Transmittal of Omaha Lead Site 

Paint Stabilization File Folder 

Said #_P^7^2 - Date: F^7^'7 0 

Address: ^ ^ 7 S ~ 7?A^^t^^ay^-h ^1 -

Contractor: CityofOmaha Year: ^ ^ / O 

Paint Stabilization 

Property File Folder Documents 

6^^or k Write Up 

LXSigned Access Agreement for subject property 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, ifapplicable 

t^Painting Agreement/City of Omaha Purchase Order 

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

Renovation Recordkeeping Checklist signed by Certified Renovator 

Property information from Douglas County Assessor's Office 

y, Other (describe): rpof- & Q ^ 

3 •~7S^7' 

City ofFOmahaRepresen Omaha Representativ t e Signature Date 

'Cn^d ^;^o Ao/ ^ 

EPA Representative Signature 

30262474 I 

Superfund 
%. CITY OF OMAHA 

PURCHASING ­ ROOM 1003 Purchase Order 

1819 FARNAM STREET f 

PURCHASE.OROERNG. REVISION PAGE ^ 

OMAHA, NE 68183-1003 

FAX# 402-444-5423 1167155 0 1 

SHIP TO: 

CITYOFOMAHA 

HOUSING & COMM DEV RM #1111 

1819 FARNAM STREET 

OMAiHA-NE 68183 

VENDOR: USA CONSTRUCTION SERVICES INC 

381lbREXELST BILL TO; 

y 

OMAHA, NE 68107-3857 CITY OF OMAHA FINANCE 

DISBURSEMENTS ROOM #1007 

1819 FARNAM STREET 

OMAHA,NE 68183 

ORIGINAL PURCHASE ORDER - VENDOR'S COPY (SEE INSTRUCTIONS BELOW) 

CUSTOMER ACCOUNT NO. VENDOR NO. DATE OF ORDER/ BUYER REVISED DATE//BUYER 

6057 09-JUL-10 H HURT 

PAYMENTTERMS SHIP VIA F.O.B. 

IMMEDIATE DESTINATION 

FREIGHTTERMS REQUESTOR/DELIVER TD CONFIRM TO / TELEPHONE 

MARUCA, T MARIE \} J 

> ITEM PART NUMBER / DESCRIPTION DELIVERY DATE QUANTITY UNIT UNIT PRICE EXTENSION • < 

All prices and amounts on this .order are express »d in : US Dollar 


NEEDED: 2,650.00 N 


09-JUL-lO 


EPA PAINT STABILIZATIOtJ 


PROGRAM GROUP 148 118 P 


5ISt AV i 


.o SHIP TO: i 


Address at top of page 


NEEDED: 650.00 N 


09-JUL-lO 


EPA PAINT STABILIZATION 


PR:0GRAM GROUP 1.48 4025i 


N 44TH ST ! • 
 O SHIP TO: i 


Address at, top of pa^e 


NEEDED: 1,050.00 N 


09-JUL-IO 


EPA PAINT STABILIZATIOtJ 


PROGRAM GROUP 148 4215; 


DAVENPORT ST 


O SHIP TO: 


Address at top of page 


NEEDED: 750.00 N 


SHIP TO: Address shown above. If shipment Is delayed or any Items not available, advise at once. Pur­

chase order number must appear on all Invoices, packages, packing lists, bill of lading, and correspondence. Total C Continued 3

SHIPPING CHARGES TO BE PREPAID, IF APPLICABLE AND ADDED TO INVOICED, copy to be fur­

nished with Invoice. 

TAX EXEMPTION: The City of Omaha Is exempt from Federal Excise Taxes and the Nebraska and City of toi^jJWu Omaha Sales Taxes. Federal I.D. 476006304;,STATE I.D. 01-0316768; Fuel Dealers Uc. 91-0316768. Cily Puichaiing Agent / 6|iyef 
Plamiing Department 

Omaha/Douglas Civic Center 

Inspector: Steve Zivn y 1819 Farnam Street, Suite 1003 

Date : 5/12/10 Omaha, Nebraska 68183 

(402) 444-5150 

Telefax (402) 546-0714 

Name: Gregory L. Schaneman R. E. Cunningham, RA, RSAME 

jSul^C r Address: 4215 Davenport Street . 

