## Transmitta l o f Omah aLea dSit e Pain t Stabilizatio n Fil e Folde r Sai d#_P^7^2

- Date : F^7^'7 0 Address : ^ ^ 7 S ~ 7?A^^t^^ay^- h ^1

- Contractor : CityofOmah a Year : ^ ^ / O 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s 6^^or k Writ e U p LXSignedAcces s Agreemen t fo r

subjec t propert y Pre-Renovation for msignedb y Propert y Owne r Pre-Renovation For mfo r

Occupant/Tenant , ifapplicabl e t^Paintin g Agreement/Cit y o f

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

damage o r

t

o replac e plants , etc. ) Renovation Recordkeeping Checklis t signe db y Certifie dRenovato r Propert y informatio n fro mDouglas Count y Assessor' s Offic e 

# y , Othe r

(describe) : & 

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## 3 •~7S^7 ' FOmahaRepresen t Dat e Cit y of Omah aRepresentativ e Signatur e 

## 'Cn^ d 

# ^;^ o Ao/ ^ EP A Representativ e Signatur e 30262474 

# 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 f PURCHASE.OROERNG
. REVISIO N PAG E ^ OMAHA , N E 68183-100 3 FAX # 402-444-542 3 116715 5 0 1
SHI P TO :

CITYOFOMAH A HOUSIN G & COM M DE V R M #111 1 181 9 FARNA M STREE T OMAiHA-N E 6818 3 VENDOR : US A CONSTRUCTIO N SERVICE S IN C 381lbREXELS T BIL L TO ; y OMAHA , N E 68107-385 7 CITY O F OMAH A FINANC 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 605 7 09-JUL-1 0 H HUR T PAYMENTTERM S SHI P VI A F.O.B
.

IMMEDIAT E DESTINATIO N FREIGHTTERM S REQUESTOR/DELIVE R T D CONFIR M T O / TELEPHON E MARUCA , T MARI E \} J > ITE M PAR T NUMBE R / DESCRIPTIO N DELIVER Y DAT E QUANTIT Y UNI T UNI T PRIC E EXTENSIO N • < Al l price s an d amount s o n thi s .orde r ar e expres s » d i n : U S Dolla r NEEDED : 2,650.0 0 N 09-JUL-l O EP APAIN T STABILIZATIOt J PROGRA M GROU P 14 8 11 8 P 5IS t A V i .o SHI P TO : i Addres s a t to p o f pag e NEEDED : 650.0 0 N 09-JUL-l O EP APAIN T STABILIZATIO N PR:0GRA M GROU P 1.4 8 4025 i N44T H S T ! • O SHI P TO : i Addres s at , to p o f pa^ e NEEDED : 1,050.0 0 N 09-JUL-I O EP APAIN T STABILIZATIOt J PROGRAM GROU P 14 8 4215 ; DAVENPOR T S T O SHI P TO : Addres s a t to p o f pag e NEEDED : 750.0 0 N

SHI P TO : Addres s show n above
. I f shipmen t I s delaye d o ran y Item s not available , advis e a t once . Pur ­ chas e orde rnumbe rmus t appea ro n al l Invoices , packages , packin g lists , bil l o f lading , an d correspondence
. 

## Tota l C Continue d 

# 3 SHIPPIN G CHARGE S T O B E PREPAID , I F APPLICABL E AN 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 Omah a I s exemp t fro m Federa l Excis e Taxe s an d th e Nebrask a an d Cit y o f 

# toi^jJ W u Omah a Sale s Taxes
. Federa l I.D
. 476006304;,STAT E I.D
. 01-0316768 ; Fue l Dealers Uc
. 91-0316768 . Cil y Puichaiin g Agen t / 6|iye f

### Plamiin g Departmen t Omaha/Dougla s Civi c Cente r Inspector : Stev e Zivn y181 9 Farna mStreet , Suit e 100 3 Date : 5/12/1 0Omaha , Nebrask a6818 3 (402 ) 444-515 0 Telefa x (402) 546-071 4 

## Name : Gregor y L . Schaneman R . E . 

## Cunningham , RA , RSAM E 

## jSul^Cr Address : 421 5 Davenport Stree t . OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEA D SIT E The Contract bi d document s consis t o f the following sections : •Genera l Responsibilitie s fo r

th e Contracto r

an d Occupant . •Lea d Hazar d Control Plan , Interi mControl o f

Lea d Base d Pain t Hazards . Th e Contracto r Shall : • Compl y wit h HUD' s "Guideline s fo r

th e Evailuatio n an d Contro l o f

Lead-Base d Pain t Hazard s i n Housing. " (Copie s ar e availabl e a t the Plannin g Department. ) •Compl y wit h Standard s calle d fo r

i

n the "Coristruction an d Rehabilitation Specifications , Housin g an d Communit y Developmen t Division , Cit y o f

Omaha, Nebraska. " (Copie s ar e available a t th e Planning Department. ) •Compl y wit h th e Stat e o f

Nebrask aHealt h an d Huma n Service s Regulation an d Licensure , Titl e 17 8 Chapte r

2 3 Lea d Bas e Pain t Regulations . •Coordinat e dail y construction schedule wit h the occupan t •Submi t informatio n cu t sheets fo r

al l substitution s o r

approve d equal s prio r

t

o writte n approva l of th e Construction Specialist . •Repai r

o

r

replac e al l item s damage d o r

disturbed during pain t stabilization activities . •Kee p wor k

sit e an d surrounding are a free 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 times . •Upo n dail y completion o f

work : clea n u p all . rubbish , exces s material , equipment , an d etc. , tha t i s coimecte d wit h the work, an d leave al l part s ofth e wor k

areas i n a neat , sanitary , lea d saf e an d presentabl e condition . •Complet e thi s project withi n 3 0 calenda r

days . Th e Occupant/Owne r

Shal l •Remov e an d stor e awa y an y persona l propert y within twent y (20) fee t ofth e are a t o b e remediated . •Provid e acces s t o electricit y an d wate r

throughou t the pain t stabilization process . •Ensur e tha t all househol d members sla y a t leas t te n fee t awa y from all wor k

area s an d als o kee p al l pet s a t least te n fee t awa y a t al l time s until th e wor k

ha s been , complete d an d th e are ahas paisse d avisua l inspection . _. Initial s (DL >

### 421 5 Davenpor t 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 of th e dwelling t o includ e bu t ho t limite dt o the siding , fascia, eaves , trim , window trim , shutters , gutters , railings , downspouts , doo r

tri m an dfoundation . D O NO T INCLUD E WINDOW S O RMA N DOORS . D O NO T INCLUD E STUCC O SIDING . •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 exterio r

lea dbase dpain t stabilization . •Al l pain t colors t o matc h existin g paint pattern . Prim e an dappl y two coat s o f approve dfinis h coat . (Refe r

t

o Plannin 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 handle da s follow s • • Al l pain t chip s an dcomponen t debri s must b

e doubl e bagge d for 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 . • All lea dpaintedcomponents an ddebri s mus t b

e removed fromth e sit e dail y unles s otherwis e approve db y the construction specialist . •Al l lead-base dpain t debri s (Chips an dcomponents ) must-be dispose do f

i

h amunicipa l soli dwast e landfill . Propert y Owne r

Dat e 

## ^IrL^.,,..^^ ' h-:K-I Q Propert y Owne r

Dat e Witnes s Dat e Occupan t (if applicable ) Dat e Occupan t (ifapplicable ) Dat e

### Exterio r Lead-base dPain t Stabilizatio n ProgramManage db y th e Cit y o f Omah afo r

EP A Regio n 7 Omah aLea dSite Th e purpos e o f thi s progra mi s t o prieven 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 . Which Home s Are Eligible ? •Home s where soi l clean-u p ha s bee n o r wil l b e don e an da n EPA contracto r ha s identifie ddeterioratin g exterio r lead-base dpaint . • •Home s ar e eligibl e onl y b y referral fromth e EPA . Wha t wor k

