Rev.
3/
31/
01
ABATEMENT
PEMIT
MATERIALS
Department
of
Health
Environmental
Hedh
Administra@
on
Lead­&
sed
Paint
Abatement
Program
APPENDIX
P
***
DISTRICT
OF
COLUMBIA
STATE
LEAD
PERMITTING
AND
NOTIFICATION
FOR
LEAD
ABATEMENT
PROJECTS
­

­
District
of
Columbia
Government
Deparment
of
Health
Risk
Assessment,
Remediation
and
CertificationDivision
December
2000
***
GOVERNMENT
OF
THE
DISTFUCT
OF
COLUMBIA
Department
of
Health
Environmental
Health
Administration
Risk
.
tssessnient,
Remediation
.
ind
Certification
Program


December
1,
2000
Dear
ContractorBusiness
Entity:

Please
be
informed
that
effective
November
30,
1999,
all
contractors,
consultants,
and/
or
business
entities
conducting
Lead­
Based
Paint
Abatement
and
related
services,
as
defined
by
the
District
of
Columbia
Code
6­
997.1(
I),
within
the
District
of
Columbia
are
required
to
obtain
a
permit
(
per
District
of
Columbia
Code
6­
997.7)
and
pay
the
associated
fee.

Permit
applicatiodnotificationsare
to
be
sent
to
the
Department
of
Health
at
least
ten
(
10)
business
days
prior
to
conducting
a
Lead­
Based
Paint
Abatement
project.

Please
submit
your
applicatiodnotificationsto:

Department
of
Health
Environmental
Health
Administration
Bureau
of
Hazardous
Material
and
Toxic
Substances
RiskAssessment,
Remediation
and
Certification
Program
51
N
Street,
N.
E.,
3rdFloor
Washington,
D.
C.
20002
Attn:
Mr.
Alexander
Okechukwu
An
application
is
enclosed
for
your
use.
If
you
have
any
questions,
please
contact
Mr.
Okechukwu
at
(
202)
535­
2690.

Sincerely,

Richard
N.
Bres
Program
Manager
Enclosure
RB/
ca
51
1Street,
>.
E.,
Third
Floor,
\\
ashington,
D.
C'.
20002
TEL
(
202)
­
335­
2690
F.
iS
(
202)
533­
1423
3
CERTIFICA'ITON,
ACCREDITATION,
TESTING,
PERMl'ITING
AND
NOTIFICATION
REOUIREMENTS
.

L
Inspector
24
hours
(
hands­
on)
8
hours
Risk
Assessor
16
hours
(
hands­
on)
4
hours
Supervisor
32
hours
(
handsa)
~

8hours
Project
Designer
32
(
hands­
on)
(
Supervisor
+
8
hours)
worker
16
hours
(
hands­
on)
8
hours
Abatement
ProjectlConunercial
Yes
(
storedoffices)

Inspector
I
Yes
Fee:
$
300
Fee:
$
300
Fee:
$
300
Fee:
$
300
Fee:
$
60
SuDervisor
I
Project
Designer
No
I
Individud
Discblines
I
Yes
I
I
1
Business
I
Yes
Homeowner
with
elevated
blood
lead
No
level
child
Elderly
*
Yes
Elderly
with
elevatedblood
lead
level
No
child
I
Zero
Bedroom
I
Yes
Built
after
1978
I
Yes
Individual
Disciplines
YeS
Individual
Disciplines
(
inspector,
Yes
supervisor,
&
risk
assessor)
*
Elderly
column
refers
to
housing
specificallyfor
the
elderly
If
applicant
hasnot
received
trainingfrom
a
D.
C.
accredited
provider,
then
a
D.
C.
refresher
will
be
required.

The
two
part:
discipline
exam
and
the
D.
C.
specific
exam
arerequired.
Lfit
is
determined
that
anapplicant's
initialexam
is
equivalent
to
D.
C.'
s
core
exam,
then
only
the
D.
C.
specific
exam
would
be
required.
1
INSTRUCTIONS
FOR
LEAD­
ABATEMENT
PERMIT
APPLICATION
AND
PROJECT
NOTIFICATION
Per
D.
C.
Code
g
6­
997.7,
contractors
who
conduct
lead­
based
paint
abatement,
as
defmed
in
D.
C.
Code
5
6­
997.1(
1),
in
the
District
of
Columbia
shall
obtain
a
permit.
Permits
are
required
for
alllead­
based
paint
abatement
projects,
regardless
of
type
of
structure
or
building
and
size
of
the
abatement
project,
Please
read
and
follow
these
instructions
when
completing
the
application.

