Version: 1.0
Approved Date: 03/11/2016
Next Review Date: 03/11/2018
Page 1 of 1
Dear
Re: Exposure Letter for Use of Carcinogen
Name of Carcinogen:
Supervisor:
Division/College/Directorate:
Date commenced working with
Carcinogen:
Completion Date of
working with
Carcinogen:
Was the Work Identified to Have
Potential for Exposure?
If Yes, was Health
Monitoring
Recommended?
If Health Monitoring was required,
details of schedule and testing
undertaken:
Records of the possible exposure are maintained within the JCU Records Management System. Requests to
obtain information can be sent to the HSE Unit.
Sincerely
JCU Health Safety & Environment Unit
Email: safety@jcu.edu.au
Date
Recipient Name
Recipient Title
Company
Address
Town Qld Post Code
Recipient Name
Senders Name
Senders Title
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