COSHH Assessment Sheet

*(Complete one sheet for each product to be used)

CoSHH Assess
Product Name: No.
Description of Substance: Assessed By:
Constituents: Date:
No. Exposed:
Task / Activity:
Risk Phrases:
Safety Phrases:
MSDS / SDS:
Suppliers Name & Address:
Form:
WEL:

Material Information:

Flammable Oxidiser Serious Toxic / Irritant Danger to Corrosive Explosive Gas Under
Health Very Toxic the Presure
Hazard Environment

Respiratory Ingestion Absorption Dermal Injection Other

Potential health hazard:

PPE Requirements:

Other

Storage Arrangements:
Packaging and Quantities Stored: Storage Requirements:

COSHH Template: Safeti Ltd (All Rights Reserved)

 COSHH Assessment Sheet
*(Complete one sheet for each product to be used)

Control Measures:
Safer alternatives available? (Please detail)

Where is substance used? Open Air Workshop Confined Space Office Other

Duration of exposure: Minutes 1-2 hours 2-4 hours 4-6 hours 6-8 hours

Exposure risk:

Monitoring:
Total enclosure of Local exhaust General workplace Wet methods
process? ventilation? ventilation? (to control dust)?

Has air monitoring been Type of monitoring Frequency of monitoring: Monitoring carried out by:
(Name & Company
carried out? method: Telephone Number)

Have employees been Have employees been

Has relevant PPE been
informed of results of instructed in safe Employees instructed:
issued?
assessment? systems of work?

Additional Control Measures:

First Aid Measures: Fire Fighting Measures:

Eye:

Skin:

Ingestion:

Inhalation:
Handling Arrangements: Spillage Arrangements:

Other Comments:

COSHH Template: Safeti Ltd (All Rights Reserved)