Doc No.

SC-HSEF# 41/17
Hazardous Substance Assessment(COSHH) Rev: 00
Page 1 of 2

Project Name: Assessment No: Date:

HAZARDOUS PROPERTIES & RISKS

__ __ __ __ __

Harmful or Irritant Corrosive Toxic Dangerous to Environment Flammable

Product Name & Type: Manufacturer Name: Supplier Name:

Contact #: Contact #:
Chemicals and Appearance:

Activity where substance is to be used:

Risks Associated with task and substance:

Route of Entry Effect First Aid Requirements

Ingestion

Inhalation

Absorption

Eyes

Risk Rating: Environmental Impact Rating:

High Medium Low High Medium Low

Control Measures
Personal Protection & PPE:

Storage Requirements:

Disposal:

Fire:

Spillage:

Periodica Review to Take Place On:

 Periodica Review to Take Place On:

Doc No. SC-HSEF# 41/17

Hazardous Substance Assessment Rev: 0
Page 2 of 2

This Hazardous Substance Assessment is to be completed prior to using any hazardous substance on a
Mercury. The information contained within this assessment must be communicated to all personnel involved
in the substances use. Records of communication must be recorded in the field below and personnel must
sign to acknowledge receipt of this information.

Date of
Name Trade/Position Signature
Communication
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