COSHH RISK ASSESSMENT RECORD

MATERIAL SAFETY DATA SHEETS FOR ALL SUBSTANCES USED ARE LOCATED IN THE DESPATCH OFFICE
PRODUCT NAME

ASSESSMENT NO.

MANUFACTURER

PRODUCT CODE

Manufacturer Contact Number

CAS Ref .

SECTION WHERE USED

DESCRIPTION

MSDS HELD

YES / NO

DATE of MSDS

HAZARD CLASSIFICATION ( Tick as appropriate )

Irritant

Corrosive

Harmful

Toxic

Very Toxic

Dangerous to
the Environment

Flammable

Explosive

Oxidising

HOW IS IT USED ?
( Describe the process, quantities used, maximum temperatures reached, exposure periods )

ARE ANY HAZARDOUS SUBSTANCES PRODUCED BY ANY PROCESS

( eg fumes from heating a substance )

WHO MIGHT IT EFFECT ?

( Consider not only those using it, but also visitors, those working near by etc )

WHAT CONTROLS ARE CURRENTLY IN PLACE ?

Total enclosure
of process

Partial enclosure
of process

General workplace
ventilation

Wet methods
( to control dust )

Respiratory
Protection

Eye Protection

Gloves

Protective
Overalls

Other
Please specify

GENERAL PRECAUTIONS & PERSONAL PROTECTION NEEDED

( Consider warning signs, ventilation, work patterns, personal hygiene / cleanliness, protective clothing )

QCR117

ISSUE 1
JULY 2006

EMERGENCY FIRST AID TREATMENT

( Eyes, skin, swallowed, inhaled and emergency phone numbers )
Eyes
Skin
Ingestion

Inhalation

ACTION IN CASE OF EMERGENCY ( Spillage, uncontrolled release, fire )

ENVIRONMENTAL IMPLICATIONS

STORAGE, DISPOSAL & TRANSPORT INFORMATION

Storage

Disposal
Transport

OVERALL ASSESSMENT OF RISK WITH REGARD TO CURRENT USAGE

OF THIS SUBSTANCE
LOW

MEDIUM

HIGH

Not classified as Hazardous

IMPROVEMENTS
Are the current controls effective ?

Does the MSDS suggest any controls that we don't have in place ?

Is air monitoring considered approriate ?

Can the process be re-engineered ?

Have we considered the use of an alternative, less dangerous substance ?

ASSESSMENT COMPLETED BY :
Name :
Position :

Signature :

Name :
Position :

Signature :

Date :

NEXT REVIEW DUE :

QCR117

ISSUE 1
JULY 2006

ASSESSMENT FINDINGS COMMUNICATED TO ALL RELEVANT PERSONS

Name :

Date :

Signature :

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Date :

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Date :

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Date :

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Date :

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Date :

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Date :

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Date :

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QCR117

ISSUE 1
JULY 2006

COSHH - Department Usage

Department -

Substance -

Who uses it ?

How is it used ?

How much is used ?

How often is it used ?

Is any PPE used ?

Are there any other controls

in place ?

How often is it used ?

Where is it kept ?