BALTIMORE LEAD PAINT DEFENSE - RENTAL HOUSING LEAD TOXICITY RISK : CHARLES JEROME WARE, LLC, (410) 720-6129

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       BALTIMORE RENTAL HOUSING LEAD TOXICITY RISK REVIEW

1. Name of Building:

2. Address of Building:

3. Age of Building:

     Built before 1940 = 3

     Built between 1940 and 1960 = 2

     Built between 1961 and 1977 = 1

4. Exterior Condition of Building

     Peeling Paint                          0  1  2  3  4

     Rotted, Painted Wood           0  1  2  3  4

     Broken, Painted Masonry     0  1  2  3  4

     Other (describe)                     0  1  2  3  4  _____________________________

5. Interior Condition

     Peeling Paint On Walls          0  1  2  3  4

     Broken Plaster On Walls       0  1  2  3  4

     Water Leaks                            0  1  2  3  4

     Painted Windows                     0  1  2  3  4

     Painted Woodwork                 0  1   2  3  4

6.  Reported Cases of Lead Poisoning

     In Building = 3

     In Housing Complex = 2

     In Neighborhood = 1

7.  Demographic Risk Factors

      Single Mother Households                                    0  1  2  3  4

      Residential Units With Children Under 7           0  1  2  3  4

TOTAL  SCORE  (Add all numbers) : ____________________

ESTIMATED RISK OF LEAD TOXICITY ::

            LOW ( total of 0  to  5)   __________________

            MEDIUM ( total of 6 to 10) -----------------------

           HIGH ( total of 11 or higher) ______________