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11 ROPES STREET UNIT 1 LEAD INSPECTION REPORT 5-10-2024 Page 1 of ILn a�tr aritt�air. � t�� rsi rt tttt�ar +irr�r �w�rrr®r now 1•II �� �itttt� t� �Ilr t� wwer�rr raw ttws 411011111111� ��ili✓t >tllllrR AII� ENVIRONMENTAL, INC. Main Office: 1 Arcadia Street Dorchester, MA 02122 Toll Free: 800-349-7779 www.asapenvironmental.com Lead Inspection If Risk Assessment St.# I Street Name 169� _S Street Type S—f Unit city. S�/n_, Zip Code 2I q 0 Number of Rooms in Unit: Owner Name Al n el/�1 , f-�:V n a , Property Type: Owner Address: ��Q f�Q 1 o Sf (A/air ' Jua 1, y0 y ❑ Singe Family Contact Information: I"Multi Family #of Units: Client Name(if different from owner): ❑ Condominium #of Units: Client Address: ❑ Day Care ❑ Other: Kev Lend Column Key Delead/IC Method Column Key Dclead/IC Method Column Laundry in Basement? ❑Yes ao COV Covered COV Covered REM Removed Finished Space in Basement?[]Yes ENO DC Drop Ceiling DIP Dipped REP Replaced MET Metal ENC Encapsulated SCR Scraped Possible Pb Water Service Line MR Metal Rep.Window MT Intact SFR Storm Frame Removed El Yes No u Not Tested NA Not Accessible MI Made Intact SLD Sealed Testing Method Used NC No Coating PRE Prepared for Far. STP Stripped Na2S Expiration Date: Tile Tile(testing suggested) Component Does Not Exist VR/MR Vinyl/Metal Rep Window X-Ray Fluorescence VB Vinyl Baseboard VR Vinyl Rep.Window Model: Pb200e Serial# 1130 Comments/Notes: ❑ Demarcation Lures ❑ Submitted for Compliance Evaluation Floor# i (level with C in building of unit being inspected) Floor# Property Diagram/Unit Labels , , , , , D B _� r , f i f l -5 f f _1 •_r•_l f...........i................ ' A(Street Side) Start Here A(Street Side)1 1 Start H e A(Street Side) Pb(lead)equal to or greater than 1.0 mg/cm2 with x-ray fluorescence or positive with Na2S is Dangerous. XRF Calibration Recorded in Log Book ✓-Check off when complete Address Verified through USPS ❑✓ ✓-Check off when complete Research on Lead Related History for Address ❑✓ ,_-.✓-­CJm0c off whe o plate www.state.ma.us/dph/clppp or 800-532-9571 . Benjamin Misch 3984 f 05 Inspector's Name(print) License# ./ / Signature Date LI/RA-revised 06/17 Address: 1'i.O.OE_S Apt#___ City L-4y)_--- Pa e 2 of INSPECTION HISTORY INTERIM CONTROL Determination e Inspector Name: Lic#_ Visual Y Risk Assessment R.A.Name: Llc#__ Signature Signature Lead Hazards? N Ur eot Pb.Hazards? Comprehensive pp�� ust a e❑ or Initial Inspection Inspector Lic#dd3 Risk Assessment Ir R.A.Name; Lic#__ '. o 7 Z $ q Signature urgentPb.xazaras7 NN Signature Lead Hazards? Visual Portion of Comp Initial 8 R.A.Name: w/Partial PCAD Y Inspector Name: Llc# Reinspec6on for Interim Control F SlgndtUlB N I Signature . Lead Hazards? Addendum(add-on Dust Taken for Risk p R.A.Name: .Lick--_ '.. to Initial Inanect _NY] Y Signature F Inspector Name: Lic#_ Assessment Reins . Signature Lead Hazards? Visual Portion of Reinspection for R.A.Name:_ .Llc#__ Addendum as Full Interim Control p Inspection Y Inspector Name: Lic#_ B Signature 111T8 Signature Lead Hazards? Dust Taken for Risk P R.A,Name: LIc#_ Assessment Reins . Walk Through for Inspector Name:.Lick BSignature Ed/Consultation Signature Risk Assess 8R.A.Name: LIc#REINSPECTION HISTORY SI nature Visual Portio❑of 8Inspector Name: .LIc#_ N g Reocc.Reins ection [,Recjifi,,,Zen' e❑t Pb.Hazards? F Signature Dust Taken for B R.A.Name;_ Lic#_ RA Recertification Visual Portion of Inspector Name: Lick_ Reocc.Reins ection p F Signature F Signature POST COMPLIANCE ASSESSMENT DETERMINATIONS Dust Taken for NF Inspector Name: LIc#_ Reocc.Reins ection Signature PCAD y Inspector Name: Lic#_ Dust Taken for p Inspector Name: Lic# Lead Hazards? BSignature Reocc.Reins ection 8 Signature Full Inspection t ` t�'t'11"y Actin es PCAD Inspector Nale: S LIc#_ Visual Portion of Inspector Name: LIc#_ 0 5 I 0 2 Y 1 Final Reins ection P N Signs are F Signature Lead Hazards? Visual portion of BInspectorName: Lic#_ Visual Portion of p Inspector Name: Lic#_ PCAD Reins ectio❑ Final Reins ecfion F Signature F Signature Dust Taken for FinIl al FF Dust Takenfor B Inspector Name:_ LIc#_ Reins . o Reocc p Inspector Name:_ LIc#_ PCAD Reins ection p F Signature F Signature Dust Taken for Final pifl Inspector Name: Lic#_ D us t Taken forPCAD Reins ecfion Blnspector Name: Lic#_ Reins . o React) Signature F Signature History rev 6/17 Address: Apt# / City �J�7� eiYl Page 3 ot7S✓ REOCCUPANCY CERTIFICATE HISTORY COMPLIANCE HISTORY(CONT.) Certificate of Certificate of Reeccu anc . Maintained Inspector Name: Lic# Inspector Name: .Lic#_ com liance Only after Si nature Signature High/Mod Risk g No Work=No Dust #rooms rule Work=7 Dust Certificate of Certificate of Reoccu anc Restored Inspector Name: Lic#_ com Stance Inspector Name: Lick_ Only after Signature Signature High/Mod Risk Dust wipes and auth. g #rooms role people Certificate of Reoccu anc Certificate of Inspector Name: Lick_ Maintained Inspector Name: Lick_ Com liance Only after Signature Si nature High/Mod Risk g #rooms role No Work=No Dust Work=7 Dust COMPLIANCE HISTORY Certificate of Letter of Full Initial Restored Inspector Name: Lic# Coro lionce Inspector Name: .LIc#_ Com liance Signature Signature No prior history/ Dustwipes and oath. No signs of UD eo le Letter of Interim OTHER HISTORY:WAIVERS[UD Control Inspector Name: Lic#_ Approved CLPPP Waiver Inspector Name: .Lick_ No prior Comp. Signature Expires in I Attach to Comp Signature Does Recertification of Interim Control roved Inspector Name: .Lick— CLPPP Waver Inspector Name: Lic#_ Expires 2 yrs from Signature original Interim Attach to comp Signature Control Does Letter of Full Deleading Inspector Name SCa r iN Lle#rob; UP IDES visual Compliance Rat❑s ecfion P Inspector Name: Lic#_ obil '1 Signature F Signature Dust wipes if No No LOC Issued Recta. Certificate of UD/DES Dust Maintained Taken B Inspector Name: Lic#_ com liance Inspector Name: Lic#_ F Signature imT Signature N No Work=No Dust o LOC Issued Work=7 Dust UD/DES Dust Certificate of Taken p Inspector Name:-Lie#_ Restored 777 1F com liance Inspector Name: LIc#_ Signature No LOC Issued Signature Dust wipes and auth. UD/DES Final eo le Reins ecfion P Inspector Name: Lic#__ F Signature No LOC Issued History rev 6/17 Page 4 of 20 EXPLANATION OF LEAD INSPECTION/RISK ASSESSMENT REPORT FORM COLUMNS This page provides general information needed to understand the lead inspection/risk assessment report.However,you should speak with the inspector/risk assessor before you start to do any work on your home. SIDE Refers to A,B,C,or D side of the building or room.See the diagram on the cover sheet.The"A"side of the building or room is the side facing the street that gives the property its address(usually,it is the front of the building).Keeping your back to this street,from the"A"side move clockwise to the"B"side on your left,the"C" side opposite you,and the"D"side to the right. Numbering is from left to right. LOCATION/ Refers to the building component(s)being tested.Some surfaces may be made up of more than one part.For SURFACE example,`Baseboard"may refer to four separate pieces of wood(one on each wall),but is still considered one surface. LEAD The actual lead result.Each surface tested must have a result recorded in the"Lead"column. • A number shows that the surface was tested with an XRF analyzer.A number equal to or greater than 1.0 mg/cmz is a dangerous level of lead. • A"pos"or Neg"shows that the surface was tested with sodium sulfide."Pos"means that there is a dangerous level of lead. • "N/A"means that the inspector was not able to test the surface.The inspector must assume the surface contains lead and require it to be deleaded.Speak to the inspector about possible alternative testing options. • "MET"or"MR"means that a metal surface was not tested.Metal handrails,metal window sills,and metal railing caps need to be deleaded if they test equal to or greater than 1.0 mg/cmz,or are marked"MET'or "NW'.All other metal surfaces must be intact. • For key to abbreviations like"COW,"VB","W'or"MR","NC","Tile","DC",see the cover page. TYPE OF Not all lead paint must be deleaded.This column tells you IF and WHY a surface needs deleading. The deleading HAZARD standards below may not apply for Interim Controls. Speak to your risk assessor for more information. • "MT'circled means that the surface is a moveable/impacted part of a window and must be deleaded in its entirety. • "SF"circled indicates that there is a storm frame present which requires the blind stop and exterior sill be deleaded as interior moveable/impacted surfaces. • "A/W circled means that the surface is"accessible mouthable"and must be deleaded to a minimum of five feet high,four inches in from the edge or comer. • "F"circled means that the surface is a"friction"surface and must be deleaded at all points of potential friction. • "L"circled means that the surface is loose and must,at a minimum,be made intact.Loose leaded floors must be sealed with paint or similar coating and pass a dust wipe. • If more than one choice is circled,the rules for deleading may change depending upon what method of deleading you choose. Speak to the inspector for more information. • "N/A"means the inspector was unable to determine if the surface was a lead hazard.The person doing the deleading must check this surface and follow all the rules for deleading. Speak to the inspector for more information. • If nothing is circled in the column,then it is likely the surface does not need deleading. Speak to the inspector for more information. Remember,this does not mean the entire surface is lead free,it just does not require deleading in its current condition. URG HAZ? This column is completed during a risk assessment,which is an evaluation of a home's suitability for Interim Control. Only a licensed risk assessor can do a risk assessment. If"Y"is circled,then this surface is considered an"Urgent Lead Hazard"and deleading is required to qualify for Interim Control. IC DATE The date the licensed risk assessor determines the surface meets the standards for Interim Control. 1C METH The deleading method or structural repair done to qualify the surface for Interim Control.Refer to the deleading codes key on the cover page. DELEAD DATE The date that the lead inspector reinspects the surface and finds that it is in compliance. DELEAD METH The method used to bring a surface into full compliance.Refer to codes in the Key on the report's cover page. EXCLUDED The amount of loose paint on a surface as measured by the lead inspector."N/A"means that the inspector was not SURFACES able to measure the loose paint,but has determined it is more than the cut-off for moderate risk making intact. RULED OUT Encapsulants only work well if the paint is in good condition.If the inspector sees that there BOX are adhesion problems with eligible surfaces in a room,he/she will rule out encapsulation as a deleading method. LIRA Exp.2017 05/10/24 Ben amin Misch I/R-3984 , Page- io Of_ Inspector(print) Lic# Signature Dale Risk Assessor r4l)ROPES ST Lic# Signature Dafe Address ofProoedv Aot # Cifv ROOM# 1 SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC 1 IC DELEAO DELEAD SURFACE HAZARD HA71 DATE METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METH A n Up Walls O:Q L NIA Y A Window Sill WI AMt L N/A Y A e Low Walls /, L N/A Y B Win Apron 0 D L N/A Y A a Baseboards I V j L /A I Y C Win Casing .0 L NIA Y A e Chair Rail LNIA Y D Header Stop OZ Mil L N/A Y Aso Radiator L NIA Y Int Stops 0.\ Mill L NIA Y Srr:Floor L Q(dusl) NIA Y 1 Win Int Sash MII L NIA Y Ceiling L WA Y 2 [PareteBettad xtrior Sill Ji MII SF L NIA Y A B Door L N/A Y 3 Mll L N/A V C D Door Edge F L NIA Y 4 inSop MII SF L NIA12 Door CasingL WA Y inx Sash d WI L N/A Y 34 Door Jamb F L NIA Y Window Sill 0.1 MII A/M L NIA Y Threshold L WA Y B Win Apron pQ L N/A Y A B Door ". L C Win Casin I �,� L WA Y _ CD Door Edge D He Slop (),I MA L N/A Y 12 Door Casing Int Stops O FM L NIA Y 34 Door Jamb 1 Win Int Sash Mn L N/A Y Threshold b Exterior Sill MII SF L NIA Y A8 Door L N/A Y 3 Part Bead M111 L N/A Y C D Door Edge F LNIA Y 4 Blind Slop Mil SF L NIA Y 12 Door Casing L N/A Y Win Exl Sash 11.1, Mil L N/Al Y 34 Door Jamb F L N/A Y A Window Sill 00 Mil A/M L NIA Y Threshold L N/A Y B Win Apron pI L N/A Y Close[Door L NIA Y C Win Casing(D L WA Y A CI Door Edge F L WA Y OD Header Stop 01 MII L N/A Y B 'Cl Casing L NIA Y Int Stops (%0 MA L NIA Y C Closet Jamb F L N/A Y 1 Win Int Sash MA L N/A Y D Closet Walls L WA ,9Y 2 Exterior Sill M/I SF L WA Y Cl Baseboard L NIA Y 3 Pan Bead 1 Close[Pole L NIA Y 4 Blind Stop MII SF L WA Y 2 Closet Shelf L NIA Y Win Exl Sash MII L N/A Y 3 CI Suppons L NIA Y A B Fireplace LNIA Y 4 Closet Floor L[I(dust) WA Y CD Mantle LNIA Y Ciosel Ceiling L N/A Y A s co Win Above 5' L N/A I Y COMMENTS/STRUCTURAL DEFECTS: ""'.Ceilin g MoIdIn4 1 Qt I L NIA1 Y am., MilL NIA Y L N/A YEXCLUDED SURFACES:Surfaces listed in these boxes can only be made IntactNIA Yby a Deleader(MORE THAN 288 SQ.IN.) NIA YSIDE LOCATION MEASURE:LOOSE PAINT ICICNIA YDATE METHOD NIA Y Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more A/M surfaces with adhesion problems LIRA Rep 2017 Room Benjamin Misch I/R-3984 / 09/10/24 g0 Paga_Ot Inspector(print) Lic# onignature Date Risk Assessor(11)ROPES ST Lic# Signature Date SAI Address of Property: Aot # City HALLWAY:Interior #_ or Common Hallway: Front Rear Floor#_ SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZI DATE METH DATE METH A o Up Wells - L WA Y Closet Door _ L N/A Y A e Low Walls L WA Y A Cl Door Edge F L N/A Y A e Baseboards 21 L WA Y B Cl Casing L N/A Y A e Chair Rall L N/A Y C Closet Jamb F L N/A Y AB Radiator L WA Y D Closet Walls L N/A Y Floor 0. L❑(dust) N/A Y Cl Baseboard L WA Y v Ceiling L NIA Y 1 Closet Pole L N/A Y Door L N/A Y 2 Closet Shelf L N/A Y C D Door Edge F L NIA Y 3 Cl Supports L N/A Y 12 Door Casing 00 L NIA Y 4 Closet Floor L❑(dust) NIA Y 34 Door Jamb 0 j F L NIA Y Closet Ceilin L N/A Y Threshold L WA Y A Window Sill f Mill AIM L N/A Y AB Door L NIA Y B Win Apron L WA Y D Door Edge F L NIA Y C Win Casing L N/A Y 12 Door Casing L NIA Y D Header Slop M/I L N/A Y 34 Door Jamb F L NIA Y Int Stops IMA L WA Y Threshold L NIA Y 1 Win Ind Sash Mll L NIA Y ABA Door J I L NIA Y 2 Exterior Sill W SF L WA Y yy Door Edge F L NIA Y 3 Pad Bead Mill L NIA Y 12 Door Casing L N/A Y 4 Blind Slop Mil SF L NIA Y 3 4 Door Jamb F L N/A Y Win Exl Sas Mitt L WA Y Threshold L N/A Y A Window Sill M/1 AIM L N/A Y A B Door L N/A Y B Win Apron L WA Y C D Door Edge F L N/A Y C Win Casing L NIA Y 1 2 Door Casing L N/A Y D Header Slop W L N/A Y 34 Door Jamb F L NIA I Y Int Slops MA L NIA Y Closet Door L N/A Y 1 Win Int Sash Mill L WA Y A CI Dom Edge F L N/A Y 2 Exterior Sill M/1 SF L N/A Y B Cl Casing L N/A Y 3 Part Bead WI L NIA Y C Closet Jamb F L N/A Y 4 Blind Stop MII SF L NIA Y D Closet Walls L NIA Y Win Ext Sashy Mill L N/A Y Cl Baseboard L N/A Y ou Win Above 5' L N/A Y 1 Closet Pole L NIA I Y Ceiling Moldin L N/A Y 2 Closet Shelf L NIAII F M/I AIM L NIA Y 3 Cl Supports L NIA Y F M/1 AN L N/A Y 4 Closet Floor L❑(dust) WA Y F Mil AIM L NIA Y Closet Ceiling I L WA Y COMMENTS/STRUCTURAL DEFECTS: EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact by a Deleader(MORE THAN 288 SQ.IN.) SIDEJ LOCATION I MEASURE:LOOSE PAINT IODATE ICMETHOD ❑ Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more A/M surfaces with adhesion problems LIRA Rep 2017 Hall Benjamin Misch I/R-3984 05/10/24 Page 20 �01_ Inspector(print) Lic# 2 Signature Date Risk Assessor(1141)ROPES ST Lic# Signature Date Address of Prooedv: Aol If City, ROOM# SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METH A e Up Walls ffJ L NIA Y Window Sill p.� Mill AM N/A Y A a Low Walls L WA Y B Win Apron sot L NIA Y I—Ltoor ards 0 L WA Y C Win Casing `� L N/A Y ail L NIA Y D Header Slop 0. Nll L N/A Y r 7 L NIA Y Int Stops 0� MII L NIA Y �p�' L❑(dusQ WA Y MII L N/A Y L NIA Y l� Exterior Sill gA YrA L NIA Y 3 Pad Bead Y CD Door Edge F L WA V 4 Blind Stop A Y 2 Door Casing CSC L WA Y Win Ext Sash Y 34 Door Jamb F L NIA Y Window Sill (�,4 Y Threshold L WA Y Win Apron Q0 Y A Door � L N/A Y C WinCasing . 0.1 Y C D Door Edge /. ' F L N/A Y D Header Stop Op MII L N/A Y Door Casing u4 L N/A Y Int Stops �� M/l L N/A Y 3 4 Door Jamb F L NIA Y 1 Win In(Sash 7M I L N/A Y Threshold L NIA Y ® Exterior Sill �Il, MII SF L N/A Y A B Door L NIA Y 3 Pad Bead F4? A YC D Door Edge F L NIA Y 4 Blind SlopA Y12 Door Casing L WA Y WnExt SashA Y34 DoorJamb F L NIA Y !!A WindowSill VThreshold L NIA Y lli' Win Apron YClosel Door (.P L NIAN CWin . Y /A1 CI Door Edge F L N/A D HeaderStop 5 W ill L NIA Y jo Cl Casing J, L NIA Int Stops 0 o NJI L N/A Y C Closet Jamb F L N/A Y 1 Win Int Sash Mil L NIA Y D Closel Walls L NIA Y 2 Exterior Sill J,Z WI SF L N/A Y Cl Baseboard 0. L NIA Y 3 Pad Bead 2 MII L NIA Y 1 Closet POW L NIA Y 4 Blind Slop ilPOW o3 SF L N/A Y 2 Closet Shelf O L NIA Y Win Ext Sash J MII L WA Y 3 CI Suppods L N/A Y AB Fireplace L WA Y 4 Closet Floor L❑(dust) NIA Y CD Manua L N/A Y Closel Collin 0. Ae c o Win Above 5' L NIA Y COMMENTS/STRUCTURAL DEFECTS: Ceilin Moldin LN/A Y v 9 F MI All L N/A y F M/11 AIM TWA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F Mil AJM LN/A Y by a Deleader(MORE THAN 288 SQ.IN.) F MII AM4 L NIA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC FMII A/M LNIA Y DATE METHOD F MII AIM L NIA Y Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LIRA Rep 2017 Room 05/10/24 Ben amin Misch 1/R-3984 / / Page Of Inspector(prinQ Lic# Sign ure Dale Risk Assessor[ 41)ROPES ST Lic# Signature Date / Address of Prooerty: Aot # City KITCHEN SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELFAD DELEAD SURFACE . HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ DATE METH DATE METH A a UP Wells to I L NIA Y A Window Sill l9'9 M/I AN L WA Y '. A B Lax Walls 0.5 L NIA Y B Win Apron C9 L WA Y '.. SLLA a Baseboards 0 Z L NIA V C Win Casing L NIA Y A e Chair Rail 6-7, L NIA Y D Header Stop M11 L WA Y As eb Radiator L NIA Y In[Slops M11 L WA Y ?