wil l b e done ? •Loos e an dflakin g lead-base dpain t wil l b e remove dsafel y fromfascia , eaves , siding , trim , windo w trim , doo r tri man dfoundation . •Surface s will.b e prime dan dpainte dt o matc h existin g pain t colo r a s closel y a s possible . What wil l no t b e done ? •Surface s whic h hav e n p pain t wil l not 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 contractor s wil l tes t pain t o n exterio r hous e surface s an dgiv e th e result s to th e City o f Omah aPain t Stabilizatio n Program . •Cit y Constructio n Specialist s wil l prepar e awor k

plan an dcontac t th e property owner for permissio n t o proceed ; •Wor k

wil l b e competitivel y bi db y approved , traine dcontractors . 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 Cit y staf f wil l prioritiz e home s base do n th e presenc e ofchildre n under ag e si x if know n an dth e severity o f th e problem . Pain t Stabilizatio n i s voluntar y an dwil l b e don e onl y v^dt h permissio n o f th e owner . 

### Initial s Gl ^Consen t fo r Acces s t o Propert y RIGH T O F ENTRY T O PREMISE S Granto r (th e propert y owner ) consent s t o an dauthorize 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 : Davtime Phone : Owner Name(s) : Gregor y L Schanema n 850-035 0 .
Addresse s o f Propertie s Covere dby thi s Agreemen t Property Addres s City/State/Zi p Code 421 5 Davenpor t St . Omaha , N E 6813 1

Granto r understand s tha t thi s grant 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 (CERCLAI4 2 USC . & 9601-9675 . o r an v other law . PURPOS E O F ACCES S Th e purpos e o f th e response ' actio n i s t o stabiliz e loos e o r flakin g exterio r lead-base dpain t o n residentia l properties , includin g day-care facilities , where remediatio n o f leadcontaminate dsoi l ha s o r

vyil 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 ont o Grantor' s propert y an dfiirther, provide s th e Grante e th e righ t t o perfor man y an dal l environmental respons e action s an dactivitie s it deem s appropriate . ENVIRONMENTA L RESPONS E ACTION S Th e envirorunental respons e action s t o b e performe do n subjec t propert y ma y includ e th e followin g activities : 1 .

Locatin g equipmen t aiid/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 sample s fromGrantor' s property .

2/12/200 7 (1 )Address : 421 5 Davenpor t St . Consen t for Acces s to Propert y (Pag e 2 ) 3 .

Plannin g an dimplenientin g th e 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 flaking pain t identifie db y EP A usin g lead-saf e method s in complianc e wit h HUD/EPA regulation s an d2 ) repaintin g accordin g t o th e attache dspecifications . TERM . . 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 complet e the envirormiental respons e activities . Upo n completio n o f th e respons e actions , al l right s an d privilege s give n by th e Granto r shal l ceas e o n tha t date , unles s extende dby asubsequen t agreement . AGREEMEN T NO T T O INTERFER E Granto r agree s no t to interfere wit h any ofth e activitie s undertake n by Grante e a t th e Property , tampe r with an y o f Grantee' s property , o r take any action s regardin g th e us e ofth e Propert y whic h vyil l endange r human health o r welfare or th e environment , or allo w other s t o us e th e Propert y in suc h marme r durin g th e termo f thi s consent . Granto r agree s t o provid e notic e andacop y o f thi s agreemen t t o prospectiv e purchasers , lessees , assigns , o r grantee s o f th e propert y o r any 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 an y transfer o f ownershi p right s to 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 an y an dall samplin g 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 ofth e propert y prio r t o remediatio n an dindicate 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 for th e abov e state dpain t stabilization , th e Grante e agree s tha t sai dpropert y wil l b e restore d a s nearl y a s possibl e t o it s original state an dconditio n a s foundimmediatel y precedin g th e beginnin g o f activitie s authorize db y thi s Agreement , follo\yin g completio n o f th e respons e activities .

