### TRANSMiTTA L o f OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL E FOLDE R 

# SAI D # : 2?9K 1 Date : Cv{2^^\\\ Address : M?>^ M C^S. ^ ^ Stabilizatio n Contractor : Professiona l Environmenta l Engineer s Year : ^0 1 PAIN T STABILIZATIO N PROPERT V FIL E FOLDE RDOCUMENT S Vide o ofpropert y (DVD ) Executiv e Summar y (\

/ Signe dAcces s Agreemen t fo r subjec t propert y C TPre-Renovatio n For msigne db y Propeity Owner D Pre-Renovatio n Fon n fo r Occupant/Tenant , if applicabl e M Paintin g Agreemen t D Settlemen t document s (i.e. , fo r damag e o r t

o replac e plants , etc. ) ^ Renovatio n Recordkeepin g Checklis t signe db y Certifie dRenovato r ^" ^ Photograph s S ^ Satisfactory close-ou t chec k lis t signe dby Propert y Owne r D Propert y close-ou t chec k lis t signe db y EP A S / Propert y informatio n fro mDougla s Count y Assessor' s Offic e

• Hazardanalysis , if prepare d D Safet y Audi t D Othe r (describe) : 

# .l/T/^lJ ^ EP A Cb RSfenature (after file folde r review ) 4037756 3 Superfun d

# 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 y Respons e 250 5 Nort h 24"^ , Suit e 21 9 Omaha , N E 6811 0 (402 ) 504-468 8 Fa x (402 ) 504-328 1



### Lea dBas e Stabilizatio n Omaha , N e Clos e Ou t Repor t 201 1 SAID#2383 7 432 4 Cas s S t

•Date s worked : 6/ 6 t o 6/6 201 1 •Pr e propert y condition : Hous e ha s painte dwoo dsidin g wit h painte dwoo dtrim s an d foundatio n areas . Pain t wa s flaking of f

i n areas . •Problem s encountered : None . •Owne r request/concerns : Colo r changes . •Inspection/closeou t dates . Owne r 6/7/1 1

## PROFESSJONA L 50 0 S . Ewing , Suit e E 

## ENVIRONMENTA L ENGINEERS , INC
. St
. Louis , M O 6310 3 (314 } 531-006 0 "f-'tUVldlii g aUi'i'-'.^/.'^C'.'/''i.- : irii'vinililii^nt^:). ! S:)Uliiu.i: ~ Fa x(314 ) 531-006 8 

# 20 h Property Owne r Close-Ou t Form (Lead-Base dPain t Stabilizatio n EPA Contrac t EP-R7-08-06 ) 

## SA.D : y.^^^-. ^ Propert y Address : ^' ^ Pl^ / (J^S S St

Owner' s Name : f i y^ S / /

S fy^T^ Performanc e Standards/Close-Ou t Criteri a YE S N O 1 . Wa s th e entir e structure(s ) painte dwit h th e exceptio n o f th e stated , exclude dareas ? 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 , columns , rails , an dexterio r surface s o f garages . 2 . Wa s al l scrapin g an dothe r preparatio n wor k

complete dsatisfactorily ? ^ 

### 3 . Were al l require darea s ofth e structure(s ) prime da s neede dan dpainte dwit h tw o to p coats ? 

## C ^
. 4 . Wa s th e pain t product s utilize dequivalen t t o a2 5 year product/quality ? - ^ 

### 5 . Ar e al l ofth e area s wher e contaminate dmaterial s hav e been spille dthoroughl y 

## 1 / vacuumed / cleaned ? 6 . Di dth e contractor collect/vacuu mal l fallin g an dscrape dpaint chip s o n th e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e an y othe r generate d 

# y debris ? 1 . I s th e gras s are athat surround s th e structure(s ) in reasonabl y goo dcondition ? ^ ^ 

### 8 . Are al l item s suc h a s polyethylen e sheeting , ladders , pain t brushes , cones , barrie r tape , 

# X etc . properl y removed ? 9 . I s ther e an y evidenc e ofpropert y damag e that wa s don e b y th e contractor ? Any property 

# w damag e need s t o b e complete dprio r t o th e EP A Close-Out . \0 . Ar e yo u satisfie dwit h th e wor k

performed ? 

