## TRANSMITTA Lof f

OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL E FOLDE R SAID#: ^20-^^ 5 

# Date : /9.\lCoiC) q Address : 13l 5 S ^ O flV ^ Remediatio n Contractor : PROFESSIONA LENVIRONMENTALENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S g^^^-^Vide o ofpropert y (DVD ) ' 'Q/ ^ Executive Summar y JE T SignedAcces s Agreement fo r

subject propert y •ET ^ Painting Agreemen t D Settiemen t document s (i.e. , fo r

damt^ e or to replac e plants , etc. ) 

## aPhotograph s i^efer ^ I2fu i ^d4^j r s A Satisfector y restoratio n signedb y Propert y Owne r D Propert y close-out check lis t signe dby EP A 0 ^ Propert y infomiatio n fiximDougla s Count y Assessor' s Office B ^ confirmation tha t lea dpamphlet "Renovat e Right " wa s receive dby PO D D D 

# ISL 

# & M Professiona l En^ironn^e^ta l Engineer s Signatur e Signatur e 3005461 3 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



## LeadBas e Stabilizatio n Omaha , N e Clos e Ou t Repor t 200 9 SAID#2026 3 131 5 S . 3 0 Ave

•Date s worked : 10/2 4 t o 10/2 6 200 9 •Pr e propert y condition : hous e ha s transi t sidin g wit hpainte dwoo dtrims . Fron t porc h i s painte dan dwa s ihver y poo r conditio n prio r t o stabilizatio n work . Man y area s o f damag e t o sidin g an dstructure . Foundatio n wa s painte dan dha darea s of crackin g an dpain t flakin g of f

al l over . •Problem s encountered : None •Owne r request/concerns : N/ A •Inspection/closeou t dates . Owne r signe d10/27 2009 . Propert y inspecte dby P E projec t manager .

# PROF I 250 5 Nort h 24 ^ Suit e 21 9 Omaha . N E 6811 0 (402 ) 504-468 8 

### "Providin g cost-effectiv e environmenta l solutions " Fa x(402 ) 504-328 1 Consultin g • Engineerin g Desig n • RemedlaUo n • Abatemen t • Emergeric yRespons e 

## Propert y Owne r

Close-Out For m (Lead-BasedPain t Stabilizatio n EP A Contirac t EP-R7-08-06 ) 

# SAID : ^QZID S PropertyAddress : l^l' S f ^ ^f ^ /% ^ (^Ao ^ «oV<o - SbQ ^ 

## Owner' s Name : rJOrJ C ^YY ) > j'^^ 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 n ofth e stated , excluded areas ? TM s wouldinclude paintin g of othe r

associate dfeature s includin g fascia , eaves , siding , all trim , porches , box beams , columns , rails , andexterior surface s o f 

# A garages . 2 . Wa s al l scraping andothe r

preparatio n wor k

completedsatisfactorily ? ^ ^ 

## 3 . Wer e al l require darea s ofth e structiu«(s ) prime da s neede dan dpainte dwit h tw o top coats ? ^ 

## 4 . Was the pain t product s utilize dequivalen t t o a3 0 yea r

product/quality ? ^ 

## 5 . Ar e all ofth e area s wher e contaminatedmaterial s have been spille dthoroughly 

# 7 vacuumed / cleaned ? 6 . Didth e contractor collect/vacuumall falling andscrapedpaint 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 ? 7 . I s the gras s are atha t surround s th e structiire(s ) i n reasonably goo dcondition ? 8 . Ar e all item s sucha s polyethylen e sheeting , ladders , paint brushes , cones , / ^ 

## barrie r

tape , etc . properly removed ? 9 . I s ther e an y evidenc e o f propert y damag e tha t wa s done b y th e contractor ? An y 

# A propert y damage need s t o b e complete dprior t o th e EP A Close-Out . 10 . Ar e ther e an y propert y item s tha t wer e temporarily re-locate db y th e contractor ; 

## tha t needto 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 

# I A bee n lef t unresolved ? Comments :

Propert y Ovme r

Signatur e Date Professiona l Environklenta l Engineer s Representativ e Dat eDCT-9-200 9 03:19 P FROM : TO:504328 1 

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## CONSEN T FO RACCES S T O PROPERT Y OMAH A LEA D SIT E REMEDIA L ACTIO N - LEAD-BASE D PAIN T STABILIZATIO N PROPERT Y ID : 'ZO'Z-Lft S PROP E RT V ADDRESS : /j^jr S ^S - .-^ ^ f^4> . DAYTIM E PHONE : UO'X ^ ??/ ' ^7o / CEL L PHONE : A"'^ - Cf/ U - li t 6 ^ E-MAIL : ^L€n^I'i'S£>u/iHe/s^-^A> ^ ,t^ ^ OWNER' S ADDRES S I FDIFFERENT : TENANr S NAM E I FAPPUCABLE : DAYTIM E PHONE : CELLPHONE : E-MAIL : 

