TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: ( DS4^ S Date: ^-QO-C ^ 

Address: .1?^ b? . T ^ 4 ^ /We . 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS 

Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

tr Video of property (DVD) 7>Gsh 

CK Executive Summary 

^ y Signed Access Agreement for subject property 

sy ^ Painting Agreement 

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

Q/ ^ Photographs P^hCL. 

oy ^ Satisfactory restoration signed by Property Owner 

U"^""^ Property close-out check list signed by EPA 

\^y ^ Property information from Douglas County Assessor's Office 

^ y confirmation that lead pamphlet "Renovate Right" was received by P0_ 

D 

g 30203863 

D Superfund 

/^jjLcL^ ^MOJL^^U^ _ EPA Signatiire T^M ^ 
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: -^xc\f\A^fc l VtW^ O 

Property Address: /S4tQ?N /[) V ^ /9-1^ 

Owner'sName: /j-f'lr^ ^ S 

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 ofthe stated, excluded 

areas? This would include painting ofother associated features including fascia, 

eaves, siding, all trim, porches, box beams, columns, rails, and exterior surfaces of y 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 y two top coats? 

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

5. Are all ofthe areas where contaminated materials have been spilled thoroughly y vacuumed/ 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 y other generated debris? 

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

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 needs to be completed prior to the EPA Close-Out. \ y 

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

\y that need to be moved back? 

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

been left utu-esolved? 

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

d//Xyuy^ 1 In lof 

EPA COR Signature Date 

.X 
PROFESSIONAL 

2505 North 24^ Suite 219 ENVIRONMENTAL ENGINEERS, INC. Omaha, NE 68110 

(402) 504-4688 "Providing cost-effective environmental solutions" Fax (402) 504-3281 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Property Owner Close-Out Form 

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

SAID: ^^VV^Ato l P^WJ^ O 

Property Address: 

Owner's Name: 

Performance Standards/Close-Out Criteria YES NO 

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

areas? This would include painting ofother associated features including fascia, 

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

garages. 

2. Was all scraping and other preparation work completed satisfactorily'/ 

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

two top coats? X 

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

5. Are all ofthe areas where contaminated materials have been spilled thoroughly ^ vacuumed/ 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? 

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

barrie

8. Ar

r

e

 tape

 all item

, etc

s

.

 suc

 properl

h as polyethylen

y removed? 

e sheeting, ladders, paint brushes, cones, X

propert

9. Is ther

y damag

e any evidenc

e needs

e

 t

 ofpropert

o be complete

y damag

d prio

e

r

 tha

 to th

t wa

e EP

s don

A Close-Out

e by the contractor

. 

? Any X

tha

10.

t

 Ar

 nee

e

d

 ther

 to b

e

e

 an

 move

y propert

d back

y item

? 

s that were temporarily re-located by the contractor K

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

been left imresolved? K 

Comments: 

'Ktf^^i^r '^'-li'^ 

Property Owner Signature Date 

yyy -o? 

Professional Enjrtfonmental Engineers Representative Date 
••fi f -

CONSENT FOR ACCESS TO PROPERTY 

OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID; CQ^ ^ ^S " PROPERTY ADDRESS; 4^V^- ^ / V ^ S ^ ^ 

OWNERNAME: 

v. <->CsPstf,J^ ^ •efson DAYTIME PHONE: S^C o "J?. ? 9^4^ 

CELLPHONE: ft^Q " <gi6? /7 E-MAIL: 

OWNER'S ADDRESS IF DIFFERENT; 

TENANT'S NAME IF APPLICABLE: 

DAYTIME PHONE: 

h ^ ^ ^ lb<i ^ 

CELL PHONE E-MAIL: 

c a l G71-3^3 ^ 

Professional Environmental Engineers, Inc. (PE) is under contract (#EP-R7-08-06) 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 are being 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, if the soil cleanup has not already been performed. I understand that the stabilization contractor 

can not provide assurances that the soil cleanup contractor will be bound to. I further 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. 

H Yes, I have read and understand the paragraph above. •4\A . A U A > r^t x /rt / ^ 1 ^ Z* ^ 

Signature of Property Ovvner «^ Date 

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-S04-4688. 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). 

^Ves , I grant access to my property and was given the pamphlet D No, I do not grant access to my property and I was 

"Renovate Right Important Lead Information for Families, Child given the pamphlet "Renovate Right, Important Lead 

Care I Infonnation for Families, Chlide Care Providers, and Schoois." 

Signal Date Signature Date 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
I;l . • 

PMMf MMQM hm^m 

._JM3 

4^^^ ^ 

AIIEA(QTOBEMIinEDc 

House worei: =_ & 

(OONn£nAU.8BCI10l«rVH^NO|,OaiiON-^tfnJCABIJO 

IMREE TO THE COLORS USTED ABOVE ONa PiininilG BEQI ^ 

UNDERSTilliD I C M NOT CHANGE THE ABOW SElfiCIlD OOLO^ 

ttHmmetumet 

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Douglas County Accoimt Informatio; Page 1 of2 V Q^-^^t^ 

Douglas County, Nebraska Property Record - R0811190000 

Print Report 

NEW FGature - Parcel Dimensions avaiiabie (8t scale 0-50 ft west of 52nd St - Vle W O n Ma D Information is valid as of 2009-6-16 Treasurer's Tax Reoort 

