ESBD_396277_1739554149784_ATTACHMENT G.L - Ellington Field JRB Final Asbestos Abatement Report Template.pdf
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- Attached to
- Hush House Transformer Replacement
- Solicitation number
- TMD25-ANG-WJ-24150007
- Issued by
- Harris County, Texas
About this file
This is a final asbestos abatement report template for Ellington Field Joint Reserve Base (JRB) in Houston, Texas. The template provides a standardized format for documenting asbestos abatement projects conducted at the base, requiring detailed information about project locations, scope of work, air monitoring results, and compliance with Texas Department of State Health Services (TDSHS) regulations. The template includes sections for project information, asbestos abatement completion reports, and various required appendices including TDSHS notifications, air sample results, chain of custody forms, monitoring data, and waste manifests.
The template provides an example project summary describing the removal of 1,350 square feet of asbestos-containing floor tile and mastic, with requirements for proper waste transportation and disposal documentation, air monitoring procedures following NIOSH Method 7400 standards, and compliance with OSHA exposure limits of 1.0 f/cc for Short Term Exposure and 0.1 f/cc for Time Weighted Average. The document requires verification of proper licensing for all contractors and subcontractors through TDSHS, detailed documentation of air sampling results, and signed waste manifests from the base Environmental Manager.
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ATTACHMENT G.L - Ellington Field JRB Final Asbestos Abatement Report Template
ELLINGTON FIELD JOINT RESERVE BASE
FINAL ASBESTOS ABATEMENT REPORT
FOR WORK PERFORMED AT:
PROJECT NUMBER:
PREPARED FOR:
Ellington Field JRB
14657 Sneider Street Houston, Texas 77034
REPORT DATE:
14657 Sneider Street
Houston, Texas 77034 281-929-2013
Project Number: Date:
FINAL ASBESTOS ABATEMENT REPORT
Date
Address of Company
Ellington Field JRB Project Number:
Prepared by: ____________________________________________
Project Manager
Reviewed by: ____________________________________________
TDSHS Asbestos Consultant, License #
Company Logo
Company Address
Table of Contents
PROJECT INFORMATION _______________________________________________ 1
ASBESTOS ABATEMENT COMPLETION REPORT 1
Project Location
PROJECT SUMMARY 1
APPENDICES _________________________________________________________ 3
Appendix 1: TDSHS Notifications
Appendix 2: Summary of Air Samples
Air Sample Results
Appendix 3: Chain of Custody Forms
Appendix 4: Summary of Monitoring
Air Monitoring Field Forms
Appendix 5: Daily Project Notes & Additional Field Forms
Appendix 6: TDSHS Certifications and Licenses
Prime and Subcontractors
Appendix 7: Pictures- (Before and After)……………………………………………………………3
Appendix 8: Signed Copies of All Waste Manifests…………………………………….3
Project Information
ELLINGTON FIELD PROJECT NUMBER:
ASBESTOS ABATEMENT COMPLETION REPORT
This report represents a summary of the asbestos abatement, project duration, and air monitoring results for the abatement project conducted on Date:
Project Location
All of the work described within this report was conducted at the following location:
Location:
Owner/Generator: Ellington Field Joint Reserve Base Environmental Manager Mr. Mark A. Garcia
Project Type: Asbestos abatement of ???????????.
Ellington Project: #######
PROJECT SUMMARY (EXAMPLE TEXT SUBMISSION)
ACME Environmental submitted the Original Notification for abatement to the Texas Department of State Health Services (TDSHS) on November 14, 20?? (Attached) to precede the 10 day notification for the State. ACME Environmental submitted an amendment on December 1, 20??
If required. The project will comply with Texas Health and Human Services, Texas Laws and Regulations under Operational Codes Chapter 1954-Asbestos Health Protection, Texas Administrative Code, Title 25, Part 1, Chapter 296-Texas Asbestos Health Protection and Federal Code of Regulations, Title 40, Chapter1, Part 61-National Emission Standards for Hazardous Air Pollutants (NESHAP).
ACME Environmental, TDSHS License Number ##-####, conducted the asbestos abatement for the project listed above. ACME Environmental, TDSHS Waste Transporter License Number ##- #### and EPA ID Number ##-#####, provided waste transportation to ##### Landfill located in Houston, Texas.
The abatement project included the removal of approximately 1,350 square feet (sf) of asbestos-containing floor tile and mastic. The materials removed from the site were collected and manifested (Manifest Number #####) per regulations set forth by the Texas Commission on Environmental Quality (TCEQ). The manifest was properly signed by the Ellington Field Base Environmental Manager signifying the military base as the generator.
Mr. Bob Doe, TDSHS Asbestos Air Monitoring Technician License Number ##-####, continually monitored work performance and compliance with federal, state and local regulations, conducted the final visual inspection for cleanliness, and provided daily air monitoring during the abatement project. All licenses can be found in Appendix 6.
ACME SUBCONTRACTOR collected and analyzed Phase Contrast Microscopy (PCM) samples according to National Institute of Occupational Safety and Health (NIOSH) methods. ACME SUBCONTRACTOR is a participant in the NIOSH Proficiency and Analytical Testing Program (PAT) and performs fiber count analysis by the NIOSH Method 7400 Revision 3, Rule A. ACME SUBCONTRACTOR is a licensed asbestos laboratory with the TDSHS, Toxic Substance Control Division for analysis of airborne asbestos fibers.
Area air monitoring was conducted by ACME SUBCONTRACTOR in accordance with the Texas Asbestos Health Protection Rules (TAHPR). Area samples were collected on December 1-6, 20XX. All of the area air samples collected outside the work area were at or below the threshold value of 0.01 fibers / cubic centimeter (f/cc) or below the limit of detection (L.O.D.).
All of the personal samples were below the OSHA Permissible Exposure Limit (PEL) for the Short Term Exposure (STEL) of 1.0 f/cc and the Time Weighted Average (TWA) limit of 0.1 f/cc.
The contract was performed in general compliance with contract documents. All ACME SUBCONTRACTOR post-abatement submittals are attached. ACME Environmental post-abatement submittals will be sent under separate cover from the contractor.
Appendices
TECHNICAL DETAILS AND ATTACHMENTS
Appendix 1: TDSHS Notifications
Appendix 2: Air Sample Results
Appendix 3: Chain of Custody Forms
Appendix 4: Air Monitoring Field Forms
Appendix 5: Daily Project Notes & Additional Field Forms
Appendix 6: TDSHS Certifications and Licenses
Appendix 7: Pictures
Appendix 8: Signed Copies of All Waste Manifests
TDSHS Notifications
Air Sample Results
Chain of Custody Forms
Air Monitoring Field Forms
Daily Project Notes & Additional Field Forms
TDSHS Certifications and Licenses
PICTURES
Copies of All Signed Waste Manifests
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