DRAFT

Ministry of Public Health

and Social HOSPITAL MAINTENANCE DEUTSCHE GESELLSCHAFT FÜR TECHNISCHE
Assistance ZUSAMMENARBEIT

MANUAL FOR

MULTI-PURPOSE STAFF

SAN SALVADOR, OCTOBER 1998

 MANUAL FOR MULTIPURPOSE PERSONNEL

1 INTRODUCTION.....................................................................................................1

2 ELECTRICITY ........................................................................................................3
2.1 Importance of electricity.
2.2 Basic components of a home network.
2.3 Wire and device joints.
2.4 Safety in working with electricity.
2.5 Installation of a spotlight or fluorescent lamp.
2.6 Frequent failures in fluorescent lamps
2.7 Installation of a male outlet.
2.8 Installation of a female outlet.
2.9 Preventive maintenance

3 PLUMBING .........................................................................................................28
3.1 Importance of plumbing.
3.2 Principles of plumbing.
3.3 Installation of a washbasin.
3.4 Installation and repair of a Siphon.
3.5 Procedure to change the gasket on a faucet.
3.6 Installation of a Toilet.
3.7 Preventive maintenance.
3.8 Frequent failures in hydraulic systems.
3.9 Necessary tools.

INTRODUCTION........................................................................................................................1
2. ELECTRICITY.....................................................................................................................2
2.2.2) COUNTER.................................................................................................................4
2.2.3) THERMAL BOX.......................................................................................................4
What is the short circuit?..........................................................................................................4
Fuses, Thermal, Integrating Safety...........................................................................................4
2.2.4) OUTLET BOXES......................................................................................................5
2.2.5) FEMALE SOCKET...................................................................................................6
2.2.6) SWITCH....................................................................................................................7
2.2.7) LIGHTING SYSTEM................................................................................................8
• Incandescent lamps...........................................................................................................8
 • Fluorescent lamps..............................................................................................................8
2.2.8) ELECTRICAL CONDUITS......................................................................................8
2.3.1) HOW TO REMOVE CONDUCTOR INSULATION.............................................11
2.3.2) HOW TO CONNECT THE CONDUCTOR TO THE SOCKETS AND
RECEPTACLES.....................................................................................................................11
2.3.4) WIRE JOINTS.........................................................................................................12
2.3.5) JOINT ISOLATION....................................................................................................13
D) Do not touch the conductors directly with your hands................................................16
E) BEFORE WORKING ON AN ELECTRICAL APPLIANCE...................................16
Monthly..................................................................................................................................22
Quarterly.................................................................................................................................22
Annually.................................................................................................................................22
Quarterly.................................................................................................................................22
Semiannually..........................................................................................................................22
Quarterly.................................................................................................................................23
Semiannually..........................................................................................................................23
Monthly..................................................................................................................................23
Quarterly.................................................................................................................................23
3. PLUMBING........................................................................................................................25
3.1) IMPORTANCE OF PLUMBING...............................................................................25
3.2) PLUMBING PRINCIPLES.........................................................................................25
3.2.1) THE TAP.....................................................................................................................25
16.2.2) CONTROL VALVES..........................................................................................28
Valve selection.......................................................................................................................28
16.2.3) THE SIPHON.......................................................................................................30
16.2.4) PIPE JOINTING..................................................................................................31
16.2.5) THE TOILET.......................................................................................................36
3.4) INSTALLATION AND REPAIR OF A SIPHON......................................................40
3.5) PROCEDURE FOR CHANGING THE GASKET ON A FAUCET.........................41
WARNING: WHAT NOT TO DO........................................................................................43
Monthly..................................................................................................................................48
Quarterly.................................................................................................................................48
 Quarterly.................................................................................................................................49
4.1.1) Installation...............................................................................................................56
4.1.2) Repair of a lock........................................................................................................59
4.3) PREVENTIVE MAINTENANCE..............................................................................61
Quarterly.................................................................................................................................61
Annually.................................................................................................................................61
Quarterly.................................................................................................................................61
Semiannually..........................................................................................................................61
ANNEX 3: MPP ROUTINES FOR MULTI-PURPOSE TECHNICIANS...............................66
 INTRODUCTION

This manual has been prepared to serve as a guide for the POLIVALENT
TECHNICIAN courses that the MSPAS/GTZ Hospital Maintenance Project, in
conjunction with the General Maintenance Department, has been developing in
different establishments of this Ministry to provide basic training in Electricity,
Plumbing and Locksmithing to certain members of the existing personnel who are
interested and willing to also assume responsibilities for Minor Maintenance in the
facilities of the establishments to which they belong.The courses are aimed at providing
basic training in Electricity, Plumbing and Locksmithing to certain members of the
existing personnel who are interested and willing to assume minor maintenance
responsibilities in the facilities of the establishments to which they are assigned.

The manual describes the basic procedures and techniques for the maintenance of the main
electrical and plumbing installations found in health facilities, and of some elements such as
doors, windows, etc. of the infrastructure so that the multipurpose technician can use them as a
reference guide in the development of his maintenance activities.

For each installation or element, the main components, their construction or assembly
techniques and the repair of the most frequent failures are described, as well as the minimum
steps to be performed periodically in the preventive maintenance of the installation's
components.

For this idea to be most successful, the training of a person as a multi-purpose technician must
go beyond the mere fact of training him or her in the framework of a course. Thus, if we seek
to implement the concept of polyvalence in the maintenance of a facility's infrastructure, we
must ensure that several preconditions are met in a timely manner, including, among others,
the following:

A) The selection of personnel to be trained should have as basic criteria:

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 1. The candidate's interest and willingness
2. Can read and write

B) Ensure that the immediate boss of the person to be trained is informed of the new
responsibilities they will acquire as multi-purpose technicians.

C) To ensure the indispensable means that facilitate the polyvalent the execution of his work:
1. Minimum set of tools.
2. Maintenance of a minimum stock of the most commonly used spare parts and supplies
such as fluorescent tubes, bulbs, gaskets, Teflon tape, etc.

D) To carry out the priority repairs that the infrastructure of the establishment needs, so that in
this way, the maintenance tasks that are demanded to the polyvalent, are within its reach to
be able to perform them.

E) The Director or person in charge of the establishment should periodically supervise,

together with the multipurpose technician, the state of the different installations, and should
take the necessary measures if the repairs or maintenance required cannot be carried out by
him.

Fulfillment of the above premises will mean that the people in charge of the management or
direction of the institutions will assume a new challenge with a true attitude of commitment, in
which case the success of this initiative will be taken for granted.

2. ELECTRICITY
2.1) IMPORTANCE OF ELECTRICITY

The importance of electricity is reflected in all technological advances, such as

computers, motors, medical equipment, factory machines, etc. In fact, there is almost no
aspect in which electricity does not play a role; its applications are so varied and
extensive that most modern activities involve electricity in one way or another.

Electricity is powerful. Under control, electricity safely performs an infinite variety of

jobs; but uncontrolled, it can be destructive; it can be controlled if the types of wiring

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and equipment are properly installed. It can be hazardous if the wrong types of wiring
or equipment are used, or even if the right types are not properly installed; and properly
installed wiring and equipment can become dangerous if not properly maintained.

At best, inadequate electrical installations can be costly and inconvenient. But, worst of
all, hazardous facilities can burn, maim and kill, [5] which becomes much more
aggravating, when it comes to healthcare facilities.

2.2) BASIC COMPONENTS OF A HOME NETWORK

An electrical network of a health facility or unit is very similar to a home network, that
is why its basic components will be discussed:

Figure from the polyvalent manual

Figure No.1: Main components of a household electrical network

2.2.1) TRANSFORMER

It is a device that transforms high voltage into low voltage. For example, from 13,000
volts it reduces it to 110 or 220 volts.

The transformer output (low voltage), is generally composed of three conductors (see
figure No. 1). Two known as live line, and one known as neutral line.
Live line: They have a voltage of 110 volts with respect to the reference (ground).
Between two live lines, there will be a voltage of 220 volts.
Neutral line: A line that has zero voltage and is normally solidly bonded to ground.

The voltage at 220 volts is used more in:

• Electric stoves,
• Air conditioning,
• Autoclaves,
• Sterilizers,
• Electric motor for tank pump, etc.

