\ 

TRANSIVIITTAL of OMAH A LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID #: HS^ I Date: 5?>QM 0 ^ 

Address: .^fS.^' ^ Pin ^ " ^ 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS 

Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

y ^ Video of property (DVD) 

(S^ Executive Summary 

0 Signed Access Agreement for subject properly 

\jf Painting Agreement 

D Settlement documents (i.e., for ddmage or to replace plants, etc.) 

y ^ Photographs VCe_^ OA A f^QlW 

&r Satisfactory restoration signed by Property Owner 

By - Property close-out check lisl signed by EPA 

M Property information from Douglas County Assessor's Office 

E/ ^ _confirmation that lead pamphlet "Renovate Right" was received by P0_ 

H ^ ^g•(^ ^ i?4^' ^ 

D 

D 

^IZ ' ^ ^ te 

4iPA Signature Date' '' ^~ 

30094403 

Superfund 
PROFESSIONAL 

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

"Providing cost-effective environmental solutions" p^^ jj^g! llt32T^ 

Consulting • Engineering Design • Remedialion • Abaieinent • Eincrgoncy Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2009 

SAID# 19421 

3533 Pine St 

• Dates worked: 07/15 to 07/16 2009 

•

 Pre property condition: House had wood siding, overall in fair condition. Garage was 

in poor condition; door paint was flaking and chipping. 

• Problems encountered: Owner claimed there was paint on plants and one drain spout 

damaged. 

• Owner request/concerns: Owner stated that he was not present when the work was 

being done and he does not know if it was primed and the two coats of paint applied. 

Issues were resolved. 

• Inspection/closeout dates. Owner signed 07/23 2009. Inspected by EPA 07/23 2009. 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"Providing cost-effective environmental solutions" 

CcrsultTK, • Enginpci nci Dos fjn • Roincrl ,'ition • Ajj'itt'n'piil • flmeig'^nry Frspoii'-o 

EPA Close-Out Form 

(Lead-Based Painl Stabilization EPA Conlraci EP-R7-08-06) 

SAID: iqM2l 

Property Address: f^S?) 3 P i O'P, ^ j 

Owner's Name: VrAi M H " /0'P>Qnin-P. 

Performance Standards/Close-Out Criteria 

2505 North 24'". Suite 219 

Omaha, NE68110 

(402) 504-4688 

Fax (402) 504-3281 

YES NO 

1. Was the entire slruclure(s) painted wilh llie exception of the staled, excluded 

areas? This would include painting of olher associaled features including fascia, 

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

garages. 

2. Was all scraping and olher preparalion work completed satisfactorily? \y 

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

two top coals? y 

4. Was the paint products utilized equivalent to a 30 year product/quality? y 5. Are all ofthe areas where contaminated materials have been spilled thoroughly 

vacuumed/ cleaned? y 

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

entire properly, roadways, alleyways, public access areas and also remove any \ y ^ olher generated debris? 

7. Is the grass area that surrounds the slruclure(s) in reasonably good condition? y 

8. Are all ilems such as polyelhylene sheeting, ladders, paint brushes, cones, 

barrier tape, etc. properly removed? \ y 

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

y property damage needs to be completed prior to the EPA Close-Out. 

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

y ^ that need lo be moved back? 

11. Are there any (known) lingering issues wilh the property owner(s) ihal have 

been left unresolved? y 

Olher Considerations/Properly Owner Discussions/Additional Work that is Required: 

/^yyJyyfTJ^ -^/^/o W 

EPA COR Signalure Dale 
•55^ '43AW 

PROFESSIONAL 

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

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

Ocr-^.jti'-g • Engiroor IT] DOE.CJ'T • Romcd L t;.">n • Alw.c riiiMit • Frnr i-i <^C'^ Pc-ifi i i^f 

Property Owner Close-Out Form 

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

SAID: (qMc^^l 

Property Address: 96"? ^ "P'y H-e ^f" 

Owner's Name: fi>ij|a ]\l . Q ' .\^f>r)n-P.I I 

Performance Standards/Close-Out Criteria YES NO 

1. Was the entire slructure(s) painted with the exception ofthe staled, excluded 

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

eaves, siding, all trim, porches, box beams, columns, rails, and exierior surfaces of y

garages. 

2. Was all scraping and olher preparation work completed satisfactorily? 

3. Were all required areas of ihe slruclure(s) primed as needed and painted wilh 

two top coals? 

