TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID #: 153^ 1 Date: ^-c^Q-^) ^ 

Address: QP,\ \ S 3 3 ^ t 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGINEERS 

Year: 2009 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

u y Video of property (DVD) 

y ^ Executive Summary 

^y ^ Signed Access Agreement for subject property 

S'^"""^ Painting Agreement 

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

y ^ Pliotograplis pfg^ ^ A A p/igf" 

B^"'^ Satisfactory restoration signed jy Property Owner 

Siy ^ Property close-out check list signed by EPA 

S-""^ Property information from Douglas County Assessor's Office 

CS—'"^ _confirmation that lead pamphlet "Renovate Right" was received by PO 

D 

D 

D 

Professional Environmentai Engineers Signalure Date 

^^^/UXJJLG ^ p^///9 

Ignature Date ' 

30094383 

Superfund 
PROFESSIONAL 

ENVIRONMENTAL ENGINEERS, INC. ''' ' 'oirNE es?!' 

"Providing cost-effective environmental solutions" ,. !^°o! c«!'ooo? 

^ Fax (402) 504-3281 

Consulting • Engineenng Design • Remediation • Abatement • Emeigency Response 

Lead Base Stabilization Omalia, Ne 

Close Out Report 

2009 

SAID# 15321 

2811 S 33 St 

• Dates worked: 06/29 to 07/01 2009 

• Pre property condition: damage to front step bricks, porch carpet ripped exposing 

wood underneath. Back door had damage from dog scratching; Garage paint was in 

poor condition and was flaking off. 

• Problems encountered: None 

• Owner request/concerns: N/A 

• Inspection/closeout dates: Owner signed 07/08, EPA 07/14/09 No issues. 
PROFESSIONAL 

2505 North 24'^ Suite 219 ENVIRONMENTAL ENGINEERS, INC. 

Omaha. NE 68110 

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

Ccrsuliing • Engireenng Oosi lyi • Remerl .ntion • Ah.itenipnt • Emngonr y Rfisnon.^-.p 

EPA Close-Out Form 

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

SAID: A3^ / 

Property Address: f-zxYj/l ~^- <-3<- ) 

Owner's Name: ^ C grf-f l0^ll<Ger " j T ^ 

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 

garages. y 

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 al! ofthe areas where contaminated materials have been spilled thoroughly 

vacuumed/ cleaned? _ t ^ 

6. Did the contractor col leet/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? 

y 

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

9. Is there any evidence of property 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 (Icnown) lingering issues with the property owner(s) that have 

y been left unresolved? 

Olher Considerations/Properly Owner Discussions/Additional Work that is Required: 

mh7 

EPA COR Signature 

Date 
Jul-08-2009 02:30 PM Mutual of Omaha 4023511247 
 1/2 


Jul 08 OS 11:50a Igit Servicas Corporation 402 403 0832 P-2 


PROFESSIONAL 

2505 North a*", Suite 219 ENVIRONMENTAL ENGINEERS, INC. Omaha, NE 68110 

(402) 504-4688 "Providing cost-effective environments solutions" Fax {402} 504-3281 

Consulting • Engineenng Design • Remedlalian • Atjatament • Emargency Response 

Property Owner Close-Out Form 

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

SAID: i53«_ Property Address: o^g , 11 S "^ 3 ?^V 

Owner's Name: ^Q-H " VOCA\\ef^r , J r" 

Performanfre Standards/Oose-Out Criteria YES NO 

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

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

eaves, siding, ail trim, porches, box beams, columns, rails, and exterior surfaces of 1/ 

garages. 

2. Was all scraping aad other prepaiation work completed satisfactorily? 

3. WeiB all required areas of tfae stnicture($) primed as needed and painted with l / 

two top coats? 

4. Was the paint products utilized equivalent to a 30 year produot/qxiality? 

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

vacuumed/ cleaned? 

6. Did the contractor collect/vacuum all &lling 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 sunrounds the stnicture(s) in reasonably good condition? -r 

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

barrier tape, etc. properly removed? 

9. Is there any evidence of property damage that was done by the contractor? Any / property damage needs to be compteted 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 badk? 

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

been left uraesolved? 

Professional EnviromtlQatal Engineers Representative Date 
S s^-i ^ 

CONSENT OFR ACCESS TO PROPERTY 

OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY ID: /9?>2.) PROPERTY ADDRESS: 2^i ( S Q 7^ ^ AT ^ 

OWNER NAME: •7 .. ' 

DAYTIMEPHONE: TdZ - 2> ^ -'IplfS^ 

CELL PHONE: Hfb2^ - L?5fl -^ h^S ' E-MAIL: sof^gji^ar^^d.j;! ^ Qj^n(\ ^ 

OWNER'S ADDRESS IF DIFFERENT C^w ^ ^ pavosi TENANT'S NAME IF APPLICABLE 

DAYTIME PHONE: ^4^ 

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 worli is being done to protect the soil cleanups that were performed by EPA contractors. 

Paint stabilization activities will include: scraping ofcracked or flaldng 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. 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. 

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 402-731^045 (South Omaha office). 

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

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

Care Providere, and Schools.' bifbrmaUon fbr Famlliet, Childe Care Providere, and Schools.' 

