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Federal Regisler/Vol~, , 178/Wednesday, September 15,....,.ef des and Regulations 50231 e Appendix B-Sample Summary Risk Assessment Notice Format Note: This following appendix will not appear in the Code of Fedenll Regulations Summai)' Notice of Lead-Based Pabtt Risk Assessment Addressl1ocatlon of propertY or structure(s) this summaI)' notice applies to: Lead-based pabtt risk assessment descripllon: DateCs) of risk assessment: Summai)' of risk assessment results (check all that apply): (a) _ No lead-based pabtt hazards were found. (b) _ Lead-based pabtt hazards were found. (c) _ A brief summary of the findings of the risk assessment Is provided below (required If any 1ead-based pabtt hazards were found). Summai)' of types and \ocatIOIIS of lead- . .. based pabtt hazards. LIst at \eaSt the housing .. unit numbers and common oieas (for multlfaml\y housing). bare soil \ocatIons, dust-lead locatIonS. andlor bul1d1ng components (including type of room or space, and the materta1 underneath the paInt). and types of lead-based pabtt hazards found: Contact person for more Infonnadon about the risk assessment: Printed name: OtganIzatIon: Street and city: State: _ ZIP: _ Phone number. L-J Person who prepared this summary notice: Printed name: e Signature: Date: Organization: Screet and city: State: _ ZIP: _ Phone number: L-J Appendix C-Sample Summary Presumption Notice Format Note: The following appendix wl11 not appear In the Code of Federal Regulations Notice That Lead-Based Paint or Lead-Based Pabtt Hazards Are Presumed to be Present Addressl1ocation of property or structureCs) this notice of presumption applies to: Type of presumption (check all that apply): (a) _ Lead-based pairlt is presumed to be presenL . (b) _ Lead-based paint hazardCs) is(are) presumed to be presenL Summary of presumption. LIst at least the hOusing unit numbers and common areas (for multlfaml\y housing). bare soli locations. dust-lead locations. and/or building components (Including type of room or space. and the material underneath the pabttl. and types of lead.based pabtt 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: 'Organization: A"lTAC~~ ~ Street and dty: State: _ Z1F: _ Phone number: L-J Appendix D-Sample Hazard Reduction Completion Notice Format Note: The following appendiX wlll not appear In the Code of Federal Regulations. Summary Notice of Completion of Lead- Based Paint Haz,ard Reduction Activity Addressl1ocatio1f&f 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 soU locations. dust-lead locations. aneIIor buUdlng components (includi,ng type of room or space. and the matertal underneath the paInt). and types of hazard reduction actlvlties perfomted at the locations listed: Date(s) of clearance testing and/or soil analyses: _ Locations of bul\dIng components with lead- based paint remaining In the rooms. spaces or areas where aCtivities were conducted: Summary of results of c:\eanll1Ce testing and soli analyses: (0) _ No c:\eanll1Ce testing was perfomted. (b) _ Clearance testing showed cleanlnce was achIeVed. (c) _ Clearance testing showed clearance was not achieved. Contact person for more Information about the hazard reduction: Printed name: Organization: Street and city: State: _ ZIP: Phone number: L-J Person who prepared this summary notice: PrInted name: Signature: Date: Organization: Street and city: State: _ ZIP: Phone number: L-J IFR Doc. 99-23016 Flied 9--14-99: 8:45 aml BIWNG. CODE 421D-32-P