MEDICAL GAS SPECIALIST MEDICAL GAS INSTALLER MEDICAL GAS .

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COURSE DATE: April 14-17, 2015COURSE LOCATION: EMGS, Inc.103 Hunter Ind. DriveVilla Rica, GA 30180DEADLINE TO REGISTER: April 1, 2015COURSE LANGUAGE: ENGLISHASSE 6005MEDICAL GAS SPECIALISTASSE 6010MEDICAL GAS INSTALLERASSE 6020MEDICAL GAS INSPECTORA 24 hour training course formedical gas systemengineers, designers, andpersonnel in need of generalmedical gas systeminformation.A 32 hour training course for medicalgas system installers which includesboth a written and a practical brazingtest. Brazing credentials are reissued on a six month time interval toinsure continuity of brazingexpertise.A 24 hour training course formedical gas systemInspectors who inspect andreview medical gas systeminstallations for bothgovernmental and privateagencies.Prerequisite: (4) years ofdocumented practical experience inthe installation of piping systems.Prerequisite: (2) years ofdocumented practicalexperience.Prerequisite: NoneCost: 650.00Cost: 750.00*Cost: 650.00COURSE OUTLINEI. DAY ONE (8 HOURS)A. NFPA 99C CODE INTRODUCTIONB. NFPA 99C CODE DEFINITIONSC. MANIFOLDSD. AIR COMPRESSORSII. DAY TWO (8 HOURS)A. PIPELINE DISTRIBUTIONB. MEDICAL GAS ALARM PANELSC. MEDICAL GAS SHUT-OFF VALVESD. VACUUM PUMPS AND LEVEL IIISYSTEMSIII. DAY THREE (8 HOURS)A. NFPA 99C 2005 EDITION CODEOVERVIEWB. NFPA 99C 2005 EDITION CODE QUIZ*Our course is approved in thefollowing states: Georgia,Tennessee, Michigan, Iowa, NorthCarolina, South Carolina, Kansasand New York. If you do work inanother state , we offer a nationalcertification from NITC for anadditional 50.00. You mustcomplete a separate NITCapplication EQUIPMENT REQUIRED FORASSE 6010 COURSE ONLY—Werecommend each person have: IV. DAY FOUR (8 HOURS)A. INSTALLATION / INSTALLERREQUIREMENTSB. WRITTEN TESTC. BRAZING COUPON TEST (ASSE 6010only—review supply list at right).Ten (10) 1-1/2” Mueller W 01063 coppercoupling fittings (standard type” L”plumbing fittings are acceptable and thefittings do not need to be cleaned foroxygen service). We highly recommendusing these ring-type couplingsrather than dimple-type. EMGS COURSES ARE TAUGHTBY A CREDENTIALED ASSE6050 INSTRUCTOR WITHOVER 20 YEARS OFEXPERIENCE IN THE MEDICALGAS INDUSTRY.Minimum 10’ of copper tubing type “L”size 1-1/2” (standard copper; does notneed to be cleaned and capped (The(10)’ of 1 ½” copper tubing can be cutinto (10) seven inch lengths and (10) fiveinch lengths for placement in our brazing jig. Please cut pipe with a tubingcutter. This will expedite your practiceand test brazing procedures. Fittingsand pipe need to have no oxidationpresent. (1) pound or 28 sticks of BCUP 5 Silverbrazing rods with a minimum of 15% silvercontent (substitute 2-15% is not acceptable).COURSE SYNOPSISThe majority of the course is taught in aclassroom setting and consists oflecture session segments, each ofwhich is accompanied by a courseworksheet. Day one, two & three arespent entirely in the classroom setting.Day four is split between some time inthe classroom and some time spent inthe shop area where each student isrequired to braze their own individualcoupons (ASSE 6010 only). The testcoupons consist of two sections of 11/2” pipe in a coupling in two separateassemblies to obtain two vertical upflowand two horizontal joints for a total of (4)brazed joints. A minimum test score of78% is required to pass the writtenexam, which consists of a 100 question,(NITC) closed book or (EMGS) open booktest. Upon successful completionof the course, a certificate, identificationcard, and brazing procedurequalification record are mailed to thestudent’s employer. A copy of the2005 edition of NFPA99C is includedin the cost of the course. Class willstart at 8:00 AM and last until 5:00 PMeach day. The class will be dismissedsomewhat earlier on the final (test) dayas some students may finish earlierthan others.

