Page 1
Building Information
Building Name
Building Address
Building Type
Year of Construction
Asbestos Survey
Has a full asbestos survey been conducted?
Date of Last Asbestos Survey
Are asbestos containing materials present?
Location of Asbestos Containing Materials
Condition of Asbestos Containing Materials
Asbestos Risk Assessment
Likelihood of Disturbance
Potential for Fiber Release
Accessibility of Asbestos Materials
Occupant Activity
Overall Asbestos Risk Level
Asbestos Management Plan
Is an Asbestos Management Plan in place?
Date of Last Asbestos Management Plan Review
Planned Asbestos Remediation Actions