TRANSMITTAL OF OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#; ^?>f?^ i Date: A ^ | O.Q>) ^OQ') 

Address: ;^nU'lf -f'^r4r € N f lA f^ Rr>> 

LBP Stabilization Contractor: PRUDENT TECHNOLOGIES, INC. Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

i / Video of property (DVD): Pre-Stabilization A rui)t-3(aUilLi.aimu VIdws 

U Executive Summary 

y Signed Access Agreement Form 

y Advance Notice Form 

y Pre-Stabilization Video Agreement Form 

y Access Tracking Form 

y Property Access Assessment Form 

y Neighbor Access Agreement Form 

y Paint Match Form 

y Pre-Stabilization Property Safety Assessment Form 

y Work-Site Hazards Analysis Checklist 

y Photographs: Pre-Stabilization Propertv Hazard Assessment Photographs 

y Douglas County Assessor Property information 

y " Property Completion Agreement Form Signed by Property Owner 

D Property Close-Out Check List Signed By EPA 

Pnident Technologies, Inc. Signature Date 

/"^cL^fc^J^ __!^l/lo _ EPATSignature ^ ' Date 

30055420 iiUHil 

Superfund 
TECHNOLOGIES, INC. 

Property Summary 

Date: 8/03/2009 | LBP STABILIZATION EPA CONTRACT EP-R7-08-07 | Month of; Aug 

Property Address; 2744 Fontenelie Bd SAID #: 63541 

A. Executive Summarv; 

a. Issues Encountered: NONE 

b. Issues Resolved: NONE 

c. Unique Findings; NONE 

d. Other Relevant Information; 

i. Access Date: 7/09/2009 

ii. Work Began; 7/15/2009 

iii. Close-Out Date: 7/16/2009 

B. Enclosures; 

1. Pre-Stabilization Video 

2. Post-Stabilization Video 

3. Signed Access Agreement Form 

4. Advance-Notice Form 

5. Pre-Stabilization Video Agreement Form 

6. Access Tracking Form 

7. Property Access Assessment Form 

8. Neighbor Access Agreement Form 

9. Property Paint Match Form 

10. Pre-Stabilization Property Safety Assessment Form 

11. Work-Site Hazards Analysis Checklist 

12. Pre- Stabilization Property Hazard Assessment Photographs 

13. Douglas County Assessor Property Information 

14. Signed Property Completion Agreement Form 

15. Property Close-Out Check List Signed By EPA 
TECHNOIiOGnSS. IN C 

Prudent Technologies, Inc. (Prudent) is under contract (Contract # EP-R7-08-07) with the U. S. Environmental Protection 

Agency (EPA) to stabilize Lead Based Paint (LBP) at a number ofproperties located in Omaha, Nebraska, including the 

property located at ^ILlL l fpiJtBMEU£^ IbLVh 

The EPA requests your pennission to allow Prudent to perform LBP Stabilization at this property. By signing this form, the 

property owner grants permission to Prudent to perform activities related to LBP Stabilization including scraping paint and 

painting ofthe referenced property. Further, the owner/tenant verifies that they have received the LBP pamphlet "Renovate 

Right." 

By signing this document I agree to allow an EPA contractor to conduct a soil cleanup at my property following completion of 

lead-based paint stabilization, ifthe soil cleanup has not already been performed. I understand diat the stabilization contractor 

cannot provide assurances of which contractor will be bound to the soil cleanup. I further understand that the soil cleanup 

contractor will make all reasonable efforts to address concems that I, as the property owner, may have regarding soil 

cleanup at my property. 

itand the paragraph above. 

Date 

Ifyou have any questions about the LBP stabilization planned for your property, please contact Prudent's Customer 

Relations/Office Manager for the Lead Based Paint Stabilization, Mrs. Shannon Holt, at (402) 504-1004 or f402W12-0223. 

General questions about the Omaha Lead Site cleanup can be directed to the EPA Public Information Centers at (402) 731­

3045 (South Omaha office) or (402) 991-9583 (North Omaha office). 

Property Access Granted By: 

ht06l£LAr ljL>6LA^f: 

Property Owner Signature: 

(Date) 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Oniaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
TlfCHNOLOCIBS. IN C 

PROPERTY INFORMATION 

(To be completed by resident and/or property owner — please print) 

RESIDENT NAME: A/O^/rt ^ L06LF & ner) Renter 

RESIDENT ADDRESS: 

^^^^ foo\€oe\\e 'e>W() 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

OWNER'S TELEPHONE NUMBER - HOME: l¥0 ^ 39T"/^ 3 WORK: (4^ > Cfil l 'fiCl ^ 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER: 1 

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHOM PLAY IN THE YARD FOR 5 HOURS OR MORE PER WEEK: 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETC.) 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: The activities to be implemented by EPA under this agreement are 

pursuant to Section 104 ofCERCLA, 42 U.S.C. 9604. EPA's right of access to the property is provided for in Section 104(e) ofCERCLA, 

42 U.S. C 9605(e), which provides entiy for "detennining the need for response, or choosing or taking any response action under this title, or 

otherwise enforcing the provisions ofthe title." 

8080 Ward Parkway, Suite 405 2505 N. 24"* Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 

Phone: (816) 363-3703 

Fax: (816) 363-3707 

Omaha, Nebraska 68110 

Phone: (402)504-1004 

Fax: (402)504-1005 

San Antonio, TX 78229 

Phone: (210)822-9588 

Fax: (210) 579-6577 
TECHNOLOGIES. 1 

Advanced notice needed. 

After signing the access you allow Prudent to begin Lead Based 

Paint Stabilization. All Plants, weeds and any vehicles or items on 

open porch (enclosed porches will NOT be stabilized) must be 

removed prior to stabilization. All Pets must be out ofyard during 

stabilization. How much notice do you need to have above 

mentioned tasks completed? Ifyou are a landlord you will need to 

contact the tenant as Prudent Technologies will only inform you. 

Do you have any pets that reside in yard? 

9^0 

Notice needed: d/^ 

Number to call to give notice: ^'/'Y- ^ ^^ 

Whom we are giving notice to: /i^j^ ^ ^ U)o a^^ 

Home Owner's Signature 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
f^^^ 

TECHNOLOGIES, INC 

PRE-STABILIZATION VIDEO FORM 

I UNDERSTAND THAT PRUDENT TECHNOLOGIES WILL BE COMING 

OUT TO SHOOT A PRE-STABILIZATION VIDEO AT MY PROPERTY. 

THE VIDEO IS JUST A TOOL USED TO DOCUMENT THE CURRENT 

PROPERTY STATUS/CONDITION. A POST VIDEO WILL ALSO BE 

SHOT PRIOR TO COMPLETION OF STABILIZATION. 

OWNERSNAME: M^O ^ O^cvet 

PROPERTYADDRESS: O-lH^i fcrOrBi^TX^f^^I> 

BVID/SAID: G'SS^ ) 

HOMEOWNERS SIGNATURE: 

PRUDENT REPRESENTATIVE SIGNATURE: 

^ /^fp:^ 

ANY CONDITIONS NEED TO BE AWARE OF BEFORE SHOOTING 

VIDEO: (LE. PETS, NOTICE NEEDED): J\^, ^ ^ /Wfr/ 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fax:(210)579-6577 
TECHNOLOGIES, INC. •eiPRoisj 

ACCESS INFORMATION TRACKING SHEET 

BVID: G2>^l:^j PROPERTY ADDRESS: 

2.7^A io(^kf\QJUAL iVAd Property Owned By: 

(If new property owner) 

Owners Phone No's: 

Uome: ^'^-^----?'^^- Work: 

Cell: A7.2:-:-l9.7^- Fax: -

Access Contractor: ASW PDA MES PE Other (Prudent) 

ACCE^^SOR CONRACT DETAIL 

^hlo ^ Lf' pr ^ ^ y ) 1 V o ^cJ: j x U poJickalfi^ 

MAA. U/ruJf iV> -Lnn; 

<^T<r^f^^ 

DATE TIME 

^E§spi 

Comments: 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
TECHNOLOGIES. INC 

Access Assessment Form: (Must be completed for every property. 

Information must be obtained from a property walk thru, not given 

by owner) 

Is the property stucco or asbestos? 

Coooa 

Ifyes, is any ofthe stucco or asbestos damaged or cracked? 

Ifyes, stop as we can't stabilize this property. It requires special preparation 

techniques. It will be returned to EPA and they will assign at a later date. 

Does this property require lots of scrapping? 

Does this property require a lift or scaffolding to reach upper levels? 

Does this property have lots of plants or items in areas where painting is 

required? 

Does this property have any significant structural damage? 

Ifyes, EXPLAIN? 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
TECHNOLOGIES^ INC 

Does this property have a garage? 

Ifyes, describe location of garage. 

( MO 

Does this property have aluminum siding? 

NO 

Ifyes, is it original factory finish or has it been painted over? 

Mo 

Does this property have any other type of structural components? (Le. roof 

shingles as siding)? 

Ifyes, EXPLAIN? 

Is this property vacant or occupied? 

Are there any pets at this property? 

CJsJh 

Are there any low hanging power lines? 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
TBCHNOLOGIES,] 

NEIGHBORHOOD PROPERTY ACCESS FORM 

IS THERE A NEIGHBORING PROPERTY THAT NEEDS TO BE ACCESSED ALONG 

WITH ASSIGNED PROPERTY TO COMPLETE STABILIZATION PROCESS? 

NO 

IF IT IS, GET ACCESS FROM ALL REQUIRED NEIGHBORHOOD PROPERTIES. 

t\lo 

8080 Ward Parkway, Suite 405 2505 N. 24*" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax:(210)579-6577 
'nCHNOLOGIBS.INC 

PAINT MATCHING FORM: 

TO BE FILLED OUT ONLY IF MATCHING COLOR 

PROPERTYADDRESS: ^1^ ^ F<3o4€ne\\ ^ i^L\j£> 

I UNDERSTAND SHERWIN WILLIAMS WILL MATCH MY CURRENT COLORS. 

Homeowner signaturei Uujf^ 

La li e 

^ ( ^P Se^^ e OA, \ ^

W

\ 

iOMJjLy 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax; (210) 579-6577 
/^' (i& srS 

TECHNOLOGIES, INC 

PRE-STABILIZATION PROPERTY SAFETY ASSESSMENT FORM 

PROPERTYADDRESS: 2.1^ ^ Pon\€n€\ ^ ^^^r ^ 

BVID/SAID: (o?>i^^\ 

PRUDENT ASSESSMENT REPERSENTATIVE: 

'ScXr^^XiV P^WxVC^xA^ 

******IF SAFETY RISK PROPERTY MUST BE TURNED OVER TO 

KATHY ROTHER BEFORE IT CAN BE ASSIGNED TO A CREW/SUB. 

REPERSENTATIVE REMARKS/FINDINGS: 

(POWER-LINE PROXIMITY TO PROPERTY, SCAFFOLDING/ LADDERS/ LIFTS 

NEEDED, UNSAFE AREAS, UNSAFE NEIGHBORHOOD...ETC.) 

REQUIRES K.ROTHER APPROVAL YES/NO 

SUBMITTED TO K.ROTHER ON: 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
# • 

TECHNOLOGIBS, INC. 

Checklist for the Worksite Hazard Analysis 

Address: ^ 7 ^ W ^rr/ct^A-^JlM ^ k^ ^ OjL ^ 

Crew; Date: 

Item OK? I Hazard / Corrective Action 

Overhead Lines LX/K-- ^ ^dlA h,.ji^J<^x ^ ^ ^' ^ ' " ^ 

In-transit Vehicle Clearance biU 

Levels around high wires 

Vehicle Clearance around 

OVv 

high wires when working 

Phone lines u ^ 

Cable lines y

Gas Line 

y Water Line i

Sewer Line 

Septic Tank 

Propane/Butane 

Access to/on Property -/iMJ^r<^ Gy oir ^ lA^auL^ 

Neighbor Access Required /l ^ 1 f ' 

High Traffic Area /\J/ ^ - i Ai ^-^.-v-^rAry- ^^CKJuAt P i^^^ 

Garage [t^ Jy ' Structures Sltl>f£i-^ ^sfu-i 

Driveway ^

fiffhuk. Sidewalk Ms-£y ) IJ. Aye^j^-^r^-^ 

Foundation AT 

Retaining Walls AJ^A 

Fences Nfh 

Trees [t 

Foliage }l,ij^s4-e^ S^yrJ- .S^-^J^_ 

General Condition ofyard ''^•^Tji' 

