Form New Lead Clearance Questionnaire

LEAD CLEARANCE QUESTIONNAIRE 15Jan13-6pm page 5

To: Grantees receiving Lead Hazard Control funding

QuanTech has been tasked to obtain information about your experience conducting clearance testing on your Lead Hazard Control (LHC) grant. Please answer the following questions based on your organization’s experience during the last 12 months. If you have any questions, contact either Gary Dewalt at 610-255-5525 or Eugene Pinzer at 202-402-7685.

1. Regarding this HUD Lead Hazard Control grant, please indicate (check one) whether your organization is:

___ a. The grantee

___ b. A subgrantee

___ c. A contractor to the grantee or a subgrantee

2. Please indicate (check one) the category that best describes your organization:

___ a. State/local health department

___ b. State/local community development, or economic development department

___ c. State/local community buildings or housing development department

___ d. Non-governmental organization

___ e. Certified abatement contractor

___ f. Certified renovation firm

___ g. Risk assessment firm

___ h. Other, please specify: ___________________________________________

3. What triggers recruitment of homes into the grant? (Please check all that apply)

___ a. Abatement order from a Health Department as a result of a child with an elevated blood lead level

___ b. Notice from a Health Department of a child with an elevated blood lead level

___ c. Building code, housing code, or other code violation

___ d. Combining lead hazard control work with other rehabilitation or modernization work

___ e. Transfer of ownership or occupancy

___ f. Lead dust levels in the home are above the lead hazard standards

___ g. Presence of deteriorated lead-based paint in the home

___ h. Neighborhood characteristics

___ i. Outreach and recruiting drives.

___ j. Other, please specify: ________________________________________

________________________________________

4. If you selected more than one trigger in the previous question, please rank the (up to three) most frequent triggers (1 = most frequent trigger, for example, a, or b, or c, etc.).

1. ______

2. ______

3. ______

5. On how many dwelling units have you performed lead hazard control work and clearance testing in the past 12 months? ________

6. Please circle the code for the most common type of dwelling you worked on:

TYPE OF DWELLING: Code

Detached Single Family House 1

Duplex/Triplex 2

Row House/Town House 3

Low Rise Apartment (1-3 Floors) 4

High Rise Apartment (>3 Floors) 5

Mobile/Manufactured Home 6

Other 7 Please specify: ______________________

7. For that most common type of dwelling, please circle the approximate percentage of that type of dwelling out of all of the dwellings you worked on (circle one):

Percentage

0-10 11-25 26-50 51-80 81-100

8. Please circle the code for the most common range of construction dates of the dwellings you worked on:

Code

1990 to Present 1

Between 1978 and 1989 2

Between 1960 and 1977 3

Between 1946 and 1959 4

Between 1940 and 1945 5

1939 or Before 6

Don’t Know 8

9. For that most common range of construction dates, how often were dwellings in that range out of all of the dwellings you worked on (circle one):

Percentage

0-10 11-25 26-50 51-80 81-100

10. After lead hazard controls have been conducted, what cleaning procedures do you typically use prior to clearance testing (check all that apply):

___ a. HEPA vacuuming

___ b. HEPA/Wet wash/HEPA cycle

___ c. Wet detergent wash using trisodium phosphate

___ d. Wet detergent wash using a general purpose cleaner

___ e. Other, please specify: ________________________________________

________________________________________

11. If you selected more than one cleaning procedure in the previous question, please rank the (up to three) most frequent cleaning procedures (1 = most frequent cleaning procedure, for example, a, or b, or c, etc.).

1. ______

2. ______

3. ______

12. How often, when doing lead hazard control work, did you seal a floor, replace a floor, or overlay a rough floor with smooth cleanable flooring before clearance testing?

