Title Page
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Company
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Conducted on
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Completed by
Safety Shower & Eye Wash Stations
- Unit #
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Unit Type?
- Eye Wash & Safety Shower Station
- Eye Wash Station (only)
- Safety Shower Station (only)
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Unit location
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Unit Station Photo
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Is the unit easily accessible and free from any obstacles?
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Is the unit reasonably clean?
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Pipework and unit free from any damange or leaks? (Visually inspect before testing)
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Activate unit and flush pipes until water is clear. Is the unit operational?
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Equipment signage highly visible and damage free?
