TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: f^'r ^ OU( 0 Date: i^\n\o"t 

Addt^ss: aqi s M i?, ^ s-H 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

t^/ ^ Video of property (DVD) ' 

^y^"^ Executive Stimmary 

0 ^ Signed Access Agreement for subject property 

tK Painting Agreement 

ettlement documents (i.e., for damage or to replace plants, etc.) 

Photographs pgitrr*—­

^ Satisfactory restoration signed by Property Owner 

D Property close-out check list signed by EPA 

Property information from Douglas Coimty Assessor's Office 

confirmation that lead pamphlet "Renovate Right" was received by P0_ 

D 

D 

D 

\x a. m. Profess viroi(&n^Tal Engiiieei^Signature Die 

^//%/l^ 

i*A Stature Date 

30054976 

•in 

Superfund 
2505 North 24*, Suite 219 

Omaha, NE 68110 

(402) 504^688 

Fax (402) 504-3281 

PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"Providing cost-effective environmental solutions" 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2009 

SAID# 33646 

3915 N. 18'" St 

• Dates worked: 09/21 to 09/23 2009 

• Pre property condition: House has mostly vinyl siding with front painted wood trims 

and foundation areas. 

• Problems encountered: None 

• Owner request/concerns: N/A 

• Inspection/closeout dates. Owner signed 10/06 2009. Property inspected by PE project 

manager. 
2505 North 24% Suite 219 

"Providing cost-effective environmental solutions' 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Property Owner Close-Out Form 

(Lead-Based Paint Stabilization EPA Contract EP-R7-08-06) 

SAID: ^^ 1 P ^ 

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Property Address: ^ ^ S Kf /R^5 4 

Owner's Name; j ? C. rSlfOJ n& i 

Performance Standards/Close-Out Criteria 

1. Was the entire structure(s) painted with the exception ofthe stated, excluded 

areas? This would include painting ofother associated features including fascia, 

eaves, siding, all trim, porches, box beams, columns, rails, and exterior surfaces of 

garages. 

2. Was all scraping and other preparation work completed satisfactorily? 

3. Were all required areas ofthe structure(s) primed as needed and painted with 

two top coats? 

4. Was the paint products utilized equivalent tb a 30 year product/quality? 

5. Are all ofthe areas where contaminated materials have been spilled thoroughly 

vacuumed/ cleaned? 

6. 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? 

7. Is the grass area that surroxmds the structure(s) in reasonably good condition? 

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

that need to be moved back? 

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

been left unresolved? 

Comments: 

. = _— 5 . 

Omaha, NE 68110 

(402) 504-4688 

Fax (402) 504-3281 

YES NO 

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Property Owner Signature Date 

Professional Enviropmental Engineers Representative Date 
CONSENT FOR ACCESS TO PROPERTY 


OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY PPnPir.BTY ADDRESS: ^^/ ^ A). J^*^ >S/ ID: ^'^CaH G 

DAYTIME PHONE: 

^ 

CELL E-MAIL: PHONE: ^5-^ ^ Q2>7 ^ 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME IF APPLICABLE: 

DAYTIME PHONE: 

CELLPHONE E-MAIL: : 

Professional Environmental Engineers, Inc. (PE) is under contract (#EP-R7-08-06) with the U.S. Environmental Protection 

Agency (EPA) to stabilize lead based paint (LBP) on residential structures at a number of properties located in Omaha, 

Nebraska. The paint stabilization worli is being done to protect the soil cleanups that are being performed by EPA contractors. 

Paint stabilization activities will include: scraping of cracked or flaking LBP from structures, application of a prime coat and two 

(2) coats of paint. Moving parts of windows and doors are not included and wiU not be addressed. 

Your cooperation is requested in giving permission to this EPA contractor (PE) to enter and have access to this property for the 

purpose of stabilizing lead -based paint as outiined on the property identified above. 

. ^* 

By signing this document I agree to allow an EPA contractor to conduct a soil cleanup at my property following completion of 

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

can not provide assurances that the soil cleanup contractor will be bound to. I further understand that the soil cleanup 

contractor will make all reasonable efforts to address concems that I, as the property owner, may have regarding soil cleanup at 

my property. 

H^s. T^ understand ttie paragraph above. 

SIgnahire of Property Oiimer Date 

I fiilly understand that by signing ttiis Consent for Access, (1) this access wiU remain in effect until the work has been 

satisfactorily completed, (2) that the Property Owner or Tenant, If applicable, will be given the Housing and Urban Development 

(HUD) and EPA pamphlet, "Renovate Right, Important Lead Hazard information for Families, Day Care Providers, and 

Schools", (3) the Property Owner or tenant will remove all obstructions from surfaces to be painted, (4) will abide by health and 

safety guidance provided by EPA, (5) will allow photography of property before and after the paint stabilization work, (6) will be 

contacted by a PE representative approximately 48 hours in advance of starting work, (7) agree not to obstruct or tamper with 

any ofthe LBP stabilization actions, and (8) will participate in final property inspection and sign the Completion Agreement and 

Property Owner Satisfaction Survey. 

Should you have any questions about the planed Lead Based-Paint stabilization activities for your property, please contact 

Professional Environmental Engineers, Inc. Project Manager, Willie Clay At 402-504-4688. General questions about the Omaha 

Lead Site cleanup can be directed to Paulette France-Isetts, EPA Remedial Project Manager 402-731-2454, or the EPA Public 

Information Centers at 402-991-9583 (North Omaha office) or 402-731-3045 (South Omaha office). 

Yes D No, I do not grant access to my property and I «M8 , I grant access to my property and was given the pamphlet 

"Renovate Right, Important Lead Infbrmatlonior Families, Chl}d ghren flie pamphlet "Renovate Right Important Lead 

Care Providers, and Schools." ^' ^ Informatton fbr Families, Chllde Care Providers, and Schools." 

D^e 

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SIgnahire Date SIgni 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
\ 

PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS: _ ?5Q/S AL /r DATE: 

BVID: .?3(^f< ^ 

AREA(S) TO BE PAINTED: 

HOUSE PROPER: ^\ ^ COLOR: 

HOUSE TRIM: COLOR: ^u\l -^rGARAGE: ^( d COLOR: 

GARAGE TRIM: _ K-iO COLOR: 

P^RCJHT tO(i <V\i^xr\(\ COLOR: 1^1. Jt 

PORCH TRIM: COLOR: 

(COMPLETE ALL SECTION, YES, NO, OR NON-APPLICABLE) 

I AGREE TO THE COLORS LISTED ABOVE. ONCE THE PAINTING 

BEGINS, I UNDERSTAND I CAN NOT CHANGE THE ABOVE SELECTED COLORS: 

PROPERTY OWNER SIGNATURE: PE ACCESOR SIGNATURE: 

ic^ ^ ^ 
- -

Douglas Coimty Account Information Page 1 of2 

'bl^HC, 

Douglas County, Nebraska Property Record - R0701450000 

Print Report 

NEW Feature - Parcel Dimensions available @ scaie 0-50 ft west of 52nd St - Vle W Ot l MS P Information is valid as of 2009-9-3 Treasurer's Tax Reoort 

New Feature ->-+-> Auto Sales Search 

' " • " 1 

Owner 

SWINEY R C 

3915 N 18 ST 

OMAHA NE 68110-0000 

"1 

Property Informatio n 

Key Number 0145 0000 07 

- ~- - - -

Account Type: Residential 

Parcel Number: 0701450000 

[ Parcel Address: i 3915 N 18 ST 

' OMAHA NE 68110-0000 

Legal Description: BOULEVARD PARK ADD LOT 14 BLOCK 8 N 20 FT & S 20 FT LT 15 40 X 125 

Value Informatio n 

Land Improv ement Total 

1 2009 ! $7,000.00 $10,900.00 $17,900.00 

2008 $7,000.00 $15,800.00 $22,800.00 

•— i 

I 2007 $7,000.00 $15,800.00 $22,800.00 

2006 $7,000.00 $15,800.00 $22,800.00 ~\ 

2005 $7,000.00 $15,200.00 $22,200.00 - 2004 $7,000.00 $13,800.00 $20,800.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.11 5000.0 1.0 125.0 40.0 No 

" 1 

Improvemen t Informatio n 

[funding 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R07... 9/11/2009 
Douglas County Account Information Page 2 of2 

Stcofid Roor 

«T2.D 94.1. 

vVl I* u 19 ^T '•«t 

Fn t Floor 

V 2 0 «|. n. 

L_'fl.l.'S.ll: -_ San-i StK-m 

CLICK TO ENLARGE IMAGE 

Square Footage: 1344.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

] 

Unit Type: Condition: Poor 

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

HVAC: I Forced Air Rooms: 6.0 

Exterior: Frame Aluminum Units: ' 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Hip Stories: 2.5 

Floorcover: | Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1918 0% 1918 91 

Detail Type Detail Description Units 

Add On Unfinished Attic W/floor 672.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 672.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch End Screen 20.0 

Porch End Screen 140.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R07... 9/11/2009