TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: 3I<?0 3 Date: T/z/^f 

Address: JlSjlB t x I'SfPI SlveeT 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGDHEERS Year: 2008 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

Wr Video ofproperty (DVD) Dg^K-g, (l\4 w 

I K Executive Summary 

y Signed Access Agreement for subject property 

W Painting Agreement . 

Oi Settlement documents (i.e., for damage or to replace planfe, etc.) 

S /' Photographs hi>^ ^ oJ^M y . 

B ^ Satisfactory restoration signed by Property Owner 

Br Property close-out check list signed by EPA 

^ Property information from Douglas Coimty Assessor's Oflfice 

D 

Signature T5a!e 

40316402 

Iiilllll 

Superfund 
, * PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"Providing cost-effective environmental solutions" 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Lead Base Paint Stabilization Omaha, Ne 

Close Out Report 

SAID# 31203 

2528 Bristol St 

• Datesworked 10/10 to 10/10 2008 

2505 North 24'^ Suite 219 

Omaha, NE 68110 

(402) 504-4688 

Fax (402) 504-3281 

• House was in poor condition, garage was very poor with structure damage. Vines and 

weeds were covering the south side of the garage that had to be removed prior to work being 

started. Owner wanted the garage color to change so it would match the house. Owner was 

pleased with the job that was done. 

• Inspected 10/16 no issues. 
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: SlT-Q-^S 

Property Address: "Z-S Z ^ &ri.s.-(o/ 

Owner's Name: J-UcA \~\OLL^-\O H 

Performance Standards/Close-Out Criteria YES NO 

1. Was the entire structure(s) painted with the exception of the 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? y L 

3. Were all required areas of the 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 of the areas where contaminated materials have been spilled thoroughly y 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 

other generated debris? 

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

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

barrier tape, etc. properly removed? y 

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. 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? 

Comments: 

CV^uTV 1^ 'o -n-o' y JertjTOwner Signature Date 

yy -^. Date Professional En>ifonmental Engineers Representative 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"Providing cost-effective environmental solutions" 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

EPA Close-Out Form 

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

SAID: ^/XO ^ 

Property Address: Zs:2.'g> ShrK^\D \ 

Owner's Name: /-.(^y v4Qut^4on 

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 of the 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 y garages. 

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

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

vacuumed/ cleaned? y 

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? ^ 

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

9. Is there any evidence ofproperty 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 

y that need to be moved back? 

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

been left unresolved? 

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

/o//6>/st 

iPA COR Signature ^ Date 
CONSENT FOR ACCCESS TO PROPERTY 


OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTYID: ^, ^ _ PROPERTY ADDRESS: ^S-^S ' &rl-hy3l 

OW.ER.SNAME: ^_^ ^ ^^ O fsV ^ 

DAY-TIME PHONE: L4 ^ y^FY S 

CELLPHONE: "'If K ZO ^ E-MAIL 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME IF APPLICABLE: 

DAY-TIME PHONE: 

CELL PHONE: E-MAIL 

Professional Environmental Engineers, Inc. (PE) is under contract (#EP-R7-08-06) witfi the U. S. Environmental Protection Agency (EPA) 

to stabilize exterior lead-based paint (LBP) on residential structures at a number of properties located in Omaha, Nebraslta. The paint 

stabilization work is being done to protect the soil cleanups that were perfonned by EPA contractors. 

Paint stabilizations activities will include: scraping of cracked or flaking LBP from structures, application of a prime coat and two (2) coats 

of paint. Any moving parts of windows and door are not included in the activities and will not be addressed. 

Your cooperatron is requested in giving pennission to this EPA contractor (PE, Inc.) to enter and have access to this property for the 

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

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 as 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, Child Care Providers and Schools" (3) the Property Owner or 

tenant will removal of obstructions from surfaces to be painted, (4) will abide by health and safety guidance provided by EPA, and (5) will 

allow photography of property before and after the paint stabilization work, (6) I wrili be contacted by a PE representative approximately 

48 hours in advance of starting woric to (7) agree not to obstruct or tamper with any of the LBP stabilization activities or equipment used to 

peribnn any LBP actions, (8) will participate in final property inspection and sign the Completion Agreement and Property Owner 

satisfaction Survey. 

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

Environmental Engineers, Inc., Project Manager, Hemian Hanner at 402-884-1185. 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 Infonnation Centers 

at (402) 991-9583 (North Omaha office) or (402) 731-3045 (South Omaha office). 

I Yes, I grant access to my property and was given I I No, I do not grant access to my property and I was 

amphlet "Renovate Right, Important Lead IHazard given the pamphlet "Renovate Right, Important Lead information 

for Families, Child Care Providers and Schools. Hazard Information for Families, Child Care Providers and 

Schools. 

Sianature "-' ^ ' " Uate Signature Date 

SPECIAL INSTRUCTIONS AND/OR CONSIOERATIONS; 
y-^^-^-"* -' -

PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS: ^^7:? % J^)^]ji) ^-' DATE )(0/.^/D ^ 


BVID -


AREA(S) TO BE PAINTED: 

HOUSE PROPER: COLOR. 

HOUSE TRIM COLOR. 

GARAGE. COLOR. 

GARAGE TRIM COLOR. 

^ . ; 

PORCH COLOR. 

PORCH TRIM, COLOR. 

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

I AGREE TO THE COLORS LISTED ABOVE. ONCE PAINTING BEGINS, I 


UNDERSTAND I CAN NOT CHANGE THE ABOVE SELECTED COLORS: 


PROPERTY OWNER SIGNATURE: 


li(ii^b&WV 

PAINT MATCH FORM 08/08 
PAINT STABILIZATION PRE-PROPERTY ASSESSMENT 

PROPERTY ADDRESS: ^ '^ 5^ ^ Rfl^; ) ^ DATE |0p/ ^ 

HK^wg z^^^ziin BVID 3)/2o:^ 

PLANT & PERMANENT LANDSCAPING TO BE REMOVE? NO |—| YES 

IF, YES WHERE: 

G^if\c ^ V^Ar-^^ vJC-^vg^ OU-y y.>€y-ay^ 

c3 

PRE- CONDmON OF FOUNDATION/STRUCTURE, i.e. BASEMENT LEAKING? 

NO YEVPS « ' ' IF, YES WHERE: 

EXISTING PAINT ON WINDOWS, DOORS, FOUNDATION, SIDEWALK,( I.E.)? NO 

YES ^ ^ IF, YES WHERE: 

VISUAL DESCRIPTION OF PROPERTY/STRUCTURE/GARAGE, (I.E.): (USE BACKSIDE IF 

NECESSARY) 

/C>9//».-?-^ y u^^'^ Doo r ^Sv^rye/e^-y Zyii^./-^-^c::/_^ 

PROPEijmr OWNER SIGNATURE 

1 
' •7--m-- ^--T",-

Confirmation Of Receipt Of Lead Pamphlet 

BVID ' 

PROPERTY ADDRESS ^^QS ^59rS£/^^MS ^ n/vMU l .\4 i ZIP CODE 

PROPERTY ADDRESS OF OWNER IF DIFFERENT THAN PROPERTY BEING PAINTED: 

PROPERTY ADDRESS ^ZIP CODE 

I have received 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 on dwelling unit. I received this pamphlet before the work began. 

Lvtfg -Uou^W^. PRINTED NAME OF RECIPIENT DATE 

f^ii(nttiste\. SUGNATURE 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 - 1 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 above at the 

date and time indicated and that the occupant refused to sign the confinnation of receipt. I further certify that I 

have left a copy of the pamphlet at the unit with occupant. 

D Unavailable For Signature - 1 certify that I have made a good faith effort to deliver the pamphlet, renovate right; 

important lead hazard infomiation for families, child care providers and schools, to the rental dwelling unit listed 

below and that the occupant was unavailable to sign the confimiation of receipt. I further certify that I have left a 

copy of the pamphlet at the unit by sliding it under the door or somewhere on the premises. 

PRINTED NAME OF PERSON CERTIFYING AHEMPTED DELIVERY DATE AND TIME LEAD 

PAMPHLET DELIVERY 

SIGNATURE OF PERSON CERTIFYING LEAD PAMPHLET DELIVERY: 

Note Regarding Mailing Option - as an altemative to delivery in person, you may mail the lead pamphlet to the owner 

and/or tenant. Pamphlet must tie mailed at least 7 days t)efore renovation. (Document with a certificate of mailing from the post 

office). 

CONFIRMATION OF RECEIPT OF LEAD PAMPHLET 08/08 
Douglas County Account Information Page 2 of3 itorma 

t 

Grantee: Barfield Jackie L 

Valid/invalid: Invalid 

Exclusion Reason: Land Contract - Agreement 

Sales Date: 2005-03-03 

Deed Type: CO Book: 2005 Page: 126351 

Price: $12,236.00 

Grantor: Robert Williams 

Grantee: Jackie Bacfield 

Valid/Invalid: Invalid 

Exclusion Reason: Land Contract - Agreement 

Sales Date: 2004-04-13 

Deed Page: Type: DE Book: 2004 046765 

Price: $0.00 

Grantor: Estate of Danda L Patterson 

Grantee: Robert N Williams Jr 

Valid/invalid: Invalid 

Exclusion Reason: Family Sale 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.15 6600.0 1.0 132.0 50.0 No 

Improvemen t Information 

Building 1 

1 1/2 Story 2528 Bristol St 

r M P 

I f 

lAfi i ; 

$»nn <19.0 ITsr 

\ M ^ «c 

A 

i t ^ iftd 

12IIIIS1IR 

BimBbcKSt toeiosq R 

CLICK TO ENLARGE IMAGE 

Square Footage: 1697.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R13... 6/27/2008 
Douglas County Account Information Page 1 of3 

Douglas County, Nebraska Property Record - R1303200000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of goth St - Vie W O n Ma p Information is valid as of 2008-6-19 

New Feature

Treasurer's Tax Report 

 -+-•- • Auto Sales Search 

Owner 

HOUSTON LUCI T 

ETAL 1 

2528 BRISTOL ST 

OMAHA NE 68111-0000 

Property Informatio n 

Key Number: 0320 0000 13 

Account Type: Residential 

Parcel Number: 1303200000 

Parcel Address: 

Legal Description: 

2528 BRISTOL ST 

OMAHA NE 68111-0000 

HAWES ADD LOT 7 BLOCK 0 E 50 FT 50 X 132 

Value Informatio n 

2008 

2007 

2006 

2005 

2004 

2003 

Land 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

Improvement 

$46,700.00 

$39,900.00 

$39,900.00 

$39,900.00 

$19,500.00 

$19,500.00 

Total 

$49,300.00 

$42,500.00 

$42,500.00 

$42,500.00 

$22,100.00 

$22,100.00 

Sales Informatio n 

Sales Date: 2007-10-31 

Deed Type: 

Price: 

Grantor: 

QC 

$25,000.00 

BARFIELD JACKIE L 

Book: 2007 Page: 123250 

Grantee: MOUSTON LUCI T ETAL 

Valid/Invalid: Invalid 

Exclusion Reason: Family Sale 

Sales Date: 2007-05-04 

Deed Type: 

Price: 

Grantor: 

QC 

$12,236.00 

Williams Robert Jr 

Book: 2007 Page: 088719 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R13... 6/27/2008