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11 PRINCE STREET PLACE LEAD INSPECTION REPORT 10-8-2021 Page of ENVIROMMENTALp. Main Office: 1 Arcadia Street Dorchester, MA 02122 Toll Free: 800-349-7779 www.asapenvironmental.com CA Lead Inspection 1 Risk Assessment St.#_�_�Street Na4 f 1240, , rC,4- Street Type { � Unit D �_ City V,f� Zip Code Q 4 :A a O Number of Rooms in Unit: Owner Name: L-2�'a V Q- L v-5 f✓1 g I Le c�n N-S C U C Property Type: Owner Address: '(g (�a{`� m 4 e S--k, -S:tl,e.an , MA ❑ S� le Family Contact Information: K3 -R_ L15a G-. Kae+ecasaZQ� �(,2G4 CoM Multi Family #of Units: Client Name(if different from owner): "T. �-pi I Li - a -x o Condominium #of Units: Client Address: Day Care ❑ Other: Kev Lead Column K ey Delead/IC Method Column Laundry in Basement? ❑Yes N 1� Delead/tC Method Column COV Covered V Covered REM Removed Finished Space in Basement?❑Yes No DC Drop Ceiling P Dipped REP Replaced MET Metal Encapsulated SCR Scraped Possible Pb Water Servi LineMR Metal Rep.Window T Intact SFR Storm Frame Removed ❑Yes ❑No Not TestedNA NotAccessible Made Intact SLD Sealed Testing Method UsedNC No Coating E Prepared for Enc. STP Snipped NazS Expiration Date: /Tile Tile Meeting suggested) � Component Does Not Exist VR/MR Vinyl/Metal Rep Window VB Vinyl Baseboard X-Ray Fluorescence VR Vinyl Rep.Window ode: Pb200i Serial# 1130 Comments/Notes: ❑ Demarcation Lines ❑ Submitted for Compliance Evaluation Floor# Property Diagram/Unit Labels (level within burg of being inspected) Floor# Y. al `@� . i • V - �- 1_4- = ............. . __, . A(Street Side) Start Here A(Street Side) Start ere Pb(lead)equal to or greater than 1.0 mg/cmZ with x-ray fluorescence or positive with NazS is Dangerous.A(Skeet Side) 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 ❑✓ ✓- hen o iplete wwwstmcma.us/dph/clppp or 800-532-9571 BeniaMin fil 3984 S1ig o Inspector's Name(print) License# re Date LI/ItA-revised 06/17 Address: 11 Prince Street PI Apt# none City Salem Page 2 of INSPECTION HISTORY INTERIM CONTROL Determination Ins ector Name: ,Lic# Visual P R.A.Name:-,Lic# Y Risk Assessment N Signature I Lead Hazards' N Signature Ur ant Ph Hazards? Comprehensive ost a en or R.A.Name: Lic# Initial Inspection Inspector Name:Linda Dube ,Lic#1978 Risk Assessment y 0 3 1111191 8 IVI Ililit�c�...((dlllll Signature N Signature Lead Hazards'? Urgent Pb.Hazards'. Comp Initial Visual Portion of NF R.A.Name: Lic# Risual Pornoection for w/Partial PCAD 8Inspector Name: ,Lic# Interim Control Signature N Signature Lead Hazards> Addendum(add-on Dust Taken for Risk P R.A.Name: ,Lic# to inijal Ins ection [E Inspector Name: ,Lic# Assessment Reins - F Signature N Signature Lead Hazards, Visual Portion of Reinspectien for R.A.Name: ,Lic# Addendum as Full Interim Control P Ins ection 8 Inspector Name: ,Lic# F Signature N Signature Lead Hazards? Dust Taken for Risk R.A.Name: ,Lic# Asscss...cut Reins walk Through for Inspector Name: ,Lic# F Signature Ed/Consultation Signature Assessment Recertification Y R.A.Name: Lic# REINSPECTION HISTORYvisuat Fortson of pnr Inspector Name:Neil Lafrance Lic#1100NSignature Reocc.Reinsection IIt`•� ll [Risk rocnt Pb.Hazards? 1 0 1 7 0 5 Signature Dust Taken for P R.A.Name: ,Lic# Visual Portion of Inspector Name:_Lic# Reece,Reins ection PRA Recertificat77 ion F Signature F Signature POST COMPLIANCE ASSESSMENT DETERMINATIONS Dust Taken for Inspector Name:Neil LaFrance ,Lic#i t-6 Reece.Reins ectionF 5 Signature PCA1 9 D 0 9 RNiSignature Inspector Name: Neil LaFrance Lic# 1100 1 0 1 7 0 0 5 Dust Taken for P Inspector Name: ,Lic#_ Lead Hazards? Reece.Reins ection F I Signature Full Inspection t Actin as PCAD Inspector Name: Ben MisSh ,Lic#3984 Visual Portion of Inspector Name:Neil LaFrance ,Lic#1100 1 0 0 8 2 1 Final Reins ection P RN Si net g 01211111919 Fn Signature Lead Hazards" Visual Portion of Inspector Name: Nei aFrance ,Lic#1100 Final Reinsection Visual Portion of P Inspector Name: ,Lic# PCAD Reins ection q?Signature FSignature1 1 2 4 0 6 Dust Taken for Reiser) Dust Taker,for PCAD Reins ection P Inspector Name: ,Lic# P Inspector Name:Neil LaFrance ,Lic#1100 Reins -(No Rcocc) F Signature t 0 2 1 1 9 9 Signature Dust Taken far Inspector Name: ,Lic# Dust Taken for Final 8 Inspector Name: ,Lic# PCAD Reins nation P P _ Reins .(No Reocc) F Signature F Signature History rev 6/17 Address: 11 Prince Street PI Apt# none City Salem Page 3 of REOCCUPANCY CERTIFICATE HISTORY COMPLIANCE HISTORY(CONT.) Certificate of Certificate of Reoccu anc Maintained 1 0 1 7 0 5 Inspector Name:Neil LaFrance Lic# 1100 Con, liana Inspector Name: Lic# Only after High/Mod Risk Signature No Work No Dust Signature (#rooms rule) Work=7 Dust Certificate of Certificate of Reoccu anc Restored Inspector Name: ,Lic#_ Con, liana Inspector Name: ,Lic# Only after Signature Signature High/Mod Risk Dust wipes and auth. g #rooms rule) people Certificate of Reoccu anc Certificate of Inspector Name: ,Lic# Maintained Inspector Name: ,Lic# Coto liance Only after Signature Signature High/Mod Risk #rooms rule) No Work=No Dust Work -7 Dust COMPLIANCE HISTORY Certificate of Letter of Full Initial Restored Inspector Name: Lic# Coto fiance Inspector Name: ,Lic# Can iancc Signature No prior history/ Signature Dust wipes and auth. No si ns of UD people Letter of interim OTHER HISTORY:WAIVERS/UD Control Inspector Name: ,Lic#_ Approved C'LPPP waiver Inspector Name: Lic# No prior Comp. Signature Ex ires in l r. Signature Attach to Camp g Does Recertification of Interim Control Inspector Name: ,Lic#_ Approved cLPPP Waiver Inspector Name: Lic# Expires 2 yrs from Signature original interim Attach to Comp Signature Control Does Letter of Full Delcading Inspector Name: Neil LaFrance ,Lic# 1100 UD/DES isual Compliance on p Inspector Name: ,Lic# 0 2 1 1 9 9 Signature F Signature Dust wipes if No ued Reocc. Certificate of UD/DES Dust Maintained Co Taken pB Inspector Name: ,Lic# to Gancc Inspector Name:-, F Signature Signature No LOC Issued No Work=No Dust Work=7 Dust UD/DES Dust Taken p Inspector Name: ,Lic# Certificate of Restored Inspector Name: Lic#Neil LaFrance 1100 F Signature Coto liance , No LOC Issued 1 1 2 4 0 6 Signature Dust wipes and auth. UD/DES Final people Reins cction p Inspector Name: ,Lic# 77-1 p Signature No LOC Issued History rev 6/17 Page 4 of I EATLANATION 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 oflead. • 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 lea 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"COV","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. • "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 Ben'amin Misch I/R-3984 10/08/21 Page-24_ Inspector(print) }Lic## ignature Date Risk Assesso ri RINCE STREET PL. Signature Cl Date SALEM f Pr W: SIDE LOCATION LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAI SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ DATE METH DATE METH a B Up Wald I Cq, L N/A Y ® Window Sill O 0 MA AM L N/A Y A e Low Walls L N/A Y B Win Apron 60 L N/A Y A e Baseboards o L NIA Y C Win Casing 0., L N/A Y A s Chair Rail L N/A Y D Header Stop QQ MA L NIA Y a a Radiator 6® L NIA Y Int Stops (� MA L N/A Y Floor 00 L®(dust) N/A Y 1 Wm Int Sash MA L N/A Y ; ,; Ceiling L N/A Y 2 Exterior Sill MA SF L WA Y A B Door L N/A Y _ _ 3 Part Bead J SlY W L N/A Y D Door Edge F L N/Al Y I_ I 1 1 4 Blind Sty M/I SF L N/A Y r Door Casing (�., - L N/A Y Wm Ezl Sash MA L N/A Y 4 Door Jamb O.1 F L N/A Y A Window Sill M/I AAd L NIA Y Threshold 69 L NIA Y I I I B Win Apron L N/A Y —� A B Door A L N/A Y C Win Casing L N/A Y D Door Edge F L N/A Y D Header Stop W L N/A Y 1® Doorcesing mL WA Y Int Slops W L N/A Y 3 4 Door Jamb F L N/A Y 1 Win Int Sash MR L N/A Y Threshold OC L N/A Y 2 Exterior Sit MA SF L N/A Y A B Door L N/A Y 3 Part Bead MA L N/A Y C D Door Edge F L N/A Y 4 Blind Slop MA SF L N/A Y 12 Door Casing L N/A Y Win Ex(Sash MA L N/A Y 34 Door Jamb F L N/A Y A Window Sill Mil AAA L N/A Y Threshold L N/A Y B Win Apron L WA Y Closet Door 0. L N/A Y C In Casing L N/A Y A Cl Door Edge F L N/A Y _ D Header Stop W L N/A Y Cl Casing 0. L N/A Y Int Stops W L N/A Y Closet Jamb 10;Jl F L N/A Y 1 Win Int Sash MA L N/A Y D Closet Walls L N/Al Y I 1 1 2 Exterior SAI M/1 SF L N/A Y ClBaseboard (jJ L N/A Y 3 Pad Bead Mil L NIA Y 1 Closet Pole y7 L N/A Y 4 Blind Stop W SF L N/A Y 2 Closet shelf ij. L NIA Y Win Ext Sash MA L WA Y 3 Cl Suppods L N/A Y A B lFireplace L N/A Y 4 Closet Floor (1 L❑(dust) N/A Y I C D IMentle I L N/A Y Closet Ceifm g L N/A Y AB Wrh Above 5' L WA Y CD COMMENTS/STRUCTURAL DEFECTS: pp�;_, Cellng Moldin, L WA Y F MA And L WA Y F MA AIM L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F MA AN L N/A Y by a Deleader(MORE THAN 288 SO,IN.) F W AN L NIA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F MA AM L N/A Y DATE METHOD FMAW LN/A Y Check the box tthis ROOM is RULED OUT for encapsulation because there are 3 or more A/M surfaces with adhesion problems LIRA Rep 2017 Room G Beniamin Misch I/R-3984 10/08/21 page 2V_ Inspector(print) Lic 771griatu a Date Risk Assesso rl Signature Date Addressotp RINCE STFt PL. Apt.