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7 RANDALL STREET, UNIT 1 FULL DELEADING COMPLIANCE LETTER A LEAD PAINT AND MOLD AIR QUALITY INSPECTION SERVICE BECAUSE A HAPPY HOME DESERVES A HEALTHY START JERRY URBAN, PRESIDENTANSPECTOR, 10 1/2 MALL ST , SALEM MA 01970 , 978-395-5035 .WWW.INSPECTOR3755.COM LETTER OF FULL DELEADING COMPLIANCE David Babineau 7 Randall St.. #2 Salem MA 01970 Dear Mr. Babineau This letter is to certify that on 4/ 19 /22 I re-inspected your property located at 7 Randall St. Unit 1 and relevant interior and exterior common areas,in the City/Town of Salem On that date,those surfaccs cited in the initial inspection report by Jerry Urban ,License# 755 conducted on 3/ 12 /22 as being in violation of Massachusetts General Laws,Chapter 111,Section 197,and 105 CMR 460.000: Regulations for Lead Poisoning Prevention and Control,were determined to be in current compliance with those same laws.Dust samples were taken and found to be within acceptable limits. 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 with the requirements of the Lead Laws referenced above 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 remain in place, and as long as surfaces reversed to correct lead hazards remain reversed and securely 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 this Letter remains valid. The second page or reverse side of this letter identifies the authorized person(s)who performed deleading on the property and a general summary of the methods used to achieve compliance with the Lead Laws. A complete Reinspection Report is attached to this letter,which specifies how and on what date each surface was brought into compliance. To the best of my knowledge,the cost of the legally required deleading is$ $6900.00 The CLPPP authorized serial number for this Letter of Full Deleading Compliance is 53843755042222-1 This number is tracked and unique to this address and unit. DO NOT LOSE THESE DOCUMENTS. If the documents are lost,you will be required to have additional private inspector services that may cost you significant amounts of money.This Letter of Full Deleading Compliance is only for the address and unit noted above.If you change the street address,unit number or any other identifying information pertaining to the residential premises referred to in this Letter of Full Deleading Compliance, this Compliance Letter may be considered null and void by the Department of Public Health and/or a municipal health office. Do not alter this document in any way.Altering this document is fraudulent and may endanger the health and safety of a child which may result in significant legal consequences. In addition to any potential civil liability which may arise as the result of the alteration of this Letter of Compliance, the Massachusetts Department of Public Health's Childhood Lead Poisoning Prevention program may seek criminal prosecution of any person who alters this document after it is originally issued. Sincerely, Jerry Urban 13755 4/ 22 /22 Inspector(print name) License# Sn Date Questions?Call the Department of Public Health at 1-800-532-9571. DO NOT LOSE THESE DOCUMENTS LOFDC-rev 06m Page l of 2 Serial Number: 53843755042222-1 Address:7 Randall St. Unit#: 1 City/Town:Salem Deleading History Deleading Contractor Samnang Sar License#:1 DC 500074 Exp.Date 2/ 11 /23 ❑✓ DS 0()4189 Deleading Methods: ❑✓ Scraping ❑ Making Intact(Exterior) ❑ Power Sanding ❑ Caustics ❑ Heat Gun Q Making Intact(interior) ❑ Removal ❑ Liquid Encapsulation ❑ Demolition ❑ Replacement Q Covering ❑ Other Work was done in the following rooms: Work was done on the following types of components: Doors/CasinOS/Jamhs_Sills, hasehoardg,Walls,Win Frames, Siding- Porch Awning Support,CWU sill/frame Start Date: 4/ 14/22 Finish Date: 4/ 14 /22 Cost: $ 6900.00 Authorization# MR- RRP w/additional Moderate Risk Training Expiration Date: Authorization# OM M Moderate Risk Deleader(owner/agent) Issuance Date: Deleading Methods: ❑ Replacement ❑ Making Intact(Interior) ❑ Liquid Encapsulation ❑ Covering ❑ Making Intact(Exterior) ❑ Removal ❑ other Work was done in the following rooms: Work was done on the following types of components: Start Date: / / Finish Date: / / Cost:$ Low Risk Deleader(owner/agent) Authorization# L AL Issuance Date: / / OE AE OB AB Deleading Methods: ❑ Covering ❑Liquid Encapsulation ❑ Replacement (ONLY doors,cabinet doors,shutters,shelves not affixed,drawers,windows on hinges) Work was done in the following rooms: Work was done on the following types of components: Start Date: / / Finish Date: / / Cost:$ LOFtx-m 0&1 Page 2 of 2 30105 Beverly Road Romulus,MI 48174 •� Ph:73"2948161;Fax:734829.8431 Certificate of Analysis; Lead In Dust Wipe by EPA Method 7000E/305013'` Client: Inspector 3755 AAT Project: 786670 7 Medtt Street 1 Sampling Onto: Marblehead,MA 01945 Date Received: 0 411 8/2 02 2 Attu: Jerry Urban Email: inspector3755Qmac.cvm;jerryurban@ntac.com Date Analyzed: 04/18/2022 Phone: 978-395-5035 Fax: Date Reported: 0 411 8/202 2 Client Project: 7 RANDALL ST 1 SALEM MA Project Location: 7 RANDALL ST 1 SALEM MA Lab Sample ID Client Code Sample Description length Width Area Results Lead Nnch1 Mu+1 (Sq n) Poo l2` 7350923 1 ROOM 1 F 12 12 1.00 24.87 7350924 2 ROOM 2 WS 4.125 35 1.00 69.94 7350925 3 ROOM 2 WT 3.125 32 0.69 52.32 7350926 4 ROOM 4 F 12 12 1.00 128.92 7350927 5 ROOM 3 WS 4 34.5 0.96 44.56 7350928 6 ROOM 3 WT 3.125 32 0.69 14.49 7350929 7 BLANK N/A N/A WA NM Analyst Signature Nathan Ditty NO=Not Detected,NIA=NotAvailable,RL=RepwWg Lima.Analytical Reporting Limit is 5 ugfsemple.For true values assume(2)significant figures. AAT Internal SOP$206.The method and batch OC are sonplable unless otherwise stated.EPA Regulatory Untie:10 ugM2(Floors, CarpeladfUncerpsted),100 ugM2(1Nuucow,SIM/9eole),40oueat2(window TroughNVN//Ext connate SudacasG HUD Grenim Ragrselory UmRB:10 uSW(tnerlor Floora),40 ug/12(Porch Floors),100 uIl(Window Sills),100 ullM2(window Troughs}The laborabry operates in accord with ISO 17026 9uldelknes and holds ltnitad scope@ of acuadra ion und6rAIHA-LAP end NY SNOB DON ELAP programs.Them results are submYted pursuant to f AAT,LLC current banns and conditions of sale.Including the compenya standard warranty and llohatlon or rabrlty provtek ns.An0ttical results ralele to the samples as received by the lab.AAT will not assume any Aablik or responsibility for the manner In which the resuhs amused or inlxpreled.All Quality Control requirements for the samples this report contains haw been met.AAT does not blank correct reported values.Sample data apply only to i bema analyzed.Resurs are calaulaNd with wips dinwnstons supplied by client Reproduction of thle docmnerd other then In Ib entirety is not authorized by AAT,LLC.'=Validated modNled method samples are Stored for 15 days following report data AIHA LAID.Lab ID#100W,NY State DOH ELAP Lab ID a11864,State of Ohio-Lab ID N 10042 deb 10 a 1009ab Date Printed: 04/18/2022 AAT Project: 786670 Page 1 of 2 Beverly ' &TA 5 Ph:734�29.8 818 E tE:73"2948431 To: Inspector 3755 AAT Project: 786670 7 Meritt Street 1 Chard Project: 7 RANDALL ST 1 SALEM MA Marblehead,MA 01945 Date Reported. 04/18/2022 AIM: Jerry Urban Emell: inspe4-,tor3755@mac.com;jerryurban@mac.o Phone: 978-395,5035 Project Location: 7 RANDALL ST 1 SALEM MA Sample Client Code Analysis Requested Completed Analyst 7350923 1 Dust Wipe 04/18/2022 Nathan Ditty 7350924 2 Dust Wipe 04118/2022 Nathan Ditty 7350925 3 Dust Wipe 04/18/2022 Nathan Ditty 7350926 4 Dust Wipe 04/1812022 Nathan Ditty 7350927 5 Dust Wipe 0 4/1 812 02 2 Nathan Ditty 7350928 6 Dust Wipe 04/18/2022 Nathan Ditty 7350929 7 Dust Wipe 04/18/2022 Nathan Ditty Rsvbwed By Quality Assurance Coordinator-Stephen Norlhcott This report Is Intended for use solely by the IndMdoal or antay to which e is addressed. it may contain Mwmatbn that Is prWMped, confidential and othervAm exempt by law from disclosure. M the reader dada information is not the interded rociplard of an employee of h Intended mcpie tk you are herevdth not ied that any dlnerninabon, disUfladlan or copying of this information is stddly prohibited.a you have received this Informelion In anr,please notiry AAT immedlately.Thank you. AIHA LAP-Lab ID#100986.NY State DOH ELAP-Lab ID#11864,State of Ohio-Lab ID#10042 Date Printed: 04/18/2022 1:04PM AAT Project 786670 Page 2 of 2 30105 Beverly Road Romulus,MI 48174 •V Ph.,73"29-8161;Fax:734429.MI Certificate of Analysis: Lead In Dust Wipe by EPA Method 700013/3050B* client: Inspector 3755 AAT Project: 788173 7 Merin Street 1 Sampling Date: 04/19/2022 Marblehead,MA 01945 Date Received: 0 4/2 012 0 2 2 Alin: Jerry Urban Email: inspector3755@rnec.00m;jerryurban@mac.com Date Analyzed: 041=022 Phone: 978-395-5035 Fax: Date Reported: 04/22/2022 chant Project. 7 RANDALL ST 1 SALEM MA Project Location. 7 RANDALL ST 1 SALEM MA Lab Sample ID Client Code Sample DescriptionLength Width Area Results Lead (inch) Onch) (Sq ft) 1d9/ft2' 7363773 1 RM 4 F 12 12 1.00 <5,00 7363774 2 RM 3 F 12 12 1.00 <5.00 7363775 3 KITCHEN F 12 12 1.00 <5.00 7363776 4 BLANK NIA N/A NIA N/D Analyst Signature tAW01) fu�� Richard Laugal NO=Not Detected,WA=NotAvafable,RL=Reporting Urnk Analytical Reporting Llmk is 5 uplsi mpb.For true values mums(2)significant figures. AAT Hama]SOP S205.The method and batch QC are acceptable unless otherwise stated.ERA Regulatory Lknns:10 LOW(Floors, CsfPGIGd/Urrrarpnesd).100 ug/fi2(Window SMISIvols).400gM(window Tnegh/well/Ext Connell surfaces}NUD Granros Regul"Limfs:10 ug1112(Iniarlor Floors).40 uqW(Porch Floors).100 urgla2(window Sets),100 ug/112(Window Troughs).The laboratory operates In accord with ISO 17025 guidelines and holds limped scopes of aaredkablm under AIHAA AP and NY$is*DON ELAP programs.Then results are subro lad pursuant to AAT,LLC currerd Urns and conditions of sale,Inciuding the c mpany s standard warranty and lknimtion of fabaty prevlakars.AneiyOeal results relate to ^...u the sarrplee as received by the lob.AAT will not assume any Nabllly or resycnslbfliy,for Ilia manner In which the rosuft are used or kletpooled.All Quality Control requlremsda for the samples this report contains haw been meL AAT does not blank eared reported values.Sample date apply only to Items analyzed.Results we celculated with wipe dimensions supplied by client.Reproduction of this donrmerd other than in its entkety Is not au0wrlmW by AAT.LLC.'=Validated madif lid medrod.Samples are stcrad for 15 days folowkg report date AMA LAP-Lab ID#1 OO t.NY State DOH FLAP-lab ID#11854.State or Oh b•Lab 1D Is 10042 t lib fD s 1000'i Date Printed: 04 Z2022 AAT Project: 788173 Page 1 of 2 30105 Beverly Road O? &qRRMTR _' Ph.7u1344529.9 6 Fax:734M-9431 To: I nspector 3755 AAT Project: 788173 7 Meritt Street 1 Client Project: 7 RANDALL ST 1 SALEM MA Marblehead,MA 01945 Date Repotted: 04/22/2022 Attn: Jerry Urban Small: inspeetor3755QmaC.Com;jerryurban@mac.o Phone: 9783955035 Project Location: 7 RANDALL ST 1 SALEM MA Sample Client Cods Analysis Requested Completed Analyst 7363773 1 Dust Wlpe 04/22/2022 Richard Laugal 7363774 2 Dust Wipe 04/22/2022 Richard Laugal 7363775 3 Dust Wipe 04/22/2022 Richard Laugal 7363176 4 Dust Wipe 04/22/2022 Richard Laugal Reviewed By Quality Assurance Coordinator-Stephen Northcott This repan Is Intended for use no" by Me Indwual or entity to whleh it Is addressed. it may contaln inftmation Mat Is prlvlege4 confidential and otherwise exempt by law from dledmm. M the reader of this information Is not Me intended recowl or an employee of H. Intended recipient,you are herewith notified that any dissemination,distribution or copying of Min Information Is strictly prohibited.If you have reoehed Mks Information In error.please nolilyMT Immediately.Thank you. AIHA LAP-Lab ID#100986,NY State DOH ELAP-Lab ID#11864,State of Ohio-Lab ID#10042 Date Printed: 04/22/2022 6:03PM AAT Project 788173 Page 2 of 2 DELEADING 1N-VOjCF Please completeh and cleark fill out appropriate inl'onnation \ante(print) Samnattg Sar _ Telephone t ?S I 1 ' 16ti, Contltam Precision Lead Paint Solutions li urk.Cell ( 7,41 1 36, - 1067 Address 71OA Summer St. Linn \1:\ ( oKir Ulr)(IS - - --- Address of Deleadinu%%ork T l /ip code LLB'-�:��1 �� -- . � 1y1 I hereby attest that all deleading acli,,mes and clean up%sere done in accordance with the Department of Labor and 11 urkfiacc De%elopment's Regulations 454(\1R 22 P)and the Childhood Lead Poisoning Presention Program ;Regulations. Ili( MR (,, 1 ElOU Signature --- - Date Only complete section retlecdnX our authoriiation/license status Deleadinu Contractor Samnanst S$r License? a D( 500074 Exp Date (1' _� E DS UU-t 189 Deleading Methods L- Scral?MU �? Demolition Power Sdndir �^ ,�, dllti[li, L Heat(ion Replacement ('uscring �'\lakin> Intact Liquid I-ncapsulatilrn L Other Wot k t%as done in the follow inj toonu Xk{a k was done on the follow_rtu t��cs of.nmpunents Start Date —q---1-q_: 12_ Pmrsh Date L1 C(Nt 1ulh�rr;auur� \1R- RRP JJ1L,•u.a�h.lcr,,le i<,. t gonna_ — _ _ _ _ - - - ISN11anCC Date Moderate Risk Deleader Issuance Datc Deleadinu Methods ----j Replacemert ❑ Making Intact(interior) Cai)Ping Baseboards L Covering ❑ Making Intact(exteri(tr) _ I lyuid Encapsulation 1kork tsas done In the f011owinu noms 1k ork 'Ads done oat Ilse following IN pes of components Start Dart: finish Date Cost Lo%% Risk Deleader.; ur1:w 1:; Authonrauou,= OL A! - -- -- I$nllanc,:Date 'M- --]AV O13'7,AH DeIcading Methods _� CusennF ❑ Liquid Encapsulation Capping Basehc,ards Replacement r(.-)\L1 doors. cabinet doors-shutters. shel%es not affixed, drawers,%sntdo%%s on Etln_ucs) %kirk %%as done in the followine rooms \k oak was done on the following types ofcomponeno, Start Date Finish Date Cost ` Questions."Call the Department of Public Health at 1-800-532-91;11. DO NO f LOSE THESE DOCI MENTS Page 1 of i INSPECTOR 375S A LEAD PAINT AND MOLD AIR QUALITY INSPECTION SERVICE 10 1/2 MALL ST • SALEM MA 01970 • 978-395-5035 JERRY URBAN,PRESIDENT A HAPPY HOME DESERVES A HEALTHY START Lead Inspection / Risk Assessment Report St# 7 Street Name Randall Street Type St Unit 1 city Salem zip code 01970-2320 Number of Rooms in Unit 6 Owner Name: David Babineau Property Type: Owner Address: 7 Randall SL,#2 ❑Single Family Contact Information: Salem MA 01970 ❑d Multi-Family #of Units 2 Client Name(if different from owner): Same as above ❑Condominium #of Units Client Address: ❑Day Care ❑ Other Keys Lead Cohema Kee Delead/IC Method Cohnnn K_ye Delead/IC Medtod Cohn Laundry in Basement? ©Yes []No COv Covered COV Covered REM Removed Finished Space in Basement? R Yes RNo DC Drop Ceiling DIP Dipped REP Replaced Possible Pb Water Service Line MET Metal FNC F.ncansulated SCR Scianed ❑yes ❑ No ©Not Tested MR Metal Rep.Window 1NT Made Intact SFR Storm Frame Removed NA Not Accessible PRE Prepped for Eno SLD Sealed Testing,Method Used NC No Coating MI Made Intact STP Stripped Na,S Expiration Date: Tile Tile(testing suggested) [;;;"I Component Does Not Exist VR/MR Vinvl/Metal Rep Window X-Ray Fluorescence VB Vinvl Baseboard VR Vinvl Rep.Window Model: RMD Serial# 286, Comments/Notes: Demarcation Lines to 4'in Rooms I through 4,majority of areas previously 0 Demarcation Lines scraped still show pos for lead Submitted for Compliance Evaluation Floor* 1 (level within building of unit being inspected) FloonV Property Diagram/Unit Labels C b C Kitchen Bath ..............;.. ...... ........... ................................................._............,.. D Room 3 € B Room 4 ., D B Room 2 ... ................;.....,......,..... ........... 2 . ... i......:......i...... ......i......i......i.....: Room 1 _ '• ................................. . Hall a 1 A(Street Side) Start Here A(Street Side) Start Here A(Street Side) Pb(lead)equal to or greater than 1.0 mg/cm2 with x-rav flourescence or positive with Na,S is Dangerous. XRF Calibration Recorded in Log Book RV , -Check off when complete Address Verified through USPS 4 -Check off when complete Research on Lead-Related History for Address wvw'%v.state.rna.us/dph/cltmp or 800-532-9571 -Che ff when complete Jerry Urban 13755 Ar- 3/12/22 Inspector's Name(print) License# X Signature Date I.I/RA revised 06/17 Address: 1 Rc,,3,a LA Apt# City 7 (,Q" Page 2 of Z'1 INSPECTION HISTORY INTERIM CONTROL Determination Inspector Name. U Visual y Risk Assessment R A Name: Lid 2 2 Z 2 N Signature J I I PNN Signature Lead Hazards? Urgent Pb.Hazards? Comprehensive Dust Taken or R.A.Name: Lid Initial inspection Inspector Name Lid Risk Assessment PN G ( 2 2 Z g Signature Lead Hazards? N Signature Urgent Ph.Hazards? g Comp Initial Visual Portion of P R.A.Name: Lids Reinspection for w/PartiaL PCAD y Inspector Name: Lid interim Control F Signature N Signature Lead Hazards? Addendum(add-on Dust Taken for Risk R.A.Name: Lidto Initial ection) MN Inspector Name: .Lie# Assessment Rem . FSignature Signature Lead Hazards? Visual Portion of Reinspection for R.A.Name: Lid Addendum as Full Interim Control Inspection y Inspector Name: Lic# F Si7TI L gnature nature N Signature Lead Hazards? Dust Taken for Risk P R.A.Name: LidAssessment Rents". e Walk Through for Inspector Name: Lie# F Signature Ed/Consultation Signature Risk Assessment Recertification R.A.Name: Lid REINSPECTION HISTORY N Signature Visual Portion of P Inspector Name: Lid Reocc.Rei ection Urgent Pb_Hazards? F Signature Dust Taken for PF R A.Name: Lid Visual Portion of. Inspector Name: Lic# RA Recertification Reocc.Rein econ I Signature F Signature POST COMPLIANCE ASSESSMENT DETERMINATIONS Dust Taken for N Inspector Name: Lid Reocc.Rein ection Signature PC' Inspector Name: Uc# Dust Taken for Inspector Name: Lid Lead Herds? N signature Reocc.Reins action F Signature Full Inspection Actin as PCAD Inspector Name: Lid - Final Portion Insedor Name Lic# Final Rein tio p acon N Signature l `' I Z Z F Signature Lead Hazards? Visual Portion of Inspector Name: Uc# Visual Portion of P Inspector Name: Lid PCAD Reinspection P Final Rei ection F Signature F Signature Dust Taken for p Inspector Name: Lid Dust Taken for Final p Inspector Name. Lie#T_ PCAD Rein 'on Rein o Reocc F Signature f 21 F Signature Dust Taken for Final P Inspector Name: LidZI PCAD st Taken for P Inspector Name: Lid Rein o Reocc PCAD Rein lion k. U ,4 I 97 t Signature F signature History rev 6/17 Address: 7 �,,�(A 5L— Apt# City S6 13w Page 3 of REOCCUPANCY CERTIFICATE HISTORY COMPLIANCE HISTORY(CONT.) Certificate of Certificate of Reoccupancy Maintained Inspector Name: Uc# Inspector Name: .Lic# Com Dance Only after Signature I I I I I Signature High/Mod Risk No Work=No Dust #rooms rule Work=7 Dust Certificate of Certificate of Reoccu c Restored Inspector Name:. LidE Com fiance Inspector Name. Lids Only after Signature I I I I ISignature High/Mod Risk Dust wipes and auth. g #rooms rule people Certificate of Certificate of Reoccupancy Maintained Inspector Name: .Lic# Inspector Name: .Lid Com fiance Only after Signature I I ITSignature High/Mod Risk g #rooms rule No Work=No Dust Work=7 Dust COMPLIANCE HISTORY Certificate of Letter of Full Initial Restored com Hance Inspector Name: Lim Inspector Name: .Lidt Compliance No prior history/ Signature P �/ Signature' Dust wipes and auth. No sigris of UD people Letter of Interim OTHER HISTORY:WAIVERS/UD Control Inspector Name: Lic# Approved CLPPP Waiver Inspector Name: Lic# No prior comp. Signature Expires in 1 yr. Attach to Comp Signature Docs Recertification of Interim Control Inspector Name: Lldt C pppoved PP Waiver Inspector Name: Lic# Expires 2 yrs from Signature Attach to CompSignature original Interim Control Does Letter of Full UD/DES Visual Deleading Inspector Name: Lic# Com Dance Rein ection p Inspector Name: Uc# Q q q Z Signature g Dust wipes if No Signature No LOC Issued Reocc Certificate of UD/DES Dust Maintained Taken Pe Inspector Name: Lid Compliance Inspector Name:__. ,LiC# F Signature Signature No LOC Issued No Work=No Dust Work=7 Dust UD/DES Dust Certificate of p Taken Inspector Name: Lie# Restored F Signature Compliance Inspector Name: 1-14 No LOC Issued Signature Dust wipes and auth. UD/DES Final people Rein ection P Inspector Name: Lic# F Signature No LOC Issued History rev 6117 Page 4 of 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 which 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 components)being tested.Generally,each separate component is considered SURFACE one surface. Some surfaces may be made up of more than one part.For example,"Baseboard"may refer to four separate pieces of wood(one running along 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(or average number)equal to or greater than 1.0 mg/cm2 is a dangerous level of lead. • A"pos"or`lncg"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.Unless the owner can get a sample to test,the inspector must assume the surface contains lead and require it to be deleaded,if necessary. • "MET'or"MR"means that a metal surface was not tested and only needs to be intact.However,if the surface is a metal handrail,metal window sill,or metal railing cap,it needs to be deleaded if it is equal to or greater than 1.0 mg/cm2,"pos,"or is"N/A." • For key to abbreviations like"COV","VB","VR"or"MR","NC","'ME","DC",Seethe 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 surface and must be deleaded in its entirety. • "SF"circled indicates that there is a storm frame present which requires the blind stop and exterior sill be deleaded as interior moveable/impacted surfaces. • "A/W circled means that the surface is"accessible mouthable"and must be deleaded to a minimum of five feet high,four inches in from the edge or comer. • "F"circled means that the surface is a"friction"surface and must be deleaded at all points of potential friction. • "L"circled means that the surface is loose and must,at minimum,be made intact. • 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 loose or intact.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 or marked"N/A"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 only 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 some type of deleading work 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 checks the surface and finds that it has been successfully deleaded and passess reinspection DELEAD METH The kind of deleading done to bring a surface into compliance.Refer to Deleading codes in the Key on the cover page of the inspection report 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 that 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 INSPECTOR 3755 * 10 1/2 11 ST. , Salem MA 01970 * 978-395-5035 S Jerry Urban I-3755 22 Page_Of�y inspector(print) Lie# Si Date Risk Assessor(print) n Lie# Signature� Dates Address of Property: 1C _ __ADL# City: jj—." ROOM# I _ SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD H DATE METH DATE METH SURFACE HAZARD DATE METH DATE METH A B Up Walls L NIA Y Window Sill 1.0 Mn L NIA Y A B LOW Wells L NIA Y B Wm Apron L WA Y A B Baseboards L NIA Y C Win Casing L NIA1 Y I A B Chair Rail L NIA Y D Header Stop ff WIL WA Yr8A RadiatorL NIA Y IntStops WI L NIA Y 4��"� j j_ Floor L dust) NIA Y Win Int Sash MA L NIA Y Ceiling L NIA Y Exterior Sill MII SF L NIA Y Door L NIA Y Lf-46f 3 Part Bead WI L WA Y Door Edge L NIA Y 4 Blind Stop WI SF L NIA Y 12 Door Casing q IA Y (�,�N Win Ext Sash w L NIA Y 3 4 Doorjamb F L NIA Y L(-1 Window Sill MII L NIA Y rL l,— Threshold L NIA Y Win Apron L NIA Y A B Door L NIA Y C Win Casing L NIA Y -bf 4v I- C D Door Edge F L NIA Y D Header Stop MA L WA Y ./ 12 Door casing L NIA Y Int Slops WI L WA Y .14 W L- 3 4 Door Jamb F L NIA Y 1 Win Int Sash Mn L WA Y n of L NIA Y Exterior Sill MA SF L WA Y A B Door L NIA Y Part Bead W L NIA Y CD Door Edge F L NIA Y 4 Blind Stop W SF L WA Y 12 Door Casing L WA Y Win Ext Sash Mll L NIA Y 34 Door Jamb F L NIA Y mdow Sill WI L NIA Y / y Threshold L NIA Y Win Apron L NIA Y Closet Door L NIA Y C 11H ing L NIA Y L A CI Door Edge F L NIA Y D Stop WI L NIA Y -4 , 1_ B CI Casing L NIA Y rj. WI L WA YC Closet Jamb F L NIA Y 1 ash WI L WA Y D Closet Walls L NIA Y 2 Sill WI SF L NIA Y CI Baseboard L NIA Y 3d v WI L WA Y 1 Closet Pole L NIA Y 4 p WI SF L WA Y 2 Closet Shelf L NIA Y Sash WI L NIA Y 3 Cl Supports L NIA Y A B Fireplace L NIA Y 4 closetFk*r LQ(dust)NIA Y CD iMantle L NIA Y Closet Ceiling L NIA Y A B Win Above 5 L NIA Y ;COMI I STRUCIURAL DEFECTS: Ceiling Moldi L WA Y K �L. F WI AN L NIA Y F WI AN L NIA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F WI AN L NIA Y by a Deleader(MORE THAN 288 SO.IN.) F Min AIM L NIA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F WI AIM L WA Y DATE METHOD F W AIM L WA Y Check the box K this ROOM is RULED OUT for encapsulation ED because there are 3 or more AIM surfaces with adhesion problems LIRA Rep 2017 Room INSPECTOR 3755 * 10 2 Mall ST. , Salem MA 01970 * 978-395-5035 Jerry Urban I-3755 31 L/ Page�—Of ZA Inspector(print) Lic# SinaVne Date Risk Assessor(print) �4AAA Vj Signature Da�Address of Property: ,(� J Apt# 1 City: � CONTINUATION OF ROOM( -c- ) 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 Door L WA Y Law Cab Fram L NIA Y CD Door Edge F L NIA Y AB Low Cab Door L NIA Y 12 Door casing L NIA Y CD Low Cab WalkL WA Y 34 Door Jamb F L NIA Y Low Cab Sh L NIA Y Threshold L NIA Y Supports L NIA Y A B Door L WA Y Drawers L NIA Y C D ow Edge F L NIA Y A Window Sill MA WL NIA Y f szv- 12 Door Casing L NIA Y B Win Apron L NIA Y 34 Door Jamb F L WA Y C Win Casing L WA Y AIV Threshold L WA Y Header Stop C.1 MA L WA Y A 8 Door L NIA Y hri Stops MA L WA Y k� C D Door Edge F L WA Y Win Int Sash MA L WA Y 12 Door Casing L NIA Y Exterior Sill MA SF L WA Y 34 Door Jamb F L WA Y Part Bead v MA L WA Y Threshold L WA Y Blind Stop MA SF L WA Y Closet Door L WA Y Win Ext Sash VA7tMA L NIA Y A CI Door Edge F L NIA Y A window Sill f MA AIM L NIA Y B Cl Casing L NIA Y B Win Apron L NIA Y C Closet Jamb F L NIA Y C Win Casing L WA Y C Closet Walls L NIA Y D Header Stop MA L WA Y O Cl Baseboard L WA Y Int Stops MA L WA Y Closet Pole L WA Y Win Int Sash MA L WA Y Closet Shelf L WA Y Exterior Sill MII Sr L WA Y CI Supports L WA Y Part Bead MII L WA Y Cl Drawers L NIA Y Blind Stop MA SF L WA Y Cl Dr Frame L WA Y Win Ext Sash MA L WA Y Closet Floor L❑(dust) WA Y B Fireplace L WA Y Closet Ceiling L NIA Y D Mantel L WA Y AS Shlvs Above 5 L WA Y B Sidelight(L) L NIA Y AS Cab Above 5' L WA YCO Sidelight(R) L N/A Y AS pg C D Cab Above 5' L WA Y C D Win Above 5 L NIA Y D Up Cab Door L WA Y CD Win Above 5 L WA Y Up Cab Weis L NIA Y F W AIM L WA Up Cab Sht. L N/A Y F W AIM L WA Supports L WA Y F W AIM L WA F MII AIM L WA F W NM L WA F MA AAd L WA F M!I AIM L WA EXCLUDED SURFACES:Surfaces fisted in these boxes can only be made intact COMMENTS/STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288 SO.IN.) SIDE LOCATION MEASURE:LOOSE PAINT IC IC DATE METHOD Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LVRA Rep 2017 Room contd. INSPECTOR 3755 * 10 1/ 1 St. , Salem MA MA 01970 * 978-395-5035 Jerry Urban I-3755 11 Page-7of Zf Inspector(print) Lic# Signs re Date 1 1 Risk Assessor(print) //'� Lic# Signature Date Add tT of Property: .kL 57— Apt.