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The voltage at 110 volts is most commonly used in:
• Lighting (spotlights, lamps, etc.)
• Connection of small and medium sized electrical appliances such as: irons, fans,
refrigerators, etc.

2.2.2) COUNTER

The meter is a device used to measure current consumption.

2.2.3) THERMAL BOX

Downstream of the meter, there is a protection and control box, also called a thermal
box. This box can be formed by blade type switches, fuses or thermal
(thermomagnetic switches). The thermal box is used to protect the circuits from
overloads or short circuits, as the fuses and thermals are responsible for interrupting the
passage of current through the circuit when it has reached dangerous levels.

What is overloading?

This occurs when the amount of current passing through a conductor is greater than its
capacity. When this happens, the conductor heats up and may melt and cause a fire.
This can happen if the current demanded by the devices connected to the line exceeds
the capacity of the conductor. The fuse and the thermal fuse are in charge of avoiding
this situation, since they interrupt the current flow before the conductor heats up.
If a line has to feed many devices, a thicker conductor should be used for the line. The
thickness of the wire is called "gauge" and the smaller the gauge number, the greater the
thickness. (See table N°2)

What is the short circuit?

It is when the live line of a circuit is connected or establishes direct contact with the
neutral or with a grounded terminal, without any device (lamp, socket, etc.). In other
words, a short circuit occurs when the two wires touch each other or when one
touches ground. When a short circuit occurs, the current through the wires (circuit) is
greater than in the case of an overload, therefore the damage is greater. When the circuit
has fuses or thermal fuses, they interrupt the current flow before any damage occurs.

Fuses, Thermal, Integrating Safety

The electrical energy that enters the thermal box from the street is divided into one or
more branch circuits, which are the ones that go to the different rooms, and feed
different devices, such as lights and sockets. Each circuit (live line conductor) coming

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out of the box must be protected by a fuse or a thermal circuit breaker.
Fuses Thermal
Fuses Fuses Fuse type 5 This half remains
of delay plug on service board

Cartridge fuse

15 to 60 Amp
Type of metal Delay readjustment

60 to 600 Amp

Single circuit Two circuits

Figure No. 2: Some types of fuses and thermal fuses

Fuses and thermal fuses are intended to prevent fires. If a line (circuit) becomes
overloaded (current carrying capacity is exceeded) the fuse or thermal controlling that
line will open the circuit, and like any circuit breaker will cut off the flow of electricity.

If it is a fuse, it will blow due to the excessive heat produced by the large amount of
current. To restore the service, it must be replaced by a new one.

If it is a thermal, it will move to the off position. To restore service once the fault has
been corrected, the thermal must be moved to the ON position. In Figure No. 2 some
fuses and thermal fuses are shown.

Note: Equipment connected to a circuit must be disconnected before reactivating a

thermal or changing a fuse.

After the protection and control box, the electric current is distributed to be used in the
lighting system and in the sockets.

2.2.4) OUTLET BOXES

Octagonal Box

Rectangular Box

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 Square Box

Figure No. 3: Outlet boxes of different shapes

The outlet boxes (See figure No. 3) are generally used to install devices such as sockets,
receptacles, switches, etc., and come in various shapes and sizes. An outlet box can also
be used to access the electrical installation, and to distribute cables or interconnect
them.

The boxes must be rigidly fixed to the surface on which they are installed or embedded
in concrete and masonry or any other construction material, but always in a rigid and
secure manner.

For domestic installations (or small health facilities) the most commonly used are:

• Rectangular box 4" X 2"

• 4" Octagonal Box
• 4" X 4" and 5" X 5" Square Boxes

2.2.5) FEMALE SOCKET

It is a device used to connect equipment and other devices that require electrical current
for their operation. The socket itself does not draw power, but anything connected to it
does draw power.
There are many types of sockets, which can be classified according to:
a) The voltage they supply:
• 110 volt sockets (See figures No. 5 y 6)
• 220 volt sockets (See figure No. 4)

b) According to their connection to ground (commonly called polarization):

• Non-grounded socket, known as non-polarized. (See figure No.5)
• Grounded socket, also known as polarized socket. (See figure No. 6)

Figure No. 4: 220 volt female socket.

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 Figure No. 5: Ungrounded (a.k.a. non-polarized) 110 V female outlet

The ungrounded socket (commonly known as unpolarized) can be of two forms:

l) It has two slots, both with equal dimensions. In this case, the connection of the live
or dead line to either of the two pins is indifferent. It is recommended not to use this
type of sockets in health facilities.
m) It has two slots, but unlike the previous one, one is smaller in length than the other.
The small slot is the one that connects to the live line, and the large slot to the
neutral. When it is necessary to use non-grounded sockets in health facilities, it is
recommended to use this type. A device with two such sockets is shown in Figure 5.

The grounded (commonly known as polarized) socket has the two parallel slots, plus a
third round or U-shaped opening for a third connector. This third opening is connected
to a grounding wire, which must be connected to the facility's grounding network.

A properly grounded socket of this type protects the equipment and the people in
contact with it from many hazards, so it should be the most widely used in health
facilities. Where this cannot be used, a non-polarized socket of the type specified above
should be used.

Figure No.6: 110 V grounded (also known as polarized) socket outlet.

2.2.6) SWITCH

These are generally used for control of small domestic and commercial appliances, as
well as lighting circuits. These allow to disconnect and connect the power supply of a
lamp or bulb (light bulb), so that they turn it off or on.

As shown in figure No. 7, the live lines are connected to the switch, and the neutral directly
to the bulb. If the live line were connected to the bulb directly and the neutral to the switch,
there would be a risk of electrocution when the socket or the connected bulb needs to be
touched; for example, when a burned out bulb needs to be changed.

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 Figure No. 7: Connection of a switch controlling a spotlight

There are different types of switches, the simplest being the one-way, two-terminal switch
used to "turn on" or "turn off" a lamp or other object from a single point location. Its
configuration is shown in figure No. 7.

2.2.7) LIGHTING SYSTEM

In the lighting system we usually have two types of luminaires, these are:
• Incandescent lamps
They are usually known as spotlights, and are marketed in different wattages, 25, 60,
75, 100 W, etc. They are installed directly in a receptacle.
• Fluorescent lamps
They are tube-shaped lamps, which produce white light. They are marketed in different
wattages, the most common are 20, 40 and 80 W.
In Table No. 1 shows a comparison between these two types of lamps.

INCANDESCENT FLUORESCENTS
Immediate start-up without auxiliary Require other auxiliary devices such as start
equipment or ballast
Small footprint Require more space

Low purchase price Higher purchase price

High cost of operation Low operating cost

High heat production Low heat production

High brightness with glare Significantly reduces glare

Table No. 1: Comparison of incandescent and fluorescent lamps.

2.2.8) ELECTRICAL CONDUITS

Electrical conduits serve to provide mechanical protection to the conductors and protect
them from the elements, as it physically insulates them and confines any heat or spark
problems caused by faults in the insulation of the conductors.

There is a wide variety of means of accommodating conductors, some are in very common
use and others are only used in specific applications. The most common are:

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• Polyduct conduit: It is widely used in residential electrical installations due to its cost
and ease of handling. Basically, it consists of a semi-flexible black plastic tube, which is
not very resistant to shocks, but it is useful for working in corrosive atmospheres. For
this reason it is not used for outdoor use. This type of conduit is manufactured with
diameters from 1/2 inch to 4 inches.

• Channeling with aluminum conduit pipe:. As its name suggests, it is mainly made of
aluminum, it is rigid and due to its mechanical resistance, it is used in weathering and
other special conditions.

2.2.9) THE DRIVERS

Conductors are classified according to thickness or gauge. The smaller the gauge number,
the greater the thickness, and consequently the greater the capacity to conduct current. (See
table No. 2 and 3) They can also be classified from

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according to their installation in those used inside pipelines, and those used on the surface.

No. OF CONDUCTOR GROSOR CURRENT CAPACITY IT CAN

(GAUGE) CARRY
Mayor Menor Menor
Menor Mayor Mayor

Table No. 2: Ratio between the number (caliber) of the conductor, thickness and current
capacity it can carry.