# flv SALEM ROOM#_c� SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAI SURFACE HAZARD HAZT�. DATE METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METH a s Up Walls 0 L N/A Y Window Sill / MA L N/A Y A s Lox,Walls � L N/A Y B Win Apron Q L N/A Y r.A s Baseboards 00 L N/A Y C Wm Casing D. L N/A Y A s Chair Rail L N/A Y D Header Stop CY.i) MA L N/A Y As Radiator OP L N/A Y Int Stops ft MA L NIA Y t Floor bQ I L®(dust) N/A I Y OT Wm Mt Sash MA L N/A Y fflCeifing I ti4l I L NIA I Y 2 Exterior sis 4.t Mn SF L WA Y A B IDoor 109 I L N/Al Y 1 3 Pert Bead MA L N/A Y D Door Edge f L" Y 4 Band Slop Mll SF L N/A Y 2 Door Casing L N/A Y Wm Ext Sash MA L N/A Y 34 Door Jamb (,O F L N/A Y Window$ill 1 . h1/I L N/A Y Threshold 0. L N/A Y B Mn Aprwr 0 L N/A Y A B Door L N/A Y _ C Win Casing 0 3 L N/A Y D Door Edge f L N/Al Y I I I I D Header Stop N MA L NIA Y _ 1 Door Casing pp L N/Al Y I I I I Int Stops 61 MA L N/A Y 3 4 Door Jamb F L N/A Y I I Win Int Sash MA L N/A Y Threshold L NIAI Y Exterior Sill MA SF L N/A Y A B fDoor 1 11 L N/A Y _ 3 Part Bead MA L N/A Y C D Door Edge F L N/Al Y I I 1 1 4 Blind Stop MA SF L N/A Y 1 2 Door Casing L N/A Y Wm Ext Sash MA L WA Y 3 4 Door Jamb f L N/A Y A Window Sill MJI AAd L N/A Y Threshold L N/A Y I B Imn Apron I I L N/A Y Closet Door L N/A I Y I L— C Win Casing L N/A Y A CI Door Edge F L N/A Y D Header Stop MA L N/A Y B CI Casing U. L N/A Y Int Stops MA L N/A Y Closet Jamb F L N/A Y 1 Win Int Sash MA L N/A Y D Closet Walls QQ L N/A Y 2 Exterior Sill MA SF L WA Y CI BaseboaN L N/A Y 3 Part Bead MA L N/A Y 1 Closet p L N/A Y I I 1 1 4 BNnd Stop MA SF L N/A Y 2 Closet Shelf L N/A Y Win Ext Sash MA L WA Y 3 CI Supports L N/A Y - A B Fireplace L WA Y 4 Closet Floor L❑(dust) N/A Y CD Mantle L N/A Y Closet Ceiling L N/A Y Ao Win AboveB L N/A Y COMMENTS/STRUCTURAL DEFECTS: im Ceiling Moll L N/A Y F MII AAA L WA Y FMA AN LN/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F MA AAA L NIA Y by a Deleader(MORE THAN 288 S0.IN.) F Mll AN L N/A Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F MA AM LN/A Y DATE METHOD F W AAA L WA Y Check the box Ifthis ROOM is RULED OUT for encapsulation because there are 3 or more AIM sudaces With adhesion problems LIRA Rep 2017 Room ®® # k � l Ben'amin Misch I/R-3984 10/08/21 pogo 2gr_ Inspector(print) Lic# gnatue Date Risk AssessoWRINCE STRE0 PL. Signature Date SALEM Address of Pr . t # dv ROOM# SIDE LOCATION/ LEAD' TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEA SURFACE HAZARD HIAZ7 DATE METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METH A e Up Walls (p L N/A Y A Window SIR /& MA L N/A Y A e Low Wells L N/A Y B Win Apron fj L N/A Y .� A e Baseboards /Or1 L N/A Y C Wm Casing /D L N/A Y r.A n Chair Raii L N/A Y D Header Stop o f M/I L N/A Y AB Radiator I'Y? 1. L N/A Y Int Stops o3 w L N/A Y t =f,'Flow L❑(dust) N/A Y 1 Win Int Sash MII L N/A Y Ceiling �F L NIA Y 2 Eztedor Sill M/i SF L WA Y A S Door L N/A Y 3 Pan Bead MA L N/A Y D Door Edge F L N/A Y 4 Blind Stop M/I SF L N/A Y 1 2 Door Casing �,. Z3- L N/A Y Win Ext Sash MA L NlA Y 3 4 Door Jamb jsj L N/A Y A Window Sill /3 M L N/A Y Threshold 0 k) L N/A Y Win Apron 0.0 L N/A Y A B Door L_N/A Y _ C Win Casing qf9 L WA Y C D Door Edge F L N/A Y D Header Stop D. AUI L N/A Y 12 Dow Casing L N/A Y Int Stops 0.0 MA L N/A Y 34 Dow Jamb F L N/A Y ® Win Int Sash MA L N/A Y Threshold L N/A Y 2 Exterior 881 f M/I SF L WA Y A B Door L N/A Y 3 Pan Bead Mfl L NIA Y C D Door Edge F L N!A Y 4 Blind Stop MA SF L N!A Y 12 Dow Casing L N/A Y Win Ext Sash MII L N/A Y 34 Door Jamb F L N/A Y A Window Sill l W1 L N/A Y Threshold L N/A Y ® in Apron 0.0 L N!A Y Closet Dow f L N/A Y C Win Casng I L L N/A Y A Cl Door Edge F L N/A Y _ D Header Stop U` ( MA L N/A Y B Cl Casing L N/A Y Int Stops 40 MA L WA Y C Closet Jamb F L N/Al Y 1 Win Inl Sash Mn L N/A Y D Closet Walls L N/A Y Exterior$ill MA SF L N/A Y Cl Baseboard L N/A Y 3 Tart Man L WA Y 1 Closet Pole L N/A Y 4 Bond Shop M/I SF L N/A Y 2 Closet Shell L N/A Y Wm Ext Sash w L N/A Y 3 CI Supports L N/A Y A B IFireplace L N/A Y 4 Closet Fbor L❑(dust) N/A Y DID Mantle L N/A Y Closet Ceiling L N/A Y AB CD Win Above 5' L WA Y COMMENTS/STRUCTURAL DEFECTS: z Ceiling Mold! 4 L NIA Y 'Pan Q FM/I AfM LWA Y F Mll AM, L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F MA AM L N/A Y by a Deleader(MORE THAN 288 S0.IN.) F WI AAM L N/A Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC FMll AM7 LN/A Y DATE METHOD F MA AMM L WA Y Check the box If this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surlsoes with adhesion problems LIRA Rep 2017 Room ®® # 3 Ben'amin NNisch I(R�39S4 ` 10/0&/21 ( Inspector(print) - Lic# ature :- Date Risk Assessor( nnl Lic# Signature Dat Address_LA ,RINCE .STREET PL. ADt # Chi. SALEM KITCHEN SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG fc IC DELEAD DELEI SURFACE HAZARD HAZ DATE METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METI A B Up Walls d L N/A Y A Wmdow Bill 6,1 p,M AM, L N/A Y A B Lam,Wad / L N/A Y � Win Apron OD L N/A Y A B B�seboa ds 63 L N/A Y C Win Casing 0) L N/A Y A B Chair Refl L N/A Y D Header Slop 01 MA L N/A Y IAs c D Radiator lop L WA y Int Stops O.0 W L WA Y ::Floor L (dusq N/A Y Wm Int Sash MA L N/A Y +�.Celin9 - L N/A Y 2 Exterior Sll J MA SF L WA Y A B Door L N/A Y 3 Part Bead 1 L NIA Y D Door Edge /, F L N/A Y 4 Blind Stop k9A SF L NIA Y 2 Door Casing ao7 L N/A Y Wm Ext Sash MA L N/A Y 3 4 Doo Jamb D.3 F L N/A Y A Window Sill b.1, MA AN L N/A Y Threshold pu L N/A Y in Apron OLI- L WA Y A B Door L N/A Y C Win Casing 09 L N/A Y D Door Edge F L N/A Y D Header Slop (YJ MA L N/A Y 1 Door Casing 03 L WA Y Inf Stops �. MA L N/A Y 3 4 Door Jamb (7 F L N/A Y 1 jWn Int Sash JQ . MA L NIA Y Threshold L NIA Y 20 Exterior Sill I Q2 MA SF L N/A Y A B Door L N/A .. _ 1 3 Part Bead MA L NIA Y "l7 Door Edge F L N/A Y 4 11311nd Stop 14. 1 MA SF L N/A Y 12 Door Casing 0% L N/A Y Ifflin Ext Sash MA L WA Y 3 4 Door Jamb 0. F L N/A Y A Up Cab Frame 6.D _ L N/A Y Threshold L N/A Y Up Cab Door 00 L N/A Y Closet Dow L N/A Y .0 Up Cab Walls A� L N/A Y A CI Dow Edge F L N/A Y 12 Up Cab Shlvs 00 L N/A Y B CI Casng L N/A Y 3 4 Supports L WA Y C Closet Jamb F L N/A Y F1, Low Cab Fram QO L N/A Y D Closet Walls 1 N/A Y Igltl Low Cab Door L N/A Y CI Baseboard L N/A Y C ow Cab Wall L N/A Y 1 Closet Pole L N/A Y Low Cab ShNa b L N/A Y 2 Closet Shel L N/A Y 12 Supports L NIA Y 3 CfSuppors L N/A Y 34 Drawers L NIA Y 4 Closet Floor L®(dusq N/A Y As c Win Above 5' L N/A Y Closet Ceiling L WA Y 'E,' Ceiing Mold' L N/A Y COMMENTS I STRUCTURAL DEFECTS: F WI ABM L WA Y F W Al L N/A Y F MA A/M L WA Y F MA AN L NIA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F MA AU L NIA Y by a Deleader(MORE THAN,288 SO.IN.) F W AN L NIA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F MA AM L NIA Y DATE METHOD F MA AM L WA Y Check the box Ifthis ROOM is RULED OUT for encapsulation because there are or more AIM surfaces with adhesion problems LIRA Rep 2017 Kitchen Kitchen t Benjamin Misch I/R-3984 j lv Page ` . Inspector(print) Lic# ' nature ae Risk Assessor(print) Signature Date Address ofProderlv:DRinrrc CTRGGT PI Apt.# City: SAI FAA PANTRY 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 METH DATE METH A n Up Wells L WA Y Q AB Up Cab Frame L NIA Y A e Low Walls L N/A Y CD Up Gab Door L N/A Y A s Baseboards �� L N/A Y Up Cab Walls L N/A Y A s Chair Rail L N/A Y 12 Up Cab Shlvs L N/A Y As CD Radiator L N/A Y 34 Supports L N/A Y -: Floor IC4V I L❑(dust) N/Al Y I I A B Up Cab Frame I- T1. L N/A Y C D Up CabDoorEENE ~ B Door L N/A Y Up Cab Walls L N/A I Y CD Door Edge F L N/A Y 12 Up Cab Shlvs L N/A Y 12 Door Casing C) L N/A Y 34 Supports L N/A Y 34 Door Jamb D3 F L N/A Y Low Cab Far, L N/A Y Threshold L N/A Y AB Low Cab Door L N/A Y AB Door _ L N/A Y _ C D Low Cab Wall L N/A Y CD Door Edge F L N/Al Y I 11-ow,Cab ShIvs L NIA Y 12 Door Casing L N/A I Y 1 12 Supports L N/A Y 34 Door Jamb F L N/A Y 1 34 Drawers L N/A Y Threshold L N/A Y Low Cab Fram L NIA Y Closet Door L N/A I Y A B Low Cab Door L N/A Y A JCIDoorEdge F L N/Al Y C D Low Cab Wall L N/A Y B CI Casing L N/A Y Low Cab Shlvs L N/A Y C Closet Jamb F L NIA Y 12 Supports L N/A Y D Closet Walls I I I L N/A Y 34 Drawers 4 L N/A Y CI Baseboard I I I L NIA Y Low Cab Fram L N/A Y 1 Closet Pole L N/A Y AB Low Cab Door L N/A Y 2 Closet Shelf L NIA Y C D Low Cab_WalI L N/A Y 3 Cl Supports L N/A Y Low Cab Shlvs L N/A Y 4 Closet Floor LQ(dust) N/A Y 12 Supports L N/A Y Closet Calling L N/A Y 34 Drawers L N/A Y AB Up Cab Frame L N/Al Y A Window Sill j. M/I L N/A Y C D Up Cab Door L N/A I Y B Win Apron L N/A Y Up Cab Its L N/A Y C Win Casing D. L N/A Y 12 Up Cab Shivs L N/A Y Header Stop 0.