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Property Management • Inspections

COSHH/DSEAR Assessment Record

This template helps in properly recording assessments for COSHH and DSEAR compliance.
Mountview
08/19/2024

COSHH/DSEAR Assessment Record

    Product Name:

    Product Description - Activity/Details of Use

    Product Picture

    Add or drag pictures

    SDS Reference

    SDS Date

    Assessor Details

    Assessor's Name

    Department

    People at Risk

    Date of Assessment

    Assessor's Signature

    Click here to sign

    Review Date

    Hazards

    Substance

    Tick if a Hazard

    If Other, please state here:

    Indicate below which form the substance takes

    If Other, please state here:

    Indicate below which route(s) of exposure the substance takes

    If Other, please state here:

    Further Information

    Workplace Exposure Limits (WELs)

    Long-term exposure level

    Short-term exposure level

    List the risks to health below from exposure to the substance

    Precautions

    Personal Protective Equipment

    List below control measures eg extraction, ventilation, supervision, include additonal controls for vulnerable persons where necessary

    Further Information

    Storage and Transport

    Recycling/Disposal

    Emergency Action

    General

    Spillage

    Fire Actions

    Steps to be taken by Staff

    Emergency Services Information

    First Aid

    Eyes

    Skin

    Swallowing

    Inhalation

    Details of Substance

    Details of hazard/dangerous substances which the product contains

    Is health surveillance or monitoring required? (remember health surveillance may be required for vulnerable persons eg pregnant/young workers those with asthma, dermatitis etc)

    • Yes
    • No
    • N / A

    Hazardous properties (include risk phasse (R)):

    Manufacturers' limitations of use

    Risk Control measures for normal use

    Describe any exposure monitoring and health surveillance

    Risk Control measures already in place

    New or Improved Risk Control measures required

    Chemical Reaction to be avoided

    Maintenance Arrangements e.g. gor extraction systems, PPE, etc..

    Assessment of Risk

    With the above risk controls the risk is

    Is the risk adequately controller?

    • Yes
    • No
    • N / A

    Can the substance be substituted for ibe that is less hazardous?

    • Yes
    • No
    • N / A
Source: Mountview (Community Member)

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