REBUILDING TOGETHER O.C. 5 - 2002

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Federal Register/Vol. ~o. 178/Wednesday. September IS. 19"-"Rules and Regulations 50231 . Appendix B-Sample Summary Risk Assessment Notice Format Note: This following appendix will not appear In the Code of Federal Regulations Summary Notice of Lead-Based Paint Risk Assessment Addressllocation of property or structure(s) this summary notice applies to: Lead-based paint risk assessment desaiption: Date(s) of risk assessment Summary of risk assessment results (check all that apply): (0) _ No lead-based paint hazards were found. (b) _ Lead-based paint hazards were found. (cl _ A brief swnmatY of the findings of the risk assessment Is provided below (required If any lead-based paint hazards were found!. Summary of types and locations of lead- . ... based paint hazatds. Us! at least the housing ., unit numbers and common aieas (for multifamily housing). bare soU locations. dust-lead locations. and/or building components (including type of room or space. and the material underneath the paintl. and types of lead-based paint hazards found: Contact person for more information about the risk assessment Printed name: Otganizatlon: Street and city: State: _ ZIP: _ Phone number. L-J Person who prepared this summary notice: Printed name: e Signature: Date: Organization: Street and city: State: _ ZIP; _ Phone number: L-J Appendix C-Sample Summary Presumption Notice Format Note: The following appendix will not appear In the Code of Fedend Regulations Notice That Lead-Based Paint or Lead-Based Paint Hazards Are Presumed to be Present Addressllocatlon of property or structure(s) this notice of presumption applies to: Type of presumption (check all that apply): (0) _ Lead-based paint is presumed to be present. . (bl _ Lead-based paint hazan:I(s) is(are) presumed to be presenL Summary of presumption. Us! at least the housing unit numbers and common areas (for multifamily housing). bare soU 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 presumed to be present: Contact person for more information about the presumption: Printed name: Organization: Street and city: State: _ ZIP: _ Phone number. L-J Person who prepared this notice of presumption: Printed name: Signature: Date: "Organtzati?n: A1TAC~e>0l 3, Street and dty: State: _ ZIP: _ Phone number: L-J Appendix D-Sample Hazard Reduction Completion Notice Fonnat Note: The following appendix will not appear in che Code of Federal Regulations. Swnmary Notice of Completion of Lead- Based Paint Hazard Reduction Activity Addressllocatiofr13f property or structure(s) this summary notice applies to: Summary of the hazard reduction activity: Start and completion date{s): Activity locations and types. List at least the housing unit numbers and common areas (for multifamily housing). bare soil locations. dust-lead locations. and/or buUdlng components (indu<ii;ng type of room or space. and the material Wldemeath the paint). and types ofhazatdreductlon activities perfonned at the locations listed: Date(s) of clearance testing and/or soli analyses: _ LocatIons of building components with lead- based paint remaInIng In the rooms. spaces or areas where ai:tlvitles were conducted: Summary of results of clearance testing and soli analyses: (al _ No clearance testing was performed. (b) _ Clearance testing showed clearance was achieved (e) _ Clearance testing showed clearance was not achieved. Contact. person for more Infonnation about the hazard reduction: Printed name: Organization: Street and city: State:_ZIP: Phone number: ~ Person who prepared this swnmary notice: Printed name: Signature: Date: Organization: Street and city: Stall!: ZIP: Phone number: ~ IFR Doc. 99-23016 FUed 9-14-99: 8:45 amI BIUJNG COOE 421D-32-P