## TRANSMITTA Lo f OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL EFOLDE R SAID# : ^rS^M ^ 

# Date : _J - ) M | Q ^ Address : M l ^ B CaS S S f Remediatio n Contractor: PROFESSIONA LENVIRONMENTA LENGINEER S Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S 

# y y Vide o o f property (DVD ) Executiv e Summar y Signe dAcces s Agreemen t fo r

subjec t property Paintin g Agreemen t 0 Settlemen t document s (i.e. , fo r

damag e o r t o replac e plants , etc. ) B ^ 

# Piiotograpii s !prg
- dr A prS T « > ^ Satisfactory restoratio n signe dby Propert y Owne r Q 

### Property close-ou t clieclc lis t signe db y EP A 

# y

^ Property informatio n fro mDougla s Count y Assessor' s Offic e 

# y

^ _confirmatio n tha t lea dpamplile t "Renovat e Right " wa s receive db y P0 _ 

# SJ^Li . OixAJ r D D



### Professional Environmental Engineer s Signature Date

EP A Signatur e ^ ^ ^ 3009442 8 Superfun d

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . ''''Tm'a'htNEe's m "Providin g cost-effectiv e environmenta l solutions " ^ i^° S cn^lo! ? ^

Fa x(402 ) 504-328 1 Consultin g • Engineerin g Desig n • Remediatio n • Atjntenien t • Emeigenc yRespons e


### Lea dBas e Stabilizatio n Oinaha , Ne Clos e Ou t Repor t 200 9 SAID #2384 9 418 8 Cas s St .

•Date s worked : 07/0 2 t o 07/1 3 200 9 •Pr e propert y condition : Hous e ha dtransi t sidin g tha t wa s painte dan din fai r condition . Woo dtri mArea s wer e in ver y poo r condition . Pain t chip s in yard . •Problem s encountered : None . •Owne r request/concerns : N/ A •Inspection/closeou t dates . Owne r signe d07/3 0 2009 . EP A inspecte do n08/05 , n o issues .

# PROFESSIONA L 250 5 Nort h24'" , Suite 21 9 

# ENVIRONMENTA L ENGINEERS , INC . Omaha . N E6811 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 • Atjaicmen l • Enie^gencyRespons e 

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

## SAID : 0?>^q ^ Propert y Address : Ml ^ f^aS S S ^ Owner' s Name : "firV^n^T/n ^ Tlv3-e.€d Y 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 , exclude d areas ? Thi s woul dinclud e paintin g o f othe r associate dfeature s includin g fascia , eaves , sidi'ng , al l trim , porches , bo x beams , columns , rails , andexterio r surface s o f 

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

complete dsatisfactorily ? y 

### 3 . Were al l require darea s ofth e structure(s ) prime da s neede dan dpainte dwith tw o to p coats ? 

# y 4 . Wa s th e pain t product s utilize dequivalent't o a3 0 yea r product/quality ? 

# y 5 . Are al l ofth e area s where contaminate dmaterial s hav e been spille dthoroughl y vacuumed / cleaned ? 

# y 6 . Di dth e contractor co l leet/vacuu mal l fallin g an dscrape dpain t chip s on th e entir e property , roadways , alleyways , publi c acces s area s andals o remov e any 

# y othe r generate ddebris ? 7 . I s th e grass are athat surround s th e structure(s ) i nreasonabl 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 an y evidenc e o f property damag e tha t wa s don e by th e contractor ? An y property damag e need s t o 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 

### that nee dt o b e move dback ? 11 . Are ther e an y (known ) lingerin g issue s wit hth e propert y owner(s ) that hav e 

# y bee n lef t unresolved ? Othe r Considerations/Property Owner Discussions/Additional Wor k

tha t i s Required :

f ' I7D A nr\T > C:/inatiir o 

## EP A CO RSignatur e 'Dat e

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC . "Providin g cost-effectiv e environmenta l solutions " Consultin g • Engineenn g Desig n " Remediatio n • AbiMement « Emeigenc yRespons e 

