TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID #: 20e(y>^ Date: 7/j^^D^ 

Address: 2Sl!ff^ I leTCe^ S f 

Remediation Contractor: PROFESSIONAL ENVIRONMENTAL ENGEVEERS Year: 2008 

PAEVT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

y Video ofproperty (DVD) 

^ Executive Sununary 

0 Signed Access Agreement for subject property 

U Painting Agreement 

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

y Photographs ._ 

Satisfactory restoration signed by Property Owner 

D Property close-out check list signed by EPA 

W .' Property information from Douglas County Assessor's Office 

^l^^^^d^k^Xg ^ iJy<^of 

Si^ature ' Date 

40318348 Iiill 

Superfund 
PROFESSIONAL 

i

1 

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

"Providing cost-effective environmental solutions" ^ |^°^| c^Mof? 1

1 

^ Fax (402) 504-3281 

Consulting • Engineering Design • Remediation • Abatement • Emergency Response 

Lead Base Stabilization Omaha, Ne 

Close Out Report 

SAID# 20863 

2569 Pierce St 

• Dates worked 12/29 to 12/30 2008 

• House was in poor condition all over, paint was coming off on all areas, broken windows, 

broken cable box, damage to siding and gutter areas, Garage had extensive damage all over 

including the main doors that were badly damaged. 

• Inspected by PE project manager 
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: 7^Jv^(X'J S c o ^ t~ 

Property Address: 2SG ^ 9,^j^-& 

Owner's Name; ypzco:^ 

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. 

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? T ^ ' 

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? 

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? 

Comments: 

j^yy^kijc ^ ^7 

Property Owner Signature 

/-y

Date 

 -^^ 

Professional Environmefual Engineers Representative 

y ' ^

Date 

 ^<yy 
KfA'. 12 08 02:47 p Eduiand Scot t 4023443488 p.2 

CONSENT OFR ACCESS TO PROPERTY 


OMAHA LEAD SITE REMEDIAL ACTION - LEAD-BASED PAINT STABILIZATION 

PROPERTY BD: yt:i(yoZ ^ PROPERTY ADDRESS: ^sr^ q y i er c-e> Sl­ 1 

0WN'£RNAM'£: 

4 AuJTMc) ^'i:^^'^' ^ OAYTiMI I PHONE: ^L| - 2>^?^ 

C£LL PHONE: E-MAIL: 

OWNER'S ADDRESS IF DIFFERENT: 

TENANT'S NAME BF APPLICABLE: 

|l 

CELLPHONE: 

DAYTIME PHONE: 

E-MAIL: 1 

Profassuoaal EaviroomcntAJ EnguiMrs, iDC. (PE) is under contract (#EP-R7-0S-06) witb tbe U.S. Eaviraomenul Protection 

Ageoey (EPA) to ttabilixe lead iMued paini (LBP) AU residenti*! structures at a number of properties located in Omaka, 

Nebraska. Tbe paint stabilizatioo work is being done io protect che soil cleanups tbat were perforated by EPA coatractor^. 

Paint stabilization activities will include: scrapins of cracked or flakini; LBP from structures, aipplkation nf a prime coat and 

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

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

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

By signing this document 1 agree to allow an EPA contractor to conduct a soil cleanup at my property rollowiog completion of 

lead-based paiot stabilization. 1 understand that the stabilization contractor cao not provide SBSurances tbat the soil cleanup 

contractor will be bouod to. f further nnders'tand tiiat the soil cleanup contraetor will make all reasonable efforts to address 

concerns tbat I, as the property owner, may have regarding soil ckanup at my property. 

I fully understand that by signing tbis Content tor Access, (1) this access will remain in effect until the work bas been 

sati»fxcturily completed, (2) lhat the Property Owner or Tenant, if applicable, will be given tbe Housing and Urban 

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

Providers, and SchooU", (3) tbe Property Owner or tenant will remove all obstructions firom surfaces to be painted, (4) will 

abide by heaUh nad safety guidance provided by EPA, (5) wUI aUow photography ofproperty before and after the paint 

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

not to obstruct or tamper with any ofthe LBP stabilizatioa actions, and (8) will participate in flnal property inspection and 

sign the Completion Agreement and Property Owner Satisfaction Survey. 

