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Annual Emergency Eyewash Station Inspection Template

While weekly inspections of your emergency eyewash stations are imperative to ensure the health and safety of your team, annual checklists are just as important for general maintenance. Are there enough stations in every room that works with hazardous material? What can be improved upon? Is the water pressure and temperature adequate? Take your time to make sure that you fulfil all OSHA requirements in order to be on the safe side and practice smart and effective risk management.

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Annual Emergency Eyewash Station Inspection Template

General Information

Inspection Site

Combination unit number

Inspection conducted by

Date & Time

Unit Inspection

Accessibility, Location & Positioning

Is the eyewash station at least 15 cm away from the nearest obstruction?

Are protective covers installed on each nuzzle to prevent airborne contamination?

Can the unit be reached within 10 seconds or 15 meters?

Is the unit on the same level as the hazard?

Is the unit free from obstructions?

Is the unit well-lit?

Is the unit identified with signage?

Fluid Delivery, Capacity & Temperature

Is the water tepid (15-37°C) and protected from freezing or excess heat?

Is the unit free from leakage?

Can the water supply be turned from "off" to "on" in less than one second?

Does the water remain flowing without user's assistance?

Does the unit provide full flow for 15 minutes?

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Additional comments or remarks

Photo proof if necessary

Recommendations

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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.

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