Coshh Assessment Form Template for Belgium

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Key Requirements PROMPT example:

Coshh Assessment Form

"I need a COSHH Assessment Form for our new laboratory facility in Brussels that will handle volatile organic solvents in chemical analysis procedures, with implementation planned for March 2025; the form must include specific provisions for fume hood specifications and automated monitoring systems."

Document background
The COSHH Assessment Form is a crucial workplace safety document required by Belgian law for any organization handling hazardous substances. This form must be completed in compliance with the Belgian Code on Well-being at Work and relevant EU regulations, including REACH and CLP. It serves as a systematic tool for identifying, assessing, and controlling risks associated with hazardous substances in the workplace. The assessment should be performed before any new hazardous substance is introduced into the workplace, when significant changes occur in processes or procedures, or at regular intervals as part of ongoing safety management. The document demonstrates due diligence in protecting worker health and safety while ensuring regulatory compliance in the Belgian jurisdiction.
Suggested Sections

1. Assessment Information: Basic details including assessment date, assessor name, location, and department

2. Substance Information: Details of the hazardous substance including product name, manufacturer, CAS number, and hazard classification under CLP

3. Hazard Identification: Detailed listing of all hazards associated with the substance based on Safety Data Sheet and CLP classification

4. Use Information: Description of how the substance is used, quantities, frequency, and who uses it

5. Exposure Routes: Identification of all possible exposure routes (inhalation, skin contact, ingestion, etc.)

6. Control Measures: Existing control measures including engineering controls, PPE, and work practices

7. Health Surveillance: Requirements for health monitoring of workers if applicable

8. Emergency Procedures: Steps to be taken in case of spills, accidents, or exposure

9. Training Requirements: Specific training needed for workers handling the substance

10. Review and Approval: Sign-off section for assessor and responsible manager

Optional Sections

1. Environmental Impact: Required when substance poses environmental risks or is subject to environmental regulations

2. Storage Requirements: Needed when specific storage conditions or incompatibilities must be managed

3. Waste Disposal: Include when substance requires special disposal procedures

4. Process Monitoring: Required for substances needing regular exposure monitoring or air sampling

5. Reproductive Hazards: Include when substance is known to pose risks to reproduction or development

6. Carcinogen/Mutagen Specific Controls: Required when substance is classified as carcinogenic or mutagenic under CLP

Suggested Schedules

1. Safety Data Sheet: Current Safety Data Sheet for the substance in accordance with REACH requirements

2. Exposure Monitoring Results: Records of any exposure monitoring or testing carried out

3. PPE Specifications: Detailed specifications for required Personal Protective Equipment

4. Emergency Contact Information: List of emergency contacts and response procedures

5. Risk Matrix: Risk assessment matrix showing likelihood and severity of hazards

6. Training Records Template: Template for recording worker training on substance handling

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions
Relevant Industries

Chemical Manufacturing

Pharmaceutical

Laboratory and Research

Industrial Manufacturing

Healthcare

Construction

Agriculture

Cleaning Services

Automotive

Electronics Manufacturing

Mining and Extraction

Textile Industry

Paint and Coatings

Waste Management

Food Processing

Relevant Teams

Health and Safety

Operations

Production

Quality Control

Research and Development

Facilities Management

Environmental Compliance

Risk Management

Manufacturing

Laboratory Operations

Maintenance

Process Engineering

Relevant Roles

Health and Safety Manager

Environmental Health Officer

Chemical Safety Specialist

Laboratory Manager

Production Supervisor

Facilities Manager

Risk Assessment Officer

Occupational Hygienist

Operations Manager

Quality Control Manager

Research Scientist

Industrial Hygienist

Safety Compliance Officer

Process Engineer

Manufacturing Manager

Industries
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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