Lead Inspector Application

To register as an active Local Lead Inspector, you must be licensed with the Ohio Department of Health as a Clearance Technician, Lead Inspector, or Lead Risk Assessor. You can then apply with the Toledo-Lucas County Health Department using this online form or through mail accompanied by a $45.00 check. You may choose to have your information listed here to be contacted by people interested in hiring a local lead inspector.

Full Name
(as registered with the Ohio Department of Health)
First Last
Business Name
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Primary Phone Number*
Other Phone Number
Email Address*
Business Website URL
Ohio Department of Health (ODH) License #*
License Expiration Date*
MM slash DD slash YYYY
Certification Type*
Are you a state or local government employee exclusively providing lead services on behalf of that government?*
Name of Agency*
Name of Supervisor*
Supervisor Phone*
Do you want to have your contact information listed on www.ToledoLeadSafe.com so potential clients can find you? *
Final Agreement and E-Signature
By checking the boxes and signing below, you certify that you have read and understand all portions of this application. This registration is provided pursuant to TMC 1760 entitled, “Residential Rental Properties and Lead Safety Compliance.” The information requested herein will be used in processing your application and optionally listed on our website, www.ToledoLeadSafe.com to assist in marketing your business. You have the right to inspect, amend, or correct this registration by resubmitting the application at any time. The Toledo-Lucas County Health Department (TLCHD) is a public agency and subject to the Ohio Records Act. This completed form may be made available to inspection or copying, in whole or in part, by the public and other governmental agencies, if not protected by federal or state law. All applications must be filled out completely. Please allow 30 days for processing. Incomplete or inaccurate applications may delay processing. Fees are non-refundable. Fees for state & local government employees are waived if exclusively providing the lead services on behalf of that government.
Consent*
I have completed all sections of this application truthfully, to the best of my knowledge and ability.
Consent*
I agree to perform all lead services work in accordance with all applicable laws and regulations.
Consent*
I understand that associated fees are non-refundable.
Applicant's E-signature*
First Last
Application Fee*
Includes $2 electronic processing fee.
Price:
Total
$0.00
Credit Card
Card Details
Cardholder Name

Final Agreement and E-Signature

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