(1) In case of Emergency:	(2) Fire Fighting medium	Carbon Monoxide (Black)
The following services are being used:	Electricity	Water	Gases: (specify)	Other:
☐	☐	n/a	Foam (cream)
Action in case of Fire:	Keep away from sources of ignition - No smoking. Take measures to prevent the build-up of electrostatic charge. Close lab doors. If needed: sound the alarm and evacuate. Call Campus Security on 0161 306 9966 immediately. Report to Supervisor and Safety Advisor.	Spillage or release measures:	Avoid breathing vapours, mist or gas. Remove all sources of ignition. Beware of vapours accumulating to form explosive concentrations. Vapours can accumulate in low areas. Room ……. has a chemical spills kits, which should be used in case of a chemical spill. For very small spills wipe up with a blue roll or leave to evaporate. If you have spilt a significant amount, evacuate all personnel (including you) to a safe area and shut off lab. You may have created a flammable atmosphere. Contact the School Safety Advisor. Incident Reporting: All incidents must be reported to Safety Advisor and Supervisor.
First aid requirements:	Call a First Aider and take provisions from the first aid station in the lab. If needed call medical help and show safety data sheet. Protection of First Aider: No action shall be taken involving any personal risk or without suitable training. In cases where it may be dangerous to give mouth-to-mouth resuscitation, carry out chest compressions only. Wash contaminated clothing thoroughly with water before removing it, or wear appropriate gloves. Accident Reporting: Accidents or near misses should be reported to Safety Advisor and Supervisor. If inhaled - If breathed in, move person into fresh air. If not breathing, give artificial respiration. Consult a physician. In case of skin contact - Wash off with soap and plenty of water. Consult a physician. In case of eye contact – Rinse thoroughly with plenty of water for at least 15 minutes and consult a physician. If swallowed - Do NOT induce vomiting. Never give anything by mouth to an unconscious person. Rinse mouth with water. Consult a physician.
This is a chemical risk assessment only and other assessments may be required. All associated assessment forms must be displayed close to the procedure.
(3) Risk Assessment Number/Code:	n/a	(4) Name and status of researcher e.g. Phd..	Joe Blogs PhD	(5) Emergency contact details:	Academic supervisor or PDRA for the lab – mobile number, office extension.
(6) Assessment Date:	16/08/2018	(7) Review/Expiry Date:	16/08/2019	(8) Building and office Number:	Schuster XXX	(9) Lab Number:	XXX	(10) People Affected:	Users and other in the vicinity
(11) Title of procedure:	Use of acetone to clean glass slides
(12) Details of procedure and where applicable reaction scheme (Including starting materials, products/by-products and pressure):	(14) Associated Assessments and Ref
Place glass slides and acetone in beaker and allow to stand. Atmospheric pressure.	General risk assessment for experiment	☐
Equip/Exp overnight running	☐
General lab activities	☒
Ionizing radiation	☐
Non-Ionizing radiation	☐
Laser Safety	☐
Biological/Bio-COSHH	☐
Radiological	☐
(13) Duration, Frequency and Temperature Range:	RA/P&M Sheets/SOP/Other (include ref):
15 minutes at room temperature, once a month	See generic lab risk assessment for lab XXX. See standard operating procedure (SOP) for cleaning glass slides.
(15) Substances used and produced	(16) Quantity used and handled	(17) Duration of potential exposure	(18) Hazard Symbols	(19) Physical and health hazard statements Highlight primary hazard	(20) Workplace Exposure Limits	(21) Control Measures	(22) Disposal Route	(23) Extremely or Highly Flammable?
