TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID #: 4fif5^' ^ Date: 1-'Q\-Cr \ 

Address: f^OO ^ ^ 1 & f^ f 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

^.^''^^ideo ofproperty (DVD) 

^y""^ Executive Summary 

Signed Access Agreement for subject property 

Q ^ Painting Agreement 

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

iay""'^ Photograph ' s JlrJt>OL. 

tK^ Satisfactory restoration signed by Property Owner 

B ^ Property close-out check list signed by EPA 

B ^ Property information from Douglas County Assessor's Office 

IJ^ confirmation that lead pamphlet "Renovate Right" was received by PO 

D 

D 30203834 

D Superfund 

ProfessionaTl Engineers Signature 

^//o//o 

Signature ate 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. ''°'Tm'a't NE earn 

"Providing cost-effective environmental solutions" ^ Consulting • Engineering Design • Remediation • Abatement • Emergency Response ^ i^^olc^tof? 

 Fax (402) 504-3281 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

2009 

SAID# 48547 

5002 S 18 St 

• Dates worked: 07/10 to 07/11 2009 

• Pre property condition: House has siding. Wood window trims in poor condition with 

paint peeling. Brick paint around the house in poor condition. 

• Problems encountered: N/A 

• Owner request/concerns: Not to paint house foundation. 

• Inspection/closeout dates. Owner signed 07/14 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: 4^SL|C)-

Property Address: ^00c y ^ Ift ?s-f. Owner's Name: p^alTZ:) 

Performance Standards/Close-Out Criteria 

2505 Nortti 24% Suite 219 

Omatia, 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 of other associated features including fascia, 

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

i/ ^ 

garages. 

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

3. Were all required areas ofthe 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? >y 

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

vacuumed/ cleaned? y ^ 

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? t ^ 

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? t/ ^ 

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 

that need to be moved back? ^ 

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

been left unresolved? iX 

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

nhlo9 

y EPA COR Signature Date 
V 

PROFESSIONAL 

2505 Nortti 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: MRS<4 ^ 

Property Address: tSO^ ^ S I S S b 

Owner's Name: l^rT ) Plprf. ^ 

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 of other associated features including fascia, 

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

garages. 

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

3. Were all required areas ofthe 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? y 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 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 y 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 y that need to be moved back? 

11. Are there any (known) lingering issues with the property owner(s) that have y been left unresolved? 

Comments: 

/ ^ (• '^^K,^\^Z 

Propert ropertyy O^ Owner Signature Date 

ital Engineers Representative Date 
CONSENT OFR ACCESS TO PROPERTY 


OMAHA LEAB SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID: ^^SM" ^ PROPERTY ADDRESS: SMEsnr ^ 

OWNER NAME: 

"j^drQ p-loJ^-t^ DAYTDVtE PHONE: S^ U -\S^ S 

CELLPHONE: __ ^ E-MAIL: 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME IF APPLICABLE: 

DAYTIME PHONE: 

CELLPHONE: E-MAIL: 

Professional Environmental Engineers, Inc. (PE) is under contract (#EP-R7-08-06) 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 were performed by EPA contractors. 

Paint stabilization activities will mclude: 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 pennission 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 stabUization. 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 aU 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) thb access will remain in effect until the work has been 

sfltisfoctorily 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 Schoob", (3) the Property Owner or tenant willremoveall obstractions from surfaces to be painted, (4) will 

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

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

not to obstruct or tamper with any ofthe 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 Enghieers, Inc Project Manager, Willie Chiy At 402-504-4688. General questions about tiie 

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). 

^ Yes, I grant access to my property and wi s given tha pamphlet D No, I do not grant access to my property and I was 

"Renovate Right Important Lead Infbnnalion fbr Families, Child ghren the pamphlet "Renovate Right, Important Lead 

Cars ProvMera, and Schools.' informationforFamillas, Chllde Can Provldere, ahd Schools.' 

UlAWcV^'g ' Sionatur Signaturee Date SIgnahire 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
Ob[nii5lmistto@ini @f (^©©©Iptt © f L@iidl FaotrapBBisfi 

mamwiAmmssi VQU^ ^009- ^ tb> \tw^s ^ raPGOBE 

PROPERTY ADDRESS OF OWINER IF DIFFERENT 1IIAN PROPERS 

PROPERIY ADDRESS aPCODE 

I have iBoeivBd a copy of the pamphlet, /iMioMto Righ t Importani Lta d HtEart Infonimlkm For fmllhs , 

CMU Ca n Pimlda n And Setno h infomiing me of the potential risk of the lead hazard exposure from 

renovation acdvily to be perfbmied on dwsDIng unit I reoeived this pamphlet before the vvoriciiegan. 

PRHIIEDNAiEOFRECIPENT ^ HATE 

ao±sU Ur^(i^W^ 

UlONMIIR IQIUTUREOFRECIPIEN E r 

SalKMHIcallon Option (For TonantOocupled OvmlllngB Only) 

If fhe tsod pampMat u m daKvared but a tenant signature was not ofatsdnsdte. y ^ 

bekwr: 

[ j RBfuaal To Sign- 1 oertily that I have made a good fMhefliDrtb deliver the pamphlet, renov^ 

lead haiaid infonnation for fsBrtUies, child care piovldere and schools: to tha r ^ 

dale and time hdicalBd and that the occupant wftiaed I D sign the wnflimatiun of receipt I liiilher oariify that I 

hawetoftaoopyof the pamphletatthe unttwilh occupant 

• Unavailable For Signaliin - 1 certify that I haw made a good fiaiih effortto deliver the pam ^ 

Important bad hazanl infonnation for families, chOd care provldere and schools,to therental dwelling unit Hatod 

below and that the occupant was unavaBaUeto sign the confinnation of receipt I further oeriify that I have left a 

copy of tha pamphlet at the unit by ending it under the door or aomewhere on the ixemlses. 

