Information
-
Site conducted
-
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:
- Employees;
- Contractors;
- Trainees;
- Visitors;
- Members of the public;
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