Document dgG5xYO3w5Re7ng9QKVRDmeG
ft E A ~ United States
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Environmental Protectior
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Agency
Region 6 - Enforcement & Compliance Assurance Division
INSPECTION REPORT
Inspection Date(s): Media Program: Regulatory Program(s)
10/21/2024 Toxics Substances Control Act (TSCA) Renovation, Repair and Painting (RRP) / 1018 Disclosure
Company Name: Facility Name: Facility Physical Location:
(city, state, zip code) Mailing address:
(city, state, zip code) County/Parish: Facility Phone Number Facility Contact:
Hunt Military Community (HMC)
Fort Sam Houston Family Housing
2739 Dickman Road #407
Ft. Sam Houston, Texas, 78234
2739 Dickman Road #407
Ft. Sam Houston, Texas, 78234
Bexar
210-514-2971
Monica Garcia
Monica.garcia@huntcompanies.com
FRS Number: Identification/Permit Number: Media Identifier Number: NAICS: SIC:
NA NA NA 53131 6531
Personnel participating in inspection:
Stan Lancaster
EPA Region 6
Angela Hays
EPA Region 6
Kiera Hancock
EPA Region 6
Andrea Price
EPA OECA HQ
Monica Garcia
Hunt Military Community
Michael R. Mathews
JBSA Fort Sam Houston
Kerrigan Simpson
JBSA Fort Sam Houston
Inspection Officer Inspection Officer Inspection Officer Inspection Officer Community Director Deputy Manager Deputy Director
EPA Lead Inspector Signature/Date
Supervisor Signature/Date
ANGELA HAYS Date: 2024.12.1 0 06:48:22 -06'00' Digitally signed by ANGELA HAYS
Angela Hays
St UC key, Troy Digitally signed by Stuckey,Troy Date: 2024.12.10 08:54:31 -06'00'
Troy Stuckey, Chief
Date Date
6ENFORM-019-R8.2 (02/12/2020)
1
Section I - INTRODUCTION
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
PURPOSE OF THE INSPECTION
To investigate facility for compliance with the Lead Based Paint Renovation, Repair or Painting (RRP) Rule and 1018 Disclosure Rule of Toxic Substances Control Act (TSCA). The inspection was initiated as part of a national initiative to inspect military bases identified to have reported elevated blood lead levels.
FACILITY DESCRIPTION
Fort Sam Houston Family Housing, located within Joint Base San Antonio, is managed by Hunt Military Communities. Hunt Military Communities (Hunt) manages 925 single family homes in 11 communities at Fort Sam Houston. Homes range in build dates from 1886 - 2006 and 434 of these homes are historic. Hunt offers housing to Active Duty, Retirees, Veterans, Department of Defence Employees, National Guard, Reservists, and other service members. Most leases are a 12-month term.
Section II - OBSERVATIONS
On October 21, 2024, at 9:20 AM, EPA inspectors Angela Hays, Stan Lancaster, Kiera Hancock, and Andrea Price arrived at the Fort Sam Houston Guard Post to make initial contact for an unannounced TSCA Lead Based Paint (LBP) Inspection at Fort Sam Houston Family Housing. Michael R. Mathers, Deputy Manager at Fort Sam Houston and Kerrigan Simpson, Deputy Director at Fort Sam Houston, met the EPA inspectors and escorted them to the Hunt Military Communities Office. EPA made entry at approximately 11:20AM. Upon entry, inspectors Hays, Lancaster, Hancock, and Price presented their credentials to Hunt Military Communities Director, Monica Garcia and explained the purpose of the inspection. The Notice of Inspection (Form 7740-3) was filled out and a copy provided to Ms. Garcia (Appendix 1).
The interview began with discussions of the property types and build dates. The properties are all singlefamily homes with a potential for children under six and pregnant women to occupy. Build dates range from 1886 to 2006. EPA explained the focus of the investigation would be only on the properties built before 1978. The inspection team requested to review documents for compliance with the TSCA 1018 disclosure. A total of 69 leases were requested for review from a selection of pre-1978 properties. Ms. Garcia was unable to supply the files at the time of the site visit. A follow up of records was requested. Ms. Garcia was unaware if any lead-based paint testing was done in the past. Hunt Military Communities has been the Property Management Company at Fort Sam Houston for approximately 4 years.
The inspection team then went on to discuss compliance with the TSCA RRP Rule. The RRP checklist was completed (Appendix 2). Ms. Garcia was unaware of Hunt's Lead Safe Firm Certification Number. Follow up of the number was requested. During the discussion, Ms. Garcia stated that typical painting work does not remove existing paint layers. Painting is performed by painting over the existing layer. If work is
2
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
needed that will disturb lead-based paint, Hunt hires vendors certified in LBP. Ms. Garcia stated Hunt employees do not perform RRP. EPA inspectors requested a copy of the standard operating procedures of how LBP is managed and the Contractor names, contact information, certifications, and assigned renovators used for LBP RRP work for the past five years.
The inspection team then drove the residential areas within Fort Sam Houston to look for active RRP work. Mr. Mathews and Ms. Simpson escorted the EPA through the pre-1978 communities. EPA was provided maps of the Privatized housing and communities (Appendix 3). During the drive one residence located at 2857 Chaffee, San Antonio TX 78234 was found to be performing active work that had a potential for LBP disturbance. The work consisted of removal of painted wood and uncontained dust. The debris was not contained at the time of site visit (Appendix 4). Inspector Hays spoke to the worker onsite, Nixon Garcia. Mr. Garcia stated he was forking for M-D Flooring. Mr. Garcia said that he did not have training for lead-based paint and was unaware if a certified renovator was assigned to the project. Mr. Garcia stated that he had limited English and provided the name of M-D Floorings owner, Geraldo Gomez for additional information. The inspectors also found active work taking place at 2800 Chaffee Road, San Antonio, TX 78234. The contractor, JP Resurfacing, was painting a shower and did not seem to fall under the LBP requirements (Appendix 4).
The inspectors conducted a closing conference and discussed the areas of concern found. The inspection team completed the Receipt for Sampling and Documents form (Appendix 5), the list of requested documents, and supplied lead-based --paint education materials to the facility. The inspection concluded at approximately 2:30PM. -
Section III - AREAS OF CONCERN Hunt Military Communities contracted out work to M-D Flooring, who did not appear have proper LBP training. Hunt Military Communities at Fort Sam Houston does not appear to have a Lead Safe Firm Certification.
Section IV - FOLLOW UP Documentation of the following information was requested by 10/28/2024. As of the publication of this report some of the documentation has been submitted to EPA and is under review. The remainder of the requested information submission has been extended to 12/13/2024.
1) Standard Operating Procedures Documentation of how RRP work is performed. 2) Hunt Military Communities Fort Sam Houston Lead Safe Firm Certification number. 3) List of lead contractors used for RRP in the past 5 years (Or since Hunt has managed property)
including:
Firm Certification Numbers Training Certifications Contact information.
4) Certified Renovator Names 3
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
5) Current Lease lead disclosures / addendums for 69 properties.
Three from Staff Post Community Seven from Artillery Post Community One from Hancock Community Fourteen from Patch Chaffee Community Fourteen from Wheaton Gram Dickson Community Three from Gorgas Community Seven from Infantry Post Community
Section V - APPENDIX Appendix 1 - Notice of Inspection (Form 7740-3) Appendix 2 - Lead RRP Compliance Checklist Appendix 3 - Maps of Communities Appendix 4 - Photo log Appendix 5 - Receipt for Samples and Documents (Form 7740-1)
4
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Appendix 1 Notice of Inspection (Form 7740-3)
5
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
~EPA
Un I 1 l 1
ENVIROI ~MENTAL PROT CTION AGENCY w shf119ton DC n 60
Notice tf ln~pc><.tion
OfCkc of (11forcc1ncnl and Compll nee A!.surnnc~
or the purpose of inspecting (including taking sampl~s. photographs, statements and other rnspectron ac11vllie 5l an e~lablishmla'rH. facility or other premises in whlrh chemical substancla's or mlxtures,articles containing same are
m~nulactured, proces~d. stored or held beiore or after their d1strrbu1ton ,n commerce (Including records. files. P3P"f~.
I[ , proc<>sses. control and facrlrues) and any conveyances ~ino used to transport chemical substance, mixtures or article~ co:1tainrng same In connection with the,r dlstrrbut1on ,n co~merce (Including records, files, papers. processes. controls and tartlit1s) bearing on whether the requ,rements of the Act are .,ppl1cable to the chemical substances. miY.tures or arti,;IPs,
I within, or associated with, such premise or conveyance have been complied with .
,I- In addrlion, this 1nspect1on extends to (check appropnatP blocks)
I n A Financr~I Data n 8. Sales Data
C1 D Pi>rsonnel Data 17 E. Research Data
n C Pricing Data I
Tile n~ture and extent of Inspection of such data specified In A through Eabove Is as follows
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Inspector's Slgnat\Jfe
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Save For in ,
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Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Appendix 2 Lead RRP Compliance Checklist
7
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
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ompliance / .)jrzf....,"
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hccklist - Renovators
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US ENVIRONMENTAL PROTECTION AGENCY
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U.S. EPA
REGION 6, DALLAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT
.___ _ _ _ _ _ __ _ ___.___
TITLE IV-LEAD HAZARD REDUCTIO:=..:N..:._ _ _ _ _
Reno, alion Firms & Renovators lnsncclion C hecklist
EPA lnsncctor Name EPA lnsucctor Telephone EPA Inspector Email Inspection Date 1nspcction Tvpc: Inspection Loca tion
Name Address Contact Na me Contact Teleph one Con tact Email Mana !!er Name l\la nal!:er Teien hone Ma nal!:cr Email
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EPA Fi rm Cer tifi ca ti on Number Na ture/Descripti on of Work: /u15 r fl.fl-t"
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Introduction & Purpose Permission to enter granted Permission to enter document signed Facility/operator provided copy of entry document Copy of Lead Base Paint Pamph let provided
OPENING CON FERENCE Y-N- Co mm ents NIA
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Page 1 of 21
COMPANY NAME: _ _,_Hi..e:Lc".....J._ t _}'--=-'.>'-'H' - - - -- -- - - - - - - - - - -
8
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
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Comment. lnfom1a tion gathen:d:
Lead
Rcno\nlion/Rcpair/Painting Compliance hccklist - Renovators
US ENVIRONMEl'ITAL PROTECTION AGENCY REGION 6, DALLAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT TITLE IV-LEAD HAZARD REDUCTION _ _ _ ___,
Did the compan) cooper.lie and provide requested documents?
ls_the compan) a licensed real estate brokerage !inn? If Ye . what is their license number?
-IL lie\_., -klr,:! L'{ ... l f;,rb, t~,!{.-,,.;-lec,
Doe, the company manage/sale/renovate target housing? I f yes. how many?_ _ _ __ __ _ _ _ __
q;J...s ll<-'f!'y Cu+ c.c ti Ct,,W)m'1r11\,2:1
A re there children under the age of 6 living in these properties? Under the age of 18? Pregnant women?
If managing properties, has any renovations been performed on these properties in the past 5 years? Was list provided? - - -- -- - - - - - - - - - - - - - -- - - -- - - - - - - - - -
#4'1: c.ltSt.> JC1ht: lc,,C"- k>rt'> Le4th1 Vlt;,i>> .,_..i.1,,i mtut-,,7, Th: 8""'rt:!'laa~ OWi\
yfvjX171l, M.A L..,tR :;f-{., NJ, fJ1,.,J-}- 4t"l"v-v-<- ut C,,l)e fr,.mV\ II] t<,)lr. (l.n.P - \"1<t1)!) (ei:i=fft,.I,. i:? k~&lo 1,r+I,. LBP. Tyfi'tt..1/., ~,:, ~ , cw:A,,.. ~,J LJ<ufl:f) .
Un,...,,.., ,..- 1,u,tl,~ elf flC&-' I r/':C Ifl t4t.,,~ / VJ:!IJYW .,,,~md -1.., -l!vll~{Jfl..f:vtgl, Hun+- ht:a, :t'c ic?D<Ml".l - All 1...t:tb " t, nW,.,te.U u,,+ {.;:, t.ceaiJ-, "'"' I of.
Inspector:
6ECD T
U Environmental Protection Agenc) Region 6 120 I Elm Street Dallas, TX 75207
Cop) o f inspection checklist and on-site report sent to:
Print ;--.;amc: _ _ _ _ _ _ _ _ __ [mai l _ _ _ _ _ _ _ _ _ _ __
Page 2 of 21
9
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
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U.S. EPA
Lead Renovation/Repair/Painting Compliance hcckli~t - Renovators
US ENVIRONMENTAL PROTECTION AGENCY REGION 6, DALLAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT TITLE IV-LEAD HAZARD REDUCTION
---~-------
lNFORl\lATION DISTRlll UTION REQUIREMENTS
#
Rel!. Ref
Question
Y-N-N/A
I 40 C .F R .
Renovation in Dwellin g Unit: Did the renovator/property
745 84(a)( I)
O\\ ncr pro pert) manager pro, idc the owner of the unit with the EPA-ao1Jro,ed lead hazard information oamphlct?
R(lo'..., v-f
Comments
2 40 C.F R 74 5 .84(a)(2)
Reno, at ion in D" cllin g nit: Did the renovator/property O\\ncr/property manager provide the adult occupant of the unit (if occupant is not the owner) with the EPA-approved lead
,,. \cvJ ~-f
rv\
huard information pamphlet?
~ Comments
3 40 C.F.R. 745.84(b)( I)
Renovation in Common Arca: Did the renovator provide the property manager/owner of the multi-fam ily housing with the EPA-approved lead hazard information/pamphlet and/or to post
informational signs?
mult1family
Comments
4 40 c .r .R. 745 .84(b)(2)
Renovation in Common Arca : Did the renovator/property manager/property owner notify in writing. or ensure written notification of, each unit of the multi-family housing and make
the pamphlet available upon request prior to the start ofthe
renovation. and/or post informational signs?
mullrfamily
f-1 I(\
Comments
5 40 CF R. 745 .84(c)(l )(i)
Renovation in C hild-Occupied Faci lity: Did the
renovator/property manager provide the 0\\ner of the building in which the child-occupied facility is located with the EPA-
annroved lead hazard information pamphlet?
Child fac1l1ty
~I,..
C o mm e nts
6 40 C F.R. 745 .84(c)( I)(ii)
Renova tion in C hild-O ccupied Facility: Did the renovator/property manager/ property O\\ ner provide an adu lt
representative of the child occupied faci lity with the pamphlet,
if the owner is not the operator of the chi ld-occupied fac ility?
Chrld facrlrty
ti I 1\
Comments
7 40 C.F.R. 745.84(c)(2)
Renovation in C hild-Occupied Faci lity : Did the renovator/property manager/property owner provide the parents and/or guardians of chi ldren using the ch ild-occupied facility
Cluld foc1hty
~,~
with the pamph let and information describing the genera l nature
and locations of the renovation and the anticipated completion
date, b) mailing or hand-<felivering the pamphlet and
renovation information. orb) posting informational signs
describing the general nature and locations of the renovation
Page 3 of 21
coMPANYNAME _ _._tl~k~~l~c--'-r~~~d.__________________
10
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
ft U.S. EPA
Lc:1d Renovation/Repair/Painting ompliancc Checklist - Renovators
US ENVIRONMENTAL PROTECTION AGENCY REGION 6, DALLAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT TITLE IV-LEAD HAZARD REDUCTION
and the anticipated completion date, posted m areas \vhcrc they
can be seen by parents or guardians of the children frequentmg
the child-occupied facility, and accompanied by a posted copy
of the pamphlet or information on how interested parents or
guardian s can review a copy of the pamphlet or obtain a copy
from the renovation fim1 at no cost to the oarents or 1rnard1ans?
Comments
8 40 C.F.R.
All Renovatio ns: Did the renovator post signs clearly defining
745.85 (I)
the work area and warning occupants and other persons not
involved in renovation activities to remain outside of the work area; to prepare, to the extent practicable, signs in the primary language of the occupants; and/or to post signs before
~ \t,t,J f-v' ~
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beginning the renovation and make sure they remain in place
and readable until the renovation and the post-renovation
cleanin[! verification have been comoleted?
C o mm en ts
TEST KITS
# Ree Ref
Qu e s tio n
I 40 C.F.R.
A ll Renova tions: D id the renovator/firm use an EPA approved
745 .88
dust test kit when determi ning the presence of lead, where the
test kit prov ided an accurate result for the oresence of lead?
Co mm e nts
Y-N-N/A
Jc1l e.,.:,,
~
FAJLURE TO ALLOW ACCESS TO RECORDS OR REFUSAL OF AN INSPECTION
# Ree: Ref I 40 C.F.R.
745.87(c)
Ou e s tion All Renovations: Did the renovator/ property owner/property manager refuse to permit entry or inspection? Fai lure or refusal to permit entry or inspection is also a violation ofTSCA 15
Y-N-N/A
y
and TSCA 6409.
Comments
FA ILURE TO E TA BLISH AND MAINTALN RECORDS, FAILU RE OR REF s LTO
MAKE RECORDS AVAILABLE
# Ree Ref
Qu e s tion
Y-N-N/ A
I 40C.F.R.
745 .237
A ll Renovations: Did the renovator/fi rm/property owner/property manager fai l or refusal to establ ish and maintain
records, or to make avai lable such record ? uch failure or
p1.:w
I)
refusal is a violation ofTSCA 6 409.
C o m m e nt s
Page 4 of 21
COMPANY NAME. _____,___-'-'U""ru.J_f,._~ f'----"-)--H'-' - - - - - - - - - - - - - - - - - -
11
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
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L ad Renova tion/Repair/Painting Compliance
'hcckli t - Renovator.
US ENVIRONMENTAL PROTECTION AGENCY
U.S. EPA
REGION 6, DALLAS, TX 7S202
TOXIC SUBSTANCES CONTROL ACT
TITLE IV-LEAD HAZARD REDUCTION
~-----------~-------
CKNOWLEDG EME T D ERTIFIC TIO TATEME TREQ rRE 1E TS
<RENOVATION PAMPHLET)
# Rel! Ref
Question
Y-N-N/A
I 40 C.f.R.
Renovation in Dwelling Unit: Did the rcnovator/ finn/property Owner
745.84(a)( I)(i) manager obtain, from the owner, a written acknowledgment
occupied
40 .F. R. 745.84(a)( I)
ofmailin_g at least 7 days prior to the renovation? that the owner had received the pamphlet, or obtain a certificate W//r
Comments
2 40 C.F.R.
Renovation in Dwelling Unit: Did the renovator/finn/property
745.84(a)(2)
manager obtain, from the adult occupant, a written
acknowledgment that the adult occupant has received the
40 C.F.R.
pamphlet, or obtain a certificate of mailing at least 7 days prior
74S.84(a)(2)(i) to the renovation?
rental
~,~
Comments
3 40 C.F.R.
Renovation in Common Area: Did the
745.84{b)(I)
renovator/firm/property manager obtain, from the owner, a
written acknowledgment that the owner has received the
40 C.F.R.
pamphlet, or that information signs have been posted, or obtain
745 .84(b)( I)(i) a certificate of mailing at least 7 davs orior to the renovation?
Multi-family
rJ I k
Comments
4 40 C.F.R.
Renovation in Common Area: Did the
745.84(b)(3)
renovator/firm/property manager prepare, sign, and date a
statement describing the steps performed to notify all
occupants of the intended renovation activities and to provide
Mul li-family
tJ IP.
the pamphlet?
Comments
s 40 C.F.R.
745 .84(b)(4)
Renovation in Common Area: Did the renovator/firm/property manager notify, in writing, the owners and occupants of the scope, locations or expected starting and ending dates of the planned renovation activities change after the initial notification, before the renovator initiated work beyond that which was described in the ori ginal notice?
Mul 1i-fornily
tJ I~
Comments
6 40 C.F. R. 745. 84 (c)( I)( i)
Renovation in Child-Occupied Facility: Did the renovator/firm /property manager obtain, from the owner of the building. a written acknowledgment that the owner had received the pamphlet, or obtained a certifi cate of mailing at
least 7 days prior to the renovation?
Child Facility
f} /Ii
Co mments
Page 5 of 21
COMPANY NAME: __~H~v,_,~I~t~-'.l~il_______________
12
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
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U.S. EPA
Lead Renova tion/Repair/Pa inting ompliance hecklist - Renovators
US ENVIRONMENTAL PROTECTION AGENCY REGION 6, DAUAS, Tl( 75202
TOXIC SUBSTANCES CONTROL ACT
TITLE IV-LEAD HAZARD REDUCTION
7 40 C.l R.
Rcnm ation in Child-Occupied Facility: Did lhe
Child Fac1hcy
745.84(c}( 1)(ii) renovator/firm/property owner/property manager oblain from
an adult representative of the child occupied facility, if the
operator of the child-occupied faci lity i not the owner of the
bui ldmg, a written acknowledgment that the operator has
lj\\-
received the pamphlet. or obtained a certificate of mai ling at
least 7 davs orior to the renovation?
Comments
8 40 C.F.R.
Renovation in Child-Occu pied Facility: Did the
Child Fac,hl)'
745.84(c)(3)
and date a statement describing the steps performed to noti fy all renovator/firm/property owner/property manager prepare, sign }:. /~
parents and guardians of the intended renovation activities and
to orovide the pamphlet?
Comments
9 40 C.F.R.
All Re novations: Did the renovator/firm/property
745.84(d)(l)
owner/occupant's name and acknowledgment of the pamph let owner/property manager include a statement recording the -rJ Ir.
receipt prior to the start of the renovation, the address of the
unit undergoing renovation, the signature of the owner or
occuoant as aoolicable, and the date of signature?
Co mm e nts
RECORD RETENTION REOUfREMENTS
# Ree Ref
Question
I 40 C.F.R.
All Renovations: Did the renovator/fi rm/property
745.86
manager/property owner retain all records necessary to
demonstrate compliance with the residential property
renovation for a period of3 years fo llowing completion of the
renovation activities?
Comments
2 40 C.F.R.
All Renovations: Did the training program maintain and make
745.225 (i)
available to EPA upon request, records for a period of3 years
and 6 months?
Comments
3 40 C.F. R.
Target Housing and Chilcl-occupied Facilities: did the
745.225,
renovator/firm/property manager/property owner/training
745.226, or
activity fai l or refuse to establish, maintain. provide copy, or
745.227 & 40 permit access to records or reports?
C.F.R. 745.235
(b)
Page 6 of 21
Y-N-N/A f.,11-"
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r.,,1c .....
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folkw-'
vf
COMPANY NAME: _ _ _...c/..ic=-11..,_~--'f-'-.'.)c....f,_/,__ _ _ _ _ _ _ _ _ _ _ __
13
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
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U.S. EPA
cad Rcnova tion/Rcp:iir/Pa inting ompliancc hccklist - Rcno\-ators
US ENVIRONMENTAL PROTI:CTION AGENCY REGION 6, DALLAS, TX 7SZ02
TOXIC SUBSTANCES CONTROL ACT TITLE IV-LEAD HAZARD REDUCTION
Comment ~
# Ree Ref
CERTI FICATION AN D RELAT ED R EQ UIR EMENTS Quest ion
I 40 C.F R.
II Renovatio ns: Did the renovator/ firm that performs, offer
74 .89(n)
or claims to perform renovations or dust sampling for
pur uant 10 40 compen ation obtain initial certification from EPA? If the firm
CFR
did not obtain initial certification, then proceed next section.
745.81 (a)(2)(ii)
Comm ents
2 40 CFR
All R enova tions: If initial certification has e,pired, did the
745.89(a& 40
EPA-certified cease renovations or dust sampling upon
C.F.R.
e,piration of certification?
745.89/b)( I)(iii)
C o mme n ts
3 40 C.F.R.
All Renovations : Did fi rm amend cert ification w ithin 90 days
745.89(b). & 40 of pertinent information change? Did Lhe fi rm halt renovations
C.F.R.
or dust ampling until its certi fication was amended?
745.89(c)
Y-N-N/A /:die,..>
if
folio,.>
vf
i=dloJ-1
vf
Co m m ents
4 40 C.F.R. 745.89(d)( I) &
All Renovatio ns: Are all ind ividuals performing renovations certified renovators or trained by certified renovators?
40 C.F.R.
745.81 (a)(2)
Comments
s 40 C F.R.
All Renovations : Is a certified renovator assigned to and
745.89(d)(2) & avai lable at each renovation?
40 C .F.R
745.8 l<a)/2)
Comm ents
6 40 C.F.R. 745.90(b) or (c)
All Renovatio ns: Did the certified renovator or dust sampling technician ensure compliance with 745.85 at all renovations to
40 CFR
which they were assigned?
745.90(a)
.~Fc11,;,..v
f<;\lt.w Ii('
re. :e..v L j'
40 C.F.R. 745.8 l(a)(3)
Co mments
Page 7 of 21
coMPANv NAME. _ _ _.....,f....,_~=1,ou.L.l:__._t~)..H, .,___ _ _ _ _ _ _ _ _ _ __
14
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
U.S. EPA
Lead
Rcnov:ition /Rcpair/Painling Compliance hccklis t - Renovator.
US (NVIRONMENTAl PROTECTION AGENCY REGION 6, DALLAS, TX 7S202
TOXIC SUBSTANCES CONTROL ACT TITLE IV-LEAD HAZARD REDUCTION
1 ; 40 crn
\II Rcno,ations: Did the renovator or du\l sampling
745 QO(b)(7)
technician. perform mg renovator or du~t ~am piing
respon5ibilitie under 40 CF R. 745 .90(b) or (c) lo maintain
and make available copies of their cour e completion
ccrtificate(s) (proofof certification) at the work site?
Comment,
8 40 CF R.
All Renovations : Did the du I sampling technician lo perform
745 .90(c}
opuonal du t clearance sampling under 745.85(c)?
Comments
9 40 CF R.
Target Housing and Child-occupied Facilities: Did the
745 .8 I (a}(3)
previously EPA-certified individual stop directing renovations
ifhe/she did not obtain recertification under 40 CFR
745.90(a)(4)?
Comments
(oilcw
.p
(.//cW
r
(.,I /ct,,
c.,,p
WORK PRACTICE STANDARDS FOR CO DUCTING RENOVATIONS
IF RENOVATIONS DID NOT OCCUR TI IrS SECTION IS NIA
Rei! Ref
Questio n
Y-N-N/A
I 40 C.F.R.
