## TRANSMITTA Lo f OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL E FOLDE R 

# SAID# : 2.231 ^ Date : 

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- A/ ^ Address : Remediatio n Coniractor : PROFESSIONA LENVIRONMENTA LENGDJEER S Year : 200 8 PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S Vide o ofpropert y (DVD ) - ^ _ Executiv e Summary Signe dAcces s Agreemen t for subjec t propert y 

# n / Paintin g Agreemen t Settlemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) Photograph s . • '_ Satisfactory restoratio n signe db y Propert y Owne r B ^ Propert y close-ou t chec k lis t signe db y EP A &y . Propert y informatio n fromDougla s Count y Assessor' s Offic e

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### Lea dBas e Stabilizatio n Omaha , N e Clos e Ou t Repor t SAID #2237 7 72 1 S 2 5 A v

•Date s worke d11/2 8 t o 11/2 8 200 8 •Hous e ha dman y rottin g boards , damag e t o roofin g areas , pain t i n very poo r conditio n al l over , basemen t window s are i n poo r conditio n withrippe dscreen s an dbroke n glass . Ol d pain t o n th e window s an dfoundatio n areas . •Inspecte d12/0 8 retume dt o repain t sout han deas t sides . 12/1 6 issue s resolve d

# 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 i solutions ' Fa x(402 ) 504-328 1 Consultin g • Enqinecrin g Desig n • Remediatio n • Abatement • Emergenc yResponse 

### Propert y Owne r Close-Ou t For m (Lead-BasedPain t Stabilization EP A Contract EP-R7-08-06 ) SAID : 

# 2^X 7 7 Propert y Address : 7(y^ ( ^ . cy S ^XT^^^Z — 

### Owner' s Name : \/iC^fO( ^ P(L^C ^ 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 n ofth e stated , exclude d areas ? Thi s woul dinclud e paintin g o f other associate dfeature s includin g fascia , eaves , siding , al l trim , porches , bo x beams , columns , rails , an dexterio r surface s o f / 

### garages . i / 

### 2 . Wa s al l scrapin g an dothe r preparatio n work complete dsatisfactorily ? 3 . Wer e al l require darea s ofth e structure(s ) prime da s neede dan dpainte dwith tw o to p coats ? X 4 . Wa s th e pain t product s utilize dequivalen t t o a3 0 yea r product/quality ? J 

### 5 . Ar e al l ofth e area s wher e contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? 

# X 6 . Di dth e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s o n th e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e an y 'y 

### 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 ? / 

### 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 any evidenc e ofpropert y damag e tha t wa s 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 . Are ther e any property item s that wer e temporaril y re-locate db y th e contractor tha t nee dt o b e move dback ? 11 . Ar e ther e any (known ) lingerin g issue s withth e property owner(s ) tha t hav e Kl ' 

### bee n lef t unresolved ? Comments : , 

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# 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 Desig n • Remediatio n • Abatemen t • Emergenc yRespons e 

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

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# )-.cA Performanc e Standards/Close-Ou t Criteri a 1 . Wa s th e entir e structure(s ) painte dwithth 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 , 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 n wor k

complete dsatisfactorily ? 3 . Were 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 year product/quality ? 5 . Are al l ofth e area s wher e 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 entir e property , roadways , alleyways , publi c acces s area s an dals o remov e any 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 ? 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 ofpropert y damag e that was 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 . 10 . Ar e ther e any property item s that wer e 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 bee n lef t unresolved ? Othe r Considerations/Property Owne r Discussions/Additiona l Wor k

that i s Required : 

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# CONSEMT OF M ACCES S T€i > PEOPEET Y OMAHA LEA ® SIT E MEMEDIA LACTIO N - LEAP-BASE D PAIN T STABILIZATIO N 1 PROPERT Y ID : ^J^O^ T PROPERT Y ADDRESS : "^cP . / c ^ ^ ^ < 5 " x^Z X 1 OWME RNAMM" ^ 

### DAYTIM E PHONE : C"^^! ] lXA( ^ ' L\xX 1 CELLPHONE : • E-MAIL : 1 OWNER' S ADDRES S I FDIFFERENT : TENANT' S NAM E I FAPPLICABLE : DAYTIM E PHONE : CELLPHONE : E-MAIL : 

# 1 1 Professiona l Environmental Engineers , Inc . (PE ) i s unde r contrac t (#EP-R7-08-06 ) wit hth e U.S . Environnienta l Protectio n Agency (EPA ) t o stabiliz e leadbase dpain t (LBP ) on residential structure s a t anumbe r of propertie s locate di n Omaha , Nebraska . Th e pain t stabilizatio n work i s bein g don e t o protec t th e soi l cleanup s tha t wer e performe dby EP A contractors . Pain t stabilizatio n activitie s wil l include : scrapin g of cracke do r flakin g LB P fromstructures , applicatio n o f aprim e coa t an d tw o (2 ) coat s o f pain t Moving part s of window s an ddoor s ar e no t include dan dwil l no t b e addressed . Your cooperatio n i s requeste di n givin g permissio n t o thi s EPA contracto r (PE ) t o ente r an dhav e acces s t o thi s propert y for th e purpos e o f stabilizin g lead-base dpain t a s outline do n th e propert y identifie dabove . B y signin g thi s document I agre e t o allo w a n EPA contracto r t o conduc t asoi l cleanu p a t m y propert y foUowug completio n of lead-base dpain t stabilization . I understan dtha t th e stabilizatio n contracto r can no t provid e assurance s tha t th e soi l cleanu p contracto r will b e boun dto . I furthe r understan dtha t th e soi l cleanu p contracto r wil l make 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 . I full y understan dtha t b y signin g thi s Consen t for Access , (1 ) thi s acces s will remai n i n effect unti l th e wor k

ha s been satbfactoril y completed , (2 ) tha t th e Propert y Owner o r Tenant , i f applicable , wil l b e given th e Housin g an dUrba n Developmen t (HUD ) an dEP A pamphlet , "Renovat e Right , Importan t Lea dHazar dinformatio n for Families , Da y Car e Providers , an dSchools" , (3 ) th e Propert y Owner o r tenan t wil l remov e al l obstruction s fromsurface s t o b e painted , (4 ) will abid e by healt han dsafet y guidanc e provide db y EPA , (5 ) wil l allo w photograph y ofpropert y before an dafte r th e pain t stabilizatio n work , (6 ) wU I b e contacte db y aPE representativ 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 han y ofth e LB P stabilizatio n actions , an d(8 ) will participat e i n fina l propert y inspectio n an d sign th e Completio n Agreement an dPropert y Owne r Satisfactio n Survey . Shoul dyou hav e an y question s abou t th e plane dLea dBased-Pain t stabilizatio n activitie s for you r property , pleas e contac t Professiona l Environmental Engineers , Inc . Projec t Manager , Willi e Clay A t 402-504-4688 . Genera l question s abou t th e Omah aLeadSit e cleanup can b e directe dt o Paulett aFrance-Isetts , EPA Remedial Projec t Manage r 402-731-2454 , o r th e EPA Publi c Informatio n Center s a t 402-991-958 3 (NorthOmah aoffice) o r 402-731-304 5 (Sout hOmah aoffice) . D Yes , I gran t acces s t o m ypropert yan d w n 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 novat e Righ t bnpoitan t Lea d InfbimatkM i fb rFamilies , Chil d give n th e pamphle t "Renovat e Right , Importan t Lea d t Provlders,,aR(t'Schools. ' Infonnatk m fo rFamilies , Child e Car e Provklers , an d Schools. " Signatur e Dat e Signatur e SPECIA L INSTRUCTION S AN D CONSIDERATION SPROPERT Y ADDiESS . 

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PROPERT Y ADDRES S O F OWNE R I F DIFFEREN T THA N PROPERT Y BEIN G PAINTED : PROPERT Y ADDRES S ZI P COD E I have receive d a copyo f th e pamphlet , Renovat e Right : Importan t Lea d Hazar d Informatio n Fo rFamilies , Chil d Care Pmvider 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 exposure fro m renovatio n activit yt o b e perfonne d o n dwellin g unit . I receive d thi s pamphlet befor e th e wor k began . PRIDiTEDNAMEOFRECfPIEN T DAT E 

# V ^ SIGNATUR E O F RECIPIEN T Self-Certificatio n Optio n (Fo rTenant-Occupie d Dwelling s Only ) i f th e lea d pamphlet was delivere d bu t a tenan t signatur e was not obtainable , yo u ma ychec k th e appropriat e bo x below : I J Refusa l T o Sig n - 1 certif ythat I have mad e a goo d fait h effor t t o delive rth e pamphlet , renovate right : importan t lea d hazar d infonnatio n fo r^milies , chil d care pmvider s an d schools ; t o th e renta l dwellin g uni t liste d above at th e dat e an d tim e indicate d an d that th e occupan t refuse d t o sig n th e confinnatio n o f receipt . I furthe rcertif ythat I hav e lef t a copyo f th e pamphiet at th e uni t wit h occupant . 

# D Unavailabl e Fo rSignatur e - 1 certif ytha t I have m^ e a goo d fait h effor t t o delive rth e pamphlet , renovat e right ; importan t lea d h^ar d infonnatio n fo rfamilies , chil d care 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 was unavailabl e t o sig n th e confinnatio n o f receip L I furthe rcertif ythat I have lef t a cop yof th e pamphle t at 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 AHEMPTE D DELIVER YDAT E AN D TIM E LEA D PAMPHLE TDEUVER Y

SIGNATUR E O F PERSO N CERTIFYIN G LEA D PAMPHLE TDELIVERY : Not e Regardin g RAailin g Optio n - a s an altemativ e to deliver yi n person , yo u ma ymai l th e lea d pamphle t to th e owne r and/o rtenant . Pamphle t mus t b e maile d a t leas t 7 day s befor e renovation . (Documen t wit h a certificat B o f mailin g fro m the pos t office) . CONFIRMATIO N O F RECEIP TO F LEA D PAMPHLE T08/0 8

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PR E -EXmXli G CONDIUQ N O F FOUNDATION/STRUCTURE , i.e . BASEMEN T LEAKING ? N O L/l J YE S ' ' IF , YE S WHERE :

EXISTIN G PAIN T O N WINDOWS , DOORS , FOUNDATION , SIDEWALKr C I.E.) ? N O |]zt l YE S n m IF , YE S WHERE :

VISUA L DESCRIPTIO N O F PROPERTY/STRUCTURE/GARAGE , (LE.) : (US E BACKSID E I F NECESSARY )

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PAIN T MATC H FOR M 08/0 8

### Dougla s County Accoun t Informatio n Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R142689000 0 Prin t Repor t

, , . • • ,• . rinn o r . . . NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t of 90t h S t - Viewo n 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 PERALT AVICTO R P 7 1 S 2 5 AV E -^yy ^

xX/1 / ^ OMAH AN E 68105-000 0 O'T ^

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- Propert yInformatio n Ke yNumber : 268 9 000 0 1 4 Accoun t Type : Residentia l Parce l Number : 142689000 0 Parce l Address : 72 1 S 2 5 A V OMAH AN E 68105-000 0 Lega l Description : JOHNSO N AD D REPLA T LOT 9 BLOC K0 S 5 F T SU B LT 2 & AL L SU B L T 3 O F 33.13X13 2 Valu e Informatio n Lan d Improvemen t T"ota / 200 8 $ 5,400.0 0 $ 53,200.0 0 $ 58,600.0 0 200 7 $ 5,400.0 0 $ 53,200.0 0 $ 58,600.0 0 200 6 $ 5,400.0 0 $ 28,600.0 0 $ 34,000.0 0 200 5 $ 5,400.0 0 $ 28,600.0 0 $ 34,000.0 0 200 4 $ 5,400.0 0 $ 28,600.0 0 $ 34,000.0 0 200 3 $5,400,0 0 $ 28,600.0 0 $ 34,000.0 0 Sale s Informatio n Sale s Date : \ 2008-06-1 1 Dee d Type : W D Soolr : 200 8 Page : 05826 9 Price : $ 29,000.0 0 Grantor : GODBERSO N MARTI N ETA L Grantee : PERALT AVICTO R P Valid/Invalid : Vali d Exclusio n Reason : , Lan d Informatio n Acre s S F Unit s DeptA i Widt h Vacan t 0. 1 ' 4356. 0 1. 0 132. 0 33. 0 N o Improvemen t Informatio n 1 • • •1 

### http://douglasne.mapping-onHne.com/DouglasCoNe/static/accountinfo.jsp?accountno=R14. . . 11/5/200 8

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CLIC KT O ENLARG E IMAG E Squar e Footage : ; 1695. 0 Percen t Complete : 100.0 % 

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Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 

### 10. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 5. 0

Roo f Type : Gabl e Stories : 2. 0 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 

### 1885 0 0 % 188 5 12 2 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 823. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Batt i Ful l 1. 0 Garag e Attache d 440. 0 Porc h Sla b Roo f Cei l 64. 0 Porc h Sla b Roo f Cei l 72. 0



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