C.M.R. 06, 096, ch. 424, app 096-424-B
This residence (or child occupied facility) at _____________________________ is certified as LEAD-SAFE (address)
A (lead inspection or risk assessment) (as defined by the Maine Department of Environmental Protection's Lead Management Regulations 06-096 C.M.R. ch. 424) for the presence of lead-based paint hazards and lead hazards other than lead in water (include if applicable), was completed on ______________________. I certify that there were no lead-based paint hazards or lead hazards (As applicable: in this residential unit and in this building's common areas) at the time this (lead inspection or risk assessment) was completed. Optional: ( Also, the property owner has a written program for performing essential maintenance practices that, when properly implemented, will correct any lead-based paint hazards or lead hazards that may develop due to normal wear and tear or direct damage of any lead-based paint that remains in the residence. Owners and occupants must comply with a mutually agreed upon plan for implementing essential maintenance practices as needed to maintain the "Lead-Safe" condition of the residence.) Reevaluation of this property is due to be completed no later than ____________________________; this certificate is no longer valid after this date.
_______________________Signature of Lead Inspector or Risk assessor
__________________ Maine Certification # ________________ Date
C.M.R. 06, 096, ch. 424, app 096-424-B