CALIBER CAPACITY COMMON USE

(AMPERES)
N°14 15
• Switches
• Lamps and spotlights
N°12 20 •- Outlets
Bias wire (grounding)

N°10 30 - Refrigerators
• Kitchen neutral
N°8 40 • Table top sterilizer
• 3-wire electric stove (3-wire)
• Compressor
• Autoclave
Table No. 3: Most used conductors and their application.

Conductors for use in pipelines. The most commonly used in residential installations are
TW (numbers 14, 12 and 10), and THW (numbers less than 8). WTs are called wires, as
they are made in solid form by a single conductor. THWs are called cables because they are
made of several wires (conductors), which are joined together (not insulated from each
other) to form a single conductor.

Conductors for surface use. These are identified by the TNM or TUF code, and are
manufactured in different configurations, such as: 2 x 14 , 3 x 14 , 2 x 10, etc. The first

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number refers to the number of insulated conductors, and the second to the conductor
gauge. For example, a TNM 2 X 14 cable means that it has 2 No.14 wires.

2.3) WIRE JOINTS AND DEVICES

2.3.1) HOW TO REMOVE CONDUCTOR INSULATION

An easy way to remove the sheath or insulation from a conductor is to use an electrician's
pliers (or pliers with a side cutter):

a) Place the wire between the cutting jaws, and squeeze hard enough to soften and break
the insulation, but not so hard as to damage the conductor.
b) Place the jaws on the wire at the point where the insulation is to be separated, squeeze
hard enough for the jaws to grab the insulation (but not so hard as to touch the
conductor).
c) Then detach the insulation by pulling it off.

If you do not have the proper type of pliers, use an electrician's knife as follows:

a) Cut the insulation up to the conductor, tilting the knife, so as to cut the insulation as
shown in Figure No. 8. This precaution reduces the danger of cutting the driver. Cuts in
the conductor weaken it and sometimes lead to failures, such as heating, or interruption
of electrical conduction.
b) After you have cut around the insulation, strip it off, leaving the conductor exposed
long enough for the purpose at hand.

Figure No. 8: Correct way to remove insulation from a conductor. When using a razor to remove insulation
from a wire, hold the razor at a suitable angle as shown in the figure.

2.3.2) HOW TO CONNECT THE CONDUCTOR TO THE SOCKETS AND

RECEPTACLES

The wire is connected to the devices by means of terminals designed for this purpose. For
wires number 10 and thinner, screw terminals are normally used (See Figure No. 9), in
which the wire is clamped around the screw, and then by tightening the screw, the wire is
clamped. These terminals are used in devices such as socket and plug sockets, switches and
receptacles.
TERMINAL SCREW
PART OF THE DEVICE WHERE THE WIRE IS TO BE CONNECTED

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 Figure No. 9: Terminal for connecting wires number 10 or thinner.
To connect a conductor (wire or cable) to a screw terminal, perform the following steps:

a) Remove the insulation from the conductor about 5 cm. If the conductor is a cable
(conductor consisting of several wires), it is best to twist the strands tightly before
connecting them to the terminal screw.
b) Loosen the terminal screw as far as it will allow (See figure No. 9).
c) Wrap the wire clockwise around the screw, as shown in Figure No. 10 (a), such that the
insulated part of the conductor, when tightened, is not more than ½ cm from the head of
the screw, as shown in figure No. 10 (b); and the bare portion of the conductor is
around the screw so that it does not overlap. Figure 10 (c) shows some errors that are
common when making a connection with this type of terminal.
d) Then tighten the screw so that its head lies flat and snug against the entire coiled portion
of the wire. If there is an excess tail, cut it off near the screw head.

(a)

(b)

(c)

Figure No. 10: Correct way of how to connect a conductor to a screw terminal. (a) Insert the wire so that
when the screw is tightened the loop closes. In other words wrap the wire around the screw in a clockwise
direction. (b) Do not leave a bare conductor near a terminal screw. (c) Avoid these common mistakes when
connecting.

2.3.4) WIRE JOINTS.

Electrical circuits are made using copper wires or cables so that electric current can flow
easily. When it is necessary to make conductor joints, any of the following four knots can

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be used: rat-tail, clamp joint, T-joint, and Western joint.
The rat-tail joint is used to join two wires of the same gauge that will not be subject to
tension.
The clamp joint is used when an electrical appliance cord or lamp cord wire is to be joined
to a solid wire.
Solid wire

Twisted cable

Figure No. 11: How to make a fastening joint.

The T-junction is used when it is desired to obtain a line derived from the main line. It
consists of removing insulation from a section of the main line and twisting the branch line
to the bare wire to form a T-shaped joint.

Figure No. 12: T-joint

The Western joint is used when two wires must be joined in the same line. This type of
joint is very strong and useful when the wire will be under tension.

Figure No. 13: Western Union

2.3.5) JOINT ISOLATION

After a joint has been made, its insulation must be equivalent to the original insulation.
There are several methods for this, the most common of which are: a) Using insulating tape.
b) Using solderless connectors.

When using insulating tape, it is necessary to carefully wrap the joint or splice. Start at one
end, placing the tape over the original insulation, then wrap it in a spiral fashion toward the
other end, allowing successive wraps to overlap slightly. Keep the tape stretched in such a
way that each time the turns overlap, they form a tightly bound whole. Work back and forth

1
until the various layers of tape are as thick as the original insulation. Be careful not to leave
gaps between the wraps of tape, so that no copper is left uncovered.

Solderless connectors are a more practical and safer method of making connections, since
the durability of the insulation is greater than that of insulating tape.

The most common are the so-called "scotch lock" (See figure No. 15), which have a steel
bushing covered with insulation; inside the bushing there is a spring, which is responsible
for holding the conductors inside it, once they have been screwed. The procedure to do so is
as follows:

a) Place the part to be insulated of both conductors parallel to each other, as shown in
Figure No. 14 (a)
b) Twist them together to form a joint, which serves as a thread for the connector.
c) Screw the connector into the joint of the conductors, as shown in Figure No. 14 (b).

(a) (b)

Figure No. 14: Solderless connector. (a ) Place the conductors parallel to each other. (b)
screw the connector into the joint of the conductors.

In this case it is required that the conductor is completely covered by the solderless
connector, so that there is no probability of short circuit.

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2.4) SAFETY AT WORK WITH ELECTRICITY
When working with electricity it is necessary to take some precautions to avoid accidents:

A) Never work on high voltage lines

Figure No. 15

B) Before working on an electrical connection , check whether it is disconnected. (Use

the VOLTAGE TESTER)

Figure No. 16

If the connection is live, de-energize it by disconnecting thermals or fuses in the thermal

box (see Figure No. 17) and check again that there is no current. If this time the line has
been disconnected, you can continue your work. If not, check the protection box (a
thermal relay is probably not working).

Place all thermocouples in

the position that allows the
OFF lever to be read.

Figure No. 17
IMPORTANT: Always check your voltage tester before use. To do this, check the voltage on
a line that you know is powered, the tester should turn on. If this does not happen, obtain a
new voltage tester.
C) NEVER WORK WITH ELECTRICITY IN A HUMID PLACE.
Moisture facilitates the conduction of electricity, making it more dangerous to work
with. For this reason, any place that is wet should be cleaned and dried before working
on an electrical network.

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 Figure No. 18

D) Do not touch the conductors directly with your hands

Use appropriate tools and, if possible, rubber gloves and shoes.

Avoid contact with metallic surfaces or grounded conductors. Something you should
keep in mind is that:
NEVER touch an energized conductor with your hand or any other part of your body.
This may result in death.

