Attachment 1 - Permit Request - Example.pdf
PDF 236 KB Posted
- Attached to
- Asbestos Surveys
- Solicitation number
- FA558724Q0036
About this file
This document is a Permit to Work Request package issued by the Department of the Air Force 48th Fighter Wing (USAFE) regarding asbestos work. It outlines the required documentation and procedures for obtaining a permit to perform both non-notifiable licensed works (minimum 5 working days to process) and notifiable licensed works (minimum 10 working days to process) at USAFE facilities in the United Kingdom.
The key details include the required documentation such as asbestos worker training certificates, risk assessments, method statements, air test certificates, and disposal certifications. The document also specifies that the USAFE project manager or contracting officer must submit all documentation to the Asbestos Program Manager for approval. Possible site inspections and clearance procedures are also detailed. The document provides guidance on the timing and submission of required documents at different stages of the asbestos work.
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Text version
DEPARTMENT OF THE AIR FORCE
48TH FIGHTER WING (USAFE)
Permit to work - Request package.
Ver:01/NDC/March 2023
Permit Checklist
• Asbestos works are permitted through the 48 FW Asbestos Program Manager (APM).
• The Permit will be issued once all documentation has been received and approved by the APM.
• Ensure all relevant sections are completed and provide all documentation required, please refer to page 3 and 4 provides guidance.
• PleaseNOTE there is a requirement of 5 working days for non licensed and 10 working days for licensed work for the APM to make required checks.
USAFE/DIO Project manager or Contracting officer.
Name Rank Facility Type of asbestos work?
provided contractor copy of asbestos records?
Issued copy of the Asbestos management and operations plan?
Is work HSE notifiable/licensable:
HSE notification licensed number from ASB5:
Air test required? Reason for air test:
Intended start date Estimate works duration (Asbestos)
Submitted for APM approval Date Submitted
RAMS Reference Number:
Primary Contractor Name Company
Contact Number Contractors PM
Are you carrying out the works? Nominated company
Have you been issued with base management plan? Name of issuer
Have you been issued Asbestos reports Name of issuer
Type of asbestos work Nominated company
Is this HSE licensable (ASB5) Provide ASB5 number
Are you removing waste off site? Carriers licence (if answered yes
Have you provided documents as requested in section 2
Submission date
RAMS Reference Number:
Project/Task Number:
Permit to work - Request package.
Ver:01/NDC/March 2023
Asbestos Sub Contractor (if required) Name Company
Contact Number Contractors PM
Have you been issued with base management plan? Name of issuer
Have you been issued Asbestos reports Name of issuer
Type of asbestos work Air test Required?
Is this HSE licensable (ASB5) Provide ASB5 number
Are you removing waste off site? If yes Carriers license no
Have you provided documents as requested in section 2 Submission date
RAMS Reference Number:
Air Test Contractor Name Company
Contact Number Name of analyst
Type of Air Test being carried out
Certification of analyst received
RAMS Reference Number:
Waste carrier Name Company
Contact Number Carriers License
Disposal site Skip type to be used
Permit to work - Request package.
Ver:01/NDC/March 2023
Below is guidance on what documents are required and at what stage of the process throughout the life of the permit to work (PTW).
Please contact the Asbestos Program Manager (APM) if you have any concerns.
Non-notifiable licensed works (NNLW) *Please note
• Minimum of 5 working days is required to process a non licensed permit request.
• If the information is not correct it can lead to delays issuing the permit
• Upon completion of asbestos works provide paperwork within 5 working days
• If Rams have required, an air test please provide this on day of works completion Permits to be displayed on site from the start of works until asbestos work is completed.
All Documentation required is to be supplied to the APM by the USAFE project manager/contracting officer.
Documentation required. Required for
PTW
Commencement of works
On day of asbestos completion
Within 5 working days of asbestos works completion
Asbestos Manager
*Asbestos worker training certificates
*Risk assessment *Method statement Hepa vacuum/DOP test
Air test certificates If required Final site report (remaining/removed ACM)
Disposal certification Possible site inspections
Permit to work - Request package.
Ver:01/NDC/March 2023
Notifiable licensed works (NLW)
*Please note
• Minimum of 10 working days is required to process a HSE licensed work permit request.
• If the information is not correct it can lead to delays issuing the permit
• Upon completion of asbestos works provide paperwork within 5 working days
• If Rams have required, an air test please provide this on day of works completion.
• All Documentation required is to be supplied to the APM by the USAFE project manager/contracting officer.
Permit to be displayed on site from the start of works until asbestos work is completed.
Documentation required. Required for
PTW
Commencement of works
On day of asbestos completion
Within 5 working days of asbestos works completion
Asbestos Manager
*Asbestos worker training
*Risk assessment *Method statement *Air test certificates *Face fit certificates *Disposal certification *HSE (ASB5) permit *Worker certification *HSE (ASB5) permit number DCU certification DOP test certification NPU certificates Possible enclosure site inspection Possible smoke test observation Possible enclosure inspection Possible observance 4 stage clearance
Copy of clearance paperwork Disposal paperwork Site diary report Final site report (remaining/removed ACM)
| Name: |
| Rank: |
| Facility: |
| Issued copy of the Asbestos management and operations plan: |
| Is work HSE notifiablelicensable: |
| HSE notification licensed number from ASB5: |
| Estimate works duration Asbestos: |
| RAMS Reference Number: |
| Name_2: |
| Company: |
| Contact Number: |
| Contractors PM: |
| Nominated company: |
| Name of issuer: |
| Name of issuer_2: |
| Nominated company_2: |
| Provide ASB5 number: |
| Carriers licence if answered yes: |
| RAMS Reference Number_2: |
| Name_3: |
| Company_2: |
| Contact Number_2: |
| Contractors PM_2: |
| Name of issuer_3: |
| Name of issuer_4: |
| Provide ASB5 number_2: |
| If yes Carriers license no: |
| RAMS Reference Number_3: |
| Name_4: |
| Company_3: |
| Contact Number_3: |
| Name of analyst: |
| RAMS Reference Number_4: |
| Name_5: |
| Company_4: |
| Contact Number_4: |
| Carriers License: |
| Disposal site: |
| Skip type to be used: |
| Dropdown1: [Please Select] |
| Date2_af_date: |
| Dropdown3: [Please Select] |
| Date4_af_date: |
| Dropdown5: [Please Select] |
| Dropdown6: [Please Select] |
| Date7_af_date: |
| Dropdown8: [Please select] |
| Dropdown9: [Yes] |
| Dropdown10: [Please Select] |
| Dropdown11: [Please Select] |
| Dropdown12: [Please Select] |
| Dropdown13: [Please Select] |
| Date14_af_date: |
| Dropdown15: [Please Select] |
| Dropdown16: [Please Select] |
| Dropdown17: [Please select] |
| Dropdown18: [Please Select] |
| Dropdown19: [Please Select] |
| Dropdown22: [No] |
| Dropdown2: [Please Select] |
| Dropdown4: [Yes] |
| Dropdown7: [Please Select] |
| Dropdown14: [Please Select] |
| Dropdown20: [Please Select] |
| Text22: |
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