Safety Shower / Eyewash Weekly Checklist

• Document No.

• Site / Facility

  Select UND1 UND2 HPT7 HPT8 ORA DUP ORA NOE

  • UND1
  • UND2
  • HPT7
  • HPT8
  • ORA
  • DUP ORA
  • NOE

• Conducted on

  Date

• Reported on

  Date

• Prepared by

• Personnel

• Safety Shower / Eyewash Unit

Unit #

• Add media

  Media

LOCATION

• Accessible within 10 seconds of hazard, apprx. 55ft/16.8m?

• Located on same level as hazard and path of travel is free of obstructions?

• Emergency equipment is well lit and identified with a highly visible sign?

COMBINATION UNIT

• Combination unit components capable of operating simultaneously and positioned so that components may be used simultaneously by the same user?

SHOWER

• Designed so that flushing flow remains on without the use of the operators hands. The valve is simple to operate and goes "off" to "on" in one second or less and actuator is not more than 69 inches from surface of floor of user?

EYEWASH / EYE/FACE WASH

• Controlled flow to both eyes simultaneously at a velocity low enough to be non-injurious?

• Outlets protected from airborne contaminants?

• Designed so that flushing flow remains on without the use of the operators hands. The valve is simple to operate and goes "off" to "on" in one second or less?