Figure No. 19

E) BEFORE WORKING ON AN ELECTRICAL APPLIANCE

(a) (b)
Figure No. 20: (a) Disconnect the line, or (b) Disconnect it
from the line.
2.5) OUTLET INSTALLATION FOR A SPOTLIGHT OR FLUORESCENT
LAMP

To install an outlet for a light bulb or lamp, follow the steps below:

a) Identify in the thermal box, the fuse or thermal that connects and disconnects the lamps,
bulbs, or sockets in the area where the new luminaire will be connected. Move the
thermostat to the OFF position, or disconnect the fuse.

b) Verify that the circuit is not overloaded by counting the number of devices (other lamps,
sockets, etc.), which are connected to the circuit, and verifying that they are few. For
further guidance, consult your supervisor.

c) Install an octagonal box where the lamp is desired, and a rectangular box where the

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 switch will be installed. If the switch is surface mounted (turtle type), it will not be
necessary to install the rectangular box.

d) Install the electrical conduit from the nearest outlet box (either outlet or luminaire) to
the octagonal box for the new luminaire. If the installation is superficial, use plastic
anchors to fasten the cable, the spacing between anchors should not exceed 30 cm. If the
conduit is in polyduct, it should be used with staples to fasten it to the wall or ceiling, or
galvanized wire in case it is installed in the ceiling.

e) From the outlet box where the electrical power will be taken from, identify the live and
neutral lines, and join them with the wires of the new trunking (Figure No. 21).
Existing Luminaire New Luminaire

Figure No. 21: Connection of a switch-controlled spotlight downstream of an existing luminaire.

f) Inside the new octagonal box, connect the live and neutral lines as shown in Figure No.
21.
g) Install the switch following the order of the elements, as shown in figure No. 22 (a).
Install it in a correct way, so that the switch does not lie on its side. The mounting
brackets have elongated holes at the ends to allow vertical installation of the device,
even if the box is not mounted straight, see figure No. 22 (b).
h) After making the splices according to the techniques shown in section 2.3.4 of this
manual, cover all exposed copper parts with insulating tape or use scotch lock.
i) In the case of a spotlight installation, install a socket or receptacle, attaching it with
screws to the octagonal box. In the case of a fluorescent lamp installation, mount the
lamp using anchors, or some means to hang them (chain, galvanized wire, conduit pipe,
etc.). It should be interconnected with the octagonal box, using TNM 2 x 14 cable. Use
metal connector. The octagonal box should be covered with a round lid.
j) Place the light bulb or fluorescent tube in the luminaire.
k) Move the thermal switch to the ON position.
l) Perform a function test.

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 a) b)
Figure No. 22: Installation method of a switch. (a) Place each of the components as shown in the figure. (b)
Always install the switch in a correct manner. The mounting brackets have elongated holes at the ends to
allow vertical installation of the device, even if the box is not mounted upright.

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2.6) FREQUENT FAILURES IN FLUORESCENT LAMPS In Table No. 4, the
causes and possible solutions to the most common problems with fluorescent lamps are
described.
PROBLEM CAUSE COMPOSTURE
Flicker, ripple • Starter ("Start") about to fail, • Change the start, the ballast or
defective ballastI or of inadequate both.
characteristics.
• New pipe • It should improve as the tube
ages.
Blinking
• Replace the tube.
• Change the start.
• Inferior quality tubing. • Check connections or splices.
• Defective starter ("Start"). • Replace the ballast with a new
• Loose contact.
one, if it persists consult your
supervisor about the type of
ballast used.
• Wrong or defective ballast. • Report it to your supervisor
Zumba
• Normal ballast hum
• Ignore it, or replace the ballast
with a low noise ballast.
• Ballast loose or overheated
• Check the temperature of the
ballast. Mount it tightly.
Tube end blackening
• Defective starter or old tube.
• Replace the starter or tube.
• Ballast in bad condition.
• Replace the ballast.
Short tube life • Replace the tube, ballast or
• Low quality tube, too many starts,
both if necessary.
wrong or defective ballast or starter.

• Loose or improper connection, • Correct

incorrect circuit voltage.
Rings of brown coloration
approximately 5 cm from the
- Common, but permissible - Do not worry
tube ends
Gray "feathers" in the lower,
- Mercury has not vaporized - Turn the tube upside
cooler parts of the tube.
Table No. 4.
down to evaporate them
NOTE: This table gives only a few hints on how to correct the fault. If faults persist or it is
not included in the chart, consult your supervisor.
2.7) INSTALLATION OF A MALE POWER OUTLET (PLUG)

The steps to be followed are as follows (See Figure No. 23):

I Ballast: Device used in fluorescent lamps, usually housed in a metal box, and basically consists of a transformer.

1
a) Insert the end of the extension cord into the hole of the male socket.
b) Separate the wires (without removing the insulation) and leave them 6 cm apart. long.
See Figure No. 23 (a).
c) Tie a safety knot, as shown in figure No. 23 (b).
d) Remove the insulation from the conductor 1.5 cm.
e) Pull the cord so that the knot is seated in the hole.
f) Attach the wires to each screw on the socket terminals.
g) Cover the live parts with the socket cover.
h) Perform a function test.

(a) (b)

Figure No. 23: How to install a male outlet. (a) Separate the wires without removing the insulation, leaving
them 6 cm long. (b) Tie a safety knot as shown in the figure.

2.8) INSTALLATION OF A SOCKET OUTLET

a) Identify the thermal or fuse that connects and disconnects the outlets closest to the
location where the outlet is to be installed.

b) Move the thermostat to the OFF position or disconnect the fuse.

c) Install a rectangular box, at a height of not less than 30 cm from the floor. Use robot
nails for fastening, making sure that the box is level.

2
d) Install the electrical conduit from the nearest outlet box (either outlet or luminaire) to
the octagonal box for the new luminaire. If the installation is superficial, use plastic
anchors to fasten the cable, the spacing between anchors should not exceed 30 cm. If
the conduit is in polyduct, staples should be used to fasten it to the wall or ceiling, or
galvanized wire in the case of the conduit being installed in the crawl space.

e) If you want to polarize the socket, you should check if there is a grounding network
nearby. If this is the case, you will have to take a driver from there (No. 14 TW) to the
socket. If there is no grounding network, you should bury a polarization bar and bring
the grounding conductor to the socket; for this action, ask for the supervisor's advice.

f) In the rectangular box of the nearest outlet, make the connection, as shown in figure No.
24 (a). The cables that go upwards in the figure are the ones that reach the new
rectangular box. Remember to identify the live and neutral line.
EXISTING BOX NEW BOX

(a) (b)

Figure No. 24: Connection of a power outlet. (a) One inlet and one outlet extension, corresponding to the
old box of the nearest outlet. (b) A single inlet to the tap, corresponding to the new box.

g) In the new rectangular box, make the connection as indicated in figure No. 24 (b).
Remember to connect the socket as specified in the wire and splice connection section
(Section 2.3).
h) After making the connections and making sure that the copper parts of the wires have
been covered with insulating tape or scotch lock, arrange the wires inside the box.
Fasten the socket using the screws provided for this purpose, similar to the installation
of a switch, as shown in Figure No. 22.

i) Tape the box with the corresponding plate.

j) Turn the power back on.

k) Perform a function test.

2
2.9) PREVENTIVE MAINTENANCE

All elements of an electrical installation are important and deserve to be inspected

periodically. The following are the preventive maintenance steps that should be provided to
luminaires, switches, sockets and electrical panels.

NOTE: If in reviewing any of these steps you find anything out of the ordinary, you should
report it to the respective supervisor.

2.9.1) LUMINAIRES

Monthly

Clean light bulbs and lamps.

After turning the switch to off, clean the light bulbs and lamps of accumulated dust with a
damp cloth. Clean the outside of the socket or lamp body as appropriate.

Quarterly

Check starts and ballasts of fluorescent lamps.

Check the operation of the start, checking the rapid ignition of the lamp. See table No. 3 of
Fluorescent lamp repair.

Annually

Check lamp assembly.

Check the screws, bolts, and other elements that support the lamp. Retighten if necessary.

2.8.2) ELECTRICAL SWITCHES

Quarterly

Securing plates.
Check the state of fixation of the plates to their respective box. If necessary, tighten the
screws so that it is securely fastened.

Semiannually

Check installation.
In those switches that have external surface connection (on the wall), check that this

2
connection is in good condition and well fastened to the wall.

2.8.3) OUTLETS

Quarterly
Securing plates.
Check the condition of the fixing of the plates, and of the socket itself. Re-tighten the
screws or any fixing means it may have.

Semiannually

Check outlet loads.

Check how many loads (appliances) are connected to a single outlet (especially if extension
cords are used). Add up the power consumption of each load, then add up the loads of all
the outlets in the same circuit, and verify that it is less than 1000 Watt.

Verify that there is electricity at outlets.

Use the voltage tester to verify that electricity is present at the sockets.

2.8.4) ELECTRICAL PANELS.

Monthly
Maintain free access to the board.
In case of an emergency, it is very important not to have obstacles to reach the panel, so
remove any object that prevents you from having free access to the panel.

