TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: QOryb ^ Date: 8'0?0n ^ 

Address: 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

^0'' ^ Video of property (DVD) 

D Executive Summary 

Q"""^ Signed Access Agreement for subject property 

y ^ Painting Agreement 

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

b - ^ Photographs dfh&r /z,.^/^ ^ &iu^ (UteJU^rt^\ 

^ y Satisfactory restoration signed by Property Owner 

^ y 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 

D 

D 

mlo'^ ProT^S^hnvIm5BiintefEngineere Signature mei 

tPA Signature . _ _ 

30055005 

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# 22002 

917 S. 27 St. 

• Dates worked: 08/06 to 08/06 2009 

• Pre property condition: Paint on property was in poor condition on the porch, trim 

and garage areas. House is mostly sided and has painted porch and trim areas. Garage 

paint was in very poor condition prior to work starting. 

• Problems encountered: None 

• Owner request/concerns: N/A 

• Inspection/closeout dates: Owner signed 08/07, Inspected by EPA 08/11/09 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: aaoo a 

Property Address: ^1-7 " ^ ^ 7 S T 

Owner's Name: |^rcU^UP / }f) f^J^jt 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 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 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 l y other generated debris? 

7. Is the grass area that surrounds the structure(s) in reasonably good condition? y 8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, ^ y barrier tape, etc. properly removed? 

9. Isthereany 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 

l y that need to be moved back? 

11. Are there any (known) lingering issues wath the property ovmer(s) that have 

y been left unresolved? 

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

y^^^i ^ J ^ ^/ii lift 

Date 
2505 North 24"^, Suite 219 

"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: ^Ql^OQ. 

Property Address l'^ ?^ a ^ ?,+ 

Owner's Name rV]^Me. ^nr-fr\^er 

Performance Standards/Close-Out Criteria 

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 

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? 

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 areeis and also remove any 

other generated debris? 

7. Is the grass area that surrounds fhe 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 

been left unresolved? 

Coirunents: 

.y 

^"fet- Property Owner Signature Date 

Omaha, NE 68110 

(402) 504-4688 

Fax (402) 504-3281 

YES NO 

y 

U 

0 

\) 

y 

J 

1/ 

v; 

W 

u 

\J 

^yyy^^ s-~o7-cy 

Professional Environiftental Engineers Representative Date 
CONSENT FOR ACCESS TO PROPERTY 


OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID: J<>^ O O o2 PROPERT Y ADDRESS: ^ i " ^ ^ ©t " f ^ "T 

DAYTIME PHONE: 

CELL PHONE: E-MAIL: 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME IF APPLICABLE: 

DAYTIME PHONE: 

CELL PHONE: 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 are being performed by EPA contractors. 

Paint stabilization activities will include: scraping of cracked or flaking LBP from structures, application ofa 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, ifthe 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. 

• YYes e , I have read 

1^\s|o7 

^ late 

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 of property 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 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 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 402-731-24S4, or the EPA Public 

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

^ Yes, 1 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 Infonnation for Families, Child given the pamphlet "Renovate Right, Important l.ead 

Care Provident? q(n Schools. ools."'/ Information for Families, Chllde Care Provldere, and Schools." 

jLL ^4d^ 

Sigiianir sigh e Dat Da e Signature Date l 

SPECIAL IMSTRUCTIONS AND CONSIDERATIONS 
PAINT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

PROPERTY ADDRESS: C\\ ^ 'S 3 ^ *!>(- DATE fi-S^Q^ 

BVID 

AREA(S) TO BE PAINTCD: 

HOUSE PROPER: COLOR,. 


HOUSETRIM COLOR 


GARAGE COLOR 


GARAGE TRIM COLOR 


PORCH -COLOR '/h/^ /f Sff/ 

PORCH TRIM_ COLOR 

(COMPLETE ALL SEdlON , YES, NO, OR NON-APPUCABLE) 

I AGREE TO THE COLORS USTED ABOVE. ONCE PAINTING BEGINS, I 


UNDERSTAND I CAN NOT CHANGE THE ABOVE SELECTED COLORS: 


PAINT MATCH FORM 08/08 
^Douglas County Account Infonnation Page 1 of3 

# zzooz. 

Douglas County, Nebraska Property Record - R1713440000 

Print Reoort 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west ot 52nd St - VlOW OH Ma P Information is valid as of 2009-7-20 Treasurer's Tax Report 

New Feature ->-•- • Auto Sales Search 

Owner 

FORESTER MICHELLE L 

917 S 27 ST 

OMAHA NE 68105-0000 ^9, - 4q?i\ -XSO'IM^I 

Property Informatio n 

Key Number 1344 000017 

Account Type: Residential 

Parcel Number 1713440000 

Parcel Address: 917 S 27 ST 

OMAHA NE 68105-0000 

Legal Description: MARSHS ADD LOT 10 BLOCK 4 50 X 124.5 

Value Informatio n 

I Land 

2009 

2008 

2007 

2006 

2005^ i 

2004 y .. . -1 . 

Sales Informatio n 

$4,800.00 

$4,800.00 

$4^800.00 

$4,800.00 

$4,800.00 

$4,800.00 

Improvement 

$89,300.00 

$89,300.00 

$89,300.00 

$84,300.00 

$84,300.00 

$84,300.00 

Total 

$94,100.00 

$94,100.00 

$94,100.00 

$89,100.00 

$89,100.00 

$89,100.00 

Sales Date: 2002-02-25 

Deed Type: j WD Book: 2213 Page: 739 

Price: I $87,000.00 

Grantor. 

Grantee: 

Valld/lnvalld: Valid 

Exclusion Reason: 

Sales Date: 2000-07-26 

Deed Type: i D Sooir: 2159 Page: 026 

Price: $77,000.00 

Grantor 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoxmtinfo.jsp?accountno=Rl 7... 7/31/2009 
^ Douglas County Account Information Page 2 of3 

Grantee: 

Valid/Invalid: valid 

Exclusion Reason: 

Sales Date: \ 1998-03-05 

Deed Type: \ D Book: 2084 Page: i68 

Price: $48,850.00 

Grantor 

Grantee: 

Valid/Invalid: valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6200.0 1.0 124.0 50.0 No 

Improvemen t Informatio n 

Building 1 

nor 

3«« icr 

Fntneer r M2.0 Bu. Pt 

TWO STORY 

Square Footage: I 1672.0 Percent Complete: ' 100.0% 

Perimeter ' 0.0 Quality: Average 

Unit Type: Condition: Good 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: I Central Air to Air Rooms: | 7.0 

Exterior: ' Frame Vinyl Units: ] 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: \ Composition Shingle Bedrooms: 4.0 

Roof Type: j Hip Stories: 2.0 

Floorcover: I Allowance Foundation: i Block 

Sprinkler Square Footage: 0.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R17... 7/31/2009 
IGIT 

Property Address J/ T ^oli'-^ l Date 

StartPate €ig/o£/^ ^ EndDate QS/TI'^I'X) ^ 

Amount Of Prime And Paint Used 

Prime (Gallons) 3 0<^i 

Poly (Boxes) S^ So:<re-g> 

Palm (Color) ^ O f ^ Amount (Gallons) / ^ Cv^ l 

Paint (Color) _ ^ Amount (Gallons) 

Paint (Color) Amount (Gallons) 

Paint (Color) Amount (Gallons) _^ 

'*^'"^<Color) Amount (Gallons)