Current through Register No. 40, October 3, 2024
(a) Each applicant for a license or
certificate as a lead professional shall comply with the requirements of RSA
130-A, and submit the following to the department:
(1) A completed "Lead License or
Certification Application" (May 2020) provided by the department for the
discipline of lead professional being applied for, certifying the following:
"I certify that I have read, understand, and agree to
comply with the New Hampshire Lead Poisoning Prevention Rules (He-P 1600) and
the Lead Poisoning Prevention Statute (RSA 130-A). I further certify that all
information contained herein, including any supplements attached, is true and
correct to the best of my knowledge and belief.";
(2) The applicable licensing or certification
fee(s) pursuant to
He-P
1612.08(a), for the discipline of
lead professional being applied for, paid by check or money order, in the exact
amount of the fee(s) and made payable to the "Treasurer, State of New
Hampshire";
(3) An original,
current, clear photograph of the applicant, such as a passport photograph;
(4) Photocopies of official
academic transcripts and/or diplomas issued by the relevant educational
institution or a GED, as required by
He-P
1612.02;
(5) A copy of the course completion
certificate for the lead educational program completed in accordance with He-P
1611 for the discipline of lead professional being applied for;
(6) With the exception of a lead abatement
worker, documentation that the applicant has passed the proficiency
examinations required by
He-P
1612.04;
(7) Documentation, including the name,
address, telephone number, and e-mail, if available, of a contact person(s) who
can verify all work experience required by
He-P
1612.02;
(8) A list of all names, trade names,
acronyms, and other identifiers used currently or in the past when performing
lead hazard reduction activities, lead inspections, or risk
assessments;
(9) A list of any
pending or completed federal, state, or local enforcement actions against the
applicant which resulted from lead hazard reduction activities, lead
inspections, or risk assessments for the 10 years preceding submission of the
application, including:
a. Notices of
warnings, violations, or administrative fines;
b. Administrative orders or consent
decrees;
c. Notices of license or
certification denial, suspension, or revocation; and
d. Pending or completed civil or criminal
actions involving the applicant; and
(10) If applying for a license as a lead
inspector or a risk assessor, signed documentation that they agree to provide
the department with proof of competency as required by
He-P
1612.02(e)(4) or (f) (4).
(b) The application required by
(a) above shall be notarized.
(c)
The applicant shall mail or hand-deliver the documents to:
Department of Health and Human Services
Division of Public Health Services
Healthy Homes and Lead Poisoning Prevention Program
29 Hazen Drive
Concord, NH 03301
