Eyewash Station Log Sheet PDF Details

When you work in a laboratory, it is important to follow the safety procedures established by your institution. One of the most important safety procedures is using an eyewash station when you get chemical in your eyes. The Eyewash Station Log Sheet can help you keep track of when you last used the eyewash station and whether or not it was effective. This sheet can also help you keep track of any other safety protocols that need to be followed.

If you want to learn a number of specific details pertaining to the PDF you will use, here is the information you might want to study prior to filling in the eyewash station log sheet.

Form NameEyewash Station Log Sheet
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other nameseyewash form, eyewash weekly form, printable eyewash station inspection forms, eyewash inspection sheet requirements osha

Form Preview Example

Safety Affairs 448-6114

Eyewash Weekly Inspection Form

An emergency eyewash fixture is provided to flush tepid water to the eye, diluting any hazardous materials that may have come into contact with the eyes.

General Requirements:

Initial and date in the corresponding box verifying the eyewash station is checked weekly for the following:

The pathway to the eyewash station is clear of obstructions

The eyewash fixture is free of obstructions in all directions

The nozzle dust caps/covers are in place and operating properly

To test the eyewash station, flush water until clear water flows continually through eyewash

head without any leaks, rust, dirt, etc. for approximately 5 seconds. ( If problems are evident, call Physical Plant at 85661)




Call Safety Affairs (at 86114) with any questions


Year ______


Week 1

Week 2

Week 3

Week 4

Week 5




































































































































































Principal Investigator:



Room #: _________________________________

Version 2011.1

How to Edit Eyewash Station Log Sheet Online for Free

The PDF editor makes it simple to prepare the printable eye wash station checklist document. You will be able to get the file right away through these simple steps.

Step 1: First, select the orange "Get form now" button.

Step 2: You can now modify your printable eye wash station checklist. Our multifunctional toolbar will let you add, erase, alter, and highlight text as well as perform several other commands.

The PDF template you wish to fill out will include the next parts:

stage 1 to filling out eyewash weekly form

Write down the details in the NOVEMBER, DECEMBER, Principal Investigator, Room, and Version field.

Filling in eyewash weekly form part 2

Step 3: Hit the button "Done". The PDF file is available to be transferred. You may download it to your pc or email it.

Step 4: To stay away from possible future difficulties, take the time to get as much as several copies of each separate document.

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