## Transmitta l o f

Oinah aLea d Site Pain t Stabilizatio n Fil e Folde r
Said #J?/7^ ^ Date : ^—V-/ 0 Address : /OO( p 3.^C . ^-f

- - . Contractor : CityofOmah aYear : P^^7 0 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s ix^or k Writ e U p Ix^igne dAcces s Agreemen t fo r

subject propert y

. Pre-Renovation for msignedby Propert y Owne r Pre-Renovation For mfo r

Occupant/Tenant , ifapplicabl e j^Taintin g AgreemenfCit y o f

Omah aPurchas e Orde r Settlemen t documents (i.e. , fo r

damag e o r

t

o replac e plants , etc. ) Renovatio n Recordkeepin g Checklis t signedb y Certifie dRenovato r l/pr e Propert y informatio n fromDougla s Count y Assessor' s Offic e l.^Othe r (describe) : [^^Kd'fa> $

Cit y of Omah aRepresentative Signatur e Dat e 

## LJo> V i)ffJf\A^Ji^^ 

# 3U0/^^I ^ EP A Representativ e Signatur e ' Dat e 3026247 0 

# miHiiiHiiii i Superfun d

# CIT Y O F OMAH A PURCHASIN G - ROO M 100 3 

### Purchas e Orde r 181 9 FARNA M STREE T REVISIO N PAG E PURCHAS E ORDE R NO . OMAHA , N E 68183-100 3 116693 9 0 . 1 FAX # 402-444-542 3

MARCO S PROFESSIONA L PAINTIN G VENDOR : MARCOASALAZA R 251 4 J S T OMAHA , N E 6810 7 SHI P TO : CITY O F OMAH A HOUSIN G & COM M DE V R M #111 1 181 9 FARNA M STREE T OMAHA,N E 6818 3 ) :

BIL L TO : -<

CIT Y O F OMAH A FINAkNC E DISBURSEMENT S ROO M #100 7 181 9 FARNA M STREE T OMAHA.N E 6818 3 ORIGINA L PURCHAS E ORDE R • VENDOR' S COP Y (SE E INSTRUCTION S BELOW ) CUSTOME R ACCOUN T NO . VENDO R NO . DAT E O F ORDER / BUYE R REVISE D DATE//BUYE R 8156 9 29-JUN-1 0 H HUR T PAYMENTTERM S SHI P VI A F.O.B .

IMMEDIAT E DESTINATIO N FREIGH T TERM S REQUEST0R«3ELIVE R T O CONFIR M T O / TELEPHON E MARUCA . T MARI E

> • -< ITE M PAR T NUMBE R / DESCRIPTIO N DELIVER Y DAT E QUANTIT Y UNI T UNITPRIC E EXTENSIO N Al l price s an d amount s o n thi s orde r ar e expres s 3 d i n : U S Dolla r NEEDED : 1,477.0 0 N 30-JUN-l O EPAPAIN T STABlLIZATIOt l PROGRA M GROU P 14 3 1006 ; S 26TH S T i O SHI P TO : i Addres s a t top o f pag e NEEDED : 1,577.0 0 N 30-JUN-l O EP APAIN T STABILIZATIO N PROGRA M GROU P 14 3 50 5 t l 41S T A V o SHI P TO : I Addres s a t top o f pa^ e

SHIPTO : Addres s show n above . Ifshipmentisdelayedoran y Item s no t available , advis e a t once . Pur ­ chas e orde rnumbe rmus t appea ro n all Invoices , packages , packin g lists , bil l o f lading , an d conespondence . Tota l ( 3.054.0 0 ^ SHIPPIN G CHARGE S T O B E PREPAID , I F APPLICABL E AiN D ADDE D T O INVOICED , cop y t o b e fur ­ nishe d wit h Invoice . TA X EXEMPTION : Th e Cit y o f Omaha'l s exemp t fro m Federa l Excis e Taxe s an d th e Nebrask a an d Cit y o f Omah a Sale s Taxes . Federa l I.D . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealer s Uc . 91-0316768 . Cit y Purchasin g Agen t / ^uye rPlaimin g Departmen t Omaha/Dougla s Civi c Cente r Inspector : Stev e Zivn y 181 9 Fama mSurcct, Suit e 100 3 Date : 5/13/1 0 Omaha , Nebrask a6818 3 (402 ) 444-515 0 Telefa x (402 ) 546-071 4 

