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FOR ADMIN USE ONLY: - phila 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the apartment number and street name in the designated fields. Ensure accuracy as this information is crucial for identification.
- Fill in the zip code and specify the floor number if applicable. This helps in locating the dwelling accurately.
- In the certifying company or individual section, print your name clearly along with your PA License number or EPA LDS Tech Certificate Number.
- The inspector or risk assessor must sign and date the verification section, confirming that a visual inspection has been conducted.
- Complete the owner’s name and address fields, along with their housing inspection license number for compliance.
- For tenant acknowledgment, have them sign and date where indicated to confirm receipt of the Lead Safe Certification.
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