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99 WEBB STREET LEAD INSPECTION REPORT 2-24-2025
Page 1 of North Shore Lead Paint Testing Service P.O. Box 734 Beverly, MA 01915 (978) 927-8152 Lead Inspection ! Risk Assessment St.# 99 Street Name Webb Street Type St. Unit None City Salem Zip Code 01970 J Number of Rooms in Unit W : Owner Name: Q 6 6 S�'f RiT I�/'�t0.Y ' T/`,s% Property Type: Owner Address: JJ'' IIt( d Ingle Family n Contact Information: Q��N A Aa r`d 04 i d o.i Multi Family #of Units: Client Name(if different from owner): ❑ Condominium #of Units: Client Address: ❑ Day Care ❑ Other: Kev Lead Column Key Delead/IC Method Column � � Delead/IC Method Column Laundry in Basement? Yes No COV Covered COV Covered REM Removed Finished Space in Basement?E]Yes QNo DC Drop Ceiling DIP Dipped REP Replaced MET Metal ENC Encapsulated SCR Scraped Possible Pb er Service Line MR Metal Rep-Window INT Intact SFR Storm Frame Removed ❑Yes � ❑ Not Tested NA Not Accessible MI Made Intact SLD Sealed Testing Method Used NC No Coating PRE Prepared for Enc. STP Stripped Na2S Expiration Date: Tile Tile(testing suggested) [;;;l Component Does Not Exist VR/MR Vinyl/Metal Rep Window X-Ray Fluorescence VB Vinyl Baseboard VR Vinyl Rep.Window Model: LPA-1 Serial# 3481 Comments/Notes: ❑ Demarcation Lines ❑ Submitted for Compliance Evaluation Floor# a Property Diagram/Unit Labels (level within building of unit being inspected) F10Or# C ----------- --------- ------------ , D ---- - -- e -- • , D B V __ _ ___ ___ L_ _ ___ cl 91 2=; 'f�' s_t�,--- „ - --- A(Street Side) Start Here A(Street Side) Start Here A(Street Side) Pb(lead)equal to or greater than 1.0 mg/cmz with x-ray fluorescence or positive with Na;S is Dangerous. XRF Calibration Recorded in Log Book g✓ ✓-Check off when complete Address Verified through USPS u ✓-Check off he co plete Research on Lead Related History for Address ❑✓ ✓ heck off h co plete �,, .imr nri_:o Jpii rippp urR00-532-9571 Thomas Dowd M-1170 02/ 24 /25 Inspector's Name(print) License# f Signature Date MIRA-remised 06/17 Address: 99 Webb St. Apt# None City Salem Page 2 off 9 INSPECTION HISTORY /�[f INTERIM CONTROL Determination Inspector Nam J?XftStic#77 zz7 visual R.A.Name: Lic# r O RN Signature Risk Assessment Signature Lead Hazards'? N Urgent Ph.Hazards? Comprehensive ust en or tCom re ection Inspector Nam Thomas d Lidt 1170 Risk Assessment 1, R.A.Name: ,Lie# 0 2 2 4 2 5 ��N N Signature Signature W U gent Pb.Haza ds? Lead Hazards? Visual Portion of B R.A.Name: ,LIC# Comp Initial RemsVisual Portion for .,Partial PCAD Y Inspector Name: ,Lic# Interim Control F Signature N Signature Lead Hazards Addendum(addon Dust Taken for Risk P R.A.Name: ,Lie# to Initial ins ection Y Inspector Name:-,Lit# Assessment Reins . F Signature N Signature Lead Hazards? Visual Portion of Reinspection£ar R.A.Name: Lie# Addendum as Full Interim Control P Inspection FYI Inspector Name: ,U F Signature N Signature Lead Hazards? Dust Taken for Risk P R.A.Name: Lic# Assessment Reins . Walk Through For Inspector Name: .Lid! F I I I I Jj Signature Ed/Consultation Signature Risk Assessment R.A.Name: ,Lic# Recertification Y REINSPECTION HISTORY j4 Visual Portion of P Inspector Name: Lic#--Lid1 Signature Reocc.Reins ection Urgent Pb.Hazards? F Signature Dust Taken£or p R.A.Name: ,Lic# RA usual Portion of Inspector Name: .Lic#_ Recertification Reocc.Re ection P F ins Signature F Signature POST COMPLIANCE ASSESSMENT DETERMINATIONS Dust Taken for p Inspector Name: .Licit Reocc.Reins c[ion F, Signature PCAD 8lnspector Name: Lic# N Signature Dust Taken for B Inspector Name: ,Lic# Lead Hazards? Reocc.Reins ection F Signature Full Inspection Actine as PCAD e Inspector Name: ,Lick_ Visual Portion of Inspector Name: ,Lic#_ Signawre Final Reins ection F Signature F Lead Hazards? Visual Portion of P Visual Portion of a Inspector Name: Lic# e Inspector Name: ,Lidl PCAD Rein ection Final Reins ection F Signature F Signature Dus'DR Taken for B Inspector Name: ,Lic# Dusl Taken for Final P Inspector Name: .Lic#_ pCuA T Rins ection Rcins (No Reocc F Signature F Signature Dust Taken For ]Signature Inspector Name: .Lic# Dust Taken for Final B Inspector Name: •Lic# PCAD Reins ection P Rei❑s . No Reocc F Signature F History rev 6/17 Address: 99 Webb St. Apt# None city Salem Page 3 of REOCCUPANCY CERTIFICATE HISTORY COMPLIANCE HISTORY(CONT.) Certificate of Certificate of Reoccu ane Maintained Inspector Name: Lic# Com dance Inspector Name: Lic# Only after Signature Signature High/Mod Risk No Work—No Dust rooms mle Work=7 Dust Certificate of Certificate of Reoceu ane Restored Inspector Name: Lic# Inspector Name: .Lic# com Hance Only after Signature Signature High,'Mod Risk Dust wipes and auth. I#rooms rule people Certificate of Certificate of Reoccu ane Maintained Inspector Name: .Llc# Inspector Name: .Lic#_ Com Hance Only after Signature Signature High/Mod