Supervisor Competency Assessment Form

• Site conducted

  Select

• Name

• Conducted on

  Date

• Prepared by

• Name:

• Company/Branch:

• Line Manager:

• 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

• Other

  Yes

  No

  N/A

1.0 RPE + PPE

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

  1

  2

  3

  4

  N/A

• 1.1 RPE Checks (Inspections, Documentation, storage, reporting)

  1

  2

  3

  4

  N/A

• 1.2 Appropriate PPE ref POW, all ops clean shaven etc

  1

  2

  3

  4

  N/A

2.0 Site Set Up

• 2.1 Assessment of site conditions against POW, ACM’s to remain etc

  1

  2

  3

  4

  N/A

• 2.2 Amendments appropriate, accurate, auditable, in the agreed remit and schedule of works

  1

  2

  3

  4

  N/A

• 2.3 DCU, erection of enclosure/air/bag in line with POW and site RA

  1

  2

  3

  4

  N/A

• 2.4 Positioning of signage, CCTV, Viewing Panels

  1

  2

  3

  4

  N/A

• 2.5 Site controlled, clean, orderly with appropriate records made

  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

• 3.2 DCU checks, waste disposal, supplies etc

  1

  2

  3

  4

  N/A

4.0 Strip Techniques – Correct to POW and Client Specification:

• 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 and transiting of Waste

  1

  2

  3

  4

  N/A

• 5.2 Bag lock Procedures/ justification if not present

  1

  2

  3

  4

  N/A

• 5.3 Waste storage, transport and disposal arrangements

  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 (appropriate for 4SC)

  1

  2

  3

  4

  N/A

7.0 General

• 7.1 Housekeeping

  1

  2

  3

  4

  N/A

• 7.2 Appearance

  1

  2

  3

  4

  N/A

• 7.3 Attitude

  1

  2

  3

  4

  N/A

• 7.4 Behavior

  1

  2

  3

  4

  N/A

• 7.5 H&S - Hazard Perception, risk assessment etc

  1

  2

  3

  4

  N/A

• 7.6 Effective teamwork and communication

  1

  2

  3

  4

  N/A

• 7.7 Punctuality

  1

  2

  3

  4

  N/A

• 7.8 Site documentation and certification

  1

  2

  3

  4

  N/A

• 7.9 Personal Certification

  1

  2

  3

  4

  N/A

• 7.10 CDM/Principle contractor requirements

  1

  2

  3

  4

  N/A

• 7.11 3rd party communication (analyst, contractors, client etc)

  1

  2

  3

  4

  N/A