RRP Test Kit Documentation Form

Owner Information

• Name of Owner/Occupant

• Address

• City, State, Zip

• Contact #

• Email

Renovation Information

• Renovation Address

• Unit #

• City, State, Zip

• Certified Firm Name

• Address

• City, State, Zip

• Contact #

• Email

• Certified Renovator Name

• Date Certified

Test Kit Information

• Test Kit #1

• Manufacturer

• Manufacturer Date

• Model:

• Serial/Lot #

• Expiration Date:

• Test Kit #2

• Manufacturer

• Manufacturer Date

• Model:

• Serial/Lot #

• Expiration Date:

• Test Kit #3

• Manufacturer

• Manufacturer Date

• Serial/Lot #

• Expiration Date:

• Model:

Test Kit Documentation Form Part 2

• Renovation Address:

• Unit #

• City, State, Zip

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

• TEST LOCATION #

• Test Kit Used

  Select Test Kit 1 Test Kit 2 Test Kit 3

  • Test Kit 1
  • Test Kit 2
  • Test Kit 3

• Description of Test Location:

• Result: Is Lead Present<br>

  Yes

  No

  Presumed

• Add media

  Media

Certified Renovator Signature

• Add signature

  Sign