# -v ^ 11 . Ar e ther e any property item s tha t wer e temporaril y re-locate dby th e contractor that ^ 

### nee dt o b e move dback ? 12 . Ar e ther e any (known ) lingerin g issue s wit h th e property owner(s ) that hav e bee n lef t unresolved ? Other Considerations/Property Owne r Discussions/Additiona l Wor k

that i s Required :Professiona l Environmenta l Engineers : EP A Pain t Stabilizatio n 201 1 

# SAID
. 7^96 ^ Propert y Addres s MJAZ H C Ol^ ^ O T Stories / Sidin g typ e 

# 1112 Transit e \A(op p dd Viny l Meta l l'l' / Stucc o Garage ? \Ye B o Yes^ ^ No Ye s N N o Painted Painted ? ? J^^. ^ J \ Where ? Sidfn g J Dat e acces s signe d 

# ?^/3wi i :: : Pre-vide o Pos t vide o Contracto rAssigne d Dat e starte d ^ J P ^ CP- ^ / / Dat e ende d Qp "^C/ ^ ^^ f Weathe rCondition s 

# 9^

Pain t use d Prim e use d 

# /7 a ^fJkJ.Oq./^/U^^ ^ ^^/-< ^

Pol y use d _V / ^ Problems/Issue s(efTective Apri l 2010 )


### RENOVATIO N RECORDKEEPIN G CHECKLIS T



# , /V 6 ?}W/(^ l Name o f Firm : 

# . Dat e an dLocatio n o f Renovation : ^^&' " / / yJoly^iPyS S S' f Brie f Descriptio n o f Renovation : Nam e o f Assigne dRenovator : / / y / Name(s ) o f Traine dWorkers : (..jr/Sf/Ci./ ? / /^'^It Q Nam e o f Dus t Samplin g Technician , Inspector , and/o r Ris k Assessor , if used : Ay// ^ 

# ^ 4 D^'Copie s o f renovato r an ddus t samplin g technician qualification s (trainin g certificates , certifications ) o n file. ^ dCertifie drenovato r provide dtrainin g to worker s o n (chec k all tha t apply) : / Q Postin g warnin g sign s [Z3ettin g u p plasti c containmen t barrier s ^j2^aintainin g containmen t •/'Avoidin g sprea do f dus t t o adjacent area s 0 " Wast e handlin g & Post-renovatio n cleanin g D Tes t kit s use db y certifie drenovato r t o determin e whether lea dwa s presen t on component s affecte db y renovatio n (identif y kit s use dan ddescrib e samplin g location s andresults : A//V ^ Q'^Wamin g sign s poste da t entranc e t o wor k

area . ^B'^Wor k

are acontaine dto preven t sprea do f dus t anddebris . p^indow s in an dwithi n 2 0 fee t ofth e wor k

are aare close d ODoor s i n an dwithi n 2 0 fee t ofth e wor k

area s are close dandseale d C/Door s that mus t b e use di n th e wor k

are aare covere dto allo w passag e bu t preven t spreado f dust . jZfGroun dcovere dby plasti c sheetin g extendin g 1 0 fee t fro mwor k

are a- plasti c anchore dt o th e /buildin g an dweighte ddow n by heav y objects .

• Ifnecessary , vertical containmen t installe dt o preven t migratio n o f dus t an ddebri s to adjacent property . 

# J Waste containe don-sit e andwhil e bein g transporte doff-site .

Renovatio n Recordkeepin g Checklis t Omah a Lea d Sit eI Oil 

### Wor k

sit e properl y cleane dafte r renovation . L/AI I 

### chip s anddebri s picke dup , protectiv e sheetin g misted , folde ddirt y sid e inward , andtape dfor Removal .

TfWor k

are aHEP A vacuume dto get pain t chip s fro mgroun dsurface , ifnecessary . Certifie drenovato r performe dpost-renovatio n cleanin g verificatio n (describ e results) :

y ^ Iceuif y unde r penalt y of la w tha t the abov e informatio n is true an dcomplete . 

# 'fi/d^/ ' 

# C:-^^-/ / Nam e an dTitle Dat e

Renovatio n Recordkeepin g Checklis t Omahc i Lea d Si'i e5/26/201 1 ^)ouQla s Count y Account Informatio n 

# ^ #?.^RT / Dougla s County , Nebrask a Pr o ^t y Recor d - R201837000 0 Prin t Repor t Vie w Interactiv e GI S Ma p Infonnatio n i s \ali d a s o f 2011-5-1 6 Treasurer' s Ta xRepor t Ne w Featur e ->->- > Subdivisio n Sale s Searc h Owne r KYE S LISBET H A 432 4 CAS S S T OMAH A N E 68131-000 0 Propert y Informatio n Ke y Number : 183 7 000 0 2 0 Accoun t Type : Residentia l Parce l Number : 201837000 0 Parce l Address : 432 4 CAS S S T 

