N 

TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID #: MOM^ Q •Date: ^"-^^0 ^ 

Address: [o??(S Ml'^fn-T . L u <,/X "B/vr l 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

^y ^ Video ofproperty (DVD) ^ 

[r Executive Summary 

y 

51/ Signed Access Agreement for subject property 

Or Painting Agreement 

D Settlement documents (i.e., for damage or to replace plants, etc.) 

n^ ^ Photographs pfiA ^ ^ a/) d /^l4i>r 

^r Satisfactory restoration signed by Property Owner 

[JK ^Property close-out check list signed by EPA 

Property information from Douglas County Assessor's Office 

^ 

confirmation that lead pamphlet "Renovate Right" was received by P0_ D 

D 

D 

g. Professional ngineers Signature "TO 

i^^-^/i1UkiJ2^^ 

- ^ ^ Ignature 

30056195 

Superfund 

^ 
2505 North 24^ Suite 219 

Omaha, NE 68110 

(402) 504-4688 

Fax (402) 504-3281 

PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"Providing cost-effective environmental solutions" 

Consulting • Engineering Design * Remediation • Abatement • Emergency Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2009 

SAID# 40490 

6815 Minne Lusa Blvd 

• Dates worked: 07/01 to 07/03 2009 

• Pre property condition: House has siding. Overall trim around the house in fair 

condition. Garage in poor condition with paint flaking. 

• Problems encountered: N/A 

• Owner request/concerns: None 

• Inspection/closeout dates. Owner signed by 07/08 2009. Inspected by EPA 07/17 2009, 

No issues. 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"Providing cost-effective environmental solutions" 

Consulting • Engineering Design * Remediation • Abatement • Emergency Response 

EPA Close-Out Form 

(Lead-Based Paint Stabilization EPA Contract EP-R7-08-06) 

SAID: qnq ^ 

2505 North 24% Suite 219 

Omaha, NE 68110 

(402) 504-4688 

Fax (402) 504-3281 

Property Address: Lpgl g M ' HnC^- LuStK '^r^ 

Owner's Name: ^^ 1 i C J O ^ CJC\ \\ OVOONJ 

Performance Standards/Close-Out Criteria YES NO 

1. Was the entire structure(s) painted with the exception of the stated, excluded 

areas? This would include painting of other associated features including fascia, 

eaves, siding, all trim, porches, box beams, columns, rails, and exterior surfaces of ^ 

garages. 

2. Was all scraping and other preparation work completed satisfactorily? ^ y 

3. Were all required areas of the structure(s) primed as needed and painted with 

two top coats? y 

4. Was the paint products utilized equivalent to a 30 year product/quality? t ^ 

5. Are all of the areas where contaminated materials have been spilled thoroughly 

vacuimied/ cleaned? « ^ 

6. Did the contractor collect/vacuum all falling and scraped paint chips on the 

entire property, roadways, alleyways, public access areas and also remove any Ly other generated debris? 

7. Is the grass area that surrounds the structure(s) in reasonably good condition? «-^ 

8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, 

barrier tape, etc. properly removed? \y 

9. Is there any evidence ofproperty damage that was done by the contractor? Any 

^ property damage heeds to be completed prior to the EPA Close-Out. 

10. Are there any property items that were temporarily re-located by the contractor 

l ^ that need to be moved back? 

11. Are there any (knovra) lingering issues with the property owner(s) that have 

been left unresolved? 1 ^ 

__ 

Other Considerations/Property Owner Discussions/Additional Work that is Required: 

a^t^icc. ijnl09 

EPA COR Signature Date ' 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. 

