Information
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Site conducted
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COSHH Risk Assessment No.
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Product Name
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Conducted on
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Manufacturer
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Product code
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Manufacturer Contact Number
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Description
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Data Sheet held
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Date of Data Sheet
Hazard Classification
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Very toxic.
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Toxic
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Corrosive
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Oxidising
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Irritant
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Harmful
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Extremely flammable
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Highly flammable
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Flammable
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Biological
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Environmental
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Sensitising
How is it used
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Describe the activity or work process. (Include how long and how often this is carried out and the quantity of substance used)
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Location of the process being carried out?
Hazardous Substances produced
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Are any hazardous substances produced by any process. (eg fumes from heating substance)
Who It Might Effect
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Identify the person at risk:
- Employees;
- Contractors;
- Trainees;
- Visitors;
- Members of the public;
Hazard Type
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Gas
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Vapour
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Mist
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Fumes
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Dust
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Liquid
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Solid
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Other
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If Other, state the nature of the hazard type?
Route of exposure
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Inhalation
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Skin
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Eyes
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Ingestion
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Other
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If other, state type?
What Controls Are Currently In Place
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Total enclosure of process
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Partial enclosure of process
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General workplace ventilation
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Wet methods (to control dust)
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Respiratory protection
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Eye protection
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Gloves
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Protective overalls
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Rubber apron
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Other
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If other, give explanation
General Precautions
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General precautions and personal protection needed (Consider warning signs, ventilation, work patterns, personal hygiene / cleanliness, protective clothing)
First Aid
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Eyes
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Skin
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Ingestion
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Inhalation
Chemical Spill
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Action in case of emergency (Spillage, uncontrolled release, fire)
Environmental
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What are the environmental implications?
Storage Disposal and transportation Information
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Storage
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Disposal
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Transport
Assessment Of Risk
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Overall assessment of risk with regard to current usage of this substance
Improvements
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Are the current controls effective
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Does the Data Sheet suggest any controls that are not in place
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Is air monitoring considered appropriate
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Can the process be re-engineered
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Has the use of an alternative less dangerous substance been considered
Assessment Review
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This assessment should be reviewed periodically or it there are any changes in the process.
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Date of next review
Assessment Completed By
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Assessor Signature