### TRANSMITTA L o f OMAH A LEAE J SIT E PAIN T STABILIZATIO N FIL E FOLDE R SAI D # : ?j0'gnL D Date : 1^^^) ^ 

# Address : 99C)7 ^ TrrAr)k\\7 ) f\^: . Remediatio n Contractor : PROFESSIONA L ENVIRONMENTA L ENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S 'hyT ^ Vide o ofpropert y (DVD ) ' t l Executiv e Summar y y SignedAcces s Agreemen t fo r

subject propert y f] Paintin g Agreemen t D Settlemen t document s (i.e. , fo r

damag e or t o replac e plants , etc. ) Q^^hotograph s [)fi^c . AA/ 1 t?Jpk r QA ^ Satisfactor y restoratio n signedb y Propert y Owne r j y Propert y close-out check lis t signedb y EP A QA " Propert y infonnatio n fiomDougla s Count y Assessor' s Office my ^ confirmation tha t lea dpamphle t "Renovat e Right " wa s receive db y P0_ D D D 

# mm ^ Professiona l f^yiroirtnu^Ia l Engineer s Signatur e

*

A Signatur e 

# ^kk

­ 3005463 9 

# iinmiii i Superfun d250 5 Nort h 24"" , Suit e 21 9 Omaha , N E 6811 0 (402 ) 504-468 8 Fa x (402 ) 504-328 1 

# 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



### Lea dBas e Stabilizatio n Omaha , N e Clos e Ou t Repor t 200 9 SAID#2637 6 280 2 Frankli n S t

•Date s worked : 09/1 8 t o 09/1 9 200 9 •Pr e propert y condition : Hous e ha s woo dsiding . Pain t o n sidin g wa s in extremel y poo r conditio n an dwa s flaking an dpeelin g of f

al l over on t o th e ground . Pain t chip s i n yard . •Problem s encountered : Pain t chips . •Owne r request/concerns : N/ A •Inspection/closeou t dates . Owne r signe d09/2 2 2009 . Propert y inspecte db y P E projec t manager .

# PROFESSIONA L 250 5 Nort h 24 ^ Suit e 21 9 

# ENVIRONMENTA L ENGINEERS , INC . Omaha , N E 6811 0 (402 ) 504-468 8 

### "Providin g cost-effectiv e environmenta l solutions " Fax (402 ) 504-328 1 Consultin g • Engineerin g Desig n • Remediatio n • Abatemen t • Emergenc y Respons e 

### EP A Close-Ou t For m (Lead-BasedPain t Stabilizatio n EP A Contract EP-R7-08-06 ) 'Z-U'SILJ O SAID : PropertyAddress : '2-g>6'Z

_^Fr7XY\\z\'\y ^ 'S' V Owner'sName : '£>rehdc \&el 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 ofth e stated , excluded areas ? Thi s wouldinclud e paintin g o f

othe r

associate dfeature s including fascia , eaves , siding , al l trim , porches , box beams , columns , rails , an dexterior surface s of 

# y garages . 2 . Was al l scrapin g andothe r

preparatio n wor k

completedsatisfactorily ? 

## A 3 . Wer e all require darea s ofth e structure(s ) primeda s neededan dpainte dwit h tw o to p coats ? 

## A 4 . Was th e pain t product s utilize dequivalen t to a3 0 yea r

product/quality ? A 5 . Ar e all ofth e area s wher e contaminatedmaterial s have bee n spille dthoroughl y vacuumed / cleaned ? \ / 

### 6 . Didth e contractor collect/vacuumall falling an dscrapedpain t chip s on th e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e an y ^ 

### othe r

generate ddebris ? 7 . I s th e gras s are atha t surround s th e structure(s ) in reasonabl y goodcondition ? ^ y 

### 8 . Ar e all item s suc h a s polyethylene sheeting , ladders , pain t brushes , cones , t 7 

### barrie r

tape , etc . properly removed ? 9 . I s ther e an y evidenc e ofpropert y damag e tha t wa s don e b y the contractor ? An y propert y damag e need s to b e completedprior to th e EP A Close-Out . .A

