Information
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Report No.
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Removal Contractor
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Site
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Site Supervisor
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Conducted on
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Prepared by
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Site Address
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Is this a Priority visit following an accident or incident on site?
1.0 - MAIN WORK TASKS
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Environmental Clean
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Removal
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Encapsulation
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Ancillary
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Supervisory
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Waste Handling
2.0 - ASBESTOS MATERIAL
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Sprayed coating
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A.I.B
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Insulation
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Cement
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Textured Coating
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Gaskets & Rope
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Floor Tiles
3.0 - ASBESTOS TYPES
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Crocidolite
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Amosite
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Chrysotile
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Actinolite
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Anthophylite
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Tremolite
4.0 - PLANNING AND DOCUMENTATION
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Is the project notifiable under ASB5 action?
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Has the ASB5 been submitted to the HSE?
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Does the ASB5 detail match the project and POW?
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ASB5 expiry date:
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Has the supervisor completed the project pre start checklist?
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Is the site file being maintained up to date (supervisor checks & inspections etc.)?
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Is the site diary/log being maintained?
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Is there a site information board displaying the EL certificate, ASB5, site plan and emergency contacts?b
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Employers Liability insurance expiry date:
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Are these documents available within the site files/documentation?
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Employees Liability insurance expiry date:
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Is there a copy of the job specific POW on site?
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Are there risk assessments for activities other than asbestos removal (hot works, working at heights, use of hand tools, confined spaces etc.)?
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Are there COSHH assessments on site (spray tack, PU foam, surfactant etc.)?
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Have the RAs, COSHH assessments and POW been read and understood by all undertaking the work (is a record maintained)?
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Is there a copy of the removal contractor's Health & Safety policy on site?
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Is there a copy of the removal contractor's asbestos licence on site?
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Is there a copy of the waste carriers licence on site?
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Is a copy of the removal contractor's general procedures document available on site?
5.0 - SITE SPECIFIC DETAILS (POW)
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Does the site layout agree with the POW and include the correct enclosure sizes and locations?
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Is the supervisor on site the one listed in plan?
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Is the scope of works/methodology/material adequately described in the POW?
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Does the plan detail when the work is to be carried out (including start/finish times and weekend variations)?
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Does the plan detail the air monitoring arrangements for the duration of the works?
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Does the plan detail the person or company providing the 4-stage clearance and to whom they are contracted to?
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If the plan has been amended, has it been signed/dated and do other records (e.g site diary) show the authorisation procedure has been followed?
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Does the plan detail the type of RPE to be used?
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Does the plan detail the arrangements for smoke testing and witnessing?
6.0 - SUPERVISORS & OPERATIVES
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Supervisor(s)
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Name of supervisor.
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Medical certificate on site?
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Medical certificate expiry date?
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Supervisory training certificate on site?
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Training certificate expiry date?
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Face-fit test certificates on site (half-mask)?
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Half-mask face-fit expiry date (max two years)?
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Face-fit test certificate on site (full-face mask)?
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Full face fit-test certificate expiry date (max 2years)?
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Is full-face mask 6-monthly inspection certificate on site?
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Serial No. of mask:
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Full face mask 6-monthly test expiry date.
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Is the supervisor(s) clean shaven?
Operative(s)
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Name of operative.
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Medical certificate on site?
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Medical certificate expiry date (max 2 years).
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Operative training certificate on site?
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Training certificate expiry date.
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Is face-fit test certificate on site (half mask)?
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Half-mask fit-test expiry date ( max 2 years).
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Is Face-fit test certificate on site (full-face mask)?
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Full-face mask fit-test expiry date (max 2 years).
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Is full-face mask 6monthly inspection certificate on site?
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Serial no. of mask:
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Full-face mask 6-monthly test expiry date.
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Is the operative clean shaven?
7.0 - HYGIENE FACILITY/DECONTAMINATION UNIT
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Is the gas installation certificate available?
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Gas cert expiry date.
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Is the Electrical test certificate available?
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DOP cert expiry date.
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Is the DOP certificate available for the NPU?
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DOP cert expiry date.
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Is the air clearance certificate available for the unit?
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Date of last air test.
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Is the DCU connected/unconnected to the enclosure as detailed in the POW?
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Is the transit procedure and route in accordance with the POW?
