Renovate 

Right

Renovate

Right

Important Lead Hazard 

Information for Families, 

Child Care Providers 

and Schools
It’s the Law!

Federal law requires that individuals receive certain information before

renovating six square feet or more of painted surfaces in a room for interior 

projects or more than twenty square feet of painted surfaces for exterior 

projects in housing, child care facilities and schools built before 1978.

n	Homeowners and tenants: renovators must give you this pamphlet 

before starting work.

n	Child care facilities, including preschools and kindergarten classrooms, 

and the families of children under the age of six that attend those facilities: 

renovators must provide a copy of this pamphlet to child-care facilities and 

general renovation information to families whose children attend those facilities.

Also, beginning April 2010, federal law will require contractors that disturb 

lead-based paint in homes, child care facilities and schools, built before 1978 

to be certified and follow specific work practices to prevent lead contamination. 

Therefore beginning in April 2010, ask to see your contractor’s certification.
1

Renovating, Repairing, or Painting?

n	Is your home, your building, or the child care facility or 

school your children attend, being renovated, repaired, 

or painted?

n	Was your home, your building, or the child care facility 

or school your children under age 6 attend, built 

before 1978? 

If the answer to these questions is YES, there are a 

few important things you need to know about leadbased paint.

This pamphlet provides basic facts about lead and 

information about lead safety when work is being done 

in your home, your building or the childcare facility or 

school your children attend.

The Facts About Lead

n	Lead can affect children’s brains and developing nervous systems, causing 

reduced IQ, learning disabilities, and behavioral problems. Lead is also harmful 

to adults. 

n	Lead in dust is the most common way people are exposed to lead. People 

can also get lead in their bodies from lead in soil or paint chips. Lead dust is 

often invisible.

n	Lead-based paint was used in more than 38 million homes until it was banned 

for residential use in 1978.

n	Projects that disturb lead-based paint can create dust and endanger you and 

your family. Don’t let this happen to you. Follow the practices described in this 

pamphlet to protect you and your family.
2

Who Should Read This Pamphlet?

This pamphlet is for you if you: 

n	Reside in a home built before 1978,

n	Own or operate a child care facility, including preschools and kindergarten 

classrooms, built before 1978, or

n	Have a child under six who attends a child care facility built before 1978.

You will learn:

n	Basic facts about lead and your health,

n	How to choose a contractor, if you are a property owner,

n	What tenants, and parents/guardians of a child in a child care facility or 

school should consider,

n	How to prepare for the renovation or repair job,

n	What to look for during the job and after the job is done,

n	Where to get more information about lead.

This pamphlet is not for:

n	Abatement projects. Abatement is a set of activities aimed specifically at 

eliminating lead or lead hazards. EPA has regulations for certification and 

training of abatement professionals. If your goal is to eliminate lead or lead 

hazards, contact the National Lead Information Center at 1-800-424-LEAD 

(5323) for more information.

n	“Do-it-yourself” projects. If you plan to do renovation work yourself, this 

document is a good start, but you will need more information to complete 

the work safely. Call the National Lead Information Center at 1-800-424-LEAD 

(5323) and ask for more information on how to work safely in a home with 

lead-based paint.

n	Contractor education. Contractors who want information about working 

safely with lead should contact the National Lead Information Center at 

1-800-424-LEAD (5323) for information about courses and resources on 

lead-safe work practices.
3

Lead and Your Health

Lead is especially dangerous to children 

under six years of age. 

Lead can affect children’s brains and 

developing nervous systems, causing:

n	Reduced IQ and learning disabilities.

n	Behavior problems.

Even children who appear healthy can have 

dangerous levels of lead in their bodies.

Lead is also harmful to adults. In adults, low 

levels of lead can pose many dangers, including:

n	High blood pressure and hypertension.

n	Pregnant women exposed to lead can transfer

lead to their fetus. 

Lead gets into the body when it is swallowed 

or inhaled.

n	People, especially children, can swallow lead dust as they eat, play, and 

do other normal hand-to-mouth activities.

n	People may also breathe in lead dust or fumes if they disturb lead-based paint. 

People who sand, scrape, burn, brush or blast or otherwise disturb lead-based 

paint risk unsafe exposure to lead.

What should I do if I am concerned about my family’s exposure to lead? 

n	Call your local health department for advice on reducing and eliminating 

exposures to lead inside and outside your home, child care facility or school. 

n	Always use lead-safe work practices when renovation or repair will disturb 

lead-based paint. 

n	A blood test is the only way to find out if you or a family member already 

has lead poisoning. Call your doctor or local health department to arrange 

for a blood test.

