Operative Competency Assessment Form

• Site conducted

  Select

• Name

• Conducted on

  Date

• Prepared by

• Name:

• Company/ Branch:

• Line Manager /Supervisor:

• Direct Employee/ Agency:

• Site Address:

• Asbestos material:

• LW/NNLW/NL:

• Task to be undertaken “at time of assessment”

• Site Set Up

  Yes

  No

  N/A

• Enclosure construction

  Yes

  No

  N/A

• Removal

  Yes

  No

  N/A

• Fine Clean

  Yes

  No

  N/A

• Waste Removal

  Yes

  No

  N/A

• Air Monitoring

  Yes

  No

  N/A

• Detent

  Yes

  No

  N/A

1.0 RPE + PPE

• (1= Poor, 2=Improvement Needed, 3=Good, 4=Excellent

• 1.1 Check RPE (Inspection, storage, cleaning, reporting)

  1

  2

  3

  4

  N/A

• 1.2 Correctly wearing appropriate PPE

  1

  2

  3

  4

  N/A

2.0 Site Set Up:

• 2.1 Signage/Understanding of POW

  1

  2

  3

  4

  N/A

• 2.2 Positioning of DCU, erection of enclosure/air/bag

  1

  2

  3

  4

  N/A

• 2.3 Positioning of signage, CCTV, Viewing Panels, Emergency Exit

  1

  2

  3

  4

  N/A

3.0 Decontamination Procedures:

• 3.1 Correct entry and exit to/from DCU and through airlock

  1

  2

  3

  4

  N/A

4.0 Strip Techniques – Correct procedures for:

• 4.1 Mist Spraying

  1

  2

  3

  4

  N/A

• 4.2 Shadow Vacuuming

  1

  2

  3

  4

  N/A

• 4.3 Multi Point Injection

  1

  2

  3

  4

  N/A

• 4.4 Wrap and Cut/Glove Bag

  1

  2

  3

  4

  N/A

• 4.5 Quill Falcon/water jetting

  1

  2

  3

  4

  N/A

• 4.6 General Use of Equipment

  1

  2

  3

  4

  N/A

5.0 Waste Procedures:

• 5.1 Bagging of Waste

  1

  2

  3

  4

  N/A

• 5.2 Bag lock Procedures

  1

  2

  3

  4

  N/A

• 5.3 Placing of Waste into Receptacles

  1

  2

  3

  4

  N/A

6.0 Final Clean:

• 6.1 Vacs, Airlock – Enclosure

  1

  2

  3

  4

  N/A

• 6.2 Use of Tools and Consumables

  1

  2

  3

  4

  N/A

• 6.3 Fine Clean

  1

  2

  3

  4

  N/A

7.0 Decontamination Procedures:

• 7.1 Plant and equipment

  1

  2

  3

  4

  N/A

8.0 General:

• 8.1 Housekeeping

  1

  2

  3

  4

  N/A

• 8.2 Appearance

  1

  2

  3

  4

  N/A

• 8.3 Attitude

  1

  2

  3

  4

  N/A

• 8.4 Behavior

  1

  2

  3

  4

  N/A

• 8.5 Punctuality

  1

  2

  3

  4

  N/A

• 8.6 Personal Certification

  1

  2

  3

  4

  N/A

• 8.7 H&S - Hazard Perception etc

  1

  2

  3

  4

  N/A