The Ohio HEA 5802 form is a crucial document used to summarize lead inspection, risk assessment, and clearance examination activities conducted within the state. This monthly summary must be completed and submitted by the 15th of each month, ensuring that all relevant activities are accurately reported. If you're ready to take action, fill out the form by clicking the button below.
The Ohio HEA 5802 form is an essential tool for tracking lead inspection and risk assessment activities. It is specifically designed for use by licensed lead inspectors, risk assessors, and clearance technicians. Each month, these professionals must complete the form to report their activities from the previous month. This includes inspections, risk assessments, and clearance examinations. If no activities occurred during the month, they simply check a box indicating "no activity." For each property inspected, the form requires detailed information, such as the property address, whether it was built before 1950, and whether any lead hazards were found. Each activity must be recorded on a separate line, ensuring clarity and accuracy. The form also provides options for submitting the summary, including mailing, faxing, or emailing it to the Ohio Department of Health. Timeliness is crucial, as submissions are due by the 15th of each month. Proper completion of the HEA 5802 form helps ensure compliance with state regulations and contributes to the ongoing efforts to prevent lead poisoning in Ohio.
Ohio Department of Health • Lead Poisoning Prevention Program
Lead Monthly Summary
Page 1 of
Lead Inspection/Risk Assessment/Clearance Examination Activity
1.In accordance with paragraph (D) of rule 3701-32-15 of the Ohio Administrative Code this monthly summary form shall be completed to report each previous month’s activities. This form should be submitted by the 15th of each month. If there was no activity performed that month, check the “no activity” box.
2.Please complete all parts of this form. This form will be returned if any information is lacking.
3.Please complete a separate line for each property address and each activity. For example, if you conducted a clearance examination at 111 Main Street and the examination initially failed, but passed upon reexamination, you should enter each examination as a separate line. One line should be completed for the failed examination and one line for the passed examination.
4.You should always indicate “Yes” to the question “Was a lead hazard found” if the property failed clearance examination.
5.You should always indicate “No” to the question “Was a lead hazard found” if the property passed the clearance examination.
6.Monthly summary forms can be submitted by one of the following methods:
•Sent by first class mail to: Ohio Department of Health,
DQA/Lead Program, 246 North High Street, Columbus Ohio, 43215
•Faxed to (614) 752-4157
•E-mailed to [email protected]
Name of licensed Lead Inspector / Risk Assessor / Clearance Technician
License number
Employer
Phone number
Employer address
Email address
City
State
ZIP
Month and year of reportable activity (one month per form only)
A No activity
Summary Information
1. Property address
OH
Was constructed before 1950?
A Yes
A No
Was a lead hazard found?
Activity performed select only one per line
Reason for activity
A Inspection
A Partial Inspection
A Abatement
A Non-Abatement
A Risk Assessment
A Partial Risk Assessment
A EBL Investigation
A Lead Safe Renovation
A Lead Hazard Screen
A Inspection and Risk Assessment
A Hazard Control Order
A Essential Maintenance Practices
A Clearance Examination
A Owner requested
If Clearance was performed, did clearance area pass? A Yes A No
2. Property address
3. Property address
HEA 5802 7/06
Page _______ of _________
4. Property address
5. Property address
6. Property address
7. Property address
8. Property address
9. Property address
Completing the Ohio HEA 5802 form requires careful attention to detail. Once you have filled it out, you will need to submit it by the 15th of each month to ensure compliance with reporting requirements. If there were no activities performed during the month, simply check the “no activity” box. Make sure to provide accurate information for each property and activity, as incomplete forms will be returned.
The Ohio HEA 5802 form is designed to document and report lead inspection, risk assessment, and clearance examination activities conducted in properties. It serves as a monthly summary that ensures compliance with the Ohio Administrative Code, specifically rule 3701-32-15. This form must be completed for each month’s activities and submitted by the 15th of the following month.
Licensed Lead Inspectors, Risk Assessors, and Clearance Technicians are responsible for submitting the HEA 5802 form. If no activities were performed during the month, the individual must still check the “no activity” box on the form. Accurate reporting is essential to maintain compliance with state regulations.
The form requires several key pieces of information, including:
Each activity must be documented on a separate line for clarity.
