Lumiform / Templates / Weekly Emergency Eyewash Station Inspection Template

Weekly Emergency Eyewash Station Inspection Template

Regularly flush and inspect your eyewash stations to always be prepared in case of an emergency and ensure their working order at all times. Preventive measures like adhering to the Occupational Safety and Health Act and ensuring the optimal functioning of your safety equipment is a necessary and responsible act that can greatly reduce risks. Use our free eyewash inspection template to conduct your weekly audits and protect yourself and your employees.

Downloaded 54 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

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

Weekly Emergency Eyewash Station Inspection Template

General Information

Site

Inspection conducted by

Date & Time of Inspection

Eyewash Station Flushing

Please flush the emergency eyewash stations weekly and check for the following:

Is the water clear?

Are the jets working properly?

Is the area around the station clear of obstructions?

Is there a bucket under the eyewash to catch the runoff?

Is the instruction sign for the usage of the eyewash station clearly legible?

Is the emergency phone contact clearly legible?

Sign Off

Additional comments

Signature

Previous template

Next template

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.