57 Lead Determinations Report Form 1995 pent
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Tat 617-522-8735
LEAD DETERMINATIONS REPORT FORM
Date of Determination:
/ - - cJ
tlaease Number:
Method Used:
Froparty Address;
eeaslption of Property:
sodium sulfide
x-Ray Fluorescence
Expiration date:
Model:
Serial Numb e
3/
S et ptooerty:
topant:
Single family
Multi-family
Garage
Fence
Other structures
Pre-1978
Post-1978
0 units
Thomni OF NotCq„
,SPIN 2 1995
Naretn ha
Childhood Lead Poisoning
Prevention Program
800322.9571
Apt. #:
avant, under six years of age:
DOB: _L/c2_=./2:_u_____
DOB:
DOB:
DOB: -_
liaat's Telephone
ty/,3
arty Ovner(s) :
toe Address:
gee telephone:
fl7 flUOrescence reading greats
Ifeeetlon to sodium sulfide indicates an illegal level a gray or
eestltutes a positive determination.
el of lead
d�lead replacement, reversal or inspection covering aint as WS report or subsequent of lead
I del a g contractor licensed b the Department be performed
Lbr
P rtment of Labor
167
£ne r y,
NOR\VICII LABORATORIES, INC.
750 North Pleasant Street, Rear
Amherst, MA 01002
(413) 549-6884
V Ll l i%✓e 1 �}% 7�O P/K■ "Mei APiJi
Address of lupectioai
leeOsl f S'.7 S/S
Ill 11 AIf / 1001 I
!A18I00M I 1001!
SIDI
10 0 1 C 1
Pb LOOS!
CORP.
DI
11t10D
1 0 t 1 1 SIDI
1
0 0 I C S
Pb
LOOS1 COMP.
DI
MITRODI
_
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_
_
• 43
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_ _
_
_
_
_ —
_ _
_ _
_
_ _
—_ —_
_ _
Upper palls
Upper tells
Loser falls
Loser falls
Chair rail
Choir rail
Baseboard
Baseboard
Door
Door
Door Casiiq-Jaab
Door
Door Caeloq-lath
Door
Door Whig-hob
Door Caling-Jeeb
Door
Door
Door Casing-Job
Door Culoq-Jaab
Ilodot Bill/Aproo
Ilodov Sill/Apron
!Woo Cosby
Hulot leader/Stop
Ilodot Sash/101._
11t.Silllhtt.leed
Endow llll/Aproo
!Soda Casing
tiudot Reader/Stop
Ilodot BashlMul.
1tt.SillIPatt.Beed
Undo, sill/Aproo
Undo, Casing
Ylodot Reeder/Stop
Ylodot Sash/Ill.
Ixt.Sill/Part.Beed
Ylodot SillfAproo
Ilodot Casing
Ilodot leader/Stop
ulodot Sash/lal._
Brt.slll/fat.lud
Ledo. Sill/Apron
Ylodot Casio;
Ilodot leader/Stop
Tiller Bash/Mel,
Irt.SilllPart.Beed
Rt.Side Sobel_
Upper Willett
Endo, Casing
Endo, BeaderlStop
Ilodot Sa,h/XUl.
Irt.Siil/Part.Beed
txt.Side Sashes
—
-
_
_
_
Opper Cebloete
Opr.Cableets tall
Opr.Cabloets fell
Opr.Cabloet Shelve
Lover Cabinets
Opr.Cabinet Shelve
Lover Cebloete
Lvt.Cebinets tall
Ltr.Cablaet Skive
Shelves
Lvr.Cabinete Sall
_
_
Ltr.Cabtoet Shelve
Shelves
Drivers
Drovers
Closet Ills
Closet Yells
Closet Door toter.
- Clout Gulag-lad
Closet laieboads
Closet Door toter.
Closet Cesiog-Jaab
Closet Baseboard'
Clout Shelves
Closet Shelves
Moor
Moor
Ceiling
Ceiling
Pb More Mao 1.2 sg/cs' vith [-ray fluorescence or positive vith WS is RAGAS.
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A SORE THAN 12 mg/cm, with x-ray fluorescence or positive with Na7S Is ILLEGAL
w
Disclaimer Concerning Lead Determination Report
The information contained in this report concerning the
presence or absence of lead paint does not constitute a
comprehensive lead paint inspection. The surfaces tested
represent only a portion of those surfaces which would be
tested to determine whether the premises are in compliance
with the Massachusetts Lead Poisoning Prevention Law
(Massachusetts General Laws, chapter 111, sections
190-199A. )
Serious lead poisoning hazards are created when materials
containing lead paint are disturbed, unless proper safety
guidelines are followed. Therefore, Massachusetts law
requires that:
Any deleading work done on the premises must be done
by a certified or licensed deleader. Letters of
Compliance will be .withheld if unauthorized deleading
has occurred.
