UNIVERSITYofLIMERICK

CHEMICAL AGENT RISK ASSESSMENT SHEET

TITLE OF ACTIVITY:______
ACADEMIC / PROJECT SUPERVISOR: ______ / LOCATION:______
(Room No.) / MODULE CODE:______
(if relevant)
ASSESSMENT UNDERTAKEN BY:______ / ASSESSMENT DATE:______ / ASSESSMENT REVIEW DATE:______

(Use labels, Safety Data Sheets (SDS) & Chem. Agent CoP to complete this table.)

/ HEALTH HAZARD CATEGORIES /

OTHER HAZARDS

/

EXPOSURE

/ Amount Used
(L or Kg) / Dustiness or Volatility (high, medium or low) / Duration of Contact
(Hr/Day) / Number of people exposed
LIST

CHEMICAL NAMES

/ Very Toxic (T+) / Toxic (T) /

Harmful (Xn)

/ Irritant (Xi) / Corrosive (C) / Sensitising (Xi) / Carcinogenic (C1) or (C2) / Mutagenic (Mut 1) or (Mut 2) / Toxic Reproduction Repro 1 or Repro 2 / Flammable (F)
Very Flammable F+ / Oxidising (O) / Explosive (E) / Danger to environment (N) / Inhalation (Sen) / Skin (Sk) / Eyes / Ingestion / OELV / BLV
NOTE OTHER SIGNIFICANT SAFETY CONCERNS:
PERSONS CARRYING OUT & DESCRIPTION OF THE ACTIVITY /

CURRENT PREVENTATIVE & PROTECTIVE MEASURES

/

ADDITIONAL PREVENTATIVE MEASURES REQUIRED

Persons carrying out activity (lecturer, technician, postgraduate or undergraduate student, maintenance, grounds, etc.):

/

STANDARDS & PROCEDURES (Name of relevant Departmental Safety COP, experimental procedures and/or other reference that controls the use of chemicals in this experiment or project):

Safety Data Sheets (Are SDS’s available for each chemical?): YES  NO 

/ (If needed to ensure that risks are kept at acceptable levels, list additional preventative measures to be used):
CONTAINMENT FACILITIES (i.e. engineering controls, fume cupboards, etc.):

Brief description of the activity and significant chemical hazards and risks involved:

PERSONAL PROTECTIVE EQUIPMENT (i.e. protective clothing, gloves, eye protection, etc.):

TRAINING (Describe training given to staff / students who will use these chemicals):
LIST OTHER PREVENTATIVES AND PROTECTIVE MEASURES:
RISK DECISION
ACCEPTABLE: 
UNACCEPTABLE:  /

If, as a result of this risk assessment, the risk decision is found to be acceptable, then progress to the next page.

If the risk decision is found to be unacceptable then the chemical agent / agents may not be used in the workplace. It may then be necessary to carry out a more detailed risk assessment.

FIRST AID

(Location of showers, first aid arrangements, antidotes, Student Medical Centre contact details, etc.):

/

SPILLS & OTHER EMERGENCY PROCEDURES

(Describe emergency procedures in event of spill: including location of clean-up materials, emergency contacts & phone numbers, and the Departmental Emergency Plan):

WASTE
(Specify if any special precautions should be taken when handling wastes and state the method of disposal): /

STORAGE

(State the correct storage conditions for the various chemical categories being assessed.):

I have completed this risk assessment and I am fully aware of the hazards involved in the above activity and of the essential safety precautions to be taken. I acknowledge with my signature here that I will comply with the safety precautions that this work requires.

Signature of AssessorDate

Researcher/Staff

I have personally ascertained that the Assessor is aware of the hazards involved in the above activity and the precautions to be taken. I am satisfied that any hazards that were identified are adequately controlled and these controls will be regularly checked. This activity is deemed to be safe and has my approval.

Signature of Supervisor: Date

Chief Technical Officer / Academic Staff / Head of Department

Chemical Agent Risk Assessment Sheet1 of 3 Document Number SF001.3