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Weekly Production Emergency Eyewash Inspection 121D

OSHA 29 CFR 1910.151 requires “...where the eyes or body of any person may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use.” ANSI Z358. 1 requires that plumbed emergency eyewash and shower stations should be visually inspected and activated every week. Equipment requires annual servicing to ensure effective operation. Proper training covering the location and use of the eyewash is required.
Urethane Sciences, LLC
05/06/2022

Weekly Production Emergency Eyewash Inspection 121D

OSHA 29 CFR 1910.151 requires “...where the eyes or body of any person may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use.” ANSI Z358. 1 requires that plumbed emergency eyewash and shower stations should be visually inspected and activated every week. Equipment requires annual servicing to ensure effective operation. Proper training covering the location and use of the eyewash is required.

    DATE OF INSPECTION

    The area around and the path to the eyewash is not obstructed.

    • Pass
    • Flag
    • Fail

    Verify nozzle caps are in place and the nozzles, nozzle caps, and bowl are clean and sanitary.

    • Pass
    • Flag
    • Fail

    Push hands-free valve to full open position. Water must flow within 1 second. Run minimum 60 seconds

    • Pass
    • Flag
    • Fail

    Verify that nozzle caps come off when the eyewash is activated and water is flowing.

    • Pass
    • Flag
    • Fail

    Verify water continues to flow until manually turned off and can be used hand-free by pushing water valve activator..

    • Pass
    • Flag
    • Fail

    Look at the water flow pattern. It should provide a non-injurious flow from both nozzle streams.

    • Pass
    • Flag
    • Fail

    The water should flow from both streams and rise to an equal height in a pattern that will flush both eyes simultaneously.

    • Pass
    • Flag
    • Fail

    Water flow covers area shown in test gauge, maximum 8” above spray heads, minimum 33" above the floor.

    • Pass
    • Flag
    • Fail

    Test Gauge

    • EyewashTestGauge.JPG
    Add or drag pictures

    Use thermometer to confirm water temperature is tepid, minimum 60°F, maximum 100°F.

    • Pass
    • Flag
    • Fail

    Continue to run eyewash and flush until water is clear.

    • Pass
    • Flag
    • Fail

    Report problems to the Safety Manager. Sign in the box to confirm inspection results.

    Click here to sign
Source: Urethane Sciences, LLC (Community Member)

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