Information

  • This inspection is used to ensure that all eye wash stations are compliant and ready to use.

  • Prepared by

  • Conducted on

  • Area being inspected?

  • EW 1 - (Bottle Station) Repairs by East Employee entrance door is present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 2 - (Bottle Station) Receiving area East side by electrical room present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 3 - (Green Pure Flow station) Receiving area Battery charging area present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 4 - (Bottle Station) HC finishing area column H4 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 5 - (Bottle Station) HC East Mezzanine by 742 #1 machine present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 6 - (Bottle Station) HC by fabric cutting area column H3 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 7 - (Bottle Station) HC by cells Column G5 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 8 - (Bottle Station) HC by by specialties facing main lunch room column F3 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 9 - (Bottle Station) HC facing east on column G1 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 10 - (Bottle Station) HC boxing area column D6 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 11 - (Bottle Station) Verticals column D3 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 12 - (Bottle Station) Verticals column D2 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 13 - (Bottle Station) Parts by stairway to CBG West side present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 14 - (Bottle Station)Parts facing North Column C1 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 15 - (Green Pure Flow station) Shipping by South West Docks present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Remove cover, are the solution bags full?

  • Is the expiration date good?

  • Inspect the drain spigot. Is the the drain lever is closed and is facing the rear of the unit?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • Is the tamper seal in place and intact?

  • EW 16 - (Bottle Station) Shutters area Column B4 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 17 - (Bottle Station) Shutters Area Column C5 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 18 - (Green Pure Flow station) Shipping area by Dock #7 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Remove cover, are the solution bags full?

  • Is the expiration date good?

  • Inspect the drain spigot. Is the the drain lever is closed and is facing the rear of the unit?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • Is the tamper seal in place and intact?

  • EW 1 - (Bottle Station) Column C13 present?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 2 - (Bottle Station) Column E11?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 3 - (Bottle Station) Column E11?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 4 - (Bottle Station) Column G11?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 5 - (Bottle Station) (Bottle Station) Column I11?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

  • EW 6 - (Bottle Station) (Bottle Station) Column I13?

  • Is the area 36" minimum around the station clear and unobstructed?

  • Is the expiration date on the bottle good?

  • Is the bottle cap sealed?

  • Is the station labeled (Pole has Green Stripe, Eye wash Signage present)

Signature

  • Signature of Auditor

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