Upgrade Building of Risk mitigation RTR Facilities MANUFACTURER

MODEL#
BI-10-02062 CONTRACT: 6601000161 Al Rashid Trading & Contracting Co
DEPARTMENT: RNGLPD DIVISION: NRTR&JNGLPD SERIAL #

Document Title Portable Eyewash Inspection Checklist Location TANK CAPACITY

PORTABLE EYEWASH INSPECTION CHECKLIST

S DAY SAT SUN MON TUE WED THU FRI COMMENTS
ITEM DESCRIPTION
NO DATE
1 Is the eyewash tank cover available
2 Is the eyewash arm intact when in closed position
3 Is the eyewash arm opening completely in open position
4 Is the water ejecting with pressure from eyewash eyepoint
5 Is the water inside the eyewash tank clean
6 Is “how to use eyewash” instructions posted
7 Does the eyewash have any physical damage/defect
8 Is there any dust accumulated on eyewash outer body
9 Is the eyewash secured with carrying/lifting handle
ADDITIONAL INFORMATION/REMARKS

LEGEND: Yes- , No- , Not Applicable-N/A

INSPECTED BY (Site Supervisor) VERIFIED BY (safety officer)
NAME
SIGNATURE

RTCC SA-RTR PROJECT SAFETY DEPARTMENT