( M/I L N/A Y 34 Supports L N/A Y Int Stops M/1 L N/A Y F M/I AM L N/A Y 1 Win Int Sash MA L N/A Y COMMENTS/STRUCTURAL DEFECTS: 2 EAedor Sill Mn SF L N/A Y 3 Part Bead M/I L N/A Y 4 Blind Stop M/1 SF L NIA Y Win Ext Sash I Vy I L NIA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F M/I AM L NIA Y by a Deleader(MORE THAN 288 SO.IN.) F MA AM L N/A Y SIDE LOCATION MEASURE:LOOSE PAINT IC I IC F M/I AM L N/A Y DATE METHOD F MA AM L N/A Y Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more ARM surfaces with adhesion problems LIRA Rep 2017 Pantry irancry 10/08/21 1024 Ben amin B4isch I/R-3984 Inspector(print) Uo# re Date Risk As Signature to / Address of Pronarty: A19 # Cihr BATHROOM# SIDE LOCATION/ LEAD TYPE OF URG to IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DEL DE SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ DATE METH DATE N A e Up Wails a 1 L WA Y AS Up Cab Frame L N/A Y A a LOW Weft L WA Y C D W Cab Door L N/A Y A S Baseboards Oo L WA Y UD Cab Wads w.. L WA Y a 8 Chou Rail / L N/A Y 12 Up Cob WN L N/A Y pp Radiator dV LWA Y - 34 Suppods L N/A Y Hoof u L®(dust) N/A Y - Low Cab From OPt WA Y Celgag LWA Y Low Cab Door rA L N/A Y B L WA Y CD Low Cob Wei D, L WA Y C D Door Edge F L WA Y - Low Cab Sh L WA Y 12 Door Casing L N!A Y 12 Supports L WA Y 34 Door Jamb d F L N/A Y 34 Drawers L WA Y Threshold LWA Y A WM w SN AAA L WA Y A B Door L N/A_Y B Wn Apron L WA Y C D Door Edge F L NIA Y C Vdn Casing L WA Y 1 2 Door Ces ng L N/A Y D Header Stop NA L N/A Y 3 4 Door Jamb F L N/A Y Int Stops M11 L N/A Y Threshold L WA Y 1 Wn int Sash W L N/A Y A B Door L NIA Y 2 Exterior BE W SF L N/A Y C D Door Edna F L N/A .Y 3 Part Bead M9 L N/A Y 12 Doorrosinng L N/A Y 4 Bgnd Sty M� SF LWA Y 34 Door Jamb F LWA Y ItNinExtSash I LN/A Y Threshold L N/A Y CD A 6 Win Above 5' L NA Y Closet Door L N/A Y I INACelling Moldir4 I L NA Y A CI Door Edge F L NIA Y Medicine Cab L NA Y B CI Caft L N/A Y _ F Mfl AN LWA Y C Closet Jamb F L N/A Y F MA AM9 LWA Y D Closet Walls L WA Y F kM AN l N/A Y Cl Baseboard L WA Y F RM AN L WA Y 1 Chef Pole L N/A Y F MA AM, LWA Y 2 Closet Shelf L N/A Y F MO AM9 L WA Y 3 CI Supports L WA Y - FM A.M0.LWA Y 4 Coset Floor L 0(duQ WA Y F W AW LWA Y ClowCelFng LWA Y FMftAWLWA Y FWAMILWA Y FMIAAALWA Y F Md AMU LWA Y f Mfl AM7 L WA Y EXCLUDED SURFACES:Surfam listed In these boxes can only be made IMa COMMENTS/STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288 So.IN.) SIDE LOCATION MEASURE:LOOSE PAINT 10 IC DATE METHOD Check the box RU&ROOM Is RULED OUT for endepsule5on bemuse there ere 3 or more AN sudaces with adhesion problem —ore Benjamin Misch I/R•3584 10/08/21 Pf e 24f_ Inspector(print) Liicc# ignatu a Date Risk AssessRrborRINCE STR-E Iy PL. Signature Apt,# city: Dat`8ALEM Address of P De ROOM# SIDE LOCATION/I LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEA SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ DATE METH DATE METH A B Up Wails L N/A Y A Window Sill 'O1 MA AM L N/A Y A B Low Wells l L NIA Y B Win Apron L N/A Y A B 1 Baaeboarda 0•I L NIA Y Mn Casing �. L N!A Y A B Chair Ratl L N/A Y D Header Stop n0.1l� MA L N/A Y Al Radiator L WA Y Int Stops v>y•MA L N/A Y FloorICY-) I L®(dust) N!A Y 10 Wm Int Sash AAA L WA Y Ceiling L NIA Y 2 Exterior Sill MA SF L WA Y B Door 0. L N/Al Y I I _ 1 1 3 Pan Bead ( MA L N/A Y C D Door Edge /, F L N/A Y _ 4 Bind Stop MA SF L N/A Y 12 IDoor Casing Q L N/A I Y-1 Win Ext Sash M/1 L N/A Y 3 4 IDoor Jamb 0,? F L N/A Y A IWndow Sill I IMA AN L NIA Y Threshold f—UQ)I L N/A Y B Win Apron IMI L WA Y A Door 00 L N/A Y Win Casing OVI L WA Y C D Door Edge F L N/A Y D Header Stop MA L N/A Y 12 Door Casing L N/A Y Int Stops O�J MA L NIA Y 34 Door Jamb F L N/A Y 1 Win Int Sash MA L WA Y Threshold L N/A Y U Exterior SRI MA SF L NIA Y AB Door _ L N/A Y 3 Part Bead 14 MII L NIA Y C D Door Edge F L N/A Y 4 Blind Stop MA SF L N/A Y 12 Door Casing L N/A Y Wm Ext Sash A4A L N/A Y 34 Door Jamb F L N/A Y A Window Sill MA AM L N/A 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 MA L NIA Y bCI Casing (/Q L NIA Y Int Stops MA L WA Y C Closet Jamb F L N/A Y 1 Wm Int Sash MA L N/A Y D Closet Wald I p, L N/A Y 2 Exterior Sill MA SF L N/A Y Cl Baseboard 0 L N/A Y 3 Part Bead MJI L NIA Y 1 Closet Pole L o L N/A Y 4 ISUnd Stop I MA SF L N/A Y 2 Closet Shen 0;zl L N/A Y Win Ext Sash MA L WA Y 3 CI Supports L N/A Y AB Fireplace L NIA Y 4 Closet Floor Y C D IMantle I L N/A Y Closet Gating L N/A Y A D Win Above 5' L WA Y COMMENTS/STRUCTURAL DEFECTS: _,+, ' Ceiling MoldingI LN/A Y F W1 AM L WA Y F MA AMA L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F MA AM L N/A Y by a Deleader(MORE THAN 288 SO.IN.) F MA AM L N/A Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F MA AM L N/A Y DATE METHOD F MA AM L NIA Y Check the box gthis ROOM is RULED OUT for encapsulation because there are 3 or more AM surfaces with adhesion problems LIRA Rep 2017 Room V # Beniamin Misch 1/11-3984 10/08/21 age 2 Inspector(print) Lic# gnatue Date RiskAss gpr,�p¢gt) INCE STREWPL. Signature Da tALEM Addr�ss_of R Aot # Cfty ROOM# 5 SIDE LOCATION/ LEAD TYPE OF® URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEF SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ DATE METH DATE METI- A B Up Walls p L N/A Y A Window Sif 0.3 MA AM L N/A Y A e Low Wal s L N/A Y B Win Apron Q L N/A Y A B Baseboards Ol L N/A Y QC Win Casing QP L N/A Y A a Chair Rail L N/A Y D Header Stop 0.( M/I L MIA Y AS Radiator L N/A Y Int Stops I OZ MA L N/A Y li'� �'Floor L®(dust) N!A Y © in Int Sash MA L N/A Y L N/A Y 2 Exterior Sill MA SF L WA Y B Door L N/A Y _ 3 Part Bead 7,T,MA L N/A Y C D Door Edge F L NIA Y 4 Blind Stop MA SF L N/A Y �1 Door Casing Q- - L N/A Y Win E)d Sash M/I L NIA Y 3 4 Door Jamb n. F L N/Al Y I I I I A Window Sib 00 MA AN L NIA Y Threshold Up L N/A Y B Win Apron L-A� L N/A Y B Door L Al Y (g) Win Casing QQ L N/A Y C D Door Edge F L NiAl Y I I I I D Header Stop Cll AAA L N/A Y 10 Door Casing L N/A Y Int Stops (fJ MA L N/A Y 3 4 Door Jamb F L WA Y 1 Mn Int Sash MA L N/A Y Threshold C7Q1 L NIA Y Exterior SAI MA SF L NIA Y A B Door L N/A Y 3 Part Bead MA L NIA Y C D Door Edge F L N/A Y 1 4 Blind Stop MA SF L N/A Y 12 Door Casing L NIA Y Wm Ext Sash MA L N/A Y 3 4 Door Jamb F L N/A Y A Window Sill W AM—L N/A Y Threshold L NIA Y B Win Apron I I I L NIA Y Closet Door, 00 L NIA Y C jwn Casing I L N/A Y �A Cl Door Edge F L N/Al Y I D Header Stop MA L N/A Y B Cl Casing co L N/A Y In[Slops W L N/A Y C Closet Jamb OZJ F L N/A Y 1 Win Int Sash NJ L N/A Y D Closet Walls Qi L NIA Y 2 Exterior Sill I SF L N/A Y Cl Baseboard LIQ L N/A Y 3 Part Bead M/I L N/A Y 1 Closet Pole L WA Y 4 Blind Stop MA SF L N/A Y 2 Closet Sheff L N/A Y Win Ext Sash MA L N/A Y 3 Cl Supports L NIA Y A B Fireplace L N/A Y 4 Closet Floor (`q l L®(dust) N/A Y C D Mantle L WA Y Closet Ceiling 13A L N/A Y ne Win Above 5' 1 L NIA Y COMMENTS/STRUCTURAL DEFECTS: g-r -„ Ce(GngMoM- L N/A Y F Mll AAA L WA Y F W AM L NIA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F W AM L NIA Y by a Deleader(MORE THAN 288 SQ.IN.) F MA AN L NIA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F MA AN L N/A Y DATE METHOD F MA AN L N/A Y Check the box if Nis ROOM is RULED OUT for encapsulation because there are 3 or more AIM Surfaces with adhesion problems LI/RA Rep 2017 Room ®o Benjamin Misch I/R-3984 10/C}8/2/1 Page Of— Inspector (print) Lic# S. ature Date Risk AssessorlpantVRINCE STREET HL. Signature Date SALEM Address of Property Apt # City HALLWAY:Interior #_ or Common Hallway: Front Rear Floor#_ SIDE LOCATION/ LEAD ];;; IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URO IC IC DELEAD DELEAD SURFACE DATE METH DATE METH SURFACE HAZARD HAZ DATE METH DATE METH A 6 Up Walls Closet Door L NIA Y A 6 Lay Walls L N/A Y A Cl Door Edge F L N/A Y A B Baseboards 10-k L N/A Y B Cl Casing L N/A Y A e Chair Rail L N/A Y C Closet Jamb F L N/A Y AB Radiator W L N/A Y D Closet Walls L WA Y Floor tS,D L❑(dust) N/A Y Cl Baseboard L N/A Y Ceiling L N/A Y 1 Closet Pole L NIA Y B Door (yt7 L N/A Y 2 Closet Shelf L N/A Y C D Door Edge F L N/Al Y I 1 3RHeaderStop rts L NIA Y 1 Door Casing G L NIA Y 4or L❑(dust) N/A Y 4 Door Jamb 60 F L NIA Y iling L Threshold W L N!A Y Aill W AMt L N/A Y B Door U L N/A Y _ BApron L-N/A Y C D Door Edge F L NIA Y Cg L NX Y 1s Door Casing O. L NIA Y Dtop . MA L N/A Y 3 4 Door Jamb F L N/A Y Int Stops MA L N/A Y Threshold OU L N/A Y 1 Wm Int Sash MA L NIA Y Door _ L N/A Y 2 Exterior Sill WSF L N/A Y C D Door Edge F L N/A Y 3 Part Bead MA L NIA Y 2 Door Casing (J� L N/A Y 4 Blind Stop W SF L WA Y 34 Door Jamb F L N/A Y Win Ext Sash MA L N/A Y Threshold L NIA Y A Window Sill W AAvI L N/A Y Door (A L N/A I Y B Wngoron L N/A Y C D Door Edge F L N/A Y - C Win Casing L NIA Y 1 Door Casing (A? I L N/A I Y D I Header Stop M l L N/A Y 134 Door Jamb 101 F L N/A Y m Stops MA L N/A Y Closet Door L N/A Y 1 Win Int Sash MA L N/A Y A CI Door Edge W F L N/A Y 2 Exterior SAI WSF L N/A Y B CI Casing_ _ L NIA I Y 3 Part Bead MA L N/A Y C Closet Jamb I F L NIA I Y 4 Blind Stop MA SF L N/A Y DK�CAin, lls L N/A Y Wm Ext Sash . W L NIA Y Clard L N/A Y o u Win Above 5' L N/A Y 1 e L N/A Y Ceiling Moldin L WA Y 2 elf L NIA Y L Cry F W AAJ L NIA Y 3 ts L NIA Y F MA AR,7 L NIA Y 4 or L❑(dust) NIA Y F MA AAd L NIA Y iling L WAVY COMMENTS/STRUCTURAL DEFECTS: EXCLUDED S FACES:Surfaces listed in these boxes Can only be made intact by a Deleader(MORE THAN 288 SO.IN.) SIDEJ LOCATION MEASURE:LOOSE PAINT IC DATE r METHOD Check the box if this ROOM is RULED OUT for encapsulation because there are or more AIM surfaces 7gwith $adhesion Jproblems rT/RARa Fl nInI1an alltlTa r 1 ( Benjamin Misch 1lR-3984 10/0P/2) Page2a Inspector(print) Lic# S' ature Date Risk Assessor pin RINCE 6TRELET FL. Signature Date tiALEM Addrelis f Pr t HALLWAY:Interior #_ [,oq I Common Hallway: Front Rear Floor#_ ,2 :02 SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DEL SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD FIAZ. DATE METH DATE METH A B Up Walk L NIA1 Y I I loset Door L N/A 7 _ A B Low Wells L N/A Y A CI Door Edge F L N/A Y A B Baseboards I I L N/A Y B Cl Casing L NIA Y A B Chair Rail I I L NIA Y C Closet Jamb F L N/A Y AS Radiator L N/A Y D Goset Walk L NIA Y Floor L�(dusq N/A Y CI Baseboard L N/A Y hx Ceiling L N/A Y 1 Closet Pole L N/A Y A B Door C� L N/A Y_ 2 Closet Shell L NIA Y D Door Edge F - L N/A Y 3 CI Supports L N/A Y Door Casing �. L N/A Y 4 Closet Fbor L❑(du-S NIA Y 3 4 Door Jamb F L N/A Y Closet Ceilin L N/A Y Threshold O.