Raetihi Health Centre Asbestos Management Survey Report.pdf

Asbestos Management Survey Report





WAIMARINO HEALTH CENTRE

Report Production

Report Prepared by:   Ali Lind

Position in Company:  Asbestos Project Manager

Signature:


Date: 19/03/2018

2

Contents Page

Section 1

  Report Details

  Introduction

  Survey Methodology

  General Recommendations for Asbestos Cement Products

  General Recommendation for Asbestos Insulation, Coatings
or Insulating Board (AIB)

  Survey Summary & Recommendations

  Risk Assessment Methods

Section 2

  Identification & Photographic Register Sheets

  Survey Recommendations

  Survey Record Sheets

  Laboratory Certificate of Analysis

  Management Inspection Record

3

Introduction
Further to an invitation from: GRANT HOOD (W.D.H.B)
AISL - Asbestos Inspection Services Limited was requested to carry out a
Management Survey at -

WAIMARINO HEALTH CENTRE, RAETIHI.

There are 2 designated categories of Asbestos surveys currently available.
These are listed below:

Management Survey

Standard sampling, identification and assessment survey (Sampling Survey),
the purpose of which is to locate as far as reasonably Practicable the presence
and extent of any suspect asbestos containing materials in the building and
their condition. This is done by the collection and analysis of samples of
suspect asbestos containing materials.

Refurbishment / Demolition Survey

Full access sampling and identification survey (Pre-demolition/Major
Refurbishment Survey). This type of survey is used to locate and describe as far
as reasonably practicable, all asbestos containing materials in the building and
may involve destructive inspection as necessary to gain access to all areas,
including those that may be difficult to reach. A full sampling programme is
undertaken to identify possible asbestos containing materials and estimates of
the volume and surface areas of asbestos containing materials made.

Access arrangements were made with aid of Mr. Grant Hood (Whanganui District
Health Board) to ensure all accessible areas were surveyed during the project.

The survey was carried out on 19/03/2018 and completed 2 days thereafter.

The survey was to include for visual inspection within the above premises.

The survey was undertaken and completed by Ali Lind member of the AISL –
Asbestos Inspection Services Limited survey team.

During the survey the building remained un-occupied.

4

Disclaimer

Every effort has been made to identify all asbestos materials so far as was
reasonably practicable to do so within the scope of the survey and
the attached report. Methods used to carry out the survey were agreed with the
client prior to any works being commenced.

Survey techniques used involves trained and experienced surveyors using the
combined approach about visual examination. and bulk sample collections
where required.
It is always possible after a survey that asbestos based materials may remain
in the property or area covered by that survey, this could be due to several
reasons:

  Asbestos materials existing outside the scope of the survey.

  Materials may be concealed or hidden by other items or covered surfaces
i.e. paint, over boarding, concealing etc. Where this is the case then
its discovery will be limited.

  Asbestos may well be hidden as part of the structure to a building and
not visible until the structure is demolished later.

  Fragments from previous asbestos removal projects may well be
present in various areas; general asbestos fragments do not form
part of this survey however all good intentions are made for its
discovery.

Where an area has been formerly stripped of asbestos i.e. plant rooms,
ducts etc. and new coverings added, it must be pointed out that
asbestos removal techniques have improved steadily over the years since its
initial introduction. Most particularly would be the Health and Safety at Work
(Asbestos) Regulations 2016, that outline enforceable strategies. Asbestos
removal prior to this regulation would not be of today’s standard and
therefore fragments may be present beneath new coverings.

This survey will detail areas accessed and all samples taken, where an area is not
covered by this survey it will be due to No Access for one reason or other i.e.
working technicians, delicate location or just simply no admittance. It may have
been necessary for the restrictions of the surveyor’s specialist to
be confirmed prior to the survey.

Admittance for the survey may be restricted for many reasons outside our
control such as height, deadlines to others, steady complications
or confined space. Where electrical equipment is present and presumed in the
way of the survey no access will be attempted until proof of its safe state is
given. Our operatives have a duty of care under the Health and Safety at Work
Act (2016) for both themselves and others.

5

Disclaimer

In the structure where asbestos has been located and not all zones have been
examined, any material that is found to be suspicious and not detailed as part of
the survey should be treated with caution and sampled accordingly.

Certain materials contain asbestos to variable grades and some may be
less densely contaminated at certain locations (Artex for example). Where this is
the case the sample taken may not be representative of the whole
product throughout, therefore composite sampling is therefore encouraged.

Where a survey is carried out under the guidance of the owner of the property or
his representative, then the survey will be as per his/her instructions and
supervision at that time.