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

Professional EnvironmenttI Engineers, Inc. Project Manager, Willie CUy At 402-S04-468S. General questions about the 

Omaha Lead Site cteaniip can be directed to Pauletta France-Isetts, EPA Remedial Project Manager 4Q2-731-24S4, or the 

EPA Public Information Centers at 402-991-9583 (North Omaha office) or 402-7310045 (South Omaha office). 

D Ves, I anutt accessfai my property md ms given the panphlet D No, I do not grant access (0 my propetty and I W l 

"Renovate Right, knportnt Lead InfonnatiM (or Families, Child givefl the pamphlet "Renovita Right, Importint Laad 

CarePravHinvandSchooIr^ ^ Infoffflallofl fer FamKlas, ChlM* Can Providen, and Sctwolt.' 

Sisnahire Data Signature Date 

SPECIAL INSTRUCTIONS AND CONSIDERATIONS 

50/3 8 3EWd Sy33NI9N3 yiAN3 JOHd OQOQTCr.f.TC n ^ "rtr t 
Nov, 12 08 02 : 48p Eduuard Scot t 4023443488 p. 3 

Confirmation Of Receipt Of Lead Pamphlet 

BVtD .yxyiCay > ^ 

PROPERTY ADDRESS. OPCODE. (y§ /OS 

PROPERTY ADDRESS OF OWNER IF DIFFERENT THAN PROPERTY BQNG PAINTED: 

PROPERTY ADDRESS .ZIP CODE 

have received a cop^ of the pamphlet, Renovate Kgh t Important Lead Hazard Infwma^on Por Families, 

C Wd Care Providers An d Schoo l Informing me of the potenfial risk of tiie tead hazard exposure from 

renovation activity to be perfbrmed on dweiling unit I received this pamphlet before the woric began. 

//v/?opr 

/^PmNTED NAME QF RECIPIENT > oZDAT. E 

Sdf-Certificalion Option (ForTenant*Occupi«d DwBllings Only) 

If Ihe lead pamphlel was delivered but a tenant signature was not obtainable, you may check the appropriate box 

below: 

D Refusal To Sign - 1 certify ^a t I have made a good faith effort to deliver the pamphlet, renovate right important 

lead hazard infonnation for Amities, & M care providers and schools; to the rental dweling unit listed above at the 

date and time indk^ited and that the occupant refused to sign the oonfirmatkm of receipt. I further certify tKat 1 

have left a copy of ^ e pam^let at the unit with occupant 

D Unavailable For Signature - 1 oettify that I have macto a good faith effort to delh/er the pamphlet, renovate right; 

important lead hazard infbrmation for families, child care providers and schools, to flte rental dwelling unit listed 

bekiw and that the occupant was unavailable to sigr\ Oie oonfirmatian of receipt. I further cert'ify that I have left a 

copy ot the pamphiet at the unit by sliding rt under the door or somewhere on the premises. 

XVBU ^^"SaAAiit-^ Il nj ^ 

PRINTED NAME OF PERSON CERnFYING AnBHPTED OEUVERY OATE ANO TIME LEAD 

PAMPHLET DEUVERY 

SICNATUREOF PERSOM^ERTIFYII NG LEAO PAMPHLET DELIVERY: 

Note RagartHng Maiing Option ~ as an alternative to delivery in person, you may mail the lead pamphtet to the owner 

and/or tenant Pamphlet must be mailed at least 7 days b^r e renovation. (Document with a cetiiricaifi of maaing from the post 

office} 

CONFIRMATION OF RECEIPT OF LEAD PAMPIHLET 08/08 

CQ /CQ -XMJ CU-miTru.!- ! SIT «n- l 
Novi 12 08 02:48 p Edujand Scot t 4023443488 p.4 

PAINT STABILIZATION PRE-PROPERTY ASSESSMENT 

PROPERTY ADDRESS , A^rf i P.PI^P .^ f DATE- fl iy(os< 

BVID y}r>?:(y 

PLAirr ft PERHANENT LANDSCAPING TO BE REMOVE? NO d D YES f—1 

IF, YES WHERE: 

i 

PRE'BOSEEfiG OONDXZIQM OF FOUNDATION/STRUCTUREr i.«. BASEMENT LEAKING? 