Risk No Work=No Dust #rooms rule Work=7 Dust COMPLIANCE HISTORY Certificate of Letter of Full Initial Com Restored Inspector Name: Lic# Hance Inspector Name: .LIC# Com Hance Si nature Signature No prior history/ g Dust wipes and auth. No signs of UD people Letter of Interim OTHER HISTORY:WAIVERS/UD Control Inspector Name: .Lic# Approved cLPPP waiver Inspector Name: ,Lint No prior Comp. Signature Expires in 1 yr. Attach to Comp Signature Does Recertification of Interim Control Inspector Name: Lic# Approved CLPPP Waiver Inspector Name: ,Lic# Expires 2 yts from Signature original Interim Attach to Comp Signature Control Does Letter of Full Deleading Inspector Name: LIC#_ UD/DES Visual Cam Hance Reins ection p Inspector Name: .Lic# Signature F Signature Dust wipes if No No LOC Issued React. Certificate of UD/DES Dust Maintained Taken Inspector Name: Lic# _ TCom liance Inspector Name: .Lic#_ F Signature Signature No Work—No Dust No LOC issued Work=7 Dust UD/DES Duns Taken p Inspector Name: ,Llc# Certificate of Restored F Signature com Hance Inspector Name: .Lic# Na LOC Issued Signature Dust wipes and auth. UD/DES Final people Reins ection P Inspector Name: ,Lic# F Signature No LOC Issued History rev 6/17 Page4of lb) 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/cm2 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/cm ,or are marked"MET"or "N/A All other metal surfaces must be intact. • For key to abbreviations like"COW,"VB","VW'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. • "M/I"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/M"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. IC 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 Thomas Dowd M•1170 aft• 02 24 25 Page sa I Inspector(print) LiC# gnahlre Date Risk Assessor(print) Lic# Signature Date Address of P : 99 Webb St. Apt.# None city. Salem ROOM# SELEAD IDE LOCATION! LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAN TYPE OF URG IC IC DDATE DMETH SURFACE HAZARD H DATE METH DATE METH SURFACE H D DATE MEfH DATE METH A B Up WBIIS Q rd L WA Y Window Sill . 1 MA L WA Y A a Low Walls L WA Y B Wm Apron //��a a4 L WA Y A B Baseboards Ir NIA Y C Wm Casing '1+1 L WA Y A 9 Chair Rail L NfA Y D Header Stop Pt MA L WA Y AB Radiator L NIA Y Int Stops 9a MII L A Y Floor 0. L Q(dust) WA Y 1 Wm Int Sash RAN L NIA Y Ceiling L WA Y 2 Exterior SIN (L MA SF L WA Y Door L WA Y 3 Pad Bead MA L WA Y C D Door Edge F L WA Y 4 Blind Stop MA SF L WA Y 12 Door Casing L WA Y Win Ext Be L WA Y 34 Door Jamb r F WA Y A Window Sill MA L WA Y Threshold 0. L NIA Y B Win Apron , L WA Y B Door t L NIA Y C Win Casing q t L A Y C Door Edge t F L WA Y ® Header Stop t MA L NIA Y 12 Dora Casing NfA Y Int Stops A,4 MII L WA Y 3 4 Door Jamb N1A Y 1 Win Inl Sash MA L NIA Y Threshold t L NIA Y 2 Exterior Sill M/I SF L WA Y Door 0 A L WA Y 3 Part Bead MA L WA Y Door Edge O t F L WA Y 4 Mind Stop Mil SF L WA Y 2 Door Casing a L WA Y Wm Ext Sash MA L WA Y 3 4 Door Jamb a L NIA Y A Window Sill Mn AIM L WA Y Threshold 0 t L WA Y B Win Apron L WA Y Closet Door L WA Y C Win Casing L WA Y Cl Door Edge 6 F L WA Y D Header Stop MA L WA Y 'B Cl Casing `la L NIA Y krf Slops MA L WA Y Closet Jamb 1a F L WA Y 1 Wm for Sash I MII L NIAJ Y D Closet Wells 1.11, L WA Y 2 Exterior Sal Mn SF L NIA I Y Cl Baseboard 11.1 L NIA Y 3 Part Brad if M11 L NVAJ Y 1 Closet Pole l L NIA Y 4 Blind Stop Mil SF L WAI Y 2 Closet shelf TV`X L WA lWin Ext Sash Mn L WA Y 3 CI Supports �' L WA Y AB Fireplace L WA Y 4 Closet Floor Q a .[](dust) NIA Y CID Mantle L WA Y As Closet Ceiling L NIA Y cc Win Abm6 1-11 L WA Y COMMENTS f STRUCTURAL DEFECTS: Ceiling Moldinj L WA Y F MA AIM L WA I Y F MA AIM L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F Mn AM L WA[_Y by a Deleader(MORE THAN 288 SO.IN.) F MII AIM L WA Y IC I IC F MII AIM L WA Y SIDE LOCATION MEASURE:LOOSE PAINT DATE METHOD F MA ARA L WA Y ❑ Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LYRA Rep 2017 Room Thomas Dowd M-1170 1Mr' 02 24 25 Page C Of Inspector(print) Lic# Si re Data Risk Assessor(print) Lie# Signature Date Add sof progkU 99 Webb St. None ci . Salem ROOM# SIDE LOCATIONI LEAD TYPEOF URG IC IC DELEAD DELEAD SIDE LOCATIOW LEAD TYPE OF URG IC IC DELFAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD DATE METH DATE METH A s UP Walls Q r0 L NIA Y A WiiMbw Stll qp, MII A Y A B Low Walls L NIA Y B Win Apm 1, L WA Y A B Baseboards �. WA Y C Win Casing L L WA Y A e Chair Rail L WA Y D Header Stop MA LWA Y As Radiator Oki L WA Y Int Stops xQ Md L NIA Y Floor t. L❑(dust) WA Y 1 Win Int Sash MII L NIA Y Ceiling L WA Y 2 Exterior Sit MII SF L WA Y A Door L WA Y 3 Part Bead L WA Y Door Edge F L WA Y 4 Blind Stop Mil SF L WA Y 12 Door Casing r L WA Y Win Ext Sash L WA Y 34 Door Jamb , F N!A Y /f� WirMow Sit M l A A LWA Y Threshold d, L WA Y I/V,9,) Win Apron �, L WA Y A B Door L WA Y C Win Casing Q- L NIA Y GO Door Edge F L WA Y D