Asbestos Inspection Services Limited cannot accept any liability for loss,
injury, damage or penalty issues due to errors or oversights contained within
this report.

Asbestos Inspection Services Limited cannot be held responsible for any
damage caused as part of this survey carried out on your behalf. Due to the
landscape and stipulation of sampling for asbestos some danger is inevitable
and will be limited to just that necessary for the taking of the sample.

6

General Recommendations for Asbestos Cement Products.

Work with cement products containing asbestos is covered by the Management and
Removal of Asbestos (November 2016) Approved Code of Practice.

An assessment of all proposed works which may disturb any asbestos should be
carried out to launch the risk existing, the appropriate precautions must be adopted
to control any exposure. This should combine the succeeding over-all principles:

  Where work on asbestos cement is inevitable, keep the materials wet
during work and avoid breakage wherever possible. Acceptable PPE
must be worn always.

  Avoid using power tools. If deemed necessary to use power tools set at the
lowest possible speed, exhaust ventilation such as cowls must be fitted to
power tool and utilising the “investigation technique” with high efficiency H
type vacuum units.

  Organise the work in a single controlled location where practicable, to
streamline control and supervision. Isolate working areas using warning
signs and tape barriers, or in case of significant fibre levels by means of a
sealed polythene work enclosure and negative pressure equipment. Air
tests must also be carried out by an independent asbestos assessor.

  Signify respirator zones where the Control Limit is likely to be exceeded
and ensure that all persons entering the zones wear appropriate RPE/PPE
are trained in its use.

  Ensure that those persons employed in working on asbestos cement are
suitably trained in the correct working practices, control methods and
anticipation of risks.

  Keep the work area clean during the work and use methods that abate dust
creation, avoid sweeping and brushing, which will make dust airborne.

  Dispose of asbestos cement waste safely as Asbestos Waste under the
statutory consignment note procedures in accordance with the Health
and Safety at Work (Asbestos) Regulations 2016.

  Avoid further disturbance of asbestos cement products wherever possible
by relocating or re-routing facilities.

  Clearly identify and label any asbestos cement products.

7

General Recommendations for Asbestos Insulation,
Coatings or Insulating Board (AIB)

Where the materials are in safe condition and the risk of disturbance is small, they
can be maintained on site. They should be identified with adequate warning signs
and routinely inspected for damages. All asbestos materials should not be drilled,
abraded or disturbed in any way.

All asbestos containing materials should be removed prior to any planned
refurbishment or demolition works, where damage is likely to be sustained during
the occupant’s activities or where future decline is likely.

Work on any of these items may only be carried out by a specialist contractor
licensed under the Health & Safety at Work Act 2016. The selected contractor is
required to notify the WSNZ at least 5 days prior to commencement of the works,
and to provide a written Method Statement as follows:

  Full explanation of the works to be carried out and its duration.

  Type, quantity and location of asbestos to be removed.

  Anticipated exposure levels and persons affected.

  Enclosure construction details, layout and location, signage and
ventilation.

  Protections to be adopted to minimize exposure to lowest possible level
and to control release of asbestos fibre beyond the work area.

  Validation for any withdrawal from preferred methods, e.g. where wet
stripping cannot be used.

  Type, use and decontamination of RPE/PPE

  Waste removal and disposal procedures

  Training and instruction of employees

  Emergency procedures on site

8

Material Assessment Methods
total risk score of between 0 and 12 is calculated using four categories
that are evaluated by the surveyor against given values. The criteria
and the respective values are as follows:

Product Type

1
Asbestos  reinforced  composites  such  as  plastics,  resins,  mastic,
roofing  felt,  vinyl  tiles,  paints  and  decorative  finishes,  asbestos
cement products.

2
Asbestos insulation board, mill boards, other low-density insulation
boards,  asbestos  textiles,  gaskets,  ropes  and  woven  textiles,
asbestos paper and felt.

3
Thermal  insulation  (e.g.  pipe  and  boiler  lagging),  sprayed  asbestos,
loose asbestos, asbestos mattresses and packing.

Condition/Extent of Damage

0
Good condition, no visible damage.

1
Low  damage,  a  few  scratches  or  surface  marks,  broken  edges  on
boards, tiles etc.

2
Medium  damage,  significant  breakage  of  materials  or  several  small
areas  where  material  has  been  damaged,  revealing  loose  asbestos
fibres.

3
High  damage  or  delamination  of  materials,  sprays  and  thermal
insulation. Visible asbestos debris.

Surface Treatment

0
Composite  materials  containing  asbestos,  such  as  reinforced
plastics, resins, vinyl tiles.

1
Enclosed sprays and lagging, asbestos insulation board with exposed
surface painted or encapsulated, asbestos cement products.