I nterior Renova tions: Did the renovation firm remove all
745.8S(a)(2)(i)( objects from the work area, including furniture, rugs, and
N
A)
1,indo11 coverings, or cover them with plastic sheeting or other
impermeable material with all seams and edges taped or
otherw ise sea led?
Comments
2 40CF.R.
Interior Renovati ons: Did the renovation firm, before
745.8S(a)(2)(i}(B beginning the renovation, close and cover all ducts opening in
t-1
)
the 11ork area with taped-down plastic sheeting or other
imocrmeable material?
Comments
3 40 C.f.R.
I nterior Renovations: Did the reno ation fim1 close windows
745.85(a}(2)(i)(C and door in the work area. cover doors with plastic sheeting or N
)
other impermeable material, and/or cover doors used as an
entrance to the work area w ith plastic sheeting or other
impemieable material in a manner that allows workers to pa~s
through while confi ning dust and debris to the work area?
Com ments
4 40 C.F R. Interi or Renovat ions: Did the renovation firm , before t-J 745 .85(a)(2)(i)( beginning the renovation. cover the Ooor surface, including
D)
installed carnet. with taoed-do" n ola~tic sheeting or other
Page 8 of 21
COMPANY NAME: ----~Y~L'~'1~f_- _,t.-._-')'-'-H_ _ _ _ _ _ _ _ _ _ _ __
15
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
r
ft U.S. EPA
Lead
lh'novation/ l{epair/Painting Compliance hecldi I - Renovator~
US ENVIRONMENTAL PROHCTION AGENCY REGION 6, DAUAS, T)( 75202
TOXIC SUBSTANCES CONTROL ACT TITLE IV-LEAD HAZARD REDUCTION
impcm1cablc material in the work area 6 feet beyond the
pcnmctcr of \Ur faces undergoing renovation or a sufficient
di,tancc to contain the du~t. whichc~cr i\ greater?
Comments
5 40 C.F R.
I nterior Renovations: Did the renovation fim1 use precauuons
745.s-(a)(2)(i)(E to ensun: that all personnel, tools. and other items, including the f.o,lo.v.,J,,
)
c:-.tcriors ofcontainers of" astc. are free of dust and debris
before leaving the work area?
Com ments
6 40 C.F.R.
Ext erior R enovati ons: Did the renovation firm, before
74S.85(a)(2)(ii)( beginning the renovation. close all doors and windows within
"1/ A
A)
20 feet of the renovation. close all doors and windows within 20
feet of the renovation on the same Door as the renovation on
multi-story bui ldings, and/or close all doors and windows on all
Doors below that are the same horizontal distance from the
renovation?
Comments
7 40 C.F.R.
Exterior Renovati ons: D id the renovation firm, before
745.85(a)(2)(ii)( beginning the renovation, ensure that doors within the work
B)
area that will be used whi le the job is being performed are
covered with plastic sheeting or other impermeable material in
a manner that allows workers to pass through while confining
1J /
dust and debris to the work area?
C om m en t s
8 40 C.F.R.
Exterior Renovations: D id the renovation firm, before
745.85(a)(2)(i i)( beginning the renovation, cover the ground w ith plastic
NI (,
C)
sheeting or other disposable impermeable material extending I 0
feet beyond the perimeter of urfaces undergoing renovation or
a sufficient distance to collect fa ll ing paint debris, whichever is
greater, unless the propert} line prevents I O feet of such ground
covering?
Comments
9 40 C.F.R.
Exterior Renovations: Did the renovation firm , before
N/f.
745.8S(a)(2)(ii)( beginni ng the renovations in certai n situations, take extra
D)
precautions in containing the work area to ensure that dust and
debris from the renovation does not contaminate other building
or other areas of the oroocrtv or migrate to adjacent proper11es?
Comments
Page 9 of 21
COMPANY NAME ____t_l-k'~O~t~f~)~~--------------
16
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
ft
U.S. EPA
---
cad Reno nlion/Rcpair/Painting Compt]ancc hccklist - Renovators
US ENVIRONMENTAL PROTECTION AGENCY REGION 6, DALI.AS, TX 75202
TOXIC SUBSTANCES CONTROL ACT
TITLE IV-LEAD HAZARD REDUCTION
10 40 .F.R.
Prohibited and restricted practices: Did the renovator/firm
74 .85(a)(3)(i) prohibit the use of open-name burning or torching of lead-
based tJaint durinu renovations?
C o m m e n ts
II 40 C.F.R.
Prohibited a nd restricted practices: Did the renovator/firm
74 .85(a)(3)(ii) prohibit the use of machines that remove lead-based paint
through high speed operation such as sanding. grinding, power
planning, needle gun, abrasive blasting, or sandblasting. unless
such machines are used with IIEPA exhaust control?
Comments
12 40 C.F.R.
Prohibited and restricted practices: Did the renovator/firm
745.85(a)(3)(i ii) restrict the operating/use of a heat gun on lead-based paint to
temoeratures below 1100 degrees Fahrenheit?
C o mm ents
13 to 40 C.F.R. Waste from renovations: Did the renovator/firm contain waste
745.85(a)(4)(i) from renovation activit ies to prevent releases of dust and debris
before the waste is removed from the work area for storage or
disposal and/or fa ilure to cover a chute ifit is used to remove
waste from the work area?
Comments
14 40 C.F.R.
Waste from renovations: Did the renovator/firm, at the
745.85(a)(4)(ii) conclusion of each work day and/or at the conclusion of the
renovation, ensure that waste that had been collected from
renovation activities was stored under containment, in an
enclosure, or behind a barrier that prevents re lease of dust and
debris out of the work area and prevents access to dust and
debris?
Comments
15 to 40 C.F.R. Waste from renovations: Did the renovation firm contain the
745.85(a)(4)(iii) waste to prevent release of dust and debris during the tran port
of waste from renovation activities?
Co m m e n ts
16 40 C.F.R.
C lea ning the work area: Did the renovation firm c lean the
745 .85(a)(5)
work area until no d ust, debris or residue remained af\er the
renovation had been comoleted?
Co mments
J 40 C.F.R.
C lea nin g tbc work area: did the renovation firm col lect all
745 .85(a)(S)(i)( pa int chips and debris and seal the material in a heav -dtll) bag
Al
without dispersinJ: any of it?
Co mm ents
1-1 ~
~
i:-o 110,u vf
Follov>
11r
[u1l0~ L'f"'
Fci10t"
ur
Follv;"' llt
Page 10 of 21
COMPANYNAME ----1~+L~1?~t-'-F:.~~~'~'-------------
17
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
r
ft
0
U.S. EPA
ca d Rc11ov11tio11/Rcpair/ Pninting ompliancc
hccklist - Renova tors
US ENVIRONMENTAL PROTECTION AGENCY REGION 6, OALIAS, TX 7S202
TOXIC SUBSTANCES CONTROL ACT TITLE IV-LEAD HAZARD REDUCTION
18 40 CI R
Clcanini: the \\ Ork area: Did the renovation firm remove the
745.85(a)(-)(i)(B proIccti,c \heeling b) misting the ~heeling before folding it,
)
folding the din} idc inward, and/or euhcr taping shut to seal
or scaling it in heavy-duty bags?
Com ments
19 .JO C.F.R
Cleaning the work area . Did thi: renovation firm keep in place
745 .85(a)(S)(i)(B the plastic sheeting used 10 isolate contaminated rooms from
)
non-conta111inated rooms until afier the cleaning and rem oval of
other sheeting?
Comments
20 40 C.F.R.
C leaning the ,,ork area: Did the renovation firm dispose o f
745 85(a)(S)(i)(B the plastic sheeting, used as occupant protection al the
)
renovation site. as waste?
Comments
21 40 C.F.R.
Cleaning the work area: Did the rcnovaIion fir111 clean all
745.85(a)(5)(ii) objects and surfaces in the work area and within 2 feet ofthe
work area. cleaning from higher to lower?
Comments
22 40 C.F.R.
C leani ng the work area: Did lhe renovation fir111 clean walls
745 .8S(a)(5)(i i)( in Ihe work area, staning at the cei ling and working down to the
A)
floor, by either vacuu111ing with a I IEPA vacuum or wiping
with a da111p cloth?
Com ments
23 40 C.F.R.
Cleaning the work area: Did the rcnovaIion firm thoroughly
745.85(a)(5)(ii)( vacuu111 all remaining surfaces and objects in the work area,
B)
including furniture and fixtures, with a I I EPA vacuum and/or
failure to use a H EPA vacuum equipped with a beater bar when
vacuu111mg caroets and ru!!s?
Commen ts
24 40 C.F.R.
Cleani ng the wor k ar ea: Did the renovation firm to wipe all
745 .85(a)(S)(ii)( re111aining surfaces and objects in Ihe work area, except for
C)
carpeIed or upholstered surfaces, wiIh a da111p clolh and/or
failure to 111op uncarpcted fl oors Ihoroughly . using a mopping
method 1haI keeps the wa h water separate from the rin se waler,
such as the 2-bucket mopping meIhod, or u ing a\\ ct mopping
svstem?