Daniaged Areas: sink ^ r ' 

holes/rotted wood 

Sprinkler Systeni • — 

Pets 1 

Insects tiju...JA^^^ ^ y ^JL.t>^ pc(^—-

Weather Conditions i ^ 1) f 

Unsafe driving conditions ,^ ^ 

Unsafe neighborhood 

L.- ^ 

Crew Contractor 

y 

2505 N. 24'" Street, Suite 308 nedical Dryt'e, Suite 4250 

Kansa' Omaha, Nebraska 68110 San Anttnio, TX 78229 

Phone: Phone: (402)504-1004 Phone/(210) 822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fa/: (210) 579-6577 

8080 
=^7^ ^0^^"^^^ S^^^ 
Valid/Invalid: Valid 

Exclusion Reason: Multiple 451 -Parti Int Valid 

Sales Date: 2001-11-12 

Pstno- ^n 

Effective until April 2010. 

Confirmation of Receipt of Lead Pamphlet 

1^1 have receiveci a copy of the pamphlet, Renovate Right: Important Lead Hazard 

information for Families, Child Care Providers and Schools informing me of 

the potential risk of the lead hazard exposure from renovation activity to be 

performed in my dwelling unit. I received this pamphlet before the work began. 

Signature of recipient 

Self-Certification Option (for tenant-occupied dwellings only) — 

If the lead pamphlet was delivered but a tenant signature was not obtainable, 

you may check the appropriate box below. 

• Refusal to sign — I certify that I have made a good faith effort to deliver the 

pamphlet, Renovate Right: Important Lead Hazard Information for Famiiies, 

Child Care Providers and Schools, to the rental dwelling unit listed below at the 

date and time indicated and that the occupant refused to sign the confirmation 

of receipt. I further certify that I have left a copy of the pamphlet at the unit with 

the occupant. 

1 ^ Unavailable for signature — I certify that I have made a good faith effort to 

deliver the pamphlet, Renovate Right: Important Lead Hazard Information for 

Families, Child Care providers and Schools, to the rental dwelling unit listed 

below and that the occupant was unavailable to sign the confirmation of receipt. 

I further certify that I have left a copy of the pamphlet at the unit by sliding it 

under the door 

^Hj^p V fi^^K<\:joJ^ 

Printed name of person certifying Attempted delivery 

date and time 

lead pamphlet delivery 

Signature of person certifying lead pamphlet delivery 

Unit Address 

Note Regarding Mailing Option — As an alternative to delivery in person, you 

may mail the lead pamphlet to the owner and/or tenant. Pamphlet must be mailed 

at least 7 days before renovation (Document with a certificate of mailing from the 

post office). 
Douglas County Account Infoly-tion A; Page 1 of 3 

Douglas County, Nebraska Property Record - R0811830000 

Print Report 

NEW Feature Parcel Dmens~onsavailable @ scale 0 50R west of 52nd St - View On Map nformation IS vahd as of 2009-6-16 Treasurer's Tax Report 

New Feature 3 3 3 Auto Sales Search 

Dwner 

NOLFE JULIUS L 

!TAL 

2744 FONTENELLE BLVD 

3MAHA NE 681 04-0000 

Property Information 

Key Number: 11 83 0000 08 

Account Type: Residential 

Parcel Number: 081 1830000 

Parcel Address: 2744 FONTENELLE BD 

OMAHA NE 681 04-0000 

Legal Description: CLAIRMONT LOT 3 BLOCK 5 50 X 125 

Value Information 

Land improvement 

2009 $6,400 00 $83,000 00 

2008 $6,400 00 $83.000 00 

2007 $6,400 00 $83.000 00 

2006 $6,400 00 $83.000 00 

2005 $6,400 00 $77,000 00 

2004 $6,400 00 $70,000 00 

Sales Information 

Sales Date: 2001 -1 1-12 

Deed Type: WD Book: 2197 

Price: $87,000 00 

Grantor: 