## Name : Yeseni aCabrer a R . E . Cunningham , RA , F.SAM E Cit y o f Omah a Director 

## Address : 1006 8 26" " Stree t Jifi i Sutde , Mayo r 

## OMAH A EXTERIO RPAINT STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEAD SIT E Th e Contrac t bi ddocument s consis t o f th e followin g sections : •. General P».esponsibilitie s fo r th e Contracto r an dOccupani . •LeadHazardContro l Plan , Interi mConfro l o f Lea dBase dPaint Hazards . Th e Contracto r Shall : •Compl y with HUD' s "Guideline s fo r th e Evaluatio n an dContro l o f Lead-Base d Pain t Hazard s i n Housing. " (Copie s ar e availabl e at th e Plannin g Department. ) •Compl y wit h Standard s calle dfor in th e "Constructio n andRehabilitatio n Specifications , Housin g an dCommunit y Developmen t Division , Cit y o f Omaha , Nebraska. " (Copie s are availabl e al th e Plarmin g Department. ) •Compl y wit h th e Stat e ofNebrask aHealt h an dHuma n Service s Regulatio n an d Licensure , Titl e 17 8 Chapte r 2 3 Lea dBas e Pain t Regulations . • , Coordinat e dail y constructio n schedul e wit h th e occupan t •Submi t infonnatio n cu t sheet s fo r all substitution s o r approve dequal s prio r t o writte n approval o f th e Constructio n Specialist . •Repai r o r replac e al l item s damage dor disturbe ddurin g pain t stabilizatio n activities . •Kee p wor k

sit e an dsurroundin g are afre e fromaccumulation s o f wast e material s o r

rubbis h cause db y th e wor k

a

t al l times . •Upo n dail y completio n o f work : clean u p al l rubbish , exces s material , equipment , an detc. , that i s connecte dwit h th e work , an dleav e al l part s ofth e wor k

area s i n a neat , sanitary , lea dsaf e an dpresentabl e condition . •Complet e thi s projec t withi n 3 0 calenda r days . Th e Occupant/Owne r Shal l •Remov e an dstor e awa y any persona l property withi n twenty (20 ) feet o f th e are a t o b e remediated . • Provid e acces s t o elecfricit y an dwater throughou t th e pain t stabilizatio n process . • Ensure tha t al l househol dmember s stay a t leas t te n fee t awa y fro mal l wor k

area s andals o kee p al l pet s a t leas t te n feet away a t al l time s unti l th e wor k

ha s bee n complete dan dth e are aha s passe davisual inspection . ,:... •- . . Initials /

### 100 6 S 26tii Stree t (Continued) 

## Lea dHazar dContro l Plan Interi mContro l o f Lea dbase dPain t Hazard s Pain t Stabilizatio n •Stabiliz e al l previousl y paintedexterio r

wood , brick , metal , concret e surface s ofth e dwelling/garag e t o includ e bu t no t limitedt o th e siding , fascia, eaves , frim, window trim , shutters , gutters , railings , downspouts , doo r

triman dfoundation . D O NO T INCLUD E WINDOW S ORMA N DOORS . D O NO T INCLUD E CEMENTITIOU S SIDING . INCLUD E VEHICL E DOOR S I F APPLICABLE . •Prepar e an dpain t al l previousl y paintedsurface s b y followin g th e Saf e Wor k

Practice s protocol fo r

EP A exterior lea dbase dpain t stabilization

­ •Al l pain t color s t o matc h existing pain t pattem . Prim e an dappl y tw o coats of approve dfinis h coat . (Refe r

t

o Plarmin g Dept . approve dpain t list). ' •I F SPRAYED , ON E COA T SHAL L B E BACK-BRUSHE D O R BACK-ROLLED . Lea dBase dPain t Wast e Lead-base dpain t wast e mus t b e hanidle da s follow s •Al l pain t chip s an dcomponeri t debri s mus t b

e double bagge dfo r

disposal . •Clea n pain t chip s fro mgroun daroun dperimete r

o

f

dwelling befor e starting , during an dafte r

th e project . •Al l lea dpaintedcomponents an ddebri s mus t be remove d fromth e sit e dail y unles s otherwis e approvedb y th e construction specialist . •Al l lead-basedpain t debri s (chip s an dcomponents ) must be dispose do f

i

n amunicipa l soli dwast e landfill . ^ert y Ownei ^ / Dat e 

# ih . ^"^-27 ^ 

# W^MLL ^ Prope l 

# yiW r ^^-^^- ^ Dat e Witne . Dat e 

# i Occupan t (

i f

applicable ) Dat e Occupan t (ifapplicable ). Dat e

### Exterior Lead-basedPaint Stabilizatio n Progra mManage db y the Cit y o f Omahafo r

EP A Region 7 OmahaLea dSit e Th e purpos e o f thi s progra mi s t o preven t yard s wher e lead-contaminate dsoi l i s cleane d u p fro mbecomin g re-contaminate db y deterioratin g exterio r lead-base dpaint . Thi s i s no t ahom e repai r program . Whic h Home s Ar e Eligible ? •Home s where soi l clean-u p ha s bee n or wil l b e don e an da n EP A contracto r ha s identifie ddeterioratin g exterio r lead-base dpaint . •Home s ar e eligibl e onl y b y referra l fromtiie EPA . Wha t wor k

vvil l b e done ? • .

Loos e an dflaking lead-base dpain t wil l b e remove dsafely fromfascia , eaves , siding , frim, windo w trim , doo r tri mandfoundation . •Surface s wil l b e prime dan dpainte dt o matc h existin g pain t colo r a s closel y a s possible . Wha t wil l no t b e done ? • • Surface s whic h hav e n o pain t wil l no t b e treated .

. • Window s o r door s wil l no t b e included . •Rotte n woo dwil l no t b e replaced . •N o housin g repai r wil l b e done . Wh o wil l perfor mth e work ? •EP A confractor s wil l tes t pain t o n exterio r hous e surface s an dgiv e th e result s t o th e Cit y o f Omah aPain t Stabilizatio n Program . •Cit y Consfructio n Specialist s wil l prepar e awor k

pla n andcontac t th e property owne r for permissio n t o proceed . •Wor k

wil l b e competitivel y bi dby approved , frainedconfractors . Whe n wil l th e wor k

b e done ? •Thi s programbega n i n 200 7 an dwil l continu e fo r severa l years . •Th e City staf f wil l prioritiz e home s base don th e presenc e o f childre n under ag e si x ifknow n an dth e severity ofth e problem . Pain t Stabilizatio n i s voluntar y an dwil l b e don e onl y wit h permissio n ofth e owner .

Initial s / f > ^	 ^ ^Consed t fo r Acces s t o Propert y RIGH T O F ENTR Y T O PREMISE S Granto r (th e property owner) consent s t o andauthorize s th e Unite dState s Environmental Protectio n Agenc y (USEPA ) o r it s authorize drepresentatives , collectivel y th e Grantee , t o ente r an dperfor m

. certai n environmental respons e activitie s upo n th e followin g describe dpremises :

Owner' s Name : Davtim e Phone : Owner Name(s) : Yeseni aCabrer a 651-252 9

Addresse s o f Propertie s Covere db y thi s Agreemen t Propert y Addres s City/State/Zi p Code • 1006S.26tiiSt . Omaha , N E 6810 5

Granto r understand s tha t thi s gran t doe s no t limi t EPA' s righ t o f acces s unde r th e Comprehensiv e Environmenta l Respons e an dLiabilitv Ac t (CERCLA ! 4 2 USC . & 9601-9675 . o r an v other law . PURPOS E O F ACCES S Th e purpos e o f th e respons e actio n i s t o stabiliz e loos e o r flaking exterio r lead-based , pain t o n residentia l properties , includin g day-care facilities , where remediatio n o f lea dcontaminate dsoi l ha s o r

wil l tak e place . Samplin g o f soi l ma y b e conducted . Thi s consen t shal l allo w Grarite e onto Grantor' s property an dftirther, provide s th e Grante e th e righ t to perfor man y an dal l envirorunenta l respons e action s an dactivitie s i t deem s appropriate . ENVIRONMENTA L RESPONS E ACTION S Th e environmenta l respons e action s t o b e performe do n subjec t property ma y includ e th e followin g activities : 1. : Locatin g equipmen t and/o r machiner y o n subjec t property i n preparatio n fo r an di n th e cours e o f th e respons e activities . 2 . Obtainin g siample s fro mGrantor' s property .

(1 ) 2/12/200 7Address : 1006S . 26ti i St . Consen t fo r Acces s to Propert v (Pag e 2 ) 3 .Plarmin g andimplementin g th e respons e actio n o n th e Grantor' s property . Thi s will include 1 ) remova l o f loos e o r flaking.paint identifie db y EP A usin g lead-saf e method s i n complianc e with HUD/EP A regulation s an d2 ) repaintin g accordin g t o th e attache dspecifications . TER M Thi s acces s agreemen t shal l b e operabl e fo r th e perio do f time it take s t o complete the environmenta l respons e activities . Upo n completio n o f th e respons e actions , al l right s an d privilege s give n b y th e Granto r shal l ceas e o n that date , unles s extende dby asubsequent agreement . AGREEMEN T NO T T O INTERFERE Granto r agree s riot t o interfere \Yit h an y o f th e activitie s undertake n b y Grante e a t th e Property , tampe r wit h any o f Grantee' s property , o r tak e an y action s regardin g th e us e ofth e Propert y whic h wil l endange r human health or.welfar e o r th e environment , o r allo w other s t o us e th e Propert y in suc h manne r durin g th e ter mo f thi s consent . Granto r agree s t o provid e notic e an dacop y o f thi s agreemen t t o prospectiv e purchasers , lessees , assigns , o r grantee s o f th e property or an y portio n o f it . Granto r agree s t o provid e 30-da y notic e t o EPA prio r t o any transfer o f ownershi p right s t o th e property . SAMPLIN G RESULT S Grante e agree s t o provid e Granto r wit h th e result s o f any an dal l sampling.and/o r analysi s resultin g fromGrantee' s respons e activitie s o n th e property . PRIO RCONDITION S AGREEMEN T Th e granto r agree s t o th e conditio n o f th e propert y prio r t o remediatio n aridindicate s o n Pag e 3 an y item s t o b e remove db y th e Granto r befor e activitie s commence . RESTORATIO N O F PROPERT Y Excep t fo r th e abov e state dpain t stabilization , tiie Grante e agree s that sai dpropert y wil l b e restore d a s nearl y a s possibl e t o it s origina l stat e an dconditio n a s foundimmediatel y precedin g th e beginnin g o f activitie s authorize db y tiiis Agreement , followin g completio n o f tiie respons e activities .

(2 )2/12/200 7

### Address : 100 6 S . 26t h St . , Omaha , NE , 68105 CURREN T CONDITIO N / PROPOSE D RESPONS E ACTIVITIES Th e purpos e of thi s sectio n i s t o provid e amutua l agreemen t as t o condition s o f

propert y prio r

t

o contractor activities . Thi s wil l als o serve a s documentation fo r

th e purpos e o f assurin g tha t restoratio n activitie s ar e completedt o th e satisfaction of th e propert y owne r

an dthe UnitedState s .Environmenta l Protectio n Agenc y (EPA) . Item s t o b e remove db v propert v owne r

prio r

t

o th e respons e activities: ' . \ , 1 . . 2 . 3 . 4 . 5 . 

### Item s NO T t o be removedb v confracto r

durin g remova l activities : I . ~ 2 . 3 . . 4 . 5 . 

### ADDITIONA L COMMENTS :

I hav e rea dth e foregoin g documen t an dunderstandtha t i t i s a n agreemen t granting permission t o th e Grantee t o ente r

th e abov e describedpremise s fo r

th e purpos e of conducting environmenta l respons e activities , ari dI agree t o it s term s an dconditions . I acknowledge ' tha t I hav e receivedth e pamphle t "Renovat e Right" . Grantor' s Signattire : ^'^,y^ ^ ( 7ld^c4f^ Dat e £-l^-J O

(3 ) 2/12/200 7

### Dougla s Count y Accoim t Information Pag e 1 of 3 Dougla s County , Nebrask a Propert y Recor d - R171423000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e Q scal e 0-5 0 ft wes t o f 52n d S t - Vie w O R Ma p Inforniatio n i s vali d a s o f 2010-4- 5 Treasurer' s Ta x Repor t Ne w Featur e " * • * ? > Aut o Saie s Searc h Owne r CABRER A YESENI A ETA L 5657 4 19 5 S T PACIFI C JUNCTIO N I A 61561-000 0 Propert y Informatio n Ke y Number : 142 3 000 0 1 7 Accoun t Type : Residentia l Parce l Number : 171423000 0 Parce l Address : 100 6 S 2 6 S T OMAH A N E 68105-000 0 Lega l Description : MARSH S AD D LO T 2 BLOC K9 1/ 2 VA C ALLE Y AD J & LO T 2 BL K9 5 0 X 132. 5 Valu e Informatio n Lan d Improvemen t Tota l 200 9 200 8 200 7 200 6 200 5 200 4 $4,800.0 0 $4,800.0 0 $4,800.0 0 $4,800.0 0 $4,800.0 0 $4,800.0 0 $43,500.0 0 $43,500.0 0 $43,500.0 0 $46,800.0 0 $46,800.0 0 $46,800.0 0 $48,300.0 0 $48,300.0 0 $48,300.0 0 $51,600.0 0 $51,600.0 0 $51,600.0 0 Sale s Informatio n Sale s Date : 2008-06-2 0 Page : Dee d Type : W D Book : 200 8 06250 2 Price : $ 53,500.0 0 Grantor : RAMIRE Z GONZAL O P Grantee : CABRER A YESENI A ETA L Valid/Invalid : Valid . Exclusio n Reason : Sale s Date : 2002-06-2 1 Dee d Type : SW D Soofr : 221 5 Page : 52 4 Price : $ 23,200.0 0 Granto r 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accOimtno=R17.. . 4/16/201 0Dougla s County Accoun t Informatio n Pag e 2 o f 3
Grantee : Valld/lnvalld : Vali d Exclusio n Reason : Sale s Date : 2001-07-1 1 Dee d Type : MO D Book : 219 5 Page : 4 3 Price : $34,360.0 0 Grantor : Grantee : Valid/Invalid : Invali d Exclusio n Reason : Foreclosur e Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 5 6600. 0 1. 0 132. 0 50. 0 N o Improvemen t Informatio n Buildin g 1

in n soinrfitlt' ^ rta«"

u r mtn ' • <

tu i 1 1/ 2 STOR Y RNISHE D

CLIC KT O ENLARG E IMAG E Squar e Footage : 1402. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor y Fi n Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 6. 0 Exterior : Fram e Shingl e Units : 1. 0 Interior : Plaste r Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl7. . . 4/16/201 0

### Dougla s Count y Accoun t Information Pag e 3 of 3 

# 1 Sprinltie rSquar e Footage : | 0. 0 Yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 191 0 0 0 % 191 0 10 0 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f l 912. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Attache d 210. 0 Porc h Enc I Soli d Wal l 120. 0



### http://dougIasne.mapping-bnline.com/DouglasCoNe/static/accountinfo. j sp?accountao= R17.. . 4/16/201 0