## TRANSMITTA Lo f

OMAHA LEAD SIT E PAIN T STABILIZATIO NFIL EFOLDE R 

# SAID# : .54-1' ^ I Date : _Lr2=ld^_ _ Address : HI Q SQhl-t r StT-^^ b Remediatio nContractor : PROFESSIONALENVIRONMENTALENGINEER S Year : 200 9 PAINT STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S ^y? ^ , Video ofpropert y (DVD ) A

AExecutiv e Summar y <S ^ SignedAcces s Agreemen t fo r

subject propert y S' ^ Painting Agreemen t D Settlemen t documents (i.e. , fo r

damage o r

t

o replac e plants , etc. ) 

# jy " Photograph s ly/j^iYc . /P./i AYi^^ y 0 ^ Satisfactor y restorationsignedb y Propert y Owne r D Propert y close-ou t chec k

list signedb y EP A \y ^ Propert y informationfro mDouglas Count y Assessor' s Office • 0 ^ confirmationtha t lea dpamphle t "Renovat e Right " was receivedb y P0 _ D D ^ D



## Dat e 

## ^c^/ d

at

e 30054544 

# nnm i

Superfun d

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . ''° ' 'omahtN E ^ m "Providin g cost-effectiv e environmenta l solution s " ^ ^ jj^g j SMSS I Consultin g • Engineerin g Desig n • Remediatio n • Abatemen t • Emergenc yRespons e



## Lea dBas e Stabilizatio nOmaha , N e Clos e Ou t Report 200 9 SAID#3412 1 171 0 Sahle r S t

•Date s worked : 11/1 7 t o 11/1 7 200 9 •Pr e propert y condition : Hous e an dgarag e hav e painte dwoo dsiding ; hous e pain t wa s inrea l poo r conditio nprio r to stabilization . Pain t wa s flaking of f

al l over th e ground . Garag e pain t wa s als o poor , bu t more intac t tha nth e house . •Problem s encountered : Pain t chip s •Owne r request/concerns : N/ A • Inspection/closeou t dates . Owne r signe d11/22 2009 . Propert y inspecte dby P Eprojec t manager .

# PROFESSIONA L 25( 6 Noit h 24 * Slit B 21 9 

# ENViRONfilENTA L ENdlNEERS , INC . Omaha . N E 6811 0 

### (402)504468 8 

## "Providin g cost-effecpv e environmenta i soiutions " Fa x(402 ) 504-328 1 Oan«uBnB»B<^»BerfngDe8lBn»Rem«ltUion«Abateinert«Bn«igancyR«pBnsa 

## Propert y Owne r Close-Ou t Fon n (Lead-Base dPain t Stabilizatio nEP A Contrac t EP-R7-08-06 ) SAID : 2 4 i ^ A PropertyAddnsss : i? " L O S/^l ) \( PT S4 Owner»sName : "r^<^/SS > A 7/ ^ Perfomumc e Staadards/OoseOn t Cittnt e YE S 

## N O 1 . Wa s Ih e entii e 8tiiictiire(8 ) painte d\«itf aIfa e exceptio no f Ifa e statBti , exdude d areas ? Thi s woul dinchid e paintin g o f oflier assocjate dfeatures inohidin g fesda, eaves , siding , a U trim , poinfaes , boK beams , columns , lails , aii dexierio r 8Ui£ ^ 

# Y 2 . Wa s a nscmiMn g an dolfae r pieparatianwoi t complete dsatjgfar^ ^ 3 . Wer e al l lequiie darea s offliBStitictnre(s)pribie da s neede dan dpainte dwifl i 

# 7 tw o to p coats ? ^ 4 . WasflicpaintprodncteiitilizedequivalepttDaBOyeariaDDdiKl/qiality ? 

# i t 5 . Ar e aUoflfa e area s ^diereoontaminatB dmaterial s hav e bee nspille dflxnoiig^y ( / 

### vacuumed/cleaned ? 6 . Dy tfa e oonliaclorooUect/vacou mal l filling an dsense dpain t diqist mIfa e oitir e propeity , roadways, alleyways , publi c acces s area s an dals o remov e an y 7 . I s fliB gras s are aflirt suaonnd s flie stnicture(ig ) i nreasonably goo dconditioo ? 8 . Ar e a U item s sud i a s polyefliylenedieeting , ladders , pahi t fanides, cooes , barrie r tape , etc . propal y removed? 