### ^O O /\ J OMAH A N E 68131-000 0 Lega l Description : POPPLETO N PAR KLO T 1 5 BLOC K1 2 5 0 X 122.6 9 Valu e Infomiatio n 201 1 201 0 200 9 200 8 200 7 200 6 Lan d $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 Improvemen t $94,600.0 0 $88,300.0 0 $88,300.0 0 $88,300.0 0 $83,200.0 0 $83,200.0 0 Tota l $101,000.0 0 $94,700.0 0 $94,700.0 0 $94,700.0 0 $89,600.0 0 $89,600.0 0 Sale s Informatio n Sale s Date : 1992-11-1 2 Dee d Type : Price : Grantor ­ $50,000.0 0 Book : 1937 Page ; 55 9

Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s 0.1 4 S F 6150. 0 Unit s 1. 0 Dept h 123. 0 Widti i 50. 0 Vacan t N o Improvemen t Informatio n

. mapping-online.com/.../accountJnfb.j
. 1/ 35/26/201 1 Dougla s Count y Accoun t Informatio n Buildin g 1 1 1/ 2 Story 432 4 Cas s S t

K

V |*' 3 ^^ \*m " ,.^o l secon d Ftoo f „-. „ Firs t Floo r

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SiimBlxt^cf l 95i;0:q ^ CLIC KTO ENLARG E IMAG E Squar e Footage : 1404. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor y Fi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : Fram e Sidin g Units : 1. 0 interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 2. 0

Roo f Type : Gabl e Stories : 1. 5 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 6 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 I Appl i lanc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 ft 960. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 396. 0 Porc h En d Soli d Wal l 144. 0

... mapping-online.com/. ../accountinfo.j..
. 2/3

## CONSEN T FO RACCES S T O PROPERT Y OMAH A LEA D SIT E REMEDIA L ACTIO N - LEAD-BASE D PAIN T STABILIZATIO N PROPERT Y I D PROPERT Y ADDRES S 

# « I OWNE RNAiVl E DAYTIM E PHON E 

### CEL L PHONE : rX O i p S ^ (J D E-MAI L OWNER' S ADDRES S I FDIFFERENT : TENANT' S NAM E I FAPPLICABLE : DAYTIM E PHONE : CEL L PHONE : E-MAIL : Professiona l Environmenta l Engineers , Inc . (PE ) i s unde r contrac t (#EP-R7-08-06 ) wit h th e U.S . Environmenta l Protectio n Agenc y (EPA ) t o stabiliz e lea dbasedpain t (LBP ) o n residentia l structure s a t anumbe r o f propertie s locate di 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 db y EPA contractors . Pain t stabilizatio n activitie s wil l include : scrapin g ofcracke do r flakin g LB P fromstructures , applicatio n o f aprim e coa t an dtw o (2 ) coat s o f paint . Movin g part s o f window s an ddoor s ar e no t include dan dwill no t b e addressed . You r cooperatio n i s requeste di n givin g permissio n t o thi s EP A contracto r (PE ) t o ente r an dhav e acces s t o thi s propert y for th e purpos e o f stabilizin g lea d-base dpain t a s outline do n th e propert y identifie dabove . B

y signin g thi s documen t I agre e t o allo w a n EP A contracto r t o conduc t asoi l cleanu p a t m y propert y followin g completio n of lead-base dpain t stabilization , if th e soi l cleanu p ha s no t alread y bee n performed . I understan dtha t th e stabilizatio n contracto r can no t provid e assurance s tha 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 cleanu p contracto r wil l mak e al l reasonabl e effort s to addres s concern s tha t I , a s th e propert y owner , ma y hav e regardin g soi l cleanu p a t m

