Non-Friable Clearance Certificate

• Certificate No.

• Select the date and time of the inspection

  Date
• Address
  Address

• Asbestos Assessor

  Select Terry O'Keeffe - AA18010016 - Expiry Date: 30/01/2023 Aaron O'Keeffe - AA20040016 - Expiry Date: 09/04/2025 Archie Britz - IP404 BOHS Qualification

  • Terry O'Keeffe - AA18010016 - Expiry Date: 30/01/2023
  • Aaron O'Keeffe - AA20040016 - Expiry Date: 09/04/2025
  • Archie Britz - IP404 BOHS Qualification

• Asbestos Removal Supervisor

• Description and location of the product that has been removed

• PCBU

• Who was the licensed Asbestos Removal Company?

  Select A&J Demolition Ltd ACMR AMR Team Ltd AR Plus Arrowsmith Builders Ltd Asbestos Contracting Ltd Asbestos Eliminators Ltd Bay Rebuild Central Demolition Cooper Young Construction Demoworx GGL Site development Earthmoving Gypsy Hill Holdings Ltd H&L Asbestos Contractors Ltd Lakes District Health Board Morecroft Contractors Ltd Morgan Project Services NZRS Owner Penny Homes Property Services Unlimited Rotovegas Roofing Suretrade Building Services Suretrade Coastal Vision Complete Earthworks

  • A&J Demolition Ltd
  • ACMR
  • AMR Team Ltd
  • AR Plus
  • Arrowsmith Builders Ltd
  • Asbestos Contracting Ltd
  • Asbestos Eliminators Ltd
  • Bay Rebuild
  • Central Demolition
  • Cooper Young Construction
  • Demoworx
  • GGL Site development Earthmoving
  • Gypsy Hill Holdings Ltd
  • H&L Asbestos Contractors Ltd
  • Lakes District Health Board
  • Morecroft Contractors Ltd
  • Morgan Project Services
  • NZRS
  • Owner
  • Penny Homes
  • Property Services Unlimited
  • Rotovegas Roofing
  • Suretrade Building Services
  • Suretrade Coastal
  • Vision Complete Earthworks

• Was there an Asbestos Survey supplied to Asbestos Consultants NZ?

  Yes

  No

  N/A

• Did the PCBU provide a survey to the removal contractor?

  Yes

  No

  Unsure - Not informed

• Was the ARCP Viewed?

  Yes

  No

  N/A

• Was the Worksafe Notification Viewed?

  Yes

  No

  N/A

• Was the Supervisor onsite during the clearance inspection?

  Yes

  No

  N/A

• Has the Asbestos Removal Supervisor advised the job is ready for the clearance inspection?

  Yes

  No

  N/A

• Are the personnel removing the asbestos appropriately trained and certified?

  Yes

  No

  N/A

• Was a decontamination area set up and satisfactory?

  Yes

  No

  N/A

• Was there adequate signage and exclusion zones set up?

  Yes

  No

  N/A

• Does the contractor hold a current Asbestos Removal Licence for the Asbestos being removed?

  Yes

  No

  N/A

• Weather type?

  Select Sunny Raining Windy Cloudy

  • Sunny
  • Raining
  • Windy
  • Cloudy

• What direction is the wind traveling?

Inspection

• Was the product being removed correct as per the ARCP and worksafe notification?

  Yes

  No

  N/A

• Has all asbestos the waste removed from site?

  Yes

  No

  N/A

• Is all residual remnants of any asbestos product clear from the excavation/work area?

  Yes

  No

  N/A

• Was the vacuum used?

  Yes

  No

  N/A

• Was the Vacuum used the same as the vacuum in the ARCP and within a current certification?

  Yes

  No

  N/A

• What type of PPE was used?

  Select Half Face Mask Full Face Mask Coveralls Gloves

  • Half Face Mask
  • Full Face Mask
  • Coveralls
  • Gloves

• Was Air Monitoring required during this removal process?

  Required

  Not Required

• Did the air monitoring return an AFR level of less than 0.01 fibres/ml.

  Yes

  No

  N/A

• Were swab tests required as part of the clearance?

  Required

  Not Required

• Did the surface swab tests return negative readings for asbestos?

  Yes

  No

  N/A

• Was soil sampling required as part of this clearance?

  Required

  Not Required

• What type of Soil testing was conducted?

  Select P.A Soil (Presence/Absence) Semi-Quant - Asbestos percentage per quantity of soil

  • P.A Soil (Presence/Absence)
  • Semi-Quant - Asbestos percentage per quantity of soil

• Did the soil testing return negative readings for asbestos?

  Yes

  No

  N/A

• Did the soil testing return negative readings for asbestos?

  Yes

  No

  N/A

• Any notes?

  Required

  Not Required

Inspection sign off

• An inspection has been undertaken by the undersigned of Asbestos Consultants NZ has found that there is no visible asbestos residue remaining as a result of the asbestos removal work in the area where the asbestos removal work was performed or in the area immediately surrounding the area where the asbestos removal work was performed.
  Therefore as far as can be determined, this removal area does not pose a risk to health and safety from exposure to asbestos.

• Inspection outcome

  Pass

  Fail

• Assessor Signature

  Sign

• Photographs once the removal process is complete.

  Media