"Providing cost-effective environmental solutions" 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Property Owner Close-Out Form 

(Lead-Based Paint Stabilization EPA Contract EP-R7-08-06) 

SAID: L\rP t ^ O 

Property Address: ( D9>( S A/I^On-f, ixi^ a 1E ^ 

Owner's Name: Tk\ \ CA a Ca\\nWn y 

Performance Standards/Close-Out Criteria 

2505 North 24% Suite 219 

Omaha, NE 68110 

(402) 504-4688 

Fax (402) 504-3281 

YES NO 

1. Was the entire structure(s) painted with the exception of the stated, excluded 

areas? This would include painting of other associated features including fascia, 

eaves, siding, all trim, porches, box beams, colimms, rails, and exterior surfaces of 

garages. 1 

2. Was all scraping and other preparation work completed satisfactorily? J 

3. Were all required areas of the structure(s) primed as needed and painted with 

\ / two top coats? 

4. Was the paint products utilized equivalent to a 30 year product/quality? \l 5. Are all of the areas where contaminated materials have been spilled thoroughly 

vacuxamed/ cleaned? / 

6. Did the contractor collect/vacuum all falling and scraped paint chips on the 

entire property, roadways, alleyways, public access areas and also remove any 

other generated debris? V

7. Is the grass area that surrounds the structure(s) in reasonably good condition? / 

8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, / barrier tape, etc. properly removed? 

9. Is there any evidence ofproperty damage that was done by the contractor? Any 

property damage needs to be completed prior to the EPA Close-Out. / 

10. Are there any property items that were temporarily re-located by the contractor 

that need to be moved back? 

11. Are there any (known) lingering issues with the property owner(s) that have 

J been left unresolved? 

Conmients: 

-€i Y/o&(<if 

Property Owner Signature 1 ^ Date 

^miQ] 

Professional Enviroimiental Engioeers Representative Date 

0 
z ^^^^\ 

CONSENT OFR ACCESS TO PROPERTY 


OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID: MOM^O" PROPERTY ADDRESS: ^K/. C /^/>t)/t' ^ ^^Z ^ /X 7 

OWNERNAME: 

ftg.]l^c ^ CT/C^l l^^^<>. DAYTIME PHONE: Vi ) / ' V ^ ^ 2 _ 

CELL PHONE: E-MAH.: 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME IF APPLICABLE: 

DAYTIME PHONE: 

CELLPHONE: E-MAIL: 

Professional Environmental Engineers, Inc. (PE) is under contract (#EP-R7-08-0Q with the U.S. Environmental Protection 

Agency (EPA) to stabilize lead based paint (LBP) on residential structures at a number of properties located in Omaha, 

Nebraska. The paint stabilization work is being done to protect the soil cleanups that were performed by EPA contractors. 

Paint stabilization activities will include: scraping of cracked or flaking LBP from structures, application of a prime coat and 

two (2) coats of paint Moving parts of windows and doors are not included and will not be addressed. 

Your cooperation is requested in giving permission to this EPA contractor (PE) to enter and have access to this property for 

the purpose of stabilizing lead -based paint as outlined on the property identified above. 

By signing this document I agree to allow an EPA contractor to conduct a soil cleanup at my property following completion of 

lead-based paint stabilization. I understand that the stabilization contractor can not provide assurances that the soU cleanup 

contractor will be bound to. I jfiirther understand that the soil cleanup contractor will make all reasonable efforts to address 

concerns that I, as the property owner, may have regarding soil cleanup at my property. 

I fully understand that by signing this Consent for Access, (1) this access will remain in effect until the work has been 

satisfactorily completed, (2) that the Property Owner or Tenant, If applicable, will be given the Housing and Urban 

Development (HUD) and EPA pamphlet, "Renovate Right, Important Lead Hazard information for Families, Day Care 

Providers, and Schools", (3) the Property Owner or tenant will remove all obstructions from surfaces to be painted, (4) will 

abide by health and safety guidance provided by EPA, (5) will allow photography ofproperty before and after the paint 

stabilization work, (6) will be contacted by a PE representative approximately 48 hours in advance of starting work, (7) agree 

not to obstruct or tamper with any of the LBP stabilization actions, and (8) will participate in final property inspection and 

sign the Completion Agreement and Property Owner Satisfaction Survey. 

