Alphabetical List of Forms and Publications
The forms and
publications in this section are available from the Wisconsin Department of
Health Services (DHS), US Environmental Protection Agency
(EPA), or US Department of Housing and Urban Development (HUD). DHS
forms may either be downloaded and printed through the
provided links or the EPA publications may either be downloaded and printed through the
provided link or ordered through the
National
Lead Information Center.
Application
for Registration of Lead-Free or Lead-Safe Property(F44011, PDF, 48 KB)
Lead investigators performing a lead-free inspection
or lead-safe investigation can use this form to apply for
registration of a property.
Blood
Lead Lab Reporting (F00017, PDF, 101 KB) Health care
providers and laboratories can use this form to report blood lead test
results of Wisconsin residents. This form is also available
in Microsoft Word
Fillable format.
Certification
Application - Company (F00171, PDF,
16 KB)
Complete this form to apply for certification of a lead
company. This can also be completed for renewal of
certification.
Certification
Application - Individual (F44003, PDF,
36 KB)
Complete this form to apply for to become certified
to do lead hazard investigations or reduction work. This can also be completed for renewal of
certification.
Contractors/Painters/Home Remodelers: Look Out for Lead (P44529, PDF,
294 KB)
A
tri-fold pamphlet for contractors providing basic information to consider
before starting a remodeling job, such as using lead-safe work practices
and notifying families with young children about how to protect their
family from lead hazards in the home.
Coping
With Your Child's Diagnosis (Exit
DHS; PDF,
590 KB)
A booklet for parents/caregivers acknowledging the emotions experienced
when told a child has been lead poisoned.
Fact
Sheet: EPA and HUD Move to Protect Children from
Lead-Based Paint Poisoning; Disclosure of Lead-Based
Paint Hazards in Housing (Exit
DHS; PDF,
31 KB)
Help
Yourself to a Healthy Home (Exit
DHS; PDF,
1.3 MB)
A self-help booklet for
parents/caregivers that covers housing-related health issues such as
asthma, lead, etc.
Lead Abatement Worker, General Supervision
Qualification Affidavit (F44015, PDF,
12 KB)
A lead company must complete this form before a
lead abatement worker performs enclosure or
encapsulation abatement activities under general supervision.
Lead In Your
Home: A Parent's Reference Guide (Exit
DHS; PDF,
362 KB)
A 70-page illustration book with
information on lead poisoning prevention for parents of
young children living in a pre-1978 home with lead-based paint.
"Lead Paint Safety: A Field Guide
for Painting, Home Maintenance, and Renovation Work" in English
(Exit DHS; PDF, 1.3 MB) and
Spanish
(Exit DHS; PDF, 1.9 MB)
A step-by-step manual that
illustrates the safety precautions to take when painting, doing
maintenance or renovating in homes built before 1978.
Lead-Based
Paint Investigation Summary Report (F44013, PDF, 15 KB)
Lead investigation companies must complete this
form or file lead investigation reports on the
internet through WALDO. NOTE: This form is fillable and can be printed,
but cannot be saved.
The
Lead-based Paint Pre-Renovation Education Rule
(Exit DHS; PDF, 362 KB)
This handbook for contractors,
property managers, and maintenance personnel describes the requirements
that apply when more than 2 square feet of lead-based paint is
disturbed.
Lead-Free
Inspection Affidavit of Property Owner (F44014, PDF, 11 KB)
Lead Investigators performing a lead-free inspection
must have this completed form or a clearance report on file.
Lead-Free
/ Lead-Safe Property Registry, Training Course, Class and
Roster Database Access Application (F44010, PDF,12 KB)
Lead Investigators, contractors, and training
providers requesting access to the Wisconsin Asbestos Lead
Database Online must complete this application.
"Look Out for Lead: Where to Look" coloring sheet in
English (PDF, 869 KB)
and Spanish (PDF, 869
KB)
An activity sheet which identifies places in the home and yard where
lead hazards can be found.
Notification of
Lead-Based Paint Activity (F44012,
PDF, 26 KB)
Lead supervisors must complete and submit this
form before lead work takes place.
Nursing
Case Management Report (P44771A, PDF, 34 KB)
Nursing Case
Management Report (Word Fillable)
This form is used for case management of children with elevated blood lead
levels.
Nursing
Case Closure Report (P44771B, PDF, 26 KB)
Nursing Case
Closure Report (Word Fillable)
This form is used for case management of children with elevated blood lead
levels.
Occupant Protection
Plan (F44016, PDF, 26 KB)
The lead company must complete and submit this form
before lead work takes place, in
accordance with form instructions.
"Parents: Look Out for Lead" in
English
(P44535, PDF, 92 KB) and Spanish
(P44535S, PDF, 92 KB)
A
tri-fold pamphlet for parents and caregivers providing
basic information about blood lead testing, where to
look for lead hazards and what to do about them.
Property
Investigation Report (P44771C, PDF, 46 KB)
Property
Investigation Report (Word Fillable)
This form is used for property investigation of properties with children
with elevated blood lead levels.
Property
Investigation Closure Report (P44771D, PDF, 24 KB)
Property
Investigation Closure Report (Word
Fillable)
This form is used for property investigation of properties with children
with elevated blood lead levels.
"Protect Your Family From Lead in Your Home" in
English (Exit
DHS; PDF,
662 KB),
Spanish
(Exit DHS), Vietnamese
(Exit DHS; PDF, 936 KB), Russian
(Exit DHS; PDF, 664 KB),
Arabic
(Exit DHS; PDF, 611 KB), and
Somali (Exit
DHS; PDF,
281 KB)
Owners of pre-1978 housing are required
to give this to tenants when entering into or renewing a rental
agreement or to prospective buyers before the sale of a
home.
"Renovate Right: Important Lead
Hazard Information for Families, Child Care
Providers and Schools" in
English (PDF, 7 MB) and
Spanish
(PDF, 4.6 MB)
General information about
legal requirements for lead-safe work practices for
homeowners, tenants, child care providers and
parents during renovation activities.
"Rental
Property Owners: Look Out for Lead" (P44535B, PDF, 334 KB)
A
tri-fold pamphlet for rental property owners who own properties built
before 1978 that may contain lead hazard and may be occupied by families
with young children. Includes information on what can be done to correct
lead hazards and about the law to notify tenants about lead hazards and
how to prevent exposure to lead.
Request
for Repairs (F44018, PDF, 20
KB)
This form is to be given to tenants by the property owner of registered lead-safe
property before repairs commence.
Testing
Your Home for Lead (Exit
DHS; PDF,
204 KB)
This booklet explains the
process of testing your home for lead-based paint,
including the lead
investigator's role.
Visual
Inspection of Registered Lead-Safe Property (F44005, PDF, 11 KB)
Property owners of a registered lead-safe property are
to complete this form annually, to maintain certification.
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Page - Lead-Safe Wisconsin Last Revised:
April 08, 2013
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