ASSE 6010 COURSE APPLICATIONCOURSE DATE: April 14-17, 2015TIME: 8:00 AMLOCATION: Villa Rica, GAREGISTRATION DEADLINE: April 1, 2015APPLICANT’S NAME:COMPANY:ADDRESS:CITY: STATE: ZIP:CONTACT PERSON:TELEPHONE NUMBER:FAX NUMBER:EMAIL ADDRESS:Paragraph 10-3.2.1 of the 2012 Edition of the ASSE 6010 Standard states “The candidates for the ASSE 6010certification shall have a minimum of four (4) years of documented experience in the field of installation of plumbing ormechanical piping systems.” This does not mean the experience has to be with medical gas systems. Please list thedocumented experience for the applicant below:Employer, City & Phone #FromToI do solemnly swear or affirm that the above statements are true.Signature of Applicant DateOptional: You can purchase a DVD of the brazing procedure for 20.00. We recommend that you practice the procedure prior toattending the course.Contact: Jennifer Darden, Training DirectorRespond by FAX:770-459-1812Respond by PHONE:770-459-5920Please include payment with your registration form. Checks can bemade payable to EMGS. We also accept Visa/MasterCard/Discover.Card Type:Amount:Name on Card:Card #:Respond by EMAIL:jdarden@emgsi.comRespond by MAIL:103 Hunter Industrial Dr.Villa Rica, GA 30180Expiration: Billing Zip:Cancellations will forfeit 50% of paid amount.

Application forMedical Gas Installer/Brazer Certification ExaminationI will be taking this exam at the instruction site upon completion of my course.I will be taking this exam at a PSI center. (Provide method of payment below.)I have a minimum of four (4) years of documented practical experience in the installation of piping systems.I will have completed the required 32-hour training course prior to my test date. (Course instruction must be conductedby a Medical Gas Systems Instructor certified to ASSE 6050. See ASSE Standard 6010, Section 10-3.2.3.) I have read the Candidate Information Bulletin for NITC Medical Gas Installer/Brazer Examination. I am requesting the examination to the NFPA 99-2005 Edition. I am requesting the examination to the NFPA 99-2012 Edition. First NameM.I.Street AddressCityLast NameSS# (Last Six)StateZipCell/Other PhoneEmail AddressHome PhoneWork PhoneTraining Course LocationTraining Course DateName of InstructorLocal Union # (If Applicable)List your present or most recent employer first. Attach any documentation you have that would prove that you have four (4)years experience in the installation of piping systems. Acceptable documentation: letters from employers, employment history,certification records, state license(s) and any other employment records. (Phone numbers are required for verification.)Employer, City & Phone #FromToI do solemnly swear or affirm that the above statements are true. I further realize that falsification of these statements shall be cause fordisqualification. By affixing my signature to this application I agree to abide by the following rules and regulations of certification holders as setforth by the NITC Certification Committee. As a holder of an NITC Certification I agree to not make any false claims about the scope of mycertification(s); I agree to not utilize an NITC certification in any manner that portrays NITC unfavorably; and furthermore, I agree to notengage in false or misleading advertising of my NITC Certification. I understand that NITC reserves the right to suspend or revoke mycertification should I violate these obligations. Should my certification be revoked, I agree to cease and desist any and all references to beingthe “holder” of an NITC Certification and shall return any certificates, including wallet sized photo identification cards to NITC.I agree to not utilize any written documents, reports, procedures, etc., with the NITC certification mark in any manner whatsoever that may beinaccurate or false.I understand and agree that my examination results may be shared with the course instructor, training coordinator or training entity.Signature of Applicant:Date:.Method of Payment(**Required Fields for credit card payments**)*Total Amount Enclosed: CheckMoney Order*Credit Card No:* CVV2:VisaMaster CardAMEX*Expiration Date:Last three or four digits on back of Visa and Master Card, Amex CVV2 on front of card.*Credit Card “Billing Address”:*Name on Card:*Credit Card “Billing Address” Zip Code:*Signature:As it appear on card (Please Print)Form # 720-20 Rev 09-23-13 (Medical Gas Installer Application).docSignature as shown on credit card1www.nationalitc.com

