TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: .54-1'^ I Date: _Lr2=ld^_ _ 

Address: HIQ SQhl-tr StT-^^b 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

^y? ^ , Video ofproperty (DVD) 

AA Executive Summary 

<S^ Signed Access Agreement for subject property 

S'^ Painting Agreement 

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

jy " Photographs ly/j^iYc. /P./iA Yi^^y 

0 ^ Satisfactory restoration signed by Property Owner 

D Property close-out check list signed by EPA 

\y ^ Property information from Douglas County Assessor's Office 

•0^ confirmation that lead pamphlet "Renovate Right" was received by P0_ 

D 

D ^ 

D 

Date 

^c^/d 

ate 

30054544 

nnmi 

Superfund 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. ''° ' 'omahtNE ^ m 

"Providing cost-effective environmental solutions " ^^ jj^gj SMSSI 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2009 

SAID# 34121 

1710 Sahler St 

• Dates worked: 11/17 to 11/17 2009 

• Pre property condition: House and garage have painted wood siding; house paint was 

in real poor condition prior to stabilization. Paint was flaking off all over the ground. 

Garage paint was also poor, but more intact than the house. 

• Problems encountered: Paint chips 

• Owner request/concerns: N/A 

• Inspection/closeout dates. Owner signed 11/22 2009. Property inspected by PE project 

manager. 
PROFESSIONAL 

25(6 Noith 24* SlitB 219 ENViRONfilENTAL ENdlNEERS, INC. Omaha. NE 68110 

(402)5044688 "Providing cost-effecpve environmentai soiutions" Fax (402) 504-3281 

Oan«uBnB»B<^»BerfngDe8lBn»Rem«ltUion«Abateinert«Bn«igancyR«pBnsa 

Property Owner Close-Out Fonn 

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

SAID: 2 4 i ^ A 

PropertyAddnsss: i? " L O S/^l) \(P T S 4 

Owner»sName: "r^<^/SS> A 7/ ^ 

Perfomumce Staadards/OoseOnt Cittnt e YES NO 

1. Was Ihe entiie 8tiiictiire(8) painted \«itfa Ifae exception of Ifae statBti, exduded 

areas? This would inchide painting of oflier assocjated features inohiding fesda, 

eaves, siding, aU trim, poinfaes, boK beams, columns, lails, aiid exierior 8Ui£ ^ Y 

2. Was an scmiMng and olfaer pieparatianwoit completed satjgfar^^ 

3. Were all lequiied areas offliBStitictnre(s)pribied as needed and painted wifli 7 

two top coats? ^ 

4. WasflicpaintprodncteiitilizedequivalepttDaBOyeariaDDdiKl/qiality? it 

5. Are aUoflfae areas ^diereoontaminatBd materials have been spilled flxnoiig^y (/ vacuumed/cleaned? 

6. D y tfae oonliaclorooUect/vacoum all filling and sensed paint diqistm Ifae 

oitire propeity, roadways, alleyways, public access areas and also remove any 

7. IsfliB grass area flirt suaonnds flie stnicture(ig) in reasonably good conditioo? 

8. Are aU items sudi as polyefliylenedieeting, ladders, pahit fanides, cooes, 

barrier tape, etc. propaly removed? m 

9. Is tfaere aiqr evidence ofpropeity damage fliat was dtmel^ flie coatractoi? Any J propeity damaig needs to be comptoed prior to tiie EPA Capse-Out 

10. Are tfaere any property items tfaat were tenqx>raiilyre4ocatBd by flie contiactor 

c> that need to be moved bade? 

11. Are tiiere any Qcnown) lingering issues wifli flie property owiiei<s) Ifaat faave 

been left unresolved? 1/ 

Comments: 

iC f/fJ>o.jao . ^y ^JyiYutJ L ^ 

Ptoperty Owner Signature Date 

A M . Professional Engineecs Rqtreaoitative Date 
CONSENT FOR ACCESS TO PROPERTY 

OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID: 3 il J-C? S PROPERTY ADDRESS: drlSO ­ SA-I^/€.^^^-f 

OWNERNAME: , , 

-^^»pfss Li e 

DAYTIME PHONE: k0j ) ^i^.^'63<^ ^ 

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 are being performed by EPA contractors. 

Paint stabilization activities will include: scraping of cracked or ilaking 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 on the property identined 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, ifthe soil cleanup has not already been performed. 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. 

^Yes , I have read I and understand the paragraph^ove. 

SMhJt^ 

Signature of Property Owner Date 

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, ifapplicable, will be given the Housing and Urban Development 

(HUD) and EPA pamphlet, "Renovate Right, Iniportant 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 ofproperty 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 ofthe LBP stabilization actions, and (8) will participate in final 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-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 ofHce). 

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

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

Care Providers, and Schools." . Infonnation fbr Families, Childe Care Providers, and Schools." 

