9-4636 Friable Asbestos Check Sheet

Friable Asbestos Check Sheet

• License Name:

• PCBU Name:

• Registered Business Address:

• ABN:

• PCBU Phone:

• PCBU Supervisor:

• Site Location
  Address

• Conducted on

  Date

• Inspection Conducted by:

• Site security adequate? WHS Regulation 2011, Clause 298

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Signage and barricading in place? WHS Regulation 2011, Clause 469.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• ARCP onsite and readily accessible? WHS Regulation 2011, Clauses 464 & 465.

  Yes

  No

  Not Verified

• Action Taken / Notice Issued / Comments

• Is the asbestos removal area enclosed? WHS Regulation 2011, Clause 477.

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is a negative pressure exhaust unit being used? WHS Regulation 2011, Clause 477.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is an air pressure of approximately negative 12 Pa being achieved? WHS Regulation 2011, Clause 477.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• How is air pressure measured? WHS Regulation 2011, Clause 477.

• Asbestos register available? WHS Regulation 2011, Clause 225.

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Has the enclosure been tested for leaks? I.e. smoke test. WHS Regulation 2011, Clause 477.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is the wet method of removal being used? WHS Regulation 2011, Clause 477.<br><br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Are there decontamination facilities for workers, plant, and equipment? WHS Regulation 2011, Clauses 471 & 483.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is air monitoring being undertaken by LAA prior to, and during removal? WHS Regulation 2011, Clauses 475 & 482.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is correct PPE & RPE being used? Full-face, particulate, filter (cartridge) P3. WHS Regulation 2011, Clauses 44 & 46.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is the supervisor onsite? WHS Regulation 2011, Clause 459.<br><br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is the supervisor named to SafeWork NSW? (check GLS database) WHS Regulation 2011, Clause 529.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Do workers hold correct training qualification? WHS Regulation 2011, Clause 460.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• SWMS prepared and onsite? WHS Regulation 2011, Clauses 299 - 303.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Relevant persons notified i.e. neighbours, occupants, other PCBU’s? WHS Regulation 2011, Clause 467.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is asbestos waste & PPE waste contained and planned to be disposed of ASAP? WHS Regulation 2011, Clause 472.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is a ‘H class’ vacuum cleaner used? *Requires maintenance & decontamination procedure WHS Regulation 2011, Clauses 471 & 483.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is there a (current) certified safety management system in place? WHS Regulation 2011, Clause 498.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice served / Comments

• What is the Expiry Date:

• Select date

  Date