­ 

### 10 . Ar e ther e an y propert y item s tha t wer e temporarily re-locatedb y th e contractor y 

### tha t needt o b e movedback ? 11 . Ar e ther e an y (known) lingering issue s wit h th e propert y owner(s ) tha t hav e bee n lef t unresolved ? tA ^ 

### Othe r

Considerations/Propert y Owne r

Discussions/Additiona l Wor k

tha t i s Required :

EP A CO RSignatur e Dat e

# PROFESSIONA L 250 5 Nort h 24 % Suit e 21 9 

# ENVIRONMENTA L ENGINEERS , INC . Omaha , N E 6811 0 (402 ) 504-468 8 

### "Providin g cost-effectiv e environmenta l solutions " Fax (402 ) 504-328 1 Consultin g • Engineerin g Desig n • Remediatio n • Abatemen t • Emergenc y Respons e 

## Propert y Owne r Close-Ou t For m (Lead-BasedPaint Stabilizatio n EP A Contrac t EP-R7-08-06 ) 

## SAID : 7.l0y^ U PropertyAddress : 29^U L JT^H^^ ^ Q ^f " Owner'sName : f^rf^Qcj a1^ ( ^ ^ Performanc e Standards/Close-Ou t Criteri a YE S N O 1 . Was th e entir e structure(s ) painte dwit h th e exceptio n ofth e stated , exclude d areas ? TW s wouldinclude paintin g o f

other associate dfeature s includin g fascia , eaves , siding , all trim , porches , bo x beams , columns , rails , an dexterior surface s of garages . • ^ 

### 2 . Was all scraping andolfae r

preparatio n wor k

complete dsatisfactorily ? 3 . Wer e all require darea s ofth e structure(s ) prime da s neededandpainte dwit h A 

### tw o top coats ? [ 4 . Was th e pain t product s utilize dequivalen t t o a3 0 yea r

product/quality ? S . Ar e all ofth e area s wher e contaminate dmaterial s hav e been spille dthoroughly J 

### vacutmied / cleaned ? 6 . Didth e contractor collect/vacuim i all fallin g andscraped paint chip s o n th e entir e property , roadways , alleyways , publi c acces s area s andals o remov e an y othe r

generateddebris ? A 7 . I s th e gras s are atha t surround s th e structure(s ) i n reasonabl y goo dcondition ? A 8 . Ar e all item s such a s polyethylen e sheeting , ladders , pain t brushes , cones , barrie r

tape , etc . properly removed ? 9 . I s ther e an y evidenc e ofpropert y damag e tha t wa s done b y th e contractor ? An y propert y damag e need s t o b e complete dprio r to th e EP A Close-Out . C ^ 10 . Ar e ther e an y propert y item s tha t wer e temporarily re-locate db y th e contractor i ^ 

### tha t needt o b e movedback ? 11 . Ar e ther e an y (known) lingerin g issue s wit h th e propert y owner(s ) tha t hav e 7 been lef t unresolved ? Comments 

# yx7 7 Propert y Owne r

Signatur e Dat e Professiona l Enviiomnenta l Engineer s Representativ e Date 9

# CONSENT FO R ACCES S T O PROPERT Y OMAH A LEA D SIT E REMEDIA L ACTION - LEAD-BASE D PAIN T STABILIZATIO N PROPERT Y ID 

## : ?4P ^ "^^Q PROPERTYADDRESS : 2-80 Z fvZlA|r|,l A ^~ ~ 

# 'T^^LJS ^ DAYTIME PHONE : CELLPHONE : E-MAIL : OWNER' S ADDRES S I F DIFFERENT : TENANT' S NAM E I F APPLICABLE : DAYTIME PHONE : CEL L 