` t Floor ❑1 ) 1 Win Inl Sash M/I L WA Y Oe} L dust WA Y i Ceiling IM L N/A Y 2 Exterior Sill MII SF L WA Y '.. AB Door L WA Y 3 Pad Bead SZ Mn L WA Y Door Edge F L NIA Y 4 Blind Stop Mg SF L NIA Y 12 Door Casing L WA Y Win Exl Sash Mn L WA Y 34 Door Jamb F L N/A Y A Window Sill M/I AIM L WA Y Threshold VA L WA Y B Win Apron L WA Y AB Door L WAI Y C Win Casing L WA Y '... C D Door Edge F L N/Al Y D Header Stop M11 L WA Y '... 12 Door Casing L WAI Y int Stops Mll L N/A Y 34 Door Jamb I F L N/Al Y 1 Win IN Sash MII L N/A Y '.. Threshold L WA Y 2 Exterior Sill Mil SF L NIA Y AB Door L NIA Y 3 Part Bead Mn L N/A Y C D Door Edge F L NIA Y 4 Blind Stop Mll SF L WA Y 12 Door Casing L WA Y Win Ext Sash M11 L NIA Y 34 Door Jamb F L NIA Y A B Up Cab Frame L N/A Y Threshold L WA Y C D Up Cob Door U.;D L NIA Y Closet Door L NIA Y Up Cab Wails 0, L N/A Y A CI Door Edge F L NIA Y 12 Up Cab Shivs QQ L WA Y B Cl Casing L WA Y 34 Supports L WA Y C Closet Jamb F L NIA Y Low Cob Fram Vz L N/A Y D Closet Wells L WA Y A B Low Cab Door L NIA Y Cl Baseboard L WA Y C D Low Cab Well p L WA Y 1 Closet Pole L WA Y Low Cab Sh Q. L NIA Y 2 Closet Shelf L N/A Y 12 Supports I L WAI Y 3 CISupports L WA V 34 Drawers N, L WAr Y 4 Closet Floor L❑(dusl) NIA Y oB Win Above 5' If L NIA Y CIosel Ceiling L WA Y <"+;:,`.?Ceiling Moldinj L NIA Y COMMENTS STRUCTURAL DEFECTS: FMA ArM LN/A Y IFJM L NIA Y L N/A Y MAL WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made Intact L NIA Y by a Deleader(MORE THAN 288 SQ.IN.) L N/A Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC LN/A Y DATE METHOD LNIA Y Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or mme AIM surfaces with adhesion problems LIRA Rep 2017 Kitchen r 05/10/24 29 Benjamin Misch i/R-3984 / / Page_01_ Inspector(print) Lic# -Signature Date Risk AssessorlllnfROPES ST Lic# Signature Date STELIVI Address of property: Aol # Cily BATHROOM# SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ7 DATE I METH DATE METH SURFACE HAZARD HAZI DATE METH DATE METH SLIL A e Up Walls 1,. L WA Y AB Up Cab frame L N/A Y A e Lox,Walls L WA Y C D Up Cab Door L N/A V A B Beseboards L WA Y Up Cab Walls L WA Y A s V. D Chair Rail L WA Y 12 Up Cab Shivs L N/A Y AB Co Radiator L WA V 34 Supports L N/A Y Floor 09 L dust WA Y �( ) Low Cab Fram W L WA Y Ceiling ti=v u' 9 L WA Y AS qDrawerso-1) oor (1 L WA Y A B Door pp L WA Y D all (A L WA Y D Door Edge F L N/A Y hivs L WA Y 12 Door Casing L WA Y 12 L WA Y 3 4 Doorjamb F L NIA Y 34 o-? L N/A Y Threshold L NIA Y A Mil AM L NIA Y A B Door L WA Y ® L NIA Y C D Door Edge F L N/A Y C Win Casing GO L WA Y 12 Door Casing L WA Y D Header Stop . MA L NIA Y 34 Door Jamb F L NIA Y In[Stops MA L WA Y Threshold L WA Y 1 Win lnl Sash Mll L NIA Y A B Door L N/A Y 2 Exterior Sill M/I SF L NIA Y C DPage F L N/A Y 3 PadBeed J wl L N/A Y 12 L N/A Y 4 Blind Stop M 1 SF L N/A Y 34F L N/A Y Win Ent Sash �(. MII L N/A Y L NIA Y cp Win Above 5' L NA Y Closet Door L WA Y +'i`:Ceiling Molifinj L NA Y A Cl Door Edge F L N/A Y 'CD Medicine Cab O. L NA Y B Cl Casing L N/A Y 4y — 0.41 F M/1 AM L N/A Y C Closet Jamb F L NIA Y FM/I AM LN/A Y D Closet walls L WA Y F Mir AM L N!A Y CI Baseboard L WA Y F MA AAA L N/A Y 1 Closet Pole L WA Y F MA AM L N!A Y 2 Closet Shelf L NIA Y F MA AIM L N/A Y 3 Cl Supports L NIA Y F Mn AM L NIA Y' 4 Closet Floor IL❑(dust) WA Y F M/I AIM L N/A Y Closet Ceiling L N/A Y F MA AMA L NIA Y F MII AM L NIA Y F MII A/M L NIA Y F MA AM LN/Al Y F MIA AM L NIA Y EXCLUDED SURFACES:Surfaces listed In these boxes can only be made Intact COMMENTS/STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288 SO.IN.) SIDE LOCATION MEASURE:LOOSE PAINT IC IC DATE METHOD Check the box it this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LIRA Rep 2017 Bath Ben'amin Misch I/R-3984 . 05/10/24Pageor_ Inspector(print) Lic# Signature Date Risk Assessor(grll)ROPES ST Lic# Signature Date Address of Property' Ant # City ROOM# _ SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METH A B Up Walls (� L N/A Y A Window Sill Mll AIM L N/A Y A e Low Walls /, L N/A Y ©Win Apron all, L N/A Y A s Baseboards p L NIA Y C Win Casing JJ L WA Y A a Chair Rail L N/A Y D Header Stop Q. WI L N/A Y As Radiator L NIA Y Int Stops CX) W1 L N/A Y Floor L Dictum) N/A Y 1 Win Int Sash Nll L WA Y Ceiling L NIA Y 2 Exterior Sill MIA SF L N/A Y Door DO L N/A Y 3 Pad Bead M/I L WA Y C D Door Edge F L N/A Y 4 Blind Stop MII SF L NIA Y 12 Door Casing so L N/A Y Win Ext Sash WI L N/A Y 34 Door Jamb 00 F L NIA Y A Window Sol MII A/M L N/A Y Threshold L NIA Y B Win Apron cis L N/A Y A B Door L N/A Y © Win Casing Q L N/A Y oor Edge F L N/A Y D Header Stop W MII L N/A Y 12 Door Casing C. L N/A Y Inl Stops 6.a i t L N/A Y 34 Door Jamb 0- F LN/A Y 1 Win lnl Sash 4.4 MJI LWA Y Threshold L WA Y 2 Exterior Sill qT Mil SF L N/A Y AB Door L NIA Y 3 Part Bead J.Z. MlI L N/A Y C D Door Edge F L N/A Y 4 Blind Slop M4 SF L NIA Y 12 Door Casing L NIA Y Win Exl Sash V4 Mill L N/A Y 34 Door Jamb F L N/A Y A Window Sill Mll AIM L N/A Y Threshold L N/A Y B Win Apron L N/A Y Closet Door L NIA Y C Win Casing L NIA Y A CI Door Edge F L N/A Y D Header Stop M/I L NIA Y B CI Casing .1� L NIA Y Inl Stops Md L NIA Y C Closet Jamb 01 F L NIA Y 1 Win lnl Sash Mn L NIA Y D Eloset Walls uo L NIA Y 2 Exterior Sill MII SF L N/A Y Cl Baseboard L N/A Y 3 Part Bead Mll L N/A Y 1 Closet Pole LWA Y 4 Blind Stop MA SF L N/A Y 2 "Closet0eiling L NIA Y in Ext Sash WI L WA Y 3 L NIA Y A B Fireplace L NIA Y 4 LQ(dust) NIA Y CD Mange L NIA Y L N/A Y eu Wm Above S' L NIA Y COMMENTS/STRUCTURAL DEFECTS: a� Ceiling Moldinj LNiA I Y F MII AIM L N/A Y FMII AM LN/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F MIA AM LN/A Y by a Deleader(MORE THAN 288 SQ.IN.) F MA AM L N/A Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F MII A/M L N/A Y DATE METHOD F MIA AM L N/A Y Check the box It this ROOM is RULED OUT for encapsulation because there are 3 or more AIM suifaces with adhesion problems LIRA Rep 2017 Room Ben 05/10/24'amin Misch I/R-3984 . Page Of Inspector(print) Lic# Signature Date Risk Assessor(11T)ROPES ST Lic# Signature Date Address of Pro ed : Ant. Cil : ROOM# SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METH n a Up Walls d, L N/A Y A Window Sill Mil AIM L N/A Y A e Low Walls L N/A Y B Win Apron .iI L NIA Y A 9 Baseboards D,O L N/A Y C Win Casing L N/A Y A e Chair Rail L NIA Y D Header Slop D. MA L N/A Y Ao Radiator L WA Y Int Stops 09 M/i —L N/A Y %=Floor pO L❑(dusQ NIA Y 1 Win Int Sash O1� WI L N/A Y Ceiling L WA Y 2 Exterior Sill Mll SF L N/A Y B Door C/0 L NIA Y 3 Pad Bead NJ LL WA Y C D Door Edge F L NIA Y 4 Blind Slop MII SF L N/A Y 12 Door Casing L NIA Y Win Exl Sash MII L NIA Y 3 4 Door Jamb (/.J F L NIA Y A Window Sill NJI AIM L NIA Y Threshold L,a,D L WA Y B Win Apron L N/A Y Aboor c9. L N/A Y C Win Casing L N/A Y C D Door Edge F L N/A Y D Header Stop M/I L NIA Y 12 Door Casing j,` L N/A Y Int Slops hvl L N/A Y 34 Door Jamb 15.7 F L N/A Y 1 Win In[Sash MJI L NIA Y Threshold L NIA Y 2 Exterior Sill M/I SF L NIA Y AB Door L NIA Y 3 Pad Bead ArJI L N/A Y C D Door Edge F L N/A Y 4 81ind Stop MII SF L NIA Y 1 2 Door Casing L NIA Y .Win Ext Sash NJI L N!A Y 34 Door Jamb F L NIA Y A Window Sill Mil AIM L WA Y Threshold L NIA Y B Win Apron L NIA Y Closet Door L NIA Y C Win Casing L N/A Y A Cl Door Edge F L N/A Y D Header Stop Mll L N/A Y ® Cl Casing �' L NIA Y Inl Stops Mll L N/A Y C Closet Jamb , F L NIA Y 1 Win Int Sash MII L WA Y D Closet Walls L WA Y 2 Exterior Sill MII SF L WA Y Cl Baseboard L / Y 3 Pad Bead MA L N/A Y 1 Closet Pole l9� L NIA Y 4 Blind Stop MA SF L NIA Y 2 Closet Shelr L NIA Y Win Ext Sash MJI L WA Y 3 CI Suppods Q. L NIA Y NB Fireplace L N/A Y 4 Closet Floor day L❑(dust) NIA Y CD Mange L NIA Y Close)Ceiling pJY, L N/A Y Cu Win Above5' I L N/A Y COMMENTS f STRUCTURAL DEFECTS: k ,Ceiling Moldint I LNIA Y F MII AIM A Y F MII A LNLNN/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F MA AIM L NIA Y by a Deleader(MORE THAN 288 SQ.IN.) F M A M L NIA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F Mill AIM L NIA Y DATE METHOD F MII AM. L N/A Y Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more AIM suifaces with adhesion problems LI/RA Rep 2017 Room 05/10/24 2r�0 Beniannin Misch I/R-3984 Paga/, of_ Inspector(print) Lic# Signature Date Risk Assessor r4t)ROPES ST Lic# Signature Date Address of Prooedy AM # City ROOM# `�_, SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METH A e Up Walls I b L NIA Y A Window Sill_OS M I AIM L WA Y A e Low Walls L NIA Y B Win Apron L N/A Y A e Baseboards ba L NIA Y C Win Casing n 0A L N/A Y A Chair Rail C> L N/A Y Header Stop ()O Mil —L NIA Y AB Radiator /. L NIA Y Int Stops op 0.1i Mll L N/A Y +:: t Floor LfJ L❑(dust) NIA Y Win Int Sash Mil L N/A Y Ceiling L NIA Y 2 Exterior Sill M/1 SF L WA Y A oor L WA Y 3 Part Bead NII L NIA Y C Door Edge F L N/A Y 4 Blind Stop MII SF L NIA Y Door Casing 0.3 L WA Y Win Ext Sash A. Nll L NIA Y 34 Door Jamb F L N/Ai Y A Window Sill 6$ Mil A/M L NIA Y Threshold L WA Y B Win Apron L N/A Y B Door L NIA Y C Win Casing Oy L NIA Y CD Door Edge F L NIA Y ® Header Slop Od Mll L NIA Y 12 Door Casing L N/A Y Int Stops 6.1 MA L NIA Y 34 Door Jamb F L NIA Y" 1 Win Int Sash ig WI L NIA Y Threshold L N/A Y Exterior Sill ,J MII SF L NIA Y A Door (,� L N/A Y 3 Pad Bead 4v— MllLYC D Door Edge F L NIA Y 4 Blind Stop MII SF L NIA Y 1 Door Casing p. L NIA Y Win Exl SashMill L NIA Y 34 Door Jamb 00 F L N/A Y A Window Sill MII AIM L N/A Y Threshold (90 L NIA Y B Win Apron L NIA Y Closet Door L NIA Y C Win Casing L N/A Y CI Door Edge t L N/A Y D Header Slop Mll L NIA Y Cl Casing L NIA Y Int Stops MII L NIA Y C Closet Jamb L NIA Y - 1 Win Int Sash dM L NIA Y D Closet walls L NIA Y 2 Exterior Sill I Mill SF L NIA Y Cl Baseboard L NIA Y 3 Pan Bead MII L N/A Y 1 Closet Pole L N/A Y 4 Blind Stop titn SF L NIA Y 2 Closet Shelf 0.1 L NIA Y Win Exl Sash tits L NIA Y 3 Cl Supports 0. L NIA I Y AB Fireplace L NtAf Y 4 Closet Floor _'n L❑(dust) N/A Y Y CD Mange L NIA Y Closet Ceiling PA L NIA A9 On Win Above 5' L N/A I Y COMMENTS/STRUCTURAL DEFECTS: Ceiling Moldin 9 L N/Al Y MN/Ay AIMN/A Y N/A YEXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact N/A Yby a Deleader(MORE THAN 288 SQ.IN.) NIA YSIDE LOCATION MEASURE:LOOSE PAINT IC IC N/A YDATE METHOD N/A Y EJ Check the box if(his ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LIRA Rep 2017 Room 05/10/24 20 Ben'amin Misch I/R-3984 PagejGOf_ Inspector(print) Lic# Signature Date Risk Assessor(�ri�QROPES ST Lic# Signature Date Address of Property: Apt.