Contra Costa County Smoke-free Multi-unit Housing Compliance Verification Form
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Full Name *
Please provide your email to receive future correspondence by email.
Address(es) of Multi-Unit Housing Residence(s) *
Please read the following requirements of the new law and indicate whether you are compliant (yes or no)
Every lease and other rental agreement for the occupancy of a dwelling unit in a multi-unit residence that is entered into, renewed, or continued month-to-month must include that smoking is prohibited in all dwelling units effective July 1, 2019. *
Disclose the policy for handling smoking complaints in effect at the multi-unit housing residence, and provide a copy of that policy to each tenant along with every new lease or rental agreement for the occupancy of a unit in a multi-unit housing residence. *
Post “No Smoking” signs with letters of not less than one inch in height, or the international “No Smoking” symbol (consisting of a burning cigarette in a red circle with a red bar across it), visibly on the exterior of every building or other place where smoking is regulated. While not required by law, it may be helpful to add information to signage indicating that the use of electronic cigarettes is also prohibited in smoke-free areas. It is not required to post “no smoking” signage inside or on the doorway of any dwelling unit in a multi-unit residence *
Do not allow ashtrays or other receptacles for disposing of smoking material where smoking is prohibited. Are you compliant? *
Do not allow smoking in smoking prohibited areas. Are you compliant? *
Please submit any questions or requests for additional information below:
Thank you for your compliance.
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