Asbestos Remediation. Ref: ASBESTOS REMEDIATION HAZARD ASSESSMENT AND RISK CONTROL. Company Name: Company Address: Asbestos Coordinator:

Transcription

1 SECTION 1: GENERAL Company Name: Company Address: Asbestos Coordinator: Telephone Number: Address: Page 1 of 19

2 SECTION 2: ACM DETAILS Asbestos Containing Material 1: Asbestos Type: Chrysotile (White) Amosite (Brown) Crocidolite (Blue) Analytical Company: Report Number: Asbestos Material & Form: Material Condition: Good Reasonable Poor Material Location: Internal External Building Number: Level Indicator: Room Number: Any Other Details: Page 2 of 19

3 SECTION 2: ACM DETAILS Asbestos Containing Material 2: Asbestos Type: Chrysotile (White) Amosite (Brown) Crocidolite (Blue) Analytical Company: Report Number: Asbestos Material & Form: Material Condition: Good Reasonable Poor Material Location: Internal External Building Number: Level Indicator: Room Number: Any Other Details: Page 3 of 19

4 SECTION 2: ACM DETAILS Asbestos Containing Material 3: Asbestos Type: Chrysotile (White) Amosite (Brown) Crocidolite (Blue) Analytical Company: Report Number: Asbestos Material & Form: Material Condition: Good Reasonable Poor Material Location: Internal External Building Number: Level Indicator: Room Number: Any Other Details: Page 4 of 19

5 SECTION 2: ACM DETAILS Asbestos Containing Material 4: Asbestos Type: Chrysotile (White) Amosite (Brown) Crocidolite (Blue) Analytical Company: Report Number: Asbestos Material & Form: Material Condition: Good Reasonable Poor Material Location: Internal External Building Number: Level Indicator: Room Number: Any Other Details: Page 5 of 19

6 SECTION 3: LOCATION RISKS & HAZARDS Brief Description of Activities: Hazards or Hazardous Conditions (which exist or which could arise) Slips, Trips, Falls Flammable Materials Electricity Chemicals Dust Fumes Moving Machinery Ejection of Materials Vehicle Movement Pressure Systems Stored Energy Confined Spaces Work at Height Noise Manual Handling Poor Lighting Temperature Hazardous Waste Access / Egress Fire Escape / Route Other Other Details: Specific Risk Assessments Required: Yes No Persons Present During Normal Operations: Operators Lone Workers Office Staff Contractors Maintenance Staff Cleaners Visitors Public Other Other Details: Page 6 of 19

7 SECTION 4: LOCATIONAL ARRANGEMENTS Hazards or Hazardous Conditions (which exist or which could arise) Days Nights Weekends to to to Security Access: Restricted Access: Yes No Special Arrangements: Yes No Hot Works Isolation Possible: Days Nights Weekends Power Isolation Possible: Days Nights Weekends Water Isolation Possible: Days Nights Weekends Fire / Smoke Detector Isolation Possible: Days Nights Weekends Mechanical Isolation Possible: Days Nights Weekends Chemical Isolation Possible: Days Nights Weekends Other Isolation Possible (State Details): Days Nights Weekends Page 7 of 19

8 SECTION 5: GENERAL RISK ASSESSMENT Identify Level of Risk (Excluding Asbestos): High Medium Low Method Statements Required (Excluding Asbestos): Yes No Details: Permits to Work Required (Excluding Asbestos): Yes No Details: Page 8 of 19

9 SECTION 6: ASBESTOS CONSULTANCY Appointment of Asbestos Consultancy: Company Name: Company Address: Contact Name: Telephone Number: Address: Insurance Details: Competency Check Details: SECTION 7: ASBESTOS RECOMMENDATIONS Asbestos Consultancy to Prepare Recommendations for the Asbestos Project: Site Visited Date: Recommendations Submitted Recommendations Agreed Recommendations Attached Page 9 of 19

10 SECTION 8: PRE TENDERING MEETING Meeting Held Date: Attendees: Name: Position: Company: Minutes Issued: Minutes Agreed: Minutes Attached: Page 10 of 19

11 SECTION 9: TENDERING PROCESS Tender Requests for the Asbestos Projects sent to: Company: Date Sent: Return Date & Time for Quotations Quotations for the Asbestos Projects Received From: Company: Quotation Cost: Any details arising from the tendering process: Page 11 of 19

12 SECTION 10: ASBESTOS REMOVAL CONTRACTOR Appointment of Asbestos Removal Contractor: Company Name: Company Address: Contact Name: Telephone Number: Address: HSE Licence No: Insurance Details: Competency Check Details: SECTION 11: PLAN OF WORK Asbestos Removal Contractor to Prepare Plan of Work for the Asbestos Project: Site Visited Date: Plan of Work Submitted Plan of Work Agreed Plan of Work Attached Page 12 of 19

13 SECTION 12: ASBESTOS ANALYTICAL COMPANY Appointment of Asbestos Analytical Company: Company Name: Company Address: Contact Name: Telephone Number: Address: UKAS No: Insurance Details: Competency Check Details: SECTION 13: PLAN OF WORK Asbestos Analytical Company to Prepare Plan of Work for the Asbestos Project: Site Visited Date: Plan of Work Submitted Plan of Work Agreed Plan of Work Attached Page 13 of 19

14 SECTION 14: PRE START MEETING Meeting Held Date: Attendees: Name: Position: Company: Minutes Issued: Minutes Agreed: Minutes Attached: Page 14 of 19

15 SECTION 15: Enforcing Authority: ENFORCING AUTHORITY INFORMATION Office: Health & Safety Executive Local Environmental Health Asbestos Removal Contractors Notification Submitted to Relevant Authority: Notification Submitted Date: Notification Number: Any Other Asbestos Licence Holders Notification Details: Company Name: Role in Project: Notification Submitted Date: Notification Number: Company Name: Role in Project: Notification Submitted Date: Notification Number: SECTION 16: STAFF PROJECT AWARENESS Staff Awareness Training required: Yes No Details: Training Completed: Date: Page 15 of 19

16 SECTION 17: REMOVAL WORKS Site Prepared Date: Permits Issued Date: Permit for: Permit Number: Expiry Date: Clearance to Proceed: Date: Permits Attached: Page 16 of 19

17 SECTION 18: ANALYTICAL MONITORING Analytical Monitoring Certificate / Report Numbers: Monitoring Type: Location / Area: Report Number: Reports Issued: Reports Agreed: Reports Attached: Page 17 of 19

18 SECTION 19: ASBESTOS WASTE Asbestos Waste removed from Site Date: Consignment Note Attached: SECTION 20: AREA HANDOVER Area Released to Asbestos Coordinator Date: All Documentation Attached: SECTION 21: PROJECT REVIEW Project Review Completed Date: Project Review Attached: Details of Issues Arising: Details of Actions Taken: Page 18 of 19

19 SECTION 22: REMOVAL VERIFICATION Asbestos Project and Document Handover Complete: Name: Position: Company: Site Asbestos Coordinator Name: Position: Company: Signed above on behalf of the Asbestos Consultancy Name: Position: Company: Signed above on behalf of the Asbestos Removal Contractor Name: Position: Company: Signed above on behalf of the Analytical Company Asbestos Register Updated: Date: Page 19 of 19