Information
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Conducted on
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Prepared by
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Location
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What issues are needed if any to enhance the lead program (If action items are needed please use DM. To Do list )
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Select date
Paperwork
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Is the cities firm certification up to date and what is the expiration date ?<br>(Note some cities will have multiple firm certifications from other states)
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Lead "Renovate Right" Brochure signed off ?
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Are the Renovate Right forms within the 60 day period?
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Using new folder-Version with "lead"highlighted Form # Inf24 or equivalent being used and filled out correctly?<br>
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Pre 1978 sign offs on contracts and being filled out correctly?
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Is the lead acknowledgement form being filled out correctly #CF14-0713
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Are the test results being given to the homeowner in a timely manner? (form# INF28)
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Are the test result sheets being filled out correctly and are they testing in multiple locations on the outside
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Are pictures being taken of the containment and clean up and placed into the folders?
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Are the measure check lists being used?
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Are all the folders getting the correct documentation placed in them (Both Folders) with all the details of the install placed in the office folders?
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Are the job clearance forms being filled out correctly? (INF 29 -0210_Checklist)
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Are the Lead Safe Workers Forms being Used and filled out ? (NF33-0410)
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Are all the Sub Contractors firm certified? <br>Please use box below to fill out details of sub crews
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How many are firm certified and what are the expiration dates
Supplies For LSWP
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Lead Cleaning wipes
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Heavy Plastic Bags (Trash Bags)
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LSWP Signs
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Non Latex Gloves
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Swiffers
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Painters Tape / Duct Tape
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Flash Lights for Clearance Testing
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Poly 4/ mill Min on hand 6 Mill in some states (Plastic) 1.5 mill for zipwall or to cover furniture
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Hepa Vacs Floor Model and a Tool Box Model (Make sure its usable with filters attached)
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Hepa Filters for both models (Floor and Tool Box)
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Respirators N/100,P/100 or Equivalent
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Tack Pads
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Disposable Coveralls
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Lead swabs in stock
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Caution tape in stock
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Zip Wall Poles
LSWP - Job Visits
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Is This Job a
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Was the Job Clearly Marked with LSWP Signage?
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Was the site taped off with caution tape ?
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Were photos of the site take before and after ?
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Was the site contained correctly? If no what are the reasons?
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Was the site cleared correctly? If no what are the reasons?
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Were the walls cleaned or wiped down with lead wipes?
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Were the floors in the work area covered with plastic and taped down? If no why?
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Were all the vents and air ducts covered ?
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Was the Furniture removed or covered in the work area?
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All door edges sealed off to rooms that are not being worked in?
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Do the Crews and Mangers have Verification Cards on site? If not why not?
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Were all the paint chips and debris picked up and protective sheeting misted ,folded dirty side inward, and Taped for removal
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Is the Job posted with all the correct documents? (See list below )
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Renovators Certificates
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Workers Logs
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Firm Certifications
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Test Results sheet/s
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Final Check Lists
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Renovate Right Sign off (Note this must be within the 60 days )
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Was thee any issues that were not covered on this list if so please add them here? Pictures if needed also.
Numbers of Trained Personnel
Areas of needed Improvements
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Areas to improve your lead program .
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Division Managers Signature
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Auditors Signature