Header Stop , M11 L NIA Y 12 Door Casing L WA Y Int Stops Qr, Mill L WA Y 34 Door Jamb F L WA Y 1 Win WSash Mil L NIA Y Threshold L WA Y 2 Exterior so MR SF L WA Y ASoD= L NIA Y 3 Part Bead M11 L WA Y C D Edge F L NIA Y 4 Blind Stop Mil SF L WA Y 12 Casing L WA Y Win EA Sash MII L WA Y 34 Jamb F L NIA Y A Windw Sill MA AIM L WA Y shold L N/A Y B Win Apron L WA Y Closet Door L NIA Y C Wn Casing L WA Y A Cl Door Edge F L WA Y D Header Slop M!I L WA Y B Cl Casing L NIA Y Mt Stops Mn L WA Y C Closet Jamb 4LE3 , 1 Win IM Sash Mn L WA Y D Closet Walls 2 Exterior Sitl MR SF L WA Y Cl Baseboard 3 Pan Bead Mill L WA Y 1 Closet Pole 4 Blind Stop MR SF L WA Y 2 Closet Shelf Win Ext Sash Mn L WA Y 3 CI Supports B Fireplace L WA Y 4 Closet Floor D Mantle L NIA Y AB Closet Ceiling L WA Y C0 Win Above 5' 9t L NIA Y COMMENTS I STRUCTURAL DEFECTS: Cuing Molillof L NIA Y F MII AM LWA Y F MR ARM LWA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F W AM L WA Y by a Deleader(MORE THAN 288 SQ.IN.) F MII ARM L WA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC FIWI AM LWA Y GATE METHOD F MII AM LWA Y ❑ Check the box if this ROOM is RULED OUT for encapsulation ecause b there are or more 3 AIM surfaces with adhesion problems LDRA Rep 2017 Room Thomas Dowd M-1170 02 24 25 Page 701' t-1 Inspector(print) Lie If Sigfiature Date Risk Assessor(print) Lic# Signature Date Add of a 99 Webb St. t.# None City- Salem ROOM# SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls O F L NIA Y A Window Sill q•l MII AI L IA Y A B Low Walls L NIA Y ® Win Apron L WA Y A B Baseboards 4 (L)N/A Y C Win Casing �.� ON Y A B Chair Rail L NIA Y D Header Stop )t l Mil L NA Y ABrn Radiator Ids( L NIA Y Int Stops qAq Mil L NIA Y Floor ) L❑(dust) NIA Y 1 Win Int Sash MII L N/A Y Ceiling L NIA Y 2 Exterior Sit Mill SF L NIA Y B Door L N/A Y 3 Part Bead ll L NIA Y C D Door Edge F L NIA Y 4 Blind Slop Mil SF L NIA Y 1 2 Door Casing a L NIA Y Win Ed Sash MII L WA Y 34 Door Jamb A. F L IA Y A Window Sill MII IA Y Threshold t L WA Y B Win Apron qi L NIA Y A B Door L NIA Y 0 Win Casing NIA Y �LC Door Edge F L NA Y D Header Stop A MII L WA Y Door Casing NIA Y Int Stops t Mll N/A Y 34 Door Jamb �. F NIA Y 1 Win Int Sash M/1 L WA Y Threshold O L WA Y 2 Exterior SiiJEM/lF L NIA Y AB Door L NIA Y 3 Part Bead L NIA Y r Edge F L NIA Y 4 Blind StopF L WA Y 12Casing A. L NIA Y Win Exl Sash L N/A Y 34Jamb F L NIA Y A Window Sit M11 ARM L N/AY shold L WA Y B Win Apron L NIA Y Closet Door L NIA Y C Win Casing L N/A Y A Cl Dow Edge F L NIA Y D Header Stop M11 L WA Y B CI Casing , L NIA Y Int Stops WI L WA Y Closet Jamb t F L N/A Y 1 Win Int Sash M11 L WA Y Closet Walls L NIA Y 2 Exterior Sit M4 SF L NIA Y Cl Baseboard L NIA Y 3 Part Bead MII L NIA Y 1 Closet Pole L NIA Y 4 Blind Slob MA SF L N/A Y 2 Closet Shelf YO L NA Y Win Ed Sash II L N/A Y 3 CI Supports t L N/A Y AB Fireplace L N/A Y 4 Closet Floor A LE](dust) NIA Y CD Mantle L NIA Y As Closet Ceiling �t� L NIA Y cc Win Above5' t L NIA Y COMMENTS I STRUCTURAL DEFECTS: Ceiling Moldin L NIA Y F Mil AIM L NIA Y F Mil AIM L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F M4 AIM L WA Y by a Deleader(MORE THAN 288 SO.IN.) F MII ARM L WA Y IC IC F!!l AN L WA Y SIDE LOCATION MEASURE:LOOSE PAINT DATE METHOD F hUl AIM L WA 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 Thomas Dowd M-1170 11fLG 02 24 25 Page g Of 9 Inspector(print) Lic# Signature Date Risk Assessor(print) Lic# Signature Date AddressofP e : 99 Webb St. A t.# None city. Salem ROOM# SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATIOW LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls Q L L NIA Y A Window Sill M11 L WA Y A B Low Walls L NIA Y 13 Win Apron L WA Y A B Baseboards r L NIA Y C Win Casing L N/A Y A e Chair Rail L NIA Y � Header Stop MA L NIA Y AB CD Radiator Q. L N/A Y Int Stops M/I L NIA Y Floor Q 11 L Q(dust) NIA Y 1 Win Int Sash R..MII L N/A Y Ceiling L NIA Y 2 Exterior Sill MA SF L WA Y B Door Q , L NIA Y 3 Part Bead MII L WA Y C D Door Edge Q tN F L NIA Y 4 Blind Stop Mll SF L N/A Y 12 Door Casing WA Y Win Et Sash Mil L NIA Y 34 Door Jamb J, F WA Y A Window Sill MA AIM L NIA Y Threshold p. L NIA Y B Win Apron L NIA Y Door c, L NIA Y C win Casing L WA Y C D Door Edge L F L NIA Y D Header Stop Mil L N/A Y 12 Door Casing , L N/A Y Int Stops MA L NIA Y 34 Door Jamb q, N/A Y 1 Win Int Sash M/I L NIA Y Threshold O.1 L WA Y 2 Exterior Sill . Mil SF L NIA Y A B Door L NIA Y 3 Pan Bead MII L NIA Y D Dow Edge F L NIA Y 4 Blind Stop MA SF L NIA Y 12 Door Casing t NIA Y Win Ext Sash Mill L WA Y 34 Door Jamb . F L IA Y A Window Sill M11 A(M L WA Y Threshold Q. L NIA Y B Win Apron LWA Y Closet Door L WA Y C Win Casing L N/A Y A Cl Door Edge F L N/A Y D Header Stop MII L NIA Y B Cl Casing L NIA Y IN Stops VIA L NIA Y ® Closet Jamb F NIA Y 1 Win Int Sash M/I L NIA Y D Closet Walls r� L NIA Y 2 Exterior Sill WI SF L N/A Y CI Baseboard �,. (L)N/A Y 3 Part Bead MIA LWA Y 1 Closet Pale L NIA Y 4 Blind S op MA SF L N/A Y 2 Closet Shelf .1 Q L N/A Y Win Ext Sash MA L WA Y 3 Cl Supports q, L WA Y 8 Fireplace L NIA Y 4 rCIoEmtF1,0:or Qr. L❑(dust) NIA Y C D Mande L NIA Y As set Ciling L NIA Y CD Win Above 5' L NIA Y COMMENTS/STRUCTURAL DEFECTS: Ceiling Moldin L N/A Y F M/1 AIM L N/A Y F MA AIM L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F Mn AIM L WA Y by a Deleader(MORE THAN 288 SO.IN.) F M11 AMt L NIA Y IC IC FMII AIM LWA Y SIDE LOCATION MEASURE:LOOSE PAINT DATE METHOD F MII AIM LWA Y Check the box 0this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LIRA Rep 2017 Room QA Thomas Dowd M-1170 2 0 24 25 Pa, e t)Of f q s Inspector(print) Lie# Sighature Date Risk Assessor(print) Lie# Signature Date dares I : 99 Webb St. t.# None Ci : Salem ROOM# SIDE LOCATION( LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE RID HAZ? DATE METH DATE METH A a Up Walls Qt L NIA Y A Window Sill 4; MII L NIA Y A a Low Walls L WA Y B Win Apron x. L WA Y A B Baseboards t N/A Y Win Casing III L NIA Y A B Chair Rail L N/A Y Header Stop JVI M/I L NIA Y AsCO Radiator O,k L N/A Y Int Stops M/I L N/A Y Floor . L❑(dust) N/A Y 1 Win Int Sash M/I L N/A Y Ceiling L NIA Y 2 Exterior Sill Mll SF L N/A Y B Door 17 L NIA Y 3 Part Bead Mil L N/A Y C D Door Edge �.� F L NIA Y Q Blind Slop MII SF L NIA Y 12 Door Casing L NIA Y Win Ext Sash Mil L WA Y 34 Door Jamb t L N/A Y A Window Sill JIWI AIM L NIA Y Threshold Q. L NIA Y B Win Apron L N/A Y Aly Door L WA Y _ C Win Casing L NIA Y C D Door Edge F L WA Y D Header Stop M/I L NIA Y 12 Door Casing L N/A Y Int Stops Mill L NIA Y 34 Door Jamb N/A Y 1 Win Ind Sash M/I L WA Y Threshold 0 6) L NIA Y 2 Exterior Sill Mill SF L WA Y A B Door 15111, L NIA Y 3 Part Bead M/I L WA Y D Door Edge O r F L NA Y 4 Blind Stop M)l SF L WA Y 12 Door Casing , L NIA Y Win Ext Sash I Mll L WA I Y 3 4 Door Jamb IDNIA Y A Window Sill Wl AIM L NIA Y Threshold L N/A Y B Win Apron L NIA Y Closet Door L WA Y C Win Casing L WA Y A Cl Door Edge F L N/A Y D Header Stop Mll L NIA Y Cl Casing L N/A Y Int Stops M/l L WA Y C Closet Jamb '(t. F NIA Y 1 Win Ind Sash M/I L WA Y D Closet Walls ,T) L NIA Y 2 Exterior Sill M/I SF L WA Y Cl Baseboard , L NIA Y 3 Part Bead M11 L N/A Y 1 Closet Pole l rE L NIA Y 4 Blind Stop Mill SF L N/A Y 2 Closet She F I L NIA Y Win Ext Sash MA L N/A Y 3 CI Suppo is r L WA Y B Fireplace L NIA Y 4 Closet Floor L❑(dust) NIA Y CD Mantle L N1A Y Closet Ceiling As L NIA Y cD Win Above 5' L WA Y COMMENTS I STRUCTURAL DEFECTS: Ceiling Moldin L NIA Y Al F MA AIM L NIA Y 4 F M/I ARAgJ/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F M/I Ann L WA Y by a Deleader(MORE THAN 288 SQ.IN.) F MII Ann L WA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F Mill AIM L WA Y DATE METHOD F Mil AIM L WA 1 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 Thomas Dowd III ?V4 WK d 02/ 24/ 25 Page,o Of Inspector(print) Lic# Signature Date Risk Assessor(print) Lic# Signature Date Address of Property: 99 Webb St. Aot.# None city: Salem KITCHEN SIDE LOCATIOW LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZI. DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls L N/A Y A Window Sill 6.0 Mill A/M L N/A Y A B Low Walls .' L NIA Y B Win Apron 0,1 L N/A Y A B Baseboards 40A L NIA Y © Wm Casing 0,( L N/A Y A s Chair Rail OA L NIA Y D Header Stop /. Mil L NIA Y As C D Radiator 0 ` L N/A Y Int Stops 01. M/I L NIA Y Floor 1 6. L(](dust) NIA Y 1 Wm Int Sash Mll L NIA Y Ceiling 0, L NIA Y 2 Exterior Sill Mil SF L N/A Y Door L NIA Y 3 Part Bead M/I L N/A Y CD Door Edge F L NIA Y 4 Blind Stop M/I SF L N/A Y 12 Door Casing % L NIA Y Win Ext Sash M/1 L N/A Y 34 Door Jamb I F L WA Y A Window Sill Mn AIM L NIA Y Threshold tu L NIA Y B Win Apron L NIA Y AB Door m,d L N/A Y C Win Casing L N/A Y DID Door Edge dj F L N/A Y D Header Stop WI L NIA Y 12 Door Casing 0,1 L WA Y Int Stops M/I L NIA Y 34 Door Jamb I F L N/A Y i Win Int Sash MA L N/A Y Threshold 1 L N/A Y 2 Exterior Sill MA SF L NIA Y A Door Qx1 L N/A Y 3 Part Bead WI L NIA Y Door Edge 4,0 F L N/A Y 4 Blind Stop WUl SF L N/A Y 12 Door Casing 6 ,V L N/A Y Win Ext Sash MA L N/A Y 34 Door Jamb i /A Y 013 Up Cab Frame 6 L NIA Y Threshold C L L NIA Y CO Up Cab Door d,� L N/A Y Closet Door L N/A Y Up Cab Walls n• L N/A Y A Cl Door Edge F L N/A Y 12 Up Cab Shlvs J. L N/A Y B CI Casing L NIA Y 34 Supports OLIL N/A Y C Closet Jamb F L NIA Y Low Cab Fram %% L N/A Y D Closet Walls L NIA Y B Low Cab Door G.( L N/A Y CI Baseboard L NIA Y Low Cab Walls d.