A sample built from fictional records: every company, unit and date below is made up. Your reports carry your own records. Back to Eyewash Station Log

Sample company (fictional) · Eyewash Station LogDraft generated Oct 30, 2026

Eyewash station log

Weekly activation

Record

CompanySample company (fictional)
TradeEyewash Station Log
CheckWeekly activation

Station

Station IDWhere it isKind
Station ID 1North bayPlumbed eyewash

Check

Check typeDateInitials of personResultIssue foundCorrective action
Weekly activationSep 30, 2026Initials of person 1PassIssue found 1Corrective action 1
Weekly activationJul 22, 2026Initials of person 11PassIssue found 11Corrective action 11
Weekly activationMay 13, 2026Initials of person 21PassIssue found 21Corrective action 21
Weekly activationMar 4, 2026Initials of person 31PassIssue found 31Corrective action 31
Weekly activationDec 24, 2025Initials of person 41PassIssue found 41Corrective action 41
Weekly activationSep 20, 2026Initials of person 51PassIssue found 51Corrective action 51
Weekly activationJul 12, 2026Initials of person 61PassIssue found 61Corrective action 61
Weekly activationMay 3, 2026Initials of person 71PassIssue found 71Corrective action 71

Next due

Weekly activation
ANSI Z358.1 FAQ: What is the Weekly Test vs. the Annual Test? (Haws) (https://www.hawsco.com/?p=821), checked 2026-10-28		Oct 7, 2026Set by rule
Annual inspection
Testing and Inspecting Your Emergency Equipment (Occupational Health & Safety) (https://ohsonline.com/articles/2017/05/01/testing-and-inspecting-your-emergency-equipment.aspx), checked 2026-10-28		Oct 30, 2026Set by rule