## TRANSMITTA Lof OMAH A LEA D SIT E PABV T STABILIZATIO NFIL EFOLDE R SAID#: £5'7f f Date : ^/l/d ^ Address : /5? ^ A J 4 dSJCC ^ 

### Remediatio nContractor : PROFESSIONA LENVIRONMENTA LENGINEER S Year : 200 8 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S WVide o o f propert y (DVD ) Kgr^YV ^ OJhle y WExecutiv e Summary M Signe dAcces s Agreemen t for subjec t propert y WPaintin g Agreemen t . 0 Settlemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) B TPhotograph s ZPrH ^ WSatisfactory restoratio nsigne db y Propert y Owne r M Propert y close-ou t chec k lis t signe db y EP A P ^ Propert y informatio nfromDougla s Count y Assessor' s Offic e

. D

• " ' D . • • .•


### Signatur e ' Dat e

4031638 6 Superfun d250 5 Nort h 24• ^

Suit e 21 9 Omaha , N E 6811 0 (402 ) 504-468 8 Fax(402 ) 504-328 1 

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC
. "Providin g cost-effectiv e environmenta l solutions " Consultin g • Engineerin g Desig n • Remediatio n • Abatemen t • Emergenc yRespons e



### Lea dBas e Pain t Stabilizatio nOmaha , N e Clos e Ou t Repor t SAID#2579 9 151 4 N 4 0 S t

•Date s worke d10/1 4 t o 10/1 6 200 8 •Som e damage dare at o tri mo n botto mo f house , Overal l hous e was i n goo dcondition . Garag e look s newe r an di n goo dcondition , n o issue s durin g stabilizatio nproces s •Inspecte d11/0 5 n o issues .

# PROFESSIONA L ENVIRONMENTA L ENGINEERS , INC
. "Providin g cost-effectiv e environmenta l solutions " Consultin g • Engineerin g Desig n • Remediatio n • Abatemen t • Emergenc yRespons e 

### Propert y Owne r Close-Ou t For m (Lead-Base dPain t Stabilizatio nEP A Contrac t EP-R7-08-06 ) SAID : 

# cgS^QT , Property Address : 

# l^j- ^ / o qo^ ^ Owner' s Name : 

## V^OWJ : 

# \ 'S< y<-^(^< ^

cK g r ^ Performanc e Standards/Close-Ou t Criteri a 250 5 Nort h 24 ^ Suit e 21 9 Omaha , NE6811 0 (402 ) 504-468 8 Fax(402 ) 504-328 1



### YE S N O 1 . Wa s th e entir e structure(s ) painte dwithth e exceptio no f th 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 nwor k

complete dsatisfactorily ? 

## y 3 . Were al l require darea s o f th 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 ? c > 5 . Ar e al l o f th e area s wher e contaminate dmaterial s hav e bee nspille dthoroughl y 

## y vacuumed / cleaned ? 6 . Di dth e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s o nth e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e any 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 ? y 8 . Ar e al l item s suc ha s polyethylen e sheeting , ladders , pain t brushes , cones , y barrie r tape , etc . properl y removed ? 9 . I s ther e any evidenc e ofpropert y damag e that wa s don e b y th e contractor ? Any y property damag e need s t o b e complete dprio r t o th e EPA Close-Out . 10 . Are ther e an y property item s that were temporaril y re-locate db y th e contracto r 

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

# y bee nlef t unresolved ? Comments : ..^^^ ^ ^ ^ .^ ^ .yj ^ K ^ ( M ^l/Ufu ^ 

# /^-J- O Property Owne r Signatur e Date 

# -^yy^yy ? y/:>-S-o y Dat e ProfessionaltnvlTOnmenta l Engineer s Representativ e

# PROFESSIONA L 250 5 Nort h 24 ^ Suit e 21 9 

# ENVIRONMENTA L ENGINEERS , INC
. Omaha , NE6811 0 (402 ) 504-468 8 

## "Providin g cost-effectiv e environmenta l solutions " Fax(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 nEP A Contrac t EP-R7-08-06 ) SAID : 

# XlS-^^QQ ^ ,^ - 

### Property Address : I 5 ^ ^ N 3 U Q Owner' s Name : -^^-.o\0(£x \^Sy^h^Xf^^^^ e < ^ 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 no f th 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 nwor k

complete dsatisfactorily ? 

