PRE-RENOVATION LEAD-BASED PAINT INFORMATION
 

PRE-RENOVATION LEAD-BASED PAINT INFORMATION

 

Acknowledgment Form

(Keep this form on file for 3 years.)

 

I have received a copy of the pamphlet, Protect Your Family From Lead In Your Home, informing me of the potential risk of lead hazard exposure from renovation activity to be performed in my dwelling unit. I received this pamphlet before the work began.

 

 

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Printed Name

 

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Signature

 

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Date

 

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Unit Address