Hereford Asbestos Site Audit Form Copy

• Document No.

• Audit Title

• Client / Site

• Auditor

  Sign

• BY SIGNING THIS FORM, THE SITE SUPERVISOR AGREES THAT THESE OBSERVATIONS AND RECOMMENDATIONS ARE A TRUE REFLECTION OF THE FINDINGS OF THIS AUDIT.

• Supervisor

  Sign

• Conducted on

  Date

• Departure time

  Date

• Personnel

• Location
  Address

• * THE FOLLOWING SECTION (1.0) MUST BE COMPLETED AND CONSIDERED SATISFACTORY BEFORE CONTINUING FURTHER WITH THIS AUDIT.

1.0 Preliminary Requirements

• 1.1 Is there a valid ( I.e in date) ASB 5 Notification Form on site for the works to be audited

  Yes

  No

• 1.2 Is there (or will there be) asbestos removal work or cleaning in progress within the enclosure during the audit.

  Yes

  No

  N/A

• 1.3 Is there provision to observe work practices within the enclosure by means of CCTV and / or viewing panel(s)

  Yes

  No

• 1.4 Is there a site specific Plan of Work available on site for the works

  Yes

  No

• 1.5 Is there a copy of the Company Standard Procedures version 4 / Generic Procedures available on site

  Yes

  No

  N/A

• 1.6 Is the Decontamination Unit fully functional in terms of power, ventilation and the provision of hot and cold running water for showering

  Yes

  No

• 1.7 Identify all isolations that have been confirmed

  Select Electricity Water Gas

  • Electricity
  • Water
  • Gas

• Comments / Clarifications

• * DO NOT PROCEED WITH THE AUDIT UNLESS EACH RESPONSE ABOVE IS AFFIRMATIVE. SHOULD ANYTHING ABOVE BE AMISS THAT CAN BE RECTIFIED IMMEDIATELY, THEN CONTINUE WITH THE AUDIT ONCE RECTIFIED.
  
  * SHOULD ANYTHING ABOVE BE AMISS THAT CANNOT BE RECTIFIED IMMEDIATELY THEN INFORM THE SUPERVISOR THAT THE AUDIT CANNOT CONTINUE.
  
  * INFORM THE COMPLIANCE MANAGER WITHOUT DELAY 029 2047 1040 THAT THE AUDIT COUL NOT BE CONTINUED AND STATE THE REASON(s)

2.0 ASB 5 Notification Form

• 2.1 What form of asbestos containing material does the ASB 5 state is being worked upon

• 2.2 What is the approximate extent of the works stated in the ASB 5

• square m

• Linear m

• No of bags

• 2.3 What is the maximum number of employees per shift stated on the ASB 5

• How many operatives (including the supervisor) are on the site

3.0 Site Documentation

• 3.1 Is the Contract Supervisor the same person as specified in the plan of work

  Yes

  No

• 3.2 Does the plan of work detail whom the contractor is contracted

  Yes

  No

• 3.3 Does the plan of work detail when the work is to be carried out? (Including start / finish times and weekend variations)

  Yes

  No

• 3.4 Does the plan of work detail the analytical company providing the 4 stage clearance

  Yes

  No

• 3.5 Does the plan of work detail who the analytical company is contracted to

  Yes

  No

• 3.6 Does the plan of work detail the type of asbestos involved

  Select Amosite Chrysotile Crocidolite

  • Amosite
  • Chrysotile
  • Crocidolite

• 3.7 Does the plan of work detail the condition of the asbestos containing material to be removed

  Good

  Fair

  Poor

• 3.8 Does the plan of work (or standard procedures) detail who is authorised to amend the plan of work

  Yes

  No

• 3.9 Are welfare facilities detailed in the plan of work and are they available for use as described

  Yes

  No

• 3.10 Does the plan of work (or standard procedures) detail decontamination entry and exit procedures

  Yes

  No

• 3.11 Does the plan of work (or standard procedures) detail the type of respirators to be used

  Yes

  No

• 3.12 Does the plan of work (or standard procedures) detail the construction method for enclosures and air locks

  Yes

  No

• 3.13 Does the plan of work (or standard procedures) detail the arrangements for smoke testing and witnessing

  Yes

  No

• 3.14 Please record name / title of proposed witness

• 3.15 Does the plan of work detail the asbestos removal technique to be used

  Yes

  No

• 3.16 Does the plan of work detail the air monitoring arrangements for the duration of the works

  Yes

  No

• 3.17 Is the scope of works adequately described in the plan of work, and does it match the details recorded on the ASB 5

  Yes

  No

• 3.18 Is there a site specific risk assessment available for inspection for hazards other than asbestos? (Hot work, work at heights, use of hand tools, confined spaces, electricity, manual handling etc)

  Yes

  No

• 3.19 Is there a set of COSHH assessments on site? (Smoke Fluid, Foam Spray Adhesive etc) NB Material Safety Data sheets on their own are insufficient

