Template

IA 09 4 Stage Clearance Reinspection Audit Form

by John Wimpenny, from the Community

This IA 09 template supports 4-stage clearance reinspection following asbestos removal. Capture audit details, review remediation scope, verify areas are free of asbestos residue, and confirm encapsulation quality. Check Stage 4 compliance, including removal of evidence and equipment, and validate certificate of reoccupation requirements such as accurate site diagrams and correct air sampling. Log non-conforming work with root cause, corrective and preventive actions, responsible persons, and due dates. Track closeout and effectiveness checks to ensure safe reoccupation.

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Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Asbestos Reoccupation Reinspection Certificate
This asbestos reoccupation reinspection template supports analysts and removal contractors in confirming that an area is safe for reentry after asbestos works. It captures client and site details, analyst and contractor names, audit date, job and shift numbers, and the scope and work areas inspected. Use it to check for evidence of dust or asbestos debris, confirm the condition and encapsulation of any remaining ACMs, note whether items are recorded on the reoccupation certificate, and identify any remaining enclosure materials or waste. Record remedial actions, recommendations, and inspector sign-off.
by Paul Roscoe, from the Community
Downloads: 10+
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Template
Certificate of Reoccupation Audit Form
This Certificate of Reoccupation audit form supports asbestos clearance checks following removal works. It guides analysts and project managers through the four stage clearance process including method statement review, enclosure integrity, decontamination unit checks, thorough visual cleaning verification, and air testing setup and counting in line with HSG248. The checklist covers PPE and RPE, calibration and equipment records, pump setup, disturbance testing, documentation, and final sign off. Use it to record non compliances, traceability details, and audit results to confirm an area is safe for reoccupation.
by Paul Roscoe, from the Community
Downloads: 20+
Get
Template
Asbestos BAM and Four-Stage Clearance Audit Template
Use this comprehensive checklist to audit asbestos Basic Air Monitoring (BAM) and Four-Stage Clearance activities on site. It covers pre-start health and safety checks, analyst competence and training, PPE and RPE, RAMS review, air sampling setup and quality control, WHO counting rules, TEAMS records, decontamination unit procedures, and stage 1-4 visual and air tests per HSG247/248. Includes acceptance of findings, reporting and certification steps, plus a vehicle audit to support safe, compliant asbestos works.
by John Wimpenny, from the Community
Downloads: 0
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Template
Asbestos Enclosure Handover Checklist
Use this handover checklist to confirm asbestos work enclosures are clean and ready for independent 4-stage clearance. Verify ACM removal locations are certified, NPU pre-filters replaced, site access obtained, and all surfaces, fixtures, cables, equipment, and voids are visibly clean. Capture photos, record inspection times, and document supervisor and analyst sign-offs for certificate of reoccupation.
by Alan Taylor-Reed, from the Community
Downloads: 0
Get

Asbestos Reoccupation Reinspection Certificate

This asbestos reoccupation reinspection template supports analysts and removal contractors in confirming that an area is safe for reentry after asbestos works. It captures client and site details, analyst and contractor names, audit date, job and shift numbers, and the scope and work areas inspected. Use it to check for evidence of dust or asbestos debris, confirm the condition and encapsulation of any remaining ACMs, note whether items are recorded on the reoccupation certificate, and identify any remaining enclosure materials or waste. Record remedial actions, recommendations, and inspector sign-off.

by Paul Roscoe, from the Community

10+

Get

Template

Certificate of Reoccupation Audit Form

This Certificate of Reoccupation audit form supports asbestos clearance checks following removal works. It guides analysts and project managers through the four stage clearance process including method statement review, enclosure integrity, decontamination unit checks, thorough visual cleaning verification, and air testing setup and counting in line with HSG248. The checklist covers PPE and RPE, calibration and equipment records, pump setup, disturbance testing, documentation, and final sign off. Use it to record non compliances, traceability details, and audit results to confirm an area is safe for reoccupation.

by Paul Roscoe, from the Community

20+

Get

Template

Asbestos BAM and Four-Stage Clearance Audit Template

Use this comprehensive checklist to audit asbestos Basic Air Monitoring (BAM) and Four-Stage Clearance activities on site. It covers pre-start health and safety checks, analyst competence and training, PPE and RPE, RAMS review, air sampling setup and quality control, WHO counting rules, TEAMS records, decontamination unit procedures, and stage 1-4 visual and air tests per HSG247/248. Includes acceptance of findings, reporting and certification steps, plus a vehicle audit to support safe, compliant asbestos works.

by John Wimpenny, from the Community

Get

Template

Asbestos Enclosure Handover Checklist

Use this handover checklist to confirm asbestos work enclosures are clean and ready for independent 4-stage clearance. Verify ACM removal locations are certified, NPU pre-filters replaced, site access obtained, and all surfaces, fixtures, cables, equipment, and voids are visibly clean. Capture photos, record inspection times, and document supervisor and analyst sign-offs for certificate of reoccupation.

by Alan Taylor-Reed, from the Community

Get

IA 09 4 Stage Clearance Reinspection Audit Form

About author

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Asbestos Reoccupation Reinspection Certificate

Certificate of Reoccupation Audit Form

Asbestos BAM and Four-Stage Clearance Audit Template

Asbestos Enclosure Handover Checklist

You might also like

Asbestos Reoccupation Reinspection Certificate

Certificate of Reoccupation Audit Form

Asbestos BAM and Four-Stage Clearance Audit Template

Asbestos Enclosure Handover Checklist