Templates
Asbestos permit to work template

Asbestos permit to work template

Make sure every asbestos-related task is authorized, documented, and controlled with a step-by-step permit process.

Use this template
or download pdf
Asbestos permit to work template

Make sure every asbestos-related task is authorized, documented, and controlled with a step-by-step permit process.

Use this template
or download pdf

This asbestos permit to work template is a specialized tool for overseeing any project where asbestos-containing materials may be disturbed. Its purpose is to formalize the authorization process so you can be sure all safety measures are in place before work begins. This is critical since the WHO and ILO estimate that asbestos exposure leads to over 200,000 deaths every year.

If you’ll be working on a building with known ACMs, the customizable template guides you through the steps to securing the area and communicate hazards, ensuring every stakeholder is informed and protected. It’s intentionally detailed to address the unique risks of asbestos, supporting you in staying compliant and safe.

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Preview of the template
Page 1
General Information
Description of Work
Permit Start Date
Permit End Date
Supervisor Name
Asbestos Identification
Has the presence of asbestos been confirmed?
Type of Asbestos
Asbestos Survey Reference
Control Measures
Have all necessary control measures been identified?
Describe the control measures to be implemented
Have the control measures been put in place?
Personal Protective Equipment (PPE)
Have all necessary PPE been identified?
Describe the PPE to be used
Have the workers been trained in the use of PPE?
Waste Disposal
Has a waste disposal plan been established?
Describe the waste disposal plan
Has the asbestos waste been double bagged and labeled?
Authorization
Permit Issued By (Name)
Permit Issued By (Signature)
Date Issued
Permit Accepted By (Name)
Permit Accepted By (Signature)
Date Accepted
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Frequently asked questions

When do you need to use an asbestos permit to work template?

You need to use an asbestos permit to work template whenever planned work may disturb asbestos-containing materials, such as during renovations, maintenance, or demolition in older buildings, to ensure compliance and safety.

Can you customize the asbestos permit to work template for different sites?

Yes, you can adjust the template to reflect site-specific hazards, local regulations, and unique workflows. This way, it remains relevant and effective for each project’s needs.

What documentation should accompany an asbestos permit to work template?

Attach relevant risk assessments, method statements, air monitoring results, and waste disposal records as well. These provide a complete safety audit trail for the work involving asbestos-containing materials.

Is the asbestos permit to work checklist suitable for short-term maintenance?

Yes, it’s designed for any duration of work involving asbestos. Having a robust permit to work system ensures that brief maintenance tasks are completed safely and with full documentation of controls and responsibilities.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.