DECONTAMINATION TASK ANALYSIS

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

WORK ORDER DETAILS

• Work Order Number:

• Requested By:

• For Hub:

CLIENT/HOUSEHOLDER DETAILS

• Claim Number:

• Client/Householder Name:

• Contact Details:

TASK ANALYSIS (Required for this work order yes/no)

• SITE CHECKS (PER VISIT)

• 1) Assess property for external hazards

  Yes

  No

  N/A

• 2) Familiarise customer with process and requirements

  Yes

  No

  N/A

• 3) Erect signs and barricades and/or check existing signs and barricades

  Yes

  No

  N/A

• 4) Don PPE (full face mask with HEPA and organic vapour cartridges, BA when entering floor cavities)

  Yes

  No

  N/A

• ---------------------------------------------------------------------------------------------------------------------------------------------------------

• 5) As per below

  Yes

  No

  N/A

• ---------------------------------------------------------------------------------------------------------------------------------------------------------

• 6) Ensure any signage being left on site is secure and visible

  Yes

  No

  N/A

• 7) Remove bundling and signage not being left on site

  Yes

  No

  N/A

• 8) Check site and leave

  Yes

  No

  N/A

• ECC AND/OR AIR SAMPLING

• follow steps 1-4 of site checks

• a) Load in equipment and ensure all is in good working order (electrical equipment is fully tagged etc)

  Yes

  No

  N/A

• b) Record observations including clients comments

  Yes

  No

  N/A

• c) Take samples as required

  Yes

  No

  N/A

• follow steps 6-8 of site checks

• DECONTAMINATE CRAWL SPACE

• follow steps 1-4 of site checks

• a) Ensure all occupants and pets are out of the area to be decontaminated

  Yes

  No

  N/A

• b) Block all foundation vents

  Yes

  No

  N/A

• c) Fog out crawl space

  Yes

  No

  N/A

• follow steps 6-8 of site checks

• DECONTAMINATION OF INTERNAL ENVELOPE OF PROPERTY

• follow steps 1-4 of site checks

• a) Load in equipment and ensure all is in good working order (electrical equipment is fully tagged etc)

  Yes

  No

  N/A

• b) Load in disinfectants and ensure they are safely stored and mixed (keep well away from the public and have MSDS at hand)

  Yes

  No

  N/A

• c) Take pre-air samples

  Yes

  No

  N/A

• d) Ensure all occupants and pets are out of the area to be decontaminated

  Yes

  No

  N/A

• e) Apply surface treatments

  Yes

  No

  N/A

• f) Pack up unnecessary equipment and load out

  Yes

  No

  N/A

• g) Set VHP and close up home

  Yes

  No

  N/A

• follow steps 6-8 of site checks

• POST TREATMENT SAMPLING

• follow steps 1-4 of site checks

• a) Upon re-entry, test VHP levels. Only re-enter if safe to

  Yes

  No

  N/A

• b) Take Air Impact Samples

  Yes

  No

  N/A

• follow steps 6-8 of site checks

• Signature of Technician Completing Task Analysis

  Sign