EP 1110-1-22
15 Sep 00
APPENDIX C
ARMY ASBESTOS - CONTAINING
MATERIAL CHECKLIST
Part 1: Damage Assessment
Installation: _______________________
Bldg/Rm No.: __________
Facility/Office: ____________________
Inspector Name/Date:____
Functional Area: ___________________
Physical. Assess damage based on evidence of surface accumulation; or the condition of the
sprayed-on or troweled-on surface materials; or physical deterioration or delamination of
materials using hand pressure.
_____(0)
None
*Non-asbestos materials; or no damage or evidence of material fallout;
or material is in fair to good condition; or nonfriable ACM, (i.e., floor
tile, wallboard, etc.); or (ACM) with less than one percent.
_____(1)
Minimal
*Isolated and very small areas (less than 10 percent) of material damage
or fallout; or controlled space and accessed by maintenance personnel
only; or uncontrolled/occupied space.
_____(2)
Low
*Visible evidence of some surface accumulation; or controlled space and
accessed by maintenance personnel only; or uncontrolled/unoccupied
space.
_____(3)
Moderate
*Visible evidence of small areas (less than 10 percent) of surface
accumulation; or controlled space and accessed by maintenance
personnel only; or uncontrolled/unoccupied space.
_____(5)
High
*Visible evidence of widespread surface accumulation; or uncontrolled
space and easily accessed by occupants.
Water.
_____(0)
None
No water damage.
_____(1)
Minor
Visible water damage (less than 10 percent) of ACM.
_____(2)
Major
Visible water damage (greater than 10 percent) of ACM.
*Note: If any one or a combination of these criteria are met, assign the corresponding value and
line out the criteria that do not apply.
C-1
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