8/17/2019 Attachment 01 of SOP 21 - Chemical Handling and Spillage Control

1/1

PPL – HSE / FM / CH / 01

Rev: 00

Emergency Eye Wash Shower Inspection Sheet

Dept. / Field / Location: ____________________ Date of Inpection: ____________ 

Location / ID ! of E"S: ____________________ 

S # Checks Y /N /NA

Suggested Action Action byTargetdate

1 I t#e a$ea %$$o%ndin& t#e E'e "a#S#o(e$ f$ee of all o)t$%ction*

+ ,ii)le i&na&e placed fo$ identification*

- n' elect$ical panel p$eent in nea$  %$$o%ndin&*

If 'e t#en elect$ical panel i cove$ed (it#platic #eet*

I t#e E'e "a# eail' activated*

I t#e #o(e$ i ope$ative )' c#ain /pedetal*

2 $e t#e no33le e4%ipped (it# p$otectedcove$*

5 I t#e (ate$ flo(in& f$o6 )ot# e'epiece*

7 I t#e flo( of (ate$ of e4%al #eit f$o6 )ot#e'epiece*

10 I t#e flo( of (ate$ clea$*

11 Doe t#e p$a' patte$n delive$ a tead't$ea6 of (ate$ o$ i f%$t#e$ divided*

1+ I (ate$ flo( ade4%ate %pon - 6in%tecontin%o% ope$ation*

1- I t#e (ate$ te6pe$at%$e contant and tepid*

1 Doe t#e (ate$ d$ain p$ope$l' f$o6 t#e)ain in8*

1 I )ae of t#e tation clean and f$ee f$o6 an'd$ain (ate$*

12 I t#e$e an' t$%ct%$al co$$oion*

15 I t#e$e an' lea8a&e t#$o% pipin& / (ate$ tan8.

Comments

P$epa$ed )' : _________________ Revie(ed )' : _____________________________HSE Rep$eentative Dept. Head / Field / Location Inc#a$&e