### TRANSMITTA Lo f OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL E FOLDE R SAI D # : gC^BS l Date : '^-30^0 ^ Address : \?^\ ^ ,5 ^ Q. ^ C^ f Remediatio n Contractor : PROFESSIONALENVIRONIVIENTA LENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FILE FOLDERDOCUIVIENT S Video o f

propert y (DVD) D Executive Summar y Qy ^ Signe d.Acces s Agreemen t fo r

subjec t propert y Qy"^ ^ Painting Agreemen t D Settlemen t documents (i.e. , fo r

ddmag e o r

t

o replac e plants , etc. ) y ^ Photograph s "^e^/i A p/)S r H^y^ ^ Satisfactor y restoration signe db y Propert y Owne r \iy ^ Propert y close-ou t chec k

list signe db y EP A Wy ^ Properl y informatio n fro mDouglas Count y Assessor' s Offic e B^ ^ _confirmation tha t lea dpamphle t "Renovat e Right " was receivedb y P O

D



### Professiona l Environmenta l Engineers Signatur e Dat e 

# y^,:/L,d^A6it
- ./Vf/ ^ Ignatur e ^ EP A Signatur e Dat ^ ^ 3009441 1 Superfun d

## PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC
. ''' ' Trilaht" N E esn o "Providin g cost-effectiv e environmenta l solutions " ^^ ^

JJ°^j 504:328 , Consultin g • Engineerin g Desig n • Remediatio n • Atiaternen t • EmergoncyRespons e



### Lea dBas e Stabilizatio n Omaha , N e Clos e Ou t Repor t 200 9 SAID #2035 1 131 7 S 2 5 S t

•Date s worked : 07/10/0 9 t o 07/10/0 9 •Pr e propert y condition : Hous e ha dviny l sidin g an dsom e transi t o n area s ofth e house , garag e wa s woo dwit hvery poo r paint . Tri mn nort hsid e neede dpainte ddu e t o i t bein g expose dwhe n stor mble w of f covering . •Problem s encountered : Non e •Owne r request/concerns : Colo r change s •Inspection/closeou t dates : Owne r signe d07/1 2 EP A 07/1 4 200 9

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC
. "Providin g cost-effectiv e environmenta l solutions " Cor.'siilt.n g • Engineerin g Dos.g n • Remerl tilir- n • Abaiomen t • En.P i joncyR^ipnns e 

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

## SAID : oiCy^' S \ Property Address : 1 3 1 '- ^ " S cJ^5 > ^ T Owner' s Name : T?MJl \C LloCePif"! ^ Performanc e Standards/Close-Ou t Criteri a 250 5 Nort h 24" , Suit e 21 9 Omaha , N E 6811 0 (402 ) 504-468 8 Fa

x(402 ) 504-328 1



### YE S N O 1 . Wa s th e entir e structure(s ) painte dwit hth 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 , columns , rails , an dexterio r surface s o f 

# y garages . 2 . Wa s al l scrapin g andothe r preparatio n wori c complete dsatisfactorily ? 

# y 3 . Were all require darea s ofth e structure(s ) prime da s neede dandpainte dwit h 

# y tw o to p coats ? 4 . Wa s th e pain t product s utilize dequivalen t t o a3 0 yea r producl/quality ? ,y 5 . Are all ofth e area s wher e contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? 

# y 6 . Di dth e contracto r collect/vacuu mall fallin g an dscrape dpain t chip s o n th e entir e property , roadways , alleyways , publi c acces s area s andals o remov e any t^ 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 ? ly 8 . Are 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 any evidenc e o f property damag e tha t wa s don e b y th e contractor ? Any property damag e need s t o b e complete dprio r t o th e EPA Close-Out . y 10 . Are ther e any property item s that wer e temporaril y re-locate db y th e contracto r t y that nee dt o b e move dback ? 11 . Are ther e any (known ) lingerin g issue s wit hth e property owner(s ) that hav e 

# y bee n lef t unresolved ? Other Considerations/Property Owne r Discussions/Additional Wor k

that i s Required :


# CUj;> t 

# iliyc o f EPA CO RSignature Date

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC
. "Providin g cost-effectiv e environmenta l solutions " Consultin g • Engineenn g Dc-s.g' i • Remed'iitio n • Abatemon t • EmergencyRespons o 

