## PAIN T STABJILIZATION FIL E FOLDE R 

# SAI D # : Z?>flQl 0 Date : /.^//7/fe ^ Address : Remediatio n Contractor : PROFESSIONA LENVIRONMENTALENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S Vide o o f piwpert y (DVD ) Executiv e Summar y SignedAcces s Agreemen t fo r

subject propert y Paintm g Agreemen t D 

## Settlemen t document s (i.e. , fo r

damag e o r

t o replac e plants , etc. ) Photograph s \k^/i , g/i A oJ^I ^ B ^ 

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

## Propert y close-out check lis t signedby EP A Propert y information fromDougla s Count y Assessor' s Office 

# y confirmation tha t lea dpamphle t "Renovat e Right " wa s receive db y P0_ 

# n D D



## Profession ^ Env^nmmenta l Engineer s Signatur e 

# m£ ^

EP A Signatur e 3005462 8 

# mmii i Superfun d

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC
. "Providin g cost-effectiv e environmenta l solution s " 

# ^'' ' ''olI^tN E es^J o ^ ^

jjjg ! 504-328 1 Consultin g • Engineerin g Desig n • Remediatio n • Abatemen t • Emergenc yRespons e



## LeadBas e Stabilizatio n Omaha , N e Clos e Ou t Report 200 9 SAID#2350 6 30 9 N . 35* " S t

•Date s worked : 10/1 7 t o 10/1 8 200 9 •Pr e propert y condition : Larg e painte dduple x wit hconcret e sidin g tha t wa s i n poo r conditio n an dcrackin g al l over . Porc han dtrim s ar e painte dwoo dan dals o i n poo r condition . Garag e ha s viny l siding . • Problem s encountered : Non e •Owne r request/concerns : Owne r wante dal l porc harea s t o matc hcolor s even thoug h the y wer e previousl y different . •Inspection/closeou t dates . Owne r signe d10/1 8 2009 . Propert y inspecte db y 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 • Abatement » 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 : "7J?S!501 O PropertyAddress : f^ Q V \?^ S .^ V Owner' s Name : ^^j ) \\ \CjlYY ] 0 "SjCphf.! ^ S Performanc e Standards/Close-Ou t Criteri a 1. Wa s th e entir e structure(s ) painte dwit hth e exception ofth e stated , excluded areas ? TW s wouldinclude paintin g of othe r

associate dfeature s includin g fascia , eaves , siding , all trim , porches , box beams , columns , rails , andexterior surface s of garages . 2. Was all scraping andothe r

preparatio n wor k

completedsatisfactorily ? 3. Wer e all requiredarea s ofth e structure(s ) prime d as neededandpainte dwit h tw o top coats ? 2 ^ 4. Was th e paint product s utilize dequivalen t to a ^ yea r

product/quality ? 5. Ar e all ofth e area s wher e contaminatedmaterial s have been spille dthoroughly vacuumed / cleaned ? 6. Didth e contractor collect/vacuumall falling andscrapedpaint chip s on th e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e an y othe r

generateddebris ? 7. Is the gras s are atha t surround s th e structure(s ) in reasonably goo dcondition ? 8. Ar e all item s suc h

as polyethylen e sheeting , ladders , paint brushes , cones , barrie r

tape , etc . properly removed ? 9. Is ther e an y evidenc e ofpropert y damag e tha t wa s done by th e contractor ? An y propert y damage need s tobe 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 d by th e contractor tha t nee d

to be movedback ? 11 . Ar e ther e an y (known) lingerin g issue s wit hth e propert y owner(s ) tha t hav e been lef t unresolved ? Conunents : v/ r

/% . i , . , t Omaha , NE 6811 0 (402 ) 504-468 8 Fa x(402 ) 504-328 1



## YE S NO
/ 1/ 

# J

• f 

# J / 

# J J / 

### il



## if 

# i^c^f-ig ; uo ^ ronert v Siimatur I Propert y Owne

Owne r r

Signatur e e Dat e 

# / ^ - / 

# T^ d^ ProfessionaTfenvironrnfenta l Engineer s Representativ e jnalEnv i Dat e

## Oct . 2 . 200 9 5:43P MC UPHILOSOPH YNo , 012 2 P . 1 

# CONSEN T FO R ACCES S T O PROPERTY OMAH A LEA D SIT E jREMEDU LACTIO N - LEAD-BASE D PAIN T STABIUZATIO N PROPgRTVlD : ^'^SO t t PROPERT Y ADDRESS ; S0?-3l l NJ . 3 S+ ^ 5•^ . OWNER ] 

