Get WI DHS F-44016 2009

Adm. Code ASBESTOS OCCUPANT PROTECTION PLAN This occupant protection plan shall remain posted for the duration of the asbestos project. DEPARTMENT OF HEALTH SERVICES Division of Public Health F-44016 Rev* 03/09 Page 1 of 1 STATE OF WISCONSIN Bureau of Environmental and Occupational Health DHS 159 Wis. Only certified persons using appropriate personal protection may enter regulated areas. Contractor - Describe the actions taken to ensure the health and safety of building occupants during this project in space below. If handwritten write clearly and legibly. Post this plan in plain view outside the regulated area for the project. Occupants Asbestos is a hazardous substance. The actions described below are meant to protect you and others nearby during this asbestos removal project. It is important to stay out of work areas while work is in progress and until permission is given to re-enter upon completion* The contractor will do daily clean-up but the regulated work area may still contain dangerous levels of asbestos until final cleaning is completed* ASBESTOS COMPANY INFORMATION Company Name Address DHS company No* City Company Contact Person State Zip Code Telephone No* ASBESTOS PROJECT INFORMATION Property Type or Property Name Property Contact Person Project work shifts am pm Project start date mm/dd/yy Project end date mm/dd/yy night PROJECT DESCRIPTION Type of project including type and amount of asbestos-containing material PROTECTIVE MEASURES Describe below actions taken to ensure occupant safety attach additional sheet if needed Containment or barrier system including negative air system glovebag full containment mini-containment etc* Ventilation system shutdown Work practices such as wet methods debris-lowering system waste handling Final cleaning and clearance description such as air scrubbing HEPA vacuuming wet cleaning encapsulant air sampling Asbestos and Lead Section 608 261-6876. Only certified persons using appropriate personal protection may enter regulated areas. Contractor - Describe the actions taken to ensure the health and safety of building occupants during this project in space below. If handwritten write clearly and legibly. Post this plan in plain view outside the regulated area for the project. If handwritten write clearly and legibly. Post this plan in plain view outside the regulated area for the project. Occupants Asbestos is a hazardous substance. The actions described below are meant to protect you and others nearby during this asbestos removal project. Occupants Asbestos is a hazardous substance. The actions described below are meant to protect you and others nearby during this asbestos removal project. It is important to stay out of work areas while work is in progress and until permission is given to re-enter upon completion* The contractor will do daily clean-up but the regulated work area may still contain dangerous levels of asbestos until final cleaning is completed* ASBESTOS COMPANY INFORMATION Company Name Address DHS company No* City Company Contact Person State Zip Code Telephone No* ASBESTOS PROJECT INFORMATION Property Type or Property Name Property Contact Person Project work shifts am pm Project start date mm/dd/yy Project end date mm/dd/yy night PROJECT DESCRIPTION Type of project including type and amount of asbestos-containing material PROTECTIVE MEASURES Describe below actions taken to ensure occupant safety attach additional sheet if needed Containment or barrier system including negative air system glovebag full containment mini-containment etc* Ventilation system shutdown Work practices such as wet methods debris-lowering system waste handling Final cleaning and clearance description such as air scrubbing HEPA vacuuming wet cleaning encapsulant air sampling Asbestos and Lead Section 608 261-6876. .