Quarterly

Check thermals.
Check that the thermals are not tripped, overheated or showing signs of overheating, and
that they connect and disconnect the power supply to their respective circuits. Make sure
they are securely fastened to the box.

2
Secure cover and screws
Make sure that the lid is not loose. Retighten the screws holding it if necessary.

2
 3. PLUMBING

3.1) IMPORTANCE OF PLUMBING

The management of water distribution within a health facility is of paramount importance

for the proper functioning of the same, and therefore it is also important to provide
maintenance to the devices intended to facilitate this service. In this manual, the commonly
used sanitary fixtures, their operation, the parts that compose them and their respective
maintenance are presented as a guide for the multipurpose technician in his daily work.

3.2) PLUMBING PRINCIPLES

Plumbing is the activity related to the supply of drinking water and sewage disposal,
through ducts and interconnected devices with different accessories which must be properly
maintained to work in optimal conditions, since water is vital for the operation of a health
service.

Basic sanitary fixtures include the following:

1. Taps
2. Bathtubs
3. Showers
4. Toilets
5. Hand wash basin
6. Wastes Washer
7. Valves

For the operation of these devices, we have two systems that we can define as follows

a) Power Supply System

b) Drainage System.

Both systems are completely independent and their failures or malfunctions are different.

3.2.1) THE TAP

Faucets, commonly called spouts, control the flow of water by means of a neoprene (or
other soft material) gasket that is pressed against the valve seat, the most frequent cause of
the faucet not stopping the flow of water is the deterioration of this gasket. This is one of the
most widely used devices in the water distribution system.

2
Taps can be divided into changeable seat taps, and fixed seat taps (Figure No. 25 and 26
respectively). When the faucet does not stop the water flow due to deterioration of the seat,
the seat can be removed for replacement. This is possible, if it is a changeable seat tap. In
the case of fixed seat faucets, it is the complete faucet that must be replaced, in short, it is
not repairable.

1. Screw cap
2. Crown set screw
3. Crown
4. Nut (or adapter)
5. O" Packing No. 1
6. Stem
7. O" Packing No. 2
8. Seat and screw packing
9. Sprinkler packing
10. Sprinkler
11. Cover
12. Threaded connector tube
13. Nut for fastening
14. Compression packing
for supply pipe
15. Nut for supply pipe
16. Bottom cover

Figure No. 25: Parts of a changeable seat tap

2
Figure No. 26: Parts of a fixed seat tap.

2
16.2.2) CONTROL VALVES

Within the water supply system, the most important component is the valves.

Valve selection

Valves are used to control or stop the flow of a fluid through pipelines. The selection of the
valve to be used depends on the desired function of the valve. The type of service together
with the operating conditions will determine the required type of valve. In general, some
valve designs are more suitable for flow and shutoff and others are intended for throttling.
There are several types of valves, the main ones are:

a) Gate valve. This is easily recognized by the protruding part below the hand. It functions
as a lift gate that rises through an opening in the valve body by turning the hand
counterclockwise. This valve allows the full flow of water to pass through. The disc
erodes rapidly when the valve is partially open. (See figure No. 27)

DISCO

Figure No. 27: Gate valve

b) Globe valve. It can be used to regulate water flow because it has a neoprene gasket that
compresses against the valve seat to shut off the flow. In case of failure, the neoprene
gasket (washer attached to the piston rod according to figure No. 28), and if the failure
persists it will be necessary to replace the valve seat.

2
 Figure No. 28: Parts of a globe valve

c) Check valves. They allow water to flow in one direction only; these valves are used in
systems that are supplied in a combined and simultaneous way from the public network
and from the cistern or elevated tank of the building. In case of failure, the entire valve
must be replaced. This valve usually works by gravity, some of these valves are built
for use only in vertical pipelines, and others, on the other hand, only for horizontal
pipelines. Hence, their correct installation is an essential issue.

2
 Figure No. 29: Cutaway view of a check valve

16.2.3) THE SIPHON

It is very important to know its function in the drainage of a health facility; the siphon is
used to seal the rest of the drainage inside the building (figure No. 30).

Figure No. 30: How the siphon forms a seal.

It is easy to guess what would happen if this seal were not used. The gas produced in the
drainage pipes would escape through the drainage holes of the appliances, causing an
unpleasant odor and the entry of microbes, insects and rodents that carry infectious and
contagious diseases into the building.

The seal formed is from water that has been used and is retained in the U-shaped section.

3
16.2.4) PIPE JOINTING
In the installations of health facilities, two types of piping are mainly used:
a) Galvanized steel pipe
b) Plastic pipe (PVC)
3.2.4.1) STEEL PIPE JOINTING
There are two methods of joining galvanized steel pipes, one is by threaded joints that
ensure a tight seal by means of pressure between the thread faces of the pipe and the
connection on the fitting; and a second method is by welding (autogenous welding). In this
document, the focus will be on the former, since it is the most commonly used in health
facilities (Figure No. 31).

Figure No. 31: Commonly used joints for galvanized steel pipes

The joints shown in Figure 31 are the most common in water distribution installations that
are constructed in galvanized steel. The threads of the

3
pipe are external and the threads on the connection are female. The threaded joint method
can be used on all diameters of galvanized pipe.
The measurements of the part to be joined or repaired can be given from center to center,
center to end, end to end and end to end. (see figure No. 32)

Center to End to end

center (E To E)
(C A C)

Center to end End to end

(C A E) (E A F)

Figure No. 32: Ways to measure a tube

A tolerance must be left for the amount of pipe to be threaded into the fitting. This tolerance
should be included when measuring prior to cutting and threading the pipe piece. Figure 33
shows normal tolerances for different diameters.

Diameter Tolerance
INTRODUCTION................................................................................................................................1
2. ELECTRICITY.............................................................................................................................2
2.2.2) COUNTER.........................................................................................................................4
2.2.3) THERMAL BOX...............................................................................................................4
What is the short circuit?..................................................................................................................4
Fuses, Thermal, Integrating Safety...................................................................................................4
2.2.4) OUTLET BOXES..............................................................................................................5
2.2.5) FEMALE SOCKET...........................................................................................................6
2.2.6) SWITCH............................................................................................................................7
2.2.7) LIGHTING SYSTEM........................................................................................................8
• Incandescent lamps...................................................................................................................8
• Fluorescent lamps......................................................................................................................8
2.2.8) ELECTRICAL CONDUITS..............................................................................................8
2.3.1) HOW TO REMOVE CONDUCTOR INSULATION.....................................................11

3
 2.3.2) HOW TO CONNECT THE CONDUCTOR TO THE SOCKETS AND
RECEPTACLES.............................................................................................................................11
2.3.4) WIRE JOINTS.................................................................................................................12
2.3.5) JOINT ISOLATION............................................................................................................13
D) Do not touch the conductors directly with your hands........................................................16
E) BEFORE WORKING ON AN ELECTRICAL APPLIANCE...........................................16
Monthly..........................................................................................................................................22
Quarterly.........................................................................................................................................22
Annually.........................................................................................................................................22
Quarterly.........................................................................................................................................22
Semiannually..................................................................................................................................22
Quarterly.........................................................................................................................................23
Semiannually..................................................................................................................................23
Monthly..........................................................................................................................................23
Quarterly.........................................................................................................................................23
3. PLUMBING................................................................................................................................25
3.1) IMPORTANCE OF PLUMBING.......................................................................................25
3.2) PLUMBING PRINCIPLES.................................................................................................25
3.2.1) THE TAP.............................................................................................................................25
16.2.2) CONTROL VALVES..................................................................................................28
Valve selection...............................................................................................................................28
16.2.3) THE SIPHON...............................................................................................................30
16.2.4) PIPE JOINTING..........................................................................................................31
16.2.5) THE TOILET...............................................................................................................36
3.4) INSTALLATION AND REPAIR OF A SIPHON..............................................................40
3.5) PROCEDURE FOR CHANGING THE GASKET ON A FAUCET.................................41
WARNING: WHAT NOT TO DO................................................................................................43
Monthly..........................................................................................................................................48
Quarterly.........................................................................................................................................48
Quarterly.........................................................................................................................................49
4.1.1) Installation.......................................................................................................................56
4.1.2) Repair of a lock................................................................................................................59
4.3) PREVENTIVE MAINTENANCE......................................................................................61
Quarterly.........................................................................................................................................61

3
 Annually.........................................................................................................................................61
Quarterly.........................................................................................................................................61
Semiannually..................................................................................................................................61
ANNEX 3: MPP ROUTINES FOR MULTI-PURPOSE TECHNICIANS.......................................66

Figure No. 33: Tolerance for threads

Threaded or flanged joints (Figure 34) connect pipes that must be disconnected frequently
for repairs. In many cases, threaded unions are used to make the final shut-off connection in
a line or to facilitate assembly or disassembly of a valve for repair purposes.

