Michigan Dch 0654 PDF Form

What is the Michigan DCH 0654 form used for?

The Michigan DCH 0654 form is a required document for any firm conducting lead-based paint abatement activities in the state of Michigan. It serves as a notification to the Michigan Department of Community Health (MDCH) - Healthy Homes Section about the intent to start such activities. This form helps ensure that all lead abatement work complies with the Michigan Lead Abatement Act of 1998, as amended, by providing the department with details of the abatement projects.

When must the DCH 0654 form be submitted?

This form must be submitted at least three business days before the planned commencement of any lead abatement activity. This advance notice allows the MDCH to ensure that all necessary safety and health regulations are being met for the protection of workers and residents.

What happens if there are changes to the project schedule?

If there are any changes to the project schedule after the initial notification has been submitted, the form has a section for revisions. This section should be filled out, indicating the revision number, and the updated form must be sent to the MDCH at least 24 hours before the change takes effect. This ensures that the department is kept informed of any adjustments to the project timeline.

What information is required on the DCH 0654 form?

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

• Notification, start, and end dates of the abatement activity
• Details about the contractor and certified lead abatement supervisor for the project
• Type of lead-based paint assessment to be conducted
• Information about the building owner and the building itself, including occupancy status and type
• Details about the agency funding the project, if applicable
• Scope of work, including whether the work is interior or exterior, the specific abatement techniques to be used, and a brief detail of the scope of the work

How do I submit the DCH 0654 form?

The completed DCH 0654 form can be mailed or faxed to the MDCH - Healthy Homes Section. The address for mailing is P.O. Box 30195, Lansing, MI 48909, with attention to the Compliance Officer. If choosing to fax the form, the number is 517-335-8800.

What should I do if the form is incomplete?

Incomplete forms will not be approved. It is crucial to review the form thoroughly before submission to ensure that all required information is included. If you discover that the form was incomplete after submission, you should complete the necessary sections and resubmit the entire form as soon as possible, noting any revision if the project schedule has changed.

When filling out the Michigan DCH 0654 form, one common mistake is not providing complete information in every required field. All sections of the form are mandatory for ensuring compliance with the Michigan Lead Abatement Act of 1998, as amended. Submitting incomplete forms can lead to delays or non-approval of the notification, potentially hindering the start of abatement activities.

Another error often seen is failing to notify the MDCH - Healthy Homes Section within the required timeframe. The form must be submitted not less than three business days before the commencement of lead-based paint abatement activities. Overlooking this critical deadline can result in legal repercussions and delay the project's initiation significantly.

Incorrect or outdated contact information is another common mistake found on the DCH 0654 form. Accuracy in the contact details for the contractor, certified lead abatement supervisor, and risk assessor is crucial for effective communication. Errors in phone numbers or missing MI Certification numbers may prevent the compliance officer from verifying credentials or reaching out with questions or clarifications, leading to possible project postponements.

Failure to specify the scope of work in sufficient detail is yet another issue that can arise. The form requires a brief description of the work to be done, such as replacing windows or encapsulating baseboards. Vague or incomplete descriptions may not provide the MDCH with enough information to assess the project adequately, possibly leading to misunderstandings or the need for clarifications, which can delay approval.

Last but not least, a significant oversight is not updating the form when project details change. If there are changes to the start date, end date, scope of work, or other critical details, the form must be revised and resubmitted at least 24 hours before the change takes effect. Failing to mark the appropriate revision number and update the form can lead to compliance issues and misunderstandings about the project's status.

When dealing with lead abatement activities in Michigan, the Michigan DCH 0654 form is a critical document for notifying the Department of Health about these activities. However, it's often just one piece of the puzzle. Several other forms and documents usually accompany this notification to ensure compliance with regulations and to provide a comprehensive overview of the project. Understanding these documents can help streamline the process and ensure all necessary information is accurately conveyed.

