Hank Schinkel

Emergency Eyewash and Shower Inspection Sheet

Weekly checks by on-site staff, operate eyewash and shower to prove correct operation adequate water flow and to flush water supply line.

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Site conducted at
Conducted on
Prepared by

Emergency Eyewash and Shower Check List

Eyewash and shower has clear access with no obstructions
Bowl and spouts are clean and free of foreign objects
Eyewash flow is continuous from both spouts (streams of water should cross)
Flow stops when handle is returned to the off position
Shower has suitable flow
Shower has continuious flow
Flow stops when handle is returned to the off position
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Hank Schinkel

Emergency Eyewash and Shower Inspection Sheet

Weekly checks by on-site staff, operate eyewash and shower to prove correct operation adequate water flow and to flush water supply line.

Use this Template

Print as PDF

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