Fitting parts A and B are screwed onto the ends of the two tubes. The third part, or nut,
holds them together so that A and B depress the gasket D to ensure a tight joint.

Figure No. 34: Union nuts (a) Threaded union nut (b) Union nut, ground seat

3.2.4.2) PLASTIC PIPE UNION (PVC)

In our environment the plastic pipe used is the so-called (PVC). These are bonded together
with a special glue known as solvent cement. Although the process is simple, the necessary
precautions must be taken to obtain an airtight joint.

3
The pipe can be cut with a fine-toothed saw and an adjustable metal cutting saw (see figure
35). The cut should be as perpendicular as possible, i.e. at 90° to the pipe. Any differences
can be corrected by using a file to square the cut at the end of the pipe and reaming the
inside diameter to remove burrs.

The parts to be coated with solvent cement must be free of any dirt, grease or oil, otherwise
the solvent cement will not achieve the necessary adhesion and a watertight bond will not be
obtained.

Prior to the application of the solvent cement, it is advisable to test the part with the fitting
in its final position and mark with a pen to verify the insertion depth of the pipe in the
fitting.

Glue is applied evenly to each piece, the pipe is inserted into the fitting and rotated slightly
¼ turn to the left and then to the right back to the original position and the pipe is pressed
tightly against the bottom of the fitting for a minimum of 30 seconds. The excess cement
that comes out of the joint is then removed with a clean rag.

Figure No. 35: Procedure for joining PVC pipe

3
16.2.5) THE TOILET

The toilet is made of the same material as porcelain sinks, which is an extremely fragile
material.

The toilet has two sections, the water tank and the bowl (see Figure 36).

Figure No. 36: The toilet and its parts

3
 LIST OF TOILET PARTS

PART DESCRIPTION
OUTLET VALVE
A Drain pipe
A1 Sanitary service tank handle
A2 Jaw pear with chain
A3 Rubber packing
A4 Support nut for outlet valve
A5 Sponge packing
Cup-tank union screw assembly
B Bolt
B1 Rubber packing
B2 Rubber packing
B3 Washer
B4 Nut
Inlet valve
C Drain pipe
C1 Adjusting screw
C2 Rubber packing
C3 Inlet valve support nut
C4 Supply tube packaging
C5 Washer
C6 Inlet valve nut
C7 Buoy or float
C8 Hose
C9 Buoy arm
Mug
D Bolt cap

3
3.3) INSTALLATION OF A WASHBASIN

SINK INSTALLATION DIAGRAM

1.1. Center line from

sink and drainage

1.2. Platen break line and fastening

1.3. Feeder tap center line.

1.4. Finished floor

Figure No. 37

2.1. Center line from

sink and drainage

2.2. Fastening nail break line

2.3. Power tap center line

2.4. Finished floor

Figure No. 38

3
 3.1 Drain inlet line

3.2 Fastening nails

3.3 Finished floor

Figure No. 39

1.1. Ventilation piping.

(exceptionally, this pipe
can be found in some
establishments).

1.2. Water seal (Siphon)

1.3. Manhole plug

1.4. Suction (negative pressure)

1.5. Drainage piping.

Figure No. 40

3
3.4) INSTALLATION AND REPAIR OF A SIPHON

For installation (see figure 41) follow the steps below:

a) Connect the sink drain pipe to the upper threaded union.
b)Fasten with a compression joint (gasket and compression nut).
c) Slide the siphon outlet into the drain connection.
d) Fasten the siphon threaded union to the siphon outlet pipe with the
compression union.

Repairs:
e) In case of leakage, tighten the compression nuts or replace the gaskets.
f) When the leak is at the end of the siphon that connects to the discharge pipe; all
traces of dirt should be removed and filled with cement paste around the siphon
pipe and then the flapper should be placed in the correct place.

FIGURE No.12. AUXILIARY GUIDE FOR THE MAINTENANCE...

4
 Figure No. 41: View of siphon with its parts.
3.5) PROCEDURE FOR CHANGING THE GASKET ON A FAUCET

1. Have at hand a crab wrench of the proper size, to place it correctly, as shown in
the figure, in order to avoid damaging the edges of the nut (see figure No. 42).
2. Place the crab wrench on the nut that connects the faucet body to the other parts
(see Fig. 25 y 26). Turn the wrench to remove the nut, and hold the hand to
prevent it from turning.
3. Separate the upper body.
4. Note the gasket on the stem, and remove the screw that holds it in place.
5. Replace the gasket, screw it onto the stem and attach the main nut to reattach
the upper part and the faucet body.

(FIGURE No. 12 Polyvalent's Manual, August 1997)

Figure No. 42: How to use an open-end wrench

4
3.6) INSTALLATION OF A TOILET

TOILET INSTALLATION PROCEDURE

First of all it is necessary to prepare the place where the toilet will be installed. as a
first step, punch as necessary to be able to insert the flange.

Figure No. 43
Glue the Plastic Flange to the drain pipe, so that the axes of the anchor bolt holes
are aligned parallel to the wall, as illustrated in Figure No. 44.

Figure No. 44
Then turn the toilet bowl upside down, take the wax gasket and place it centered on
the bowl drain gland.

Figure No. 45
Once the wax gasket is in place, return the cup to its original position by carefully
approaching the flange with the anchor bolts until it is fully seated. Thus the weight
of the cup will compress the wax gasket, which will form a seal against any water

4
leakage or bad odor (Figure No. 45).
WARNING: WHAT NOT TO DO
You should not glue the cup to the floor with gray cement (Figure No. 46), because
if you need to remove it to make a repair or remove a leak, you will not be able to
remove it, except with a mallet and chisel, with the risk of breaking it. It is not even
advisable to whitewash or fill the perimeter of the toilet base with porcelain.

Figure No. 46

Now attach the bolts, nuts and washers that will hold the cup to the floor.

Figure No. 47
Once the cup is in place, the tank must be installed with its accessories, which
usually come in a plastic bag inside the tank. (See figure No. 48)

4
 ACCESSORIES
Figure No. 48
Start by placing the tank (see Figure No. 49) in a lateral position, taking care to
place a thick cloth on the floor beforehand.
Figure No. 49

4
Then insert the inlet valve (see Figure No. 50) inside the tank into the
corresponding hole, making sure that the conical gasket is in place so that the
threaded end is sticking out of the tank at the bottom, lightly tighten the nut, if the
valve is in the correct position, hand tighten the nut as much as you can, and then,
with a wrench, apply a 1/4 turn making sure that the valve does not turn, holding it
by the tank.If the valve is in the correct position, tighten the nut as much as
possible by hand, and then, with a wrench, apply 1/4 turn, making sure that the
valve does not turn, holding it by the pipe with your hand.

Figure No. 50
Now insert the discharge (outlet) valve (see figure No. 51) inside the tank into the
large hole, making sure that the tapered gasket is in place so that the threaded end
is sticking out of the tank at the bottom. Slightly tighten the nut, tighten the valve.
When it is in the correct position, tighten the nut as much as possible by hand, then,
with a wrench, apply 1/4 turn, making sure that the valve does not turn, holding it
by hand, never by the barrel.

4
 Figure No. 51

Insert the lever of the handle (see figure No. 52) through the corresponding hole.
Then insert the left-hand thread nut and tighten it.
Hook the chain that comes on the discharge valve to the end of the handle lever.

Figure No. 52

Take the float rod (see figure No. 53) and attach its threaded end to the shut-off
actuator of the inlet valve, then take the nut and tighten. Be careful that the float
does not rub against the tank walls or the overflow tube at any time. Adjust the
filling speed (with the valve closing actuator). Adjust the water level (by varying
the float position).
Figure No. 53

Now connect the inlet valve to the overflow pipe of the discharge valve with the
plastic hose (see Figure No. 54).

