Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Has asbestos been removed to satisfaction of inspector.
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Is work area specific to scope of works safe for re-entry?
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Can works continue / re-commence?
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Visual clearance certificate issued by inspector?
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Is clearance for a piece of plant?
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Time and Date of Inspection
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Location and Type of Asbestos Removed
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Location and Type of Asbestos Removed
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Location and Type of Asbestos Removed
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No visible asbestos containing material debris/residue remaining in immediate area and/or surrounding area of asbestos removal.
- Yes
- No
- Not at this time
- Suspected asbestos containing material remaining under slab/sub-floor - nil access
- Suspected asbestos containing material debris remaining in rubble/rubbish/piles of in associated debris
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Class of Asbestos Material
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Appropriate method of removed, including PPE?
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Exclusions
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Exclusions
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Exclusions
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Extra information of areas requiring further attention.
- Yes
- No
- Not at this time
- Suspected asbestos containing material remaining under slab/sub-floor - nil access
- Suspected asbestos containing material debris remaining in rubble/rubbish/piles of in associated debris
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Other issues requiring attention.
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Removal conducted under air monitoring?
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Photograph of Site (if applicable)
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DISCLAIMER : This certificate is valid at the time of issuance and until the site is re-entered or altered. Once the site is changed from its state at the time of inspection the certificate is null and void, and any variances post-inspection will require a further inspection. G.E.O.H. Holds no responsibility to the client following the re-entry and re-commencement of works. If you have any queries or issues with the aforementioned please discuss it with your hygienist prior to the hand over of the site.
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SIGNED :
