C.M.R. 06, 096, ch. 424, app 096-424-B.1
This residence (or child occupied facility) at _____________________________ is certified as LIMITED LEAD-SAFE (Lead-based paint and dust only) (address)
A (lead inspection or risk assessment) (as defined by the Maine Department of Environmental Protection's Lead Management Regulations 06-069 C.M.R. ch. 424) for the presence of lead-based paint hazards limited to lead-based paint and lead dust, was completed on ______________________. I certify that there were no lead-based paint 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. Soil sampling was not conducted. Owners and residents should presume that any bare soil is a potential lead hazard. (Optional: Also, the property owner has a written program for performing essential maintenance practices that, when properly implemented, will correct any 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 this residence.) A reevaluation of this property is due to be completed no later than ________________________; this certificate is no longer valid after that date.
_______________________Signature of Lead Inspector or Risk assessor
__________________ Maine Certification # ________________ Date
C.M.R. 06, 096, ch. 424, app 096-424-B.1