LDH School Lead Testing Application
The Water Infrastructure Improvements for the Nation Act or “WIIN Act” of 2016 authorizes the Environmental Protection Agency (EPA) to award grants to states and tribes to assist local and tribal educational agencies in voluntary testing for lead in drinking water at schools and child care programs. The Louisiana Department of Health (LDH) is administering the WIIN Grant Project for Louisiana and will offer free lead testing in drinking water at eligible schools/child care programs.

Eligible Entities:
Public schools and child care (early childhood education program) facilities are eligible. Priority will be given to schools/programs in underserved and/or low-income communities, elementary/child care facilities for children 6 and under, and older facilities built before 1988. Private schools are not eligible to participate, however private child care facilities are eligible.

Conditions:
Lead testing must be conducted in accordance with the EPA’s 3Ts for Reducing Lead in Drinking Water Toolkit available at the following web address:
https://www.epa.gov/ground-water-and-drinking-water/3ts-reducing-lead-drinking-water-toolkit.  
Schools/programs must make the testing results publicly available and notify parents, teachers, and employee organizations of the availability of the results.  

Application:
To volunteer for free lead testing in drinking water at your school or child care program, complete the below information. Complete one application per school or child care facility. Items denoted by an asterisk are required.

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电子邮件地址 *
Facility name *
Enter the name of the public school or licensed child care facility where you wish lead testing conducted.
Facility type *
Select the type of facility. If the facility serves as both a school and as a child care center for very young children, please select "Child care center".
Parish *
Enter the name of the parish in which the above named facility is located. Do not abbreviate and do not include the word “Parish”. Example: “East Baton Rouge”, but not “EBR”, and not “EBR Parish”, and not “East Baton Rouge Parish”.
Street address *
Enter the physical street address where the above named facility is located. Do not enter a P.O. Box address.
City *
Enter the name of the city where the above named facility is located.
Zip code *
Enter the zip code where the above named facility is located.
Facility build date *
Enter the approximate date the above named facility was constructed. If you only know the year, use December 31 of that year. The current calendar year may already be entered; please change this to the correct construction year.
年
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月
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日
Plumbing modifications
List any plumbing improvements, at the above named facility since its construction, that may reduce lead in drinking water. Example: "replaced all water fountains with certified low-lead units". If no plumbing modifications have been made you can ignore this question.
Plumbing modification date
Enter the latest date of any plumbing improvements, at the above named facility, that would reduce lead in drinking water. The current calendar year may already be entered; please change this to the correct modification year. If no plumbing modifications have been made you can ignore this question and any date information.
年
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月
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日
Current child enrollment *
Enter the total number of children enrolled at the above named facility.
Percent of children 6 and under *
Enter the percentage of the enrolled children that are 6 years old or younger. Example: If 50% (half) of the enrolled children are age 6 or younger, enter the number "50" below.
Percent of children receiving free/reduced lunch *
Enter the percentage of the enrolled children that qualify for free or reduced-cost meals. Example: If 30% of the enrolled children qualify for free or reduced-cost meals, enter the number "30" below.
Building count
Enter the total number of buildings (classrooms, cafeteria, gym, etc) at the facility. Only enter a single number for the entire facility.
Water outlets
Enter the approximate number of water outlets (drinking fountains, classroom/kitchen sinks, etc.) used for consumption and cooking in the facility.
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