AAAA Emergency Shower and Eyewash Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

IDENTIFICATION

• Is the unit identified with a highly visible sign complying with AS1319 and that that sign is in good condition?

  Yes

  No

  N/A

• Is the unit clearly visible and well illuminated?

  Yes

  No

  N/A

• Are test tags secured to the unit and are updated on the inspection of equipment to show the last inspection date, initialed by the tester and comments noted?

  Yes

  No

  N/A

OBSTRUCTIONS

• Is the path of travel free from obstruction that may inhibit the immediate use of the equipment?

  Yes

  No

  N/A

• Showers: Is the centre of the shower no less than 406mm from any obstruction?

  Yes

  No

  N/A

• Eye Washes: Are the nozzles no less than 153mm from the wall or nearest obstruction?

  Yes

  No

  N/A

CHECK PARTS

• Are all parts in place and in good condition?

  Yes

  No

  N/A

• If a shut off valve is fitted, are systems in place to prevent unauthorised closure?

  Yes

  No

  N/A

• Showers: Is the shower valve and rod assembly aligned to ensure proper operation?

  Yes

  No

  N/A

• Showers: Is the shower head fitted and in good condition (no corrosion)?

  Yes

  No

  N/A

• Eye Wash: Are dust covers fitted and will open automatically when activated?

  Yes

  No

  N/A

• Eye Wash: Are the units in good condition (no broken parts or corrosion)?

  Yes

  No

  N/A

• Eye Wash: If aerators are fitted, are they in good condition (not damaged or missing)?

  Yes

  No

  N/A

OPERATION OF SHOWERS

• Activate the shower for a period long enough to verify operation and ensure flushing fluid is available?

  Yes

  No

  N/A

• If the shower is located indoors, is there provision for drainage?

  Yes

  No

  N/A

• Are self contained units monitored to determine if flushing fluid needs to be changed or supplemented?

  Yes

  No

  N/A

• Are test recorded on the test tag?

  Yes

  No

  N/A

OPERATION OF EYE WASH & FACE WASH

• Activate the eye wash for a period long enough to verify operation and ensure that flushing fluid is available (weekly)?

  Yes

  No

  N/A

• If the shower is located indoors, is there provision for drainage?

  Yes

  No

  N/A

• Are self contained units monitored to determine if flushing fluid needs to be changed or supplemented?

  Yes

  No

  N/A

• Are test recorded on the test tag?

  Yes

  No

  N/A

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