Co mm ents
25 40 c.r R
SIand ards for post- r enova tion cleanin g verifica tion : Did Ihe
745.85(b)( I )(i) renornIor perform a vi ual in pection o f the inIcrior \\ Ork area
to deIem1ine "hcther dust debris or residue is sIill present 10
Page 11 of 21
h1lo.,.,
v('
h,1~..J uP
F"ull~
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i="c,(/c:.,.,
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,:::,110 ....
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ur
-
1-o/lcW vp
F'oll, -> LJf
COMPANY NAME: -----'-~~li""l''-"-\:-_,__f~Sul..1..\_ _ _ _ _ _ _ _ _ _ _ _ _ __
18
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
ft U.S. EPA
ad R novation/Repair/Painting omplianc] hecklist - Renovator
US ENVIRONMENTAL PROTECTION AGENCY REGION 6, CALLAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT
TITLE IV-LEAD HAZARD REDUCTION
rem ove du st. debri or re idue by re-cleanin g if necessary,
and/or ocrform another vi sual inspection?
Comments
26 40 C.F.R.
tandard. for pos t- re no atio n cleani ng veri fi cation: Did the
74 .8 "(b)( I)(ii)( renovator verify that each interior windowsill in the work area
A)
ha been adequately cleaned using a disposable cleaning
cloth(s) compared to the cleaning verification card following
the pre cribed procedures, pursuant to 40 C .F.R. 745 .85 (b)( I)(ii) (A) or failure by a certified renovator to arrange for
the collection dust clea rance sampl es as part of optional dust
clearance testing?
Co mments
27 40 C.F.R.
Standards for post-renovation cleaning verifica ti on: Did the
745 .85(b)( I)(ii)( B)
renovator fail to verify that eac h interior floor in the work area has been adequate ly cleaned us ing a disposable cleaning
cloth(s) compared to the cleani ng verification card following the prescribed procedures pursuant to 40 C.F.R. 745 .85 (b)(l)( ii) (B) or fai lure by a ce rtified renovator to arrange for the collection dust clearance sa mpl es as part of optional dust
clearance testing?
Comments
28 40 C.F.R.
Standard s for pos t- renovation cleaning verification: Did the
745.85(b)( I)(iii) renovator wai t until interior wo rk area passes post-renovation
cleaning verification before removi ng sie:ns?
Com ments
29 40 C.F.R.
Standards for post- renovation cleaning verification: Did the
745.85(b)(2)
renovator perform a visual inspection of th e exterior work area
to determine whethe r du st, debris or res idue is till present, to
remove dust, debri or res idu e by re-cleaning if nece sary,
and/or perform anoth er visual insoect ion?
Com ments
30 40 C.F. R.
Stand a rd s for po t- renovation clea ning verification: Did the
745.85(b)(2)
renovator wai t unti I ex terior work area passe vi ual inspection
before removin g sig ns?
Co mments
31 40 C.F.R.
745 .85(c)
Standard fo r pos t- renovation cleaning verification : Did th renovation fi rm arrange for perfo rm ance of opti ona l du l clea rance testing at the co nclu ion of'lhe reno ation if required
to do so by the per o n co ntractin g for the r nova ti on, a Fed 'faL
State, Territoria l, Tr ibal, or loca l law or rcRulation?
F"'''";_,)
t,f
(.,,low
c>f
rc/1"..J
cf
Fell~.., f
~"ll"v
vf f, II''"
-f
Page 12 of 21
COMPANY NAME: _ __ _ __,_/1~1,.,1_1-'-"''f---'t'--~5.f./.__ _ _ _ _ _ _ _ _ _ __
19
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
ft
'&
U.S. EPA
cad Rcnovation/Repair/Painling ompliancc hccklisl - Renova tors
US ENVIRONMENTAL PROTECTION AGENCY REGION 6, DALLAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT
TITLE IV-LEAD HAZARD RE:D.::.U::.C.::.T:.:1.O::.:N.:~ - - - - '
Comments
32 40 C.F.R.
Standards for posl- rc110, atio11 clean in g verification: Did the
74. 8S(c)(:!)
reno,ator have the optional dust clearance tesung performed by
a certified in pector, risk assessor or dust sampling technician at
the conclusion of the renovation?
Com ments
33 40 C.F R
Standard for post-re11ovation cleani ng verificatio n: Did the
74 .85(c)(3)
renovation firm re-clean the work area until dust clearance
results are below clearance standards?
Comments
(Jlr-w vt'
,:::J,t6,.,.....,.,
INSPECTION/RISK ASSESMENT/ABATEMENT
WORK PRACTICE STANDARDS
APPLICABLE ONLY IF CERTIFlED INSPECTIONS AND ASSESSMENTS OCCUR.ED
# Re!! Ref
Quest ion
Y- N - N/ A
I 40 C.F.R.
Target Housing and C hild-occupied Facilities: Did the
745.227(a)( I) renovator/ lim, perform all lead-based paint activities pursuant to the work practice standards, appropriate requirements, ti/
methodolo1Ties and clearance levels soecilied and referenced?
Comments
2 40 C.F.R. 745.227(a)(2)
Target Housing and C hild-occupied Facilities: Did the renovator/firm ensure lead-based paint activity described by the certified individual as an inspection, lead-hazard screen, risk
~/
assessment or abatement, was performed by a certified
indiv idual?
Comments
3 40 C.F. R. 745.227(b)( I)
Target Housing and C hild-occupied Facilities: D id the renovator/ firm ensure an inspection was conducted only by a
't1 IA
person certi lied by EPA as an inspector or risk assessor and, if
conducted. must be conducted acco rding to the prescribed
orocedures?
Com ments
4 40 C.F.R. Target Housing and Child-occ upied Facilities: Did the If IA
745.227(b)(2) renova1or/lim1 conduct an inspection at select locations
according to documented methodo logie 10 be tested for the
oresence of lead-based oaint?
Comments
5 40 C.F. R. Target Housing and Child-occupied Facilities: Diel the 74S.227(b)(2)/il renovator/firm test for lead-based oai111 eac h interior and/or ~/A
Page 13 of 21 coMPANv NAME _ _ _ _--1.Hi.!..I...Lo.w1-_.!..F..t.">..!..!Ht____ _ _ _ _ _ _ _ _ _ __
20
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
ft
~
U.S. EPA
cad Rc11ova tio11/Rcp. ir/Painting omp]iance Chccl< li, t - Renova tors
US ENVIRONMENTAL PROTECTION AGENCY REGION 6, DALLAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT
,____ _ _ _ _ _ _ _ _ _ _....__ _ _ _ TITLE IV-LEAD HAZARD REDUCTION
e.\terior component with a dist111ct painting hi tory in a
residential cl\\elling and/or child occunied facility?
Comments
6 40 C.F.R.
Target llou ing and Child -occupied Facilities: Did the
745.227(b)(2)(ii) renovator/firm test for lead-ba ed paint each interior and/or
exterior component with a di tinct painting history in a multi-
family dwelling?
Commen ts
7 40 C.F.R.
Target Hou ing and C hild-occupied Facilities: Did the
745 .227(b)(3)(i) renovator/fim1 ensure that paint am pied for analysis to
determine the presence of lead was conducted using documented methodologies which incorporate adequate quality
control procedures?
Comm ents
8 40 C.F.R.
Ta rget Ho usi ng and Chi ld -occupied Facili ties: Did the
745 .227(b)(3)(ii) renovator/firm ensure that all collected paint chip samples were
analyzed accord ing to 40 C.F.R. 745 .227(t) Lo determine if
they contain detectable leve ls of lead that can be quantified
numerically?
Comments
9 40 C.F.R. 745 .227(b)(4)
Target Housing and Child-occupied Facilities: Did the inspector or risk assessor prepare an inspection report that
includes the requi red information?
Com ments
10 40 C.F.R. 745 .227(c)( I)
Target Housin g and Child-occupied Facilities: Did the renovator/firm ensure that a lead hazard screen was conducted only bv a oerson certified bv EPA as a risk assessor?
Comments
JI 40 C.F.R.
Ta rge t Hous ing and Child-occupied Facilities: Did the
745.227(c)(2)(i) renovato r/firm ensure that a lead hazard screen included the
collection of backgro und information regardin g the physical
characteristics of the res identi al dwe lling or child-occupied fac il ity and occupant use patterns that may cause lead-based oaint exposure to one or more child ren age 6 yea rs and under?
Com ments
12 40 C.F.R.
Target Hou ing and Chi ld-occ upied Facilitie : Did the
745.227(c)(2)(ii) renovator/firm ensure a lead hazard crcen include a vi ual
(A)
in soect.ion to deterrn ine the oresencc of deterioraicd paint?
Co mments
~,1
tJ It-
l-l If\
1-l I\
r-, l\\
f\l I\\
t-1/~
Page 14 of 21
COMPANY NAME : ----~H~(~>r1~t~t~.''-->t i " - - - - - - - - - - - - - - - -
21
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
ft
cad Renovation/Repair/Pa inting ompliance
hrck lisl - Renovators
US ENVIRONMENTAL PROTECTION AGENCY
U.S. EPA
REGION 6, DALLAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT
~------------....__ ____TITLE IV-LEAD HAZARD REDUCTION
13 40 C.F R..