# m 9 . I s tfaer e aiq r evidenc e ofpropeit y damag e fliat wa s dtmel ^ flie coatractoi ? An y 

# J propeit y damai g need s t o b e comptoe dprio r t o tiie EP A Capse-Ou t 10 . Ar e tfaer e an y propert y item s tfaa t wer e tenqx>raiilyre4ocatB db y flie contiacto r 

# c > tha t nee dt o b e move dbade ? 11 . Ar e tiiere an y Qcnown) lingerin g issue s wifli flie propert y owiiei<s ) Ifaa t faave bee nlef t unresolved ? 

# 1 / Comments :



## i C f/fJ>o.ja o ^y L . ^JyiYutJ ^ Ptoperty Owne r Signatur e Dat e 

# A M . Professional Engineec s Rqtreaoitativ e Dat e

# CONSEN T FO RACCES S T O PROPERT Y OMAHA LEAD SIT EREMEDIALACTIO N- LEAD-BASE D PAIN T STABILIZATIO N PROPERT Y ID : 3 i l J-C ? S PROPERT Y ADDRESS : drlSO ­ SA-I^/€.^^^- f OWNERNAME : , , 

# -^^»pfs s Li e DAYTIM EPHONE : k0j ) ^i^.^'63<^ ^ CELLPHONE : E-MAIL : OWNER' S ADDRES S I FDIFFERENT : TENANT' S NAMEI FAPPLICABLE : DAYTIM EPHONE : CELLPHONE : E-MAIL : Professiona l Environmenta l Engineers , Inc . (PE ) i s unde rcontrac t (#EP-R7-08-06 ) wit h th e U.S . Environmenta l Protectio n Agenc y(EPA ) t o stabiliz e lea d base d pain t (LBP ) o n residentia l structure s a t a numbe ro f propertie s locate d i n Omaha , Nebraska . Th e pain t stabilizatio n wor k i s bein g don e t o protec t th e soi l cleanup s tha t ar e bein g performe d b yEP Acontractors . Pain t stabilizatio n activitie s wil l include : scrapin g o f cracke d o rilakin g LB P fro m structures , applicatio n of a prim e coa t an d tw o (2 ) coat s o f paint . Movin g part s o f window s an d door s ar e no t include d an d wil l no t b e addressed . You rcooperatio n i s requeste d i n givin g permissio n t o thi s EP Acontracto r(PE ) t o ente ran d hav e acces s t o thi s propert yfo rth e purpos e o f stabilizin g lea d -base d pain t a s outline d o n th e propert yidentine d above . B ysignin g thi s documen t I agre e t o allo wa n EP Acontracto rt o conduc t a soi l cleanu p a t m ypropert yfollowin g completio n o f lead-base d pain t stabilization , ifth e soi l cleanu p ha s no t alread ybee n performed . I understan d tha t th e stabilizatio n contracto r ca n no t provid e assurance s tha t th e soi l cleanu p contracto rwil l b e boun d to . I furthe runderstan d tha t th e soi l cleanu p contracto rwil l mak e al l reasonabl e effort s t o addres s concern s tha t I , a s th e propert yowner , ma yhav e regardin g soi l cleanu p a t m yproperty . ^Yes , I hav e rea d I an d understan d th e paragraph^ove . 

