 IN. (51 BY 102 MM) LUMBER SPACED 16 IN. (406 MM) OCD. STEEL STUDS TO BE
<br />REFER TO URL BOOK FOR PROPER PENETRATION ASSEMBLY SUBMIT URL DETAIL TO WIRING INSPECTOR WITH
<br />MIN 3-5/8 IN. (92 MM) WIDE AND SPACED 24 IN. (610 MM) OCD.
<br />PERMIT APPLICATION
<br />B GYPSUM BOARD - 5/8 IN. (16 MM) THICK, 4 FT (1219 MM) WIDE WITH SQUARE OR TAPERED EDGES. THE
<br />GYPSUM BOARD TYPE, THICKNESS, NUMBER OF LAYERS, FASTENER TYPE AND SHEET ORIENTATION SHALL BE
<br />AS SPECIFIED IN THE INDIVIDUAL U300, U400 OR V400 SERIES DESIGNS IN THE URL FIRE RESISTANCE
<br />DIRECTORY. THE HOURLY F RATING OF THE FIRE STOP SYSTEM IS EQUAL TO THE HOURLY FIRE RATING OF THE
<br />WALL ASSEMBLY IN WHICH IT IS INSTALLED.
<br />CABLE CONDUIT SLEEVE THROUGH PENETRATION
<br />Earn FIRE STOP SYSTEM FOR 1 HR RATED AND SMOKE TIGHT STUD WALLS
<br />NTS
<br />F RATING - 1 AND 2HR (SEE ITEM 1)
<br />TRATING -OHR
<br />SYSTEM No. W-L-3065
<br />A
<br />1U WALL ASSEMBLY - THE 1 AND 2 HR FIRE RATED GYPSUM WALLBOARD/STUD WALL ASSEMBLY SHALL BE CONSTRUCTED OF THE
<br />MATERIALS AND IN THE MANNER SPECIFIED IN THE INDIVIDUAL U300, U400 OR V600 SERIES WALL AND PARTITION DESIGNS IN THE
<br />URL FIRE RESISTANCE DIRECTORY AND SHALL INCLUDE THE FOLLOWING CONSTRUCTION FEATURES:
<br />A STUDS - WALL FRAMING MAY CONSIST OF EITHER WOOD STUDS OR STEEL CHANNEL STUDS. WOOD STUDS TO CONSIST OF NOM
<br />2 BY 4 IN. LUMBER SPACED 16 IN. OCD. STEEL STUDS TO BE MIN 2-1/2. WIDE AND SPACED MAX 24" OCD.
<br />B GYPSUM BOARD - NOM 5/8 IN. THICK GYPSUM BOARD, WITH SQUARE OR TAPERED EDGES. THE GYPSUM BOARD TYPE,
<br />THICKNESS, NUMBER OF LAYERS, FASTENER TYPE AND SHEET ORIENTATION SHALL BE AS SPECIFIED IN THE INDIVIDUAL U300,
<br />U400 OR V600 SERIES DESIGN IN THE URL FIRE RESISTANCE DIRECTORY. MAX DIAMETER OF OPENING IS 5-1/2 IN. WHEN
<br />SLEEVE (ITEM 2) IS EMPLOYED. MAX DIAMETER OF OPENING IS 4 IN. WHEN SLEEVE (ITEM 2) IS NOT EMPLOYED.
<br />THE F RATING OF THE FIRE STOP SYSTEM IS EQUAL TO THE FIRE RATING OF THE WALL ASSEMBLY.
<br />FOR BLOCK WALLS
<br />R
<br />O FLOOR OR WALL ASSEMBLY - LIGHTWEIGHT OR NORMAL WEIGHT (100-150 PCF OR 1600-2400 KG/M3)
<br />CONCRETE. EXCEPT AS NOTED IN TABLE UNDER ITEM 4, MIN THICKNESS OF SOLID CONCRETE WALL
<br />ASSEMBLY IS 4-1/2 IN. (114 MM). WALL ASSEMBLY MAY ALSO BE CONSTRUCTED OF ANY UL CLASSIFIED
<br />CONCRETE BLOCKS
<br />O3 PACKING MATERIAL - POLYETHYLENE BACKER ROD OR NOM 1 IN. (25 MM) THICKNESS OF TIGHTLY - PACKED
<br />MINERAL WOOL BATT OR GLASS FIBER INSULATION FIRMLY PACKED INTO OPENING AS A PERMANENT FORM.