# City ROOM#�,_ SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ1 DATE METH DATE METH A a Up Walls L NIA Y A L NIA Y A a Low Walls L WA Y B /,' L NIA Y A e Baseboards L N/A Y 77 C �. L N/A Y A s Chair Rail L NIA Y D L NIA Y AD Radiator L N/A Y V Ol7 L N/A Y - Floor L (dust) N/A Y 1 ` - L NIA Y ?''"rr Ceiling L WA Y 2 ' 01 L N/A Y A B Door 6o L N/A Y 3 q%4s 0 L NIA Y D Door Edge F L NIA Y 4 L N/A Y 2 Door Casing D, L WA Y X r,* L NIA Y 34 Door Jamb U.J F L NIA Y A Window Sill M11 AIM L NIA Y Threshold bJ L NIAJ Y B Win Apron L N/A Y A B Door CA L N/A Y C Win Casing L N/A Y D Door Edge F L N/A Y D Header Stop MII L N/A Y 1 oor Casing L N/A Y Int Stops M11 L N/A Y 34 Door Jamb F L N/A Y 1 Win lnt Sash M/I L N/A Y Threshold L NA Y 2 Exterior Sill WI SF L WA Y A B Door GO, L NIA Y 3 Part Bead M/1 L NIA Y D Door Edge F L NIA Y 4 Blind Stop Mn SF L NIA Y 12 Door Casing W I. NIA Y Win Ext Sash Mil L NIA Y 4 Door Jamb F L NIA Y A Window Sill Ml NM L NIA Y Threshold W L NIA Y B Win Apron L N/A Y �DF' cO L NIA Y C Win Casing L NIA Y CL NIA Y D Header Slop 51 L N/A Y • L NIA Y Inl Slops NJI L N/A Y L NIA Y - 1 Win Inl Sash Mll L WA Y L NIA Y 2 ExledwSill hUl SF L N/A Y p :J AO L NIA Y 3 Pad Bead M/I L NIA Y S ZA! L N/A Y 4 Blind Stop M11 SF L WA Y C, oo L WA Y Win EA Sash hUl L N/A Y (jJ L NIA Y AB Fireplace L NIA Y N/A Y C D Mange L NIA Y l N/A Y AD co Win Above 5' L NIA Y COMMENTS/STRUCTURAL DEFECTS: '�`,':,`":Ceiling Moldin LN/A Y F Mill A/M L N/A Y F Mll AM L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made infacl F MII AM L N/A Y by a Deleader(MORE THAN 288 SQ.IN.) F MA A/M LWA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC FMII A/M LN/A Y DATE METHOD F Mill AM L N/A Y ❑ Check the box If this ROOM is RULED OUT for encapsulation because there are 3 or more A/M surfaces with adhesion problems LI/RA Rep 2017 Room Benjamin Misch I/R-3984 " / 0/J/10/24 Pagel`-o0f_ Inspector(print) Lie# gnature Date if Risk Assessor(prhill ROPES .STLic# Signature 1 Date ALEM Address of Pro ert : Apt.# city: STAIRCASE# ] L SIDE LOCATIONI I LEAD TYPE OF URG SIC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METH A a Up Walls L A Y A Window Sill Mil A/M L NIA Y A B Low Walls 00 L NIA Y B Win Apron L NIA Y A a Baseboards l L NIA Y C Win Casing L N/A Y A B Chair Rail 0•1 L N/A Y D Header Slop MID L N/A Y AB CD Radiator L NIA Y Int Stops MWI L WA Y '.. =:!Floor CIN L Q(dust) WA Y 1 Wm int Sash MVI L N/A Y 1 Ceiling L NIA Y 2 Extedor Sill Mlll SF L N/A Y Door Y) L WA Y 3 Pad Bead M111 L N/A Y C D Door Edge Z F L N/A Y 4 Blind Slop Mill SF L NIA Y 12 Door Casing O. L WA Y Win Ext Best I IM11 L N/A Y 34 Door Jamb 0;l F L N/Al Y A Window Sill MID AIM L NIA Y Threshold UN L WA Y B Win Apron L N/A Y A B Door (A L WA Y C Win Casing L N/A Y D Door Edge F L N/A Y D Header Stop MID L NIA Y 12 Door Casing OT L NIA Y Inl Slops Mil L NIA Y 34 Door Jamb F L NIA Y 1 Win Inl Sash Mill L N/A Y Threshold L NIA Y 2 Exterior Sill WI SF L N/A Y A B Door L N/A Y _ 3 Part Bead Mill L N/A Y C D Door Edge F L N/A Y 4 Blind Stop MID SF L WA Y 1 2 Door Casing L NIA Y Win Ext Sash MID L N/A Y 3 4 Door Jamb F L N/A Y Newel Post /. L N/A Y Threshold L NIA Y Railing Cap AIM L N/A Y A B Door L WA Y Handrail 0.1 AIM L NIA Y CD Door Edge F L NIA Y Balusters /. L N/A Y 12 Door Casing L NIA Y Lower rail L WA Y 34 Door Jamb F L NIA Y Treads Oj F L NIA Y Closet Door L N/A Y _ Risers ba L WA Y A Cl Door Edge F L N/A Y Sbinger /. L NIA Y B Cl Casing L WA Y Tread edge>5 L NIA Y C Closet Jamb F L N/A Y Landing Boor CW L ❑(dust) N/A Y D Closet Walls L WA Y Floor Edge '60 L NIA Y Cl Baseboard L N/A Y Floor Casing L WA Y 1 Closet Pole L N/A Y F Mil AIM L NIA Y 2 Closet Shelf L WA Y F Mil AIM L N/A Y 3 CI Supports L N/A Y F MII AIM L N/A Y 4 Closet Floor L (dusQ N/A Y F M/1 AIM L N/A Y Closet Ceiling L N/A Y F Mil AIM L NIA Y EXCLUDED SU ACES:Surfaces listed in these boxes can only be made intact COMMENTS/STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288 SQ.IN.) SIDE LOCATION MEASURE:LOOSE PAINT IC T IC DATE METHOD ElCheck the box if this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LIRA Rep 2017 Stair / 05/10/24 20 Ben amin Misch I/R-3984 ,/ / / Page 5 Of_ Inspeclor(print) Lie# ignature Date Risk Assessor i f OPES T Lic# Signature Date / dor Clivi PORCH (side) (floor) SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ?j DATE I METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METH A e Siding L WA Y A B Window Sill AIM L NIA Y C D Comer eoaMs L NIA Y C D Win Casing L N/A Y Upper Trim30. Q WA Y 12 Window Sesh L NIA y Ceiling ILA aL WA Y 3 4 Mullions L N/A Y ±�. Joists L WA Y AB Window Sill AIM L WA Y Storm Door A L N/A Y C D Win Casing L WA Y A B Slim Door Edg F L NIA Y 12 Window Sash L NIA Y C D Door 00 L N/A Y 34 Mullions L WA Y Door Edge /. F L NIA Yri�i'i Support Clm_ns 00 L WA Y 12 Door Casing04 L WA Y i Newel post JO L N/A Y 34 Door Jamb 0 F L N/A Y Railing Cap ON AIM L N/A Y Threshold4 L WA Y �� Handrail 00 NM L NIA Y Kicicplala L WA Y € balusters 00 L WA Y Storm Door L WA Y _ F`f'r Lower Rail (54 L N/A Y A B Slrm CoorEdg F L NIA Y '+�.,: Treads Dp F L WA Y C D Koor 6 L NIA Y i,Wsers 00 L NIA Y Door Edge F L WA Y ,Stringer /. L WA Y 12 Door Ceaing C. L NIA Y ett ; 3 4 Door Jamb -Tread Edge 0o L WA Y (J� F L NIA Y 7 T.Lower Walls L WA Y Threshold r16 L NIA Y r,„`s;;�Lattice L WA Y Kidcplale (g. L WA Y ;rrLower Tdm L WA Y A B Window Sill p j Aim L NIA Y Floor o p L (dusir WA Y C D Win Casing (q� L NIA Y F M/I APot L WA Y 12 Window Sash L NIA Y FMB AAA L NIA Y 34 Mullions L N/A Y F W AIM L NIA Y A B Window Sill Co.. AIM L N/A Y F MII AM L NIA Y C D Win Casing L WA Y F M/l AN L WA Y 12 Window Sash L WA Y FMB AAA L N/A Y 3 4 Mullions L WA Y FMB AN L WA Y A B Window Sill AIM L WA Y F M/I AN L NIA Y C D Win Casing L N/A Y F MII AAA L WATy 1 2 Window Sash L WA Y F M AAA L NIA4 Mullions L NIA YF MA AAA L NIA COMMENTS/STRUCTURAL DEFECTS: (dust)'•Applies only to porches used as Interior space COMMENTS/STRUCTURAL DEFECTS: EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only by a licensed deleader. SIDE LOCATION MEASURE LOOSE PAINT IC IC (MORE THAN 2880 SQ.IN.)