144 Notification of Deleading 1996 (2) 1 +a1� he
,. _en (101 daps p i� to a
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n
Cl 450 LYS, 20. 00 Lea
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ter-
certify that I have .o:cplic with :Lc .i
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for :s
ce. that i qv~auent will
10,11cv t 10'0,-rink activities .r.., ..
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/,:OMMONWEALTA OE' IVSAS SAC:10.4'FTTO
Department of Labor & Industries and Lrpartrner.0
NOTIFICATION OF DELEADING WORK
AL 3 0 1996
T
All section, of this form SW15_ o . - te.1 _.. :du:
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as 0'a 22.CO and 105 am ,60.00E .,, ncs.. re_e_• , ,r.JNCF'iHAMPTON BOARD OF HEALTH
FILE yea
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Contractor performing project /0/O / t__�ys_Cet/ F/
Lead Paint Inspector d(/L
,ding work is being
License t; f
bic_771 -7
c
?.;dress of Project
__.Ld' nq Nome (i` anY)
rbLael- /r7/2
Deleading Method: get/iv Scrapings ..
_ J Fn^.psi:io:t Covering
please i ::Dinln
FA/
Owner 57.,,(6-‘7 (7:) [CA,-
P.t>< JO/
name yLnt� C 'vi ,P2 r
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