2
Unsealed  asbestos  insulation  board  or  encapsulated  lagging  and
sprays.

3
Unsealed lagging and sprays.

9

Material Assessment Methods

Asbestos Type

1
Chrysotile (white) asbestos.

2
Amosite (brown) asbestos.

3
Crocidolite (blue) asbestos.

The algorithms shown against each situation are added together to give a total material
risk score, for conciseness, the register we have prepared contains only the total risk
score rather than the component scores.

The total score for each situation can be broadly classified using the following bands:

Material Risk Score

0 - 3  Very Low Risk

4 - 6  Low Risk

7 – 9 Medium Risk

10 – 12 High Risk

It  is  likely  that  high  risk  items  will  be  highlighted  in  the  report  text  and  that  some
immediate action will be required.
Other  items  may  also  be  measured  for  consideration  where  the  decision  of  the
surveyor recommends this would be beneficial.

10

Priority Assessment Formula

A priority risk score of between 0 and 12 is calculated using four categories that
are evaluated by the duty holder.

Although a surveyor may have some of the information which will contribute to
the risk assessment and may be part of an assessment team, the duty holder is
required to make a risk assessment based on the survey findings and their
detailed knowledge of the activities carried out within the premises. The criteria
and the respective values are as follows:

Normal occupant activity

Assessment
Score
Examples of score variables
factor

Main type of
0
Rare disturbance activity (e.g. little used store room)
activity in area
1
Low disturbance activities (e.g. office type activity)

2
Periodic disturbance (e.g. industrial or vehicular

activity which may contact ACMs)

3
High levels of disturbance, (e.g. fire door with

asbestos insulating board)
Secondary

activities for
As above
area

11

Priority Assessment Formula

Likelihood of disturbance

Assessment
Score
Examples of score variables
factor

Location
0  Outdoors
1  Large rooms or well-ventilated areas
2  Rooms up to 100 m2
3  Confined spaces

Accessibility
0  Usually inaccessible or unlikely to be disturbed
1  Occasionally likely to be disturbed
2  Easily disturbed
3  Routinely disturbed

Extent/amount
0  Small amounts or items (e.g. strings, gaskets)
1  <10 m2 or <10 m
2  10 m2 to 50 m2 or 10 m to 50 m
3  >50 m2 or >50 m

Human exposure potential

Assessment
Score
Examples of score variables
factor

Number of
0
None
occupants
1
1 to 3

2
4 to 10

3
>10
Frequency of
0
Infrequent
use of area
1
Monthly

2
Weekly

3
Daily
Average time
0
<1 hour
area is in use
1
1 to 3 hours

2
3 to 6 hours

3
>6 hours

12

Priority Assessment Formula

Maintenance activity

Assessment
Score
Examples of score variables
factor

Type of
0
Minor disturbance (e.g. possibility of contact
maintenance
when gaining access)
activity
1
Low disturbance (e.g. changing light bulbs in

asbestos insulating board ceiling)

2
Medium disturbance (e.g. lifting one or two

asbestos insulating board ceiling tiles to access

a valve)

3
High levels of disturbance (e.g. removing many

asbestos insulating board ceiling tiles to replace

a valve or for re-cabling)

Frequency
of
0
ACM unlikely to be disturbed for maintenance
maintenance
1
<1 per year
activity
2
>1 per year
3
>1 per month

The score for each variable is determined by calculating the average score of the
appropriate factors.

The algorithms shown against each section are added together to give a total priority
risk  score,  for conciseness,  the  register we  have  prepared  contains  only  the  overall
risk score rather than the component scores.

Priority Risk Score

0 - 3  Very Low Risk

4 - 6  Low Risk

7 – 9  Medium Risk

10 – 12 High Risk

13

Overall Hazard Risk Assessment Formulae

The material and priority assessment scores provide an overall hazard risk score for
each situation which can be broadly classified using the following table:

Material Assessment

10-12
7-9
5-6
1-4

10-12

nt

7-9
me

s

s
e

s

ty As

4-6

riori

P

0-3

Key

High Risk
Total score = 19-24

Medium Risk
Total score = 13-18

Low Risk
Total score = 7-12

Very Low Risk
Total score = 1-6

14

Specific Locations that may contain asbestos based material’s or
Presumed to Contain Asbestos Containing material’s.

  ID: CARD NO:001
Photograph No.

Location/Area
External-Gable Ends
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
85.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:002
Photograph No.

Location/Area
External-Front Entry
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
16.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:003
Photograph No.

