## TRANSlMiETTA Lo f

OMAHA LEAD SUT E PAIN T STABILiZATIO N FIL E FOLDE R 

# SAI D # : 0 h4-1-2 ^ Date : ^ < 7. ' 0 ^ Address : 

# 7.^0?
. ?opple.tn n /W ^ Remediatio n Contractor : PROFESSIONA LENVIRONMENTA LENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUIVIENT S y\y(de o o f property (DVD ) u Executiv e Summary Signe dAcces s Agreemen t fo r subjec t property Paintin g Agreemen t D 

### emen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) Photograph s DT g Satisfactory restoratio n signe dby Property Owne r 

## y

^ Propert y close-ou t chec k lis t signe dby EP A 

# y Property informatio n fromDougla s County Assessor' s Offic e 

# y

^ confirmatio n tha t leadpamphle t "Renovat e Right " wa s receive dby P O D D D



### Professional Eiiviwrimenta l bngineer s Signatur e

^ Date 3009441 3 'un d

## PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC
. "Providin g cost-effectiv e environmenta l solutions " 

## '''''ol' t NEesiJ o ^^. ^

[JQ^ J lQX32T^ Consultin g • Engineerin g Desig n • Remediatio n • AbaiCMicii l • Emoryonc yRespons e



### Lea dBas e Stabilizatio n Omaha , Ne Clos e Ou t Repor t 200 9 SAID #2047 2 270 3 Poppleto n Ave .

•Date s worked : 08/1 4 t o 08/1 7 200 9 •Pr e propert y condition : Hous e ha dwoo dsidin g wit hwoo dtrim s flakin g an dchippin g paint , woo dporc hfloor s an dtri mare awa s al l in poo r condition . Pain t chip s i n yard . •Problem s encountered : Non e •Owne r request/concerns : Colo r change . Owne r ha dman y color s o n hous e an d change dman y thing s wit hhi s color . •Inspection/closeou t dates . Owne r signe d08/1 8 2009 . EP A signe d8/2 1 200 9 No issues .

# 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 " Fa x (402 ) 504-328 1 Consultin g • Engineenn g Oesigr i • ReirieuiMtifii i • AtKnenion t • rntPrcio'ii.'.
. F;f",.|«iiK t 

### EP A Close-Ou t For m (Lead-BasedPain t Stabilization EP A Contract EP-R7-08-06 ) 

## SAID . so,m-2 ) Propert y Address : ^ Q TC^ ^ 

# yv^ . f\s/e ^ Owner' s Name : 

# r\\iAr}\ ^ ^ 

# hylpc
. Performanc e Standards/Close-Ou t Criteri a YE S N O I . Wa s th e entir e structure(s ) painte dwit hth e exceptio n ofth e stated , exclude d areas ? Thi s woul dinclud e paintin g o f othe r associate dfeature s includin g fascia , eaves , siding , all trim , porches , bo x beams , columns , rails , andexterio r surface s o f 

# y garages . 2 . Wa s all scrapin g an dothe r preparatio n wor k

complete dsatisfactorily ? 

# y 3 . Were all require darea s ofth e structure(s ) prime da s neede dandpainte dwit h tw o to p coats ? 

# y 4 . Wa s th e pain t product s utilize dequivalen t l o a3 0 yea r product/quality ? 

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

### 6 . Di dth e contracto r collect/vacuu mall fallin g andscrape dpaint chip s o n th e entir e property , roadways , alleyways , publi c acces s area s andals o remov e any / 

### other generate ddebris ? 7 . I s th e gras s are athat surround s th e structure(s ) i n reasonabl y goo dcondition ? 

# y 8 . Are al l item s suc ha s polyethylen e sheeting , ladders , paint brushes , cones , barrie r tape , etc . properl y removed ? \ 

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

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

# y tha t nee dto b e move dback ? 11 . Are ther e any (known ) lingerin g issue s wit hth e property owner(s ) tha t hav e bee n lef t unresolved ? 

# y Other Considerations/Property Owne r Discussions/Additional Wor k

tha t i s Required :



### /^J^rhdT/ ^ EP A CO RSignatur e Dat e i

# PROFESSIONA L 250 5 Nort h 24'i \ Suit e 21 9 

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

### "Providin g cost-etfectiv e environmenta l solutions " Fa x(402 ) 504-328 1 Consultin g • Engineerin g Des.g n " Remed.atio n • Abatemen t » Emeigenc yRespons e 

## Property Owne r Close-Ou t For m (Lead-Base dPain t Stabilizatio n EP A Contrac t EP-R7-08-06 ) SAID : ,3rim^"3:3 , Propert y Address : Q^Q S , POpjOkteTt , I\J ^ Owner' s Name : J^^ai^aa n ' P IX/^ . 

