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Run: Lead-Based Paint Visual Assessment and Disclosure Log

Log lead-based paint disclosures and visual assessments for pre-1978 housing units in one place. Use it to track what was disclosed, what was observed, and w...

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Property and Unit Information

Property Name (required)

Unit Number or Identifier (required)

Property Address (required)

Year Built (required)

Is this unit or property built before 1978? (required)

Disclosure Record

Was the lead-based paint disclosure provided? (required)

Disclosure Date (required)

Disclosure Delivery Method (required)

Was tenant acknowledgment received? (required)

Acknowledgment Date

Visual Assessment Details

Assessment Date (required)

Assessor Name (required)

Assessment Scope (required)

Assessment Result (required)

Hazard Observations and Corrective Actions

Hazard Location (required)

Observed Condition (required)

Describe the observed condition without collecting unnecessary personal information.

Are interim controls or repairs needed? (required)

Follow-Up Due Date

Corrective Action Notes

Attestation and Audit Trail

Submitter Name (required)

Submitter Role (required)

Compliance Notes

Use this field for brief audit trail notes only. Do not include unnecessary PII.

I attest that this record is accurate to the best of my knowledge and was completed in accordance with applicable HUD lead-based paint documentation requirements. (required)

Yes No N/A

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Email (required)

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