## TRANSMITTA Lo f OMAH A LEA D SIT E PAIN T STABILIZATIO NFIL EFOLDE R SAI D # : /-K3/ 7 Date : (p/so//)' ^ Address : 30l ^ SS 3 ^^CeJ c 

## Remediatio n Contractor : PROFESSIONALENVIRONMENTALENGINEER S Year : 200 8 PAINT STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S PVide o o f propert y (DVD ) ^^W ^ Qj^kx ' M Executiv e Summar y M SignedAcces s Agreemen t fo r

subject propert y U Paintin g Agreemen t D Settlemen t documents (i.e. , fo r

damag e o r

to replac e plant's , etc. ) WPhotograph s D^Xtye. . WSatisfactor y restoratio n signe dby Propert y Owne r B ^ Propert y close-out chec k

lis t signedby EP A B ^ Propert y information fi-omDougla s Count y Assessor' s Office 

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4031633 6 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 yRespons e



### Lea dBas e Stabilizatio nOmaha , N e Clos e Ou t Repor t SAID #1431 7 307 2 S 3 3 S t

•Date s worke d11/1 2 t o 11/2 0 200 8 •Hous e ha dpoo r pain t o nth e window s an dtri mareas , area s o f th e hom e ha dt o b e washe d prio r t o workin g o n i t du e t o th e dirt buildu p o nth e botto mo f th e foundation . Garag e ha d very poo r pain t in area s an dpainte r hadt o returnseveral time s t o completel y scrap e th e area s completel y t o preven t ne w pain t fromcomin g of f in th e future . •Inspecte d11/1 7 returne dt o repain t botto mtri mo nsout hsid e window , touc hup pain t o n area s o f garage , clean overspray o nfenc e o nsout hsid e o f house . 12/0 2 al l issue s resolved .

# 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 yRespons e 

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

# /•^.yv y Property Address : 

# 3oy ^ X ^ c5? 7 c5 ? Owner' s Name : 

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## '''0/^ } air
Performanc e Standards/Close-Ou t Criteri a YE S N O 1 . Wa s th e entir e structure(s ) painte dwit hth e exceptio no f th e stated , exclude d areas ? Thi s woul dinclud e paintin g o f othe r associate dfeature s includin g fascia , r \ 

### 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 nwor k

complete dsatisfactorily ? / \ 

### 3 . Were al l require darea s o f th e structure(s ) prime da s neede dan dpainte dwith tw o to p coats ? < 

### 4 . Wa s th e pain t product s utilize dequivalen t t o a3 0 year product/quality ? < 

### 5 . Are al l o f th e area s wher e contaminate dmaterial s hav e bee nspille dthoroughl y vacuumed / cleaned ? t 

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

# X 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 ? 

# 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 ? < 

### 9 . I s ther e an y evidenc e o f property damag e that was 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 . v^ ' 

### 10 . Are ther e an y property item s that were temporaril y re-locate db y th e contracto r that nee dt o b e move dback ? <'' ' 11 . Are ther e an y (known ) lingerin g issue s withth e property owner(s ) that hav e 

# X bee n lef t unresolved ? Comments : 

# P1 

# /

2 - 'i- o ^ L i _ ^A-g^ ^ 

### Property Owne r signatur e Date m r Professional Environmenta l Engineer s Representativ 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-eftecOv e erwironmema i solutions " Fa x(402 ) 504-328 1 

### EP A Close-Ou t For m (Lead-Base dPain t Stabilizatio n EP A Contrac t EP-R7-08-06 ) SAID : 

# A/S/ 7 Property Address : Owner' s Name : Performanc e Standards/Close-Ou t Criteri a YE S N O 1 . Wa s th e entir e structure(s ) painte dwithth e exceptio no f th 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 i / 

### garages . 2 . Wa s all scrapin g an dothe r preparatio nwork complete dsatisfactorily ? z / 

### 3 . Were al l require darea s o f th e structure(s ) prime da s neede dan dpainte dwith tw o to p coats ? 4 . Wa s th e pain t product s utilize dequivalen t t o a3 0 year product/quality ? 5 . Ar e al l o f th e area s wher e contaminate dmaterial s hav e bee nspille dthoroughl y vacuumed/ cleaned ? 6 . Di dth e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s o nth e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e an y i ^ 