( L N/A Y Tow 1 Closet Pole L NIA Y L Cab Shlv, t L N/A Y 2 Closet Shelf L NIA Y 12 Supports Qa L N/A Y 3 Cl Supports L N/A Y 34 Drawers t L N/A Y 4 Closet Floor4TURALDEFECTS: L❑ AS (dust) NIA Y c D Win Above 5' % L N/A Y Closet Ceiling L WA Y Ceiling Moklin L NIA Y COMMENTS I STRU F MII AIM L N/A Y F MII ABM L NIA Y F MA AIM L NIA Y F MA AIM L NIA I Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F W AIM L NIA Y by a Deleader(MORE THAN 288 SQ.IN.) F MA AIM L N/A Y SIDE LDCATION MEASURE:LOOSE PAINT IC F MA AIM L WA V DATE METHODIC I FANI A1M LWA 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 Kitchen Thomas Dowd M-1170 7Jum 02 /24 /25 Paget I Of + Inspector(print) Lic# Signature c Date Risk Assessor (print) Lid Signature Dale Address of Property: 99 Webb St Apt # None city- Salem BATHROOM# SIDE LOCATIONI I LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE MEfH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls • L WA Y Up Cab Frame 01( L NIA Y A 8 Low Walls p•0 I N/A Y C Up Cab Door 611 L NIA Y A B Baseboards �� L NIA Y Up Cab Walls ,6nl EL NIA Y A e Chair Rail .0 L NIA Y 1 2 Up Cab Shlvs V A L N/A Y G p Radiator Q•� L N/A Y 3 4 Supports t L N/A Y Floor i9+ L (dust) WA Y Low Cab Fran >. L NIA Y Ceiling L WA Y B Low Cab Door ! L NIA Y A B Door ♦ L NIA Y Low Cab Wall l L NIA Y Co Door Edge 0.0 F L NIA Y Low Cab Shiva L NIA Y 1 2 Door Casing d• L NIA Y 12 Supports L NIA Y 34 Door Jamb +� NIA Y 3 4 Drawers L NIA Y Threshold 6k L NIA Y A 15- Cl Sill p Mll AIM L N/A Y AB Door L NIA Y ® mn L NIA Y C D Door Edge F L WA Y C sing 0.1 L NIA Y 12 Door Casing L WA Y D r Stop 01 M/I L N1A Y 34 Door Jamb F L WA Y ps 1 Mll L NIA Y Threshold L NIA Y 1 t Sash Mll L NIA Y AB Door L NIA Y 2 r Sill Mll SF L NIA Y C D Door Edge F L NIA Y 3 ead )All L NIA Y 12[Door Casing L NIA Y 4 top M/I SF L N/A Y 34 oor JambF L N/A Y xt Sash M/I L N/A Y As hreshold L NIA Y CD bove 5' 11 L NA Y Closet Door L N/A Y Ceiling Moldi L NA Y -- B g A Cl Door Edge F L NIA Y o Medicine Cab p •1 L NA Y B Cl Casing L NIA Y F MII ARM L NIA Y C Closet Jamb F L N/A Y F Mill ARM L WA Y D Closet Walls L NIA Y F M/l ARM L N/A Y CI Baseboard L NIA Y F Mil AIM L NIA Y 1 Closet Pole L NIA Y F MA AIM L NIA Y 2 Closet Shoff L NIA Y F W AIM L NIA Y 3 Cl Supports L NIA Y F MA AIM L NIA Y 4 Closet Floor L❑(dust) NIA Y F W AIM L NIA Y Closet Ceiling L WA Y F MII ARM L NIA Y F M/I AIM L N/A Y F Mill AIM L WA Y F M/I AIM L WA Y F Mll 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 SQ.IN.) SIDE LOCATION MEASURE:LOOSE PAINT I IC DATT E METHOD 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 Bath Thomas Dowd M-1170 rr W 02 / 24 / 25 Page j&j 1 Inspector(print) Lic# Signature Date Risk Assessor(print) Lic# Signature Date Address of Pro 99 Webb St. Apt.# None i : Salem HALLWAY: ter o #_ or Common Hallway: Front Rear Floor# SIDE LOCATION! I LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ, DATE MEZH DATE METH A a Up Walls 14 L NIA Y Closet Door L NIA Y A B Low WaIIs {� L WA Y A Cl Door Edge F L N/A Y A 9 Baseboards {•q L N/A Y B Cl Casing L N/A Y A B jJ"b1 il L NIA Y C Closet Jamb F L NIA Y Ae L NIA Y D Closet Walls L N/A Y 01 L[](dust) N/A Y Cl Baseboard L NIA Y Or L NIA Y 1 Closet Pole L N/A Y B Q ,t L WA Y 2 Closet Shelf L NIA Y C D ge Dr F L N/A Y 3 Cl Supports L N/A Y 12 sing I L NIA Y 4 Closet Floor L�(dust) NIA Y 34 b 1 F L N/A Y Closet Ceilng L WA Y ld 0• L N/A Y A Window Sill /I A/M L N/A Y A Door 6x L NIA Y B Win Apron L WA Y C D Door Edge 01 F L N/A Y C Win Casing L N/A Y 12 Door Casing A WA Y D Header Stop M/I L N/A Y 34 Door Jamb it NfA Y Int Stops MR L NIA Y Threshold t L N/A Y 1 Win Int Sash M/1 L N/A Y A B Door O,U L NIA Y 2 ExtemrSill MII SF L NIA Y 0@ Door Edge Ott F L NIA Y 3 Part Bead Mil L NIA Y 12 Door Casing 1 L NIA Y 4 Blind Slop M/I SF L N/A Y 34 Door Jamb WA Y Win Ext Sash MII L NIA Y Threshold Q1. L WA Y A Window SAl M/l A/M L WA Y Aloor 1 L NIA Y B Win Apron L WA Y C Dow Edge 0 t, F L NIA Y C Win Casing L NIA Y 12 Dow Casing i L NIA Y D Header Stop M1I L N/A Y 3 4 Door Jamb 911 Y Int Stops Mll L NIA Y Closet Door 0 L NIA Y 1 Win Int Sash MR L NIA Y A Cl Door Edge it F L NIA Y 2 Extenw Sill M/I SF L WA Y B Cl Casing L N/A Y 3 Part Bead M/I L WA Y C Closet Jamb L N1A Y 4 Blind Stop Mll SF L N/A I Y D Closet Walls 9• IA Y Win Ext Sash Mil L N/A Y Cl Baseboard 9 A6 L WA Y co Win Above 5' L NIA Y 1 Closet Pole L N/A Y Ceiling Moldint L NIA Y 2 Closet Shelf 4► L NIA Y C F Mil AIM L NIA Y 3 Cl Supports I L NIA Y V AA4 F M/I ABM L WA Y 4 Closet Floor O IV L Q(dust) WA Y F MII ARM L WA Y Closet Ceiling W L NIA 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 ICDATE IC METHOD ❑ Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LFRA Rep 2017 Hall Thomas Dowd M-1170 a406 (IJ64. 02124 /25 Page 0 Of Inspector(print) Lic# Signature Date Risk Assessor(print) Lic# Signature DaSe Address of Property:t 99 Webb St. Apt.# None city Salem STAIRCASE# rAenr r SIDE LOCATIOW LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LFAD TYPE OF URGI IC DELFAD DELEAD SURFACE HAZARD HAZ. DATE METH DATE METH SURFACE H D HAZ? METH DATE METH A B Up Walls 0. L WA Y Window Sill L M11 [kV L N/A Y A B Low Walls /� a ee L N/A Y B Win Apron R. L N/A Y A B Baseboards A 1�-lL NIA Y C Win Casing q.'