Jump to main content or area navigation.

Contact Us

Enforcement in New England

Lead-Based Paint
Pre-Renovation Rule
Tip/Complaint Form

Directions: Complete as much as possible. Fields with an asterisk * are required.

1.

(a.) Name, address, and telephone number of Contractor(s):

Name:*
Street:*
City:*
State:*
ZIP:*
Phone:*
Alternate Phone:

(b.) Name, address and telephone number of Property owner(s) and/or manager(s):

Name:
Street:
City State: ZIP:
Phone:
Alternate Phone:

(c.) Address of residence where alleged violation occurred:

Street:
City State: ZIP:

(d.) Your name, address, and telephone number:

You are a: if other:
Name:
Street:
City: State: ZIP:
Phone:
Alternate Phone:
E-mail:

2. General Information

(a.) Was the residence built before 1978?*
   
(b.) Do children currently live in the residence?*
   
(c.) If yes, what are their ages?
   
(d.) Are there children with elevated blood lead levels at this address?*
   
(e.) Type of Housing:* If other:

3. Renovation

(a.) Type of renovation work that was completed:
If other:
   
(b.) Start date of renovation work:
   
(c.) Did the renovator disturb more than 6 square feet of interior painted surface?
   
(d.) Did the renovator disturb more than 20 square feet of exterior painted surface?

4. Notification

(a.) Did Owner/Tenant receive an EPA-approved lead hazard information pamphlet ("Renovate Right" pamphlet)
   
(b.) Did Owner/Tenant receive written notification prior to start of renovation?
   
(c) Is the renovation work still ongoing?

5. Comments

 

Serving Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, & 10 Tribal Nations

Jump to main content.