Title Page
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Job Number
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Location
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Location
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Client Details
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Conducted on
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Prepared by
Type of work undertaken
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Removal
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Repair
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Encapsulation
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Environmental Clean
General site information
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ASB5
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NNLW
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F10
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Project team details
Site access and working arrangements
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Start date
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Finish date
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Duration of project
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Working times?
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Mon-Fri?
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Weekend Working?
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Shift working?
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Shift pattern?
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Continual works?
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Out of hours working?
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Number of operatives per shift?
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Number of supervisors per shift?
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Void property?
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Access arrangements?
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Occupied property?
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Access control to asbestos removal working area?
Type of premises
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School
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Office
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Factory
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Retail
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Residential
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Other
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Please state
Vehicle and skip access
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Good
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Poor
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Other
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Please state
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Photo where van is located
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Please state
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Photo where waste van/skip is located
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Please state
Hygiene Facility (DCU)
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Direct connection?
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If NO justification? (Eg flat)
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Modular
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Standard
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Alley cat
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Self contained
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Photo where DCU is to be located
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Photo were water is to be obtained
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Please state
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Photo were power is to be obtained
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Please state
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Photo were foul drain is located
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Please state
Quantity of asbestos waste and disposal arrangements
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Estimated amount of waste generated by works (bags, wraps, weight)
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Is skip required?
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Photo were skip is to be located
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Location and size
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Coharts
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ATS
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Bowmers
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Pinden
Survey details (if any)
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Analytical company name
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Management
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Refurbishment
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Bulk samples
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Other
Type of asbestos
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Amosite
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Chrysotile
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Crocidolite
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Other
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state which type
Type of application
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Pipe work
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Soffit
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Ceiling
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Wall
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Debris
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Floor
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Beams/cross sections
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Internal/External
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Photo(s) of asbestos location(s)
Type of ACM
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Spray coating
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Cement
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Insulation
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AIB
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Textured coating
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Debris (material type unknown)
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Other
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state which
Condition of asbestos
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Good
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Poor
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Fair
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Requires pre clean
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Other
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state which
Asbestos fixings
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Nailed
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Screwed
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Bolted
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Other (eg glued)
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state which
Existing services (pipe work, plant)
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In service
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Off line
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Redundant
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N/A
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Photo(s) of services (if any)
Emergency arrangements
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Fire
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First Aid
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Client/ PC arrangements
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Photo(s) of muster points
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state where
Control measures to be taken
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Fully controlled
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Two stage
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Respirator zone
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Two stage
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Speed frame
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Timber frame
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state what size
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Bag lock?
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If NO justification?
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CCTV
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How many
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VIsion panels?
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How many?
Working techniques to be used
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Injection machine (BS8520)
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Spray bottle
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Airless sprayer
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Encapsulation
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Internal/External
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Wrap and cut
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Shadow vac
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Partial enclosure
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Other (eg ALG Memo 03/12)
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State which
Working at height requirements
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None
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Ladders
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Steps
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Podiums
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Internal/External
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Hop ups
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Tower scaffolds
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Fixed scaffolds
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Does the scaffold need a licence or design?
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Qty
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Types
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Mobile elevated working platform?
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Type required
Analytical services
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Sensible Asbestos Solutions
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Ace Consultants
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Environtec
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Leftfield Environmental
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REC
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CARE
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DMV
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Shield Onsite Services
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Anchem
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PCS Asbestos Consultants
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PCS Asbestos Consultants
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4 stage
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Reassurance
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Air test RIS van
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Personal, background and leaks
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Perimeter testing
Enclosure(s) details (location and sizes)
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Enclosure 1
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Photo of enclosure location
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Enclosure 2
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Photo of enclosure location
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Enclosure 3
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Photo of enclosure location
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Enclosure 4
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Photo of enclosure location
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Enclosure 5
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Photo of enclosure location
Fibre control equipment
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500 NPU
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1000 NPU
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1500 NPU
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2000 NPU
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4000 NPU
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H type vac
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Multi point injection
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Is water available on site?
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Photo of water location
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If no how is to be sourced?
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Is power available on site?
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If no how is to be sourced?
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240 volt, 110 via transformer
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10kva hard wired
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Photo of power supply
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If no how is to be sourced?
Transit and waste route
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Waste route to skip or waste van
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Photo of route
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Transit route to DCU
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Photo of route
Safety wear
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Full face mask
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Half face mask
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Type 5/6 disposable overalls
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Safety boots
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Gloves
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Hard hats
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Ear protection
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Googles
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Hi vis vest
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Fall arrest (harness and lanyard)
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Other
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State type
Non asbestos risk assessment
Access and egress
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Any restricted access?
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Confined spaces?
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Working at height?
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Work equipment?
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Adequate lighting?
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Fragile roofs?
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Unstable work areas?
Work at height
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Edge protection?
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Hand rails?
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Harnesses?
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Fragile roof?
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Equipment?
Work environment
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Adequate lighting?
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Floors/walkways in good condition?
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Any spill ages or even ground?
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Are stairs in good condition?
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Explosive atmosphere?
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Hot/cold environment? (Plant room, boiler/chill store)
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Hot/cold surfaces? (Radiators/pipe work)
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Noise
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Sharps? (Needles, broken glass etc)
Services
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Are services are to be isolated?
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Isolated by?
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Are services are concealed?
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Where?
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Gas
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Water
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Steam
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Electric
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Other
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State type
Debris
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Existing debris
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Sharps?
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Guano?
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Other
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State type
Water
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Is there area likely to be flooded?
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Is the area near water?
Fire
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Rats
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Pigeons
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Dermatitis
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Mold
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Hand Arm Vibration
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Manual Handling
Fire
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Sources of heat?
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Sources of fuel (flammable materials, liquids)
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Hot works?
COSHH
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Hazardous chemicals present or to be used?
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Special PPE/RPE required?
Welfare
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Supplied by the client?
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Supplied by RIS?
Additional comments
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Add drawing
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