I&TS HSW Management Sub-System
3.1-13F01 Asbestos Removal Control Plan – Class B
The purpose of this Asbestos Removal Control Plan (ARCP) for Class B Asbestos Removal is to ensure that adequate controls are
implemented to protect the safety of persons conducting asbestos removal or disturbance and to ensure that adequate and timely
notifications are made to affected stakeholders.
1.
COMPANY DETAILS
Removal Company Name
Company
office location
Supervisor name & phone number
Asbestos removal licence number
EPA Disposal Licence Number
Person commissioning the work
name & phone number
2.
Company
ASBESTOS DETAILS
Campus
Building
Start Date
Time
Room/Site
End Date
UoA
Permit
No
Time
Asbestos Process
Including
Restrictions
Non-Friable
Asbestos Material
Type
Cement Roofing
Ceiling tiles
Wall Cladding
Vinyl floor tiles/sheet
Fence
Eaves
Soil
Zelemite/resin/mastic
Details
Other
Asbestos
Condition
Quantity (approx. in
Good
Extensive damage
Minor Damage
Significant Weathering
Painted
Unsealed
Fire damage
Slightly Weathered
m2)
SafeWork SA Application Required for
the removal of ACM
Warning
Authorised by
Filepath
Asbestos Register Available
Yes
No
Yes
No
SafeWork SA
Notification No
This process is uncontrolled when printed. The current version is available on the I&TS Website.
Director of Infrastructure & Chief Information Officer
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Review Date:
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January 2016
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I&TS HSW Management Sub-System
3.1-13F01 Asbestos Removal Control Plan – Class B
3.
NOTIFICATION DETAILS
Person responsible for
notification
Stakeholders to be
notified
4.
Date notification sent
RESPONSIBILITIES AND SITE SECURITY
Person responsible for the security
and safety of the removal site
If removal is >1 day, how will the
site be secured after hours
Asbestos removal boundaries
Contact Number
Barrier Mesh and Signage
Spotter required
Doors Secured
Emergency Exits secured
Lifts isolated
Other
Barricade and Signage location:
LEGEND
Barrier
Signage
Personal decontamination area
Skip/Truck location
Air Monitors
Removal routes
Work area sketch/photo
5. EMERGENCY DETAILS
Evacuation muster point
Equipment location
Fire extinguisher
First aid kit
Contractor emergency
contact
First aid officer
Other
Contact number
Contact number
Emergency procedure
EMERGENCY SERVICES CALL 000
Warning
Authorised by
Filepath
UoA SECURITY CALL 83135990
This process is uncontrolled when printed. The current version is available on the I&TS Website.
Director of Infrastructure & Chief Information Officer
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Review Date:
January 2014
January 2016
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I&TS HSW Management Sub-System
3.1-13F01 Asbestos Removal Control Plan – Class B
6.
PERMIT/PERMISSION TO WORK
UoA Permit/Permission required in addition to
asbestos removal/disturbance
7.
Hot Work
Confined Space
General
ISOLATIONS AND ELECTRICAL SAFETY
Isolations
Required
Details of any
electrical issues
Essential Services
Fire Indicator Panel
Protect from damage
Controls
required
De-energise
Fire Suppression Systems
Removal
Lock out/tag out
Provide details
Other
Person responsible for implementing control measures
SET UP OF REMOVAL AREA
Area
preparation
8.
Yes
Do flooring and other surfaces require containment from asbestos dust?
Floors
Ceiling Space
Offices
Corridors
Air vents
Doors
Window
Lift
No
Air con
Stairwell
Other
Method of
containment
9.
AIR MONITORING
Note: The final location and number of air sampling units will be determined by the licensed asbestos assessor. Any variation to the original plan
must be amended and initiated by the assessor.
Air monitoring
company
Number of sample units
Contact Person
Phone:
10. PPE
Listed PPE must be worn at all
times during the removal
process; other PPE may be
required and will be listed on
the attached JSA
Respirator
Type
Overalls
Type
Gloves
Type
Boots
Type
11. REMOVAL METHOD
Details
Whenever possible dry
asbestos should not be
worked on
Wet
Details
Dry
Warning
Authorised by
Filepath
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I&TS HSW Management Sub-System
3.1-13F01 Asbestos Removal Control Plan – Class B
12. EQUIPMENT
Equipment is to be compliant with WHS Reg 2012 SA s446
Hand tools
Power tools
Spray Equipment
Low pressure trigger
Vacuuming equipment is industrial and
complies with AS 60335.2.69:2003?
Other
Hand pump
Yes
No
Equipment number
All tools and equipment used in ACM work are inspected prior to work commencing?
Yes
No
13. DECONTAMINATION
ACM Removal area decontamination methods:
Equipment decontamination methods:
Wet
Dry
Wet wiping
Wet
Dry
Wet wiping
Disposed
Double bagged & tagged
Personal decontamination methods
Wet wiped
Vacuum
14. DISPOSAL
Waste disposal methods
Yes
Will removed ACM be held on site for more than 1 day?
No
How will ACM held on site be secured from unauthorised access?
EPA transport licence number
Proposed waste disposal
depot
15. WORKER SIGN OFF – all workers must sign off to verify that they understand the requirements of this control plan and that they have
completed training and are competent to conduct the ACM removal
Name
Signature
Date
Name
Signature
Date
Name
Signature
Date
Name
Signature
Date
Name
Signature
Date
Name
Signature
Date
Name
Signature
Date
Name
Signature
Date
Name
Signature
Date
16. TRAINING
All workers that have signed this ARCP are adequately trained to
undertake the task and training documentation is provided
All workers have completed the UoA Contractor induction?
Yes
Supervisor
Yes
No
Workers
Yes
No
No
Person responsible for updating the worker exposure records
Warning
Authorised by
Filepath
This process is uncontrolled when printed. The current version is available on the I&TS Website.
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January 2016
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I&TS HSW Management Sub-System
3.1-13F01 Asbestos Removal Control Plan – Class B
17. COMPLETION OF ACM REMOVAL WORK
UoA Project Manager and WHS Advisor notified via text message that the work has been completed and
that the area is safe for habitation
Yes
No
Client advised to amend the asbestos register to reflect the work undertaken?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
N/A
Yes
No
Clearance certificate provided to the UoA Project Manager and WHS Advisor?
Prescribed waste transport certificate provided to UoA Project Manager and WHS Advisor?
Results of air monitoring provided to UoA Project Manager and WHS Advisor?
A map detailing the items removed and their location has been provided to UoA Project Manager and
WHS Advisor?
Photographs have been provided to UoA Project Manager and WHS Advisor?
UoA Asbestos removal permit has been signed off and returned to the UoA Project Manager and WHS
Advisor?
N/A
18. CONTRACTOR SIGN OFF
I confirm that the ACM removal has been completed as per the above plan, the site has been left in a clean and safe condition and
documentation is accurate to the best of my knowledge
Name
Signature
Company
Date
19. UoA Sign Off
All documentation has been provided to Campus Services for their records?
Name
Position
Warning
Authorised by
Filepath
Signature
Yes
No
Date
Department
This process is uncontrolled when printed. The current version is available on the I&TS Website.
Director of Infrastructure & Chief Information Officer
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January 2016
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