Signature Date Signature Date 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
• » 

PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS: 3 i f J O Still/^.K S + DATE: 

BVID: 

AREA(S) TO BE PAINTED: 

HOUSE PROPER:. / I J yjjlyjIX V COLOR: 

—h) • 

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 THE PAINTING 

BEGINS, I UNDERSTAND I CAN NOT CHANGE THE ABOVE SELECTED COLORS: 

PROPERTY OWNER SIGNATURE: PE ACCESOR SIGNATURE: 

\ (^JyCfhAt^^^^^yyCCYu< t ^ 
2007 

Douglas County Account Information Page 1 of3 

3HV -^ I 

Douglas County, Nebraska Property Record - R0702070000 

Print Report 

NEW Feature - Parcel Diniensiona available @ scale 0-50 fl west of 52nd St - VlOW OH Itflap : 'or-^i"- o- ;s vaiia as of 2Q09-1''-3 Treasurer's Tax Report 

New Feature ->•->-+ Auto Sales Search 

Owner 

c/o rC^RESTuAKS 

?A\> , '^OSA CA 95406-0787 

Property Informatio n 

Key Number:

Account Type:

Parcel Number:

Parcel Address: 

Legal Description:

Value Informatio n 

Land 

rjob 

200G 


200G 


200E 


20Q4 


Sales Informatio n 

Sales Date: 

Deed Type: 

Price: 

Grantor: 

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

Sales Date: 

Deed Type: 

Price: 

Grantor: 

 0207 OOOO 07 

 Residential 

 0702070000 

 BOULEVARD PARK SUB DIV LOT 5 BLOCK 1 40 X 115 

17^0 SAHLER ST 

OMAi-iANE 68110-0000 

$7 000 00 

$7,000 00 

$7,00000 

$7,000.00 

$7,000 00 

$7 OQO 00 

Improvement 

$23,300,00 

$27,200 00 

$27,200.00 

$27,200.00 

$6,500.00 

$5,900.00 

Total 

$30,300.00 

$34,200.00 

$34,200.00 

$34,200.00 

$13,500.00 

$12,900.00 

2004-01-13 

WD M 

$M00,000.00 

'^orrest Enterprises, LLC 

Forrest L Jinks 

Book: 2004 Page: 024780 

•\/!u!tipie Parcel Sale 

1996-09-26 

$19,500.00 

Book: 2046 Page: 492 

http://douglasne.mupping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 11/10/2009 
Douglas County Account Information Page 2 of 3 

Grantee; 

Valid/Invalid:

Exclusion Reason: 

 valid 

Lan d Informatio n 

Acres

0.1

 SF 

 4600.0 

tJIn/ts

1.0

 Depth 

 115.0 

Width

40.0

 I Vacant 

I No 

Improvemen t

Building 1 

 Informatio n 

Square Footage: 1063 0 Percent Complete 100.0% 

Perimeter 0.0 Quality Fair 

Unit Type: Condition: Fair 

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

HVAC: Forced Air Rooms: 6.0 

Exterior- Frame Sidmg Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type- Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built 

-^915 0 0% 

Detail Type Detail Description 

Add On Fence Chain Link 

Appliance Allowance 

Basement Bsmnt Block 8 ft 

Fixture Base Fixtures 

Fixture Bath Full 

http://douglasne.mapping-online.com/DouglasCoNe/slatic/accountinfo.isp?accountno=RO... 11/10/2009 
IGIT 

PropcrtyAddress i?-i O SAlllerS + Pate 

StartDrtg /Y'ftl'Or EndDrt* Y / -/ I -Qf 

Amoun t O f Prime An d Paint Used 

PrinM(Gailom) 

PDly(Bo»es) 

Pamt (color) 

Paint (Cokn) 

PBM (Coloi) 

2^ 

I'^l^ttp Amount (GaOons) 

Pn-fZ-U ^ / C fiy (/Amount CGalloMi 

^ 1 Cl / Amount (Gallons) 

2J^ 

2^ 

Paint (Color) _ Amount (Gatons) 

Paint (Colof) Amount (Gallons) 
PROFESSIONAL ENVIROMENTAL ENGINEERS,INC. 

REUNION DIARIA DE SEGURIDAD 

Fecha: U/lC\(OC ^ 

Proyecto: Midtown Remodeling 

niO Shaler 

Sitio de actividad: 

Tareas dianas: 

1. Site preparation/scrying. 

2. Pai nting. 

3.Clean-up. 

Primordid/Peligros Potenciales: 

1. Personal lead contamination 3.Eletricity. 

2. Site lead contamination. 4.Falls. 

Herramientas de tratxyo: 

1. Step letter.. 3. Paint spiy machines. 

2. Knife. 4. Others. 

Practicas de Trabajo/Acciones Correctivas: 

I. 3. 

2. 4. 

Llamadas Previas: 

1. 3. 

2. 4. 

Firma de registro del Empleado: 

.n£/.L?«i2^/.>.C:). 11., 

3. 

4...£^..VaA ik.'^/S<aZi:^<^^ 14., 

5 HA^SX X '^f.iiif^i.*^ :^Y..±tiSlL.ciA5.. 

6 16.. 

7 17.. 

8 18.. 

9 19.. 

10 20.. 

11 21.. 

12 22.. 

Fiimade del Sitio Fecha