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COSHH Risk Assessment Template UK

This document provides a template for a Control of Substances Hazardous to Health (COSHH) risk assessment, to simplify the process of assessing common hazardous substances. The template collects key information such as the name and supplier of the substance, hazards identified and required personal protective equipment, exposure limits, control measures, and an assessor summary. The completed assessment determines if the task is safe to carry out, or requires further action or should be discontinued.

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Kyle Robertson
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462 views6 pages

COSHH Risk Assessment Template UK

This document provides a template for a Control of Substances Hazardous to Health (COSHH) risk assessment, to simplify the process of assessing common hazardous substances. The template collects key information such as the name and supplier of the substance, hazards identified and required personal protective equipment, exposure limits, control measures, and an assessor summary. The completed assessment determines if the task is safe to carry out, or requires further action or should be discontinued.

Uploaded by

Kyle Robertson
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
  • COSHH Risk Assessment Template
  • Hazard Identification and PPE
  • Substance Properties and Control Measures
  • COSHH Assessment Procedures
  • Assessment Comments and Summary
  • Review and Sign-off

Landal Green Parks UK LTD COSHH RISK ASSESSMENT TEMPLATE

COSHH RISK ASSESSMENT TEMPLATE


Use our risk assessment template to simplify the COSHH risk assessment process for your common hazardous substances:
Name of COSHH Date of
Supplied by:
Substance: Reference: Assessment:
Young/
Persons at Risk: Staff Public Visitors Contractor Pregnant Review Date:
Workers
Print name:
Print name:
Assessor: Supervisor:
Signed:
Signed:

Description of
Method of Use:
Substance:
Site and
Location of Department:
Substance:
Hazards Identification and PPE
Routes of Entry: Personal Protective Equipment (Tick Required Boxes): Tick here for none
Inhalation

Absorption

Ingestion
Hand Protective Protective
Safety Glasses Face Shield Face Mask Respirator
Protection Clothing Footwear
Location of PPE:

Hazard & Precautionary Occupational Exposure Maximum Exposure Limits Workplace Exposure Limits
Statements: Standard (OES): (MEL): (WEL):

Frequency and Duration of Exposure

Duration:
Amount Used: How Many Times per Day:
 1–5 minutes
 Small (millilitres)  1–5
 6– 0 minutes
 Medium (litres)  5–10
 31– 60 minutes
 Large (cubic metres)  More than 10
 1 hour+
Substance Properties (Tick all that apply)

You should review the current MSDS for your product and ensure that the correct symbols are ticked.

Control Measures
General Precautions First Aid Measures

Further Controls Required Responsibility By When Date Completed


Spillage Procedure Fire and Explosion Prevention

Handling and Storage Disposal Considerations

COSHH Assessment Comments


Assessor Summary
1. Has the assessment considered all factors
pertinent to the use of the substance? If NO,
please give details of further action required.
2. Has the assessment considered the
practicability of preventing exposure? If NO,
please give details of further action required.
3. Has the assessment considered the steps to
be taken to achieve and maintain adequate
control of exposure where prevention is not
reasonably practicable? If NO, please give
details of further action required.
4. Has the assessment considered the need for
monitoring exposure to the substance? If NO,
please give details of further action required.
5. Has the assessment identified all action
required to comply with regulations? If NO,
please give details of further action required.

COSHH Assessment Please tick


The task is safe to be carried out with current
Tick if no further action required.
control procedures.
The task is safe to be carried out subject to Tick if use of the substance is not causing
significant problems but requires some action
to bring it within COSHH guidelines. Action
actions listed.
should be prioritised and specific dates set for
completion.
Tick if the task or substance has potential to
Task/substance is unsafe, significant
cause significant problems to users; use of
noncompliance with health & safety
substance to be discontinued until problems
standards.
have been rectified.

The task/process should be re-assessed on a regular basis either annually, or if there are significant changes to the task or process or if there
is a significant change in personnel who carry it out it e.g. young/inexperienced workers, pregnancy, workers with pre-existing conditions
such as asthma, dermatitis, etc.
Assessor Name:
Date:

This Assessment has been discussed with the user and their line
Signed:
manager and action agreed.
Date:

User: Line Manager:

Landal Green Parks UK LTD COSHH RISK ASSESSMENT TEMPLATE COSHH RISK ASSESSMENT TEMPLATE Use our risk assessment template to s
Hazards Identification and PPE Routes of Entry: Personal Protective Equipment (Tick Required Boxes): Tick here for none Inhal
Substance Properties (Tick all that apply) You should review the current MSDS for your product and ensure that the correct sy
Spillage Procedure Fire and Explosion Prevention Handling and Storage Disposal Considerations COSHH Assessment Comments
Assessor Summary 1. Has the assessment considered all factors pertinent to the use of the substance? If NO, please give detai
actions listed. significant problems but requires some action to bring it within COSHH guidelines. Action should be priorit

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