#8A HIP Manual Change -LSHR
Lead Safe Housing Rule
Policy and Procedure Manual
Addendum
May 22, 2009 (revised August 12, 2009)
HOME IMPROVEMENT PROGRAM
Prepared By: City of Janesville
Neighborhood Services
Funded By: U.S. Department of Housing & Urban Development
1
TABLE OF CONTENTS
3-4 Definitions
5 Part I: Goals and Objectives of the Program
5-6 Part II: Requirements
a.)Eligible Activities & Costs
b.)Determination level of program applicability
7 Part III: Program Implementation
8-10 Part IV: Contract Requirements
11-12 Attachments A-B
13-16 Appendix A-D
17-18 Sample Proposal
19 Visual Assessment Form
20 Clean-up Checklist
2
DEFINITIONS
Abatement
means any measure or set of measures designed to permanently eliminate lead-based paint hazards.
Abatement includes, but is not limited to: (NOTE: Specialized training and state licensing is required to perform
this level of treatment)
Encapsulation:
(1) the application of an encapsulant which means a substance that forms a barrier between
lead-based paint and the environment using a liquid-applied coating or an adhesively bonded covering.
Enclosure:
(2) the use of rigid, durable construction materials that are mechanically fastened to the substrate in
order to act as a barrier between lead-based paint and the environment.
Removal:
(3) the separating of the paint from the substrate and disposal of the removed paint. Methods may
o
include one or all of the following; wet scraping, using a heat gun below 1100F, abrasive vacuum sanding and
or chemical stripping.
Replacement
(4) : the elimination and disposal of both the paint and its substrate. The element is then replaced
with a similar component.
Clearance testing
means an individual who is independent from the Contractor hired to do wipe sample testing
of specific areas to determine work is complete and strict guidelines are met.
Deteriorated paint
means paint that is cracking, flaking, chipping, peeling, or otherwise separating from the
substrate of a building component.
Distinct painting history
means the application history, as indicated by its visual appearance or a record of
application, over time, of paint or other surface coatings to a component or room.
HEPA
(High Efficient Particulate Air) a specialized filter used primarily in vacuum cleaners to trap lead dust
particles. Only filters rated at 99.97% can be used in lead reduction work.
Interim Control
means a set of measures designed to reduce lead based paint hazards for a shorter period of
time at a lower cost.
Lead-based pain
t means paint or other surface coatings that contain lead equal to or in excess of .7 milligrams
per square centimeter or more than 0.06 percent by weight.
Lead-based paint hazard
means any condition that causes exposure to lead from lead-contaminated dust, lead-
contaminated soil, or lead-contaminated paint that is deteriorated or present in accessible surfaces, friction
surfaces, or impact surfaces that would result in adverse human health effects.
“Lead free”
means a surface by surface inspection and testing reveals the absence of lead-based paint.
“Lead safe”
means that all surfaces are intact and test results show lead dust levels to be below permissible
levels at the time of inspection.
Lead safe manner
means the procedures for minimizing lead dust generation and soil contamination during
maintenance activities, as defined by the United States Environmental Protection Agency (EPA) and the United
States Department of Housing and Urban Development (HUD). If these procedures are correctly implemented,
the risk of lead exposure to maintenance personnel, children, residents, and the families of maintenance
personnel can be minimized. The course meets requirements for training maintenance workers on lead-based
paint hazards to be able to perform interim controls or standard treatments
3
Occupant notification
means that Federal law requires contractors and owners of rental properties to inform
occupants about the risks of lead-based paint before non-emergency repair, maintenance, and home renovation
work begins. This law applies for all work on surfaces greater than 2 square feet per component. Contractors
and property owners must distribute copies of the pamphlet Protect Your Family From Lead In Your Home
before any work starts.
Occupant protection
means actions taken to protect occupants from lead-based paint hazards during the
rehabilitation and/or lead remediation process.
Paint condition ratings “intact”“fair”
means if it is not fully then it is rated as unless more than 10 square feet
of deteriorated paint on exterior components with large surface areas; or more than 2 square feet of deteriorated
paint on interior components with large surface areas (e.g., walls, ceilings, floors, doors); or more than 10
percent of the total surface area of the component is deteriorated on interior or exterior components with small
“poor”
surface areas (window sills, baseboards, soffits, trim) then it is rated as .
Risk assessment
means an on-site investigation to determine the existence, nature, severity, and location of
lead-based paint hazards, and the provision of a report by the individual or the firm conducting the risk
assessment, explaining the results of the investigation and options for reducing lead-based paint hazards.