Slgnahire Date 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 
•€@oiiiroin}iniiii@ini ©f (^©©©optJ ©f L®iidl FsouupCiiidfi 

Z^(t b o 3 3 Sr r apcQEiE ^/0 C 

PROPERTY ADDRESS OF OVtfNER IF DIFFERENT THAN PROPERTY BEING PAINTED: 

PROPERTY ADDRESS ZIP CODE 

I have reoeivBd a oopy of Ihe pamphlet, RenoMBto %Af c Important Laad Hasard Inhumation For Famllha, 

C h M Cara PnvUara An d Schoola informing me of the potentlal risk of the lead hazanJ exposure from 

renovation activity to lie perfonned on duueliing unit. I reoeived this pamphlet before the woric began. 

/^PMNTED NAME OF RECIPIENT ^ DATE 

8alf«Ceiflflcatlon Option (For Tenant-Occupied Dwalllngi Only) 

If the lead pamphlet was delivered but a tenant signature was not obtainable, you may Ohedc the appropriate box 

below: 

\ j RalUial To Sign - 1 oeriHy that I have made a good faith effort b deliver the pamphtet, renovate right important 

tead hazard Infonnatton for familtes, child cars provfators and schoote; to the rental dwelling unit listed above at the 

date and time Indicated and that the oraupant refused to sign the oonfhmatten of rscelpL I further oertHy that I 

have telt a (X)py of the pamphlet at the unit wHh oocupanl 

D Unavaltabto For Signature - 1 (»rtify that I have made a good faith effort to deliver the pamphtet, renovate right: 

important tead hazanl infonnatton for families, child care pravUers and schools, to ttie rsntal dwelling unK listed 

below and ttiat ttte occupant was unavallabte to sign ttie oonflmiatton of receipL I further certify ttiat I have teft a 

(X)py of ttta pamphtait atttie unit by sliding It under the door or somewhere on ttie premises. 

PRINTED NAMEEOFreUON OF reUON CERTIFYM i O ATTEMPTED DEUVBTr DATE AND TOVIE LEAD 

PAMPHLET DBJVERY 

ATURE 0FPER80N CERTIFYING LEAD PAMPHLET 

Note OigBnflng BIslHng Opiion - as an aNsmaflvB to dsfiuery ki person, you may mai ttie tead pamphtet to ttie ownar 

and/ortenanL Parophtat must be malted atteast 7 days before lanovatton. (Di)Guinem«#ao8rtlflcSbofmallngframihepoat 

CONFIRMATION OF RBCEIPT OP LEAD PAMPHLET 08/06 
'A IIT*?- J 

PUDPEmVADBflESS!. DATE 

BVID ­

p 

HOUSE TRIM. jOOLOIt 

GARAlQ^. JCOLOR. 

QARAfiETRIM. JCXILOIL 

JOOLOIL 

PORCH miML GOLOR. 

(GOMPUTl MJL SBCnOlli YERr NQr OR NON-APPUCABLE) 

p^usnTrnTOHraRBOoaios 
Douglas County Account Information Page 1 of3 

/S32/ 

Douglas County, Nebraska Property Record - R1409670000 

Print Report 

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

New Feature ••-•- • Auto Sales Search 

Owner 

WALKER JR SCOTT ' 5 0 

ETAL / ^ 

2811 S 33 ST 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number 0967 OOOO 14 Co5C»-Uc\S S^.H-^ 6e\\ 

Account Type: Residential ./ jDODCNd^^^ (K^C^Cj^lrxi 

Parcel Number 1409670000 

Parcel Address: 2811 S33ST 

OMAHA NE 68105-0000 

Legal Description: ILER ADD LOT 15 BLOCK 3 50 X 114.5 

Value Informatio n 

Land Improvement Total 

2009 $6,000.00 $80,900.00 $86,900.00 

2008 $6,000.00 $80,900.00 $86,900.00 

2007 $6,000.00 $80,900.00 $86,900.00 

2006 $6,000.00 $79,900.00 $85,900.00 

2005 $6,000.00 $79,900.00 $85,900.00 

2004 $6,000.00 $79,900.00 $85,900.00 

Sales Informatio n 

Sales Date: 1998-10-01 

Oeed Type: Boolr; I 2103 Page: 628 

Price: $83,500.00 

Grantor: 

Grantee: 

Valid/invalid: Valid 

Exclusion Reason: 

Sales Date: 1997-05-28 

Deed Type: Book: 2061 Page: 483 

Price: $67,000.00 

Grantor. 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R140... 6/9/2009 
Douglas County Account Information Page 2 of3 

Grantee: 

Valid/invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.13 5700.0 1.0 114.0 50.0 No 

Improvemen t Informatio n 

Building 1 

TWO STORY I -i*f:M t , 

ua 

9'i­

'li- JF 

»9 

» i ? 

-a,E . 

73(IOt,F 

CLICK TO ENLARGE IMAGE 

S^!ii2£SLSSSUSSSL. 

Square Footage: 1456.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Forced Air Rooms: 7.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywali Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 2.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1910 0% 1910 98 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 720.0 

littp://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R140... 6/9/2009 
IGIT 

Property Address p l ^ I ( S ' ^ 3 ^T ~ Date p ^ I /fS(c7/9^ 

Start Date [i?-'l^~0 ^ End Date '^ ^ b\-CQ\ 

Amount Of Prime And Paint Used 

Prime (Gallons) i^ \ 

Poly (Boxes) tP ^ 

Paint (Color) \J)\fl /[ ^ Amount (Gallons) 'S d ^ { 

Paint (Color) t^ P f |c <^ ca >/ Amount (Gallons) Q / 

Paint (Coior) fig g^g, Amount (Gallons) Q y flcy / 

Paint (Color) Amount (Gallons) 

Paint (Color) Amount (Gallons)