Free Michigan Dch 0654 Template

Michigan Dch 0654 - Usage Steps

Filling out the Michigan DCH-0654 form is a vital step for any firm planning to conduct lead-based paint abatement activities within the state. This form serves as a notification to the Michigan Department of Health and Human Services (MDHHS) of the intent to undertake such work, adhering to the stipulation that the department must be informed not less than three business days before the commencement of the activities. Accuracy and completeness are crucial when filling out this form, as incomplete notifications are not processed.

1. Notification Date: Enter the current date when you are filling out the form.
2. Start Date: Specify the day when the abatement activity is scheduled to begin.
3. End Date: Indicate the planned completion date for the abatement activity.
4. Revision #: If you are making changes to a previously submitted notification, enter the revision number here. For first-time submissions, leave this blank.
5. Reason for revision: Required only if you are submitting a revised notification, otherwise, leave this blank.
6. Fill in the scheduled work hours, including whether weekends are included.
7. Provide the Contractor Name and their MI Certification #.
8. Enter the name and phone number of the Contact Person.
9. For the project, list the Certified Lead Abatement Supervisor's MI Certification # and the Risk Assessor's MI Certification #.
10. Select the Type of lead-based paint assessment being conducted (Risk assessment, Inspection, Assumed).
11. Detail the Building Owner's name and phone number.
12. Fill in the Project/Site City, Zip, Address, and Apartment numbers if applicable.
13. Mark the Building Type and Occupancy Type.
14. List the Housing Agency funding the project, if applicable, along with the contact person and their phone number.
15. Check the appropriate boxes under Scope of Work to indicate where the abatement activity will take place (Interior, Exterior, etc.) and provide a brief detail of the scope of work.
16. Once the form is completely filled out, it must be mailed or faxed to the MDCH - Healthy Homes Section at the address or fax number provided at the top of the form.
17. Remember to return the completed form at least three (3) business days prior to the commencement of the abatement work. If the project schedule changes after submission, you must mark the appropriate revision number at the top of the form and send it in at least 24 hours prior to the change.

Ensuring that the DCH-0654 form is correctly filled out and submitted in a timely manner is essential for compliance with the Michigan Lead Abatement Act. Failure to do so could result in delays in your project or potential legal complications. Always double-check the information provided for accuracy before submission to avoid any issues.

What is the purpose of the Michigan DCH-0654 form?

The Michigan DCH-0654 form is used to notify the Department of Health and Human Services about lead-based paint abatement activities in the state of Michigan. Firms conducting these activities must inform the department at least three business days before starting, as mandated by section 333.5472 of the Michigan Lead Abatement Act of 1998, as amended. This ensures that all abatement activities are conducted safely and in compliance with state regulations.

What information is required when filling out the DCH-0654 form?

All sections of the DCH-0654 form must be completed for the notification to be approved. Required information includes:

1. Notification date, start date, and end date of the abatement activity.
2. Revision number and reason for any changes to previously submitted information.
3. Scheduled work hours and whether weekends are included.
4. Contractor name, contact person, and their Michigan certification numbers.
5. Type of lead-based paint assessment to be conducted.
6. Building owner, project/site address, and occupancy details.
7. Detailed scope of work.

How do I submit the completed DCH-0654 form?

The completed DCH-0654 form can be submitted via mail or fax to the MDCH - Healthy Homes Section. The mailing address is P.O. Box 30195, Lansing, MI 48909, with the attention directed to the Compliance Officer. If faxing, send it to 517-335-8800. Make sure to send in the form at least three business days before the commencement of abatement work.

What should I do if the schedule for my abatement project changes?

If there are any scheduling changes for the abatement project, you must mark the appropriate revision number at the top of the DCH-0654 form, explaining the reason for the change. Then, resubmit the updated form at least 24 hours before the new scheduled start date. This helps ensure that all parties are informed about the project's timing and can prepare accordingly.

Is it necessary to notify about lead abatement activities for every project?