Target Ho using and C hild-occupied Facilities: Did the
745.227( )(2)(ii) reno ator/firm ensure a lead hazard screen includes a visual
(B)
in pection to locate al least two dust samples performed
accordinu to the orescribed methodologies?
Commen ts
14 40 C.F.R.
Target Housing a nd C hild-occupied Facilities: Did the
745.227(c)(3)
renovator/finn ensure a lead hazard screen includes the
collection and analysi of dust samples according to the
orescribed methodologies?
Comments
15 40 C.F. R.
Target Housi ng and C hild-occupied Facilities: Did the
745.227(c)(4)
renovator/finn ensure a lead hazard screen includes the
co llection and analysis of paint samples according to the
orescribed methodologies?
Comments
16 40 C.F.R. 745 .227(c)(5)
Target Housing and C hild-occupied Facilities: Did the renovator/firm ensure a risk assessor prepared a lead hazard
screen report that includes the required information found in the
regulation?
Comments
17 40 C.F.R. 745 .227(d)(1)
Target Housing and C hild-occupied Facilities: Did the renovator/firm ensure a risk assessment was conducted o nly by
a person certified bv EPA as a risk assessor?
Comments
18 40 C.F. R. 745.227(d)(2)
Ta rget Housing and Child-occupied Facilitie : Did the renovator/firm ensure that a risk assessment includes a visual inspection of the residential dwelling or child-occupied facility
to locate the existence of deteriorated paint, assess the extent
and causes of the deteriora tion, and other potential lead-based
paint hazards?
Comm ents
19 40 C.F.R.
Target Housing a nd C hild-occupied F acilities: Did the
745 .227(d)(3) renovato r/firm ensure that a lead hazard screen includes the
collection of background information regarding the phy ical
characteristics of the residential dwel ling or child-oc upied
fac ility and occupant use patterns that may cause lead-ba ed
oaint exoosure to one or more children age 6 years and under?
Comments
/
rJ//\
rJ '1'
t-J/~ tv Irt 1-J Irf
rJ/ I\
Page 15 of 21
COMPANY NAME - - - - - ~H'-'.-.L._1..)....l..__.._t...,_')..L1.1;_ _ _ _ _ _ _ _ _ __
22
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
-ft
U.S. EPA
L ad Renovation/ Repair/Painting ompliance
hcckli t - Renovator
US ENVIRONMENT Al PROTECTION AGENCY REGION 6, DAUAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT TITLE IV-LEAD HAZARD REDUCTION
20 40 C.F.R. 745.227(d)(4)
Ta rget Hous in g and hild-occupi cd Faciliti : Did the renovator/firm test for the presence of lead on each surface
dctennined to have a disti nct painting history?
C o m m e nt s
21 40 .F. R. 74- .227(d)(5)
Residential Dwelling : Did the renovator/finn collect and analyze for lead concentration dust samples (either composite
or ingle-surface am ples) from the interior window sill(s) and floor(s) in all living areas where one or more children, age 6 and under, are most likely to come into contact with dust?
Co mments
22 40 C.F. R. 745.227(d)(6)
Mu lti-family Dwell ings a nd Child-occupied Facilitic : Did the renovator/firm collect and analyze interior window sill and floor dust am ples (either composite or single-surface samples) for lead concentration from the prescribed locations?
Comments
23 40 C.F. R. 745.227(d)(7)
Child-occupied Facili ties: Did the ren ovator/firm collect and analyze interior window sill and noor dust samples (either
composite or si ngle-surface samples) for lead concentration in each room, hall way or stairwell uti lized by one or more children, age 6 and under, and in other common areas in the chi ld occupied faci lity?
Comments
24 40 C.F .R. 745.227(d)(8)
Target Ho usin g and Child-occupied Facilities: Did th e renovator/firm collect and ana lyze soil samples for lead
concentrations in the prescribed locat ions?
Comm ents
25 40 C.F.R. 74- .227(d)(9)
Ta rget Ho usin g and C hild-occupied Facilities : Did the renovator/firm conduct all paint, dust, or soil sampling or
testi ng using documented methodologies that incorporate adequate qual ity control procedures?
Commen ts
26 40 C.F.R.
Ta rge t Ho usin g and Child-occupied Facili ties: Did th e
745.227(d)(l0) renovator/firm analyze any collected paint chip, du t, ors ii
samples accordi ng to 40 C.F.R . 745 .227(f) to determine if they contain detectable levels of lead that can be quantified numerica lly?
Com ments
27 40 C.f-.R. 745 .227(d)( 11
Target Ho usin g :i nd Child-occ upied Facilit ies: Did the
renovator/firm/ri sk as e so r prepare a ri k a cs mcnt rep rt that includes the req uired in fo rm ation?
,-ii
tl I
ti I f. 1-11
\JI\\
i'l\~
t-1 l ~
tl \I\
Page 16 of 21
coMPANY NAME:-----~i~lu~n~t~E_s'--'H"-----------
23
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
-ft
U.S. EPA
.___ _ _ _ _ _ __ __
ad Rcno ation/Rcpair/Pninting ornplinnce he ldi~t - neno ators
US EN\IIRONMENTAL PROTECTION AGENCY REGION 6, DALLAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT
-1.._ _ _ _ _T.:.:l.T.:..L::.E: IV-LEAD HAZARD REDUCTION
Comment~
2 40 C.F.R.
Tar~ t llousinit and C hild-occup ied Faci liti es: Did the
74"._27(c)(I)
reno ator/fim1 en urc that an aba tement is conducted only by a
person certified by EP . and , if conducted, is conducted
occordinu to the orescribcd oroccdurcs?
Comments
29 40 C.F.R. 7C227(e)(2)
Targe t Hou ing a nd C hild-occupi ed Fa ci liti es: Did the firm
ensure a certified renovator wa available to be onsite for each
abatement project during all work site preparation, during the
po t-abatement cleanup of work areas, and to be onsite at other
times during the abatement or available by telephone, pager or
answering service and able to be presen t at the work site in no
more than 2 hours?
Co mm ents
30 40 C.F.R. 7C227(e)(3)
Target Hou sing and C hild -occupied Facilities: Did the finn ensure a certified renovator was avai lable to direct activities and ensure that all abatement acti vities are conducted according
to the requ irements of 40 C. F.R. 745.227(e) and all other
Federal. State and loca l reauirements?
Comm ents
31 40 C.F.R. 745.227(e)(4)(i-
Ta rget Housing a nd C hild-occupied Faciliti es: Did the renovation firm noti fy EPA o f lead-based paint abatement
v)
activities or to update notifi cati on as prescribed and by the
designated deadl ine?
Comments
32 40 C.F.R.
Ta rget Housi ng and Chi ld -occ upied Facilitie : Diel the
745 .227(e)(4)(vi) renovation firm include the des ignated in formation in each
no tificatio n?
Comments
33 40 C.F. R.
Target Housin g and Child-occupied Facilities: Did the
745 .227(e)(4)(vii certified fi rm accompli sh written or electroni c not ification via
)
one of the prescri bed meth ods?
Comments
34 40 C.F.R.
Target Housin g and Child-occupied Facilities: Did the
745 .227(e)(4)( ii renovat ion firm begi n lead-based paint abatement acti vities on
i)
the date and at the location specified in either the origina l or
uodated Noti ficatio n?
Comments
3- 40 C.F. R.
Target Ho using a nd Child-occ upi ed Fac ilities: Did the
745 .227(e)(4\/ix\ certified ren ovation fi rm or individ ual notify EPA before
Page 17 of 21
rJ Ir--
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iJ Ifl rJ l I\ ~ Ir,
tJ IP<
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tJ 1ft
COMPANYNAME: -------+-H.uku.O.u+__.f~:?..,_L'f:!l.:- - - - - - - - -- - -
24
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
ft
U.S. EPA
ad R nova tio n/Rc pa ir/Pain ting ompliancc hccklist Renovators
US ENVIRONMEflfTAL PROTECTION AGENCY REGION 6, OAUAS, TX 75202
TOXIC SUBSTANCES CONTROL ACT TITLE IV-LEAD HAZARD REDU CTI ON
engaging in lcad-ba ed paint abatement ac11vitics defined in 40
c.r-.R. 6 745 .223?
Comm ents
36 40 C.F.R.
Target ll ou ing a nd C hild -occ upi ed Facilit ies: Did the
745 .2_7(e)(5)
certified renovation firm or in div idual deve lop a written
occu pant protectio n plan fo r all abatement project and in
accordance wi th the oresc ribed orocedures?
Comm ents
37 40 C.F. R. 745.227(e)(6)(i)
T arget Housing a nd C hi ld-occupied Facilit ies: Did the certified firm/renovator prohibit the use o f open-fl ame burn ing or torching of lead-based oaint durin g abatement activit ies?
