## Transmitta l o f

Omah aLea d Site Pain t Stabilizatio n Fil e Folde r Said #^ft>f ^ Date : ^-^"-/-f / Address : 7 O i ^ S^B ^ 37 ^ Contractor : Cit v o f

Omah aYear : P- * / / 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s .2: 1 Wor k

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# y, i gne d Acces 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/Paintin g Agreement/Cit y o f

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

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o replac e plants , etc. ) Renova:tio n Recordkeepin g Checklis t signe db y Certifie dRenovato r

_Propert y informatio n fromDougla s Count y Assessor' s Offic e U^Oth& T (describe) : ( hnfO ^ 

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—3-/5~-/«3 ^ Cit y of Omah aRepresentativ e Signatur e Dat e EP A Representativ e Signatur e / 'Dat e 3026250 1 

### Superfun d

## CIT Y O F OMAH A PURCHASIN G - ROO M 100 3 181 9 FARNA M STREE T 

### Purchas e Orde r OMAHA , N E 68183-100 3 FAX # 402-444-542 3 / ' PURCHAS E ORDE R rio . 117734 5 REVJSIO N 0 PAG E 

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CITYOFOMAH A HOUSIN G & COM M DE V R M # 1 11 1 181 9 FARNA M STREE T • OMAHA.N E 6818 3 G&MPAINTINGCOIN C VENDOR : > , BIL L TO : 1370 7 CUMIN G S T CITl ' O F OMAH A FINANC E OMAHA , N E 681S4 DISBURSEMENTS ROO M #1007 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 . i/ENDO R NO . DATEOFORDERAJUYE R REVISE D DAT&BUYE R 9129 8 bl-SEP-l l HHUR T PAYMENTTERM S SHI P VI A F.O.B. . DESTINATIO N FREIGHTTERM S REQUESTOR/DELIVE R T O CONFIR M T O / TELEPHON E RUELAS . MARGARE T P ^ ITE M PAR T NUMBER / DESCRIPTIO N DELIVERYDAT E lUANTIT Y UNI T UNH " PRIC E EXTENSIO N Al l .price s and amounts ; o n thi s orde r ar e expres s j d i n : U S Doi : a r NEEDED : 2,140.0 0 N 01-SEP-l l EP APAIN T STABILIZATION PROGRA M GROU P 23 8 ­ 101 4 S 3 1 S T o SHI P TO : Addres s a t to p o f pa^ e NEEDED : 980.0 0 N 01-SEP-l l EP APAIN T STABILIZATION PROGRA M GROU P 23 8 ­ 260 1 MASO NS T o SHI P TO :

. Addres s a t to p o f pag e

INSTRUCTION S T O VENOO R UnlO M othtnvl M state d al l price s F.O.B . destinatio n Thi s I s you r"notiflcatio n o f paymen t l o follow" withi n 3 0 day s o f dallvof y o f above inerchandls e o rservic e Tnta i ( 3.120.0 0 ) Perfonned . I f Invoice s wer e not previousl y sutxnltted , pleas e mai l I n duplicat e t o th e Dou^a s Count y Purchasin g Dept , Roo m 90 2 Civi c Center , 181 9 Fama m St. , Omah a Nebrask a 68183 . Pleas e refertnce th e County Orde rNumbe rshow n abov e o n al l Invoice s o rcorrespondence . I f there are an y question s pleas e cal l 402-444^7155 . C<iiinlirPurth»tlrffA(nftt/Buy« r^Plannin g Departmen t Omihi/'Dougla s Civi c Ceaie t Inspector : Chri s Grummion s iai 9 ?«n».'nStreet , Suit e iio o Date

- 8/1/1 1 Omaha , Nebrjsk 3 6Sl3 3 (402)444-515 0 Telefa x (402 ) 444-6i<f l 

### Name ; Kathlee n Vinto n R . E . 

### Cunningham , RA , F.SAM H 

## jSiXor . Address : 101 4 s 3 1 S t OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EPA OMAHA LEA D SIT E Th e Contrac t bi ddocument s consis t ofth e followin g sections : •Genera l Responsibilitie s fo r th e Contracto r an d Occupant . •Lea d Hazar d Contro l Plan , Interi mContro l o f Lead BasedPain t Hazards . 

