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Report and assessor identification
Operator name COIN Company Assessor
Establishmentaddress
COIN Site Team/unit
Date of report COIN Service Order Discipline
ASSESSMENT RECORD
DESCRIPTIVE ASPECTS
Please note - all rows are expandable
Descriptive CriterionSaet! Report
ResCo""ents
#$%The safety report should ive details to allo! communication !iththe competent authority"
Dan&ero's S'bstances
#$(The safety report should identify the ma#imum $uantities of everydanerous substance present% or potentially present% on the
establishment"#$)&or each danerous substance identified% the safety report shoulddescribe its chemical name 'includin common use chemical name( andCAS number% accordin to I)*AC nomenclature"
#$*The safety report should describe the physical and chemicalbehaviour of each danerous substance identified% relevant to normaloperatin conditions and foreseeable accident conditions"
#$+The safety report should describe the immediate and delayed harmto man and the environment for each danerous substance identified"
Environ"ent
#$,The safety report should describe the environment of the
establishment in sufficient detail to allo! the conse$uences ma+oraccidents to be assessed"
#$The safety report should describe the environment of theestablishment in sufficient detail to allo! the contribution of e#ternalfactors to ma+or accidents at the establishment to be assessed"
,ersion -". April 00.
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