WORKPLACE CHEMICAL AUDIT FORM
All areas are required to ensure that their workplace is checked to confirm there are no hazardous chemicals in the area.
Please note general household cleaning products are not classified as hazardous (e.g. Windex, dishwashing liquid). Please ensure however that any
general household cleaning products in the workplace are appropriately labelled with any relevant safety information available.
Refer to the NOHSC Approved Criteria for Classifying Hazardous Substances for further information on classifying hazardous chemicals.
If it is established that the work area does not have any hazardous chemicals or has only has general household cleaning products, sign the below
declaration. If there are hazardous chemicals in your work area, please continue to the Hazardous Substance Audit form beginning on Page 2.
No Hazardous Substances in the Workplace declaration form
Location
Date of Audit
I confirm that the above mentioned area has no hazardous chemicals in the workplace and that where there are general household cleaning products,
appropriate labelling and safety information is available.
Audited By
Endorsement and Sign-Off
Name
Signature
Signature
Date
Supervisor / Manager
Dean / Director
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Instructions for Hazardous Substances Audit
 In preparation for the hazardous substances audit, obtain a copy of the area chemical register/stock holdings and an incompatibilities report from
ChemAlert
 Not all sections of the audit form will be applicable to all areas. If not applicable, please answer “N/A”.
 Answering “No” to any questions indicates a need for corrective action to be identified and implemented.
 ECU is migrating to the Globally Harmonised System (GHS) of Classification and Labelling of Chemicals. An overview of GHS is available here. It is
recommended that where action arising from this audit requires a new / updated SDS, labelling or placarding that they meet GHS requirements. GHS
compliant SDS can be printed from ChemAlert.
 Ensure that the sign off at the end of the audit form is completed and signed by all required parties.
For further assistance or guidance please contact the Safety and Employment Relations team on extension 2302 or [email protected]
HAZARDOUS SUBSTANCES AUDIT FORM
ACTION FOR COMPLIANCE
1
Are all hazardous substances used in your
work area recorded in the chemical
register in ChemAlert?
2
Are stocks maintained as equal to or less
than the allowable maximum volumes
recorded in ChemAlert?
YES
NO
N/A
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
TARGET
COMPLETION
DATE
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DATE
COMPLETED
ACTION FOR COMPLIANCE
3
YES
NO
N/A
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
TARGET
COMPLETION
DATE
Are Safety Data Sheets (SDS) available in
the area for all hazardous substances
used?
If no, up to date GHS compliant SDS need to
be obtained.
4
5
6
Are all Safety Data Sheets (SDS) kept in
the area dated as less than 5 years old?
If no, up to date GHS compliant SDS need to
be obtained.
Have risk assessments been completed
for the hazardous substances held and
used?
Are the risk assessments reviewed every 5
years or if circumstances change?
Refer to the Guidelines for the Assessment
of Risks from the Use of Hazardous
Substances document
7
Have approvals for the use of any
carcinogens or products listed in schedule
5 of the Occupational Safety and Health
Regulations been obtained from WorkSafe
in conjunction with the Radiation Biosafety
and Hazardous Substances Committee?
A list of the substances concerned is
attached at Appendix A. If approval has not
been received, please contact
[email protected] for further information
on the approval process.
8
Have approvals for the use of any
mutagens or tetragens been obtained from
the Radiation Biosafety and Hazardous
Substances Committee (RBHSC)?
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DATE
COMPLETED
ACTION FOR COMPLIANCE
YES
NO
N/A
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
TARGET
COMPLETION
DATE
Refer to the SDS for details of whether the
hazardous substance is a mutagen or
tetragen.
If approval has not been received, please
contact [email protected] for further
information on the approval process.
Are all containers of hazardous
substances suitable and undamaged?
9
10
Note – hazardous substances should only be
decanted into fit for purpose containers and
labelled according to the Occupational Safety
and Health Regulations section 5.12(3)
For GHS WHS Regulations schedule 9 Part 3
Are all containers adequately labelled
according to Occupational Safety and
Health Regulations section 5.12?
If no, any new labelling should be GHS
compliant to WHS regulations schedule 9
part 3.
11
Are all areas in which hazardous
substances are used or stored well
ventilated in accordance with the
requirements of the relevant SDS?
12
Are all hazardous substances safely stored
and protected from damage?
13
Is compatibility of dangerous goods
considered when storing?
Storage incompatibility reports can be run
from ChemAlert
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DATE
COMPLETED
ACTION FOR COMPLIANCE
14
YES
NO
N/A
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
If Yes, complete Flammable Liquids
section of this audit form
Auditors
TARGET
COMPLETION
DATE
Does the area have any chemicals
identified as Chemicals of Security
Concern?
A list of Chemicals of Security Concern is
available here
15
Are security measures in place for any
chemicals identified as Chemicals of
Security Concern?
16
Does the area have any substances that
are considered precursors to illicit drugs
that require additional storage and security
requirements?
Refer to the requirements of National Code
of Practice for Chemicals of Security
Concern
Refer to the class 1 precursors/reagants in
the Code of Practice for Supply Diversion
into Illicit Drug Manufacture
17
Are security and inventory control
measures in place for any substances that
are considered precursors to illicit drugs
Refer to the Code of Practice for Supply
Diversion into Illicit Drug Manufacture
18
Does the area have any flammable gases
and if so, are they stored securely,
protected from damage and away from
ignition sources
19
Does the area contain flammable liquids
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DATE