1. Acetone, liquid	2.5 L bottle, 10 mL used	15 minutes	Click Here Click Here	H225 Highly flammable liquid and vapour. H319 Causes serious eye irritation. H336 May cause drowsiness or dizziness. Can be absorbed through the skin. EUH066 Repeated exposure may cause skin dryness or cracking. Beware of vapours accumulating to form explosive atmosphere.	STEL 1500 ppm, 3620 mg/m3 TWA 500 ppm, 1210 mg/m3	P210 - Keep away from heat, hot surfaces, sparks, open flames and other ignition sources. No smoking. P261 - Avoid breathing vapours. Use a fume hood. Avoid contact with skin and eyes. Restricted access to competent personnel. Butyl rubber 0.3 mm EN166 safety glasses with side shields. Flame retardant lab coat. Store in a cool place. Store in a flammable cabinet. Keep container tightly closed in a dry and well-ventilated place. Containers which are opened must be carefully resealed and kept upright to prevent leakage.	Waste acetone should be disposed of via School Safety Advisor. Do not dispose of in general waste or down the sink. Small quantities leave at the back of a fume hood to evaporate	☒
2. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	Click here to enter text.	Click here to enter text.	Click here to enter text.	☐
3. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	Click here to enter text.	Click here to enter text.	Click here to enter text.	☒
4. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	Click here to enter text.	Click here to enter text.	Click here to enter text.	☐
5. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	Click here to enter text.	Click here to enter text.	Click here to enter text.	☐
6.Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	Click here to enter text.	Click here to enter text.	Click here to enter text.	☐
7. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	Click here to enter text.	Click here to enter text.	Click here to enter text.	☐
8. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	Click here to enter text.	Click here to enter text.	Click here to enter text.	☐
(24) Operation is (mark as appropriate): Open ☒ Closed ☐ Pressurised ☐ Pressure relief system ☐ other ☐ Please specify here.
(25) Are you carrying out an activity/chemical reaction that is at risk of a thermal runaway or explosion? No If yes, what additional controls are required? Click here to enter text.
(26) Will the activity involve handling or storage of pyrophoric or unstable substances such as peroxide? No If yes, what additional controls are required? Click here to enter text.
(27) Will flammable vapours, solid particles, fibrous particles etc. capable of forming an explosive atmosphere be present? Yes If yes, what additional controls are required? Keep quantities to a minimum, if large spill evacuate room immediately. Keep ignition sources away from procedure.
(28) Can less hazardous substances be used? No
(29) Procedure for checking effectiveness of control measures Ensure gloves, safety specs and lab coat are in good condition, free from defects Ensure the fume cupboard is functioning correctly through checks. Check gloves for pin holes before use.
(30) If Carcinogens, mutagens or reproductive toxins (CMR), skin sensitisers, respiratory sensitisers, occupational asthmagens or nanoparticles are listed, is the fitness to work certificate for each individual still valid? No	(31) If any of the Substances above are highly flammable and extremely flammable, What control measures are in place? Keep quantities to a minimum, if large spill evacuate room immediately. Keep ignition sources away from procedure.
(32) Is lone working permitted for this procedure? Yes If yes, what additional controls for lone working are required? Accompanied buddy – Jane Doe, PDRA Remote buddy – Regular contact over email or telephone with Jane Doe, PDRA	(33) Is out of hours working permitted for this procedure? Yes If yes, what additional controls for out of hours working are required? Buddy system in place Carry a fully charged mobile phone Contact Security for help on 0161 306 9966 Ensure no tailgating into building
(34) Additional control measures or relevant information. Click here to enter text.
(35) Risk rating of the experiment: Low
Signatories We have discussed this chemical risk assessment and understand the hazards and the associated control measures required. A copy of this form must be displayed close to the reaction.
(36) Signature of Assessor: ………Joe Bloggs……………………………………………………… (37) Signature of Approver: …………Academic Supervisor………………………………………… (38) Signature of Verifier: ……………………………………………………………………… (where necessary)	Print Name: ………………………………………………………………………………… Print Name: ………………………………………………………………………………… Print Name: …………………………………………………………………………………	Date: …………………………………………………………… Date: …………………………………………………………… Date: ……………………………………………………………