### Th e Contractor Shall : •Contracto r an d al l subcontractorfs ) shal l complet e an d iubmi t a"Citizenshi p Attestation " / "Emplove e Ctassification " for mt u th e Plannin g Department , pe r Stat e requirements , befor e fina l pavmen t ca n b e issued . •Compl y with HUD' s "Guideline s for th e Evaluatio n an d Contro l o f Lead-Base d Pain t Hazard s in Housing. " (Copie s ar e availabl e a t th e Plannin g Department. ) •Conipl y vi'it h Standard s calle d for in th e "Constructio n an d Rehabilitatio n Specifications , Housin g an d Communit y Developmen t Division , City o f Omaha , Nebraska. " (Copie s are availabl e at th e Plannin g Department. ) •Compl y wit h th e Stat e o f Nebrask aHealt h an d Human Service s Regulatio n an d Licensure , Titl e 17 8 Chapte r 2 3 Lea d Bas e Pain t Regulations . •Coordinat e dail y constructio n schedul e wit h th e occupan t •Submi t infonnatio n cut sheet s for al l substitution s o r approve d equal s prio r t o writte n approva l o f th e Constructio n Specialist . •Repai r o r replac e al l item s damage do r disturbe dduringpain t stabilizatio n activities . •ICee p work sit e an d surroundin g are afre e fro maccumulation s o f wast e material s o r rubbis h cause d b y th e wor k

a t al l tinies . •• Upondail y completio n o f work : clea n u p al l rubbish , exces s material , equipment , and etc. , thai t i s connecte dwith th e work , an dleav e al l part s o f th e wor k

area s in aneat , sanitarj' , lea d saf e an d presentabl e condition . •Complet e thi s projec t withi n 3 0 calenda r days . Th e Occupant'Owne r Shal l •Remov e and . stor e awa y an y persona l propert y withi n twent y (20 ) feet o f th e are at o b e remediated . • Provid e acces s to electricit y an dwate r throughou t fh e pain t stabilizatio n process . • Remov e voluntee r tree s an dvegetatio n fro mth e dri p lin e ofth e roof , an d cu t bac k shrub s an d bushe s a t leas t t^v o fee l fro mth e house . •JEnsur e tha t al l househol d member s sta y a t leas t te n fee t awa y fro mal l wor k

area s and als o kee p al l peit s at leas t te n feet awa y a t al l time s unti l the wor k

ha s beer i complete d an d th e are aha s passe d avisua l inspection . Initial s 

# j<:V _(Continued ) 

## Lea d Hazar d Contro l Plan InterimControl of Lea dbase dPain t Hazard s Pain t Stabilizatio n •Stabiliz e al l previousl y painte dan d newl y installe d e.xterior wood , brick , metal , concret e surface s ofth e dwellin g and/o r garag e on include d property to includ e bu t no t limite d to th e siding , fascia , eaves , trim , windo w trim , shutters , gutters , railings , porc h floor, downspouts , doo r tri man dfoundation . •Pain t al l metal , stucco , an d transit e siding . •• Prepar e an d pain t al l previousl y painte d surface s by followin g th e iSaf e Wor k Practice s protoco l for EP A exterio r lea d base d paint stabilization . •Al l pain t color s to matc h existin g pain t pattem . Prim e an d appl y tw o coat sof approve d SATI N finish. "Satin " nnis h is standard , "Flat " finis h pe r Constructio n approval . (Refe r to Plannin g Dept . approve d pain t list) . • IF SPRAYED , 0N £ COA T SHAL L BE BACK-BRUSHE D ORBACK

ROLLED . 

