This 17,000 SF facility is a combination ambulatory surgical center and dialysis clinic providing critical care services to patients with end-stage renal disease in Denver’s Lowry area. Expansive soils dictated a structural steel foundation over a crawlspace supported by auger cast piles and a perimeter grade beam. Sophisticated mechanical, electrical, and plumbing systems were also required to ensure the precise control of temperature, humidity, and sterilization necessary for a facility of this kind. Despite over 120 weather delay days due to snow and ice, the project was completed with no recordable safety incidents or lost days.