PAINT STABILIZATION FILE FOLDER 

SAID#: 7 inOfts Date: /^jyj/)' ^ 

Address: ^7.|" ^ l>\r;vPir. !viRemediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ . ideo of property (DVD) ' 

Executive Summary 

Signed Access Agreement for subject property 

Painting Agreement 

D 

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

Photographs bJjy ^ ^QcJ Of^ ^ 

S ^ 

Satisfactory restoration signed by Property Owner 

D 

Property close-out check list signed by EPA 

0^ 

Property information from Douglas County Assessor's Office 

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

D 

D 

D 

Signature ^ ^ 

yi^^T2/'4, ^rJh^t^ - Signature 

4 ^ 

30056203 

i«niiHiii 

Superfund 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. ''°'Trllaht NEesm 

"Providing cost-effective environmental solutions" ^ <j°^| ^?1i^?? 

^ Fax (402) 504-3281 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2009 

SAID# 21008 

3217 Pacific St 

• Dates worked: 09/24 to 09/24 2009 

• Pre property condition: House has mostly vinyl siding with wood painted trim areas. 

Trim paint was in very poor condition and was flaking off all over. 

• Problems encountered: N/A 

• Owner request/concerns: None 

• Inspection/closeout dates. Owner signed 09/28 2009. Property inspected by PE project 

manager. 
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: 

2.100ft 

Property Address: ?.7.| ^ PnOiRr . fSV" 

Owner'sName: "^^n H \TJrV]rif)d'tlPerformance 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 

; garages. 

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

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

\J two top coats? 

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

5. Are all of the 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 J other generated debris? 

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

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

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

that need to be moved back? J 

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

been left unresolved? 

Comments: 

<TjJ<i^ardo GiJTrlio 

Property Owner Signature Date 

Professional EnvJrmmiental Engineers Representative Date 
09/1G/2009 11:48 FAX 402444G017 0003/004 

CONSENT FOR ACCESS TO PROPERTY 


OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID: _9JfiQ ^ PROPERTY ADDRESS; ^Ol > Y^OLTJ fl'C Sf" 

owMi^^. ^ ^rrTQrv/e'Z. _ DAYTIME PHONE: _ 6?/^ - dfS. ^ Q 

CELLPHONE: 689-i^</^ 9 E-MAa: 

OWNER'S AMHIESS IP DIFFERENT: 

TENANT'S NAME IP APPLICABLE: 

DAYTIME PHONE: 

CELLPHONE! ErMAIL: 

Prttftuioaal Eavinmmemal Ensiiicen, be . (PE) b a»der coBtraet (fOSf-m-VMSi with tbe UJS. Eiivlniiim«itel PnitBctiM 

AencT (EPA) to atabBn lead bued pflM (IJr) OS raldwtial ftrmctorw at a a«nb ^ 

Ndvasba. Tb* palat ftabiUatton workto betaig time to pratact tba Mil ckampa tbat a n beiag pCTfonned bf EPA coBtncton. 

Faint atabOiiatiiHi actMtla wUl faKbide: BcraplBg of crackad or flabiiig LBP from alnictnrai, applteation of a prtue coat and tiro 

(2) coats of paiat. Moving parta of irindowa and doon areaot faicladad and iviB not be addnoKd. 

Your cooptratloDto rcqaot ^ in givins pcmtosloo to thto EPA coattnctor (PE) to enter aad have acccaa to thb property Ibr the 

paipoM of ftabOtaiBg lead -bated paiat as ootUned oa the property Uentilltd above. 

By ligBing thb doenment I agree to aUow an EPA coatractoK to coadact a aoU deannp at my property foUowfaig eompMinn of 

|ead-4iaaed pabit etabBbalion. If Ihe nil deanap bia not already been perfbrmed. I nndenland that the fltabflBathm eoirtnwtor 

can not provide a§sarBDCCS that the wll deannp contiactor will be bonnd ia. I farther undentand (feat the eoil deannp 

oootraetor win make aD reaaonable afCnrti to addreu eoneenu that I, as ttie propefty owner, may have regarding aott deannp at 

my property. 

SloniliiiaofPtapii^OlMr ( J M . 

I fhllynadeivlnnd that by eigniag thb Consent te Aecen, (1) thtoacccai wlU remain In eileet nattt the woik haa bw^ 

mlbfhctoiily completed, (2) that the Propeity Owner or Tenant, if appUcaUe, wiU be given the Housing and Uiban Devehipment 

(HUD) and EPA pamphlet, **llcnovate Right, Important Lead Haxard Information for PamlUes, Day Ckre Provftleti, and 

Schoob". C3) the Property Owner or teoant will remove all obWrvictloaB from enrfaeca to be pafaitad, (4) will abMe by health and 

safMy gaidanee piwlded by EPA. (5) wiU aUow photography of property before and aller the pataitrtabiliaatfain work, (ti) wlU be 

eonlaeted by a PE repieseatative appnixhnatdy 41 honn ia advance of starting work, (7) agree not to obstract or tamper witt 

any of the LBP stabilmathw actions, and (B) win partidpate In final property iaspection and sign the Comphtion Agreement and 

Property Owner Satbfaction Survey. 

ShonU you have any qnestnns about the planed Lsad Based-Paiat stabOizatfim activitks for yonr |M«perty, pleaae contact 

Profeasmnal Environmental Engtaeers, Inc. Project Manager, Wfflle Qay At 4ai404-4ti88. General qoestions aboat the Omaha 

Lead Site deannp can be directed t« Pnnletta France-Isetts, EPA Remedial Project Manager 400-731-2454, or the EPA Fnblic 

luformatioB Ceaten at 4«2^1-9S83 (North Omaha oflice) or 40^731-^045 (South Omaha oflke). 

0Yes,iBr»«eecesstBnqrprapsr|yand««ghmlbepeni|rfitat D iio,ldeintgniiteB8esetPiivpre|iaf(ysbdlaM 

'RsnonlBRI^tlnipaitartLaadMNRndonforFMlllH.CliU gbenfliepaiBiilital-RmovslBWBii^bipeitaBtLeail 

CsRhovWM^sndSriioob.'' intonnailoabrFamllto.ChldsCanPtoiMBn,sndSeheeh.-

Ognahae Dsts 

r 

SPECIAL iNSTRUCnONS AND COHMOERATlONS 
09/16/2009 11:49 FAX 4024446017 0004/004 

PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS: ^^- H ^rJ^Pj C 5 b DATE: ^^ W 0"] 

Djm n inn , f^FL BVID: 

AREAfS) TO BE PAMTH): 

7 

HOUSE PROPER: : COLOR: 

^rs.^ f^^rl\o^ 

HOUSE TRIM: \ ^P ^ COLOR: _Jis-Stio£- L 

GARAGE: nr^n-/vppVir/i4rio 001^. y 

GARAGE TRIM: K ^ / As w COLOR: ^ 

PORCH: : . COLOR: _LOQii£d . 

PORCH TRIM: ^^ ^ COLOR: ll^W>4-P . 

(COMPLETE ALL SECTION, YES, NO, OR NON-APPUCABL£) 

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: 

12-iLiiLA noAdio ^ 
Douglas County Account Information 

Page 1 of3 

2­ • ^ 3IDD& 

Douglas County, Nebraska Property Record - R1236480000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VlO W Of l MB P Information is valid as of 2009-8-3 Treasurer's Tax Report 

New Feature -*-•- • Auto Sales Search 

Owner 

HERNANDEZ ROCIO 

3217 PACIFIC ST 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number 3648 0000 12 

Account Type: Residential 

Parcel Number 1236480000 1100 & 

Parcel Address. 3217 PACIFIC ST 

OMAHA NE 68105-0000 

Legal Description: HANSCO M PLACE LOT 24 BLOCK 7 W 40 E 50 FT LTS 23& 40 X 100 

Value Informatio n 

Land Improvement Total 

2009 $5,200.00 $73,400.00 $78,600.00 

2008 $5,200.00 $73,400.00 $78,600.00^ 

2007 $5,200.00 $73,400.00 $78,600.00 

2006 $5,200.00 $48,500.00 $53,700.00 

2005 $5,200.00 $48,500.00 $53,700.00 

2004 $5,200.00 $48,500.00 $53,700.00 

Sales Informatio n 

Sales Date: 2005-08-30 

Deed Type: WD Book: 2005 Page: 112328 

Price: $80,000.00 

Grantor MICHAEL A FAILLA 

Grantee: ROCIO HERNANDEZ 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 2004-08-07 

Deed Type: WD Book: 2004 Page: 134689 

Price: $55,000.00 

Grantor: H. R. SCHUETT ETAL 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12... 8/25/2009 
Douglas County Account Information Page 2 of3 

Grantee: ' MICHAEL A FAILLA 

Valid/Invalid: valid 

Exclusion Reason: 

Sales Date: 1993-05-07 

Deed Type: D Book: 1950 Page: 590 

Price: $27,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.09 4000.0 1.0 100.0 40.0 No 

Improvemen t Informatio n 

Building 1 

« g i«iy 

TWO STORY 

•JJll 73n 

M^ y>» 

•s^W 

JO 13 B air n a 

10 

;&ttt«qn 

CLICK TO ENLARGE IMAGE 

Square Footage: 1554.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Good 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 8.0 

Exterior: Frame Siding Units: 10 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 2.0 

Floorcover: 1 Allowance Foundation: I Block 

Sprinkler Square Footage: 0.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl2... 8/25/2009 
PropertVAddress 3<^. / 9-^^^^"^ ^ ' Date <^y'3^|f) W 

S»r. 0«. (]\7.LljnQ End D.« ^[^LljnQ 

Amount Of Prime And Paint Used 

Prime (Gallons) Q A-^O- | 

Poly (Boxes) <3<P>0/^(Q^S 

Paint (Color) t J J H / I e Amount (Gallons) i - S~G^ I 

Paint (Color) Amount (Gallons) 

Paint (Color) Amount (Gallons) 

Paint (Color) Amount (Gallons) 

Paint (Color) Amount (Gallons) 
) !• 

PROFESSIONAL ENVIROMENTAL ENGINEERSJNC. 

REUNION DIAIUA DE SEGURIDAD 

Fecha: Q ^ X T 

Proyecto: Omaha paint stabilization project 

Lugar. 

Sitio de actividad: -31 l> V c'xT ^ ^ 

Tareas dianas: 

1. Site prepaiation/scraping. 

2. Pai nting. 

3.Clean-up. 

Primordiid/Peligros Potenciales: 

1. Personal lead contamination 3.Eletricity. 

4.Falls. 2. Site lead contamination. 

Herramientas de trabajo: 

1. Step letter.. 3. Paint spiy machines. 

4. Otiiers. 

2. Knife. 

Practicas de Trabajo/Acciones Correctivas: 

1 . 3. 

2. 4 . 

Llamadas Previas: 

1 . 3. 

2. 4 . 

Firma de registro del Empieado: 

fjte ? ..... .>.. [.C^ItXjSSitSiw«..{.....ytj. J. 12., 

i;/^{a'..^.lS M:h^Z^.. 16., 

17., 

18., 

9..., .19.. 

10., .20.. 

11., .21.. 

12., .22., 

Firma de (del Sitio Fecha