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18 Notification of Deleading 1994 ii .AD) 9/86UDD Lruq an0 OJTJJo S r-,, - :Aurdmo:7 .---r74-nWg-eT 1u7171 77,y//�,jj7� J�SvW57.]0""-:pau6iS �p /��� a4v0 ° q1 9 '7iTeq put, a6pa)n3t aay/Ei ■ 30 aq] o, :.Ja>>oo pup or): cT u..icc=19.19ou rigs ri pauTrluoo uni]rm,yt'q at, ]uP ' 00'091 HWD SOT 'cuopelllfoj 1.,»uoD pur unpuane:d buTuofiod pra9 pup 'OD'tL 1 is 'cacl,e7nfai] LuTpWSTep ccOEngc.rtt 'W 7o gl Tranuow__.D aW pc.::clapun pur grq DL'S ■eq, 'AJr ,ad ;n esl■irued ml; lopun 'wugrlc Aga:oq peub1ETapun 041 iba:pid o1PO4CIH 3n la,riIad wiriS aq, uo pO ]( TT Ei eocime)d 71) un]caiumai TVS1 slr'p 15:0 ■cngocjGVW '9 Aouaby punuooro;Us Open/t1,T rut: 3T Naoa trDC. 'S 2 ;'.. v; 'r -n.,'U 'ITT.' UL - iLpi,cur_ DDT /..4a3c'S TVT2 IJnpui 3o u; luTAAG 'Eailcm.p:i par ,oa ru 3c ,uaw: ]rdag . '.Ta:; - t .l_!a] J:: ca:nq 'u:r.) c `rt../J'-au { uoq ' t FIT:. V'.; 'uTrrd prn'- e . ;aaT:s quo : SOU 'u:'eal'. =ii' r ._.._>Trnap mraho:a u- .TUa;.ulT fr2TucElOd pray p'"gpltq:: ' 2;SC0JTO '( Luc JT. 'cacl ,u' a^luapn.' aql Jc u1Jr.17.r.o.., tout:. 7TV '2 TUC f.:, , I ' ati, Jo E500droD • . •5u;pralap jr T fuTtm'Laq au: cc Ti pd cdrp -'Eea7 pr cuoc,ad Lu1ncllc; aql o3 pol.rnoad of ' 1; ET 'peal Jr Elena snCTa(urp 'p._ot le' .a“Puu o1.9i-E o : , . _ ..1st 'rn r! J • f.uucer- :u- lenouat : pcq;aw pur a,rp oq: ) 'OD 091 UWD Sel p':2 oe zz dic 1.4 ' ,ETS li: ': tnrg TraaUOD E,:eEn4)t LSpur ' '. 4( E::V r_: in "i. L :e.r q]Tr .urpooce ri MV 2 1 1994 DEPMTMEVf OF PUBLIC BFALT'd/DEPARTMENT OF LABOR 6 INDUSTRIES ora /sea NOTIFICATION OF DELEADING All sections of tide fora must be completed in order to comply with the notification requirements of M.G.L. C. III 5197 1VL�O.f LLIL—/ /� ?:CE SUNDER Lead Paint Inspector ///fJ /et? 125/{°<' eSua//te of 7n_Ipecr ion n/r� Contractor performing project/:- rJ14b% LGn l2ACf�iIr1 Llcensu $ CCe�O�/3 ,Address of Project A� Building Nome (if any) Floor Street Address /a /n%Che /,n✓ v Toe • city /kr /Arr+fr Inn Zip 0/(7100 / S-f Apt. 0o. 2- Deloeding Method: DRY SCRAPING HEAT GUN ENCAPSULATION DEMOLITION (circle ell thet apply) COWER SANDING (AJGTICS IlEPLACEMP 1 OTHER If "Other" selected, please explain Check one: dwelling Is Multi-family N./ single family Start date //A j f� .___ Completion Date ya?//3o when will work be done: am t/ pm weexemdo? Project Supervisor Name to/co/4r.J / �hiEldetl License I,pC 000.62„R Property Owner /nRrke4 Pf_sizcrAILS Address 7;0 "Wain ( 1 t City //O 7CLC_ state ±144 . Zip Telephone (q/3 ) d4& — / Sao In case of emergency, contact what per son r____ILGTAbf 1a Phone: Area code required da(5//3 ) a %- /7,70 evenln(Vf3) ,4-37- ?709 (OVER) 00343/5 rev 11/L6/d9