### Propert y Owne r Close-Ou t For m (Lead-BasedPain t Stabilization EP A Contrac t EP-R7-08-06 ) SAID : 

# 303S 1 Propert y Address : Owner' s Name : 

# 1 C. Keen-e- r 

# m l
Performanc e Standards/Close-Ou t Criteri a 250 5 Nor1h24' ^ Suit e 21 9 Omaha , N E 6811 0 (402 ) 504-468 8 Fa

x(402 ) 504-328 1



### YE S N O 1 . Wa s th e entir e structure(s ) painte dwit hth 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 , columns , rails , an dexterio r surface s o f 

# y garages . 2 . Wa s al l scrapin g an dothe r preparatio n wor k

complete dsatisfactorily ? ^ 

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

# y 4 . Wa s th e paint product s utilize dequivalen t t o a3 0 yea r product/quality ? 

# X 5 . Are al l ofth e area s wher e contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned' ' 

# y 6 . Di dth e contracto r 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 any othe r generate ddebris ? 

# y 7 . I s th e gras s are athat surround s th e structure(s ) i n reasonabl y goo dcondition ? 

# X 8 . Are al l item s suc ha s polyethylen e sheeting , ladders , pain t brushes , cones , barrie r tape , etc . properl y removed ? 

# X 9 . I s there any evidenc e o f property damag e that wa s don e by th e contractor ? An y property damag e need s t o b e complete dprio r to th e EPA Close-Out . ; < 

### 10 . Are ther e any property item s that wer e temporaril y re-locate dby th e contracto r that nee dt o b e move dback ? 

# V 11 . Are there any (known ) lingerin g issue s wit hth e property owner(s ) that hav e bee n lef t unresolved ? 

# y Comments : 

# T/U/ ^ Propert y Owne r

Signatur e Dat e 

# 7-^^-^ / ifessional-tnvi^wm i Professio n nmenta l Engineers Representative Dat e

# CONSENT FO RACCES S T O PROPERT Y OMAH A LEA D SIT EREMEDIA LACTIO N - LEAD-BASE D PAIN T STABILIZATIO N PROPERT Y ID : ,^Ci2: S \ PROPERT YADDRESS : 

# i^i n 

# s ^. s ^- ^ OWNE RNAM E PCUA. \ ^ rAcNfV ^ V-ygjE-Op rDAYTIM E PHONE : :EI3 L PHONE : *V\C\^CnnL p E-MAIL : CE U OWNER' S ADDRES S I FDIFFEREN T TENANT' S NAM EI FAPPLICABLE : DAYTIM EPHONE : 

# t^ouuuica\ ^ . ,_, , . , CEL LPHONE : \QI^'-\\\D H 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 ofcracke d o rflakin 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 as outline d o n th e propert yidentifie 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 . 1 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 , as th e propert yowner , ma yhav e regardin g soi l cleanu p a t m yproperty . ^^L/es , I hav e read^n d undarstan^ th e paragrap h above
. 

## MAJ A 

# (o7^'7/o ^ ilgnatur 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 acce.s 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 , i f applicable , wil l b e give n th e Housin g an d Urba n Developmen t (HUD ) an d EP Apamphlet , "Renovat e Right , Importan 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 yo f propert 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 office)
. M Yes , I gran t access t o m ypropert yan d wa s give n th e pamphle t D No , I d o no t gran t acces s t o m ypropert yan d I wa s "Renovat 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 Providers , an d Schools. " Informatio n fo rFamilies , Child e Car e Providers , an d Schools. " Sianatur e Dat e Signatur e Dat e SPECIA L INSTRUCTIONS AN D CONSIDERATIONS

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### 4 Dougla s County Accoun t Informatio n Pag e 1 of 3 

# c2)3r / Dougla s County , Nebrask a Propert yRecor d - R221948000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t of 52n d S t - ViC W O n Ma P Informatio n i s vali d a s o f 2009-6- 3 Treasurer' s Ta xRepor t Ne wFeatur e «•-•" • Aut o Sale s Searc h 

