UNIVERSITY OF NOTTINGHAM - FACULTY OF ENGINEERING

Process and Risk Assessment Record

Any Change to Processes, Location or Circumstances, Requires a Review of the Current
Process and Risk Assessment.
Section 1: General Information
Assessment Number: (Leave blank)

Location / Building and Room Number: (where the process

etc. will be carried out)

Title of Process/Activity/Project/Experiment and/or Rig Name/Number:

Assessor Name: (Person completing assessment record)

Academic/Line Manager/Other Supervisor

Name:

Status:

Status:

Signature:
Signature:
Date:
Laboratory Supervisor
Name:

Date:
Area Safety Officer
Name:

Signature:

Signature:

Date:

Date:

Emergency Shut-Off Procedure:

(Include annotated digital photographs on a separate page)

IN CASE OF EMERGENCY CONTACT DETAILS:

Name:

Contact Telephone Number(s):Ext.

Physical conditions of rig/activity:

Mobile:

Chemicals involved: (List any chemicals used in the process)

Temperature: (Details)
Pressure: (Details)
Machinery: (Details)
Electrics : (Voltage details)
Environmental considerations:

Equipment details: (identify tools and equipment to be

used)

Special precautions for chemicals and experimental

work:

Details of any biological effects:

Other notes:

Date of Issue: January 2015

Date of Printing: 19 November

2015

UNIVERSITY OF NOTTINGHAM - FACULTY OF ENGINEERING

Process and Risk Assessment Record

Section 2: Risk Assessment:

ACTIVITY FOR
ASSESSMENT
Name the activity,
machine, equipment in
use, etc.

ASSOCIATED HAZARD
(something with the
potential to cause harm)
List the significant hazards
associated with each subject
e.g., electricity, moving parts,
flammable liquid, hazardous
materials, fumes, noise, dust,
sharps, etc.

PEOPLE INVOLVED
List the groups(s) of
people who might be at
risk i.e. Undergrad,
Postgrad, Technicians,
Cleaners, Visitors etc.

ASSOCIATED RISK
(the potential harm
arising from the
hazard)
Give a brief statement
for each hazard e.g.
electrocution, crushed
limbs, cut hand, eye
damage, respiratory
irritation, chronic illness
etc.

EX
List for each hazard
control the risk
(extraction syste
Portable Applia

Section 3: Safe Operating Procedure, Process Description, Operating Instructions, Method

Statement, etc. (a step by step instruction on what to do this is a full description of the work you intend to do)

Section 4: Flow diagrams:

(for the process include labelling of items such as switches, valves, pressure gauges

and other important items)

Section 5: Photographs.

(of equipment and rigs, provide general/annotated photographs to show important items:
e.g. valves, pressure gauges, emergency stops, etc. These should match with any diagrams in Section 4.)

Date of Printing: 19 November 2015

UNIVERSITY OF NOTTINGHAM - FACULTY OF ENGINEERING

Process and Risk Assessment Record

Section 6: Suppliers literature.

(other than Material Safety Data Sheets)

(e.g. Manuals, Certificates, Calibration/Conversion Charts, Relevant Graphs, Etc. This should be relevant to the work you are
doing. Do not include full manuals unless they are relevant to your work. )

Section 7: Any necessary working calculations.

Section 8: Other information.

(Any other information not included in any other section that is relevant to the
experiment/procedure/operation of the equipment.)

Section 9: Material Safety Data Sheets (MSDS).

(for all materials used)

Section 10: Control of Substances Hazardous to Health (COSHH) Assessment:

Name of assessor:
Date:
Name of
Quantity:
chemical(s)/
substance(s):
Synonyms:
CAS No:
Safe storage:
Building and room No: Cabinet/category:
(MSDS section 7)
(How will you meet the
standards specified?)

Other:

Physical Properties:
(e.g. Liquid, powder,
granules, fibres, gas etc.)
(MSDS section 9)

Hazard
classification and
category:
(MSDS section 2)

Date of Printing: 19 November 2015

UNIVERSITY OF NOTTINGHAM - FACULTY OF ENGINEERING

Process and Risk Assessment Record

Pictograms:

*Delete as applicable
(MSDS section 2)

Signal word and

hazard statements:
(MSDS section 2)

Precautionary
statements:
(MSDS section 2)

Duration of exposure to
substance: NOT the
duration of the process.

Frequency of exposure:

Time: e.g.
hrs, mins,
secs.

Workplace Exposure Limits: (WEL)

(MSDS section 8)

Long-term exposure
limit:(8-hrs TWA

Short-term exposure limit

(STEL):(15-minute reference

reference period) (ppm

mg/m3 )

period) (ppm mg/m3 )

(e.g. times per day/week

etc.)

Is a written protocol for

safe handling required?

(Are there specific requirements for

handling this substance? e.g. Mercury,
HF, Arsenic etc.)

Yes/No
If Yes give details:

Is air monitoring
required?

(Do air samples need to be taken to

check airborne contamination?)

Are occupational health

checks required?

(Are health checks required to monitor

the health effects of exposure?)

Yes/No

Yes/No

If Yes give details:

If Yes give details:

Give details of engineering control measures in place:

(i.e. how are you going to meet the standards

specified in the MSDS section 8? e.g. Extraction Unit, Fume Cupboard, Glove Box etc.)

Required Personal
Protective
Equipment (PPE):
(MSDS section 8)

*Identify items
required

Laboratory
Coat
Disposable
Gloves
Protective
Apron

X Howie Coat
Heavy Duty
Gloves
Face Shield

Safety
Glasses
Gauntlets
Other:

Disposal Procedures:
(MSDS section 13)

Date of Printing: 19 November 2015

X Safety
Boots/Shoes
Dust
Mask/Respirator
Other:

UNIVERSITY OF NOTTINGHAM - FACULTY OF ENGINEERING

Process and Risk Assessment Record

Emergency Procedures
SPILLAGE/ACCIDENTAL RELEASE MEASURES:
(MSDS section 6)

FIRE-FIGHTING MEASURES:
(MSDS section 5)

FIRST AID MEASURES: (MSDS section 4)

In case of eye contact:

In case of skin contact:

In case of ingestion:

In case of inhalation:

Section 11: Training

Date of Printing: 19 November 2015

UNIVERSITY OF NOTTINGHAM - FACULTY OF ENGINEERING

Process and Risk Assessment Record

Persons trained and authorised to operate the process/activity/project/experiment or

equipment.
Name:
Trained/Authorised by:
Signature:
Date:

Section 12: Declaration

To be signed by all personnel working to this Process and Risk Assessment
I confirm that I have read this Process and Risk Assessment and understand the hazards, risks and
control measures associated with the process. I will not make any changes to the processes, location
or circumstances, without completing and submitting a revised or new Process and Risk Assessment.
Name:
Signature:
Date:

Section 13: Review

This Process and Risk Assessment must be reviewed on a regular basis, if there are any changes to
the processes, location or circumstances, or, if it is deemed to be no longer suitable.
Reviewed by:
Signature:
Date:

Date of Printing: 19 November 2015