TRANSMnTAL of OMAHA LEAD SOTE 

PAINT STABU^IZATION FILE FOLDER 

SATO*: /8S52 ^ Date: //m m 

A^: )q3i So. ^4 ^ ^-t " I 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

Oy ^ Video ofproperty (DVD) 

tl Executive Simunaiy 

^ y Signed Access Agreeinen t for subject property 

S""" ^ Painting Agreemen t 

D Settlement documents (i.e., for dainage or to replac e plants, etc.) 

- ^ ^ Photographs h^y?j j q-f ^ . 

a^^^adsfectory restoration signed by Property Owner 

(B|lr Property close-out check list signed by EPA 

I& Properly information fiwm Dougla s County Assessor's Office 

y _confiimation tha t lead pamphle t "Renovat e Right " wa s received b y PO _ 

a ^ 

D 

D 

\ ^ Professional Eim(^ninenta i Engineers Signature 

ii mE PA Signatur e 4 ^ 

30054997 

Superfund 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. ''° ' ""ol'tNE 6'8?!o 

"Providing cost-effective environmental solutions" ^ \t?^, c^too? ** Fax (402) 504-3281 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2009 

SAID^ 18832 

1931 S 34 St. 

• Dates worked: 10/19 to 10/24 2009 

• Pre property condition: Large home with wood and slate siding that was in poor 

condition. Siding had areas of damage and it appears as if homeowner is doing 

renovations to property. Back garage was not painted due to owner doing work and it 

was not previously painted. 

• Problems encountered: None 

• Owner request/concerns: N/A 

• Inspection/closeout dates: Owner signed 10/27, Inspected by PE project manager.. 
PROFESSIONAL 

2505 North 24"', Suite 219 ENVIRONMENTAL ENGINEERS, INC. Omaha, NE 68110 

(402) 504-4688 "Providing cost-effective environmental solutions" Fax (402) 504-3281 

Consulting ° Engineering Design • Remediation ' Abatement • Emergency Response 

Property Owner Close-Out Form 

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

SAID: /S S^2^ 

Property Address: J^V^i , ^ ^^ 4 < ^ 

Owner's Name: j^TjT\C\< ^ J T O/^N^ ^ 3 ^ - 4(^ 03 

Performance Standards/Close-Out Criteria YES NO 

1. Was the entire structm'e(s) painted with the exception ofthe stated, excluded 

areas? This would include painting of other associated features including fascia, 

eaves, siding, all trim, porches, box beams, columns, rails, and exterior sturfaces of 

garages. X 

2. Was all scraping and other preparation work completed satisfactorily? T 

3. Were all required areas ofthe structure(s) primed as needed and painted with 

two top coats? [ X 

4. Was the paint products utilized equivalent to a 30 year product/quality? ?

5. Are all ofthe areas where contanoinated materials have been spilled thoroughly 

vacuiuned/ cleaned? y 

6. Did the contractor collect/vacuum all falling and scraped paint chips on the 

entire property, roadways, alleyways, public access areas and also remove any 

other generated debris? X 

7. Is the grass area that svuroimds the structm'e(s) in reasonably good condition? y 8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, 

barrier tape, etc. properly removed? X 

9. Is there any evidence ofproperty damage that was done by the contractor? Any 

property damage needs to be completed prior to the EPA Close-Out. M, 1 g ^ 

10. Are there any property items that were temporarily re-located by the contractor 

that need to be moved back? 

i 11. Are there any (known) lingering issues with the property owner(s) that have 

been left unresolved? y 

Comments: 

yO'^7'0/ 

Professional Envir^imental Engineers Representative Date 
CONSENT FOR ACCESS TO PROPERTY 

OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTV ID: ^ K5)'2> ^ PROPERTV ADDRESS: /^3 / * ^ ^ 4 'Sj ' 

O^jN^iyVjE:. ^ ^ Rlalce . DAYTIME PHONE: >^^'-^4P ' V(^^? 3 

CELL PHONE: V^c^ ' V^/ ^ ' SV^ ^ E-MAIL: . 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME IF APPLICABLE: 

DAYTIME PHONE: ^ 

CELL PHONE: E-MAIL: .-

Proressional 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 flaking 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 identified 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, if the 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. 