� L N/A Y A s Chair Rail L NIA Y D Header Stop �r� M1I L NIA Y AB co Radiator d.d L WA Y Int Stops M11 L NIA Y Floor .1 L[](dust) NIA Y 1 Win Int Sash M/I L N/A Y Ceiling d.1 L NIA Y 2 Exterior Sill Mil SF L NIA Y Door 0.1 L NIA Y 3 Part Bead Mil L WA Y C D Door Edge . IA Y 4 Blind Stop Mil SF L NIA Y 1 2 Door Casing 0.1 L NIA Y Win Ext Sash M/l L N/A Y 34 Door Jamb 5 F NIA Y A Window Sill MII A/M L NIA Y Threshold 04 L NIA Y B Win Apmn L N/A Y A Door L WA Y C Wm Casing L N/A Y C D Door Edge F L N/A Y D Header Stop M/1 L N/A Y 12 Door Casing . N/A Y Int Stops M/I L NIA Y 34 Door Jamb . F L IA Y 1 Win Int Sash M11 L NIA Y Threshold . L NIA Y 2 Ezterpr Sill M1I SF L NIA Y A B Door . L WA Y 3 Part Bead M/I L NIA Y D Door Edge y L NIA Y _ 4 Blind Stop M/I SF L NIA Y 12 Door Casing 11) L N/A Y Win Ext Sash M11 L NIA Y 3 4 Door Jamb at- ®N/A Y Newel Post L N/A Y Threshold e.1 L NIA Y Railing Cap AIM L N/A Y B DoojEdge % L WA Y Handrail VIA ANI L NIA Y D Doo F L NIA Y Balusters L N/A Y 12 Doo L N/A Y Lower rail L NIA Y 34 Doo NIA Y Treads Or F L N/A Y Closet Door ,, L N/A Y Risers ¢A L NIA Y A Cl Door Edge L NIA Y Stringer L NIA Y CI Casing A, L N/A Y Tread edge>5 L NIA Y Closet Jamb NIA Y Landing floor 1 L ❑(dust) N/A Y D Closet Walls WA Y Floor Edge L NIA Y Cl Baseboard L N/A Y Floor Casing L NIA Y 1 Closet Pole f� L NIA Y F M/I A M L N/A Y 2 Closet Shell %4 L N/A Y FMA ARM LWA Y 3 Cl Supports l O L WA Y F M71 ARM L NIA Y 4 Closet Floor 0, L❑(dust) NIA Y F M l ARA N!A Y Closet Ceiling L NIA Y 9 Q 1 a F M!1 1A Y EXCLUDED SURFACES:Surfaces listed in these boxes ran only be made intacCOMMENTS I STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288 SQ. IN.) EE MEASURE:LOOSE PAINT ICEMETHOD1 DATE ❑ Check the box if this ROOM is RULED OUT for encapsulation because then:are 3 or more A/M surfaces with adhesion problems LIRA Rep 2017 Stair Thomas Dowd M-1170 02 / 24 / 25 Page Of Inspector(print) Lie# S" nature Dale Risk Assessor(print) Lie# Signature Date Address of Property: 99 Webb St. Apt# None city Salem STAIRCASE# 1K fM SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD I TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ. DATE METH DATE METH A B Up Walls r L N/A Y A Window Sill 611 MII AIM L N/A Y A B Low Walls D r L WA Y Win Apron Q ` L NIA Y A B Baseboards L NIA Y C Win Casing (7 to L NIA Y A B Chair Rail oil L WA Y D Header Stop D.` Mll L NIA Y AB CD Radiator L N/A Y Int Stops Q A MAL NIA Y Floor 6 l LEI(dust) NIA Y 1 Win Int Sash Mll L NIA M4 SF L N!A !I L N!A Mll SF L N!A !I L N/A Y Ceiling L NIA Y 2 Exterior Sill Y A B Door Q� L WA Y 3 Part Bead Y Co Door Edge 11 F F L NIA Y 4 Blind Stop Y 1 2 Door Casing a L NIA Y Win Ex!Sash Y 34 Door Jamb 9 r� F L NIA Y A Window Sill 0. MII AIM L NIA Y Threshold rl L NIA Y B Win Apron C rl L NIA Y A Door r L NIA Y ® Win Casing Qr L NIA Y D Door Edge F F L NIA Y D Header Stop 11 MII L NIA Y 12 Door Casing L NIA Y Int Stops 1 WI L NIA Y 34 Door Jamb �v F L WA Y Win Int Sash WI L NIA Y Threshold 0 p L WA Y 2 Exterior Sill {.l Mll SF L NIA Y B Door 4 L N/A Y 3 Part Bead MA L NIA Y C Door Edge d v F L NIA Y 4 Blind Stop MA SF L NA Y 1 2 Door Casing Q, L NIA Y e,y;� Win Ext Sash M/l L NIA Y 34 Door Jamb J• F L N/A Y Newel Post L NIA Y Threshold v L N/A Y Railing Cap -1+ IA Y AB Door NA Y _ Handrail L AIM L N/A Y Co Door Edge L NIA Y p Balusters L N!A Y 12 Door Casing 011 L N/A Y SIAv Lower rail L NIA I Y 34 Door Jamb F L NIA Y Treads F L N/A Y Closet Door L NIA Y Risers 610 L N/A Y A Cl Door Edge F L NIA Y Stringer L NIA Y B CI Casing L NIA Y Tread edge>5 L NIA Y C Closet Jamb F L NIA I Y Landing floor L ❑(dust) NIA Y D Closet Walls L N/A Y Floor Edge L NIA Y Cl Baseboard L WA Y Floor Casing L NIA Y 1 Closet Pole L WA Y F M71 Am1 L NIA Y 2 Closet Shelf L WA Y F MII AIM L N!A Y 3 Cl Supports L NIA Y F Mtl AfM L N/A Y 4 Closet Floor L[—](dust) N/A Y F MII NM L N/A Y Closet Ceiling L NA Y F AUI AIM L N1A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact COMMENTS 1 STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288 SQ.IN.) IC C SIDE LOCATION MEASURE:LOOSE PAINT DATE METHOD ❑ Check the box it this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LURA Rep 2017 Stair Qt;Thomas Dowd M•1170 02/ 24/ 25 Page�Of !9 Inspectorr(print) Lic# nature Date Risk Assessor(print) Lic# Signature Date Address of Property 99 Webb St. ADL# None citr Salem BASEMENT/LAUNDRY AREA SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH CD Walls i L N!A Y c o Serviceboard Q. L N/A Y A B Walls t L NIA Y A B Shelves y L WA Y AS Walls C L NIA Y C D Supports L NIA Y A B Walls X1 L WA Y A B Shelves L NIA Y Go Baseboards L WA Y C D Supports L N/A Y AB C B Chair rails L N/A Y A B Shelves A L NIA Y Floor L❑(dust) NIA Y C D Supports L N/A Y Ceiling i. L N/A Y —AV Window frame 6.1 MA L NIA Y AB ChimneyD, , L N/A Y CD Window Sash VIL Mll L N/A Y JLL As Support Colu 0%11 L N/A Y 12 Exterior Sill