Information Sheet forMedical Gas Installer/Brazer Certification ExaminationTO QUALIFY FOR THIS EXAMINATION all candidates must meet the requirements of the ASSE Series6000, Professional Qualifications Standard for Medical Gas Systems Personnel, Standard 6010, Section10-3.2. Applicants should include the following:A Candidate Information Bulletin hasbeen developed to help ensure yoursuccess. Since the informationcontained in each section of the Bulletinwill answer many of the questions youmight have, it is required reading prior toproceeding with this application.Download a copy fromwww.nationalitc.com or call (877) 4576482 to request a copy.1. Successful completion of a minimum 32-hour trainingcourse conducted by an instructor certified to ASSE 6050and2. Successful completion of a written and a practicalexamination covering all facets of ASSE Standard 6010,NFPA 99, and NFPA 55 and3. A minimum of four years of documented practicalexperience in the installation of piping systems.THE EXAMINATION FEE is One Hundred Fourteen Dollars ( 114.00). This must be prepaid. Please makecheck or money order payable to NITC. Visa, Master Card or American Express are also accepted. Themethod of payment must be attached at the time of submission; or contact NITC to provide credit cardpayment information by phone at (877) 457-6482. For NITC No-Show, Reschedule, Cancellation andRefund Policy refer to the Candidate Bulletin.For re-testing, or those who cannot attend the examination with their instructor, the multiple-choiceexamination is available computer-based at PSI centers. To locate a PSI center near you visithttp://www.nationalitc.com/NITCService.cfm?GO NEWS&NEWSID 36.For Individuals requesting to take an examination at a PSI center there will be an additional twentyfive dollar ( 25.00) processing fee. These fees vary according to the length of time allowed for theexaminations. Please contact our office to confirm what the processing fee will be for yourexamination.Exams given at PSI centers require that an email address be provided. You will receive an e-mailconfirmation with your login information to schedule the exam date and time. For any examinationscheduled at a PSI center, cancellation and rescheduling must be made at least 48 hours prior to theassigned date and time or a rescheduling fee will be assessed.All electronic devices are prohibited. No PDAs, cellular telephones, or any other types of devices thatrecord or send data are allowed to be used during the examination.Keep this page for your records. Return Page 1 to NITC via fax (213) 351-7632, e-mail tocrystalg@nationalitc.com, or mail to the address shown below. For more information call (877)457-6482.Form # 720-20 Rev 09-23-13 (Medical Gas Installer Application).doc2www.nationalitc.com

Map to EMGS, Inc.103 Hunter Industrial Drive0 mi0.20.40.6Copyright 1988-2003 Microsoft Corp. and/or its suppliers. All rights reserved. http://www.microsoft.com/mappoint Copyright 2002 by Geographic Data Technology, Inc. All rights reserved. 2002 Navigation Technologies. All rights reserved. This data includes information taken with permission from Canadian authorities 1991-2002 Government of Canada (StatisticsCanada and/or Geomatics Canada), all rights reserved.0.8

Hotels in Villa Rica/Douglasville areaVILLA RICAComfort Inn132 Hwy. 61 ConnectorVilla Rica, GA, US, 30180(678) 941-34012.9 miles awayDays Inn(770) 459-8888195 Highway 61 ConnectorVilla Rica, GA 301802.83 miles awaySuper 8(770) 459-8000128 Highway 61 ConnectorVilla Rica, GA 301802.68 miles awayBest Western(770) 459-6669124 W Montgomery St.Villa Rica, GA 301802.8 miles awayAmerican Inn & Suites(770) 459-5793615 Edge Rd.Villa Rica, GA 301800.37 miles awayDOUGLASVILLEHoliday Inn Express770-949-57305479 Westmoreland PlazaDouglasville, GA 301348.48 miles awayHampton Inn6371 Douglas BoulevardDouglasville, GA 30135770-577-211010 miles awayEnvironmental & Medical Gas Services103 Hunter Industrial Dr. Villa Rica, GA 30180Website: www.emgsi.com

Successful completion of a written and a practical examination covering all facets of ASSE Standard 6010, NFPA 99, and NFPA 55 and . 3. A minimum of four years of documented practical experience in the installation of piping systems. THE EXAMINATION FEE is One Hundred Fourteen Dollars ( 114.00). This must be prepaid. Please make

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