1.
Please
include
the
address
of
the
abatement
property,
lot,
square
number,
and
Wad,
if
applicable.
2.
Please
check
the
type
of
notifcation.
If
thisis
an
amended
notification
or
you
wish
to
cancel
a
former
notification,
please
indicate
the
Permit
Number
you
were
issuedforas
project.
3.
Print
or
type
name
and
address
of
the
lead
abatement
contractor.
4.
Print
or
type
the
name
and
telephone
number
of
the
contractor s
contact
person
for
thisparticular
project
5.
Print
or
type
the
contractor s
District
of
Columbia
Business
Entity
certificationnumber.
6.
Print
or
type
the
name
of
the
assigned
supervisor
for
thisproject.
7.
Print
or
type
the
telephone
number
and
beeper
or
cellular
telephone
number
for
the
assigned
supervisor.
8.
Print
or
type
the
property
owner
(
FullName);
and
if
Merent
from
the
abatement
address,
print
or
type
the
address
of
the
property
owner.
9.
Describe
the
present
use
of
the
property
or
structure;
i.
e.,
residential
building,
commercial
building,
bridge,
tower,
etc.
10.
Print
or
type
the
approximatedate
the
facility/
struclurewas
built.
A
year
will
suffice.
11.
Print
or
type
the
approximateamount
of
lead­
based
paint
to
be
abated.
12.
Print
or
type
the
type
of
lead
abatement
method
to
be
employed;
ie.,
removal,
encapsulation,
replacement,
etc..
13.
Print
or
type
the
provisions
for
medical
surveillance
and
worker
protection.
14.
Give
a
brief
description
of
the
areas
adjacent
to
the
abatementproject,
i.
e.,
residential
housinglapartment,
commercial
buildings,
office
buildings,
playground,
etc.
15.
Please
state
the
intended
disposal
site
of
generated
waste.
If
hazardous
waste
is
generated,
please
describe
how
you
intend
to
comply
with
the
hazardous
waste
requirements
of
Title
20
DCMR
Chaptea
40­
54.
16.
Please
state
the
amount
of
the
contract
to
conduct
the
abatement
If
the
project
involves
other
work
thatis
not
considered
lead­
based
paint
abatement;
doEt
include
thataspart
of
the
abatement
contract.
17.
Please
state
the
amount
of
abatementpermit
fee
submitted.
As
indicated
on
the
application,
permit
fee
equals
$
40.00plus
3%
of
the
abatement
cost
If
the
contract
for
lead­
abatement
is
for
$
2,000.00,
the
total
permit
fee
equals:
$
40.00+(.
03X$
2,000.00)=$
40.00+$
60.00=$
100.00
18.
Print
or
type
the
start
and
completion
dates
and
the
hours
in
which
lead
abatement
activities
will
be
conducted.
If
you
are
applyhg
for
the
permit
and
do
not
know
the
exact
start
dates,
you
may
leave
thisblank
and
notify
this
office
no
less
than
10
business
days
prior
to
the
start
of
the
project.
Also
provide
the
permit
number,
property
address,
project
supervisor s
name,
beeper
number
and
identify
the
name
of
the
abatement
contractor
on
the
notification.

Please
be
sure
to
sign
and
date
the
application,
and
include
the
attachments
that
are
required
to
be
submitted.
Upon
review
and
approval
of
the
application,
a
permit
will
be
issued.
The
pennit
will
be
valid
only
for
the
duration
of
the
project
or
for
one
year,
whichever
is
less.
Any
change
in
startor
completiondateswill
require
aa
amended
notification.
The
permit
must
be
maintained
at
the
project
site
at
all
times
and
available
upon
request
from
the
Department
of
Health
inspectors.^^
notification
must
be
submitted
ten
(
10)
business
days
prior
to
the
start
of
the
lead
abatement
project.
Please
submit
 0.
­

DEPARTMENT
OF
HEALTH
ENVIRONMENTAL
HEALTH
ADMINISTRATION
BUREAU
OF
HAZARDOUSMATERIAL
AND
TOXIC
SUBSTANCES
LEADPOISONINGPREVENTION
DIVISION
51
N
STREET,
N.
E.,
3RoFLOOR
WASHINGTON,
D.
C.
ZOO02
ATTENTION:
MR
ALEXANDER
OKECHUKWU
***
GOVERNMENT
OF
THE
DISTRICT
OF
COLUMBIA
­
­

1.

