HMC Eye Wash Station Inspection

• Location

  Select

• Station location

  Dental

  Pharmacy

  Medical

• Conducted by

Portable Eye Wash Station #1 (Facilities Cage)

• Is the path to the eyewash unobstructed?

  Yes

  No

• Are the nozzle caps are in place to prevent contamination?

  Yes

  No

• Are the nozzles, nozzle caps, and bowl/sink clean?.

  Yes

  No

• Does water flow within 1 second when valve is fully opened?

  Yes

  No

• Does the nozzle come off when the eyewash station is activated?

  Yes

  No

• The water continues to flow until manually turned off and can be used without requiring the use of the operator’s hands.

  Yes

  No

• The water flow is gentle/non-injurious. If a dual-stream eyewash, both streams rise to equal height in a pattern that will flush both eyes simultaneously.

  Yes

  No

• The station reservoir is filled at least half way with eye washing solution.

  Yes

  No

• The station is free of physical damage and does not leak.

  Yes

  No

• Float Covers been securely fastened.

  Yes

  No

• Water was flushed until it ran clear

  Yes

  No

• Any problems were reported immediately to CEO, CMO or COO.

  Yes

  No