� L N/A Y A Window Sill W AAA L N/A Y A B Door L N/A Y B Win Apron -L N/A Y D Door Edge F L N/A Y _ C Win Casing L N/A Y 1 Door Casing L N/A Y D Header Stop MJI L NIA Y 3 4 Door Jamb F L N/A Y Int Stops WI -L NIA Y Threshold L NIA1 Y 1 Wm Int Sash k1ll L N/A Y A B Door L NIA I Y _ 2 Exterior Sill MA SF L N/A Y D Door Edge F L N/Al Y I I 1 1 3 IPart Bead . MJI L N/A Y 12 Door Casing L N/A I Y I 1 4 Blind Stop . MA SF L N/A Y 4 Door Jamb IC4 F L N/Al Y I I Win Exl SasVT MA L N/A Y Threshold L N/A Y A Window Sill MA AAA L N/A Y A B Door L N/A Y B Win Apron L N/A Y C D Door Edge s F L NIA Y C Win Casing L N/A Y 12 Door Casing L N/A Y D Header Stop MA L N/A Y 3 4 Door Jamb F L N/A Y Inl Slops MA L N/A Y Closet Door L N/A Y _ 1 Win Int Sash MA L NIA Y A ICI Door Edge F _ L N/A Y 2 Exterior SIII MJI SF L N/A Y B CI Casing - L N/A Y v 3 Part Bead AAA L N/A Y C Closet Jamb F L N/A Y 4 Blind Stop . MA SF L N/A Y D Closet Walls L N/A Y Wn Ext Sash MA L N/A Y CI Baseboard L N/A Y c D Win Above S' L N/A Y 1 Closet Pole L N/A Y y�° �-„.;CaAing filoldint N/A Y 2 Closet she L N/A Y FW AAA L N/A Y 3 Cl Supports LN/A Y FMII AM LN/A Y 4 Closet Floor L®(dust) NIA Y F M/I AW1 L NIA Y Closet Ulm L N/A Y COMMENTS/STRUCTURAL DEFECTS: EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact by a Deleader(MORE THAN 288 SO.IN.) SIDE LOCATION MEASURE:LOOSE PAINT tc DATE C rnETrtoo Check the box Ifthis ROOM is RULED OUT for encapsulation because there are 3 or more ANA ca surfaces 1with $adhesion problems LIRA Ren 9017 Hall a v t Benjamin Misch I(R-3984 /I Page 274— Inspector(print) Lie# Sfinature Date Risk Assessor(print) Lic# Signature Date AddressofPro -PRIfy.E STREET'gPL. Apt.# City: SALEM STAIRCASE#__ SIDE LOCATION/ LEAD, ®TYPE OF URG m IC 77 DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ4 DATE METH DATE METH SURFACE HAZARD HAZ DATE METH DATE METH A e Up Wails DI 14 L N/A Y A Window Sill 65D MW A!M L NIA Y A E Low Walls L N/A Y B Win Apron 0` L N/A Y A e Baseboards C] L N/A Y C Win Casing 09 L N/A Y A B Chair Rail L NIA Y D Header Stop OQj MA L NIA Y As cD Radiator L N/A Y Int Stops 0.� Mdl L N/A Y Floor L❑(dust) N/A Y 1 Win Int Sash MA L N/A Y .:¢.Ceiling L N/A Y 2 Exterior Sill .2_1W] SF L N/A Y B Door L N/A Y 3 Pad Bead . MII L N/A Y C D Door Edge F L N/A Y 4 Blind Stop MA SF L NIA Y Door Casing (7 L N/A Y Win Ezt Sash M/I L NIA Y 34 Door Jamb Ud F L N/A Y A Window Sill p. W AIM L N/A Y Threshold L N/A Y - B- Win Apron - L NIA Y A B Door 00 L N/A Y Win Casing (�\ L N/A Y D Door Edge F L N/A Y D Header Stop CTIO MA L N/A Y 12 Door Casing L N/A Y Int Stops (7 MW L NIA Y 3 4 Door �( F L NIA Y 1 Win Int Sash MA L NIA Y Thres old O! / L N/A Y 2 Exterior Sill Z, M/I SF L N/A Y B Door L N/A Y (5 3 Part Bead J M/I L NIA Y C D Door Edge /. F L N/A Y �/,�. 4 Blind Stop Mll SF L N/A Y 1 Door Casing L N/A Y Win Ext Sash /I L N/A Y 3 4 Door Jamb F L N/A Y Newel Post o. L N/A Y Threshold L WA Y Railing Cap o. A/M L N/A Y Door L NIA Y Handrail (7 AM. L N/A Y C D Door Edge F L N/A Y Balusters L N/A Y 1 2 Door Casing L N/A Y Lower rail L N/A Y 3 4 Door Jamb F L N/A Y Treads F L N/A Y Closet �R/ _ L N/A Y Risers O. L N/A Y A Cl Door ge F L NIA Y Stringer L N/A Y B CI Casing L N/A Y Tread edge>5 L N/A Y C Closet Jamb F L_N/A Y Landing floor L ❑(dust) N/A Y D Closet Walls L N/A Y Floor Edge L NIA Y Cl Baseboard Pk} L N/A Y Floor Casing L N/A Y 1 Closet Pole L N/A Y O.0 FM/IAMLN/Al Y 2 Closet Shelf k4 L N/A Y F W AM L N/A Y 3 Cl Supports L N/A Y F M/1 AM L N/A Y 4 Closet Floor 0 L❑(dust) N/A Y F Mill AM L NIA Y Closet Ceiling L NIA Y F MW AM L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact COMMENTS/STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288 SQ.IN.) L LV, — C,o 3. ee-2�-443A 4 ri aA SIDE LOCATION MEASURE:LOOSE PAINT IC IC ,�f'..Qyf�-d g05ps DATE 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 Stair &O-I'Stalrs a k Benjamin Misch I/R-3984 jnjdojn4 Pai(et-1A.— Inspector(print) Lic# Signature Dare Risk Assessor(print) Lic# Signature Date Address ofPfOclafw'PRINCE STREET PL. Apt.# City: SALEM STAIRCASE# a Q� --( 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 HAZ9 DATE METH DATE METH A e Up Walls 0R0 L N/A Y A Window Sill W AM L N/A Y A a Low Walls L N/A Y B Win Apron L N/A Y A s Baseboards"' L N/A Y C Win Casing L N/A Y A B Chair Rail /. L N/A Y D Header Stop MA L N/A Y C p Radiator /. L N/A Y Int Stops M/I L N/A Y Floor C L[:](dust) N/A Y 1 Wm Int Sash MA L NIA Y Ceiling L N/A Y 2 Exterior Sill MA SF L NIA Y B Door U'J L N/A Y 3 Pad Bead M/1 L N/A Y C D Door Edge 7 F L N/A Y 4 Blind Stop MA SF L N/A Y 12 Door Casing L N/A Y lWin Ext Sash M/1 L N/A Y 3 4 Door Jamb 00 F L N/A Y A Window Sill IW AN L N/A Y Threshold -- L N/A Y - B Win Apron L NIA AID Door d L N/A Y C Win Casing L N/A Y C D Door Edge F L N/A Y D Header Stop MA L N/A Y 1 2 Door Casing 6. L N/A Y Int Stops MA L N/A Y 34 Door Jamb F L N/A Y 1 Win Int Sash MA L N/A Y Threshold DO L N/A Y 2 Exterior Sill M/1 SF L N/A Y A B Door _ L NIA Y 3 Pad Bead MA L N/A Y C D Door Edge F L N/A Y 4 Blind Stop M/1 SF L N/A Y 12 Door Casing L N/A Y Win Ext Sash M/1 L N/A Y 3 4 Door Jamb F L N/A Y Newel Post 0 L N/A V Threshold L N/A Y Railing Cap (fJ AM L N/A Y A B Door L N/A Y Handrail AM L N/A Y C D Door Edge F L N/A Y Balusters L N/A Y 12 Door Casing L N/A Y Lower rail L N/A Y 3 4 Door Jamb F L N/A Y Treads F L N/A Y Closet Door p.� L N/A Y Risers L N/A Y A CI Door Edge F L N/A Y Stringer L N/A Y V Cl Casing Cn I L N/A Y Tread edge>5 L N/A Y C Closet Jamb &I I F L N/A Y -. Landing floor CW I L❑(dust) N/A I Y D Closet Walls jQ0 I L N/A Y Floor Edge N I L NIA1 Y CI Baseboard (q} L N/A Y Floor Casing QO L N/A Y 1 Closet Po L N/A Y F M/I AM, L N/A Y 2 Closet Shelf 00 L N/A Y F Mn AM L N/A Y 3 CI Supports tV L N/A Y F MA AAA L N/A Y 4 Closet Floor O0 L❑(dust) N/A Y F M/I AAA L N/A Y Closet Ceiling 01 L N/A Y F NA AM L N/A 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 D TE METHOD ` � (n v Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more AM surfaces with adhesion problems LIRA Rep 2017 Stair -frI^,V on Stairs l 19-/2--f 10/06/21 Benjamin Misch I/R-3984 / / Pa a Inspector(print) Lic# ature Date Risk Assessor HLqHCW I L Signature Address of Prooenw: Apt.# City PORCH —f —(side) (floor) -;si cqj a- u SIDE LOCATION/ 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 AB ISiding D.b L N/A Y AB Wndow Sill ABM L NIA Y C D Comer Boards b. L NIA Y C D Win Casing L N/A Y - N,; Upper Tdm MA L NIA Y 1 2 Window Sash L NIA Y Ceigng L WA Y 34 Munione L N/A Y s,;� Joists L N/AYJ A B Window Sill AN L N/A Y oftRnnOCN� L N/A Y C D Win Casing LWA Y ABF L NIA Y 12 Window Sash LN1A Y CD L N/A Y 34 Mullions L NA Y F L N/A Y '" ;.:Support Cimns / L NIA Y 12 L NIA Y '' 'Newel post (� L N/A Y 34 L N/A Y , Railing Cep UD AAA L N/A Y L N/A Y HandraA AN ® L•NIA Y Kickpfate luo L NIA Y ;)•;ti Balusters (JO L NIA Y Slomn Door L NIA Y `^"' Lower Rag (JJ L WA Y A B Strm Door FA F L N/A Y B`. Treads F L N/A Y C D Door 1$ ,� L N/A Y `s Risers L WA Y Door Edge F L N/A Y ' ' Stringer L N/A Y A _ 1 2 Door Casing L NIA Y kR Tread Edge (� L NIA Y ;., 34 Door Jamb F L N/A Y "Lower Wails L WA Y Threshold /�1L L N/A Y "~'``'j1{�.: Lattice d d L WA Y Kicdplate L N/A Y Lower Tdm L N/A Y . JA BWftdowSifiti.p AIM L N/A Y :':Fbor L®(dust)' WA Y C D (yp L N/A Y F MA AIM L N/A Y 12 ,e L WA Y F MII AN L N/A Y 34 L NIAL Y I I I I F M/I AM L NIA Y IC B Window Shc oi3 AAd L NIA Y F MA AN L NIA Y D Win Casing l L NIA Y F M/I AML N/A Y 2 Window Sash L N/A Y F MA AN L N/A Y 4 Mullions L N/A Y F MII AN L N/A Y A B Window Sill lA AN L N/A Y F MA AN L N/A Y C D Win Casing (fJ L N/A Y F M/I AIM L N/A Y 12 Wndow Sash L N/A Y F MA AR1, L NIA Y 34 Mullions L NIA Y F MA AN L N/A Y 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 AIM surfaces with adhesion problems LIRA Ren 2017 Porch -Porch I s� g ,;�►Zq 10/06/21 Beniamin Misch I/R-3984 If If Page 01 Inspector(print) ,\ Lic# ature Dale Risk Assessor ) Signature Address of PrQ&rfw AN,# CAv PORCH _L(side) I (floor) f# SIDE LOCATION/ 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' Siding 0 L N/A Y AB Window Sill AN L N/A Y C D Comer Boards E L N/A Y C D Win Casing L NIA Y Upper Trim 114 L N/A Y 12 Window Sash L NIA Y Gelling MA L NIA Y 34 Mugions L NIA Y LiaoJoists X, L NIA Y A B Window Sill AMI L N/A Y Storm Door _ L NIA Y _ C D Win Casing L NIA Y A B strm Door Ed F L NIA Y 12 Window sash L N/A Y C D Door 1i L N/A Y 34 Mullions L N/A Y Door Edge F L N/A Y Support Clmns L WA Y 12 Door Casing L N/A Y Newel post CSJ L WA �Y 34 Door Jamb JO F L N/A Y ,g Railing Cap W AN L NIA Y Threshold !SG L NIA Y '.'Handrail k90 AN L N/A Y Kickplate 00 L N/A Y ,'.,` Balusters (7J L N/A Y � Stain Door L N/A Y „; Lower Rail L N/A Y $ut A B Sum Door E F L N/A Y ''. Treads F L NIA Y C D Door �\ (/J L N/A Y _ "g Risers QQ L N/A Y Door Edge F L NIA Y Stringer L NIA Y 12 Door Casing 0. L N/A Y 'py'a. Tread Edge (fJ L N/A Y 34 Door Jamb l) F L N/A Y Lower Walls ./' L WA Y Threshold nSG L N/A Y ;.