Any renovating or rehabilitation of premises
containing dangerous levels of lead paint must be done
in compliance with the procedures set forth in the
regulations issued by the Department of Labor and
Industries (454 CMR 22. 11) , including sealing off the
work area from adjacent areas, and using a HEPA vacuum
and TSP for final clean-up.
Any deleading work done on the basis of this report will
not qualify the owner or occupant for a state tax credit,
nor will the cost of such deleading be reimbursable under
any state loan or grant programs. In order to qualify for
such programs, the premises must first be subject to a
comprehensive lead paint inspection.
If a child under six resides in this dwelling, the owner
may face criminal or civil liabilities unless all lead
paint violations have been corrected. This lead report
cannot assure that the property owner has met his or her
obligations under the law.
It is unlawful for rental property owners to use the
presence of lead as the basis for discrimination against
tenants or potential tenants with young children.
Areas where there are peeling, chipping, or flaking lead paint and dust should be cleaned.
Wet sponging and mopping with detergents containing phosphate, like tri-sodium
are best for this type of cleaning. Windows sills are often a major source of lead exposure.
They should be periodically cleaned if xin poo.
condition, the best thing to do may be paint
keeps the lower sash (closed and If they are in poor
sash for ventilation. Contact paper may be applied to areas of open only the upper
walls, or other surfaces as a temporary peeling paint uson e window slum
cleaner to clean mporars measure. We se not recommend that you use your vacuum
up paint chips because it will disperse fine particulate into the air. Sometimes
furniture can be moved to form a child-protective barrier to cover deteriorating paint or plaster.
If deteriorating paint or plaster is in the child's bedroom, use another room as the childs room,
if possible. Think of those parts of the home where your child spend most of his or her time,
and try to keep them as clean as you can before deleading.
Lead paint can contaminate soil. If the exterior surfaces of your home have chipping, peeling
or flaking lead paint, do not allow your child to play in the soil around the house and be careful
not to track soil from these areas into the house. Follow the advice of your code enforcement
inspector about soil on your property.
07-30-91
F.Weld
•nor
Forsberg
slaty
Mulligan
saloner
,l% Co�v�pyo ncu �of✓f sacrr���ZUss
91a fJ
305 cfou!/Wave4, Oartor4 dla 02130-3597
617-522-3700, Fax 617-522-8735
RESIDENTIAL LEAD ABATEMENT ADVISORY
• Childhood Lad
Poisoning
Prevarseon Program
800332.9571
The process of abating lead paint is very dangerous. For this reason, the Department of
cr and Industries' Deleading Regulations, 454 CMR 22.00, rewire that only a certified or
mused deleading contractor can remove or cover lead paint, or replace a fixture or surface
cted with lead paint. Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000,
re additional requirements to make sure that occupants of a dwelling unit are not exposed
lead hazards. The most important requirement is that the dwelling unit not be occupied
ile the unit is being deleaded It is very important that occupants think carefully about what
rir daily needs will be during the time they are away from home, and take along all that they
I need. No one should return to a dwelling unit undergoing deleading. Both property owners
i tenants must take their responsibilities seriously and cooperate fully to assure the protection
all concerned. Tenants, property owners or other residents should not interfere with the
-k being completed safely.
Tenants of the unit to be deleaded and other residents must receive written notification
least five days prior to the beginning of any lead paint removal/abatement. All furnishings
I possessions of every type should be removed or stored in plastic bags in non-work areas.
s includes all children's clothing, toys, stuffed animals, bedding, etc. Everything should be
loved and closets must be emptied. Possessions not removed from the work area should
put in plastic bags and left in the center of the room, only as a last resort. The reasons for
k extensive precautionary measure is to protect every household article from lead dust
tamination. Very fine dust is extremely hazardous and especially difficult to remove.
A very thorough final clean-up will be conducted by the deleader no sooner than 24 hours
sr the completion of active deleading. This is to ensure that fine airborne particulate will
:le out and be removed in the final clean-up. Occupants can return only after a lead inspector
ermines that a residential premises or dwelling unit is safe for occupants to return to through
reoccupancy reinspection. Occupants should leave a phone number where they can be reached
hat the inspector can notify them when it is safe to return home.
While there is no substitute for deleading and thorough clean-up to protect children from
i exposure, there are some important steps that can be taken even before deleading occurs.
lr public lead inspector's advice and counsel should be carefully followed because of their
sonal knowledge of your child's home environment.
