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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.
Date Inspected Inspected By
Equipment In Good Working Condition?
Y or N*
Corrective Actions Taken (if needed)
* IF EQUIPMENT IS NOT OPERATING PROPERLY, PROBLEM MUST BE REPORTED TO FACILITIES.
LOCATION: _____________
MONTH: _____________ YEAR: _________ (Optional)