### TRANSMITTA L of OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL EFOLDE R 

# SAID# : SlSP ^ Date : 1-'Q.O'0 ^ Address : Q^-Df i S ^ <A^= ^ AjQ ^ Remediatio n Contractor: PROFESSIONA LENVIRONMENTA LENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S 0^

^ Vide oof propen y (DVD ) tJ ' Executiv e Summar y Q ^ Signe dAcces s Agreemen t fo r subjec t propert y
• Q'''' ^ Paintin g Agreemen t D Settlemen t document s (i.e. . fo r ddmag e or to replac e plants , elc. ) ^ Photograph s E-y ^ Satisfactor y restoratio n signe d by Properly Owner Uy"" ^ Propert y close-ou l chec k lis l signe d by EP A ^y ^ Propert y informatio n fro mDougla s Counl y Assessor' s Offic e [ly'' ^ _conrimiatio n tha i lea dpamphle t "Renovat e Right " wa s receive d by P0 _ B 

### " ^ 

### ^ " ' lAuAu T D 

## n

Professional Environmental Engineer s Signalure Dal e

hP A Signature Dal e '

0 Superfun d /\ '

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . ''' ' Ta' t NE'?8?! O "Providin g cost-effectiv e environmenta l solution s " ^^ ^

jj° | H^Hf^ Consultin g • Engineerin g Desig n • Remedialio n • At.iaternen t • Emeigenc yRespons e



### Lea dBas e Stabilizatio n Omalia , Ne Clos e Ou t Repor t 200 9 SAID#212 8 270 8 N 4 5 Av e

•Date s worlied : 07/07/0 9 t o 07/09/0 9 •Pr e propert y condition : Woo dsidin g witl i pain t in poo r condition , pain t chip s aroun d tii e iious e an dgarag e areas . •Problem s encountered : Non e •Owne r request/concerns : N/ A •Inspection/closeou t dates : Propert y owne r signe do n 7-10 , EP A o n 7/14/09 . N o issue s

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

# ENVIRONMENTA L ENGINEERS , INC . Omaha , NE6811 0 (402 ) 504-468 8 

## "Providin g cost-effectiv e environmenta l solutions " Fa x (402 ) 504-.328 1 ConsLiltin Q ' Engineeriii g Desig n • Rcn"iedijitio n • Abaterrent ' Enio^gencyResponr. e 

## EP A Close-Ou l For m (Lead-Base dPaint Stabilizatio n EP A Contrac l EP-R7-08-06 ) 

## SAID : Q\S); ^ Propert y Address : 3(^0 ^ |V l M 5* ^ A/€ ^ Owner' s Name : Scoi V /\\\\^'^^^^^
- Performanc e Standards/Ciose-Ou t Criteri a YE S N O ] . Wa s th e entire slructure(s ) painte dwit hthe e.xception ofth e stated , exclude d areas ? Thi s woul dinclud e paintin g o f olhe r associale dfeature s includin g fascia , eaves , siding , all trim , porches , bo x beams , columns , rails , andexterio r surface s of ^ 

### garages . 2 . Wa s all scrapin g andother preparalio n wor k

complete dsatisfactorily ? ^ 

### 3 .Were all require darea s of th e struclure(s ) prime da s neede dandpainte dwit h 

## i X tw o to p coats ? 4 . Wa s th e pain t product s utilize dequivalen t t

o a3 0 yea r product/quality ? y ^ 

### 5 . Are all ofth e area s where contaminate dmaterial s hav e been spille dthoroughl y vacuumed / cleaned ? 

# y 6 . Didth e contracto r collect/vacuu mall fallin g andscrape dpain t chip s o n th e entire property , roadways , alleyways , publi c acces s area s andals o remov e any other generate ddebris ? y ^ 

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

### 8 .Are all item s suc ha s polyethylen e sheeting , ladders , paint brushes , cones , ^ 

### barrier tape , etc . properl y removed ? 9 . I s there any evidenc e o f property damag e Iha t wa s don e b y th e contrador ? An y ^ 

### property damag e need s t o b e complete dprio r to the EP A Close-Out . 10 . Ar e ther e any property item s tha t were temporaril y re-locate dby th e contracto r

- 

### tha t needto b e move dback ? 11 . Are there any (known ) lingerin g issue s wit hth e property owner(s ) tha t hav e y been lef t unresolved ? Other Considerations/Property Owner Discussions/Additional Wor k

tha t i s Required :