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Is the outside of the unit clean?
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Are there sufficient DCU's/showers for the number of personnel on site (1-shower: 4-persons)?
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Are the DCU legs down and is it level and is it connected to the mains water and power? Is the unit adequately earthed?
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Are there usable warning signs on the external clean/dirty entry doors?
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Have lockers been provided in the clean end?
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Are there adequate methods of heating the DCU in cold weather?
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Do the showers have adequate supply of hot water?
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Are all doors (internal and external) self closing and in working order?
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Is the waste water from the DCU filtered and discharging to foul sewer?
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Are the latest emergency evacuation instructions posted in the clean end of the DCU?
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Have liquid soap, shampoo, nail brushes and clean dry towels been provided?
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Are hooks available in the shower to hang RPE whilst showering?
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Are there sufficient, working power points in the clean end to charge RPE battery packs?
8.0 - SITE PREPARATION
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Has all non-contaminated loose equipment and material been removed from the working area?
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Have all floor ducts, risers, electrical sockets and other openings been covered and sealed inside the area?
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Has the supervisor confirmed all openings in plant, pipes, walls & ceilings (including hidden voids) been sealed?
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Has all electrical plant been isolated or effectively protected from the ingress of water or surfactant materials?
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During preparation/sheeting is the correct PPE & RPE being used?
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Are all employees wearing supplied logo clothing? Is it clean? Do they look and act 'professional'?
9.0 - AIRLOCK/BAGLOCK
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Does the airlock consist of at least 3 (1 x 1 x 2m) compartments with vision panel (600 x 300mm located in dirty end?
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Is the outer flap in place?
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Are the flaps weighted at the bottom with ends taped?
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Do the flaps overlap and cover the openings?
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Is there a hand-held spray in the dirty end (for cleaning of boots & RPE)?
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Is the airlock tidy and free of all dust, dirt and debris?
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Does the airlock have suitable signage displayed?
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Has a separate baglock been provided where reasonably practicable to do so?
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Does the baglock have a viewing panel in the centre stage (min 300mm x 600mm)
10.0 - WORK AREA/ENCLOSURE
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Is the enclosure constructed in accordance with the general procedures (1000 gauge ploy; 50mm2 timber or use cleanable surfaces of area)
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If flame retardant polythene is required by POW, is it being used?
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Has a clear Perspex inspection/viewing panel (600 x 300mm min) or CCTV been incorporated into the enclosure?
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Are all parts of the enclosure visible via the panel(s) or CCTV?
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Are the work areas/enclosures on carpet? If so, has boarding been used to overlay the carpet?
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Are there sufficient ASBESTOS warning signs displayed around the area?
11.0 - PPE & RPE
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Are the asbestos removal operatives wearing full overalls, with a hood (type 5, cat 3)?
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Ae they wearing Wellington boots?
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Are the overalls on the outside of their boots?
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Are their hoods on the outside of their RPE harness strap?
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If a transit procedure is being operated, are work and transit overalls of a different colour?
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General Work:
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Transit:
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Stripping/Removal:
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Are the masks worn as stated in the POW?
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Is any other PPE required on site and is it being correctly used?
12.0 - CONTROL MEASURES: - DUST REDUCTION/WET STRIPPING
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Is the system being used in accordance with that specified in the POW?
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Is the system set-up and being operated correctly?
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Does the system ensure dust levels are being reduced to the lowest practicable levels?
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Do the results of personal air monitoring indicate that the methods used are effective?
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Are the surfactants/wetting agents only been used on cold surfaces?
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Are exposure records available on site?
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Check the service records of the equipment. Has it been serviced according to the manufacturers schedule?
13.0 - NEGATIVE PRESSURE UNITS
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Does the unit(s) extract from the enclosure at a point far enough away from the airlock enclosure as possible to ensure good air-flow through the enclosure without any dead spaces, or is a roving head in place? Is there sufficient negative pressure?
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Is NPU(s) correctly sheeted to enclosure wall, or if inside, sheeted over including vent hose?
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Does the unit(s) vent to atmosphere outside the building? Or if venting inside, is regular air monitoring being undertaken?
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Is the ducting in good condition?
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Does the pre filter look to be working efficiently?
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Does the unit(s) have DOP/electrical test certificates?
Neg Pressure Unit
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NPU Serial No.