## y ' 3 . Were al l require darea s o f th e structure(s ) prime da s neede dan dpainte dwith 

# y 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 ? 

# y 5 . Ar e al l o f th e area s wher e contaminate dmaterial s hav e bee nspille dthoroughl y 

# y vacuumed / cleaned ? 6 . Di dth e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s o nth e 

# y 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 nreasonabl y goo dcondition ? y 8 . Ar e al l item s suc ha s polyethylen e sheeting , ladders , pain t brushes , cones , 

## y barrie r tape , etc . properl y removed ? 9 . I s ther e any evidenc e ofpropert y damag e that wa s don e b y th e contractor ? An y 

## y property damag e need s t o b e complete dprio r t o th e EP A Close-Out . 10 . Ar e 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 ? 

# y 11 . Ar e ther e an y (known ) lingerin g issue s vsdt hth e property owner(s ) that hav e 

# y bee nlef t unresolved ? Othe r Considerations/Property Owne r Discussions/Additiona l Wor k

that i s Required :

- S£^<ts^<r ^ S*uU

_"Slit , 5-c<-cup« . * ^ai-^-<r


## OzuAj/y-^ ^^hLc^\JiLM ^ A CO RSignature ' Dat e--'•';;•»*"•>««* ' 

# EN CONSEN TT FO R ACCCES S TO PROPERT Y OMAH ALEA D SIT E REMEDIA L ACTIO N - LEAD-BASE D PAIN TSTABILIZATIO N 

## \ ^ y PROPERTYID : PROPERT YADDRESS : . j , 

## ^%0 ^ 

## /SI? ) 

# K(
. MO' ^ OWNER' S NAM E 

### Sri o t i tyw i ri > Ph ft^

CA ^ t>7 . 

### TCgJckjO/d b DAY-TIM E PHONE : i^uu^K^wx. ^ 

## S1^''0\1CJ P CEL L PHONE : E-MAIL . OWNER' S ADDRES S IF DIFFEREN T 

# '^rSgc ^ nn.o^ic^i^M^ . f^g l TENANT' S NAM E IF APPLICABLE : _DAY-TIM E PHONE : CEL L PHONE : E-MAI L Professiona l Environmenta l Engineers , Inc . (PE ) is unde rcontrac t (#EP-R7-08-06 ) wit h th eU. S. Environmenta l Protectio n Agenc y(EPA ) to stabiliz e exterio rlead-base d pain t (LBP ) on residentia l structure s at a numbe r ofpropertie s locate d in Omaha , Nebraska . Th e pain t stabilizatio n vi/or k is bein g don e to protec t th e soi l cleanup s tha t wer e perfonne d byEP Acontractors . Pain t stabilization s activitie s /ni l include : scrapin g ofcracke d orflakin g LB P fro m structures , applicatio n of a prim e coa t an d tw o (2 ) coat s ofpaint . An ymovin g part s ofwindow s an d doo rar e no t include d in th e activitie s an d wil l no tbe addressed . You rcooperatio n is requeste d in givin g permissio n to thi s EP Acontracto r(PE , Inc. ) to ente ran d hav e acces s to thi s propert yfo rth e purpos e ofstabilizin g lead-base d pain tas outline d on th e propert yidentifie d above . I full yunderstan d tha t bysignin g thi s Consen t Fo rAccess , (1 ) thi s acces s wil l remai n in effec t unti l th e wor k ha s bee n satisfactoril y complete d (2 ) tha tas th e Propert yOwne rortenant , if applicable , wil l be give n th e Housin g an d Urba n Developmen t (HUD ) an d EP A pamphlet , "Renovat e Right , Importan t Lea d Hazar d Informatio n fo rFamilies , Chil d Car e Provider s an d Schools " (3 ) th e Propert yOwne ror tenan t wil l remova l ofobstruction s fro m surfaces to be painted , (4 ) wil l abid ebyhealt h an d safet yguidanc e provide d byEPA , an d (5 ) wil l allo wphotograph yof propert ybefor e an d afte rth e pain t stabilizatio n work , (6 ) I wil l be contacte d byaPE representativ e approximatel y 48 hour s in advanc e ofstartin g wor kto (7 ) agre e no t to obstruc tortampe rwit h an yofth e LB P stabilizatio n activitie s orequipmen t use d to perfom i an yLB P actions , (8 ) wil l participat ein fina l propert yinspectio n an d sig n th e Completio n Agreemen t an d Propert yOwne r satisfactio n Survey
. Shoul d yo u hav e an yquestion s abou t th e planne d Lea d Based-Pain t stabilizatio n activitie s fo ryou rproperty , pleas e contact : Professiona l Environmenta l Engineers , Inc. , Project Manager , Hemia n Hanne r at 402-884-1185 . Genera l question s abou t th e Omah a Lea d Sit e cleanu p ca n be directe d to Paulett a France-Isetts , EP ARemedia l Project Manage r402-731-2454 , orth e EP APubli cInfomiatio n Center s at (402 ) 991-958 3 (Nort h Omah a office ) or(402 ) 731-304 5 (Sout h Omah a office)
. I'es , I gran t acces s to mypropert yan d wa s give n ]No , I do no t gran t acces s to mypropert yan d I wa s liepiamphle t "Renovat e Right , Importan t Lea d Hazard give n th e pamphle t "Renovat e Right , Importan t Lea d Informatio n fo rFamilies , Chil d Care Provider s an d Schools
. Hazard Informatio n fo rFamilies , Chil d Care Provider s an d Schools
. Signatur e Dat e Signatur e Dat e SPECIA L INSTRUCTION S AND/O R CONSIDERATIONS :•V^r v•••: • '-^••- T "