Figure No. 54

4
Place the neoprene gasket on the threaded end of the discharge valve (see Figure
No. 55).

Figure No. 55

Carefully lower the toilet tank with the bolts and neoprene gasket until they engage
with the holes in the bowl end (drain and bolt holes) then tighten the nuts
alternately from below.
Figure No. 56
Once the tank has been properly attached to the bowl and we are sure that it has
been plumbed, we connect the water outlet to the tank, by means of a supply pipe
and preferably with a straight control tap when the water outlet is on the floor, or
angled when the water outlet is on the wall.

Figure No. 57

4
3.7) PREVENTIVE MAINTENANCE

3.7.1) TOILETS

Monthly

Verify the existence of water leaks in the supply pipe, inlet valve and outlet valve.
Check for moisture in or around the supply pipe. If it is very wet, wipe the supply
tube and inlet valve dry with a cloth and check if the leak is in either of these
components. For the outlet valve, drop some cigar ash (or other light, solid
material), and see if the ash at the bottom disappears; if it does, the outlet valve is
leaking. If it remains, it means that there is no leakage.

Check float
Normally if the water level inside the tank coincides with the corresponding mark
then the float float buoy will not leak.

Check the seat.

Tighten the rate fixing bolts if they are loose. If there is excessive flaking of the
surface enamel, chipping, or any of the plastic support plugs are missing,
recommend replacement of the seat.

3.7.2) LAVAMANOS

Quarterly

Verify the existence of water leaks in faucet, supply pipe and siphon.
Check for the presence of water on the floor or adjacent to the sink. If present,
close the supply valve and dry the faucet, supply pipe and siphon. Reopen the
valve, and verify where the leak is coming from, and mark the exact location.

Check anchorage.
Check the condition of the sink anchors visually on the underside of the sink.
Check for extreme corrosion of anchors, or cracking of the wall. Then manually
check its stability.

Verify the permeability of the Siphon.

Check the water flow through the drain by opening the faucet fully for about 20
seconds. If the drain is not sufficient, disassemble the siphon and clean it.

4
3.7.3) TAPS AND VALVES

Quarterly

Check key rotation.

It consists of checking that the wrenches turn normally, checking the degree of
wear on the stem thread and tightening the handle screw if necessary.

Check for leaks

If there are leaks, replace the gaskets

4
 3.8) LIST OF FREQUENT FAILURES IN HYDRAULIC SYSTEMS
SYSTEMS AVERIES CAUSES POSSIBLE SOLUTIONS
1. Rainwater drainage Blockage of canals, downspouts and • Leaf fall in canals Periodically check and clean rainwater
culverts • Use of receiving boxes as dumpsters gutters and downspouts, especially before
• Solids washed away by rain and during the rainy season, as well as
drainage boxes, drainage pipes, and gutters,
etc.
2. Sinks and a) Water leakage at the faucet. a) Wear of the gasket due to aging and/or misuse. a) Replace the gasket, base or seat or
washbasins b) Aging, corrosion, poor coupling. replace the faucet.
b) Water leakage in siphon. b) Replace the siphon gasket or the siphon
c) Neglect, introduction of objects into the siphon. itself.
c) Drain blockage c) Remove objects in the siphon, open
manhole plug. If you do not have it,
disassemble and clean it
3. Toilets a) Leakage in outlet valve. a) Hardening and loss of elasticity of the "pear" or a) Change the "pear" or outlet valve.
outlet valve.
b) Leak in inlet valve b) Aging of mechanical parts and inlet valve b) Change gaskets or complete inlet valve.
gaskets. c) Change hand.
c) Broken handle or knob c) Misuse of the handle (too much force)
d) Remove the obstruction with the use of a
d) Bowl siphon clogged. d) Introduction of objects into the cup. suction cup, wire or other utensil.

4. Taps a) Continuous dripping or leaking a) Change gaskets, base or seat or replace

b) Dripping in the gland nut
5. Cisterns and a) Leakage in float valve.
elevated tanks. b) Check valve does not work.
c) Foot valve does not retain.
d) Constant start-ups of pumping
equipment
NOTE: c and d only for cisterns.
6. Plumbing Leaking joints (liners, elbows, tees)
faucet.
a) Aging and wear of gaskets and stem. b) Reinstall the faucet, this time using
b) Poor installation (non-use of Teflon tape). Teflon tape.
a, b and c) Valve aging. a, b and c) Change valves.
d) Loss of pressure (air) in the tank or rupture of the d) Add air to the tank with a compressor or
separation membrane. change it if the membrane is broken.
a) Inadequate procedure or use of poor quality a, b and c) Reinstall the pipe.
glue.
b) Lack of use of Teflon in galvanized pipe.
c) Corrosion of galvanized pipe.
Table No. 4

5
5
3.9) NECESSARY TOOLS

The basic tools needed by a multi-purpose technician are shown in Annex 2. The
following will explain the use and importance of those tools that correspond to the
plumbing section.

a) Stillson wrench: used for screwing or unscrewing steel pipes.

b) The adjustable wrench or crab wrench: used to remove or install nuts.
c) The saw: it is used to cut both metal and plastic pipes. The frame is extensible and
allows the adaptation of various types of leaves.
d) The seat change wrench: it is a great help for changing the seat on replaceable seat
faucets when the seat has completely deteriorated.
e) The tape measure: it is indispensable for the plumber's various activities.

5
4) LOCKSMITHING AND PAINTING

4.1) DOORS

Doors are very important because they are the elements that provide security to the
establishment. The proper functioning of these is deteriorated by misuse, heavy closing,
environmental humidity, etc.

An important element inside the doors are the locks or commonly called plates, they are used
in the doors for security purposes, and change their shape depending on the place where
they are placed; that is, if it is for interiors or exteriors. There are several types of plates:
patch, single or double pin and knob plates. Their misuse damages the mechanical system.

4.1.1) Installation

For the installation of the lock use the template presented in Annex 1.

1. Position the lock

Mark a line on the door at the height the lock should be. The normal height is 1 meter
above ground level. Place the template on the outside of the door and mark the center of
the 54 mm hole on this line in the direction of the door width, also in the direction of the
door thickness mark the center of the 23 mm hole. as illustrated in the template (see
Figure No. 58)

Figure 58: Placement of the template to mark the 54 mm hole center.

2. Drill two holes.

Drill the 54 mm and 23 mm diameter holes at the indicated points on the door (see figure
No.59).

5
 Figure 59: Drilling of 54 and 23 mm diameter holes.

3. Place the latch

Mount the latch body in its housing, insert the latch in the 23 mm hole and fasten it with
screws. Make sure that the latch is in the right direction and fasten it with two screws.

Figure 60: Placement of the latch.

4. Mount the outer knob

Insert the knob that carries the handle on the outside of the door, inserting the handle into
the hole of the latch (see figure No. 61).

Figure 61: Placement of the outer knob.

5. Screw on the shield holder
Place the shield holder on the inner side and fasten it with two screws. Check the correct
operation of the lock (see figure No. 62).

5
 Figura 62: Placement of the shield holder.

6 . Fit the shield

Fit the shield trim to the shield holder and apply light finger pressure on the shield and it
will snap into place (see figure No. 63).

Figura 63: Placement of the embellishing shield.

7. Mount the inner knob

Mount the inner knob on its shaft, and by pressing the protruding pin on it, insert it into
the corresponding hole of the knob. Check the perfect fastening of the knob (see figure
No. 64).

Figura 64: Inner knob assembly.

8. Install the striker
Mark the centerline of the frame to match the centerline of the door edge and make the
pocket in the jamb to the required height. Install the striker with the supplied lag screws.
Figura 65: Installation of the striker.

5
9. Disassembly
It is operated in reverse order to its assembly:
• Press on the pin located on the knob atand pull the knob outward.
• With the help of a screwdriver, lift the inner shield by levering the two notches you
will find on the shield seat.
• When the shield is removed, the two shield holder screws will be visible. Disassemble
and operate in reverse order of assembly.
Figura 66: Disassembly of a lock

4.1.2) Repair of a lock

Procedure:
1. Removing the knob by manipulating the latch
2. Unscrew the support plate and slide the cylinder.
3. Then go to remove the latch.
4. Check the mechanical cylinder and latch to detect the defect, if it is not repairable you
can proceed to change it according to steps 4,5,6,7 and 8 of the previous section.