Co mm e nts
38 40 C.F. R.
Target Housi ng a nd C hil d-occupied Faci lities: Did the
745.22 7(e)(6)( ii ) certified firm /renovator prohibit the use of machines that
rem ove lead-based pai nt through sand ing, grinding, abras ive
blasting, or sandb lasti ng, un less such machines are used w ith
HE PA exhaust control whi ch removes pa rt icles of0.3 micron s
or lamer from the air at 99.97 oercent or greater efficiencv?
Comm ents
39 40 C.F. R.
Target Ho usin g and Child-occupi ed Facilities: Did the
745.22 7(e)(6)( iii certified fi rm/renovator prohibit th e dry scrapin g of lead -based
)
paint unless it is used in conjuncti on wi th heat guns or around
electrica l outl ets or when treating defective paint spots tota li ng
no mo re th an 6 square feet in any one roo m, hall way, or
sta irwell or totalin g no more than 20 squ are feet on exterior
s urfaces ?
Comm ents
40 40 C.F. R.
Ta rget Ho usin g and Child -occupied Fa cilities : Did th e
745.22 7(e)(6)(iv) certi fied firm/renovator restrict the operating ofa heat gun on
lead-based paint at temperatures be low 11 00 degrees
Fa hre nh e it ?
Com ments
4 1 40 C.F.R. 74 5 .22 7(e)(7)
Ta rget Hou in g a nd C hild -occ upied Fa cilities: Di d th e certi fi ed !inn /renovator cond uct soil abatement , wh en necessarv, accordin g to the prescribed meth ods?
Co mm ents
42 to 40 C.F. R. 745 .227(e)(8)
Ta rge t Ho usi ng a nd C hild-occupied F aci liti es: Di I th e ce rtified fi rm/renova tor ha ea certifi ed inspector or ri k
assessor oerfo rm the post-abatement clearance 1Jroceclures?
Co mm ents
tl ,~
~ '"'
t-1 I\\
t-1 \~
t-1 (\\
t-i l (\
iJ \\\
Page 18 of 21
COMPANY NAME: _ _ _ _----'--'H=u.,_,1_,.,_f_,_,_B<..J.l.1.1_ _ _ _ _ _ _ _ _ __
25
,,,- .
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
U.S. EPA
nd Rcnovn tion/Rcpuir/Pninting omplinncc hccklist - Renova tor
US ENVIRONMENTAL PROTECTION AGENCY REGION 6, DALLAS, TX 7S202
TOXIC SUBSTANCES CONTROL ACT
TITLE IV-LEAD HAZARD REDUCTION
43 40 C.F R. ~ 74 .227(e)(8)(i)
Tar,::ct Housing and hild-occupicd Facilities: Did the certified firm have an inspector or ri k a\scssor to perform a vi~ual in,pection aflcr abatement to determine ifdeteriorated
painted urface~ and/or isiblc amounts ofdust, debris or
re idue arc still present and to remove any hazards that still
remain?
Comments
44 40 F.R.
Target Housing and Child-occupied Facilitie : Did the
745.227(e)(8)(ii) certified firm/renovator wai l umil the required visual in pcction
and any nece ary post-abatement cleanups were completed
before performing clearance sampling for lead in dust?
Comments
45 40 .F.R.
Target Housina a nd Child-occupied Facilities: Did the
745.227(e)(S)(ii i certified fim1/renovator take dust samples for clearance
)
purpo es using documented methodologies that incorporate
adeauate auality control procedures?
Comments
46 40 C.F.R.
Target Housing and Child-occupied Facilities: Did the
745.227(e)(8)(iv) certified firm/renovator wait a minimum of I-hour after
completion of final post-abatement cleanup activities to collect
dust samples for clearance purposes?
Comments
47 40 C.F.R.
Target Housing and Child-occupied Facilities: Did the
74 .227(e)(8)(v) certified firm/renovator collect the required dust samples from
(A)
the prescribed surface in the designated rooms after conducting
an abatement with containment between abated and unabated
areas?
Com ments
48 40 C.F.R.
Target Housing and Child-occupied Facilities: Did the
745.227(e)(S)(v) certified firm/renovator collect the required dust sample from
( B)
the prescribed surfaces in the designated room after conducting
an abatement with no containment?
Commen ts
49 40 C.F.R.
Target Housing and Child-occupied Facilitie : Did the
745.227(e)(8)(v) certified firm/renovator conduct a visual inspection and clean
( )
horizontal, outdoor surfaces or visible du t and debri . perform
visual inspection for paint chips on the dripline and remo e and
properly dispo e ofany paint chip fo und followi ng an exterior
oaint abatement?
Com ments
rv I"
ti 1\
iv I~
r-JI ~ ~II\
tJ 111
tJ I\\
Page 19 of 21
COMPANY NAME. _ _ _ ___,1...i.:4l.,,/l).u.t--1.f--'':l!..I.H.!__ _ _ _ _ _ _ _ _ __
26
I
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
ft U.S. EPA
ad Reno ntion/Rcpair/Painting ompliance hcckli t - Renovator
US ENVIRONMENTAL PROTECTION AGENCY REGION 6, DAUAS, TX 75202
TOX IC SUBSTANCES CONTROL ACT TITLE IV-LEAD HAZARD REDUCTION
50 40 C'.F.R. ~
Target Ho usin g and hild -occ upicd Facil ities: Did the
74 .227(c)(8)(vi) certified firm /reno ator elect the room . hallways or stairwells
for sampling according to documented methodologies?
Com men ts
:1 40 C.F.R.
Target Hou ing a nd C hild -occ upi ed Facil ities: Did the
74 -.227(c)(8)( ii certified inspector or risk assessor compare the residual lead
)
level from dust sa mples with clearance levels to determine if
level exceeds the app licab le clearance level?
Comments
-2 40 C.F.R.
Ta rget Housi ng and Cb ild -occupied Facilities: Did a
74 - .227(e)(8)(vii certified inspector or risk assessor re-c lean and retest the
)
su rface of components that were determined to have failed
clearance testing after abatement?
Comments
53 40 C.F.R.
Target Housing an d Child-occupied Facilities: Did the
745 .227(e)(8)(vii certified fi rm/renovator use the sta nd ard clearance levels for
i)
lead in dust of 40 ftg/ft2 for floors , 250 g/ ft2 for interior
window sills, and 400 g/ft2 for win dow trough s to determine
ifa level in a samo le exceeds the aoolicab le clearance level?
Comments
54 40 C.F.R.
Target Housing and Child -occupied Faci liti es: Did a
745.227(e)(9)
certified firm/ renovator perform random sampling in a
multifamily dwelling with similarly constructed an d mai ntain ed
residentia l dwellings according to the prescribed methods?
Comments
55 40 C.F.R.
Target Housing and Child-occupied Facilities: Did a
745.227(e)( 10) certified renovator/supervi sor or project designer prepare an
abatement report th at includes the reauired inform at ion?
Comments
56 40 C.F.R.
Target Housing and Child-occupied Facilities: Did a
745.227(()
certified renovator ensure that all paint chi p, dust, or soi l
samples obtained are co ll ected by a certified ri sk assessor or
oaint insoector and anal yzed bv an EPA recogni zed laboratory?
Comm ents
57 40 .F.R.
Target Housi ng and Child-occupied Facilities: Did th e
745 .227(g)
certi fied renovato r limit compo ite dust sa mpling to on ! those
situati ons speci ti ed?
Co mm ents
tJI~
tl \ i-
t,) \I
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Pag 20 of 21
COMPANY NAME: ----~~ll~O~t__._F-=~'-'-t-"--1_____________
J
27
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
ft
U.S. EPA
Lead Renova tion/Repair/Painting Compliance hecklist - Renovators
US ENVIRONMENTAL PROTCTION AGENCY REGION 6, OALIAS, TX 7S202
TOXIC SUBSTANCES CONTROL ACT
.__ _ _ _ _ _ _ _ _ __J_ _ _ __..T:'....'..IT~L:=E...I'.V. -~LEAD HAZARD REDUCTION
s 40 C.F.R. ~
74 .2 27(h)
Target Ilo using a nd C hihl -occ upicd Faci lities: Did lhC certified rcnov:itor make a detcnnmat1on on lhe presence of lcad-baseu paint?
Comments
59 40 CFR
Target !lousing a nd Ch ild -occupied Facilities: Is 1he firm
745 .233
certified performs, ofTcrs or claims to perform renovations or
du t sampling for compensation to obtain initial certification
from EPA. under40 C.F.R. 745.226?
Comments
tJ try tl \'
# Re!! Ref l 40 C.F.R.
745 .227/d)(l)
LEAD-BASED PAINT RISK ASSESSMENTS Ouestion Is the person perfonning a risk assessment certified by EPA as
a risk assessor?
Y-N-NIA
,.i I II.
Comments
2 40 C.F.R. 745 .227(d)(2)
Did a certified renovator conduct a visual inspection for risk
.i r\\
assessment of a child-occupied facility to locate the existence of
deteriorated paint, assess extent and causes of deterioration, and
other notcntial lead based naint hazards?