## Propert y Owne r Close-Ou t For m (Lead-BasedPain t Stabilization EP A Contract EP-R7-08-06 ) SAID : Q5^^ ^ Propert y Address : M i 8f t CjO^f J S V Owner' s Name : 

# TSry^ n fj I in aTJ^O-ecd y Performanc e Standards/CIose-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 gof othe r associate dfeature s includin g fascia , eaves , siding , al l trim , porches , bo x beams , columns , rails , an dexterio r surface s of 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 das neede dan dpainte dwith tw o to p coats ? 4. Wa s th e pain t product s utilize dequivalen t to a 30 yea r product/quality ? 5. Ar e 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 onth e entire property , roadways , alleyways , publi c acces s area s andals o remov e any othe r generate ddebris ? 7. Is th e gras s are atha t surround s th e structure(s ) inreasonabl y goo dcondition ? 8. Are al l item s suc has polyethylen e sheeting , ladders , pain t brushes , cones , barrier tape , etc . properl y removed ? 9. Is there an y evidenc eof property damag e that wa s don eby th e contractor ? An y property damag e need s to be complete dprio r to th e EPA Close-Out . 10 . Ar e ther e an y property item s that wer e temporaril y re-locate d by th e contracto r that nee d to be 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 ? Comments : 250 5 Nort h24' \Suit e 21 9 Omaha , NE6811 0 (402 ) 504-468 8 Fa

x (402 ) 504-328 1



### YE S NO

., /

- 

# V ­ 1 V ^ 

# y~

r /

- 

### \/- '



## 5^ , 

# s j . 

### '9 ^ —r— =

I



# y 

# l-'^Ayn a /'^ ^ —/0O(Z^
- t^J^ f Propert y Owne r

Signatur e Dat e ^ 

# 7-J o - °i ^ Professiona l l "fenvifertmenta l Engineers Representativ e :essiona EnviS Dat e

# CONSEN T FO RACCES S T O PROPERT Y OMAH A LEA D SIT EREMEDIA LACTIO N - LEAD-BASE D PAIN T STABILIZATIO N PROPERT Y ID : 23^H3 [ PROPERT Y ADDRESS : 

# ^/9i< < C'^S S Si
OWNE RNAMJE :

g^'pTo^T-^/v ^ l/^^j2oJ^ f DAYTIM E PHONE : ^/d?j-'7y^9 Q ...„„«,.,«. . Lf/^X-^-^q n 0_ E-MAIL : f^ U "yg f JSc^^-f-e/^J ? ( \^K// ! / P/ ? . ( f < S CELLPHONE : ^/0?)-^y O 

## /^"KD OWNER' S ADDRES S I FDIFFEREN T TENANT' S NAM EI FAPPLICABLE : DAYTIM EPHONE : CELLPHONE : E-MAIL : Professiona l Environmenta l Engineers , Inc . (PE ) i s unde r contrac t (#EP-R7-08-06 ) wit hth e U.S . Environmenta l Protectio n Agenc y (EPA ) t o stabiliz e lea dbase dpain t (LBP ) o n residentia i structure s a t anumbe r o f propertie s locate dinOmaha , 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 din 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 nperformed . I understan dtha t th e stabilizatio ncont.'-acto r ca n no t provid e assurance s tha t th e soi l cleanu p contracto r wil l b e boun dto . 1 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 . 

## 0^ ( es , I have/rea i m dunderstaiit i th1 paragrap habove . 

# y!ry\^ _ ii.^7 7 QyA./^ i 

# -7^30 ? Signatur e o fPropert yOwne 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 in 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 nfo 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 , (S ) wil l allo w photograph y of 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 in 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 in Tma l 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 properly , pleas e contac t Professiona l Environmenta l Engineers , Inc . Projec t Manager , Willi e Cla y A t 402-504-4688 . 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 402-731-2454 , 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) . i^^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 no t gran t acces s t o m ypropert yan d I wa s "Innovat e Right , Impoitan 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 Schools. " Informatio n fo rFamilies , Child e Car e Providers , an d Schools. " 