OMAHA EXTERIOR PAINT STABILIZATION PROGRAM 

FOR THE EPA OMAHA LEAD SITE 

The Contract bid documents consist of the following sections: 

• General Responsibilities for the Contractor and Occupant. 

• Lead Hazard Control Plan, Interim Control of Lead Based Paint Hazards. 

The Contractor Shall: 

• Comply with HUD's "Guidelines for the Evailuation and Control of Lead-Based 

Paint Hazards in Housing." (Copies are available at the Planning Department.) 

• Comply with Standards called for in the "Coristruction and Rehabilitation 

Specifications, Housing and Community Development Division, City of Omaha, 

Nebraska." (Copies are available at the Planning Department.) 

• Comply with the State of Nebraska Health and Human Services Regulation and 

Licensure, Title 178 Chapter 23 Lead Base Paint Regulations. 

• Coordinate daily construction schedule with the occupant 

• Submit information cut sheets for all substitutions or approved equals prior to 

written approval of the Construction Specialist. 

• Repair or replace all items damaged or disturbed during paint stabilization 

activities. 

• Keep work site and surrounding areafree from accumulations of waste materials 

or rubbish caused by the work at all times. 

• Upon daily completion of work: clean up all. rubbish, excess material, equipment, 

and etc., that is coimected with the work, and leave all parts ofthe work areas in a 

neat, sanitary, lead safe and presentable condition. 

• Complete this project within 30 calendar days. 

The Occupant/Owner Shall 

• Remove and store away any personal property within twenty (20) feet ofthe area 

to be remediated. 

• Provide access to electricity and water throughout the paint stabilization process. 

• Ensure that all household members slay at least ten feet awayfrom all work areas 

and also keep all pets at least ten feet away at all times until the work has been, 

completed and the area has paissed a visual inspection. _ . 

Initials (DL > 
4215 Davenport Street (Continued) 

Lead Hazard Control Plan 

Interim Control of Lead based Paint Hazards -

Paint Stabilization 

• Stabilize all previously painted exterior wood, brick, metal, concrete 

surfaces of the dwelling to include but hot limited to the siding, fascia, 

eaves, trim, window trim, shutters, gutters, railings, downspouts, door trim 

and foundation. DO NOT INCLUDE WINDOWS OR MAN DOORS. 

DO NOT INCLUDE STUCCO SIDING. 

• Prepare and paint all previously painted surfaces by following the Safe 

Work Practices protocol for EPA exterior lead based paint stabilization. 

• All paint colors to match existing paint pattern. Prime and apply two 

coats of approved finish coat. (Refer to Planning Dept. approved paint 

list). 

• IF SPRAYED, ONE COAT SHALL BE BACK-BRUSHED OR 

BACK-ROLLED. 

Lead Based Paint Waste 

Lead-based paint waste must be handled as follows 

•• All paint chips and component debris must be double baggedfor disposal. 

• Clean paint chips from ground around perimeter of dwelling before 

starting, during and after the project. 

• All lead painted components and debris must be removedfrom the site 

daily unless otherwise approved by the construction specialist. 

• All lead-based paint debris (Chips and components) must-be disposed of ih 

a municipal solid waste landfill. 

Property Owner Date 

^IrL^.,,..^^' h-:K-IQ 

Property Owner Date 

Witness Date 

Occupant (if applicable) Date 

Occupant (ifapplicable) Date 
Exterior Lead-based Paint Stabilization Program Managed by the City of 

Omaha for EPA Region 7 

Omaha Lead Site 

The purpose of this program is to prievent yards where lead-contaminated soil is cleaned 

up from becoming re-contaminated by deteriorating exterior lead-based paint. This is 

not a home repair program. 

Which Homes Are Eligible? 

• Homes where soil clean-up has been or will be done and an EPA contractor has 

identified deteriorating exterior lead-based paint. • 

• Homes are eligible only by referral from the EPA. 

What work will be done? 

