Site Paperwork and Certificate/s for the Air Monitoring of Asbestos Fibres At ANY SITE ANY STREET ANY TOWN ANY DISTRICT ANY CITY ANY POSTCODE.

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1 Site Paperwork and Certificate/s for the Air Monitoring of Asbestos Fibres At For Job No: Date/s: GBNS Partnership Limited 2 Great Wincey Farm Brent Hall Road Finchingfield Essex. CM7 4JZ T: F: E: consultant@gbnsasbestos.co.uk W: Company Reg. No: GBNS/ LF039/ REV05/SAJ

2 Statement of Cleanliness. Job No: Air Test Report No: T Date: Page 1 of 3 Area to be assessed: ANY AREA Name of contact who confirmed site is clean and dry: SITE SUPERVISOR Preliminary check of site condition and job completeness. Brief description of Asbestos remedial work undertaken: REMOVAL OF TEXTURED COATING TO THE CEILING Any Comments, Amendments or Asbestos remaining. Disclaimer: Samples of less than 480 litres are reported but not covered by UKAS accreditation. Declaration of Visual Inspection to work area. I have checked that textured coating was removed and the area was cleaned thoroughly. I inspected the work areas to make sure that there were no visible traces of dust or debris. Finish Time: 12:00 Duration of visual inspection: 15 Mins. Assessed by: Reassurance air monitoring of the work area following completion. No. of pumps used in area: 2 This area is SAFE to be returned to normal use. See attached Air test Report Certificate and Drawings for Fibre Concentration Results: T Time: 13:30 Assessed by: Declaration of Site Representative. Print Name Signed I have received and checked all paperwork and understand that the area is SAFE to be Returned to normal use. Date of Completion: Name of Analyst: Analyst Signature: GBNS/ LF073/ REV02/SAJ

3 Air Test Report Certificate Job No: Weather Conditions: Microscope Ref: Apparent Graticule Diameter: Time Piece Ref: Site Lab Location: Sample Number Type Code TP08 Area to be Assessed on Site: Start / End Time MS µm Barometer Ref: Start / End Flow Rate Air Test Report No: T Date: Page 2 of 3 NPL Test Slide Ref: Stage Micrometer Ref: MOBILE LAB ANY AREA SUNNY Sample Time (mins) BAR01 Sample Vol (ltrs) Site Conditions and Equipment Used S12-01 Flow meter Ref: Exposed Filter Dia. (mm) Site Temperature: Site Pressure: Type Code: NPL Test Slide Block 5 Seen: Results No. Fibres Counted Thermometer Ref: HF01 Graticule Areas Counted C - Clearance R - Reassurance Calc. Fibres (f/ml) YES TH02 o C mb Date Samples Taken: Date Samples Counted: P - Personal B - Background Detection Reported Limit (f/ml) Conc. (f/ml) Flow rate Correction required: Field Blank Number: ABC1234 L - Leak S - Site Lab Test Sample Location NO R R 12: : : : < <0.01 Sample Point 1 Sample Point END COMMENTS: CONCLUSION Samples taken and fibres counted as specified in HSG248, for which this lab is accredited, at the time were found to be - DISCLAIMER Smoke test witnessing and leak samples less than 480 litres are reported but not covered by UKAS accreditation. SATISFACTORY Name of Analyst: Signed: Date: GBNS/ LF062a/ REV14/SAJ

4 Sample Location Drawing Sheet. Job No: Air Test Report No: T Date: Page: 3 of 3 Area to be assessed on Site: ANY AREA Works Carried Out: REMOVAL OF TEXTURED COATING These Drawings are for guidance purposes only to identify the approximate location from where the samples Enclosure Size: 25 m2 were taken, and are not to scale. Sample Approximate enclosure dimensions in metres. Head END H: 2.5 W: 5 L: 5 Pump Sample Location Transit / Waste Route * Enclosure / Area Airlocks Key NPU Decom Unit D Skip / Waste Van S Name of Analyst: Signature: Date: GBNS/ LF062b/ REV15/SAJ

5 Photo Sheet Job No: Air Test Report No: Location on Site: ANY AREA T Date: Page 1 of 1 Area prior to works undertaken Area after works complete Name of Analyst: Signature: Date: GBNS/ LF062c/ REV11/SAJ