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 — Multi-Surface Polish (Petroleum Wax / Silicone Flammable Aerosol)

This pre-completed COSHH assessment covers multi-surface polish in pressurised aerosol form — a petroleum-based wax and silicone polish with LPG propellant used for cleaning and polishing hard surfaces in offices, hospitality and commercial cleaning.

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, chemical name (petroleum wax / silicone in hydrocarbon solvent; LPG propellant), SDS reference and physical state
• Health effects and first aid — inhalation, ingestion, skin contact and eye contact, with specific first aid for each route
• Flammable aerosol hazard — flash point of carrier solvent below 0°C; keep away from all ignition sources; do not pierce or burn containers even when empty
• Workplace exposure limits — LPG propellant TWA 1000 ppm and STEL 1250 ppm, from workplace exposure limits guidance
• CLP hazard classification — Flammable, Irritant and Pressurised gas pictograms
• PPE requirements — including eye protection, nitrile or PVC gloves, and organic vapour respirator where ventilation is limited
• Emergency procedures — spillage and fire response for flammable aerosol

Who Is This COSHH Assessment For?

This assessment is suitable for any workplace where aerosol surface polish is used, including:

• Office and commercial cleaning contractors
• Hospitality and accommodation facilities
• Schools and educational establishments
• Facilities management and janitorial teams

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.