Lead Poisoning Prevention
Forms

The forms on this page do not meet the regulatory requirements for the EPA's new Renovation, Repair and Painting (RRP) Rule. For the required forms, visit the EPA's RRP website.

NOTICE: Please read the Tennessen Warning before submitting any information to the Minnesota Department of Health.

To apply for lead worker, lead supervisor, lead inspector, lead project designer or lead risk assessor license, the following form must be completed and submitted to MDH:

If you are applying for your lead firm certification, the following form must be completed and submitted to MDH:

NEW! This form is now a fillable form! Fill in the fields online, print off a copy and then fax or mail it to MDH. If you are a lead certified firm and are conducting regulated lead work, the following form must be submitted to MDH five (5) calendar days before your project begins:

Once a certified lead firm completes regulated lead work, they must complete a lead hazard reduction report and maintain it for three years. Use this template to complete your lead hazard reduction report:

If you are registering as a lead sampling technician, the following form must be completed and submitted to MDH:

Training course providers must apply for a training course permit at least 60 days in advance of holding the course with this form:

Training course providers must notify MDH five (5) calendar days before the start of the training course with this form:

Training course providers must submit a list of trainees to MDH within five (5) calendar days of the completion of the course with this form:

If you wish to take the EPA's Third Party Independent Exam for Lead Supervisor, Lead Inspector or Lead Risk Assessor, complete the following form and submit it to MDH:

Updated Tuesday, 04-Jun-2013 15:03:01 CDT