### TRANSMITTA Lo f OMAH A LEA D SIT E PAIN T STABILIZATIO NFIL EFOLDE R 

## SAID# : iMLoS qDate : _g|^y_|_Q3 _ Address : ^SC^Q Q S T^C ^ A f Remediatio nContiactor : PROFESSIONALENVIRONMENTALENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERTY FIL EFOLDERDOCUMENT S B''^^^^ide o of propert y (DVD) y ^ Executive Summar y \^

—SignedAcces s Agreemen t fo r

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

damage o r

t

o replac e plants , etc. ) Ok'-^'^Photograph s pX ^ . npA TY^V T [B ^ Satisfactor y restorationsigne db y Propert y Owne r D Propert y close-ou t chec k

list signe db y EP A ^Sr ' Propert y informatio nfro mDouglas Count y Assessor' s Office Gy _confirmationtha t lea dpamphle t "Renovat e Right " was receivedb y P0 _ D D 

# "^m m ProfessionaltoivTroAmenta l Engineer s Signatur e ' Dat e

/ ' EP A SiglTatur e 'Dat e 3009437 9 

# iiiii i Superfun d

## PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . ''° ' 'ol'nrNEesn o "Providin g cost-effectiv e environmenta l solutions " ^ Consultin g • Engineenn g Desig n • Remediatio n • At^nteincn t • Emeiyenc vRespons e 

### ^ 1^°^ | fn^oo! ! Fa x(402 ) 504-328 1



### Lea dBas e Stabilizatio nOmaha , N e Clos e Ou t Repor t 200 9 SAID #1465 9 302 2 S 3 3 S t

•Date s worked : 07/2 0 t o 07/2 2 200 9 •Pr e propert y condition : Hous e ha dwoo dsidin g infai r conditio nwit hsom e spot s wlier e pain t wa s flaking. Tri man dbric k o ngarag e an daroun dth e hous e ingoo dconditio n overall . •Problem s encountered : N/ A •Owne r request/concerns : Owne r commente dh e wishe dpainter s woul dhav e tape dof f an dcovere dth e window s befor e painting , als o di dno t prim e an y bar e spot s of wood . Issue s solved . •Inspection/closeou t dates . Owne r signe dby 07/2 4 2009 . Inspecte db y P Eprojec t manage r 07/2 4 2009 .

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . "Providin g cost-effectiv e environmenta l solutions " Consultin g • Engineerin g Desig n • Remed'atio n • Abatement « F.meigenc yRespons e 

### Propert y Owne r Close-Ou t For m (Lead-Base dPain t Stabilizatio nEPA Contrac t EP-R7-08-06 ) 

# SAID : NloF. ^ Propert y Address : SCk)< 2 S J^ S y T Owner' s Name : iDcm l <: C ( , • Ikmrsl," ^ Performanc e Standards/Ciose-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 nofth 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 garages . 

# t 2 . Wa s all scrapin g an dothe r preparatio nwor k

complete dsatisfactorily ? 3 . Were al l require darea s ofth e structure(s ) prime da s neede dan dpainte dwit h 

# 7 tw o to p coats ? 4 . Wa s th e pain t product s utilize dequivalen t to a3 0 yea r product/quality ? 

# t 5 . Are all ofth e area s wher e contaminate dmaterial s hav e beenspille dthoroughl y vacuumed / cleaned ? 

# J 6 . Di dth e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s o nth e entire property , roadways , alleyways , publi c acces s area s an dals o remov e any 

# J . othe r generate ddebris ? 

# i 7 . I s th e greis s are athat surround s th e structure(s ) i nreasonabl y goo dcondition ? 8 . Are all item s suc ha s polyethylen e sheeting , ladders , paint brushes , cones , barrier tape , etc . properl y removed ? 

# 7 9 . I s there any evidenc e o f property damag e that wa s don e b y th e contractor ? An y property damag e need s t o b e complete dprio r t o th e EP A Close-Out . 

# J 10 . Are there an y property item s tha t were temporaril y re-locate db y th e contracto r 

# J v/ that nee dt o b e move dback ? 11 . Ar e there an y (known ) lingerin g issue s withth e property owner(s ) that hav e bee nlef t unresolved ? 

# i Comments : Q /HJ^M ~ 

### - - / ^ - - i 

# MM


# y,ysr^ y-^'i-Qc ^ Property Owner Signature Date 

# /g/^ ^ y-^^'J-o p Professional Envircsmnenta l Engineer s Representativ e Date

# CONSEN T FO RACCES S T O PROPERT Y OMAH A LEA D SIT EREMEDIA LACTIO N- LEAD-BASE D PAIN T STABILIZATIO N PROPERT Y iP : )^lt;>*N ^ PROPERT Y ADDRESS : '2>097oK . ^Qchf- K SSft OWNEij^NAm ^

^ fhl^SL-B- YDAYTIMEPHONE : G ^ 3^ 1 ~9 S iS ' CEL LPHONE : {HCfX ) (y^ I •~3ZJT / E-MAIL : Y^'j'i\)U^d\Z.^( k AO L . CO M OWNER' S ADDRES S I FDIFFERENT : TENANT' S NAM EI FAPPLICABLE : DAYTIM EPHONE : CEL LPHONE : E-MAIL : Professiona l Environmenta l Engineers , Inc . (PE ) i s unde rcontrac t (#EP-R7-08-06 ) witl i 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 fpropertie 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 rflaking LB P fro m structures , applicatio n of a prim e coa t an d tw o (2 ) coat s o fpaint . Movin g part s o fwindow 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 yidentifle 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 . ^S^Yes , I hav e rea d an d uKdjerstand ^ pMfgrap l Signatur e o fPropert yOwne r Date 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 , 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 fpropert 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 fstartin 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 flnal 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 rproperly , 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 offlce ) o r402-731-304 5 (Sout h Omah a offlce) . Yes , I gran t acces s 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

Care Prpvjders , an d Schools. " Informatio n fo rFamilies , Child e Car e Providers , an d Schools. " 

## l-IS-cf f Signatur e Signatur e Dat e SPECIA L INSTRUCTION S AN D CONSIDERATION S

## PAIN TSTABILIZATIO N PRE-PROPERT Y PAIN TMATC H ASSESSMEN T PROPERT YADDRESS : 3 0 9,0 ^ JOgf KoJ->r ^

DAT E 

# : 7-/5-Q 9 BVID :
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0 r ^ i 1^ 3 AREA(S ) T O B E PAINTED : HOUSE PROPER : Vkfe-i'm^Ul U WilV KCOLOR : U ^

1 'IM\J\ L

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### f^\0' i v\\^2i— ^ HOUSE TRIM : BJ/k? ^ ^/ ^

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### GARAG E TRIM : B^Ac H BE/ W ^QO ^ COLOR : (AorY\\\f \ Q^ SU M 

## PORCH : M , prialyi Q 5of O COLOR : 

## fApmtin a -S o N

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### 6\^c ^ Be/>- M ioo/ ^ COLOR : MorK\iino > -S^/ g (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 TCHANG E TH E ABOV E SELECTE D COLORS : PROPERT YOWNE R SIGNATURE : P E ACCESO R SIGNATURE : 

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### Dougla s Count y Accoun t Information Page 1 of 2 

# *_i!^£ a Dougla s County , Nebrask a Propert yRecor d - R194252000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t of52n d S t - VIC W O n Ma P Informatio n i s vali d a s o f 2009-6-1 6 Treasurer' s Ta xRepor t Ne wFeatur e ••-•- • Aut o Sale s Searc h Owne r HEMSLE YDONAL D L %,r v 

