ASBESTOS PROJECT INSPECTION REPORT

City of Milwaukee

Department of Neighborhood Services

Environmental Health Section

Address of Project: _____________________________________________

Date of Project: _____________________________________________

Contractor: _____________________________________________

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Environmental Controls

(29 CFR 1926.58), (29 CFR 1910.1001), (40 CFR Part 61), (40 CFR 763), (NR 447)

NOK

Project area adequately secured

Warning signs posted

Electrical power to area shut off

Temporary power with GFCI installed

Temporary water lines (if necessary)

Written emergency action plan on site

Emergency phone number

Daily employee / visitor log-in sheet

Shut down of all HVAC systems

Temporary lighting used

Full containment / critical barriers

Negative air

Number of Machines

Negative air vented outside

Proper decontamination area

Number of Stages

Showers with hot and cold water, soap and towels

Shower water filtered

Wetting agents used

Waste load-out provided

Asbestos double-bagged, labeled and goose necked

Disposal facility

Personal Protective Equipment

(29 CFR 1910.1001 Appendix C), (29 CFR 1910.134), (40 CFR Part 763)

NOK

Number of workers on site

ID cards present, certification and or training type

Respirators provided

Type

Written respirator protection program

Disposable clothing used


Air Monitoring Clearance

(29 CFR 1926.58), (40 CFR Part 763)

NOK

Personal Monitoring

Sampler

Laboratory

Results

Visual inspection prior to clearance

Lockdown applied

Clearance monitoring

Sampler

Laboratory

Results

Comments:


Inspector: ____________________________________

Date: ____________________________________

Source: City of Milwaukee

Department of Neighborhood Services

Environmental Health Section