Home > Legal > Legal > Rent and Lease Template > Maine Rent and Lease Template > Maine Radon Rental Disclosure Template

Maine Radon Rental Disclosure Form


Maine Radon Rental Disclosure Form
Maine Radon Rental Disclosure Form
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 Health 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
Maine Radon Rental Disclosure Form