Signature by the certified supervisor indicates that the described lead
hazard control area(s) have passed visual clearance criteria. Provide
detailed description of each Lead Hazard Control Area.
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
BY:________________________________________________________________________
Certified Supervisor
Date
Print name and title ______________________________________________________
CONTRACTING OFFICER ACCEPTANCE OR REJECTION
The Contracting Officer hereby determines that the Contractor has performed
visual inspection of the lead hazard control area and by quality assurance
inspection, finds the Contractor's work to be:
________ Acceptable, ready for performance of clearance sampling
________ Unacceptable, Contractor instructed to re-clean the lead hazard
control area
BY: Contracting Officer's Representative
___________________________________________________________________________
Signature
Date
Print name and title_______________________________________________________
SECTION 13281A
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