close
lumiform
Lumiform Mobile audits & inspections
Get App Get App

Annual Eyewash Station Inspection

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.

Downloaded 46 times

Rated 5/5 stars on Capterra

Say goodbye to paper checklists!

Lumiform enables you to conduct digital inspections via app easier than ever before
  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 5,000 expert-proofed templates

Digitalize this paper form now

Register for free on lumiformapp.com and conduct inspections via our mobile app

  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 4000 expert-proofed templates
Rated 5/5 stars on Capterra

Annual Eyewash Station Inspection

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?

Sign Off

Additional comments or remarks
Photo proof if necessary
Recommendations
Signature
Share this template:

Ensure Workplace Safety with an Annual Eyewash Station Inspection


An annual eyewash station inspection is a critical part of workplace safety to ensure that the eyewash station is working correctly in the event of an emergency. The eyewash station is essential in the event of a hazardous chemical splash or other eye injuries, providing immediate flushing of the eyes to reduce the risk of injury.


During the annual inspection, a trained professional will check the eyewash station's water flow, temperature, and location to ensure that it meets the standards set by the American National Standards Institute (ANSI). The inspector will also check for any damage or wear on the equipment and ensure that the area around the eyewash station is clear and accessible.


Failing to conduct an annual inspection or neglecting to maintain the eyewash station properly can result in significant fines and legal liabilities if an accident occurs. By conducting an annual eyewash station inspection, companies can ensure the safety of their employees and comply with regulatory requirements.

Similar templates