## SMhJt ^ Signatur e o f Propert yOwne r Dat e I full yunderstan d tha t b ysignin g thi s Consen t fo rAccess , (1 ) thi s acces s wil l remai n i n effec t unti l th e wor k ha s bee n satisfactoril ycompleted , (2 ) tha t th e Propert yOwne ro rTenant , ifapplicable , wil l b e give n th e Housin g an d Urba n Developmen t (HUD ) an d EP Apamphlet , "Renovat e Right , Iniportan t Lea d Hazar d informatio n fo rFamilies , Da yCar e Providers , an d Schools" , (3 ) th e Propert yOwne ro rtenan t wil l remov e al l obstruction s fro m surface s t o b e painted , (4 ) wil l abid e b yhealt h an d safet yguidanc e provide d b yEPA , (5 ) wil l allo wphotograph yofpropert ybefor e an d afte rth e pain t stabilizatio n work , (6 ) wil l b e contacte d b ya P E representativ e approximatel y4 8 hour s i n advanc e o f startin g work , (7 ) agre e no t t o obstruc t o rtampe rwit h an yofth e LB P stabilizatio n actions , an d (8 ) wil l participat e i n fina l propert yinspectio n an d sig n th e Completio n Agreemen t an d Propert yOwne rSatisfactio n Survey . Shoul d yo u hav e an yquestion s abou t th e plane d Lea d Based-Pain t stabilizatio n activitie s fo ryou rproperty , pleas e contac t Professiona l Environmenta l Engineers , Inc . Projec t Manager , Willi e Cla yA t 402-504-4688 . Genera l question s abou t th e Omah a Lea d Sit e cleanu p ca n b e directe d t o Paulett a France-Isetts , EP ARemedia l Projec t Manage r402-731-2454 , o rth e EP APubli c Informatio n Center s a t 402-991-958 3 (Nort h Omah a office ) o r402-731-304 5 (Sout h Omah a ofHce) . B^Yes , I gran t access t o m ypropert yan d im s give n th e pamphle t D No , I d o not gran t access t o m ypropert yan d I wa s "Renovate Right , Importan t Lea d Infonnatio n fo rFamilies , Chil d give n th e pamphle t "Renovate Right , Importan t Lea d Car e Providers , an d Schools. " . Infonnatio n fb rFamilies , Child e Car e Providers , an d Schools. " Signatur e Dat e Signatur e Dat e SPECIA L INSTRUCTIONS AN D CONSIDERATIONS• » 

## PAIN TSTABILIZATIO N PRE-PROPERT Y PAIN TMATC H ASSESSMEN T PROPERT YADDRESS : 3 if J O Still/^. KS + DATE : BVID :

AREA(S ) T O B E PAINTED : HOUS E PROPER: . 

### / I J yjjlyjIX V COLOR : 

# —h ) • HOUS E TRIM : COLOR : GARAGE : COLOR : GARAG E TRIM : / COLOR : • PORCH : COLOR : ^ \ ' — PORC H TRIM : COLOR : (COMPLET E AL L SECTION , YES . NO , O R NON-APPLICABLE ) 

## I AGRE E TO TH E COLOR S LISTE D ABOVE . ONC E TH E PAINTIN G BEGINS , I UNDERSTAN D I CA N NO TCHANG E TH E ABOV E SELECTE D COLORS : PROPERT YOWNE R SIGNATURE : P E ACCESO R SIGNATURE : \ 

# (^JyCfhAt^^^^^y t yCCYu< ^200 7 

### Dougla s Count y Accoun t Informatio n Pag e 1 of 3 

# 3H V - ^ I Dougla s County , Nebrask a Propert yRecor d - R070207000 0 Prin t Repor t NE W Featur e - Parce l Diniension a availabl e @ scal e 0-5 0 f l wes t of 52n d S t - VlO W O H Itfla p : 'or-^i" - o - ; s vaii a a s o f 2Q09-1''- 3 Treasurer' s Ta xRepor t Ne wFeatur e ->•->- + Aut o Sale s Searc h Owne r c/ o rC^RESTuAK S ?A\> , '^OS ACA95406-078 7 Propert yInformatio n Ke yNumber : Accoun t Type : Parce l Number : Parce l Address : Lega l Description : Valu e Informatio n Lan d rjo b 200 G 200 G 200 E 20Q 4 Sale s Informatio n Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : 020 7 OOO O 0 7 Residentia l 070207000 0 BOULEVAR D PAR KSU B DI V LO T5 BLOC K1 4 0 X 11 5 17^0 SAHLE R S T OMAi-iAN E 68110-000 0