Safe work practices
means the procedures for minimizing lead dust generation and soil contamination during
work activities, as defined by the (EPA) and the United States Department of Housing and Urban Development
(HUD). If these procedures are correctly implemented, the risk of lead exposure to the workers, children,
occupants, pets and the workers families can be minimized.
Soil covering
means soil which has been separated from human contact by the placement of a barrier such as a
deck, fence, pavement or concrete, grass seed or sod, thorny or dense bushes, mulch, gravel or other
landscaping materials.
Standard treatments
means a series of hazard reduction measures designed to reduce all lead-based paint
hazards in a dwelling unit without the benefit of a risk assessment or other evaluation. Stabilization of
deteriorated paint, the provision of smooth and cleanable horizontal surfaces, the correction of conditions
causing rubbing, binding or crushing of painted surfaces and the treatment of bare soil.
Worker protection
means that workers shall be provided with a pre-employment physical to determine blood
lead level and ability to wear appropriate respirator protection. Workers shall also be provided with a changing
area equipped with washing facilities and protective clothing.
4
Part I: Goals and Objectives of the Program
The City of Janesville has administered various programs relating to housing rehabilitation since 1978. Funding
for these programs has come from a variety of federal and state sources. The current sources include the
Community Development Block Grant (CDBG) Program and the Home Investment Partnership Program
(HOME) administered by the U. S. Department of Housing and Urban Development (HUD).
HUD has issued regulations to reduce lead-based paint (LBP) hazards in housing built before 1978 that are
assisted by the federal government. Steps must be taken to make sure that any potential LBP hazard existing be
identified and corrected. It is highly likely that in housing built before 1978 may contain interior and exterior
surfaces containing LBP. All surfaces should be treated as if they are LBP and appropriate precautions taken.
Remedial action is outlined under the “work specifications” which includes all areas where work is to be
performed and it also includes other areas of concern where found. Any work performed on a property built
prior to 1978 that disturbs a painted surface must be performed by a contractor or person recognized as properly
trained in using safe work practices, proper site preparation, appropriate work methods and cleanup. All
chipping, cracking and/or peeling paint surfaces where loose paint exists must be addressed, corrected and
maintained. Continued maintenance and periodic reevaluation is essential in reducing potential future lead risk.
The Office of Community Planning and Development (CPD) and the Office of Healthy Homes and Lead
Hazard Control (OHHLHC) have jointly created the “Lead-Safe Housing Rule Checklist” and associated
documents to aid in the implementation and compliance with the Lead-Safe Housing Rule (LSHR). The LSHR
(24 CFR part 35, subparts B-R) became effective in all jurisdictions January 10, 2002. It implements sections
1012 and 1013 of the Residential Lead-Based Paint Hazard Reduction Act of 1992, which is Title X of the 1992
HCD Act. The LSHR requirements are based on practical experiences and new scientific methods for
evaluating and controlling lead hazards in federally assisted housing.
Part II: Requirements
a.)Eligible Activities & Costs
The following are eligible activities and costs under this program.
1. Combined lead paint inspections and risk assessments, including lead dust, soil and paint chip
testing and associated laboratory costs.
2. Interim controls or standard treatments.
3. Abatement measures which may include any one or all of the following; removal, replacement,
encapsulation and/or enclosure.
4. Occupant protection and temporary relocation of occupants when lead hazard control
intervention work supported by this program is conducted in a unit.
5. Clearance activities.
6. Undertaking minimal housing rehabilitation activities that are specifically required to carry out
effective lead hazard control, and without which the lead hazard control could not be completed
and maintained.
5
b.)Determination level of program applicability
6
Part III: Program Implementation
OUR RESPONSIBILITIES:
Visual assessment prior to Risk Assessment/Lead Paint Assumption and Clearance.
Establish one contractor or trained person responsible for final cleaning, all interim controls or standard
treatments.
Owner and/or Contractor (trained responsible party) to receive copy of Federal Regulations (CFR
§35.1330/1335/1340).
RISK ASSESSORS RESPONSIBILITIES:
Visible paint chips in soil, window troughs or on floor is an immediate fail. Visual assessment and
recommendations to pass clearance to be given to the Housing Rehab Specialist.
Work site (area) clearance to be done only if specifically requested by the Housing Rehab Specialist.
Additional work is not to be required except for routine "house-keeping/maintenance". Owner to be made
aware of the limited nature of the Risk Assessment /Clearance. A note should be made to the owner regarding
limits of liability and valid for that specific moment in time.
