Information

  • COSHH Risk Assessment No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Address
  • Personnel

  • Product Name

  • Manufacturer

  • Product code

  • Manufacturer Contact Number

  • Section where used

  • Description

  • MSDS held

  • Date of MSDS

Hazard Classification

  • Very toxic.

  • Toxic

  • Corrosive

  • Oxidising

  • Irritant

  • Harmful

  • Extremely flammable

  • Highly flammable

  • Flammable

  • Biological

  • Environmental

  • Sensitising

How is it used

  • Describe the activity or work process. (Include how long and how often this is carried out and the quantity of substance used)

  • Location of the process being carried out?

Hazardous Substances produced

  • Are any hazardous substances produced by any process. (eg fumes from heating substance)

Who It Might Effect

  • Identify the person at risk:

Hazard Type

  • Gas

  • Vapour

  • Mist

  • Fumes

  • Dust

  • Liquid

  • Solid

  • Other

  • If Other, state the nature of the hazard type?

Route of exposure

  • Inhalation

  • Skin

  • Eyes

  • Ingestion

  • Other

  • If other, state type?

What Controls Are Currently In Place

  • Total enclosure of process

  • Partial enclosure of process

  • General workplace ventilation

  • Wet methods (to control dust)

  • Respiratory protection

  • Eye protection

  • Gloves

  • Protective overalls

  • Rubber apron

  • Other

  • If other, give explanation

General Precautions

  • General precautions and personal protection needed (Consider warning signs, ventilation, work patterns, personal hygiene / cleanliness, protective clothing)

First Aid

  • Eyes

  • Skin

  • Ingestion

  • Inhalation

Chemical Spill

  • Action in case of emergency (Spillage, uncontrolled release, fire)

Environmental

  • What are the environmental implications?

Storage Disposal and transportation Information

  • Storage

  • Disposal

  • Transport

Assessment Of Risk

  • Overall assessment of risk with regard to current usage of this substance

Improvements

  • Are the current controls effective

  • Does the MSDS suggest any controls that are not in place

  • Is air monitoring considered appropriate

  • Can the process be re-engineered

  • Has the use of an alternative less dangerous substance been considered

Assessment Review

  • This assessment should be reviewed periodically or it there are any changes in the process.

  • Date of next review

Assessment Completed By

  • Assessor Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.