### TRANSiVIITTA L of OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL E FOLDE R SAI D #: ^.^-R] ] Date : '^-c^Q-Q ^ Address : Remediatio n Contractor: PROFESSIONA LENVIRONIVIENTA LENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S Vide o of property (DVD ) Executiv e Summar y l^y ^ Signe dAcces s Agreemen t fo r subjec t property s y Paintin g Agreemen t D 

### Settlemen t document s (i.e. , fo r ddmag eor to replac e plants , etc. ) S>^^^Photograph s pfg ^ /:?>i aQ^f ^ Q^ Satisfactor y restoratio n signe d by Property Owne r ^^y ^ Propert y close-ou t clieclc lis t signe d by EP A ^y"' ^ Propert y informatio n fro mDougla s Count y Assessor' s Offic e y ^ confirmatio n tha t leadpamphle t "Renovat e Right " wa s receive d by P0 _ 

# S^i ^ D D



### Professional Environmental Engineer s Signature Date 

# a ^ A Signatur Signatur e e 3009442 7 Superfun d

## PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . ''° ' Trn'a' t NEtsn o "Providin g cost-effectiv e environmenta l solutions " ^^ ^

[J°^J 50^:323^ Consultin g • Engineerin g Oesig n • Remediatio n • Abatemen t • Emergenc yRespons e



### Lea dBas e Stabilizatio n Omaha , Ne Clos e Ou t Repor t 200 9 SAID #2381 1 356 1 Cas s S t

•Date s worked : 06/1 6 t o 06/1 9 200 9 •Pr e propert y condition : Hous e ha dstee l sidin g tha t ha dpeelin g pain t o n on e side , Garag e an dfron t hous e stair s wer e stabilized . Pain t wa s poo r o n garag e an dpeelin g off . •Problem s encountered : N/ A •Owne r request/concerns : Non e •Inspection/closeou t dates : 7/14/0 9 N o issue s

Additiona l Comments :

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . "Providin g cost-effectiv e environmenta l solutions " Corsultin g • Engineerin g Des'g n • P'jrrjclT.tio n • .Ab.ntrnipn t • > Envrinenc yRespons e 

### EP A Close-Ou t For m (Lead-BasedPain t Stabilization EP A Contract EP-R7-08-06) 

# J^s^ n SAID : Propert y Address : _ 

# 3 S( ^ I <^^s: s ^ y Owner' s Name : C_jQ)r O 

# -j\^ M CArH^WdA : Performanc e Standards/Close-Ou t Criteri a 250 5 Nort h 24" \ Suit e 21 9 Omaha , N E 6811 0 (402 ) 504-468 8 Fa

x(402 ) 504-328 1



### YE S N O 1 . Wa s th e entir e structure(s ) painte dwit hth e exceptio n ofth e stated , exclude d areas ? Thi s woul dinclud e paintin g ofolhe r associate dfeature s includin g fascia , eaves , siding , al l trim , porches , bo x beams , columns , rails , andexterio r surface s o f 

# y garages . 2 . Wa s al l scrapin g an dothe r preparatio n wor k

complete dsatisfactorily ? 

# y " 3 . Were al l require darea s ofth e structure(s ) prime da s neede dandpainte dwit h tw o to p coats ? 

# y 4 . Wa s th e pain t product s utilize dequivalen t t o a3 0 yea r product/quality ? 

# y 5 . Are al l ofth e area s where contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? 

# y 6 . Didth e contracto r co l leet/vacuu mal l fallin g andscrape dpain t chip s o n th e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e any 

# y othe r generate ddebris ? 7 . I s th e gras s are atha t surround s th e struclure(s ) in reasonabl y goo dcondition ? 

# y 8 . Are al l item s suc ha s polyethylen e sheeting , ladders , pain t brushes , cones , 

# y barrie r tape , etc . properl y removed ? 9 . I s ther e any evidenc e o f property damag e that wa s don e by th e contractor ? An y property damag e need s t o b e complete dprio r t o th e EPA Close-Out . i ^ 

### 10 . Ar e ther e any property item s tha t wer e temporaril y re-locate dby th e contracto r that nee dt o b e move dback ? 

# y 11 . Are ther e any (known ) lingerin g issue s wit hth e property owner(s ) that hav e been lef t unresolved ? 

# y Other Considerations/Property Owner Discussions/Additiona l Wor k

tha t i s Required :



# (2u/ij(/i^y/j.)cCciJ^-^ ^ 

# II/4ID' / EP A CO RSignatur e 'Date '

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . "Providin g cost-effectiv e environmenta l solutions " Consultin g • Engineerin g Desig n • Remediatio n • Abatemen t • Emergenc yRespons e 

### Propert y Owne r Close-Ou t For m (Lead-BasedPain t Stabilization EP A Contract EP-R7-08-06) SAID : '9 3 8 1 \ Propert y Address : ?^^ID\

### Cf^i'S S SJ " Owner' s Name : Pnr^^ n j ^- OjQ>rhvv ^ r I < ^



# k i Performanc e Standards/CIose-Ou t Criteri a 250 5 Nort h 24 ^ Suit e 21 9 Omaha , N E 6811 0 (402 ) 504-468 8 Fa

x (402 ) 504-328 1



### YE S N O 1 . Wa s th e entir e structure(s ) painte dwit hth e exceptio n ofth e stated , exclude d areas ? Thi s woul dinclud e paintin g o f othe r associate dfeature s includin g fascia , eaves , siding , al l trim , porches , bo x beams , colurrms , rails , an dexterio r surface s o f V 

### garages . 2 . Wa s al l scrapin g an dothe r preparatio n wor k

complete dsatisfactorily ? V 

### 3 . Wer e al l require darea s ofth e structure(s ) prime da s neede dan dpainte dwit h tw o to p coats ? V 

### 4 . Wa s th e pain t product s utilize dequivalen t t o a3 0 yea r product/quality ? V 

### 5 . Ar e al l ofth e area s wher e contaminate dmaterial s hav e bee n spille dthoroughl y 1 

### vacuumed / cleaned ? 6 . Di dth e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s o n th e entir e property , roadways , alleyways , publi c acces s area s andals o remov e any 

### y othe r generate ddebris ? 7 . I s th e gras s are athat surround s th e structure(s ) i n reasonabl y goo dcondition ? i > 

### 8 . Are al l item s suc ha s polyethylen e sheeting , ladders , pain t brushes , cones , "J 

### barrie r tape , etc . properl y removed ? 9 . I s ther e any evidenc e o f property damag e that wa s don e b y th e contractor ? An y y property damag e need s t o b e complete dprio r t o th e EP A Close-Out . 10 . Are ther e an y property item s tha t wer e temporaril y re-locate db y th e contracto r 

# J that nee dt o b e move dback ? 11 . Are ther e any (known ) lingerin g issue s withth e property owner(s ) tha t hav e J bee n lef t unresolved ? Comments :

y < 3 A »< * < c = i * . . t . 

# X 

# ^/o ^ Propert y OM/xtt x Signatur e / y Dat e 

## y - y 

## -O/ P Professiona l Ermfonmenta l Engmeers Representative Dat e

## * ^ srcnr\ j 

## CONSEN T OF RACCES S T O PROPERT Y OMAH A LEAD SIT E REMEDIALACTIO N - LEAD-BA$£D PAIN T STABILIZAIIO N PROPERT Y ID : J?^K/^ ~ PROPERT Y ADDRESS : 3S<£> / <^S* > - 2 7 ^ O/P/j^ ^ A ^ OWNE RNAME : 

## d/}/CD/yA l Ai . d^Tv^y/^AT ' DAYTIM EPHONE : ^f e '5¥S-^702 ^ CEL LPHONE : 4^1 " 709'^/i ^ E-MAIL : (1 ^ t^/^Tv^/^/'O/pT^ ^ <^^^/^ " OWNER' S ADDRES S I FDIFFERENT : TENANT' S NAME I FAPPLICABLE : DAYTIMEPHONE : CELLPHONE : E-MAIL : Professiona l Envlronoienta ) Engineers , Inc . (PE ) i s unde r contrac t (#EP-R7-0S-06 ) wit hth e U.S . Environmenta l Protectio n Agenc y (EPA ) t o stabili7. e leadbase dpain t (LBP ) o n residentia l structure s a t anumbe r o

f propertie s locate di n Omaha , Nebraska . Tb e pain t stabilizatio n wor k

i s bein g don e t o protec t th e soil cleanup s tha t were performe db y EPA contractors . Pain t stabilizatio n activitie s will include ; scrapin g of cracke do r flaking LB Pfromstructures , applicatio n ofaprime coat an d tw o (2 ) coat s o f paint . Moving part s o f window s an ddoor s BrcJO t include dan dwill no t b e addressed . You r cooperatio n i s requeste di n givin g permissio n t o thi s EP A contracto r (PE ) t o ente r an dhav e acces s t o thi s propert y fo r th e purpos e o f stabilizin g lead-base dpain t a s outline do n th e propert y identifle dabove . By signin g thi s documen t I agree t o allo w an EPA contracto r t o conduc t asoi l cleanu p a t m y properl y following completio n of lead-base dpain t stabilization . I understan dtba t th e stabilizatio n contracto r ca n no t provid e assurance s tha t th e soi l cleanu p contracto r will b e boun dto . I furthe r understan dtha t th e soi l cleanu p contracto r wil l make al l reasonabl e effort s t o addres s concern s tha t I , a s th e propert y owner , ma y hav e regardin g soil cleanu p a t m y property . I full y understan dtha t b y signin g thi s Consen t fo r Access , (1 ) thi s acces s will remai n in effec t unti l th e work ha s bee n satisfactoril y completed , (2 ) tha t th e Propert y Owner o r Tenant , i f applicable , will b e given th e Housin g an dUrba n Developmen t (HUD ) an dEPA pamphlet , "Renovat e Right , Importan t Lea dHazar dinformatio n fo r Families , Da y Car e Providers , an dSchools" , (3 ) th e Propert y Owne r o r tenan t wil l remov e al l obstruction s fro msurface s t o b e painted , (4 ) wil l abid e b y healt han dsafet y guidanc e provide db y EPA , (5 ) will allo w photograph y o f propert y befor e an dafle r th e pain t stabilizatio n work , (6 ) will b e contacte db y aP E representativ e approximatel y 4 8 hour s in advanc e o f startin g work , (7 ) agree no t t o obstruc t o r tampe r wit han y ofth e LB P stabilizatio n actions , an d(8 ) will participat e i n fina l propert y inspectio n an d sig n th e Completio n Agreemen t an dPropert y Owne r Satisfactio n Survey . Shoul dyo u hav e an y question s abou t th e plane dLeadBased-Pain t stabilizatio n activitie s fo r you r property , pleas e contac t Professiona l Environmenta l Engineers , Inc . Projec t Manager , Willi e Cit y At 40Z-S04-468S . Genera l question s abou t th e Omah aLeadSite cleanu p ca n b e directe dt o Paulett aFrance-Isetts , EPA Remedial Projec t Manage r 402-731-2454 , o r th e EP A Publi c Informatio n Center s a t 402-991-958 3 (NorthOmah aofTice ) o r 402-731-304 5 (Sout hOmah aofflce) . 

# I Yes , I gran t acces s t o m ypropert yan d W M 0lv« n tli a pampli M D No , I d o no t gran t acces s t o m yproparl yan d I wa s "Renovat e Right . Importin t Les d Informatio n fb rFamilies , Chil d give n th o pamphle t "Renovat e Right , Importan t Lea d Car e Providers , an d Schoote. " . Inlbrmatio n fb rFamilies , Child e Car e ProvlderB , an d Schools. ' Signatur e Dat e SPECIA L INSTRUCTION S AN D CONSIDERATION S

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# PscmmmmB S ?)5^ l Cfi-s s ^/ mca mL?P/3 / PROPERT YADDRES S O F OVIfNE R IF DIFFEREN TTHA N PROPERT YBEIN G PAINTED : PROPERT YADDRES S ZI P COD E I hav e received a tnp y of th e pamphlet . Ranoval s Righ t hnportan t Laa d Ham d Informatio n Fo rFamlllaa , Cha d Car a PmvU m An d School a inlbnnin g m e of th e potentia l risk of th e lea d hazar d exposur e fro m renovatton activit y to ti e performe d o n dwellin g unit . I reoeived thi s pamphle t t)elbr e th e wor k l)egan . 

# C ' /y- ^ 

# "" / ^ flAM RECmEN ^ I PRINTE D M E O F in T DAT E

CAGNATUR E O F RECIPIEN T

Self-CertincBllo n Optto n (Fo rTenantOccupla d Dwelling s Only ) Ifth e lea d pamphte t wa s delivere d tiu t a tenan t signatur e wa s no t obtainable , yo u ma ychec k th e appropriat e bo x beknv : [ J Rehisa l T o Sig n - 1 certif ytha t I hav e mad e a goo d fait h efibr t I D delive rth e pamphlet . lenoval B righ t Impoftan t lea d hazan l Infonnatto n fo rfemilles, ohl M car e provMer s an d schools ; to th e rental dwellin g uni t liste d abov e at th e dal e an d tim e indicate d an d tha t th e occupan t lefuse d to sig n th e confirmalio n of receip t I furthe rcertif ytha t I hav e lef t a cop y ofth e pamphle t at Ih e uni t wH h oocupan l L l Unavallabi a Fo rSignalur e - i certif ytha t i hav e mad e a goo d fait h effor t to deltve rth e pamphtet , renovat e right ; importan t lea d hazar d infonnatto n fo rfamllteB , chil d car e pravMer e an d sdtoote , to th e renta l dwellin g uni t liste d beto wan d tha t th e occupan t wa s unavaDabt o to sig n th e oonflrmatto n ofreceipt I furthe rcertif ytha t i hav e teft a cop y ofth e pamphtei t at th e uni t bysIMIn g It unde rth e doo r orsomewher e on th e premises . 

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### ^ Dougla s Count y Accoun t Information .£XIX ^ A ^ Pag e 1 of 3

1 Dougla s County , Nebrask a Propert yRecor d - R130479000 0 | Prin t Reoor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 n wes t of 52n d S t - Vie wo n Ma p 1 Informatio n i s vali d a s o f 2009-6- 3 Treasurer - s Ta xRepor t Ne wFeatur e ••-•" • Aut o Sale s Searc h | I Owne r|

CARTWRIGH T CAROLY N M 356 1 CAS S S T OMAH AN E 68131-000 0 Propert yInformatio n | Ke yNumber . 047 9 00001 3 1 Accoun t Type : Residentia l Parce l Numtie r 130479000 0 1 Parce l Address : 356 1 CAS S S T OMAiHAN E 68131-000 0 Lega l Description : HAWTHORN E AD D LO T 2 BLOC K5 W 5 0 F TLT S 1 & 5 0 X 10 0 | Valu e Informatio n Lan d Improvemen t 

### Tote l 1 200 9 $5,700.0 0 $92,000.0 0 $97,700.0 0 200 8 $5,700.0 0 $92,000.0 0 $97,700.0 0 200 7 $5,700.0 0 $92,000.0 0 $97,700.0 0 200 6 $5,700.0 0 $92,000.0 0 $97,700.0 0 200 5 $5,700.0 0 $92,000.0 0 $97,700.0 0 200 4 $5,700.0 0 $75,400.0 0 $81,100.0 0 1 Sale s Informatio n i Sale s Date : 2004-07-1 5 1 Dee d Type : W D 1 Book : 200 4 Pa^ : 09673 8 1 Price : $99,500.0 0 1 Granto r Maveric k Resource s Grantee : Caroly n M Cartwrigh t Validnnvalid : Vali d Exclusio n Reason : Sale s Date : 2003-09-0 4 1 Dee d Type : TR D . - Book : 1200 3 Page : j 23276 2 | Price : $80,100.0 0 1 Granto r CAMILLEHAWKT R | 

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

### Dougla s County Accoun t Infonnatio n Pag e 2 of 3

^ ^ . . . • • ' . Grantee : MAVERIC KRESOURCE S LL C Valld/lnvalld : Invali d Exclusio n Reason : Foreclosur e 5a/e s Date : 1999-08-3 0 Dee d Type : Book : 213 5 Page : 12 4 Price : $ 99,500.0 0 Granto r Grantee : Valld/lnvalld : Vali d Exclusio n Reason : Sale s Date : 1997-08-2 6 Dee d Type : Book : 

### 206 9 Page : 69 7 Price : $ 82,500.0 0 Granto r Grantee : Valld/lnvalld : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Untt s Depti i 

### Widti i Vacan t 0.1 1 5000. 0 100. 0 50. 0 N o 

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# 26I M s U5 ^ 1 . Sit e preparation/scraping . 2 . Pa i nting . 3.Clean-up . Primordial/Peligro s Potenciales : 1 . Persona l lea dcontaminatio n 3.Eletricity . 2 . Sit e lea dcontamination . 4.Falls . Herramientas d e trabajo : 1 . Ste p letter. . 3 . Pain t spr y machines . 2 . Knife . 4 . Others . Practicas d e Trabajo/Accione s Correctivas : 1 . 3 . 2 . 4 . Llamada s Previas : I . 3 . 2 . 4 . Firm ad e registr o de l Empleado : 

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