The Hills Shire Council

THSC Asbestos Identification Report Form

This form is to be completed and emailed to Work Health & Safety Coordinator where asbestos containing material is suspected.

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Information

ECM# / Works Order Number
Site Location
Ward Location
Land tenure
Conducted on
Prepared by
Additional Personnel

Date identified
Description of location
Type of material suspected to be asbestos
- Bonded
- Friable
- Suspected
- Fibre Cement Sheet
- Not known
- Asbestos Contaminated Waste
QUANTITY- If less than 10m2, issue works order to appropriate staff. If greater than 10m2, engage appropriate contractor.
Is it less than 10m2
Action taken
Action required
Name of Supervisor Contacted
Comments
Any additional works required
Photographs of material
Please sign on completion of inspection

The Hills Shire Council

THSC Asbestos Identification Report Form

This form is to be completed and emailed to Work Health & Safety Coordinator where asbestos containing material is suspected.

Use this Template

Print as PDF

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