### othe r generate ddebris ? 7 . I s th e gras s are athat surround s th e structure(s ) i nreasonabl y goo d i ^ 

### 8 . Ar e al l item s suc ha s polyethylen e sheeting , ladders , pain t brushes , cones . barrie r tape , etc . properl y removed ? 9 . I s ther e an y evidenc e o f property damag e tliat was 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 . 10 . Ar e ther e an y propert y item s that wer e temporaril y re-locate db y th e contractor ^ 

### that nee dt o b e move dback ? 11 . Are ther e any (known ) lingerin g issue s withth e property owner(s ) that hav e bee nlef t unresolved ? Othe r Considerations/Property Owner Discussions/Additiona l Wor k

that i s Required : 

## "// 7 "^oic ^ Sick
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### EP A CO RSignatiu- e 

## ' Dat e

# CONSEN T OF RACCES S T O PROPERT Y OMAH A LEA D SIT EREMEDIA LACTIO N- LEAD-BASE D PAIN T STABILIZATIO N PROPERT Y ID : / V ^ ' 7 ' PROPE R T Y ADDRESS : _ 

# S . 3 3 S f OWNE RNAME : DAYTIM l ] PHONE : CEL LPHONE : E-MAIL : OWNER' S ADD l [lES S I FDIFFERENT : TENANT' S NA M [ EI FAPPLICABLE : V DAYTIM l : PHONE : CEL LPHONE : E-MAIL :

- Professiona l Environmenta l Engineers , Inc . (PE ) i s unde r contrac t (#EP-R7-08-06 ) wit hth e U.S . Environmenta l Protectio n Agenc y (EPA ) t o stabiliz e lea dbase dpain t (LBP ) o nresidentia l structure s a t anumbe r o f propertie s locate di nOmaha , Nebraska . Th e pain t stabilizatio nwor k i s bein g don e t o protec t th e soi l cleanup s tha t wer e performe db y EP A contractors . Pain t stabilizatio nactivitie s will include : scrapin g of cracke do r flakin g LB Pfro mstructures , applicatio nof aprim e coa t an d tw o (2 ) coat s of 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 nt o thi s EP A contracto r (PE ) t o ente r an dhav e acces s t o thi s propert y fo r th e purpos e of stabilizin g lea d-base dpain t a s outline do nth e propert y identifie dabove . B y signin g thi s documen t I agre e t o allo w a nEP A contracto r t o conduc t asoi l cleanu p a t m y propert y followin g completio no f lead-base dpain t stabilization . I understan dtha t th e stabilizatio ncontracto r ca nno 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 t o 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 my property . I fully understan dtha t b y signin g thi s Consen t fo r Access , (1 ) thi s acces s wil l remai nineffec 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 , if applicable , wil l b e give nth e Housin g an dUrba n Developmen t (HUD ) an dEP A pamphlet , "Renovat e Right , Importan t Lea dHazar dinformatio nfo r Families , Day Car e Providers , an dSchools" , (3 ) th e Propert y Owne r o r tenan t wil l remov e al l obstruction s fro msurface s t o b e painted , (4 ) will abid e b y healt han dsafety 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 db y aP Erepresentativ e approximatel y 4 8 hour s i nadvanc e o f startin g work , (7 ) agre e no t t o obstruc t o r tampe r withan y o f th e LB Pstabilizatio nactions , an d(8 ) will participat e infinal propert y inspectio nan d sig nth e Completio nAgreemen t an dPropert y Owne r Satisfactio nSurvey . Shoul dyo u hav e an y question s abou t th e plane dLea dBased-Pain t stabilizatio nactivitie s fo r you r property , pleas e contac t Professiona l Environmenta l Engineers , Inc . Projec t Manager , Willi e Cla y A t 402-504-4688 . Genera l question s abou t th e Omah aLea dSit e cleanu p ca nb e directe dt o Paulett aFrance-Isetts , EP A Remedia l Projec t Manage r 402-731-2454 , o r th e EP A Publi c Informatio nCenter s a t 402-991-958 3 (Nort hOmah aoffice ) o r 402-731-304 5 (Sout hOmah aoffice) . D 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 Car^^rovi^ers , an d Schools. " Informatio n fo rFamilies , Child e Care Providers , an d Schools. " 

### ^A^-^iU x 

# ll-r-o K Hat e Signatur e Dat e SPECIA L INSTRUCTION S AN D CONSIDERATION S

# I Confirmatio n O f Receip t O f Lea d Pamphle t BviD /s^ n PROPERTYADDRES S H^Q l ^ S - 3 3 a p COD E L g Q l O ^ PROPERT Y ADDRES S O F OWNE R I F DIFFERENT THA NPROPERT Y BEING PAINTE D PROPERT Y ADDRES S ^ZI P COD E i hav e receive d a cop yo f th e pamphlet , Renovat e Right : Importan t Lea d Hazar d Informatio n Fo rFamilies , Chil d Car e Provider s An d School s informin g m e o f th e potentia l ris k o f th e lea d hazar d exposur e fro m renovatio n activit yt o b e perfomie d o n dwellin g unit . I receive d thi s pamphle t l)efor e th e wor k began .

