Title Page
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Audit No.
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Customer Details: The University of Qld
Audit Details
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Safety Shower/Emergency Eyewash Location
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Building Name and Number
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Floor Level
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Room Number
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SS/EYE WASH Identification number
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Add a photo of the ID Plate
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Add a photo of Installation
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Conducted on
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Conducted by
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Name
Safety Showers
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Is the Safety Shower hard plumbed to water supply?
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Discontinue audit
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Is Access to the Safety Shower inhibited?
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Report to Supervisor
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Add photo
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Is the pathway through the Lab to the Safety Shower inhibited?
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Report to Supervisor
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Add photo
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Is the Safety Shower outlet height, between 2083 mm & 2438mm?
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Report to Supervisor
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Record height
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Add photo
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Record height
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Is the flow rate above the minimum 75.7 L/min?
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Report to Supervisor
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Record flow rate
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Add photo
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Record flow rate
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Add photo
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Is there a minimum of 406mm from the centre of the Safety Shower which is free from obstruction?
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Report to Supervisor
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Detail obstruction
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Add photo
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Does the Control Valve remain open without the use of your hands?
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Report to Supervisor
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Give details
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Is the Safety Shower in an enclosure?
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Give details & confirm that there is 864mm diameter of unobstructed area around centre of SS
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Add photo
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Can this or any other Safety Shower be accessed from anywhere in the Lab in 10 seconds?
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Detail issues
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Add photo
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Are Safety Shower locations clearly marked & visible through the entire Lab?
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Give details
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Add photo
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Is the water from the Safety Shower tepid (i.e. between 15.6’c -37.8’c)?
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Report to supervisor
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Record temperature
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Add photo
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Record temperature
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Can you activate shower & measure spray pattern for Compliance with Figure 6.1 from AS4775
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Give details
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Add photo
Emergency Eyewash
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Is the Eyewash hard plumbed?
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Discontinue audit and report to supervisor
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Is the access to the Eyewash inhibited?
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Report to supervisor
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Add a photo
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Is the pathway through the Lab to the Eyewash inhibited?
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Report to supervisor
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Add a photo
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Does the Eyewash have protection from airborne contaminants?
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Do they remove without a separate motion to the operation of the Eyewash
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Report to supervisor
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Give details
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Add a photo
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Is the Eyewash Unit hands free once operated?
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Report to supervisor
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Give details
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Add a photo
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Is the Eyewash Unit positioned with outlet nozzles between 838mm and 1143mm?
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Report to supervisor
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Give details
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Add a photo
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Is the Eyewash Unit positioned with outlet nozzles having a minimum 153mm clearance from any wall or obstruction?
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Report to supervisor
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Give details
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Add a photo
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Is the Eyewash Unit flow rate above 1.5L/M @ 210 kpa when measured with flow meter?
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Report to supervisor
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Record flow rate
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Add a photo
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Record flow rate
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Add a photo
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Does the Eyewash Unit flushing fluid cover the test gauge as described in AS4775?
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Report to supervisor
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Give details
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Add a photo
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Is the water from the Eyewash Unit tepid (i.e. between 15.6’c – 37.8’c)?
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Report to supervisor
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Record temperature
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Add a photo
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Record temperature
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Add a photo
Eye/Face Wash
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Is the Eye/Face Wash hard plumbed?
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Discontinue audit and report to supervisor
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Is the access to the Eye/Face Wash inhibited?
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Report to supervisor
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Add photo
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Is the pathway through the Lab to the Eye/Face Wash inhibited?
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Report to supervisor
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Add photo
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Does the Eye/Face Wash have protection from airborne contaniments?
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Report to supervisor
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Give details
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Add photo
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Do they remove without a separate motion to the operation of the Eye/Face Wash?
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Is the Eye/Face Wash Unit hands free once operated?
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Report to supervisor
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Give details
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Add photo
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Is the Eye/Face Wash Unit positioned with outlet nozzles between 838mm and 1143mm?
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Report to supervisor
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Give details
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Add photo
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Is the Eye/Face Wash Unit positioned with outlet nozzles having a minimum 153mm clearance from any wall or obstruction?
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Report to supervisor
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Give details
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Add photo
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Is the Eye/Face Wash Unit flow rate above 11.4 L/M @ 210 Kpa when measured with flow meter?
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Report to supervisor
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Record flow rate
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Add photo
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Record flow rate
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Add photo
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Does the Eye/Face Wash Unit flushing fluid cover the test gauge as described in AS4775?
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Report to supervisor
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Give details
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Add photo
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Add photo
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Does the Control Valve remain open without the use of your hands?
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Report to supervisor
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Give details
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Add photo
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Is the water from the Eye/Face Wash Unit tepid (i.e. between 15.6’c – 37.8’c)?
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Report to supervisor
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Record temperature
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Add photo
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Record temperature
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Add photo
Sign Off
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Name of Person
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Person's Name
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Sign here
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Compliant or non-compliant