HomeMy WebLinkAboutLead Assessment - 01/26/1999 OJH<OJH
ON THE WATER
A lead assessment was done at 2101 Minerva on 1/26/99.
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G
Sue Zinth, RN
OSHKOSH PUBLIC HEALTH DIVISION
The XK -3 is an instrument used to measure the presence of lead.
LEAD LEVELS DETECTED USING XK LEAD: IN-PAINTANALYZERI
!Sampling Address: 2/o/ /1/2 er va, . DATE OF SAMPLING: //a 6 /9?
iNO. SURFACE INSPECTED 1 P ee t Isus e atp 1ST 2ND 1. 3RD , AVE.* (AC TION
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17` 1
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19 I I I 1
20
21
22
23
24 1 1 1
25
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Paint Code: 1st digit 1 =Good. Paint intact and does not chalk. 2 =Fair. Largely intact with cracks & chipping.
(two digits) 3 =Poor. Peeling, chalking, blistering, flaking, or separated from substrate.
2nd digit T= Evidence of teeth marks N =No evidence of teeth marks
Substrate Code: 01 =Wood 02= Plaster 03= Drywall 04= Ceiling Tile 05 =Brick 06 =Stone 07= Concrete
08= Concrete/Cinder block 09= Stucco 10= Aluminum Siding 11= Asbestos/Cement Siding 12 =Metal I3 =Other
Action Code t = . MONITOR 3. Minimum HEPA- vacuum, phosphate wash & dean water
rinse, re -paint or vamish, let dry, seal with polyurethane or
other durable coating then monitor. If it can't be maintained
2 = Minimum phosphate wash & dean water rinse, re -paint see Lead Veld Option attachment or long term solutions.
where needed then monitor.
e 3,71.nf ) , J 1 A/t/
* NOTE: The above values are expressed in mg. /sq.cm. of lead. Inspector
These values are 'apparent' lead concentrations, not corrected concentrations.
Corrected levels were not calculated because they require destructive scrapping.
LEAD INSPECTION FORM
LEAD SWABS
NAME
•
ADDRESS 02 /0/ NV // er ' DATE //Qt / 7
CITY /ZIP Ot, Akoc f'/ / /) / j 90/
1ST FLOOR
TRIM DOORS WINDOWS CEILINGS WALL$ FLOORS
ROOM
REMARKS
LIVING
DINING
KITCHEN re -Er i T
PANTRY
BATHROOM
BEDROOM t
BEDROOM •
•
. LOO -
•
TRIM DOORS WINDOWS CEILINGS WALLS FLOORS
ROOM
REMARKS •
-- ,
BEDROOM •
BEDROOM
BEDROOM
BATHROOM O iu t . not
EXTERIOR
TRIM DOORS WINDOWS CEILINGS WALLS FLOORS
ROOM
REMARKS
PORCH
SIDING p M211111
GARAGE
SHED J •
OTHER
TRIM DOORS WINDOWS CEILINGS WALLS FLOORS
ROOM
_ REMARKS
REMARKS
BASEMENT
•
0
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/) fir T C, z f/r�nc� 7!1 u �i i" 9 /' c'v
( +) positive for lead /
( -) negative for lead INSPECTOR %// �J'/
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