TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: -gSnQO Date: & / M j 0O[ 

Address: ^^ H f J M 9^ 5+ 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

D^^'^ideo ofproperty (DVD) p/^sj " 

Executive Summary 

%y^ Signed Access Agreement for subject property 

^y ^ Painting Agreement 

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

tL-'''^^Photographs ftcJoro. 

H" Satisfactory restoration signed by Property Owner 

^r Property close-out check list signed by EPA 

^"^"^ Property information from Douglas Coimty Assessor's Office 

(D'^ confirmation that lead pamphlet "Renovate Right" was received by P0_ 

D 

° ^

30203851 

 III • Superfund 

Professioiial Eiwironmental Engineers Signature ^ 

^ 

EPA Signature W^ 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. ''' ' ""ollit NE esfto 

"Providing cost-effective environmental solutions" ^ Sc«too!? ^ Fax (402) 504-3281 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2009 

SAID# 85080 

2720 N 48 St 

• Dates worked: 07/15 to 07/17 2009 

• Pre property condition: House had vynal siding with wood trims on basement windows 

and wood sided garage. All painted areas had flaking paint and were in poor condition. 

• Problems encountered: None 

• Owner request/concerns: N/A 

• Inspectioii/closeout dates. Owner signed 07/15, EPA signed 07/23 2009, no issues. 
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: Z'^Dl^O 

1l2, 0 JO U^^^ Property Address: 

Owner'sName: Robe r V ^OIf S>P^O 

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 of other associated features including fascia, 

eaves, siding, all trim, porches, box beams, columns, rails, and exterior surfaces of v ^ 

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 y two top coats? 

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 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? u ^ 

8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, y barrier tape, etc. 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. 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 >y been left unresolved? 

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

y^Jj:^^:>^.^^l^i^^XeCt 

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: ISOM. s^ Property Address: nnro A) us 

Owner's Name: P^pb^v F/3f^fvv^/] 

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, colimms, rails, and exterior surfaces of 

garages. 

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

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 30 year product/quality? 

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

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? Z^ 

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

barrier tape, etc. properly removed? V 

9. Isthereany 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 X" been left unresolved? 

Comments: 

Date / 

7-J^-op 

Professional Ens«tfbrmiental Engineers Representative Date 
CONSENT FOR ACCESS TO PROPERTY 

OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID: ^SO^ ^ PROPERTY ADDRESS: o?^Q O ] 4 H>5 ^ 

DAYTIME PHONE: ^^f \ ~ M03> ^ 

CELLPHONE: E-MAIL: 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME IF APPLICABLE: 

DAYTIME PHONE: 

CELLPHONE: E-MAIL: 

Professional Environmental Engineers, Inc. (PE) is under contract (#£P-R7-08-06) with the U.S. Environmental Protection 

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

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

Paint stabilization activities will include: scraping of cracked 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 property following completion of 

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

' Yes, I haveread and understand the paragraph above. 

Signature of Property Owner 

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 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 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 Clay At 402-S04-4688. 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 office) or 402-731-3045 (South Omaha office). 

F YYes « , I grant access to my property and was given the pamphlet D No, I do not grant access to my property and I was

' "mnovate Riglit, Important Lead Infonnation for Families, Child given the pamphlet "Renovate Right, Important Lead 

Care Providers, and School; Information fbr Families, Childe Care Providers, and Schools." 

j<m^ d^idm/}^^, Signature / / Dal Signature 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS: 2^QC > f J > ^ 8 !^ T DATE: 

BVID: 

AREA(S) TO BE PAINTED: 

HOUSE PROPER: 

HOUSE TRIM: 

GARAGE: 

GARAGE TRIM: _ 

PORCH: 

PORCH TRIM: 

J^ ^ f ^ C)

v|& ^ 

\/P S 

^C ^ 

AJ n 

tov 

(COMPLETE ALL SECTION, YES 

 COLOR: 

COLOR:

COLOR:

 U)\A\H ^

1 

 (X) Uv+< ^

 , ^ 

 f P 

COLOR: C^K l ic ^ 5 f 

COLOR: 

COLOR: 

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: CESOfS SIGNATURE: 
Douglas County Account Information Page 1 of2 

Douglas County, Nebraska Property Record - R2416560000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VlOW OH Ma P Information is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature ->-•- • Auto Sales Search 

Owner 

FORSMAN ROBERTA 

ETAL 

2720 N 48 ST 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number. 1656 0000 24 

Account Type: Residential 

Parcel Number 2416560000 

Parcel Address: 2720 N 48 ST 

OMAHA NE 68104-0000 

Legal Description: WEARNE PARK LOT 6 BLOCK 1 40 X 106.4 

Value Informatio n 

Land Improvement Total 

2009 $5,400.00 $67,200.00 $72,600.00 

2008 $5,400.00 $67,200.00 $72,600.00 

2007 $5,400.00 $67,200.00 $72,600.00 

2006 $5,400.00 $67,200.00 $72,600.00 

2005 $5,400.00 $27,200.00 $32,600.00 

2004 $5,400.00 $27,200!00 $32,600.00 

Sales Informatio n 

Sales Date: 1993-06-06 

Deed Type: a

Book: 1957 Page: 168 

Price: 

Grantor 

$29,500.00 

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

Valid 

Land Informatio n 

Acres SF ' Units Depth Width Vacant i 

0.09 4240.0 1.0 106.0 1 40.0 No 

Improvemen t Infor mation 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno==R241... 7/8/2009 
Douglas County Account Information Page 2 of2 

Building 1 

1 1/2 Story Fin 2720 N 48 St 

l i 

End Sflw* »vai 

104 »4» 

CLICK CLICK TO ENLARGE IMAGE TO ENLARGE IMAGE 

Square Footage: 1315,0 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: Forced Air Rooms: 6.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Batlis: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinlder Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1916 0% 1916 90 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 912.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 242.0 

Porch End Solid Wall 104.0 

Porch Wood Deck 100.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R241... 7/8/2009 
MC Services, LLC 

Property Address 

Start Date 7-1 5 -OQ End Date 

Amount Of Prime And Paint Used 

Prime (Gallons) 

Poly (Boxes 

Paint (Color 

Paint (Color 

Paint (Color; 

Paint (Color 

Paint (Color 

Ml\S^\e Amount (Gallons) _s 

Amount (Gallons) 

Amount (Gallons) 

Amount (Gallons) 

Amount (Gallons) 
Professional Environmental Engineers, Inc. 

INTERVENCI6N DE SEGURIDAD 

Nombre del Proyecto: Q/ 1 l ^ N YP'O ^ 

Fecha de la Intervencion: ( -" 1W~Q ^ 

Pellgros de Salud Primordial; McK^ 

Preocupaclones Primordlales de H & S:_ 

Tareas Diarias: >.mm 

s^^m^ 

>.p\TM 

Equlpo Usado en el Lugar de Traabjo: 

Casco Duro Bcalera y

Gafas de Seguridad 3: Elevadores 

Zapatos GFCI ^^^^ ^ ^ ^ 3 

^ 

.X 

Guantes de Trabajo Chalecos de Seguridad y Generadores Otro X 

Equlpo LIsto para Respuesta de Emergencia a DIsposiclon Inmedlata: 

Conducir Reunion Diaria de Seguridad A 

Estuche de Primeros Auxilios ic Procedimientos de Emergencia 

^ 

GFCI en sitio > 

Deficiencias: 

Acciones Corretivos: 

Interventor Fecha ^IMi 

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