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DOP expiry date.
14.0 - CLASS-H- VACUUM CLEANERS
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Are there a minimum of 2 No. vacuums on site?
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Is there one in the area near the airlock for decontamination?
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Are the hoses and electric flex in good condition?
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Have they got current DOP/electrical test certificates?
H-Vac
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H-Vac Serial No.
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DOP expiry date.
15.0 - WASTE HANDLING & DISPOSAL
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Does the waste route follow the one in the POW?
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Is the waste route clean with no signs of debris?
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Are the bags marked in accordance with the current legislative requirements?
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Is the waste correctly double bagged and sealed before leaving the area?
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If waste is being temporarily stored, is the area labelled and secure?
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Are ASBESTOS waste skips in use on site?
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Is the skip locked at all times when not in use?
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Is the waste skip of the totally enclosed type?
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Is there suitable ASBESTOS warning signs displayed on the skip(s)?
16.0 - TRANSIT PROCEDURES
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Is transit footwear available and is it stored in clean section of airlock?
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Are there sufficient pairs for the number of people in the work area?
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Are transit coveralls stored in clean end of airlock?
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Are transit routes correctly protected (e.g. exposed' carpeted areas covered)?
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Is suitable transit route signage displayed?
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If site is occupied (other trades etc) is transit route barriered off or are personnel accompanied?
17.0 - AIR MONITORING ARRANGEMENTS
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Is the company and regime identified in the POW undertaking the air monitoring?
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Is a visual inspection carried out by the supervisor once the stripping is complete?
18.0 - COMMUNICATION
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Is there a suitable system in place to allow easy two-way communication between workers inside the enclosure and those working outside the enclosure?
19.0 - EMERGENCY PROCEDURES- are they in place/available for:
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Medical emergency inside the enclosure?
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Loss of electric power?
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Failure of the enclosure?
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Is there a qualified first-aider available on site?
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Is a copy of the first-aiders certificate in the site file?
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Are they in-date for refresher training?
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Is there an adequately stocked first-aid kit available on site?
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Are there records to show the first-aid kit(s) are checked on a regular basis?
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Are all items contained within the first-aid kit(s) in-date (no expiry dates exceeded)?
20.0 - FIXED SCAFFOLDING
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Is there are fixed scaffolding in use on site?
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Does the scaffold form part of the enclosure or was its installation liable to disturb ACMs when erected?
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Was the scaffold erected by a licensed scaffold contractor?
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Name of scaffold contractor:
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Has a scaffold-tag been displayed in the scaffold?
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Has the scaffold sign-off been completed on the tag?
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Have the required 7-day inspections been undertaken by a competent person and detailed on the tag?
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Are double hand-rails and toe-boards fitted to all open edges?
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Is there a safe means of access to every working platform?
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Are all gaps and openings in or around the working platform through which anyone or materials can fall been adequately covered?
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Where timber boards have been used, are they adequately protected to prevent contamination?
21.0 - COMPANY VEHICLES
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Has it been air tested within last 2 months?
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Date of last test.
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Is the outside of van clean?
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Is the body work in good order with no obvious signs of damage?
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Are all light lenses present in place and undamaged?
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Is the cab of the van clean and tidy (no signs of smoking materials)?
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Is storage area clean and well ordered (there are should be no masks hung up or loose)?
22.0 - CORRECTIVE ACTIONS
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Corrective actions are designated as 'High', 'Medium' or 'Low' risk.
High risk actions are considered a serious failure which could potentially lead to serious injury or a regulatory noncompliance which could lead to an enforcement officer issuing a Prohibition or Improvement notice. High risk actions should be completed as soon as is reasonably practicable.
Medium.risk actions are considered as important as they may lead to less serious injury or have been highlighted because the contractor is not meeting the standards expected of a professional competent contractor. These actions should be given a reasonable timeframe for completion, usually between 1 and 6 months.
Low risk actions are not normally considered as compulsory actions, but if completed would assist the company with improving its safety management systems, policies and procedures, as well as demonstrating a commitment to safety management by the contractor. A suitable timeframe for these actions to be implemented would be 3 to 12 months.
High Risk Action
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Add media
- Medium Risk Action
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Add media
- Low Risk Action
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Add media
SIGN OFF
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Auditor
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Site Supervisor