TRANSMITTAL OF OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: ^6' ^ Date: - ^ BJPiJT^') 

Address: ^rgj.-T FftftrikU N -^ Y • 

LBP Stabilization Contractor: PRUDEN T TECHNOLOGIES , INC. Year: 2009 

PAINT STABILIZATIO N 

PROPERT Y FILE FOLDE R DOCUMENT S 

^ Videoof property (DVD): Pre-Stabilization & Post-Stabilization Videos 

Si Executive Summary 

^ Signed Access Agreement Form 

1*^ Advance Notice Form 

7 Pre-Stabilization Video Agreement Form 

B Access Tracking Form 

V Property Access Assessment Form 

7 Neighbor Access Agreement Form 

t/ Paint Match Form 

K Pre-Stabilization Property Safety Assessment Form 

S^ Work-Site Hazards Analysis Checklist 

y Photographs: Pre-Stabilization Propertv Hazard Assessment Photographs 

y Douglas County Assessor Property information 

y Property Completion Agreement Form Signed by Property Owner 

D Property Close-Out Check List Signed By EPA 

Pnident 'technologiesTlnc. Si^a t Ignature 

^PA Signature 

30055203 

Superfunc 
TECHNaLOGIES^ INC 

Property Summary 

Date: 8ig4/2009 | LBP STABILIZATION EPA CONTRACT EP-R7-08-07 | Month of: Aug 

Property Address: 4215 Franklin St. SAID #: 26140 

A. Executive Summarv: 

a. Issues Encountered: NONE 

b. Issues Resolved: NONE 

c. Unique Findings: NONE 

d. Other Relevant Information: 

i. Access Date: 8/13/2009 

ii. Work Began: 8/20/2009 

iii. Close-Out Date: 8/22/2009 

B. Enclosures: 

1. Pre-Stabilization Video 

2. Post-Stabilization Video 

3. Signed Access Agreement Form 

4. Advance-Notice Form 

5. Pre-Stabilization Video Agreement Form 

6. Access Tracking Form 

7. Property Access Assessment Form 

8. Neighbor Access Agreement Form 

9. Property Paint Match Form 

10. Pre-Stabilization Property Safety Assessment Form 

11. Work-Site Hazards Analysis Checklist 

12. Pre- Stabilization Property Hazard Assessment Photographs 

13. Douglas County Assessor Property Information 

14. Signed Property Completion Agreement Form 

15. Property Close-Out Check List Signed By EPA 
JUL. 14.2009 7:26m 8. SECURITY NO.270 P.l 

1 3 200 9 2 : PR NT TECHNOLOGIES 402 m i l 005 J u l oePM ':'.•/••:•.'.- . .<»«• 

Prudent Teehnologics, Ine. (Prudent) i» under contract (Contnwc *l Lf-Kl-Ot-QT) widt tlie U. S. Environmenttl Piotwstion • 

Agency (EPA) to stabilize Lead Based Paim (LBP) at a number ofproperties located in Oniaha, Nebraska, including the ', 

property located at ^TLS S P'<'<>f>K.L^f^ S V 

ThD BPA requests your permHsion to allow Prudent to perfomi LBP Stabilization at diis property. By signing ttita form, th; 

property ownar grants permissian to Prudent to perform activities related TO LBP Stabilization including scraping paint and i 

painting ofthe referenced propeity. Fuller, the owner/tenant verifies that they have received the LBP pamphlet "Renovate 

Right." ; 

By signing this docimieTit 1 agree to allow an EPA cootractor to conduer a soil cleanup at my property following cotnpletioi^of 

lead-based paint stabilization, if the soil oleanup has not already been perfonned. I understand diat the stabilization contractor 

cannot provide assurances of which contractor will be bound to the soil cleanup. 1 ftinher undcntand that the soil cleanup I 

eontrador will malce all reasonable effons to address concems that 1, as the property owner, tnay have regarding soil ! 

cleanup at tny property. 