COMPLETED
ACTION FOR COMPLIANCE
YES
NO
N/A
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
TARGET
COMPLETION
DATE
Is regular atmospheric monitoring or health
surveillance monitoring required for the
substances used in accordance with the
requirements for the SDS?
If yes, is it undertaken?
20
A list of the substances that require health
monitoring in accordance with Schedule 5.3
of the OS&H Regulations is attached at
Appendix B.
Is there any bulk quantity storage of
hazardous liquids? If yes, is the area
bunded?
21
Bulk, in relation to a hazardous chemical,
means any quantity of a hazardous
chemical that is either in a container with a
capacity exceeding 500 litres or net mass of
more than 500 kilograms
Are building placards required?
If yes, are they displayed?
22
23
Placards are required if placard quantities of
any Dangerous Goods are stored within the
premises. Placard quantities are defined in
schedule 1 of the Dangerous Goods Safety
(Storage and Handling of Non-explosives)
Regulations 2007)
Are emergency isolation switches
available, clearly identified and regularly
tested?
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DATE
COMPLETED
ACTION FOR COMPLIANCE
24
If there is a fume cupboard, is a CO2 fire
extinguisher located nearby?
25
Are emergency eye wash stations and
showers readily accessible in accordance
with AS4775?
26
Is storage and consumption of food and
drink prohibited in areas where hazardous
substances are used / stored?
27
Are spill kits available to clean up spills?
28
Are procedures in place to clean up spills
and people in the immediate vicinity aware
of such procedures?
26
27
YES
NO
N/A
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
TARGET
COMPLETION
DATE
Are all hazardous substances disposed of
according to the SDS requirements?
Are all workers, students and visitors who
use the workplace made aware of the
hazardous substances used and how to
access the Safety Data Sheets (SDS)?
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DATE
COMPLETED
ACTION FOR COMPLIANCE
28
Are workers and students working with
hazardous substances adequately trained
and competent to do so?
If no, is supervision provided?
29
Are workers and students who use the
workplace trained to take necessary action
in an emergency? i.e. spills, fire etc.
30
Is appropriate PPE available, in good
repair and being worn as per SDS
requirements?
31
Is training/instructions provided on the
correct use and maintenance of PPE?
YES
NO
N/A
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
TARGET
COMPLETION
DATE
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DATE
COMPLETED
FLAMMABLE LIQUIDS AUDIT CHECKLIST
Must be completed where an area has flammable liquids
Storage of flammable chemicals must comply with Australian Standard AS1940:2004 The Storage and Handling of Flammable and Combustible Liquids.
Connect to Standards Australia
ACTION FOR COMPLIANCE
YES
NO
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
DATE TO BE
COMPLETED
Storage of minor amounts intended as day-to-day working stock:
1
2
Do the quantities of flammable and
combustible liquids stored fall within the
allowable quantities for minor storage as
noted in Table 2.1 of AS1940:2004?
Do minor storage areas meet the
requirements of section 2.2 of
AS1940:2004 in terms of:
- Separation distances for multiple
minor stores on the same
premises being separated by at
least 20m indoor and 15m
outdoor?
- Separation of buildings containing
minor stores
- Separation between minor stores
and other stores
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DATE
COMPLETED
FLAMMABLE LIQUIDS AUDIT CHECKLIST
Must be completed where an area has flammable liquids
Storage of flammable chemicals must comply with Australian Standard AS1940:2004 The Storage and Handling of Flammable and Combustible Liquids.
Connect to Standards Australia
ACTION FOR COMPLIANCE
YES
NO
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
DATE TO BE
COMPLETED
General Requirements
3
Are containers kept closed when not in
use?
4
Is there room to open/decant flammable
liquids away from ignition sources?
5
Is the storage/decanting area clear of
combustible waste materials and
residues?
6
Are flammable liquids stored and used
away from escape routes and at least 3m
from any ignition source?
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DATE
COMPLETED
FLAMMABLE LIQUIDS AUDIT CHECKLIST
Must be completed where an area has flammable liquids
Storage of flammable chemicals must comply with Australian Standard AS1940:2004 The Storage and Handling of Flammable and Combustible Liquids.
Connect to Standards Australia
ACTION FOR COMPLIANCE
7
YES
NO
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
DATE TO BE
COMPLETED
Are relevant staff and students trained in
the use and handling of flammable and
combustible liquids?
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DATE
COMPLETED
ACTION FOR COMPLIANCE
YES
NO
ACTION REQUIRED/COMMENT
PERSON
RESPONSIBLE
DATE TO BE
COMPLETED
Storage of amounts other than those classified as minor storage
8
Do the amounts of flammable and
combustible liquids stored meet the
storage requirements of AS1940:2004?
9
Do storage locations and separation meet
requirements of AS1940:2004
Are flammable cabinets constructed
according to regulations
10
(double-walled sheet steel construction, gap
not less than 40mm between the wall; gaps
are either an air space or filled with noncombustible insulation; floor forms a liquidtight compound at least 150mm deep. All
shelves are perforated for free air
movement) and does the cabinet need to
be externally vented?
11
Are cabinet doors self-closing, close-fitting
and held shut at all times?
12
Are cabinets marked legibly with the
maximum capacity of the cabinet, a class
label and words “no smoking, no ignition
sources”?
13
Are appropriate types of fire extinguishers
available in the area that are suitable for
the range of sustances being used?
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Hazardous Substances Audit Details
Location
Date of Audit
Audited By
Endorsement and Sign-Off
Signature
Signature
Name
Date
Supervisor / Manager
Dean / Director
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Appendix A. List of Carcinogens requiring WorkSafe Approval
Schedule 5.4 — Carcinogenic substances to be used only for research or analysis


