Chemical Risk Assessment Form

Chemical Name Assessor

Location/Room No. Date

No. of people working in this location

Area Hazard Risks Protection and Prevention Measures Risk Rating

Storage
Use

Waste .

Emergency Procedures
In case of fire:
Extinguishing media:

In case of accidental release:

Personal Protection Equipment

First Aid

Other Information

Assessor's signature Supervisor's signature (if assessor is a student)