# PHONE : i}i0^1^7l27 A E-MAIL : ] 'rofessional Environmenta l Engineers , In c (PE ) i s unde r contrac t (#EP-R7-08-06 ) wit h th e U.S . Environmenta l Protectio n Agency (EPA ) t o stabiliz e lea dbase dpain t (LBP ) o n residentia l structure s a t anumbe r of propertie s locate di n Omaha , Nebraska . Th e pain t stabilizatio n work 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 EP A contractors . Pain t stabilizatio n activitie s wil l include : scrapin g o f cracke do r flakin g LB P fromstructures , applicatio n o f aprim e coa t an dtw o (2 ) coat s o f pain t Movin g part s o f window s an ddoor s ar e no t include dan dwil l 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 ) to ente r an dhav e acces s t o thi s propert y for th e purpos e o f stabilizin g lead-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 to allo w a n EP A contracto r to conduc t asoi l cleanu p a t m y propert y foUowin g completio n o f lead-base dpain t stabilization , if th e soi l cleanu p ha s no t alread y been 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 make al l reasonabl e efiort 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 . 

# jf^h ^ Dat e I full y understan dtha t b y signin g thi s Consen t for Access , (1 ) thi s acces s will remai n i n effect unt U 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 tenant wil l remov e al l obstruction s fromsurface s t o b e painted , (4 ) will abid e b y healt h 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 ) wil l b e contacte dby aP E representativ e approximatel y 4 8 hour s i n advanc e of startin g work , (7 ) agre e no t to obstruc t o r tampe r wit h an y o f flie LB P stabilizatio n actions , an d(8 ) wil l participat e i n fina l propert y inspectio n an dsig n th e Completio n Agreemen t an d Propert y Owner Satisfactio n Survey . Shoul dyo u hav e an y question s abou t th e plane dLeadBased-Pahi t stabilizatio n activitie s fo r you r property , pleas e contac t Professiona l Environmenta l Engineers , In c Projec t Manager , Willi e Cla y A t 402-504-4688 . Genera l question s abou t th e Omah a LeadSite cleannp ca n b e directe dto Paulett aFrance<Isetts , EP A Remedial Projec t Manage r 402-731-2454 , o r th e EP A 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) . J^^ , I gran t acces s t o m y propert y an d w m 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 I wa s (lj;Renovat e Right , Importan t Lea d Infbrmatio n fb rFamilies , Chil d give n th e pamphle t "Renovat e Right , Importan t Lea d Informatio n fo rFamiUes , Chlld e Car e Provldere , an d Schools. " Slgnahir e Dat e SPECIA L INSTRUCTION S AN D CGNSIDERATKM S

### PAIN T STABILIZATIO N PRE-PROPERT Y PAIN T MATC H ASSESSMEN T

AREA{S ) T O B E PAINTED : HOUS E PROPER : _ COLOR :

HOUS E TRIM : COLOR : 

## r^^^r ^ vw * ^ ^ ' n.- ^ 

### GARAGE : COLOR : \


### GARAG E TRIM : _ COLOR : \



### PORCH : COLOR : 

# -4 . 

# U —

PORC H TRIM : COLOR : (COMPL b 1 b 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 SIGNATUR I PE ACCESO R SIGNATURE : 

# X 

# yDougla s County Accoun t Informatio n Pag e 1 of 2 

# c5C^T 6 Dougla s County , Nebrask a Propert y Recor d - R221269000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 tt wes t o f 52n d S t - VJO W O n Ma P Informatio n i s vali d a s o f 2009-9- 3 Treasurer' s Ta x Repor t Ne w Featur e ->-*- > Aut o Sale s Searci i Owne r BEL L BREND A J 280 2 FRANKLI N S T OMAH A N E 68111-000 0 Propert y Informatio n Ke y Numbe r126 9 000 0 2 2 Accoun t Type : Residentia l Parce l Number : 221269000 0 

# r^o o 

# M Parce l Address : 280 2 FRANKLI N S T OMAH A N E 68111-000 0 Lega l Description : Valu e Informatio n SHINN S 2N D AD D LO T 1 2 BLOC KS S 6 7 1/ 2 F T 6 0 X 67. 5 