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




2-Acetylaminofluorene [53-96-3]
Aflatoxins
4-Aminodiphenyl [92-67-1]
Benzidine [92-87-5] and its salts (including benzidine dihydrochloride [531-85-1])
bis(chloromethyl) ether [542-88-1]
Chloromethyl methyl ether [107-30-2] (technical grade containing bis(chloromethyl) ether)
4-Dimethylaminoazobenzene [60-11-7]
2-Naphthylamine [91-59-8] and its salts
4-Nitrodiphenyl [92-93-3]
Schedule 5.5 — Carcinogenic substances to be used only for purposes approved by the
Commissioner




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
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
Acrylonitrile [107-13-1]
Benzene [71-43-2] when used as a feedstock and containing more than 50% of benzene by
volume
Cyclophosphamide [50-18-0] (cytotoxic drug) when used in preparation for therapeutic use
in hospitals and oncological treatment facilities and in manufacturing operations
3,3-Dichlorobenzidine [91-94-1] and its salts (including 3,3-dichlorobenzidine
dihydrochloride [612-83-9]
Diethyl sulfate [64-67-5]
Dimethyl sulfate [77-78-1]
Ethylene dibromide [106-93-4] when used as a fumigant
4,4’-Methylene bis(2-chloroaniline) [101-14-4]-MOCA
Beta-Propiolactone [57-57-8] (2-propiolactone)
o-Toluidine [95-53-4] and o-Toluidine hydrochloride [636-21-5]
Vinyl chloride monomer [75-01-4]
Schedule 5.6 — Carcinogenic substances — asbestos

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

Actinolite asbestos [77536-66-5]
Amosite [12172-73-5] (brown asbestos)
Anthophyllite asbestos [77536-67-5]
Crocidolite [12001-28-4] (blue asbestos)
Chrysotile [12001-29-5] (white asbestos)
Tremolite asbestos [77536-68-6]
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Appendix B. Hazardous Chemicals Requiring Health Monitoring
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Acrylonitrile
Arsenic (inorganic)
Asbestos
Benzene
Cadmium
Chromium (inorganic)
Creosote
Crystalline silica
Isocyanates
Lead (inorganic)
Mercury (inorganic)
4,4'-methylene bis(2-chloroaniline) [MOCA]
Organophosphate pesticides
Polycyclic aromatic hydrocarbons (PAH)
Pentachlorophenol (PCP)
Thallium
Vinyl chloride 196
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