PnHIEDNAMEOPFERBOHCERIIFVi E0PFER80H m ATTEMPfGD DEUVERY DATE AMD THE LEAD 

AniRE OvPERBON CBmFYINO LEAD nUU ^ 

Note Rsgadbig flWBng Optton - as an aHamaiiwBto dalvery h peiBon. you may mafl the M 

andtortenanL Pamphtat must be maJtod at least 7 days beforeranoi«Baon. (DooumsirtiiiiihacBriltoteofinsilngtomfhspas^ 

OONFIRMATIQNOFRECEIPTQFLEADPAtffttEr 0008 
MOOT imBSLQi^?fl@[i^^ mic^p^oipi^w 

mapBmrA0E»iESS ^00^-bA^^ ' DATE . 

.

BMD — 

HOUSE TRIM .COLOR_ V ^ u^W-A^^P^ 

lO o jOOIXML 

GARAflETHIM. ^ OOLOB 

T 

fc^X £Q i^VyCViar, 

^ 

: ! ^ JPMitWL ^^-Wr\ LjO^'i^Sr' 

PORCH TRIML 

QSk V^^ 0 ^ 

IMREE TO THE CXMJORS LISTED ABOVE. ONCE PAUmNG BEGINS^ I 

UNDERSTAND I CAN NOT CHANGE THE ABOVE COLORS: 

f/mftasawnsaomit 
Douglas County Account Information Page 1 of2 

l-S 

Douglas County, Nebraska Property Record - R0413750002 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VJOW O n Ma P Information is valid as of 2009-6-3 Treasurer's Tax Report 

New Feature -•"•" • Auto Sales Search 

Owner ^8'5^ > 

FLOREZ PEDRO 

ETAL 

5002 S 18 ST 

OMAHA NE 68107-0000 '^in-ig^b 

Property Informatio n 

Key Number: 1375 0002 04 

Account Type: Residential 

Parcel Number: 0413750002 

Parcel Address: 5002 S 18 ST 

OMAHA NE 68107-0000 

Legal Description: SOUTH OMAHA CITY LOTS LOT 2 BLOCK 105 ALL LOT 1 & N 1/2 LOT 2 BLK 

105 65X130 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$4,800.00 

$4,800.00 

$4,800.00 

$4,800.00 

$4,800.00 

$4,800.00 

Improvement 

$34,000.00 

5,700.00 

$40,000.00 

$40,000.00 

$40,000.00 

$40,000.00 

Total 

$38,800.00 

$40,500.00 

$44,800.00 

$44,800.00 

$44,800.00 

$44,800.00 

Land Informatio n 

Acres 

0.19 

SF 

8450.0 

Units 

1.0 

Depth 

130.0 

Width 

65.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R041... 6/9/2009 
Douglas County Account Information Page 2 of 2 

CLICK TO ENLARGE IMAGE ; I.,.TM. 

Square Footage: 1170.0 

Perimeter 0.0 

Unit Type: 

Built As: 1 1/2 Stc 5ry Fin 

HVAC: Forced Air 

Exterior: Frame Siciing 

Interior: Drywall 

Roof Cover: Compos ition Shingle 

Roof Type: Gable 

Floorcover: Allowance 

Year Percent Year Built _ modeled Remodeled 

1900 1992 0% 

Detail Description 

Appliance Allowance 

Basement Bsmnt Block 8 ft 

Fixture Additional Fixtures 

Fixture Base Fixtures 

Fixture Bath Full 

Porch ^ End Solid Wall 

I- -stUoor 

/i.'iDsc! n 

Bsmr* 3i':!C», S * 7*2 Ov j R 

CLICK TO ENLARGE IMAGE 

Percent Complete 100 0% 

Quality Fair 

Condition: Poor 

Condo Square Footage: 0.0 

Rooms: 7.0 

Units: 1.0 

Baths: 1.0 

Bedrooms: 4.0 

Stories: 1.5 

Found ation: 

Sprinkler Square Foe >tage: 0.0 

Adjusted Year 

Built Physical A ge 

1900 09 

Units 

1.0 

712.0 

1.0 

1.0; 

1.0 

120.0 : 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R041... 6/9/2009 
JC Painting 

Property Address

Start Date

Prime (Gallons) 

Poly (Boxes)

,Paint (Color) 

Paint (Color) 

Paint (Color) 

Paint (Color) 

Paint (Color) 

 '50 0 ^ S. i ^ S T Date H ­ 09i-<DCf 

>n~ /d -^ O ^ Complete Date p ~ \ I - Q ^ 

Amount Of Prime And Paint Used 

 J2^ 

CAJ^iA-e Amount (Gallons) n f 

Amount (Gallons) 

Amount (Gallons) 

Amount (Gallons) 

Amount (Gallons)