M/1 L NIA Y Door 09 N/A Y 34 Part Bead 1« Mll L WA Y C D Door Edge ,. NIA Y Win Ext Sash M!I L WA Y 12 Door Casing 0& L NIA Y Alindow framed MII L WA Y 34 Door Jamb v. F L N/A Y C Window Sash Mt_MR L NIA Y Threshold ! L WA Y 12 Exterior Sill UYL MR L NIA Y A B Door _ N/A Y 34 Part Bead Mq L N/A Y Door Edge N/A Y eA 1 7 1 1 Win Exl Sash VIFIVII L WA Y 12 Door Casing L NIA Y AB Window frame or. Mil L WA Y 34 Door Jamb / Y C6 Window Sash 74U MII L N/A Y Threshold %11 L WA Y 12 Exterior Sit t& WI L NIA Y Closet Door L N/A Y 34 Part Bead MII L N/A Y A Cl Door Edge F L N/A Y Win Ext Sash M/1 L WA I Y B Cl Casing L NIA Y Newel Pasts l L WA Y C Closet Jamb F L NIA Y AB Handrail AIM L NIA Y D Closet Walls L NIA Y C D Balusters L NIA Y Cl Baseboard L WA Y 12 Tower—rail 0♦ L NIA Y 1 Closet Pcle L N/A Y 34 Treads F L N/A Y 2 Closet Shelf L N/A Y Risers L N/A Y 3 Cl Supports L NIA Y Stringer L NIA Y 4 Closet Floor L❑(dust) WA Y Tread Edge L NIA Y Closet Ceiling L WA Y Landing floor L ❑(dust) NIA Y A B Cabinets L N/A Y A B Oil Tank L N/A Y AB Benches L N/A Y AB Win Above5- TT L WA Y C D Supports L NIA Y F Mrl ARM L WA Y A a Pipes L NIA Y F Mil ARM L WA Y A 9 Sink b, L NIA Y F Mll ARA L WA Y A BD Drainpipe lb x L N/A Y F M/I ARM L NIA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact CommentslSimctural Detects by a Deleader(MORE THAN 288 SQ.IN.) SIDE LOCATION MEASURE:LOOSE PAINT Ic DATE Ic METaDD Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more A/M surfaces with adhesion problems LT/RA Rep 2017 Bsmnt/Laundry Thomas Dowd M-1170 02 124 125 Page LOf l Inspector(print) Lic# Aignature Date 1 I Risk Assessor (print) Lic# Signature Date Address of Property 99 Webb St Apt # None City Salem EXTERIOR A Side SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION1 I LEAD TYPE OF LIRG IC IC DELEAD DELEAD A SURFAC HAZARD HAZ? DATE METH DATE METH A SURFACE HAZARD HAZ? DATE METH DATE METH Siding ff 11 L NIA Y Window Sill AIM L N/A Y Corner Boards 10 rA L NIA Y A Win Casing L NIA V A Lower Trim 0.� L NIA Y lWindow Sash L WA Y Upper Trim L NIA Y Cellar Wm Sill AIM L WA Y Win Above 5' (Q L NIA Y A Cal Win Frame L NIA Y Porch Above 5' L NIA Y # Cal Win Sash L NIA Y Storm Door latl L NIA Y Screen Frame V j L NIA Y VDoorEdge ge ) F L NIA Y Cellar Win Sill AIM L NIA Y t NIA Y A Cal Win FrameL NIA Y f12 F L NIA Y # Cel Win Sash L WA Y 0✓ L NIA Y Screen Frame L NIA Y F L NIA Y Cellar WinSill AIM L NIA Y • L WA Y A CelWin Fram L NIA Y L NIA Y Cel Win Sash L NIA Y Stonn Door 4. L NIA Y Screen Frame L NIA Y .. F L NIA Y FoundaIon r A Y ,Door y L NIA Y A bulkhead L WA Y SirmDuorEdge Door Edge 0.• F L NIA Y Fences L WA Y 3 4 Door Casing L WA Y Shutters Q jo L NIA Y Door Jamb F L NIA Y Newel post oil L NIA Y Threshold L NIA Y Railing Cap B r AIM L NIA Y Kickplate L WA Y Handrail Q .1 JAIM L N/A Y Door L NIA Y A Balusters 114 1 L WA Y A Door Edge F L NIA Y kLandingftoor i L WA Y 1 2 Door Casing L NIA Y Q. F L NIA Y 3 4 Door Jamb F L NIA Y 0. L NIA Y Threshold L WA Y a L N/A Y Kickplate L NIA Y a% L N/A Y Window Sill J A/M L NIA Y L NIA Y ''/A Win Casing I J L NIA Y L WA Y #( Window Sash L NIA Y Drain Pipes L NIA Y Window Sill I AV L NIA Y A Elec Conduit L WA Y A Win Casing $A L NIA Y ON Fill Pipe L NIA Y # Window Sash L WA Y Overhang Tmr L NIA Y COMMENTS I STRUCTURAL DEFECTS: A lamp Past L NIA Y A dA1 rs FWI Aral LNIA Y A F WI AIM L NfA 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 IC METHOD (Square Feet) (PPM) DATE METH A Play Area A Bare Soil A Comments: A LIRA Rep 2017 Ext A r q 000, Thomas Dowd M-1170 Z021 24/ 25 Page/ 70f1 Inspector(print) Lic# Sign lure Date 1 1 Risk Assessor (print) Lic# Signature Date Address of Property 99 Webb St. Apt # None Citv7 Salem EXTERIOR B Side SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATIONI LEAD TYPE OF URG IG IC DELEAD DELEAD B SURFACE HAZARD HAZ? DATE METH DATE METH B SURFACE HAZARD HAZ? DATE METH DATE METH Siding L/ L WA Y Window Sill AIM L NIA Y Corner Boards L NIA Y B Win Casing L NIA Y B Lower Trim p, L NIA Y Window Sash L NIA Y Upper Trim IVA L N/A Y Cellaf Win Sill r 'AI IA Y Win Above 5' [.d L N/A Y B kC,'1I Win I'mm 1.� L IA Y Porch Above 5' L N/A Y # Win Sash L WA Y Storm Door L N/A Y en Frame L WA Y Strm Door Edge F L NIA Y Cellar Win Sir LM L N/A Y B Door L NIA Y B CeI Wm Fmnne L N/A Y 1 2 Door Edge F L NIA Y 9 CeI Wm Sash L NIA Y 3 4 Door Casing L NIA Y Screen Frame L NIA Y Door Jamb F L NlA Y Cellar Win Sill AIM L N/A Y Threshold L WA Y B Cal Win Frame L MA Y Kickplate L WA I Y # CeI Win Sash L NIA Y Storm Door L N/A Y Screen Frame L NIA Y Stnn Door Edge F L WA Y Foundation 61NUA Y B Door L N/A Y 8 bulkhead L WA Y 1 2 Door Edge F L NIA Y Fences Q L WAI Y 3 4 Door Casing L NIA Y Shutters L WAI Y Door Jamb F L NIA Y Newel post L WA Y Threshold L NIA Y Railing Cap AM L WA Y Kickplate L N/A Y Handrail AIM L N/A Y Door L NIA Y B Balusters L NIA Y B Door Edge F L N/A Y