Pettit monthly and Emergency Shower Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Pettit Second Floor

• North lab hallway emergency shower/eyewash. Was the test performed and does it operate properly?

  Safe

  At Risk

  N/A

• South lab hallway emergency shower/eyewash. Was the test performed and does it operate properly?

  Safe

  At Risk

  N/A

• Is it free of any other hazards or problems?

  Yes

  No

  N/A

Pettit First Floor

• North lab hallway emergency shower/eyewash. Was the test performed and does it operate properly?

  Safe

  At Risk

  N/A

• South lab hallway emergency shower/eyewash. Was the test performed and does it operate properly?

  Safe

  At Risk

  N/A

• Is it free of any other hazards or problems?

  Yes

  No

  N/A

Pettit Basement/Loading Dock

• Loading Dock emergency shower/eyewash. Was the test performed and does it operate properly?

  Safe

  At Risk

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Is it free of any other hazards or problems?

  Yes

  No

  N/A