2.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.
DEPARTMENT
OF
HEALTH
ENVIRONMENTAL
HEALTH
ADMINISTRATION
BUREAU
OF
HAZARDOUS
MATERIAL
AND
TOXIC
SUBSTANCES
LEAD
POISONING
PREVENTION
DIVISION
LEAD­
BASEDPAINT
ABATEMENT
PERMIT
APPLICATION
ANDNOTIFICATION
PROPERTY
LOCATION/
ADDRESS:

SQUARE
#
LOT
#
WARD#

TYPE
OF
NOTIFICATION:
ORIGINAL
AMENDED
CANCEL
IF
NOT
AN
ORIGINAL
NOTIFICATION,
PRIOR
PERMIT
NUMBER
ISSUED:

ABATEMENT
CONTRACTOR:

ADDRESS:

CITY:
STATE:
ZIP
CODE:

CONTACT
NAME:

TELEPHONE
NUMBER:
FAX
NUMBER:

CONTRACTOR S
DISTRICTOF
COLUMBIALEAD
CERTIFICATION
NUMBER:

NAME
OF
SUPERVISOR
ASSIGNED
TO
THE
PROJECT:

SUPERVISORS
D.
C.
LEAD
CERTIFICATION
#

CONTACT
NUMBER
FOR
ASSIGNED
SUPERVISOR:
TELEPHONE
BEEPERKELL
PHONE
PROPERTY
OWNER:

ADDRESSOF
OWNER
(
if
Werent
from
project
location)

CITY:
STATE:
ZIP
CODE:

PRESENT
USE
OF
PROPERTY/
STRUCTURE:

DATE
THE
FACILITY/
BUILDING/
STRUCTURE
WAS
BUILT:

APPROXIMAm
AMOUNT
OF
LEAD­
BASED
PAINT
TO
BE
ABATED
(
in
square
or
linearfeet):

Square
Feet:
Linea
Feet:

DESCRIPTION
OF
LEAD
ABATEMENT
METHODS
TO
BE
EMPLOYED:

PROVISIONS
FOR
MEDICAL
SURVEILLANCE
AND
WORKERPROTECTION
3
PAGE
2
LEAD­
BASED
PAINT
ABATEMENT
PERMIT
APPLICATION
AND
NOTIF'ICATION
14.
DESCRIPTIONOF
AREA@)
IMMEDIATELYADJACENT
TO
ABATEMENT
SITE:

15.
LIST
THE
INTENDED
DISPOSAL
SITE
OF
GENERATED
WASTE,
AND
IF
HAZARDOUS
WASTE
IS
GENERATED,
PLEASE
DESCRIBE
THE
INTENDED
COMPLIANCE
WITHTHE
REQUIREMENTS
FOR
HAZARDOUS
WASTE
PRESCRIBEDBY
TITLE
1L20
DCMR
CHAPTERS
40­
54:

16.
AMOUNT
OF
ABATEMENT
CONTRACT:
$

17.
AMOUNT
OF
LEAD
ABATEMENT
PERMIT
FEE
SUBMITTED:
$

I
cerhfy
that
the
above
information
is
accurate,
true
and
correct
to
the
best
of
my
knowledge
and
that
all
lead
abatement
willbe
conducted
in
accordancewith
allapplicable
work
practice
standardsof
Federal
andDistrict
of
Columbia
laws.
I
also
cerhfy
that
any
hazardous
waste
generatedas
a
result
of
thisproject
will
be
Qsposed
of
in
compliance
with
the
requirementsfor
hazardous
waste
disposal
as
prescribedby
Title
20
DCMR
Chapters
40­
54.
Fully,
I
attest
that
only
appropriatelyD.
C.
certified
individualswillbe
used
for
all
abatementwork
and
that
no
outstanding
debts
are
owed
to
the
District
of
Columbia
Government.

Signatureof
ContractorEitle
Date
NOTE:
PLEASE
ENSURE
THE
FOLLOWG
AREATTACHED
WITH
THISNOTIFICATION:

COPY
OF
CONTRACTORSDISTRICT
OF
COLUMBIA
CERTIFICATON
*
COPY
OF
CONTRACTORSCURRENT
LIABILI'IY
INSURANCE,
INCLUDING
PROFESSIONAL,
E"
MENTAL
AND
GENERAL,
LIABILITY
COPY
OF
CONTRACT
FOR
THE
LEAD­
ABATEMENT
PROJECT
APPROPRIATE
PERMIT
FEE
(
make
check
or
money
order
payable
to
the
D.
C.
Treasurer;
applicationfees
are
non
refundable)
SCOPE
OF
WORK
OFFICE
USE
ONLY
DATE
RECEIVED
PROJECT
PERMIT
NUMBER.

