Scribd Logo
Upload

Welcome to Scribd!

  • 244 views

    COSHH Assessment Form

    Uploaded by

    mohamed atef
    1. This document is a COSHH (Control of Substances Hazardous to Health) assessment form used to evaluate potential hazards posed by chemical substances. 2. It collects information on the substance being assessed, number of employees exposed, hazards identified, and whether the substance is hazardous by inhalation, ingestion, or absorption. 3. The form also addresses existing controls, personal protective equipment requirements, workplace exposure limits, accident/spill response measures, disposal procedures, and firefighting measures.

    Copyright:

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

    COSHH Assessment Form

    Uploaded by

    mohamed atef
    244 views2 pages
    1. This document is a COSHH (Control of Substances Hazardous to Health) assessment form used to evaluate potential hazards posed by chemical substances. 2. It collects information on the substance being assessed, number of employees exposed, hazards identified, and whether the substance is hazardous by inhalation, ingestion, or absorption. 3. The form also addresses existing controls, personal protective equipment requirements, workplace exposure limits, accident/spill response measures, disposal procedures, and firefighting measures.

    Original Description:

    Assessment form

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    1. This document is a COSHH (Control of Substances Hazardous to Health) assessment form used to evaluate potential hazards posed by chemical substances. 2. It collects information on the substance being assessed, number of employees exposed, hazards identified, and whether the substance is hazardous by inhalation, ingestion, or absorption. 3. The form also addresses existing controls, personal protective equipment requirements, workplace exposure limits, accident/spill response measures, disposal procedures, and firefighting measures.

    Copyright:

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

    COSHH Assessment Form

    Uploaded by

    mohamed atef
    1. This document is a COSHH (Control of Substances Hazardous to Health) assessment form used to evaluate potential hazards posed by chemical substances. 2. It collects information on the substance being assessed, number of employees exposed, hazards identified, and whether the substance is hazardous by inhalation, ingestion, or absorption. 3. The form also addresses existing controls, personal protective equipment requirements, workplace exposure limits, accident/spill response measures, disposal procedures, and firefighting measures.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    COSHH Assessment Form

    HSE-PRC-17024-F1

    Substance: Assessment #:
    Supplier: Emergency #:

    No. Employees Involved: CAS #

    How is it Used?

    HAZARDS (delete/ add as appropriate)


    Harmful to the
    Corrosive Highly Toxic Toxic Harmful Flammable Explosive Other
    Environment

    HAZARD TYPE (delete/ add as appropriate)


    Gas Vapour Mist Fume Dust Liquid Solid Other
    Description: Yes/ No Notes (incl. Relevant Exposure Standards, Safety and Risk Phrases)
    Hazardous by inhalation?
    Hazardous by ingestion?
    Hazardous by absorption?
    Irritant to the eyes?
    Irritant to the skin?
    Harmful to the environment?
    Observations on task and possible exposures (incl. Existing Controls (incl. Enclosures, Ventilation, SWI’s etc.):
    Storage, Movement, Handling, Use, etc.):

    Hazard Assessment (attach additional information as an appendix): N/A YES NO


    1. Is manufacturers Safety Data Sheet (MSDS) available?
    2. Has the ‘lowest hazard’ substance suitable for the task been selected?
    3. Has specific training required for handling this substance been provided?
    4. Is exposure monitoring required?
    5. Are additional control measures required?
    6. Are control measures routinely maintained, examined and tested?
    7. Is health surveillance necessary?
    8. Are Emergency Response Plans (first aid, fire, spill etc.) available and up to date?
    9. Is appropriate storage and dispensing requirements for the substance provided?
    10. Must an Authorised Waste Disposal Contractor dispose of the substance?
    11. Are all necessary permitting requirements understood and in place?
    Require Personal Protective Equipment (state type and standard).
    Respirator Dust Mask

    Safety Goggles Face Shield

    Gloves Protective clothing

    V 1.0 Issue Date: Page 1 of


    COSHH Assessment Form
    HSE-PRC-17024-F1

    First Aid Measures

    Inhalation

    Skin Contact

    Eye Contact

    Ingestion
    Workplace Exposure Limits (WEL)
    Long term exposure limit (8hr TWA) Short term exposure limit (15 mins)

    Accidental release control measures

    Disposal arrangements

    Fire Fighting Measures

    Any further information:

    Assessor
    Name (print) Signature

    Date SDS Review


    Date

    V 1.0 Issue Date: Page 2 of

    You might also like