Form Hea 5801 PDF Details

In an effort to safeguard public health, particularly from the hazards of lead exposure, the Ohio Department of Health has established a comprehensive protocol for the management of lead abatement projects through the use of the HEA 5801 form. This form serves multiple critical functions: it acts as a preliminary notification to the health department about planned lead abatement activities, thereby facilitating regulatory oversight and ensuring compliance with both state and federal health standards. The form requires detailed information about the project, including the identification of the lead abatement contractor, the start and end dates of the project, the specific type of abatement activities to be conducted, and the location of the project. Compliance with the mandate to submit this form well before the commencement of any lead abatement project—ten calendar days for standard notifications, or three days for those submitted via the online system—is crucial for lead abatement contractors. This process underscores the commitment of the Ohio Department of Health to prevent lead poisoning, particularly in environments occupied by vulnerable populations such as children in schools and childcare facilities. By mandating this formal notification process, the department aims to maintain a safe and healthy environment by minimizing the exposure risks associated with lead-based paint and other lead-containing materials.

QuestionAnswer
Form NameForm Hea 5801
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameshea5801 lead prior notification login form

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Do Not Write In This Space

Postmark

Date received

Notiication number

Ohio Department of Health • Lead Poisoning Prevention Program

Prior Notiication of Lead Abatement Projects

Carefully read all the instructions and questions prior to completing the notiication form

1.Each lead abatement contractor shall notify the department of health at least 10 calendar days prior to the commencement of a project as required by Chapter 3742 of the Ohio Revised Code and Chapter 3701-32 of the Ohio Administrative Code. If the on-line prior notiication system is utilized the project notiication period is reduced to no less than three days.

2.Three day notiications utilizing the on-line system shall be submitted via access from the Ohio Department of Health webpage www.odh.ohio.gov. Ten day written notiications shall be legibly completed and sent to the Ohio Department of Health, Division of Quality Assurance, Attn: Lead Poisoning Prevention Program, 3rd loor, 246 North High Street, Columbus, Ohio 43215. You may also e-mail the original notiication to lead@odh.ohio.gov.

3.Please complete all sections of the notiication. The notiication will be returned if any information is lacking. The appropriate waiting period will commence when all information requested is supplied.

4. Type of notiication: c Original

cCancellation

c Revision # ____________________ Revised section number(s) _______ ________ ________

Complete the following information. Please be accurate and speciic when giving locations, names and dates.

5. Building owner name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

City

 

State

 

 

ZIP

 

 

 

 

 

 

 

Contact person

 

 

 

Telephone #

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. Licensed Lead Abatement Contractor

 

 

 

 

 

 

 

 

 

 

 

 

License #

Expiration date

 

E-mail address

 

 

 

 

 

Employer

 

 

Telephone #

 

 

 

(

 

)

 

 

 

 

 

 

 

 

 

Employer street address

 

City

State

 

 

ZIP

 

 

 

 

 

 

Name of Risk Assessor/Inspector who performed testing, if applicable

 

License #

 

 

 

 

 

 

 

 

 

 

 

Project Information

7. Building type (check one)

 

 

 

County

 

 

 

Single family residential

c Multi-family residential

cChild Care Facility

c School

 

 

c

 

 

 

 

 

 

 

 

 

 

Address

 

 

City

State

ZIP

 

 

 

 

 

 

 

 

Site location (Include brief directions)

Project Description

8. Types of abatement

 

 

 

 

 

 

 

 

c Exterior work

c Component replacement

c Enclosure

c Encapsulation

c Dust abatement

 

c

Interior work

 

c Paint removal

c Soil

c Other (specify) ________________________________________________________________________________________

 

 

 

 

 

 

 

 

Abatement dates

9. Start date

 

 

 

 

Completion date

 

 

 

 

 

 

 

 

 

Hours of operation

 

 

 

 

 

 

 

c _________________ am to_________________ pm

c _________________ pm to_________________ am

 

 

 

 

 

 

 

 

 

Days of operation

 

 

 

 

 

 

 

c Monday

c Tuesday

c Wednesday

c Thursday

c Friday

c Saturday

c Sunday

Comments

10. Signature of person iling this notiication

Date

HEA 5801 (Rev. 06/11)

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This PDF will need particular details to be filled out, therefore make sure to take some time to provide what's requested:

1. Start completing your Form Hea 5801 with a selection of essential blanks. Get all the necessary information and ensure nothing is omitted!

Tips on how to prepare Form Hea 5801 part 1

2. After this array of fields is completed, you're ready insert the essential details in Employer, Employer street address, City, Name of Risk AssessorInspector who, Project Information, Building type check one c Single, Address, City, Site location Include brief, Project Description, Telephone, State, License, County, and State so you can move forward further.

Ways to complete Form Hea 5801 step 2

3. Completing Days of operation c Monday c, Comments, Signature of person iling this, Date, and HEA Rev is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Part # 3 for completing Form Hea 5801

Those who work with this form generally make some errors when completing Days of operation c Monday c in this area. You need to go over everything you enter here.

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