  Yes

  No

• 3.20 Is there a copy of the current valid licence available for inspection

  Yes

  No

• 3.21 Is there documented evidence on site confirming current insurance cover for both employers liability and public liability? E.g insurance schedule

  Yes

  No

• 3.22 Are daily site and plant inspection records (including DCU, enclosure, air locks, NPU's & vacuum cleaners) available for inspection and up to date

  Yes

  No

• 3.23 Does the NPU inspection record include manometer / pressure gauge readings for each NPU in use (including DCU)

  Yes

  No

• 3.24 Has the smoke test record for the enclosure been completed and do the witness details match those stated in the plan of work ? (I.e as 3.14)

  Yes

  No

  N/A

• Comments / Clarifications

4.0 Site Supervisor and / or Operative(s)

• 4.1 Supervisor's Name

• In enclosure

  Yes

  No

• Current Medical Certificate

  Yes

  No

• Evidence of competence<br>Either RSPH Competence Certificate no more than 12 months old or current Training Certificate or evidence through Training Needs Analysis

  Yes

  No

• Face fit test certificate for RPE in use

  Yes

  No

• Examination record for RPE in use<br>Daily if in enclosure, current monthly if not

  Yes

  No

• Adequate response when questioned regarding emergency procedure? (If not in enclosure)

  Yes

  No

• Supervisor / Operative(s) Clean shaven. (If out of enclosure, or if seen before entry)

  Yes

  No

• Operatives

Operative 4.2

• 4.2 Name

• In enclosure

  Yes

  No

• Current Medical Certificate

  Yes

  No

• Evidence of competence<br>Either RSPH Competence Certificate no more than 12 months old or current Training Certificate or evidence through Training Needs Analysis

  Yes

  No

• Face fit test certificate for RPE in use

  Yes

  No

• Examination record for RPE in use<br>Daily if in enclosure, current monthly if not

  Yes

  No

• Adequate response when questioned regarding emergency procedure? (If not in enclosure)

  Yes

  No

• Supervisor / Operative(s) Clean shaven. (If out of enclosure, or if seen before entry)

  Yes

  No

• Comments / Clarifications

• 4.3 For certificates where the name of HAS has not been recorded on the certificate.<br> Has each copy been individually authenticated by or under the direction of senior management, with a statement confirming their validity.

  Yes

  No

  N/A

5.0 Site Organisation

• 5.1 Does the sketch plan included in the plan of work match the site set up, including the positions of the NPU, air lock, bag lock (if applicable), viewing panels / CCTV and DCU as a minimum

  Yes

  No

• 5.2 Do viewing panels and / or CCTV show all areas so far as is reasonably practicable

  Yes

  No

• 5.3 Is each viewing panel (where applicable) at least 600 x 300 mm

  Yes

  No

• 5.4 Are there adequate warning signs which comply with the Safety Signs and Signals Regulations? (Including the black hand prohibition symbol)

  Yes

  No

  N/A

• 5.5 Is there a suitably stocked First Aid Kit available on site

  Yes

  No

6.0 Plant on Site / Certification

• 6.2 Are current DOP test certificates (or copies) available and relevant to each vacuum on site

  Yes

  No

• 6.1 Are there at least 2 H-type vacuum cleaners on site

  Yes

  No

  N/A

• 6.3 Does the number and capacity of the NPU's in use correspond with that stated in the plan of work

  Yes

  No

• 6.4 Are current DOP test certificates (or copies) available and relevant to each NPU on site

  Yes

  No

• 6.5 Is there a current DOP test certificates ( or copy) available on site for the NPU within the dirty end of the DCU

  Yes

  No

• Comments / Clarifications

7.0 Enclosure / Airlock

• 7.1 Is the enclosure in sound condition and constructed so as to prevent the spread of asbestos

  Yes

  No

• 7.2 Is the airlock free from visible asbestos debris

  Yes

  No

• 7.3 Is a bucket and sponge (or similar) available for decontamination of respirator

  Yes

  No

• 7.4 Are the airlock openings either oval or rectangular in shape

  Yes

  No

• 7.5 Do the flaps cover the airlock openings adequately

  Yes

  No

• 7.6 Are all the airlock flaps weighted

  Yes

  No

• 7.7 Is each stage of the airlock at least 1m x 1m x 2m (height)

  Yes

  No

• 7.8 If 7.7 is No was this variation justified in the Plan of Work

  Yes

  No

• 7.9 Does the inner stage of the airlock have a viewing panel at least 600 x 300 mm

  Yes

  No

• 7.10 If 7.9 is No, please indicate why not

• Comments / Clarifications

8.0 Air Extraction Equipment

• 8. 1 Is the extract sited in relation to ideal air management

  Yes

  No

• 8.2 is the extract capable of providing either a minimum of 8 air changes per hour (enclosures > 120 cubic m) or airflow at least 1000 cubic m per hour for smaller enclosures

  Yes

  No

• 8. 3 Is the extract vented to outside atmosphere where practical

  Yes

  No

• 8. 4 Does each NPU have a non return flap on the exhaust side of the HEPA filter

  Yes

  No

• Comments / Clarifications

9.0 Observed Work Practices

• 9.1 Is the pre filter (or roving head) the only part of the NPU exposed to the working area ( I.e NPU sheeted out if inside enclosure)

  Yes

  No

• 9.2 Does the RPE (including filter) being used, match that stated in plan of work

  Yes

  No

• 9.3 Are all components of full face RPE uniquely identifiable ? E.g mask, blower and battery identified / marked / tagged with name or item / serial number.