CONTRACTOR RESPONSIBILITIES:
Follow cleaning procedures upon completion of the project. To contact the Risk Assessor at least 48 hours
prior to cleaning and to schedule directly a time at least one hour after and not more than 24 hours after cleaning
has been completed.
Bare soil will not be tested but will be treated with a minimum of grass seed and straw. (Weather permitting)
i.e. snow cover, etc. Owner will agree to treat first available favorable condition with staff visual inspection
required.
To provide a copy of the pamphlet, Renovate Right: Important Lead Hazard Information for Families, Child
Care Providers and Schools informing owner of the potential risk of the lead hazard exposure from renovation
activity to be performed in dwelling unit.
OWNER RESPONSIBILITIES:
Provide booklet “Protect Your Family From Lead In Your Home.” To tenant of rental property.
Utilities and sanitary facilities;
Removal of wall hangings and window curtains;
Moving of furniture away from exterior walls to center of room;
Removal of debris or items from around the outside of the house;
All packing of breakable and valuable items;
Current home owner liability and fire insurance;
Monitoring of painted surfaces, repairing any damaged paint and property maintenance after occupancy.
7
Part IV: CONTRACT REQUIREMENTS
Article I Contract Document
This document shall be attached to the Property Owner/Rehab Contractor Contract and is hereby incorporated
therein. In the event of a conflict among contract documents, the provisions in this addendum shall prevail over
all others.
Article II Scope of Services
All lead-based paint activities performed, including waste disposal, shall be in accordance with applicable
Federal, State, or local laws, ordinances, codes or regulations governing evaluation and hazard reduction. In the
event of discrepancies, the most protective requirements prevail. These requirements can be found in: OSHA
29 CFR 1926—Construction Industry Standards, 29CFR 1926.62—Construction Industry Lead Standards, 29
CFR 1910.1200—Hazard Communication, 40 CFR Pt.261—EPA Regulations, HUD Title X parts 1012-1013.
The use of paint containing more than 0.06 percent dry weight of lead on any interior or exterior surface is
prohibited. The level of lead hazard reduction is determined by the level of federal assistance. That calculation
is attached to this contract as Exhibit A and incorporated herein.. For work up to and including $5,000, safe
work practices must be used for all rehabilitation activities, and paint disturbed during the work must be
repaired. For work over $5,000 up to and including$25,000, interim controls must be performed on the hazards
or
identified by the risk assessment and paint disturbed during the rehabilitation must be repaired standard
treatments must be carried out for the entire unit. For work over $25,000, surfaces painted with lead-based paint
that are disturbed during rehabilitation and hazards identified by the risk assessment all must be abated. Interim
Controls may be performed on exterior surfaces if those surfaces are not undergoing rehabilitation.
Article III Worker Protection and Prohibited Methods
Workers shall be provided with a pre-employment physical to determine blood lead level and ability to wear
appropriate respirator protection. Workers shall also be provided with a changing area equipped with washing
facilities and protective clothing. All safe work practices shall be used. The following methods shall not be
used to remove paint that is, or may be, lead-based paint:
1. Open flame burning or torching;
2. Machine sanding or grinding without a high-efficiency particulate air (HEPA) local exhaust control;
3. Abrasive blasting or sandblasting without HEPA local exhaust control;
4. Heat guns operating above 1100 degrees Fahrenheit or charring the paint;
5. Dry sanding or dry scraping, except dry scraping in conjunction with heat guns or within 1.0 ft. of electrical
outlets, or when treating defective paint spots totaling no more than 2 sq. ft. in any one interior room or space,
or totaling no more than 20 sq. ft on exterior surfaces;
6. Paint stripping in a poorly ventilated space using a volatile stripper that is a hazardous substance in
accordance with regulations of the Consumer Product Safety Commission and/or a hazardous chemical in
accordance with the Occupational Safety and Health Administration regulations.
Article IV Records
Records must be kept of each evaluation, clearance or hazard reduction report for at least three years.
Article V Fines
The Contractor is fully responsible for the means and methods of executing the scope of work. Therefore, the
Contractor and Subcontractor agree to hold the Owner and the City harmless in the event of any fines from
federal or local agencies controlling the lead hazard reduction work. The Contractor or Subcontractor agree to
immediately (within 30 days) satisfy any and all fines or judgments presented by OSHA, EPA, the local or state
health department, the state office of lead hazard control and any other governmental agency having jurisdiction
over the lead hazard reduction work.
8
Article VI Worker Training
All workers involved in lead hazard reduction activities must either be supervised by an EPA or State of
Wisconsin Abatement Supervisor or have received HUD-approved training in lead-safe work practices prior to
commencement of work.