_ DATE METHOD ❑ Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more A/M surfaces with adhesion problems LIRA Rep 2017 Porch Benjamin Misch I/R-3984 r ` / 95/10/24 Page14200f_ Inspector(print) LIC# lignature Dale Risk Assessor (prItA ROPES STLio# Signature 1 Date 6ALEM Address of Pro Apt.# City: EXTERIOR Side SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SI E LOCATION/ LEAD TYPE OF URG IC IC IDELFAD DELEAD SURFACE HAZARD HAZ DATE METH DATE METH SURFACE HAZARD HAZI DATE METH DATE METH Siding J L WA Y Window Sill (,4 AIM L N/A Y U Corner Boards Co L WA Y Win Casing (0J L N/A Y li Lower Trim (Al, L WA Y Window Sash L WA Y Upper Trim L N/A Y r Win Sill 77 AIM L NIA Y Win Above 5' CV4 L WA Y lAt•I Win Frame L NIA Y Porch Above 5' j,%Pj (L)N/A Y del Win Sash L NIA Y Storm Door L N/A Y L N/A Y Strm Door Edge F L N/A Y Cellar Win Sill /A Y Door L NIA Y CeI Win Fram 14, N/A Y '.. 1 2 Door Edge F L NIA Y CeI Win Sash L WA Y '.. 3 4 Door Casing L WA Y Screen Frame WL N/A Y Door Jamb F L N/A Y Cellar Win Sill 141 A9 6 N/A Y Threshold L N/A Y Cot Win Frame1 .5 L N/A Y Kidcplate L N/A Y # Cot Win Sash ^J 2� L NIA Y Storm Door L NIA Y a Screen Frame JEO L N/A Y Strm Door Edge F L N/A Y Foundation 01 L N/A Y '.. Door L N/A Y Bulkhead L N/A Y 1 2 Door Edge F L NIA Y Fences L NIA Y 3 4 Door Casing L WA Y Shutters L NIA Y Door Jamb F L N/A Y Newel post L NIA Y Threshold L N/A Y Railing Cap A/M L NIA Y Kickplate L NIA Y Handrail AIM L NIA Y Door L WA Y A Balusters L N/A Y Door Edge F L N/A Y Lower Rail L N/A Y 1 2 Door Casing L NIA Y Treads F L N/A Y '. 3 4 Door Jamb F L NIA Y Risers L N/A Y Threshold L WA Y Tread edge L N/A Y Kidcplale L NIA Y Landing floor L NIA Y Window Sill AN L NIA Y Stringer L NIA Y Win Casing L WA Y Lalgce 4 L NIA Y Window Sash `1 L WA Y Drain Ppes L NIA Y Window Sill C-A AIM L NIA Y Elec Conduit L NIA Y Win Casing L N/A Y Oil Fill Pipe L NIA Y Window Sash L NIA I Y Overhang Trim Lpr L WA Y COMMENTS STRUCTURAL DEFECTS: Support Clmns L N/A Y F MII AIM L N/A Y F Mill APd L NIA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made Soil Test Results(Must be less than 400 ppm for play area 11200 ppm for bare soil) intact by a Deleader(MORE THAN 2880 SQ.IN.) LOCATION AREA MEASUREMENT RESUL REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT ICDATE ICMETHOD (Square Feel) I (PPM)l DATE I METH D Play Area D Bare Soil D Comments: D LIRA Rep 2017 Ext D Benjamin Misch I/R-3984 / p5/10/24 Page 40f_ Inspector(print) Lic# gnalure Date / / I Risk Assessor (priltA ROPES 8TUc# Signature Date 6ALPM Address of Prooerty: Apt.# City EXTERIOR B Side SIDE LOCATION/ LEAC TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD B SURFACE HAZARD HAZI, DATE METH DATE METH B SURFACE HAZARD HAZ7 DATE METH DATE METH Siding L NIA Y Window Sill AIM L NIA Y Corner Boards (21 L WA Y B Win Casing L NIA Y B Lower Tdm L WA Y # Window Sash L N/A Y Upper Trim L WA Y Cellar Win Sill /0 Afb 0 N/A Y '... Win Above 5' or L N/A Y B Gel Win Fiame.Lj$ WA Y Porch Above 5' 1 L WA Y # CeI Win Sash v L NIA Y Storm Door L NIA Y Screen Frame ,.p L N/A Y Slnn Door Edge F L NIA Y Cellar Win Sill 23 WA Y B Door L N/A Y B Cel W n Fram /5 NIA Y 1 2 Door Edge F L N/A Y # Call Win Sash J2, L NIA Y 3 4 Door Casing L NIA Y Saeen Frame .Dp L NIA Y Door Jamb F L N/Al Y Cellar Win Sill AIM L NIA Y Threshold L N/Al Y B Gel Win Frame, L N/A Y Kickplate L NIA I Y # CeI Win Sash L N/A Y Storm Door L WA Y Saeen Frame L WA Y Shm Door Edge F L NIA Y IFoundabon H1L L N/A Y '.. B Door L NIA Y 8 IBulkhead I I< L WA Y 1 2 Door Edge F L N/A Y Fences o p L WA Y 3 4 Door Casing L WA Y IShufters L WA Y Door Jamb F L NIA Y Newel post L WA Y Threshold f L N/A Y Railing Cap AIM L WA Y '.. Kickplale L NIA Y Handrail AIM L N/A Y Door L NIA Y B Balusters L N/A Y B Door Edge F L N/A Y Lower Rail L N/A Y 1 2 Door Casing L NIA Y Treads F L N/A Y 3 4 Door Jamb F L NIA Y Risers L N/A Y Threshold L N/A Y Tread edge L N/A Y Kickplate L WA Y Landing floor L WA Y Window Sill AIM L WA Y Stringer L N/A Y B Win Casing ," 1 L NIA Y Ttd; L N/A Y #I Window Sash L N/A Y Drain Pipes L NIA Y Window Sill AIM L N/Al Y B Else Conduit t%o L WA Y B Win Casing OV I L N/Al Y Oil Fill Pipe L WA Y #a Window Sash V4 I L NIAJ Y Overhang Trim C61 L WA Y COMMENTS/STRUCTURAL DEFECTS: B Support Cimns L WA Y B FMII AN LNIA Y B F M/I AIM L NIA I Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made Soil Test Results(Must be less than 400 ppm for play area/1200 ppm for bare soil) intact by a Deleader(MORE THAN 2880 SQ.IN.) LOCATION AREA MEASUREMENT RESULJ REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT ICDATE IC METHOD (Square Feet) (PPM) DATE METH B Play Area B Bare Soil B Comments: B LIRA Rep 2017 Ext B 05/10/24 20 Ben amin Misch I/R•3984 / / / Page1B Of Inspector(print) Licq ignature Date Risk Assessor r t OPES ST Licp Signature Date / SAIEM Address of P e : Ant, C•1 . PORCH C/ (side) (floor) SIDE LOCATION/ LEAD TYPEOF URG IC IC DELEAD DELEAD ISIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ DATE METH DATE METH A B Skiing L WA Y A B Window Sill AIM L N/A Y CD Comer Boards LN/A Y CD Win Casing LNIA Y K r Upper Trim IS L WA Y 12 Window Sash L N/A Y Ceiling OA L N/A Y 3 4 Mullions L N/A Y Jolats fa$ L A Y A B Window Sill AIM L N/A Y Storm Door L WA Y C D Win Casing L N/q y —' A B Sinn Door E F L N/A Y 12 Window Sash L N/A Y C D Door L N/A Y 34 Mullions L N/A Y l, ,� Support .0 Door Edge F L N/A Y 7 WA Y 12 Door Casing CC L WA Y s4,4 Newel post 0) 1 L N/A Y 34 Door Jamb UPF L NIA Y Railing Cap 01P I AM L N/A Y Threshold L WA Y ur Handrail aA AIM L N/A Y a Kickplate L N/A Y Ou'.