### Lea d Base dPaint Wast e Lead-base d pain t wast e mus t be handle d as follow s •Al l pain t chip s an d componen t debri s mus t be doubl e bagge dfor disposal . •Clea n pain t chip s fro mgroun d aroun dperimete r of dwellin g befor e starting , durin g an d after th e project . •Al l lea d painte d component s an d debri s mus t be remove dfro mth e sit e dail y unles s otherwis e approve d by th e construction specialist . •- Al l lead-base d pain t debri s (chip s an dcomponents ) mus t be dispose d of in a municipa l soli d wast e landfill . Propert y Owne Owne r r ^rbnert v Dat e / PropertyOwne r Dat e Witnes sDat e Occupan t (ifapplicable ) Dat e Occupan t (i f applicable ) Dat e

### Exterior Lead-base dPaint Stabilizatio n Progra mManage d b y the,Cit y o f Omah afo r

EP A Region 7 OmahaLea dSit e The purpos e o f thi s progra mi s t o preven t yard s wher e lead-contaminate d soi l i s cleane d up fro mbecomin g re-contaminate d b y deterioratin g exterio r lead-based paint . Thi s i s no t ahome repai r program . Which Home s Ar e Eligible ? •Home s wher e soil clean-u p ha s bee n or will b e don e an d a n EP A contracto r has identifie ddeterioratin g exterior lead-base d paint . •Home s ar e eligibl e onl y b y referra l fro mthe EPA . Wha t wor k

will b e done ? •Loos e and flakin g lead-base d pain t wil l b e remove d safel y fro mfascia , eaves , siding , trim , windo w trim , doo r triman d foundation . •Surface s wil l b e primed an d painted t o match 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 no pain t wil l no t b e treated . •Window s or door s will not b e included . •.Rotten woo d wil l not b e replaced . •N o housin g repai r will b e done . Who will perfor mthe work ? •EP A contractor s will tes t pain t o

n exterior hous e siuface s an d giv e tlie results t o the Cit y o f OmahaPain t Stabilizatio n Program . •Cit y Constructio n Specialist s wil l prepar e awor k

pla n an d contact th e propert y owne r fo r permissio n t o proceed . •Wor k

wil l b e competitively bi d b y approved , traine d contractors .

• When wil l th e wor k

b

e done ? •Tbi s progra mbega n i n 2007 an d will continu e fo r severa l years . •The Cit y staf f will prioriti2: e home s base d o n the presence o f childre n unde r age six if known an d th e severit y o f th e problem . ' Paint Stabilizatio n i s voluntar y an d wil l b e done only wit h permissio n ofth e owner . 

### Initial s \(_\ fConsen t for Acces s t o Propert y RIGH T O F ENTR Y TO PREMISE S Grantor (th e propert y owner ) consent s t o an d authorize s the Unite d State s Environmenta l Protectio n Agenc y (USEPA) o r it s authorize d representatives ^ collectivel y th e Grantee , t o ente r an d perfon n cenai n environmenta] respons e activitie s upon thefollowin g describe d premises : Owner' s Name : Davtim e Phone : Owne r Name(s) : Kathleen Vinto n

Addresse s o f Propertie s Covere d b y thi s Agreemen t Propert y Addres s City/State/Zi p Cod e 101 4 S 3 1 S t Omaha , N E 68105

Grantor tinderstand s tha t thi s gran t doe s not limit EPA' s righ t o

f acces s unde r th e Comprehensiv e Environmenta l Respons e an dLiabilit v Ac t fCERCLA) . 4 2 USC . & 9601-9675 . o r an v othe r law . PURPOS E OF ACCES S The purpos e o f the respons e actio n i s to stabiliz e loos e o r flaJcing exterio r lead-base d pain t o

n residential properties , including day-car e facilities , wher e remediatio n o f lea d contaminated soi l ha s o

r will tak e place . Samplin g o f soil ma y b e conducted . Thi s consen t shal l allow Grante e ont o Grantor' s propert y an d further, provide s th e Grantee th e right t

o perfor man y an d al l environmenta l respons e action s an d activitie s i t deems appropriate . ENVIRONMENTA L RESPONS E ACTION S Th e environmenta l respons e action s t o b e performe d o n subjec t propeit y ma y includ e th e followin g activities : 1 .

Locatin g equipmen t and/o r machiner y o n subject propert y i n preparation fo r an d i n th e cours e o f the respons e activities . 2 .

Obtainin g sample s fro mGrantor' s property .Address : 101 4 S 3 1 S t Consen t fo r Acces s t o Propert y (Pag e 2 ) 3 .Plannin g an d implementing the respons e actio n o n th e Grantor' s property . Thi s wil l includ e 1 ) remova l o f loos e or flakin g pain t identified b y EP A usin g lead-saf e methods i n complianc e wit h HUD/EP A regulation s an d 2 ) repaintin g accordin g t o th e attache d specifications . r- TER M Thi s acces s agreemen t shall b e operable fo r th e perio do f tim e i t take s t o complet e th e environmenta l respons e activities . Upo n completion o f the respons e actions , al l right s an d privilege s give n b y the Granto r shal l ceas e o n tha t date , unles s extende d b y asubsequen t agreement . AGREEMEN T NOT T O INTERFER E Granto r agree s not t

o interfer e wit h an y of the activitie s undertake n b y Grante e a t th e Property , tampe r wit h an y of Grantee' s property , o r tak e an y action s regardin g th e us e o f th e Propert y whic h wil l endange r huma n healt h o r welfar e or th e environment , or allo w other s t o us e th e Propert y i n 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 d acop y o f this agreement l o prospectiv e purchasers , lessees , assigns , o r grantee s o f th e propert y o r an y portio n of . it . Granto r agree s t o provide 30-da y notic e to EP A prior to an y transfe r o

f ownershi p right s t o th e property . SAMPLING RESULT S Grante e agree s t o provid e Granto r wit h the result s o f an y an d al l samplin g and/o r analysi s resultin g fromGrantee' s respons e activitie s o n the property . PRIO RCONDITIONS AGREEMEN T The grantor agree s to th e conditio n o f the propert y prior t

o remediatio n an d indicate s o n Pag e 3 an y item s t o b e removed b y th e Granto r befor e activitie s commence . RESTORATION Q F PROPERT Y Excep t fo r the abov e state dpain t stabilization , the Grante e agree s tha t sai d propert y wil l b e restore d a s nearl y a s possibl e t o it s origina l stat e an d condition a s foun d immediatel y precedin g th e begirmin g o f activitie s authorize d b y thi s Agreement , followin g completio n o f th e respons e activities ,Address : 101 4 S.3 1 St , Omaha , NE , 6810 5 CURREN T C0NT)ITION/PROPOSED RESPONS E ACTIVITIE S Th e purpos e o f thi s sectio n i s t o provid e amutua l agreemen t a

s t o condition s o f propert y prio r t

o contracto r activities . Thi s wil l als o serve a s documentatio n fo r the purpos e o f assurin g tha t restoratio n activitie s ar e completed t o the satisfactio n of th e propert y owne r an d th e Unite d State s Environmenta l Protectio n Agenc y (EPA) . Item s to b e removed b y propert v owne r prior t

o th e respons e activities : 1 . • 2 . 3 . . • 4.

­ 5 . Item s NO T t o b e removed b v contracto r during remova l activities : ! • . 2 . 3 . 4 . .5 . • ADDITIONA L COMMENTS : 

## ~xhli ^ ChTbr S -7 ^ (^UAJT . 

## ..TXrHi ^ <rahr. \/ P 

## t n cUi:^^

­ C>( 3 o-c£:i^J^}Ad<^ y .

I hav e rea d th e foregoing documen t an d understand tha t i t

i s a n agreemen t grantin g pennission l o the Grante e t o ente r th e above described premise s fo r th e purpos e o f conductin g environmenla i respons e activities , an d I agree t o it s terms an d conditions . I acknowledg e tha t I hav e receive d th e pamphle t "Renovat e Right" . Grantor' s Signature : j/^p^-jz ^ \p j^y ^ V A A./^W ^ Dat e " g /c ^ \\ \Dougla s Count y Accoun t Informatio n Pag e 1 of 4 Douglai B County , Nebrask a Propert y Recor d - R162852000 0 Prin t Repor t Vie w Interactiv e GI S Ma p Informatio n i s vali d a s o f 2012-2-2 8 Treasurer' s Ta x Repor t Ne w Featur e - 4 - » - > Subdivisio n Sale s Searc h Owne r VINTO N KATHLEE N 8 ETA L 101 4 8 3 1 8 T OMAH A N E 68105-000 0 Propert y Informatio n Ke y Number : 285 2 000 0 1 6 Accoun t Type : Residentia l Parce l Number : 162852000 0 Parce l Address : Lega l Description : 101 4 8 3 1 S T OMAH A N E 68105-000 0 LINNHUR8 T AD D LO T 8 BLOC K0 E 14 1 F T 4 0 X 14 1 Valu e Informatio n 201 1 201 0 200 9 200 8 200 7 200 6 Lan d $6,000.0 0 $6,000.0 0 $6,000.0 0 $6,000.0 0 $6,000.0 0 $6,000.0 0 Improvemen t $86,000.0 0 $86,000.0 0 $94,200.0 0 $94,200.0 0 $94,200.0 0 $66,600.0 0 Tota l $92,000.0 0 $92,000.0 0 $100,200.0 0 $100,200.0 0 $100,200.0 0 $72,600.0 0 Sale s Informatio n Sale s Date : 2004-11-0 1 Dee d Type : Price : Grantor : W D $103,000.0 0 Maxc o Book : 200 4 Page : 14528 2

Grantee : Kathlee n S Vinto n Validnnvaiid : Vali d Exclusio n Reason : Sale s Date : 2004-07-2 6 Deec f Type :

Price : Grantor : W D $62,060.0 0 KN0W8K I FAMILY T R Book : 200 4 Page : 11618 8

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R16. . . 3/14/201 2Dougla s County Accoun t Informatio n Pag e 2 of4
Grantee : MAXC O IN G Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 2 5640. 0 1. 0 141. 0 40. 0 N o Improvemen t Informatio n Buildin g 1 1, 5 STOR Y FINISHE D 101 4 S 3 1 S T BHIr t BIOCI I S n 7SI.0l f Slaor i 2. 1 ',\ \FinlFI c t^ \• irstFto€3 r

2 i 915 0 s l

C

t
QMlott d " ] " 16 0 CLIC KT O ENLARG E IMAG E CUC KT O ENLARG E IMAG E Squar e Footage : 1639. 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 Aluminu m Units : 1. 0 Interior : Drywal l Baths : 2. 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 Sprinkle rSquar e Footage : 0. 0 Yea rBuii t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 191 0 0 % 191 0 10 2 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1. 0 Applianc e Fireplac e Masonr y 1. 0 Applianc e Securit y Syste m 1. 0 Basemen t Bsmn t Bloc k 9 ft 768. 0 http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl6. . . 3/14/201 2

### Dougla s Count y Accoun t Information Pag e 3 of 4

Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 2. 0 Garag e Detache d 360. 0 Porc h Enc I Soli d Wal l 187. 0 Porc h . Sla b Roo f Ceilin g 16. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?acc9untno=R16.. . 3/14/201 2

### Dougla s Count y Accoun t Information Pag e 4 of 4

Th e abov e ma p i s powere d by Google , an d i s intende d t o provid e a genera l ide a o f a property' s location . I f yo u requir e a mor e exact propert y location , yo u nia y us e th e Interactiv e GI S Map s tha t ar e maintaine d b y ou r offlce .



### http://douglasne.mapping-onIine.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R16.. . 3/14/201 2