COSHH ASSESSMENT

Project: HSE Ref. No. HSE/AMS/DCT/015 Rev.0 (PS)

Product Name Assessment No.

Safety Data Sheet

Description of Substance
Attached

Workplace Exposure Limits Assessed by

Task / Activity Date

Suppliers contact details Review Date

SUBSTANCE PROPERTIES

YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO

Route of Exposure Persons at Risk

Users of
Members of
Skin Eyes Inhalation Product Visitors
Public
s
Cuts / Other Young
Ingestion Injection
Abrasions Workers Persons

PPE REQUIREMENTS

YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO

ADDITIONAL CONTROL MEASURES

General Precautions Control Measures

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 COSHH ASSESSMENT
Project: HSE Ref. No. HSE/AMS/DCT/015 Rev.0 (PS)

First Aid / Hygiene Arrangements Fire Precautions

LEV Requirements Monitoring Requirements

Transport Arrangements Storage Requirements

Spillage Procedures Disposal Requirements

COMMENTS

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 COSHH ASSESSMENT
Project: HSE Ref. No. HSE/AMS/DCT/015 Rev.0 (PS)

Are hazards to health adequately controlled with all control measures in place? Yes No

Assessment Prepared by

Name
Signatur
e
Date

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