# TRANSMITTA Lof OMAHA LEAO SffT E PAIN T STABILIZATIO N FIL EFOLDE R 

# SAID# : 20M4 L Date : Address : 

# 41 ^

Vlmh/s.]^pfV ^ Ave ^ Remediatio n Contractor : PROFESSIONA LENVIRONMENTA LENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUIVIENT S {y Vide o o f property (DVD ) « 

### ^y Executiv e Summary y' ^ Signe dAcces s Agreemen t fo r subjec t property ^y ^ Paintin g Agreemen t D Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) y ^ Photograph s p>r<g-^fV O pflg T ^jy ^ Satisfactory restoratio n signe db y Property Owne r D Property close-ou t chec k Us t signe dby EPA y ^ Property informatio n fromDougla s Count y Assessor' s Offic e y ^ confirmatio n that leadpamphle t "Renovat e Right " was receive db y P O D D D



### ntal ngineer s S i Professiortal^nvironmenta l Eri gnatur e 

# ->^#2 EPA Signatur e 3009440 9 

# iilii l Superfun d

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

# ''^'''ol'htNEtBn o ^^ ^

[Jp^ j sJtsS ? Consultin g • Engineerin g Desig n • Remediatio n • Abatemen t • EmergencyRespons e



### Lea dBas e Stabilizatio n Omaha , Ne Clos e Ou t Repor t 200 9 SAID #2004 4 41 5 Woolwort hAve .

•Date s worked : 08/0 1 t o 08/0 3 200 9 •Pr e propert y condition : Hous e ha dviny l sidin g wit hwoo dpainte darea s tha t wer e i n poo r condition . Pain t chip s all ove r th e yard . •Problem s encountered : Non e •Owne r request/concerns : N/ A •Inspection/closeou t dates . Owne r signe d08/0 4 2009 . Propert y inspecte db y P Eprojec 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 " Fa x (402 ) 504-328 1 Consultin g • Engineerin g Des.g n • Remediatio n • Abatemen t • Emeigenc yRespons e 

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

# SAID : 2^4 4 Propert y Address : ^/S ^ CJod// J JfT ^ /df M Owner' s Name : /Dj'C-L' . /Cn^olnJ

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 associale dfeature s includin g fascia , 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 dother preparatio n wor k

complete dsatisfactorily ? 

## 7 ^ 3 . Wer e al l require darea s ofth e structure(s ) prime da s neede dan dpainte dwit h tw o to p coats ? 4 . Wa s th e pain t product s utilize dequivalen t t o a3 0 yea r product/quality ? 

# g 5 . Are all ofth e area s where contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? 6 . Di dth e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s o n th e entire 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 atha t smround s th e structure(s ) in reasonabl y goo dcondition ? 8 . Are al l item s suc ha s polyethylen e sheeting , ladders , pain t brushes , cones , barrier tape , etc . properl y removed ? 9 . I s there an y evidenc e o f property damag e that wa s don e b y th e contractor ? Any property damag e need s t o b e complete dprio r t o th e EPA Close-Out . 

# 7 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 there any (known ) lingerin g issue s wit hth e property owner(s ) that hav e been lef t unresolved ? 

# 7 Comments : 

# y-^^/p 9 Property Ovraer Signatur e Date 

# <^-y-^ ^ Professional Environmenta l Engineer s Representativ e Date

# CONSENT FO RACCES S T O PROPERT Y OMAH A LEA D SIT EREMEDIA LACTIO N - LEAD-BASE D PAIN T STABILIZATIO N PROPERT YID : ZOO^ ^

PROPERT YADDRESS : ^/ y 6^^^^dU^y / /^'f/ l \\\pf > OWNE RNAM E 

## 73Jn a y o y t i ) yy t t vC n DAYTIM E PHONE : //?/(/• - 9 ^ 5 " ^ 1 CEL LPHONE : E-MAIL : 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 rcontrac t (#EP-R7-08-06 ) wit h th e U.S
. Environmenta l Protectio n Agenc y(EPA ) t o stabiliz e lea d base d pain t (LBP ) o n residentia l structure s a t a numbe ro 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 Acontractors . Pain t stabilizatio n activitie s wil l include : scrapin g ofcracke 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 ar e no t include d an d wil l no t b caddressed
. 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 properl yfo rth e purpos e o f stabilizin g lea d -base d pain t a s outline d o n th e propert yidentifie d above
. 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 o f lead-base d pain t stabilization , ifth e soi l cleanu p ha s no t alread ybee n performed
. I understan d tha t th e stabilizatio 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 effort s t o addres s concern s tha t 1 , as th e propert yowner , ma yhav e regardin g soi l cleanu p a t m yproperty . 1 ^

