EP 1110-1-22
15 Sep 00
Name, address and telephone number of [each] accredited laboratory conducting analysis of
samples.
Survey findings including a list of all materials sampled and analyzed, the analytical results,
and lists of Friable ACM, Non-friable ACM, and Non-ACM.
Laboratory analytical data sheets including identification and results of QC samples to include
duplicates and laboratory blanks used by the Laboratory to measure precision and accuracy,
samples, batch identification if applicable, and Chain-of-Custody forms
Copy of Laboratory [NVLAP] [or] [AIHA] accreditation for bulk ACM analysis
2.3.5
Contractor Certification of Project Data Validity
The Contractor shall certify that all field data collected for purpose of determining the presence of
asbestos are valid and meet the DQOs.
2.4
TASK 4 Asbestos Survey and Assessment Report
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NOTE: The SOW editor should confer with the installation POC to determine the
specific reporting formats required.
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The Contractor shall prepare an Asbestos Survey and Assessment Report containing the elements
described in Paragraphs 2.4.1 through Paragraph 2.4.7 below. An Asbestos Survey and
Assessment Report shall be prepared for each facility to document the findings of the asbestos
survey.
2.4.1
General Report Contents
Installation name and location
Address (street, city, state and zip) and building identification number of assessed facility
Facility manager or POC [and phone number]
Contractor firm name, [address (street, city, state and zip)] [phone number]
Date of assessment
Name, signature and certification number of each inspector, management planner, and
projected designer participating in the survey and assessment
Name, address, and telephone number of the Contract firm and POC doing the assessment,
Executive summary of survey and assessment including a list of all ACM
Asbestos Sampling Plan with Sample Location Documentation
Laboratory Report
Recommendations
Decision tree flow chart and explanation of Hazard Ranks/Assessments
Bulk sample log
Extent of materials drawing for each floor (estimated amounts)
Photograph log
Photographs of each homogenous area
A-13
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