Randall Lamb first performed a master planning MEP study to identify system deficiencies and offer recommendations to rebuild the hospital's infrastructure. Design of the new infrastructure included addition of a detached chiller building with associated primary/secondary chilled water variable flow pumps and cooling towers. A new rooftop four-pipe distribution system was designed for installation above the main facility corridors and will be the backbone for future extension to service additional air handling equipment when needed. The owner immediately realized reduced energy costs and cooling/heating system reliability. We have completed over 350 projects for the Scripps Health network of healthcare facilities in the greater San Diego area.