Estructure provided structural engineering services to convert 20,000 sf of unoccupied cold-shell space to a state-of-the art ambulatory surgery center. The new facility includes a linear accelerator suite, a CT suite, three operating rooms, a general procedure room and associated support spaces. The linac is housed inside a 4-foot-thick concrete vault structure (designed by Nelco) supported on large grade beams with micropiles to prevent new load on existing building foundations. The tall story height allowed for two new air handling units to be suspended above the ceiling on steel platforms with catwalks. The design team developed creative solutions to limit the transmission of noise and vibrations from the second-floor gym to the operating and procedure rooms below. These included floor-mounted steel portal frames to support surgical booms, a spring-isolated ceiling system, and custom detailing of full-height partitions with neoprene isolation.