$ 7 00 0 0 0 $7,00 0 0 0 $7,0000 0 $7,000.0 0 $7,00 0 0 0 $ 7 OQ O 0 0 Improvemen t $23,300,0 0 $27,20 0 0 0 $27,200.0 0 $27,200.0 0 $6,500.0 0 $5,900.0 0 Tota l $30,300.0 0 $34,200.0 0 $34,200.0 0 $34,200.0 0 $13,500.0 0 $12,900.0 0 2004-01-1 3 W D M $M00,000.0 0 '^orres t Enterprises , LL C Forres t L Jinks Book : 200 4 Page : 02478 0

•\/!u!tipi e Parce l Sal e 1996-09-2 6 $19,500.0 0 Book : 204 6 Page : 49 2



### http://douglasne.mupping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO. . . 11/10/200 9

### Dougla s Count y Accoun t Informatio n Pag e 2 o f 3 Grantee ; Valid/Invalid : Exclusio n Reason : vali d

Lan d Informatio n Acre s 0. 1 S F 4600. 0 tJIn/t s 1. 0 Dept h 115. 0 Widt h 40. 0 I Vacan t I N o Improvement Buildin g 1 Informatio n

Squar e Footage : 

### 106 3 0 Percen t Complet e 100.0 % Perimete r 

### 0. 0 Qualit y Fai r Uni t Type : Condition : Fai r

Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 6. 0 Exterior - Fram e Sidm g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type - Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footag e 0. 0 Yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t -^91 5 0 0 % Detai l Typ e Detai l Descriptio n Ad d O n Fenc e Chai n Lin k Applianc e Allowanc e Basemen t Bsmn t Bloc k 8 ft Fixtur e Bas e Fixture s Fixtur e Bat h Ful l 

### http://douglasne.mapping-online.com/DouglasCoNe/slatic/accountinfo.isp?accountno=RO. . . 11/10/200 9

### IGI T PropcrtyAddres s i?-i O SAlllerS + Pat e StartDrt g /Y'ftl'O rEndDrt * Y/ -/ I -Q f Amoun t O f Prim e An d Pain t Use d PrinM(Gailom )

PDly(Bo»es ) Pam t (color ) Pain t (Cokn ) PB M (Coloi ) 

# 2 ^ I'^l^tt p Amoun t (GaOons) Pn-fZ-U ^

/ C fiy(/Amoun t CGalloM i ^ 1 Cl / Amoun t (Gallons ) 

# 2J ^ 

# 2

^ Pain t (Color )

_Amoun t (Gatons ) Pain t (Colof ) Amoun t (Gallons )

### PROFESSIONA LENVIROMENTA LENGINEERS,INC . REUNIO NDIARI AD ESEGURIDA D Fecha : U/lC\(OC ^ Proyecto : Midtow nRemodeling 

# ni O Shale r Siti o d e actividad : Tarea s dianas : 1 . Sit e preparation/scrying . 2 . Pa i nting . 3.Clean-up . Primordid/Peligro s Potenciales : 1 . Persona l lea dcontaminatio n 3.Eletricity . 2 . Sit e lea dcontamination . 4.Falls . Herramienta s d e tratxyo : 1 . Ste p letter. . 3 . Pain t spi y machines . 2 . Knife . 4 . Others . Practica s d e Trabajo/Accione s Correctivas : I . 3 . 

### 2 . 4 . 

### Llamada s Previas : 1 . 3 . 

### 2 . 4 . 

### Firm ad e registr o de l Empleado : 

## .n£/.L?«i2^/.>.C:) . 11. , 3 . 4...£^..Va Aik.'^/S<aZi:^<^ ^ 14. , 5 HA^SXX

### '^f.iiif^i.* ^ :^Y..±tiSlL.ciA5. . 6 16. . 7 17. . 8 18. . 9 19. . 1 0 20. . 1 1 21. . 1 2 22. . Fiimad e del Siti o Fecha