Article VII Occupant Protection During Lead Hazard Reduction
The Contractor shall provide the City with a copy of the written Occupant Protection Plan as required by 40
CFR Pt. 745. Actions must be taken to protect occupants from lead-based paint hazards if the units will not be
vacant during the rehab project. Occupants may not enter the work site during the lead hazard reduction
activities. Reentry is permitted only after such activities are completed and the units have passed a clearance
examination. Occupants of the unit do not have to be relocated under the following circumstances:
1. Rehab work will not disturb lead-based paint or create lead contaminated dust;
2. Hazard reduction activities can be completed within one 8 hour daytime period and the work site is contained
to prevent safety, health or environmental hazards;
3. Exterior-only work is being performed where the windows, doors, ventilation intakes and other openings near
the work site are sealed during hazard reduction activities, and cleaned afterward, allowing for a lead-safe entry
to be maintained;
4. Hazard reduction activities will be completed within 5 calendar days and the work area is sealed, the area
within 10 feet of the containment area is cleaned each day, occupants have safe access to sleeping areas,
bathroom and kitchen facilities; and occupants are not permitted into the work sites until after clearance has
been achieved.
Article VIII Temporary Relocation During Lead Hazard Reduction
If occupied units are to undergo more extensive lead hazard reduction activities, the occupants must be
temporarily relocated. Most often, furniture and occupant belongings can be covered and sealed with protective
plastic sheeting, although storage of major furniture and removal of all small furnishings during the hazardous
materials reduction work may sometimes be necessary. The Owners/Occupants are responsible for carefully
packing all breakables, removing all clothing from closets, and protecting any personal property. During the
hazard reduction work, only workers trained in lead hazard reduction may enter the work site. This means that
neither owners nor occupants are permitted to return to the work site during the day or at night. If the
Owner/Occupant has special needs to re-enter the site, the City must be contacted. Only when the unit has been
cleaned to the federally-mandated standards and passed a clearance examination is it safe and permissible for
the Owner/Occupant to return to their home. The City will notify the Owner/Occupant with an Authorization
for Re-Occupancy. If work is done in stages, interim dust lead clearance must be obtained prior tore-occupancy
by the owners or occupants and other non-lead related rehabilitation workers. Final lead dust clearance must be
repeated following the rehabilitation work to verify that the residence is free of lead hazards. If needed, there
shall be an allowance for relocation costs of $500 per week for owner occupants. The Federal Uniform
Relocation Act for temporary relocation costs will apply when tenants are required to relocate. Payment will be
made once costs/expenses are verified. The total allowance has been made part of this contract and based upon
the time designated in the bid for lead hazard removal.
Article IX Worksite Preparation and Containment
The worksite shall be prepared to prevent the release of leaded dust, and contain lead-based paint chips and
other debris from hazard reduction activities within the worksite until they can be safely removed. Practices that
minimize the spread of leaded dust, paint chips, soil and debris shall be used during worksite preparation. All
objects that cannot be moved (cabinets, appliances, built-in furniture) shall be covered with plastic sheeting at
and securely in place. Floors in the worksite shall also be covered with plastic sheeting sealed with tape.
9
Article X Cleaning Up and Clearance
The contractor shall keep the premises clean and orderly during the course of the work and all debris shall be
removed on a continuous daily basis and not be allowed to accumulate. All exposed interior surfaces shall be
cleaned using a HEPA vacuum and wet washed with a detergent solution and clean water rinse to reduce the
lead content. Clearance may not be performed sooner than one hour after completion of the final cleanup.
Clearance dust sampling is for settled leaded dust and is a two-phase process. The initial clearance evaluation is
a Visual Examination done by the City followed by “environmental sampling” for leaded dust.
1. The visual examination determines that the work on all interior and exterior surfaces to be treated was
completed, that there are no deteriorated paint surfaces, and that no visible settled dust or debris is present in
interiors and within 10 feet of exterior walls if exterior work was performed.
2. Environmental sampling involves dust sampling on the interior work area. The clearance examiner may
decide that exact sampling scheme based on the type of treatment (s), visual observation, and professional
judgment.
3. Clearance samples must determine the lead dust levels of the work site prior to re-occupancy.
4. Clearance must be performed by an individual who is independent from the Contractor hired to do the work.
The following dust lead clearance thresholds must be met:
Floors—40 ?g/ft2
Interior window sills—250 ?g/ft2
Exterior window troughs—400 ?g/ft2
5. Clearance must be performed by an EPA or State certified Risk Assessor, Lead Paint Inspector or a Clearance
Technician.