# . J

200 9 200 8 200 7 200 6 200 5 200 4 ^ Lan d $1,000.0 0 $1,000.0 0 $1,000.0 0 $1,000.0 0 $1,000.0 0 $1,000.0 0 Improvemen t $40,500.0 0 $40,500.0 0 $40,500.0 0 $40,500.0 0 $40,500.0 0 $31,100.0 0 Tota l $41,500.0 0 $41,500.0 0 $41,500.0 0 $41,500.0 0 $41,500.0 0 $32,100.0 0 Sale s Informatio n Sale s Date : 1992-12-3 1 Dee d Type : D Book : 194 1 Page : 07 3 Price : $22,620.0 0 Grantor ; Grantee : Valid/Invalid : vali d Exclusio n Reason : Lan d Informatio n Acre s 0.0 9 S F 4020. 0 Unit s 1. 0 Dept h 67. 0 Widt h 60. 0 Vacan t N o Improvemen t Informatio n
http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=R22. . . 9/11/200 9

### Dougla s Count y Accoun t Informatio n Pag e 2 of 2 Buildin g 1 Tw o Slor y 280 2 Frankli n S t

Firs

t Floo r M0. « s^.n . /* * »> » IK'S'I!'? ? S»OS » F» . "

JU L

SsimSlctkll R MJO'..|F l CLIC KT O ENLARG E IMAG E Squar e Footage : 1100. 0 Perimete r0. 0 Uni t Type :

Buil t As : j 2 Stor y HVAC : Centra l Ai rt o Ai r Exterior : Interior : Fram e Sidin g Drywal l Roo f Cover : Compositio n Shingl e

Roo f Type : Hi p Floorcover : Allowanc e Yea rBuil t 188 4 yea r Remodele d Percen t Remodele d 0 % Percen t Complete : 100.0 % Quality : Averag e Condition : Averag e Cond o Squar e Footage : 0. 0 Rooms : 6. 0

Units : Batfis : 1. 0 1. 0 Bedrooms : ', 2. 0 Stories : 2. 0 

### + Foundation : ! Bloc k Sprinkle rSquar e Footage : { 0. 0 Adjuste d Yea r Buil t Physica l Ag e 188 4 12 4 Detai l Typ e /^plianc e Basemen t Fixtur e Fixtur e Porc h Porc h Detai l Descriptio n Allowanc e Bsmn t Bloc k 8 ft Bas e Fixture s Bat h Ful l Sla b Roo f Cei l Sla b w/Step s Unit s 1. 0 520. 0 

### 1.

0 1. 0 24. 0 16. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22. . . 9/11/200 9PROFESSIONA L ENVlROMENTA L ENGINEERS,INC . REUNIO N DIARI A D B SEGURIDA D 

# F«b. : o q jl Q l^lCCP j Proyecto : Omah apain t stabilizatio n projec t Luga r Siti o d e actividad : ^g( J ^ f^^S^K^^ / Tarea s dianas : 1 . Sit e preparation/scrying . 2 . Painting . 3.Clean-up . PrimordisJ/Peligro s Potenciales : 1 . Persona l lea dcontamination 2 . Sit e lea dcontaminatioi L Herramienta s de trabajo : 1 . Ste p letter. . 2 . Knife . Practica s d e Trabajo/Accione s Correctivas : 1 . 2 . Llamadas Previas : 1 . 2 . Firm ade registr o del Empleado : 

# i.0CiiiSN|^aS&l&..EZ-. ' 1.. . 4...^m^i^^...77^jS.loii. ' 14. . 5 15. . 6 16. . 7 17. . 8 18. . 9 19. . 1 0 .20. . 12. , .22. , 1 1 21. . P ^ ^

3.Eletricity . 4.FaUs . 3 . Pain t spiy machines . 4 . Odiers . 3 . 4 . 3 . 4 .



# .Q±LA.ll.o° i Firm ade del Siti o Fech a