��,Latice (/p MN/A N/A Y Kickplate (l.� L N/A Ys=�` Lower Trim Q Y A B Window Sill G9 A/M L N/A Y Floor D� L (dus Y C D Win Casing O, L N/A Y F MII AM Y 1 2 Window Sash a L N/A Y F M/1 AM Y 3 4 Mullions L N/A Y F Mil AM YA B Window Sill (� AIM L N/A Y F MII AM YDWin Casing I L WA Y FMII AN Y12 Window Sash !L L N/A Y F MA AM Y3 4 MuAions / L N/A Y F M AM YWindow Sill iyj AIM L N/A Y F M/I AM Y 1C D Win Cash L N/A Y F Mil A/M L NIA Y 1 2 window Sash _ L N/A Y F MA AM L N/A Y 34 Mullions 2a L NIA Y F N I AM L NIA Y COMMENTS/STRUCTURAL DEFECTS: (dust)`•Applies only to porches used as Interior space COMMENTS/STRUCTURAL DEFECTS: (3 is EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only by a licensed de_leade_r. 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 AIM surfaces with adhesion problems t.i/R A Ren 7n 77 Pnrnh Porch Ylo �/ 10/06/21 j12' - I3en'amin Misch I/R-3984 / / Page Inspector(print \\ Lic# ' nature Date Risk rtssessorpnnt)"' '•- 1 Signature -- Address of Prooedv- Anf n City EXTERIOR A Side N ff 13 , 4 /S SIDE LOCATION/ LEA TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD A SURFACE HAZARD HAZ DATE METH DATE METH A I SURFACE HAZARD HAZ DATE METH DATE METH Siding OQ L N/A Y Sill L04 AN L WA Y Comer Boards 0 -�� L N/A Y A CqL N/A Y A Lower Tdm L N/A Y # Sash CodL N/A Y Upper Tim L NIA Y Cellar Win Sill D.l AIM L N/A Y Wn Above 5' MA L N!A Y A Cel Win Frem 0.1 L WA Y Porch Above 5 L N/A Y #vY Cel Win Sash G,/ L N/A Y Stone Door L N/A Y a Screen Frame L NIA Y Sam Door Edge F L N/A Y kCe,111WVm r Win Sill AIM L N/A Y A Door L N/A Y A ra L NIA Y 1 2 Door Edge F L N/A Y n SashC 4/' L N/A Y 3 4 Door Casing L N/A Y en Frame L N/A Y Door Jamb F L N/A Y Caller Win Sill AAd L N/A Y Threshold L NIA Y A Cel Win Fram Co/ L N/A Y Kickplate L WA Y Cel Win Sesh Caf L NIA Y Storm Door L NIA Y Scxeen Frame L NIA Y Sum Door Edge - F L N/A Y ® Foundation AF- L N/A Y A Door L NIA Y A Bulkhead L N/A Y 1 2 Door Edge F L N/A Y Fences L N/A Y 4 Door Casing L N/A Y Shutters L N/A Y Door Jamb F L N/A Y Newel post I L N/A Y Threshold L N/A Y Ratting Cap AIM L N/A Y Kickplate L N/A Y Handrail AAd L NIA Y Door L N/A Y A Balusters L NIA Y A Door Edge F L N/A Y flower Rail I L NIA Y 1 2 Door Casing L WA Y Treads F L NIA Y 3 4 Door Jamb F L N/A I Y Risers L N/A Y Threshold L N/A Y Tread edge L WA Y Kickplate L N/A Y Landing goon L N/A Y Window Sig A/M L N/A Y Stringer L N/A Y A Win Casing L N/A Y Lattice L WA Y # Window Sash L NIA Y Drain Pipes L N/A Y Window Sill AIM L N/A Y A Elec Conduit L N/A Y A Win Casing L N/A Y Oil Fill Pipe L NIA Y # Window Sash L NIA Y Overhang Tit Col L N/A Y COMMENTS STRUCTURAL DEFECTS: I A ILamp Post III LN/A Y A I FM/1 AN LN/A Y A I F MA AN L 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 SO.IN.) LOCATION AREA MEASUREMENT RESUL REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT IC DATE T METHOD - (Square Feet) (PPM) DATE METH A Play Area 1 -- — Bare Soil A _ Comments: A p LIRA ReD 2017 Rxt A V vtp idrer 10/06/21 ) 2 Benjamin Misch I/R-398 �✓` / / Pak a _ Inspector(print) Lic# ' nature - Date Risk Asses ( n i Signature —Date—"/ Address9f ropertv Apt # ck EXTERIOR B Side SIDE LOCATION/ LEA TYPE OF URG IC IC DELEAD DELEAD *SIDELE.All TYPE OF URG IC IC DELEAD DELEA1 B SURFACE HAZARD HAZ DATE METH DATE METH HAZARD HAZT DATE METH DATE METH Siding L N/A Y AN L N/A Y Comer Boards L N/A Y L N!A Y B LowerTdm G L N/A Y L N/A Y Upper Trim A 0 L N/A Y Cellar Wm Sol s A/M L NIA Y Win Above 5' PEA L N/A Y B Cel Wm Fram L N/A Y Porch Above 5' L N/A Y CeI Wm Sash - L WA Y Storm Door L N/A Y Screen Frame L N/A Y Surn Door Edge F L N/A Y Cellar Win Sold AAA L N/A Y B Door L N/A Y B Cell Win Frame_Mt L N/A Y 1 2 Door Edge F L N!A Y c' Cal Wm Sash L N/A Y 3 4 Door Casing L N/A Y Screen Frame L N/A Y Door Jamb F L N/A Y Caoar Wm Stll A/M L N/A Y Threshold L N/A Y B Cel Win Fre L N/A Y Kickplate L N/A Y Cel Wm Sash L N/A Y �— Storm Door L N/A Y Screen Frame L N/A Y Stan Door Edge F L N/A Y _ Foundation L WA Y B Door L N/A Y B Bulkhead L N/A Y 1 2 Door Edge F L NIA Y Fences L N/A Y J 4 Door Casing L N/A Y Shutters L N/A Y Door Jamb F L N/A Y Newel post L NIA Y Threshold L N/A Y Rating Cep Kickplate L N/A Y Handrail AIM L N!A Y Door L N/A Y B Balusters I I I L N/A Y B Door Edge F L N/A Y ILowetRail I I I L N/A Y 1 2 Door Casing L N/A Y Treads F L N/A Y 3 4 Door Jamb F L N/A Y Risers L N/A Y Threshold L N/A Y Tread edge L N/A Y Kickplate L N/A Y Landing floor L N/A Y Window Sill A/M L N/A Y Stringer L N/A Y B Win Casing L N/A Y Lattice L N/A Y # Window Sash L WA Y Drain Pipes �/ L N/A Y Window Sill AIM L N/A Y B Elec Conduft 091 L N/A Y B Win Casing L N/A Y Oil FI I Pipe L N/A Y # Window Sash L N/A Y Overhang Trim G L N/A Y COMMENTS/STR TURALDEFECTS: B IsupportGmn L N/A Y B F W ABM L WA Y B F MII AM L WA 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 METH (Square Feet) (PPM) DATE METH Play Area S Bare Soil El -- Comments: ® g, Lt/RA Pen 2nr7 FvtR 10/06/211�2 Benjamin Misch I/R-3984 ! / Page a Inspector(print) UC# ature Date Risk Assessor ) Signature Q' Address PORCH � G(side) )S (floor) 4 i t7� SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZi DATE METH DATE METH SURFACE HAZARD HAZi METH AB Siding cc L NIA Y A B Window Sill AN L N/A Y C D Comer Boards p L NIA Y C D Win Casing L NIA Y Upper Trim L NIA Y 12 Window Sash L N/A Y �fy Ceiling L NIA Y 34 Mullions L NIA Y Joists L N/A Y A B Window Sill AM L N/A Y Storm Door _L NIA Y C D Win Casing L N/A Y B E;hm Door Ed F L N/A Y 12 Window Sash L N/A Y iff D®rJckplate 00 L N/A Y 34 Mullions - L NIA Y F L N/A Y �.Support Cimns 00 L N/A Y 12g (f>J L N/A Y �' '.Newel post UO L N/A Y 3 4 OD F L N/A Y "'M Railing Cap 00 AM L NIA Y t�� L N/A Y �.; '�".Handrail AMI L N/A Y L N/A Y �,>�` r Balusters Oz L NIA Y ;r , $Kd#stDe00' or L N/A Y >'�-Laver Rail � LNIA Y A B Edg F L N/A Y Treads F L N/A Y I (� L N/A Y Risers U, L NIA Y —� e F L N/A Y ''Stringer (,>7 L NIA Y 12ing 0. L WA Y '. .;:Tread Edge (� L N/A Y ti. 3 4b /j,. F L N/A Y ' Lower Walls L WA Y o1L L N/A Y Lattice Q.O L N/A Y k'" Jir L N/A Y 4� Lower Trim 00 L N/A Y '> AB Window Sill AIM L NIA Y Floor O.Q L❑(dusq' WA Y CD Win Casing L N/A Y F Mil AN L NIA Y 12 Window Sash L N/A Y F M/i AN L N/A Y 3 4 Mullions I J. I L N/A Y F Mill AN L N/A Y A B Window Sill AIM L N/A Y F MA AM L N/A Y C D Win Casing L NIA Y F MII AM L N/A Y 12 Window Sash L N/A Y F MII AM L NIA Y 34 Mullions L N/A Y F Mil AN L NIA Y A B Window Sig AAJ L N!A Y JF M/I AN L NIA Y C D Win Casing L NIA Y F Mill AM NIAly 12 Window Sash L N/A Y FWI AM LNIA 3 4 Mullions L NIA Y F MII AN LNIA COMMENTS/STRUCTURAL DEFECTS: (dust)°•Applies only to porches used as interior space COMMENTS/STRUCTURAL DEFECTS: � �-14i) EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only by a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAIN m IC a IC (MORE THAN 2880 SO.IN.) DATE METHOD ❑ Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems Porch /&� F1l ® 10/06/21 Beniarnin Misch I/R-3984 Inspector(print) \ Lie# • ature Date Risk Assessor CE Signature Address of Prooedw' Apt # City: PORCH (side) ! _ (floor) a) /j j- i5 SIDE LOCATION/ LEAD TYPE OF URG IC IC IDELEADI DELEAD SIDEJ LOCATION/I LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAV DATE METH DATE METH SURFACE HAZARD HAZ DATE METH DATE METH AB Siding L N/A Y AB Window Sill AM L N/A Y C D Comer Boards (� L N/A Y C D Win Casing L N/A Y Upper Trim L N/A Y 12 Window Sash L N/A Y ' Ceiling -11) L NIA Y 34 Mullions L N/A Y n Joists L N/A Y AB Window Sill AM L N/A Y Storm Door L NIA Y C D Win Casing L N/A Y B Sam Door Ed F L N/A Y 12 Window Sash L NIA Y e. C D Door 01z) L N/A Y 34 Mullions L NIA Y Door Edge F L N/A Y °t Support Cimns L N/A Y 12 Door Casing ()O L WA Y _ ',.;,,Newel post L NIA Y 3 4 Door Jamb F L NIA Y Railing Cap AM L N/A Y Threshold G L N/A Y p Handrail AM L N/A Y rt Kac plate UO L NIA Y ?. Balusters L NIA Y is-,` S tormoor L NIA Y . , Lower Rail C L NIA Y ACCr Edge F L N/A Y Treads (f J F L N/A Y C D (A L N/A Y �;�� Risers L NIA Y s., y, e F L NIA Y '. Stinger L NIA Y 12ing 0 L N/A Y " Tread Edge Q L N/A Y 3 4b F L N/A Y eT• Lower Wags L NIA Y d L N/A Y 5 Lattice Oz. L N/A Y L N/A Y c', '^Lower Tdm L NIA Y A B Window Sill A/M L NIA1 Y I I F Floor L®(dust)° WA Y CD Win Casing L NIA Y F MA AIM L NIA Y 12 Window Sash L N/A Y F MA AM L NIA Y 3 4 Mullions L N/A Y F MA AM L N/A Y A B Window Sill AIM L N/A Y F MII AM L N/A Y C D Win Casing W L_N/A Y F NJI AN L NIA Y 12 Window Sash L N/A Y -•_ F MA AM L N/A Y 3 4 Mullions L NIA Y F MA AM L N/A Y A B Window Sill AAM L N/A Y F M/1 AM L N/A Y C D Win Casing d L N/A Y F Mll AAA L N/A Y 1 2 Wndow Sash L N/A Y FMII AM LN/A Y 3 4 Mullions L NIA Y F Mll AM L N/A Y COMMENTS/STRUCTURAL DEFECTS: (dust)*•Applies only to porches used as Interior space COMMENTS/STRUCTURAL DEFECTS: ( -, -/-- :0 !S 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 AM surfaces with adhesion problems Porch Flr® �3 10/06/21 2 Benjamin Misch I/Rm3984 1 / Pag _ Inspector(print) \\ Lic# ' nalura Date Risk Assess in b Signature a / EXTERIOR C Side SIDE LOCATION/ LEA TYPE OF URG IC IC DELEAD DELEAD ESIDE76—cam LEAD TYPE OF URG IC IC DELEAD DELEAD C SURFACE HAZARD HAZ7 DATE METH DATE METH SURFACE HAZARD HAZ DATE METH DATE METH Siding 00 L N/A Y Sill p.