<br />PACKING MATERIAL TO BE RECESSED FROM BOTH SURFACES OF WALL AS REQUIRED TO ACCOMMODATE THE
<br />REQUIRED THICKNESS OF CAULK FILL MATERIAL (ITEM 4)
<br />3A FORMING MATERIAL - AS AN ALTERNATE TO THE PACKING MATERIAL IN ITEM 3, NOM 4 IN. (102 MM) WIDE
<br />STRIPS OF MIN 1/2 IN (13 MM) THICK COMPRESSIBLE MAT TO BE STACKED TO A THICKNESS GREATER THAN
<br />THE WIDTH OF THE ANNULAR SPACE AND COMPRESSION FITTED, EDGE -FIRST, TO FILL THE ANNULAR SPACE
<br />TO A MIN 4 IN. (102 MM) DEPTH. AS AN OPTION, THE STRIPS OF MIN 1/2 IN. (13 MM) THICK
<br />COMPRESSIBLE MAT MAY BE FOLDED IN HALF, LENGTHWISE, AND STACKED TO A THICKNESS GREATER THAN
<br />THE WIDTH OF THE ANNULAR SPACE AND COMPRESSION FITTED EDGE -FIRST TO FILL THE ANNULAR SPACE TO
<br />A MIN 2 IN. (51 MM) DEPTH. TOP OF FORMING MATERIAL TO BE RECESSED FROM TOP SURFACE OF FLOOR
<br />OR FROM BOTH SURFACES OF WALL AS NECESSARY TO ACCOMMODATE THE REQUIRED THICKNESS OF CAULK
<br />FILL MATERIAL
<br />® FILL, VOID OR CAVITY MATERIAL - CAULK, SEALANT- IN WALL ASSEMBLIES, REQUIRED CAULK THICKNESS TO
<br />BE INSTALLED SYMMETRICALLY ON BOTH SIDES OF WALL, FLUSH WITH WALL SURFACE. AT POINT CONTACT
<br />LOCATION BETWEEN PENETRANT AND SLEEVE OR BETWEEN PENETRANT AND CONCRETE, A MIN 1 /4 IN. (6
<br />MM) DIAM BEAD OF CAULK SHALL BE APPLIED AT TOP SURFACE OF FLOOR AND AT BOTH SURFACES OF
<br />WALL THE HOURLY F RATINGS AND THE MIN REQUIRED CAULK THICKNESSES ARE DEPENDENT UPON A
<br />NUMBER OF PARAMETERS, AS SHOWN IN THE FOLLOWING TABLE:
<br />1A STEEL SLEEVE- NOM 16 IN. (406 MM) DIAM (OR SMALLER) SCHEDULE 10 (OR HEAVIER) STEEL SLEEVE CAST
<br />OR GROUTED INTO WALL ASSEMBLY. SLEEVE MAY EXTEND A MAX OF 2 IN. (51 MM) BEYOND EITHER
<br />SURFACE OF WALL AS AN ALTERNATE, NOM 16 IN. (406 MM)DIAM (OR SMALLER) MIN 0.028 (0.71 MM)
<br />THICK GALVANIZED SHEET STEEL SLEEVE CAST OR GROUTED INTO WALL ASSEMBLY FLUSH WITH WALL
<br />SURFACES.
<br />O THROUGH PENETRANTS - ONE METALLIC PIPE, CONDUIT OF TUBING TO BE INSTALLED EITHER
<br />CONCENTRICALLY OR ECCENTRICALLY WITHIN THE FIRESTOP SYSTEM. MAX ANNULAR SPACE BETWEEN PIPE,
<br />CONDUIT OR TUBING AND EDGE OF THROUGH OPENING OR SLEEVE IS DEPENDENT ON THE PARAMETERS
<br />SHOWN IN ITEM 4. MIN ANNULAR SPACE BETWEEN PIPE OR CONDUIT AND EDGE OF THROUGH OPENING IS 0
<br />IN. (POINT CONTACT). MAX ANNULAR SPACE TO BE AS SHOWN IN THE TABLE IN ITEM 4. PIPE, CONDUIT OR
<br />TUBING TO BE RIGIDLY SUPPORTED ON BOTH SIDES OF WALL ASSEMBLY. THE FOLLOWING TYPES AND SIZES
<br />OF METALLIC PIPES, CONDUITS OR TUBING MAY BE USED:
<br />A STEEL PIPE - NOM 30 IN. (762 MM) DIAM (OR SMALLER) SCHEDULE 10 (OR HEAVIER) STEEL PIPE.
<br />B CONDUIT - NOM 6 IN. (152 MM) DIAM (OR SMALLER) RIGID STEEL CONDUIT TUBING.
<br />C CONDUIT - NOM 4 IN. (102 MM) DIAM (OR SMALLER) STEEL ELECTRICAL METALLIC TUBING.
<br />2O METALLIC SLEEVE (OPTIONAL) - NOM 4 IN. DIAMETER (OR SMALLER) STEEL ELECTRICAL METALLIC TUBING (EMT) OR SCHEDULE 5 (OR
<br />HEAVIER) STEEL PIPE OR MIN 0.016 IN. THICK (28 GAL) GALV STEEL SLEEVE INSTALLED FLUSH WITH WALL SURFACES. THE ANNULAR
<br />SPACE BETWEEN STEEL SLEEVE AND PERIPHERY OF OPENING SHALL BE MIN 0 IN. (POINT CONTACT) TO MAX 1 IN. WHEN SCHEDULE
<br />5 STEEL PIPE OR EMT IS USED, SLEEVE MAY EXTEND UP TO 8 IN. BEYOND THE WALL SURFACES.
