Fiber Release Episode Report




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.SV VERSION#="1.1" added version #, minor changes 05/02/2001 15:23:01

.SV VERSION#="1.11" made version # visible JEL 04/19/2002 17:23:34

Vers 1.2 Converted to WP file jw 9/24/04

Fiber Release Episode Report


1. Address, building, and room number(s) (or description of area) where episode occurred:

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2. The release episode was reported by ___________________________ on ____________ (date).

3. Describe the episode: ______________________________________________________

______________________________________________________________________________

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______________________________________________________________________________

4. The asbestos containing material was cleaned up by the following procedures:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

5. List personnel involved in cleanup:

______________________________________________________________________________

______________________________________________________________________________

Signed:_________________________________________________ Date:__________________

(Asbestos Program Manager)




Environmental Management Institute 82016



C:\RESOURCE\ASBESTOS\DES_PERS\FORMS\FIBR_REL.FRM.wpd


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