### W'llifr ^ S'hi>J>l\ejn S DAYTIM E PHONE : fe< 2 ) 2g0-2.£,32 . CELLPHONf c 0H)l)nt'i3fl ! E-MAIL: ^ tpK^V S (gcrfrlgUoy\ , tf^^j OWNER' S ADDRES S I FMFFEReNT : 35l S L^JKr^-t^ C /\yt * STFH^^^J^/^"^^^"''^^ * 

## t^ft<y''^'»DAYTIM EPHONE : 6g3^ ) IS^'- f 70 g 

# ^5S^^i£5MlM5 8 E-MAIL : PrtiMfioRa l Eavironmenta l Engincen » Ine . (PC ) to unde r contrac t (#EP-R7-08-0( ) wit htb e ULS . Environmeata l ProCMtio a Agenc y (EPA ) t o stabilis e lendbase dpain t (JLBP ) o n residential atrBCture i a t anHnbe r o f propertie s locate dl aOAtha , NebrMka . Tb e pain t stabilizatiO B wor k I

f bein g don e t o protec t th e lol l cteanup i dit i ar e bein g perfbrnc db y EPA contrector h Faul t atabillzatio n activitie s wil l include : serspio g o f cracke do r flaking LB P fremvtruetures , appUeatio n e f aprin aeoa t an dtw o Q ) coBt i of pain LMovin g pan s o f windov n an ddoo n iQjis t locludMi an dwil l no t b e addreued . You r fsioperatio n i s requeite di n givla g perminlo n t o tb » £P A cmtriicto r (PE ) t o inte r an dhav e iccei s t o tb b propert y fer th e parpoi e o f stabiiiztn g Icft d-taic dpain t a s outline don th * proptrt y idcnilfle dabove . B y tignin s thi s documen t I agre e t o allo w a n RP A contneto r t o conduc t asoi l clcinu p i t m

y propert y fbllowhi g eonpledo n o f te«d4Msedpala t stabiliathMi , I f th e w U eltanu p h u no c alread y bee n perbmed . 1 uadentaa dthi t th e etabilintio n ciostnMto r ca n no t provid e assunnec s tba 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 eJeanup contracto r wil l mak e al l reasonabl e effort s t o addr« H coocen u tba t 1 , a s th e propert y owaer , ma y hav e regardin g loi l duaop a t n y property . H y«a,lharaM d aaiMunofPrsatityOMM f ' Dal e I fkill y uderstao dtha t b y iignin g tbi s Consen t for Access , (1 ) thi s acces s wil l remai n in effec t unti l th e wor k ha s bee n sadiflictorU y completed , (2 ) tha t di e Propen y Owne r o r Tmani « i f appUnbl* , will b e give n tb e Houio g an dUrban Devekipncn t (HUD ) an dEPA pamphlet , ^Reaovat e Right , Importan t Lea dHatnr dinfonMilie afar Famiiice , Dia y Car e Providers , aa d Schools' , (3 ) th e Propen y Owne r o r tenan t wil l remov e al l obstnictloo s firo msarftcs s t o b e painted , (4 ) wil l aMd * b y healt han d safety guidanc e pnnide db y EPA , (S ) wil l tlhn v photograph y ofpropert y befbr e an dafte r th e pain t iiabiliBtip n worii , (6 ) wil l b e contaew db y n F E representativ e approiimatd y 4 8 hour s i n advaw e ofstariio g worti , (7 ) agre e ne t l o obstruc t o r tampe r wit h an y ofth e LBPstabilintlo n actwns , an d(8 ) wil l participat e fai fina l propert y in«peeilon an dsig n th e Compledo aAgreeinen t m d Proper^ r Owne r Satiilbetio n Snrvey . Shon U yo ahav e an y question s abou t th e plJac dLeadBascdt-Pihi t stabUintlo o aaivitle s fo r yoo r property , pleas e contac t Pvoteslaoa l Environmenia l Cngtnecrs , IncProjec t Maaager , Willi e Cb y A t 402-504-4688 . Ceaera l question s abou t th * Omah a Lea dSit e cleann p can b e directe dt o Panlett i France-iitttS i EPA Remedia l Projec t Manage r 402-73t^ H o r th e BPA Publi c InfbnnatM n Center s a t 402>99l*9Sg 3 (NorthOmah aofffee ) o r 402-731-304 5 (Sovt hOmah aoffice) . . B Yaa , IBim t eee w t em y prepsrtHiiiii l wa s ^Ym t ti t ismphlse 0 Ntt,ldeiMtgniitaeeaeateniypi«p«rty«ndlM a give n thepsoipMat'IbMOvst B Righ ^ bnporlan t Laa d iBtaimittei i kifvaXm , CMM * Ca nPmddara, sn dkbeols. "

mniiaiii n I 'IW s atgnahir a' 'Dm e Bignaii mDate . SmaU . MSTKUCnON S AN D CONSIDERATION S v

