HomeMy WebLinkAbout0054 ELM STREET - Health 54 ELM STREET, HYANNIS
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Poisoning
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LEAD DETERMMI ATI NS REPORT FORM
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Date .of Dete ina i an: a
Inspector: AM
License #:
Method used: vodium, Sulfide Expiration date:
X-Ray Fluorescence Model:
Serial :
�•-�.." ' ""a"��/ �o Apt• n
Property Address:
hescription of Proper y: J
Single family
Multi-family units
Garage
Fence
Other structures
Age of Property: Pre-1978
Post-1978
Occupant:
° Ewl
Occupants I der .s2xx y rs of age:
e/ /V(.T, DOB:
. 4AI G' DOB:
DOB:
Occupant 's Telephone
• T o
Property Owner(s) : d lid Q_
owner' s Address: r
owner' s Telephone: ^� -
An X-ray fluorescence reading greater than 1. 3 mg/cm2 or a gray or
black reaction to sodium.sulfide indicates an illegal level of lead
and constitutes a positive determination.
Any removal, replacement, or covering of lead paint as a result of
this report or subsequent inspection must be performed only by a
k, deleading contractor licensed by the Department of Labor and
MW Industries.
UM
175
SOURCE Pb
LOCATION
Window parting N
1, Child' s bedroom bead/exterior sill area
2. Child' s bedroom
Window sill
Window parting
3. Living room bead/exterior sill area
Window parting
4 . Kitchen bead/exterior sill area
_ Flaking Paint
5, Interior. . ...
6. Exterior
Flaking paint
Cellar window units
7 . Exterior
Window sills below 5 '
g, Exterior Main entry door or door .�
9, Exterior casing
Outside corner of baseboard
10. Interior
11.
ir rail
itchen or Bathroom Cha
K
1
Window sill
2. Bathroom
13 . Exterior
Threshhold
Interior hallway Stair tread or stringer
14 .. I
(common area)
Balusters
15. Interior hallway
(common area) I
Door casing
16. Interior hallway I
(common area)
Stair read o= rises
117 . I Porch I I
I ailing, cap I
18. Porch .
19. Porch
Balusters J
. I
Support, columns
20. Porch (<6" diameter or square) I
Staircase stringer I
21. Porch
Bulkhead I
22. Exterior amb
Door casing or- 7
Garage/Outbuilding
176
24. Interior Closet door or baseboard
(uncapped)
25. Interior Cabinet door, shelf, or
/n�
wall
126. G ,ltO . .
27. o
a
S/
28.
29
30.
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i
•,1 tLf���, .
} 177