# i isih-' T'.W^'^^'^ f 

## KS C 

# Confirmatio n O f Receip t O f Lea d Pamphle t BVI D A5'^QS ^ PROPERT YADDRES S iSl? ) K l H O S"" t ZI P COD E Cp^U ] PROPERT YADDRES S O F OWNE R I F DIFFEREN TTHA N PROPERT YBEIN G PAINTED : 

### PROPERT YADDRES S 9^^(f ^ V^\A\tii> ^ K J ZI P COD E /p^ / 3 ^ I hav e receive d a cop yo f th e pamphlet , Renovat e Right : Importan t Lea d Hazar d Informatio n Fo rFamilies , Chil d Car e Provider s An d School s Informin g m e o f th e potentia l risk o f th e lea d hazar d exposur e fro m renovatio n activit yt o b e performe d o n dwellin g unit . I received thi s pamphle t befor e th e wor k began . 

# ^ 

# ?--/ % -O v PRINTE D NAM E O F RECIPIEN T DAT E

SIGNATUR E O F RECIPIEN T Self-Certificatio n Optio n (Fo rTenant-Occupie d Dwelling s Only ) I fth e lea d pamphle t wa s delivere d bu t a tenan t signatur e wa s no t obtainable , yo u ma ychec k th e appropriat e bo xbelow : 

# D Refusa l T o Sig n - I certif ytha t I hav e mad e a goo d fait h effor t t o delive rth e pamphlet . Renovat e Right : Importan t Lea d Hazar d Informatio n fo rFamilies , Chil d Car e Provider s an d Schools ; t o th e renta l dwellin g uni t liste d abov e a t th e dat e an d tim e indicate d an d tha t th e occupan t refuse d t o sig n th e confimiatio n o f receipt. I furthe rcertif ytha t I hav e lef t a cop yo f th e pamphle t a t th e uni t wit h occupant . 

# D Unavailabl e Fo rSignatur e - I certif ytha t I hav e mad e a goo d fait h effort t o delive rth e pamphlet . Renovat e Right ; Importan t Lea d Hazar d Infonmatio n fo rFamilies , Chil d Car e Provider s an d Schools , t o th e rental dwellin g uni t liste d belo w an d tha t th e occupant wa s unavailabl e t o sig n th e confinnatio n o f receipt , i furthe rcertif ytha t I hav e lef t a cop yo f th e pamphle t a t th e uni t b yslidin g i t unde rth e doo ro rsomewher e o n th e premises . 

# Lor i \X\\ \ PRINTE D NAM E O F PERSO N CERTIFYIN G AHEMPTE D DELIVER YDAT E AN D TH KLEA D PAMPHLE T DELIVER Y 

# -^y ) irJ Q SIGNATUR E O F P E PERSO N CERTIFYIN G LEA D PAMPHLE TDELIVERY : Not e Regardin g Mailin g Optio n - as a n altemative t o deliver yi n person , yo u ma ymai l th e lea d pamphlet t o th e owne rand/o rtenan t Pamphlet mus t b e maile d at least 7 days befor e renovation . (Documen t wit h a certificat e o fmailin g fro m th e pos t office)
.

