Information
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This inspection is used to ensure that all eye wash stations are compliant and ready to use.
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Prepared by
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Conducted on
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Area being inspected?
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EW 1 - (Bottle Station) Repairs by East Employee entrance door is present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 2 - (Bottle Station) Receiving area East side by electrical room present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 3 - (Green Pure Flow station) Receiving area Battery charging area present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 4 - (Bottle Station) HC finishing area column H4 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 5 - (Bottle Station) HC East Mezzanine by 742 #1 machine present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 6 - (Bottle Station) HC by fabric cutting area column H3 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 7 - (Bottle Station) HC by cells Column G5 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 8 - (Bottle Station) HC by by specialties facing main lunch room column F3 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 9 - (Bottle Station) HC facing east on column G1 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 10 - (Bottle Station) HC boxing area column D6 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 11 - (Bottle Station) Verticals column D3 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 12 - (Bottle Station) Verticals column D2 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 13 - (Bottle Station) Parts by stairway to CBG West side present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 14 - (Bottle Station)Parts facing North Column C1 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 15 - (Green Pure Flow station) Shipping by South West Docks present?
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Is the area 36" minimum around the station clear and unobstructed?
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Remove cover, are the solution bags full?
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Is the expiration date good?
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Inspect the drain spigot. Is the the drain lever is closed and is facing the rear of the unit?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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Is the tamper seal in place and intact?
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EW 16 - (Bottle Station) Shutters area Column B4 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 17 - (Bottle Station) Shutters Area Column C5 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 18 - (Green Pure Flow station) Shipping area by Dock #7 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Remove cover, are the solution bags full?
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Is the expiration date good?
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Inspect the drain spigot. Is the the drain lever is closed and is facing the rear of the unit?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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Is the tamper seal in place and intact?
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EW 1 - (Bottle Station) Column C13 present?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 2 - (Bottle Station) Column E11?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 3 - (Bottle Station) Column E11?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 4 - (Bottle Station) Column G11?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 5 - (Bottle Station) (Bottle Station) Column I11?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
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EW 6 - (Bottle Station) (Bottle Station) Column I13?
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Is the area 36" minimum around the station clear and unobstructed?
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Is the expiration date on the bottle good?
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Is the bottle cap sealed?
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Is the station labeled (Pole has Green Stripe, Eye wash Signage present)
Signature
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Signature of Auditor