Asbestos Monitoring Report

ASBESTOS MONITORING REPORT AND SERVICE AGREEMENT

Project Name:   Client Name:

Project Address:

Monitoring Period (Start):   Monitoring Period (End):   Report Date:

RECITALS

WHEREAS, Client Name: has retained Consultant Name: to perform asbestos monitoring and related air and bulk sampling services at the Project Address specified above; and

WHEREAS, Consultant will perform monitoring services in accordance with recognized industry practices, applicable occupational exposure criteria, and the Scope of Work set forth in this report and agreement; and

WHEREAS, the parties desire to document the results of monitoring activities and to set forth the terms and conditions governing performance, payment, confidentiality and legal remedies.

SCOPE OF WORK

MONITORING SUMMARY

Number of Samples Collected:   Sampling Methods: Bulk Air (PCM) Air (TEM) Visual/Clearance

SAMPLING RESULTS (SUMMARY)

Provide individual sample summaries. Attach laboratory reports for details.

Sample 1 ID:  Location:  Type:  Result:

Sample 2 ID:  Location:  Type:  Result:

Sample 3 ID:  Location:  Type:  Result:

Laboratory Summary:

AIR MONITORING AND CLEARANCE CRITERIA

Method Used:   Action Level / Clearance Criteria:

CORRECTIVE ACTIONS & RECOMMENDATIONS

CHAIN OF CUSTODY & ATTACHMENTS

Attachments Included: Laboratory report(s) Photos Full chain of custody

PAYMENT TERMS

Total Fee for Services: $

Late Payment Fee:   Billing Contact:

TERM AND TERMINATION

Service Commencement Date:   Service Completion Date:

Either party may terminate this Agreement for cause upon written notice specifying the nature of the breach. Termination for convenience by Client requires written notice of prior to the effective termination date. Upon termination Consultant will be paid for work performed and documented expenses through the termination date.

CONFIDENTIALITY

Consultant acknowledges that information provided by Client and data generated in the course of monitoring services may include confidential or proprietary information. Consultant will treat such information as confidential and will not disclose it to any third party without prior written consent of Client, except as required by law or to fulfill the obligations of sampling, analysis, laboratory reporting, or as required for health and safety compliance. This confidentiality obligation survives termination of this Agreement for a period of three years.

GOVERNING LAW

This Agreement and any dispute arising out of or related to the performance of services shall be governed by and construed in accordance with the laws of the state specified by Client in writing prior to commencement of services. The parties submit to the exclusive jurisdiction of the courts of that state for resolution of disputes.

ENTIRE AGREEMENT

This document, together with any attachments and laboratory reports expressly incorporated herein, constitutes the entire agreement between Client and Consultant with respect to the subject matter and supersedes all prior or contemporaneous agreements, proposals, negotiations, and communications, whether written or oral. Any amendment must be in writing and signed by authorized representatives of both parties.

CERTIFICATION

I hereby certify that the information contained in this Asbestos Monitoring Report is accurate to the best of my knowledge, that samples were collected and handled in accordance with applicable industry procedures, and that laboratory analyses were performed by accredited personnel. I further certify that corrective action recommendations are limited to those observations made during the monitoring events documented in this report.

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