### Owne r KEENE R PAU L C ETA L 

# y 131 7 S 2 5 S T OMAH AN E 68105-000 0 

# -sqa-3-g-J o Propert yInformatio n Ke yNumtier : 194 8 000 0 2 2 

# • 70 T (-^Ci*^ / Accoun t Type : Residentia l Parce l Numbe r 221948000 0 Parce l Address : 131 7 S 2 5 S T OMAH AN E 68105-000 0 Lega l Description : SHULL S 2N D AD D LO T1 8 BLOC K1 2 5 0 X 12 6 Valu e Informatio n Lan d Improvemen t Tote l 200 9 $4,900.0 0 $80,400.0 0 $85,300.0 0 200 8 $4,900.0 0 $80,400.0 0 $85,300.0 0 200 7 $4,900.0 0 $80,400.0 0 $85,300.0 0 

### 200 6 $4,900.0 0 

### $79,000.0 0 $83,900.0 0 200 S $4,900.0 0 $79,000.0 0 $83,900.0 0 200 4 $4,900.0 0 $79,000.0 0 $83,900.0 0 Sale s Informatio n Sale s Date : 2003-07-2 5 Dee d Type : W D Book : 200 3 Page : 16124 9 Price : $51,334.0 0 Grantor : Gale n R Myers ETA L Grantee : Pau l C Keene rETA L Valld/lnvalld : Vali d Exclusio n Reason : Sale s Date : 1996-06-0 6 Dee d Type : Book : 203 9 Page : 55 0 Price : $ 65,000.0 0 Granto r 

### http://dougIasne.mapping-onIine.com/DougIasCoNe/static/accountinfo.jsp?accountno=R221. . . 6/9/200 9

# . i Dougla s County Accoun t Informatio n Pag e 2 o f 3 Grantee : Valid/invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Granto r Grantee : Valid/Invalid : Exclusio n Reason : Lan d Informatio n Acre s S F Vali d
1993-06-1 4 

### $46,950.0 0

Vali d

Untt s 0.1 4 6300. 0 

### 1. 0 Improvemen t Informatio n Buildin g 1

Squar e Footage : Perimete r Uni t Type :

Buil t As :

HVAC : Exterior : Interior : Roo f Cover -

Roo f Type : Floorcover : 

### 1706. 0 0. 0 2 Stor y Centra l Ai rt o Ai r Fram e Viny l Plaste r Compositio n Shingl e Gabl e Allowanc e Book : 

### 195 3 Page : 

### 397

Dept h Widti i Vacan t 126. 0 50. 0 N o

ri^ i 9i M vw M « »

FIr Kfine r 174. 0 sq * Secon d FlO M 

# 7

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. ft 

# V ^ ^ 2 STOR Y

er-> « BUCKS 1 1

5i»:»>( a I ! CUgjyjOENLARGEIJ ^ Percen t Complete : 

### 100.0% Quality : Averag e Condition : Averag e Cond o Squar e Footage : 0. 0 Rooms : 7. 0

Units : 1. 0 Baths : 3. 0 Bedrooms : 3. 0 Stories : 2. 0 Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 

### http://douglasne.mapping-online.eom/DougIasCoNe/static/accountinfo. j sp?accountno=R221.. . 6/9/200 9

### M C Services , LL C Propert yAddres s Start Dat e \o \ | O /- O vTS r En d Dat e 

# 7-/o^0 ^
Amoun t O f P Prim e (Gallons )

Pol y(Boxes ) Pain t (Coior ) Pain t (Color ) Pain t (Color ) ^ 

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# i ^

Pain t (Color ) Amoun t (Gallons ) Pain t (Color ) Amoun t (Gallons )

## Professiona l Environmenta l Engineers , Inc
. INTERVENCIO N D E SEGURIDA D Nombr e de l Proyecto : )o \ ( ^ Z O Q V Fech a d e l a Intervencion:' ( ~ [ O ""VJ ^ Peligro s d e Salu d Primordial : i^CXC 3 Preocupacione s Primordiale s d e H & S:
_ Tarea s Diarias : 1 .pCWri ^ kVYj A 

# j.-Qmnm ^ Equip o Usad o e n e l Luga rd e Traabjo : Casc o Dur o y Escaler a " ^ Gafa s d e Segurida d y Elevadore s Zapato s GFC I ^ Guante s d e Trabaj o J^,
. Chale'Co s d e Segu rida d Generadore s ~y . 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 Politic o d e Salu d ySegurida d d e l a Compani a GFC I e n siti o y . Deficiencias :
Accione s Corretivos :

Interventor : Fecha : Superviso rde l Sitio : Cc^c/o ^

^- < ^^•w.-l:<gSJecha : f ' ^ 0 • O ^