• Loose and flaking lead-based paint will be removed safely from fascia, eaves, 

siding, trim, window trim, door trim and foundation. 

• Surfaces will.be primed and painted to match existing paint color as closely as 

possible. 

What will not be done? 

• Surfaces which have np paint will not be treated. 

• Windows or doors will not be included. 

• Rotten wood will not be replaced. 

• No housing repair will be done. 

Who will perform the work? 

• EPA contractors will test paint on exterior house surfaces and give the results to 

the City of Omaha Paint Stabilization Program. 

• City Construction Specialists will prepare a work plan and contact the property 

owner for permission to proceed; 

• Work will be competitively bid by approved, trained contractors. 

When will the work be done? 

• This program began in 2007 and will continue for several years. 

• The City staff will prioritize homes based on the presence ofchildren under age 

six if known and the severity of the problem. 

Paint Stabilization is voluntary and will be done only v^dth permission of the owner. 

Initials Gl ^ 
Consent for Access to Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States Environmental Protection 

Agency (USEPA) or its authorized representatives, collectively the Grantee, to enter and perform 

certain environmental response activities upon the following described premises: 

Owner's Name: 

Davtime Phone: 

Owner Name(s): Gregory L Schaneman 

850-0350 . 

Addresses of Properties Covered by this Agreement 

Property Address 

City/State/Zip Code 

4215 Davenport St. Omaha, NE 68131 

Grantor understands that this grant does not limit EPA's right of access under the Comprehensive 

Environmental Response and Liabilitv Act (CERCLAI42 USC. & 9601-9675. or anv other law. 

PURPOSE OF ACCESS 

The purpose of the response' action is to stabilize loose or flaking exterior lead-based paint on 

residential properties, including day-care facilities, where remediation of lead contaminated soil has 

or vyill take place. Sampling of soil may be conducted. This consent shall allow Graritee onto 

Grantor's property and fiirther, provides the Grantee the right to perform any and all environmental 

response actions and activities it deems appropriate. 

ENVIRONMENTAL RESPONSE ACTIONS 

The envirorunental response actions to be performed on subject property may include the following 

activities: 

1. Locating equipment aiid/or machinery on subject property in preparation for and in the course of 

the response activities. 

2. Obtaining samples from Grantor's property. 

2/12/2007 (1) 
Address: 4215 Davenport St. 

Consent for Access to Property (Page 2) 

3. Planning and implenienting the response action on the Grantor's property. This will include 

1) removal of loose or flaking paint identified by EPA using lead-safe methods in compliance 

with HUD/EPA regulations and 2) repainting according to the attached specifications. 

TERM . . 

This access agreement shall be operable for the period of time it takes to complete the 

envirormiental response activities. Upon completion of the response actions, all rights and 

privileges given by the Grantor shall cease on that date, unless extended by a subsequent 

agreement. 

AGREEMENT NOT TO INTERFERE 

Grantor agrees not to interfere with any ofthe activities undertaken by Grantee at the Property, 

tamper with any of Grantee's property, or take any actions regarding the use ofthe Property which 

vyill endanger human health or welfare or the environment, or allow others to use the Property in 

such marmer during the term of this consent. Grantor agrees to provide notice and a copy of this 

agreement to prospective purchasers, lessees, assigns, or grantees of the property or any portion of 

it. Grantor agrees to provide 30-day notice to EPA prior to any transfer of ownership rights to the 

property. 

SAMPLING RESULTS 

Grantee agrees to provide Grantor with the results of any and all sampling and/or analysis resulting 

from Grantee's response activities on the property. 

PRIOR CONDITIONS AGREEMENT 

The grantor agrees to the condition ofthe property prior to remediation and indicates on Page 3 any 

items to be removed by the Grantor before activities commence. 

RESTORATION OF PROPERTY 

Except for the above stated paint stabilization, the Grantee agrees that said property will be restored 

as nearly as possible to its original state and condition as found immediately preceding the 

beginning of activities authorized by this Agreement, follo\ying completion of the response 

activities. 

