Lead-Based Paint Forms

	Form 1:  *	If you are doing abatement work, inspections, risk assessments, on lead-based projects in the State of Nebraska your company needs to be a Certified Firm.  This is an application for an Initial License or Renewal of License for Certified Firms Performing Lead-Based Paint Projects Forms (Abatement Contractors, Consulting Company, Own Business Contractors, HUD Housing).
	Form 2: *	If you need a 10-day waiver to start a project early or a waiver to do a procedure that is limited by the regulations, use these forms.
	Form 3 & 4:	If you are doing lead-based paint work in the State of Nebraska you need to be certified either as:  Inspector, Risk Assessor, Project Designer, Supervisor, Worker, Visual Lead Hazard Advisor, and Elevated Blood Lead Level Investigator.  In addition, Lead-Based Paint Occupational Medical Examination Forms for Supervisors and Workers only. Individuals - Lead-Based Paint Occupation Certification and Limited Certification.
	Form 5:  *	If you are, doing lead abatement projects on lead-based paint projects in the State of Nebraska, these are the notification forms  to use.
	Form 6:  *	If you would like to be able to do training for lead-based paint work in the State of Nebraska, use these forms.

These forms (indicated by an *) may be completed on-line, however, they cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. If you complete the form on-line, you must print the form and mail it to the address below.

 

Nebraska Department of Health & Human Services
Asbestos Control/Lead-Based Paint Program
301Centennial Mall South
P.O. Box 95026
Lincoln, Nebraska 68509-5007
Lead-Based Paint Hot Line: 888-242-1100 ext 1 in Nebraska only
Phone:  (402) 471-0386
Fax: (402) 471-8833
E-mail: bobbie.mills@dhhs.ne.gov

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