2007 Asbestos Hazard Emergency Response Act (AHERA) Triennial Reinspection Report

Asbestos Hazard Emergency Response Act (AHERA)
Triennial Reinspection Report
* = Required Field

1.	Name of School District or BOCES *
2.	Building Name *	40 character limit - Building Name
3.	SED Control Number (Bldg ID) *	4 digits with no hyphen D Control Number
4.	Street Address of Building *	40 character limit - Building Name


The completed 2007 AHERA Triennial Reinspection Report is correct and the responsibilities of the local education agency have been met, pursuant to 40 CFR §763.
LEA Asbestos Designee Name *	40 character limit - Building Name
Email Address *	40 character limit - Building Name
Telephone Number *	40 character limit - Building Name

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	Assurances of AHERA Documentation (40 CFR §763)
I.	An individual has been designated and trained to ensure that 40 CFR §763 is properly implemented pursuant to §763.84(g). *
	Yes No

II.	The actions of all individuals, who carry out asbestos inspections, reinspections, and periodic surveillance, develop and update asbestos management plans, and develop and implement response actions are performed pursuant to 40 CFR §763. *
	Yes No

III.	All custodial and maintenance staff are trained in accordance with §763.92 and all other applicable federal and/or State regulations. *
	Yes No

IV.	A detailed description of steps taken annually to notify all workers and building occupants, or their legal guardians, regarding asbestos inspections, response actions, post-response action activities, including reinspections and periodic surveillances, are included in the asbestos management plan (§763.93(e)(10)). *
	Yes No

V.	Short-term workers, such as utility workers, are provided with information indicating the locations of known and assumed asbestos containing building material (ACBM) (§763.84(d)). *
	Yes No No known or assumed ACBM present in this building

VI.	Warning labels identifying known and assumed ACBM are posted in routine maintenance areas, such as boiler rooms. (§763.95). *
	Yes No No known or assumed ACBM present in this building

VII.	A periodic visual – six month surveillance of all known and assumed ACBM is conducted at least once every six months and documented in the asbestos management plan (§763.92(b)).*
	Yes No No known or assumed ACBM present in this building

VIII.	The plan includes detailed information on all asbestos abatement response actions and activities, including the location of the response action; start and completion dates; names, addresses, signature, and credentials of all asbestos abatement contractors; and the name, signature, and accreditation of each person performing the activity (§763.94)).*
	Yes No No known or assumed ACBM present in this building

IX.	If ACBM was removed, the name and location of the approved disposal site is documented in the plan. (§763.94). *
	Yes No

X.	The LEA has and will consider whether any conflict of interest may arise from the interrelationship among certified personnel and whether that should influence the selection of certified personnel to perform activities under 40 CFR §763. *
	Yes No