I have ami understand the ^Y" . WLAI ^ 

Signature of Pro| Date 

I fully understand that by signing this Consent for Access, (I) this access will remain in effect until the work has been 

satisfactorily completed, (2) that the Property Owner or Tenant, if applicable, will be given the Housing and Urban Development 

(HUD) and EPA pamphlet, ''Renovate Right, Important 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 office). 

»^ Yes, 1 graht access to my property and was given the pamphlet D No, t do not grant access to my property and I was 

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

Care-Providers, and Schools." Information for Families, Childe Care Providers, and Schools." 

%i^ //)/^m 

Signature Signature Date 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
\y \ 

PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS: \ ^^ \ S 3 ^ c^ j DATE: 10' ^ 

BVID: / O c5 ^ Z . 

AREA(S) TO BE PAINTED: 

HOUSE PROPER: J a M^iB^^if-s I/H ^ COLOR: 

HOUSE TRIM: ly/^y ^ COLOR: (iJA/Jy ^ 

GARAGEK-Jlc : ///: ) COLOR: ^ 

/2 ^ ^^.j^^^^/f/ ^ \^J^.J^^ 

GARAGE TRIM://y JU > COLOR: 

PORCH : iMy y COLOR: (^yj/J^, ^ 

• ^y).y>£^ ^ jd^A^j2^ ^?-A^^2^^ y ^ ^ ^yyy/ii^y y :j^.^^ j 

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: 

^.So/1 
Douglas County Accoimt Information Page 1 of3 

^ /8357 I.s 

1 \_ y fc-^ 

Douglas County, Nebraska Property Record - R2540870000 

Print Reoort 

NEW Feature - Parcel Dimensions available ® scale 0-50 ft west of 52nd St - VIS W OH Ma O Information is valid as of 2009-9-15 Treasurer's Tax Reoort 

New Feature -•-•- • Auto Sales Search 

Owner 

BLAKE PATRICIA J 

OMiHA^Il8105-0000 J^-lS " H^oO ^ Q % ' S7<^ C 

Property Informatio n WISCX ^IZ- ^ 

Key Number 4087 OOOO 25 ^ 

Account Type: Residential 

Parcel Number 2540870000 

Parcel Address: 19318 34 ST 

OMAHi ^NE681( D5-0000 

Legal Description: WINDS JOR PLAC :E LOT 39 BLOC K 0 N 44.5 W 95 FT LOT 39 44.5 X 95 

Value Informatio n 

Land fmprovement Total 

2009 $5,400.00 $101,100.00 $106,500.00 

2008 $5,400.00 $101,100.00 $106,500.00 

2007 $5,400.00 $101,100.00 $106,500.00 

2006 $5,400.00 $79,800.00 $85,200.00 

2005 $5,400.00 $79,800.00 $85,200.00 

2004 $5,400.00 $79,800.00 $85,200.00 

Sales Informatio n 

Sales Date: 1995-09-26 

Deed Type: D Book: 2018 Page: 064 

Price: $58,00 0.00 

Grantor: 

Grantee: 

Valid/invalid: Valid 

Exclusion Reason: 

Sales Date: 1991-10-04 

Deed Type: D Book: 1913 Page: 743 

Price: $42,950.00 

Grantor 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accountno=R25... 9/20/2009 
Douglas County Account Information Page 2 of 3 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.09 4275.0 1.0 95.0 45.0 No 

