Chemical description

  • Description of chemical and its function

  • Manufacturer name

  • Manuafacturer contact details

  • Provide code/number

  • Scan product barcode

  • Photograph both sides of container

Hazard Classification

  • Hazard symbols (old)

    no label
  • Hazard symbols (new)

    no label
  • Hazard type

  • Details of hazard type

  • Photograph of symbol

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?

  • Photograph of process or activity

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:

  • Specify person(s) at risk

Hazard Type

  • Identify hazard type

  • Specify hazard type

Exposure route

  • Identify exposure route

  • Specify exposure route

What Controls Are Currently In Place

  • Identify control measures

  • Specify control measure

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

  • Score in report will show 1 for each hazard, each exposure route and each hazard type (1 for each)
    Contrast this score with the suitability of the control measures

  • 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 name and Signature

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