LPPD
APPROVAL
BY:
SIGNATURE:
DATE:

APPROVED
0
PENDING
n
DENIED
0
.
NOTIFICATION
ASSIGNMENT
FOR
INSPECTION:
INSPECFOR
DATE:

18.
START/
COMPLETIONDATE@)
OF
PROJECT:
(
If
unknown
at
time
of
permit
application,
you
may
leave
blank
and
no@
this
office
no
less
than10business
days
prior
to
the
staxt
of
the
project:
Not6cations
may
be
faxed
to
Alexander
Okechukwuat
FAX
(
202)
535­
1423.

PERMIT
NUMBER:
PROPERTY
ADDRESS:

START
DATE:
COMPLETIONDATE:

WORKHOURS:
FROM
A.
M.
TO
P.
M.

PROJECT
SUPERVISOR:
BEEPER
NUMBER:

CONTRACTOR
NAME:
DEPARTMENT
OF
HEALTH
ENVlRONMENTAL
HEALTH
ADMlNISTRATION
CONSTRUCTION
PERMIT
APPLICATION
­
SUPPLEMENTAL
FORM
­
ENVIRONMENTAL
QUESTIONNAIRE
PROJECT
ADDRESS:
LOT:
SQUARE:
PROJECT
DESCRIPTION:

Note:
please
answer
all
11
questions
in
this
questionnaire,
by
checking
either
column
 
Yes 
or
 
No 
for
each
question.
If
you
answer
 
Yes 
to
any
Of
the
questions
1
­
IO,
you
should
contact
the
correspondingofficets)
indicated
in
column
 
contact
persodoffice 
as
soon
as
possible.
If
You
aqswer
Yes 
10
question
1I,
please
follow
the
instructions
in
the
column
 
contact
persodoffice .
Until
this
application
is
reviewed
and
approved
by
the
concerned
OffiCe(
s),
the
permit
will
not
be
issued.

SCOPE
OF
PROJECT
1
YES
NO
i1
1
Does
the
total
cost
of
the
project
exceed
$
1
million
(
based
on
1989
In
2000,
this
cost
is
$
1.380.000
This
does
not
apply
if
the
project
is
an
internal
renovation
only
and
there
1i
will
be
no
change
in
the
use
of
the
building
2
Will
the
proposed
use
involve
the
construction
of
a
facility
for
the
handling,
transfer,
storage,
disposal
or
treatment
of
solid
waste,
medical
waste,
or
recyclable
materials?

undergroundstorage
tank
(
UST)?

4
Will
the
work
to
be
performed
involve
theassessment
or
cleanup
of
groundwater
associated
with
the
release
of
rnatenals
from
an
underground
storage
tank
~
usT)?

Will
the
proposedproject
involve
the
installation
or
drilling
of
wells
other
than
for
the
purposes
stated
in
questions
3
and
4?

Will
the
proposed
project
involve
the
generation,
treatment.
storage,
disposal
or
transportation
of
chemicals
or
other
substances
which
may
be
considered
hazardous?

Will
the
proposedproject
involve
construction
which
will
disturb
the
sediment
in
rivers,
streams
or
wetlands?

8
Will
the
work
lo
be
performedinvolve
the
rostajlation.
removal.
abandonment,
or
repair
of
an
underground
storage
tank
(
UST)
system7
,
9
Will
the
proposed
project
result
in
the
discharge
into
the
air
of
1I
~

gases.
dust,
or
the
creation
of
any
objectionable
odors?