As part of their normal behavior, young children place things in their mouths, especially
s, and their own fingers. If there are paint chips and dust in your home, they may end up
/our child's mouth. Children's toys pick up lead dust, as will food and candy that falls on
floor and most of all, their fingers. It is especially important to wash your child's toys,
to try to keep your child's hands clean, particularly at meal time.
e e e /gez.zac
e� C
g0.24timent OISZIOlt and ✓ltd*mlacec
g (5n l
#00 ..,d8e .fA.f, 02202
lead Removal Program
Division of Industrial safety
Boston
Nee Bedford
Douglas Dever, Manger
George Gonnella, Inspector
Paul Petrorsti, Inspector
Peter smith, Inspector
Brian Nang, Inspector
Michael DiPietro, Supervisor
Gary Gaspar, Inspector
Don Linhares, Inspector
Laurence Robert Lamrre, Supervisor
Worcester Stuart Ring, Supervisor
Teresa Dominguez, Inspector
Michael Bard, Inspector
Steven Troiano, Inspector
Springfield Edmund Predette, Supervisor
Gregory Rower, Inspector _
William lambert, Inspector
Pittsfield Raymond Whalen, Supervisor
Jon Lifvgrea, Inspector
Richard Walsh, Ins,, for
617-727-6155
617-727-1933
617-727-4990
617-727-0611
508-792-7635
413-734-1421
413-445-4214
g ±Y7
ex./. 9gyes Yt
LAS od.Yeac ✓azaanUzO ✓ yv,
305 .9csaA,Sie4, Jamaica,
, 02130
illiam F. Weld
Governor
vid P. Forsberg
Secretary
vid H. Mulligan
Commissioner
NOTICE TO TENANTS OP LEAD PAINT HAZARDS
Dangerous levels of lead in violation of the Lead Law (M.G.L. C. III, ss. 190-199A) and
the Regulations for Lead Poisoning Prevention and Control (105 CMR 460.000) have been found
in apartment no. , in this building. Children exposed to lead paint hazards are at risk
of contracting lead poisoning. This disease affects the normal behavioral and intellectual
development of children, especially children under the age of 6 years.
If you have children under six years of age, it is important that they be screened for lead
poisoning on a periodic basis. If your child has not been screened recently, you should request
your child's doctor or health care provider to perform the screening. Screening is the only
way lead poisoning can be detected.
Since lead paint has been found in a unit in this building, it is quite possible that your unit
may have lead paint too. If you have children under six years of age, you are advised to speak
to your landlord about having your apartment inspected for lead paint. You can call your local
board of health for a lead inspection, or call 1-800-532-9571 for further advice. It is against
Massachusetts law for landlords to discriminate against tenants because of lead paint hazards
in their apartment, or to threaten or take reprisals against tenants.
You will receive a notice five days in advance of the date on which deleading will begin
in the unit stated above. While the deleading is being conducted, keep your children out of
the areas being worked on. Common hallways, staircases and porches may be deleaded. Use
an alternative staircase during this process. If your unit is on the same floor on which deleading
work is being done, be sure that your doorway is temporarily sealed with masking tape or similar
material so that fine lead dust cannot be blown in, around or under the door. If you do not
have an alternative means of exit from your apartment, speak to your landlord or the deleading
contractor, to coordinate the work. Check window sills and doorways for visible dust after
deleading. Lead dust can be cleaned-up with a high phosphate detergent, like tri-sodium phos-
phate. If you notice lead dust from deleading in your apartment, notify the deleading contractor.
Properly conducted, deleading work should not result in lead dust contamination of your
building. If lead paint dust or paint debris is not properly cleaned up at the end of the workday,
or if work areas are not properly contained to prevent dust and debris from being dispersed,
notify your landlord or call the Department of Labor and Industries at the numbers on the
reverse side of this notice.
lam F.Weld
3ovemor
tes D.Baker
ieeretary
d H.Mulligan
mmiasioner
glzt atrono zwepai fJkssao
(artcaitve/,�{�LCei�✓[eOa/f�Off�/L��O� ��jn�m�� tJCIYXCe&
`LP/JO/'flnent�YI4X.L(i ✓i.CalA
L t 4 ZGoiwtoi,r 'L%dtdkite
305 cforAtittee4 006E0,4.a 02130-3597
617-522-3700, `Fax 617-522-8735
Childhood Lead Poisoning
Prevention Program
800-532-9571
NOTICE TO OWNER AND TENANTS' RIGHTS AND REMEDIES
OLATION
has been determined that the residential premises or dwelling unit and common areas at the address
ed on the accompanying order contain dangerous levels of lead in paint or other coating in violation
M.G.L.C. 111, ss. 196 and 197 and 105 CMR 460.000,Regulations for Lead Poisoning Prevention and
Introl. The owner of the residential premises is required by M.G.L. C.111, S. 197 to abate lead
Rations whenever a child under 6 years of age resides on the property or in special cases when directed
local or state authorities.
its violation endangers or materially impairs the health, safety or well-being of persons occupying the
emises. The violation was not caused by the occupants of the premises nor by any person(s) acting
der the control of the occupants.