# %J7/ U 

# mk - EP A CO RSignature

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

# ENVIRONMENTA L ENGINEERS , INC . Omaha , NE6811 0 (402 ) 504-468 8 

## "Providin g cost-effectiv e environmenta l solutions " Fa x (402 ) 504-328 1 Consultin g • Engineerin g Desig n • Remediatio n • Abatemen t • EmergencyRespons e 

### Propert y Owne r Close-Ou t Fon n (Lead-Base dPaint Stabilizatio n EP A Contrac t EP-R7-08-06 ) 

# SAID : ?.|?ft
- Propert y Address : ^. ^ C^ ^ t^ y 9 H ^ ' V^ ^ Owner' s Name : ^SjQrVl T _ 

# ^^j.^.ri . Performanc e Standards/Close-Ou t Criteri a YE S N O 1 . Wa s th e entir e structure(s ) painte dwit hth e exceptio n ofth e staled , 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 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 ) prline da s neede dan dpainte dwit h tw o to p coats ? 

# •t y 4 . Wa s th e pain t product s utilize dequivalen t t

o 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 

# y vacuumed / cleaned ? 6 . Di dth e contracto r collect/vacuu mall fallin g andscrape dpain t chip s o n th e entire property , roadways , alleyways , publi c acces s area s andals o remov e any 

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

### 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 there any evidenc e o f property damag e tha t wa s don e by th e contractor ? Any property damag e need s l o b e complete dprio r to th e EPA Close-Out . 

# y 10 . Are there any property item s that wer e temporaril y re-locate db y th e contracto r that nee dto b e move dback ? 

# l y 11 . Are ther e any (known ) lingerin g issue s wit hth e propert y owner(s ) tha t hav e , 

### been lef t unresolved ? 

# y Comments :

n / ) c Proper|y^0wne r Signature Dat e 

# y-J o -o p 

# ild4 . Professfona' l Environmental Engineer s Representativ e Dat e^2-.4 9 17p. m 06-18-200 9 1 M AVANTA S dO.^-71''-7 , 

# o 2 5^ 4 CONSEN T OF RACCES S T O PROPERT Y OMAH A LEA D SIT E REMEDIA L ACTIO N - LEAD-BASE D PAIN T STABILIZATIO N PROPERTVrD ; ^ I j ^ PROPERTY ADDRESS : 2-^0 9 M
- H 5 " ^ AVe . OWNE RNAME : 

# SoiV r

^\\;so A DAYTIM EPHONE : ^ 8 0 " W2 Z j TELLPHONE : "S S f ) " 4 2- L 1 E-MAIL : ^ LO ^ Y 6-at.\\\'Loi\ ^ ^^W o . Co m OWNER' S ADDRES S I FDIFFERENT ; TENANT' S NAM EI FAPPUCABLE : DAYTIM EPHONE : rRMPHONR : E-MAIL : ProfeMtoiu I EBvlroameuts l Engineer* , la c (PE ) i s undt r contrac t (#£P-R7-08-0 ^ wit hth e U.S . EaviraumenU l Protectio a Agenc y (EPA ) t o stAbUiz e len dbase dpain t (LBP ) o n residentU ) ctructurc t A

t anunibe r o f propertie s loeitn l i n Omaba , Nebraska . Th e pain t stabilizatio n wor k i s bein g don e t o protec t tb e soi l cleanup s tha t wer e performe db y EP A contractors . Pain t stabilisatio n activitie s wil l include : scrapin g o f cracke do r finkin g LB PDro mstructurea , applicatio n o f apriq« e coa t an d tw o (2 ) coat s o f pain t Movin g part s o f window s an ddoor s ar e no t iuclnde dan dwil l no t l>

c addrtssad . You r cooperatio n i s reqaesto di n givin g penntssio n t o thi s EP A contracto r ^E ) t o ente r an dhav e acces s t o tb b propert y fo r th e pnrpos c o f stablUkln g lea d-baae dpain t a s outline do n th e prapert y identifie dabove . B y lignio g Uii s docuraen t I agre e t o allo w au EP A contracto r t o conduc t asoi l cleanu p a t m

