Title Page

  • Site conducted

  • Conducted on

  • Prepared by

EGMS Portable eye wash monthly checklist

  • Does the station have a minimum of 1L of eyewash solution ?

  • Is the expiration date on any eyewash bottles within the expiration period?

  • Are the station and bottles free from dust and dirt ?

  • Are the eyewash bottles intact with unbroken seals?

  • Is the station well-lit and signposted and free from obstruction?

  • Is the station able to securely hold the eyewash bottles?

  • Comments/Actions Needed

  • Inspector Signature

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