Yes , I hav e rea d an d understan d th e par^rap h abovi /TC-'^to/v.-/ ' Signatur e o f P|6pert yOtwne r Dat e 1 full yunderstan d tha t b ysignin g thi s Consen t fo rAccess , (1 ) thi s acces s 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 Developmen 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 an 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 l b e contacte d b ya PE representativ e approximatel y4 8 hour s i n advanc e o f startin g work , (7 ) agre e no t t o obstruc t o rtampe rwit h an yo f th e LB P stabilizatio n actions , an d (8 ) wil l participat e i n Fina l propert yinspectio n an d sig n th e Completio n Agreemen t an d Propert yOwne rSatisfactio n Survey
. Shoul d yo u hav e an yquestion s abou t th e plane d Lea d Based-Pain t stabilizatio 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-Isetts , EP ARemedia l Projec t Manage r402-731-2454 , o rth e EP APubli c Informatio n Center s a t 402-991-958 3 (Nort h Omah a office ) o r402-731-304 5 (Sout h Omah a office)
. 

# A 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 not gran t access 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 e Providers , an d Schoob Informatio n fo rFamilies , Child e Car e Providers , an d Schools. " choote. " 

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### Dougla s County Accoun t Informatio n Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R090240000 0

__-_„„„ - __„_._.-. . __«..~~.~TM_TMTM.—TM J __,__,.-..... . .....-.„. ­ -iTM-.-.........TM - Prin t Repor t Informatio n i s vali d a s o f 2009-6-1 6 NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t of S2n d S t - VlO W O n Ma P Treasurer' s Ta xRepor t Ne wFeatur e «•••- • Aut o Sale s Searc h Owne r SMIT H SHARO N K 41 5 WOOLWORT H AV E OMAH AN E 68108-000 0 

# •SMU-SM^O-i.-^ ^ iscftVJ ^ Propert yInformatio n Ke yNumber
. 024 0 OOO O 0 9 Accoun t Type : Residentia l Parce l Number : 090240000 0 Parce l Address : 41 5 WOOLWORT H A V 

# rso^ s OMAH AN E 68108-000 0 Lega l Description : CREDI TFONCIE R LO T3 BLOC K2 1 1 5 FTSTRI P AD J O N N & E 5 5 F T55X14 7 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $ 5,400.0 0 

### $30,900.00 $ 36,300.0 0 200 8 $ 5,400.0 0 $ 30,900.0 0 $ 36,300.0 0 200 7 $ 5,400.0 0 $ 27,200.0 0 $ 32,600.0 0 200 6 $ 5,400.0 0 $ 27,200.0 0 $ 32,600.0 0 200 5 $ 5,400.0 0 $ 27,200.0 0 $ 32,600.0 0 200 4 $ 5,400.0 0 $ 19,400.0 0 $ 24,800.0 0 Lan d Informatio n Acre s S F Unit e Dept h WidO i Vacan t 0.1 8 8085. 0 

### 1. 0 147. 0 55. 0 

### N o Improvemen t Informatio n Buildin g 1



### http://dougIasne.mapping-onIine.com/DougIasCoNe/static/accoimtinfo.jsp?accoimtno=R090. . . 7/9/200 9

## Douglas Count y Accoun t Information Pag e 2 of 2

1 1/ 2 Stor yFi n 41 5 Woolwort h A v i,'a«( i 

# I f

m iiml^tyit'talaif^ !<i>»l » «'HlP!»»*««|W.'i-;?4'-' l CLIC KT O ENLARG E IMA^ E jgyCjy^ENLARGEJJJlAgE ^ Squar e Footage : 936. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Fai r

BuiitAs : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Force d 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 : 2. 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 Physica l Ag e Remodele d Remodele d Buit t 189 0 0 % 189 0 11 9 Detei l Typ e Detei l Descriptio n Unit e Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 792. 0 Fixtur e Bas e Fixture s 

## 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h Sla b Roo f Cei l 120. 0 Porc h Sla b Roo f Cei l 120. 0 Use r Hal f o f 2n d floo rfi n pe rowne r 1. 0



## http://dougIasne.mapping-onIine.com/DougIasCoNe/static/accountinfo.jsp?accoimtno=R090.. . 7/9/2009

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