4. Was the painl products utilized equivalent lo a 30 year product/quality? y^ 

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

vacuumed/ cleaned? 

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

\ y entire properly, roadways, alleyways, public access areas and also remove any 

olher generated debris? hSo\- tt^V.y>c\i^ - ujfldfigi uptio fio.pjrA pt>.p7r4--Wp r Aapi tUuf )iOi iL. f 

7. Is the grass area that surrounds ihe struclure(s) in reasAnaol sonaDy goocd conddition i ? 

8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, 

barrier tape, etc. properly removed? ^o r -^KL ^nti-i pur-i U-/^ 

9. Is there any evidence of properly damage Ihal was done by the contrador? Any 1 y property damage needs to be completed prior to the EPA Close-Out. cV^iOn S/'<?uf 

10. Are there any properly ilems that were temporarily re-localed by the contractor 

thai need to be moved back? 

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

been lefl unresolved? 

Comments: - t ^^^j^ i hiK ^ Ai n i^;iA)( [A^Ct^ hV'n^cUA( So rt c\gl ^ 

OJJJS\ , —1) ^\K.iKK. 7-J.3-<g^ 

PropertyT©wner Sig Date 

-/'^S-0^ 

Professional Environmental Engineers Representative Dale 
CONSENT FOR ACCESS TO PROPERTY 

OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID: ^RaT PROPERTY ADDRESS: 'P^'S^' ^ '•P\' H'tL S ^ 

JQWNERNAME: ^ , ^ ii 

DAYTIME PHONE: 3^ 4 ^ H'^ Q ij> 

CELL PHONE: E-MAIL: 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME IF APPLICABLE: 

DAYTIME PHONE: 

CELLPHONE: E-MAIL: 

Professional 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 ofcracked 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, ifthe 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. 

D Yes, I have read and understand the paragraph above. 

Signature of Property Owner Date 

I fully understand that by signing this Consent for Access, (1) this access will remain in effect until the work has been 

satisfactorily completed, (2) that the Property Owner or Tenant, if applicable, will bc 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, (S) will allow photography of property 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 flnal 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 offlce). 

/ , Yes, I grant access to my property and was given the pamphlet D No, I do not grant access to my property and I was 

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

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

0<^V^AA^ ^M^O^ 

Date Signature Date 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS: i ^ 3 3 -Rn-e ^-h DATE: 

BVID: 

AREA(S) TO BE PAINTED: 

HOUSE PROPER:. COLOR: OTYJJLJ A 

HOUSE TRIM: COLOR: ^^^^JiJ^TTi} ^ 

GARAGE: COLOR: ^31) ^ 

GARAGE TRIM: _ COLOR: \^^^5CEJ^ 

PORCH: COLOR: 

PORCH TRIM: COLOR: 

(COMPLETE ALL SECTION, YES, NO, OR NON-APPLICABLE) 

I AGREE TO THE COLORS LISTED ABOVE. ONCE THE PAINTING 

BEGINS, I JJMJ£RSTAND I CAN NOT CHANGE THE ABOVE SELECTED COLORS: 

PE ACCESOR SIGNATURE: 
Douglas Coimty Account Information Page 1 of2 

_*La^zA 

Douglas County, Nebraska Property Record - R1038770000 

Print Report 

NEW Feature - Parcel Dimensions availabie @ scale 0-50 ft west of 52nd St - Vie w Ort Ma P Information is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature -•«•- • Auto Sales Search 

Owner 

ODONNELL PAULA N 9 ^ -S'sos3533 PINE ST 

OMAHA NE 68105-0000 ik n

^ Property Informatio n 

Key Number: 3877 000010 ^

^^f ^ 

Account Type: Residential iX- Parcel Numtier 1038770000 

Parcel Address: 3533 PINE ST 

OMAHA NE 68105-0000 

Legal Description: FIELD CLUB TERRACE LOT 4 BLOCK 0 49 X 129 

Value Informatio n 

Land Improvement Total 

2009 $6,300.00 $107,300.00 $113,600.00 

2008 $6,300.00 $107,300.00 $113,600.00 

2007 $6,300.00 $107,300.00 $113,600.00 

2006 $6,300.00 $100,500.00 $106,800.00 

2005 $6,300.00 $100,500.00 $106,800.00 

2004 $6,300.00 $100,500.00 $106,800.00 

Sales Informatio n 

Sales Date: 1990-05-09 

Deed Type: D Book: \ 1877 Page: 538 

Price: $57,500.00 

Grantor 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.13 6076.0 1.0 124.0 49.0 No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl 03... 7/8/2009 
Douglas County Account Information Page 2 of2 

