New Jersey Department of Health

Consumer, Environmental and Occupational Health Service

Environmental and Occupational Health Assessment Program

P. O. Box 369, Trenton, NJ 08625-0369

ASBESTOS MANAGEMENT PLAN - HOMOGENEOUS MATERIAL IDENTIFICATION	FOR STATE USE ONLY
Building Assessed

Homogeneous ID No.

Sampled

Assumed	Homogeneous ID No.

Sampled

Assumed	Homogeneous ID No.

Sampled

Assumed	Homogeneous ID No.

Sampled

Assumed
Description of Material	Description of Material	Description of Material	Description of Material
List All Locations	List All Locations	List All Locations	List All Locations
Total Footage

Total Footage of Damage

% Damage of Total

Total Footage

Total Footage of Damage

% Damage of Total

Total Footage

Total Footage of Damage

% Damage of Total

Total Footage

Total Footage of Damage

% Damage of Total

Damage Severity *

Major	Minor

Severe	Occasional	Damage Severity *

Major	Minor

Severe	Occasional	Damage Severity *

Major	Minor

Severe	Occasional	Damage Severity *

Major	Minor

Severe	Occasional

ASB-8

MAR 13	* See Instructions.

F

ASB-8 New Jersey State Department of Health _____________________________________________

Elaine White

2004-12-20

ewhite

NJDHSS