University of Colorado

Department of Environmental Health & Safety

Notification of Asbestos & Lead Paint Operations and Maintenance

Work Order #:
Name:
Phone Number:
Email Address:
Supervisor:
Supervisor Phone Number:
Supervisor Email Address:
Requested Start Date: Anticipated End Date:
Building: Room Number(s):
Description of Work:
Description of asbestos containing material that may be affected (include location, type, and quantity):
NOTE: Notification form must be submitted for all Asbestos maintenance work. Maintenance on areas larger than three (3) square or three (3) linear feet, or more than one small bag of asbestos material cannot begin before receipt of approval from EH&S Absestos Office.