For more information about the health effects of exposure to lead, visit

the EPA lead website at www.epa.gov/lead/pubs/leadinfo.htm or call 

1-800-424-LEAD (5323). 

There are other things you can do to protect your family everyday.

n	Regularly clean floors, window sills, and other surfaces.

n	Wash children’s hands, bottles, pacifiers, and toys often.

n	Make sure children eat a healthy, nutritious diet consistent with the USDA’s 

dietary guidelines, that helps protect children from the effects of lead.

n	Wipe off shoes before entering house. 
4

Where Does the Lead Come From?

Dust is the main problem. The most common way to get lead in the body is from 

dust. Lead dust comes from deteriorating lead-based paint and lead-contaminated 

soil that gets tracked into your home. This dust may accumulate to unsafe levels. 

Then, normal hand to-mouth activities, like playing and eating (especially in young 

children), move that dust from surfaces like floors and windowsills into the body. 

Home renovation creates dust. Common renovation activities like sanding, 

cutting, and demolition can create hazardous lead dust and chips. 

Proper work practices protect you from the dust. The key to protecting yourself 

and your family during a renovation, repair or painting job is to use lead-safe work 

practices such as containing dust inside the work area, using dust-minimizing work 

methods, and conducting a careful cleanup, as described in this pamphlet.

Other sources of lead. Remember, lead can also come from outside soil, 

your water, or household items (such as lead-glazed pottery and lead crystal). 

Contact the National Lead Information Center at 1-800-424-LEAD (5323) for 

more information on these sources.
5

10 20 30 40 50 60 70 80 90 100

Between

1940 - 1960

Between

1960 - 1978

Before 1940

24%

69%

87%

Percentage of Homes Likely to Contain Lead

Age of Homes

Checking Your Home for 

Lead-Based Paint

Older homes, child care facilities, and schools are more likely to contain 

lead-based paint. Homes may be single-family homes or apartments. They may 

be private, government-assisted, or public housing. Schools are preschools and 

kindergarten classrooms. They may be urban, suburban, or rural.

You have the following options:

You may decide to assume your home, child care facility, or school contains 

lead. Especially in older homes and buildings, you may simply want to assume 

lead-based paint is present and follow the lead-safe work practices described in 

this brochure during the renovation, repair, or painting job.

You or your contractor may also test for lead using a lead test kit. Test kits 

must be EPA-approved and are available at hardware stores. They include detailed 

instructions for their use. 

You can hire a certified professional to check for lead-based paint. These 

professionals are certified risk assessors or inspectors, and can determine if your 

home has lead or lead hazards. 

n	A certified inspector or risk assessor can conduct an inspection telling you 

whether your home, or a portion of your home, has lead-based paint and 

where it is located. This will tell you the areas in your home where lead-safe 

work practices are needed. 

n	A certified risk assessor can conduct a risk assessment telling you if your home 

currently has any lead hazards from lead in paint, dust, or soil. The risk assessor 

can also tell you what actions to take to address any hazards.

n	For help finding a certified risk assessor or inspector, call the National Lead 

Information Center at 1-800-424-LEAD (5323). 
6

For Property Owners

You have the ultimate responsibility for the safety of your family, tenants, 

or children in your care. This means properly preparing for the renovation and 

keeping persons out of the work area (see p. 8). It also means ensuring the 

contractor uses lead-safe work practices.

Beginning April 2010, federal law will require that contractors performing 

renovation, repair and painting projects that disturb lead-based paint in homes, 

child care facilities, and schools built before 1978 to be certified and follow 

specific work practices to prevent lead contamination.

Until contractors are required to be certified, make sure your contractor 

can explain clearly the details of the job and how the contractor will minimize 

lead hazards during the work.

n	Ask if the contractor is trained to perform lead-safe work practices and to 

see a copy of their training certificate.

n	Ask them what lead-safe methods they will use to set up and perform the 

job in your home, child care facility or school.

n	Ask if the contractor is aware of the lead renovation rules. For example, 

contractors are required to provide you with a copy of this pamphlet before 

beginning work. A sample pre-renovation disclosure form is provided at the 

back of this pamphlet. Contractors may use this form to make documentation 

of compliance easier. 

n	Ask for references from at least three recent jobs involving homes built 

before 1978, and speak to each personally.