Improvemen t Informatio n 

Building 1 

1 1/2 STORY UNFINISHED 

IJlUUSii M 

'7 

.-.» i 

•.SaallioFi 

CLICK TO ENLARGE IMAGE 

Square Footage: ' 1205.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 4.0 

Exterior: Frame Siding Units: 1.0 

Interior: j Drywall Baths: 1.0 

Roof Cover: ' Composition Shingle Bedrooms: i 2.0 

Roof Type: ; Hip Stories: 1.5 

Floorcover: Allowance Foundation: I Block 

f- Sprinkler Square Footage: | 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1907 0% 1907 102 

Detail Type Detail Description Units 

Add On Unfinished Attic W/floor 1205.0 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 1.0 

Basement Bsmnt Block 8 ft 1205.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R25... 9/20/2009 
H^^maiVy 

JC Painting 

Property Address tC\?>V S ­ 7^4^ sr\ ­ Date 1Q — '^ S-0< ^ 

Start Date [ 0 ~ 1 ^ ­ O Q Complete Date |_ 0-^4-o<^. 

Amount Of Prime And Paint Used 

Prime (Gallons) ~S^ 

Poly (Boxes) <3 ^ 

Paint (Color) S^^ 

Paint (Color) 

Paint (Color) 

Paint (Color) 

Paint (Color) 

Amount (Gallons) 

Amount (Gallons) 

^ ^ 

Qj 

Amount (Gallons) r^ g fi^^l ^-^^^ 

Amount (Gallons) 

Amount (Gallons) 
. '^ 

Professional Environmental Engineers, Inc. 

SAFETY AUDIT 

Project Name: //f^/ h ~^^/.^-h 

Date of Audit: f O " ^ O -O f 

Primary Health Hazards: 4^/:A ? o y^ef r.{/<~:^ 

Primary H 8. S Concerns: COO J ^^ y 

Dally Tasks: 1 es6->^ff'r ^ ^ 

2. P-yj' <rm' c^y 

3 f .s4 . ¥n4^ ^ 

Equipment Used at Jobsite: 

Hard Hat P/" Ladder ^ / 

Safety Glasses ^ / Boom Lifts ___ ^ 

Steel Toed Shoes ^ / GFCI ^ / 

Work Gloves / Safety Vests / 

Generators \ / Other y 

Equipment Ready for Emergency Response at Immediate Disposal: 

Daily Safety Meeting Conducted y 

First Aid Kit '/ . 

Emergency Procedures y ^ 

Company Health and Safety Policy 

GFCI on-site t 

Deficiencies: xy'/y^ 

Corrective Actions: 1/ v ^ /^ A y 

Auditor: ^^/-. x \^(/1 \ Cyr^T ^ Date: /f ) -^- O -ig>f 

Site Supervisor: '^^.t„.,^iLQ^\r.\...t^ Date: t Q-3-i-c^c ^ 
PROFESSIONAL ENVIRONMENTAL ENGINEERS, INC. 

DAILY SAFETY MEETING 

Date: / ^ - ^ d " ^ ^ 

Project: Omaha Paint Stabilization Project 

Location: / f 1? I ^ ^V.^ ^ 

Site Activity: 

Daily Tasks: 

1. ^^Cyp^pyc/^ 1^ 

2. /P lr I )7^f>i y 

3. y/<7 V^^^ 

Primary/Potential Hazards: 

1. 4rs-r. h (? r/'^ C>^c/^ 3.

Work Tools: 

1. gg< ^ hl^dy ? 3.

2. ^fit^^ft/ ^ 4.;

Work Practices/Corrective Actions: 

1. yAy/y r 3. 

2. 4. 

Previous Close Calls: 

]. w/y ^ 3. 2. 4. 

Employee Sign In Log: 

1. yycj-y (yi 1^ r.yo' ^ 3. 2. LrpHC / 4. 5. ffl^f^^ >- 6. 

7 8. 

Site Health & Safety Signature

 h)rv^yh a ^ Cpp/^ ^ y 

 hr^C^hf^ ^ 

 ^(yn^YG^e^^< ^ 

 Date