DEQ Form 110-503 "Project Designer/Supervisor Lead-Based Paint Activity Quarterly Report" - Oklahoma

What Is DEQ Form 110-503?

This is a legal form that was released by the Oklahoma Department of Environmental Quality - a government authority operating within Oklahoma. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2016;
  • The latest edition provided by the Oklahoma Department of Environmental Quality;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of DEQ Form 110-503 by clicking the link below or browse more documents and templates provided by the Oklahoma Department of Environmental Quality.

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Download DEQ Form 110-503 "Project Designer/Supervisor Lead-Based Paint Activity Quarterly Report" - Oklahoma

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For DEQ Use Only:
Entry#:
Project Designer/Supervisor
Date Entered:
Lead-Based Paint Activity Quarterly Report
☐No Lead-Based Paint Activity performed this quarter.
Qtr 2 Apr-June
Qtr 3 July-Sep
20
20
th
th
(Due Jul 10
)
(Due Oct 10
)
Note: Choose a report quarter. A separate report required for each quarter
Qtr 4 Oct-Dec
Qtr 1 Jan-March
20
20
th
th
(Due Jan 10
)
(Due Apr 10
)
Abatement Workers
Abatement Type
Property Information
Activity Date
(list of workers that worked on property)
(check all that apply)
Name:
Certification Number:
Interior Abatement
Date Built (Do not use unknown):
1.)
1.)
Start Date:
Address:
Exterior Abatement
2.)
2.)
Soil Abatement
Stop Date:
City:
3.)
3.)
Other:
4.)
Zip:
4.)
Name:
Certification Number:
Interior Abatement
Date Built (Do not use unknown):
1.)
1.)
Address:
Exterior Abatement
Start Date:
2.)
2.)
Soil Abatement
City:
3.)
Stop Date:
3.)
Other:
4.)
Zip:
4.)
Name:
Certification Number:
Interior Abatement
Date Built (Do not use unknown):
1.)
1.)
Address:
Exterior Abatement
2.)
2.)
Soil Abatement
Start Date:
City:
3.)
3.)
Other:
4.)
Zip:
Stop Date:
4.)
Please e-mail to
LBPReporting@DEQ.OK.GOV
or mail to Department of Environmental Quality, Attn: LBP Staff, PO Box 1677, Oklahoma City, OK 73101-1677
Project Designer/Supervisor Name:
Certification#:
Date:
DEQ Form #110-503
Revised 10/1/16
For DEQ Use Only:
Entry#:
Project Designer/Supervisor
Date Entered:
Lead-Based Paint Activity Quarterly Report
☐No Lead-Based Paint Activity performed this quarter.
Qtr 2 Apr-June
Qtr 3 July-Sep
20
20
th
th
(Due Jul 10
)
(Due Oct 10
)
Note: Choose a report quarter. A separate report required for each quarter
Qtr 4 Oct-Dec
Qtr 1 Jan-March
20
20
th
th
(Due Jan 10
)
(Due Apr 10
)
Abatement Workers
Abatement Type
Property Information
Activity Date
(list of workers that worked on property)
(check all that apply)
Name:
Certification Number:
Interior Abatement
Date Built (Do not use unknown):
1.)
1.)
Start Date:
Address:
Exterior Abatement
2.)
2.)
Soil Abatement
Stop Date:
City:
3.)
3.)
Other:
4.)
Zip:
4.)
Name:
Certification Number:
Interior Abatement
Date Built (Do not use unknown):
1.)
1.)
Address:
Exterior Abatement
Start Date:
2.)
2.)
Soil Abatement
City:
3.)
Stop Date:
3.)
Other:
4.)
Zip:
4.)
Name:
Certification Number:
Interior Abatement
Date Built (Do not use unknown):
1.)
1.)
Address:
Exterior Abatement
2.)
2.)
Soil Abatement
Start Date:
City:
3.)
3.)
Other:
4.)
Zip:
Stop Date:
4.)
Please e-mail to
LBPReporting@DEQ.OK.GOV
or mail to Department of Environmental Quality, Attn: LBP Staff, PO Box 1677, Oklahoma City, OK 73101-1677
Project Designer/Supervisor Name:
Certification#:
Date:
DEQ Form #110-503
Revised 10/1/16