Document ExkbpJ6XbjoxOe1bEN4dKxdzV

Document No: R8FQPForm-2018 R0 Effective Date: 4/5/2017 EPA Region 8 TSCA 402c Renovation, Repair and Painting Rule Recordkeeping Inspection Checklist 1 of 8 BASIC INSPECTION INFORMATION Inspection Date/Time: 3/10/2023 09:00 ICIS #: 3601510458 Presented EPA credentials to person in charge and explained purpose and scope of inspection Inspection Entry: Entry Permitted. Entry Denied. (Provide details in notes.) NOI signed by: Joe Hockett, Owner Facility Information Firm Name: Mountain States Restoration, LLC Owner Name & Contact Information: DBA or Former Names: 4300 Thatcher Avenue Pueblo, Colorado 81005 719-225-8208, joe@msrpueblo.com Person(s) interviewed: Joe Hockett Firm size (# employees, annual revenues, # projects/yr): 12-15 employees, 10-15 projects/yr Type of work (general contracting, windows, kitchen &bath,etc.): Service area: Restoration services Pueblo County and surrounding area Work done on : target housing child-occupied facilities Certified firm? Yes (copy certificate) No - give Small Entity Guide to Renovate Right and get explanatory statement If firm is certified, obtain copies of records for several properties, as applicable: Description/Scope of work (contracts, work orders, change orders, etc.) Lead testing documentation Determination that lead-based paint was/was not present on the components affected by the renovation Documentation that a certified renovator was assigned Documentation that uncertified workers were trained by a certified renovator Documentation of compliance with applicable RRP work practice standards Signed and dated receipt of Renovate Right pamphlet to owner/occupant Document No: R8FQPForm-2018 R0 Effective Date: 4/5/2017 EPA Region 8 TSCA 402c Renovation, Repair and Painting Rule Recordkeeping Inspection Checklist 2 of 8 Facility Name: Mountain States Restoration, LLC Inspection Date: 03/10/2023 #1 Address of property renovated: When did the renovations occur? From to What year was the property built? Provide a detailed description of the project and/or the permit pulled. Was the property tested for the presence of lead? Yes No Who conducted the test? Summary of records provided/obtained (attach to inspection report) RRP Certification # #2 Address of property renovated: When did the renovations occur? From to What year was the property built? Provide a detailed description of the project and/or the permit pulled. Was the property tested for the presence of lead? Yes No Who conducted the test? Summary of records provided/obtained (attach to inspection report) RRP Certification # Document No: R8FQPForm-2018 R0 Effective Date: 4/5/2017 EPA Region 8 TSCA 402c Renovation, Repair and Painting Rule Recordkeeping Inspection Checklist 3 of 8 Facility Name: Mountain States Restoration, LLC Inspection Date: 03/10/2023 #3 Address of property renovated: When did the renovations occur? From to What year was the property built? Provide a detailed description of the project and/or the permit pulled. Was the property tested for the presence of lead? Yes No Who conducted the test? Summary of records provided/obtained (attach to inspection report) RRP Certification # #4 Address of property renovated: When did the renovations occur? From to What year was the property built? Provide a detailed description of the project and/or the permit pulled. Was the property tested for the presence of lead? Yes No Who conducted the test? Summary of records provided/obtained (attach to inspection report) RRP Certification # Document No: R8FQPForm-2018 R0 Effective Date: 4/5/2017 EPA Region 8 TSCA 402c Renovation, Repair and Painting Rule Recordkeeping Inspection Checklist 4 of 8 Facility Name: Mountain States Restoration, LLC Inspection Date: 03/10/2023 #5 Address of property renovated: When did the renovations occur? From to What year was the property built? Provide a detailed description of the project and/or the permit pulled. Was the property tested for the presence of lead? Yes No Who conducted the test? Summary of records provided/obtained (attach to inspection report) RRP Certification # #6 Address of property renovated: When did the renovations occur? From to What year was the property built? Provide a detailed description of the project and/or the permit pulled. Was the property tested for the presence of lead? Yes No Who conducted the test? Summary of records provided/obtained (attach to inspection report) RRP Certification # Document No: R8FQPForm-2018 R0 Effective Date: 4/5/2017 EPA Region 8 TSCA 402c Renovation, Repair and Painting Rule Recordkeeping Inspection Checklist 5 of 8 Facility Name: Mountain States Restoration, LLC Inspection Date: 03/10/2023 #7 Address of property renovated: When did the renovations occur? From to What year was the property built? Provide a detailed description of the project and/or the permit pulled. Was the property tested for the presence of lead? Yes No Who conducted the test? Summary of records provided/obtained (attach to inspection report) RRP Certification # #8 Address of property renovated: When did the renovations occur? From to What year was the property built? Provide a detailed description of the project and/or the permit pulled. Was the property tested for the presence of lead? Yes No Who conducted the test? Summary of records provided/obtained (attach to inspection report) RRP Certification # Document No: R8FQPForm-2018 R0 Effective Date: 4/5/2017 EPA Region 8 TSCA 402c Renovation, Repair and Painting Rule Recordkeeping Inspection Checklist 6 of 8 Facility Name: Mountain States Restoration, LLC Inspection Date: 03/10/2023 #9 Address of property renovated: When did the renovations occur? From to What year was the property built? Provide a detailed description of the project and/or the permit pulled. Was the property tested for the presence of lead? Yes No Who conducted the test? Summary of records provided/obtained (attach to inspection report) RRP Certification # #10 Address of property renovated: When did the renovations occur? From to What year was the property built? Provide a detailed description of the project and/or the permit pulled. Was the property tested for the presence of lead? Yes No Who conducted the test? Summary of records provided/obtained (attach to inspection report) RRP Certification # Document No: R8FQPForm-2018 R0 Effective Date: 4/5/2017 EPA Region 8 TSCA 402c Renovation, Repair and Painting Rule Recordkeeping Inspection Checklist 7 of 8 Facility Name: Mountain States Restoration, LLC Inspection Date: 03/10/2023 Inspection Summary - Inspector Comments and Findings Inspector reviewed RRP Rule requirements with company representatives. Inspector provided copies of Small Entity Compliance Guide to Renovate Right booklet and the Renovate Right pamphlet. Company representative provided certifications including Mountain States Restoration LLC, NAT-58281-3, expires November 10, 2025 and Jerry Thomas, R-I-20-18814-1096, expires October 5, 2025. Inspector reviewed building permits and identified Mountain States Restoration LLC projects at pre-78 built residential properties potentially subject to the Renovation, Repair and Painting (RRP) Rule. Inspector requested information from the company representative related to these projects demonstrating compliance with the RRP Rule. No information has been provided by the company representative. Document No: R8FQPForm-2018 R0 Effective Date: 4/5/2017 EPA Region 8 TSCA 402c Renovation, Repair and Painting Rule Recordkeeping Inspection Checklist 8 of 8 Facility Name: Mountain States Restoration, LLC Inspection Date: 03/10/2023 RECORD OF REVIEW Inspector Inspector who prepared report: Laurence Labrie Date report completed: 05/01/2023 Signature: LAURENCE LABRIE (Affiliate) Date: 2023.05.01 09:18:04 -06'00' Digitally signed by LAURENCE LABRIE (Affiliate) Reviewed by: Britta Copt Title: Enforcement Officer Signature: Date: 05/01/2023 Reviewer Digitally signed by BRITTA COPT Date: 2023.05.01 12:22:17 -06'00'