PROJECT NAME: AL-RAWABE BSP 9047

ELEMENT 1.4d
EMERGENCY SHOWER EYE WASH INSPECTION CHECKLIST

LOCATION Battery Room SHOWER EYE WASH ROOM No. 01 MONTH August

LEGEND OK – ACCEPTABLE, NOT - NOT ACCEPTABLE, ELM– EQUIPMENT LOST OF MISSING, REP – EQUIPMENT BEING REPAIRED, N/A – NOT APPLICABLE
RAISE THE ISSUES THROUGH CORRECTION REPORT (BEFORE & AFTER PHOTO) FOR ACTION TAKEN

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Date 1

9
Time
Emergency Signs
available
Controls (Levers/
Chains/Floor step)
Water supply control
valve (open)
Water Temperature

Strength of water flow

Equipment clean

Floor Demarcation

Cleaning Supplies
Emergency Numbers
posted
Emergency Signs

Cleaner Signature

Supervisor Signature

Safety Officer Name: _______________________________ Signature: _____________________ Date: _____________________

(Reviewed By)

Site Manager Name: _______________________________ Signature: _____________________ Date: _____________________

(Accepted By)

Page 1 of 1 Rev.2 [08-April-2019] Projects Business Unit