� AM L NIA Y Corner Boards L N/A Y 0;3 L NIA Y C Lowerltim C-4 L N/A Y salsash L NIA Y Upper Trim L N/A Y Cedar Win Sill 1 /dC L N/A Y Win Above 5' P>Q L N/A Y C CsI Win Fram Cad L WA Y Pesch Above 5 L N/A Y N a Cal Win Sash ro,/ L NIA Y Storm Door L N/A Y Screen Frame L N/A Y Sbm Door Edge F L N/A Y Cellar Win Sill AM L N/A Y C Door L WA Y C Cel Win Frem lIJ L N/A Y 1 2 Door Edge F L N/A Y Cel Wm Sash C c/' L NIA Y 3 4 Door Casing L N/A Y Screen Frame L N/A Y Door Jamb F L N/A Y lCeliff Win Sit I Oi) AM L WA Y Threshold L NIA Y C Cei Win Frem Op L WA y Kickplate L N/A Y U CeI in Sash l NIA Y Stone Door L N/A Y l Sam Frame L N/A Y Smn Door Edge F L N/A Y Foundation N(. L NIA Y C Door L NIA Y C Bulkheads O:.0 L NIA Y 1 2 Door Edge F L N/A Y Fences /' L NIA Y 4 Door Casing L N/A Y Shuders L N/A Y Door Jamb F L N/A Y Newel post Threshold L N/A Y Raidng Cap AM L WA Y Kickplate L N/A Y lHandraij I I. I&M L NIA Y Door L N/A Y C 18alusters 1 1. 1 L N/A Y C Door Edge F L N/A Y ILowerRail 1 1. 1 L N/A Y 1 2 Door Casing L N/A Y Treads F L N/A Y 3 4 Door Jamb F L N/Al Y I Risers L N/A Y Threshold L N/A Y Tread edge L N/A Y Kickplate L N/A Y Landing floor L N/A Y Window Sill tDo A/M L N/A Y Stringer L N/A Y C Win Casing t7t1 VA y p Lattice L N/A Y p Window Sash L N/A Y Dram Pipes L N/A Y Window Sill AM L N/A Y C Elec Conduit L N/A Y C Win Casing L N/A Y Oil Fill Pipe L N/A Y # Window Sash L N/A Y Overhang Trim C.p/ L N/A Y COMMENTS/STRUCTURAL DEFECTS: I C Isupport Clmn L N/A Y C F Md AM,L N/A Y C F W AM L NIA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made S Results(Must be less than 400 ppm for play area/1200 ppm for bare soil) I oil Testntact by a Deleader(MORE THAN 2880 SQ.IN.) LOCATION AREA MEASUREMENT RESUL REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT Ic oAtE C rnrmi (Square Feet) (PPM) DATE METH C PlayArea Bare soil C Comments: C LIRA Roo 2017 Ryt C g'1,ytPridir Lq � 10/0if 2 Benjamin Misch !/R-3984 / Pag Inspector print Lic# Si ure Dale Risk Assess IR NC Signature r EXTERIOR D Side SIDE LOCATION/ LEA TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAC D SURFACE HAZARD HAZ DATE METH DATE METH D SURFACE HAZARD HAZ? DATE METH DATE METH Siding L N/A Y Window Sill AMI L NIA Y Comer Boards © L N!A Y D Win Casing L N/A Y D Lower Trim L NIA Y 9 Window Sash L NIA Y Upper Tdm PPA L N/A Y .� Cellar Win Sill O;? MI L NIA Y Win Above 5' >JA L N/A Y D CeI Win Fram 01D L N/A Y Porch Above 5 L N/A Y Gel Win Sash Gnu L WA Y Storm Door _ L N/A Y / Screen Frame L N!A Y Shim Door Edge F L NIA Y _ Cellar Wm Sill by AM L N/A Y D Door L NIA Y D CeI Win From Q 1 L NIA Y 1 2 Door Edge F L N/A Y # Cal Wm Sash Lq/ L NIA Y 3 4 Door Casing L N/A Y Screen Frame / L N/A Y Door Jamb F L N/A Y Cellar Win Sill AN L N/A Y Threshold L N/A Y D Cel Win Fre L N/A Y Kickplate L N/A Y # Cal Win Sash L N/A Y Storm Door L WA Y Screen Frame L WA Y Sbm Door Edge F L N/A Y Foundation G L N/A Y D Door L N/A Y _ D Bulkhead L NIA Y 1 2 Door Edge F L N/A Y Fences L N/A Y 4 Door Casino L NIA Y Shutters L WA Y Doorjamb 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 N/A Y Door L N/A Y D Balusters L N/A Y D Door Edge F L N/A Y JLowerRail I I I L NIA Y 1 2 Door Casing L NIA Y Treads F L NIA Y 3 4 Door Jamb F L N/A -Y Risers L N/A Y Threshold L N/A Y Tread edge L N/A Y Kickplate L N/A Y Landing floor L N/A Y Window Sill A/M L N/A Y Stringer L N/A Y D Win Casing L N/A Y Lattice L N!A Y # Window Sash L N/A Y Drain Pipes L WA Y Window Sill A/M L N/A Y D Elec Conduit L D Win Casing L N/A Y Oil Fill Pipe /. L N/A Y # Window Sash L N/A Y Overhang T 1 641 L WA Y COMMENTS/STRUCTURAL DEFECTS: D Support Clin /. L NIA Y D F M/I AN L WA Y D FW AN LN/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can onty 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 MBASUREN ENT RESUL REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT ro DATE IC METx (Square Feet) (PPM) DATE METH Play Area _ Bare Soil D __.. Comments: LIRA Ren2nt7 Far n ®�tr'ia� gi W'foirlA ' Le CERTIFICATION OF REST'OREI?COMIPLL4NCE AA Addendum to Letter of Full Comnlia®es ENVIRONMENTAL-SERVICES,INC. December 4, 2006 Mr. Michael Whalen 1 Lafayette Housing Limited Partnership 102 Lafayette St. Salem, MA 01970 Dear Mr. Whalen This letter is to certify that I visually reinspected your property, located at 11 Prince St. Place apartment no. and relevant common areas,in the City Salem of for full deleading compliance on 11/24/2006. On that date,all surfaces documented as being in violation of the Lead Law per the post compliance assessment report dated were found to he in full compliance with the applicable Massachusetts General Laws and regulations. Massachusetts law does not require the abatement and containment of all residential lead paint. The residential premises or dwelling unit and relevant common areas shall remain in full compliance only as long as there continues to be no peeling, chipping or flaking lead paint, all reversed woodwork remains reversed, and all coverings, including encapsulants,forming an effective barrier over lead paint or other leaded materials remain in place. The law grants you a 30-day maintenance period to repair deteriorated lead paint or detached coverings over such paint, and to clean up, during which time your Letter of Full Compliance remains valid. The reverse side of this letter indicates the authorized person(s) who performed deleading on the property and a general summary of the methods used to re-delead surfaces that came out of compliance. A complete reinspection report is attached to this letter, which specifies how and on what date each surface was brought into restored compliance. Do not lose these documents. This Letter shall serve as an attachment to the Letter of Full Compliance issued by Neil LaFrance on 2/11/1999. Sincerely, LeadSafe Environmental Services, Inc. 4il N . L ranceMLead Inspe' a4 ctor M 1100 LFADSAFE ENVIRONMENTAL SERVICES,INC. 2925 ELM STREET, D16HTON, NIASSACHUSEM 02715 TELEPHONE & FAx (508) 669-5088 WEBSiTE WWWLEADSAFE.BIZ 4 �i I P.0.80X 577 w 30 RIVER STREET CONTRACTING,INC. METHUEN, MA 018" Now , ,�,Q C('MJTRACTING. INC. f9T9 559-3072 01844 I its 114_6 ECHO CONTRACTING,INC. D 1547 EXTERIOR:C DOORS cow ik Cmubg W®ef 6 / j If W L4 W BMDS*—J--J_ _.f 1 S Phone: (978) 975-1383 " Fax: (978)975-1390 " E-mail: mail@mechocontracting.com A Le ENVIRONMENTAL SERVICES,INC. LETTER OF LEAD PAINT(RE)OCCUPANCY REINSPECTION CERTIFICATION S NOTICE DOES NOT CONSTITUTE COMPLIANCE December 10, 2005 Mr. Marcos Ortiz Lafayette Housing Limited Partnership 102 Lafayette St. Salem, MA 01970 Dear Mr. Ortiz, This letter is to serve as notification that a(re)occupancy reinspection was performed at 11 Puce Ste Place, in the City of Salem on 1011712005. At that time, all applicable interior dwelling unit surfaces met the conditions for(re)occupancy set in 105 CMR 460.760(A)of the Regulations for Lead Poisoning Prevention and Control. This notice does not constitute full deleading or interim control compliance. Prior to the(re)occupancy reinspection, all high-and moderate-risk deleading work was completed and no additional such work will be permitted following the completion of the cleanup required by 105 CMR 460.160(D). No other interior dwelling unit deleading other than certain low-risk deleading activities performed in accordance with 105 CMR 460.175 may occur unless the conditions of 105 CMR 460.160(A)through(E)are repeated. This is ONLY notification that the conditions for(re)occupancy have been met.Dust samples were taken and found to be within acceptable limits. No Letter of Full Compliance or Letter of Interim Control will be issued until all applicable common area surfaces have been deleaded or brought under interim control according to 105 CMR 460.000 and 454 CMR 22.00. Sincerely, LeadSafe Environmental Services, Inc. Master Lead Inspector/Risk Assessor DPH License Number MI 100 LEADSAFE ENVIRONMENTAL SERVICES.INC. 2925 ELM STREET, DIGHTON, MASWHUSETTS 02715 TELEPHONE &FAX (508) 669-5088 WESSITE WWW.LEADWE.BIZ SCHNEIDER LABORATORIES INCORPORATED 2512 W. Cary Street • Richmond, Virginia• 23220-5117 804-353-6778 . 