~
10
Will
the
proposed
project
involve
the
removal,
handling,
transportation,
disposal,
or
encapsulationof
asbestos?

i
 ­
Please
bring
with
you
a
copy
of
your
asbestos
survey,
ten­
day
notification
form,
and
asbestos
abatement
permit
fee
11
Was
the
building
built
before
19787
(
Lead­
basedpaint
may
be
present)

AFFID
OFFICE
USECONTACT
PERSOWOFFICE
(
InitiaVDate)

(
202)
535­
2289.
EIS
Coordinator.
EHA
(
202)
535­
2289.
 ISCoordinator,
EHA
(
202)
535­
2525,
UndergroundStorage
Tank
Division,
 HA
(
202)
535­
2250.
Air
Quality
Division,
EHA
(
202)
535­
2525,
UndergroundStorage
Tank
Division,
 HA
(
202)
535­
2190,
Water
Quality
Division,
 HA
(
202)
535­
2250,
Air
Quality
Division.
EHA
(
202)
535­
2190.
Water
Quality
Division,
EHA
(
202)
535­
2290,
Hazardous
Waste
Division.
 HA
(
202)
535­
2190,
Water
Quality
Division.
 HA
(
202)
535­
2525,
Underground
Storage
Tank
Division,
 HA
(
202)
535­
2250,
Air
Quality
Division.
EHA
(
202)
535­
2250,
Air
Quality
Division,
EHA
If
you
answer
 
Yes 
to
this
question,
please
answer
the
questions
and
follow
the
mstructionson
the
 
Lead
Hazard
Control
Questionnaire 
to
determine
if
you
need
a
permit
to
conduct
a
Lead
Abatement
Project
1!

2
,

1
I
hereby
certify
that
I
have
the
authority
of
the
owner
of
the
property
to
make
this
application.
I
declare
that
the
answers
to
the
above
questions
in
this
Questionnaire
are
complete
and
correct
to
the
best
of
my
knowledge.

Signature
Name
(
print)

Acid
ress
Date
Phone
OFFICE
USE
ONLY
__
__

COMMENTS
AND
PERMIT
RESTRICTIONS:

I
~~
.


US6
RtVtRSE
IF
NECESSARi
tHA
i~
m
k
li
99­
1300
­
Rev8580
36
i;!
DEPARTMENT
OF
HEALTH
ENVIRONMENTAL
HIAL T1­
tADMINIS 
I RA I ION
BUREAU
OF
tIAZARDO1lSMA Il<
RIALAND I OXIC
S[
IHSI ANCKS
RISK
ASSESSMENT,
RI~
ME~~
IA I ION,
DIVISION
(
RARCI))
ANI)
(
XR I IFI<~
A \ 
I ION
LEAD
t
I
AjrXRI)
CONI RO1,
QIJ
EST1ON
N
AI
RK
Project
Address:

Name
of
owner
Address
of
owner
Phone
#
Square
#­
Lot
#
Ward
#

Note:
Please
answer
all
questions
by
checking
 
YES 
or
 
NO .
If
you
answer
 
YES 
to
any
question,
contact
the
Risk
Assessment,
Remediation,
and
Certification
Division
at
5
1
N
Street,
N.
E.,
3 
d
Floor
or
call
(
202)
535­
2637
for
a
lead
abatement
permit
application.

AFFIDAVIT
I
hcrt.
hv
certifv
that
I
have
the
authority
to
represent
the
owner
of
the
property
and
to
answer
this
questionnaire.
I
declare
that
the
answers
to
the
atxw
questions
are
accurate,
true
and
complete
to
the
best
of 
my
knowledge.
FACT
SHEETS
AND
ANNOUNCEMENTS
FACTSHEET
Vot.
2
No.
2
November
1998
D.
C.
LAW
11­
221
 
LEAD­
BASED
PAINT
ABATEMENT
AND
CONTROL
ACT
OF
1996 ­

SUMMARY
The
Environmental
Health
Administration,
State
Lead
Certification
and
Training
Program
are
announcing
the
D.
C.
Law
I
1­
21I
 
Lead­
BasedPaint
Abatement
and
Control
Act
of
1996. 
This
law
regulates
the
removal
of
lead
in
the
District
of
Cdumbia
and
requires
person@)
contracted
to
lead
hazard
reduction
services
and
related
training
e
Workerflraining
discipline
fees
e
Abatement
Project
permit
fees.

Work
Practice
standards
and
procedures
for
condudng
lead­
based
pant
ha7ard
redudon
and
related
consumer
outreach/
education
advlties.

ENTITIES
EXEMPT
FROM
THE
LAW
0
Individuals
who
perform
e
Housing
constructed
after
I978
PENALTIES/
FINES
Entibes
in
wolabon
of
the
law
will
be
fined
and/
or
imprisoned
pursuant
to
the
Act.

FOR
MORE
INFORMATION
Please
contact:

D.
C
Department
of
Health
Environmental
Health
AdministratJon
Lead
Poisoning
Prevention
Division,
State
Lead
Certification
and
Training
Program
on
202­
442­
5828.

