HB01

• HB Job No

• Client name

• Client contact details

• Site Address

• Site picture

  Media

• Conducted on

  Date

• Prepared by

General site information

Working hours

• Mon-Fri

• Sat - Sun

• 08.30 - 16.30

• Out of hours working e.g 18:00- 06:00

Type of premises

• School

• Office

• Factory

• Shop

• Residential

• Other

• Other please state.

• Picture of site

  Media

Survey details (if any)

• Management survey

• Refurbishment survey

• Bulk samples only

• Other please state

Vehicle access

• Good

• Poor

• Other

• Other please state

• Picture where vehicles can be situated

  Media

Asbestos Type

• Amosite

• Chrysotile

• Crocidolite

• Other

• Other please state

Type of application

• Pipe work

• Soffit

• Ceiling

• Wall

• Debris

• Floor

• Beams/cross sections

• Other

• Other please state

• Pictures of asbestos location

  Media

Specifications to be removed

• Spray coating

• Cement

• Insulation

• Asbestos insulation boarding

• Textured coating

• Encapsulation/environmental clean

• Other

• Other please state

Condition of asbestos

• Good

• Poor

• Fair

• Requires pre clean

• Other please state

Existing services status (pipe work, plant)

• In service

• Off line

• Redundant

• N/A

• Picture of any services

  Media

Site specific items

• Number of operatives on site

• Is the property vacant?

  Yes

  No

  N/A

• If not vacant what are the access arrangements?

Control measures to be taken

• Fully controlled conditions

  Yes

  No

  N/A

• Semi controlled conditions

  Yes

  No

  N/A

• Minimum controls

  Yes

  No

  N/A

• CCTV to be used

  Yes

  No

  N/A

• Viewing panels to be used

  Yes

  No

  N/A

• Picture of area of work

  Media

Working techniques to be used

• Injection machine

• Spray bottle

• Airless sprayer

• Encapsulation

• Encapsulation. Internal or external please specify

• Wrap and cut

• Shadow vac

• Partial enclosure

• Other please state

Access requirements

• None

• Ladders

• Steps

• Popup towers

• Hop up

• Tower scaffolding

• Fixed scaffolding

• Does the scaffolding need to be licensed?

  Yes

  No

  N/A

• Mobile elevated working platform

Type of air monitoring

• 4 stage clearance

• Reassurance

• Personal, background and leaks

• Perimeter testing

Quantity of asbestos waste and disposal

• Enclosure size

• Sq M / Lm of asbestos

• Van for waste

• Skip for waste

• Will the client be providing waste disposal?

  Yes

  No

  N/A

Fibre control equipment

• 500 NPU

  Select quantity 1 quantity 2 more than 2

  • quantity 1
  • quantity 2
  • more than 2

• 1500 NPU

  Select quantity 1 quantity 2 more than 2

  • quantity 1
  • quantity 2
  • more than 2

• 4000 NPU

  Select quantity 1 quantity 2 more than 2

  • quantity 1
  • quantity 2
  • more than 2

• H type vac

  Select quantity 1 quantity 2 more than 2

  • quantity 1
  • quantity 2
  • more than 2

• Airless sprayer

  Select quantity 1 quantity 2 more than 2

  • quantity 1
  • quantity 2
  • more than 2

• Multi needle injection machine

Decontamination unit

• Is water available on site at time of removal?

  Yes

  No

  N/A

• Picture of where water can be located

  Media

• Is power available on site at time of removal?

  Yes

  No

  N/A

• Picture of where power can be located

  Media

• Self contained to be used

Transit and waste route

• Position of van

• Picture and where van can be situated

  Media

• Waste route to van

• Position of skip

• Picture of where skip can be situated

  Media

• Waste route to skip

• Position on DCU

• Picture of where DCU can be located

  Media

• Transit route to DCU

Safety wear

• Full face mask

• Half face mask

• Type 5/6 disposable overalls

• Safety boots

• Gloves

• Hard hats

• Ear protection

• Goggles

• High vis vest

• Harness

• Other

• Other please state

Non asbestos risk assessment

Access/egress

• Any restricted areas?

  Yes

  No

  N/A

• Confined spaces ?

  Yes

  No

  N/A

• Work at height?

  Yes

  No

  N/A

• Work equipment?

  Yes

  No

  N/A

• Adequate lighting?

  Yes

  No

  N/A

• Fragile roofs?

  Yes

  No

  N/A

• Unstable work areas?

  Yes

  No

  N/A

Work at height

• Edge protection ?

  Yes

  No

  N/A

• Hand rails?

  Yes

  No

  N/A

• Harnesses?

  Yes

  No

  N/A

• Fragile roof?

  Yes

  No

  N/A

• Equipment?

  Yes

  No

  N/A

Work environment

• Is there adequate lighting?

  Yes

  No

  N/A

• Are the condition of the floors good?

  Safe

  At Risk

  N/A

• Any spillages?

  Safe

  At Risk

  N/A

• Are the stairs condition good?

  Safe

  At Risk

  N/A

• Noise

  Safe

  At Risk

  N/A

• Sharp surfaces

  Safe

  At Risk

  N/A

Services

• Are services disconnected?

  Yes

  No

  N/A

• Are services concealed?

  Yes

  No

  N/A

• Gas

  Safe

  At Risk

  N/A

• Water

  Safe

  At Risk

  N/A

• Electric

  Safe

  At Risk

  N/A

Debris

• Existing debris

  Yes

  No

  N/A

• Needles

  Yes

  No

  N/A

• Sharp objects

  Yes

  No

  N/A

Waste disposal

• Transit/waste route

  Safe

  At Risk

  N/A

• Transfer notes required

  Yes

  No

  N/A

• Storage /skip area clear?

  Yes

  No

  N/A

COSHH

• Hazardous chemicals present or being used?

  Yes

  No

  N/A

• Special PPE needed?

  Yes

  No

  N/A

Working area water

• Is there area likely to flood?

  Yes

  No

  N/A

• Is the area of work near water?

  Yes

  No

  N/A

Fire

• Ignition source

  Yes

  No

  N/A

• Fuel present

  Yes

  No

  N/A

• Hot works

  Yes

  No

  N/A

Health hazards

• Hand arm vibration

  Yes

  No

  N/A

• Dermatitis

  Yes

  No

  N/A

• Leptospirosis

  Yes

  No

  N/A

• Manual handling

  Yes

  No

  N/A

Welfare facilities

• Supplied by client?

  Yes

  No

  N/A

• Supplied by HB?

  Yes

  No

  N/A

• Any other additional comments.

• Diagram sketch

  Drawing