California Lease Agreement - Rental Inspection Checklist Page 8
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17Disclosure of Information on Lead-Based Paint and/or Lead-
Based Paint Hazards
Lead Warning Statement
Housing built before 1978 may contain lead-based paint. Lead from paint, paint chips, and dust can pose
health hazards if not managed properly. Lead exposure is especially harmful to young children and
pregnant women. Before renting pre-1978 housing, lessors must disclose the presence of known lead-
based paint and/or lead-based paint hazards in the dwelling. Tenants must also receive a federally
approved pamphlet on lead poisoning prevention.
Landlord’s Disclosure
(a) Presence of lead-based paint and/or lead-based paint hazards (check (i) or (ii) below):
(i) ____ Known lead-based paint and/or lead-based paint hazards are present in the housing
(explain):
____________________________________________________________________________________
_____________________________________________________________________.
(ii) ____ Lessor has no knowledge of lead-based paint and/or lead-based paint hazards in the
housing.
(b) Records and reports available to the lessor (check (i) or (ii) below):
(i) ____ Lessor has provided the lessee with all available records and reports pertaining to lead-based
paint and/or lead-based paint hazards in the housing (list documents below):
____________________________________________________________________________________
______________________________________________________________________.
(ii) ____ Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint
hazards in the housing.
Tenant’s Acknowledgment (initial)
(c) ________ Tenant has received copies of all information listed above.
(d) ________ Tenant has received the pamphlet Protect Your Family from Lead in Your Home.
Agent’s Acknowledgment (if any) (initial)
(e) ________ Agent has informed the landlord of the landlord’s obligations under 42 U.S.C. 4852d and is
aware of his/her responsibility to ensure compliance.
Certification of Accuracy
The following parties have reviewed the information above and certify, to the best of their knowledge, that
the information they have provided is true and accurate.
Lease Agreement
8 / 17
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business