4.1.3) Repair of a collapsed door

If the door sits on the floor (is uneven), it is removed as follows:
1. Remove the hinges with a flat or cross screwdriver.
2. Check the screw holes.
3. If these are too large for the screws, place wooden plugs with glue and re-drill
where the hinge is screwed.
4. Check if they are correctly positioned, if not, level them with a plumb line (see
figure No. 67) and fastening pins are secured or placed.
5. Reposition the door to the correct position and level.
FIGURE PAGE 45 MULTI-PURPOSE MANUAL 97.

5
 Figure No. 67: Correct use of a plumb bob to verify the sag of a door.

4.2) PAINTING

Painting is one of the most important aesthetic details in a Health Post or Center, so
preventive and corrective maintenance is recommended.

To paint a brick wall repainted and thinned with water or oil paint, proceed as follows:
1. The wall is scraped with a spatula to remove old paint and parts damaged by fungus
due to humidity.
2. Clean or wash the part to be painted or retouched.
3. Prepare the paint by adding ¼ of water per gallon, if it is out of water. If it is oil-based,
add 1/3 of mineral solvent or similar (the area to be covered per gallon of water-based
paint is 40 - 50 square meters).
4. If a door or piece of furniture is painted with oil paint, use a No. sandpaper. 0: The
surface is cleaned and painted immediately.

NOTE: It is advisable to clean the parts most prone to fouling periodically. A sponge with
soap and water is used for this purpose. These parts should be painted once a year or when
and where overly soiled areas are visible.

6
4.3) PREVENTIVE MAINTENANCE

4.3.1) DOORS

Quarterly

Adjusting and lubricating hinges and locks

Verify the proper functioning of locks and hinges on each door. Lubricate with oil in such
a way that it does not drip. Adjust locks and/or hinges if necessary. If the lock mechanism
does not work, disassemble it, clean its parts and grease it.

Check overhangs
Verify the overhang of the door using a plumb or level. Correct if necessary.

Annually
Painting doors
Paint the doors with oil paint preferably. If it is metallic, apply anticorrosive first and then
the paint. Avoid changing the color of doors unless you have been authorized to do so by
the appropriate person. Take into account the considerations given in this manual.

NOTE: The key hole should not be oiled or greased, it should be lubricated with graphite
powder.

4.3.2) WINDOWS

Quarterly

Adjust operators and hinges.

Semiannually

Lubricating Blacksmith Shop

Apply oil or grease to the visible rotating parts of the windows, as well as to the inside of
the operators.

BIBLIOGRAPHY .

[1] . Basic Electrical and Plumbing Course I. Aimed at personnel of MSPAS health units

6
 and posts. Future Multipurpose Technicians". Hospital Maintenance Project. EL
SALVADOR, 1992.

[2] . "Hospital Maintenance Magazine" No. 1. MSPAS/GTZ. El Salvador, 1992.

[3] . Basic Electrical and Plumbing Course II. Aimed at personnel of MSPAS health units
and posts. Future Multipurpose Technicians". Hospital Maintenance Project. EL
SALVADOR, 1992.

[4] . Manual for Multipurpose Personnel I. San Salvador, August 1997.

[5] . "Practical manual of electrical installations". H. P. Richter, W. Creighton Schwan.

Editorial CECSA, 1991.

[6] . "Technician's Handbook for Hospital Engineering". Published by the order of the
Ministry of Foreign Affairs of the federal Republic of Austria. 1989.

[7] . "Carpentry and joinery course". Volume 1, Spanish version. A. B. Emary. 1992.
Editorial Limusa, Grupo Noriega Editores. GIMG.

[8] . "Repair of small household appliances". Phyllis Palmore-Nevin E. Andre. Editorial

Reverté. 1989.

[9] . "Auxiliary Guide for the maintenance of drinking water and drainage systems in
health units and health posts". MSPAS/AID Agreement No. 519-0308. Eng.
Oswaldo Ramirez. SAN SALVADOR, 1991.

6
 ANNEXES
ANNEX 1: TEMPLATE FOR LOCK INSTALLATION

6
INSTRUCTIONS FOR USING THE TEMPLATE

The template shown is made to be used in doors of: a) 40 mm. thickness and b) 32 mm. thickness.
The template should be used as follows:
a. On 40 mm doors. thickness, use the markings indicated by the dimensions a) (door thickness
= 40 mm, entrance = 70 mm) and on 32 mm doors. thickness use those indicated by b) (door
thickness = 32 mm, entrance = 60 mm).
b. Place the template on the inside of the door at the height where the sheet metal will be placed.
c. Fold the template on the dotted line so that the part of the template labeled "door thickness" is
parallel to the thickness of the door and the other part on the inside of the door.
d. With the template correctly positioned, mark the hole centers according to the thickness of the
door.
e. Once the hole centers are marked on the door proceed to drill the 23 mm holes. and 54 mm.
diameter.

6
 ANNEX 2: LIST OF TOOLS AND MATERIALS REQUIRED
FOR THE MULTI-PURPOSE TECHNICIAN.

TOOLS

DESCRIPTION QUANTITY
Toolbox 1
Measuring tape 3 mt. 1
10" adjustable wrench 1
Voltage tester 1
Pliers for electrician 1
Saw frame 1
12" Stillson wrench 1
Seat change wrench 1
Flat and phillips screwdrivers (6 pieces) 1
Hammer 1
Electrician's knife 1

SPARE PARTS STOCK

DESCRIPTION QUANTITY U. M.
Insulating tape No.33 Roll 2
TNM Cable No. 2 X 12 Mts. 12.5
Galvanized Wire No. 14 Lb. 4
Teflon tape Roll 4
Standard faucet packings Box 2
Glue for P.V.C. Tube 1
Permatex Tube 1
Saw Steel silver each 2
φ ½" PVC pipe C-315 Mts 6
Smooth φ ½" PVC elbows
each 4
Male PVC φ ½" adapter
each 4
PVC female adapter φ ½".
each 4
Universal Union H.G. of ½" each 2
Nipple T/R H.G. of ½" each 4
Niple H.G. of φ ½" X 4" each 4

6
 ANNEX 3: MPP ROUTINES FOR MULTI-PURPOSE TECHNICIANS

HOSPITAL MAINTENANCE PROJECT

Ministry of Public Health Deutsche Gesellschaft für
and Social Technische Zusammenarbeit
Assistance

M.P.P. PROGRAMMING OF ROUTINES FOR MULTIPURPOSE PERSONNEL

Planned Preventive Maintenance
HEALTH UNIT: Name of the polyvalent:
Element / Frec Jan Feb Sea Apr May Jun Jul Aug Sep Oct Nov Dec.
Activity
1 Doors
Adjusting and Trim. P
lubricating
hinges and R
locks
Check Trim. P
overhangs
R
Painting Annual P
doors
R
2 Window
Trim. P
Adjust
operators and
hinges
R
Lubrication of Seme P
blacksmiths
R
3
Luminaire s
Cleaning light Men. P
bulbs and
lamps R

6
6
Check start Trim. P
and ballasts
R
Annual. P
Check lamp
assembly R

6
7
 Element/ Frec Jan Feb Sea Apr May Jun Jul Aug Sep Oct Nov Dec.
Activity
4 Electrical
switch
Securing Trim. P
license plates
R
Check Semes P
installation
R
5 Power
Outlets
Securing Trim. P
license plates
R
Semes. P
Check the
loads of R
socket outlets
Verify Semes P
electrical
connections at
outlets R
6 Electrical
Panels
Men. P
Keep free
Access to the R
board
Thermal Trim. P
check
R
Trim. P
Secure cover
and screws R

6
8
 Element / Frec Jan Feb Sea Apr May Jun Jul Aug Sep Oct Nov Dec.
Activity
7 Toilets
Month. P

Check for
water leaks in
supply pipe, R
inlet valve
and outlet
valve.
Check float Men. P

R
Check the Men P
seat
R
8
Sink s
Trim P

Check for
leaks in
faucet, supply R
pipe and
siphon.
Check Trim . P
anchorage
R
Check Trim P
permeability
of the siphon

R
9 Taps and
valves
Verify key Trim P
rotation

6
9
Verify Men. P
existence of
water leaks

Health Unit Director's

signature
Date

7
0