9-4636 Non Friable Asbestos Check Sheet

Non 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

• Asbestos register available? WHS Regulation 2011, Clause 463.

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is correct PPE & RPE being used? i.e. disposable type 5 / category 3 coveralls, disposable respirator least preferred, lace less safety footwear, latex gloves. WHS Regulation 2011, Clause 44.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is the supervisor readily available? i.e. less than 20 minutes away from site. 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/s? WHS Regulation 2011, Clauses 39 & 316.<br>

  Yes

  No

  Not Verified

• Action Taken / Notice Served / Comments

• Is there decontamination facilities for workers, plant, and equipment? WHS Regulation 2011, Clause 471.<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

• Site Description. i.e School, Police Station, Residential.

• Stage of removal i.e. external cladding 50% removed, roof removed etc.

• Any further comments.