OCCUPATIONAL HEALTH AND SAFETY MANAGEMENT SYSTEM

TECHNICAL QUOTATION INFORMATION

Applicable to

OH&S 18001:2007 OR I.S. ISO45001:2018

Return completed questionnaire with any other relevant information to:
Certification Services NSAI 1 Swift Square Northwood Santry Dublin 9
For North American Applications:
NSAI North America – East 402 Amherst Street Nashua NH 03063

1.0	Company Information
Applicant Name: (Company/organisation)
Address:
Contact Name:
Telephone No.:
Email Address:
Website URL:
2.0	Organisation / Facility(s) for which included in scope of OH&S
Applicant Name: (Company/organisation)
Address:
Contact Name:
Telephone No.:
Email Address:
Website URL:
2.1	Outline processes within the scope OH&S
2.2	Outline if any of the processes are outsourced

3.0	Hazard Identification
Yes	No
Chemical or biological substances	☐	☐
Ionising / non ionising Radiation	☐	☐
Asbestos	☐	☐
Pressure vessels and their control	☐	☐
Compressed air equipment	☐	☐
Portable Electrical Equipment	☐	☐
Elevated noise levels	☐	☐
Pneumatic and Hydraulic control systems	☐	☐
Steam / High pressure water boilers	☐	☐
Machines / Machining activities	☐	☐
Contact with moving machinery	☐	☐
Lifting equipment	☐	☐
Assembling / dismantling heavy components	☐	☐
Office ergonomic factors	☐	☐
Manual handling, lifting and carrying	☐	☐
Transport usage, Truck, Forklifts	☐	☐
Exposure to Airborne contaminants	☐	☐
Control of external contractors	☐	☐
Welding & Hot work	☐	☐
Potential for falling material	☐	☐
Ladders, platforms and scaffolding	☐	☐
Building activities on site	☐	☐
Demolition activities on site	☐	☐
Flammable or explosive materials	☐	☐
Working at heights	☐	☐
Activities near high voltage powers lines	☐	☐
Activities in wells, underground earthworks or tunnels	☐	☐
Others (list below):

4.0	Breakdown of staff by department/process
Outline shift pattern if any
Department Staff Numbers Activity Shift if applicable

COMPANY REPRESENTATIVE
Name:
Title:
Signature:
Date: