New Jersey Department of Health

Consumer, Environmental and Occupational Health Service

P. O. Box 360

Trenton, NJ 08625-0360

STATEMENT OF EDUCATION AND EXPERIENCE REQUIREMENTS

LEAD INSPECTOR / RISK ASSESSOR

Education and Experience Requirements

Prior to training, all individuals applying for a lead Inspector/Risk Assessor permit must certify that they meet the minimum education and experience requirements as set forth in N.J.A.C. 8:62-3.2. A permit will be issued only to those applicants who meet the following:

One (1) year experience in a related field (e.g., lead, asbestos, environmental remediation work, construction-related health and safety inspection) and one of the following:

1.	A Bachelor's degree and one (1) additional year of experience in a related field.

2.	Certification as a sanitary inspector-grade 1, health officer, an industrial hygienist, an engineer, a registered architect, or an environmentally-related scientific field such as a environmental scientist.

3.	A high school diploma (or equivalent) and at least two additional years experience in a related field.
Certification

I do hereby certify that I have read the above education and experience qualifications for a lead Inspector/Risk Assessor permit. I understand that I will be required to submit proof of my education and experience when I submit my "Application for Lead Permit" to the New Jersey Department of Health (NJDOH). I also understand that such information will be subject to verification by the NJDOH. If such information submitted is found to be false, I may be subject to the penalty provisions of N.J.A.C. 8:62, which may include the revocation of any permit(s) issued by the NJDOH and/or a civil administrative penalty of $1000 to $5000 per violation.

Please check one of the following:

I meet the above requirements I do not meet the above requirements
Name of Trainee (Print)

Signature	Date

Name of Training Manager (Print)

Agency Number

Signature	Date

CEHS-17

JAN 14

cehs-17

ewhite

2013-11-25

NJDOH