6. If a component, such as a floor, fails the clearance dust standard, the floor in the room that failed must then
be re-cleaned. A clearance dust sample must then be taken. The first clearance cost was made part of the total
cost of rehabilitation. All subsequent cleaning and clearances costs shall be the sole responsibility of the
Contractor.
Article XI Handling of Lead Wastes/Disposal
The Contractor is solely responsible for complying with federal and state requirements for the safe handling of
lead wastes and the disposal thereof.
Article XII Owner Responsibilities
Owners shall provide utilities, sanitary facilities, and fire insurance. Owners shall be responsible for monitoring
potential hazards, repairing damaged surfaces, and maintaining the property to prevent hazards from occurring
after occupancy.
10
LEAD-SAFE HOUSING RULE CHECKLIST
For
GENERAL COMPLIANCE DOCUMENTATION
(Program participants can use this checklist as a guide for determining whether or not they are proceeding in a manner
required by the LSHR, and that they are maintaining documentation for each CPD-assisted project. Field Office staff can
use the checklist as a means for familiarizing themselves with the kinds of documentation that should be maintained in
order to demonstrate LSHR compliance. Compliance with the program-specific requirements may not be substantiated
solely by the documents included on this general checklist.Additional guidance is provided as referenced in the
checklist.)
As appropriate, the following documents should be maintained in CPD-assisted project files for properties constructed
before January 1, 1978, in order to demonstrate general knowledge and compliance with basic LSHR requirements.
Standard forms are available in the Federal Register (FR), as indicated by the sources noted below. Citations from 24
CFR part 35 are also provided as additional references.
Applicability Form
____ [§35.115] – A copy of a statement indicating that the property is covered by or exempt from
1
Lead Safe Housing Rule.
(Note: (A) If the property is exempt, the file should include the reason for the exemption and no further
documentation is required; (B) if the property is covered by the Rule, the file should include the appropriate
documentation to indicate basic compliance, as listed below.)
Summary Paint Testing Report or Presumption Notice
____ [§35.930(a)]– A copy of any report to indicate the
presence of lead-based paint (LBP) for projects receiving up to $5,000 per unit in rehabilitation assistance. If no
2
testing was performed, then LBP is presumed to be on all disturbed surfaces.
Risk Assessment Report
____ [§35.930(c)(2)] – A copy of a report (in addition to the requirements of §35.930(a)) to
indicate any presence of lead-based paint hazards for projects receiving more than $5,000 per unit in rehabilitation
4
assistance.
(Note: If the property receives more than $25,000 in assistance, more stringent requirements apply, including compliance
with applicable state requirements, as appropriate. [See §35.930(d)].
Notice of Evaluation
____ [§35.125(a)] – A copy of a notice demonstrating that an evaluation summary was provided
3, 4
to residents following a lead-based-paint inspection, risk assessment or paint testing.
Clearance Report
____ [§35.930(b)(3)]– A report indicating a “clearance examination” was performed of the work-
site upon completion.
Notice of Hazard Reduction Completion
____ [§35.125(b)] – Upon completion, a copy of a notice to show that a
5
LBP remediation summary was provided to residents.
Source: Federal Register (FR), 64 FR 50139-50231, published September 15, 1999 -- Requirements for Notification,
Evaluation and Reduction of Lead-Based Paint Hazards in Federally Owned Residential Property and Housing Receiving
Federal Assistance. The appendices are on pages 50230-50231.
1
LSHR Regulation Applicability Form (See Attachment B to this memorandum.)
2
Appendix C--Summary Presumption Notice
3
Appendix A--Summary Inspection Notice
4
Appendix B--Summary Risk Assessment Notice
5
Appendix D--Hazard Reduction Completion Notice
11
ATTACHMENT B
LEAD-SAFE HOUSING RULE -- APPLICABILITY FORM
Address/location of subject property:
____________________________________________________________________
Regulation Eligibility Statements (check all that apply):
____ Property is receiving Federal funds.
____ Unit was built prior to 1978.
Note: If both Eligibility Statements above have been checked, continue with the Exemption Statements below.
Otherwise, the regulation does not apply, sign and date the form.
Regulation Exemption Statements [24 CFR 35.115] (check all that apply):
____ Emergency repairs to the property are being performed to safeguard against imminent danger to human
life, health or safety, or to protect the property from further structural damage due to natural disaster, fire
or structural collapse. The exemption applies only to repairs necessary to respond to the emergency.
____ The property will not be used for human residential habitation. This does not apply to common areas
such as hallways and stairways of residential and mixed-use properties.