800-785-LABS(5227) • (FAX) 804-353-6928 Excellence in Service and Technology AIHA/ELLAP 100627, NVLAP 101160-0, NYELAPlNELAC 11413,CAELAP 2078, NO 593 LABORATORY ANALYSIS REPORT Lead Analysis by EPA 305OB17420 Method ACCOUNT#: 1945-05-1108 DATE COLLECTED: 1 0/1 712 0 0 5 CLIENT: LeadSafe Environmental Services DATE RECEIVED: 10/18/2005 ADDRESS: 2925 Elm Street DATE ANALYZED: 10/18/2005 Dighton, MA 02715 DATE REPORTED: 10/18/2005 PO NO.: PROJECT NAME: Lafayette Housing PROJECT NO.: JOB LOCATION: 11 Prince St Place SAMPLE TYPE: WIPE SLI Client Sample Sample Dilution Total Lead Sample Sample Description Area Factor Lead Cone No. No. W) (I1g)` (pgfft2) 28692236 D11 PSP-01 Rm 4 Floor 1.00 1 <20.0 <20.0 28692237 D11 PSP-02 Rm 4 Sill 0.85 1 <20.0 <23.5 28692238 011 PSP-03 Rm 4 Trough 0.62 1 < 20.0 < 32.3 28692239 D11 PSP-04 Kitchen Floor 1.00 1 < 20.0 <20.0 28692240 D11PSP-05 Rm 1 Sill 0.85 1 <20.0 <23.5 28692241 D11 PSP-06 Rm 2 Trough 0.62 1 <20.0 < 32.3 213692242 D11PSP-07 Field Blank 1 <20.0 Analysis Run ID: 35738 ANALYST: CHARLIE BOU-CHAKRA Total no. of pages in report=` --B: s6uey, Lab DTrifc-t®r Minimum Reporting Limp 20 jig Total Lead, Effective 316101, EPA Lead H&AW Standards: 40 pg&2 for floors and 250 pg/f 2 for interior window sills, based on weighted average of all samples taken. EPA Clearance Standards are 40 pgrYt2 for floors, 250 pglyt2 for interior window sills, 400 pgift2 for window troughs. Industrial projects may have limits established per project. ELLAP certification applies only to samples taken on ASTM E 1792 wipe media. llr'23! Dt]5 16:aa 19;86516161 DADS < I _ Daleadin Invoiog I till a>ffi ( .' AN -q Zip 0;`.3` 3 Address of ZIP _P s2 I hereby that all up were dome in with the of Labor and W 's 454 22.00 ffid she P • Prevention PzugraneN m 1,5 AM Si a Datc-��� co section your autba tle a sty titlat saadiag. - . usawas Ldeiald L9uJII W infOVCiw1Ag147�$i: 'Pi ®Yl OV41 Work was at the of C/.0.3!j hz,2y i Smxt 0 Q/� F ;LO 11 IP Caat S modwft risk 2t AudiacizagaL d' (" • ) (a:cterj,,v Coves Liqlaw ammPolatim Capping bsssbo"r w Plonk Was is ffie fbHowOg roams: s. WQW&was tioathefoU0wivgtypesof 0 0 m p on mts: _. Dam ,� F' / Cost 8 LOW-risk t Auumixulon N: lawRbk gnothodc cmvrias Ligtdd encapffWgim Capper , ds I$Cp �4(tlaace.tnDfrst�mr�, � an_.in.�) ttlotk was in the following room: StwtD te:,-�1 J RuMI2akbe:1 i_ Cast:S (mot a DPT:i PaHq s agents&Memotanduma institute for Environmental Edu,atioa State Lead F7atioaa Manual C-?5 c •o•. Post-CompHanee Assessment Deter ingtion RePOrt Page 1 of 3 Method Used: ® Na's Exp.Date L_ERDSAFE ENVIRONMENTAL_SERVICES,INC. X-Ray Fluorescence 2925 ELM STREET Model RMD Serialx1042 DIGHTCON.MA 02715 Aigid TELEPHONE/FAX 508.609-5058 Address Apt.# 11 Prince St.Place City Zip Code Salem 01970 Own Occ? ❑Y ®N Owner Name: Leh a HousingLimited Partnership 978-825.4005 Singtc Family ❑ Multi Family Owner Address 102 LafavBte St Salem.MA 01970 #Units 4 Condominium ❑ _ Day Care ❑ 001RE Reason or PCAD: 0 Case Menagenant Ana A..niblwNkuuable CAP CmPnd NV Nnviot ti ❑Parental Request ❑BOH Referral CAP CeppW cov CweRd (Private mT rnw, DIP D w wood ❑Other L Lowe ENC E-q—tewd sit s Mn Mo NnT MI Merle l v VWyI MET Mew PRE Prepertd A AWmimm Comments: NA NotA 11. REV ftbo• Aunpe peteX"a NC No Coaling ke Repuwd NEG Nsom REV R.W d oC outpdzc. Pos ft.Ka SCR Scnq dtobvenAmne VR Vlert Repl PDL Pftkj ly".&d wr vi®yl tik AR Ahm Fmkamap , initial Lead 1nsnection/ft1sk Assessme®t glistory )Date of Initial 311111998 inspector/Risk Linda Dube Lie#A 1978 Inspection/Risk Assessment: Assessor Document(s)Issued: ❑Letter of Full Initial Lead Inspection BY: Lie,# Date: Compliance - ®Letter of Lead Paint Re-Occupancy By:Neil M.LaFrance Lic,#M 1100 Date: I Zl10lOS Rc-inspection Certification ®Letter of Full Deleading Compliance By:Neil LaFrance Lie.#M 1100 Date:2111/1999 ❑Letter of interim Control By: Lie.# Dace: Letter of Recertification of Interim By: Lie.# Date: Control Post Compliance Assessmeat Pri—erminutiOn inspector/Risk Assessor: Neil LaFrance Lie. # Date:9119/2005 Hazards Found? ®Yes ❑No M 1100 pMt Signature Urgent Hazards Yes No Found? Certification of Restored *Document Compliance 12/4l06 M 1100 issued Name of Compliance Document Date Signal= Lie.# *The Compliance Document and Post Compliance Assessment Determination must be attached to the Letter of Full Initial Lead Inspection Compliance,Letter of Full Deleading Compliance or Letter of Interim Control originally issued by: Neil LaFrance M 1100 2/11/1999 Inspector/Risk Assessor Lie.# Daze EXPLANATION OF POST-COMPLIANCE ASSESSMENT DETERMINATION REPORT COLUMNS This page provides general information needed to understand the post-compliance assessment determination report.The report is used to document surfaces that must be addressed to achieve maintained/restored deleading compliance or restored interim control. The specific columns completed on the violation page depend on whether you have an existing letter of compliance or letter of interim control.You should speak with your inspector or risk assessor before you start to do any work on your home. ROOM Refers to the room,common area,or exterior location of the surface being assessed.See the diagram on the cover page. 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 SURFACE Refers to the building component(s)being tested.Some surfaces may be made up of more than one part For example. "Baseboard"may refer to four separate pieces of wood(one on each wall),but is still considered one surface. LEAD The actual lead test result An insp ectodrisk assessor must test any surface that was not tested on the initial lead inspection/risk assessment report In the event the Inspectmrlrisk assessor conducting the post compliance assessment determination(PCAD)discovers leaded surfaces not previously tested,or his/her test results conflict with the initial inspection results,CLPPP trust be contacted to provide guidance in correeting the discrepancies or missed surfaces. TYPE OF Not all lead paint must be deleaded.This column tells you IF and WHY a surface needs deleading.Speak with your HAZARD inspector or risk assessor for more information. ® MRT"circled means that the surface is a moveable(impacted surfhee and must be deleaded in its entirety for deleading compliance.For interim control,the surface may not need to be addressed if the paint is not loose.Speak with your inspector or risk assessor for more infornation. 6 "AIM"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 for deleading compliance.For interim control,the surface must,at a minimum, be made intact 8 "L"circled means that the surface is loose and must,at a minimum,be made intact a If more than one choice is circled,the Hiles for deleading may change depending upon what method of deleading you choose.Speak to the inspector or risk assessor for more information. URGENT This column applies only to properties under interim control.if"Y"is circled,then this surface is considered an"Urgent HAZARD Lead Hazard"and some type of deleading work is required.Speak with your risk assessor for more information- VIOLATION/ The inspector/risk assessor will use this column to describe the condition of the-surface out of compliance as it relates to STRUCTURAL deleading compliance or interim control. DEFECT TREATMENT The date the licensed inspector or risk assessor determines the surface once again meets the standards for Full Deleading DATE Compliance or Interim Control. TREATMENT The method used to return a surface to the required standards for Full Deleading Compliance or Interim Control,the METHOD structural repair completed to qualify for Interim Control.Refer to the deleading codes key on the cover page. EXCLUDED The amount of loose paint on a surface as measured by the lead inspector."DUA"means that the inspector was not able to SURFACES measure the loose paint,but has determined it is more than the cut-off for moderate risk making intact Once the thirty-day maintenance period has expired,surfaces listed here can only be made intact by a licensed deleader.There are still other tow and moderate-risk deleading activities,such as covering,that may be done by someone who is not a licensed deleader.Note: The thirty-day period to make repairs without a deleader does not apply in cases where a child is identified as being poisoned or has an elevated biood lead level.In these cases,only authorized people are permitted to conduct any deleading activities.Talk to your inspector or contact CLPPP before starting any work ' SOIL TEST If your property receives certain federal funding,soil testing may be required.There is also a space for the risk assessor to RESULTS indicate amount of bare soil,laboratory resul%method of remediation,and the date of remediation.Check with your funding agency for more information. POST-COMPLIANCE ASSESSMENT DETERMONATION Page 3 of 3 Salem 01970 11 Prince St.Place Address of Property A t.