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Paint Hazards Child Inquiry

ANNUAL NOTICE FOR PREVENTION OF LEAD BASED PAINT HAZARDS—INQUIRY REGARDING CHILD
You are required by law to inform the owner if a child under six years of age resides or will reside in your dwelling or dwelling unit (dwelling/unit). Beginning on January 1, 2020, the term “resides” means that a child under six routinely spends 10 or more hours per week in the dwelling/unit. If such a child resides or will reside in the dwelling/unit, the owner of the building is required to perform an annual visual inspection of the dwelling/unit to determine the presence of lead-based paint hazards. IT IS IMPORTANT THAT YOU RETURN THIS FORM TO THE OWNER OR MANAGING AGENT OF YOUR BUILDING TO PROTECT THE HEALTH OF YOUR CHILD. If you do not respond to this notice, the owner is required to attempt to inspect your dwelling/unit to determine if a child under six years of age resides there.
If a child under six years of age does not reside in the dwelling/unit now, but does come to reside in it at any time during the year, you must inform the owner in writing immediately. If a child under six years of age resides in the dwelling/unit you should also inform the owner immediately if you notice any peeling paint or deteriorated surfaces in the dwelling/unit during the year. You may request that the owner provide you with a copy of any records required to be kept as a result of a visual inspection of your dwelling/unit.
Please complete this form and return one copy to the owner or his or her agent or representative by February 15th. Keep one copy of this form for your records.

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166-188 W4 Annual Lead Paint Form: Feedback Form
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