Always make sure the contract is clear about how the work will be set up, 

performed, and cleaned.

n	Share the results of any previous lead tests with the contractor.

n	Even before contractors are required to be certified you should specify in the 

contract that they follow the work practices described on pages 9 and 10 of 

this brochure. 

n	The contract should specify which parts of your home are part of the work 

area and specify which lead-safe work practices should be used in those areas.

Remember, your contractor should confine dust and debris to the work area 

and should minimize spreading that dust to other areas of the home. 

n	The contract should also specify that the contractor clean the work area, verify 

that it was cleaned adequately, and re-clean it if necessary.

Once these practices are required, if you think a worker is failing to do what 

they are supposed to do or is doing something that is unsafe, you should:

n	Direct the contractor to comply with the contract requirements,

n	Call your local health or building department, or

n	Call EPA’s hotline 1-800-424-LEAD (5323). 
7

For Tenants, and Families of Children 

Under Age Six in Child Care Facilities 

and Schools

You play an important role ensuring the ultimate 

safety of your family. 

This means properly preparing for the renovation and 

staying out of the work area (see p. 8).

Beginning April 2010, federal law will require that 

contractors performing renovation, repair and painting 

projects that disturb lead-based paint in homes, child 

care facilities and schools built before 1978 that a child 

under age six visits regularly to be certified and follow 

specific work practices to prevent lead contamination.

The law will require anyone hired to renovate, repair, or 

do painting preparation work on a property built before 

1978 to follow the steps described on pages 9 and 10 

unless the area where the work will be done contains 

no lead-based paint.

Once these practices are required, if you think a worker is failing to do what 

they are supposed to do or is doing something that is unsafe, you should:

n	Contact your landlord,

n	Call your local health or building department, or 

n	Call EPA’s hotline 1-800-424-LEAD (5323).

If you are concerned about lead hazards left behind after the job is over, you can 

check the work yourself (see page 10). 

If your property receives housing assistance from HUD (or a state or local agency 

that uses HUD funds), you must follow the more stringent requirements of HUD’s 

Lead-safe Housing Rule and the ones described in this pamphlet. 
8

Preparing for a Renovation

The work areas should not be accessible to occupants while the work 

occurs. The rooms or areas where work is being done may be blocked off or 

sealed with plastic sheeting to contain any dust that is generated. The contained 

area will not be available to you until the work in that room or area is complete, 

cleaned thoroughly, and the containment has been removed. You will not have 

access to some areas and should plan accordingly.

You may need:

n	Alternative bedroom, bathroom, and kitchen arrangements if work is 

occurring in those areas of your home.

n	A safe place for pets because they, too, can be poisoned by lead and can 

track lead dust into other areas of the home.

n	A separate pathway for the contractor from the work area to the outside, in 

order to bring materials in and out of the home. Ideally, it should not be through 

the same entrance that your family uses.

n	A place to store your furniture. All furniture and belongings may have to be 

moved from the work area while the work is done. Items that can’t be moved, 

such as cabinets, should be wrapped in heavy duty plastic.

n	To turn off forced-air heating and air conditioning systems while work is done. 

This prevents dust from spreading through vents from the work area to the rest 

of your home. Consider how this may affect your living arrangements.

You may even want to move out of your home temporarily while all 

or parts of the work are being done.

Child care facilities and schools may want to consider alternative 

accommodations for children and access to necessary facilities.
9

During the Work

Beginning April 2010, federal law will require 

contractors that are hired to perform renovation, 

repair and painting projects in homes, child care 

facilities, and schools built before 1978 that disturb 

lead-based paint to be certified and follow specific 

work practices to prevent lead contamination.

Even before contractors are required to be certified 

and follow specific work practices, the contractor 

should follow these three simple procedures, 

described below:

1. Contain the work area. The area should be

contained so that dust and debris do not escape

from that area. Warning signs should be put up

and heavy-duty plastic and tape should be used 

as appropriate to:

n Cover the floors and any furniture that cannot be moved.

n Seal off doors and heating and cooling system vents.

These will help prevent dust or debris from getting outside the work area.