New Feature -^ -* -* Auto Sales Search 

Owner 

PETERSON RICHARD L 

ETAL 

2463 N 45 AVE 

OMAHA NE 68104 

Property Informatio n 

Key Number: 1119 0000 08 

Account Type: Residential 

Parcel Number: 0811190000 

Parcel Address: 2463 N 45 AV 

OMAHA NE 68104-0000 

Legal Description: CLAIRMONT LOT 38 BLOCK 2 50 X 125 

Value Informatio n 

Land Improvement Total 

2009 

2008 

2007 

2006 

2005 

2004 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$65,200.00 

$65,200.00 

$65,200.00 

$65,200.00 

$58,200.00 

$52,900.00 

$71,600.00 

$71,600.00 

$71,600.00 

$71,600.00 

564,600.00 

559,300.00 

Sales Informatio n 

Sales Date: 2000-05-15 

Deed Type: D Book: 2152 Page: 159 

Price: $61,000.00 

Grantor 

Grantee: 

Valid/Invalid: Valid 

• 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6250.0 1.0 125.0 50.0 No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R08... 7/13/2009 
Douglas County Account Information 

Building 1 

Square Footage:

Perimeter 

Unit Type: 

Built As: 

HVAC:

Exterior: 

Interior: 

Roof Cover: 

Roof Type: 

Floorcover: 

Year Built Remodeled Remodeled 

1923 

Detail Type 

Add On 

Appliance 

Basement 

Fixture 

Fixture 

Fixture 

Garage 

Porch 

Porch 

 1456,0 

0.0 

2 Story 

 Central Air to Air 

Frame Siding 

Drywall 

Composition Shingle 

Hip 

Allowance 

year Percent 

0 0% 

Detail Description 

Fence Chain Link 

Allowance 

Bsmnt Block 8 ft 

Base Fixtures 

Bath Full 

Bath Half 

Detached 

End Screen 

End Screen 

Page 2 of 2 

FifStFlOW S«c-oo*Fk>ar 

728 0 sq. ft 72a Osq « 

S^i' 

l-KK ,.i 

2 STORY 

CLICK TO ENLARGE IMAGE 

Percent Complete: , 100.0% 

Quality:

Condition: 

Condo Square Footage: 

Rooms: 

Units: 

Baths: 

Bedrooms: 

Stories: 

Foundation: 

Sprinkler Square Footage: 

Adjusted Year 

 Average 

Fair 

0.0 

6.0 

1.0 

1.5 

3.0 

2.0 

Block 

0.0 

Physical Age Built 

1923 86 

Units 

1.0 

1.0 

728.0 

1.0 

1.0 

1.0 

260.0 

80.0 

112.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R08... 7/13/2009 
MC Services, LLC 

Property Address QAlT)? ^ P . ^ D [\fe . Date H ~ WO ^ 

Start Date I ' I Q " Cr A End Date 

Amount Of Prime And Paint Used 

Prime (Gallons) 1 

Poly (Boxes) \lh 

Paint (Color) A^iiiis Amount (Gallons) e Ki 

Paint (Color) MM Amount (Gallons) 

'D 

Paint (Color) M Amount (Gallons) i 

Paint (Color) Amount (Gallons) 

Paint (Color) Amount (Gallons) 
Professioncsl Environmental Engineers, Inc. 

INTERVENCi6N DE SEGURIDAD 

Nombre del Provecto:£A(o!^ V-^sA;^{W ^ 

Fecha de la Intervencion: 1 ^ \ O v-J ^ 

Pellgros de Salud Prinnordial: \tSCA( 3 — — 

Preocupaclones Primordlales de H & S: 

Tareas Diarias: 1. ST Y^QppW^OV 

3. o\mn\T^o\ 

Equlpo Usado en ei Lugar de Traabjo: 

Casco Duro Bcalera y 

Gafas de Seguridad >< Elevadores X 

Zapatos GFCI y 

Guantes de Trabajo . Chalecos de Seguridod^^ 

Generadores y Otro ^**=^ 

Equlpo Usto para Respuesta de Emergencia a Disposicion inmedlata: 

Conducir Reunion Diaria de Seguridad ) y 

Estuche de Primeros Auxilios ><C) 

Procedimientos de Emergencia fi<l 

Politica de Salud y Seguridad de lo Companfa - ^ 

GFCI en sitio y 

Deficiencias:, 

Acciones Corretivos: 

Interventor: Cc yp ^ / g r/Zo^r^'s ' Fecha:. 

Supervisor del Sitio: Fecha: 
PROFESSIONAL ENVIRONMENTAL ENGINEERS, INC. 

REUNI6N DIARIA DE SEGURIDAD 

Fecha: H-l^-Q^ ^ 

Proyecto: Omaha Paint Stabilization Project 

Sitio de Actividad:. 

Tareas Diarias: 

Primordial/Peligros Potenciales: 

2. \i{y(\ ^^YT\a\V^ 4 

Herramientas de Trabajo: 

^^.V^ ^ 3. %crc\pQcr ^4i 

Practicas del Trabajo/Acciones Correctivas: 

1. 3._ 

2. ; 4. 

Llamadas previas: 

1. 3. 

2. 4. 

Firma de Registro del Empleado: 

1. ^^^/^ c ye^^y^^/L<r 3. 2. -To^fX^ i=X7,\IPJ^ 4.. 

yj/y-4/ ^ '^-\\-oa 

Firma de Salud y Seguridad del Sitio Fecha