Asbestos Program Forms

  • PDF Form 1*
    Application for an initial or the renewal of licensed asbestos business entities; or for the waiver of entities not primarily engaged in asbestos projects.

  • PDF Form 2
    Form to waive specific requirements established in Department regulations, or to request an alternative work practice.

  • PDF Form 3*
    Application for initial asbestos occupation licensure and limited occupation licensure.

  • PDF Reinstatement*
    Application for reinstatement to practice an asbestos occupation: for revoked, expired, inactive, lapsed, or the voluntary surrender of licenses without disciplinary action.

  • PDF Form 4*
    Asbestos occupation medical examination form, to be filled out by the MD performing the individual's physical exam.

  • PDF Form 5
    Asbestos project notification form.

  • PDF Nebraska Asbestos Waste Shipment Report Form*
    Form to be filled out by the contractor, facility, or operator who generates asbestos waste.

  • PDF NESHAP
    Form for the notification of a demolition or renovation project; may be used in lieu of Form 5. Needs to be filed, regardless of the presence of asbestos.

  • NESHAP Notification Database
    Search for current NESHAP projects by county notified to NDEQ.

  • PDF Form 5A
    Supplemental form to accompany the NESHAP, in lieu of submitting Form 5.

  • PDF Form 6*
    Application for asbestos occupation training course approval.

  • PDF Form 7*
    Form to request a waiver of a license in order to perform an emergency asbestos project.

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*Forms may be completed online, however, they cannot be submitted via email due to the fact they require original signatures. If you complete the form online, it must be printed and mailed to the appropriate department for processing.

Forms 2, 5, 5A and the NESHAP may be scanned and emailed to Shelley Ball, faxed, mailed or hand-delivered.

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PO Box 95026, Lincoln, NE  68509-5026
402-471-0386 Toll Free 888-242-1100, Ext. 1 (NE only)
Fax 402-471-5026

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Asbestos Program Page

Environmental Health Program