Building 1 

flSliSf 61* (i s f 

I SMRuitCal 

DBtitr«xiijuM,K 

«•« f) S f 

TWO STORY 

CLICK TO ENLARGE IMAGE 

9F'^T9I1!^'^9F'"*9^ 

Square Footage: 1352.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Fair 

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

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywali Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Hip Stories: 2.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1925 0% 1925 83 

Detail Type Detail Description Units 

Add On Unfinished Attic W/floor 676.0 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 1.0 

Basement Bsmnt Block 8 ft 676.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 324.0 

Porch Slab Roof Ceil 208.0 

User Needs TLC 1.0 

http://douglasne.mapping-onIine.com/DouglasCoNe/static/accoimtinfo.jsp?accoimtno=R103... 7/8/2009 
TC 

Property Address J ^ 3 3 l ^ i /^-fi :ST Date n~l<- ^ Q 

Start Date " ^ ~ I S -o ^ End Date 

Amount Of Prime And Paint Used 

Prime (Gallons) 

Poly (Boxes JL 

Paint (Color .3(^ j i,x.i>) ; V,^ Amount (Gallons) iS Q 

Paint (Color Amount (Gallons) 

Paint (Color Amount (Gallons) 

Paint (Color^ Amount (Gallons) 

Paint (Color Amount (Gallons) 
PROFESSIONAL ENVIRONMENTAL ENGINEERS, INC. 

REUNION DIARIA DE SEGURIDAD 

.-ocha.7 -n^o ^ 

Pioyecto. Omoho Rami Stabilizalion PiOje_c1 

Sitio de Actividad 

Tareas Dianas: 

2. Pv^t vy^ o<X~ 

3 P'lVX^^Z _ - - ­

Primordial/Peligros Potenciales: 

1 ..Bo--^ day . 

3. COible.^—4<_i6lec-V<\ctclcici. 

4. "T.ecWo d.e cc>-6cv. 

Herramientas de Trabajo: 

3. ferooWcx^ 

2. _poY\poy2> 4 Oie^'e-'rc?^ciov^et> 

Practicas del fiobajo/Acciones Correctivos: 

M/ ^ 

3 

4 

Llomadas previas: 

1 _ M A. _ 

3. 

2. 

4. 

Firmo de Registro del Empleado: 

3. 

2. Da:^.!!i.<:^ tv^u.^Z-_ _ 4. 

5. LO\(i^.<^ir <:)^./v-i^rv<Sp. 6. 

8. 

::rf, . l^^/diiy^._ ^ - SL ^ — O ^ 

Firma de SSlud y Seguridad del Sitio Fecl^o 
Professional Environmental Engineers, Inc. 

INTERVENCION DE SEGURIDAD 

Nombife del Pi'OyCCto. 7) »!> 0~i^ . » .^^^^ t?T.i 

Fecho de lo Intervencion _7jjr. if ' Z.^ / 

Peligros de Saiud Primordial: Ho + ci cxy 

Preocupaciones Primordiales de H & S: 

Tareas Diarias: 1. ^t ) OTO ^ ^CKf.. 

2. P/^N^ATIC^VI 

3. P^kA^i^^V^ 

Equipo Usado en el Lugar de Traabjo: 

K 

Gafas de Seguridod

Zapotos

Guantes de Trabajo

Generodores

 >c.

 X­

 >C,

 _ Elevadores 

 GFCI . ^. . 

 Chalecos de Segundod

 Otro Jc 

 -^ . 

Equipo Listo para Respuesta de Emergencia a Disposicion Inmediata: 

Conducir Reunion Diaria de Seguridad ... "/• 

Estuche de Primeros Auxilios -y^ 

Procedimientos de Emergencia v:_ 

Politica de Salud y Seguridad de lo Compania y_ 

GFCI en sitic >L. 

Deficiencias: M/^ 

Acciones Corretivos. _K\ / f\ 

inieiveoior 

Supervisoi del Sitio: CkAA^a^ /^dHSt^^i^'ey^ Fecha- __^- r^,^ -- o T"