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 | Word | PDF | Word | PDF |
| Form 5.1 Building Condition Form for Lead Hazard Risk Assessment | Word | PDF | Word | PDF |
| Form 5.2 Report of Visual Assessment (for Lead Hazard Risk Assessment) | Word | PDF | Word | PDF |
| Form 5.3 Field Paint Chip Sampling Form | Word | PDF | Word | PDF |
| Form 5.4a Field Sampling Form for Dust. (Single-Surface Sampling) | Word | PDF | Word | PDF |
| Form 5.4b Field Sampling Form for Dust. (Composite Sampling) | Word | PDF | Word | PDF |
| Form 5.5 Field Sampling Form for Soil | Word | PDF | Word | PDF |
| Form 5.6 Questionnaire for a Lead Hazard Risk Assessment of More Than Four Rental Dwelling Units | Word | PDF | Word | PDF |
| Form 5.7 Format for an Executive Summary of a Lead Hazard Risk Assessment. | Word | PDF | Word | PDF |
Chapter 6: Ongoing LBP Maintenance |
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| Form 6.0 Report of Visual Assessment (for Ongoing Lead-Safe Maintenance). | Word | PDF | Word | PDF |
| Form 6.1 Report of Visual Assessment of Bare Soil for Lead-Safe Maintenance | Word | PDF | Word | PDF |
| Form 6.2 Log of Visual Assessments for Ongoing Lead-Safe Maintenance | Word | PDF | Word | PDF |
| Form 6.3 Lead-Based Paint Inventory | Word | PDF | Word | PDF |
| Form 6.4 Lead Hazard Control Inventory | Word | PDF | Word | PDF |
| Form 6.5 Lead-Safe Maintenance Work Order | Word | PDF | Word | PDF |
Chapter 7: LBP Inspection |
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| Form 7.1 and 7.5 Single-Family and Multifamily Testing LBP Testing Data Sheet | Word | PDF | Word | PDF |
| Form 7.2 Calibration Check Test Results | Word | PDF | Word | PDF |
| Form 7.3 Substrate Correction Values | Word | PDF | Word | PDF |
| Form 7.4 Selection of Housing Units | Word | PDF | Word | PDF |
| Form 7.6 Multifamily Housing: Component Type Report | Word | PDF | Word | PDF |
Chapter 13: Abatement by Encapsulation |
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| Form 13.1 Encapsulant Patch Test Documentation | Word | PDF | Word | PDF |
| Form 13.2 Lead-Based Paint Encapsulation Visual Monitoring Form | Word | PDF | Word | PDF |
Chapter 15: Clearance |
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| Form 15.1 Visual Assessment - Lead Hazard Clearance Examination. | Word | PDF | Word | PDF |
| Form 15.2 Field Sampling Form for Dust-Lead Hazard Clearance Examination (single-surface sampling) | Word | PDF | Word | PDF |
| Form 15.4 Clearance Report Review Worksheet | Word | PDF | Word | PDF |
Chapter 16: Investigation and Treatment of Housing with EBL Children |
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| Form 16.1 Resident Questionnaire for Investigation of Children with Elevated Blood Lead Levels (EBL) | Word | PDF | Word | PDF |