TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

Date: AOLMl 

Stabilization Contractor: Professional Environmental Engineers Year: 2DX l 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUIVIENTS 

0^ Video ofproperty (DVD) 

Executive Summary 

Signed Access Agreement for subject property 

Pre-Renovation Form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, if applicable 

Painting Agreement 

tJ Settlement documents (i.e., for damage or to replace plants, etc.) 

Renovation Recordkeeping Checklist signed by Certified Renovator 

AT 

Photographs 

Satisfactory close-out check list signed by Property Owner 

Property close-out check list signed by EPA 

Property information from Douglas County Assessor's Office 

Hazard analysis, if prepared 

40377560 Q

 Safety Audit Hilill ts Other (describe): 

Superfund 

IDate' 4 i ^ 

t 

EPAfcoiCSIg lature 

(afterfile folder review) 
2505 North 24*, Suite 219 

Omaha, NE 68110 

(402) 504-4688 

Fax (402) 504-3281 

PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"Providing cost-effective environmental solutions" 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2011 

SAID# 39848 

2449 Bauman Av 

• Dates worked: 9/21 to 9/22 2011 

• Pre property condition: House and garage have painted wood siding with painted 

wood trims and foundation areas. Paint was flaking off in areas. 

• Problems encountered: None. 

• Owner request/concerns: Color change. 

• Inspection/closeout dates. Owner 9/22/11 ^Of^ 1/2^// / 
2011 

PROFESSION)^ 

2505 North 24'^, Suite 219 ENVIRONMENTAL ENGINEERS, INC. Omaha, NE 68110 

(402) 504-4688 "Providing cost-effective environmental solutions" Fax (402) 504-3281 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

EPA Close-Out Form 

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

SAID: 

im^ 

Property Address: 299 ^ L>C(l/f1^0h 

Owner's Name: y\^8\!l|0 ^%^V\C ^ 

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. 

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

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

4. Was the paint products utilized equivalent to a 25 year product/quality? 

5. Are all ofthe areas where contaminated materials have been spilled thoroughly vacuumed/ i X 

cleaned? 

6. Did the contractor collect/vacuum all falling and scraped paint chips on the entire property, y roadways, alleyways, public access areas and also remove any other generated debris? 

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

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

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

damage needs to be completed prior to the EPA Close-Out. 

• ^ 10. Has the property owner signed the completion form? 

11. Are there any property items that were temporarily re-located by the contractor that need to 

be moved back? 

12. Are there any (known) lingering issues with the property owner(s) that have been left 

unresolved? 

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

EPA COR Signature ' Date 
PROFESSIONAL 

2505 North 24% Suite 219 ENVIRONMENTAL ENGINEERS, INC. Omaha, NE 68110 

(402) 504-4688 "Providing cost-effective environmental solutions" Fax (402) 504-3281 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Property Owner Close-Out Form 

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

SAID: 

Property Address. ^^^T , . j^^^l^k T ^'J ^ 

Owner's Name: T " ^^V W ^'W ^ 

I­ p- j •r- ^ 

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. 

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

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

two top coats? K 

4. Was the paint products utilized equivalent to a 30 year producL'quality? < 

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

vacuumed/ cleaned? K 

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 ^ 

other generated debris? 

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

< 8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, \ 

barrier tape, etc. properly removed? 

9. Isthereany evidence ofproperty damage that was done by the contractor? Any 

property damage needs to be completed prior to the EPA Close-Out. K 

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

that need to be moved back? < 

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

been A JL left unresolved? 

Comments: 

^A>/// 

Property Owner Signature Date 

lAw 

Professional Enviroimiental Engineers Representative Date 
Professional Environmental Engineers: EPA Paint Stabilization 2011 

sAiD# :^fflM8J 

Property Address nm hmn^ Au 

Stories/Siding type\ ] I k L Transite Wood Vinyl Metal Stucco 

Garage? Yes No Painted? Yes No 

Where? Siding 

Date access signed 

0/l^/ n M/ 0 

Trim 

Pre-video 4{|/^l| l 

Post video 

Contractor Assigned / l j4i/M.jQ^ 

Oate started 9' ^ "/" ^ Date ended ^ ' I'X-7] 

Weather Conditions 

Paint used 

Prime used 

Poly used 

Problems/Issues 
(ci'rci;i.i\e April 2iD10) 

RENOVATION RECORDKEEPING CHECKLIST 

Name of Firm: Sl^\^fe/LA£7 ^ikfTid^, 

Date and Location of Renovation: 

Brief Description of Renovaiion; 

Name of Assigned Renovator; /VyHM^g^A^ 0^7' . 

Name(s) of Trained Workers: 

Name of Dust Sampling Technician. Inspector, and/or Risk Assessor, if used: 

A Copies of renovator and dust sampling technician qualifications (training certitlcates. certincations) on fil 

'T~- Certified renovator provided training to workers on (check alt that apply)­

^Posting warning signs 7 Setting up plastic containjnent harriers 

'{('Maintaining containment ^Avoiding spread of dust to adjacent areas 

3,^VVaste handling '/^Post-renovation cleaning 

ij^r—Test kits used by certified renovator to determine whether lead was present on components affected b> 

renovation (identify kits used and describe sam.plmg locations and results. 

5^ Warning signs posted at entrance to work area. 

.feC^ork area contained to prevent spread of dust and debris 

^Windows in and within 20 feet ofthe work area are closed 

j / Doors in and within 20 feet ofthe work areas are closed and sealed 

^Doors that must be used in the work area are covered to allow passage but prevent spread of dust. 

vGround covered by plastic sheeting extending 10 feet from work area - plastic anchored to the 

nuilding and weighted down by heavy objects. 

Ifnecessary. vertical contairunent installed to prevent migration of dust and debris to adjacent 

dro perty. 

?—Waste contained on-site and while beins transported otT-site 
ijiiectiv'.' .^\prii 2010) 

5!S-\V'ork site properly cleaned after renovation. 

I^All chips and debris picked up. protective sheeting misted, folded dirty side inward, and taped for 

rem.ovai. 

^ Work area HEPA vacuumed to get paint chips from ground surface, ifnecessary. 

(ZS Certified renovator performed posi-renovation cleaning verification (describe results)' 

^ ! cenify under penalty of law that the above information is true and complete 

Name and Title Date 
mB 

Douglas County , Nebraska Propert y Record - R174994000 0 

Print Report 

View Interactive GIS Mao Infomiation is valid as of 2011-7-29 Treasurer's Tax Report 

New Feature -•-*- > Subdivision Sales Search 

Owne r ^^r<xM^ ^'U 

STARKS KEVIN D 

ETAL 

2449 BAUMAN AVE 

OMAHA NE 68112-0000 (uoz] qS7-^^7^ f^oz] Hf^i-Ho^ 

Propert y Infomiatio n 

Key Number: 4994 0000 17 

Account Type: Residential 

Parcel Number: 1749940000 


Parcel Address: 2449 BAUMAN AV 

OMAHA NE 68112-0000 

Legal Description: MINNE LUSA LOT 17 BLOCK 8 42 X120 

Value Informatio n 

Land Improvement Total 

2011 $5,700.00 $83,500.00 $89,200.00 

2010 $5,700.00 $83,500.00 $89,200.00 

2009 $5,700.00 $83,500.00 $89,200.00 

2008 $5,700.00 $83,500.00 $89,200.00 

2007 $5,700.00 $70,400.00 $76,100.00 

2006 $5,700.00 $70,400.00 $76,100.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.11 5040.0 1.0 120.0 42.0 No 

Improvemen t Informatio n 

Building 1 
2449 Bauman Av« 

1 IG S»ofy F=in 

'JB^ ^ 0J ifb 

t^tr itff 

•*e TD 

11 D Srssis­ U l r 

? » 

'I * 

'» 

Mr 

T n ? 

CUCK TO ENUkRGE IMAGE 

Square Footage: 1647.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: 1 1/2 Story Fin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 5.0 

Exterior: Frame Shingle Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Stiingle Bedrooms: 2.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year 

year Built Physical Age Remodeled Remodeled Built 

1918 0% 1918 91 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 1.0 

Basement Bsmnt Block 8 ft 1080.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 360.0 

Porch End Solid Wall 132.0 
CONSENT FOR ACCESS TO PROPERTY 

OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZ.\TION 

PROPERTY ID PROPERTV ADDRESS; . J2.MMQ . _ _ Um w ^vT 

IWN'ER NAAl MT^v^-^ DAYTIME PHONE: H^^'H^7-^OZ3 

CELLPHONE: ^0 1 -R§C^'M7 a / E-MAIL: d:2L'in/jJi Z ( g r^)^ , i^^f -

OWNER'S ADDRESS IF DIFFERENT: S^h l ^ 

TENANT'S NAME IF APPLICABLE: 

M/A DAYTIME PHONE: /U/ ^ 

CELLPHONE: MA. E-MAIL: /t/// r 

Professional Environtnental Engineers, Inc. (PE) is under contract (**EP-R7-08-06) with ttie U.S. Environmental Protection 

Agency (EPA) to stabilize lead based paint (LBP) on residential structures at a nutnber of properties located in Omaha, 

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

Paint Stabilization activities will include: scraping ofcracked or flaking LBP from structures, application of a prime coat and two 

(2) coats of paint. Moving parts of windows and doors are not 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 identified above. 

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

lead-based paint stabilization, if the soil cleanup has not already been performed. 1 understand that the stabilization contractor 

can not provide assurances that the soil cleanup contractor will be bound to. 1 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. 

pGes, 1 have read ai understand the paragraph abo V<^/ tl 

Signature of Property Owner Date 

I fully understand that by signing this Consent for Access, (I) 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 abideliy health and 

safety guidance provided by EPA, (5) will allow photography of property before and after 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 of the 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 Clay or Kelley Sanders At 402-504-4688. General questions 

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

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

Yes, I grant access to my property and was given the pamphlet D No, I do not grant access to my property and 1 was 

Renovate Right, Important Lead Information for Families, Child given the pamphlet "Renovate Right, Important Lead 

Care Providers, and Schools.' Information for Families, Childe Care Providers, and Schools." 

A^^^ ^ ..JL^^ '^/lohi 

Signature ' Date Signature Date 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS: 2-HM.^ "B/Wfn/ ^ /\\J)b DATE ^/)DA/ 

BVID :i9m 

3^(7 (vjoi i^twzTUt pr^^'&M -^iR€t/as \x^^z ^fwj^s i 

AREA(S) TO BE PAINTED: 

HOUSE PROPER: / ^ COLOR: blue Q^e^SuxM) ••f 

HOUSE TRIM: COLOR: jiAH^ 

GARAGE: r . COLOR: ml^ Uk e )

GARAGE TRIM: M ^ .COLOR: jlJhrr Mi ^ fPORCH: //. COLOR: /l/Z/ t 

PORCH TRIM: f^ COLOR: lOhihc 

(COMPLETE ALL SECTION, YES, NO, OR NON-APPLICABLE) 

I AGREE TO THE COLORS LISTED ABOVE. ONCE THE PAINTING 

BEGINS, I UNDERSTAND I CAN NOT CHANGE THE ABOVE SELECTED COLORS: 

PROPERTY OWNER SIGNATURE PE ACCESOR SIGNATURE: 

: ^ - ^ ^ ^ 

. ^ ^ 

~ 
PRE-RENOVATION FORM ~ OWNER 

This form is to be used by the firms contracted by the Environmental Protection Agency-Region 7 to perform Lead-Based 

Paint stabilization activities at the Omaha Lead Site, Omaha, Nebraska. 

Owner Connrmation 

Pamphlet Receipt 

^ttJiSLve received a copy ofthe lead hazard information pamphlet. Renovate Right: Important Lead Hazard Information for 

Families, Child Care Providers and Schools, informing me ofthe potential risk ofthe lead hazard exposure from renovation 

activity to be perfonned in/on my dwelling unit. I received this pamphlet before the work began. 

Owner Acknowledgment 

"5J)(A) I confirm that I own and live in this property, that no child under the age of 6 resides here, that no pregnant woman 

resides here, and that this property is not a child-occupied facility. 

Note: A child resides in the primary residence of his/her custodial parents, legal guardians, foster parents, or 

informal caretaker if the child lives and sleeps most of time at the caretaker's residence. 

Note: A child-occupied facility is a pre-1978 building visited regularly by the same child, under 6 years of age, on at 

least two different days within any week, for at least 3 hours each day, provided that the visits total at least 60 hours 

annually. 

^B ) 1 understand that the renovation firm, contracted by the Environmental Protection Agency (EPA), will be using leadsafe work practices required by EPA's Renovation, Repair and Painting Rule. 

Keu](\} 7). Srmc s 

Printed Name of Owner-Occupant 

/7. .Mu,^._ . V/o/u 

-r 

Signature of Owner-Occupant Date