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    Coshh Risk Assessment Form: Substance / Trade Name

    Uploaded by

    Borislav Vulić

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Coshh Risk Assessment Form: Substance / Trade Name

    Uploaded by

    Borislav Vulić
    85 views2 pages

    Original Title

    4_5769336058688833358.pdf

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    85 views2 pages

    Coshh Risk Assessment Form: Substance / Trade Name

    Uploaded by

    Borislav Vulić

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 2

    COSHH RISK ASSESSMENT FORM

    Substance / Trade Name (Name the substance involved in the process and its manufacturer)

    Safety Data Sheet Provided Yes No

    Quantities Used

    Value

    Persons at Risk Employees Contractors Public


    Other (state who)

    Workplace Exposure Limits (WELs) Long-term exposure level (8hrTWA)

    Short-term exposure level (15mins)

    Approved Uses

    Risks to Health - HAZARDS - Prior to July 2015, hazards were symbolised by the following images:

    Toxic / Dangerous for Highly Extremely


    Corrosive Harmful Carcinogenic Irritant Oxidising Flammable
    Very Toxic the Environment Flammable Flammable

    As of July 2015, hazards are symbolised by the following images:


    Serious Health Hazardous for the Gas Under
    Corrosive Acute Toxicity Health Hazard Oxidising Flammable
    Hazard Environment Pressure

    Hazard Type Gas Vapour Mist


    Fume Dust Liquid
    Solid Other (state)

    Route of Exposure Eyes Skin Ingestion


    Inhalation Other (state)

    Risks to Health
    from Identified
    Hazards

    Record Keeping | © Copyright Gauntlet Health & Safety Page 1


    Recommended Control Measures Ensure cuts are covered Avoid contact with eyes Ventilation
    Training Supervision Extraction

    Other (Please state)


    E.g. Use gloves to avoid prolonged or
    repeated skin contact. Avoid breathing in
    vapours or dust. Do not drink or smoke
    whilst using this product.

    Include special measures for vulnerable groups,


    such as disabled people and pregnant workers.

    Is Health Surveilance Monitoring in Place? Yes No

    Protective Equipment to be Worn

    Specific Proective Equipment to be Worn

    First Aid – ALWAYS REMOVE PERSON FROM SOURCE OF CONTAMINATION

    First Aiders

    First Aid Kit Located at…

    Emergency Contact Information

    Storage Requirements / Disposal Requirements

    Spillage Management

    Is Exposure Adequately Controlled? Yes No


    Risk Rating Following Control Measures Low Medium High
    Further Action Required? Yes No

    Detail Action Required

    Action Required By Who?

    Action Required By When?

    All Actions to be Completed By?

    Completed By: Date: Review Date:

    Record Keeping | © Copyright Gauntlet Health & Safety Page 2

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