COSHH RISK ASSESSMENT SHEET
Name of National Paint Lacquer Thinner COSHH
Substance: Reference:
Date of
Supplied By:
Assessment:
Person at Workers Public Staff
Review Date:
Risk: Visitors/Inspector’s Contractor
Name: Name:
Assessor: Supervisor:
Signature: Signature:
Description of Method of
Substance: Use:
Site and
Location of Department:
Substance
HAZARD IDENTIFICATION AND PPE
Routes of Entry: Personal Protective Equipment (Tick Required Boxes): Tick here for none
Inhalation
Absorption
Ingestion
Hand Protective Protective Safety Face Face
Location of PPE: Respirator
Protection Clothing Footwear Glasses Shield Mask
Description of exposure monitoring (describe proposed exposure monitoring for chemicals and give results in relation to any occupational exposure limits for
the chemical concerned)
Storage requirements?
Spill retention local exhaust Access control/locked cupboard Incompatible
materials/chemicals (give details)
Ventilation
How have workers been provided with information or training? (Give details)
Training Course Individual instruction supported by written information
Substance Properties (Tick all that apply
You should review the current MSDS for your product and ensure that the correct symbols are ticked.
PREVENTION MEASURES
What are the control measures are required for this chemical, other than PPE?
General Ventilation Work Instructions or Procedures (Give ref. no.)
Glove Box
Fume cupboard
Capturing hood
OTHER PRECAUTIONS AND EMERGENCY PROCEDURES
Safety shower/eye wash Absorbent Materials (specify)
First Aid (give details) Fire Protection measures (Give details)
EVALUATION AND ACTIONS
Are all the controls detailed above currently in place? Yes No
If these controls are not in place or additional controls are required, state action to be taken.
Please note-hazardous chemical agents must NOT be used if adequate control measures are not in place.
Remedial action required Date Completion Assigned to
COSHH Assessment Comments
Assessor Summary Yes/No Further Action
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
Tick if no further action required.
with current control procedures.
Tick if use of the substance is not causing significant
The task is safe to be carried out subject to problems but requires some action to bring it
actions listed. within COSHH guidelines. Action should be
prioritized and
specific dates set for completion.
Tick if the task or substance has potential to cause
Task/substance is unsafe, significant non- significant problems to users; use of substance to be
compliance with health & safety standards. discontinued until problems 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. inexperienced
workers, workers with pre-existing conditions such as asthma, dermatitis, etc.
Assessor’s Name: Date:
This Assessment has been discussed with the user and their line manager and Signed:
action agreed.
User: Line Manager: Date:
