## TRANSMITTA Lof OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL E FOLDE R SAID# : ;^^O l Date : ^-^'Q ^ 

# Address : D^c> ^ IjxnmQr t Av e Remediatio n Contractor : PROFESSIONA L ENVIRONMENTA L ENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S y ^ Vide o of propert y (DVD ) ppg ^ Q y Executiv e Summary [y ^ Signe dAcces s Agreeriien t for subjec t propert y ^^ y Paintin g Agreemen t D Settlemen t document s (i.e. , for damag e or to replac e plants , etc. ) & ^ Photograph s j)g^>/ p n^pr l /jp/i ^ ffl^ ^ Satisfactory restoratio n signe dby Propert y Owne r ^ y Property close-ou t chec k lis t signe d by EP A ^y ^ Propert y informatio n fro mDougla s Count y Assessor' s Offic e HI

—confirmatio n tha t lea dpamphle t "Renovat e Right " wa s receive d by P0
_ D D • D



### Professiona l Environmenta l Engineer s Signatur e Dat e 

# lo

_ ^ EP A Signatur Dat e Ignatur e e 3005627 8 

# • 01 Superfun d250 5 Nort h 24^8011 6 21 9 Omaha , N E 6811 0 (402 ) 504-468 8 Fa x (402 ) 504-328 1 

# 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 y Respons e



### Lea dBas e Stabilizatio n Omaha , N e Clos e Ou t Repor t 200 9 SAID #3550 1 220 4 Larimor e Av e

•Date s worked : 07/24 t o 07/2 7 200 9 •Pr e propert y condition : Hous e ha dviny l sidin g an dth e only area s o f

pain t wer e o n th e porc h ceilin g an d soffi t areas , al l area s wer e poo r wit h flaking paint . •Problem s encountered : None •Owne r request/concerns : N/ A •Inspection/closeou t dates . Owne r signe d07/2 7 2009 . EPA signe d08/0 7 2009 .

# 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 y Respons e 

## EP A Close-Out For m (Lead-BasedPain t Stabilizatio n EP A Contract EP-R7-08-06 ) SAID : 

# 355 0 PropertyAddress : ^DO'A ^ I Cinmr^f-e . t\J e Owner'sName : ^\rhnrc\TToOlYia S 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 ) paintedwit h the exceptio n ofth e stated , excluded areas ? Thi s wouldinclude paintin g of othe r

associate dfeature s including fascia , eaves , siding , al l trim , porches , box beams , columns , rails , an dexterior surface s o f 

# y garages . 2 . Was all scraping an dothe r

preparatio n wor k

complete dsatisfactorily ? 

# y 3 . Wer e all require darea s ofth e structure(s ) primeda s neededan dpainte d wit h tw o top coats ? t y 

### 4 . Was th e pain t product s utilize dequivalen t to a3 0 yea r

product/quality ? 

# y 5 . Ar e all ofth e area s wher e contaminatedmaterial s hav e bee n spilledthoroughly vacuumed / cleaned ? 

# y 6 . Didth e contractor collect/vacuumal l falling an dscrapedpain t chip s on th e entir e property , roadways , alleyways , publi c acces s area s an dals o remove an y 

# y othe r

generate d debris ? 7 . I s th e gras s are atha t surroimd s th e structure(s ) in reasonabl y goodcondition ? 

# y 8 . Ar e all item s suc h a s polyethylene sheeting , ladders , pain t brushes , cones , barrie r

tape , etc . properly removed ? 

# y 9 .I s ther e an y evidenc e ofpropert y damag e tha t wa s done b y the contractor ? An y t y 

### propert y damag e need s to b e completedprior t

o th e EP A Close-Out . 10 . Ar e ther e an y propert y item s tha t wer e temporarily re-locate db y the contractor tha t needt o b e movedback ? t y 11 . Ar e ther e an y (known) lingerin g issue s wit h th e propert y ovmer(s ) tha t hav e 

# y bee n lef t unresolved ? Othe r

Considerations/Propert y Owne r

Discussions/Additiona l Wor k

tha t i s Required :



# ^y/^^yM^y < P

A CO RSignatur e Dat e250 5 Nort h 24 ^ Suit e 21 9 Omaha , N E 6811 0 (402 ) 504-468 8 

### "Providin g cost-effectiv e environmenta l solutions " Fax (402 ) 504-328 1 Consultin g • Engineerin g Desig n » Remediation«Abatemen t • Emergenc y Respons e 

## Propert y Owne r

Close-Out For m (Lead-BasedPain t Stabilizatio n EP A Contract EP-R7-08-06 ) 

# 3^^^ / SAID : PropertyAddress : ^-<^0 ^ LyXCc/ ^ O^Jt ^ Ar/Pt ^ Owner'sName : iS t ^QJ X f\(2^L ^ 'Tl^rOnAA- ^ Performanc e Standards/Close-Ou t Criteri a YE S N O 1 . Was th e entir e structure(s ) painte d wit h th e exceptio n ofth e stated , excluded areas ? Thi s would includ e paintin g o f othe r

associate d feature s includin g fascia , eaves , siding , all trim , porches , bo x beams , columns , rails , an dexterior surface s of 

# J garages . 2 . Was all scraping an d othe r

preparatio n wor k

completedsatisfactorily ? 

# y 3 . Wer e all requiredarea s o f th e structure(s ) prime da s neededandpainte dwit h tw o to p coats ? 4 . Wa s th e pain t product s utilize dequivalen t to a3 0 yea r

product/quality ? 5 . Ar e all ofth e area s wher e contaminatedmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? —I—:
_ 

### 6 . Didthe contracto r

collect/vacuumall falling an dscrapedpaint chip s o n 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 th e gras s are atha t surround s fh e structure(s ) in reasonabl y goo dcondition ? 

# y 8 . Ar e all item s suc h a s polyethylene sheeting , ladders , pain t brushes , cones , barrie r

tape , etc . properl y removed ? 9 . I s ther e an y evidenc e ofpropert y damag e tha t was don e b y th e contractor ? An y propert y damage need s to b e completedprio r

to th e EP A Close-Out . 

# y 10 . Ar e ther e an y propert y item s tha t wer e temporarily re-locate db y th e contractor tha t needto b e move dback ? 11 . Ar e ther e an y (known) lingerin g issue s wit h th e propert y owner(s ) tha t hav e bee n lef t unresolved ? Comments : 

# jy^^y—yyn! ^ iV^'-srf^ f 

### 'ropert y Owne r

Signatur e Dat e X ( 

# —yy^ ^ 7 - ^ A ^J ^ Dat e Professiona l Envipwunenta l Engineer s Representativ e

# CONSENT FO R ACCES S TO PROPERT Y OMAHA LEA D SIT E REMEDIA L ACTIO N -LEAD-BASE D PAIN T STABILIZATIO N PROPERT Y ID : 3^^^\PROPERTYADDRESS : 0^0 ^ l^Cy^^Of- ^ ^Q ^ 

# y\c\\oyyS ^ "f^^pvYia s DAYTIM E PHONE : 

# ^zSy^^^^ j CELLPHONE : E-MAIL : OWNER' S ADDRES S IF DIFFERENT : TENANT' S NAM E IF APPLICABLE : DAYTIM E PHONE : CELLPHONE : E-MAIL : Professiona l Environmenta l Engineers , Inc . (PE ) is unde r contrac t (#EP-R7-08-06 ) wit h th e U.S . Environmenta l Protectio n Agenc y (EPA ) to stabiliz e lead base d pain t (LBP ) on residentia l structure s at anumbe r of propertie s locate d in Omaha , Nebraska . Th e pain t stabilizatio n wor k

is bein g don e to protec t th e soi l cleanup s tha t ar e bein g performe d by EP A contractors . Pain t stabilizatio n activitie s wil l include : scrapin g of cracke d or flakin g LB P fromstructures , applicatio n of aprim e coat an d tw o (2 ) coat s of paint . Movin g part s of window s an d door s ar e no t include d an d wil l no t be addressed . Your cooperatio n is requeste d in givin g permissio n to thi s EP A contracto r (PE ) to ente r an dhav e acces s to thi s propert y for th e purpos e of stabilizin g lea d-base d pain t as outline d on th e propert y identifie d above . By signin g thi s documen t I agre e to allo w an EP A contracto rto conduc t asoi l cleanu p at my propert y following completio n of lead-base dpain t stabilization ,if th e soi l cleanu p ha s no t alread y bee n performed . I understan d tha t th e stabilizatio n contracto r ca

n no t provid e assurance s tha t th e soil cleanu p contracto r wil l be boun d to . I furthe r understan dtha t th e soi l cleanu p contracto r wil l make al l reasonabl e effort s to addres s concem s tha t I, as th e property owner , ma y hav e regardin g soi l cleanu p at my property .
^

Yes , I hav&na d an d understan d th e Daragra|$ h above
. signatur e of Propert y Owne rDat e I full y understan dtha t by signin g thi s Consen t for Access , (1 ) thi s acces s will remai n in effect unti l th e wor k

ha s bee n satisfactoril y completed , (2 ) tha t th e Propert y Owner or Tenant ,if applicable , willbe give n th e Housin g an dUrba n Development (HUD ) an dEP A pamphlet , "Renovat e Right , Importan t Lea d Hazar d informatio n for Families , Da y Car e Providers , an d Schools" , (3 ) th e Propert y Owne ror tenan t wil l remov e al l obstruction s fro msurface s to be painted , (4 ) will abide by healt h an d safet y guidanc e provide d by EPA , (5 ) will allo w photograph y ofpropert y befor e an d afte r th e pain t stabilizatio n work , (6 ) willbe contacte d by a PE representativ e approximatel y48 hour s in advanc e of startin g work , (7 ) agre e no t to obstructor tampe r wit h an y ofth e LB P stabilizatio n actions , an d (8 ) wil l participat e in final propert y inspectio n an d sig n th e Completio n Agreemen t an d Property Owner Satisfactio n Survey . Shoul d yo u hav e an y question s abou t th e plane d LeadBased-Pain t stabilizatio n activitie s for you r property , pleas e contac t Professiona l Environmenta l Engineers , Inc . Projec t Manager , Willi e Cla y

At 402-504-4688 . Genera l question s abou t th e Omah a LeadSit e cleanu p ca n

be directe d to Paulett aFrance-Isetts , EPA Remedia l Projec t Manage r 402-731-2454 , or th e EP A Publi c Informatio n Center s at 402-991-958 3 (Nort h Omah aoffice) or 402-731-304 5 (Sout h Omah aoffice) . 

# 4 Yes , I gran t acces s to my propert y an d wa s give n th e pamphle t D No , I do no t gran t acces s to my propert y an d I wa s

Renovat e Righ t Importan t Lea d Informatio n forFamiiies , Chil d ghre n th e pamphle t "Renovat e Right , Impoitan t Lea d Caff i i Providers Providers , , an an d Schools. Schools. " " Infomiatio n forFamilies , Chiid e Car e Providers , an d Schools. " Signatur e Dat e Signatur e Dat e SPECIA L INSTRUCTION S AN D CONSIDERATION S

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### D«ugla s County Accoun t Informatio n Pag e 1 of 2 Dougla s County , Nebrask a Propert y Recor d - R113324000 0 Prin t Repor t NE W Featur e - F Parce l Dimension s availabl e ® scal e 0-5 0 f t wes t o f 52n d S t - Vle W O H Ma D Informatio n i s vali d a s o f 2009-6-1 6 Treasurer' s Ta x Reoor t Ne w Featur e ->-•• • Aut o Sale s Searc h Owne r THOMA S RICHAR D 220 4 LARIMOR E AV E 

# 9 ^ -?3g ^ OMAH A N E 68110-000 0 Propert y Informatio n Ke y Numbe r 332 4 000 0 1 1 Accou n t Type : Residenti a Parcel N umbe r 11332400 C 1 0 Parce l Address : 220 4 LARIMOR E A V OMAH A N E 68110-000 0 Lega l Description : FORD S SARATOG A LO T 1 4 BLOC K0 E 1 FT LT 1 & AL L 4 4 X 13 5 Valu e Informatio n Lan d Improvemen t Tota l 200 9 200 8 200 7 200 6 200 5 200 4 $2,500.0 0 $2,500.0 0 $2,500.0 0 $2,500.0 0 $2,500.0 0 $2,500.0 0 i $51,000.0 0 $51,000.0 0 $51,000.0 0 $51,000.0 0 $6,300.0 0 $5,700.0 0 $63,500.0 0 $53,500.0 0 $53,500.0 0 $53,500.0 0 $8,800.0 0 $8,200.0 0 Lan d Informatio n Acre s \ S F Unit s Dept h Widt h Vacan t 0.1 3 5 940. 0 1. 0 135. 0 44. 0 N o Improvemen t Info r matio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accoimtno=R113. . . 7/8/200 9D«ugla s Count y Accoun t Informatio n Pag e 2 of 2

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CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : ; 1835. 0 Percen t Complete : 100.0 % Perimete ri 0. 0 Quality : Fai r Unit Type : Condition : Fai r BuiitAs : \ 1 1/ 2 Stor y Fi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 9. 0 Exterior : Fram e Viny l Units : 1. 0

Interior : Drywal l Baths : 1. 0 Roo f Cover : Connpositio n Shingl e Bedrooms : 4. 0

Roo f Type : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 190 0 0 % 190 0 10 9 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 1235. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h Sla b Roo f Cei l 48. 0 Porc h Sla b Roo f Cei l 24. 0 Porc h Sla b w/Step s 9. 0 Use r Atti c Ful l Finis h 600. 0

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