  Yes

  No

• 9.4 Are colours of coveralls as stated in the plan of work or standard procedures

  Yes

  No

• 9.5 Are disposable working coveralls and transit coveralls 'category 3 type 5/6'

  Yes

  No

• 9.6 Are all items of necessary PPE being properly worn? (E.g overalls not tucked into boots, overall hood headstraps etc)

  Yes

  No

• 9.7 Does the dust suppression method being used match that stated in the plan of work

  Yes

  No

  N/A

• 9.8 Is the dust suppression method suitable for type of work or material? ( if needle injection machine used, please state manufacturer)

  Yes

  No

  N/A

• 9.9 Does the asbestos removal technique being used match that stated in the plan of work

  Yes

  No

  N/A

• 9.10 Has the waste been appropriately bagged? ( e.g immediately and single bagged if still in enclosure )

  Yes

  No

  N/A

• Comments / Clarifications

10.0 Hygiene Facility

• 10.1 Is the unit positioned in relation to the work area as stated in the plan of work

  Yes

  No

• Direct connection ?

  Yes

  No

• Transit arrangement ?

  Yes

  No

  N/A

• 10.2 If the unit is not directly connected to the enclosure, would it have been reasonably practicable to do so

  Yes

  No

• 10.3 Is the transit route as short as possible and away from occupied areas

  Yes

  No

• 10.4 In addition to item 1.6 above, is the unit fully functional / in working order ? (Heating, lighting, water filter, drains etc)

  Yes

  No

• 10.5 Are the internal doors and external door to the dirty end all fully self closing

  Yes

  No

• 10.6 Is there an adequate number of shower heads for operatives ? (I.e at least one for every 4 operatives)

  Yes

  No

• 10.7 Is there a nailbrush provided in the shower area

  Yes

  No

• 10.8 Is the unit in good condition and clean so far as is reasonably practicable

  Yes

  No

• 10.9 Are towels provided

  Yes

  No

• 10.10 Are the clean end and dirty end doors marked (including prohibited entry and mandatory PPE signage, where required)

  Yes

  No

• 10.11 Is there a clearance test certificate from the previous job, for the dirty and shower compartments of the hygiene unit

  Yes

  No

• Date of DCU clearance test

  Date

• Comments / Clearance

11.0 Waste

• 11.1 Are the waste disposal arrangements as described in the plan of work

  Yes

  No

• 11.2 Is the waste transit route free from residual or spilt waste

  Yes

  No

• 11.3 Where applicable, is there sufficient means to segregate waste from equipment / supplies within the company vehicle

  Yes

  No

• 11.4 Has a separate bag lock been provided

  Yes

  No

• 11.5 If 11.4 is No, was this justified in the plan of work? ( NB "small amount of waste" is not a valid justification

  Yes

  No

• 11.6 Is each stage of the bag lock at least 1m x 1m x 2m (height)

  Yes

  No

  N/A

• 11.7 If 11.6 is No was this variation justified in the Plan of a Work

  Yes

  No

• 11.8 Is the bag lock free from visible asbestos debris

  Yes

  No

  N/A

• 11.9 Does the inner stage of the bag lock have a viewing panel at least 600 x 300mm

  Yes

  No

  N/A

• 11.10 If 11.9 is No please indicate why not

• Comments / Clarifications

12.0 Company Vehicle(s)

• Enter Reg, Make and Model

Vehicle 12.

• 12.1 Reg, Make and model

• Is the van reasonably tidy and with minimal risk of the spread of asbestos

  Yes

  No

• Is the waste section free of all asbestos material

  Yes

  No

  N/A

13.0 Scaffolding

• 13.1 Is the asbestos removal contractor using any scaffolding on site

  Yes

  No

• 13.2 Was a subcontractor used to erect the scaffolding

  Yes

  No

• Severn Scaffold Division utilised

• 13.3 Was the scaffolding liable to disturb asbestos while being erected

  Yes

  No

• Name the subcontractor and write down their licence number

14.0 Further Comments / Clarifications

• Did you note any new hazards not previously identified

  No

  Yes

• Please list the hazards

• Have these hazards been controlled, Status is ?

  Safe

  At Risk

  N/A