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Doc57Iss06TM20.02.2020
Air Monitoring Test Report: Page of
Client & Address: Site Address:
For the Attention of: Analyst/s Name:
Description of Works:
Plan of Work No: Removal Contractor:
Report Issue Date: Authorised Signatory: Position:
1: This report provides certified quantification of the airborne fibre concentration when determined by the method specified in
HSE Guidance Document HSG 248.Fibres counted fall within the World Health Organisation (WHO) Method definitions of a
countable fibre, no distinction is made in this report between potential asbestos fibres or non asbestos fibres.
2: Sampling strategies have been employed in accordance with HSE guidance document HSG 248. Unless otherwise indicated,
static sampling has been employed. Code letters may suffix the sample number to indicate the purpose of the test. This will be
indicated on each report.
3: Where Westland Environmental Safety Ltd has been instructed to carry out ONLY reassurance air monitoring after works on
asbestos containing materials and the customer has requested NO visual inspection for obvious signs of asbestos dust and debris,
then in doing so, the client accepts the responsibility of certifying cleanliness and fitness for reoccupation of which the air
monitoring results may form a part.
4: Air sampling, fibre counting and 4 stage clearance falls within our schedules of UKAS accredited tests and follows the guidance
laid out in HSG 248, however opinions and interpretations expressed in this report are outside the scope of accreditation.
The following types of test/inspection were undertaken and are contained within this report (Tick as Appropriate)
Air monitoring in accordance with HSE guidance document HSG 248 background, reassurance, leak, personal‐ (See test report pages for details) These tests alone do not provide 4 stage clearance certification for reoccupation (See point 4 above)
Fibre counting in accordance with HSE guidance document HSG 248 world health organisation method (WHO)
Decontamination unit clearance as in accordance with HSE guidance document HSG 248
4 Stage clearance in accordance with HSE Guidance Document HSG 248. Area tested and deemed fit for normal occupancy (Refer to 4 stage clearance certification for each enclosure regarding pass or fail)
Area tested and deemed fit for normal occupancy. This is not part of a 4‐stage clearance but includes a visual examination for obvious signs of asbestos dust and debris.
Report Amendment Log:
Date: Amendment/s:
Certificate of Reoccupation
Project No. Page of
Doc58Iss06 TM17.12.2019
Licensed Asbestos Removal Contractors Details (Name & Address)
LARC Office Number:
Contractor Supervisor Name:
Start Time of 4‐Stage Clearance Process
Date of the Assessment:
Stage 1 of 4: Preliminary Site Assessment Yes/No/NA Comments (Use Comments Page If More Space Is Required) Does the plan of work/method statement define the entire working area?
Is the enclosure/air extraction intact and operating?
Has a satisfactory smoke test been witnessed by either the supervisor or analyst?
Has any leak testing been undertaken during the asbestos removal works?
Is an adequate hygiene unit on site, operating and free from obvious asbestos debris?
Is there a hygiene unit clearance certificate available from previous site works?
Does the hygiene unit require clearance certification following the completion of this 4 stage clearance?
Are the skip areas, waste and transit route(s) free from obvious asbestos debris?
Are the waste and transit route(s) suitably highlighted?
If waste is to be transported using a contractor’s waste van, is the segregated driving area free from waste bags and obvious asbestos debris?
Are there viewing panels present to the enclosure?
If there are no viewing panels to the enclosure, is CCTV available and operational?
Is there a bucket and sponge available in the airlock?
Is the works location suitably lit?
Is the works location free from obvious asbestos waste bags and debris?
Is suitable access equipment available for the inspections to be made?
Has the access equipment to be utilised been verified by the analyst as safe to use?