# i Profesaiona i Environmenta l Engineers , lac . (PE ) i s unde rcontrac t («EP-R7-08-06 ) wit h th e U.S . Environmenta l Protectio n Agenc y(BPA ) t o stabiliz e lea d base d pain t (LBP ) o n residentia l structure s a t a number-o 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 Acontractor^ . I Pain t stabilizatio n activitie s wil l include : scrapin g o f cracke 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 ^f c 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 rtl| e purpos e o f stabilizin g lea d -base d pain t a s outline d o n th e propert yIdentifie d ab^ve . i 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 of ; lead-base d pain t stabilization , i f th e soi l cleanu p ha s no t alread ybee n performed . I understan d tha t th e stabilizatk> 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 efTort 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 .

tUtt . Dal e j I fkill yunderstan d tha t b ysignin g thi s Consen t fo rAccess , (I ) thi s access 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 Developm^ 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 a^ 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 B b e contacte d b ya PE representativ e approximatel y4 8 hour s i n advanc e o f startin g worli , (7 ) agre e no t t o obstruc t o rtampe rwitl ) an yofth e LB P stabilizatio n actions , an d (8 ) wil l participat e i n final propert yinspectio n an d sig n th e Completio n Agreemen t an d Propert yOwne rSatisfactio n Survey . i Shoul d yo u hav e an yquestion s abou t th e plane d Lea d Based-Pain t stflbilbatio 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-lsetts , EP ARemedia l Projec t Manage r402-731-2454 , o rth e EP APubli ^ Informatio n Center s a t 402-991-958 3 (Nort h Omah a ofnce ) o r402-731-304 5 (Sout h Omah a office) . B Yn , I gnm t acces s t o m ypropotyan d w » give n th e psmphle t D No , I d o no t gran t acces s t o m ypropert yand ! wa s "Renovil a Right . Important Lea d Infomiatio n forFamlliSB , Chil d give n th e pamph M "Renovat e Righ t Importan t Lea d tnfomiatto n fo rFamlllea , Child a Car e Pravidara , an d Schools. ' Slgnftur s Dat e Signatur e Dat e SPECIA L MSTRUCnONS AN D CONSIDERATION SDCT-9-200 9 03:19 P FROM : TO:504328 1 P. 3 

### PAIN T STABILIZATIO N PRE-PROPERT Y PAIN T MATC H ASSESSMEN T PROPERT Y ADDRESS : \1^\ ^ 5 . .g^ ^ f^^ yDATE : |0/I S BVID :

AREA(S ) TO BE PAINTED : HOUS E PROPER : 

# Y^4_ COLOR : 

### C?/^t / HOUS E TRIM : 

# ye 5 COLOR : 

### &j^fy GARAGE : COLOR : 

# yo
GARAG E TRIM : _ COLOR : 

# Uo

PORCH : COLOR : 

# ^loo ^ 

# Jo

PORC H TRIM : COLOR : 

### Lt^O J 

# ^ o (COMPLET E AL L SECTION , YES , NO . OR NON-APPLICABLE )


### \ AGRE E TO TH E COLOR S LISTE D ABOVE. ONC E TH E PAINTIN G BEGINS , t UNDERSTAN D I CA N NOT CHANG E TH E ABOV E SELECTE D COLORS : PROPERT Y OWNE^IGNATURE r\ «E^IGNATURE : : A

## Douglas Count y Accoim t Information Page 1 of 2 

# Z02.G 3 Dougla s County , Nebrask a Propert yRecor d - R123791000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t of S2n d St - Vie w O n Ma P Informatio n is vali d as of 2009-9- 3 Treasurer' s Ta xRepor t Ne wFeatur e -•-•- • Aut o Sale s Searc h Owne r I SMIT S JAC KL ETA L 53 53 4 4 COOPE

COOPE R R

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D D Pk M I I ^r^ t I / 

## ASHLAN D NE 68003-550 5 MHH'o^Oo S S S I ' ^10 ' UC A Propert yInformatio n Ke yNumbe r 379 1 000 0 12 Accoun t Type : Residentia l Parce l Number : 123791000 0 Parce l Address : 1315S30AV__ i ~t)U?iAHAN E 68105-000 0 Lega l Description : HANSCO M PLAC E LO T 19 BLOC K 11 50 X 15 0 Valu e Informatio n Lan d Improvemen t Tota l 200 9 200 8 $6,800.0 0 $6,800.0 0 $58,500.0 0 $58,500.0 0 

