Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
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What is the name of contractor completing the survey?
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What is the name of the surveyor completing the survey?
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What is the building type?
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What type of survey is it?
- Full refurbishment survey
- Management survey
- Refurbishment survey to specified room
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Have all areas been accessed for assessment that should have been within the scope of survey?
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Have all suspected ACMs been sampled or referenced in the survey?
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Have all sample sites been cleaned and sealed to a suitable standard?
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Has the survey been undertaken considerately without creating unnecessary damage?
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Does the written survey reflect the areas and ACMs/suspected ACMS found on site?
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Has the surveyor undertaken the survey in a methodical sequence?
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Is there any asbestos debris present, following the survey?
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Are there any ACM's missed off the survey?
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Are the ACM's missed high risk or low risk?
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Is a re-visit required by the contractor?
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Assessment summary?
- Acceptable
- Improvement required
- Substantial improvement required
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Add signature
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Select date