2/12/200 7 (2 )Address : 421 5 Davenpor t St. , Omaha , NE , 6813 1 CURREN T CONDITIO N / PROPOSED RESPONS E ACTIVITIE S Th e purpos e o f thi s sectio n i s t o provid e amutual agreemen t a s t o condition s o f propert y prior t o contracto r activities . Thi s wil l als o serv e a s documentatio n fo r th e purpos e o f assurin g tha t restoratio n activitie s ar e complete dt o th e satisfactio n o f th e propert y owner an dth e Unite dState s Environmental Protectio n Agenc y (EPA) . Item s t o b e remove dbv propertv owner prio r t o th e respons e activities : I . 2 . 3 . 4 . 5 . Item s NO T to b e remove db y contracto r durin g removal activities : 1 . • 2

­ 3 . • • 4 . 5 . ADDITIONA L COMMENTS :

I hav e rea dth e foregoin g documen t an dunderstan dthat it i s a n agreemen t grantin g permissio n t o th e Grante e to ente r th e abov e describe dpremise s fo r th e purpos e o f conductin g environmental respons e activities , an dI agre e t o it s term s an dconditions . I acknowledg e tha t I hav e receive dth e pamphle t "Renovat e Right" . Grantor' s Signature : -^Adk.ayr,<fyy, ^ '_

_Dat e ir:2.-7 0

(3 ) 2/12/200 7

### Dougla s Count y Accoun t Information Pag e 1 of 3 Dougla s County , Nebrask a Propert y Recor d - R144531000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e Q scal e 0-5 0 f t wes t o f 52n d S t - Vle W O H Ma p Informatio n i s vali d a s o f 2010-4- 5 Treasurer' s Ta x Repor t Ne w Featur e r * r > •?•, Aut o Sale s Searc h Owne r SCHANEMA N GREGOR Y L 50 5 N 4 1 AV E # 2 OMAH A N E 68131-000 0 Propert y Informatio n Ke y Number : 453 1 000 0 1 4 Accoun t Type : Multipl e Re s Parce l Number : 144531000 0 Parce l Address : 421 5 DAVENPOR T S T OMAH A N E 68131-000 0 Lega l Description : KILB Y PLfliC E LO T 2 0 BLOC K6 1/ 2 VA C ALLE Y & E 2 5 N 31. 2 F T LT 1 9 & W 3 3 E 5 8 N 1 0 FT LT 1 9 & E 1/ 2 LT 2 0 Valu e Informatio n 200 9 200 8 200 7 200 6 200 5 200 4 Lan d $12,400.0 0 $12,400.0 0 $12,400.0 0 $12,400.0 0 $12,400.0 0 $12,400.0 0 Improvemen t $125,000.0 0 $125,000.0 0 $125,000.0 0 $90,000.0 0 $90,000.0 0 $90,000.0 0 Tota l $137,400.0 0 $137,400.0 0 $137,400.0 0 $102,400.0 0 $102,400.0 0 $102,400.0 0 Sale s Informatio n Sale s Date : 2001-04-2 4 Dee d Type : Price : Granto r Q C $89,000.0 0 Book : 217 9 Page : 24 1

Grantee : Valld/lnvalld : Vali d Excl Reason : usio n CORRECTIO N O F TITL E Sale s Date : 1995-08-3 1 Deec f Type :

Price : Grantor : $76,650.0 0 Book : 201 5 Page : 42 9



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R14.. . 4/16/201 0Dougla s Count y Accoun t Informatio n Pag e 2 o f 3

Grantee : 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 1 4968. 0 1. 0 72. 0 69. 0 N o Improvemen t Informatio n Buildin g 1 421 5 Davenpor t Duple x Tw o Stor y

u r

img'Mlklwai l
. • IJ L -JE S

CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 2192. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : En d Condition : Averag e

Buil t As : Duple x Tw o Stor y Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 12. 0 Exterior : Fram e Stucc o Units : 2. 0 Interior : Drywal l Baths : 2. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 6. 0

Roo f Type : Hi p Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 192 2 0 % 192 2 8 8 Deta/ 7 Typ e Detai l Descriptio n Unit s Ad d O n Unfinishe d Atti c W/floo r 1123. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 1118. 0 http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R14. . . 4/16/201 0

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

Basemen t Basemen t Fixtur e Fixtur e Porc h Porc h Porc h Porc h Porc h Use r Use r Minima l Finis h Outsid e Entranc e Bas e Fixture s . , Bat h Ful l Cvr d Woo d Dec k Cvr d Woo d Dec k Enc I Soli d Wal l Enc I Soli d Wal l End
. Soli d Wal l 2 1/ 2 sty unfinishe d verifie d w/owne r 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.. . 4/16/2O1 0