# IL^iiO f { I^ Q Signatur e Dat e Signatur e Dat e SPECIA L INSTRUCTION S AN D CONSIDERATION Sct , 

# pm mmm mm^EBBmEM i ^/i%' Kr^^^ "ir t 

# 7-^ -^ - 

# n f HM D 

## -

GOUH L 

# -j^kiii LaOi /

3(y J if)O i \/yf ^ c^y ^ 

# 7^ 3 HOUSE miN . ^ 

## GOUNt . 

# br>d rr 2 J 5o ^ fo8^ 9
GARilOI . /-^ ^ 

## JOOUM L 

# - 6 Wi r J

Z 

# € ^ ^>- ^ (^ ^ 

## QASSAfienOH . 

# y-e ^ JOOLOI L 

# lor/0 > r-jg/ ^ -S^-<>' (^Q....L^ ^ 

# v^^
- f^(^ ^ t::?r.j > C J -^ ^ (no f 

# roROi. nnrn w ^ ^ 

# .^^IfS . hciCL^. rj^ ^

sc ^ (r^ec^f c (OONnSI B JOLSBCIIOI ^ VB ^ NQlpORNON-APHJCMBU ) 

# I AfiRE E T D TH E COUOR S USTE D ABOVE . ONC E PAIIfnN G BEGINS ^

I UNDERSTAN D I CA N NO TCHANG E TH E ABOV E SEUBCTE D COLORS :

wmtmimmmm m

# r Dougla s Count y Accoun t Information Page 1 of3 

# ^ 2^^M ^ 1 • * • ——— —»-- - - —

Dougla s County , Nebrask a Propert yRecor d - R201813000 0 Prin t Reoor t NE W F^satur s - Parce l Dimension s availabl e O scal e 0-5 0 f t wes t of 52n d S t - VlO W O n MB D Informatio n i s vali d a s o f 2009-6-1 6 Treasurer' s Ta xReoor t Ne wFeatur e -•••- • Aut o Sale s Searc h Owne r TWEED YBRYA N P ETA L 418 8 CAS S S T OMAH AN E 68131-000 0 

### Propert yInformatio n 5* 5 L D ­ ^ ^ ^ ^ Ke yNumber : 181 3 000 0 2 0 Accoun t Type : Residentia l Parce l Number . Parce l Address : 

## 201813000 0 418 8 CAS S S T OMAH AN E 68131-000 0 

## f^O Q K / Lega l Description : POPPLETO N PAR KLO T1 1 BLOC K1 1 5 0 X 123.8 1 Valu e Informatio n Lan d Improvemen t Tote l 200 9 $ 6,400.0 0 $ 94,900.0 0 $ 101,300.0 0 200 8 $ 6,400.0 0 $ 94,900.0 0 $ 101,300.0 0 200 7 $ 6,400.0 0 $ 81,000.0 0 $ 87,400.0 0 200 6 $6,400.0 0 $ 81,000.0 0 $ 87,400.0 0 200 5 $ 6,400.0 0 $ 81,000.0 0 $ 87,400.0 0 200 4 $ 6,400.0 0 $ 58,000.0 0 $ 64,400.0 0 Sale s Informatio n Sale s Date : 2006-03-2 1 Dee d Type : W D Btiok : 200 6 Page : 02977 7 Price : $0.0 0 Granto r Brya n Tweed y Grantee : Brya n Tweed yEta l Valld/lnvalld : Invali d Exclusio n Reason : Sale s Date : 1995-03-0 2 Dee d Type : D Sooft : 200 0 i Page : 34 5 i Price : $ 55,000.0 0 Granto r 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R201.. . 7/8/2009

## Dougla s Count y Accoun t Information Page 2 of3 Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Untt s Depti i Widt h Vacan t 0.1 4 

### 6150. 0 1. 0 

### 123. 0 50. 0 

### N o Improvemen t Informatio n Buildin g 1 21/2StOf y 418 8 Cas s S t

• <p * FttXFI W |n > » « TM.II8q.n . imets^n .

t'OT « »; * e n ?iS « 0 'i j f ! 9|.ICI^T9^N|^f^9f|^G E JgUCICrgJENLAR^ ^ Squar e Footage : 

