TRANSiVIITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID #: ^.^-R] ] Date: '^-c^Q-Q ^ 

Address: 

Remediation Contractor: PROFESSIONAL ENVIRONIVIENTAL ENGINEERS 

Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

l^y ^ Signed Access Agreement for subject property 

s y Painting Agreement 

D Settlement documents (i.e., for ddmage or to replace plants, etc.) 

S>^^^Photographs pfg^ /:?>ia Q^f^ 

Q^ Satisfactory restoration signed by Property Owner 

^^y ^ Property close-out clieclc list signed by EPA 

^y"'^ Property information from Douglas County Assessor's Office 

y ^ confirmation that lead pamphlet "Renovate Right" was received by P0_ 

S^i ^ 

D 

D 

Professional Environmental Engineers Signature Date 

A Signatur Signaturee a ^

30094427 

Superfund 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. ''° ' Trn'a't NEtsno 

"Providing cost-effective environmental solutions" ^^^ [J°^J 50^:323^ 

Consulting • Engineering Oesign • Remediation • Abatement • Emergency Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2009 

SAID# 23811 

3561 Cass St 

• Dates worked: 06/16 to 06/19 2009 

• Pre property condition: House had steel siding that had peeling paint on one side, 

Garage and front house stairs were stabilized. Paint was poor on garage and peeling 

off. 

• Problems encountered: N/A 

• Owner request/concerns: None 

• Inspection/closeout dates: 7/14/09 No issues 

Additional Comments: 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"Providing cost-effective environmental solutions" 

Corsulting • Engineering Des'gn • P'jrrjclT.tion • .Ab.ntrnipnt •> Envrinency Response 

EPA Close-Out Form 

(Lead-Based Paint Stabilization EPA Contract EP-R7-08-06) 

J^s^n SAID: 

Property Address: _ 3 S(^ I <^^s:s ^ y 

Owner's Name: C_jQ)rO -j\^ M CArH^WdA: 

Performance Standards/Close-Out Criteria 

2505 North 24"\ Suite 219 

Omaha, NE 68110 

(402) 504-4688 

Fax (402) 504-3281 

YES NO 

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

areas? This would include painting ofolher associated features including fascia, 

eaves, siding, all trim, porches, box beams, columns, rails, and exterior surfaces of y garages. 

2. Was all scraping and other preparation work completed satisfactorily? y" 

3. Were all required areas ofthe structure(s) primed as needed and painted with 

two top coats? y 

4. Was the paint products utilized equivalent to a 30 year product/quality? y 5. Are all ofthe areas where contaminated materials have been spilled thoroughly 

vacuumed/ cleaned? y 

6. Did the contractor col leet/vacuum all falling and scraped paint chips on the 

entire property, roadways, alleyways, public access areas and also remove any 

other generated debris? y

7. Is the grass area that surrounds the struclure(s) in reasonably good condition? y 8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, 

barrier tape, etc. properly removed? y

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. i ^ 

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 

Other Considerations/Property Owner Discussions/Additional Work that is Required: 

(2u/ij(/i^y/j.)cCciJ^-^^ II/4ID'/ 

EPA COR Signature 'Date' 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"Providing cost-effective environmental solutions" 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Property Owner Close-Out Form 

(Lead-Based Paint Stabilization EPA Contract EP-R7-08-06) 

SAID: '9 3 8 1 \ 

Property Address: ?^^ID \ Cf^i'SS SJ " 

Owner's Name: Pnr^^ n j ^ - OjQ>rhvv^ r I <^ ki 

Performance Standards/CIose-Out Criteria 

2505 North 24^ Suite 219 

Omaha, NE 68110 

(402) 504-4688 

Fax (402) 504-3281 

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, colurrms, rails, and exterior surfaces of V 

garages. 

2. Was all scraping and other preparation work completed satisfactorily? V 

3. Were all required areas ofthe structure(s) primed as needed and painted with 

two top coats? V 

4. Was the paint products utilized equivalent to a 30 year product/quality? V 

5. Are all ofthe areas where contaminated materials have been spilled thoroughly 1 

vacuumed/ cleaned? 

6. Did the contractor collect/vacuum all falling and scraped paint chips on the 

entire property, roadways, alleyways, public access areas and also remove any y other generated debris? 

7. Is the grass area that surrounds the structure(s) in reasonably good condition? i> 

8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, "J barrier tape, etc. properly removed? 

9. Is there any evidence of property damage that was done by the contractor? Any 

y 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 J that need to be moved back? 

11. Are there any (known) lingering issues with the property owner(s) that have J been left unresolved? 

Comments: 

y <3 A »< * <c = i *. .t . 

X ^/o ^ 

Property OM/xttx Signature / y Date 

y - y -O/P 

Professional Ermfonmental Engmeers Representative Date 
*^ srcnr\j 

CONSENT OFR ACCESS TO PROPERTY 

OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BA$£D PAINT STABILIZAIION 

PROPERTY ID: J?^K/^ ~ PROPERTY ADDRESS: 3S<£>/ <^S* > -2 7 ^ O/P/j^^ A ^ 

OWNER NAME: 

d/}/CD/yAl Ai. d^Tv^y/^AT ' DAYTIME PHONE: ^f e '5¥S-^702 ^ 

CELL PHONE: 4^1 " 709'^/i ^ E-MAIL: (1 ^ t^/^Tv^/^/'O/pT^^ <^^^/^" 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME IF APPLICABLE: 

DAYTIMEPHONE: 

CELLPHONE: E-MAIL: 

Professional Envlronoienta) Engineers, Inc. (PE) is under contract (#EP-R7-0S-06) with the U.S. Environmental Protection 

Agency (EPA) to stabili7.e lead based paint (LBP) on residential structures at a number of properties located in Omaha, 

Nebraska. Tbe paint stabilization work is being done to protect the soil cleanups that were performed by EPA contractors. 

Paint stabilization activities will include; scraping of cracked or flaking LBP from structures, application ofa prime coat and 

two (2) coats of paint. Moving parts of windows and doors BrcJOt included and will not be addressed. 

Your cooperation is requested in giving permission to this EPA contractor (PE) to enter and have access to this property for 

the purpose of stabilizing lead -based paint as outlined on the property identifled above. 

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

lead-based paint stabilization. I understand tbat the stabilization contractor can not provide assurances that the soil cleanup 

contractor will be bound to. I further understand that the soil cleanup contractor will make all reasonable efforts to address 

concerns that I, as the property owner, may have regarding soil cleanup at my property. 

I fully understand that by signing this Consent for Access, (1) this access will remain in effect until the work has been 

satisfactorily completed, (2) that the Property Owner or Tenant, if applicable, will be given the Housing and Urban 

Development (HUD) and EPA pamphlet, "Renovate Right, Important Lead Hazard information for Families, Day Care 

Providers, and Schools", (3) the Property Owner or tenant will remove all obstructions from surfaces to be painted, (4) will 

abide by health and safety guidance provided by EPA, (5) will allow photography of property before and afler the paint 

stabilization work, (6) will be contacted by a PE representative approximately 48 hours in advance of starting work, (7) agree 

not to obstruct or tamper with any ofthe LBP stabilization actions, and (8) will participate in final property inspection and 

sign the Completion Agreement and Property Owner Satisfaction Survey. 

Should you have any questions about the planed Lead Based-Paint stabilization activities for your property, please contact 

Professional Environmental Engineers, Inc. Project Manager, Willie City At 40Z-S04-468S. General questions about the 

Omaha Lead Site cleanup can be directed to Pauletta France-Isetts, EPA Remedial Project Manager 402-731-2454, or the 

EPA Public Information Centers at 402-991-9583 (North Omaha ofTice) or 402-731-3045 (South Omaha offlce). 

I Yes, I grant access to my property and W M 0lv«n tlia pampliM D No, I do not grant access to my proparly and I was 

"Renovate Right. Importint Lesd Information fbr Families, Child given tho pamphlet "Renovate Right, Important Lead 

Care Providers, and Schoote." . Inlbrmation fbr Families, Childe Care ProvlderB, and Schools.' 

Signature Date 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
©©(mtfomnnigii©!!!) @f l^(i(S@Dpi£ ©If Lsnd l FgioinipffBll®^ 

PscmmmmBS ?)5^l Cfi-ss ^/ mcam L?P/3/ 

PROPERTY ADDRESS O F OVIfNER IF DIFFERENT THA N PROPERTY BEING PAINTED: 

PROPERTY ADDRESS ZIP CODE 

I have received a tnp y of the pamphlet. Ranoval s Righ t hnportan t Laa d Ham d Information Fo r Famlllaa, 

Cha d Cara PmvU m An d School a inlbnning m e of the potential risk of the lead hazard exposure from 

renovatton activity to tie performed o n dwelling unit. I reoeived this pamphlet t)elbre the work l)egan. 

C ' /y-^ "" 

/ ^ PRINTED flAMME OF RECmENinT ^ DATIE 

CAGNATUR E O F RECIPIENT 

Self-CertincBllon Optton (For TenantOccupla d Dwelling s Only ) 

If the lead pamphtet was delivered tiut a tenant signature was not obtainable, you may check the appropriate box 

beknv: 

[ J Rehisal T o Sign - 1 certify that I have made a good faith efibrt I D deliver the pamphlet. lenovalB right Impoftant 

lead hazanl Infonnatton for femilles, ohlM care provMers an d schools; to the rental dwelling unit listed above at the 

dale and time indicated and that the occupant lefused to sign the confirmalion of receipt I further certify that I 

have left a copy of the pamphlet at Ihe unit wHh oocupan l 

L l Unavallabia For Signalure - i certify that i have made a good faith effort to deltver the pamphtet, renovate right; 

important lead hazard infonnatton for famllteB, child care pravMere and sdtoote, to the rental dwelling unit listed 

betow and that the occupant was unavaDabto to sign the oonflrmatton of receipt I further certify that i have teft a 

copy of the pamphteit at the unit by sIMIng It under the door or somewhere on the premises. 

JSJ^VWV^ Saa,^ckay 5. 

PRINTED NAME OP ffiRSON CERnFYMO ATTEMPTED DEUVBTr DATE ANO TIME LEAD 

PAMPHLET DEUVERY 

<K7^\ ^^^y^j^J^' 

ATURE OKPERSON CERTIFYiNO l£AD PAMPHLET 

H o b RsgfBrilng Hslin g Option - as an sItemallwB to defivery in person, you may mall the tead pamphtet to ihe owner 

endtortonanL Pamphtet must be maited at teatf 7 days before ranovBflon. (|}o(aiimntNlihaoBillliG8bof(nallrigliomih8po8t 

OONFIRUATION OF RECEIPT OF LEAD PAtJPHLET 08X18 
mBG^T-Smiflymill©!)^ IP[^i#TO(Pi{^T¥ ^SiiiS(^E6^T 

Z^lplQ/^SS ^ / DAU. 

SVIO 

KEMovey BIO rr y YES m 

^-TD ^ /^ycJ^/Q/MyPREHaasEOiG GONDIIIQII OP FOUNDAnoN/smiicniR^ I A BASEMENT 

NO • ' YES ' ' IF, YES WHERE: 

EXanNO PAINT ON WINBMMVB^ iMXNISir fOUNDATIONr SIDEWrAUg( LE.)7 NOl—I 

YBS c m IF, YES WHERE: 

OP PROKRTf/SnillCniRE/GARAlQI^ (LE.): (use BACK noe IP 

I Vl-o\\ "Sojv 

wspmtmim.w^mBSi 

yUid/iu% LlTT^iy^
|0)Kf S 

DATE 

BVID 

C30I1J0BL 

HOUSETRIM. Ul^\ \ _CX)LOIt 

GARAO^ JOOLOR^ 

GARAGE TRIM K\A, A9Jf ^ /y^^/OOklM. i^/^jh ^ 5 ^^V 

<rM/^7.grff ^CJLXJDOUML 

(OOMPLErE All . SECnODi YOir NQ, OR NON-APfUCABLE) 

I AfiREf TO THi COLORS USTED ABOVE. ONCE PAINTING BEGINS I 

UNDERSTAND I CAN NOT CHANGE THE ABOVE SELECTED COLORS: 

PADMrmiioHroRGOflam 
^ Douglas County Account Information .£XIX^ A^ Page 1 of3 

1 Douglas County, Nebraska Property Record - R1304790000 | 

Print Reoort 

NEW Feature - Parcel Dimensions available @ scale 0-50 n west of 52nd St -View on Map 1 Information is valid as of 2009-6-3 Treasurer-s Tax Report 

New Feature ••-•" • Auto Sales Search | 

I Owner | 

CARTWRIGHT CAROLYN M 

3561 CASS ST 

OMAHA NE 68131-0000 

Property Informatio n | 

Key Number. 0479 000013 1 

Account Type: Residential 

Parcel Numtier 1304790000 1 

Parcel Address: 3561 CASS ST 

OMAiHANE 68131-0000 

Legal Description: HAWTHORNE ADD LOT 2 BLOCK 5 W 50 FT LTS 1 & 50 X 100 | 

Value Informatio n 

Land Improvement Totel 1 

2009 $5,700.00 $92,000.00 $97,700.00 

2008 $5,700.00 $92,000.00 $97,700.00 

2007 $5,700.00 $92,000.00 $97,700.00 

2006 $5,700.00 $92,000.00 $97,700.00 

2005 $5,700.00 $92,000.00 $97,700.00 

2004 $5,700.00 $75,400.00 $81,100.00 1 

Sales Informatio n 

i Sales Date: 2004-07-15 1 

Deed Type: WD 1 Book: 2004 Pa^ : 096738 1 

Price: $99,500.00 1 

Grantor Maverick Resources 

Grantee: Carolyn M Cartwright 

Validnnvalid: Valid 

Exclusion Reason: 

Sales Date: 2003-09-04 1 

Deed Type: TRD . - Book: 12003 Page: j 232762 | 

Price: $80,100.00 1 

Grantor CAMILLEHAWKTR | 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R130... 6/9/2009 
Douglas County Account Infonnation Page 2 of3 ^ ^ . . . • • ' . 

Grantee: MAVERICK RESOURCES LLC 

Valld/lnvalld: Invalid 

Exclusion Reason: Foreclosure 

5a/es Date: 1999-08-30 

Deed Type: Book: 2135 Page: 124 

Price: $99,500.00 

Grantor 

Grantee: 

Valld/lnvalld: Valid 

Exclusion Reason: 

Sales Date: 1997-08-26 

Deed Type: Book: 2069 Page: 697 

Price: $82,500.00 

Grantor 

Grantee: 

Valld/lnvalld: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Untts Deptii Widtii Vacant 

0.11 5000.0 1.0 100.0 50.0 No 

Improvemen t Informatio n 

Building 1 

Two Bvmnt VIOCH e n Story 7ae.ot(|.«. 

3561 Cass st 

Sf "1 

Firnnpof 

*"' e2e,e»«.«, 

CLICK TO ENLARGE IMAGF 

Square Footage: 1596.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R130... 6/9/2009 
IGIT 

Property Address

Start Date 

3 ^ ^ ^ ^c^ ^ >S S 4 " 

End Date 

.Date ^Y/^^/^f 

Amount Of Prime And Paint Used 

Prime (Gallons) • ^ G^ \ 

Poly (Boxes) 

Paint (Color) 

Paint (Color) 

Paint (Color) 

Paint (Color) 

• ^ 

J^Llfa 

£Z33 . 

JUZML 

Amount (Gallons)

Amount (Gallons)

Amount (Gallons)

Amount (Gallons) 

 /<^

 /

 /

 /^/j / 

 (Sd / 

 ^z?/ 

Paint (Color) Amount (Gallons) 
PROFESSIONAL ENVIROMENTAL ENGINEERS.INC. 

RELINION DIARIA DE SEGURIDAD 

Fecha:0f/oS/o 9 

Proyecto: Omaha paint stabilization project 

Lugar: 

Sitio de actividad: 3 S'(DJ . CCBS S S> "J" (^-vvOl 

Tareas dianas: 26IM s U5 ^ 

1. Site preparation/scraping. 

2. Pai nting. 

3.Clean-up. 

Primordial/Peligros Potenciales: 

1. Personal lead contamination 3.Eletricity. 

2. Site lead contamination. 4.Falls. 

Herramientas de trabajo: 

1. Step letter.. 3. Paint spry machines. 

2. Knife. 4. Others. 

Practicas de Trabajo/Acciones Correctivas: 

1. 3. 

2. 4. 

Llamadas Previas: 

I. 3. 

2. 4. 

Firma de registro del Empleado: 

I. JMJ/Jl.ae./.(/2.({......S:z.c.:Zyf.pQ.yi.l?:. 11. 

5.ffrrkf/7j>/.. TZ.uy..^..?.. 15., t..Uf^(/.j>co.^.....^a.ti.Ch<z'7i 16. iipix{tia..fitt3^tyy>adh.JbCi()dUs^.. 17.. 

8..»3ft.?^*«....aTC<ltO^...G*.k:'^7?-. 18., 

9 19.. 

10 20.. 

n 21.. 

12 22.. 

.O...fc/Q.3./.Q 9 

Firma de Fecha