Effective form templates

This example COSHH risk assessment has been prepared using the
F-HS5 COSHH Assessment form template which has been designed to record and manage the risks associated with substances hazardous to health and includes:

• Substance details
• Physical description
• Health effects and first aid
• Workplace exposure limits (WELs)
• CLP hazard classification — visual hazard icons
• Risk rating
• Control measures
• PPE required — visual PPE icons
• Environmental considerations

The file is supplied in fully editable MS Word format and can be easily customised and saved to Google Docs format if required. The document uses pre-defined style formatting throughout with styles to match the risk-ratings. All text is in Calibri font for improved readability.
The following document labelling is included in the footer:

• Form number and title
• Information-classification
• Version
• Page number / total pages

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COSHH Assessment — Glass Cleaner (Isopropanol / Ethanol / Ammonia Aqueous Solution)

This pre-completed COSHH assessment covers glass and window cleaner — a water-based solution of isopropanol or ethanol (typically 5–20%) with surfactants and ammonia or glycol ether solvents. Low hazard under normal use conditions; the primary risk is eye irritation from spray contact.

What Does This COSHH Assessment Cover?

The assessment is fully completed and ready to use, covering all sections required for a complete hazardous substance risk assessment:

• Substance identification — trade name (Glass Cleaner / Polycote or equivalent), chemical name (aqueous isopropanol/ethanol with surfactants and ammonia), SDS reference and physical state
• Health effects and first aid — minimal hazard under normal use; spray mist in poorly ventilated areas may cause mild respiratory irritation; mild ingestion irritation; mild skin dryness; mild eye irritation; specific first aid for each route
• Low hazard in normal use — at normal use concentrations this product presents minimal acute hazard; primary precaution is eye protection when spraying and storing away from children
• Workplace exposure limits — no specific WEL for formulation; isopropanol STEL 500 ppm; ammonia TWA 25 ppm and STEL 35 ppm, from workplace exposure limits guidance
• CLP hazard classification — Irritant pictogram
• PPE requirements — including eye protection where splash risk exists during high-volume use
• Emergency procedures — spillage: wipe up with cloth; store in bunded area; fire: not classified flammable at use concentration

Who Is This COSHH Assessment For?

This assessment is suitable for any workplace where glass cleaner is used, including:

• Commercial cleaning contractors
• Office and facilities management teams
• Hospitality and accommodation facilities
• Retail and commercial premises

COSHH Compliance

This document provides ready-to-use evidence of COSHH compliance and supports occupational health and safety management. The assessment is based on the F-HS5 COSHH Assessment template, is fully editable in Microsoft Word, and can be customised with your company details, site-specific information and review dates.