· Web viewVisual clearance inspection only required by Competent person at end of job. Name hygiene services provider: 20. Asbestos waste disposal arrangements including EPA approved

ASBESTOS WORK PERMIT Issue Date:01/07/16ReviewDate:01/07/18

It is prohibited to do any building or maintenance work in GPNSW building elements containing ACM or where it is presumed to be present, without formal written approval by GPNSW Authorised Representative

All contractors must obtain this Asbestos Work Permit before commencing work from a GPNSW Authorised Representative.

Approval requires the following criteria to be met and information provided to GPNSW Representative along with a Safe Work Method Statement Prior to work commencing.

The permit is only valid for the time specified on the permit This permit must be carried and produced when requested

Part A Work DetailsName of permit requestor Business nameContact Number Date of workLocation of work- Building room noDescription of work

Permit validation period From Date: / / Time:____am/pm To Date: / /Time:____am/pmGPNSW Authorised Representative

Name Permit Number(from objective)Position

Part B.Criteria to meet - On the job – before work starts, during & after Y/N N/A Comments / details

1. Building Asbestos Register information has been provided and checked by Contractor and /or Project Co-ordinator and/or other GPNSW Authorised Representative.

2. A technical scope of works has been prepared on behalf of GPNSW by a Competent person ( Asbestos Consultant)

3. Are has been physically inspected and the job assessed by Contractor and/or Project Co-ordinator.

4. If there is ACMs known or presumed to be in the area- what is the current risk factor rating of the AC material involved?

5. Is project or work likely to disturb or damage the asbestos materials in place e.g.: removal, cleaning?

6. Contractor or organisation is licensed and competent to remove asbestos and can show either :

Class A licence ( for removal of any amount of friable asbestos material)

Class B licence ( for removal of >10m2bonded asbestos material)

Removal of bonded asbestos <10m2 -does not require a licence but person must be competent and comply with” Asbestos Removal Code”.

Licence No.

7. A site-specific Asbestos Removal Control Plan is to be provided and reviewed by a GPNSW Authorized Representative before starting work.

8. GPNSW Hazardous Material Management Plan requirements and procedures for removal / maintenance or minor work are understood by all persons doing the work.

Custodian: WHS ManagerUncontrolled copy when printed

©GPNSWApproved by: Place Management Version: 1.1Number: SMS-02-FM-A1175703 Page 1 of 3



9. Are GPNSW employees, students or visitors at risk of exposure to airborne asbestos fibres from this planned work?

10. Has the Building occupants been notified / consulted about intended ACM work before work commences?

11. Barricading, sealing of work area will be / has been done prior work start.

12. Access to area will be strictly controlled during work to minimise number of persons at risk?

13. Arrangements have been made with Facilities Management for turning off air conditioning on / in affected areas if appropriate.

14. Appropriate PPE and clothing is to be worn by workers.

15. Safe work practices will be followed as per Asbestos Removal Code for :

Drilling – low speed abrasive power or pneumatic tools only.

Sealing / painting, coating or cleaning of ACM Inspection

16. Wet wiping or vacuuming of surfaces with HEPA rated vacuum equipment will be used to suppress / contain dust during work.

17. Personal decontamination facilities have been arranged for workers?

18. Equipment decontamination arrangements are in place for tools, respirators, other PPE,

19. Asbestos hygiene services are required for this project and have been arranged?

Air monitoring is required during work period for the project?

Air monitoring ( for clearance) is required upon completion of work - Mandatory for jobs >10 m 2

Visual clearance inspection only required by Competent person at end of job.

Name hygiene services provider:

20. Asbestos waste disposal arrangements including EPA approved transfer vehicle and asbestos waste transfer certification (copy to GPNSW) is in place.

Disposal location:

Other:

All asbestos work is to be completed as per received Asbestos Removal Control Plan and in compliance with WHS Regulations. If during the work, further unknown or suspected asbestos materials are encountered, work must cease immediately. Notify GPNSW Authorised Representative. PC should note that independent hygiene audits may be initiated by GPNSW randomly.

GPNSW Authorised Representative

Name: Signature: Date





I understand the requirements as outlined in the Hazardous Materials Management Plan for the site and undertake to meet WHS Regulations for this asbestos work.

Principal Contractor representative responsible for the asbestos work on site.

Name/Company: Signature: Date:



Documents

· Web viewVisual clearance inspection only required by Competent person at end of job. Name hygiene services provider: 20. Asbestos waste disposal arrangements including EPA approved