ANAHEIM INTERFAITH SHELTER - 2003

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Federal Register/Vol. 64, :178/Wednesday, September 15, 199( Iles and Regulations 50231 • Appendix &-Sample Summary Risk Assessment Notice Format Note: This following appendix will not appear in the Code of edetal Reguladotu Sumrnaty Notice of Lead-Based Paint Risk A~ment Address/location of property or structure(s) this summary notice applies to: Date; Street and city. Lad-based paint risk assessment derrtption: Date(s) of risk aaessnuitt: Stmnnaty of risk assessment resula (check all that apply): ~dNo lead-baxd print hazards were rol _ Leadbasedtabnhazataawere brief summary of the P~ hazazds were tottna. Sumrmry oE•type and locations of kmd- lurdtnu~mhersemnrttortmtn~s(for g multifamily hotrsttrg). bare soil lotxdons. dusFIead leodons, and/or buffding cattponents (inclttdtng type of room or space. and the marital underneath the and types of lad-based paint hazards Cottatt person for mere trifOtmatlort aban . the tt5k assessment: Printed name: Orgardzedom Street and city: State: _ ZIP; _ phone number. (~ Person who prepared this summary notice: Printed name: __ __ _ _ • Signature: Organization: State: _ ZIP: _ Phone number: (_) Sreet and city: Appendix D-Sample Hazard State: _ ZIP:._ Phone number: (_, Reduction Completion Notice Format Note: The following appendix will not Appendix C-Sample Strmmaty appear to the Code of Federal Reguladons. Prestrmption Notice Forrrtat Summary Notice of Completion of Lad- Note:The followingappendix will not Based Paint Hazard Reduction Attivity appear in the Code of Federal Reguladons Address/locedoifbf property or structure(s) Notice That Lead-Based Paint or lead-Bawd ~~ ' nonce applies t°' Paint Hazards Are Presumed to be Present Address/locetion of property err strutture(s) this notice of presumption applies to: S f h utnmary o the azard teducdon attivlty. Stan and completion date(s): Atttvity loranons and types. List at least the Type of p~rsumpdan (check all that apply): housing unit numbers and wmtnon areas (for (a) _ Lead-based paint is presumed to be mtdtlfamily housing), bare soil locettons. present ~ dust-lead lotadotss. and/or building (b1 ~ Lad-based paint hazard(s) is(are) oomponeris (including type of room or presumed m be present space, and the material undemath the Summary of presumptlon. List at least the paint), and types of hazard reduclon housing unit numbers and common areas (for actlvttia perfottned ac the locations listed; mukifamity housitrg). bare soil loradorts. dust-lead locedons, and/or building mmpottertts (including type of room or ' space. arxt the material underneath the paint), and types oflead-based paim hazards presumed ro be present: Contact parson for more information shout the presumptlon Printed name: Cngattizatton; Street and city: State: =2[P: _, Phone number. (_~ Person who prepared this nonce of presumpdon: Printed name: Signature: Date: _ 'Orgartlzadom Dace(s) of deatance testlngand/or soil. analyses _ l.ocetlons of building componentswithlead- based paim remaining in the rooms, spaces or areas where a~[iviries were conduced: Summary of taints of clearance testing and soil analyse: (a) ~No clearance tesdrrg was performed. (b) _ garance testing showed clearance was achieved. (rJ _ Clarattce testing showed Neatattce was trot atideved Cotrtatt persar for more lnfotmation about the hazard reducion: Printed name OfgatltTAH011: Street and sty. State: _ Z~: Phone number, (~ Person who prepared this swnmary nottce: Printed name: Signature: Date: -__ Orgaztbadore Street and city. State: _ ZIP: Phone number: l_..,~ (FR Dom 99-23016 Filed 9-14-99; 8:45 am] aniwo coot: azto-az.•p grfactrntt~.sr- 3