CONFIRMATIO N O F RECEIP TO F LEA D PAMPHLE T 06/08--.- ' •;^^v-.—TTMI.^.--3—.Trpr,y- ^ 

# PAIN TSTABILIZATIO N PRE-PROPERT Y y-*^ . 

# PAIN TMATC H ASSESSMEN T
PROPERT YADDRESS : 

# IQ[ ^ U . H O S t DAT E 

# q/iiLJo r Orr^c W^J ^ ^iiii
- BVI D 

# as^o ^ AREA(S ) T O B E PAINTED : HOUS E PROPER : K|_ Q COLO R
HOUS E TRI M COLO R 

# U£ i 

# (/A. it? . ^


### GARAGE
. COLO R 

# 1 ^ 

# i [JAM J (xi ^ 

# uAldTk . GARAG E TRI M COLO R 

# 'i f
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# \M. A COLO R 

# iUP ^
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### PORC H TRI M A^COLO R ^ 

### (COMPLET E AL L SECTION , YES , NO , O R NON-APPLICABLE ) 

# I AGRE E T O TH E COLOR S LISTE D ABOVE . ONC E PAINTIN G BEGINS , I UNDERSTAN D I CA NNO T CHANG E TH E ABOV E SELECTE D COLORS : PROPERT YOWNE R SIGNATURE : P E ACCESSO R SIGNATURE : 

# ^ iSMiiJu^W ^ P dC ^ ^Ji p

PAIN TMATC H FOR M 0810 8Dougla s Count yAccoun t Informatio n 

### Pag e 1 of 2 Dougla s County , Nebrask a Pro^rty Recor d - R192162000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t of 90t h S t - ViewO P Ma p Informatio n i s vali d a s o f 2008-6-1 9 Treasurer' s Ta xRepor t Ne wFeatur e ->-»- > Aut o Sale s Searc h Owne r SCHUMACHE R ROBER T ETA L 953 6 MILITAR YR D OMAH AN E 68134-000 0 Propert yInformatio n Ke yNumber : 216 2 000 0 1 9 Accoun t Type : Residentia l Parce l Number : 192162000 0 Parce l Address : 151 3 N 4 0 S T OMAH AN E 68111-000 0 Lega l Description : ORCHAR D HIL L LO T1 4 BLOC K5 S 4 0 FTLT S 1 3 & 4 0 X 10 0 Valu e Informatio n Lan d Improvemen t Tota l 200 8 $ 2,100.0 0 $ 44,800.0 0 $ 46,900.0 0 200 7 $ 2,100.0 0 $ 44,800.0 0 $ 46,900.0 0 200 6 $ 2,100.0 0 $ 44,800.0 0 $ 46,900.0 0 200 5 $ 2,100.0 0 $ 25,300.0 0 $ 27,400.0 0 200 4 $ 2,100.0 0 $ 25,300.0 0 $ 27,400.0 0 200 3 $2,100.0 0 $ 25,300.0 0 $ 27,400.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 9 4000. 0 1. 0 100. 0 40. 0 N o Improvemen t Informatio n Buildin g 1 Two Stor y 151 3 N 4 0 S t 

# ± VFrsn«o r 

# y

e-.iTvrBICIClte t 4J70s?f ; CLIC KT O ENLARG E IMAG E Squar e Footage : 1365. 0 Percen t Complete : 100.0 % 

# k ' ttp://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 92162000 0 7/8/200 8Dougla s Count yAccoun t Informatio n 

### Pag e 2 of 2 Perimete r0. 0 ^ W Uni t Type :

Buil t As : 2 Stor y HVAC : Force d Ai r Exterior : Fram e Sidin g Interior : Drywal l Roo f Cover : 1 Compositio n Sfiingl e

Roo f Type : Gabl e Floorcover : Allowanc e Percen t ^-'•«"' « Remodele d Remodele d 191 6 0 0 % Detai l Typ e Detai l Descriptio n Ad d O n Fenc e Chai n Lin k Applianc e Allowanc e Basemen t Bsmn t Bloc k 8 f t Fixtur e Bas e Fixture s Fixtur e Bat h Ful l Garag e Detache d Porct i Sla b Roo f Cei l ^^Quality : Averag e Condition : Averag e Cond o Squar e Footage : 0. 0 Rooms : 6. 0

Units : 1. 0 Baths : 1. 0 Bedrooms : 3. 0 Stories : 1. 5 Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Adjuste d Yea r Buil t Physica l Ag e 191 6 9 0 Unit s 1. 0 1. 0 672. 0 1. 0 1. 0 240. 0 192. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 92162000 0 7/8/200 8