# r- HALLWAY n #_ or Common Hallway: Front Rear Floor# SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ. DATE METH DATE METH SURFACE HAZARD HAZ. DATE METH DATE METH A B Up Walls L NIA Y Closet Door L NIA Y SLL A B LOW Walls L NIA Y A Cl Door Edge F L NIA Y A B Baseboards /A Y B Cl Casing L N/Al Y A B Chair Rail L NIA Y C Closet Jamb F L NIA Y AS Radiator L NIA Y D Cbsetwails L NIA Y JUL Floor Aq L❑(dust)NIA Y Cl Baseboard L WA Y Calling L NIA Y 1 Closel Pole L N/A Y Al B Door L NIA Y 2 Closet Shelf L NIA Y C D Door Edge &L F L NIA Y 3 CI Supports L N/A Y 12 Door Casing L NIA Y 4 Closet Floor L (dust)N/A Y 34 Door Jamb F L NIA Y laoset Ceiling L NIA Y Threshold L NIA Y A window Sill JW AIM L N/A Y B Door L NIA Y B win Apron L WA Y D Door Edge F L NIA Y C Win Casing L N/A Y 12 Doorcasing L /A Y -111 IN./A D Header Stop Min L NIA Y 34 Door Jamb F /A Y N.J Int Stops MA L WA Y Threshold L NIA Y 1Win Int Sash W L WA Y A B Door IA Y 2 Exterior Sill MII SF L NIA Y Door Edge 01 L NIA Y 4411 3 Part Bead MA L WA Y 1 Door Casing (-L)NIA Y 4 Blind stop MA SF L NIA Y 34 Door Jamb F L N/A Y Win Ext Sash M!I L NIA Y Threshold L NIA Y A Window Sill Min AIM L NIA Y A B Door L NIA Y B Win Apron L N/A Y C D Door Edge F L NIA Y C Win Casing L NIA Y 12 Door casing L N/A Y D Header Stop MA L NIA Y 34 Door Jamb F L N/A Y Int Stops MA L NIA Y Closet Door L NIA Y 1 Win Int Sash MA L NIA Y A Cl Door Edge F L N/A Y 2 Exterior Silt Mn SF L WA Y B Cl Casing L N/A Y 3 Part Bead Mill L WA Y C Closet Jamb F L NIA Y 4 Blind Stop MA SF L NIA Y D Closet walls L NIA Y Win Ext Sash Mn L WA Y G Baseboard L NIA Y AB Win Above 5 L WA Y 1 Closet Pole L NIA Y Ceiling MoldIrK L WA Y 2 Closet Shelf L N/A Y F Min AIM L WA Y 3 a Supports L NIAJ Y F W AIM L N!A Y 4 Closet Floor L❑(duq NIA Y F MA AIM L WA Y Closet Ceiling L NIA I Y COMMENTS/STRUCTURAL DEFECTS: EXCLUDED SUR ACES:Surfaces listed in these boxes can only be made intact by a Deleader(MORE THAN 288 SQ.IN.) IDE LOCATION MEASURE:LOOSE PAINT he DATE Vic kETNOD Check the box N this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LIRA Rep 2017 Hall INSPECTOR 3755 * 10 1/ all ST. , Salem MA 01970 * 978-395-5035 Jerry Urban I-3755 I (2 Z2- Page '00 of Zj Inspector(print) Lic# St nIWl Date Risk Assessor(print) c# Signature D Sj�.• ROOM# " SIDE LOCATION/ LEAD TYPE OF URG 1C IC DELEAD DELEAD SIDE LOCATION! LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ. DATE METH DATE METH SURFACE HAZARD HAD DATE METH DATE METH A B Up Walls L NIA Y A window sit MA NIA Y f A B Low Walls L NIA Y Win Apron 2. L NIA Y „� f A B Baseboards <13N/Al Y ( C Win Casing L NIA Y LM-1% A B Chair Rail L N/A Y D Header Stop Mn L WA Y y_� Radiator Q.( L NIA Y Int Stops Ma L WA Y Floor t/ L[3dust)N/A Y 1 Wm Int Sash Mn L WA Y Caging ( L NIA Y 2 Exterior SM Mn SF L WA Y A B Door IA Y 3 Part Bead W L WA Y D Door Edge F L NIA Y �I y 4 Blind Stop W SF L WA Y 12 Door casing NIA Y 4J .1 Win Ext Sash Mn L NIA Y 34 Door Jamb F L NIA Y 44 41 U,, A window Sil MII AIM L NIA Y Threshold 2 L NIA Y B Win Apron L NIA Y A Door L NIA Y .,1 C Win Casing L WA Y Door Edge F L NIA Y 44-iy D Header Stop Mn L WA Y 1 2 Door Casing L NIA Y ,f y 1- Int Stops W L N/A Y 34 Door Jamb L N/A Y W 1 Win Int Sash Mn L WA Y Threshold L NIA Y 2 Exterior Sill Mn SF L WA Y A B Door L N/A Y 3 Part Bead W L WA Y C D Door Edge F L NIA Y 4 Blind Stop Mn SF L WA Y 12 Door Casing L N/A Y lWin Ext Sash M/I L N/A Y 34 Door Jamb F L NIA Y A Window Sit Mn AN L WA Y Threshold L NIA Y B Win Apron L WA Y Closet Door NIA Y / C Win Casing L WA Y A Cl Door Edge L NIA Y y D Header Stop Mn L WA Y B CI Casing L N/A Y Int Stops WI L WA Y Closet Jamb F L NIA Y J� 1 Win Int Sash WI L WA Y Closet Walls NIA Y J Mj 2 Exterior Sill WI SF L WA Y Cl Baseboard <WNIA Y .I 3 Part Bead M/I L WA Y 1 Closet Pole L L WA Y 4 Blind Stop M/I SF L WA Y 2 Closet Sheff WA Y Win Ext Sash MII L WA Y 3 CI Supports rj L NIA Y j. B Fireplace L WA Y 4 Closet Floor 6V L❑(dust)NIA Y CD IMantle L N/A Y Closet Caging L NIA Y —((.( t- AB CD Win Above S L N/Al Y MMENTS I STRUCTURAL DEFECTS: Caging MoldiN L NIA Y ,1 A-+L- F W AIM L N/A Y F W AIM L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F W AIM L N/A Y by a Deleader(MORE THAN 288 SO.IN.) F Wn AIM L WA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F W AIM L N/A Y DATE METHOD F W AIM L N/A I Y Check the box if this ROOM is RULED OUT for encapsulation L El because there are 3 or more AIM surfaces with adhesion problems LIRA Rep 2017 Room INSPECTOR 3755 * 10 1/2 MAll ST. , Salem MA 019 0 * 978-395-5035 �,+ Jerry Urban I-3755 �(;2 Z Page l Of-L Li (print) Lic# SignW Date Risk Assessor(print) Lic# Signature Date II Add n3ss of Prrwerty: IC..�1��,�(�( S� Ant.# ( City: 5-4,k ,.. ROOM At 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 DATE METH DATE METH A B UX—LLp Walls L NIA Y A Window sal 2 Min AIM NIA Y ../�( SGN' A B Low Wells L N/A Y Win Apron NIA Y /Y A n Baseboards L NIA Y IN ( C m Casing A Y Y../Y A B Char Rail L NIA Y D Header Stop W L NIA Y A e Radiator p 3 L NIA Y Int Stops W L NIA Y y../rf Floor L dust)NIA Y 1 Win Int Sash W L N/A Y Ceiling L NIA Y 2 Exterior Sill W SF L NIA Y B Door L NIA Y 3 Part Bead w L NIA Y C D Door Edge F L NIA Y 4 Blind stop MII SF L NIA Y 12 Doorcasing L NIA Y �(M winExtSash Mn L NIA Y 34 Doorjamb.* L NIA Y ! A window so ##I AIM L NIA Y Threshold L NIA Y B win Apron L NIA Y A B Door L NIA Y C win Casing L NIA Y Door Edge V. F L NIA Y D Header Stop Min L NIA Y 1 Door Casing /A Y �l M Int Stops W L WA Y 3 4 Door Jamb F IA Y U$d) y 1 win Int Sash Mll L NIA Y Threshold L NIA Y 2 Exterior Si i Mn SF L NIA Y A B Door L NIA Y 3 Part Bead Mn L NIA Y C D Door Edge F L NIA Y 4 Blind Stop Mn SF L N/A Y 12 Door Casing L NIA Y Win Ext Sash hN L NIA Y 34 Door Jamb F L NIA Y A window sit M11 AIM L NIA Y Threshold L NIA Y B Win Apron L N/A Y Closet Door L NIA Y C win Casing L NIA Y A Cl Door Edge F L NIA Y D Header Stop MII L NIA Y CI Casing L NIA Y Int Stops M/I L N/A Y C Closet Jamb F CPNIA Y 1 Win IntSash Mll L NIA Y D Closet Walls fVNIA Y (4114 A,.1 2 Exterior Sill MII SF L N/A Y G eb Basoard L Y V 3 Part Beed M11 L NIA Y 1 Closet Pole L NIA Y 4 Blind Sbop WI SF L NIA Y 2 Closet Shelf L NIA Y Win Ex!Sash M/l L N/A Y 3 CI Supports L NIA Y B Fireplace L N/A Y 4 Closet Floor �✓ LQ(dust)NIA Y D Mantle L NIA Y Closet Ceiing /A Y •(N M A a Win Above 6 L N/A Y COMMENTS I STRUCTURAL DEFECTS: Ceiling Mold' L NIA Y -4 V4 paa� 1;S }a $,q.& � � s�,r-r iom") F M/I AIM L WA Y Q/`.y ht7(ICE F W AIM L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F M/I AIM L NIA Y by a Deleader(MORE THAN 288 SQ.IN_) F M11 AIM L N/A Y IC IC F W AIM L WA Y SIDE LOCATION MEASURE:LOOSE PAINT DATE METHOD F M/I AIM L NIA Y Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems L1/RA Rep 2017 Room INSPECTOR 3755 * 10 1/2 Mall St. , Salem MA MA 01970 * 978-395-5035''uu J Z Page L Of All Inspector(print) Lic# SignaGi Data Risk Assessor(print) (� Uc# Signature Date Address of Property: ? I� 'a'a ' it ADL# BATHROOM# 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 a Up Walls L WA Y B Up Cab Frame a2 L WA Y A 8 Low Walls L NIA Y C D Up Cab Door L WA Y A n Baseboards f f L WA Y Up Cab Walls 6 L WA Y A e Chair Rail L NIA Y 12 Up Cab Shlvs Q. L NIA Y AS CD Radiator L NIA Y 34 Supports L NIA Y Floor L❑(dust)NIA Y Low Cab Fra L WA Y Ceiling L WA Y Low Cab Door L WA Y A B Door L NIA Y CD Low Cab Wal4C,,3 L N/A Y 11 Edge F L N/A Y Low Cab Sh L NIA Y T4D Casing p L NIA Y 12 Supports L NIA Y Jamb F L NIA Y 34 Drawers L N/A Y shold A L NIA Y A Window Sill MA AIM L N/A Y A B Door L NIA Y B Win Apron L NIA Y C D Door Edge F L NIA Y C Win Casing L N/A Y 12 Door Casing L N/A Y D Header Stop MA L WA Y 34 Door Jamb j F L WA Y Int Slops MA L WA Y Threshold L NIA Y 1 Wm Int Sash MII L WA Y A B Door L WA Y X7md—StDp MA SF L WA Y C D Door Edge F L WA Y MA L WA Y 12 Door Casing L NIA Y MA SF L N/A Y 34 Door Jamb F L WA Y h Min L NIA Y Threshold L N/A Y 5 !� L NA Y Closet Door L WA Y Ceiling Moldin L NA Y A Cl Door Edge F L N/A Y AS Medicare Cab L NA Y B CI Casing L N/A Y F W AAA L WA Y C Closet Jamb F L NIA Y F W AN L WA Y D Closet Walls L NIA Y F W AN L WA Y Cl Baseboard L N/A Y F W ARM L WA Y 1 Closet Pole L NIA Y FIN AIM L WA Y 2 Closet Shelf L WA Y F W AAA L WA Y 3 a Supports L WA Y F Min AIM L WA Y 4 Closet Floor tL❑(dust) NIA Y F W AAA L NIA Y Closet Ceiling L N/A Y F MA AAA L WA Y F MA AIM L WA Y F IWI AN LWAI Y F MA AIM LWAI Y F W AIM L WA I Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intactCOMMENTS/STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288 SQ.IN.) SIDE LOCATION MEASURE:LOOSE PAINT IC IC DATE METHOD Check the box if this ROOM is RULED OUT for encapsulation EJ because there are 3 or more AIM surfaces whh adhesion problems LURA Rep 2017 Bath INSPECTOR 3755 * 10 2 Mall St. , Salem, MA 01970 * 978-395-5035 Jerry Urban I-3755 1 1 2 I Page (( Of t�1 Inspector(print) Lic# re Date 1 Risk Assessor(print) Lic#rr Signature Address of Property: ! .t A1-- Aot# ( City- _ KITCHEN SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAP. DATE METH DATE METH SURFACE HAZARD HAZ1 DATE METH DATE METH A s Up Walls b L WA Y A window Sill O W AIM L WA Y A B I.Ow Walls L WA Y B Win Apron L WA Y A B Baseboards L WA Y Win Casing Q L WA Y A B Chair Rail L NIA Y D Header Stop MA L WA Y AS PRBdiatm d(� L NIA Y Int Stops W L WA Y L (dust)WA Y 1 Win Int Sash MA L WA Y L WA Y 2 Exterior SB MA SF L WA Y B L NIA Y 3 Part Bead MA L NIA Y D Door Edge F L NIA Y 4 Blind Stop MA SF L NIA Y 2 Door Casing L WA Y win Ext Sash MA L NIA Y 34 Door Jamb F L NIA Y A window Sill 0.1 MA AIM L NIA Y Threshold L NIA Y B Win Apron L NIA Y AB jDoorL NIA Y C win Casing + L NIA Y F L NIA Y Header Stop NIA L NIA Y 12 L WA Y Int Stops MA L WA Y 34 F L NIA Y 1 Wn krt Sash MA L NIA Y L WA Y 2 Exterior Sal MA SF L WA Y B Door L WA Y 3 Part Bead Mll L WA Y C D Door Edge F L WA Y 4 Blind Stop MA SF L WA Y I Door Casing L NIA Y Win Ext Sash 16 MA L NIA Y 3 4 Door Jamb F L NIA Y I AA3 Up Cab Frame L NIA Y Threshold L NIA Y Up Cab Door L NIA Y Closet Door ( L NIA Y Up Cab Walls ( L NIA Y Cl Door E F L WA Y 12 Up Cab Shlvs L WA Y 3 Casing L NIA Y 34 Supports L WA Y C Closet Jamb F A Y -14 Low Cab Fram Q L WA Y D Closet Walls i{, A Y .lH A B Low Cab Door Q. L WA Y Cl Baseboard L a Y 1 Low Cab Walk 0.1 L WA Y 1 Closet Pole L WA Y Low Cab ShM L WA Y 2 Closet Shelf L WA Y 12 �Dm,�,, & L WA Y 3 3 Supports L WA Y 1.. 34 L WA Y 4 Closet Floor L (dust)NIA Y AS Wi o n Above 5- L WA Y Closetceiing L NIA Y �� NL CeilingMoktin L WA Y -44 V COMMENTS 1 STRUCTURAL DEFECTS: F MII AN L WA Y F W AIM L WA Y F W AN L WA Y F W AIM L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact F W AIM L WA Y by a Deleader(MORE THAN 288 SQ.IN.) F W AIM L WA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F W AdN L WA Y DATE METHOD F W AN L WA Y Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more A/M surfaces with adhesion problems LURA Rep 2017 Kitchen INSPECTOR 3755 * 10 1/2 all ST. , Salem MA 01970 * 978-395-5035 Jerry Urban I-3755 2 Page 014 Inspector(print) Lic# Sign Date Risk Assessor(print) Lic# Signature Dace--- r Address of Property: ? �j� � �� Apt# Ch: 7,i`,'•vA—••• . CONTINUATION OF ROOM( j SIDEJLOCATION] LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAV DATE METH DATE METH SURFACE HAZARD HAV DATE METH DATE METH All�Door L NIA Y Low Cab Fram L NIA Y C D Door Edge F L NIA Y AB Low Cab Door L NIA Y 2 Door Casing a.b L WA Y C D Low Cab Walk L WA Y 34 Door Jamb F L WA Y Low Cab SW. L WA Y Threshold L NIA Y Supports L NIA Y AQ Door Q. L NIA Y Drawers L NIA Y C D tour Edge F L NIA Y A Window Sill MA AIM L WA Y Door Casing L NIA Y B Win Apron L N/A Y 3 4 Doorjamb IL.L F L WA Y C Win Casing L WA Y Threshold G. L WA Y D Header Stop MA L WA Y A B Door L NIA Y Irn Stops MA L WA Y C D Door Edge F L WA Y Win Int Sash MA L WA Y 12 Door casing L WAII Y Exterior Sill MA SF L WA Y 34 Door Jamb F L WA Y Part Bead MA L WA Y Threshold L NIA Y Bind Stop MA SF L WA Y Closet Door L N/A Y Wn Ext Sash MA L NIA Y Cl Door E F L NIA Y A Window Sill MA AIM L NIA Y B CI Casing L NIA Y B Win Apron L NIA Y C Closet Jamb F L N/A Y C Win Casing L WA Y C Closet Walls L /A Y „� D Header Stop MA L NIA Y D a Baseboard 6.7 L WA Y Int Stops MA L NIA Y Closet Pole L WA Y Win Int Sash MA L WA Y Closet Shell L L WA Y Exterior Sit IMA SF L WA Y Ci Supports L WA Y laL Part Bead MII L WA Y Cl Drawers L NIA Y Blind Stop MA SF L WA Y CI Dr Frame L WA Y Win Ext Sash MA L WA Y Closet Floor 0. LQ(dust)WA Y B Fireplace L WA Y Closet Ceiling NIA Y 444CO Mantel L NIA Y AB Shiva Above 5 L NIA Y B SM*ht(L) L NIA Y AB Cab Above 5' L N/A Y D Sidelight(R) L N/A Y AB CD Cab Above 5' L WA Y CD Win Above S L NIA Y C D Up Cab Door L NIA Y CD Win Above 5' L WA Y Up Cab Wass L N/A Y F AAA AN L WA Up Cab Shlvs L NIA Y F AAA AIM L WA Supports L WA Y F W AAA L WA F M/1 AIM L NIA F AAA AAN L WA F M/I AIM L WA F W AIM L WA EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact COMMENTS/STRUCTURAL.DEFECTS: II by a Deleader(MORE THAN 288 SO.IN.) S� tr f PAS :,► 411,44-4.or,&i S +kA e ti AJ l� 1 SIDEIC IC DATE LOCATION MEASURE:LOOSE PAINT METHOD a Check the box tf this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LYRA Rep 2017 Room contd. INSPECTOR 3755 * 10 1/ Mall ST. , Salem MA 01970 * 978-395-5035 Jerry Urban I-3755 QZ. Page 13ofOf Inspector(print) Lic# Date Risk Assessor(print) Lic# Signature E D Address of Pmmrty: 1 � Aot.#_ l city, d Q.�n ROOM# SIDEjRadiatDr N/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD E HAZARD DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B L N/A Y A mdowSill MA AW WA Y A B L NIA Y B win Apron 0 L WA Y -/ L., A s s J. L Y C Win Casing L NIA Y 411 t4 A B Chair L N/A Y Header Stop MA L WA Y AS 6. L NIA Y Int Stops MA L NIA Y .11NL❑(dust)N/A Y 1 win Int Sash MA L N/A Y Ceiling L NIA Y 2 Exterior sift MA SF L NIA Y B Door L N/A Y y�( j (y.. 3 Part Bead MA L NIA Y C D Door Edge F L N/A Y —1 W ` 4 Blind Stop MA SF L WA Y 2 Door Casing L NIA Y rJL. Win Ext Sash MA L NIA Y 34 Door Jamb L NIA Y K•ty A window sal d MA L NIA Y e Threshold L N/A Y B Win Apron L NIA Y jw A B Door L NIA Y .(4 • 1.. C win Casing L NIA Y ' (� C Edge { L NIA Y .) Y Header Stop Mll L NIA Y �/ ) 12 Door Casing NIA Y ,111 Int Stops W L WA Y 34 Door Jamb L NIA Y .INS �/ 1 Int Sash Mn L NIA Y Threshold L NIA Y Exterior Sill MA SF L NIA Y Door L NIA Y 3 Part Bead v W L NIA Y C D Door Edge ,l F L NIA Y 4 Blind Stop Mn SF L WA Y 1@ Door Casing L WA Y 1 `N�, Win Ext Sash Min L NIA Y 3 4 qEdge FL Y A window Sil MII l NIA Y Y B Win Apron J L NIA Y 44 Ad„ Y '„f L. C Win Casing L N1A Y Y r Header Stop W1 L N/A Yg Y Int Stops MA L WA Y C Closet Jamb F L NIA Y L 1 win Int Sash Mll LWA Y D Closet Walls �. L NIA Y 2 Exterior Sill Mil SF L N/A Y Cl Baseboard NIA Y .� © Part Bead WI L WA Y 1 Closet Pole N/A Y y, 4 Blind Stop WI SF L WA Y 2 Closet Sheff Q.L L WA Y m Ext Sash Wl L NIA Y 3 ClSupports L NIA Y �(� V B Fireplace LWA Y 4 Closet Floor aU,LQ(dust)WA Y D jMantla L NIA Y Closet Ceiling /A Y y�t� /{r.I A e Win Above 5 L N/A Y CWMENTS I STRUCTURAL DEF CTS: ( r/+ Ceiling L WA Y ( ;V dVa. � e�s���k� pgJkC T� FMA AIM LWA Y Qf 3z \ F W AIM L N/A Y EXCLUDED SU FACES:Surfaces listed in these boxes can only be made intact F MA AIM L N/A Y by a Deleader(MORE THAN 288 SQ.IN.) F Mn AIM L NIA Y SIDE LOCATION MEASURE:LOOSE PAINT IC IC F MA AAA LWA Y DATE METHOD F M/1 AIM L NIA Y Check the box V this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaoes with adhesion problems LYRA Rep 2017 Room INSPECTOR 3755 * 10 1/2 Mall ST. , Salem MA 01970 * 978-395-5035 Jerry Urban I-3755 3I(LI'b-2 pap ftOfZ_q Inspector(print) Lie# Date 1 I Risk Assessor(print) Lie# Signature Da t� CONTINUATION OF ROOM( ) SIDEjhr ON/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD CE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAV DATE METH DATE METH A NIA Y t Low Cab From L WA Y D e F L NIA Y ` AB Low Cab Door L WA Y 2 ng A Y (� ` CD Low Cab Wa L NIA Y34 b F L NIA Y 1.{ �. Low Cab Sh L NIA Y (� L NIA Y Supports L NIA Y A L NIA Y Drawers L NIA Y C�D1 F L NIA Y A Window Sill MA AIM L WA Y 0 Door Casing IA Y .� B Win Apron L NIA Y 34 Door Jamb F L NIA Y l`1 i t�— C Win Casing L NIA Y Threshold (� L NIA Y D Header Stop MII L WA Y A B Door L NIA Y Int Slops MII L NIA Y D Door Edge F L NIA Y Win Int Sash MA L NIA Y 12 Door casing NIA Y �� EderiorSill MII SF L WA Y 34 Door Jamb F WA Y / Part Bead MII L WA Y Threshold L NIA Y Blind Stop MII SF L NIA Y Closet Door A Y y�a1 Win Ext Sash MA L WA Y A Cl Door Edge Ej L NIA Y A Window Silt MA AIM L N/A Y B CI Casing L N/A Y B Wn Apron L NIA Y C Closet Jamb '�PjNAjY .t y 1, C Win Casing L NIA Y C Closet Walls 3 Y D Header Stop MA L NIA Y CI Baseboard Y - L W Shops MA L WA Y Closet Pole Y Win Int Sash MA L WA Y Closet Shelf V Exterior Sill MA SF L NIA Y CI SupportsIC L WA Y ',y�,. Part Bead MA L NIA Y CI Drawers L NIA Y Blind Stop MA SF L NIA Y Cl Dr Frome L NIA Y Win Ext Sash MA L WA Y Closet Floor L❑(dust)WA Y B Fireplace L WA Y Closet Ceiling OA, L NIA Y C D Mantel L WA Y AB CD Shlvs Above 5 L N/A Y AB Sidelight(L) L WA Y AB Cab Above 5' L N/A Y C D Sidelight(R) L N/A Y AB CD Cab Above 5' L N/A Y C p Win Above 5 L NIA Y C D Up Cab Door L N/A Y C D Win Above 5' L NIA Y Up Cab Walls L NIA Y F W AIM L WA Up Cab Shlvs L WA Y F W AIM L WA Supports L NIA Y F W AN L WA F M11 AIM L WA F W AW L WA [_ F W AIM L WA F W AN L WA EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact COMMENTS I STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288$0.IN.) SIDEIC IC LOCATION MEASURE:LOOSE PAINT DATE a Check the box 9 this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems L"A Rep 2017 Room contd. INSPECTOR 3755 * 10 1/2 Mall St. , Salem, MA 01970 * 978-395-5035 Jerry Urban I-3755 Q)� Page LSof2' Inspector(print) Lic# SignatiMl Date 1 I Risk Assessor(print) Lic# Sgnalure Da STAIRCASE# _ -j 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 HAP DATE METH DATE METH A B Up Walls L NIA Y Window Sill Q. MA AIM L NIA Y Jow Weis L WA Y Win Apron U•t L NIA Y aseboards L N/A Y C Win Casing 6 L N/A Y hair Rail L NIA Y D Header Stop MA L N/A Y adiator L NIA Y Int Stops . MA L NIA Y Floor 11 L❑(dusl) N/A Y 1 Win Int Sash MA L N/A Y Ceiling L N/A Y 2 ExterlorSif M/I SF L N/A Y B Door L N/A Y 3 Part Bead MA L WA Y D Door Edge Q. F L NIA Y 4 Blind Stop Mn SF L N/A Y 12 Door Casing L NIA Y Win Ext Sash MA L N/A Y 34 Door Jamb F L NIA Y A Window Sill MA AIM L N/A Y Threshold L N/A Y B Win Apron L NIA Y A B Door L N/A Y C Win Casing L N/A Y D Door Edge d.1 F L WA Y D Header Stop MA L N/A Y 2 Door Casing .Z L WA Y Int Stops MA L N/A Y 34 Door Jamb o. F L WA Y 1 Win Int Sash MA L N/A Y Threshold L WA Y 2 Exterior Sill MA SF L N/A Y AB Door L N/A Y 3 Part Bead MA L N/A Y CD Door Edge F L N/A Y 4 Blind Stop MA SF L WA Y 12 Door Casing L N/A Y Win Ext Sash MA L N/A Y 34 Door Jamb F L NIA Y Newel Post L NIA Y Threshold L N/A Y Railing Cap AN L WA Y A B Door L N/A Y Handrail AtW L N/A Y C D Door Edge F L WA Y Balusters �j L WA Y 12 Door Casing L NIA Y Lower rail L NIA Y 34 Door Jamb F L N/A Y Treads Q.� F L NIA Y Closet Door L N/A Y Risers p. L NIA Y A CI Door Edge F L NIA Y Stringer p. L NIA Y B Cl Casing L N/A Y Tread edge> L NIA Y C Closet Jamb F L WA Y Landing floor L ❑(dust) NIA Y D a mt was L N/A Y Fbor Edge h.( L WA Y Cl Baseboard L NIA Y %or Casing L N/A Y 1 Closet Pole L NIA Y F MII AIM L WA Y 2 Closet Shell L WA Y F W AN L WA Y 3 a Supports L WA Y F W AIM L WA Y 4 Closet floor L❑(dust) NIA Y F Mil AN L WA Y Closet Ceiling L WA Y F Min ANA L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intactCOMMENTS/STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288 SQ.IN.) SIDE LOCATION MEASURE:LOOSE PAINT IC IC DATE METHOD ❑ 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 Stair INSPECTOR 3755 * 10 1/2 M 11 St. , Salem MA MA 01970 * 978-395-5035 Jerry Urban I-3755 II Z 2�'` Page&OfL Inspector(print) Lic# Sig Date Risk Assessor(print) Lic# �� Signature Date AoL# i • HALLWAY Interior # or moron Ilway: Front ear loor#_LlF' SIDEHSURFACE TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD HAZARD DATE METH DATE METH SURFACE HAZARD HAZ. DATE METH DATE METH A e L NIA Y Closet Door L WA Y A L NIA Y A CI Door Edge F L NIA Y A e Baseboards L NIA Y B Cl Casing L WAI Y A B Char Rail L NIA Y C Closet Jamb F L NIA Y As Radiator L NIA Y D Closet Walls L NIA Y JQL Floor L❑(dust)NIA Y Cl Baseboard L N/A Y Calling I K4L NIA Y „/ ; 1 Closet Pole L N/A Y A IA Y 2 Closet Shelf L NIA Y D Door Edge F L NIA Y •I _ZgL 3 ClSupports L NIA Y 2 Door Casing � NIA Y ..! 4 Closet Floor L (dust)NIA Y 34 Door Jamb F L NIA Y ���y Closet Ceiling L NIA Y Threshold 2 L NIA Y A Window Sill W AIM L N/A Y A Door L N/A Y B Win Apron L WA Y C D Door Edge F L N/A Y C Win Casing L WA Y DoorCasng /A Y 4 D Header Stop W L WA Y 3 4 Door Jamb F /A Y 1�. Int Slops Mn L N/A Y Threshold L N/A Y 1 Win Int Sash W L WA Y B Door L NIA Y 2 Exterior Sul Min SF L WA Y Door Edge F L NIA Y 3 Part Bead Min L N/A Y 12 Door casing Q. L N/A Y 4 Blind Stop Mll SF L WA Y 34 Door Jamb Q. F L N/A Y Wirt Ext Sash M11 L NIA Y Threshold L N/A Y A Window Sill Mll AIM L NIA Y A B Door L N/A Y B Win Apron L N/A Y C Edge F L NIA Y C Win Casing L N/A Y 12 Door Casing 2, L N/A Y D Header Stop Mn L N/A Y 34 Door Jamb F L N/A Y Int Stops M/I L WA Y Closet Door L NIA Y 1 Win Int Sash M11 L NIA Y A CI Door Edge F L NIA Y 2 Exterior sili W SF L NIA Y B CI Casing L NIA Y 3 Part Bead Mll L WA Y C Closet.lamb F L NIA Y 4 BtndSlop Mlt SF L N/A Y D Closet Walls L NIA Y rn Ext Sash Mil L NIA Y Cl Baseboard L N/A Y C o Win Above S L N/A Y 1 Closet Pole L NIA Y Calling Mold' L N/A Y 2 Closet Shelf L N/A Y J TL F Mn AIM L WA Y 3 CI Supports L N/A Y 4-ZE 1!!L F M!!AFd L WA I Y �.. 4 Closet Floor L❑(dust)N1A Y F M t AIM L WA Y Closet Ceiling L NA Y COMMENTS/STRUCTURAL DEFECTS: EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact by a Deteader(MORE THAN 288 SQ.IN.) IDE LOCATION MEASURE:LOOSE PAINT IC DATE IC METHOD ❑ Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LI/RA Rep 2017 Hall INSPECTOR 3755 * 10 11 Mall St. , Salem, MA 01970 * 978-395-5035 Jerry Urban I-3755 1 / 2 Page 0OfZI-f Inspector(print) Lic# S a Date J I Risk Assessor(print) Lic# Signature Datr— Addre of Propertym :7 Q'I"t Alle I— AnL 4) Cibr, 7 STAIRCASE# C „ SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAT? DATE METH DATE METH SURFACE HAZARD HAT? DATE METH DATE METH A e Up Wa 0 L WA Y A Window Sill MA AIM L N/A Y A B Low a IA Y B WYn Apron L WA Y A B Baseboards L NIA Y C Win Casing L NIA Y A B Chair Rail L N/A Y D Header Stop Mn L NIA Y As c D Radiator L NIA Y Int Slops MA L N/A Y Floor L❑(dust) NIA Y 1 Win Int Sash MA L WA Y Ceiing Q L NIA Y 2 Exterior Sill MA SF L NIA Y A B Door L N/A Y 3 Part Bead M/I L N/A Y Cj6 boor Edge F L N/A Y 4 Blind Stop MA SF L N/A Y 12 Door Casing L N/A Y Win Ext Sash MA L NIA Y 34 Door Jamb F L NIA Y A Window Sill MA AN L WA Y Threshold L N/A Y B Win Apron L N/A Y A B Door L N/A Y C Win Casing L WA Y C D Door Edge F L WA Y D Header Stop MA L N/A Y 1 2 Door Casing L WA Y Int Stops MA L WA Y 34 Door Jamb F L NIA Y 1 Win Int Sash MA L NIA Y Threshold L WA Y 2 Exlerlor Sil MA SF L WA Y A B Door L WA Y 3 Part Bead MA L WA Y C D Door Edge F L WA Y 4 jEffind Stop MA SF L NIA Y 12 Door Casing L N/A Y lWin Ext Sash MA L NIA Y 34 Door Jamb F L N/A Y Newel Post 4C L WA Y Threshold L NIA Y Railing Cap AIM L WA Y AB Door L NIA Y Handrail AIM L NIA Y C D Door Edge F L WA Y Balusters L NIA Y 12 Door casing L NIA Y Lower rail L NIA Y 34 Door Jamb F L NIA Y Treads 64 F L N/A Y Closet Door L N/A Y Risers O. L NIA Y A CI Door Edge F L WA Y Stringer L NIA Y B a Casing L WA Y Tread edge>5 L WA Y C Closet Jamb F L WA Y Landing floor L ❑(dust)NIA Y D Closet Walls L NIA Y Floor Edge Q L NIA Y Cl Baseboard L NIA Y Floor Casing L NIA Y 1 Closet Pole L N/A Y F MA AIM L WA Y 2 Closet Shelf L WA Y F MA AN L WA Y 3 CI Supports L WA Y F MA AM L WA Y 4 lCloset Floor L[](dust)N2 Y F MA A NA L WA Y Closet Ceiing L WAI Y I I F MA AN L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact COMMENTS I STRUCTURAL DEFECTS: by a Deleader(MORE THAN 288 SQ.IN.) SIDE LOCATION MEASURE:LOOSE PAINT IC IC 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 .L V►0t'JGI TUT J 100 1V 1/ L 1"idll Ol.. 0aJLttlll1, PLA V 17/V 7 /O—avo—o VJo Jerry Urban 1-3755Ur- 112 / ZZ Page.LOf91 Inspectorr(print) Uc# Signatu Date Risk Assessor(print) �7 c# I Signature / D e Address of Property: / Pet t ��A �}.— Apt.