Federal Lead and State Lead (N261) Programs

Community Action Agency (CAA)

Updates & Notices

Notifications

Effective 6/18/2020 - A copy of the signed Declaration of Covenants and Restrictions must be submitted with the Multi-Family Phase 1 request for payment. The Document Checklist and Lead Guide have been revised to reflect this change.

Effective 5/11/2020 - the Environmental Review process has changed significantly. Refer to the Instructions on Completing Environmental Review Worksheets before proceeding with the environmental review process for a Federal Lead project.

See MaineHousing Notice 2020-001, effective 5/11/2020, for clarification regarding (1) Lead Guidance and Procedures (Lead Guide); (2) Environmental Reviews; (3) Project Summary Sheets; (4) Form bundles; and (5) Electronic signature. All MaineHousing Notices are located on the CAA Portal under "Updates & Notices" (left menu).

The Maine State Housing Authority (MaineHousing) is pleased to provide its Community Action Agency partners with web access to State Lead Paint Hazard Abatement Program forms and guidance.

Instructions

Forms are pdf writable. Download the "Forms Bundle" and complete its cover sheet to auto-populate the forms. Use Adobe's bookmark navigation feature to view and/or print forms in the bundle. Individual forms are also available to download, populate and print as needed.
NOTE: The web site is not designed to retain data. Save form(s) to your computer-network before populating. Do not save blank forms on your computer for future use; download blank forms from the web site to ensure that you are using the most current version. Tip: Save the website to your browser favorites bar for quick access.

Program Forms
Program Tools & Brochures
Program Guidance & Manuals

Program Forms

SHPO Form (rev 03/2020)
PDF, 85.15 KB
Owner Materials Cost Reimbursement Request Form and Process (rev 4/28/2020 STATE LEAD ONLY)
PDF, 98.21 KB
Appendix F Income Recertification
PDF, 77.97 KB
Appendix K - Waiver Request
PDF, 33.42 KB
Appendix N - Change Order
PDF, 40.65 KB
Appendix 1C - Billing Invoice
PDF, 56.96 KB
Appendix 1A - Single-Family Project Summary Sheet rev 05/11/2020
PDF, 78.49 KB
Appendix 1A - Multi-Family Project Summary Sheet up to 10 units
PDF, 261.11 KB
Appendix 1A - Multi-Family Project Summary Sheet up to 5 units
PDF, 187.05 KB

Phase 1

BUNDLE - SINGLE-FAMILY PHASE 1
PDF, 714.35 KB
BUNDLE - SINGLE-FAMILY PHASE 1 AND PHASE 2 combined
PDF, 898.39 KB
BUNDLE - MULTI-FAMILY PHASE 1- up to 5 Units
PDF, 3.92 MB
BUNDLE - MULTI-FAMILY PHASE 1- up to 10 Units
PDF, 5.01 MB
BUNDLE - MULTI-FAMILY PHASE 1 AND PHASE 2 - up to 5 Units combined
PDF, 4.63 MB
Appendix 1B-SF1 Phase 1 Single Family Document Checklist
PDF, 185.53 KB
Appendix 1B-MF1 - Phase 1 Multi-Family Document Checklist
PDF, 85.71 KB
Appendix A - Owner Application
PDF, 210.42 KB
Appendix A1-SF Applicant Information (Single-Family)
PDF, 30.18 KB
Appendix A1-MF Applicant Information (Multi-Family)
PDF, 58.83 KB
Appendix B - Tenant Application and Information
PDF, 231.64 KB
Appendix C-A Construction Contract
PDF, 107.03 KB
Appendix C-B Construction Escrow Agreement
PDF, 55.11 KB
Appendix D - Blood Testing Release Form
PDF, 37.15 KB
Appendix E Authorization to Release Information
PDF, 53.82 KB
Appendix G Child Under 6 Visiting Form
PDF, 61.25 KB
Appendix H - Declaration of Covenants and Restrictions
PDF, 87.35 KB
Appendix HH-6 - Healthy Homes Intervention Compliance Agreement (FEDERAL LEAD ONLY)
PDF, 48.83 KB
Appendix J - Bid Tabulation Sheet
PDF, 46.48 KB
Appendix LD-1 - Notice of Grant Pre-Approval
PDF, 41.80 KB
Appendix LD-2 - Grant Agreement
PDF, 106.63 KB
Appendix LD-C Relocation Assistance Acknowledgement
PDF, 44.73 KB
Appendix Y - Refusal to Bid
PDF, 32.06 KB
EXHIBIT C- Lead Design Plan Specifications
DOCX, 56.10 KB

Reports

Appendix R1 - Quarterly Report Supplemental Information (FEDERAL LEAD ONLY)
PDF, 41.44 KB
Appendix R2 - Annual Verification of Compliance
PDF, 87.15 KB
Appendix R3 - HUD Section 3 Verification Data
PDF, 53.70 KB

Phase 2

BUNDLE - SINGLE-FAMILY PHASE 2
PDF, 446.57 KB
BUNDLE - MULTI-FAMILY PHASE 2 - up to 5 Units
PDF, 799.54 KB
BUNDLE - MULTI-FAMILY PHASE 2 - up to 10 Units
PDF, 1.25 MB
Appendix 1B-SF2 - Phase 2 Single-Family Document Checklist
PDF, 127.21 KB
Appendix 1B-MF2 - Phase 2 Multi-Family Document Checklist
PDF, 138.42 KB
Appendix I-B - Contractor Certificate and Release of Liens
PDF, 32.73 KB
Appendix I-C - Contractor Payment Request
PDF, 67.85 KB
Appendix M - Pre-Construction Conference Report
PDF, 33.35 KB
Appendix P - Letter of Lead Compliance
PDF, 38.98 KB
Appendix Q - Certificate of Final Inspection
PDF, 81.09 KB
Appendix R - Paint Plus Essential Maintenance Practices
PDF, 77.02 KB

Environmental Review

Instructions for Completing Environment Review Worksheets
PDF, 122.04 KB
SAMPLE Multi-Family-Environmental Review Worksheets Bundle
PDF, 255.76 KB
SAMPLE Single-Family-Environmental Review Worksheets Bundle
PDF, 255.03 KB
Multi-Family Environmental Review Worksheets Bundle 05202020
DOCX, 55.79 KB
Single-Family Environmental Review Worksheets Bundle 05202020
DOCX, 57.06 KB

Program Tools & Brochures

Program Guidance & Manuals

Federal and State Lead Programs Guidance (rev 06/18/2020)
PDF, 787.94 KB
Lead Contractor Standards and Conditions (rev 02/2020) Exhibit C-1
PDF, 450.55 KB
MHN 2020-001 - Lead 05112020
PDF, 135.02 KB

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