Title Page
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Conducted on
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Prepared by
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Location
Eyewash Annual Report
- Facility Area
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Facility Area:
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Pictures of Unit:
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Type of Unit:
- Safety Station
- Eyewash
- Eye/Face Wash
- Portable Eyewash
- Emergency Shower
- Eyewash/Drench Hose
- Faucet/Deck Mounted
- Eyewash Bottle (Supplemental Equipment)
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Current Unit's Manufacturer:
- Guardian
- Haws
- Bradley
- Speakman
- Encon
- Hughes
- Acorn
- Honeywell
- Oval
- N/A
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Water supply delivers required flow when shower and eye or eye/face wash are operated simultaneously.
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Hands-free stay-open valve activates in one second or less.
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Height of water column is between 82" (208.3 cm) and above 96" (243.8 cm) above the floor.
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Shower delivers 20 gallons (75.7 liters) of water per minute for 15 minutes in the required pattern.
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Easily located, accessible actuator is no more than 69" (173.3 cm) above floor.
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Center of the water pattern is at least 16" (40.6 cm) from any obstruction.
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At 60" (152.4 cm) above the floor, the water pattern is at least 20" (50.8 cm) in diameter.
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Spray heads are protected from airborne contaminants. Covers are removed by water flow.
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Unit delivers at least 3.0 GPM (11.4 liters) (for eye/face wash) or 0.4 GPM (1.5 liters) (for eyewash) for 15 minutes.
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Valve actuator is easy to locate and readily accessible to user.
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Water flow pattern is positioned between 33" (83.8 cm) above floor and 53" (134.6 cm) from the floor and at least 6" (15.3 cm) from the wall or nearest obstruction.
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Installed within 10 seconds (approximately 55 feet) of hazard, on the same level as hazard and with unobstructed travel path.
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Identify location with highly visible sign. Area around safety station shall be well-lit.
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Water delivered shall be tepid (60-100°F).