### 1686. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

BuiitAs : 2 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 : 2. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 4. 0

Roo f Type : Gabl e Stories : 2. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 YearBuit t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Bu m Physica l Ag e 191 5 0 % 191 5 9 3 Detai l Typ e Detei l Descriptio n Unit e Ad d O n Fenc e Woo d 

### 1. 0 Applianc e Allowanc e 

### 1. 0 Basemen t Bsmn t Bloc k 8 ft 768. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 2. 0 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R201.. . 7/8/2009

### JC Paintin g Propert yAddres s ^1^ 9 CCiS: s <sT' Dat e ^ ­ D ^

­ O C f Star t Dat o " H >- ^Q j ^ Q Q Complet e Dat e ^ \ ­ 3 O —O C | 

### Amoun t O f Prim e An d Pain t Use d Prim e (Gallons ) ^ <P' t (^cy Pol y(Boxes ) ^ Pain t (Color ) " ^

«-,i, ^ vo O Vft Amoun t (Gallons ) jHP O ^-Cl. Q Pain t (Color ) g>>A j T'i<^ - ((?8(gCy? Amoun t (Gallons ) /- • C ? j . Pain t (Color ) S.y-> ^ ­ VQ^^* ^ Amoun t (Gallons ) "pprc-iV . cj^j^t o 3 C l Pain t (Color ) Amoun t (Gallons ) Pain t (Color ) Amoun t (Gallons )

### PROFESSIONAL ENVIRONMENTA L ENGINEERS , INC . REUNIO N DIARI AD E SEGURIDA D 

# .'lu , <?y/yj//^ ^ i-'iovc i If ) f .'nicili u Puiii l .Slf.ibili.^dlif.)' ! I'fojoc t

SIIK j (i rA clivirinr I 1(1 1 cer . DiOfifv , 

### yl/f- i



## • i (^^cy^pi/^ r l'rimf)niial/rcligi'~> s Prttcnciolc s


### lleacjrnionli')^ . 6 c Tiobojc ; '6 4 Piocticu b de l liabaio/Acciotie s Coitectivas : 

# ' '^Cr^p74/r - 3 7 4 > t hr~<if
- r A Ujniado s pieviub . 

### 3 . 4 FiMii a d e Registi o de l l-mpleoci o 

### l^€tr^ ^ ^LTYD^^- . 

### 3 

# 2 CQL^M ^ 

# M^yy\ , 4 (^ 

# /

/if:cKae\..^Kt i or\^ \ 8

Ti l I n n d e Salu d ySegundo d de l S i 11 0 fech n <^^ ^

## Professiona l Environmenta l Engineers , Inc . INTERVENCIO N DE SEGURIDA D Nombr e de l Proyecto " _^Z^' ^

.(7^^' > ^ _^- ^ Fech o d e l a Intervencion - 

# a?/7^y/ C/

_y / yJ'/0

_> Peligro s d e Salu d Primordial : /Y/pyC Z 3Xy Preocupacione s Primordiale s d e H & S : Tarea s Diarias : 1 . ^ ^^ L ^/j£>^ B . .
Equip o Usad o e n e l Luga rd e Traabjo : Casc o Dur o y. Escaler a y Gofo s d e Segundo d y ._Elevadore s y Zopoto s ^ . _GFC I .j> ^ Guonle s d e Trabaj o XJ , Chaleco s d e Segundo d .x C Generadore s yOtr o ^< 1 Equip o List o par a Respuest a d e Emergenci a a Disposicio n Inmediata : Conduci rReunio n Diari a d e Segurida d Estuch e d e Pnmero s Auxilio s Procedimiento s d e Emergenci a Politic a d e Salu d ySegundo d d e l o Compani a GFC I e n siti o Deficiencias : Accione s Corretivos :

Inteivento i 

# : //'c/y . .^rr ' yFechQ , :'^y^f y^ Superviso rde l Siti o 

# cwi^i . Q,.bt^ cFprh n yy^7^/^ y