ASB-SF-008 Asbestos Exposure Record.v3

• Name:

• Position:

  Date

• Date:

  Date
• Location:
  Address

• Job Number:

• Completed By:

• Week Ending:

Monday AM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Monday PM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Tuesday AM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Tuesday PM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Wednesday AM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Wednesday PM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Thursday AM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Thursday PM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Friday AM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Friday PM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Saturday AM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Saturday PM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Sunday AM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE

Sunday PM

• Asbestos Removal or Cleaning (A)

  Yes

  No

  N/A

• Encapsulation (B)

  Yes

  No

  N/A

• Non Asbestos (C)

  Yes

  No

  N/A

• RPE Used

  Full

  1/2

  None

• Type of ACM

  Select 1 - Sprayed Coating 2 - Pipe Insulation / Lagging 3 - AIB 4 - Cement 5 - Textured Coating 6 - Vinyl Floor Tiles 7 - Other

  • 1 - Sprayed Coating
  • 2 - Pipe Insulation / Lagging
  • 3 - AIB
  • 4 - Cement
  • 5 - Textured Coating
  • 6 - Vinyl Floor Tiles
  • 7 - Other

• Total Hours Wearing RPE