NO ^^- J YES ' ' IFrYESWHERE: 

EXXSIINS PADiT ON WINDOWS^ DOORS, FOUNDATION, SIDEWALKrC Z^E*)? NO z n 

YES [23 IF,YESWHER& / / 

^i^y^t ^ ^ny y yy/yi^ y 7tt}uie 

VISUAL DESCRIPTION OF PROPERTY/STRUCTURE/GARAGEr Cl-E.): (USE BACK 5IOE IF 

NECESSARY) 

(^^nyo^L nL7s (j/i^^K iaii<,iAa/ly/wy r(^y,y^ ZK /^/)rsf<^'y't 

ytn/I aLuL. i^i^-^ f/y^^ ^/>i/^/.yr 

S9/f9 39Vd Sa3a^I9N3 yiAN3 -n>w aannTCCk.Tc- r\-, .«#• 
how-,12 08 02:48p Edward Scott 4023443488 p. 5 


PAiNT STABILIZATION PRE-PROPERTY 

PAINT MATCH ASSESSMENT 

oonPfOTYAnDiiess.' .Q^Co ^ Y'lgic y S h DATE _ III I'L h i 

BVID yy:\'Pry>y> 

AREA(S) TO BE PAINTED: 

HOUSE PROPER: COLOR. 

HOUSE TRIM. _COlJORL 

GARAGE- .COLOR. 

GARAGE TRIM. .COLOR^ 

PORCH. _COLOR^ 

PORCHTRIM. .COLOR. 

(COMPLETE ALL SECTION, YES, PlOr 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 KMIM OBNtt 

se/se 39Vd Sa33NI9N3 iJlAN3 JOyd nqOflTPChTC nr-0 0 
Douglas County Account Information Page 1 of2 

Douglas County, Nebraska Property Record - R2218210000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 90th St - VJeW Ofl Ma p Information is valid as of 2008-9-4 Treasurer's Tax Report 

New Feature -»-»- • Auto Sales Search 

Owner 

SCOTT EDWARD 

2569 PIERCE ST 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number: I 1821 0000 22 

Account Type: Residential 

Parcel Number: 2218210000 

Parcel Address: 

Legal Description: 

2569 PIERCE ST 

OMAHA NE 6810

SHULLS 2ND AD

5-0000 

D LOT 4 BLOCK 8 E 50 FT 

Value Informatio n 

2008 

2007 

2006 

2005 

2004 

2003 

Land 

$5,400.00 

$5,400.00 

$5,400.00 

$5,400.00 

$5,400.00 

$5,400.00 

Improvement 

$65,500.00 

$65,500.00 

$62,200.00 

$62,200.00 

$62,200.00 

$62,200.00 

Total 

$70,900.00 

$70,900.00 

$67,600.00 

$67,600.00 

$67,600.00 

$67,600.00 

Land Informatio n 

Acres 

0.19 

SF 

8400.0 

Units 

1.0 

Depth 

168.0 

Width 

50.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22... 11/5/2008 
'Douglas County Account Information Page 2 of 2 

*'1 F*St Floor , rs»:<»*3 Roar L, i,\ I03<0sqn Ljf 2 0sq,fl. P 

!»» I •* 

1 m STORY FirsllSHED 

CLICK TO ENLARGE IMAGE 

Square Footage: \ 1604.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Fair 

Built As: 1 1/2 Story Fin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Frame Shingle Units: 1.0 

Interior: Plaster Baths: 2.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: I Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year YearBuilt Physical Age Remodeled Remodeled Built 

1910 0% 1910 98 

Detail Type Deta/7 Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 1034.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 2.0 

Garage Detached 440.0 

Porch Slab Roof Ceil 165.0 

User Attic Full Finish 570.0 

http://douglasne.mapping-online.com/DougIasCoNe/static/accountinfo.jsp ?accountno=R22... 11/5/2008