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Federal Register/Vol. 64, .8/Wednesday, September 15, 199f and Regulations 50231 -- Date:Street and dry. Organization: __ Sute: _ Z1P: _ Phone number, U Street and city. Appendix D—Sample Hazard State: _ ZIP: _ Phone number: L-J 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 Assessment Notice Format Now This following appendix will not appear in the Code of Federal Regulations Summary Notice of Lead -Based Paint Risk Assessment Address/location of property or structures) this summary notice applies to: Lead -based paint risk assessment description Date(s) of risk assessment Summary of risk assessment results (check all that apply): (a) _ No lead -based paint hazards were found. (b) _ Lead -based paint hazards were found. (c) _ A brief summary of the findings of the risk assessment is provided below (required if any lead -basest paten hazards were found). Summary of types and locations of lead- - .based paint hazards. List at least the housing unit numbers and common areas (for multifamily housing). bate 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 found: Now The following appendix will not appear in the Code of Federal Regulations Notice That Lead -Based Paint or Lead -Based Paint Hazards Are Presumed to be Present Address/location of property or structures) this notice of presumption applies to: Type of presumption (check all that apply): (a) _ Lead based paint is prestued to be present (b) _ Lead -based paint hazards) is(are) presumed to be present. . Summiry of presumption. List at least the housing unit numbers and common areas (for multifamily housing). bare soil locations. dust -lead location. and/or building components (including type of room o space, and the material underneath the paint), and types of lead -based paint hazards presumed to be present: Based Paint Hazard Reduction Activity Address/locatiorief property or suticture(s) this summary notice applies to: Summary of the hazard reduction activity. Stan and completion date(s): Activity locations and types. List at least the hawing unit numbers and common areas (for multifamily housing). 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 hazard reduction activities performed at the locations listed: Date(s) of clearance testing and/or soil analysex — Locations of building components with lead - based paint remaining in the roomsspaces or areas where activities were conducted: Contact person for more information about the presumption Printed nanne: l)tganization: Contact person for more information about - the risk assessment: Street and city. Printed rant - State: _ZIP: _ Phone number. C--) Organization: Person who prepared this notice of Street and city. presumption: Printed name: • State: _ ZIP: _ —Phone C Sig Person who prepared this summary notice: Date: Printed name: Organi'ation Summary of ninths of clearance testing and soil analyses. (a) _ No clearance testing was performed- (b) _ Clearance testing showed clearance was achieved. (c) —Clearance testing showed clearance was not achieved - Contact person for snore information about the hazard reduction: Printed cane: Organization: Street and city. State: _ ZIP - Phone ntnnber.(_) Person who prepared this summary notice: Printed cane: Signature: Date= Organization Street and city: State: _ ZIP: Phone nuunber. IFR Doc. 99--23016 Filed 9-14-99; 8:45 aml 13' nG coot �toaz-e A-(lACitme>` 3