Lower Rail L NIA Y 1 2 Door Casing L NIA Y Treads F L NIA Y 3 4 Door Jamb F L WA Y Risers L NIA Y Threshold L N/A Y Tread edge L N/A Y Kickplate L NIA Y Landing floor L WA Y Window Sillo Stringer L WA Y B Win Casing L N/A Y Lahice L N/A Y #� Window Sash L NIA Y Drain Pipes r L WA Y Window Sill OG A/M L NIA Y B Elec Conduit L NIA Y B Win Casing L NIA Y OB Fill Pipe L NIA Y Window Sash L N/A Y Overhang Td L NIA Y COMMENTS I STRUCTURAL DEFECTS: B Support Clmn L NIA Y B F Mll AIM L WA Y B F M/I AIM 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/1200 ppm for bare soil) intact by a Deleader(MORE THAN 2880 SQ.IN.) LOCATION AREA MEASUREMENT [RESUL REMEO REMED SIDE LOCATION MEASURE:LOOSE PAINT rc DATE Ic rnerH (Square Feet) M) DATE METH B Play Area B Bare Soil B Comments: B LIRA Rep 2017 Ext B Thomas Dowd M-1170 02 124125 Page 0 r Inspector(print) Lic# Si6nature Date Risk Assessor (print) Lic# Signature Date Address of Property, 99 Webb St. Apt.# None city, Salem EXTERIOR C Side SIDE LOCATIONI LEA TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD C SURFACE HAZARD HAZ? DATE METH DATE METH C SURFACE I HAZARD HAZ. DATE METH DATE METH Sidingit 11V L NIA Y Window Sill AIM L N/A Y Corner Boards L NIA Y C Wm Casing G L N/A Y C Lower Trim L WA Y # 3 Window Sash X L NIA Y Upper Trim M L N/A Y Cellar Win Sill AIM L NIA Y Win Above 5' Gt L N/A Y C Cal Win Fmm L NIA Y Porch Above 5' L N/A Y # Cal Win Sash L NIA Y Storm Door L NA Y Screen Frame L NIA Y ® Strm Door Edge F L N/A. Y Cellar Win Sill AMt L WA Y Door 6,11 L NIA Y C Cel Win Frame L WA Y 1 2 Door Edge 0�% F L NIA Y Cel Win Sash L WA Y 3 4 Door Casin L NIA Y Screen Frame L NIA Y Door Jamb 0, F L NIA Y Cellar Win Sill AIM L N/A Y Threshold 0 r L NIA Y C CeI Win Fram L NIA Y Kickplate O r L WA Y Eel Win Sash L NIA Y Storm Door L N/A Y Screen Frame L NIA Y Stmi Door Edge F L WA Y Foundation ONIA Y C Door L WA Y C Bulkhead L WA Y 1 2 Door Edge F L N/A. Y Fences (♦ L WA Y 3 4 Door Casing L N/A I Y Shutters L WA Y Door Jamb F L N/A Y I Newel post L WA Y Threshold L NA1 Y I Reding Cap AN L N/A Y Kickplate L NIA Y Handrail AIM L NIA Y Door 0 NIA Y C Balusters L NIA Y C Door Edge d. N/A Y Lower Rail L NIA Y 2 Door Casing L N/A Y PTreads F L N/A Y 3 4 Door Jamb , iA Y Risers L NIA Y Threshold L N/A Y Tread edge L WA Y Kickplate L N/A Y Landing floor L WAI Y Window Sill AIM L N/A Y Stringer L N/A Y C Win Casing (f V L N/A Y Lattice L N/A Y #I Window Sash L NIA Y Drain Pipes L N/A Y Window Sill AMt L NIA Y C Elec Conduit L N/A Y C Win Casing V L NIA Y OR Fill Pipe L NIA Y #7,Window Sash (/ L WA Y Overhang Trig L NIA Y COMMENTS 1 STRUCTURAL DEFECTS: C Support Clmnsi L NIA Y C F MA AIM L WA Y C F W 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 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 Ic METeo (Square Feet I (PPM)l DATE I METH C Play Area C Bare Soil C Comments: C LIRA Rep 2017 Ext C Thomas Dowd M-1170 2 02 124 125 Page !At Inspector(print) Lic# Jignatura Date Risk Assessor (print) Lic# Signature Date Address ofProoertY 99 Webb St Apt # None City: Salem EXTERIOR D Side SIDE LOCATION/ -EAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD D SURFACE HAZARD HAZ? DATE METH DATE METH D SURFACE HAZARD H DATE METH DATE METH Siding 711 77-L NIA Y Window Sill CAtAAJM L NIA Y Corner Boards d#A L NIA Y D Wm Casing (At, L NIA Y D Lower Trim L NIA Y Window Sash L NIA Y Upper Trim L NIA Y Cellar Win Sill N/A Y Win Above 5' r>V1 L NIA Y D Cat Win Fra r� N/A Y Porch Above 5' L NIA Y #1 Cal Win Sash L WA Y Storm Door L NIA Y Screen Frame L WA Y Strm Door Edge j F L NIA Y Cellar Win SNI -L NIA Y D Door L NIA Y D Call Wm FrameR,. L NIA Y 1 2 Door Edge F L NIA Y #1,CeI Win Sash L WA Y 3 4 Door Casing L NIA Y !/ Screen Frame L WA Y Door Jamb F L NIAI Y Cellar Win Sill JAIM_ L WA Y Threshold L NIAJ Y D Cal Win Frame L N/A Y Kickplate L NIA Y N Gel Win Sash L WA Y Storm Door L NIA Y Screen Frame WA Y Sim Door Edge F L N/A Y Foundation S.1 a L IA I Y D Door L NIA Y D Bulkhead L WA Y 1 2 Door Edge F L NIA Y Fences f1 L WA Y 3 4 Door Casing L N/A Y Shutters L WA Y Door Jamb F L N/A Y Newel post L WA Y Threshold L N/A Y Railing Cap AIM L N/A Y Kickplate L N/A Y Handrail AIM L WA Y Door L NIA Y D Balusters L WA Y D Door Edge F L NIA Y Lower Rail L WA Y 1 2 Door Casing L NIA Y Treads F L WA Y 3 4 Door Jamb F L NIA Y Risers L WA Y Threshold L NIA Y Tread edge L WA Y Kickplate 1. L N/A Y Landing floor L WA Y Window Sill AIM L NIA Y Stringer L WA Y D Win Casing a. L N/A Y Lattice L WA Y "IWindow Sash L N/A Y Drain Pipes p L WA Y Window Sill AIM L NIA Y D Elec Conduit L WA Y Win Casing L NIA Y Oil Fill Pipe L NIA Y # Window Sash L NIA Y Overhang Trim L WA Y COMMENTS I STRUCTURAL DEFECTS: D isupport Clmn L WA Y D F Mn AIM L WA Y D F WI ARM 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 ICWTa (Square Feet) (PPM) DATE METH D Play Area D Bare Soil D Comments: D LIRA Rep 2017 ExL D