Company Name
Hazardous Substances Risk Assessment - Process p1
Employee
Designation
Location
Department / Section
Date of Assessment
Time of Review
Task Being Assessed
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Description of Process
Those at Risk
Employees
Contractors
Visitors
Public
Young Persons
New and Expectant Mothers
Other
The Task Categoroes
Transferring
Pelletising
Mixing
Drying
Dust Extractions
Screening
Laminating
Dipping
Sieving
Storing
Weighting
Surface Coating
Other
Nature of Exposure
Inhalation
Ingestion
Injection
Skin Contact
Eye Contact
Other
Comments on Exposure
Control Measures Required
Requirements for Maintenance, Examination and Test Control Measures
To be filled in by Assessor / Manager / Supervisor:
Assessor / Manager / Supervisor
Reference No
Signed
________________________________
Date
Display sign-off
Email
Confirm
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