<br />O3 CABLES - AGGREGATE CROSS -SECTIONAL AREA OF CABLE IN OPENING TO BE MAX 45 PERCENT OF THE CROSS -SECTIONAL AREA
<br />OF THE OPENING. THE ANNULAR SPACE BETWEEN THE CABLE BUNDLE AND THE PERIPHERY OF THE OPENING TO BE MIN 0 IN. TO
<br />MAX 1 IN. CABLES TO BE RIGIDLY SUPPORTED ON BOTH SIDES OF THE WALL ASSEMBLE. ANY COMBINATION OF THE FOLLOWING
<br />TYPES OF SIZES OF COPPER CONDUCTOR CABLES MAY BE USED:
<br />A MAX 7/C No. 12 AWG WITH POLYVINYL CHLORIDE (PVC) INSULATION AND JACKET.
<br />B MAX 25 PAIR No. 24 AWG TELEPHONE CABLE WITH PVC INSULATION AND JACKET
<br />C TYPE RG/U COAXIAL CABLE WITH POLYETHYLENE (PE) INSULATION AND PVC JACKET HAVING A MAX OUTSIDE DIAMETER OF 1/2 IN.
<br />D MULTIPLE FIBER OPTICAL COMMUNICATION CABLE JACKETED WITH PVC AND HAVING A MAX OD OF 5/8 IN.
<br />E THROUGH PENETRATING PRODUCTS* - MAX THREE COPPER CONDUCTOR No. 8 AWG. METAL -CLAD CABLE.
<br />AFC CABLE SYSTEMS INC
<br />F MAX 3/C (WITH GROUND) (OR SMALLER) No. 8 AWG COPPER CONDUCTOR CABLE WITH PVC INSULATION AND JACKETING.
<br />® FILL, VOID OR CAVITY MATERIAL*- SEALANT - FILL MATERIAL APPLIED WITHIN THE ANNULUS, FLUSH WITH EACH END OF THE STEEL
<br />SLEEVE OR WALL SURFACE. FILL MATERIAL INSTALLED SYMMETRICALLY ON BOTH SIDES OF THE WALL A MIN 5/8 IN. THICKNESS OF
<br />SEALANT IS REQUIRED FOR THE 1 OR 2 HR F RATING. AND ADDITIONAL 1/2 IN. DIAMETER BEAD OF FILL MATERIAL SHALL BE
<br />APPLIED AROUND THE PERIMETER OF SLEEVE ON BOTH SIDES OF THE WALL WHEN SLEEVE EXTENDS BEYOND SURFACE OF WALL
<br />HILT] CONSTRUCTION CHEMICALS, DIV OF HILT] INC - CP601 S, CP606 OR FS-ONE SEALANT.
<br />* BEARING THE URL CLASSIFICATION MARK
<br />BUNDLED CABLES FIRE STOP
<br />Earn PENETRATION FOR STUD WALLS
<br />NTS
<br />4-1/2 (114) 1/2-6 (13-152) 1-3/8 (35) 1/4 (6) (a) 2
<br />MIN WALL NOM PIPE TUBE MAX ANNULAR MIN CAULK F
<br />THICKNESS IN OR CONDUIT DIAM IN SPACE IN THKNS IN RATING HR
<br />2-1/2 (64) 1/2-12 (13-305) 1-3/8 (35) 1/2 (13) 2
<br />2-1/2 (64) 1/2-12 (13-305) 3-1/4 (83) 1 (25) 2
<br />(a) MIN 2 IN (51 MM) THICKNESS OF MINERAL WOOL BATT INSULATION OR FORMING MATERIAL (ITEM 3A)
<br />REQUIRED ANNULAR SPACE.
<br />(b) MIN 1 IN (25 MM) THICKNESS OF MINERAL WOOL BATT INSULATION REQUIRED IN ANNULAR SPACE ON
<br />BOTH SIDES OF WALL ASSEMBLY. MIN 1 IN. (25 MM) THICKNESS OF CAULK TO BE INSTALLED FLUSH WITH
<br />EACH SURFACE OF WALL ASSEMBLY.
<br />rA" CONDUIT FIRESTOP PENETRATION
<br />'\E=FOR 1 HR AND 2HR BLOCK WALLS
<br />NTS
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<br />NEW CABLES AND CONDUITS
<br />EXISTING CEILING
<br />4' MINIMUM
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<br />Ems, BARRIER ELEVATION
<br />NTS
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<br />0
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<br />PROVIDE SIGNAGE "AUTHORIZED-J
<br />PERSONNEL PASSAGE AREA ONLY"
<br />(TYPICAL BOTH SIDES)
<br />eTEMPORARY
<br />�°' BARRIER PLAN VIEW
<br />Ms
<br />ALL PENETRATIONS SHALL BE 2 HOUR RATED
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<br />REV 1& GENERAL REV. 02/13/18
<br />AHCA STAGE III MAIL —IN
<br />REVIEW 12/26/17
<br />DATE 12/26/17
<br />DRAWN LF/BMA
<br />CHKD BY BOB DONNELLY
<br />E301
<br />
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