Hazardous Chemical Risk Assessment

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Substance Name

• Is Substance classified as a DG Enter name "TAP HERE"

  Yes

  No

• If YES will it be stored at the Business

  Yes

  No

• Enter DG Class "TAP HERE"

  Ongoing use

  Can be discarded

• Sub Risk "TAP HERE"

  Yes

  No

  N/A

• Package Group "TAP HERE"

  Yes

  No

  N/A

• U.N. no. "TAP HERE"

  Yes

  No

  N/A

• MSDS Date Issue Inside 5 years "TAP HERE"

  Yes

  No

• Is the substance classed as hazardous (If unspecified treat as hazardous)

  Yes

  No

Details of Use/Hazard Evaluation (Evaluate the work practices of the substance in use at the business)

• Where and who is the substance used (If there different tasks or applications use spare sections below

  Ongoing use

  Can be discarded

• SPARE "TAP HERE" if required

  Yes

  No

  N/A

• SPARE "TAP HERE" if required

  Yes

  No

  N/A

• How is it applied (e.g. sprayed, applied with a rag etc) "TAP HERE"

  Ongoing use

  Can be discarded

• Quantity Used (Specify approx amount used, frequency and units e.g.1kg bag per day etc.) "TAP HERE"

  Ongoing use

  Can be discarded

• Are emissions generated during use "TAP HERE" to describe if required

  FUMES

  MIST

  VAPOURS

  DUST

• How often is the potential for exposure (Frequency of exposure) "TAP HERE"

  Ongoing use

  Can be discarded

• Duration of exposure (How long during shift? length of shift?) "TAP HERE"

  Ongoing use

  Can be discarded

• Number of people potentially exposed/using product (Including others in the vicinity) "TAP HERE"

  Ongoing use

  Can be discarded

• Does there appear to potential for exposure by the following

  Yes

  No

  N/A

• ********** Skin Absorbtion

  Yes

  No

• ********** Inhalation

  Yes

  No

• ********** Eye Contact

  Yes

  No

• ********** Ingestion During Use

  Yes

  No

• Are there safe work procedures in place for the use of this substance

  Yes

  No

• Are they effective and adhered to

  Yes

  No

• How are they communicated to employees "TAP HERE"

  Written

  Verbally

  Competency

• Does it have the potential to enter drains or watercourses etc. If YES what are the risks "TAP HERE"

  Yes

  No

• Has monitoring ever been undertaken

  Yes

  No

• ********* If YES what is the report number "TAP HERE"

  Yes

  No

• ********** Did results exceed exposure standards

  Yes

  No

• Has health surveillance ever been carried out

  Yes

  No

• ********** Reference/Details of results

  Ongoing use

  Can be discarded

• Is the appropriate information in place on all containers including those decanted (Product label, DG Label, Safety Phrases)

  Yes

  No

HEALTH EFFECT OF SUBSTANCE

• From the MSDS, is there a significant short term (acute) or long term (chronic) health hazard for the substance

  Yes

  No

• ********** Eyes

  Yes

  No

  N/A

• ********** Skin

  Yes

  No

  N/A

• ********** Ingestion

  Yes

  No

  N/A

• ********** Inhalation

  Yes

  No

  N/A

• ********** Chronic

  Yes

  No

  N/A

Adequacy of Controls (determined by comparing what the MSDS recommends and how it is used)

• Is there specific PPE required

  Yes

  No

• ********** Precautions suggested in MSDS "TAP HERE"

  Safe

  At Risk

  N/A

• ********** Existing Precautions and Controls in use for each step of the task "TAP HERE"

  Safe

  At Risk

  N/A

• **********Are Current Precautions Adequate

  Yes

  No

• ********** Actions Required "TAP HERE"

  Safe

  At Risk

  N/A

• Are particular engineering controls required

  Yes

  No

• ********** Precautions suggested in MSDS "TAP HERE"

  Safe

  At Risk

  N/A

• ********** Existing Precautions and Controls in use for each step of the task "TAP HERE"

  Safe

  At Risk

  N/A

• **********Are Current Precautions Adequate

  Yes

  No

• ********** Actions Required "TAP HERE"

  Safe

  At Risk

  N/A

• Are administrative controls required and job specific training required for this substance

  Yes

  No

  N/A

• ********** Precautions suggested in MSDS "TAP HERE"

  Safe

  At Risk

  N/A

• ********** Existing Precautions and Controls in use for each step of the task "TAP HERE"

  Safe

  At Risk

  N/A

• **********Are Current Precautions Adequate

  Yes

  No

• ********** Actions Required "TAP HERE"

  Safe

  At Risk

  N/A

• Are there precautions required for the safe handling of this substance

  Yes

  No

  N/A

• ********** Precautions suggested in MSDS "TAP HERE"

  Safe

  At Risk

  N/A

• ********** Existing Precautions and Controls in use for each step of the task "TAP HERE"

  Safe

  At Risk

  N/A

• **********Are Current Precautions Adequate

  Yes

  No

• ********** Actions Required "TAP HERE"

  Safe

  At Risk

  N/A

• Are there any other precautions for use specified

  Yes

  No

  N/A

• ********** Precautions suggested in MSDS "TAP HERE"

  Safe

  At Risk

  N/A

• ********** Existing Precautions and Controls in use for each step of the task "TAP HERE"

  Safe

  At Risk

  N/A

• **********Are Current Precautions Adequate

  Yes

  No

• ********** Actions Required "TAP HERE"

  Safe

  At Risk

  N/A

• Are there disposal or recycling requirements

  Yes

  No

  N/A

• ********** Precautions suggested in MSDS "TAP HERE"

  Safe

  At Risk

  N/A

• ********** Existing Precautions and Controls in use for each step of the task "TAP HERE"

  Safe

  At Risk

  N/A

• **********Are Current Precautions Adequate

  Yes

  No

• ********** Actions Required "TAP HERE"

  Safe

  At Risk

  N/A

• Are there emergency response procedures or facilities required

  Yes

  No

  N/A

• ********** Precautions suggested in MSDS "TAP HERE"

  Safe

  At Risk

  N/A

• ********** Existing Precautions and Controls in use for each step of the task "TAP HERE"

  Safe

  At Risk

  N/A

• **********Are Current Precautions Adequate

  Yes

  No

• ********** Actions Required "TAP HERE"

  Safe

  At Risk

  N/A

Additional Actions

• Task steps "TAP HERE" The task steps should be used to identify the hazards and risk at each step in the process)

  Yes

  No

  N/A

Select appropriate hazardous substance conclusion,, based on the assessment conducted

• If the words carcinogenic, toxic, harmful, corrosive, irritant or sensitising are located on the MSDS, then the risk is significant and the appropriate conclusion is 2 or 3

• Conclusion 1: Risks are not significant and are not likely to increase

  Yes

  No

• Conclusion 2: Risks are significant but are already effectively controlled

  Yes

  No

• Conclusion 3: Risks significant and current controls are inadequate

  Yes

  No

• Conclusion 4: Uncertain about risks - not enough information or uncertain about degree of exposure, need additional advice

  Yes

  No

  N/A

• If Conclusions 3 or 4 are reached,, an assessment on the following will need to be undertaken

• Is monitoring required "TAP HERE" to provide details

  Yes

  No

  N/A

• Is health surveillance required "TAP HERE" to provide details

  Yes

  No

  N/A

Determine for the task what the appropriate risk rating is using the Toll Group RISC system RA matrix

• Consequence "TAP HERE" to provide details and enter RATING

  Yes

  No

  N/A

• Likelihood "TAP HERE" to provide details and enter RATING

  Yes

  No

  N/A

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