y property . 'Yes.lha v

I full y understan dtha t b y signin g thi s Consen t fo r Access , (I ) thi s acces s will remai n i n effec 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 , will b e give n th e Housin g an dUrba n Developmen t (HUD ) an dEP A pamphlet , ''Renovat e Right , Importan t Lea dHazar dinformatio n fo r Families , Da y Car e Providers , an d Schools" , (3 ) th e Propert y Owne r o r tenan t will remov e al l obstruction s fro msurface s t o b e painted , (4 ) wil l abid e b y health an d safet 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 ) will b e contacte db y aP E representativ e approximatel y 4 8 hour s in advanc e of startin g work , (7 ) agre e no t t o obstruc t o r tampe r wit h an y of th e LB P stabilizatio n actions , an d(8 ) wil l participat e i n fmal propert y inspectio n an dsig n th e Completio n Agreemen t an d Propert y Owne r Satisfactio n Survey . Shoul dyo u hav e an y question s abou t th e plane dLea dBased-Pain t stabilizatio n activitie s fo r you r property , pleas e contac t Professiona l Environmenta l Engineers , Inc . Projec t Manager , Willi e Cla y o r Kelle y Sander s At 402-504-4688 . Genera l question s abou t th e Omah aLea dSit e cleanu p ca n b e directe dt o Pauiett aFrance-Isetts , EPA Remedia l Projec t Manage r 402-731-2454 , o r th e EPA Publi c Informatio n Center s a t 402-991-958 3 (Nort h Omah aoffice ) o r 402-731-304 5 (Sout h Omah aoffice) . h i Ves , I gran t acces s t o m y propert y an d wa s give n th e pamphle t D No , I d o no t gran t acces s t o m y propert y an d 1 wa s ^novat e Right , Importan t Lea d Informatio n fo rFamilies , Chil d give n th e pamphle t "Renovat e Right , Importan t Lea d Car e Rn/viders,,an d Schools. " Informatio n fo rFamilies , Child e Car e Providers , an d Schools. ' Signatur e Date SPECIA LINSTRUCTION S AN D CONSIDERATION S

## PRE-RENOVATIO N FOR M ~ OWNE R Thi s for mi s t o b e use db y th e firms contracte db y th e Environmental Protectio n Agency-Regio n 7 t o perfor mLead-Base d Pain t stabilizatio n activitie s at th e Omah aLea dSite , Omaha , Nebraska . Owne r Confirmatio n Pamphle t Receip t iXrlhav e receive dacop y ofth e lea dhazardinformatio n pamphlet , Renovate Right : Importan t Lea dHazar dInformatio n fo r tarnilies . Chil dCar e Provider s an dSchools , informin g m e ofth e potential ris k ofth e lea dhazar dexposur e fro mrenovatio n activit y t o b e performe din/o n m y dwellin g unit . 1 receive dthi s pamphle t befor e th e wor k

began . Owne r Acknowledgmen t [A ) I confir mthat I ow n an dliv e i n thi s property , tha t no chil dunder th e ag e o f 6 reside s here , tha t n o pregnan t woma n rdfeide s here , andthat thi s property i s no t achild-occupie dfacilit>' . Note : A chil dreside s i n th e primar y residenc e o f his/her custodial parents , lega l guardians , foste r parents , o r informa l caretake r if th e chil dlive s an dsleep s mos t o f tim e a t th e caretaker' s residence . Note : A child-occupie dfacilit y i s apre-197 8 buildin g visite dregularl y b y th e same child , under 6 year s o f age , o n a t leas t tw o differen t day s withi n an y week , fo r a

t leas t 3 hour s eac h day , provide dtha t th e visit s tota l a t leas t 6 0 hour s annually . ) o (B ) I understan dtha t th e renovatio n firm , contracte dby th e Environmental Protectio n Agenc y (EPA) , wil l b e usin g lead

sSf e wor k

practice s require dby EPA' s Renovation , Repai r andPaintin g Rule . 

# I i^l.^,f A A
. Vyc , Printe dNam e o f Owner-Occupan t 

# ^-^j-l l Signatur e d f Owner-Occupan t \ j Dat e

### PAIN T STABILIZATIO N PRE-PROPERT Y PAIN T MATC H ASSESSMEN T PROPERT Y ADDRESS : ^3oC ^ U^^ S $ 7 

### OATE: G-^/'J I 

# BVID : 23B3' 7

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

# o COLOR : 

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T T HOUS E TRIAA : 

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# 4J ^ ^ GARAGE : COLOR : 

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# , ^ IJVAV 4 g./ ^ GARAG E TRIM : 

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(COMPLET E AL L SECTION , YES , NO , O R NON-APPLICABLE )



### I AGRE E T O TH E COLOR S LISTE D ABOVE
. ONC E TH E PAINTIN G BEGINS , I UNDERSTAN D I CA N NO T CHANG E TH E ABOV E SELECTE D COLORS : PROPERT Y OWNE R SIGNATURE : P E ACCESO R SIGNATURE : 

# ^ X

T ^