Has the Licensed Asbestos Removal Contractor Site Supervisor confirmed that a satisfactory visual inspection of the enclosure has been completed? (Analyst not to proceed to Stage 2 until completed/confirmed)
Yes/No/NA Supervisor Name: Supervisor Signature:
Stage 1 Pass Fail Time: Date: Analyst Name: Analyst Signature:
Certificate of Reoccupation
Project No. Page of
Doc58Iss06 TM17.12.2019
Stage 2 of 4: Visual Inspection Yes/No/NA Stage 2 of 4: Visual Inspection Yes/No/NA
Are the airlock(s) & baglock(s) are free of waste bags, materials and unnecessary equipment?
Has a lock down spray been applied to surfaces?
Have all asbestos containing materials been removed or encapsulated as per the plan of works/method statement?
Was remedial action/further removal/cleaning works required?
Are there any known asbestos containing materials to remain in the enclosure?
Were all areas accessible to visually inspect?
Are all of the interior surfaces of the enclosure free from debris and fine settled dust?
Are there any areas sheeted out of the enclosure?
Stage 2 Comments:
Visual Inspection
Start Time:
Visual Inspection
End Time: Total (Mins)
Stage 2 Pass Fail Time: Date: Analyst Name: Analyst Signature:
Certificate of Reoccupation
Project No. Page of
Doc58Iss06 TM17.12.2019
Site Enclosure Plan
*The information contained within this drawing is not to scale, is for reference purposes only and is a true reflection
of the site enclosure and adjacent locations.
Analyst Signature:___________________ Asbestos Removal Contractor Supervisors Signature:_________________
Certificate of Reoccupation
Project No. Page of
Doc58Iss06 TM17.12.2019
Asbestos Removal Contractors Supervisor Acknowledgement:
I have been advised by the analyst that the Certificate of Reoccupation been issued because the area has of the 4‐Stage Clearance process in accordance with HSG 248 The analyst’s guide for sampling, analysis and clearance procedures.
Removal Contractors Supervisor Signature:__________________________ Time: Date:
Stage 3 of 4: Pre‐Clearance Air Monitoring Yes/No/NA Comments (Use Comments Page If More Space Is Required) Are all of the areas dry?
Are the air extraction units off and sealed?
Is there any evidence of the use of lock down sprays?
Is the original floor surface uncovered?
Stage 3 of 4: Post‐Clearance Air Monitoring State Comments (Use Comments Page If More Space Is Required) Area of the enclosure? (If Over 3m in Height Must Recorded as 3).
Dust disturbance using brush or a broom?
Total time of disturbance? (Recommended 1.5 minutes per pump)
Number of air samples required/ collected?
Clearance Test Number
Set 1 Results F/ml
Set 2 Results F/ml
Are at least 80% of the sample fibre concentrations below the limit of quantification? (Please Select)
Stage 3 Pass Fail Time: Date: Analyst Name: Analyst Signature:
Stage 4 of 4: Final Site Assessment Yes/No/NA Comments (Use Comments Page If More Space Is Required) Former work enclosure and the immediate surrounding area are free from any visible debris, asbestos waste bags and waste?
Skip areas and transit/waste routes are free from any visible debris, asbestos waste bags and waste?
All ACM’s in the scope of work have been removed and any known ACM’s remaining in situ are intact, sealed and labelled?
Access equipment has been inspected after dismantling and is free from Asbestos materials?
Stage 4 Pass Fail Time: Date: Analyst Name: Analyst Signature:
Air Monitoring Test Report
Project No. Page of
Air Sampling and the evaluation of membrane filters are undertaken in accordance with in house method(s) based on HSG 248. All opinions & interpretations are outside of the scope of UKAS Accreditation. Doc51Iss04TM04.03.2016
Type of Test (HSG248) Flow Lt/min Min Vol Type of test (HSG248) Flow Lt/min Min Vol Comments sheet used? Comments:
Leak (L), Background (B) 8‐12 480Lt Assessment of respirator 1‐4 40Lt Signature of Analyst:
Reassurance (R), Clearance (C) 8‐12 480Lt Control Limit 10 min 0.6f/ml (P) 4 40Lt
Personal (P) 1‐4 40Lt Control Limit 4hr 0.1f/ml (P) 1 240Lt
Client: Sampling/Analysis By: Client Address: Test Date: Site Address: Location of fibre counting
Site Location: Is the area suitable for testing?
