Free COSHH Assessment Template
COSHH Assessment
General Information
Criteria |
Details |
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Assessment Reference No. |
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Assessor's Name |
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Date of Assessment |
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Department/Location |
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Substance/Product Name |
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Purpose/Use of Substance |
Substance Identification
Criteria |
Details |
Rating (1-5) |
---|---|---|
Hazard Classification |
Flammable Liquid, Irritant |
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Physical Form |
Liquid |
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Route of Exposure |
Inhalation, Skin Contact |
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Manufacturer/Supplier Info |
NovaChem Industries, Tacoma, WA 98401 |
Hazard Evaluation
Criteria |
Description |
Rating (1-5) |
---|---|---|
Potential Health Effects |
Eye irritation, dizziness from vapor, skin dryness |
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Environmental Impact |
Toxic to aquatic life if released in large quantities |
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Risk of Fire/Explosion |
Yes – highly flammable |
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Emergency Response Needed |
Evacuate area, use fire extinguisher (Class B) |
Exposure Risk Assessment
Task/Activity |
Frequency |
Duration |
Number of Workers Exposed |
Control Measures |
---|---|---|---|---|
Cleaning lab equipment |
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Transferring to smaller containers |
Control Measures
-
Engineering Controls:
-
Administrative Controls:
-
Personal Protective Equipment (PPE):
Storage and Disposal
Criteria |
Details |
Rating (1-5) |
---|---|---|
Storage Requirements |
Store in a cool, dry, well-ventilated area away from ignition sources. |
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Spill/Leak Response |
Use absorbent material to contain spills. Dispose of as hazardous waste. |
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Disposal Method |
Collected by licensed waste management service. |
Assessment Conclusion
Criteria |
Details |
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Overall Risk Rating |
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Further Actions Required |
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Review Date |
Approval
Name |
Position |
Signature |
Date |
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Ensure that this assessment is reviewed regularly and updated as necessary to maintain a safe and compliant work environment.