Solargain: WHS-F-025- Asbestos Kit Contents Audit Form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• For details of the drilling procedure, please refer to your training manual: WHS-PR-005 Drilling into Asbestos Rev 2

Details of Van/Vehicle the kit is in

• Vehicle Registration Number

• Division?

  PV

  HW

  Service

  I.P.

• Person Responsible for this?

Kit Details

• The brands of each kit item is not restricted to the brands specified here.

• Bag (This bag or similar)[Expected Quantity is 1 Per Van/Vehicle]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If need be)

• Respirator (This mask or similar alternative) [Expected Quantity is 1 Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If need be)

• Disposable Coverall (Or Similar) [Expected Quantity is 1 Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Disposable Shoe Cover (Or Similar) [Expected Quantity is 1 Pair Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Safety Gumboots (Or Similar) [Expected Quantity is 1 Pair Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Glasses Safety - Visitor (Or Similar) [Expected Quantity is 1 Pair Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Asbestos Bag 700 x 1100mm (Or Similar) [Expected Quantity is 1 Pair Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• PVC Sand Dipped Glove 45cm (Or Similar) [Expected Quantity is 1 Pair Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Bag of Rags (1.5kg) (Or Similar) [Expected Quantity is 1 Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Assorted Multi-purpose Plastic Buckets (9.3L) (Or Similar) [Expected Quantity is 1 Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Aqua Systems 500ml Multi Purpose Trigger Spray Bottle (Or Similar) [Expected Quantity is 1 Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Selleys 250ml Aquadhere Interior Adhesive (Or Similar) [Expected Quantity is 1 Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Monarch 2.6 x 3.6m Blue Plastic Drop Sheet (Or Similar) [Expected Quantity is 1 Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Foam Cup (Or Similar) [Expected Quantity is 1 Per Bag/kit]

  

• Available?

  Yes

  No

  N/A

• In Good Working Conditions?

  Yes

  No

  N/A

• Note (If Applicable)

• Shave Foam 250g (Or Similar) [Expected Quantity is 1 Per Bag/kit]

  

Audit Inspection Notes and Action Items

• What are the findings and action items of the inspection/audit?

Details of Person Who Conducted the Inspection

• Name:

• Division

  PV

  HW

  Service

  I.P.

• Date of Inspection:

  Date

• Signature:

  Sign