2. Minimize dust. There is no way to eliminate dust, but some methods make 

less dust than others. For example, using water to mist areas before sanding 

or scraping; scoring paint before separating components; and prying and 

pulling apart components instead of breaking them are techniques that 

generate less dust than alternatives. Some methods generate large amounts 

of lead-contaminated dust and should not be used. They are:

n	Open flame burning or torching.

n	Sanding, grinding, planing, needle gunning, or blasting with power tools 

 and equipment not equipped with a shroud and HEPA vacuum attachment. 

n	Using a heat gun at temperatures greater than 1100°F.

 3. Clean up thoroughly. The work area should be cleaned up daily to keep it as 

clean as possible. When all the work is done, the area should be cleaned up 

using special cleaning methods before taking down any plastic that isolates

the work area from the rest of the home. The special cleaning methods

should include:

n	Using a HEPA vacuum to clean up dust and debris on all surfaces, 

 followed by

n	Wet mopping with plenty of rinse water.

When the final cleaning is done, look around. There should be no dust, paint chips, 

or debris in the work area. If you see any dust, paint chips, or debris, the area 

should be re-cleaned.
10

For Property Owners: 

After the Work is Done

When all the work is finished, you will want to know if your home, child care 

facility, or school has been cleaned up properly. Here are some ways to check.

Even before contractors are required to be certified and follow specific work 

practices, you should:

Ask about your contractor’s final cleanup check. Remember, lead dust is often 

invisible to the naked eye. It may still be present even if you cannot see it. The 

contractor should use disposable cleaning cloths to wipe the floor of the work area 

and compare them to a cleaning verification card to determine if the work area was 

adequately cleaned.

To order a cleaning verification card and detailed instructions visit the EPA lead 

website at www.epa.gov/lead or contact the National Lead Information Center at 

1-800-424-LEAD (5323) or visit their website at www.epa.gov/lead/nlic.htm.

You also may choose to have a lead-dust test. Lead-dust tests are wipe 

samples sent to a laboratory for analysis.

n	You can specify in your contract that a lead-dust test will be done. In this case, 

make it clear who will do the testing.

n	Testing should be done by a lead professional.

If you choose to do the testing, some EPA-recognized lead laboratories will send 

you a kit that allows you to collect samples and send them back to the lab for 

analysis.

Contact the National Lead Information Center at 1-800-424-LEAD (5323) for lists 

of qualified professionals and EPA-recognized lead labs.

If your home, child care facility, or 

school fails the dust test, the area 

should be re-cleaned and tested again.

Where the project is done by contract, it 

is a good idea to specify in the contract 

that the contractor is responsible for 

re-cleaning if the home, child care 

facility, or school fails the test.
11

You may need additional information on how to protect yourself and 

your children while a job is going on in your home, your building, or 

childcare facility. 

n	The National Lead Information Center at 1-800-424-LEAD (5323) or 

www.epa.gov/lead/nlic.htm can tell you how to contact your state, 

local, and/or tribal programs or get general information about lead 

poisoning prevention.

• State and tribal lead poisoning prevention or 

 environmental protection programs can provide 

 information about lead regulations and potential

 sources of financial aid for reducing lead 

 hazards. If your State or local government has 

 requirements more stringent than those 

 described in this pamphlet, you must follow 

 those requirements.

• Local building code officials can tell you the 

 regulations that apply to the renovation work 

 that you are planning.

• State, county, and local health departments 

 can provide information about local programs, 

 including assistance for lead-poisoned children 

 and advice on ways to get your home checked 

 for lead.

n	The National Lead Information Center can also 

provide a variety of resource materials, including 

the following guides to lead-safe work practices.

Many of these materials are also available at 

www.epa.gov/lead/pubs/brochure.htm.

• Lead Paint Safety, a Field Guide for Painting, 

 Home Maintenance, and Renovation Work

• Protect Your Family from Lead in Your Home

• Lead in Your Home: A Parent’s Reference Guide

For Additional Information

For the hearing impaired, call the Federal Information Relay Service at 

1-800-877-8339 to access any of the phone numbers in this brochure.
12

EPA Regional Offices

EPA addresses residential lead hazards through several different regulations. EPA 

requires training and certification for conducting abatement, education about 

hazards associated with renovations, disclosure about known lead paint and lead 

hazards in housing, and sets lead-paint hazard standards. 

Your Regional EPA Office can provide further information regarding lead safety and 

lead protection programs at www.epa.gov/lead.