y propert y followin g completio ao f tead-bitse dpain t sUbilization . I understan dtha t th e stabilizatio n contracto r ca n no t provid e assnranoe atlu t th e sol i claauu p contracto r wil l b e boun dto . I ftirther understan dtha t tb e soi l cleanu p contracto r wil l nuk e al l reasonabl e effort s t o addres s concem s tha t I , A S (h e propert y owner , ma y bav e regardin g soi l cleanu p « t m y property . I full y understan dtha t b y siffning thi s Consen t fo r Access , (1 ) thi s acxes s wil l r«niBi n i n etbc t unti l th e wor k ha s bee n satisfactoril y completed , (2 ) tha t th e Propert y Owne r o r Tenant , i f applicable , wil l b e give n tb e Housin g an dt/rba o Developmen t (HUD ) an dEP A pamphlet , "Renovat e Rigbt , Importan t Lea dHazar dinEormatio n fb r Families , Da y Car t Providers , an dSchools" , (3 ) th e Propert y Owne r o r (coan t wf l i remov e al l obstruction s fro msurface s t o li e painted , (4 ) wil l abid e b y healt han dsafet y guidanc e provide db y EPA , (5 ) wil l allo w photograph y o f propert y befor e an dafte r th e pain t stabilizatio n work , (6 ) wil l b e contacte db y aF E representativ e approximatel y 4 8 hour s I n advanc e o f startin g work , (7 ) agre e no t t o obstmc t o r tampe r withan y o f tii e LB Pstabilizatio n actions , MM I (8 ) wi Q participat e i n flu l propfirt y lospectlloi i an d sig n th e Completio B Agreemen t aa dPropert y Owne r Satisfactio n Survey . Shoul dyo n hav e an y question s aboo t th e plane dLea dBased^Paln t stabitizatio o activUk s fo r yoo r property , pleas e contac t Professiona l Envlronmeuta l Engiaeers , Inc . Projec t Masagej- , Willi e Cla y A t 402-504-4688 . Genera l question s abou t th e Oinah aLea dSi U cleanu p ur n b e db«cte dt o Panlett aFrance-Isetts , EP A Remedia l Projec t Manage r 402-731-24S4 , o r tb e EP A Publi c Ittformatin n Center s a t 40^991-9$8 ^ (Nort hOmah aoffice ) o r 402-731-304 3 (Sout hOmsh aofHce) . 

## 'efva. . Yas , I gran t accos t t o m ypropert yan d VM M Btve n tit t pamphie t D Noiidonotgrantaccaattomypfopaityindlwa s "Remirat e Mslrt , impoftin t Laa d InfonnatkH i fo rFamiRas , Ch M glMf ) th a psfflidile t "ftanovst t Right , Inipottan t Lea d MonnsUo n fa rFtmiHei , Ctiftt a Cara PrevMert , an d Schools. " 

# /

^^c ^ 4-l?-6 1 shir e DII B Signttur e )PECIA L (NSTRUCTON S AM D CONSOEHATION S egaeiest'i e etii e 2002/68/0 : Sy33NI9N 3 yiAN 3 iOa d 90/Z 8 39W d402-717-778 8 AVANTA S 12:49:5 4 p. m 06-18-200 9 2/ 4 

# 7,10 1 ^Hs ' a,onn E(;p ^

.!«....••mi l miiniiiiiiiiii i _, . -I - PftOPeiT YAP0RE8 S O F OWNS t I F DffFeR0I TTHA N PROJ^T YBBN Q PA ^ PROPa?n rADDRES S _ . flPCQOE hav e reosivsd a cop yo f tl) a patnpt M Aworaf e A ^ btiporttn t LM d Ikw d fahmathi i Fo rFmBht , ChO d C M fVoWdw s AIM I ScMt (nfonnin g m e o f th e potentia ! risk o f th e lea d hazar d exposur e fro m renwaticinaiM yt o b e performe d o n dwetlln s uni t I recehradtN e pamphle t beibr e th e woil t bagan .
-^nnrrcMilAllBrffBeMOIM r0 nA m

'pnMiH)NAiiEOFRecfnai r^SAT E uiticoFReoinBi r 8alM:artiflcdia n OpHo n (ForTenuitOccuple d DwelHng s Only ) I f(h e iBs d pamphle t wa s dailvBre d (Ml t a tanan t signatur e wa s rw t obynabb . yt u below ; Rahiaa l T o Sig n - 1 ceitt y(ha t I hav e mad e a ooo d faX h e(f« t b delive rth e pam ^ (aa d hazar d InlbrrMAo n lo rfarnWeft , ohU d car e pronrt ^ dat e an d NnwIndlGalB d an d tha t th e oo(»pantifrfiaB d to eig n th e oontimia ^

i fudhe roerW ytha t I hav e M l a cop yoTlh e pamph M a t (h e uni t MK h Quupatrt .

- (JiuwaRM e Fo ragiMtun-- 1 certif ytha t I hav e mad e a goo d fallhef M to dal ^ invorlBn t lea d hazar d Infoimatio n forfmyiles . dti U belo wam i (ha t th e occupan t wa s iinavatebl e to aig n li e GonftonaSono rrecall I furthe roaitif ythat ) hav a (eft a cop yo f & » pamphle t a t th e uni t b yslidin g i t unde rth e doo ro reomewha m o n th e preinises . PRNTaNAKOPPERaONCeRnPYM Q ATTEVTB ) DEUVER YIMT £ AN D TM E LEA D nantjjDBJVER y ^ OQNMIffiEdrv^ERBO N CERTIFYil O LEAD MIVHLE TDEUVERY : N9t o Rigandin g Main g Optio n ' a s a n Asmril wto daivif yi n pera ^ andtotsnan t ParnphMinuitbemalfldfl£las8i7daiisb8toreiBnow(lon < (DaQumntwftsoernialBofntftaginmhsptn t tAct) . a)MWftTONOfRBCaPTOft£ADP/«(»HE Tgjig t S0/E 0 BBf d Sy33NI9N 3 aiAN 3 JOd d 8900IE;gfIE : Bt^-.TB 2032/60/0 14/ 4 12:50:4 7 p.m . 06-18-200 9 402-717-778 8 AVANTA S

• >J



# mm i mm mmmm m : P^O ^ K J M ^

fK/gjJAT E /Jl^JQ^ I BW AiieA( D T O W PMNTID : 

# So^ ^

0, 5 C^^^en + 

# I M L ' 1 

# fosir ootDR S^oxg , a ^ C^-JCO'K V HOW E 

# 7Wf l M^? > JDDU M 

# 5a(^ ^ ^^ 3 H^-^s-g ^ 'f^y-^_ r QAMQE-mi i 

# i^W(a^9. \ WWHJ ^ 

# S^rc^g ^

Q S C^rrgr\ V

KMCHUCI H 

# S^. ^ S<^m ^

^-^' C<-^rc£f\'\ ' (OOPMCreAILttCnOt^YH^HOtrORIIOfHIPfUaklU ) 

# I AfiR KT O TH E OOUNI S USn O ABOVE . ONC E PiUNTlN Q BBQUi$ rI UNDERSTAN D I CA N NO TCNJUIIGE TH E ABOV E SELEO ^ OOlJOIt t

PABsrcoMfiHraiiKiaM s Sy33NI9N 3 aiAN 3 JOHd 8908I£St?Te 5t?:ia 2802/8B/0 T S0/S 0 3DWd

## Dougla s Count y Accoun t Information Pag e 1 of 3 Dougla s County , Nebrask a Propert yRecor d - R081166000 0 Prin t Reoor t NE W Featuf B - Parce l Dimension s availalil e (3 1 scal e 0-5 0 f t wes t of 52n d S t - Vie W 0 0 IMa O Informatio n i s vali d a s o f 2009-6- 3 Treasurer' s Ta xReoor t Ne wFeatur e ••-•- • Aut o Sale s Searc h | Owne r ALLISO N SCOTTD 270 8 N 4 5 AV E 1 OMAH AN E 68104-000 0 | 1 Propert yInformatio n | Ke yNumber : 116 6 000 0 0 8 1 Accoun t Type : Residentia l 1 Parce l Numbe r 081166000 0 1 Parce l Address : 270 8 N 4 5 A V OMAH AN E 68104-000 0 1 Lega l Description : CLAIRMON TLO T1 2 BLOC K4 N 4 5 F T4 5 X 12 5 1

Vaiu e Informatio n 1 Lan d improvemen t 

### Tota l 1 200 9 200 8 200 7 200 6 200 5 ^200 4 $6,000.0 0 $6,000.0 0 $6,000.0 0 $6,000.0 0 $6,000.0 0 $6,000.0 0 $61,900.0 0 $61,900.0 0 $61,900.0 0 $61,900.0 0 $62,500.0 0 $56,800.0 0 $67,900.0 0 $67,900.0 0 $67,900.0 0 $67,900.0 0 $68,500.0 0 $62,800.0 0 1

1 1 Sale s Informatio n 1 Sale s Date : 2003-12-2 9 1 Dee d Type : W D Book : j 200 4 Page : 01065 9 1 Price . $70,000.0 0 1 Grantor - BRIA N ELTZ E ETA L i Grantee : SCOTTALLISO N | Validnnvaild . 

### Vali d 1 1 Exclusio n Reason : Sale s Date : 1995-10-2 6 1 Dee d Type : 

## D 1 Book : 1 201 7 Page : 

## 22 8 1 Price : $50,600.0 0 1 Granto r 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accountno=R081.. . 6/8/2009

### Dougla s County Accoun t Infomiatio n Pag e 2 o f 3 Grantee : Valid/invalid : Exclusio n Reason : Vali d Sale s Date : Deec f Type :

Price : Granto r 1992-03-2 3 $47,000.0 0 Book : 193 7 Page : 25 5

Grantee : Valid/invalid : Exclusio n Reason : Vali d Sale s Date : Dee d Type : Price : Grantor : 1991-08-0 7 $21,000.0 0 Book : 190 4 Page : 02 0

Grantee : Vaiid/lnvaiid : Exclusio n Reason : Invali d Invali d Sal e Lan d Informatio n Acre s S F 0.1 2 5625. 0 Improvemen t Informatio n Buildin g 1 Unit s 1. 0 Dept h 

### 125. 0 Widt h 45. 0 Vacan t N o

?7ft«H<5Ai ; 

# W L ^IP^JMP - ''^ H

21/ 2 STOR YUNFI N ' 6 ^

C U i 8 M 4

. , ...M a—. . ^.: : ' ., ^

$toon a Floo r

744 0 W l ft U i

V^^^^^^B" " *** " 1 CLIC KT O ENLARG E IMAG E 1 ^yCmj^N^RgEJjMAgE ^ Squar e Footage : Perimete r 1533. 0 0. 0 Percen t Complete : Quality : 100.0 % Averag e 

### http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=R081. . . 6/8/200 9

## M C Services , LL C Propert yAddres s 'Z^O b ^ ^ jS'^A^^ ^ Dat e T-^O-Q^ . Start Dat e ' ^ ~ 1 ~C)0 \ En d Dat e ^ - ^ ^ Q ^ 

## Amoun t Of Prim e An d Pain t Use d Prim e (Gallons ) ^ 

# Q Pol y(Boxes ) '^ - Pain t (Color ) '\J^.\\QO O Amoun t (Gallons ) ' / y ^

" "w * Pain t (Color ) Amoun t (Gallons ) I Pain t (Color ) \NV^\ W. Amoun t (Gallons ) 

# 5 Pain t (Color ) Amoun t (Gallons ) Pain t (Color ) Amoun t (Gallons )

## Pirofessiona B Environmenta l Engineers , One . JNTERVENCIO N D E SEGURIDA D Nombr e de l Proyecto : t~TO o H 5 ^ h O Fech a d e l o Intervencion : 1 I IO ' \ O^ X Peligro s d e Salu d Primordial : CiSsT^'W ^ ^XCL^C^JV: ^ 

### ' ( \ lo U G Preocupacione s Primordiale s d e H & S : Tarea s Diarias : 

### 1 . ^:5<^i^^^^^^ ^ fp^>(=i^5;^c ^ 

### 2 . 3 . t^^^^^^^t^VM^^I' ^ Equip o Usad o e n e l Luga rd e Traabjo : Casc o Dur o Escaler a £_____ Gafa s d e Segurida d < ^

Elevadore s Zapato s GFC I Guante s d e Trabaj o Chaleco s d e Segurida d Generadore s Otr o Equip o List o par a Respuest a d e Emergenci a a Disposicio n Inmediata : Conduci rReunio n Diari a d e Segurida d Estuch e d e Primero s Auxilio s Procedimiento s d e Emergenci a Poli'tic o d e Salu d ySegurida d d e l a Compani o GFC I e n siti o Deficiencies : Accione s Corretivos :

Interventor : Vf{9(^ C / (

V C Fecha : 1 1 \\^\^ \ Superviso rde l Sitio:^- ^ Fecha :