____ Housing “exclusively” for the elderly or persons with disabilities, with the provision that children less
than six years of age will not reside in the dwelling unit.
____ An inspection performed according to HUD standards found the property contained no lead-based paint.
____ According to documented methodologies, lead-based paint has been identified and removed; and the
property has achieved clearance.
____ The rehabilitation will not disturb any painted surface.
____ The property has no bedrooms.
____ The property is currently vacant and will remain vacant until demolition.
If any of the above Exemption Statements have been checked, the Regulation does not apply. In all cases, sign
and date the form.
I, ________________________________, certify that the information listed above is true
(Printed Name) and accurate to the best of my knowledge.
_________________________________________ ________________________
Signature Date
_________________________________________
Organization
12
Appendix A--Summary Inspection Notice
LEAD HAZARD EVALUATION NOTICE
Address: _____________________________________________________
_____________________________________________________________
Evaluation Completed (circle one):
Paint Inspection Paint Testing Risk Assessment
Date: _________________
Summary of Results:
____ No lead-based paint or lead-based paint hazards were found.
____ Lead-based paint and/or lead-based paint hazards were found. (See attachment for details)
Contact person for more information about the risk evaluation:
Printed name: __________________________
Signature: ____________________________
Date: ____________________________
Organization: _____________________________
Street: ___________________________
City & State ______________________________
Zip ____________________________
Phone #: ___________________________
Person who prepared this notice:
Printed name: ________________________
Signature: _____________________________
Date: ___________________________
Organization: _____________________________
Street: ______________________________
City & State _____________________________
Zip ____________________________
Phone #: _____________________________
13
Appendix B--Summary Risk Assessment Notice
Summarize the types and locations of lead-based paint hazards below or attach your own summary. The
summary must list at least the 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 lead-based paint hazards found:
Contaminated Soil
Areamg/g (ppm)Location
___ None
___ Perimeter
___ Play Area
___ Other
Contaminated Dust
Area µg/SF Location
___ None
___ Windowsill
___ Floor
___ Other
___ Other
Other Hazards
Component* Location Condition Friction or Lead Content
Impact Surface? (if known)
(good, fair, poor) mg/cm² (ppm)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
*
Components include but are not limited to (interior and exterior) windows, doors, trim, fences, porches, walls and floors.
14
Appendix C--Summary Presumption Notice
LEAD HAZARD PRESUMPTION NOTICE
The property listed below has not been evaluated for lead-based paint but it has been presumed that lead-based
paint or lead based paint hazards are present.
Address/location of property or structure(s) this notice of presumption applies to:
__________________________________________________________________________________________
__________________________________________________________________________________________
Types of Presumption
(Check all that Apply)
____ Lead-based paint is presumed to be present.
____ Lead-based paint hazard(s) is (are) presumed to be present.
Contact person for more information about the presumption:
Printed name: ______________________________ Street: ______________________________
Signature: ____________________________ City & State ______________________________
Date: ______________________________ Zip ______________________________
Organization: ______________________________ Phone #: ______________________________
Person Who Prepared this Notice of Presumption:
Printed name: ______________________________ Street: ______________________________
Signature: ____________________________ City & State ______________________________
Date: ______________________________ Zip ______________________________
Organization: ______________________________ Phone #: ______________________________
Summary of Presumption.
List the bare soil locations, dust-lead locations, and/or building components
Presumed Hazards (including type of room or space and the material underneath the paint):
Bare Soil
(list any areas of bare soil):
Dust Locations
(check the following that apply):
?
Window sills
?
Window troughs
?
Floors
Other presumed lead hazards locations
(check any of the following components that have deteriorated paint
or are friction or impact surfaces):
Exterior
?
Windows
?
Doors
?
Trim
?
Cladding
?
Outbuildings
?
Fences
?
Porch A
?
Porch B
Interior
?
Trim
?
Doors
?
Windows
?
Walls
?
Floors
?
Ceilings
15
Appendix D--Hazard Reduction Completion Notice
Notice of Lead Hazard Reduction
Property Address:_________ ____________________ Today’s Date:________________________
Summary of the Hazard Reduction Activity:
Start Date: _________ _________________________ Completion Date: _____________ ______
Location and type of activity.
(List the location and type of activity conducted or attach a copy of the summary page
from the clearance report or the lead hazard scope of work providing this information.)
____________________________________________________________ ____________________________
________________________________________________________________________________________
________________________________________________________________________________________
_______________________________________________________________________________________
Date(s) of clearance testing: _____________________________
Summary of results of clearance testing:
(a) _____________ No clearance testing was performed.