Yes, notification is required for any lead-based paint abatement activity conducted in Michigan, regardless of the project's size or duration. This ensures that the State is aware of all abatement efforts, helping to maintain public health and safety standards.

Can the DCH-0654 form be used for both interior and exterior abatement work?

Yes, the DCH-0654 form is designed to cover both interior and exterior lead-based paint abatement work. It includes sections where you can specify the scope of work, whether it involves interior activities, exterior activities, or both, along with detailed descriptions of the tasks planned.

Who can fill out the Michigan DCH-0654 form?

The DCH-0654 form must be filled out by or on behalf of the firm that is conducting the lead abatement activities. This includes providing the firm's Michigan certification number, details of the certified lead abatement supervisor for the project, and the contact information of the person filling out the form. Ensuring that the form is filled out correctly and completely is crucial for compliance with Michigan lead abatement laws.

Submitting the Michigan DCH 0654 form is a crucial step for companies carrying out lead-based paint abatement activities in Michigan. However, the process can be full of pitfalls if not approached carefully. Here are nine common mistakes people make when filling out this form, all of which can lead to delays and potential compliance issues.

1. Not notifying on time: Companies must notify the department at least three business days before starting the abatement. Failure to do so can result in penalties and project delays.
2. Submitting incomplete forms: The form clearly states that all information is required. Incomplete submissions will not be approved, so double-check every section before sending it.
3. Overlooking the revision section: If there are any changes to your project schedule, it's mandatory to note the revision number and submit the form at least 24 hours before the change. This step is often missed.
4. Confusion over project dates: Make sure the start and end dates are correctly entered. Confusion or typos here can lead to misunderstandings about the project timeline.
5. Incorrect certification numbers: The form asks for MI Certification numbers for the contractor, the certified lead abatement supervisor, and possibly a risk assessor. Mixing these up or entering them incorrectly can invalidate your notification.
6. Failure to specify the work scope: The scope of work must be detailed clearly. Whether it's interior or exterior work, encapsulation, or component removal, vague descriptions won’t pass muster.
7. Misidentifying the building type: The form differentiates between single-family, multi-family, rental, and other building types. Accurately identifying this ensures proper handling of your notification.
8. Forgetting about weekend work: If the abatement work includes weekends, this must be indicated. Failing to do so could lead to scheduling conflicts and non-compliance with notification requirements.
9. Neglecting contact information: Complete and correct contact information for the contractor, project supervisor, and risk assessor (if applicable) is vital. Any errors here can lead to communication breakdowns.

While filling out governmental paperwork like the Michigan DCH 0654 form may seem daunting, avoiding these common mistakes can streamline the process. Ensuring that all sections are thoroughly and accurately completed, and that the form is submitted on time, are your best bets for keeping your lead abatement project on track. Remember, the goal is to ensure the safety of everyone involved, from workers to residents, by properly managing and notifying of lead abatement activities. So, take the time to review your form before submission, and keep the lines of communication open with the Healthy Homes Section.

When preparing for lead abatement activities in Michigan, the Michigan DCH 0654 form is crucial, but it's not the only document you'll need. To ensure compliance and smooth project execution, several other forms and documents often accompany the DCH 0654. Below is a list of these documents, each described briefly to help you understand their purpose and importance.

1. Lead Abatement Contractor Application: This form is for firms applying for certification to conduct lead abatement. It verifies that the firm meets state requirements.
2. Lead Abatement Project Plan: A detailed plan that outlines the objectives, methods, and procedures for the abatement project, ensuring safe and effective lead removal.
3. Risk Assessment Report: Prepared by a certified risk assessor, this report identifies lead hazards in the property and recommends ways to control them.
4. Lead Inspection Report: A comprehensive analysis conducted by a certified inspector that identifies the presence of lead-based paint in the property.
5. Occupant Protection Plan: Outlines measures to protect residents from lead exposure during abatement, including temporary relocation if necessary.
6. Lead Abatement Worker Certification: Documentation that individuals performing abatement have completed the required training and are certified to work with lead-based paint.
7. Post-Abatement Report: A report detailing the abatement work performed, including methods used, clearance levels achieved, and confirmation that the work area is safe for re-occupancy.
8. Notification of Hazardous Waste Generation: Notifies state authorities of any hazardous waste generated during abatement and outlines plans for its proper disposal.
9. Clearance Examination Forms: Completed by a licensed risk assessor or lead inspector after abatement, verifying that the area meets state criteria for lead safety.