2/12/2007 (2) 
Address: 4215 Davenport St., Omaha, NE, 68131 

CURRENT CONDITION / PROPOSED RESPONSE ACTIVITIES 

The purpose of this section is to provide a mutual agreement as to conditions of property prior to 

contractor activities. This will also serve as documentation for the purpose of assuring that 

restoration activities are completed to the satisfaction of the property owner and the United States 

Environmental Protection Agency (EPA). 

Items to be removed bv propertv owner prior to the response activities: 

I. 

2. 

3. 

4. 

5. 

Items NOT to be removed by contractor during removal activities: 

1 . • 

2­

3 . • • 

4. 

5. 

ADDITIONAL COMMENTS: 

I have read the foregoing document and understand that it is an agreement granting permission to 

the Grantee to enter the above described premises for the purpose of conducting environmental 

response activities, and I agree to its terms and conditions. I acknowledge that I have received the 

pamphlet "Renovate Right". 

Grantor's Signature: -^Adk.ayr,<fyy, ^ '_ _ Date ir:2.-7 0 

(3) 2/12/2007 
Douglas County Account Information Page 1 of3 

Douglas County, Nebraska Property Record - R1445310000 

Print Report 

NEW Feature - Parcel Dimensions available Q scale 0-50 ft west of 52nd St - Vle W OH Ma p Information is valid as of 2010-4-5 Treasurer's Tax Report 

New Feature r* r> •?•, Auto Sales Search 

Owner 

SCHANEMAN GREGORY L 

505 N 41 AVE #2 

OMAHA NE 68131-0000 

Property Informatio n 

Key Number: 4531 0000 14 

Account Type: Multiple Res 

Parcel Number: 1445310000 

Parcel Address: 4215 DAVENPORT ST 

OMAHA NE 68131-0000 

Legal Description: KILBY PLfliCE LOT 20 BLOCK 6 1/2 VAC ALLEY & E 25 N 31.2 FT LT 19 & W 33 E 

58 N 10 FT LT 19 & E 1/2 LT 20 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$12,400.00 

$12,400.00 

$12,400.00 

$12,400.00 

$12,400.00 

$12,400.00 

Improvement 

$125,000.00 

$125,000.00 

$125,000.00 

$90,000.00 

$90,000.00 

$90,000.00 

Total 

$137,400.00 

$137,400.00 

$137,400.00 

$102,400.00 

$102,400.00 

$102,400.00 

Sales Informatio n 

Sales Date: 2001-04-24 

Deed Type: 

Price: 

Grantor 

QC 

$89,000.00 

Book: 2179 Page: 241 

Grantee: 

Valld/lnvalld: Valid 

Exclusion Reason: CORRECTION OF TITLE 

Sales Date: 1995-08-31 

Deecf Type: 

Price: 

Grantor: 

$76,650.00 

Book: 2015 Page: 429 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R14... 4/16/2010 
Douglas County Account Information Page 2 of 3 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.11 4968.0 1.0 72.0 69.0 No 

Improvemen t Information 

Building 1 

4215 Davenport 

Duplex Two Story 

ur 

img'Mlklwail .• IJL -JES 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 2192.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: End Condition: Average 

Built As: Duplex Two Story Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 12.0 

Exterior: Frame Stucco Units: 2.0 

Interior: Drywall Baths: 2.0 

Roof Cover: Composition Shingle Bedrooms: 6.0 

Roof Type: Hip Stories: 2.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1922 0% 1922 88 

Deta/7 Type Detail Description Units 

Add On Unfinished Attic W/floor 

1123.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 1118.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R14... 4/16/2010 
Douglas County Account Information Page 3 of3 

Basement 

Basement 

Fixture 

Fixture 

Porch 

Porch 

Porch 

Porch 

Porch 

User 

User 

Minimal Finish 

Outside Entrance 

Base Fixtures . , 

Bath Full 

Cvrd Wood Deck 

Cvrd Wood Deck 

EncI Solid Wall 

EncI Solid Wall 

End. Solid Wall 

2 1/2 sty unfinished 

verified w/owner 

600.0 

1.0 

1.0 

2.0 

47.0 

47.0 

28.0 

44.0 

28.0 

1.0 

1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountao=R14... 4/16/2O10