(b) _____________ Clearance testing showed clearance was achieved.
(c) _____________ Clearance testing showed clearance was not achieved.
List any components with known lead-based paint that remain in the areas where activities were conducted. List the
location of the component (e.g. kitchen-door, bedroom-windows).
________________________________________________________________________________________
________________________________________________________________________________________
Person who prepared this summary notice
Printed Name: _________________________________
Signature: _____________________________
Title: ______________________________________
Organization: __________________________
Address: __________________________________________________________________________________
Phone: ______________________ Fax: ________________________________________
Owner: _________________________________ Date: _______________________
(Give to Property Owner with work-write up)
If you have any questions about this summary, please contact ______ ______ at _______________
16
PROPOSAL
CDA CONTRACT # -
CONTRACTOR ID#
Proposal #
Name:
Page Page # 1 of
Address:
City State Zip
Date: 8/14/2009
Phone #:
CERTIFICATION #
Proposal Submitted To: Work To Be Performed At:
Name: Michael Cody Street: Same
Street: 327 Milton Ave. City: Janesville
City: Janesville State: WI Zip Code 53548
State: WI Zip Code: 53545 Date of work write-up 8/14/2009
Telephone (608) 563-0479 Date of Risk Assessment 5/29/2008
Numbers:
We hereby propose to furnish all the materials and perform all the labor necessary for the completion of:
LEAD HAZARD REDUCTION (Interim Controls) in conjunction with REHABILITATION WORK
Work as outlined in the attached request for bid lead hazard reduction work write-up. See conditions on back
All material is guaranteed to be as specified, and the above work to be performed in accordance with the
drawings and specifications submitted for above work and completed in a substantial workmanlike manner and in
accordance with local, state and federal regulations for the sum of:
($ . )
With payments to be made as follows: In full upon completion and acceptable final clearance.
Any materials ordered with a City of Janesville purchase order will be deducted from the contract amount.
NOTE:
Additional funds requested over the contract amount will not be honored without prior written program approval.
Work to be started: On or before Work to be completed: On or before
Any alteration or deviation from above specifications involving extra costs, will be executed only upon written
orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes,
accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance upon above
work. Workmen's Compensation and Public Liability Insurance on above work to be taken out by the Contractor
Respectfully Submitted___________________________________________________
(Name of Contractor’s Business)
Per___________________________________________________
Authorized Signature (owner or agent)
45
NOTE: This proposal may be withdrawn by us if not accepted within days.
ACCEPTANCE OF PROPOSAL
The above process, specifications and conditions are satisfactory and are hereby accepted. You are authorized to
do the work as specified. Payment will be made as outlined above. Accepted this ______day
of_______________________20______
Signature __________________________________Signature _______________________________
17
PROPOSAL
(back page)
Contractor acknowledges the following:
?
Has familiarized him/herself with the project and surroundings.
?
Will notify the Housing Rehabilitation Specialist that he/she has scheduled with the homeowner the day that
contractor will start the project by moving; worker, materials and equipment onto jobsite.
?
Is current in carrying Workmen's Compensation and Public Liability Insurance regarding work within this contract
and will informed the homeowner to carry fire, tornado and any other necessary insurance.
?
If required, will accomplish all work that disturbs a painted surface according to Federal Regulations, and will only
use workman to conduct work who are trained in safe work practices as defined in 24 CFR Part 35, §35.1330 of the
Code of Federal Regulations. More information is available by calling the National Lead Information Center at 1-
800-424-LEAD or www.epa.gov/lead. Training may be obtained by contacting Milwaukee Lead and Asbestos
Information Center by calling (414) 481-9070 or www.mlaic.com
?
Price to include all labor and material necessary to complete the work including tax, permits, clean up, removal and
disposal of all debris.
?
All work to meet local ordinances, State codes and Federal Housing (HUD) requirements.
?
All material to be guaranteed as specified and the work will be performed in accordance with all drawings and
specifications and completed in a workmanship like manner installed per the manufactures recommendations and
industry standards in accordance with the scope of work.
?
Will provide proper and adequate disposal and clean up on a daily basis.
?
Is responsible for meeting any applicable building codes, ordinances or regulations as they may pertain to the scope
of work. Contractor will be responsible for obtaining any necessary permits, and the costs associated with said
permits is included in the bid price. And will prior to requesting any payments submit documentation that all
necessary permits were obtained.
?
Exercise reasonable care in moving equipment & materials about dwelling to avoid damage to shrubbery and
premises.