Should you have any questions about the planed Lead Based-Paint stabilization activities for your property, please contact 

Professional Environmental Engineers, Inc. Project Manager, Willie Clay At 402-504-4688. General questions about the 

Omaha Lead Site cleanup can be directed to Pauletta France-Isetts, EPA Remedial Project Manager 402-731-2454, or the 

EPA Public Information Centers at 402-991-9583 (North Omaha office) or 402-731-3045 (South Omaha office). 

I Yes, I grant access to my propaity and «M 8 given the pamphlet D No, I do not grant access to my propaity and I «w» 

"Renovate Right, Important Laad Infomiation for Families, Child given the pamphlet 'Renovate Right, Important Lead 

Cars ProyUera, and Schools.' Information for Families, Chlide Care Provldere, and Schools." 

j^ . CW ^ i A . t Signahire Data 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
•: O(0)i^i(mrasittfl@ini ©IF ll(S(g(iDpit ©if L®aidl [PiioiniplhiD©^ 

PROPERTV ADDRESS OPCODE. 

PROPSOY ADDIO S OF OWNgR IF DlfTirei T mA N raOP^ 

PROP^TY ADDRESS aPCODE 

I have reoeivBd a copy of ihe pamphlet, Ranavata Right Important Laad Haxa/d InfomaSon For Famlltea, 

ChIM Can PiwUa n And Schoola informing me of the potential risic of the lead hazard exposure from 

renovation activity to be peribrmed on dwelling unit I received this pamphlet before the wortc began. 

K/^At(lla i^dipudCUU \y - ^-!'h-C\q 

/^pmNTED NAME OF RECIPIENT ^ ^ DATE 

REOFRECmENT ^ 

SeifCeiflfleallon Optton (For TomnlOociipM DwelllngB On ^ 

If the lead pamphlet was delivered but a tenant signature was not obtaindUe. you may checl( the q)proprtate box 

below: 

[ J RflAnal To Sign-I certify that I ham made a good fMh effort I D delivBr the pamphlet lenovato righting 

lead hazanl Infonnatlonforfamilies, child care piDvidere and schools;tothe rented dwelHng unit OsM 

date and time Indicatod and that the occupant letused to sign the twnnmiatiuii of receipt I further certify that I 

have tsft a copy ofthe pamphlet at the unR wNh occupant 

D Uiwvallabfo For SHinalui*--1 certify that I have made a good fMh efforttodeliver the pamph 

Important lead hazaid InfonnaHonforfiamilles. chlid care provldere end schools, to the rental dwelDng unit listod 

below and that the occupant was unavalafaletosign the oonHrmation of receipt I further certify that I have toft a 

copy of the pampMet at the unit by sliding It under the door or somewhere on the premises. 

PRMTEDNANEEOPFERBON OP PERSONI CERHFYM Q ATTEHPIE D DBJVEmr DATE AND TIME LEAD 

MHPHUErDBJVEmr 

anNATUR ATURE OMIROMERSO N CpniFYB CpniFYB n LEAD PAMPHLE PAMPHU T DEUVERY:

• I 

Note RsgwdlRg lUOng Optton - tt an altamailvetodslvary in person, you may msfl Ih^ 

anVortanant PampMst must be maHad at least 7 days before renovaiion. (DnantentiMaoeifliGateafroaainefm 

olios). 

