TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: )3lplo'^ Date: 44 o^ 

Address: 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

y' ^ Video of property (DVD) 

^y ^ Executive Summary 

^ y Signed Access Agreement for subject property 

(H Painting Agreement 

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

Q-/^ Photographs 

[B^^ Satisfactory restoration signed by Property Owner 

n Property close-out check list signed by EPA 

^r Property information from Douglas County Assessor's Office 

HI—^ confirmation that lead pamphlet "Renovate Right" was received by P0_ 

D 

D 

D 

Engineers Signature ^ ^ 

y^Jt-/t^}^Jyi44rf,. \i^7£ tl*A Signature ' D'ate 

30094375 iiiiiii 

Superfund 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. ''° ' ""ZZMEVUI 

"Providing cost-effective environmental solutions" ^ |^°^| l?!t't^l^. ^ Fax (402) 504-3281 

Consulling • Engineering Design • Rerneamlion • Anaiement • Frnprcjcncv Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2009 

SAID# 12667 

3914 S 9 St 

• Dates worked: 07/06 to 07/06 2009 

• Pre property condition: House has vinyl siding with wood trim that have flaking paint, 

wood porch floors and trim were all in poor condition. Paint chips in yard. 

• Problems encountered: N/A 

• Owner request/concerns: None 

• inspection/closeout dates. Owner signed 07/27 2009, inspected by i*E project manager. 
PROFESSIONAL 

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

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

Consulting • Engineering Design • Remediation • Aliaiement • Emergency Response 

Property Owner Close-Out Form 

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

SAID: IQlolo ^ 

Property Address ^qiH s. q .-sf 

Owner •sName: Pen-Cf" . 5>ri ^ I'.pO n,"^fc y 

Performance Standards/Close-Out Criteria YES NO 

1. Was the entire structure(s) painted with the exception ofthe 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? -y 3. Were all required areas ofthe structure(s) primed as needed and painted with 

two top coats? 

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

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

vacuumed/ cleaned? i / 

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 tX 

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, 

barrie ^ r 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? ^ 

11. Are there any (known) lingering issues with the property owner(s) that have i ^ been left unresolved? 

Comments: 

1k-\^g'^ 

Property Owner Signature Date 

Professionaial l EnvironmentafEngineer t s Representative Date ^ 
»iC S :2 /00 2 

07/01.'2C0 5 

CONSENT FOR ACCESS TO PROPERTY 

OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID: /^( ^ U ~] PROPERTY ADDRESS: 2m^.^S73^i^ 

L ^ l 

CELLPHONE: (jj^^7 ^Z^^(6 ^ E-MAIL: ^ 

OWNER'S ADDRESS IF DIFFERENT: _^_ _ 

TENANT'S NAME IF APPLICABLE: 

DAYTIME PHONE: 

CELL PHONE: E-MAIL: 

Professional Euvironmental Engineers. Inc. (P£) is under contract (#EP-R7-08-06) with the U.S. Environinental Pratection 

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 are being performed by EPA contractors. 

Paint stabilization activities will include: scraping ofcracked or flaking LBP from structures, application ofa 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 ou the propert>' identified above. 

By signing this document I agree to> allow an EP.'V contractor to conduct a soil cleanup at my property following completion of 

lead-based paint stabili2ation, if the soil cleanup has not already been performed. 1 understand that the stabilization contractor 

- <all-1ro^p^avide assurances'that-thcTioil cieanup-contmctor wHi be^ bound to. I firrttrer~Ilnder.nan(l that the soiTcleanup 

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

ray promrrty. 

n/kk 

Date 

I fully understand that by signing this Consent for Access, (I) tfais access will remain in effect until the work has been 

satisfactorily completed, (2) that tbe 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 

School.«", (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 widi 

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

Property Owner Satisfaction Surveiy. 

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 402-5(M-468S. General questions about the Omaha 

Lead SHe cleanup can be directed to Pauletta 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, I grant access to my property and was given the pamphlet D No, ido not grant access to my property and I was 

Renovate Right, Important Lead Infonnation for Familie$, Child given the pamphlet "Renovata Right, important Lead 

Provideis, and Schools.* information for Families, Childe Care Providen, and Schools.' 

"l/ljol 

Signature \ C I Date Slgnahire Date 

SPECIAL INSTRUaiONS ANO CONSIDERATIONS 
PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS: _ 39/ ^ X y - DATE: 

HOUSE PROPER:. 

HOUSE TRIM: 

GARAGE: 

GARAGE TRIM: 

PORCH: 

PORCH TRIM: 

(COMPLETE 

AREA(S) TO BE PAINTED: 

COLOR: 

COLOR: 

_ COLOR: _ 

_ COLOR: _ 

_ COLOR: _ 

_ COLOR: _ 

BVID: /^////f ^ 

pnaidlo 

f 

— 

r ^ ^ 

L y 

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 
Douglas Coimty Accoimt Information Page 1 of3 

• =fr |2UU'> 

Douglas County, Nebraska Property Record - R2346970000 

Print Report 

NEW Feature - Parcel Dimensions available (S scale 0-50 ft west of 52nd St - VlO W O n Ma D Information is valid as of 2009-6-3 Treasurer's Tax Reoort ' 

New Feature -i^- * -* Auto Sales Search \ 

Owner 

SCHIPANSKY RENEE 

3916 8 9 ST 

OMAHA NE 69107-0000 

Property Informatio n 

Key Number: 4697 OOOO 23 

Account Type: Residential 

Parcel Number 2346970000 

Parcel Address: 3914 S 9 ST 

OMAHA NE 68107-0000 

Legal Description: VAN CAMPS ADD LOT 16 BLOCK 3 N 1/2 LTS 15 & 62.5 X 98 

Value Informatio n 

Land Improvement Total 

2009 $4,900.00 $89,300.00 $94,200.00 

2008 $4,900.00 $67,100.00 $72,000.00 

2007 $4,900.00 $67,100.00 $72,000.00 

2006 $4,900.00 $67,100.00 $72,000.00 

2005 $4,900.00 $47,100.00 $52,000.00 

2004 $4,900.00 $42,700.00 $47,600.00 

Sales Informatio n 

Sales Date: 2006-08-14 1 

Deed Type: WD Book: 2006 Page: 093457 

Price: $97,000.00 

Grantor HAIZLIP JON R ETAL 

Grantee: 

SCHIPANSKY RENEE 

Validnnvalid: 

Valid 

Exclusion Reason: 

Sales Date: 2004-01-15 

Deed Type: WD Book: 2004 Page: 009235 

Price: $76,000.00 

Grantor 

Rose M Dworak 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R234... 6/9/2009 
Douglas County Account Information Page 2 of3 

Grantee: Jon R Haiziip etal 

Valld/lnvalld: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6174.0 1.0 98.0 63.0 No 

Improvemen t Informatio n 

Building 1 

1 1/2 FINISHED STORY 

» « S » ST 

[ First Floor 

r 858.0' '*« Second Floor t i'i 

S12.Cr 

BMttt C«K 8 « 

CLICK TO ENLARGE IMAGE ii£U&!L!i2i£Ilii£SSyS!£SL 

Square Footage: 1152.0 Percent Complete: 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 Vinyl Units: 1.0 

Interior: Drywali Baths: 1.5 

Roof Cover: Composition Shingle Bedrooms: 2.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1890 2006 0% 1919 90 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 858.0 

Basement Fair Finish 527.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoiintno=R234... 6/9/2009