First Aid Kit Contents and Expiry Check
Check a kit against the contents list that applies to it and leave a dated record of what was missing, what had expired and what was put back.
IN-01 1 page
Incident and first aid records · IN-07
Eyewash and Safety Shower Check Record
A free printable eyewash and safety shower check record — station, location, flush done, water clarity and flow, expiry on sealed bottles, access and who checked it.
Download Free · no sign-up
One page. Choose your paper size — both versions are laid out identically, so neither one gets shrunk to fit.
Print it and write on it
Fill it in type and save
The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.
What this sheet is for
Turn a flush that everybody assumes is happening into a dated line somebody has put their name against, and catch a blocked or obstructed station early.
Who it is for
Workshops, labs, garages, farms, salons, pools and anywhere a plumbed station or sealed eyewash bottles are kept.
How to use it
- List the site and give each station its own reference at the top.
- Run the station, and record the date, who did it and whether the water ran clear.
- Describe the flow in your own words rather than guessing a figure.
- Check that nothing has been stacked in front of the station or its signage.
- Copy the expiry date printed on any sealed eyewash bottle, and note what needs doing.
What is on the sheet
One page, top to bottom:
Printed under the title: A record of each flush and look-over of an eyewash station or safety shower — that water ran, what it looked like, and the dates on any sealed bottles.
Your routine, recorded. This sheet records what was done and what was seen. How often a station is flushed, and what flow or clarity is acceptable, come from the equipment's own instructions and from the site's own routine — there are no figures printed here.
Write-on lines: Site / building · Station reference · Location
Flush and inspection record
Table, 12 rows: Date · Station · Flushed · Water ran clear · Flow observed · Access clear · Bottle expiry · Checked by · Action needed
Questions
Why is there no interval printed on this sheet?
Because it depends on the station, the manufacturer's instructions and how the place is run. The sheet records that a flush happened on a given date; the routine behind it is yours to set and yours to state.
Why record flow in words rather than a number?
Because measuring it properly needs equipment most people keeping this record do not have. A plain note — steady, weak, spluttering, nothing — is honest and is enough to show a change over time.
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