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Lead

EPA New England Lead-Based Paint Renovation, Repair & Painting Rule Tip/Complaint Form

All questions, tips or complaints about lead in drinking water should be directed to the Safe Drinking Water Hotline.

Directions: Complete as much as possible.

This form is for alleged violations in Connecticut, Maine, New Hampshire and Vermont.

For alleged violations occurring in:

Massachusetts
Please contact the Massachusetts Lead and Asbestos Program at (617) 626-6960
Rhode Island
Please contact the Rhode Island Department of Health at leadprogram@health.ri.gov, or call the HEALTH Information Line (401) 222-5960.
U.S. State Not Listed Here
Contact EPA using our Report Environmental Violations page.

1.

(a.) Name, Address, and Telephone Number of Contractor(s)

Name (Required)

Street

City

State (Required)

Zip Code

Phone

Alternate Phone

(b.) Name, Address and Telephone Number of Property Owner(s) and/or Manager(s)

Name

Street

City

State

Zip Code

Phone

Alternate Phone

(c.) Address of Residence or Child-Occupied Facility Where Alleged Violation Occurred

Street

City

State (Required)

*For alleged violations occurring in: Massachusetts; Rhode Island; a U.S. state not listed here, contact EPA using our Report Environmental Violations page.

Zip Code

(d.) Your Name, Address, and Telephone Number

You are a

if other

Name

Street

City

State

Zip Code

Phone

Alternate Phone

E-mail

2. General Information

(a.) Did the renovation, repair, or painting project disturb painted surfaces in a residence built before 1978 or a child-occupied facility? (Required)

Yes

Unknown

(b.) Do children currently live in the residence? (Required)

Yes

Unknown

(c.) If yes, what are their ages?

(d.) Are there children with elevated blood lead levels at this address? (Required)

Yes

Unknown

(e.) Type of Housing (Required)

if other

3. Renovation

(a.) Type of renovation work that was completed

if other

(b.) Estimated start date of renovation work

Month

Day

Year

(c.) Is the renovation work still ongoing? (Required)

Yes

Unknown

(d.) Was the renovation work conducted using lead-safe work practices (for example, covering work areas with taped-down plastic sheeting, cleaning all surfaces and objects by using a High Efficiency Particulate Air ("HEPA") vacuum cleaner or wiping with a damp cloth, and performing cleaning verification)? (Please provide more information in the comments section.)

Yes

Unknown

(e.) Would you be able to provide EPA New England with photographs and/or videos of the alleged violations? (Please provide URLs to the photos/videos in the comments section.) (Required)

Yes

Potentially

4. Comments

More information helps EPA respond more effectively. Please include all of the relevant details you may have.

Sending Photos/Videos Via E-Mail

Leave this field blank