?
Will verify the use of all products and product colors with Homeowner and with Neighborhood Services where
specifically requested within the scope of work.
?
That he/she will immediately inform the Homeowner and Neighborhood Services of any conditions discovered
which effect the implementation of any specifics of the scope of work.
?
That he/she and the homeowner will obtain approval from Neighborhood Services prior to entering into any changes
to the scope of work so that a change order could be drafted by you the contractor prior to implementation of any
change.
?
Will inform the owner that he/she must remove any valuables from walls while work is performed.
?
All product use and directions must be followed per the manufacture specifications and recommendations. Work to
be completed in a workmanship like manner per industry guidelines and established standards.
?
That he/she, if required, will coordinate clearance testing with Wisconsin Housing Inspection at (608) 756-3228.
All areas in this project must not exceed the following HUD lead dust standards in order to be considered
2 2 2
complete: 40µ/ft(micrograms per square foot) of lead for floors; 250µ/ft of lead for widow sills; 400 µ/ftof
lead for window troughs (wells). Contractor will be responsible to pay for additional clearance testing.
18
VISUAL ASSESSMENT FORM
Date:
Address:
Owner:
Contractor:
Location Identify visible areas of dust, paint chips, painted debris, and
deteriorated paint. Note areas of friction and impact (i.e. walls,
ceiling, floors, doors, windows, trim, cabinets, etc.)
Entry Area
Living Room
Dining Room
Kitchen
Common Area
Bedroom #1
Bedroom #2
Bath #1
Exterior
Other:
Other:
19
Protocol for the Cleanup of Lead Dust
Children, pregnant women, individuals with high blood pressure or animals should be removed and kept away from
the areas to be cleaned.
Protect yourself; avoid carrying lead dust to your car or your home. Change out of your work clothes and place them in
a plastic bag to be washed separately. Clean off shoes or wear disposable shoe covers. Wash hands and face before
eating, drinking or smoking and at the end of the day
not
Do eat, drink, smoke, chew gum or tobacco, apply cosmetics or lip balms while cleaning.
Turn off forced air heating and air-conditioning. Close off rooms that have been cleaned or are not part of the
cleanup. Be careful not to spread dust and contaminate other areas while cleaning.
Gather the following items needed to perform a proper and adequate cleaning:
?
2 spray bottles
?
Paper towels
?
Cleaning detergent
?
Heavy-duty 6-mil plastic garbage bags
?
Latex or rubber gloves
?
2 or 3 large buckets.
?
Mop with disposable heads
?
Disposable mop head
?
Duct tape
?
not
HEPA Vacuum (Standard household or shop vacuums with HEPA filters are acceptable)
?
Be thorough-don’t rush.
Use HEPA-wash-HEPA procedure and repeat until no residue is left.
?
Start your cleanup work in the room or area furthest away from an exterior door. Carefully move any furniture
and replace when done cleaning. Clean and vacuum all horizontal surfaces including chair rails, countertops,
shelves, baseboards, floors, door tops, window troughs, windowsills and casing etc. Work from the top of each
room toward the bottom and from the furthest corner in the direction of the door.
?
Mix a cleaning solution. 1 part detergent to 10 parts water.
?
Fill one spray bottle with the cleaning solution. Fill other bucket and spray bottle with warm clear water.
?
Wear the latex or rubber gloves during the clean up process.
?
Pick up any loose paint chips and other debris. Put into a heavy-duty plastic garbage bag.
?
HEPA-Vacuum surfaces.
?
Mist surfaces that are to be cleaned using the solution bottle. Wipe wet surface with paper towel.
?
Spray the surface with water from the other spray bottle. Wipe away water with a clean paper towel
?
NOTE:
Use one paper towel per surface area, such as one window.
?
Bare floors are to be HEPA-Vacuumed then mopped with the phosphate solution, rinsed with clear water using a
not
sponge. Dispose of mop head and sponge when each room and job is finished. Change rinse water often. Do
use a broom or a conventional shop type or household vacuum.
?
Allow surfaces to dry and then HEPA-Vacuum once more.
?
Discard latex or rubber gloves, paper towels, mop heads and sponges into the heavy-duty plastic garbage bag.
Seal with duct tape and place it in with normal household garbage.
?
Dirty water should be flushed down the toilet. Never get rid of in a sink or dump out on the ground.
?
HEPA-Vacuum carpeted vinyl or wood floor surfaces.
?
Contact the Risk Assessor at least 48 hours prior to cleaning and to schedule directly a time at least one hour after
and not more than 24 hours after cleaning has been completed.
20