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Health and Safety

Executive

Control of Asbestos Regulations 2012 (CAR) regulation 9

Notification of asbestos work

*Is this a new notification or are you updating previously submitted details?

About you, the licence holder

Note: for addresses you must provide Address Line 1 or 2, Town and postcode at minimum

(eg building name)

(eg street)

(eg district)

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To improve the management of licensed asbestos work through auditing by the asbestos industry, HSE may share

limited data provided on the ASB5 form with trade associations and relevant bodies. The data shared will be limited to: name of licensee, licence expiry date, site location, dates of work, nature of work.


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Health and Safety

Executive

Notification of asbestos work

Job details

Who are you contracted to?

Contact

Main site address where asbestos work is to be carried out

Note: for addresses you must provide Address Line 1 or 2, Town and postcode at minimum

(eg building name)

(eg street)

(eg district)

*Multiple site addresses?

Local authority area

Person preparing plan of work

Name

Site supervisor

Name

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Health and Safety

Executive

Notification of asbestos work

Job details (continued)

Timing and duration of work

*Does this notification

require a waiver?

*Will there be night working?

*Will there be weekend working?

*Will there be a significant cessation / pause during the asbestos work?

About the work

*ACM Type (choose all that apply)

*Work to be undertaken (you must choose at least one)

*General condition of asbestos material

*The main type of asbestos (you must choose at least one)

*Number of persons employed per shift:

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Health and Safety

Executive

Notification of asbestos work

Control measures and risks

*What combination of control measures will be used to reduce exposure as low as is reasonably practicable?

*How will the work be supervised and monitored? (you must choose at least one)

*Are there any non-asbestos risks that make the

asbestos work more difficult?

(e.g. work on or in proximity to hot surfaces, work near live electrical installations, restricted working space, overhead removal, working at height)

*Is the asbestos removal taking place on special premises? (Nuclear licensed site, Offshore platform, Railway premises)

Other licensed asbestos holders

*Are other licensed asbestos holders involved in this work? ( eg: scaffolders, supervisory licence holders)

If Yes, insert the name of each asbestos licence holder and click Add to include them in the list.

*Who is the enforcing authority?

Authorisation

Notified by

Please check your email address below. Ensure that you change if incorrect as this is the email address that your acknowledgement and a copy of the form will be sent to.

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