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 — Patination Oil (Hydrocarbon Solvent Blend)

This pre-completed COSHH assessment covers patination oil — a hydrocarbon solvent-based oil blend applied to lead sheet and flashings to accelerate natural patination and prevent staining of surrounding masonry. Used by roofers and plumbers working with lead sheet in traditional and heritage building applications.

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 (Patination Oil / Lead Patination Oil), chemical name (hydrocarbon solvent oil blend), SDS reference and physical state
• Health effects and first aid — inhalation causing mild respiratory irritation; ingestion with aspiration pneumonia risk; repeated skin contact causing sensitisation and defatting; eye irritation; specific first aid for each route
• Flammable liquid — flash point typically 30–60°C; keep away from ignition sources; store in original sealed containers in a cool, dry, well-ventilated place
• Workplace exposure limits — white spirit carrier TWA 575 mg/m³; consult product SDS for exact values
• CLP hazard classification — Flammable and Irritant pictograms
• PPE requirements — including safety spectacles, chemical-resistant footwear, coveralls and gloves
• Emergency procedures — spillage: eliminate ignition sources, absorb with inert material; fire: use foam or CO2

Who Is This COSHH Assessment For?

This assessment is suitable for any workplace where patination oil is applied, including:

• Roofing contractors working with lead sheet and flashing
• Heritage and conservation building contractors
• Plumbers and building maintenance teams handling lead
• Architectural metalwork and heritage restoration specialists

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.