• Lead Abatement Contractor Application: This form is necessary for firms looking to become certified in lead abatement work. It includes information on the business and its employees who will perform lead abatement tasks.
• Risk Assessment Report: A detailed report that identifies the presence, type, and severity of lead-based paint hazards in a property. It's a critical document that outlines the scope of work for abatement activities.
• Occupant Protection Plan: This document outlines the measures that will be taken to protect the building's occupants from lead exposure during abatement activities. It's crucial for ensuring safety and compliance with health standards.
• Clearance Report: After the completion of lead abatement activities, a clearance report is needed to prove that the area is safe and free of lead-based paint hazards. This involves visual assessment and dust sampling.
• Worksite Monitoring Log: This log tracks the daily activities and conditions at the abatement site, including worker activities, safety measures, and environmental conditions. It's essential for monitoring the project's progression and compliance with safety protocols.
• EPA Lead-Safe Certified Firm Application: Although not specific to Michigan, firms conducting lead abatement work must also be certified by the EPA. This application is necessary for obtaining or renewing EPA lead-safe certification, which is required in addition to state certification.

The careful completion and gathering of these documents, along with the Michigan DCH 0654 form, form the backbone of a well-documented and compliant lead abatement project. By understanding each document's role and requirements, firms and individuals can more effectively manage lead hazards and contribute to safer, healthier environments.

The Michigan DCH 0654 form, used for the notification of lead abatement activities, shares similarities with a variety of other forms and notifications across different regulatory environments. Here are six documents that have purposes in common with the DCH 0654:

• Notification of Renovation, Repair and Painting Activities (EPA Form 7450-20): Similar to the Michigan DCH 0654 form, this document is used to notify relevant authorities—specifically the Environmental Protection Agency (EPA)—about activities that might involve the disturbance of lead-based paint in pre-1978 homes and child-occupied facilities. Both forms require the notifier to provide specifics about the project, including the start and end dates, the type of property being worked on, and the scope of work.

• Asbestos Abatement Project Notification: Used to inform state environmental protection agencies or the EPA about planned asbestos removal work, this form parallels the DCH 0654 form as both are aimed at reducing exposure risks to harmful substances during abatement projects. They each require information on the project timeline, location, and the contractor's certification details.

• Hazardous Waste Manifest: While primarily used for tracking hazardous waste from the point of its generation to the disposal site, this document shares the procedural DNA with the DCH 0654 in terms of regulatory compliance and the necessity to provide detailed information about the nature of the work and the parties involved.

• Building Permit Application: Typically required for construction or major renovation projects, a building permit application has clear parallels to the DCH 0654 form, as both involve notifying authorities about significant work on properties. The information required often includes the project's scope, duration, and contractor details, ensuring that the work complies with local codes and regulations.

• Notice of Intent (NOI) to Discharge Under a General Permit: This document is necessary for operations that discharge wastewater or stormwater under a general permit. It is similar to the DCH 0654 form because both require the filer to notify regulatory bodies in advance of certain activities that have environmental impact considerations, including detailed information about the activity and the applicant.

• Occupational Safety and Health Administration (OSHA) Notification of Demolition: Before undertaking demolition activities, this notification must be filed with OSHA to ensure worker safety and compliance with safety regulations. Like the DCH 0654 form, it involves notifying a regulatory body about activities that could pose health hazards, outlining the project's scope, and the measures taken to mitigate risk.

These documents, although used in different regulatory contexts, share the fundamental purpose of safeguarding public health, the environment, and worker safety through the proactive notification of potentially hazardous activities.

When preparing to fill out the Michigan DCH 0654 form for notification of lead abatement activity, it's important to approach the process with care and attention to detail. To assist in the accurate and efficient completion of this form, here's a helpful guide outlining essential dos and don'ts:

• Do ensure that you have all the necessary information at hand before starting to fill out the form. This includes contractor certification numbers, project details, and contact information.
• Do notify the Michigan Department of Health and Human Services (MDHHS) Healthy Homes Section at least three (3) business days before starting any abatement activities, as required by law.
• Do precisely indicate the start and end dates for the abatement activities to keep records straight and avoid any legal or administrative issues.
• Do clearly mark any changes to the project schedule by revising the document with the appropriate revision number indicated at the top and submitting the form at least 24 hours in advance of the change.
• Do include a detailed scope of work in the provided section. This information should be comprehensive and cover all activities associated with the project.
• Don't leave any field incomplete. Incompleteness can lead to the rejection of your notification, causing delays in your project timeline.
• Don't forget to include the MI certification numbers for the contractor, lead abatement supervisor, and risk assessor involved in the project. These are crucial for compliance with Michigan regulations.
• Don't overlook the checkbox sections, such as the type of lead-based paint assessment and the occupancy status of the building. These details are vital for the state's records and aid in the assessment of the project's impact.
• Don't hesitate to contact the Healthy Homes Section for any questions or clarifications regarding the form. It's better to get answers beforehand than to make errors that could hold up your project.