Yes. I have read and understand the paragraph above. ^ 

^ ^ (MXT - Signature of Property Owner 

Date 

Ifyou have any questions about the LBF stabilization planned fbr your property, please contact Pnidem's Customer \ 

R£latiQH8/Offica Manager for the Lead Bated Paint Stabilintion. Mr*. Shannan H9^^ at (402) 504-1004 or MOimil-MM. 

General questions tibout the Omaha Lead Site cleanup can be directed to the EPA Public Informatioo Centers ai (402) 731 

3045 (South Omaha office) or (402) 991-9583 (North Omaho ofnce). 

PropcrQ' Access Graited By: 

(Please Prim Name) 

Property Owner Sigpiature: JiA^j ^ (dytjCZT^ 

(Signature) 

(Date) 

1080 Ward ParKway, Suite 405 3506 N. 24** Street, Sulta 30S «242 MMllcfll Drive, StrilO 4250 

UitSBS City, MO 64114 Omahii. Mebnsha 6B110 San Antenio, TX 7S229 

>hon«:<81B)»«3-0703 Phono: (402) 604-1004 Phone: (210) e32-»68B 

'sur (810) 363-3707 Fax: (402)504-1003 Fax; (310) 6794677 
JUL.14.2009 7:26PM SPIF^ & SECURITY NO.270 P.2 

J u l 13 200 9 2 : 06P n PR NT TECHNOLOGIES 4029M100 b p. 3 i.fy,^ 

MK3PERTVINF0PMAT10N 

(T» be completed by re«idedt and/or property owner - pleaie prlat) 

% RESIDENT NAME: iCCLrtry (fl.r4 ^ ^^Z > Ranter 

f , RESIDENT ADDRESS: ^ ^ A / r fl . , I 

^ ^^^ 5fao^rvVLVifN sV (\AAlLkSL (oJU l 

^ IF RENTAL, PROPERTY OWNED BY: 

^ OWNER'S MAiLINO ADDRESS; 

1^ OWNER'S TELEPHONE NUMBiR • H^ : ^t^jJUk ^T.S''^ ^ I WORK: _1 >. 

1^ NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: U NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER: 

A NUMBER OF CHILDREN UNDER 7 YEARS OLD WHOM PLAY IN THE YARD FOR S HOURS OR MORE PER WEEK: 

f COMMENTS OR SPECIAL INSTRUCTIONS: (IE. DOGS. ENTRY GATES. ETC.) 

• f ^ 

1 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS; Tbe activitiei to be implemented by EPA under thii a£reenicnt ire • 

pursuant to Section 104 of CBRCLA, 42 L'.S.C. 9604. EPA's right ofaccess to the property is provided for in Seciion 104(e) of CERCL/A, 

42 U.S. C 9603(e)k which provides enoy for "detemWninB the need (br response, or choosing er tslcing any response •ctian under this titlej or 

otherwise enlbrcing dte provisions of die tide." \ 

)80 Ward Pstihway, Suite 40S 2608 N. SV" Gh«et, Suite 308 4242 Mffdleei orl^ . Suite 4260 

ahsas City, MO 64114 Omaha. Nebrasko 68110 San Amonio. TX7a22» bono. (816) 363-3709 Phone: (402) S04-1004 Phone: (210)022.9fi08 

8ii-(81C) 363-3707 Tax: (402t S04-1006 Fax: (210) S7»-6ii77 
SPir£I & SECURITY NO.270 P.3 

J u l 13 200 9 2i06P M PRIHN T TECHNOLOGIES 402 ! 100 5 JUL.14.2009 7:26PM r£i Y Y

# ' 

Advanced notice needed. 

After signing the access you allow Pnident to begin Lead Based 

Paint Stabilization. All Plants, weeds and any vehicles or iteins on 

open porch (enclosed porches will NOT be stabilized) must be 

removed prior to stabilization. All Pets must be ont of yard during 

stabilization. How much notice do you need to have above 

mentioned tasks completed? Ifyou are a landlord you will need to 

contact the tenant as Prudent Technologies will only inform you. 

)( Do you have any pets that reside in yard? Afn 

y^ Notice needed: <\^ kdArS 

)< Number to caU to give notice: /-<?(?^^5^2.J^ J 33 / f7^^^^^ 

^ Whom we are giving notice to: ^ ^ ^ T\/ljLr 

^ Home Owner^s Signature 

KMJLC:^ Ck^^^^., 

6080 Wkrd Perkwey, Suite 40B 2505 N. 24"* Stmt. Suite 308 4242 NIedleal Drive, SuH« 4250

Kansan City. MO 64114 OnrahB, NebresKe U110 Sen Antonio, TX 78220 

Phono: (016) 363-3709 Phone: 4402) 404-1004 Phone: (210) 822-S6B8 

Fa):(B16)a«»-3707 For (402)504-1005 F«X! (210) 679^677 

 i 
JUL.14.2009 7:26flM SPF^Ufij A ' & SECURITY NO.270 P.4 

J u l 13 200 9 2:0GP n PR 402 ! a 00 5 T TECHNnUOQIES 

lOUXJIBNINCT 

PRE-STABILIZATION VIDEO FORM 

I UNDERSTAND THAT PRUDENT TECHNOLOGIES WILL BE COMING 

Ot T TO SHOOT A PRE-STABILIZATION VIDEO AT MY PROPERTY. 

THE VIDEO IS JUST A TOOL USED TO DOCUMENT THE CURRENT 

PROPERTY STATUS/CONPrriON. A POST VIDEO WILL ALSO BE 

SHOT PRIOR TO COMPLETION OF STABILIZATION. 

^ OWNERSNAME: /(^^^^ (kr-K^ 

Ax^5 VfAr»v;Ur> s t PROPERTY ADDRESS: 

BVID/SAID: 'X(o\S\^ 

A HOMEOWNERS SIGNATURE: JULAJL ^ /(UytJly ^ 

PRUDENT REPRESENTATIVE SIGNATURE: 

0 ^ 

ANY CONDITIONS NEED TO BE AWARE OF BEFORE SHOOTING 

VIDEO: (I.E. PETS, NOTICE NEEDED): M 

I 

• (

I 

I 

i 

I 

OOOO Ward PerVwejr, Suits 405 2S06 N. 24" Siroet Svlte MO 4242 Madleal Drive, Sulb 4250 ' 

Kensas City, mo 44114 Oniaha, NeOrasM 68110 San Anlonlo,TX 78229 t 

PHotio: (S16; a63-)70» PhoM: (402I 504.1004 Phono: (210) 822*9SB8 ; 

F»x: (616) 36d-4707 Pax: (402)904.1005 fa)i:(2lO)579-eS77 
TECHNOLOGIES, INC. 

ACCESS INFORMATION TRACKING SHEET 

BVID: aG\^ 0 PROPERTY ADDRESS: Ma\ c r. . . 

Property Owned By: 

(If new property owner) 

Owners Phone No's: Home: Work: 

Cell: Fax: -

Access Contractor: ASW PDA MES PE Other (Prudent) 

DATE TIME ACCESSOR CONRACT DETAIL 

^IhPf ^ ^anle^f Wi/feJ/Pfeftu fvtii-lUr^ 

t^- O Qh/\ W t k ( ^ " ^ < ^ ^ t ^

3 

Comments: 

8080 Ward Parkway, Suite 405 2505 N. 24" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 84114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax:(210)579-6577 
TECHNOLOGIES, INC. 

Access Assessment Form: (Must be completed for every property. 

Information must be obtained from a property walk thru, not given 

by owner) 

Is the property stucco or asbestos? 

If yes, is any ofthe stucco or asbestos damaged or cracked? 

If yes, stop as we can't stabilize this property. It requires special preparation 

techniques. It will be returned to EPA and they will assign at a later date. 

Does this property require lots of scrapping? 

Does this property require a lift or scaffolding to reach upper levels? 

Does this property have lots of plants or items in areas where painting is 

required? 

Does this property have any significant structural damage? 

If yes, EXPLAIN? 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone:(816)363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
TECHNOLOGIES. INC. 

Does this property have a garage? 

If yes, describe location of garage. 

Does this property have aluminum siding? 

If yes, is it original factory finish or has it been painted over? 

Does this property have any other type of structural components? (I.e. roof 

shingles as siding)? » jy\ 

If yes, EXPLAIN? 

Is this property vacant or occupied? 

Are there any pets at this property? 

M3 

Are there any low hanging power lines? 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fax:(210)579-6577 
JUL.14.2009 7:27AM & SECURITY _NO.270 P.S 

J u l 13 200 S 2:07P M PR ^ T TECHNOLOGIES 402 ! klOOS p . 6 

t 

PAINT MATCHING FORM: 

TO BE FILLED OUT ONLY IF MATCHING COLOR 

PROPERTY ADDRESS: <^aN 5 VfanV^Vi o s V 

BVID: SlG\OiO 

I UNDERSTAND SHERWIN WILLIAMS WILL MATCH MY CURRENT COLORS. 

A HJomoownor sicnatarc: 

IJUZZ^ — 

i 

i 8080 Ward Parlcway. Suite 408 2S09 M. 24* Stnsat, SoMe 300 4242 MMiiea(Oriv«,Bui'le 4290 > Kar^et city, MO 84114 Omaha, Nabraaka 88110 SanAntOhle.TX7e22S ! Phana: (816) Ma-sros Phone: (402)604-1004 PhonK (210)e22«es i Fax: (818) 363.8707 Fte: (402)604.1009 Fan: (210) S70-6ST7 : 
TECHNOLOGIES. 1 

NEIGHBORHOOD PROPERTY ACCESS FORM 

IS THERE A NEIGHBORING PROPERTY THAT NEEDS TO BE ACCESSED ALONG 

WITH ASSIGNED PROPERTY TO COMPLETE STABILIZATION PROCESS? 

ti 

IF IT IS, GET ACCESS FROM ALL REQUIRED NEIGHBORHOOD PROPERTIES. 

Mt> 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone:(816)363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
sf^'^"^ 

TECHNOLOGIES, INC 

PRE-STABILIZATION PROPERTY SAFETY ASSESSMENT FORM 

PROPERTY ADDRESS: Mais Pv^tAi^ <;.]' . 

BVID/SAID: ' ^ h \ ^ ^ 

PRUDENT ASSESSMENT REPERSENTATIVE: 

f^fixl ;Q-A>^ t^-^^-^ 

******IF SAFETY RISK PROPERTY MUST BE TURNED OVER TO 

KATHY ROTHER BEFORE IT CAN BE ASSIGNED TO A CREW/SUB. 

REPERSENTATIVE REMARKS/FINDINGS: 

(POWER-LINE PROXIMITY TO PROPERTY, SCAFFOLDING/ LADDERS/ LIFTS 

NEEDED, UNSAFE AREAS, UNSAFE NEIGHBORHOOD...ETC.) 

REQUIRES K.ROTHER APPROVAL YES/NO 

SUBMITTED TO K.ROTHER ON: 

j 8080 Ward Parkway, Suite 405 2505 N. 24*" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
TECHNOLOGIES. 1 

Checklist for the Worksite Hazard Analysis 

Address 

Crew: Date: 

Item n OK? Hazard Corrective Action 

Overhead Lines r^r^ feeLcruM-^ 

In-transit Vehicle Clearance 

Levels around high wires 

Vehicle Clearance around 

high wires when working 

Phone lines 

Cable lines 

Gas Line 

Water Line 

Sewer Line 

Septic Tank 

Propane/Butane 

Access to/on Property 6^- Neighbor Access Required 

High Traffic Area 

Garage IZ)£(J j-Unibo A^ik i \,)^^ - r^4, ty-T/^ -d- ^ 

Structures _m ^ 

Driveway fi{/ -poAl ^ ( ^ 

Sidewalk tA. LW^fi^hi 

Foundation 2ILZffi Sr^flT^^^ ^ 

Retaining Walls 

Fences ^cuE 

Trees 

Foliage E^E^i^^^^ 

General Condition of yard -^cA ij^r^Yt ^ '^^ S 

Damaged Areas: sink 

holes/rotted wood 

Sprinkler System 

Pets 

Insects 

Weather Conditions 

Unsafe driving conditions 

Unsafe neighborhood ^ 

»ub-Contractor Ute Safety Oflicer 

yy 

8080 Ward Parkway, SuiteV 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402) 504-1004 Phone: (210)822-9688 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax:(210)579-6577 

i 
\ ^s ^ ^^^ w z^ m 

vl^m 

>r' ^^^iMMg l •P^^B 

1'^^^^^^^H if ^^^^ ^ 

f:^^"^ M ^ 


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i4 i * ^^-'. -^ »1^^^B^^ 

B^^M­

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1 
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i 
JUL.14.2009 1:57PM SftFJ & SECURITY NO.272 P.l Ju l 14 2009 8:S3nM PRUI rr TECHNOLOGIES 4025( 1005 f.v2. 

Current Sample Pre-Renovation Form 

Effecttve until April 2010. 

Confirmation of Receipt ot Lead Pamphlet 

/ y&kl have received a copy of tho pamphlet, Renovate fiight: Important Lead Hazard 

InformaUon for Families, Child Care Providers and Schools infornning me of 

lhe potential risk of the lead hazard expostra from renovation activif/ to be 

perfomried in my dwelling unit. I rescelved this pamphlet Oefore the work began. 

^-'^'^^ f 

Printe^pame of recipient 

Date 

y^/c/. ^ 

Signature of recipient 

Self-Certification Option (for tenant-occupied dwellings only) •— 

If the lead pamphlet vvas delivered t>ut a tenant signature wae not obtainable, 

you may checl< the aporopriate box below. 

Q Refusal to sign — I certify that I have n?ade a good talth eltcrt to deliver the 

pamphlel, /7enova?e Right Important Lead Hazard information for Families, Chiid Care Providers and Schools, to tha rental dwelling unit listed below at the 

date and time indicated and that the occupant refused to sign the confirmation 

of receipt, i further certify that I have left a copy of the pamphlet at the unit with 

the occupant. 

Q Unavailable for signature — I certily that I have made a good faith eftort to 

deliver the pamphlet, Renovate Rght: Important Lead Hazard Information lor 

Families, Child Care providers and Schools, to the rental dwelling unit Isted 

below and that ths occujMint was unavailable to sign the confirmation of receipt, I further certify that I have left a copy of the pamphlet at t'^e unit by sliding it 

un(der the door 

^0>^^^]e.eV MV> ^ Y^^xhii ?->;>-09 

Printed name of person certifyi.ng 

Attenriptftd delivery date and time 

lead pamphlet delivery 

Signature of person certifying lead pamphlet delivery 

UnltAddress 

Note Regarding Mailing Option — Ae an altemative to delivery in person, you 

may mail the lead pamphlet to the owner and/or tenant. Pamphlet must be mailed 

at least 7 days before renovation (Document with a certificate of mailing from the 

post office). 
Douglas County Account Info^^tion Page 1 of3 

Douglas County, Nebraska Property Record - R0906700000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - Vie W O n Ma p Information is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature ->-»-> Auto Sales Search 

Owner 

WeCKLE KAREN 

^-^ o • 

4215FfRANKLINST 

OMAHA NE 68111-0000 

Property Informatio n 

Key Number: 0670 0000 09 

Account Type: Residential 

Parcel Number: 0906700000 

Parcel Address: 4215 FRANKLIN ST 

OMAHA NE 68111-0000 

Legal Description: CREIGHTONS 2ND ADD LOT 4 BLOCK 6 LOT 4 

Value Informatio n 

Land Improvement Total 

2009 $6,700.00 $56,300.00 $63,000.00 

2008 $6,700.00 $56,300.00 $63,000.00 

2007 $6,700.00 $56,300.00 $63,000.00 

2006 $6,700.00 $56,300.00 $63,000.00 

2005 $6,700.00 $39,800.00 $46,500.00 

2004 $6,700.00 $39,800.00 $46,500.00 

Sales Informatio n 

SalesDate: 2004-02-27 

Deed Type: WD SooAf; 2004 Page: 028851 

Price: $64,400.00 

Grantor: Edward D Coleman etal 

Grantee: Karen Weckle 

Valid/Invalid: Valid 

Exclusion Reason: 

SalesDate: 1997-08-21 

Deed Type: D Book: 2069 Page: 168 

Price: $44,000.00 

Grantor: 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R090... 7/6/2009 
'Ki-v:*'S'!'?vtv-'i.1.Jl!|-M.,'M - •'•:^!>:-^l^j^, "••i' Kli^i*'t^j ^ ^i;;4i'i. •;^-..->•>)..:•,,,"'. vT-^IC^-i*..• fe".^' «••' iAv«^' - .vA-''.'^ V'rii?v¥';;•:"•••>• 'i':.'Wt..'^!^.*.-^ 

Douglas County Account Info^^tion Page 2 of3 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.16 7200.0 1.0 150.0 48,0 No 

Improvemen t Informatio n 

Building 1 

itmiaf* 

1^1 • lil i ^ IMi'lMkni « f 

ARCH 2005 - DOUGLAS COUNTY ASSESSOR 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1458.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Fair 

Built As: 1 1/2 Story Unfin Condo Square Footage: 0.0 

HVAC: 1 Central Air to Air Rooms: 5.0 -fExterior: Frame Siding Units: 1.0 

Intenor: Drywall Baths: ! 1.0 

Roof Cover: Composition Siiingle Bedrooms: 2.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1924 0% 1924 84 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Appliance Security System 1.0 

Basement Bsmnt Block 8 ft 988.0 

Fixture Base Fixtures 

Fixture Bath Full 1.0 

http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=R090... 7/6/2009 
Douglas County Account Info^^tion ^ ^ Page 3 of 3 

Garage Detached 352.0 

Porch EncI Screen 96.0 

Porch EncI Screen 36.0 

Porch Slab Roof Ceil 24.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R090... 7/6/2009 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, ENC. SERVICES 

RDC 

To: Tyler Carter From: Mr. Chandra Shekar 

Fax: 402-354-3378 Pages: 1 + 

Phone: 402-354-3379 Date: 7/13/09 

Re: 4215 Franklin St, Omaha, NE 

Mr. Carter: 

Prudent Technologies (Prudent) is EPA contractor for stabilizing lead based paint 

(LBP). The referenced property has been assigned to us. Please sign on the access 

agreement and fax it back to us. 

If you have any questions, please feel free to call me at 402-504-1004. 

Sincerely, 

cy - ^ 

Mr. Chandra Shekar, P.E. 

Project Manager 

C^^T(?^ 

-iMS(2_ 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 218 4242 Medical Drive, Suite 7250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
TECLINOLOGIES, INC. 

Prudent Property Close-Out Form (Lead-Based Paint Stabilization) 

SAID: r^^l^ O 

Property Address: l7^ ^ /^yaA/l//o /9^^< ^ 

Owner's Name: f~J\ iQf\ CCU3Q ^ 

S.NO Performance Standards/close-Out Criteria 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, aii trim, porches, box 

beams, columns, rails, and exterior surfaces of garages. 

/

2 Was all scraping and other preparation worl( completed 

^!e satisfactorily? " 

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

^ C painted with two top coats? i 

4 Are all ofthe areas where contaminated materials have been spilled 

thoroughly vacuumed/ cleaned? ^ o 

5 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? 

6 Is the grass area that surrounds the structure(s) in reasonably good 

condition? SC 

7 Was the paint products utilized equivalent to a 30 year 

product/quality? ^ 

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

^ c cones, barrier tape etc properly removed? 

9 Is there any evidence of property 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? 6lc 

11 Are there any (known) lingering issues with the property owner(s) 

that have been left unresolved? ^c 

12 Other Considerations? Property Owner Discussions? Additional 

Work that is Required scPrudent Representative Signature 

Date: 

Property Owner Signature: 

^,pa. ^ / 

2505 N. 24" Street, Suite 308 4242 Medical Drive, Suite 4250 

I Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

\ Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fax: (210) 679-6577