Region 1 

(Connecticut,

Massachusetts, 

Maine, New Hampshire, 

Rhode Island, Vermont)

Regional Lead Contact

U.S. EPA Region 1

Suite 1100

One Congress Street

Boston, MA 02114-2023

(888) 372-7341

Region 2

(New Jersey, New York, 

Puerto Rico, Virgin Islands)

Regional Lead Contact

U.S. EPA Region 2

2890 Woodbridge Avenue

Building 205, Mail Stop 225

Edison, NJ 08837-3679

(732) 321-6671

Region 3

(Delaware, Maryland, 

Pennsylvania, Virginia, 

Washington, DC, 

West Virginia)

Regional Lead Contact

U.S. EPA Region 3

1650 Arch Street

Philadelphia, PA 

19103-2029

(215) 814-5000

Region 4

(Alabama, Florida, 

Georgia, Kentucky, 

Mississippi, North Carolina, 

South Carolina, Tennessee)

Regional Lead Contact

U.S. EPA Region 4

61 Forsyth Street, SW

Atlanta, GA 30303-8960

(404) 562-9900

Region 5

(Illinois, Indiana, 

Michigan, Minnesota, 

Ohio, Wisconsin)

Regional Lead Contact

U.S. EPA Region 5

77 West Jackson Boulevard

Chicago, IL 60604-3507

(312) 886-6003

Region 6

(Arkansas, Louisiana, 

New Mexico, 

Oklahoma, Texas)

Regional Lead Contact

U.S. EPA Region 6

1445 Ross Avenue, 

12th Floor

Dallas, TX 75202-2733

(214) 665-6444

Region 7

(Iowa, Kansas, 

Missouri, Nebraska)

Regional Lead Contact

U.S. EPA Region 7

901 N. 5th Street

Kansas City, KS 66101

(913) 551-7003

Region 8

(Colorado, Montana, 

North Dakota, South Dakota, 

Utah, Wyoming)

Regional Lead Contact

U.S. EPA Region 8

1595 Wynkoop Street

Denver, CO 80202

(303) 312-6312

Region 9

(Arizona, California, 

Hawaii, Nevada)

Regional Lead Contact

U.S. Region 9

75 Hawthorne Street

San Francisco, CA 94105

(415) 947-8021

Region 10

(Alaska, Idaho, 

Oregon, Washington)

Regional Lead Contact

U.S. EPA Region 10

1200 Sixth Avenue

Seattle, WA 98101-1128

(206) 553-1200

EPA Contacts
13

CPSC 

The Consumer Product Safety

Commission (CPSC) protects the 

public from the unreasonable risk of 

injury or death from 15,000 types of 

consumer products under the agency’s 

jurisdiction. CPSC warns the public 

and private sectors to reduce exposure 

to lead and increase consumer 

awareness. Contact CPSC for further 

information regarding regulations and 

consumer product safety.

CPSC 

4330 East West Highway

Bethesda, MD 20814

Hotline 1-(800) 638-2772 

www.cpsc.gov

CDC Childhood Lead 

Poisoning Prevention Branch

The Centers for Disease Control 

and Prevention (CDC) assists state 

and local childhood lead poisoning 

prevention programs to provide a 

scientific basis for policy decisions, 

and to ensure that health issues are 

addressed in decisions about housing 

and the environment. Contact CDC 

Childhood Lead Poisoning Prevention 

Program for additional materials and 

links on the topic of lead.

CDC Childhood Lead Poisoning 

Prevention Branch

4770 Buford Highway, MS F-40

Atlanta, GA 30341

(770) 488-3300

www.cdc.gov/nceh/lead

HUD Office of Healthy Homes 

and Lead Hazard Control

The Department of Housing and 

Urban Development (HUD) provides 

funds to state and local governments

to develop cost-effective ways to 

reduce lead-based paint hazards in 

America’s privately-owned low-income 

housing. In addition, the office enforces 

the rule on disclosure of known lead 

paint and lead hazards in housing, 

and HUD’s lead safety regulations in 

HUD-assisted housing, provides public 

outreach and technical assistance, 

and conducts technical studies to help 

protect children and their families from 

health and safety hazards in the home. 

Contact the HUD Office of Healthy 

Homes and Lead Hazard Control for 

information on lead regulations, outreach efforts, and lead hazard control 

research and outreach grant programs.

U.S. Department of Housing 

and Urban Development

Office of Healthy Homes 

and Lead Hazard Control

451 Seventh Street, SW, Room 8236

Washington, DC 20410-3000

HUD’s Lead Regulations Hotline

(202) 402-7698

www.hud.gov/offices/lead/d

Other Federal Agencies

Current Sample Pre-Renovation Form

Effective until April 2010.

