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<br />Federal Register/Vol. 64."""". 178/Wednesday. September IS. 199V'les and Regulations 50231 <br /> <br />e <br /> <br />Appendix B-Sample Summary Risk <br />Assessment Notice F annat <br /> <br />Note: This following appendix will not <br />appear In the Code of Federal Regulations <br />Swnmary Notice of Lead-Based Paint Risk <br />Assessment <br />Addressilocation of property or structure(s) <br />this summary notice applies to: <br /> <br />~ paint risk assessment desa1ption: <br />Date(s) of risk assessment: <br />Summary of risk assessment results (check <br />all that apply): <br />(al _ No leed-based paint hazards were <br />found. <br />(b) _ Lead-based paint hazards were <br />found. <br />(c) _ A brief sumnwy of the findings of <br />the risk ossessment Is provided below <br />(required If any lead-based palnt hazards <br />were found). <br />Summary of types and JocationS of lead- . <br />a. besed paint hazards. Us! at least the housing <br />_ unit numbers and common aieas (for <br />multifamily housing). bare soil \ocattons. <br />dust-lead loc:atlons. and/or bu\ldIng <br />components (including type of room or <br />space. and the matet1al underneath the <br />patnt). and types of lead-based paint hazards <br />found: <br /> <br />Contact petson for more lnfannat10n about <br />the risk assessment: <br />Printed name: <br /> <br />Organtzatlon: <br /> <br />Street and city: <br /> <br />State: _ ZIP: _ Phone number. L.J <br /> <br />Person who prepared this sumnwy notice: <br />Printed name: <br /> <br />e <br /> <br />Signature: <br /> <br />Date: <br /> <br />Organization: <br /> <br />Street and city: <br />State: _ ZIP: _ Phone number: L...J <br /> <br />Appendix C-Sample Summary <br />Presumption Notice Fonnat <br /> <br />Note: The following appendix will not <br />appear In the Code of Federal Regulations <br />Notice That Lead.Based Paint or Lead-Based <br />Paint Hazards Are Presumed to be Present <br />AddresslJocation of property or structure(s) <br />this notice of presumption applies to: <br /> <br />Type of presumption (check all that apply): <br />(a) _ Lead.based paint Is presumed to be <br />present. <br />(b) _ Lead-based paint hazard(s) Is(are) <br />presumed to be present. <br />Summary of presumption. Us! at least the <br />housing unit numbers and common areas (for <br />multifamily houstng). bare soll1ocatlons. <br />dust.lead locations. and/or building <br />components (including type of room or <br />space. and the material underneath the <br />paint). and types oflead-based paint hazards <br />presumed to be present: <br /> <br />Contact petson for more information about <br />the presumption: <br />Printed name: <br /> <br />Organ_n: <br />Street and dty: <br />State: _ ZIP: _ Phone number. L.J <br /> <br />Person who prepared this notice of <br />presumption: <br />Printed name: <br /> <br />Signature: <br />Date: <br /> <br />Urganization: <br /> <br />A1TAC~e..Jr ~ <br /> <br />Street and city: <br /> <br />State: _ ZIP: _ Phone number: L-J <br /> <br />Appendix D-Sample Hazard <br />Reduction Completion Notice Format <br /> <br />Note: The following appendix will not <br />appear in the Code of Federal Regulations. <br />Summary Notice of Completion of Lead- <br />Based Paint Hazard Reduction Activity <br />Addressilocatioifef property or structure(s) <br />this summary notice applies to: <br /> <br />Summary of the hazard reduction activity: <br />Stan and completion date(s): <br /> <br />Activity locations and types. Ust at least the <br />housing unit numbers and common areas (for <br />multifamlly housing). bare soli locations. <br />dust-lead locations. and/or building <br />componerus (including type of room or <br />space. and the material underneath the <br />paint). and types of hazard reduction <br />activities performed at the locations listed: <br /> <br />Date(s) of clearance testing and/or soil <br />analyses: _ <br />Locations of building components with lead. <br />based paint remaining In the rooms. spaces <br />or areas where ai:tlvltles were conducted: <br /> <br />Swnmary of results of clearance testing and <br />soli analyses: <br />(a) _ No clearance testing was <br />perfonned. <br />(b) _ Clearance testing showed <br />clearance was achieved. <br />(e) _ Clearance testing showed clearance <br />was not achteYed. <br /> <br />Contact person for more Information about <br />the hazard reduction: <br />PrInted name: <br />OrganIzatIon: <br />Street and dty: <br />State: _ ZIP: <br />Phone number. L..J <br />Person who prepared this summary notice: <br />PrInted name: <br />Signature: <br />Date: <br />Organl2atlon: <br />Street and city: <br />State: _ ZIP: <br />Phone number. L.J <br /> <br />(FR Doc. 99-23016 Filed 9-14-99: 8:45 am) <br /> <br />BILLING CODE 421o-32-P <br />