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The PC326 MDR-1 form plays a crucial role in the certification of mold damage remediation. Specifically designed for use in Texas, this certificate is essential for ensuring that properties are safe for habitation after undergoing mold remediation. When a property owner addresses mold issues, professionals must document that the necessary clean-up and remediation processes have been completed effectively. The form requires key details such as the certificate number, date of issuance, and the property’s specific description—address, lot, and block information. Additionally, it outlines certifications from both mold assessment consultants and remediation contractors, affirming that the mold issue has been effectively resolved or that no mold damage was detected at all. Each section of the form necessitates signatures and license numbers to validate the legitimacy of the certification. This thorough documentation not only affirms compliance with health regulations but also provides peace of mind to property owners, tenants, and potential buyers. Understanding the significance of the PC326 MDR-1 form is essential for anyone involved in mold remediation processes.

Pc326 Mdr 1 Example

PC326 MDR-1| Eff. 12/15/05

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CERTIFICATE OF MOLD DAMAGE REMEDIATION

Certificate Number

 

 

 

 

 

 

 

Date of Issuance

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

State

 

 

 

 

 

 

Zip

 

Property Description:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number

 

Street

 

 

 

 

 

 

 

 

Lot

 

 

 

Block

 

Addition or Tract

 

 

 

City

 

 

 

 

County

 

 

 

 

SIGN APPROPRIATE CERTIFICATION

Mold Assessment Consultant License Holder Certification

I hereby certify that based on visual, procedural and analytical evaluation, the mold contamination identified for this project has been remediated as outlined in the mold management plan or remediation protocol.

I further certify with reasonable certainty that the underlying cause or causes of the mold that were identified for this project in the mold management plan or remediation protocol have been remediated. A copy of the written evaluation that forms the basis for my certification has been provided to the person named in this certificate.

Mold Assessment Consultant

Department of State Health Services

Date

License Holder Signature

License No. and Expiration Date

 

Mold Remediation Contractor License Holder Certification

I hereby certify that I completed mold remediation on this project and will provide the mold remediation certificate to the property owner no later than the 10th day after the date of completion.

Mold Remediation Contractor

Department of State Health Services

Date of Completion

License Holder Signature

License No. and Expiration Date

 

OR

Mold Assessment Consultant or Adjustor License Holder Certification

I hereby certify that I have inspected the property described in this certificate and that based on my inspection I have determined that the property does not contain evidence of mold damage. A copy of the written evaluation that forms the basis for my certification has been provided to the person named in this certificate.

Mold Assessment Consultant/Adjustor

Department of State Health Services

Date

License Holder Signature

License No. and Expiration Date

 

Texas Department of Insurance | www.tdi.texas.gov

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Form Characteristics

Fact Name Description
Form Title PC326 MDR-1 is officially titled "Certificate of Mold Damage Remediation."
Effective Date The form has been effective since December 15, 2005.
Purpose of the Form This certificate is used to document the remediation of mold damage in a property.
Issuance Information Each certificate will have a unique certificate number and the date of issuance listed on it.
Property Details The form requires specific property details including street address, city, county, and other locating information.
Certification by Consultant A licensed mold assessment consultant must certify that mold has been remediated according to the management plan.
Completion of Remediation The mold remediation contractor certifies completion and must provide a copy of the certificate to the property owner within ten days.
Inspection Certification If applicable, a mold assessment consultant or adjustor must certify that no evidence of mold damage is found upon inspection.
Governing Laws This form is governed by regulations from the Texas Department of State Health Services and Texas Department of Insurance.

Guidelines on Utilizing Pc326 Mdr 1

Once you have gathered all necessary information, you can proceed to fill out the PC326 MDR-1 form. Make sure to provide accurate details as this form will serve as a formal certificate of mold damage remediation.

