Fill and Sign the For Possible Lead Based Paint Hazards is Recommended Prior to Purchase Form

Lead-Based Paint Disclosure (Sales) ________________________________________ ___________________ California _____________________ Street Address City State Zip Code WARNING! LEAD FROM PAINT, DUST, AND SOIL CAN BE DANGEROUS IF NOT MANAGED PROPERLY Disclosure of Information on Lead-Based Paint and/or Lead-Based Paint Hazards Lead Warning Statement Every purchaser of any interest in residential real property on which a residential dwelling was built prior to 1978 is notified that such property may present exposure to lead from lead-based paint that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence quotient, behavioral problems, and impaired memory. Lead poisoning also poses a particular risk to pregnant women. The Seller of any interest in residential real property is required to provide the buyer with any information on lead-based paint hazards from risk assessments or inspections in the Seller's possession and notify the buyer of any known lead-based paint hazards. A risk assessment or inspection for possible lead-based paint hazards is recommended prior to purchase. Seller'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) _____ Seller has no knowledge of lead-based paint and/or lead-based paint hazards in the housing. (b) Records and reports available to the seller (check (i) or (ii) below): (i) _____ Seller has provided the purchaser with all available records and reports pertaining to lead-based paint and/or lead-
Based paint hazards in the residential dwelling (ii) seller has informed the purchaser of the existence of all records and reports pertaining to lead-based paint and/or lead-based paint hazards (explain). (c) the residential dwelling is under seller's control in an area known to be known for lead paint hazards.   (d) seller has no knowledge that the property has lead paint. (e) the purchaser is not an individual who has a history or likelihood of acquiring or transmitting blood lead levels which exceed the action level. (f) seller has no knowledge that the purchaser may suffer lead-based paint skin effects. (g) seller has no knowledge that the purchaser is pregnant or could become pregnant while the property is under the seller's control. (h) seller has no knowledge of any history of adverse health effects or exposure for the purchaser or children residing in the home. (i) seller has no knowledge or records related to the purchaser's or children's history of exposure to lead from lead-based paint. (j) any report, inspection or risk assessment conducted on the property by a health authority or licensed or credentialed environmental health professional has been completed and the findings have been certified for accuracy and are available to the seller. (k) seller has an adequate system of recording and reporting on all lead-based paint and lead-based paint hazards in residential buildings in his/her possession and control. (l) seller is aware of all regulations and rules applicable to lead-based paint, including the California integrated lead service line (CILSS) act of 1990 (cal 90-820-a) (as amended) (1). (m) seller makes reasonable efforts to keep the property in a well-maintained and safe condition (a reasonable attempt to repair damaged paint is a good defense for liability) (2) for compliance with this section, seller must make all reasonable efforts within reasonable technical control to keep the property and buildings it owns in a lead-based paint-free condition, including but not limited to, cleaning lead-based paint surfaces, cleaning, spraying and flushing any lead-based paint surface with a chemical that has been approved by the EPA or another agency for removal of lead from paint, removing and flushing lead-based paint soil, and maintaining the property so that it complies with lead mitigation requirements set forth in other provisions of this part (3). (4) seller has been unable within a reasonable time to make all reasonable efforts to keep the