Confirmation of Receipt of Lead Pamphlet

o	I have received a copy of the pamphlet, Renovate Right: Important Lead Hazard 

Information for Families, Child Care Providers and Schools informing me of

the potential risk of the lead hazard exposure from renovation activity to be 

performed in my dwelling unit. I received this pamphlet before the work began.

Printed name of recipient Date

Signature of recipient

Self-Certification Option (for tenant-occupied dwellings only) —

If the lead pamphlet was delivered but a tenant signature was not obtainable, 

you may check the appropriate box below.

o	Refusal to sign — I certify that I have made a good faith effort to deliver the 

pamphlet, Renovate Right: Important Lead Hazard Information for Families, 

Child Care Providers and Schools, to the rental dwelling unit listed below at the 

date and time indicated and that the occupant refused to sign the confirmation 

of receipt. I further certify that I have left a copy of the pamphlet at the unit with 

the occupant.

o	Unavailable for signature — I certify that I have made a good faith effort to 

deliver the pamphlet, Renovate Right: Important Lead Hazard Information for 

Families, Child Care providers and Schools, to the rental dwelling unit listed 

below and that the occupant was unavailable to sign the confirmation of receipt. 

I further certify that I have left a copy of the pamphlet at the unit by sliding it 

under the door.

Printed name of person certifying Attempted delivery 

 date and time

lead pamphlet delivery

Signature of person certifying lead pamphlet delivery

Unit Address

Note Regarding Mailing Option — As an alternative to delivery in person, you may mail the 

lead pamphlet to the owner and/or tenant. Pamphlet must be mailed at least 7 days before 

renovation (Document with a certificate of mailing from the post office).

Future Sample Pre-Renovation Form 

This sample form may be used by renovation firms to document compliance with the 

Federal pre-renovation education and renovation, repair, and painting regulations.

Occupant Confirmation

Pamphlet Receipt

o	I have received a copy of the lead hazard information pamphlet informing me of the 

potential risk of the lead hazard exposure from renovation activity to be performed in 

my dwelling unit. I received this pamphlet before the work began.

Owner-occupant Opt-out Acknowledgment 

o	(A) I confirm that I own and live in this property, that no child under the age of 6 

resides here, that no pregnant woman resides here, and that this property is not a 

child-occupied facility. 

Note: A child resides in the primary residence of his or her custodial parents, legal 

guardians, foster parents, or informal caretaker if the child lives and sleeps most of the 

time at the caretaker’s residence.

Note: A child-occupied facility is a pre-1978 building visited regularly by the same 

child, under 6 years of age, on at least two different days within any week, for at least 

3 hours each day, provided that the visits total at least 60 hours annually.

If Box A is checked, check either Box B or Box C, but not both.

o	(B) I request that the renovation firm use the lead-safe work practices required 

 by EPA’s Renovation, Repair, and Painting Rule; or 

o	(C) I understand that the firm performing the renovation will not be required to use the 

 lead-safe work practices required by EPA’s Renovation, Repair, and Painting Rule. 

Printed Name of Owner-occupant

Signature of Owner-occupant Signature Date

Renovator’s Self Certification Option (for tenant-occupied dwellings only)

Instructions to Renovator: If the lead hazard information pamphlet was delivered 

but a tenant signature was not obtainable, you may check the appropriate box below.

o	Declined – I certify that I have made a good faith effort to deliver the lead hazard 

information pamphlet to the rental dwelling unit listed below at the date and time 

indicated and that the occupant declined to sign the confirmation of receipt. I further 

certify that I have left a copy of the pamphlet at the unit with the occupant.

o	Unavailable for signature – I certify that I have made a good faith effort to deliver 

the lead hazard information pamphlet to the rental dwelling unit listed below and that 

the occupant was unavailable to sign the confirmation of receipt. I further certify that 

I have left a copy of the pamphlet at the unit by sliding it under the door or by (fill in 

how pamphlet was left).

Printed Name of Person Certifying Delivery Attempted Delivery Date

Signature of Person Certifying Lead Pamphlet Delivery

Unit Address 

Note Regarding Mailing Option –– As an alternative to delivery in person, you may mail the 

lead hazard information pamphlet to the owner and/or tenant. Pamphlet must be mailed at 

least seven days before renovation. Mailing must be documented by a certificate of mailing 

from the post office.

Note: This form is not effective until April 2010.