# 1 City: 50,.o v, BASEMENTILAUNDRY AREA 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 rM Walls L NIA Y AB Serviceboard L NIA Y B Walls bd L N/A Y A B Shelves L NIA Y B Walls d.It L NIA Y C D Supports L N/A Y As Waus P L NIA Y A B Shelves L N/A Y AB CD Baseboards L NIA Y C D Supports L N/A Y AB c D Chair rails L NIA Y A B Shelves L N/A Y Floor G L❑(dust) NIA Y C D Supports L NIA Y Ceiling L L NIA Y A Windowframe M/I L N/A Y AsGo Chimney d.1 L NIA Y C D Window Sash M/I L N/A Y AB Support Colum bG L NIA Y 12 E)derior Sill VI(( M/I L N/A Y Door G. L NIA Y 3 4 Part Bead V M!1 L NIA Y C D Door Edge F L NIA Y iWin EA Sash Aff M/I L NIA Y 12 Door Casing L NIA Y AB Window frame .v M/I /A Y 34 Door Jamb F L NIA Y CCD indow Sash V M/1 L N/A Y Threshold L L NIA Y 12 E derior Sill K WI L NIA Y A B Door L NIA Y 3 4 Part Bead \f?C M/I L NIA Y D Door Edge 6. F L NIA Y Win EA Sash MA L NIA Y 12 Door Casing L NIA Y A B Window frame M/I L NIA Y 34 Door Jamb F L NIA Y C D Window Sash MII L NIA Y Threshold L NIA Y 12 Exterior Sill M11 L NIA Y Closet Door L N/A Y 3 4 Part Bead M/I L NIA Y A CI Door Edge F L N/A Y lWin Fed Sash Mil L NIA Y B Cl Casing L N/A Y Newel Posts L N/A Y C Closet Jamb F L NIA Y AB Handrail AIM L N/A Y D Closet Walls L NIA Y C D Balusters L N/A Y Cl Baseboard L N/A Y 12 Lower rail L NIA Y 1 Closet Pole L N/A Y 34 Treads F L NIA Y 2 Closet Shelf L N/A Y Risers L N/A Y 3 Cl Supports L N/A Y Stringer L NIA Y 4 Closet Flo L (dust) NIA Y I I Tread Edge L NIA Y Closet Ceiling L NIA Y Landing floor L ❑(dust) N/A Y A B Cabinets L N/A Y A B Oil Tank 6.2 L N/A Y A B Benches L N/A Y A B Win Above 5 L NIA Y C D Supports L NIA Y F MA AIM L N/A Y A a Pipes Ob L N/A Y F W A/M L N/A Y A B Sink L N/A Y F MA A/M L NIA Y A B Drainpipe L N/A Y F MA AN L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made intact Commants/Struetural Defects by a Deleader(MORE THAN 288 SQ.IN.) SIDE LOCATION MEASURE:LOOSE PAINT IC DATE f1C METHOD ❑ Check the box if this ROOM is RULED OUT for encapsulation because there are 3 or more A1M surfaces with adhesion problems LIRA Rep 2017 Bsmnt/Laundry INSPECTOR 3755 * 10 1 all St. , Salem, MA 01970 * 978-395-5035 /2 Jerry Urban I-3755 / Z/ ZZ Page aOf&f Inspector(print) Lic# Sig Date Risk Assessor(print) Lic# Signature Date _ Addre f PORCH A (side) I J— (floor) SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDEJ LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ7 DATE METH DATE METH AB Siding Y A B window Sill AIM L WA Y CD Comer Bards L N/A Y C D Win Casing L WA Y Upper Trim L NIA Y 12 window Sash L WA Y Ceiling L N/A Y 34 Minions L WA Y Joists L WA Y A B window sa AM L N/A Y Storm Door L WA Y C D Win Casing L N/A Y rStrm Door Ed F L N/A Y 12 window Sash L WA Y Door Q L WA Y 34 Mullions L WA Y Door Edge 0. F L WA Y Support Clm A Y Door Casing L WA Y Newel post �/ L NIA Y Door Jamb ( F L WA Y Railing Cap AIM L N/A Y Threshold L WA Y Handrail AIM L WA Y IGckplate ( L NIA Y Balusters L WA Y Stone Door L N/A Y Lower Rai 1z L NIA Y B Strm Dow Edge F L N/A Y Treads F L WA Y C D Door L WA Y Risers L NIA Y Door Edge F L WA Y Stinger L NIA Y 12 Door Casing L N/A Y Tread Edge 4 Q L NIA Y 34 Door Jamb F L N/A Y Lower Walls L WA Y Threshold L NIA Y Lattice L NIA Y I(ickpiate L NIA Y Lower Trim L NIA Y B Window Sill L A/M L N/A Y Fkwr LQ(dusl)• N/A Y D win Casing 44j. % L WA Y F MA AIM L WA Y 12 window rv. L WA Y F W AIM L WA Y 34 Mullions p. L NIA Y F W AN L WA Y $ window Sill AIM L NIA Y F MA AIM L WA Y C D win Casing L N/A Y F W AN L WA Y 12 window sash 4 L N/A Y F W AN L WA Y 34 Imullions L N/A Y F bN AM L WA Y AS window Sul AIM L WA Y F W AIM L WA Y C D win casing L WA Y F MA AIM L WA Y 12 window sash L WA Y F MA AIM L WA Y 4 Mullions L WA Y F MA AMI L WA Y MMENTS I STRU11TURAL DEFECTS: durd)••Applies only to pordw used as interior space COMMENTS I 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 SO.K) DATE METHOD ❑ Check the box N this ROOM is RULED OUT for encapsulation because there are 3 or more AIM surfaces with adhesion problems LIRA Rep 2017 Porch INSPECTOR 3755 * 10 1/2 Mall St. , Salem, MA 01970 * 978-395-5035 Jerry Urban I-3755 0� 111 122. PageL—Of Inspector(print) Lic# Sign Date Risk Assessor (print) Lic# Signature Date- Address of Property: -7 &.,,4-�'W- ADt.# { Cjty4 .„.„ EXTERIOR A Side SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD A SURFACE HAZARD HAZ? DATE METH DATE I METH A SURFACE HAZARD' HAZ DATE METH DATE METH Siding A Y -rDa Window Sill J(ZV AIM L N/A Y Comer Boards L WA Y A Win Casing L N/A Y A Lower Trim J. L NIA Y 3 Window Sash V L NIA Y Upper Trim t f L NIA Y Cellar Win Sill AIM L NIA Y Win Above 5' L NIA Y (— A Cel Win Frame L NIA Y Porch Above 5 L NIA Y N Cel Win Sash L NIA Y Storm Door L NIA Y Screen Frame L N/A Y Strm Door Edge F L NIA Y Cellar Win Sill AIM L WA Y A Door L NIA Y A Cel Win Frame L NIA Y 1 2 Door Edge F L WA Y N Cal Win Sash L WA Y 3 4 Door casing L NIA Y Sam Frame L N/A Y Door Jamb F L WA Y Cellar Win Sill AIM L WA Y Threshold L WA Y A Cel Win Frame L NIA Y Kickplate L WA Y # Cel Win Sash L NIA Y Storm Door L NIA Y Screen Frame L NIA Y Stmn Door Edge F L NIA Y Foundation Z L NIA Y A Door L NIA Y A Bulkhead L NIA Y 1 2 Door Edge F L NIA Y Fences L WA Y 3 4 Door Casing L N/A Y Shutters L NIA Y Door Jamb F L WA Y I Newel post L WA Y Threshold L WA Y Railing Cap AIM L WA Y Kidcplate L NIA Y Handrail AIM L NIA Y Door L NIA Y A Balusters L N/A Y A Door Edge F L N/A Y Lower Ral L NIA Y 1 2 Door Casing L NIA Y Treads F L WA Y 3 4 Door Jamb F L N/A Y Risers L WA Y Threshold L NIA Y Tread edge L NIA Y KidgAate L NIA Y Landing floor L NIA Y Window Sill AIM L NIA Y Stringer L WA Y A Wm Casing L N/A Y Lattice L N/A Y LAN Window SashRE L NIA Y Drain Pipes L NIA Y Window Sill AIM L N/A Y A Elec Conduit L NIA Y A Win Casing L N/A Y Oil Fill Pipe L N/A Y Wmdow Sash L N/A Y Overhang Trim L NIA Y COMMENTS/STRUCTURAL DEFECTS: A Lamp Post L NIA Y A F M/I AN L NIA Y A F M/l AIM 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 sold) intact by a Deleader(MORE THAN 2880 SO.IN.) LOCATION AREA MEASUREMENT RESULT REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT IC DATE IC METH (Square Feet) (PPM) DATE METH A Play Area A Bare Soil A Comments: A LIRA Rep 2017 Ext A INSPECTOR 3755 * 10 1/2 Mall St. , Salem, MA 01970 * 978-395-5035 Jerry Urban I-3755 t' !1 /--- 'I) / I Z/ Z2 Page?tOf2.!! Inspedor(print) Licfl Svqre Date Risk Assessor (print) Lic# Signature Add sofftmu& Apt,# City: EXTERIOR B Side SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD B SURFACE HAZARD HAZ. DATE METH DATE METH B SURFACE HAZARD HAZ7 DATE METH DATE METH Siding 7 C& L NIA Y Window Sill AIM L NIA Y Comer Boards QV L NIA Y B Win Casing L N/A Y B Lower Trim U L NIA Y Window Sash L N/A Y Upper Trim L N/A Y Cellar Win Sill v L N/A Y Win Above 5' L N/A Y M B C9I Win Frame L N/A Y Porch Above 5' L NIA Y Gel Win Sash L NIA Y Storm Door L NIA Y Screen Frame vj 01 L NIA Y Shm Door Edge F L NIA Y Cellar Win Sill N/A Y / B Door L NIA Y B Cal Win Frame NIA Y , 1 2 Door Edge F L NIA Y Call Win Sash L NIA Y 3 4 Door Casing L NIA Y Screen Frame L N/A Y Door Jamb F L N/A Y Cellar Win Sill ZAIM L NIA Y Threshold L N/A Y B Gel Win Frame L NIA Y iCickplate L NIA Y -�Cel Win Sash V L NIA Y Stone Door L NIA Y Screen Frame L N/A Y Stan Door Edge F L NIA Y Foundation L NIA Y B Door L N/A Y B Bulkhead L NIA Y 1 2 Door Edge F L N/A Y Fences L NIA Y 3 4 Door Casing L NIA Y Shutters L N/A Y Door Jamb F L N/A Y Newel post L N/A Y Threshold L N/A Y Railing Cap AIM L N/A Y Ipckplate L N/A Y Handrail L NIA Y Door L NIA Y B Balusters L NIA Y B Door Edge F L NIA Y Lower Rail L NIA Y 1 2 Door Casing L N/A Y Treads F L NIA Y 3 4 Door Jamb F L N/A Y Risers L NIA Y Threshold L NIA Y Tread edge L N/A Y Kickplate L N/A Y Landing floor L NIA Y Window Sill AIM L NIA Y Stringer L NIA Y B Win Casing L N/A Y Lattice L N/A Y Window Sash L N/A Y Drain Pipes L NIA Y Window Sill AIM L N/A Y B Elec Conduit L NIA Y B Win Casing L NIA1 Y 1 01 Fill Pipe L N/A Y Window Sash L N/Al Y I Overhang Trim L NIA Y COMMENTS/STRUCTURAL DEFECTS: B Support Clmn L NIA Y B F MA AIM L N/A Y B F MA A/M 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 SO.IN.) LOCATION AREA MEASUREMENT RESULT REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT IC DATE IC METHOD (Square Feet) (PPM) DATE METH B Play Area B Bare Soil B Comments: B LIRA Rep 2017 Ext B INSPECTOR 3755 * 10 1/2 M&11 St. , Salem, MA 01970 * 978-395-5035 Jerry Urban I-3755 ae 3 / 12 U PagegOf Inspector(print) Lic# Signajh Date I 1 Risk Assessor(print) Lic# Signature ( Da Addr of Property: lk&(A 51- PORCH C (side) l S} (floor) SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDEJ LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAV DATE METH DATE METH AS Siding ,/ L WA Y B window Sol AIM L WA Y CD Comer Boards L WA Y C D win Casing L NIA Y Upper Trim �, L NIA Y 12 window sash L WA Y Caning L WA Y 34 Mullions L WA Y Joists L NIA Y B window sill AN L WA Y Storm Door p L WA Y C D win Casing L WA Y Stan Door Ed F L WA Y 12 window sash L WA Y C D Door 1 L N/A Y 34 Mullions L WA Y Door Edge F L NIA Y Support Clm O.t L WA Y 1 2 Door Casing L N/A Y Newel post L N/A Y 3 4 Door Jamb G. F L WA Y Railing Cap AIM L WA Y Threshold L WA Y Handrail AIM L WA Y Kd*te L WA Y Balusters L WA Y Storm Door L WA Y Lower Rai L N/A Y B Strm Door Ed F L NIA Y Treads F L NIA Y D Door L WA Y Risers A L NIA Y Door Edge F L WA Y Stringer L WA Y 12 Door Casing L N/A Y Tread Edge 6 L N/A Y 34 Door Jamb F L N/A Y Lower Walls L N/A Y Threshold L WA Y Lattice L NIA Y Ia "te L NIA Y Lower Trim 40.6 L NIA Y Window Sill AIM L NIA Y Floor LQ(dusp' WA Y C D Win Casing L WA Y F Min AtYI L WA Y 12 window Sash L N/A Y F W AM L WA Y 34 Mulliorns L NIA Y F W AM L WA Y B window sill AIM L N/A Y F W AN L WA Y C D win Casing L N/A Y F Min AN L WA Y 12 Window Sash L N/A Y F Min AN L WA Y 34 Mullions L WA Y F W AM L WA Y B Window Sill AIM L WA Y F W AMt L WA Y C D Win Casing L WA Y F W AM L WA Y 12 WndowSash L NIA Y F W AN L WA Y 34 Mullions L WA Y F Mn AIM L WA Y OMMENTS I STRUC RAL DEFECTS: duet)'-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. SIDELOCATION 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 LYRA Rep 2017 Porch INSPECTOR 3755 * 10 1/2 all St. , Salem, MA 01970 * 978-395-5035 Jerry Urban I-3755 3 / Z/ Z Z Page ZIOfI Inspector(print) Lic# Ign u Date Risk Assessor (print) nn � - ! Lic# Signature Da Address of Prooe&: -) IC.