Document ID: chunk:federal_register_of_legislation:F2016L00418:body:0:p57
Version: federal_register_of_legislation:F2016L00418
Segment Type: other
Provision Reference: 
Character Range: 155684–159306

licensed asbestos assessor must carry out the clearance inspection and complete a clearance certificate if satisfied that the area is safe to reoccupy.

Client details
Name of client:

Client contact details:

Removal work details
Date removal work carried out:

Site address where removal work is being carried out:

Details of the specific asbestos removal work area(s):

Name of licensed asbestos removalist:

Name and contact details of licensed asbestos removalist supervisor (if different to removalist):

Inspection details
Date of clearance inspection:

Time of clearance inspection:

SECTION B – ASBESTOS REMOVAL WORK PAPERWORK
                                                                                                                                                        Yes  No
Do you have a copy of the asbestos removal control plan ?
Do you have a copy of the notification form?
Is the removal work consistent with the control plan and the notification form? (e.g. use of enclosures, decontamination facilities, waste facilities)

SECTION C – ASBESTOS REMOVAL WORK AREA

1.  Visual Inspection
                                                                                                                                                  Yes  No
Inspection of the specific area detailed in Section A found no visible asbestos remaining as a result of the asbestos removal work carried out.
Is air monitoring required (if no, proceed to Section E)
Can the area be reoccupied?
Has additional information been attached? (e.g. photos, drawings, plans)

2.  Air monitoring
                                                                                                      Yes  No
Air monitoring was carried out as part of the clearance inspection. The result was below 0.01 f/ml.
Has the air monitoring sample been analysed by a NATA-accredited laboratory?
Is the air monitoring report attached?
Can the area be reoccupied?

SECTION D – ENCLOSURES

1.  Prior to dismantling the enclosure
                                                                                                                                    Yes  No
The area within the enclosure and the area immediately surrounding the enclosure was inspected and no visible asbestos was found.
Air monitoring was carried out as part of the clearance inspection. The result was below 0.01f/ml.
Is the air monitoring report attached?
Can the enclosure be dismantled?

Number of samples collected:____________________

         Sample 1  Sample 2  Sample 3  Sample 4  Sample 5
RESULTS

2.  After the enclosure was dismantled and removed
                                                                                                                                                                                             Yes  No
An inspection of the area in which the enclosure was erected and the area immediately surrounding the area where the enclosure was erected was inspected and no visible asbestos was found.
Air monitoring was carried out as part of the clearance inspection. The result was below 0.01f/ml.
Is the air monitoring report attached?
Can the area be reoccupied?

Number of samples collected: ____________________

         Sample 1  Sample 2  Sample 3  Sample 4  Sample 5
RESULTS

SECTION E – CLEARANCE DECLARATION
I declare that:
    * the former enclosure, asbestos removal work area and the surrounding area are free from any visible asbestos
    * the transit route and waste routes are free from any asbestos,
    * all asbestos in the scope of the removal work has been removed and any