## ^^ V ETA L 

## Co^ ^ 302 2 S 3 3 S T OMAH AN E 68105-000 0 ^;jJ€(Ji _ 

## 9<^r ^ 

# 341-^^^1 6 Propert yinformatio n ^i^ ^

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c,iX'ic.£ > Ke yNumbe r 425 2 000 0 1 9 Accoun t Type : Residentia l Parce l Numbe r 194252000 0 Parce / Address : 302 2 S 3 3 S T OMAH AN E 68105-000 0 Lega l Description : PARKVAL E LO T6 BLOC K4 4 0 X 13 0 Vaiu e Informatio n Lan d Improvemen t Tota l 200 9 $ 5,800.0 0 $ 107,600.0 0 $ 113,400.0 0 200 8 $ 5,800.0 0 $ 107,600.0 0 $ 113,400.0 0 200 7 $ 5,800.0 0 $ 107,600.0 0 $ 113,400.0 0 200 6 $ 5,800.0 0 $ 93,400.0 0 $ 99,200.0 0 200 5 $ 5,800.0 0 $ 93,400.0 0 $ 99,200.0 0 200 4 $ 5,800.0 0 $ 93,400.0 0 $ 99,200.0 0 Sale s Informatio n Sale s Date : 1992-03-1 1 Dee d Type : Book : 192 4 Page : 74 9 Price : $ 40,000.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 1 5200. 0 1. 0 130. 0 40. 0 N o Improvemen t Informatio n 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R194.. . 7/9/2009

### Dougla s Count y Accoun t Information Page 2 of 2
Buildin g 1

Firs t Floo r 8S 7 0Gq.ft . s«canttftoa r 68S.0»Q.f t

2 STOR Y ^.tnKliu.^ t

• "iB w ^ CLIC KT O ENLARG E IMAG E Squar e Footage : 1575. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 8. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal i Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 191 6 0 % 191 6 9 2 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1. 0 Applianc e Fireplac e Masonr y 1. 0 Basemen t Bsmn t Bloc k 8 ft 880. 0 Basemen t Minima l Finis h 100. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 320. 0 Porc h En d Soli d Wal l 64. 0 Porc h Sla b Roo fCei l 18. 0 Porc h Woo d Dec k 105. 0 

### http://douglasne.mapping-onIine.com/DouglasCoNe/static/accotmtinfo.jsp?accoimtno=R194.. . 7/9/2009

### Propert yAddres s Start Dat e

Prim e (Gallons )

Pol y(Boxe s ,Pain t (Colo r Pain t (Colo r Pain t (Colo r Pain t (Colo r Pain t (Colo r 

# J C Paintin g Hd^ ^ -s . 5 3 ^4 - 

## Dat e ^-{I r-0 ^ 1 " 9 0 ^ 0 ^ Complet e Dat e 

# >n - 

# a:z- o Amoun t O fPrim e An d Pain t Use d

3 L 5IA 3 

# t l ^ Amoun t (Gallons ) |t ^ a Amoun t (Gallons ) j O ^ 

### Amoun t (Gallons ) Amoun t (Gallons ) Amoun t (Gallons )

## Professiona l Environmenta l Engineers , Inc . INTERVENCIO N DE SEGURIDA D Nombr e Cii? ! Proyei,t o 

# .5^^ ^ 333 T Fech o d e l a Inlervencion : 0//yi/ ^ Peligro s d e Salu d Primordial : Preocupacione s Primordiale s d e H & S : Tarea s Didricis : '< L 

# 2. pc/^^C ^ 3 /y^'y^y ^ Equip o Usad o e n e l Luga rd e Traabjo :

Equip o List o par a Respuest a d e Emergenci a a Disposicio n Inmediata : Casc o Dur o Escolet a Gate s d e Segurida d Zapato s Guante s d e Trabaj o Generadore s 

# ^ y X y Elevadore s GFC I y:.. . . Ctioleco s d e Segurida d Otr o y 

# y. Conduci rReunio n Diari a d e Segurida d Estuch e d e Primero s Auxilio s Procedimiento s d e Emergenci a Politic a d e Salu d ySegurida d d e l a Compani a GFC I e n siti o Deficiencias :
Accione s Corretivos . 

# f^/cj? ^ & Iritefveriioi . 

## 'f l Urro-^ v recnu . Superviso rde l Sitio: U -cc^tJ L pt^hi** ^ Fecho : ^Jy-^/^/yfPROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . REUNIO N DIARI AD E SEGURIDA D 

# Fecho . D]/^'A ^ Proyecto " Omoh o Poin t Stabilizatio n Proiec t 

## Lugor : ^^^ 3 Z 3 <^' l Siti o d e Actividad ' Tarea s Dianas " I 2 . p r/ /Jh. ' 

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# ' p a y / Primordial/Peligro s Potenciales : 3 2 . ._ _ _ . 4 . Herramienta s d e Trabajo : 

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### 3 . 4 . 6 . 7 M - ^ ^Ua> - y7^ ^ * ^

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### 8 . Firm a d e Salu d ySegurida d de l Siti o Fech a