### TRANSMITTA Lo f OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL EFOLDE R 

## SAI D # : IM^K< 3 Date: ^-'QC^'C ^ Address : .^00 1 S ^^" ^ S f Remediatio n Contractor : PROFESSIONA LENVIRONMENTA LENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S 

### Q ^ Video o f

propert y (DVD ) y Executive Summar y Q^""' ^ Signe dAcces s Agreemen t fo r

subjec t propert y y ^ Painting Agreemen t D Settlemen t documents (i.e. , fo r

ddmag e o r

t

o replac e plants , etc. ) [ FPhotograph s J^fV> ^ a.i A p^ T y ^ Satisfactor y restoration signe db y Propert y Owne r y ^ Propert y close-ou t chec k

list signe db y EP A Zy ^ Propert y informatio n fro mDouglas Count y Assessor' s Offic e ^ y _confirmation tha t lea dpamphle t "Renovat e Right " was receivedb y P0 _ D D D



### Professiona l Environmenta l Engineers Signatur e Dat e

"El^ A Signatur e Da? e ' 3009438 2 

# iiiii i Superfun d

## PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . ''' ' 'omarNE'eafi o "Providin g cost-effectiv e environmenta l solutions " ^ i^°^ | c^llo! ? ^ Fa x(402 ) 504-328 1 Consultin g • Engineenn g Desig n • Remediatio n • Abatemen t • Emergenc yRespons e


### Lea dBas e Stabilizatio n Omaha , N e Clos e Ou t Repor t 2U0 9 SAID #1488 2 300 1 S 3 4 S t

•Date s worked : 07/02/0 9 t o 07/06/0 9 •Pr e propert y condition : Woo dsidin g wa s i n fai r conditio n i n man y area s wit hfe w area s tha t wer e poor . Owne r ha s replace dman y woo dboards , Vine s wer e coverin g area s an dha dt o b e remove dprio r t o stabilizatio n wori i began . Prio r pain t splatter s o n sidewall ( areas . •Problem s encountered : Non e •Owne r request/concerns : N/ A •Inspection/closeou t dates : Owne r signe d07/08 , EP A 07/09/0 9 N o issues .

# PROFESSIONA L 250 5 Nort h 24' ^ Suit e 21 9 

# ENVIRONMENTA L ENGINEERS , INC . Ornaha , N E 6811 0 (402 ) 504-468 8 

### "Providin g cost-effectiv e environmenta l solutions " Fa x(402 ) 504-328 1 Consultin g • Engineenn g Des.g n • Roaied'Otior , • Abatamen t • Emeigenc yRespon'=' e 

### EP A Close-Ou t For m (Lead-BasedPain t Stabilization EP A Contrac t EP-R7-08-06 ) SAID : iMRR a Propert y Address : r^DD ) *S . 9^" ^ S-\
­ Owner'sName : M\|CD . |V \

### r.& ) I i \f- ^ Performanc e Standards/Ciose-Ou t Criteri a YE S N O 1 . Wa s th e entir e struclure(s ) painte dwit hth e exceptio n ofth e stated , exclude d areas ? Thi s woul dinclud e paintin g o f othe r associate dfeature s includin g fascia , eaves , siding , all trim , porches , bo x beams , columns , rails , an dexterio r surface s o f 

# y garages . 2 . Wa s all scrapin g an dothe r preparatio n wor k

complete dsatisfactorily ? y ^ 

### 3 . Wer e all require darea s ofth e structure(s ) prime da s neede dan dpainte dwit h tw o to p coats ? y ^ 

### 4 . Wa s th e pain t product s utilize dequivalen t to a3 0 yea r product/quality ? 

# y 5 . Are all ofth e area s wher e contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? 

# y 6 . Di dth e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s o n th e entir e property , roadways , alleyways , publi c acces s area s andals o remov e any othe r generate ddebris ? 

# y 7 . I s th e gras s are athat surround s th e structure(s ) i n reasonabl y goo dcondition ? ^ 

### 8 . Are all item s suc ha s polyethylen e sheeting , ladders , pain t brushes , cones , barrie r tape , etc . properl y removed ? 

# y 9 . I s ther e any evidenc e o f property damag e tha t 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 EPA Close-Out . y y 

### 10 . Are ther e any property item s tha t wer e temporaril y re-locate db y th e contracto r that nee dt o b e move dback ? t y 

### 11 . Are ther e any (known ) lingerin g issue s wit hth e property owner(s ) that hav e bee n lef t unresolved ? 

# y Othe r Considerations/Property Owne r Discussions/Additional Wor k

that i s Required : yf'/^f
- // a/SJ-uej s


## yM^x^^j^j^^^^^j/'^y ^ EP A CO RSignatur e ' Dat e

# 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 

## Property Owne r Close-Ou t Form (Lead-Base dPain t Stabilizatio n EP A Contrac t EP-R7-08-06 ) SAID : iM^a a Propert y Address : ?S&O l S . ?.Q ^ Sf
- Owner'sName : M' l lcj & f\/[ r RMA ) f^ ^ 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 . Wa s th e entir e structure(s ) painte dwit hth e exceptio n ofth 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 all scrapin g an dothe r preparatio n wor k

complete dsatisfactorily ? 

# y 3 . Were al l require darea s ofth e structure(s ) prime da s neede dan dpainte dwit h tw o to p coats ? 

# v / 4 . Wa s th e pain t product s utilize dequivalen t t o a3 0 yea r product/quality ? v / 5 . Ar e al l ofth e area s wher e contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? 

# y 6 . Di dth e contracto r collectyvacuu mal l fallin g an dscrape dpain t chip s o n th e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e any othe r generate ddebris ? 

# y 7 . I s th e gras s are athat surround s th e structure(s ) i n reasonabl y goo dcondition ? 

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

# y 9 . I s ther e any evidenc e o f property damag e tha t wa s don e b y th e contractor ? Any property damag e need s t o b e complete dprio r t o th e EPA Close-Out . ^ / 

### 10 . Are ther e an y property item s tha t wer e temporaril y re-locate db y th e contracto r tha t nee dt o b e move dback ? / 

### 11 . Are ther e an y (known ) lingerin g issue s wit hth e property owner(s ) tha t hav e bee n lef t unresolved ? / 

### Comments : 

# 7 / ^ ^ 

# ' y 1 Propert y Owne r

Signatur e Dat t 

# 7 ' t ' ? Professiona l E i enta l Engineer s Representative Dat e

# ,W\ / CONSEN T OF RACCES S TO PROPERT Y OMAHA LEAD SIT EREMEDIALACTIO N ~ LEAD-BASE D PAIN T STABmiZATIO N 

# 2 .

PROPERT Y ADDRESS : jofi ] 5 . 3 4 * M/tct PROPERT Y ID : lU'X?)^
- OWNERNAME :



## ]Ai\^t.H'G-> ^ DAYTIMEPHONE : V^^-^^''^^^ ^ E-MAIL : rv\ll<e<v\QWtAA.<v5it.^Fa.Js . ft ^ CEL LPHONE : V^S
- S ^ ^ 1
- 0 i Q 2 OWNER' S ADDRES S I FDIFFERENT : TENANT' S NAMEI FAPPLICABLE ; DAYTIMEPHONE : CELLPHONE : E-MAIL : Professional Environmeota l Engineers , Inc . (PE ) i s unde r cantrac t (#EP-R7-08-06 ) wit htli e U.S , Environmenta l Protectio n Agenc y (EPA ) t o stabiliz e len dbase dpain t (LBP ) o n residentia l structure s a t anmnbe r of propertie s locate di n Omaha , Nebraska . Th e pain t stabllizatb n wor k i s bein g don e t o protec t th e soi l cleanup s tha t wer e performe db y EP A contractors . Pain t stabilizatio n activitie s will include : scrapin g o f cracke do r flaking LB Pfro mstructures , applicatio n o f aprime coat an d tw o (2 ) coat s o f pain t Movin g part s of window s an ddoor s ar e no t include dan dwill no t b c addressed . Your 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 tfa

e purpos e o f stabilizin g lead-base dpain t a s outline do n th e properl y identifie dabove . B y signin g thi s documen t I agre e t o allo w a n EPA contracto r t o conduc t asoi l cleanu p a t m y propert y following completio n of lead-base dpain t stabilization . I understan dtha t th e stabilisatio n contracto r ca n no t provid e assurance s tha t th e soi l cleanu p contracto r will b e boun dto . I furthe r understan dtha t th e soil cleanu p contracto r wil l make al l reasonabl e effort s to addres s concern 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 . I full y understan dtba t b y signin g thi s Consen t fo r Access , (I ) thi s acces s wU l remai n iu effect unti l th e wor k

ha s been satisfactoril y completed , (2 ) tha t tli e Propert y Owne r o r Tenant , i f applicable , wil l b e given th e Housin g an dUrba n Devekipmon t (HUD ) an dEP A pamphlet , "Renovat e Right , Importan t Lea dHazar dinformatio n for Families , Da y Car e Providers , an dSchools" , (3 ) th e Propert y Owne r o r tenan t wil l remov e al l obstruction s fro msurface s t o b c painted , (4 ) wil l abid e b y healthan dsafet y guidanc e provide db y EPA , (5 ) wil l allo w photograph y o f propert y before an dafter th e pain t stabilizatio n work , (6 ) will b e contacte dby aP Erepresentativ e approximatel y 4 8 hour s in advanc e o f startin g work , (7 ) agre e no t t o obstruc t o r tampe r wit han y ofth e LB Pstabilizatio n actions , an d(8 ) will participat e i n flnal propert y inspectio n an d sig n th e Completio n Agreement an dPropert y Owne r Satisfactio n Survey . Shoul dyou hav e an y question s abou t th e plane dLeadBased-Pain t stabilizatio n activitie s for you r property , pleas e contac t Professional Environmental Engineers , Inc . Projec t Manager , Willi e Clay At 402-504-4688 , Genera l question s abou t th e Omah aLeadSite cleanu p ca n b e directe dt o Paulett aFrance-Isetts , EP A Remedial Projec t Manage r 402-731-2454 , o r th e EPA Publi c Informatio n Center s a t 40^991-9S8 3 (Norfli Omah aoffice) o r 402-731-304 5 (Sout hOmah aoffice) , 

# y Yet , I gran t acce u t o m ypropert yan d wa t give n th t pamphle t D No , I d o no t gran t acces s t o m ypropert yan d I wa s Renovat e Right , Importan t Lea d InfoHnado n fo rFamlllas . Chil d gIva n th e pamphle t "Ranovat e Right , Importan t l^a d Car e ProvMera , an d Schooli.' ' Informatio n fo rFamillea , Child e Car e Providart , an d Schooli. " Signttur e Dat e SPECIA L INSTRUCTION S AN D CONSIDERATION S QOCJ-N]sSNIfJN] H :\V^i' £60117 7 I'l^ ^ 

# m

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# J I hav B lecGiva d a oo() yo f th e pamphlet , Ruumt a SHifi t ktiporlM t Laa d Hasart I lafonaaOo n Fo rFamllm , ChU d Car a Pm/hhi a An d School i MiamUn q m e o f fh e potentia l ris k o f th e lea d hazar d exposur e fifo m renovatio n activil yt o b a perfonne d o n dwellin g uni t I reoeive d ihi s pamphle t befbr e th e wor k began . 

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

# r Dougla s County , Nebrasic a Propert yRecor d - R194261000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t of 52nc l S t - VJe W Of l Ma P Informatio n i s vali d a s o f 2009-6- 3 Treasurer' s Ta xRepor t Nevif Featur e ••-•- • Aut o Sale s Searci i Owne r MCGUIR E MIK E P 

### "'^^^^^^^ZOT - 31> Q -2S"OQ ^ ETA L 300 1 S 3 4 S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber . 426 1 OOO O 1 9 Accoun t Type : Residentia l 

# J . ^ - Parce l Numbe r 194261000 0 Parce l Address : 300 1 8 3 4 S T OMAH AN E 68105-000 0 Lega l Description : PARKVAL E LO T1 4 BLOC K4 4 0 X 13 0 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $ 5,800.0 0 $ 110,300.0 0 $116,100.0 0 200 8 $ 5,800.0 0 $ 110,300.0 0 $116,100.0 0 200 7 $ 5,800.0 0 $ 110,300.0 0 $116,100.0 0 200 6 $ 5,800.0 0 $ 94,100.0 0 $ 99,900.0 0 200 5 $ 5,800.0 0 $ 94,100.0 0 $ 99,900.0 0 200 4 $ 5,800.0 0 $ 94,100.0 0 $ 99,900.0 0 Sale s Informatio n Sale s Date : 2001-11-0 2 Dee d Type : W D Book : 219 6 Page : 50 4 Price : $ 90,000.0 0 Grantor : Grantee : Valld/lnvalld : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Wtdt h Vacan t 0.1 1 5200. 0 1. 0 130. 0 40. 0 N o Improvemen t Informatio n 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R194.. . 6/8/2009

### Dougla s County Accoun t Infomiatio n Pag e 2 of 2
Buildin g 1

K H fa y 1 1 ' Secon d Floo r

6560sqn . I ;'ta »

TwoSlor y

«-t f %n>fe'MM>M* < 

### 9H?!^T9ifl^'^9^'fl!A9 i Squar e Footage : 

### 1737. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 8. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal i Baths : 1. 5 Roo f Cover : Compositio n Siiingl e Bedrooms : 4. 0

Roo f Type : Hi p Stories : 2. 0 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 192 1 0 % 192 1 8 7 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 863. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Fixtur e Bat h Hal f 1. 0 Garag e Detache d 198. 0 Porc h Sla b Roo f Cei l 

### 160. 0

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