�AJ �. 1 Apt. A EXTERIOR C Side SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD C SURFACE HAZARD HAZ? DATE METH DATE METH C SURFACE HAZARD HAZ. DATE METH DATE METH Siding Y L N/A Y Window Sill A/M L N/A Y Comer.Boards L N/A Y C Win Casing L NIA Y C Lower Trim L NIA Y Window Sash L NIA Y Upper Trim L NIA Y Cellar Win Sill A/M L N/A Y Win Above 5' L N/A Y I ��JV C Cal Win Frame L N/A Y Porch Above 5' L NIA Y —ILA L # Cal Win Sash L NIA Y Storm Door 3 L N/A Y Screen Frame L NIA Y Strm Door Edge 3 F L N/A Y Cellar Win Sill AIM L NIA Y C Door A L N/A Y C Cal Win Frame L N/A Y 1 2 Door Edge d F L N/A Y 0 Cel Win Sash L NIA Y 3 4 Door Casing L N/A Y Screen Frame L NIA Y Door Jamb F L N/A Y Cellar Win Sill AIM L NIA Y Threshold 94 1 L NIA Y C Cel Win Frame L N/A Y Kickplate L NIA Y Cel Win Sash L N/A Y Storrs Door L N/A Y Screen Frame L NIA Y Strm Door Edge F L N/A Y Foundation L N/A Y C Door L NIA Y C Bulkhead L NIA Y 1 2 Door Edge F L NIA Y Fences L N/A Y 3 4 Door Casing L NIA Y Shutters L N/A Y Door Jamb F L NIA Y Newel post L N/A Y Threshold L NIA Y Railing Cap AIM L N/A Y IGckplate L N/A Y Handrail AIM L NIA Y Door L NIA Y C Balusters L NIA Y C Door Edge F L NIA Y Lower Rail L NIA Y 1 2 Door Casing L N/A Y Treads F L NIA Y 3 4 Door Jamb F L NIA Y Risers L NIA Y Threshold L NIA Y Tread edge L NIA Y IGckplate L NIA Y Landing floor L NIA Y Window Sill AIM L NIA Y Stringer L N/A Y C Win Casing L NIA Y Lattice L N/A Y # Window Sash L NIA Y Drain Pipes 6_5 L NIA Y Window Sill AN L NIA Y C Elec Conduit L N/A Y C Win Casing L NIA Y Oil Fill Pipe L N/A Y Window Sash L NIA Y Overhang Trim L NIA Y COMMENTS I STRUCTURAL DEFECTS: C Support Clmn 0 L NIA Y C F W AIM L WA Y C F W AIM 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/1200 ppm for bare soil) intact by a Deleader(MORE THAN 2880 SO.IN.) LOCATION AREA MEASUREMENT RESULT REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT IC DATE IC METHOD (Square Feet) (PPM) DATE METH C Play Area C Bare Soil C Comments: C LIRA Rep 2017 Ext C INSPECTOR 3755 * 10 1/2 all St. , Salem, MA 01970 * 978-395-5035 Jerry Urban I-3755 3I L / 2z Page L-tiof14 Inspector(print) Lie# SignW6 Date Risk Assessor (print) Lie# Signature Date Address of Property* 7 Q aiJ�.�1/<< �L AOL# ._ City: M EXTERIOR D Side SIDE LOCATION/ LEAE 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 HAZ? DATE METH DATE METH Siding L NIA Y Window Sill J AIM L NIA Y Comer Boards L N/A Y D Win Casing Coj L NIA Y D Lower Trim L NIA Y All Window Sash L N/A Y Upper Trim L NIA Y Cellar Win Sill ew AIM L N/A Y Win Above 5' L NIA Y D Cal Win Frame 11 L NIA Y Porch Above 5 L NIA Y # 1 Cal Win Sash U Q L NIA Y Storm Door L NIA Y Screen Frame L N/A Y Stm►Door Edge F L NIA Y Cellar Win Sill ,, AIM L WA Y D Door L NIA Y D Cat Wm Fram %,/ L NIA Y 1 2 Door Edge F L N/A Y N L Cel Win Sash V L N/A Y 4 Door Casing L NIA Y Screen Frame V L N/A Y Door Jamb F L NIA Y Cellar Win Sill AIM L NIA Y Threshold L NIA Y D Cal Win Fnmm L N/A Y Kickplate L N/A Y Al 1 Cal Win Sash v L N/A Y Storm Door L NIA Y Screen Frame �`\ L N/A Y Strm Door Edge F L N/A Y Foundation L N/A Y D Door L NIA Y D Bulkhead L NIA Y 1 2 Door Edge F L N/A Y Fences L NIA Y 3 4 Door Casing L NIA Y Shutters L NIA Y Door Jamb F L N/A Y Newel post L NIA Y Threshold L NIA Y Railing Cap AIM L NIA Y Kickplate L N/A Y Handrail AIM L NIA Y Door L N/A Y D Balusters L N/A Y D Door Edge F L NIA Y Lower Rail L N/A Y 1 2 Door Casing L N/A Y Treads F L NIA Y 3 4 Door Jamb F L NIA Y Risers L N/A Y Threshold L N/A Y Tread edge L N/A Y tGdgtlate L NIA Y Landing floor L N/A Y Window Sill p b AIM L N/A Y Stringer L WA Y D Win Casing L N/A Y Lattice L NIA Y Window Sash L NIA Y Drain Pipes L NIA Y Window Sill AIM L N/A Y D Elec Conduit L NIA Y D Win Casing L N/A Y Oil Fill Pipe L NIA Y Window Sash L N/A Y Overhang Triff L N/A Y COMMENTS I STRUCTURAL DEFECTS: D Support Clmn L N/A Y D F MII AN L WA Y D F MII AIM L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can only be made Sal 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 RESULT REMED REMED SIDE LOCATION MEASURE:LOOSE PAINT IC DATE rC METH (Square Feet) (PPM) DATE METH D Play Area D Bare soil D Comments: D LVRA Rep 2017 Ext D >>UPLOAD LETTERHEAD IN THIS SPACE<< LEAD DETERMINATION REPORT FORM St.# Street Name Street T e Unit city Zip Code S Dl9'TD 71 Date of Determination:2 /� Sodium Sulfide expiration date: 12- Number of Rooms in Unit X-Ray Fluorescence: Model: Serial#: Property Type: Owners Name: J06A &Ipeu, &Cal Lea- p64w to" Owner Address: 2 ❑Single Family Multi Family #of Units 2 Contact Information: —< Condominium #of Units Home built before 1978? Yes ❑No ❑Day Care ❑Other LEAD HAZARDS? Yes ❑No Property Diagram/Unit Labels Floor# 1 (level within building of unit being inspected) C S B D n V �] A(Street Side) A(Street Side) Start Here A gray or black reaction to sodium sulfide or an X-ray fluorescence reading equal to or greater than 1.0 mg/cmz indicates a dangerous level of lead and constitutes a positive determination and violation of the Lead Law. Deleading must not be undertaken based on this report. A licensed lead inspector must do a full inspection identifying all lead hazards in order for you to qualify for a Compliance Letter. IA-4y llm y Dq= 1 2(71L Inspector' Name License# 77 Signature Date J 6ff r1t.8 6,ro ?_2 Z hz!20 Inspecto (print) 91 Lic# e Date Address of Property: # SIDE LOCATION SOURCE Pb Hazard Tune (circle one) (circle one) (circle one) (circle one) (circle) A B C® m Child's bedroom R #� !Window sill POS U INC (g L A B C D Child's bedroom Rm# Window Int sash Ext sash Exterior sill POS NEG INC M/I L A C D Child's bedroom Rm#1 Door edge koor jam NEG INC F A B C D Child's bedroom Rm# Baseboard Window casing Door casing POS NEG INC L A B C D Child's bedroom Rm# Baseboard Win casing Door casing POS NEG INC L A B C® Kitchen Bath Room#Z indow si Handrail Railing cap POS ® INC L A B C D Kitchen Bath Room# Window sill Handrail Railing cap POS NEG INC A/M L A B C D Kitchen Bath Room# Window Int sash Ext sash Exterior sill POS NEG INC M/I L A B C D Kitchen Bath Room# Window Int sash Ext sash Exterior sill POS NEG INC M/I L A B D Kitchen Bath Room# Z, Door edge o � NEG INC F or jam A®C D itche Bath Room# Door edge oor j amb POS INC L A B C D Interior hallway Stair tread Door edge Doorjamb POS NEG INC F L A B C D Interior hallway Window Int sash Ext sash Exterior sill POS NEG INC M/I L common area A B C D Interior hallway Stair tread Door edge Doorjamb POS NEG INC F L (common area) A B C D Interior hallway Window sill Handrail Railing cap POS NEG INC A/M L common area A B C D Interior stairway Stair tread Door edge Doorjamb POS NEG INC F L (common area) A B C D Porch Stair tread Door edge Doorjamb POS NEG INC A/M L A B C D Porch Railing cap Handrail Windowsill below 5 POS NEG INC A/M L A B C D Exterior Cellar window sill POS NEG INC A/M L A B C D Exterior Window sills below 5' POS NEG INC A/M L A B C D Exterior—Main Entry Stair tread Door edge Doorjamb POS NEG INC F L A B C D Exterior Main entry door casing POS NEG INC L A B C D Exterior Siding Window casings Door casings POS NEG INC L A B C D Garage/Outbuilding Siding Window casings Door casings POS NEG INC L A B C D Garage/Outbuilding Window sills below 5' POS NEG INC A/M L A B C D POS NEG INC A B C D POS NEG INC A B C D POS NEG INC A B C D POS NEG INC J- ,H Key for Hazard type: A/M=Accessible/Mouthable L=Loose F=Friction M/I=Moveable/Impact