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1 A <br /> ENVIRONMENTAL INVESTIGATION <br /> The environmental professional (EP) has performed an environmental investigation on site and- <br /> tested paint, dust and soil. <br /> ❑ No paint, dust or soil lead hazards were found- <br /> 0 These/environmental lead hazards were found. <br /> ouf ` ion t'r ;rrt Gs 4 r' 6-¢ W avll rn;14-0W t/'s hm <br /> TI C 35033) 4uJ on nlsrgrA,zol !`r orr� <br /> cpas, 1 U T! GG,e 503 <br /> J This remediation was req/u, <br /> red. <br /> M,4-f- m 6, Z en !m d rrf-4c/P sad 1-r,,M0 R <br /> 11 ar // <br /> �ba - d u,r G ortf kt� �tG Lrt G ur S✓la tr i s,1 Gd lr'17 <br /> ® The family was informed of the lead hazards found and rernediations needed. <br /> 0 The property owner was notified of the lead hazards found and remediations required. <br /> ❑ Environmental clearance of the lead hazards on the property was achieved. <br /> ❑ Environmental clearance has not been achieved, as follows: <br /> w // a1a� SI aG//tolo�' /a d/ If"a�c� cY( fill roiell n r i La rG 1�� 'W/O/y� <br /> L?` in f a'Gr ,�1�rl�ett, a",t (.[1N3aflao, 0lf Go7hk d£ ,/MNt�t .Z� �1iT f/rq td H+u1f <br /> If you have any questions regarding the environmental investigation, please contact- <br /> / I-f Saw eem <br /> Environmental Proressional E-mail <br /> q) qtj-9�� _&o q)�'6F 939 2 <br /> Plionc Fax <br /> Most Likely Sources <br /> The PHN and EP think these are the most likely sources of this client's lead poisoning. <br /> LAI <br /> Ga►thrr„�f. �Qrf.n �S G�il�.s'd�tiv a�'�s. <br /> Signature of Public Health Nurse Date Signed <br /> A �W/ _ eiLo,/0g <br /> Signature of Environmental Professional Date Siened <br /> March 2004 Lead Poisoning Follow-up Form California Department of Health Services—CUPEt Appendix C <br />