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EHS - Environmental Health & Safety

REHS.D.14
COSHH ASSESSMENT
Associated DCR: NONE
Location(s) Affected:

Status:

Version:

Rhymney

Import Effective

1.0, CURRENT

COSHH ASSESSMENT
General Information
Department

Assessment Ref / Issue No

Substance
Trade Name
Name of Substance
(list constituents if known)
Frequency
of
Use
/
Exposure
Quantity used per operation
Material Safety Data Sheet
Yes
available

No

Revision Date / No

The Task / Substance *

Describe the task / *how the Substance is used and handled

Hazardous Properties
Hazard

Y/N

(List specific details where relevant)

Toxic
Flammable
Carcinogenic
Corrosive
*

Delete as applicable

This Document is Confidential and Proprietary. Unless Otherwise Marked, It is an Uncontrolled Copy.

Import Effective

Describe where the task is performed / *Substance is used

EHS - Environmental Health & Safety
REHS.D.14
COSHH ASSESSMENT
Associated DCR: NONE
Location(s) Affected:

Status:

Version:

Rhymney

Import Effective

1.0, CURRENT

Hazard
Biological
Harmful
to
Environment
Asphyxiant

Y/N

(List specific details where relevant)

the

Irritant
Harmful
Reactive
Other
(please
describe)
List R phrases

Specify monitoring / health surveillance requirements:

Operational Control
Required

Y/N

List Specific Details

Y/N

List Specific Details

General Ventilation
Fume Hood
Local Extraction
Other

Protective
Equipment
Required
Dust Mask / Respirator
Eye Protection
Face Shield
Gloves (specify type)
Chemical Resistant
Clothing
(please list)
Other

This Document is Confidential and Proprietary. Unless Otherwise Marked, It is an Uncontrolled Copy.

Import Effective

List S phrases
List Occupational Exposure Standards / Limits:

EHS - Environmental Health & Safety
REHS.D.14
COSHH ASSESSMENT
Associated DCR: NONE
Status:

Version:

Rhymney

Import Effective

1.0, CURRENT

Import Effective

Location(s) Affected:

This Document is Confidential and Proprietary. Unless Otherwise Marked, It is an Uncontrolled Copy.

EHS - Environmental Health & Safety
REHS.D.14
COSHH ASSESSMENT
Associated DCR: NONE
Location(s) Affected:

Status:

Version:

Rhymney

Import Effective

1.0, CURRENT

Are the risks
adequately
Yes
controlled?

* If no, list actions below that will
reduce the risks to an acceptable
level
Responsibility

Target Completion
Date

Import Effective

Corrective Actions

No *

This Document is Confidential and Proprietary. Unless Otherwise Marked, It is an Uncontrolled Copy.

EHS - Environmental Health & Safety
REHS.D.14
COSHH ASSESSMENT
Associated DCR: NONE
Location(s) Affected:

Status:

Version:

Rhymney

Import Effective

1.0, CURRENT

Agreed By

Name

Position

Date

Risk
Assessor(s)

Import Effective

QA
/
EHS
Specialist

This Document is Confidential and Proprietary. Unless Otherwise Marked, It is an Uncontrolled Copy.

EHS - Environmental Health & Safety
REHS.D.14
COSHH ASSESSMENT
Associated DCR: NONE
Location(s) Affected:

Status:

Version:

Rhymney

Import Effective

1.0, CURRENT

HISTORY PAGE
Revision:

1

Comments:

SCR:

R00996

App Date:

14/05/04

Originator
:

Claire
Bolton

Document derived from HS.D.03 in line with ISO 9001:2000 numbering and format
changes. Sections added for risk controls and corrective actions.

Originator:

Import Effective

Comments:

This Document is Confidential and Proprietary. Unless Otherwise Marked, It is an Uncontrolled Copy.