Asbestos Disclosure Statement

# Asbestos Disclosure Statement **Property Address:** ___________ **City, State, ZIP:** ___________ **Assessor's Parcel Number (APN):** ___________ **Seller Name(s):** ___________ **Year Property Built (approximate):** ___________ **Date of Disclosure:** ___________ --- ## About Asbestos Asbestos is a group of naturally occurring fibrous silicate minerals that were widely used in building materials through the 1970s and into the 1980s. Asbestos-containing materials (ACMs) are common in homes and commercial buildings constructed before 1980 and are found in materials including but not limited to: floor tiles and adhesives, ceiling tiles, roof shingles, pipe and duct insulation, textured paints and patching compounds, fireproofing materials, and certain drywall compounds. Asbestos fibers are not dangerous when the material is in good condition and left undisturbed ("non-friable"). However, when ACMs are damaged, disturbed, or deteriorating ("friable"), they can release fibers into the air. Inhalation of asbestos fibers is associated with serious lung diseases including mesothelioma, asbestosis, and lung cancer. The EPA, OSHA, and most state environmental agencies regulate asbestos inspection, handling, and abatement. **Answer Key:** Yes · No · Unknown · Not Applicable --- ## Part I — Known or Suspected ACMs **1. Are you aware of any asbestos-containing materials (ACMs) in or on the property?** ___________ **Known or suspected ACM locations and materials (if Yes):** ___________ **2. Please indicate which of the following materials are known, suspected, or have been identified as ACMs at the property:** | Material | Status | |---|---| | Floor tiles (vinyl asbestos tile / VAT) or adhesives | ___________ | | Ceiling tiles or textured ceilings (popcorn/acoustic) | ___________ |