  1. Enter the Certificate Number and the Date of Issuance at the top of the form.
  2. Fill in your Name and the Mailing Address, including City, State, and Zip Code.
  3. Provide the Property Description: include the Number, Street, Lot, Block, Addition or Tract, City, and County.
  4. Select the appropriate certification option based on your role (Mold Assessment Consultant, Mold Remediation Contractor, or Mold Assessment Consultant/Adjustor).
  5. For Mold Assessment Consultant License Holder Certification, certify the remediation as outlined and date it. Include your Signature, License No., and Expiration Date.
  6. If you are a Mold Remediation Contractor, confirm completion of the work. Fill in the Date of Completion and provide your Signature, License No., and Expiration Date.
  7. If you are selecting the Mold Assessment Consultant or Adjustor certification, certify that no mold damage exists based on your inspection. Include your Signature, License No., and Expiration Date in this section.

Carefully review the form for completeness and accuracy before submission. Ensure that all signatures are included, as this will enhance the validity of the certificate.

What You Should Know About This Form

What is the purpose of the PC326 MDR-1 form?

The PC326 MDR-1 form is used to certify that mold damage remediation has been completed on a property. This certification serves to assure property owners and other stakeholders that any mold contamination has been adequately addressed, as per the established mold management plan or remediation protocol.

Who can complete and sign the PC326 MDR-1 form?

The form can be completed and signed by a licensed Mold Assessment Consultant or a Mold Remediation Contractor. These professionals are responsible for assessing and remediating mold damage and must have the appropriate licensing from the Department of State Health Services.

What information is required on the form?

The PC326 MDR-1 form requires specific information, including the certificate number, date of issuance, name and mailing address of the property owner, a description of the property, and details about the mold remediation work performed. This information is crucial for tracking and verifying remediation efforts.

How soon after completing remediation must the form be provided to the property owner?

The Mold Remediation Contractor must provide the mold remediation certificate to the property owner no later than the tenth day after the completion of the remediation work. Timely submission is important for ensuring that property owners have proper documentation of the remediation efforts.

What happens if mold damage is found after the PC326 MDR-1 certificate is issued?

If mold damage is identified after the issuance of the PC326 MDR-1 certificate, it may require further assessment and potentially additional remediation. The certification only reflects the condition of the property at the time of inspection and should not be viewed as a lifetime guarantee against mold issues.

Can the form be used for properties that do not currently show evidence of mold?

Yes, the PC326 MDR-1 form can also be used to certify that a property does not contain evidence of mold damage. This option is available for Mold Assessment Consultants or Adjustors who have inspected the property and found no signs of mold contamination.

How can someone verify the credentials of the person signing the form?

To verify the credentials of the person signing the PC326 MDR-1 form, you can check their license status through the Texas Department of State Health Services. This verification ensures that the professional is properly licensed and authorized to perform mold assessments or remediation.

Is the PC326 MDR-1 form required for all mold remediation projects?

The use of the PC326 MDR-1 form may be required based on local regulations or property owner agreements. It is advisable to consult with local health authorities or legal experts to determine whether the form is needed for specific mold remediation projects.

Common mistakes

When filling out the PC326 MDR-1 form, it is critical to avoid common errors that can lead to delays or complications. One major mistake is failing to include all required fields. Information such as the certificate number, date of issuance, and property description must be completed accurately. Omitting any of these details can render the form incomplete, necessitating a resubmission.

Another frequent error is mismatched names or addresses. The certification must reflect the correct names and mailing addresses for both the property owner and the contractor. Discrepancies can cause confusion and may affect the validity of the remediation certification.

Individuals often forget to check their signatures. A completed form without a signature lacks authenticity. Make sure that all parties involved, including the mold assessment consultant and the remediation contractor, sign their respective sections. Furthermore, not providing the license number and expiration date is another easy mistake to make that could invalidate the documentation.

Inadequate description of the property also poses issues. The property description should include specific details such as the number, street, lot, and block information fully. A vague description can lead to misidentification of the property, complicating future assessments or claims.

