Sample Renovation Recordkeeping Checklist

TSCA Section 402 and Section 404 Training and Certification, Accreditation and Standards for Lead-Based Paint Activities and Renovation, Repair, and Painting (Renewal)

attach08

RRP firm checklist / in-house or landlord / third party disclosure

OMB: 2070-0155

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Sample Renovation Recordkeeping Checklist
Name of Firm:
Date and Location of Renovation:
Brief Description of Renovation:
Name of Assigned Renovator:
Name(s) of Trained Worker(s), if used:
Name of Dust Sampling Technician,
Inspector, or Risk Assessor, if used:
___	 Copies of renovator and dust sampling technician qualifications (training certificates, certifications) on file.
___	 Certified renovator provided training to workers on (check all that apply):
		 ___	 Posting warning signs 	

	

___ Setting up plastic containment barriers

		 ___	 Maintaining containment 		

___ Avoiding spread of dust to adjacent areas

		 ___ Waste handling	 		

___ Post-renovation cleaning

		 ___	Test kits used by certified renovator to determine whether lead was present on components affected
				 by renovation (identify kits used and describe sampling locations and results):
___	 Warning signs posted at entrance to work area.
___	 Work area contained to prevent spread of dust and debris
		 ___	All objects in the work area removed or covered (interiors)
		 ___	HVAC ducts in the work area closed and covered (interiors)
		 ___	Windows in the work area closed (interiors)
		 ___	Windows in and within 20 feet of the work area closed (exteriors)
		 ___	Doors in the work area closed and sealed (interiors)
		 ___	Doors in and within 20 feet of the work area closed and sealed (exteriors)
		 ___	Doors that must be used in the work area covered to allow passage but prevent spread of dust
		 ___	Floors in the work area covered with taped-down plastic (interiors)
		 ___	Ground covered by plastic extending 10 feet from work area—plastic anchored to building and
				 weighed down by heavy objects (exteriors)
		 ___	If necessary, vertical containment installed to prevent migration of dust and debris to adjacent
				 property (exteriors)
___	 Waste contained on-site and while being transported off-site.
___	 Work site properly cleaned after renovation
		 ___	All chips and debris picked up, protective sheeting misted, folded dirty side inward, and taped
				 for removal
		 ___	Work area surfaces and objects cleaned using HEPA vacuum and/or wet cloths or mops (interiors)
___	 Certified renovator performed post-renovation cleaning verification (describe results, including the
		 number of wet and dry cloths used):
		
		 ___	If dust clearance testing was performed instead, attach a copy of report
___	 I certify under penalty of law that the above information is true and complete.
Name and title 								

Date
29


File Typeapplication/pdf
File TitleSample Renovation Recordkeeping Checklist
SubjectChecklist to help contractors comply with the recordkeeping requirements of the Renovation, Repair, and Painting (RRP) rule, whi
AuthorUS EPA, OCSPP, Office of Pollution Prevention and Toxics
File Modified2011-05-18
File Created0000-00-00

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