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COSHH Assesment Form

COSHH Assessment Form

Uploaded by

Clark Angelo Juan
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73 views3 pages

COSHH Assesment Form

COSHH Assessment Form

Uploaded by

Clark Angelo Juan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

COSHH Assessment Form

Page No 1 of 3

Project/Location MTB Etihad Premium Date of Assessment Date of Review 0


Lounges, Abu Dhabi
Name of Assessor Designation Signature

Name of Common Name


Substance (if different)
SUBSTANCE DETAILS

Manufacturer Contact Number


(where applicable) (if applicable)
Solid Liquid Gas Vapor Other (Specify)
Type of Substance    

Less than 1 1-5 liter/kg 6-10 More than 10 Other (specify)


Size of container liter/kg liter/kg liter/kg
   

Is the Substance YES NO Size of the second container


decanted  

Hazard and
Symbol on the
container
corrosive flammable Highly Harmful Irritant Dangerous for
flammable environment
    

Others
May cause

Toxic Very toxic Explosive Oxidizing Bio Hazard

    

Possible Entry Inhaled Ingested Skin Eye


Route     Other (Specify)

Is alternative YES NO
Substance
available?  

OC21-F01, Rev. 03 | 02-Oct-16


COSHH Assessment Form Page No 2 of 3

THE WORK ACTIVITY


Describe the floor coatings range to provide increased 'anti-slip' properties in both dry and wet
work Activity conditions to improve safety.

Possible Entry Diluted Undiluted Other (Specify)


Route   

Who may be DEPA staff Subcontractor Visitor Public Other (Specify)


affected?     Workers engaged in the activity
nearby.

No of people 1-5 6-10 11-15 16-20 Other (Specify)


exposed    
CONTROL MEASURES
Storage
Arrangement Prevent unauthorized access. Store in original container. Keep in a well-ventilated place.
Observe label precautions. Store in accordance with local regulations
General Wash hand Two people ventilated PPE required Others:
Precautions after Use Present area
   
Special
Precautions
PPE Used

Hand Gloves Safety Shoe Dust mask Goggles Respirator Face shield
     
Others :
(Specify)
EMERGENCY ARRANGEMENT
Skin
First Aid

Eye

Inhalation

Ingestion
Others
Spillage

Disposal

Fire

RISK RATING (Using DEPA Risk Matrix)


COSHH Assessment Form Page No 3 of 3

Severity  Negligible First aid injury  Minor Injury  Major Injury  Severe Fatal

Likelihood  Very Unlikely  Unlikely May happen  Likely  Very likely  Certain or
Imminent
Risk category High Risk Medium Risk Low Risk
  

Note:
This assessment is to be kept for reference in the project. A copy of the relevant Material Safety Data Sheet should be kept with
this assessment. Depending on the risk category decide if extra training and control measures required (You might use a
separate sheet for extra control measures). All the information to be communicated to all operatives in tool box talks before
commencing the job.

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