Pr
be
trained.
certified
and/
or
accredited,

EFFECTIVE
DATE
DC
Law
I
1­
22
I
became
final
on
January2,
1998.

WHAT
IS
REQUIRED?
.
i erson(
s)
engaged
to
remove.
remodel,
or
renovate
lead
painted
c>
tructuresmust
be
trained,

(
ertified
and/
or
accredited.

A
lead
abatement
permit
1
i
iiiit
be
obtained
at
least
lo
(
1.1
i
I
pi
lor
to
any
iead
I
~.~
luctiori
dctivitiej
I
ldbility
insurance
must
be
I
1
~

I
!

0
lead­
based
paint
activities
at
residences
which
they
own
unless
the
residence
is
occupied
by
a
non­
owner
or
non­
immediate
family
mernber(
s)
or
a
child
resides
or
frequently
visits
subject
property
who
is
younger
than
eight
years
old
Housing
for
the
elderly
or
persons
with
disabilities;
unless
any
child
under
the
age
of
eight
years
resides.
is
expected
to
reside
in
orr
egular­
lyvisits
such
housing
Any
zero
bedroom
unit.
such
ds
an
efficiency
apartment
 
0
fhtained
by
businesses
and
1
kk
Assessors
l
.
NOTICE
TO
THE
GENERAL
PUBLIC
LEAD­
BASEDPAINT
ABATEMENT
PERMIT
AND
NOTIFICATION
Effective
November
30,1999,
The
Department
of
Health,
Environmental
Health
AdministrationWill
begin
enforcing
Lead­
Based
Paint
Abatement
Permit
and
Notification
requirements
mandated
by
District
of
Columbia
Code
6­
997.7.

All
contractors
conducting
Lead­
Based
Paint
Abatement,
as
defined
by
D.
C.
Code
6.997.1(
l),
within
*
theDistrict
of
Columbia,
are
required
to
submit
a
notification,
pay
the
associated
fee,
and
obtain
a
permit,

Notifications
are
to
be
sent
to
the
Department
of
Health
at
least
ten
(
10)
business
days
prior
to
the
commencement
of
any
lead­
based
paint
abatement
project.

Permit
applications
are
available
at
the
Lead
Poisoning
Prevention
Division
located
at
51N
Street,
N.
E.
on
the
3  
floor
or
you
may
contact
Ms.
Susan
Mayo
at
202­
5351919

EFFECTIVE
NOVEMBER
30,1999
***
­
­
GOVERNMENT
OF
THE
DISTRICT
OF
COLUMBIA
Department
of
Health
ENVIRONMENTAL
HEALTH
ADMINISTRATION
LEAD
POISONING
PREVENTION
DIVISION
LEAD
ABATEMENT
PERMIT
Permit
Number
LP­
021
8
P
Date
2/
22/
00
E
Address
of
work:
3700
MASSACHUSETTS
AVE.
N.
W
lot
38
square1398
ward
##
­
3
R
Permission
is
hereby
granted
to:
WORCESTER
EISENBRANDT,
INC.

M
who
is
authorized
to
perform
the
work
described
herein
at
the
address
shown
above
in
strict
accordance
with
all
District
of
Columbia
and
Federal
Laws
I
T
Contractor
Distnct
of
Columbia
Certification
#
DC­
00490
Description
of
work:
WET
SCRAPE
EXTERIOR
STEEL
LINTELS;
USE
GRINDER
W/
HEPA
StarlingDate
2/
29/
00
Expiration
Date
09//
00
I
I
Dr.
Ivan
C.
A.
Walks
Director
Permit
Clerk
THIS
PERMIT
MUST
ALWAYS
BE
DISPLAYED
CONSPICUOUSLY
AT
THE
WORK
SITE
UNTIL
THE
PROJECT
IS
COMPLETED
IIPON
COMPLETION
OF
THIS
PROJECT,
NOTIFY
THE
LEAD
POISONING
PREVENTION
DIVISION
AT
(
202)
535­
2690
 
THIS
PERMIT
IS
ONLY
VALID
FOR
THE
DATES
NOTEDON
THIS
PERMIT.
YOU
MUST
NOTIFY
THE
LEAD
POISONING
PREVENTION
DIVISION
IF
THERE
IS
A
CHANGE
IN
START
DATE
OR
COMPLETION
DATE.