There are three acceptable methods for submitting the HEA 5802 form:
Choose the method that best suits your needs while ensuring timely submission.
If any information is missing from the HEA 5802 form, it will be returned for completion. To avoid delays, ensure that all sections are filled out accurately and thoroughly before submission.
If a property fails a clearance examination, the form must reflect that a lead hazard was found by indicating “Yes” to the relevant question. This is crucial for tracking and addressing lead hazards effectively.
Yes, each activity must be reported on a separate line. For example, if a clearance examination initially fails but passes upon reexamination, both results must be documented individually. This detailed reporting helps maintain accurate records and compliance with health regulations.
Incomplete Information: One of the most common mistakes is not filling out all sections of the form. If any part is missing, the form will be returned, causing delays in processing.
Failing to Separate Activities: Each property and activity must be documented on a separate line. For instance, if a clearance examination failed and then passed, both results should be recorded individually. Overlooking this can lead to confusion and inaccuracies.
Incorrect Responses to Lead Hazard Questions: It's crucial to answer the questions regarding lead hazards accurately. If a property fails the clearance examination, the answer should always be "Yes" to the question about whether a lead hazard was found. Conversely, if it passes, the answer should be "No." Misunderstanding this can lead to serious reporting errors.
Missing Submission Deadline: The form must be submitted by the 15th of each month. Failing to meet this deadline can result in penalties or further complications with reporting.
Improper Submission Method: Ensure that the form is sent through the correct channels, whether by mail, fax, or email. Using an incorrect method could result in the form not being received, leading to potential issues.
When dealing with lead inspection and risk assessment in Ohio, several forms and documents accompany the Ohio HEA 5802 form. Each of these documents serves a specific purpose in the process of lead hazard management and compliance with state regulations.
Understanding these documents is essential for compliance and effective management of lead hazards. Each form plays a critical role in ensuring safety and health in properties, especially those built before 1950, where lead exposure risks are more prevalent.
The Ohio Hea 5802 form shares similarities with the EPA Form 3510-1, which is used for reporting lead-based paint activities. Both forms require detailed documentation of inspections and assessments related to lead hazards. The EPA form also emphasizes the importance of reporting activities performed in a specific timeframe and mandates that all relevant information be included to ensure compliance. Just like the Hea 5802, the EPA form allows for a summary of multiple properties and activities, ensuring that all necessary data is captured for regulatory review and public health protection.
Another document comparable to the Ohio Hea 5802 is the HUD Lead-Based Paint Disclosure form. This form is utilized during real estate transactions to inform buyers and tenants about potential lead hazards in properties built before 1978. Similar to the Hea 5802, the HUD form requires property owners to disclose any known lead hazards and to provide documentation of any inspections or remediation efforts. Both forms aim to enhance transparency and protect public health by ensuring that individuals are informed about lead risks associated with older properties.
The Lead Hazard Control Grant Application is also similar to the Ohio Hea 5802 form. This application is used by entities seeking funding to address lead hazards in residential properties. Like the Hea 5802, it requires detailed information about the properties involved, including inspection results and the types of lead-related activities planned. Both documents focus on the importance of systematic reporting and accountability in lead hazard management, reflecting a commitment to improving public health outcomes.
Lastly, the Lead Risk Assessment Report aligns closely with the Ohio Hea 5802 form. This report documents the findings of a risk assessment conducted to identify lead hazards in a property. Both documents emphasize the necessity of thorough documentation of activities and findings, ensuring that stakeholders are aware of any lead hazards present. The risk assessment report serves as a critical tool for informing remediation efforts, just as the Hea 5802 provides a monthly summary of ongoing lead hazard management activities.
When filling out the Ohio HEA 5802 form, it’s essential to follow specific guidelines to ensure accuracy and compliance. Here are five important do's and don'ts to keep in mind:
Understanding the Ohio HEA 5802 form is crucial for compliance with lead poisoning prevention regulations. However, several misconceptions exist regarding this form. Here are seven common misconceptions, along with clarifications for each.
By addressing these misconceptions, individuals involved in lead inspections and risk assessments can ensure compliance with Ohio's lead poisoning prevention regulations.
When filling out the Ohio HEA 5802 form, it’s important to keep a few key points in mind to ensure accuracy and compliance. Here are the main takeaways: