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Audit

General Information

Department

Persons involved in COSHH Assessment

People at Risk

other people at risk

Hazard Identification

Add + activity or work process

Process

How long will it take?

How often will it be repeated?

How much substance is used?

Locaton of the process or work being carried out

Hazard
Indicate below which form the substance takes
Indicate below which route(s) of exposure the substance takes

Workplace Exposure Limits (WELs)

Long-term exposure level

Short-term exposure level

List the risks to health below from exposure to the substance

Control Measures

List below control measures eg extraction, ventilation, supervision, include additonal controls for vulnerable persons where necessary

Is health surveillance or monitoring required? (remember health surveillance may be required for vulnerable persons eg pregnant/young workers those with asthma, dermatitis etc)

Personal Protective Equipment
Identify type and specification

Other PPE

Provide standard measures for each PPE required

First Aid Measures

Write first measures when in contact with these chemicals

Storage and Disposal of Substances and Contaminated Containers

How do you store these substances?

Means of Disposing Hazardous Waste

Other means

Summary

Is the exposure adequately controlled?

Risk rating after following control measures

Completion
Full Name and Signature of the Inspector

COSHH Risk Assessment Form Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 335

This Control of Substances Hazardous to Health (COSHH) form is used to control the exposure to hazardous substances to prevent serious illnesses and health problems. Identify the hazards associated with the activity or work process observed and list the control measures and personal protective equipment to be used when handling these substances. Also record first aid measures in case of an emergency. Next record means of disposing hazardous wastes and contaminated containers. Lastly, summarize the report by providing a risk rating after following the control measures. Use iAuditor to conduct better risk assessments to reduce or eliminate health hazards.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

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Audit

General Information

Department

Persons involved in COSHH Assessment

People at Risk

other people at risk

Hazard Identification

Add + activity or work process

Process

How long will it take?

How often will it be repeated?

How much substance is used?

Locaton of the process or work being carried out

Hazard
Indicate below which form the substance takes
Indicate below which route(s) of exposure the substance takes

Workplace Exposure Limits (WELs)

Long-term exposure level

Short-term exposure level

List the risks to health below from exposure to the substance

Control Measures

List below control measures eg extraction, ventilation, supervision, include additonal controls for vulnerable persons where necessary

Is health surveillance or monitoring required? (remember health surveillance may be required for vulnerable persons eg pregnant/young workers those with asthma, dermatitis etc)

Personal Protective Equipment
Identify type and specification

Other PPE

Provide standard measures for each PPE required

First Aid Measures

Write first measures when in contact with these chemicals

Storage and Disposal of Substances and Contaminated Containers

How do you store these substances?

Means of Disposing Hazardous Waste

Other means

Summary

Is the exposure adequately controlled?

Risk rating after following control measures

Completion
Full Name and Signature of the Inspector