Location/Area
Physiotherapy (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
33.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:004
Photograph No.

Location/Area
Community Base Storage (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
7.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.

15

Specific Locations that may contain asbestos based material’s or
Presumed to Contain Asbestos Containing material’s.

  ID: CARD NO:005
Photograph No.


Location/Area
W/C toilet (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
3.0.0m2
Current Status/Overall score
Good Condition / Very Low Risk.
Recommended Action
Sample required for repairs work.
  ID: CARD NO:006
Photograph No.

Location/Area
Treatment Room (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
12.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:007
Photograph No.

Location/Area
Kitchen (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
8.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:008
Photograph No.

Location/Area
Switch Boards
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
4.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.

16

Specific Locations that may contain asbestos based material’s or
Presumed to Contain Asbestos Containing material’s.

  ID: CARD NO:009
Photograph No.

Location/Area
Community Room 1 (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
17.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:010
Photograph No.

Location/Area
Community Rooms toilet (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
8.5m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:011
Photograph No.

Location/Area
Community Room 2 (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
17.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:012
Photograph No.

Location/Area
Maternity 3 (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
25.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.

17

Specific Locations that may contain asbestos based material’s or
Presumed to Contain Asbestos Containing material’s.

  ID: CARD NO:013
Photograph No.

Location/Area
Maternity Room 3&4 bathroom (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
10.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:014
Photograph No.

Location/Area
Maternity Room 4 (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
25.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:015
Photograph No.


Location/Area
Maternity Room 5 (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
25.0m2
Current Status/Overall score
Good Condition / Very Low Risk.
Recommended Action
Sample required for repairs work.
  ID: CARD NO:016
Photograph No.

Location/Area
Sluice (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
2.5m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.

18

Specific Locations that may contain asbestos based material’s or
Presumed to Contain Asbestos Containing material’s.

  ID: CARD NO:017
Photograph No.

Location/Area
Lounge/Day Hospital (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
1.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:018
Photograph No.


Location/Area
Maternity Bathroom (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
5.0m2
Current Status/Overall score
Good Condition / Very Low Risk.
Recommended Action
Sample required for repairs work.
  ID: CARD NO:019
Photograph No.

Location/Area
Linen (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
2.5m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:020
Photograph No.

Location/Area
Cleaners (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
2.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.

19

Specific Locations that may contain asbestos based material’s or
Presumed to Contain Asbestos Containing material’s.

  ID: CARD NO:017
Photograph No.

Location/Area
Staff (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
2.5m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:018
Photograph No.


Location/Area
Staff toilet (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
4.0m2
Current Status/Overall score
Good Condition / Very Low Risk.
Recommended Action
Sample required for repairs work.
  ID: CARD NO:019
Photograph No.

Location/Area
Radiology (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
25.5m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:020
Photograph No.

Location/Area
Radiology VR (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
10.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.

20

Specific Locations that may contain asbestos based material’s or
Presumed to Contain Asbestos Containing material’s.

  ID: CARD NO:017
Photograph No.

Location/Area
Radiology DR (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
2.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:018
Photograph No.

Location/Area
Radiology Waiting Rm (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
4.0m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:019
Photograph No.

Location/Area
Files (Floor)
Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
6.5m2
Current Status/Overall score
Good Condition / Very Low Risk.

Recommended Action
Sample required for repairs work.
  ID: CARD NO:020
Photograph No.


Location/Area

Sample No.
Presumed the presence of ACM.
Laboratory Analysis Findings
Sample not taken.
Quantity
.0m2
Current Status/Overall score
Good Condition / Very Low Risk.
Recommended Action
Sample required for repairs work.



21

Inspection Record

Enter site name

Date
Print Name
Signature
Company Name
Phone Number

22

Survey Record Sheet

Ref:  WDHB
Site Address: Waimarino Health Centre, Raetihi
Date: 19/03/18

Survey Type:
Management Survey

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Location/Area Description
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/Presumed  Quantity
Description
Type
ik
Pr
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A
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No
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O Action
001

External-Gable End
Presumed  85.0m2
Gable lining
Compressed  1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
board
board
before commencing proposed works activity.
002

External-Front Entry
Presumed  16.0m2
Soffit lining
Compressed  1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

board
board
before commencing proposed works activity.
003

Internal-Physiotherapy  Presumed  33.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

before commencing proposed works activity.
(Floor)
backing
004

Internal-Community
Presumed  7.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

before commencing proposed works activity.
Base Storage (Floor)
backing
005

Internal-W/C toilet
Presumed  3.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

before commencing proposed works activity.
(Floor)
backing
006

Internal-Treatment Room Presumed  12.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

before commencing proposed works activity.
(Floor)
backing
007

Internal-Kitchen (Floor)  Presumed  8.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

backing
before commencing proposed works activity.
008

Internal-Switch board
Presumed  4.0m2
Suspect backing
Compressed  1  0  0  1  0  0
0
0
0  0  1  Sample analysis for repairs works essential

board
board
before commencing proposed works activity.
009

Internal-Community
Presumed  17.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
before commencing proposed works activity.
Room 1 (Floor)
backing
010