Percentage of Units

0-10 11-25 26-50 51-80 81-100

13. In the last 12 months, what percentage of floors tested failed to pass clearance on the first try? ______% If 0% skip to question 15

14. In the last 12 months, what percentage of floors failing clearance on the first try also failed to pass clearance on the second try? ______%

15. After a clearance failure on a floor, please identify the type of action taken and roughly how often (percent) this action was used to achieve clearance (percents need not add to 100 if more than one action was used to ensure clearance):

a. Re-cleaning only (% of all units): ______%.

b. Sealing (% of all units): ______%.

c. Replacement (% of all units):______%.

d. Overlaying (% of all units): ______%.

e. Other (% of all units):____%. Please specify: _________________________

_________________________

16. How many dust wipe clearance samples on floors were collected in the past 12 months? _______

17. How many dust wipe clearance samples on windowsills were collected in the past 12 months? _______

18. What is the reporting limit of your laboratory for floor lead dust wipe samples (generally indicated by a less-than sign (<) preceding the laboratory reported result)? _____ µg/ft²

19. For units passing clearance in the last 12 months, how often were your floor clearance levels in the following ranges (please make entries in each of the five questions a through e below; use an entry of 0 for no clearance levels in a given range):

a. What percent of all floor samples were reported as "less than" (below the laboratory’s reporting limit for floor samples)? _____%

b. What percent of all floor samples below 40 µg/ft² were 30 to 39 µg/ft²? _____%

c. What percent of all floor samples below 40 µg/ft² were 20 to 29 µg/ft²? _____%

d. What percent of all floor samples below 40 µg/ft² were 10 to 19 µg/ft²? _____%

e. What percent of all floor samples below 40 µg/ft² were below 10 µg/ft² _____%

20. In the last 12 months, what percentage of windowsills tested failed to pass clearance on the first try? ______% If 0% skip to question 22

21. In the last 12 months, what percentage of windowsills failing clearance on the first try also failed to pass clearance on the second try? ______%

22. After a clearance failure on a windowsill, please identify the type of action taken and roughly how often (percent) this action was used to pass clearance (percents need not add to 100 if more than one action was used to ensure clearance):

a. Re-cleaning only (% of all units): ______%

b. Sealing (% of all units): ______%

c. Replacement (% of all units):______%

d. Other (% of all units):____%. Please specify: __________________________

23. For units successfully passing clearance in the last 12 months, how often were your final windowsill clearance levels in the following ranges (please make entries in each of the five questions a through e below; use an entry of 0 for no clearance levels in a given range):

a. What percent of all windowsill samples were reported as "less than" (below the laboratory’s reporting limit for windowsill samples)? _____%

b. What percent of all windowsill samples below 250 µg/ft² were 200 to 249 µg/ft²? ____%

c. What percent of all windowsill samples below 250 µg/ft² were 150 to 199 µg/ft²? ____%

d. What percent of all windowsill samples below 250 µg/ft² were 100 to 149 µg/ft²? ____%

e. What percent of all windowsill samples below 250 µg/ft² were below 100 µg/ft²? ____%

24. In the last 12 months, what percentage of window troughs tested failed to pass clearance on the first try? ______% If 0% skip to question 22

25. In the last 12 months, what percentage of window troughs failing clearance on the first try also failed to pass clearance on the second try? ______%

26. After a clearance failure on a window trough, please identify the type of action taken and roughly how often (percent) this action was used to pass clearance (percents need not add to 100 if more than one action was used to ensure clearance):

a. Re-cleaning only (% of all units): ______%

b. Sealing (% of all units): ______%

c. Replacement (% of all units):______%

d. Install tough liner (% of all units):_____%

e. Other (% of all units):____%. Please specify: __________________________

27. For units successfully passing clearance in the last 12 months, how often were your final window trough clearance levels in the following ranges (please make entries in each of the five questions a through e below; use an entry of 0 for no clearance levels in a given range):

a. What percent of all window trough samples were reported as "less than" (below the laboratory’s reporting limit for window trough samples)? _____%

b. What percent of all window trough samples below 400 µg/ft² were 300 to 399 µg/ft²? ____%

c. What percent of all window trough samples below 400 µg/ft² were 200 to 299 µg/ft²? ____%

d. What percent of all window trough samples below 400 µg/ft² were 100 to 199 µg/ft²? ____%

e. What percent of all window trough samples below 400 µg/ft² were below 100 µg/ft²? ____%

END OF QUESTIONNAIRE. THANK YOU FOR PARTICIPATING