Comments
Target Housing Maior = one or more occupants under age 6 and/or pregnant woman S1gnif1cant = no information about age of the youngest occupant, or one or more occupants between ages of 6 and 17
Minor= no occupant s under age 18
Child Occupied Facility Major= one or more occupants under age 6 (by definition, a child-occupied facility 15 regularly visited by one or more
children under 6) Minor= renovation act1v1ttes were completed during a period when children did not access the facility (e.g., as summer vacation) and there 15no continuity of enrollment (1.e., the same children are not returning after the break).
Page 21 of 21 COMPANY NAME . _ _ _ _ _...HL!...loL<..UOJ:.\.:......r!_-s.LJl.H.!___ _ _ _ __ _ _ __
28
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Appendix 3 Maps of Communities
29
U.S. ARMY
-r l 1s _ [FGo -------+ ""~Duro l
lnf~ntr"f' Post Ouplt"v
oll
CGO
-
lnfan~~S..l'\flt'F.lm~
1 21
'""... ___ ~
.;.__-1-_1_00_ _
f ..l!W
60
Staff "_-_ _ _ _ _ _ _+-15
FGO
,,.co- - - - i
JNCO GO
W.1tk1MtNTKe Whe-..ton/Gr-~ham Dtck:m.ln
2 ~ Jt.lCO ,-- ~
W ~ ~ m Dtdmain CGO. 20
CPT Onty
WhHton/G.-.~n fGO I 107
FGO
~ m n (COL Onlyl
7
Art1l~ty POS1
Jg
:::-~ I:
172
Hams~ hts
9
I
~-!" ~-,a1~
C.- ---,
1 --
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Privatized Housing
Provider: Hunt Military Communities
925 homes ,- 434 Historic ,- 491 Non-historic
- Hi
Infantry Post
--
Staff Post Art!lleiy Post Wheaton/Graham/01ckman Hancock Gorgas Hams Heights Watkins Terrace Patch Chaffee/Marvin R Woods
i ;ffii j 188611948 1881-86 1905-08 1931-34 1905-08 1934 2004 1995-96 1934/2006
30
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
(_ _
ARTILLARYPOST
ADDRESS MAP
JOM"a~SANA."ffll!NK)
rou SAM MOUST0tf
ICAl.l.1- Dollff" iNf-
31
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
DEPARTME).,- ,'JR FORCE
WHEATON-ORAHAM
ADDRESS MAP
JOM L\ll SAN ANtQNlO fOI\TWIHOUSTOt,a
ICAl.11,oQ D,,\lllA.'t-
32
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
..
,,,.
- - --
...,,, urwmym;pnp;rnrm1m,;1w
lf'P!CIMPD:11.,,.IBINC>JriOIA liM
9"f:':Q,IDNU'!lf:!I::-
_GORGAS CTR
..... ADDRESS MAP
JO.D..lf,a.ADSA."Nff'OJ,llD
33
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
/
- .,,.
- a1 I '::P:U"lr:811 l1JIP fQft Il1f CUI RIY91.HP
II!'fUAOOAUl"M!lfSINCt:f9Iffl Fet9
QAUCIII?M,,.,C!I -
HANCOCK ADDRESS MAP
IOINT SASE SA."1 MiOh'lO fOUS.U.IIIOl.'STO.~
ICALl-1 .. "1'&AJ'-
34
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
_,,,..
----
=---=----
DEPARTMENT- ,UJ. FORCE @'
"
0 '
0
'r",.i'2ii.b'imff"
TM
-
ADDRESS MAP
IOOo'Tt.ASllA.\f.orrotiJO
tCAU'.11".1,'11""G',";l"'L"J'u"l"- '
35
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
'...-'
r-----L..__J-
0
11 XI
d im-A!mv1osr
ADDRESS MAP
JO..l.>,,T...I..A.U..S,A._.'l~
~ - a,,,n.:w..-
36
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
I,. r
... ~ , 03570
HO
110
*
OU 000:ANTRY POST
ADDRESS MAJ>
JOl,,TIA!!SA."A.'i'T'O'OO
ICM'.I"'-""n'",,","ri"w"t-
37
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Appendix 4 Photo log
38
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010001.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:10 PM Photographer: Stan Lancaster Description: Debris in corner of work area with paint chips at 2857 Chaffee Road San Antonio TX 78234
39
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010002.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:11 PM Photographer: Stan Lancaster Description: Baseboard prepared to paint at 2857 Chaffee Road San Antonio TX 78234
40
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010003.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:11 PM Photographer: Stan Lancaster Description: Baseboard prepared to paint at 2857 Chaffee Road San Antonio TX 78234
41
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010004.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:11 PM Photographer: Stan Lancaster Description: Sanding dust and paint chips on floor at 2857 Chaffee Road San Antonio TX 78234
42
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010005.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:13 PM Photographer: Stan Lancaster Description: Debris from work at 2857 Chaffee Road San Antonio TX 78234
43
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010006.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:14 PM Photographer: Stan Lancaster Description: Baseboards prepared for paint at 2857 Chaffee Road San Antonio TX 78234
44
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010007.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:15 PM Photographer: Stan Lancaster Description: Baseboards prepared for paint at 2857 Chaffee Road San Antonio TX 78234
45
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010008.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:16 PM Photographer: Stan Lancaster Description: Paint chips on ground at 2857 Chaffee Road San Antonio TX 78234
46
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010009.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:16 PM Photographer: Stan Lancaster Description: Paint chips on ground at 2857 Chaffee Road San Antonio TX 78234
47
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010010.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:18 PM Photographer: Stan Lancaster Description: Painted baseboard at 2857 Chaffee Road San Antonio TX 78234
48
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010011.JPG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:19PM Photographer: Stan Lancaster Description: Painted baseboard 2857 Chaffee Road San Antonio TX 78234
49
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010012PG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:30PM Photographer: Stan Lancaster Description: Debris from shower stall work at 2800 Chaffee Road San Antonio TX 78234
50
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010013PG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:30PM Photographer: Stan Lancaster Description: Debris from shower stall work at 2800 Chaffee Road San Antonio TX 78234
51
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Photo File Name: P1010014PG Date of Photo: 10/21/2024 Time of Photo: Approximately 12:33PM Photographer: Stan Lancaster Description: Contractor vehicle performing work at 2800 Chaffee Road San Antonio TX 78234
52
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Appendix 5 Receipt for Samples and Documents
(Form 7740-1)
53
Hunt Military Community at Fort Sam Houston Inspection Date: 10/21/2024
Uni tt!d StatM
7
ENVIRONMENTAL PROTECTION AGENCY
-~
- Wa shington, DC 20460
Receipt for Samples and Documents Office of Enforcement and Compliance Assurance
1 lnvest19at1on ldent1f,cat1on
2 Company Name
IDate
I lnspec:t,on No
IV/.21 L~~it 111 1v ;IJ - c.u1
3 Inspector Address
I Daily Seq No.
11 01
forI .x""- /1,:;...u-fvn. - /1"1rd- Yl,/,ti:-r;u_J
I
to, n,n!1!li6",,_kt.. c..
4 Company Address
I/2<)/ Fl,1\ ~'f<zc:i
).? 31 l),c.t,,.,~ n-'"-IA C, '-/,J), Fut-+ 5.4""'
/) 1:t/ ,. , Te;i c., , ; 5'1.?J
11 /-11A...,J WI' r~XC> I / i J..3'~/
For tntemal [PA us.. Cop,es of this fonn may be provided to rec,p,ent as ac~nowledgm.-nt of the documents and sampl.-s of ch.-rr>,cal
svb,tances and/or mnctures descnbed below collected In connect,on with the administrauon and enforcement of the Toxic Subst,mces Control
Act
Receipt of Document(s) and/or Sample(s) Described Is Hereby Acknowledged
No
I I
,I.
3
Descnpt1on
filufujl~ Ljrh.;,t,,,
II ~I
I H~, ~\l11T"7 l...,y)t1'<-1111.hl, t-'r;vc,t.~.t Hu..,,..) vty ( '-I l.v(J,c,. )
I J Ir,0;v1-<.wtl "-..,,n.....,1, #z)w,~ tl"\-'r'' fur prt- l'JJt tu.ntrMt11J~, (7,vv,_u I
I'
I
I
I'
I
I
I
II II' . Opuonal Duplicate or Split Samples Requested and Provided Not Requested ,..:....
lnspector:~s__/
S1gna,tu,c!
N~ vf'-./e.4. M,,... "~--zcz.,5-;lz,
Tnle [ ;!, , ~ , I-. r
II Date IJo/~~ f
Claimant'~ , ~
Signature
~l,(.,C. )
IName lri1Y1rJ1,\I/\ ,L, ' \~\rt?n\iv
IT,tle I\{\~\(v C:o.1 ~C\ ii Date I\0
1~1 ]~
PA rorm 71401 IRMI } / 161
1-lntP<-"<IOf Copy
54