List of Attachments

Attachment 3. Blood Lead in JNC EI: List of Attachments

LIST OF ATTACHMENTS

1. Supporting Statement A

2. Supporting Statement B

3. JNC EI List of Attachments

4. Example of Prior EI Final Report

5. ATSDR Cleared Factsheets for Reducing Exposure to Lead

5A. Keep Lead Out of the Body by Eating Healthy Food

5B. Protect Your Family from Lead in Your Home

5C. Protect Your Family from Lead in Your Yard

5D. Safe Gardening in Lead-Contaminated Soil

5E. Pregnancy and Lead: Stay Healthy During Pregnancy

6. Privacy Impact Assessment Form

7. JNC EI Protocol (and Pertinent Appendices)

Appendix A: Background

Appendix C: Fact Sheets and Recruitment Material

C1. Exposure Investigation Fact Sheet

C2. Newton County Recruitment Flyer

C3. Jasper County Recruitment Flyer

C4. Social Media Recruitment Content

Appendix D: ATSDR Privacy Act Statement, Consent, Permission and Assent Forms

D1. ATSDR Privacy Act Statement

D2. ATSDR Adult Consent Form for Blood Testing

D3. ATSDR Parental Permission Form for Blood Testing (child under )

D4. ATSDR Child Assent Form for Blood Testing (minor non-participant)

D5. EPA Consent Form

D6. MDHHS Consent Form

Appendix E: ATSDR Data Collection Forms

E1. ATSDR JNC EI Questionnaire

E2. ATSDR Biological Testing Tracking Form

Appendix F: Environmental Sampling Protocols

Appendix G: Health and Safety Plan

Appendix H: Sample Results Letter to Participants

H1. ATSDR Results Letter

H2. EPA Sample Results Letter

Appendix I: Data Collection Forms Used by Partnering Agencies

I1. Home Schematic (Form 100)

I2. Interior Environmental Paint Assessment (Form 110)

I3. External Environmental Paint Assessment (Form 120)

I4. Dust Wipe Collection (Form 200)

I5. Soil Composite Sample Collection (Form 300)

I6. Private Well Water Collection (Form 400)

I7. Public Water Kitchen Tap Collection (Form 500)

8. Project Research Determination