Asbestos dutyholder and responsibility record

Enter the registered or commonly used name of the school.

Enter the address covered by this record. If the school occupies more than one site, identify the site covered here.

Select all arrangements that apply to the premises covered by this record.

Enter the date on which the information was prepared or last reviewed.

Enter the name and job title or role of the person completing or reviewing the record.

Enter the individual’s full name or the corporate body’s legal or operating name. Create a separate record entry for each dutyholder where responsibility is shared.

Select the type that best describes the dutyholder named above.

Provide a work telephone number, email address or service contact route that can be used to discuss asbestos management responsibility.

Describe the specific premises or access areas for which this dutyholder has responsibility. Include building names, blocks, floors, rooms, plant areas, grounds or shared access areas as applicable.

Select all bases that apply and explain the relevant arrangement in the following field.

Describe the agreement, lease, tenancy, ownership, control arrangement or other basis relied on. Include relevant parties, reference numbers, effective dates and any limits or exclusions that affect asbestos management responsibility. Do not use this field to assume responsibility where the arrangement has not been verified.

Select yes if another dutyholder also has responsibility for any premises, systems, activities or access arrangements covered by this entry.

If responsibility is shared or not yet established, identify the other individual or corporate dutyholders involved and describe the area or function connected with each. If responsibility is not shared, enter “None identified”.

List any asbestos management functions delegated by this dutyholder, such as maintaining records, arranging surveys, controlling access, coordinating work or communicating information. State who receives each function and any limits on the delegation. If none are delegated, enter “None”.

Where functions have been delegated, identify the named person or organisation, job title or service, and contact route. If no functions are delegated, enter “Not applicable”.

Describe how the suitability of training for staff with delegated asbestos responsibilities is established, recorded and reviewed. If no staff have delegated responsibilities, state that.

Describe who must be contacted when responsibility is unclear, information is missing, work may affect asbestos-containing materials, or an asbestos management concern cannot be resolved. Include names or roles, contact routes and any out-of-hours arrangement.

Describe how the arrangements, delegated functions and controls are checked, by whom, and how often. Include how issues, gaps or changes in responsibility are recorded and followed up.

Enter the date by which this responsibility record is planned to be reviewed, or the date required by the relevant local arrangement.

Record any uncertainty about dutyholder status, premises boundaries, contractual responsibility, delegated roles or escalation arrangements, together with the action needed and the person or organisation responsible for resolving it. If none, enter “None”.

Confirm only that the information entered in this record has been checked against the available responsibility, contractual, tenancy or control information. This confirmation does not determine legal responsibility where that has not been established.

• Tick when complete