Asbestos Notification Form
Complete form has to be at OHSA, Chemical Section (email: chemicalagents.ohsa@gov.mt) prior to the commencement of any work related to Asbestos or of material containing Asbestos subject to Regl. 3(2) of LN 323/2006
For OHSA use ONLY
File Number
Name and Surname
(that requested Asbestos work to be carried out)
MFSA Company Registration Number
Address of Site
(where Asbestos work will be carried out)
Details of Company / Person responsible for Asbestos work engaged by Client
(details in page 1)
Company Name or
Name of responsible Person
Company MFSA Reg. Number or
ID Card Number of responsible Person
Please indicate if any Asbestos work was subcontracted to third parties
If above reply is "YES", please insert details in Point a) and b) respectively otherwise insert "N/A"
a) Company Name or
Name of responsible Person
b) Company MFSA Reg. Number or
ID Card Number of responsible Person
Name and ID Card Number of Person supervising the Activity
Commencement Date of Work
Please confirm that workers are fully informed and trained in a manner that is suitable and sufficient to satisfy the obligations of LN 323/2006
Expected duration of Works (in full days)
Maximum number of persons employed in the work at any one time
PA Asbestos Disposal Permit Number
(attach copy of PA Authorisation)
Exact Address / Location (or Department) from where Asbestos work will be carried out
Estimated quantities (cubic m)
Estimated quantities (cubic m)
Estimated quantities (cubic m)
Activity of Work involved
These work methods should be avoided.
If any of the below are ticked, justification must be included in a separate note.
Specific reference to control measures must be included in the Plan of Work (next page)
Please attach a copy of the Plan of Work (as per Section 11 of LN 323/2006)
Document Reference Number
Please attach a copy of the Assessment of Risk (as per Section 3 of LN 323/2006)
Document Reference Number
Applicant's Declaration
hereby certify that the information shown within this Notification Form is correct to the best of my knowledge as given today
Prior to the commencement of any work related to asbestos or of material containing asbestos subject to Regl. 3(2) of LN 323/2006, the completed form has to be at OHSA, Chemical Section
(email: chemical@ohsa.mt)
The Data Protection Act XXVI, 2001 requires that the Occupational Health and Safety Authority (OHSA) informs you that this form may include information about you (this is called 'personal data' in the Act) and that we are a 'data controller' for the purposes of this Act.
OHSA will process the data for health and safety purposes. OHSA may disclose the data to any person or organisation for the purposes for which it was collected or where the Act allows disclosure.
As data subject, you have the right to ask for a copy of the data and to ask for any inaccurate data to be corrected.