Eye Wash & Safety Shower Inspection Checklist - SS-5101

Area: Tank Farm Location: North of TK-108 Date & Time:

Sr.No. Points to check Yes No N/A

1 Is the eye wash & safety shower identified by a highly visible sign? ✔

2 Is the area surrounding the wash & safety shower station free of all obstructions? ✔

3 Is there any visible corrision? ✔

4 Is the unit free from sharp projections in the operating area of the unit? ✔

5 Is thewash & safety shower easily activated? ✔

6 Are the nozzles equipped with protective covers? ✔

7 Are the covers removed by activation of the eyewash? ✔

8 Is the water flowing from both eyepieces & shower? ✔

9 Is the flow of water of equal height? ✔

10 Is the flow of water clear? ✔

11 Does the water drain from the bowl/sink? ✔

Remarks if any: Found ok

Inspected by (Name): Hashmat Munir Khan Signature:

Form No.: QHSSE-FO-041 Rev.: 00 Date: 1 Jan 2018