LOCATION: _____________
MONTH: _____________ YEAR: _________ (Optional)
WEEKLY EMERGENCY EQUIPMENT MAINTENANCE LOG
Single and Dual Head Eyewashes, Showers, Drench Hoses, Combination Units
•
Equipment must be run WEEKLY for 3 minutes and until water is sediment-free.
•
Inside of eyewash cap must be cleaned WEEKLY with alcohol.
•
Water must come on within one second of activation.
•
Water must feel tepid (if so equipped).
•
Water must have adequate pressure (based on hand and visual inspection).
•
Eyewash caps must be present and in working condition.
Equipment In Good Working Condition?
Date Inspected
Inspected By
Corrective Actions Taken (if needed)
Y or N*
* IF EQUIPMENT IS NOT OPERATING PROPERLY, PROBLEM MUST BE REPORTED TO FACILITIES.