The DHEC 3422 form serves as a critical document for entities seeking a Group License in the asbestos sector. It is meticulously structured to capture essential details, beginning with basic organizational information such as the company name, mailing, and street addresses. It also requires the identification of the company official and their title, along with contact information, to ensure clear and direct lines of communication. Intricately linked to workforce management, the form delves into specific personnel details, including names, social security numbers, and disciplines, alongside their training outcomes marked as pass or fail, with corresponding training providers, instructors, and exam dates. This meticulous documentation underpins the form’s intent to regulate and oversee asbestos-related activities safely and responsibly. Additionally, it outlines a tiered fee schedule based on the number of personnel involved, starting from a minimum fee for up to 10 people and increasing incrementally, aimed at making the licensing process scalable and financially structured for groups of various sizes. The completion and signing of this form signify an important step towards compliance with regulations governing asbestos management, highlighting its crucial role in safeguarding public health and ensuring the integrity of asbestos management practices.
Question | Answer |
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Form Name | Form Dhec 3422 |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | d 3422 dhec asbestos section form |
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Application Form For Group License |
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Asbestos Section |
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1. Company Name: |
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4. Group License Number: |
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2. Mailing Address: |
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5. Company Official: |
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6. Title: |
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(City) |
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(State) |
(Zipcode) |
7. Telephone #: |
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3. Street Address: |
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8. |
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(City) |
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(State) |
(Zipcode) |
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Name |
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SS Number |
Discipline |
(P)ass |
Training Provider/Instructor |
Exam Date |
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(F)ail |
(MM/DD/YYYY) |
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DHEC 3422 |
8/96 |
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Disciplines Under Group License
Class IV Worker Disturbing RACM |
O & M Worker |
Roofer Worker |
Roofer Supervisor |
AHERA Worker |
AHERA Supervisor |
Air Sampler |
Project Designer |
Building Inspector |
Mgmt. Planner |
Fee Schedule For Group License
up to 10 people |
$ |
25.00 minimum fee |
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11th to 20th person |
$ |
2.50 |
per person |
21st to 50th person |
$ |
5.00 |
per person |
51st to 90th person |
$ |
7.50 |
per person |
91st or more persons |
$500.00 maximum fee |
Name
SS Number
Discipline (Pass/Fail)
Training Provider/Instructor Exam Date
10.Total Fee Due:
11.Signature: