### TRANSMTTTA Lo f OMAH A LEA D STT E PAIN T STABILIZATIO N FIL EFOLDE R
SAID# : 2Sn^ ^ Date : l/^l/c ^ Address : /JT/ V A / ^ D S t 

### Remediatio n Contractor : PROFESSIONA LENVIRONMENTALENGINEER S Year : 200 8
PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S
\ Y M D D M S ^ M M Vide o o f propert y (DVD ) Executiv e Summar y SignedAcces s Agreemen t fo r

subject propert y Paintin g Agreemen t Settlement document s (i.e. , fo r

damag e o r

t o replac e plants , etc. ) Photograph s Satisfactor y restoratio n signedb y Propert y Owne r Propert y close-out check Us t signe db y EP A Propert y information fix>m Dougla s Coimt y Assessor' s OfBc e



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# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC

. "Providin g cost-effectiv e environmenta l solutions " Consultin g • Engineerin g Desig n » Remediatio n • Abatemen t • Emergenc yRespons e 250 5 Nort h 24' ^ Suit e 21 9 Omaha , N E 6811 0 (402 ) 504-468 8 Fax(402 ) 504-328 1



### Lea dBas e Pain t Stabilizatio nOmaha , N e Clos e Ou t Repor t
SAID#2579 9 151 4 N 4 0 S t

•Date s worke d10/1 4 t o 10/1 6 200 8

•Som e damage dare at o tri mo n botto mo f house , Overal l hous e was i n goo dcondition , Garag e look s newe r an di n goo dcondition , n o issue s durin g stabilizatio nproces s
•Inspecte d11/0 5 n o issues

.p. 2 No v 05 08 05:32 p Devi n J. Faulkne r 402-289-9740



## PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC

. "Provicfin g cost-effectiv e environmenta l solutions " Consultin g ' Engineerin g Ooiiq n • flfcoiodpeiion • Abateme m • Emergsnc yRespons a Propert y Owne r Close-Ou t For m (Lead-Base dPaint Stabilizatio n EP A Contrac t EP-R7-08-06 ) 

# SAID : ;2siq q Propert y Address : 

## /&t q A) ^ O S t Owner' s Name : 

## 0?. o '.X A 

## pQ_u\Kr^ x Performanc e Standards^Close-Ou t Criteri a 1. Wa s th e entire structure(s ) painte dwit hvh e exceptio n ofth e stated , exclude d areas ? Thi s woul dinclud e psiinting of other associate dfeature s includin g fascia , eaves , siding , all trim , porches , bo x beams , columns , rails , an dexterio r surface s of garages ^ 2. Wa s alt scrapin g an dother preparatio n wor k

complete dsatisfactorily ? 3, Were al l require darea s ofth e strucnire(s ) prime d as neede dan dpaiate dwit h tw o to p coats ? 4. Wa s th e pain t product s utilize dequivalen t to a30 year product/quality ? 5, Ar e al l ofth e area s where contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? 6. Di dtb e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s on th e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e any othe r generate ddebris ? 7. Is th e gras s are athat sunround s tli e structure(s ) inreasonabl y goo dcondition ? 8. Are al l item s suc h as polyethylen e sheeting , ladders , pain t brushes , cones , banie r tape , etc
. properl y removed ? 9. Is ther e an y evidenc e of propert y daniag e tha t wa s don eby th e contractor ? Any propert y damag e need s tobe complete dprio r to th e EP A CIose-OuL 10
. Ar e ther e an y propert> iteni s that were temporaril y re-locate d by th e contracto r that nee dto be move dback ? 11
. Ar e ther e any (known ) lingerin g issue s withth e propert y uwnet(s ) that hav e been lef t unresolved ? Comments : 

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

# ENVIRONMENTA L ENGINEERS , INC

. Omaha , N E 6811 0 (402 ) 504-468 8 

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

### EP A Close-Ou t For m (Lead-Base dPain t Stabilizatio nEP A Contrac t EP-R7-08-06 ) SAID : 

# 3S79 q Property Address : AS/' A A ) WA ) ^ ^ Owner' s Name : P^ U c f \/Po,^ ) ^Oe c Performanc e Standards/Close-Ou t Criteri a YE S N O 1
. Wa s th e entir e structure(s ) painte dwithth 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 , colimms , rails , an dexterio r surface s o f

- 

### garages . 2
. Wa s al l scrapin g an dothe r preparatio nwor k

complete dsatisfactorily ? u ^ 

### 3
.Wer e al l require darea s ofth e structiu-e(s ) prime da s neede dan dpainte dwith ^ 

### tw o to p coats ? 4
. Wa s th e pain t product s utilize dequivalen t t o a3 0 year product/quality ? 

## ^ X 5
. Ar e al l ofth e area s wher e contaminate dmaterial s hav e bee nspille dthoroughl y vacuimied / cleaned ?

- ^ 

### 6
. Di dth e contractor collect/vacuu mal l fallin g an dscrape dpain t chip s o nth e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e an y ^ y othe r 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
. 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 an y evidenc e ofpropert y damag e that 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 EP A Close-Out

. 10
.Ar e ther e an y property item s that wer e temporarily re-locate db y th e contracto r L ^ 

### that nee dt o b e move dback ? 11
. Ar e ther e an y (known ) lingerin g issue s withth e property owner(s ) that hav e / 

### bee n lef t imresolved ? Othe r Considerations/Property Owne r Discussions/Additiona l Wor k

thati s Required :



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### Dougla s Coimt y Accoim t Informat l 

# t Pag e 2 of 2

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CLIC KT O ENLARG E IMAG E Squar e Footage : Perimete r Uni t Type :

Buil t As :

HVAC : Exterior : Interior : Roo f Cover :

Roo f Type : Floorcover :
Yea rBuil t 191 5 Detai l Typ e Ad d O n Applianc e Basemen t Fixtur e Fixtur e Fixtur e Garag e Garag e Porc h 1040. 0 0. 0
1 1/ 2 Stor yFi n Centra l Ai rt o Ai r Fram e Sidin g Drywal l Compositio n Shingl e Gabl e Allowanc e
Yea r Percen t Remodele d Remodele d 0 % Detai l Descriptio n Fenc e Chai n Lin k Allowanc e Bsmn t Bloc k 8 f t Additiona l Fixture s Bas e Fixture s Bat h Ful l Detache d Detache d En d Soli d Wal l Fvsftoo r» • Hf f daLATdRu f 4III0Sl| n

e.(i»iHmi <

OiTTr t tkc i 1 ^ I t 9C0?qC i CLIC KT O ENLARG E IMAG E Percen t Complete : Quality : Condition : Cond o Squar e Footage : Rooms :

Units : Baths : Bedrooms : Stories : Foundation : Sprinkle rSquar e Footage : Adjuste d Yea r 100.0 % Averag e Averag e 0. 0 7. 0 1. 0 1. 0 3. 0 1. 5 Bloc k 0. 0 Physica l Ag e Buil t 191 5 9 1 Unit s 1. 0 1. 0 640. 0 1. 0 1. 0 1. 0 192. 0 264. 0 144. 0



### http://dougIasne.mapping-onlme.com/DouglasCoNe/static/accountinfo.jsp?accountno=R1921300000 7/8/200 8

### Dougla s County Accoun t Informati Pag e 1 of 2 ^ Dougla s County , Nebrask a Propert yRecor d - R192130000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f 90t h S t - Vie W O n Ma p Informatio n i s vali d a s o f 2008-6-1 9 Treasurer' s Ta xRepor t Ne wFeatur e -•->- • Aut o Sale s Searc h Owne r FAULKNE R DANIE L J ETA L 811 5 8 4 2 S T BELLEVU E N E 68147-000 0 Propert yInformatio n Ke yNumtier : 213 0 000 0 1 9 Accoun t Type : Residentia l Parce l Number : 192130000 0 Parce l Address : 151 4 N 4 0 S T OMAH AN E 68111-000 0 Lega l Description : ORCHAR D HIL L LO T2 2 BLOC K4 S 4 4 FTLT S 2 1 & 4 4 X 9 0 Valu e Informatio n Lan d Improvemen t Tota l 200 8 $2,200.0 0 $47,400.0 0 $49,600.0 0 200 7 $2,200.0 0 $47,400.0 0 $49,600.0 0 200 6 $2,200.0 0 $47,400.0 0 $49,600.0 0 200 5 $2,200.0 0 $45,300.0 0 $47,500.0 0 200 4 $2,200.0 0 $45,300.0 0 $47,500.0 0 200 3 $2,200.0 0 $45,300.0 0 $47,500.0 0 Sale s Informatio n Sale s Date : 1995-11-0 3 Dee d Type : Sooilr : 202 1 Page : 00 7 Price : $38,000.0 0 Grantor : 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 4356. 0 1. 0 99. 0 44. 0 N o Improvement Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 92130000 0 7/8/200 8