2012 HUD GUIDELINES FORMS

     

    Chapter 5: Risk Assessment

    ENGLISH VERSION

    SPANISH VERSION

    Form 5.0 Questionnaire for a Lead Hazard Risk Assessment of an Individual Occupied Dwelling Unit

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    Form 5.1 Building Condition Form for Lead Hazard Risk Assessment

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    Form 5.2 Report of Visual Assessment (for Lead Hazard Risk Assessment)

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    Form 5.3 Field Paint Chip Sampling Form

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    Form 5.4a Field Sampling Form for Dust. (Single-Surface Sampling)

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    Form 5.4b Field Sampling Form for Dust. (Composite Sampling) 

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    Form 5.5 Field Sampling Form for Soil

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    Form 5.6 Questionnaire for a Lead Hazard Risk Assessment of More Than Four Rental Dwelling Units

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    Form 5.7 Format for an Executive Summary of a Lead Hazard Risk Assessment.

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    Chapter 6: Ongoing LBP Maintenance

     

     

    Form 6.0 Report of Visual Assessment (for Ongoing Lead-Safe Maintenance).

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    Form 6.1 Report of Visual Assessment of Bare Soil for Lead-Safe Maintenance

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    Form 6.2 Log of Visual Assessments for Ongoing Lead-Safe Maintenance

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    Form 6.3 Lead-Based Paint Inventory

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    Form 6.4 Lead Hazard Control Inventory

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    Form 6.5 Lead-Safe Maintenance Work Order

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    Chapter 7: LBP Inspection

     

     

    Form 7.1 and 7.5 Single-Family and Multifamily Testing LBP Testing Data Sheet

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    Form 7.2 Calibration Check Test Results

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    Form 7.3 Substrate Correction Values

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    Form 7.4 Selection of Housing Units

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    Form 7.6 Multifamily Housing: Component Type Report

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    Chapter 13: Abatement by Encapsulation

     

     

    Form 13.1 Encapsulant Patch Test Documentation

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    Form 13.2 Lead-Based Paint Encapsulation Visual Monitoring Form

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    Chapter 15: Clearance

     

     

    Form 15.1 Visual Assessment - Lead Hazard Clearance Examination.

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    Form 15.2 Field Sampling Form for Dust-Lead Hazard Clearance Examination (single-surface sampling)

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    Form 15.4 Clearance Report Review Worksheet

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    Chapter 16: Investigation and Treatment of Housing with EBL Children

     

     

    Form 16.1 Resident Questionnaire for Investigation of Children with Elevated Blood Lead Levels (EBL)

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