OCMFIRMATIONOFRECEiPrOFlEADPAMPHljET (0108 
L"pl5 pA^^y^[us^BO DATl 

(OOMMffE AIJL SBCnOHr YBiir NQr OR NON-APfUCMnE) 

I AfiREE TO tHE COLORS USTED ABOVE. ONCE PAUfnilG BEGIliS^ I 

UNDERSTAND I CAN NOT CHANGE THE ABOVE SEUECTED COLORS: 

p/ttsreaATOHPORssosfos 
Douglas County Account Information Page 1 of3 

iDougla s County, Nebraska Property Record - R17507< lOOOO 

Print Report 

NEW Feature - Parcel Dimensions available @ sc Information is valid as of 2009-6-3 ale 0-50tt west of sznd St - View On IMap 

Treasurer's Tax Repnit 

New Featuri »-»-»- » Auto Saies Search 

Owner

CALLOWAY FELICIA

ETAL 

6815 MINNE LUSA BLVD 

1 OMAHA NE 68112-0000 

1 Property Informatio n

1

1

1

 Key Number 

Account Type: 

 Parcel Number 

 Parcel Address: 

Legal Description: 

Value Informatio n

Land 

1 — . .......

15074 0000 17

Residential 

1750740000 

6815 r IINNELU SA BD 

OMAI-IA NE 681 12-0000

1 MINNI E LUSA LC 3T 13 BLOCK 12 47.3X120

2009 $6,000.0 0 

2008 $6,000.0 0

2007 $6,000.0 0

2006 • $6,000.0 0

2005 $6,000.00

2004 $6,000.00

Sales Infornr lation L 

Sale s Date: 

Deed Type: L 

1 Price: • 1 

Grantor 

L 

Grantee: 1 

Valid/Invalid: 

Exclusion Reason: 1 

L 

L Sales Date: 1 

L ' ' ' 

Deed Type: | 

Price: 

L -

Gr antor j L 

2004-11-05 

WD 1 

1 

$96,00( ).00 

FAITH A WHI 

FELICIA CAL 

Valid

2004-11-05

WD 

$0.00 

-

Improvement 

$97,900.00 

I $97,900.00 i „ , 

j $84 

] $84 

,600.00 

,600.00 

 $84,600.00 

 $55,900.00 

1 Total 

Book: 1 2004 

TE ETAL 

LOWAY 

•— 

FELICIA CALLOW fAY 

 •-] 

1 

| 

1 

1 

1 

| 

{ 

$103,900.00 1 

$103,900.00 

$90,600.00 

$90,600.00 1 

$90,600.00 

$61,900.00 

1 

Page: ' 146280 

-

1 

1 

Book: 2004 Page: 145429 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R175... 6/9/2009 
Douglas County Account Information Page 2 of 3 

Grantee: i FELICIA CALLOWAY ETAL 

Valid/Invalid: ; invalid 

Exclusion Reason: Family Sale 

Sales Date: 

Deed Type: 

Price: 

Grantor: 

Grantee: 

1997-02-06 

$45,850.00 

Book: 2058 Page: 663 

Valid/Invalid: 

Exclusion Reason: 

Valid 

Sales Date: 

Deed Type: 

Price: 

Grantor 

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

1992-01-31 

D 

$44,500.00 

Valid 

Book: 1921 Page: 029 

Land Informatio n 

Acres SF 

0.12 5640.0 

Improvemen t Informatio n 

Building 1 

Units 

1.0 

Depth 

120.0 

Width 

47.0 

Vacant 

No 

' ^ 

SSI5 isfcnif LitM Bt.'d. 

2 Story 

S.W^^i5 ft 

I n 

unwi^j.i.tj.MiMi'.t-w.iiiJb.-MTArrgB!? 

CLICK TO ENLARGE IMAGE 

CLICK TO ENLARGE IMAGE 

Square Footage: 1248.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R175... 6/9/2009 
IGIT 

Property Address ^^^g T M^^ f h/SG ( Date 

Start Date ^|Oun ^ End Date 

Amount Of Prime And Paint Used 

Prime (Gallons) 5 (^^( 

Poly (Boxes) X. 

Paint (Color) -IM-l^i/f€. - Amount (Gallons) 

Paint (Color) Oer.k (S\n Y- Amount (Gallons) X Gr?/ 

Paint (Color) Amount (Gallons) 

Paint (Color) Amount (Gallons) 

Paint (Color) Amount (Gallons)