Check for environmental risks in your home!


This checklist will introduce you to the topics covered in the Assessment Guide. By completing the

checklist, you can discover which topics in the Assessment Guide may be most applicable to your home.

"Yes" answers indicate potential problems or health concerns you will want to investigate.


  1. Site Assessment                                                                                                           Check box if yes



  a. Is your soil sandy or gravelly, allowing water to drain through quickly?


  b. Is there a potential source of contamination --such as manure,

  pesticide or fertilizer storage, fuel tank, septic system drainfield, or

  eroding soils -- on your property located within 100 feet of a well, lake,

  stream, or wetland?


  c. Is the water table less than 10 feet below the soil surface?



  2. Stormwater Runoff


                                                                                                                                                Check box if yes

  a. Do the downspouts from your roof gutters empty onto paved surfaces

  instead of grass, mulch or gravel, and thus keep rain from soaking into

  the ground?


  b. Are fertilizers, pesticides or salts stored where floodwaters might reach



  c. Are some parts of your property, particularly slopes, sparsely planted

  and without mulch, exposing the soil to erosion?



  3. Drinking Water Wells


                                                                                                                                                Check box if yes

  a. Has it been more than 2 years since your water was tested for

  bacteria and nitrates?


  b. Do you have a dug or driven well instead of a drilled well?


  c. Does your well casing extend less than 12 inches above the ground,

  or is there a low area where surface runoff can collect around the well



  d. Do you have abandoned wells on your property that are not properly

  filled and capped?



  4. Household Wastewater Treatment


                                                                                                                                                Check box if yes

  a. Has it been more than 3 years since your septic tank was last pumped

  or inspected?


  b. Have you noticed any signs of a failing septic system, such as slow

  drains, odors or soggy ground over the drainfield?


  c. Do you have standard toilets and faucets, and not water-conserving




  5. Hazardous Household Products


                                                                                                                                                 Check box if yes

  a. Do you use products without knowing whether or not they are



  b. Do you ever pour hazardous chemicals -- such as antifreeze, oil,

  paints, stains, polishes or solvents -- down the drain, in a ditch or on the



  c. Do you burn plastics, batteries or chemicals that could contaminate

  the air?



  6. Lead Contamination


                                                                                                                                                Check box if yes

  a. Was your home built before 1978 (the year when lead was banned from



  b. Do children under the age of six live in your home?


  c. Are painted surfaces inside and outside your home peeling, chipping or



  d. Is your drinking water delivered through pipes that are lead or in

  contact with lead solder?



 7. Yard and Garden Care


                                                                                                                                                Check box if yes

 a. If you use fertilizer, has it been longer than 3 years since you had your

 soil tested for nutrients?


 b. Do you ever use pesticides without reading the label or following the

 recommended doses or application instructions?


 c. Do you have bare areas of soil on your property that are susceptible to



 d. Are lawn and garden chemicals stored in an area exposed to activities

 that could damage containers or result in chemical spills?





 8. Liquid Fuels


                                                                                                                                                 Check box if yes

 a. Do you store fuel for your lawnmower or other gas-powered equipment

 in non-approved containers -- such as glass jars, plastic jugs or rusted



 b. Do you store fuel or heating oil in an underground fuel tank?


 c. If you have an above-ground fuel tank, does it lack protection against

 leaks or spills (e.g., a catch basin or concrete spill pad?)



 9. Indoor Air Quality


                                                                                                                                                Check box if yes

 a. Do odors such as those from cooking linger in the air in your home?


 b. In winter, do you often notice condensation on the inside of your



 c. Have you noticed symptoms -- such as irritated eyes, coughing or

 sneezing -- that most often develop when you stay indoors at home?



 10. Heating and Cooling Systems


                                                                                                                                                 Check box if yes

 a. Has it been 2 or more years since your fuel-burning heating system was

 inspected for proper ventilation and energy efficiency?


 b. Are your energy bills relatively large for the size of your home?


 c. Do you feel cold drafts around windows and doors during winter?


 d. Does your attic lack the recommended amount of insulation?



 11. Household Trash


                                                                                                                                                Check box if yes

 a. Do you purchase products that you don't really need (e.g. buy tools that

 could be borrowed or shared)?


 b. Do you buy products wrapped in excessive packaging?


 c. Do you throw away yard and food waste that could be composted?