Content Overview
Understanding Florida Dh 1777
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What is the purpose of the Florida DH 1777 form?
The Florida DH 1777 form is used to report radon measurements in nonresidential buildings. This includes facilities such as hospitals, schools, and nursing homes. The form is essential for documenting compliance with state regulations regarding radon testing and ensuring the safety of occupants in these facilities.
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Who is required to complete the DH 1777 form?
The form must be completed by the facility owner or an authorized representative. It is necessary for any nonresidential building that requires radon measurement as part of its health and safety regulations. Each facility must submit a separate form, even if they are located at the same address.
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What information is needed to fill out the DH 1777 form?
To accurately complete the form, the following information is required:
- Facility name and address
- Owner's name and contact information
- Type of facility (e.g., hospital, school, nursing home)
- Building details, including age and foundation type
- Measurement results and dates
- Name and certification number of the person who performed the measurement
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How are radon measurements reported on the DH 1777 form?
Radon measurements are reported by indicating the type of measurement (initial, retest, or follow-up) along with the results in the appropriate units (pCi/L or WL). Details such as the dates of measurement, the name of the person who placed the device, and the specific location within the building are also required for clarity and accuracy.
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Where should the completed DH 1777 form be sent?
Once the form is completed, it should be sent to the Department of Health, Bureau of Environmental Health, Radon Program. The mailing address is 4052 Bald Cypress Way, Bin #A12, Tallahassee, FL 32399-1720. Alternatively, the report can be scanned and emailed to RadonReports@FLhealth.gov for submission.
Common mistakes
Filling out the Florida DH 1777 form can be a straightforward task, but it's easy to make mistakes that could lead to delays or complications. Here are eight common pitfalls to avoid:
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Missing Facility Information:
Ensure that all required details about the facility, including its name and physical address, are accurately filled out. Incomplete information can cause processing delays.
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Incorrect Owner Information:
Double-check that the owner's name and contact details are correct. Errors here can lead to miscommunication and issues down the line.
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Improper Facility Type Selection:
Make sure to select the correct facility type from the provided options. Each type may have different testing requirements, and selecting the wrong one could lead to non-compliance.
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Inaccurate Building Information:
Provide the correct building name or ID number if applicable. Also, ensure the street address is accurate, especially if it differs from the facility site.
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Measurement Details Errors:
When reporting measurements, be clear about the type of measurement and the dates it was conducted. Missing or incorrect dates can invalidate your results.
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Not Including Required Signatures:
If measurements are performed by a radon measurement business or facility staff, ensure that the appropriate signatures are included. Missing signatures can lead to rejection of the form.
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Failure to Certify the Measurements:
It's essential to certify that the measurements were performed according to the relevant regulations. This certification is a crucial part of the form.
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Ignoring Submission Guidelines:
After completing the form, follow the submission instructions carefully. Whether mailing or emailing, ensure that it reaches the correct department to avoid delays.
By being aware of these common mistakes, you can help ensure that your Florida DH 1777 form is filled out correctly and submitted without issues. Take your time, double-check your entries, and don’t hesitate to reach out for help if needed!
How to Use Florida Dh 1777
Completing the Florida DH 1777 form is an important step in reporting radon measurement results for nonresidential buildings. After filling out the form, it must be submitted to the appropriate health department to ensure compliance with state regulations. Follow these steps to accurately complete the form.
- Section 1: Facility and Owner Information
- Enter the Facility Name as registered with the state.
- Provide the Physical Location (Street Address) of the facility.
- Fill in the City, County, and Zip Code.
- List the Name of Contact Person and Name of Owner.
- Include the Street Address, City, State, and Zip of the owner.
- Provide a Phone Number for the contact person and the owner.
- Indicate the Facility Type by checking the appropriate box.
- Section 2: Building Information
- Enter the Building Name or ID Number if applicable.
- Provide the Street Address of Building if different from the facility site.
- Indicate the total number of buildings at the address and specify which building requires testing.
- State the Number of Measurements required during this testing period.
- List the Cumulative Number of Measurements reported for this testing period.
- Fill in the number of stories and occupied stories of the building.
- Provide the Age of Building in years or the year it was built.
- Specify the Foundation/Floor System by checking the appropriate box.
- Check the appropriate box for the HVAC System type.
- Section 3: Results
- Indicate the Measurement Type (Initial or 5 Year Retest, Follow-up).
- Provide the Dates of Measurement (From/To).
- Enter the Name of Person who performed the measurement.
- If applicable, include the Certificate Number.
- Fill in the Story and Room where the measurement took place.
- Record the Result and Units of measurement.
- Indicate the Time in Hours for the device used.
- Section 4: Measurements by a Radon Measurement Business
- Provide the Name of Business and Certificate Number.
- Enter the Name of Specialist and their Certificate Number.
- Ensure the Signature of Specialist is included.
- Section 5: Measurements by Facility Staff
- Include the Authorized Representative of the facility.
- Enter the Date of completion.
Once the form is completed, it should be sent to the Department of Health, Bureau of Environmental Health, Radon Program. You can mail it to the specified address or scan and email it for convenience. For any questions or assistance while filling out the form, a helpline is available to provide support.
File Specs
| Fact Name | Fact Description |
|---|---|
| Form Purpose | The Florida DH 1777 form is used for mandatory radon measurements in nonresidential buildings, ensuring compliance with state health regulations. |
| Governing Laws | This form is governed by Chapter 64E-5 of the Florida Administrative Code and Chapter 404 of the Florida Statutes, which outline radon measurement standards. |
| Submission Requirement | Facilities must submit this form to the Department of Health after completing radon measurements, either by mail or via email. |
| Measurement Types | The form accommodates different measurement types, including initial tests, five-year retests, and follow-up measurements. |
| Facility Types | Various facility types are recognized, such as hospitals, nursing homes, and schools, requiring separate submissions for each facility. |
| Certification | Measurements must be performed by certified professionals, and the form includes sections for their certification details and signatures. |
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