# tr Performanc e Standards/Close-Ou t Criteri a YE S NO I. Wa s th e entir e structure(s ) painte dwit hth e exceptio n ofth e stated , exclude d areas ? Thi s woul dinclud e paintin gof othe r associate dfeature s includin g fascia , eaves , siding , al l trim , porches , bo x beams , coluntms , rails , an dexterio r surface s of 

## ly garages . 2. Wa s al l scrapin g an dothe r preparatio n wor k

complete dsatisfactorily ? 

# u 3. Were all require darea s ofth e structure(s ) prime d as neede dan dpainte dwith \j 

### tw o to p coats ? 4. Wa s th e pain t product s utilize dequivalen t to a 30 yea r product/quality ? 

# u 5. Ar e al l ofth e area s wher e contaminate dmaterial s hav e bee n spille dthoroughl y 

# V vacuumed / cleaned ? 6. Di dth e contractor collect/vacuu mall fallin g an dscrape dpain t chip s on th e entire property , roadways , alleyways , publi c acces s area s andals o remov e any other generate ddebris ? / / 

### 7. Is th e gras s are atha t surroimd s th e structure(s ) in reasonabl y goo dcondition ? \ / 

### 8. Are al l item s suc has polyethylen e sheeting , ladders , pain t brushes , cones , \j barrie r tape , etc . properl y removed ? 9. Is ther e an y evidenc eof property damag e tha t was don eby th e contractor ? An y t/ 

### property damag e need s tobe complete dprio r to th e EPA Close-Out . 10 . Are ther e an y property item s that wer e temporaril y re-locate d by th e contracto r 

# )J that nee dtobe move dback ? 11 . Ar e ther e an y (known ) lingerin g issue s withth e property owner(s ) tha t hav e been lef t unresolved ? Comments : y i 

# /- wg y Propecf y Qv/ x Dat e 

# '^-ll-o ^ Professiona iona l l Environmenta l Engineer s Representativ e Dat e 

# 0

## CONSEN T FO RACCES S T O PROPERT Y OMAH A LEA D SIT E REMEDIA LACTIO N - LEAD-BASE D PAIN T STABILIZATIO N PROPERT Y ID : r^(Ti"l ^ PROPERT Y ADDRESS : O ^ 7 O 5 f'hppl e t/ n R\J ^ OWNE RNAME : 

## Ab^i-Kar x Q^i ^ DAYTIM E PHONE : 4P7-

- ^0(g-'^Q4 S CELLPHONE : 4o2

- -B>Ofc > '-^M S E-MAIL : n /AVVyAxf X . Dv\Vz? . (°LCi>n^y^ UOmW\ M 

## /.c^ m OWNER' S ADDRES S I FDIFFERENT : TENANT' S NAM EI FAPPLICABLE : 

### DAYTIM E PHONE : CEL L PHONE : E-MAIL : Professiona l Environmenta l Engineers , Inc . (PE ) i s unde r contrac t (#EP-R7-08-06 ) withth e U.S . Environmenta l Protectio n Agenc y (EPA ) t o stabiliz e lea dbase dpain t (LBP ) o n residentia l structure s a t anumbe r o f propertie s locate di 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 db y EP A contractors . Pain t stabilizatio n activitie s wil l include : scrapin g ofcracke do r flakin g LB Pfro mstructures , applicatio n of aprim e coa t an dtw o (2 ) coat s o f paint . 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 ) t o ente r an dhav e acces s t o thi s propert y fo r th e purpos e o f stabilizin g lea d-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 t o allo w a n EP A contracto r t o conduc t asoi l cleanu p a t my propert y followin g completio n o f lead-base dpain t stabilization , if th e soi l cleanu p ha s no t alread y bee n performed . I understan dtha t th e stahili79tin n contracte r cai i Hu t ijiuviii c assurance s [ha 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 m

y property .

Yes , I hav e rea d an d uaderctan d th e pongrap h above , ^ ' 

## 7-// - O' f /^natur e o f Propert y0*ne r Dat e I fully understan dtha t b y signin g thi s Consen t fo r Access , (1 ) thi s acces s wil l remai n i n effec 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 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 , Day Car e Providers , an d Schools" , (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 ) wil l abid e b y healt han d safety 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 n advanc e o f startin g work , (7 ) agre e no t t o obstruc t o r tampe r wit h an y ofth e LB Pstabilizatio n actions , an d(8 ) wil l participat e i n final propert y inspectio n an dsig n th e Completio n Agreemen t an d Propert y Owne r Satisfactio n Survey . Shoul dyo u hav e an y question s abou t th e plane dLea dBased-Pain t stabilizatio n activitie 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-S04-4688 . Genera l question s abou t th e Omah a Lea dSit e cleanu p ca n b e directe dt o Paulett aFrance-Isetts , EP A Remedia l Projec t Manage r 402-731-24S4 , o r th e EP A Publi c Informatio n Center s a t 402-991-958 3 (Nort hOmah aoffice ) o r 402-731-304 5 (Sout hOmah aoffice) . ^y^Yes , I gran t acces s t o tn 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 Righ t importan t Lea d Informatio n fo rFamilies , Chil d give n th e pamphle t "Renovat e Right , Importan t Lea d Care Providers , an d Schools. " Informatio n fo rFamilies , Child e Car e Providers , an d Schools. " 