�s v Balusters 0. L N/A Y Storm Door L WA Y `t Lower Rail Oz L WA Y A B Stan Door Edg( F L N/A Y , ty� Treads 00 F L NIA Y C D Door L WA Y - Risere M L WA Y r»�. Door Edge F L N/A Y c` 'Sbingo, CZ L WA Y 12 Door Casing L N/A Y ==Tread Edge E) L WA Y 3 4 Door Jamb F L N/A Y %i Lower Walls � L WA Y Threshold L NIA Y M'g Lowce L WA Y EF Kickplate LNIA Y .c* sr` Lower Trim � L WA Y A B Window Sill A/M LNIA Y z ' CAJ ..., ;Floor UJ L�(dusQ* WA Y CD Win Casing G4 L NIA Y F M/l AN L WA Y 2 Window Sash L N/A Y F M/1 AN L NIA Y 34 Mullions L NIA Y F MA AM L NIA Y AB Window Sill AIM L N/A Y F MA AIM L NIA Y C D Win Casing (pf L N/A Y F MA AIM L NIA Y 10 Window Sash L Wq Y F Mg AIM LNIA Y 3 4 Mullions L WA Y . F Mn AIM—L N/A Y A B Window Sill All L WA Y F MA AN L N/A Y CID Win Casing L N/A Y F M8 AIM L NIA Y 1 2 Window Sash L WA Y F M/I AN L WA Y 3 4 Mullions L NIA Y F MA RM L N/A Y COMMENTS/STRUCTURAL DEFECTS: (dust)`•Applies only to porches used as inferior space COMMENTS/STRUCTURAL DEFECTS: EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only by a licensed del)ader. SIDE LOCATION MEASURE:LOOSE PAINT IC I IC (MORE THAN 2880 SO.IN.) DATE METHOD ❑ Check the box it this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LIRA Rep 2017 Porch \Benjamin Misch I/R-3984 t / 95/10/24 Page a 001' inspector(print) Lic# Signature Dale Risk Assessor (prl t ROPES SRI Signature Date 6AI M Address of Property: Apt # City EXTERIOR C Side SIDE LOCATIOW LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD C SURFACE HAZARD HAZ7 DATE METH DATE METH C SURFACE HAZARD HAZ7 DATE METH DATE METH Siding L N/A Y IShuftefs dow Sill AIM L NIA Y Corner Boards L WA Y C Casing L N/A Y C Lower Tdm pq L N/A Y # dow Sash L WA Y Upper Tdm 61n4 L WA Y lar Win Sill AIM L WA Y Win Above 5' L N/A Y C Win Fram L NIA Y Porch Above 5' dpi L IA Y # CalWin Sash L WA Y Storm Door L N/A Y en Fram L NIA Y Slim Door Edge F L NIA Y lar Win Sill (J L AIM L NIA Y C Door (A L WA Y C W n Frame 4 L NIA Y 1 2 Door Edge F L WA Y # CalW n Sash N L L N/A Y 3 4 Door Casing L N/A Y en Frame L NIA Y Door Jamb F L NIA Y lar Win Sill AIM L N/A Y Threshold L WA Y C Win Frame L N/A Y Kickplale L NIA Y # Win Sash L NIA Y Storm Door L N/A Y en Frame L NIA Y Stan Door Edge F L N/A Y ndation rJ.4 L N/A Y C Door L N/A Y C khead /. ' L N/A Y 1 2 Door Edge F L NIA Y ces p.7 L NIA Y 3 4 Door Casing L WA Y Hers L N/A Y '.. Door Jamb f F L NIA Y Newel post L N/A Y Threshold L WA Y Railing Cap AIM L N/A Y Kickplale F L NIA Y Handrail AIM L NIA Y Door _ L NIA Y C Balusters L NIA Y C Door Edge F L NIA Y Lower Rail L NIA Y '.. 1 2 Door Casing L WA Y Treads F L N/A Y 3 4 Door Jamb F L NIA Y Risers L NIA Y Threshold L NIA Y Tread edge L NIA Y Kickplate L WA Y Landing floor L WA Y Window Sill AIM L N/A Y Stinger L NIA Y C rWmdo8w8Sash ing L N/A Y Lattice L N/A Y # L N/A Y Drain Pipes L NIA Y Window Sill AIM L WA Y C Elec Conduit L NIA Y C jWn Casing L NIA Y Oil Fill Pipe L NIA Y '.. # Window Sash L NIA Y Overhang Tdm p,if L WA Y COMMENTS/STRUCTURAL DEFECTS: C Support Claims L NIA Y C FMIIAM LN/A Y C F Mll AIM L N/A Y -Ej EXCLUDED SURFACES:Surfaces listed in these boxes can only be made Soil Test Results(Must be less than 400 ppm for play area/1200 ppm for bare soil) intact by a Deleader(MORE THAN 2880 SQ.IN.) LOCATION AREA MEASUREMENT RESUL REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT ICDATE IC METHOD (Square Feet) (PPM) DATE METH C Play Area C Bare Soil C Comments: C LT/RA Rep 2017 Ext C Benjamin Misch I/R-3984 1 ` / 95/10/24 P� OQf_ Inspector(print) Lic# � ig6nature Date Risk Assessor (priltj HOPES 6ILic# Signature Date ALEM Address of Property: Ant # City EXTERIOR_D Side SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD D SURFACE HAZARD HAZ7 DATE METH DATE METH D SURFACE HAZARD HAZ7 DATE METH DATE METH Siding L WA Y Window Sill AIM L NIA Y '.. Coiner Boards L WA Y D Win Casing L NIA Y D Lower Trim ( L WA Y # Window Sash L N/A Y Upper Trim r L N/A Y Cellar Win Sill N.(o /A Y Win Above 5' (p L WA Y D Cal Win Frame /. ( L NIA Y Porch Above 5' L WA Y # CeI Win Sash L NIA Y Storm Door L N/A Y Screen Frame 00 L NIA Y Sum Door Edge F L N/A Y Cellar Win Sill AIM L NIA Y D Door uz L NIA Y D CeI Win Fram Z NIA Y 1 2 Door Edge F L N/A Y # Cal Win Sash L NIA Y 3 4 Door Casing UP L N/A Y Saeen Frame L NIA Y FK,ckpla[e F L N/A Y Cellar Win Sill AIM L NIA Y IS.L L WA Y D Cal Win FrameL NIA Y 06 L NIA Y # Cal Win Sash L NIAJ Y Storm Door L NIA Y Screen Frame L NIA Y Stan Door Edge F L NIA Y Foundation r1L L WA Y D Door L NIA Y D Bulkhead L WA Y 1 2 Door Edge F L NIA Y Fences L NIA Y 3 4 Door Casing L WA Y Shutters L WA Y Door Jamb F L NIA Y Newel post f L N/A Y Threshold L WA Y Railing Cap AIM L WA Y Kickplale L NIA Y Handrail AIM L N/A Y Door L NIA Y D Balusters L N/A Y '.. D Door Edge F L NIA Y Lower Rail L N/A Y 1 2 Door Casing L NIA Y Treads F L N/A Y 34 Door Jamb F L NIA Y Risers L N/A Y Threshold L WA Y Tread edge L NIA Y '.. Kickplale L NIA Y Landing floor L NIA Y Window Sill AIM L NIA Y Stringer L NIA Y '.. D Win Casing L N/A Y LaWee L WA Y # Window Sash L NIA Y Drain Pipes L N/A Y Window Sill AIM L NIA Y D Elec Conduit L N/A Y D Win Casing L NIA Y Oil Fill Pipe L N/A Y # Window Sash L WA Y Overhang Trim C44 L WA Y COMMENTS/STRUCTURAL DEFECTS: D Support Clams L NIA Y D F M/I AM L N/A Y D F Mil AIM L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made Soil Test Results(Must be less than 400 ppm for play area 11200 ppm for bare soil) intact by a Deleader(MORE THAN 2880 SQ.IN.) LOCATION AREA MEASUREMENT RESUL REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT IC DATE I IC METHOD (Square Feel) (PPM) DATE METH D Play Area D Bare Soil D Comments: D LI/RA Rep 2017 Exl D