Together with the Michigan DCH 0654 form, these documents form the backbone of a comprehensive lead abatement project. By ensuring each form is accurately completed and submitted as required, contractors can help protect the health of Michigan residents, particularly children, from the dangers of lead exposure. Staying informed and compliant with these documents is essential for a successful lead abatement effort.

The Michigan DCH 0654 form, used for notifying the department of lead-based paint abatement activities, shares similarities with various other legal and regulatory documents. These documents often require detailed information regarding construction, abatement, and renovation activities, focusing on ensuring safety and compliance with state and federal regulations.

The EPA's Lead Renovation, Repair and Painting (RRP) Rule Notification Form is one example. Like the DCH 0654, this form mandates that contractors performing work which disturbs lead-based paint in homes, child care facilities, and schools built before 1978 notify the appropriate agency before starting. Both forms require the submission of specific details about the project, including the type of building, occupancy status, and scope of work. Additionally, they need information on the contractors and their certification numbers, emphasizing the importance of qualified professionals handling lead-based substances.

HUD's Lead-Based Paint Hazard Control Grant Program Application shares similarities with the DCH 0654 form in terms of its focus on lead safety and compliance. While the HUD application is designed for entities seeking funding for lead hazard control, both documents highlight the importance of detailed project descriptions, including the address, scope of work, and occupancy information. Both forms also play a crucial role in protecting residents, especially in low-income and vulnerable communities, from the dangers of lead exposure.

Lastly, state-specific lead notification forms, similar to Michigan's DCH 0654, exist in many states. These forms, while varying in format and specific requirements, universally require notification of any lead abatement activities. Key similarities include the need for contractor certification details, project timelines, and specific activities being performed to address lead hazards. The aim is to ensure that states can monitor and regulate lead abatement activities effectively to prevent lead poisoning, particularly in children.

When preparing to submit the Michigan DCH-0654 form for notification of lead abatement activity, there are several important do's and don'ts to keep in mind to ensure that the process is completed smoothly and in compliance with the state requirements. Follow these guidelines carefully to avoid common pitfalls.

Do:

1. Review the entire form before filling it out to understand all the required information.
2. Provide complete and accurate information for every section to avoid delays or rejection.
3. Notify the MDCH - Healthy Homes Section at least three (3) business days before the start of abatement activities, as mandated by law.
4. If there are any changes to your project's schedule, mark the revision number at the top of the form and submit the updated information at least 24 hours before the change.
5. Include the correct MI certification numbers for the contractor, lead abatement supervisor, and risk assessor.
6. Clearly describe the scope of work in detail, including specific activities like window replacement or paint removal.
7. Check the appropriate boxes for the type of lead-based paint assessment and the occupancy and building types.
8. Ensure that the contact information for the contractor, building owner, and housing agency is accurate and up-to-date.
9. Double-check that all dates (notification date, start date, end date) are correctly entered.
10. Keep a copy of the form for your records after submitting it to the MDCH - Healthy Homes Section.

