## TRANSMITTA Lo f OMAH A LEA D SIT E PAIN T STABILIZATIO NFIL EFOLDE R SAID# : 

# 2JI^'^ ^

# Date : Alj-l//D i Address : 

# 43'4 0 Parke r St Remediatioi i Contractor : PROFESSIONA LENVIRONMENTA LENGINEER S Year : 200 8 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S 0 ^ Vide o o f propert y (DVD ) w

A Executiv e Summary S /

Signe dAcces s Agreemen t for subjec t property M Paintin g Agreemen t D Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) B ^ Photograph s M Satisfactory restoratio nsigne db y Property Owne r D Propert y close-ou t chec k lis t signe db y EP A M Propert y informatio nfromDougla s County Assessor' s Offic e D , ^_ _ Q • ' • • • • - ' "


### Signatur e Dat e

4031828 7 

# Ulii f Superfun d250 5 Nort h 24« \ Suit e 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 • Engineenn g Desig n • Remediatio n • Abatemen t • Emergenc yRespons e



### Lea dBas e Pain t Stabilizatio nOmaha , N e Clos e Ou t Repor t SAID#2694 5 434 0 Parke r S t

•Date s worke d12/2 8 t o 12/2 9 200 8 •Hous e ha dcrack s i n concret e sidin g an dth e bac k scree ndoo r wa s tom . Th e fron t porc hwas weak in area s an dth e pain t was i n poo r condition . •Inspecte d12/3 0 b y PEprojec t manager . EP A wa s unavailabl e for inspection .

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . "Providin g cost-efiBctiv e enviivnmeiita i solutions " Consultin g = Engineerin g Desig n <> Remediatio n » Abatemen t = Emergenc yRespons e 

## Propert y Ovme r

Close-Out For m (Lead-Base dPain t Stabilizatio nEP A Contrac t EP-R7-08-06 ) SAID : 

# 1/ ^ 9'A S Property Address : 

# i^l^ O /hm: nP 250 5 Nort h24* , Suite 21 9 Onnaha , N E6811 0 (402 ) 504-468 8 Fa

x (402 ) 504-328 1



### Owner' s Name : 

## Ha y /B&MniU L p u 59S^^3 ^ 1 Performanc e Standards/Close-Ou t Criteri a YE S N O 1 . Wa s th e entire structure(s ) painte dwithth e exceptio nofth e stated , exclude d areas ? Thi s woul dinclud e paintin g o f othe r associate dfeature s includin g fascia , eaves , siding , al l trim , porches , bo x beams , columns , rails , an dexterio r surface s o f / 

### garages . 2 . Wa s al l scrapin g an dothe r preparatio nwor k

complete dsatisfactorily ? / 

### 3 . Were all require darea s ofth e structure(s ) prime da s neede dan dpainte dwith / 

### tw o to p coats ? 4 . Wa s th e pain t product s utilize dequivalen t t o a3 0 year product/quality ? ./ ' 

### 5 . Are al l ofth e area s wher e contaminate dmaterial s hav e bee nspille dthoroughl y vacuumed/cleaned ? / 

### 6 . Di dth e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s o nth e entire property , roadways , alleyways , publi c acces s area s an dals o remov e an y other generate ddebris ? / 

### 1 7 . I s th e gras s are athat surround s th e structure(s ) i nreeisonably goo dcondition ? / 

### 8 . Are al l item s suc ha s polyethylen e sheeting , ladders , pain t brushes , cones , barrier tape , etc . properl y removed ? / 

### 9 . I s ther e any evidenc e ofpropert y damag e that wa s don e b y th e contractor ? An y property damag e need s t o b e complete dprio r t o th e EP A Close-Out . 

# A 10 . Are there any property item s that were temporaril y re-locate db y th e contracto r that nee dto b e move dback ? / 

### 11 . Are ther e any (known ) lingerin g issue s withth e property owner(s ) that hav e bee nlef t unresolved ? / 

### 1 Comments : 1

* ' Ci'U..M.Aj< ^ X I 

# LJM
- Property Owner Signature Date 

# Vz/ ^ Professional Environmental Engineer s Representativ e Date

# CONSEN T FO R ACCCES S T O PROPERT Y

• ".r,,:-.* - 

### OMAH ALEA D SIT E REMEDIA L ACTIO N - LEAD-BASE D PAIN TSTABILIZATIO N PROPERT YID : PROPERT YADDRESS : 

# Jy5 WPari ^ S A ACf^Hf ^ OWNER' S NAME : 

# TTr>A i C<\cxLLK\.cp . _DAY-TiM E PHONE : 

# 59? ' 

# J^^T i CEL LPHONE : E-MAI L OWNER' S ADDRES S I F DIFFERENT : TENANT' S NAM E I F APPLICABLE : _DAY-TIM E PHONE : CEL L PHONE : E-MAI L Professiona l Environmenta l Engineers , Inc . (PE ) i s unde rcontrac t (#EP-R7-08-06 ) wit h th e U . S . Environmenta l Protectio n Agenc y(EPA ) t o stabiliz e exterio rlead-base d pain t (LBP ) o n residentia l structure s a t a numbe ro fpropertie s locate d i n Omaha , Nebraska . Th e pain t stabilizatio n wor k i s bein g don e t o protec t th e soi l cleanup s tha t wer e performe d b yEP Acontractors . Pain t stabilization s activitie s wil l include : scrapin g o fcracke d o rflakin g LB P fro m structures , applicatro n o f a prim e coa t an d tw o (2 ) coat s o fpain t An ymovin g part s o fwindow s an d doo rar e no t include d i n th e activitie s an d wil l no t b e addressed . You rcooperatio n i s requeste d i n givin g pennissio n t o thi s EP Acontracto r(PE , Inc. ) t o ente ran d hav e acces s t o thi s propert yfo rth e purpos e o fstabilizin g lead-base d pain t a s outline d o n th e propert yidentifie d above . I full yunderstan d tha t b ysignin g thi s Consen t Fo rAccess , (1 ) thi s acces s wil l remain i n effec t unti l th e wor k ha s bee n satisfactoril y complete d (2 ) tha t a s th e Propert yOwne ro rtenant , i f applicable , wil l b e give n th e Housin g an d Urba n Developmen t (HUD ) an d EP A pamphlet , "Renovat e Right , Importan t Lea d Hazar d Informatio n fo rFamilies , Chil d Car e Provider s an d Schools " (3 ) th e Propert yOwne ro r tenan t wil l removal o fobstruction s fro m surface s t o b e painted , (4 ) wil l abid e b yhealt h an d safet yguidanc e provide d b yEPA , an d (5 ) wil l allo wphotograph yo f propert ybefor e an d afte rth e pain t stabilizatio n work , (6 ) I wil l b e contacte d b ya P E representative approximatel y 4 8 hour s i n advanc e o fstartin g wor k t o (7 ) agre e no t t o obstmc t o rtampe rwit h an yo fth e LB P stabilizatio n activitie s o requipmen t use d t o perfom i an yLB P actions , (8 ) wil l participat e i n fina l propert yinspectio n an d sig n th e Completio n Agreement an d Propert yOwne r satisfactio n Survey . Shoul d yo u hav e an yquestion s abou t th e planne d Lea d Based-Pain t stabilizatio n activitie s fo ryou rproperty , pleas e contact : Professiona l Environmenta l Engineers , Inc. , Projec t Manager , Hemia n Hanne ra t 402-884-1185 . Genera l question s abou t th e Omah a Lea d Sit e cleanu p ca n b e directe d t o Paulett a France-Isetts , EP ARemedia l Projec t Manage r402-731-2454 , o rth e EP APubli cInformatio n Center s a t (402 ) 991-958 3 (Nort h Omah a office ) o r(402 ) 731-304 5 (Sout h Omah a office) . Yes , I gran t acces s t o m ypropert yan d wa s give n ]No , I d o no t gran t acces s t o m ypropert yan d i wa s

ipiiie t "Renovat e Rigiit , importan t Lea d Hazard give n tli e pampliie t "Renovat e Rigiit , Importan t Lea d Informatio n fo rFamilies , Ciiii d Care Provider s an d Sciioois . Hazard Informatio n for Families , Ciiii d Car e Provider s an d Sciiools . ^Z^S^-^^CcJi ^ 

# "T/ K Signatur e \ \

\ > Dat e Signature Date SPECIA LINSTRUCTION S AND/O R CONSIDERATIONS :

# Confirmatio n O f Receip t O fLea d Pamphle t BVI D ^GP^V S PROPERT YADDRES S 

# Q^^ o P/-y.^ /

s /

ZI P COD E & m PROPERT YADDRES S O F OWNE R I F DIFFEREN TTHA N PROPERT YBEIN G PAINTED : PROPERTYADDRES S ^ZI P COD E I hav e receive d a cop yo f th e pamphlet , Renovat e Right : Importan t Lea d Hazar d Informatio n Fo rFamilies , Chil d Car e Provider s An d School s informin g m e o fth e potentia l ris k o f th e lea d hazar d exposur e fro m renovatio n activit yt o b e peifoime d o n dwellin g unit . I receive d thi s pamphle t befor e th e wor k began . 

# /M^u.Y,\ ^ TY^c ^

/o-lho ^ PRINTE D NAM E O F RECIREN TDAT E 

### "'"^^^g^<^>^c ^ SIGNATUR E O F RECIPIEN T Self-Certificatio n Optio n (Fo rTenant-Occupie d Dwelling s Only ) I f th e lea d pamphle t wa s delivere d bu t a tenan t signatur e wa s no t obtainable , yo u ma ychec k th e appropriat e bo x below : I J Refusa l T o Sig n - 1 certif ytha t 1 hav e mad e a goo d fait h effort t o delive rth e pamphlet , renovat e right : importan t lea d hazar d infomnatio n fo rfamilies , chil d car e provider s an d schools ; t o th e renta l dwellin g uni t liste d abov e a t th e dat e an d tim e indicate d an d tha t th e occupan t refuse d t o sig n th e confirmatio n o freceipt . I furthe rcertif ytha t I hav e lef t a cop yo f th e pamphle t a t th e uni t wit h occupant . I- I Unavailabl e Fo rSignatur e - 1 certif ytha t I hav e mad e a goo d fait h effort t o delive rth e pamphlet , renovat e right ; importan t lea d hazar d infomiatio n fo rfamilies , chil d car e provider s an d schools , t o th e rental dwellin g uni t liste d belo wan d tha t th e occupan t wa s unavailabl e t o sig n th e confirmatio n o freceipt I furthercertif ytha t I hav e left a cop yo fth e pamphle t a t th e uni t b yslidin g i t unde rth e doo ro rsomewher e o n th e premises . 

# -Keile u ^nJ^ d )o/j/ld & PRINTE D NAM E O F PERSO N CERTIFYIN G AHEMPTE D DELIVERYDAT E AN D TIM E LEA D PAMPHLE TDELIVERY

SIGNATUR E ORPERSO N CERTIFYIN G LEA D PAMPHLE TDELIVERY : Not e Regardin g Mailin g Optio n - a s a n altemative t o deliver yi n person , yo u ma ymai l th e lea d pamphlet t o th e owne r and/o rtenant . Pamphlet mus t b e maile d a t leas t 7 days befor e renovation. (Document wit h a certificat e o fmailin g fro m th e pos t office) . CONFIRMATION OF RECEIP TO F LEA D PAMPHLE T08/0 8

# PAIN TSTABILIZATIO N PRE-PROPERT YASSESSMEN T PROPERT YADDRESS : ^i^ O fhc^Up / i " / DAT E l^/llp ^ 

# CV\C^Kc. ^ i^ ^ (j)%\\ l BVI D S.CoQ^ ^ PLAN T& PERMANEN TLANDSCAPIN G T O B E REMOVE ? N O fTT I YE S [ - 

## 2 IF , YE S WHERE :

PRE-EXISDJ^G CONDmO M O F FOUNDATION/STRUCTURE , i.e . BASEMEN TLEAKING ? M^ k I , KI VB C I 1 T E VBCUrUPDC ' 

### N O L A YE S IF , YE S WHERE :

EXISTIN G PAIN TO N WINDOWS , DOORS , rFOUNDATION , SIDEWALK, ( LE.) ? NOfX l YE S 1— 1 IF , YE S WHERE : 

# [rr?(c.v . fbo / Lj^^l l 1^ 7 

### S^^^ 3 

## /^i?./q^K ^ ') n r^j n f^^i ^ 

## SrML ^ V )



### VISUA L DESCRIPTIO N O F PROPERTY/STRUCTURE/GARAGE , (I.E.) : (US E BACKSID E I F NECESSARY ) ^^^ r 

## ,!^/^c/ ^ $^^r:^ A-A^o^ ^

PROPERTYOWNE R SIGNATUR E iCCES^E R SIGNATUR E 

### IQ M 

# i

# PAIN TSTABILIZATIO N PRE-PROPERT Y PAIN TMATC H ASSESSMEN T PROPERT YADDRES S 

# : lAH^C i Orvy^W^^ A) ^ PAJLLI A r



# Cn U DAT E BVI D 

# to///k /Qfn^^ S AREA(S ) T O B E PAINTED : HOUS E PROPER : COLO R HOUS E TRI M

GARAGE . _COLOR _ _COLOR ^ \/^Ay(^y(/' ^ M()N A 

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# 7 # ^// W i,-^ . S- ^ Gf}\\(j>j i 

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GARAG E TRI M COLOR . PORC H COLOR .

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### PORC H TRIM . COLOR . (COMPLET E AL L SECHON , YES , NO , O R NON-APPLICABLE ) 

# I AGRE E T O TH E COLOR S LISTE D ABOVE . ONC E PAINTIN G BEGINS , I UNDERSTAN D I CA NNO T CHANG E TH E ABOV E SELECTE D COLORS : PROPERT YOWNE R SIGNATURE : P E ACCESSO R SIGNATURE : 

# >-^^>^_^-"^ t

PAIN TMATC H FOR M 08/0 8

### Dougla s Count y Accoun t Informatio n Pag e 2 o f 2

,.j^" "
—as?* '
CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1241. 0 Percen t Complete : 100.0 % Perimete r0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : ; Fram e Stucc o Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo fCover : \ Compositio n Shingl e Bedrooms : 2. 0 Roo f Type : \ Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinide rSquar e Footage : 0. 0 Yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 191 6 0 % 191 6 9 2 Deta/ 7 Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 708. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 336. 0 Porc h En d Scree n 50. 0 Porc h Sla b Roo fCei l 184. 0 Porc h Woo d Dec k 150. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.js p ?accountno=RO.. . 10/11/200 8

### Dougla s Count y Accoun t Informatio n Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R090603000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f 90t h S t - Vie W O n IVIa p Informatio n i s vali d a s of 2008-9- 4 Treasurer' s Ta xRepor t Ne wFeatur e -*-*- • Aut o Sale s Searc h Owne r JA YMAURIC E ETA L 434 0 PARKE R S T OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumber : 060 3 000 0 0 9 Accoun t Type : Residentia l Parce l Number : 090603000 0 Parce l Address : Lega l Description : 434 0 PARKE R ST OMAH AN E 68111-000 0 CREIGHTON S 2N D AD D LO T1 9 BLOC K1 5 0 X 13 0 Valu e Informatio n 200 8 200 7 200 6 200 5 200 4 200 3 Lan d $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 Improvemen t $43,300.0 0 $43,300.0 0 $43,300.0 0 $43,300.0 0 $43,300.0 0 $43,300.0 0 Tota l $49,700.0 0 $49,700.0 0 $49,700.0 0 $49,700.0 0 $49,700.0 0 $49,700.0 0 Lan d Informatio n Acre s 0.1 4 S F 6500. 0 

### Units 1. 0 Dept h 130. 0 Widt h 5 0. 0 Vacan t N o Improvement Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO. . . 10/11/200 8