In some cases, people neglect to provide the date of completion for mold remediation. The law requires that this date is submitted no later than 10 days after completing the work. Delays in reporting this information could trigger penalties or additional scrutiny.

Additionally, individuals often misinterpret the certification sections. Each section of the form has specific requirements. Ensure that the right certification is chosen based on the role played in the remediation process, whether as a consultant, contractor, or adjustor. Mixing these roles can invalidate the certification.

Another common oversight is failing to attach the necessary documentation. This should include written evaluations that support the claims made in the certifications. Without proper documentation, the certifications lack credibility.

People sometimes assume that verbal confirmations are sufficient. This assumption is problematic. Written certifications are legally required, and relying on verbal agreements can jeopardize the remediation process.

Lastly, failing to maintain copies of the submitted form can turn problematic. Keeping a copy ensures that all parties can reference the original submission in case of disputes or further inquiries. Each of these mistakes can undermine the effectiveness of the remediation and lead to legal complications.

Documents used along the form

The PC326 MDR-1 form serves as a crucial document for certifying mold damage remediation. Several other forms and documents are often used alongside it to support the remediation process and ensure compliance with regulations. Below is a list of these essential forms, along with brief descriptions for each.

  • Mold Management Plan: A detailed plan outlining the strategies and steps for mold remediation. It specifies procedures, identifies potential sources of mold, and provides guidance on prevention measures.
  • Mold Assessment Report: This document is prepared by a mold assessment consultant following an inspection. It details the findings related to mold damage and identifies areas that require remediation.
  • Mold Remediation Protocol: A step-by-step guide used by contractors during the remediation process. It includes specific techniques, safety measures, and equipment needed to effectively remove mold.
  • Work Authorization Form: A document that authorizes mold remediation work to begin. The property owner typically signs this form to permit contractors to enter the property and carry out necessary actions.
  • Post-Remediation Verification Report: After remediation, this report confirms that mold has been effectively removed. It includes results from any tests conducted post-remediation to ensure the property is safe.
  • Property Owner Acknowledgment Form: This form serves as documentation that the property owner has been informed of the remediation process. It often requires the owner’s signature to acknowledge understanding of the work being performed.
  • Insurance Claim Form: This document is used to submit a claim to an insurance company for mold damage. It typically includes details about the damage, costs incurred for remediation, and any relevant supporting documents.

Each of these forms plays an important role in ensuring a thorough and compliant mold remediation process. Proper documentation helps protect the interests of property owners and remediation professionals alike, fostering a safer living environment.

Similar forms

The PC326 MDR-1 form is an important document related to mold damage remediation. It ensures that proper evaluations and certifications are made regarding mold remediation efforts. Other documents that share similarities with the PC326 MDR-1 include the following:

  • Certificate of Mold Damage Assessment: This document provides an official acknowledgment that a mold assessment has taken place. It details the findings from the evaluation and often includes information about the extent of mold damage, much like the PC326 MDR-1.
  • Mold Remediation Protocol: Similar to the PC326 MDR-1, this protocol outlines the specific steps that must be taken to remediate mold contamination. It serves as a guide for remediation contractors by detailing procedures that ensure thorough mold removal.
  • Mold Stabilization Report: This document reports on the actions taken to stabilize an environment that has been affected by mold. Like the PC326 MDR-1, it verifies that steps have been implemented to prevent further mold growth.
  • Post-Remediation Verification Form: This form is used to confirm that mold remediation has been successfully completed. It typically includes inspection results and has similar verification processes to ensure accuracy, mirroring the certifications found in the PC326 MDR-1.
  • Mold Inspection Certificate: After a property has been inspected for mold, a certificate may be issued that summarizes the findings. This closely aligns with the PC326 MDR-1, which certifies mold presence or absence.
  • Property Condition Assessment Report: This report evaluates the overall condition of a property, including any mold issues. Similar to the PC326 MDR-1, it may assess the state of mold remediation once conducted and document the results.
  • Emergency Mold Remediation Agreement: In urgent situations, this agreement outlines the expectations and responsibilities of parties involved in immediate mold remediation efforts. Its purpose is reminiscent of the PC326 MDR-1, focusing on timely and effective responses to mold issues.
  • Mold Exclusion Certification: This certification confirms that a property has been assessed and deemed free from mold damage or contamination. Like the PC326 MDR-1, it represents a formal guarantee regarding the health and safety of the living environment.

