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1 Federal Register/Vol. 64, 178/Wednesday. September I5. 199E Iles and Regulations 50231 Date: Street and city. . Organization: State: _ ZIP: _ Phone number. L- . Street and city. Appendix D—Sample Hazard State: _ZIP: _Phone number: U Reduction Completion Notice Format Note: The following appendix will not Appendix C—Sample Summary appear in the Code of Federal Regulations - Presumption Notice Format Summary Notice of Completion of Lead - Appendix B—Sample Summary Risk None: The following appendix will not Based Paint Hazard Reduction Activity Assessment Notice Format appear in the Code of Federal Regulations Addressnooatiolrof property or structure(s) Note: This followin appendix will not g ppend Notice That Lead -Based Paint or this summary notice applies to: ' appear in the Code of Federal Regulations Paint Hazards Are Presumed to be Present Summary Notice of Lead -Based Paint Risk Address/location of property or structtue(s) Assessment this notice of presumption applies to: Summary of the heard reduction activity. Addressnocetion of property or structure(s) Stan and completion date(s): this summary notice applies to: - Activity locations and types. List at least the -yared paint description: e Stmtmary of risk assessment results (check all that apply): (a) No lead -based paint hazards were (b) _ Lead -based paint hazards were found. (c) _- A brief sum inary of the findings of the risk s provided below (required -based paint hazards were ftnn4. Summary of types and locations of lead - based paint hazards. List at least the housing unit numbers and common areas (for mulifamily housho. bare soil locations. dust -lead locations, and/or building components (including type of room or space, and the material underneath the paint). and types of lead -based paint hazards fond: Contact person for more inft cation about the risk assessment: Printed name: Type of presumption (check all that apply): (a) _ Lead -based paint is presumed to be present. (b) _ Lead -based paint hazard(s) is(are) presumed to be present. Summary of presumption. last at least the housing unit numbers and common areas (for multifamily housing). bare soil locations. dust -lead locations, and/or building components (including type of room or spam and the material underneath the paint), and types of lead -based paint hazards presorted to be present housing unit numbers and common areas (for multifamily housing), bare soil locations. dim -lead locations, and/or building components (including type of room or space. and the material underneath the paint). and types of hazard reduction activities performed at the locations listed: Date(s) of clearance testing and/or soil analyses — Locations of building components with lead - based paint remaining in the rooms. spaces or areas where activities were conducted: - Summary of results of clearance testing and - soil analyses: (a) _ No clearance testing was performed. (b) _ Clearance testing showed clearance was achieved- (C) _ Clearance testing showed clearance Contact person for more information about was not achieved' the presumption: Printed name: . Organization Street and city. State: _ ZIP: _ Phone number. U Contact person for more information about the hazard reduction: Printed name: Organization: Street and city. State: _ 23P: Phone number: U Person who prepared this summary notice: Organization: Printed name' Person who prepared this notice of Signature: Street and city. presumption Date: Printed name'. Organization: State: _ ZIP: _ Phone number. U Person who prepared this summary notice: Primed name: . Signature: Street and city - signature: State: _ ZIP: Date: Phone number. U Organization: (FR Doc 99-23016 Filed 9-14-99; 8:45 am) BRLRJG CODE tate-a2-e - AtrActtmeN5r- 3