Coshh Form Template UK

The Coshh Form Template UK is provided in multiple formats, including PDF, Word, and Google Docs, featuring customizable and printable examples.

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Coshh Form Template UK

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COSH Form Template UK

1. Substance Information

2. Hazard Classification

3. Risk Assessment

4. Control Measures

5. Emergency Procedures

6. Personal Protective Equipment (PPE)

7. First Aid Measures

8. Storage Requirements

9. Disposal Considerations

10. Training Requirements

11. Declaration

I declare that the information provided is accurate and complete to the best of my knowledge.

I have read and understood the COSHH assessment and will adhere to the guidelines provided.

Date of Assessment:

Assessor’s Name:

Supervisor’s Name:

PDF

WORD

Examples

Coshh Form Template UK (1)

Department:
[Name of the Department]
[Department ID]
[Department Address]
[Department Phone]
[Department Email]

Product:
[Name of the Substance/Chemical]
[CAS Number]
[Storage Location]
[Storage Conditions]

Introduction:
This Coshh Form outlines the necessary information and safety measures regarding the handling and use of the specified substance, effective from [Start Date].

Section 1: Hazard Identification
This section details the potential hazards associated with the substance, including [List of hazards such as toxic, flammable, corrosive, etc.].

Section 2: Risk Assessment
A thorough risk assessment has been conducted, identifying risks such as [List specific risks related to exposure, handling, and storage].

Section 3: Control Measures
The following control measures are in place to minimize risk: [List methods such as PPE, ventilation systems, training requirements, etc.].

Section 4: Emergency Procedures
In case of an emergency, follow these procedures: [Detailed steps for spill management, first aid measures, and reporting incidents].

Section 5: Training Requirements
All personnel involved in handling this substance must complete training in [Specify training requirements and refreshment periods].

Signed by:
[Signature of the Responsible Person]
[Name of the Responsible Person]
[Date]

Coshh Form Template UK (2)

Department:
[Name of the Department]
[Department ID]
[Department Address]
[Department Phone]
[Department Email]

Product:
[Name of the Substance/Chemical]
[CAS Number]
[Storage Location]
[Storage Conditions]

Introduction:
This Coshh Form provides essential information regarding risks and safety protocols for using [Name of the Substance], commencing from [Start Date].

Section 1: Composition and Ingredients
The chemical composition of the substance includes: [List of ingredients and their concentrations].

Section 2: Health Hazards
This section describes the health impacts of exposure, e.g., [List effects such as respiratory issues, skin irritation].

Section 3: Safety Precautions
Recommended safety precautions include: [Use of PPE, safety showers, eye wash stations].

Section 4: Disposal Considerations
Dispose of waste materials in accordance with local regulations. Recommended methods include: [List disposal methods].

Section 5: Review Date
This form will be reviewed on [Review Date]. Any amendments must be documented and signed by the responsible person.

Signed by:
[Signature of the Responsible Person]
[Name of the Responsible Person]
[Date]

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PDF – 1 PDF – 2