## Oct . 2 . 200 9 5:43P MC UPHILOSOPH Y ^0.012 2

P. 2 PAIN T STABILIZATIO N PRE-PROPfiRT Y PAIN T MATC H ASSESSMEN T PROPERT Y ADDRESS : 36?-31 1 ^.35 ^

SfpATB : /9ci ^ Z , Jgg ^ 3 0 f aJ i 3l\^lklViv-Frfji l S^veg f BVlD:
.

AREAfS ) TO B E PAINTED : HOUS E PROPER : 

# H B l COLOR : 

# [/jkr-h ^ ^OC aA

H0U9ETRIM : 

# •^£ S COLOR : 

# uikr- k GARAGE : W<^ ' yiVs/ l Sp-rflV j COLOR:
. OARAQ ETRIM : \^* > W 

## COLOR : Uyk\^4 ^ 

# VE ? 

# ruu^ ) c^^- . nR.A ^ 1 . gyt PORCH : ' 

### (


### PORC H TRM: . 

# :i& s COLOR : lAVKr-fe ^ (COMPLET E AL L SECTION , YES , NO , O R NON-APPUCABLE ) 

# \h;c-^ V Q^ V 9nrc K \x^c\ur7.c.cy ^ b(\^iA03A} M I AGRE E T O TH E COLOR S LISTE D ABOVE
. ONC E TH E PAINTIN G BEGINS , I UNDERSTAN D 1 CA N NO TCHANO E TH E ABOV E SELECTE D COLORS : PROPERT Y OWNE R SiONATUREs P E ACCESO R SIGNATURE : 

# ^>J^y<y^Ms
. ^^^y^

• M M \

### £)pugla s County Accoun t Informatio n Pag e 1 of 3 Dougla s County , Nebrask a Propert yRecor d - R130446000 0 Prin t Repor t NE W Featur e - ParT:e l D(mension s availabl e @ scal e 0-S O f t wes t of 52n d S t - VJO W O n Ma P j Informatio n i s vali d a s o f 2009-9- 3 Treasurer' s Ta xRepor t Ne wFeatur e ->->- • Aut o Sale s Searc h 

### Owne r STEPHEN S WILLIA M O 351 5 LAFAYETT E AV E OMAH AN E 68131-133 8 

# 341A
- 2>G2> H 

# i/inscj-qb.^
- Propert yInformatio n Ke yNumbe r Accoun t Type : Parce l Numbe r Parce l Address : Lega l Description : Valu e Informatio n : Lan d 

### 200 9 ' 200 8 

### ^ 200 7 

### ' 200 6 

### A 2005 1 200 4 Sale s Informatio n Sale s Date : Dee d Type : Price : Granto r Grantee ; Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : • 044 6 000 0 1 3 Multipl e Re s 130446000 0 30 9 N 3 5 S T OMAH AN E 68131-000 0 HAWTHORN E AD D LO T 1 7 BLOC K3 5 0 X 13 6 Improvemen t Tota l 

### $6,500.00 $6,500.00 $82,900.0 0 $82,900.0 0 $89,400.0 0 $89,400.0 0 - H 

### $6,500.00 $51,500.0 0 $58,000.0 0



### $6,500.00 $51,500.0 0 $58,000.0 0 $6,500.0 0 $51,500.0 0 $58,000.0 0 $6,500.0 0 $51,500.0 0 $58,000.0 0
2003-06-0 2 Q C Book : 200 3 Page : 14406 3 $0.0 0 Lis a Simnn s 

### ' A Willia m Stephen s invali d Famil ySal e 1991-08-1 5 D Book : 191 1 Page : 65 5 $51,500.0 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R13. . . 9/11/200 9

### Dougla s County Accoun t Informatio n Pag e 2 o f 3
Grantee : Valid/Invalid : vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 5 6800. 0 1. 0 136. 0 50. 0 N o Improvemen t Informatio n Buildin g 1 

### TW O STOR Y B««B.,c.B n Duple xMM«s F 309N36 a

Firs t Floo r Secon d Floo r I " " BIM. D s F a U DS F

9libnfWlitC>i4r u

M M I
CLIC KTO ENLARG E IMAG E CLIC KTO ENLARG E IMAG E Squar e Footage : 1788. 0 Percen t Complete : 100.0 % Perimete r0. 0 Quality : Averag e Uni t Type : En d Condition : Averag e

