Facilities Management

Asbestos Notification

The College under California Health and Safety Code Section 25915, et seq., is required to notify each employee, tenant and contractor regarding asbestos containing materials ("ACM").  This signed and dated form will acknowledge receipt of the Asbestos Notification memorandum.

The purpose for this notification is to alert you to material and surfaces that must not be disturbed in any way.  The following acts should not involve Asbestos-containing material: nails, anchors, drilling holes, removal of pipe insulation, and damage by foreign objects.  If you need to modify a surface or object identified in this report as containing Asbestos or if you have any questions regarding this notification, please contact Dale Withers, Director of Facilities, at 965-7150.

*indicates a required field

Name


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Agreement


*I verify that I have read and understand the Asbestos Containing Materials document posted above. You must have read and understood the document. If you have not read this document you should not submit this form.