DIVISION 6 ASBESTOS AUDIT

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Type of audit being conducted

  Business

  Residential

  Other

  Not Applicable

EXECUTIVE SUMMARY

• Summary of Audit

ROOM / LOCATION INSPECTED

• External cladding

  Yes

  No

  N/A

• Eaves

  Yes

  No

  N/A

• Roof

  Yes

  No

  N/A

• Entry / Hallways

  Yes

  No

  N/A

• Room 1

  Yes

  No

  N/A

• Room 2

  Yes

  No

  N/A

• Room 3

  Yes

  No

  N/A

• Room 4

  Yes

  No

  N/A

• Room 5

  Yes

  No

  N/A

• Room 6

  Yes

  No

  N/A

• Room 7

  Yes

  No

  N/A

• Room 8

  Yes

  No

  N/A

• Room 9

  Yes

  No

  N/A

• Room 10

  Yes

  No

  N/A

• Bathroom / Washroom

  Yes

  No

  N/A

• Kitchen

  Yes

  No

  N/A

• Laundry

  Yes

  No

  N/A

• Toilet / Powder Room

  Yes

  No

  N/A

• Flooring

  Yes

  No

  N/A

• Electricals

  Yes

  No

  N/A

• Other areas not specified

  Yes

  No

  N/A

SAMPLES TAKEN

• Sample 1

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 2

• Priority / Rating

  Zero

  One

  Two

  Three

  Four

• Sample 3

• Priority / Rating

  Zero

  One

  Two

  Three

  Four

• Sample 4

• Priority / Rating

  Zero

  One

  Two

  Three

  Four

• Sample 5

• Priority / Rating

  Zero

  One

  Two

  Three

  Four

• Sample 6

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 7

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 8

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 9

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 10

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 11

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 12

• Priority / Rating

  Zero

  One

  Two

  Three

  Four

• Sample 13

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 14

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 15

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 16

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 17

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 18

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

• Sample 19

• Priority / Rating

  Zero

  One

  Two

  Three

  Four

• Sample 20

• Priority / Rating

  Select Zero One Two Three Four

  • Zero
  • One
  • Two
  • Three
  • Four

LABORATORY RESULTS

• Laboratory Testing Samples

• Date of Testing

• Sample Findings

OTHER HAZARDOUS MATERIAL IDENTIFIED

• Hazards

  Yes

  No

  N/A

PHOTOGRAPHS

• Photograph 1

  Media

• Photograph 2

  Media

• Photograph 3

  Media

• Photograph 4

  Media

• Photograph 5

  Media

• Photograph 6

  Media

• Photograph 7

  Media

• Photograph 8

  Media

• Photograph 9

  Media

• Photograph 10

  Media

DRAWING / SKETCHES

• Drawings

  Drawing

NOTES

• Additional Comments

  Yes

  No

  N/A