### TRANSMITTA L o f OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL E FOLDE R SAID# : f^'r ^ OU( 0 Date : 

# i^\n\o" t 

# Addt^ss : aqi s M i?, ^ s- H Remediatio n Contractor : PROFESSIONA L ENVIRONMENTA L ENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S t^/ ^ Vide o o f propert y (DVD ) ' ^y^" ^ Executiv e Stimmar y 0 ^ SignedAcces s Agreemen t fo r

subject propert y t K Paintin g Agreemen t ettlemen t document s (i.e. , fo r

damag e o r to replac e plants , etc. ) Photograph s pgitrr*—

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

### Propert y close-out check lis t signedby EP A Propert y informatio n fromDougla s Coimt y Assessor' s Office confirmation tha t lea dpamphle t "Renovat e Right " wa s receive dby P0 _ D D D 

# \ x a . m . Profes s viroi(&n^Ta l Engiiieei^Signature Di e 

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A Statur e Dat e 3005497 6 

# • i n Superfun d250 5 Nort h 24* , Suit e 21 9 Omaha , N E 6811 0 (402 ) 504^68 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 yRespons e



### Lea dBas e Stabilizatio n Omaha , N e Clos e Ou t Repor t 200 9 SAID#3364 6 391 5 N . 18' " S t

•Date s worked : 09/2 1 t o 09/2 3 200 9 •Pr e propert y condition : Hous e ha s mostly viny l sidin g wit h fron t painte dwoo dtrim s an dfoundatio n areas . •Problem s encountered : Non e •Owne r request/concerns : N/ A •Inspection/closeou t dates . Owne r signe d10/0 6 2009 . Propert y inspecte dby P E projec t manager .250 5 Nort h 24 % Suit e 21 9 

### "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-BasedPain t Stabilizatio n EP A Contrac t EP-R7-08-06 ) SAID : ^^ 1 P ^ 

# u Propert y Address : ^ ^ 

# S K f /R^5 4 Owner' s Name ; j ? C . rSlfO J n& i Performanc e Standards/Close-Ou t Criteri a 1 . Was th e entir e structure(s ) painte dwit h th e exceptio n ofth e stated , excluded areas ? Thi s wouldinclude paintin g ofothe r associate dfeature s includin g fascia , eaves , siding , all trim , porches , bo x beams , columns , rails , an dexterior surface s of garages . 2 . Was all scraping an dothe r

preparatio n wor k

completedsatisfactorily ? 3 . Wer e all require darea s ofth e structure(s ) prime da s neededandpainte dwit h tw o top coats ? 4 . Wa s the paint product s utilize dequivalen t t

b a3 0 yea r

product/quality ? 5 . Ar e all ofth e area s wher e contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? 6 . Didthe contractor collect/vacuumall falling an dscrapedpaint chip s on the entir e property , roadways , alleyways , publi c acces s area s an dals o remov e an y othe r

generateddebris ? 7 . I s th e gras s are atha t surroxmd s th e structure(s ) i n reasonably goo dcondition ? 8 . Ar e all item s such a s polyethylen e sheeting , ladders , paint brushes , cones , barrie r

tape , etc . properly removed ? 9 . I s ther e an y evidenc e o f propert y damag e tha t wa s don e by th e contractor ? An y propert y damag e need s t o b e completedprio r to 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 di e contractor tha t needto b e movedback ? 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 :

. = _— 5 . Omaha , N E 6811 0 (402 ) 504-468 8 Fa x(402 ) 504-328 1



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# R L S/^-^^"^^ ^ /i)'6'0 7 Propert y Owne r

Signatur e Dat e Professiona l Enviropmenta l Engineer s Representativ e Dat e

# CONSENT FO R ACCES S T O PROPERT Y OMAHA LEA D SIT E REMEDIA L ACTIO N - LEAD-BASED PAIN T STABILIZATIO N PPnPir.BT Y ADDRESS : ^^/ ^ A) . J^* ^ >S / 

### PROPERT Y ID : ^'^CaH G DAYTIME PHONE : ^ E-MAIL : 

### CEL L PHONE : ^5-^ ^ Q2>7 ^ OWNER' S ADDRES S I FDIFFERENT : TENANT' S NAM E I FAPPLICABLE : DAYTIME PHONE : E-MAIL : CELLPHONE : Professiona l Environmenta l Engineers , Inc . (PE ) i s unde r contrac t (#EP-R7-08-06 ) wit h th e U.S . Environmenta l Protectio n Agency (EPA ) t o stabiliz e leadbase dpain t (LBP ) on residentia l structure s a t anumbe r o

f propertie s locate din Omaha , Nebraska . Th e pain t stabilizatio n worl i i s bein g don e t o protec t th e soi l cleanup s tha t ar e bein g performe dby EP A contractors . Pain t stabilizatio n activitie s wil l include : scrapin g of cracke do r flakin g LB P fromstructures , applicatio n o f aprim e coa t an dtw o (2 ) coat s o f paint . Movin g part s o f window s an ddoor s ar e no t include dan dwi U no t b e addressed . You r cooperatio n i s requeste di n givin g permissio n t o thi s EP A contracto r (PE ) t o ente r an dhav e acces s t o thi s propert y for th e purpos e o f stabilizin g lead-base dpain t a s outiine do n th e propert y identifie dabove .

. ^

* B y signin g thi s documen t I agre e t o allo w an EP A contracto r t o conduc t asoi l cleanu p a t m y propert y followin g completio n o f lead-base dpain t stabilization , if th e soi l cleanu p ha s no t alread y bee n perfonned . I understan dtha t th e stabilizatio n contracto r can no t provid e assurance s tha t th e soi l cleanu p contracto r wil l b e boun dto . I furthe r understan dtha t th e soi l cleanu p contracto r will make al l reasonabl e effort s t o addres s concem s tha t I , a s th e propert y owner , ma y hav e regardin g soi l cleanu p a t m

y property . 

### H^s . 

# T ^ understan d ttie paragrap h above . SIgnahir e o f Propert yOiime r Dat e I fiill y understan dtha t b y signin g ttiis Consent for Access , (1 ) thi s acces s wi U remai n i n effect unti l th e wor k

ha s bee n satisfactoril y completed , (2 ) tha t th e Propert y Owne r o r Tenant , I f applicable , will b e give n th e Housin g an dUrba n Development (HUD ) an dEP A pamphlet , "Renovat e Right , Importan t Lea dHazar dinformatio n fo r Families , Da y Car e Providers , an d Schools" , (3 ) th e Propert y Owne r o r tenan t will remov e al l obstruction s fromsurface s t o b e painted , (4 ) wil l abid e b y healt h an d safet y guidanc e provide db y EPA , (5 ) will allo w photograph y o f propert y before an dafte r th e pain t stabilizatio n work , (6 ) wil l b e contacte db y aP E representativ e approximatel y 4 8 hour s i n advanc e o f startin g work , (7 ) agre e no t t o obstruct o r tampe r wit h an y ofth e LB P stabilizatio n actions , an d(8 ) will participat e i n final propert y inspectio n an dsign th e Completio n Agreemen t an d Propert y Owner Satisfactio n Survey . Shoul dyou hav e an y question s abou t th e plane dLea dBased-Pain t stabilizatio n activitie s fo r you r property , pleas e contac t Professiona l Environmenta l Engineers , Inc . Projec t Manager , Willi e Cla y A t 402-504-4688 . General question s abou t th e Omah a LeadSite cleanu p can b e directe dt o Paulett e France-Isetts , EP A Remedial Projec t Manage r 402-731-2454 , o r th e EPA Publi c Informatio n Center s a t 402-991-958 3 (Nort h Omah aoffice) o r 402-731-304 5 (Sout h Omah aoffice) . D No , I d o no t gran t acces s t o m ypropert yan d I «M 8 Yes , I gran t acces s t o m ypropert yan d wa s give n th e pamphle t "Renovat e Right , Importan t Lea d Infbrmatlonio rFamilies , Chl} d ghre n flie pamphle t "Renovat e Righ t Importan t Lea d Car e Providers , an d Schools. " ^' ^ Informatto n fb rFamilies , Chlld e Car e Providers , an d Schools. " 

### D^ e 

# r^ SIgnahir e Dat e SIgn i SPECIA L INSTRUCTION S AN D CONSIDERATION S\ 

### PAIN T STABILIZATIO N PRE-PROPERT Y PAIN T MATC H ASSESSMEN T PROPERT Y ADDRESS : _ 

# ?5Q/ S A L 

# / r DATE : BVID : .?3(^f< ^

AREA(S ) TO B E PAINTED : HOUS E PROPER : ^\ ^ COLOR : HOUS E TRIM : COLOR : 

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# -^rGARAGE : ^( d COLOR : GARAG E TRIM : _ COLOR : 

### K-i O P^RCJH T tO( i 

### <V\i^xr\( \ COLOR : 

# 1^1 . 

# J t PORC H TRIM : COLOR : (COMPLET E AL L SECTION , YES , NO , O R NON-APPLICABLE )



### 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 : PE ACCESO R SIGNATURE : 

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### Dougla s Coimt y Accoun t Information Pag e 1 of 2 

# 'bl^HC , Dougla s County , Nebrask a Propert yRecor d - R070145000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scai e 0-5 0 f t wes t o f 52n d S t - Vle W Ot l MS P Informatio n i s vali d a s o f 2009-9- 3 Treasurer' s Ta xReoor t Ne w Featur e ->-+- > Aut o Sale s Searc h

' " • " 1 Owne r SWINE Y R C 391 5 N 1 8 S T OMAH A N E 68110-000 0 " 1 Propert yInformatio n Ke yNumbe r014 5 000 0 0 7

- ~- - - - Accoun t Type : Residentia l Parce l Number : 070145000 0 [ Parce l Address : i 391 5 N 1 8 S T ' OMAH A N E 68110-000 0 Lega l Description : BOULEVAR D PAR KAD D LO T 1 4 BLOC K8 N 2 0 FT & S 2 0 F T LT 1 5 4 0 X 12 5 Valu e Informatio n Lan d Impro v emen t Tota l 1 200 9 ! $7,000.0 0 $10,900.0 0 $17,900.0 0

200 8 $7,000.0 0 $15,800.0 0 $22,800.0 0 •— i I 200 7 $7,000.0 0 $15,800.0 0 $22,800.0 0

200 6 $7,000.0 0 $15,800.0 0 $22,800.0 0 ~\ 200 5 $7,000.0 0 $15,200.0 0 $22,200.0 0

- 200 4 $7,000.0 0 $13,800.0 0 $20,800.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 1 5000. 0 1. 0 125. 0 40. 0 N o

" 1 Improvemen t Informatio n 

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### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R07.. . 9/11/200 9

### Dougla s County Accoun t Informatio n Pag e 2 of 2

Stcofi d Roo r «T2. D 94.1 . vV

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L_'fl.l.'S.ll : -

_San- i StK- m CLIC KTO ENLARG E IMAG E Squar e Footage : 1344. 0 Percen t Complete : 100.0 % Perimete r0. 0 Quality : Averag e ] Uni t Type : Condition : Poo r

Buil t As : I 2 1/ 2 Stor yUnfi n Cond o Squar e Footage : 0. 0 HVAC : I Force d Ai r Rooms : 6. 0 Exterior : Fram e Aluminu m Units : ' 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Hi p Stories : 2. 5 Floorcover : | Allowanc e Foundation : Bloc k Sprinkle 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 8 0 % 191 8 9 1 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Unfinishe d Atti c W/floo r 672. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 ft 672. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h En d Scree n 20. 0 Porc h En d Scree n 140. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R07. . . 9/11/200 9