Asbestos Inspection Report Form
Site ID
Original Inspection Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Re-inspection Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Adress
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Structure
Structure ID
Structure Type
Structure Purpose
Structure Comments
Materials
Material ID
Material Type
Material Description
Material Quantity
Material General Comments
Material Condition Rating
1
2
3
4
5
6
7
8
9
10
Water Damage Rating
1
2
3
4
5
6
7
8
9
10
Exposed Surface Area Rating
1
2
3
4
5
6
7
8
9
10
Accessibility Rating
1
2
3
4
5
6
7
8
9
10
Activity and Movement Rating
1
2
3
4
5
6
7
8
9
10
Friable Rating
1
2
3
4
5
6
7
8
9
10
Asbestos Content Rating
1
2
3
4
5
6
7
8
9
10
Hazard Ranking
1
2
3
4
5
6
7
8
9
10
Priority Level
1
2
3
4
5
Removal Details
Removal Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Contractor Name
Manufacturer
Was a sample taken?
Yes
No
Sample ID
Received Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Analysis Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Any Further Information About Asbestos Inspection
Submit
Should be Empty: