TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: (34 7 Date: (^/^^[G^ 

Address: 4l4 0 S / 3 Str£^ f 

Remediation Conlractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS Year: 2008 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

B ^ Video of property (DVD) ['WoTg, ol^ ^ 

0 Executive Summary 

y Signed Access Agreement for subject property 

y Painting Agreement 

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

D Photographs i>^f ^ QJ^JTy Satisfactory restoration signed by Property Owner 

y Property close-out check list signed by EPA 

y Property information from Douglas County Assessor's Office 

VUt/n-oJ 

Ignature cC Dat Date

e 

40316320

iliill 

Superfund 
PROFESSIONAL S 2505 North 24"\ Suite 219 I ENVIRONMENTAL ENGINEERS, INC. Omaha, NE 68110 

(402) 504-4688 "Providing cost-effective environmental solutions" Fax (402) 504-3281 

Consulting • Engineering Design • Rcnaediation • Abatement • Emergency Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

SAID# 1347 

4740 S 13 St 

• Dates worked 11/10 to 11/11 2008 

• House paint ad structure was in very poor condition and had paint with red, white, and blue 

colors. Owner had the color changed to white and grey colors. The house has painted 

asbestos siding and was damaged in areas. The gutters and soffit were deteriorating and in 

very poor condition. Owner had took out a window and covered it with wood that was 

painted over. 

• Inspected 10/02, Returned to re-scrape front steps. 10/03 issues resolved 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"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) 

/JV7 SAID: 

Property Address: y/^^ S. / J ^ ^ 

Owner's Name: /Tl/'^I^Ct tg / L h /y^e^- ^ 7X 

Performance Standards/Close-Out Criteria 

2505 North 24 ^ Suite 219 

Omaha, NE 68110 

(402) 504-4688 

Fax (402) 504-3281 

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

^ garages. 

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

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

two top coats? V

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

5. Are all of the 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 surrounds the structure(s) in reasonably good condition? V"^ 

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

barrier tape, etc. properly removed? r 

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 

K that need to be moved back? 

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

been left unresolved? 

Comments: 

Property Owner Signature -= ^ C 

Professional Environmental'Mgineers Representative 

/2- -E~c)t 

Date 

J 2 ' D'^ F 

Date 

X 
PROFESSIONAL 

2505 North 24'^ Suite 219 ENVIRONMENTAL ENGINEERS, INC. Omaha, NE 68110 

(402) 504-4688 "Providing cost-effective environmental solutions" Fax (402) 504-3281 

Consuiting • Engineering Design • Remediation • Abatement • Emergency Response 

EPA Close-Out Form 

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

SAID: l^M 7 

Property Address: m^ o S­ 1^ s^ 

Owner's Name: 

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, 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 of the structure(s) primed as needed and painted with 

. ^ two top coats? 

4. Was the paint products utilized equivalent to a 30 year product/quality? i ^

5. Are all of the areas where contaminated materials have been spilled thoroughly y 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 surrounds 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 the contractor 

i y that need to be moved back? 

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

been left unresolved? y 

Other Considerations/Property Owner Discussions/Additional Work that is Required: 

y^/or 

iPA COR Signature 
CONSENT OFR ACCESS TO PROPERTY 

OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID: /3V 7 PROPERTY ADDRESS: ^7^ 0 S, /3 J/ 

OWNER NAME: 

P(\ l cWxe^V AJ I ^ ^^ ^ '^^ ^ DAYTIME PHONE: 

CELL PHONE: E-MAIL: 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME IF APPLICABLE: 

DAYTIME PHONE: 

CELL PHONE: 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 work is being done to protect the soil cleanups that were 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 will 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 outlined 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. 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 

concerns that I, as the property owner, may have regarding soil cleanup at my property. 

I fully understand that by signing this Consent for Access, (1) this access will 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 of the LBP stabilization actions, and (8) will participate in flnal 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 Pauletta France-lsetts, 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). 

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

"Renovate Right, Important Lead Information for Families, Child given the pamphlet "Renovate Right, Important Lead 

Care Providers, and Schools." Information for Families, Childe Care Providers, and Schools." 

signature Signature Date 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
L 

Confirmation Of Receipt Of Lead Pamphlet 

BVID 

PROPERT/ ADDRESS ^/4^ ^ ^ - / 3 S ^ ZIP CODE 

PROPERTY ADDRESS OF OWNER IF DIFFERENT THAN PROPERTY BEING PAINTED: 

PROPERTY ADDRESS ^ZIP CODE 

I have received a copy of the pamphlet, Renovate Right: Important Lead Hazard Information For Families, 

Child Care Providers And Schools informing me of the potential risk of the lead hazard exposure from 

renovation activity to be performed on dwelling unit. I received this pamphlet before the work began. 

^41^^Art. /} kjfuffh-r^^Tt \ ^ i\l ^A r 

PRINTED NAME OF RECIPIENT L) QATE 

Self-Certlficatlon Option (For Tenant-Occupied Dwellings Only) 

If the lead pamphlet was delivered but a tenant signature was not obtainable, you may check the appropriate box 

below: 

y Refusal To Sign - 1 certify that I have made a good faith effort to deliver the pamphlet, renovate right: important 

lead hazard infonnation for families, child care providers and schools; to the rental dwelling unit listed above 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 occupant. 

D Unavailable For Signature - 1 certify that I have made a good faith effort to deliver the pamphlet, renovate right; 

important lead hazard infomiation for families, child care providers and schools, to the rental dwelling unit listed 

below and that the occupant was unavailable to sign the confinnation of receipt. I further certify that 1 have left a 

copy of the pamphlet at the unit by sliding it under the door or somewhere on the premises. 

PRINTED NAME OF PERSON CERTIFYING AHEMPTED DELIVERY DATE AND TIME LEAD 

PAMPHLET DELIVERY 

SIGNATURE OF PERSON CERTIFYING LEAD PAMPHLET DELIVERY: 

Note Regarding Mailing Option - as an aitemative 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). 

CONFIRMATION OF RECEIPT OF LEAD PAMPHLET 08/08 
PAINT STABILIZATION PRE-PROPERTY ASSESSMENT 

PROPERTY ADDRESS: DATE 


Rvin 


PUVNT & PERMANENT LANDSCAPING TO BE REMOVE? NO [^3 YES r 

IF, YES WHERE: 

PRE-EXISIING CONDIIION OF FOUNDATION/STRUCTURE, i.e. BASEMENT LEAKING? 

i Nn

O I 1 VBYECS I 1 TE VBCUfUBDC- IF, YES WHERE: 

EXISTING PAINT ON WINDOWS, DOORS, FOUNDATION, SIDEWALK,( I.E.)? N0| 

YES [I ^ IF, YES WHERE: 

VISUAL DESCRIPTION OF PROPERTY/STRUCTURE/GARAGE, (I.E.): (USE BACK SIDE IF 

NECESSARY) 
PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS .- V7y^ S /,5 .5^ DATE 

BVID -

AREA(S) TO BE PAINTED: 


HOUSE PROPER: COLOR 


HOUSE TRIM COLOR 


GARAGE COLOR 


GARAGE TRIM COLOR 


PORCH COLOR. 

PORCH TRIM. COLOR 

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

I AGREE TO THE COLORS LISTED ABOVE. ONCE PAINTING BEGINS, I 


UNDERSTAND I CAN NOT CHANGE THE ABOVE SELECTED COLORS: 


PROPERTY OWNER SIGNATURE: PE ACCESSOR SIGNATURE: 

lAfyuuU /)• UiA 

PAINT MATCH FORM 08/08 
CV Services 

Property Address ^7//67 5 73^- ^ Date 

Start Date // ~ /o^'^O^ Complete Date / / 

Prime (Gallons) 

Poly (Boxes) 

Paint (Color) 

Paint (Color) 

Paint (Color) 

Paint (Color) 

Paint (Color) 

Amount Of Prime And Paint Used 

2. Amount (Gallons) 

Amount (Gallons) 

Amount (Gallons) 

Amount (Gallons) 

Amount (Gallons) 

/ 

^ 

^ 
Douglas County Account Information Page 1 of 3 

I 

Douglas County, Nebraska Property Record - R1719200000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 90th St - VIe W OM Ma p Information is valid as of 2008-9-4 Treasurer's Tax Report 

New Feature -•->- > Auto Sales Search 

Owner 

WILBERGER MICHAEL D 

ETAL 

3362 TAMIVIY ST 

BELLEVUE NE 68123-0000 A<=\\- (a\'3P\ 

Property Informatio n 

Key Number: 1920 0000 17 

Account Type: Residential 

Parcel Number: 1719200000 

Parcel Address: 4740 8 13 ST 

OMAHA NE 68107-0000 

-+- Legal Description: MAXWELL & FREEMANS ADD LOT 8 BLOCK 3 40 X 120 

Value Informatio n 

2008 

2007 

2006 

2005 

2004 

2003 

Land 

$5,600.00 

$5,600.00 

$5,600.00 

$5,600.00 

$5,600.00 

$5,600.00 

Improvement 

$62,200.00 

$62,200.00 

$50,400.00 

$50,400.00 

$50,400.00 

$39,700.00 

Total 

$67,800.00 

$67,800.00 

$56,000.00 

$56,000.00 

$56,000.00 

$45,300.00 

Sales Informatio n 

Sales Date: 2004-03-15 

Deed Type: WD Book: 2004 Page: 033986 

Price: $38,000.00 

Grantor: Monument Street Funding II LLC 

Grantee: Micliael D Wilbarger 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 2004-01-29 

Deed Type: TRD Book: 2004 Page: 015083 

Price: $57,864.00 

Grantor: STEFFI SWANSON TR 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R17... 11/5/2008 
Douglas County Account Information Page 2 of 3 

Grantee: MONUMENT STREET FUNDING II LLC 

Valid/Invalid: \ invalid 

Exclusion Reason: i Foreclosure 

Sales Date: 1997-10-09 

Deed Type: Book: 2077 Page: \ 669 

Price: $45,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.11 4800.0 1.0 120.0 40.0 No 

Improvemen t Informatio n 

Building 1 

$«caiieFioer 

2?2t^ R 

aw 

M « 

( f t 

M * i WB- ' 

Si^ 

m 1 l,Q Story 

&s«M ita * £ ft 

»6JS». «. 

iM0ir-'-M^^ MMfrii 

lilW*l.l*«[.MIM»,Wt^.!li.'t.'<.M.-IAU.l:. *«#». <^t^m»m^ CLICK TO ENLARGE IMAGE 

! CLICK TO ENLARGE IMAGE | 

Square Footage: | 1028.0 Percent Complete: i 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywail Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=R17... 11/5/2008 i