## PAIN T STABILIZATIO N FIL E FOLDE R SAID# : 7 inOft sDate : /^jyj/)' ^ 

# Address : ^7.|" ^ l>\r;vPir . !vi Remediatio n Contractor : PROFESSIONA L ENVIRONMENTA LENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S ide o o f propert y (DVD ) ' ^ . 

## Executiv e Summar y SignedAcces s Agreemen t fo r

subject propert y Paintin g Agreemen t D 

## Settlemen t document s (i.e. , fo r

damag e or to replac e plants , etc. ) 

## Photographs bJjy ^ ^Qc J Of^ ^ S ^ 

## Satisfactor y restoratio n signedby Propert y Owne r D 

## Propert y close-out check lis t signedby EP A 

## 0 ^ Propert y information fromDougla s Count y Assessor' s Office 

## 0 ^ confirmation tha t lea dpamphle t "Renovat e Right " wa s receive db y P0 _ D D D 

## Signatur e ^ ^ 

## yi^^T2/'4 , 

# ^rJh^t^ - Signatur e 

# 4 ^ 3005620 3 

# i«niiHii i Superfun d

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . ''°'Trllah t NEes m "Providin g cost-effectiv e environmenta l solutions " ^ <j°^ | ^?1i^? ? ^

Fa x(402 ) 504-328 1 Consultin g • Engineerin g Desig n • Remediatio n • Abatemen t • Emergenc yRespons e 

## Lea dBas e Stabilizatio n Omaha , N e Clos e Ou t Repor t 200 9 SAID#2100 8 321 7 Pacifi c S t

•Date s worked : 09/24 t o 09/24 200 9 •Pr e propert y condition : Hous e ha s mostly viny l sidin g wit hwoo dpainte dtri mareas . Tri mpain t wa s i n ver y poo r conditio n an dwa s flaking of f

al l over . •Problem s encountered : N/ A •Owne r request/concerns : Non e •Inspection/closeou t dates . Owne r signe d09/2 8 2009 . Propert y inspecte dby PE projec t manager .

# 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-BasedPaint Stabilizatio n EP A Contrac t EP-R7-08-06 ) SAID : 

# 2.100ft Propert y Address : ?.7.| ^ PnOiRr . fSV " Owner'sName : "^^n H \TJrV]rif)d'tl 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 . Was th e entir e structure(s ) painte dwit hth e exceptio n of th e stated , excluded areas ? Thi s wouldinclude paintin g of other associate dfeature s includin g fascia , eaves , siding , all trim , porches , box beams , columns , rails , andexterior surface s of ; 

## garages . r- ' 

## 2 . Wa s all scraping andothe r

preparatio n wor k

completedsatisfactorily ? 3 . Wer e all require darea s of th e structure(s ) prime da s neededandpainte dwit h \ J tw o top coats ? 4 . Wa s the paint product s utilize dequivalen t to a3 0 yea r

product/quality ? u 5 . Ar e all of the area s wher e contaminate dmaterial s hav e been spille dthoroughl y vacuumed / cleaned ? ^ 

## 6 . Didthe contractor collect/vacuumall falling andscrapedpaint chip s on th e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e an y 

## J othe r

generateddebris ? 7 . I s the gras s are atha t surround s th e structure(s ) i n reasonably goo dcondition ? 

# J 8 . Ar e all item s such a s polyethylene sheeting , ladders , paint brushes , cones , J barrie r

tape , etc . properly removed ? 9 . I s ther e an y evidenc e ofpropert y damag e tha t wa s done by th e contractor ? An y propert y damage need s to b e completedprior to th e EP A Close-Out . u 10 . Ar e ther e an y propert y item s tha t wer e temporarily re-locate dby th e contractor tha t needto b e movedback ? 

## J 11 . Ar e ther e an y (known) Ungerin g issue s wit hth e propert y owner(s ) tha t hav e K J 

## bee n lef t unresolved ? Comments : 

# <TjJ<i^ard o GiJTrli o Propert y Owne r

Signatur e Dat e Professiona l EnvJrmmienta l Engineer s Representativ e Dat e09/1G/200 9 11:4 8 FA X 402444G01 7 0003/00 4 

# CONSENT FO R ACCES S T O PROPERT Y OMAH A LEA D SITE REMEDIA L ACTIO N - LEAD-BASE D PAINT STABILIZATION PROPERT Y ID : _9JfiQ ^ PROPERT Y ADDRESS ; ^Ol > Y^OLT J 

## fl' C Sf " owMi^^. ^ ^rrTQrv/e'Z . _DAYTIM E PHONE : 

## _6?/^ - dfS. ^ Q CELLPHONE : 689-i^</^ 9 E-MAa: OWNER' S AMHIES S I P DIFFERENT : TENANT' S NAM E I P APPLICABLE : DAYTIM E PHONE : CELLPHONE ! ErMAIL : Prttftuioaa l Eavinmmema l Ensiiicen , be . (PE ) b a»de r coBtrae t (fOSf-m-VMS i wit htb e UJS . Eiivlniiim«ite l PnitBcti M Aenc T (EPA ) t o atabB n lea dbue dpfl M (IJr ) O S raldwtial ftrmctor w a t aa«nb ^ Ndvasba . Tb * pala t ftabiUatto n wor kto betai g tim e t o pratac t tb aMi l ckamp atba t a n beia g pCTfonnedb f EP A coBtncton . Fain t atabOiiatiiH i actMtl awU l faKbide: BcraplB g o f cracka do r flabiii g LB P fromalnictnrai , applteatio n o f aprtu e coa t an dtir o (2 ) coat s o f paiat . Movin g part ao f irindow aan ddoo n areao t faicladadan divi B no t b e addnoKd . You r cooptratlo D to rcqaot ^ i n givin s pcmtoslo o t o tht o EP A coattncto r (PE ) t o ente r aa dhav e acccaat o th b propert y Ib r th e paipo M o f ftabOtaiB g lea d-bate dpaia t a s ootUne do ath e propert y Uentillt dabove . B y ligBin g th b doenmen tI agre e t o aUo w a n EP A coatracto K t o coadac t aao U deann p a t m y propert y foUowfai g eompMin n o f |ead-4iaae dpabi t etabBbalion . If Ih e ni l deana p bi ano t alread y bee n perfbrmed . I nndenlan dtha t th e fltabflBathmeoirtnwto r ca n no t provid e a§sarBDCC S tha t th e wl l deann p contiacto r wil l b e bonn dia . I farthe r undentan d(fea t th e eoi l deann p oootraeto r wi n mak e a D reaaonabl e afCnrt i t o addre u eoneen u tha t I , a s ttie propeft y owner , ma y hav e regardin g aot t deann p a t m y property . SloniliiiaofPtapii^OlM r ( J M . I fhllynadeivlnn dtha t b y eignia g th b Consen tte Aecen , (1 ) thtoaccca i wl U remai n I n eilee t natt t th e woi k ha abw ^ mlbfhctoiil y completed , (2 ) tha t th e Propeit y Owne r o r Tenant , i f appUcaUe , wi U b e give n th e Housin g an dUiba n Devehipmen t (HUD ) an dEP A pamphlet , **llcnovat e Right , Importan t Lea dHaxar dInformatio n fo r PamlUes , Da y Ckr e Provftleti , an d Schoob" . C3 ) th e Propert y Owne r o r teoan t will remov e al l obWrvictloa B fromenrfaec at o b e pafaitad , (4 ) wil l abM e b y healt han d safM y gaidane e piwlde db y EPA . (5 ) wi U aUow photograph y o f propert y befor e an dalle r th e patai trtabiliaatfain work , (ti ) wl U b e eonlaete db y aP E repieseatativ e appnixhnatd y 4 1 hon n i aadvanc e o f startin g work , (7 ) agre e no t to obstrac t o r tampe r wit t an y o f th e LB P stabilmath w actions , an d(B ) wi n partidpat e I n fina l propert y iaspectio n an dsig n th e Comphtio n Agreemen t an d Propert y Owne r Satbfactio n Survey . Shon U yo u hav e an y qnestnn s abou t th e plane dLsa dBased-Paia t stabOizatfi mactivitk s for yon r |M«perty , pleaa e contac t Profeasmnal Environmenta l Engtaeers , Inc . Projec t Manager , Wfflle Qa y A t 4ai404-4ti88 . Genera l qoestion s aboa t th e Omah a Lea dSit e deann p ca n b e directe dt « Pnnlett aFrance-Isetts , EP A Remedia l Projec t Manage r 400-731-2454 , o r th e EP A Fnbli c luformatio B Ceate n a t 4«2^1-9S8 3 (Nort hOmah aoflice ) o r 40^731-^04 5 (Sout hOmah aoflke) . 0Yes,iBr»«eecesstBnqrprapsr|yand««ghmlbepeni|rfita t D iio,ldeintgniiteB8esetPiivpre|iaf(ysbdla M 'RsnonlBRI^tlnipaitartLaadMNRndonforFMlllH.Cli U gbenfliepaiBiilital-RmovslBWBii^bipeitaBtLeai l CsRhovWM^sndSriioob.' ' intonnailoabrFamllto.ChldsCanPtoiMBn,sndSeheeh. - Ognaha e Dst s r SPECIA L iNSTRUCnON S AN D COHMOERATlON S09/16/200 9 11:4 9 FA X 402444601 7 0004/00 4 

## PAIN T STABILIZATIO N PRE-PROPERT Y PAIN T MATC H ASSESSMEN T PROPERT Y ADDRESS : ^^- H ^rJ^Pj C 5 b DATE : ^^ W 0" ] 

# Djm n inn , f^F L BVID :

AREAfS ) T O B E PAMTH) : 

# 7 HOUS E PROPER : : COLOR : 

# ^rs. ^ f^^rl\o ^ HOUS E TRIM : \ ^P ^

COLOR : _Jis-Stio£- L 

# GARAGE : nr^n-/vppVir/i4ri o 001^ . 

# y

GARAG E TRIM : K ^

/ As w COLOR : ^ 

## PORCH : : . COLOR : _LOQii£d . PORC H TRIM : 

## ^^ ^

COLOR : ll^W>4-P . (COMPLET E AL L SECTION , YES , NO , O R NON-APPUCABL£ ) 

## I AGRE E T O TH E COLOR S LISTE D ABOVE . ONC E TH E PAINTIN G BEGINS , I UNDERSTAN D I CA N NO T CHANG E TH E ABOV E SELECTE D COLORS : PROPERT Y OWNE R SIGNATURE : P E ACCESO R SIGNATURE :



# 12-iLiiL A noAdio ^

### Dougla s County Accoun t Informatio n Pag e 1 of 3 

# 2­ • ^ 3IDD & Dougla s County , Nebrask a Propert yRecor d - R123648000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t of 52n d S t - VlO W Of l MB P Informatio n i s vali d a s o f 2009-8- 3 Treasurer' s Ta xRepor t Ne w Featur e -*-•- • Aut o Sale s Searc h Owne r HERNANDE Z ROCI O 321 7 PACIFI C S T OMAH A N E 68105-000 0 Propert yInformatio n Ke yNumbe r364 8 000 0 1 2 Accoun t Type : Residentia l Parce l Numbe r123648000 0 

# 110 0 

# & Parce l Address . 321 7 PACIFI C S T OMAH A N E 68105-000 0 Lega l Description : HANSCO M PLAC E LO T 2 4 BLOC K7 W 4 0 E 5 0 F T LT S 23 & 4 0 X 10 0 Valu e Informatio n Lan d Improvemen t Tota l 

### 2009 $5,200.0 0 $73,400.0 0 $78,600.0 0 200 8 $5,200.0 0 $73,400.0 0 $78,600.00 ^ 200 7 $5,200.0 0 $73,400.0 0 $78,600.0 0 

### 200 6 $5,200.0 0 $48,500.0 0 $53,700.0 0 200 5 $5,200.0 0 $48,500.0 0 $53,700.0 0 200 4 $5,200.0 0 $48,500.0 0 $53,700.0 0 Sale s Informatio n Sale s Date : 2005-08-3 0 Dee d Type : W D Book : 200 5 Page : 11232 8 Price : $80,000.0 0 Granto r MICHAE L A FAILLA Grantee : ROCI O HERNANDE Z Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 2004-08-0 7 Dee d Type : W D Book : 200 4 Page : 13468 9 Price : $55,000.0 0 Grantor : H . R . SCHUETT ETA L 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12. . . 8/25/200 9

### Dougla s Count y Accoun t Informatio n Pag e 2 of 3 Grantee : ' MICHAE L A FAILLA Valid/Invalid : vali d Exclusio n Reason : Sale s Date : 1993-05-0 7 Dee d Type : D Book : 195 0 Page : 59 0 Price : $27,000.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 

### 0.0 9 4000. 0 

### 1. 0 100. 0 40. 0 N o Improvemen t Informatio n Buildin g 1

« g i«i y TW O STOR Y

• JJl l 73 n

M ^ y> » 

## • s^ W J O 1 3 B ai r n a

1 0

;&ttt«q n CLIC KT O ENLARG E IMAG E Squar e Footage : 1554. 0 Percen t Complete : 100.0 % Perimete r0. 0 Quality : Averag e Uni t Type : Condition : Goo d

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 8. 0 Exterior : Fram e Sidin g Units : 1 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : 2. 0 Floorcover : 1 Allowanc e Foundation : I Bloc k Sprinkle rSquar e Footage : 0. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl2. . . 8/25/200 9

### PropertVAddres s 3<^. / 9-^^^^"^ ^

' Dat e <^y'3^|f) W S»r . 0« . (]\7.Lljn Q En d D. « ^[^Lljn Q 

## Amoun t O f Prim e An d Pain t Use d Prim e (Gallons ) Q A-^O - |

Pol y(Boxes) <3<P>0/^(Q^ S Pain t (Color ) t J J H / I e Amoun t (Gallons ) i - S~G^ I Pain t (Color ) Amoun t (Gallons ) Pain t (Color ) Amoun t (Gallons ) Pain t (Color ) Amoun t (Gallons ) Pain t (Color ) Amoun t (Gallons )) ! •

PROFESSIONA L ENVIROMENTA L ENGINEERSJNC . REUNIO N DIAIU A D E SEGURIDA D Fecha : Q ^ X T Proyecto : Omah apain t stabilizatio n projec t Lugar . Siti o d e actividad : 

# -3 1 l > 

# V c'x T ^ ^

Tarea s dianas : 1 . Sit e prepaiation/scraping . 2 . Pa i nting . 3.Clean-up . Primordiid/Peligro s Potenciales : 1 . Persona l lea dcontaminatio n 3.Eletricity . 4.Falls . 2 . Sit e lea dcontamination . Herramientas d e trabajo : 1 . Ste p letter. . 3 . Pain t spi y machines . 4 . Otiiers . 2 . Knife . Practica s d e Trabajo/Accione s Correctivas : 1 . 3 . 2 . 4 . Llamada s Previas : 1 . 3 . 2 . 4 . Firm ad e registro de l Empieado : 

# fjte ? .... . .>. . [.C^ItXjSSitSiw«..{.....ytj . J . 12. , i;/^{a'..^.l S M:h^Z^. . 16. , 17. , 18. , 9... , .19. . 10. , .20. . 11. , .21. . 12. , .22. , Firm ad e (de l Siti o Fech a