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Federal Register/Vol. 64, .8/Wednesday, September 15, 199! r and Regulations 50231 Dale: Street and dty ' ~ Organization: _ State: _ ZIP: _ Phone number. ~~ Street and city. Appendix D-Sample Hazard State: _ ZIP: _ Phone number: (_, Reduction Completion Notice Forma[ Nolc The following appendix will not Appendix C-Sample Summary appear in the Code oC Federal Regulations. Presumption Notice Fot-mat - Summary Nonce of Completion of Lead- Appendix B-Sample Sttmmary Risk Note: The following appendix wi11 not Based Paint 1{azard Reduction Activity Assessment Notice Format appear in the Code of Federal Regulations Addrus/ltxatiorl'Bf property or swdure(s) Note This following appendix wilt not Notice That Lead-Based Paint or Lead-Based this summary rotice applies to: appear inihe Code of Federal Regutatiorss paint ]iazards pro presumed to be Present Stmtnwy Notice of teal-Based Paint Risk Address/Iootion of property or srtuaure(s) Assessment Address location of property or structure(s) this nonce of presumption applies to: Summary of the hazard reduction activity. this summary nonce applies to: Start and completion date(s): Activity locations and types. Ilu at least the Type of presumption (check all that apply): hawing emit numbers and common areas (ftx (a) ,Lead-based paint is presumed to be multifamily Iwusittg). bare soil lncauotts. tee-based t risk assessment desai s l~ ~ present dun-lead loratioru, and/or building Date(s) of t Wt assessment lb) _ Lead-based paint hazard(s) Is(are) cornponems (Including type of room or Stanmary oCrisk assessrttent rrurlts (dick preseuned to be present space. and the material untiemeath the all that apply): Stmunazy of presumption. liu az least the paint). and types oC hazard redution (a) _ No lead-based patr# hazards were housing uNt numbers and common areas (for activities performed az tite lootiorss listed: found multifamily houslttg), bare soil lootioru, (b) _ Lead-based paint hazards were dust-lead locatioru, and/or building found. components (indud6tg type of loom w (e) _. A brMtsuntmary oC the findings of space, and the material underneath the the rLsk assessment is provided blow paint). and types of lead-based paint hazards (requbed Y arty lead-based paint ttamrtis presumed to be present were fotmiQ. Date(s) of dearartce testbtg and/or soil Stmunary ~ types and locations o[ lead- - . based pairK hazards. List at least the housing Lor ti u of building components with lead- urdt nturtbe[s and contmwt areas (for multifamlly housing). bare soil locations, based palm remaining in the rooms. spaces dust-lead locauorts and/or building or areas where activities were conducted: components (utduding type of room or span, and the material urxMirteath the paint). and types of lead-based paint hazards - touttd Summary of results of dearance testing and soil analyses: (a) ^ No clearance testing was performed. - (b) _ Clearance testing showed clearance was atltleved (c) _ Cltatarxe testing showed dearaoce Contatt person for more information about was not achieved the presumption Corttau person for mae information abom Printed name the hazard reduction: Printed name: lhg:mizauon Cganization: . Contact. person Ctx Hare information about Street and dry. - ~ the risk assessment Street and dry. S~-, yam; Printed name: Phone number. (_,~ - State: ~ ZIP: _ Phone number. (_) Person who prepared this summary notice: Organization Printed name: Person who prepared this nonce of - Signature: Sweet and dry. presumption: Date: Printed name: Organization State: _ 21P: _ phone number. (_, Street and dty. Signature: Scare: gyp: Person who prepared this sutntltary notice: Date: _ Phone ntunber. ( , Printed name: _ Organization lFR Doc 99-23016 Filed 9-14-99: 8:95 amj . Signature: - otttx+c coos azto-az-r Ana~k~tEt,~f- 3