Internal-Community
Presumed  8.5m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
before commencing proposed works activity.
Room 1 (Floor)
backing

23

Survey Record Sheet

Ref:  WDHB
Site Address: Waimarino Health Centre, Raetihi
Date: 19/03/18

Survey Type:
Management Survey

t

n

re
ity

re

e
e
t
o
re

c o
n
re
c tiv

c o

e
tm
y p
a

A
c

a
k S
p

s u

f
y p

o
k S
n
re
s T
is
o

c e
c e
n
is

T
c c u
d
x p
l R

n
l
a
is k S

itio
e
o
a
E
n

l O

c t T
c
s to
ity
o
n
tia
ll R
u
d
a
e
ria
a
rb
lih
a
n
te
ty R
ra
ID Card No
Photo No

Sample Ref

Product
Asbestos
d
n
tu
ri
o
te
rm
e
m
te
in

o
rf
a
c tiv
is
u
a
o
v e
Location/Area Description
u
s b
o
/Presumed
Quantity
Description
Type
ik
Pr
C
S
A
M
No
A
L
D
H
P
M
Pri
O Action
011

Internal-Community
Presumed
17.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
Room (Floor)

backing
before commencing proposed works activity.
012

Internal-Maternity 3
Presumed
25.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
(Floor)

backing
before commencing proposed works activity.
013

Internal-Maternity 3&4
Presumed
10.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
before commencing proposed works activity.
Bathroom (Floor)

backing
014

Internal-Maternity 4 (Floor)  Presumed
25.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

backing
before commencing proposed works activity.
015

Internal-Maternity 5 (Floor)  Presumed
25.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

backing
before commencing proposed works activity.
016

Internal-Sluice (Floor)
Presumed
2.5m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

backing
before commencing proposed works activity.
017

Internal-Lounge/Day
Presumed
1.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
before commencing proposed works activity.
Hospital (Floor)

backing
018

Internal-Linen (Floor)
Presumed
2.5m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

backing
before commencing proposed works activity.
019

Internal-Cleaners (Floor)
Presumed
2.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

backing
before commencing proposed works activity.
020

Internal-Maternity Bathroom Presumed
5.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
before commencing proposed works activity.
(Floor)

backing

24

Survey Record Sheet

Ref:  WDHB
Site Address: Waimarino Health Centre, Raetihi
Date: 19/03/18
Survey Type:
Management Survey

t

n

re
ity

re
re

e
e
t
o

c o
n
re
c tiv

c o

e
tm
y p
a

A
c

a
k S
p

s u

f
y p

o
k S
n
re
s T
is
o

c e
c e
n
is

T
c c u
d
x p
l R

n
l
a
is k S

itio
e
l O
o
a
E
n

c t T
c
s to
ity
o
n
tia
ll R
u
d
a
e
ria
a
rb
lih
a
n
te
ty R
ra
ID Card No
Photo No

Sample Ref

Product
Asbestos
d
n
tu
ri
o
te
rm
e
m
te
in

o
rf
a
c tiv
is
u
a
o
v e
Location/Area Description
u
s b
ik
o
/Presumed
Quantity
Description
Type
Pr
C
S
A
M
No
A
L
D
H
P
M
Pri
O Action
021

Internal-Staff (Floor)  Presumed
2.5m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

backing
before commencing proposed works activity.
022

Internal Staff toilet
Presumed
4.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
(Floor)

backing
before commencing proposed works activity.
023

Internal-Radiology
Presumed
25.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
before commencing proposed works activity.
(Floor)

backing
024

Internal-Radiology VR
Presumed
10.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
before commencing proposed works activity.
(Floor)

backing
025

Internal-Radiology DR
Presumed
2.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
before commencing proposed works activity.
(Floor)

backing
026

Internal-Radiology
Presumed
4.0m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential
before commencing proposed works activity.
Waiting Rm (Floor)
backing
027

Internal-Files (Floor)
Presumed
6.5m2
Suspect vinyl or
Vinyl resin
1  0  0  1  0
0
0
0
0  0  1  Sample analysis for repairs works essential

backing
before commencing proposed works activity.
028





25