CHECKLIST FOR SAFETY SHOWER CUM EYE WASH FOUNTAIN OPERABILITY

WEEKLY RECORD

Date: Year: 2008

Sr. Points Safety Shower Location & Tag No. Remarks

No.
Prod. Plant Quality
Gr. Floor Control Lab.
SW-1 SW-2 SW-3 SW-4 SW-5
1 Water supply to eye wash
shower is continuous for at
least 2 minutes
2 Any water leakage found
through any joints
3 Eye wash operating pad is
working satisfactorily
4 Head wash operating knob is
working satisfactorily
5 Protection caps are available
with eye was spray nozzles &
properly placed
6 Strainer is installed upstream
of eye washer assembly.
7 Water coming out of the eye
washer / head washer is clean
& free from suspended
particles.
8 Any other problem

Done By : Checked By :