# city zip Neil LaFrance M l loo 9119/2OO5 inspector(print) Lic.# Sipifture Date Risk Assessor rim Lic.# Si Date sga FullAddress Apt. Room Side Surface Lead Type of Um Comments Treatment Treatment of Property Hazard Hazard Date Method 11 Prince St. new Place Room 4 closet wall 3.8 L Y violation 10/17/06 MI atched Pbxl removed 9A5 Prince Exterior from both St Place Commons Exterior C-1 Door Lhe Poe AIM N sides 1121t08 REP Door Pkod removed from both Exterior C-2 Door Lite I Poe I AIM I N I skies 1121M REP Door EXCLUDED SURFACES:After 30 days,surfaces listed in the box below out be made intact only by a licensed deleader. Only a licensed deleader can make these surfaces intact in cases where a child is identified as being lead poisoned or has an elevated blood lead level,even within 30 days.Contact your inspector or CLPPP for more information. i ROOM SIDE EXCLUDED SURFACE MWIVRE:LOOSE PAMT TREATMENT TREATMENT More than 288 square hicbes per room DATE METHOD More than 1440 square inches on the earerior SOIL TEST RESULTS:Must be less than 400 ppm for play area/less than 12W ppm for bare soil. LOCATION AREA MEASUREMENT RESULT REMED REMED COMMENTS SQUAREFEET (PPAQ DATE METHOD NOTICE OF POST-COMPLIANCE LEAD HAZARDS Dear Lafayette Housing Limited Partnership: I have completed a post-compliance assessment determination(PCAD)at property owned by you at I I Prince St Place,,Salem MA This PCAD revealed that certain leaded areas no longer meet the standards of the Letter of Compliance for he unit. See the attached post-compliance assessment determination report for more details. If this property has been cited by a code enforcement inspector or a housing quality standards inspector,you must follow the requirements for correcting the hazards provided to you by that inspector.Otherwise,follow the instructions in this letter. In homes where there are no children with elevated lead levels(15 mcg/dl or above)*:Within 30 days from this PCAD, work needed to correct post-compliance lead hazards may be done by any person over the age of 18.Although no specialized training is required,the person doing the work must work in accordance with the"Safety Procedures for Renovation and Rehabilitation"outlined in the Division of Occupational Safety's Deleading Regulations,454 CMR 22.11 or in the CLPPP booklet"Safe Work Practices:Maintaining Compliance in Your Home."A copy of these procedures may be obtained by contacting the Childhood Lead Poisoning Prevention Program at 800.532-9571. In homes where there ARE children with elevated lead levels(15 meg/dl or above):Even within 30 days from this PCAD,all work needed to correct post-compliance lead hazards must be performed by authorized people.The level of authorization required depends on whether the corrective work to be done is considered high-risk(such as scraping large amounts of loose paint),moderate-risk(such as replacing woodwork),or low-risk(such as covering).In addition,other rules required for deleading projects must be followed,including a 10-day advance deleading notification and relocation of occupants during certain types of activities.Contact CLPPP at 800-532-9571 for more information about how to become authorized before doing any work. In all cases:Once hazards are corrected,the owner should bring a lead inspector in to document the work.The inspector will check that all lead hazards have been corrected,there are no signs of paint chips,dust,or debris,and that dust samples meet acceptable standards If all this is completed within 30 days of the PCAD the inspector will issue a"Certification of Maintained Compliance,"an addendum to the Letter of Full Compliance. In cases where authorized workers were required,the owner must also provide to the inspector a deleading invoice from the authorized worker. If work is not done and documented within 30 days of the PCAD,all work to correct lead hazards may only be performed by authorized people, even when there are no children with elevated lead levels in residence. The level of authorization required depends on whether the corrective work to be done is high-risk,moderate-risk,or low-risk.In addition,other rules required for deleading projects must be followed,including a 10-day advance deleading notification and relocation of occupants during certain types of activities.Contact CLPPP at 800-532-9571 for more information about how to become authorized before doing any work. Inspectors do not have authority to grant extensions beyond the 30day period. After 30 days,once the work is done and documented by the lead inspector as being completed, including dust samples and collection of invoices from authorized workers,the unit will be eligible for a"Certification of Restored Compliance," an addendum to the Letter of Full Compliance. in cases where corrective work is not performed by appropriately authorized people,when required, CLPPP will revoke the Letter of Full Compliance.CLPPP may issue in its place a letter documenting the history of unauthorized deleading at the property. Property owners are urged to maintain their properties in good repair at all times.When corrective work is necessary,owners should carefully follow the requirements for post-compliance corrections,to ensure that children and workers are not put at risk,and to ensure that the owner does not subject him/herself to strict liability for failing to properly maintain the A O /pro ,t!l M 1100 9/19/2005 Inspector Signature / C/°° Lie.# Date *Property owners are not permitted to ask an occupant to disclose a child's blood lead level.In the absence of a voluntary disclosure by the parent of a child with an elevatod blood lead level,the owner may proceed under the assumption that there is no elevated child in residence. Boston Regional Office 10 Lewis Street Lincoln, MA 01733 Clayton (781) 259-0800 Fax(787)259.1355 ENVIRONMENTAL LETTER OF FALL DELEADINC COMPLUNCeO N 5 U LTA N TS February 17, 1999 Mr. James Haskell Salem Point Properties 102 Lafayette St. Salem, Massachusetts 01970 Dear Mr. Haskell This letter is to certify that I inspected the property located at 11 Prince St. Place, and relevant common areas, in the city or town of Salem for full deleading compliance on February 11, 1999,and on that date those surfaces cited in the initial inspection report of March 11, 1998 were found to be in compliance with Massachusetts General Laws, Chap. 111, Sec. 197 and 105 CMR 460.000: Regulations for Lead Poisoning Prevention and Control. Massachusetts law does not require the abatement or containment of all residential lead paint. The residential premises or dwelling unit and relevant common areas shall remain in compliance only as long as there continues to be no peeling, chipping or flaking lead paint or other accessible leaded materials, as long as coverings and/or encapsulants forming an effective barrier over such paint or other leaded materials remains in place, and as long as surfaces reversed to correct lead hazards remain reversed and securely in place. See the reverse side of this document for the location(s) of surfaces which were covered, encapsulated or reversed as an abatement method to achieve compliance, if applicable. A complete reinspection report is attached to this letter. To the best of my knowledge,the cost of legally required deleading is$3,300.00. Sincerely, Clayton Environmental Consultants Neil LaFrance Master Lead Inspector Lie. #M1100 cc: CLPPP Clayton Environmental Consultants is a Division of Clayton Group Services,Inc. Atlanta • Boston • Chicago • Cleveland Danbury Dctroil Honolulu • Indianapolis • Los Angeles • Miami Minneapolis • New York • Philadelphia Portland Rockford San rrancisco • Savannah • Seattle Wichita 11 Prince St. Place , Salem INSPECTION AND ABATEMENT HISTORY Linda Dube A1978 Name & license # of inspector who performed initial inspection A&A Services Deleading Co. DC 000440 Name(s)and license#(s)of Department of Labor and Industries authorized deleading contractor(s)who performed abatement and/or containment. Name(s) and addresses of unlicensed homeowner or agents who performed low-risk abatement and/or containment. AREAS WHERE LEAD PAINT OR OTHER LEADED MATERIAL HAS BEEN COVERED, ENCAPSULATED OR REVERSED AS A LEAD ABATEMENT METHOD. INTERIOR Room# Side Surface/Fixture Type of COV/REV/ENC Rear staircase door lite covered with plexiglass Front staircase outside edge of treads and risers covered with wood Basement A door edges to 1 n laundry covered with wood Basement A door casing to I' laundry covered with wood Basement B door edges to laundry covered with wood Basement C door edges to bulkhead covered with wood Basement C door casing to bulkhead covered with wood EXTERIOR Side Surface/Fixture Type of COV/REV/ENC A(L) Cellar window sill covered with aluminum D (L) Cellar window sill covered with aluminum A Window frames covered with aluminum B Window frame (<5') covered with aluminum C Window frames covered with aluminum D Window frames covered with aluminum