A representative of a certified firm may complete this sample form or a similar form when notifying EPA of lead-based paint abatement activities.
Paperwork Reduction Act Notice: This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2070-0195; EPA ICR No. 2507). The public reporting and recordkeeping burden for this collection of information is estimated to be 5,251,320 hours per year. Burden is defined in 5 CFR 1320.3(b). Responses to this collection of information are mandatory (40 CFR 745). An agency may not conduct or sponsor, and a person is not required to, respond to a collection of information unless it displays a currently valid OMB control number. You may send comments regarding the EPA's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Please include the OMB Control No. in any correspondence. Send only comments to this address.
You may need a PDF reader to view some of the files on this page. See EPA’s About PDF page to learn more.