Buil t As : Duple xTw o Stor y Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 10. 0 Exterior : Fram e Stucc o Units : 2. 0 Interior : Drywal l Baths : 2. 0 Roo f Cover : Compositio n Shingl e Bedrooms : i 4. 0

Roo f Type : Gabl e Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 192 5 0 % 192 5 8 3 Defa/ 7 Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 864. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 2. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RI3. . . 9/11/200 9

## 16I T PropertyAddres s r^rf i K ) ? ) 5 ^ S "f " Dat e _ StartDat e ic ) / S U O " J EndDat e ICD/S^/Q' ^ 

## Amoun t O f Prim e An d Pain t Use d Prim e (Gallons ) t? ^ ^rr^ ( Pol y(Boxes ) 3 A n Xi > Q Pain t (Color ) \ X ) U I f ^ Amoun t (Gallons ) D o & ^

I Pain t (Color ) ^Qtf M /rlrA V Amoun t (Gallons ) 3 ^ ^ / Pain t (Coior ) Amoun t (Gallons ) Pain t (Color ) Amoun t (Gallons ) Pain t (Color ) Amoun t (Gallons )

## Oct . 2 . 200 9 5;51P MC U PHILOSOPH Y No . 012 3 P . 2 

# CONSEN T FO R ACCES S T O PROPERTY OMAH A LEA D SIT E REMEDIA LACTIO N - LEAD-BASED PAIN T STABILIZATIO N FROFfRT Y ID : PROPERT Y ADDRESS : SO^-31 1 fsj . 3 5"* ^ Sj^ . ^^??uSl v S-h^^k^Jn S DAYTIM E PHONE : fi^2) 2gO-2&,32 . CELLPHONE
. froOfSl-i3fyISMAIL : 

### Stf>kflS&creii^ki6!(\.^d u OWNER' S ADDRES S IFmFFSMST : 3 51 5 LO-J^-^ii c A^^ ' 

## „ . (PiWAAiL , KJ S ^Si%J7t33 8 TENANT' S NAM E IFAPPLICABLE: , /'ii'- > /' ^ A > o 2<to k Fr-^zyrta< r 3ftt^ ^ t^^«t»»*^->DAYTlM E PHONE : (^3b ; 18^ " r/O ^ CELLPHONf c C^O^Jb^1 " 6 T 5 O E-MAIL: PrefasislosA l Eavironmenta l Engineers , In c(PC ) is unde rcontmc t (#EP^R7-0S-0 O wit b th e VS
. EaviraaBieBia l Pntaetm i Aeeac y(EPA ) t o siabilic e toad base d palp t (LBP ) o n resideBtia l atnictiira s a t a narnhc ro fpropertie s locate d h i OsMiha , Nebraska
. Tb e pala t stabiUzado n wor k Is bein g doo ct o protec t th e sol i cleadu| M tha i ar e beia g perfbnae d b yEP AcoatraciDrs
. Pain t stabillzado D activitie s wU I include : scrapia g o f cracks d o rflaking LB P tn m stmctares , applicatto a of a prba e coa t aa d tw o (2 ) c o m o fpain t MeviB g pa m o fwbidow s an d door s ar e wo t loclvdc d an d wil l no t b e addressed
. You rcoepenitio B I s requeste d I n livin g permlsslO B t o thi s EP Acoatracto r(PE ) t o ente ran d hav e acee n t o thi s propert yIb rth e parpos e o fstabilbtn g lea d -base d pain t a s outline d o n th e propert yidentifie d above
. B ys^fa vthi s documen t I ngre ct o allo wa n RP Acontneto rt o conduc t n soi l cleanu p a t m ypropert yfolktwin g completio n o f lead-bafc d pain t stnbilintiOB , I fth e soi l cleanu p ha s no t alread ybee n perfonned
. i understna d tha t th e stabiiiatin n eoatnido r cn n no t provid e assurance s tha t th e soi l cleanu p contracto rwil l b e bonn d tft
. I hirtbe rundentan d tha t th e soi l elennu p contracto rwil l mak e ni l reasonabl e eflbrt s t o addres s concern s tha t I , a s th e propert yowner , ma yhav e rq^ardln g soi l rieaaap a t 010

^ property . 9 Yes
. I hs M IM d I OgMitprtofPraiMrtSrOMH f ' M e I full yunderstan d tha t b ysignin g thi s Consen t forAccess , (I ) tiii s acces s wil l remai n in effec t unti l tli e wor k iia s bee n satisfhctoril ycompleted , (2 ) tha t th e Propen yOwne ro rTenant , i fapplicable , wi n b e give n tb e Hoosin g an d Urba n Deveiopnen t 01UD ) an d EP Apamphlet , "Renovat e Right , iBiporian t Lea d Hixnn l infemiaiio n fo rnunilias
. Da yCir e Providers , an d Schoob" , (? ) tb e Propert yOwne ro rtenan t wil l remov e ni l obstruction s tn m surfsce s t o b e painted , (4 ) wil l abid e b yhealt h an d mflttj rgnldane e provUe d b yEPA , (5 ) wil l ilio wphotograph yofpropert ybclbr a an d afte rth e pain t stabiliatw n work , (6 ) wi U b e contacte d b ya P E representativ e approximatel y4 8 hour s I n advanc e u fstartin g werk , (7 ) ng m no t lo obslrae t o rtanpe rwit h an yo fth e LB P stabllimtio n actions , an d (1 ) wil l participat e I n fina l propert yIh^peeiio n en d sig n th e Completio n Agreemen t an d Propert yOwne rSntlffhetfe n Survey
. Shon U yo n hav e an yquesthm s abou t th e plane d Lea d Based-Pain t stnbiliiatio o nctivltie s fo ryon rpropeny , pleas e contac t ProfmsionB l Eovironmenca l Engineers , Inc
. Projec t Mnonier , Willi e Cb yA t 402404.468& I Cenen l qnestion s nbou t th i Omah a Len d St e cknnn p ca n b e directe d t o Pantett t France-lsetts , EP ARemedia l Projec t Mnnnge r402-731-0454 , o rth e EP APnbi k Infftfmatto a Cente n a t 402>99f*9SS 3 (Nort h Omah a offlce ) o r402-731-304 5 (Sout h Omah a office)
. ^ L 

### P/e«i e raw / + U pa.»»».phl ^ ff i K y\\3&rr ^

ojuitti s Cahovej , M YeS,iiWWe8esseloinafprBpsitnsn4<WS|i»in(IH>>wphl M D IfoildenatgniitKCBBtoraypniief^aadliia B »sHnniiinrHninits,niii i olvsnntpsnipiMKMwmtonBhtliiipmtMtlsM l InfenMlle n tD rPsmidss ; Ch M Ca m PioridanMn d Sdieob. "

Wlmmmttt LI 'IW . SUgBthii f' 'DM B SIgnsb m Dsts
. SPECIA L INgmUCnON S AN D CONSiDERAIIO m

## Oct . 2 . 200 9 5:52P MC U PHILOSOPH YNo , 012 3 P. 3 PAIN TSTABILIZATIO N PRE-PROPgRT Y PAIN TMATC H ASSESSMEN T PROPERTYADDRESS : 30? ^ 31 1 Ki.35 ^ S^l^ATE : gc;f
. 2. , Iglg ^ 

# 50 f « ^ 31i^'^)Vfy-Frf-f ^ S-fveg P BVID :


### AREA(3 ) T O B E PAINTED : HOUS E PROPfiK:
. 

# i£ ^

COLOR ; 

# wkr-h ^
HOUS E TRIM : 

# ^ £ ^

.COLOR : 

# uiUr- ^
GARAGE : 

## Kf t ' VlVv/ l SrrflV j COLOR : 

## OARAO E TRIM : \e ^

i P COLOR : U/K^-) ^ 

# M£ g Ci^iAr ) ^^ . nuTT f PORCH:
. PORC H TRIM : ^^ ^

COLOR : ^\\)+<L
. (COMPLET E AL L SECTION , YES , NO , O R NON^PPUCABLE )


## I AGRE E T O TH E COLOR S LISTE D ABOVE
. ONC E TH E PAINHN Q BEGINS , 1 UNDERSTAN D I CA N NO TCHANG E TH B ABOV E SELECTE D COLORS : PIVSPCRtY OWNE R SIGNATURE : P E ACCESO R SIGNATURE :



# ^^L^C^MA
. y^i^ ^

## Oct . 2 . 200 9 5:51P MC UPHILOSOPH YNo , 012 3 P. 

# FA X r s 3 fAQES Date : Ocjtobe r

2,200 9 To : Professional Environmenta l Engineers , Inc . 250 5 N . 24 * St . Omaha , N E 6811 0 

# Fax:(402)504-328 1 From : WilliamStephens , Ovme r

o f

309-311N . 35^ ^St . Daytim e phone : (402) 280-263 2 Subject : EP APaint Stabilizatio n Consen t fo r

Acces s t o Propert y 

# Comments : Pleas e mai l th e pamphlet "Renovate Right , Importan t Lea dInfomiation... " t o m y hom e address : 351 5 Lafayett e Ave . Omaha , N E 68131-133 8