MagHansen
E4.22D1 COSHH Assessment Record
Task
Mixing & Applying – G500 Solvent & G2000 Adhesive –
Primer Mix
Area /
ASSESSMENT
Location
No
Assessed
Date
By
12.08.
03
Title
Review by
Personnel Performing Task
Time Spent
(Please list below)
(Minutes/day)
1.
8hours
Training Given *
Yes✓
No✗
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Assessment to be conducted in Association with Hazard Data Sheets.
* Training MUST be given BEFORE allowing personnel to conduct task.
E4.22D1
Issue: 1
Issue Date: October 2002
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MagHansen
E4.22D1
COSHH Assessment Record
The Substance
Please denote the properties of the substances used in the task with a ✓
or ✗, as appropriate, below:
Flammable
Yes✓
No✗
Toxic
Yes✓
No✗
Yes✓
✗
✓
✓
Corrosive
Irritant
Harmful to
No✗
Oxidising
Yes✓
No✗
Harmful
Yes✓
✗
No✗
✗
Explosive
the
Environment
Yes✓
No✗
✗
Yes✓
No✗
✗
Substance (s) Used In
Yes✓
No✗
✗
Nature of Hazard(s) Associated with
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Task
Substance
(List below)
1.G500
2.G2000
Highly Flammable
Irritating to eyes
Highly Flammable
Irritating to eyes
3.
4.
5.
E4.22D1
Issue: 1
Issue Date: October 2002
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MagHansen
E4.22D1 COSHH Assessment Record
Substance(s)
Storage Required
Method of Transportation
Disposal Controls
G500 & G2000
 Locked in steel cabinet
 Kept in closed original
 Allow product to cure in
Primer Mixture
containers
mixing container and
dispose of as directed by
ML JV management.
 Kept in a cool dry place
 Mix at site of application.
 Location specified by LMjv
management
 No smoking or hot work
 Kept in closed original
container
E4.22D1
Issue: 1
Issue Date:
October 2002
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MagHansen
E4.22D1 COSHH Assessment Record
Substance(s)
G500 & G2000
Source(s) of Exposure
Duration of Exposure –
Level of Exposure
Each Source
(High, Med or
(Minutes / Hour)
Low)
 Splashes to skin - application
30
Med
 Splashes to eyes – mixing
<1
Low
 Splashes to skin - mixing
2
Med
Primer Mixture
E4.22D1
Issue: 1
Issue Date:
October 2002
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E4.22D1 COSHH Assessment Record
 Skin Contact – drips from brush
30
High
 Splashes to eyes - application
30
Med
 Inhalation of vapours – Open mixing pot
60
High
 Inhalation of vapours – concrete surface
60
High
 Inhalation of Vapours - Brush
60
High
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Issue Date:
October 2002
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E4.22D1 COSHH Assessment Record
Substance(s)
Control Measure(s) Required to Work Safely
Further Actions
Required
Yes ✓
No ✗
Complete
Assessment
Additional
Complete
Sheet - Page
6
G500 & G2000
Primer mix
 Wear hooded disposable coveralls at all times, dispose of soiled
✓
garments and at end of shift
 Mix small quantities, sufficient for primer immediate area
✓
 Wear close fitting goggles at all times
✓
 Wear Nitrile Rubber Gloves – mixing, applying, any contact with
✓
primer
 Use in well ventilated area – at present all apertures are open, good
✓
through draft
 Place brush / roller in sealed bag after use
✓
E4.22D1
Issue: 1
Issue Date:
October 2002
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E4.22D1 COSHH Assessment Record
 Use disposable Brush / Roller – use one day and dispose
 Establish exclusion zone
✓
 No smoking or hot work to take place in area
✓
 Wash hands after use, before breaks and at end of shift
✓
Control Measures Required are precautions available now or at short notice – they must be in place to protect health
and safety, before the task is started.
Further Actions may be monitoring and purchase of equipment, which is not immediately available - planning is
required. However, if these precautions are considered to be essential to allow the task to start, they must be in
place.
Substance(s)
Further Actions Required
Date
Due by
G500 & G2000
Primer mix
Completed
 Site manager/supervisor to check that controls are in place and in
use
E4.22D1
Issue: 1
Issue Date:
October 2002
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E4.22D1 COSHH Assessment Record
 Regular visit from Hansen health and safety management dept
E4.22D1
Issue: 1
Issue Date:
October 2002
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