Grantee: 

Valid/lnvalid: Valid 

Exclusion Reason: Multtple 451-Partl lnt Valtd 

Sales Date: 2001 -1 1-1 2 

Deed Type: WD Book: 2197 

Price: $1 00 

Grantor: 

63541 


Total 

$89,400 00 

$89.400 00 

$89,400 00 

$89.400 00 

$83,400 00 

$76.400 00 

Page: 18 

Page: 19 
I

«^Jy|•7Jfcrt*fc^•ww^'j:^^^l|*54 ^ ? •••; 

s ' " ' 

 Douglas Couniy Account Infon«|tion Page 2 of 3 V 

Grantee: 

Valid/Invalid: > invalid 

Exclusion Reason: Multiple 451 Parti Int Invalid 

Sales Date: 2000-09-05 

Deed Type: D Book: 2162 193 

Price: $6,506.00 

Grantor 

Grantee: 

Valid/Invalid: invalid 

Exclusion Reason: Sale by Govt Agency 

Sales Date: 2000-08-29 

Deed Type: D Book: 2162 Page: 047 

Price: $29,000.00 

Grantor: 

Grantee: 

Valid/Invalid: ! invalid 

Exclusion Reason: Foreclosure 

Land Informatio n 

Acres SF Writs Depth Width Vacant 

0.14 6250.0 1.0 125.0 50.0 No 

Improvemen t Informatio n 

Building 1 

i^WFDWENiL.EKl 

- -'L^A' 

Tirel Floor Second Flcor 

„,c| 836 Osq *. 746 3 vq R 

2 STORY 

9S6Cm.a 

CLICK TO ENLARGE IMAGE 

Square Footage: 1584.0 Percent Complete: 100.0% 

Perimeter : 0.0 Quality: Average 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R081... 7/7/2009 
Douglas County Account Infooagion Page 3 of3 

Unit Type: Condition: Fair 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Gable Stories: 2.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

^^^'•S"' " RemTJeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1918 2001 0% 1980 29 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 1.0 

Basement Bsmnt Block 8 ft 836.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 192.0 

Porch EncI Screen 42.0 

Porch Slab Roof Ceil 162.0 

http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=R081... 7/7/2009 
# • 

mil TECHNOLOGIES, INC. 

Prudent Property Close-Out Form (Lead-Based Paint Stabilization) 

SAID: Ar06gcA-ixVU^ ^ 

Property Address: .^7^ ^ fhAjf^/Ul^tie feU/b 

Owner's Name: ^\)(nCVfr UOQUA' ^ 

S.NO Performance Standards/close-Out Criteria Yes NO 

1 Was the entire structure(s) painted with the exception ofthe stated, 

excluded areas? This would include painting of other associated 

features including fascia, eaves, siding, all trim, porches, box 

beams, columns, rails, and exterior surfaces of garages. 

y 

2 Was all scraping and other preparation work completed 

satisfactorily? y 

3 Were all required areas of the structure(s) primed as needed and 

painted with two top coats? y 

4 Are all of the areas where contaminated materials have been spilled 

thoroughly vacuumed/ cleaned? y 

5 Did the contractor collect/vacuum all falling and scraped paint chips 

on the entire property, roadways, alleyways, public access areas 

and also remove any other generated debris? y 

6 Is the grass area that surrounds the structure(s) in reasonably good 

condition? y 

7 

8 

Was the paint products utilized equivalent to a 30 year 

product/quality? 

Are all items such as polyethylene sheeting, ladders, paint brushes, 

cones, barrier tape etc properly removed? 

y 

i/ ^ 

9 Is there any evidence of property damage that was done by the 

contractor? Any property damage needs to be completed prior to ^ 

the EPA Close-Out. 

10 Are there any property items that were temporarily re-located by the 

contractor that need to be moved back? y ^ 

11 Are there any (known) lingering issues with the property owner(s) 

that have been left unresolved? ^ y 

12 Other Considerations? Property Owner Discussions? Additional 

Work that is Required 

^y 

Prudent Representative Signature 

Date: 

Property Owner Signature^ 

Date: 

\b s^UUl'O^ 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone:(816)363-3703 Phone: (402) 504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210)579-6577