# ?y,.. , ed^f^ . 7iM t SignAut e / Date Signatur e Dat e SPECIA L INSTRUCTION S AN D CONSIDERATION S

# lr? : ' 

# PMM T MMC U mBEmmEM T KmnBmmmesS s 210 3 Pop^ls^o ^ A ^ DAT E 

# g//(Vp q BVI D - I AREA(S } TO B E PAINHED s 6. / 

## l44 « 

# ^Yaf(\^ e %f \SVi /

2^5. ^ HmisB-nm i y^.^ ^v^^ ^ COLO RDov^ r

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COLO R (GOMPLEf E A U SECnOl i YES ^ n aO RNON-APPUCABLE ) 

## I AGRE E T O TH E GOLOR S LISTE D ABOVE
. ONC E PAINnN G BEGIN S I UNDERSTAN D I CA N NO T CHANG E TH E ABOV E SEUECTE D COLORS :

PADMrmTQHroRESOQn S

### Dougla s Coimt y Accoim t Information Pag e 1 of3 

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Dougla s County , Nebrask a Propert yRecor d - R123842000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e ( S scal e 0-S O f t wes t of 52n d S t - VlO 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 DYK E NATHA N P ETA L 270 3 POPPLETO N AV E OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 384 2 OOO O 1 2 Accoun t Type : Residentia l Parce l Numbe r 123842000 0 Parce l Address : 270 3 POPPLETO N A V OMAH AN E 68105-000 0 Lega l Description : HANSCO M PLAC E LO T 2 BLOC K1 4 E 5 0 FT LT S 1 & 5 0 X 10 0 Valu e Informatio n Lan d Improvemen t Tote l 200 9 $4,400.0 0 $93,900.0 0 $98,300.0 0 200 8 $4,400.0 0 $93,900.0 0 $98,300.0 0 200 7 $4,400.0 0 $93,900.0 0 $98,300.0 0 200 6 $4,400.0 0 $70,400.0 0 $74,800.0 0 200 5 $4,400.0 0 $70,400.0 0 $74,800.0 0 200 4 $4,400.0 0 $70,400.0 0 $74,800.0 0 Sale s Informatio n Sale s Date : 2007-04-0 2 Dee d Type : W D Book : 1 200 7 Page : 03757 9 Price : $114,000.0 0 Grantor : Rogers Michae l eta l Grantee : Dyke Natha n P eta l Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 2005-04-2 2 Dee d Type : W D Book : 200 5 Page : 04739 9 Price : $107,000.0 0 Granto r JOH N L LINCOL N ETA L 

### http://dougIasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RI23.. . 7/8/200 9

### Dougla s Count y Accoun t Informatio n Pag e 2 o f 3
Grantee : MICHAE L RODGER S ETA L Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Untt s Dept h Widti i Vacan t 0.1 1 5000. 0 

### 1. 0 100. 0 50. 0 N o Improvemen t Informatio n Buildin g 1

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## 1
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_ Squar e Footage : 1675. 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 : 6. 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 : 1. 5 Floorcover : Allowanc e 

### Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r YearBuit t 

### Physical Ag e Remodele d Remodele d Bu m 

### 191 7 0 % 191 7 9 1 Detei l Typ e 

### Deteil Descriptio n Untt s Ad d O n Unfinishe d Atti cW/floo r 1040. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 1040. 0 Fixtur e Bas e Fixture s 1. 0 

### http://dougIasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RI23. . . 7/8/200 9

### IGI T 

# y ^ Propert y Addres s / J ^ O 3 ) T^n/9|f-Jol | Dat e Star t Date n)^/i4/oQ | End oat e V ^ I J j ^ / Q ^ 

### Amoun t O f Prim e An d Pain t Use d Prim e (Gallons )

Pol y(Boxes Pain t (Color ; 

# 7^-^T ) Amoun t (Gallons) 

# J G<^ / Pain t (Color ] 

# ^f^ S Amoun t (Gallons ) 

# ^BgA / Pain t (Colo r Amoun t (Gallons ) 

# gfr A Pain t (Colo r 

# (7iH { Amoun t (Gallons) 

# i7>^\ Pain t (Colo r Amoun t (Gallons)