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Free Eyewash Station Inspection Checklist and Weekly Tag (PDF + Printable)

Brian Story, Co-founder of AED Log

By Brian Story

Co-founder, AED Log

Updated October 12, 2026 · 3 min read

Free printable PDF

A free weekly eyewash station inspection checklist based on ANSI Z358.1’s weekly activation, plus a printable tag to initial at each check.

  • Page 1: the nine weekly checks for one station, with a column for each week of the month
  • Page 2: two weekly inspection tags with a 52-week log
  • The same nine checks as AED Log’s weekly eyewash station inspection

Download the eyewash checklist and tag PDFPDF, letter size. No email required.

The free weekly eyewash station inspection checklist: nine checks, from activating and flushing the station to signage and fluid expiration, with a column for each week of the month and rows for the date and initials

The weekly eyewash station inspection checklist

Each week, activate the station and check nine things: that it flushed, that both nozzles flow evenly, that the fluid is clear and tepid, that access is clear, that the covers and sign are in place and, for self-contained units, that the fluid is in date.

  • Was the station activated and flushed this period?
  • Does fluid flow from both nozzles?
  • Is the flow adequate and even?
  • Is the fluid clear and acceptable?
  • Is the water tepid (approx. 60–100°F)?
  • Is access to the station unobstructed?
  • Are the protective nozzle covers in place?
  • Is the signage present and visible?
  • For self-contained units: is the flushing fluid within its expiration date? (self-contained units only)

ANSI/ISEA Z358.1 calls for plumbed stations to be activated weekly and every station to be inspected once a year. OSHA hasn’t adopted the standard, but uses it to judge whether a station is suitable under 29 CFR 1910.151(c). For the full rules, read the eyewash station requirements guide.

The printable weekly eyewash inspection tag

The tag hangs on the station and holds a year of weekly checks: a row for each week, with the date and the initials of whoever activated it.

Two printable weekly eyewash station inspection tags on one page, each with the weekly checks and a 52-week log of date and initials
Page 2: two weekly eyewash inspection tags per sheet, each with a 52-week log.

Each tag has the station’s ID and location, whether it’s plumbed or self-contained, the fluid’s expiration date, and the weekly checks as a reminder. Print it on card stock or put it in a clear sleeve so it survives the spray.

How to use the checklist and tag

Activate the station each week, answer the nine checks, initial the checklist and the tag, and take the station out of service if anything fails.

  1. Print page 1 for each station each month, and hang a tag from page 2 on the station.
  2. Fill in the station’s ID, location and type, and the fluid’s expiration date if it’s self-contained.
  3. Each week, activate the station and let it run, then answer the nine checks Y or N for that week.
  4. Write the date and your initials at the bottom of the week’s column, and initial the tag.
  5. If any answer is N, tag the station out of service and report it right away.
  6. Once a year, have every station inspected against ANSI Z358.1, and file the sheets with your safety records.

Track eyewash inspections automatically instead

AED Log schedules each station’s weekly check, records who did it and when, and alerts you when a check is missed or fails.

  • The same nine weekly checks on any phone, started from the station’s QR label.
  • Reminders before each weekly check is due, and alerts when it’s overdue.
  • Self-contained units’ fluid expiration dates tracked with a warning.
  • Eyewash stations are an add-on at $10 per station per year.

See eyewash station inspection software.

Never miss a weekly eyewash check

Reminders every week, a record of who activated each station, and alerts when a check fails.

45 days free. No credit card required. Then plans from $114 a year.