Following these guidelines will ensure a smoother process in fulfilling your legal obligation to notify the state of Michigan about your lead abatement activities, thus contributing to the safe management of environmental health risks.

Understanding the Michigan DCH-0654 form is crucial for anyone involved in lead abatement activities within the state. Despite its importance, there are several misconceptions about this form. Let's clear up some of the most common misunderstandings.

• Only the actual work start and end dates are needed.

  This is incorrect. The form requires not just the start and end dates of the abatement activity but also any revisions to these dates. It's essential to notify the Department at least three business days before beginning work and at least 24 hours prior to any changes in the schedule.

• It's okay to submit incomplete forms.

  In reality, all sections of the DCH-0654 form must be filled out. Incomplete forms will not be approved. The form requires detailed information, including type of lead-based paint assessment, contractor details, building occupancy status, and a brief detail of the scope of work. Providing all requested information is mandatory.

• Weekend work doesn’t need to be specified.

  This is a misunderstanding. The form explicitly provides an option to indicate whether weekend work is included in the project schedule. Specifying work hours, including whether weekends are involved, is a requirement. This information helps in understanding the project timeline fully.

• Any firm can fill out and submit the form.

  Incorrect. The firm conducting the lead-based paint abatement activities must be certified to operate in Michigan. The form asks for MI certification numbers for the contractor, lead abatement supervisor, and risk assessor involved in the project. Without proper certification, the firm is not authorized to perform abatement work in the state.

Proper understanding and completion of the DCH-0654 form are integral to lead abatement projects in Michigan. By dispelling these misconceptions, firms can ensure they meet all legal requirements and contribute to a safer environment.

When undertaking lead-based paint abatement activities in Michigan, the DCH 0654 form is a crucial document that must be filled out and submitted accordingly. Here are some key takeaways about filling out and using this form:

• Timely Notification: Any firm conducting lead abatement in Michigan must notify the Healthy Homes Section by submitting the DCH 0654 form at least three business days before starting the project. This is essential to comply with §333.5472 of the Michigan Lead Abatement Act.
• Complete All Sections: Every part of the form requires information. Incomplete notifications will not be processed, which could delay the project. It’s important to review the form thoroughly to ensure no section is left blank.
• Revisions and Updates: If there are any changes to the project schedule or scope, the form allows for revisions. These updates must be communicated at least 24 hours before the change takes effect, preventing any legal or scheduling issues.
• Designating Key Roles: The form requires details about the contractor, certified lead abatement supervisor, and risk assessor involved in the project. Including their certification numbers and contact information is crucial for official records and verification.
• Specifying the Project: Clear details regarding the start and end dates, scheduled work hours, and whether weekends are included must be provided. This helps in planning and compliance monitoring.
• Site Information: Accurate details about the project site, including the building owner, address, occupancy status, and building type, are needed. This ensures that the project is correctly registered and assessed by the authorities.
• Scope of Work: A detailed description of the work to be done, whether it involves interior or exterior work, encapsulation, enclosure, component removal, or other activities, must be included. It helps in understanding the project's impact and safety measures required.
• Agency Involvement: If a housing agency funds the project, this must be noted along with the contact person’s information. It’s important for funding and regulatory compliance.
• Communication is Key: Maintaining open lines of communication with the Healthy Homes Section by providing clear, concise, and complete information on the form can aid in the smooth execution of the project. Compliance officers are there to help, and timely updates can resolve issues before they escalate.

The proper use of the Michigan DCH 0654 form not only complies with legal requirements but also ensures the safety and well-being of Michigan residents by properly managing and documenting lead abatement activities.