These documents play essential roles in ensuring that mold-related issues are adequately addressed, similar to the purpose served by the PC326 MDR-1.

Dos and Don'ts

When filling out the PC326 MDR-1 form, there are specific actions you should take and avoid to ensure accuracy and compliance.

  • Do: Carefully read all instructions provided with the form before you begin filling it out.
  • Do: Provide complete and accurate information in every section, including the certificate number and property description.
  • Do: Ensure that all required signatures are obtained before submitting the form.
  • Do: Keep a copy of the completed form for your records after submission.
  • Don't: Leave any sections blank; missing information can lead to delays or rejection.
  • Don't: Use white-out or similar products to correct mistakes; instead, strike through and initial any errors.

Following these guidelines can help facilitate a smoother submission process for the PC326 MDR-1 form.

Misconceptions

Understanding the PC326 MDR 1 form is essential for homeowners and contractors involved in mold remediation. However, several misconceptions can complicate compliance and proper use. Here are ten common misunderstandings about this form:

  1. It is not necessary if mold is not visible. Many people believe that the form is irrelevant unless visible mold is present. In reality, it is also essential to assess the potential for hidden mold and document any findings.
  2. Only the contractor needs to sign the form. While the mold remediation contractor's signature is critical, a certified mold assessor must also provide their certification depending on the situation.
  3. The form guarantees complete mold removal. Completing the form does not guarantee that all mold has been removed; it only certifies that remediation efforts were completed according to the specified plan.
  4. It can be submitted anytime after remediation. The form must be submitted within specific timelines, typically no later than ten days after remediation is completed.
  5. All mold issues fall under the same guidelines. Not every mold situation requires the same assessment or remediation actions. Each case must be evaluated individually, based on the severity and source of mold contamination.
  6. The form is sufficient for all insurance claims. While the form can assist with documentation, insurers may require additional information or documentation specific to the policyholder's coverage.
  7. Homeowners do not need a copy of the evaluation report. Homeowners should always receive a copy of the written evaluation that supports the certification. It is crucial for record-keeping and potential future claims.
  8. The certification remains valid indefinitely. Certifications from this form are not permanent. Reassessments are necessary if conditions change or if further mold issues arise.
  9. Failure to use the form leads to minor consequences. Not utilizing the correct form can result in fines, legal issues, or the inability to sell the property in the future.
  10. Anyone can fill out the form. The form must be completed by licensed professionals. It should only be signed by those with the proper training and credentials.

Awareness of these misconceptions helps ensure proper use of the PC326 MDR 1 form and fosters safer living environments.

Key takeaways

When completing the PC326 MDR-1 form, keep these key points in mind:

  • The form is known as the Certificate of Mold Damage Remediation.
  • It became effective on December 15, 2005, and must be used for mold remediation certification.
  • Each certificate has a unique certificate number and the date of issuance must be filled in.
  • Ensure that you provide accurate details for the property, including the address, city, county, and any relevant lot or block information.
  • The form requires certification by a licensed Mold Assessment Consultant or a Mold Remediation Contractor.
  • Licensing information, including the license number and expiration date, needs to be included in the certification sections.
  • Property owners must receive the mold remediation certificate no later than ten days after the remediation is completed.
  • A written evaluation, which supports the certification, must be provided to the person named on the certificate.
  • It's possible for a Mold Assessment Consultant or Adjustor to certify that there is no evidence of mold damage after an inspection.

Remember, accuracy and completeness are crucial when filling out this form to ensure compliance and protect property interests.