## -i ­ $65,300.0 0 $65,300.0 0 200 7 $6,800.0 0 $58,500.0 0 $65,300.0 0 200 6 $6,800.0 0 $60,200.0 0 $67,000.0 0 200 5 $6,800.0 0 $60,200.0 0 $67,000.0 0 200 4 $6,800.0 0 $60,200.0 0 $67,000.0 0 Lan d Informatio n Acre s SF Unit s Dept h Widt h Vacan t 0.1 7 7500. 0 1. 0 150. 0 50. 0 No Improvemen t Informatio n Buildin g 1



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 2.. . 9/11/200 9

### Dougla s Count y Accoun t Informatio n Pag e 2 of 2

aifae t 

## TW O STOR Y I SJ O

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### la

w CLIC KTO ENLARG E IMAG E Squar e Footage : Perimete r 1940. 0 0. 0 Uni t Type :

Buil t As : I 2 Stor y HVAC : i Force d Ai r Percen t Complete : 100.0 % Quality : Averag e Condition : Averag e Cond o Squar e Footage : 0. 0 Rooms : i 9. 0 Exterior : Fram e Shingl e Units : 2. 0 Interior : Drywal l Baths : 2. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 4. 0

Roo f Type : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : ! 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 188 3 0 % 188 3 12 6 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 

### 1. 0 Basemen t Bsmn t Bloc k 8 f t 934. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 2. 0 Porc h Sla b Roof Cei l 

### 149. 0 Porc h Sla b Roof Cei l 56. 0 Use r 2 UNI T CONVERSIO N 1. 0 Use r code i 25tomode l 1. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12. . . 9/11/200 9

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## J C Paintin g ) 31 S S ' 3d'f' ^

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## Amoun t Of Prim e An d Pain t Use d _^ .



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## Professiona l Environmenta l Engineers , Inc . SAFET Y AUDI T Projec t Name : A 3 > /5 ^ 

# 3 o s l Dat e o f Audit : I S -/" V -^ f Primar yHealt h Hazards : 7[sckt ! ^- g e^>^^>- > Primar yH & S Concerns : 

# J;3 ' 

# <L^^ ^ Dall yTasks : 1 . ^-Sarc yp / p T 2 Qyjmer ' 

## I n h^-T T 3 . ^ 

### Equipmen t Use d a t Jobsite : Har d Ha t Ladde r Safet yGlasse s Boo m Lift s Stee l Toe d Shoe s j ^ GFC I Wor k Glove s ^^ ^

Safet yVest s Generator s ^^. ^ Othe r Equipmen t Read yfo rEmergenc yRespons e a t Immediat e Disposal : Dail ySafet yMeetin g Conducte d /^y ^ 

### Firs t Ai d Kit Emergenc yProcedure s 

## -A ^ Compan yHealt h an d SafetyPolicy"^^A A GFC I on-sit e I ^ ^ Deficiencies : - N\^i ^ Correctiv e Actions : 

# i ^

Auditor : M,Q..9v/.'t^ l .^JUJT- ^ 

### Date : ^ A- 1 0 ^ O ^ SiteSupen/isor : 'Ar^*^'e>ii7^^^^o>c&-4!*Ki Date : '^o-^Co^C i < ^

### PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . DAIL Y SAFET Y MEETIN G 

# Date : j2^--/^^'^ 7 Project : Omah a Pain t Stabilizatio n Projec t Location : /3l S "3 Q 5 / Site Activity: . Dail yTasks : 

## 3 ! 

## 'p/' n^' ^ - ^ Primary/Potentia l Hazards : 

# 3< - <^^o ^ 3 . ^S<Axera< ^ 2 . CL&So\e . Wor k Tools : .^^S>Gy>X e tzx - 3 . 'Q'=''VV\.'? > o- ^ 2 . JPXO^VvQ w 4 . \C,« . vtgJ^-OL^.q' < Q ^ 

### Wor k Practices/Correctiv e Actions : 1 - vj\< V 3 . 2 . 4 . Previou s Clos e Calls : 3 . 2 . 4 . Employe e Sig n I n Log : l.<!>g><gt3. rme^r\do'u>' ^ 3 . 4 . ^/l/T o ^!l>-oT - 

### 6 . 7 . 8 . Sit e Healt h & Safet ySignatur e Dat e