Test kit serial No. Stage micrometer ID No. Effective membrane filter width (mm) 22 Laboratory air test required?
Microscope ID No. Phase ring check Barometer/Timer/ Thermometer I.D No. Temperature (°c) RPE check
HSE NPL test slide ID No. Graticule diameter (µm) Air pressure (mb) Tally Counter 1 – I.D Number Triacetate check
No. of visible test bands High Flow Meter I.D No. Low Flow Meter I.D No. Tally Counter 2 – I.D Number Acetone check
No. Test Pump Cowl Location Flow Rate Time Volume (Litres)
Fibres Counted
Graticule Areas
Evaluated
Calculated Result
Limit of Quantification
(f/ml)
Reported Result (f/ml) Start Interim Finish Start Finish Mins
Fibre Concentration equation= 1000 N D2 / V n d2 f/ml Areas to be counted where 480 litres is exceeded= n=96 000/V Limit of Quantification= (96 000/ V n) X 0.010 f/ml Key- N=Fibres counted, D=Diameter of exposed filter (mm), V=Volume of air (litres), n=Graticules evaluated, d=Diameter of graticule (um)
Site Photograph Log
Project No. Page of
Doc89Iss02TM17.12.2019
Photograph No. Photograph No. Photograph No.
Photograph Description:
Photograph Description:
Photograph Description:
Photograph Comments: Photograph Comments: Photograph Comments:
Photograph No. Photograph No. Photograph No.
Photograph Description:
Photograph Description:
Photograph Description:
Photograph Comments: Photograph Comments: Photograph Comments:
Analyst Name: Signature: Date:
Site Photograph Log
Project No. Page of
Doc89Iss02TM17.12.2019
Photograph No. Photograph No. Photograph No.
Photograph Description:
Photograph Description:
Photograph Description:
Photograph Comments: Photograph Comments: Photograph Comments:
Photograph No. Photograph No. Photograph No.
Photograph Description:
Photograph Description:
Photograph Description:
Photograph Comments: Photograph Comments: Photograph Comments:
Analyst Name: Signature: Date:
Certificate of Inspection – Hygiene Unit
Project No. Page of
Doc59Iss05TM08.03.2017
Name & Address of Removal Contractor:
Office Number:
Supervisors Name:
Site Address: Date:
Hygiene Unit ID Number:
Analyst’s Name
Stage 1 Visual Inspection Yes/No/NA
Comments
Hygiene unit is free of waste bags, materials, dust, debris contaminated clothing and unnecessary equipment etc?
Interior surfaces of the unit are free from debris and fine settled dust and dry?
Remedial action/further removal/cleaning works required?
STAGE 1 PASS FAIL Time: Date: Analysts Signature:
Stage 2 Clearance Air Monitoring State or Yes/No
Plan:
Are the air extraction units off and sealed?
Was the brushing disturbance carried out?
Area (m²) of the shower and dirty end of the hygiene unit?
Time taken for dust disturbance?
Number of air samples required/collected?
STAGE 2 PASS FAIL Time: Date: Analysts Signature:
Test kit serial No. Stage micrometer ID No. Effective membrane filter width (mm) 22 Microscope ID No. Graticule diameter (µm) Barometer/Timer/Thermometer I.D No.
HSE NPL test slide ID No. Temperature (°c) Air Pressure (mb)
No of visible test bands Flow Meter I.D No. Tally Counter No’s
Asbestos Removal Contractors Acknowledgement:
issued because the I have been advised by the analyst that the hygiene certificate of reoccupation area of the clearance process.
Removal Contractor Supervisor Signature: Time: Date:
No. Pump Cowl Flow Rate Time Volume (Litres)
Fibres Counted
Graticule Areas
Evaluated
Calculated Result
Reported Result (f/ml)
Start Interim Finish Start Finish Mins Limit of Quantification
(f/ml)