IA 09 4 Stage Clearance Reinspection Audit Form Issued August 18

• IA 09 4SC Reinspection Audit Form Issued August 18

  IA 09 4SC Reinspection Audit Form Issued August 18

• Audit Number

• Satisfactory

  Unsatisfactory

  Observation

Audit details

• Audit Number

• Auditor

• Auditee

• Audit Type

  4 SC Reinspection-AIB

  4SC Reinspection-Thermal

  4sSC Reinspection-Spray

• Conducted on

  Date

Remediation Works

• Scope of works

• Has the works been completed as per the licensed contractor RAMS?

  Satisfactory

  Unsatisfactory

  Observation

• Is the area free from any asbestos residue/debris/dust related to the removal works?

  Satisfactory

  Unsatisfactory

  Observation

• Are there any remaining ACMs within the former enclosure/Site of works?

  ACMs remain as per POW

  No ACMs remain

  ACMs remain not identified within POW

• Has any encapsulation works been completed to a satisfactory standard?

  Satisfactory

  Unsatisfactory

  Observation

• Has all evidence of the removal/remediation works been removed from site? e.g. Tape/polythene/staples/timber etc.

  Satisfactory

  Unsatisfactory

  Observation

• Has all contractor equipment been removed from site?

  Satisfactory

  Unsatisfactory

  Observation

• Has any hired equipment been removed from site?

  Satisfactory

  Unsatisfactory

  Observation

• Daily Site Log completed?

  Satisfactory

  Unsatisfactory

  Observation

• Site diagram accurate and records transit/waste routes, skip position <br>, enclosure site, airlock/bag-lock and dimensions?

  Yes

  No

  N/A

• Correct number of air samples taken for enclosure volume?

  Satisfactory

  Unsatisfactory

  Observation

• Any remaining ACMs correctly recorded?

  Satisfactory

  Unsatisfactory

  Observation

• LARC Supervisor signature present?

  Satisfactory

  Unsatisfactory

  Observation

• All 4 stages correctly completed?

  Satisfactory

  Unsatisfactory

  Observation

• Audit Assessment Comments

• Auditor Signature

  Sign

Non Conforming Work List

• Finding 01

  Select Training Equipment Control Planning Procedures Human Error Document Control Negligence

  • Training
  • Equipment Control
  • Planning
  • Procedures
  • Human Error
  • Document Control
  • Negligence

• Finding 02

  Select Training Equipment Control Planning Procedures Human Error Document Control Negligence

  • Training
  • Equipment Control
  • Planning
  • Procedures
  • Human Error
  • Document Control
  • Negligence

• Finding 03

  Select Training Equipment Control Planning Procedures Human Error Document Control Negligence

  • Training
  • Equipment Control
  • Planning
  • Procedures
  • Human Error
  • Document Control
  • Negligence

• Finding 04

  Select Training Equipment Control Planning Procedures Human Error Document Control Negligence

  • Training
  • Equipment Control
  • Planning
  • Procedures
  • Human Error
  • Document Control
  • Negligence

• Finding 05

  Select Training Equipment Control Planning Procedures Human Error Document Control Negligence

  • Training
  • Equipment Control
  • Planning
  • Procedures
  • Human Error
  • Document Control
  • Negligence

Investigation

• Investigation Details

• Root Cause

• Corrective/Preventative/Improvement actions

• Person/s Responsible for completing actions

• Agreed timescale for close out

  Date

• Actual close out date

  Date

• Effectiveness Checks

• Effectiveness Checks Date

  Date