NANTS' RIGHTS AND REMEDIES
le presence of the above violation entitles the occupants of the premises to the following statutory rights
d remedies. These remedies are somewhat complex and occupants are advised to obtain legal assistance
d/or legal advice before using any of them.
(1) Alternative Housing. M.G.L. C. s.197 and 105 CMR 460.160(A) require that a dwelling unit
or residential premises shall not be occupied while deleading is being conducted. The residential
premises or dwelling unit cannot be reoccupied until deleading is completed, it is cleaned up ac-
cording to procedures specified in 105 CMR 460.160 (D), and it meets the conditions of a reoccu-
pancy reinspection specified in 105 CMR 460.760(A). It is the responsibility of the landlord and
tenant to work out an acceptable plan for alternative housing and any costs associated with alter-
native housing and/or rent abatement. Tenants under lease and tenants at will have legal rights
applicable to this circumstance and are advised to seek legal assistance in those circumstances
in which a satisfactory arrangement cannot be reached.
(2) Protection From Retaliatory Rent Increase 2 Eviction. The landlord may not increase rent or
evict occupants in reprisal for their having reported a violation or suspected violation of the
Lead Law. Landlords'who threaten or take reprisals against a tenant for exercising his/her
rights under M.G.L. C. 111, ss. 190-199A are liable for damages under M.G.L. C. 186, s. 18
and M.G.L. C. 93a.
(3) Rent Withholding. (M.G.L. C. 239, s. 8A) After the landlord has been notified of the lead paint
violations,the occupants may withhold rent as long as lead paint violations remain uncorrected,
provided that they are up to date in rent when they start rent withholding. To fully protect
themselves against attempted evictions, occupants may need to place withheld monies in an
escrow (separated savings) account. If these conditions are met, occupants may not be evicted
for non-payment of rent or for any other cause which is not the fault of the occupants.However,
However, as soon as the violation is certified as having been corrected, all withheld monies may
have to paid to the owner.
(4) "Rent Receivership". M.G.L. C. 111, ss. 127C to 127J). The occupants and/or the Childhood
Lead Poisoning Prevention Program may petition the court to allow rent to be paid into court
rather than to the owner, provided that the occupant is up to date in rent. The court may then
appoint a "receiver" who may spend as much of the rent money as is needed to correct the viola-
tion.
(5) Abatement of Rent. May be awarded through a court action under decisions of the Massa-
chusetts Supreme Court Judicial Court case, Boston Housing Authority vs. Hemingway, 293
NE3d 831, 363 Mass. 184 (1973). In such an action, the court determines the value of the
premises with violations and reduces the amount of rent due.
(6) Landlord Liability - Compensatory and Punitive Damages. Pursuant to M.G.L. C. 111, s. 199,
the owner of any residential premises is financially liable for all damages associated with a case
of childhood lead poisoning arising from his/her failure to abate lead paint, plaster or other lead
hazards when a child under six years of age will reside or resides in the premises. The owner
of any dwelling unit or residential premises, who is notified of a dangerous level of lead in paint,
plaster or other material present upon his or her premises, and who does not satisfactorily cor-
rect or remove the dangerous conditions, shall in addition to actual damages, be subject to puni-
tive damages, which are three times the actual damages found.
REPAINTING
Violations of the Lead Law constitute violations of the State Sanitary Code. Although repainting of
surfaces from which lead paint or other coatings have been removed is not required for compliance with
he Regulations for Lead Poisoning Prevention and Control, repainting of such surfaces is required under
he State Sanitary Code, 105 CMR 410.021. It is important that deleaded surfaces be sealed and can be
)asily cleaned. Repainting of deleaded surfaces may not occur until after the surfaces have been
-einspected while bare and approved for repainting by a licensed lead inspector.
Repainting of deleaded surfaces on the interior of the dwelling unit and interior common areas must be
:ompleted within thirty days of the reoccupancy reinspection. Exterior surfaces must be repainted within
shirty days of the compliance reinspection.
This requirement does not apply to surfaces where lead paint has been covered or a new fixture or
surface installed to replace a leaded one.
Tenants are advised to call their local board of health if the required repainting is not completed as
dipulated above.
Revised
D5/03/93
MASSACHUSETTS DE ARTMEHT Or PUBLIC HEALTH
ChilOnooC L.\C Pol•onlnp Pr.nntlon Program•
30t South Btr.•t, Boston 02130
Date Posted:
Owner:
Address:
This dwelling contains
DANGEROUS
Lead Paint which is
Hazardous to the health
of small Children .
This notice may not be
removed until all premises
have been found to comply
with General Laws
c . 111 s . 197 .
DATE 14___ Per Order