Third Space COSHH assessment - all sites v2-2019

• Chemical name

• Conducted on

  Date

• Describe the activity

• Location of chemical

• Picture of location

  Media

• Persons at risk

  Select Employees Visitors

  • Employees
  • Visitors

• Chemical or product name

• Product picture

  Media

• Add safety data sheet information

  Media

• Hazard classification

  Select Explosive Flammable Oxidising Corrosive Acute toxicity Hazardous to the environment Health hazard Serious health hazard Gas under pressure

  • Explosive
  • Flammable
  • Oxidising
  • Corrosive
  • Acute toxicity
  • Hazardous to the environment
  • Health hazard
  • Serious health hazard
  • Gas under pressure

• Solid state or liquid?

  Select Solid Liquid

  • Solid
  • Liquid

• Indicate which form the substance takes

  Select Gas Vapour Mist Fume Dust Liquid Solid Other state

  • Gas
  • Vapour
  • Mist
  • Fume
  • Dust
  • Liquid
  • Solid
  • Other state

• Indicate below which route of exposure the substance takes

  Select Inhalation Skin Eyes Ingestion

  • Inhalation
  • Skin
  • Eyes
  • Ingestion

• List possible harm

  Select Skin irritation Burns Eye injury Fire Inhalation causing toxic effect Poisoning Explosion

  • Skin irritation
  • Burns
  • Eye injury
  • Fire
  • Inhalation causing toxic effect
  • Poisoning
  • Explosion

• List control measures

control measure

• Control measure

• Details of training requirements

  Select COSHH training PPE training External training (add in comments) Manual Handling training First Aid Training

  • COSHH training
  • PPE training
  • External training (add in comments)
  • Manual Handling training
  • First Aid Training

• List PPE required

  Select Dust mask Respirator Gloves Footware Visor Goggles Overalls

  • Dust mask
  • Respirator
  • Gloves
  • Footware
  • Visor
  • Goggles
  • Overalls

• Detail safe storage

• Picture of storage area

  Media

• Disposal of waste substances

  Select Hazardous waste General waste Biological waste Return to supplier

  • Hazardous waste
  • General waste
  • Biological waste
  • Return to supplier

• Persons involved in COSHH assessment

  Select Maintenance operatives Competent persons

  • Maintenance operatives
  • Competent persons

• Risk level

  Acceptable low risk

  Acceptable medium risk

  Acceptable cautious higher risk

  Unacceptable high risk

• Add any notes

• Is the exposure adequately controlled?

  Yes

  No

The risk assessment should be reviewed annually or earlier if there is reason to believe that it is no longer valid or if there has been a significant change to the matters to which it relates.

• Intended review date

  Date

• Add signature

  Sign

• Seek further assistance