Information

  • Conducted on

  • Prepared by

  • Location
  • Overall Store Grade. (0 to100%)

  • What issues are needed if any to enhance the lead program (If action items are needed please use DM. To Do list )

  • Select date

Paperwork

  • 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)

  • Lead "Renovate Right" Brochure signed off ?

  • Are the Renovate Right forms within the 60 day period?

  • Using new folder-Version with "lead"highlighted Form # Inf24 or equivalent being used and filled out correctly?<br>

  • Pre 1978 sign offs on contracts and being filled out correctly?

  • Is the lead acknowledgement form being filled out correctly #CF14-0713

  • Are the test results being given to the homeowner in a timely manner? (form# INF28)

  • Are the test result sheets being filled out correctly and are they testing in multiple locations on the outside

  • Are pictures being taken of the containment and clean up and placed into the folders?

  • Are the measure check lists being used?

  • 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?

  • Are the job clearance forms being filled out correctly? (INF 29 -0210_Checklist)

  • Are the Lead Safe Workers Forms being Used and filled out ? (NF33-0410)

  • Are all the Sub Contractors firm certified? <br>Please use box below to fill out details of sub crews

  • How many are firm certified and what are the expiration dates

Supplies For LSWP

  • Lead Cleaning wipes

  • Heavy Plastic Bags (Trash Bags)

  • LSWP Signs

  • Non Latex Gloves

  • Swiffers

  • Painters Tape / Duct Tape

  • Flash Lights for Clearance Testing

  • Poly 4/ mill Min on hand 6 Mill in some states (Plastic) 1.5 mill for zipwall or to cover furniture

  • Hepa Vacs Floor Model and a Tool Box Model (Make sure its usable with filters attached)

  • Hepa Filters for both models (Floor and Tool Box)

  • Respirators N/100,P/100 or Equivalent

  • Tack Pads

  • Disposable Coveralls

  • Lead swabs in stock

  • Caution tape in stock

  • Zip Wall Poles

LSWP - Job Visits

  • Is This Job a

  • Was the Job Clearly Marked with LSWP Signage?

  • Was the site taped off with caution tape ?

  • Were photos of the site take before and after ?

  • Was the site contained correctly? If no what are the reasons?

  • Was the site cleared correctly? If no what are the reasons?

  • Were the walls cleaned or wiped down with lead wipes?

  • Were the floors in the work area covered with plastic and taped down? If no why?

  • Were all the vents and air ducts covered ?

  • Was the Furniture removed or covered in the work area?

  • All door edges sealed off to rooms that are not being worked in?

  • Do the Crews and Mangers have Verification Cards on site? If not why not?

  • Were all the paint chips and debris picked up and protective sheeting misted ,folded dirty side inward, and Taped for removal

  • Is the Job posted with all the correct documents? (See list below )

  • Renovators Certificates

  • Workers Logs

  • Firm Certifications

  • Test Results sheet/s

  • Final Check Lists

  • Renovate Right Sign off (Note this must be within the 60 days )

  • 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

  • Number of trained renovators that are installers (Subs) Windows /Siding

  • Mangers/Service Techs that are trained Renovators

  • Patio Department that have Trained Renovators

  • Number of Subs that have there own firm Certification?

  • How much are the installers getting to do lead jobs? (per Window,Door,Garage door?)

  • How much are the installers getting to do lead jobs? (per siding job?)

Areas of needed Improvements

  • Areas to improve your lead program .

  • Division Managers Signature

  • Auditors Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.