2. Is the Sole Purpose of the Unit As an Emergency Shower?

Emergency Showers

Emergency Showers: General

Yes No N/A [ ] [ ] [ ] 1. Are suitable facilities provided for quick drenching and flushing of the body from exposure to injurious corrosive materials? 29 CFR 1910.151(c) [ ] [ ] [ ] 2. Is the sole purpose of the unit as an emergency shower?

Emergency Showers: Design and installation

Yes No N/A [ ] [ ] 3. Is the shower constructed of materials that will not corrode while fluid is flushing? [ ] [ ] 4. Has the unit been installed in accordance with the manufacturer's [ ] [ ] 5. Is the supply piping of plumbed showers adequately sized to meet flow requirements? (ANSI Z358.1- [ ] [ ] 6. Is the flushing fluid column at least 82 inches, but not more than 96 inches, in height from the floor or platform? (ANSI Z358.1-2014) [ ] [ ] 7. Is the valve actuator located no more than 69 inches above the floor or [ ] [ ] 8. Once activated, can the shower be used without requiring the use of the operator's hands? (ANSI Z358. 1-2014) [ ] [ ] 9 .

Emergency Showers: Location

Yes No N/A [ ] [ ] [ 1 0 . [ ] [ ] [ 1 1 . [ ] [ ] [ 1 2 . [ ] [ ] [ 1 3 . [ ] [ ] [ 14. Is the path of travel to the shower free of obstructions a door) that may inhibit [ ] [ ] [ ] 15. Is a highly visible sign positioned to clearly identify the location of the shower? (ANSI Z358.1-2014)

Emergency Showers: Operation

Yes No N/A [ ] [ 16. Are manual or automatic valve activators easy to locate and readily accessible? (ANSI Z358.1-2014) [ ] [ 17. Is the valve operable? [ ] [ 18. Can the valve be activated “off” to “on” in one second or less? (ANSI Z358.1-2014) [ ] [ 19. Does the valve remain open without the use of the operator's hands? (ANSI Z358.1-2014) [ ] [ 20. Is the valve free of corrosion? (ANSI Z358.1-2014) [ ] [ 21. Are the shower piping connections free of leaks? (ANSI Z358.1- 2014)

Emergency Showers: Flushing fluid

Yes No N/A [ ] [ ] [ 22. Is the flushing fluid used potable water, preserved water, preserved buffered [ ] [ ] [ 23. Is the temperature of the flushing fluid between 60 and 100 [ ] [ ] [ 24. Is the flow of flushing fluid at a controlled velocity to be non- [ ] [ ] [ 25. Does the shower deliver a minimum of 20 gallons of flushing fluid per minute for 15 minutes? [ ] [ ] [ 26. Does the spray pattern have a minimum diameter of 20 inches? [ ] [ ] [ 27. Is the center of the spray pattern located at least 16 inches from any [ ] [ ] [ 28. Is the spray pattern at least 60 inches above the floor or platform? [ ] [ ] [ 29. Is the flushing fluid substantially dispersed throughout the pattern? [ ] [ ] [ 30. Is stored flushing fluid protected against airborne contaminants?

Emergency Showers: Maintenance and inspection

Yes No N/A [ ]31. Are manufacturer operating instructions readily accessible to maintenance personnel? (ANSI Z358.1-2014) [ ]32. Are plumbed showers activated weekly? (ANSI Z358.1-2014) [ ]33. Are self-contained showers visually checked in accordance with the manufacturer's instructions to determine if flushing fluid needs to be changed or supplemented? (ANSI Z358.1-2014) [ ]34. Are all showers inspected annually? (ANSI Z358.1-2014) [ ] [ ] [ ] 35. Are manufacturer [ ] [ ] [ ] 36. Have employees been [ ] [ ] [ ] 37. Have employees been