Forms by Use by Asbestos Designated Persons / Program Managers
To assist asbestos program managers and AHERA designated persons in managing their responsibilities, the Institute provides a set of sample forms and documents. Forms specific to AHERA requirements for K-12 schools are marked DP.
Most documents are in Microsoft Word format so they can be completed electronically or modified for local use. If you do not have a copy of Microsoft Word, a downloadable free viewer is available. A few forms are in Microsoft Excel; a downloadable free Microsoft Excel viewer is available.
Checklists for Maintaining Compliance
- Sample Cover Sheet for Building-Specific Management Plans (DP)
- Memoranda to Purchasing Office:
- AHERA-Required Annual Notification Statements (DP):
- AHERA-Required Annual Notification Recordkeeping Form
- Notification and Information for demolition of buildings and structures (NESHAP Notifications).
Signs and Labels
All Trained Persons:
All Training Events:
Asbestos Designated Person:
Asbestos Awareness Training Initial:
Asbestos Awareness Training Refresher:
Asbestos O&M Worker:
Asbestos Licensed Persons:
Inspection and Surveillance Requirements
Requirements for Performing Routine Work
Organizing to ensure maintenance work is performed and recorded properly:
- Asbestos Work Order Form
- Form for Recording Asbestos O&M Work (DP; can use Work Order Form above as an alternative)
Respiratory Protection Program Forms:
- Respirator Fit Test Recording Form and Protocol
- Certification of Voluntary Respirator Use
- OSHA-Required Appendix D for Voluntary Respirator Use
- Notification Information and Forms for O&M Projects Exceeding the NESHAP Cutoffs (NESHAP Notifications)
Fiber Release Episode Requirements
Excluding Newly Constructed Facilities from Inspection Requirements
* These materials are copyrighted by the Environmental Management Institute or their issuing state. You may make as many copies as many as you need for your own use but they must not be used as training materials without the written permission of the Institute.