Don't:

• Leave any sections blank. All information is required, and incomplete notifications will not be approved.
• Guess on certification numbers or other required details; verify all information before submission.
• Ignore the requirement to include scheduled work hours and whether weekends are included in the project timeline.
• Forget to specify the revision number and reason for any changes if you're updating previously submitted information.
• Overlook the need to indicate both the interior and exterior scope of work if both are applicable to your project.
• Assume you don't need to notify the MDCH if your project is small or seems minor; all lead-based paint abatement activities must be reported.
• Submit the form after the work has already started. Late notifications can result in penalties.
• Use outdated contact information for the compliance officer or the fax number, as this could delay processing.
• Misplace your copy of the submitted form, as it may be needed for future reference or in case of an audit.
• Underestimate the importance of accurately reporting the project/site city, zip, and address. Inaccurate location information can cause significant issues.

There are several misconceptions about the Michigan DCH 0654 form, a crucial document for lead abatement activities in the state. Understanding these misconceptions is essential for firms and contractors involved in lead-based paint abatement.

• It's only for large firms: Some people mistakenly believe the DCH 0654 form is only required for large firms. However, any entity, regardless of size, conducting lead-based paint abatement in Michigan must submit this form to the Michigan Department of Health and Human Services.
• Notification is optional: Another common misconception is that notification through the DCH 0654 form is optional. In reality, notifying the department at least three business days before starting any abatement activity is a legal requirement under the Michigan Lead Abatement Act.
• It can be submitted anytime before the project starts: The form must be submitted at least three business days prior to the commencement of abatement activities. Waiting until the last minute or submitting it late can lead to penalties.
• Changes don't need to be reported: If there are any changes to the project schedule or scope, a revised DCH 0654 form must be sent in at least 24 hours before the change. Failing to report changes undermines compliance with the regulation.
• Weekend work doesn't need to be specified: The form clearly asks whether weekends are included in the scheduled work hours. This detail is crucial for compliance and safety monitoring, contradicting the notion that weekend work does not need to be specified.
• Only interior or exterior work needs to be reported: A misconception exists that you only need to report either interior or exterior work. The form requires detailing whether the work will be inside, outside, or both, including specific abatement methods and target areas.
• Personal contact information is not necessary: Every section asking for contact information, including that of the contractor, supervisor, risk assessor, building owner, and any funding agency, is essential. Not providing this information can lead to an incomplete notification, resulting in non-approval.

Correctly understanding and complying with the requirements of the Michigan DCH 0654 form is vital for those involved in lead abatement projects. Ensuring all the required information is accurately and timely submitted helps in safeguarding public health and the environment from lead hazards.

Filling out and using the Michigan DCH 0654 form correctly is crucial for any firm conducting lead-based paint abatement activities in Michigan. Here are key takeaways to ensure compliance and smooth operations:

• Timely notification is mandatory. Firms must notify the Department of Community Health's Healthy Homes Section at least three business days before starting any lead abatement project. This is a strict requirement under §333.5472 of the Michigan Lead Abatement Act of 1998, as amended.
• All sections of the form must be completed. Incomplete notifications will not be processed, which could delay project start times.
• For project changes, the form contains a provision for revisions. If there are any changes to the project schedule, the firm must mark the revision number at the top of the form and submit the update at least 24 hours before the change.
• The form requires detailed information about the contractor, including the MI certification number, contact person, and contact details. Providing accurate information here ensures the responsible parties are contactable for any clarifications or issues.
• Project specifics, including the start and end dates, work hours, and whether work will be conducted on weekends, must be clearly defined. This information helps in scheduling inspections and managing public expectations.
• Type of lead-based paint assessment and abatement work must be explicitly stated, including whether the project involves risk assessment, inspection, encapsulation, enclosure, component removal, paint removal, or soil. Each type of work has specific regulatory requirements and implications.
• Information regarding the building owner, occupancy status, building type, and detailed scope of work is critical. This data helps in assessing the project's potential impact on occupants and neighbors and in planning the appropriate safety measures.
• The involvement of a certified lead abatement supervisor and risk assessor for the project is necessary. Their MI certification numbers and contact information are required on the form, underscoring the importance of having qualified professionals overseeing abatement activities.

Adhering to these guidelines not only ensures compliance with Michigan's lead abatement regulations but also promotes the safety and well-being of workers and residents in the affected properties.