Landlords Disclosure of Radon Gas Hazards in a Residential Rental Property

Landlords Disclosure Of Radon Gas Hazards In A Residential Rental Property

HHE-810 2011-10-26

Residential Rental Unit Number Or Other Identifier:______________________________________________

Residential Rental Unit Address (Rental complex name if applicable, street address, city, state, zip code):

________________________________________________________________________________________

A radon test in the unit identified above was completed on _____/______/_____. A re-test must be completed

within 10 years. (day) (month) (year)

OR

Radon testing was not conducted in the unit identified above but was conducted in other parts of the building where

the unit is located. The testing was completed on _____/______/_____. A re-test must be completed within 10

years. (day) (month) (year)

The radon level found in the above identified unit (or, if the unit was not tested, the highest level found during

testing in other parts of the building) was __________ pCi/l. A copy of the original results report is available for

viewing by the Lessee or potential Lessee. Radon levels of 4 pCi/l or higher shall be mitigated within six months of

the test completion date. (Exception: If a permit is required for mitigation, the mitigation shall be completed within

six months of permit approval date.)

A document explaining the hazards of radon,

Radon in Rental Housing-A Serious Hidden Danger to Family He alth is

attached.

.

__________________________________________________________________________________

_

ACKNOWLEDGEMENT OF RADON GAS HAZARDS DISCLOSURE

The signatures below acknowledge that the landlord or their agent has disclosed to the lessee or potential lessee

information about elevated radon gas as required by 14 M.R.S.A. Section 6030-D. This acknowledgement does

not constitute a waiver of any rights.

______________________________________ ___________________________________________

Landlord (printed) Date Landlord (signed) Date

______________________________________ ___________________________________________

Lessee (printed) Date Lessee (signed) Date

______________________________________ ___________________________________________

Lessee (printed) Date Lessee (signed) Date

______________________________________ ___________________________________________

Agent (printed) Date Agent (signed) Date

Fillable Printable Landlords Disclosure of Radon Gas Hazards in a Residential Rental Property