PRINTE D NAM E O F RECIPIEN T^ DAT E

SIGNATUR E O F RECIPIEN T Self-Certificatio n Optio n (Fo rTenant-Occupie d Dwelling s Only ) I f th e lea d pamphle t wa s delivere d bu t a tenan t signatur e wa s no t obtainable , yo u ma ychec k th e appropriat e bo x below : I J Refusa l T o Sig n - 1 certif ytha t I hav e mad e a goo d fait h effort t o delive rth e pamphlet , renovat e right : importan t lea d hazard infonnatio n fo rfamilies , chil d car e provider s an d schools ; t o th e renta l dwellin g uni t liste d abov e a t th e dat e an d tim e indicate d an d tha t th e occupan t refuse d t o sig n th e confirmatio n o f receipt . I furthe rcertif ytha t I hav e left a cop yo f th e pamphle t a t th e uni t wit h occupant . 

# D Unavailabl e Fo rSignatur e - 1 certifytha t I hav e mad e a goo d fait h effort t o delive rth e pamphlet , renovat e right ; importan t lea d hazar d infonnation fo rfamilies , chil d car e provider s an d schools , t o th e renta l dwellin g uni t liste d belo wan d tha t th e occupan t wa s unavailabl e t o sig n th e confinnatio n o f receipt . I furthe rcertifytha t I hav e lef t a cop yo f th e pamphle t a t th e uni t b yslidin g i t unde rth e doo ro rsomewher e o n th e premises .

PRINTE D NAM E O F PERSO N CERTIFYIN G ATTEMPTE D DELIVER YDAT E AN D TIM E LEA D PAMPHLE TDELIVER Y

SIGNATUR E O F PERSO N CERTIFYIN G LEA D PAMPHLE TDELIVERY : Not e Regardin g Mailin g Optio n - as a n alternative t o deliver yi n person , yo u ma ymai l th e lead pamphlet t o th e owne r and/o rtenant . Pamphlet must b e maile d a t least 7 day s befor e renovation . (Documen t with a certificat e o f mailin g fro m tti e pos t office) . CONFIRMATIO N O F RECEIPTO F LEA D PAMPHLE T

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.^ ^ PAIN TMATC H FOR M 08/0 8Dougla s Count y Accoun t Informatio n Pag e 1 of 2 

# IM'SLI^ I Dougla s County , Nebrask a Propert yRecor d - R194292000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f 90t h S t - Vie W O Q Ma p Informatio n i s vali d a s o f 2008-9- 4 Treasurer' s Ta xRepor t Ne wFeatur e -•->- > Aut o Sale s Searc h Owne r BANNE R BRIA N T ETA L 307 2 S 3 3 S T OMAH AN E 68105-000 0 

## 5M\-'?>0^ ^ Propert yInformatio n Ke yNumber : 429 2 000 0 1 9 Accoun t Type : Residentia l Parce l Number : > 194292000 0 Parce l Address : 307 2 S 3 3 S T OMAH AN E 68105-000 0 Lega l Description : \ PARKVAL E LOT6 BLOC K8 4 1 X 130 Valu e Informatio n Lan d Improvemen t Total 200 8 $5,900.0 0 $80,300.0 0 $86,200.0 0 200 7 $5,900.0 0 $80,300.0 0 $86,200.0 0 200 6 $5,900.0 0 $67,800.0 0 $73,700.0 0 200 5 $5,900.0 0 $67,800.0 0 $73,700.0 0 200 4 $5,900.0 0 $67,800.0 0 $73,700.0 0 200 3 $5,900.0 0 $68,100.0 0 $74,000.0 0 Sale s Informatio n Sale s Date : 1997-05-1 4 Dee dType : D Book : \ 206 5 Page : 37 3 Price : $69,950.0 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 2 5330. 0 1. 0 130. 0 41. 0 N o Improvemen t Informatio n
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CLIC KTO ENLARG E IMAG E Squar e Footage : 1097. 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 yFi n Cond o Squar e Footage : • 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 5. 0 Exterior : Fram e Stucc o Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 2. 0

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