## Transmitta l o f

Oniah aLea dSite Pain t Stabilizatio n Fil e Folde r Said #^716-7- ? Date : ^",^7-/ 0 Address : H^ l S •33 > S-7

- Contractor : Cit v o f

Omah aYear : «^< ^ 7 0 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s ^i^/Wor k Writ e U p ^•^Signe dAcces s Agreemen t fo r

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

OccupantTenant , ifapplicabl e J^ . Paintirig 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 \y ^ Propert y informatio n fro mDouglas Count y Assessor' s Offic e ^Other (describe) : r/>AfQ. S

Cit y of Omah aRepresentativ e Signattir e Dat e
EP A Representativ e Signatur e 7 Dat e 3026246 7 

# llll l Superfun d1 

# CITYOFOMAH A PURCHASIN G - ROO M 100 3 

### Purchas e Orde r

181 9 FARNA M STREE T REVISiC N PAG E PURCHAS E ORDE R NO . OMAHA . N E 63183-100 3 116882 0 0-

FAX # 402-444-542 3

J & C PAINTIN G LL C VENDOR : 161 6 VINTO N S T OMAHA , N E 6810 7 ^HI P TO : CITYOFOMAH A HOUSIN G & COM M DE V RM#111 1 181 9 FARNA M STREE T OMAHA,N E 6818 3
> . <

BIL L TO :

CIT Y 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 10214 0 22-SEP-1 0 H HUR T PAYMENTTERM S SHI P VI A F.O.B .

IMMEDIAT E • DESTINATIO N FREIGH T TERM S REQUESTOR/DELIVE R T O (:ONFIR M T O /

TELEPHON E ZIVNY , STEVE N D ' (402)917-268 9

> • < 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 5 d i n : U S Del]a r NEEDED : 1,375.0 0 N 23-SEP-l O EP APAIN T STABILIZATIOt J PROGRA M GROU P 17 2 1141 ! S 33R D S T i O SHI P TO : ; Addres s a t to p o f pag e

SHI P TO : Addres s show n above . I f shipmen t i s delaye d o ran y jtenn s no t 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 ( ^-^^so o ) 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 City o f Omah a I s exemp t fro m Federa l Excis e Taxe s an d th e Nebrask a an d City o f Omah a Sale s Taxes . Federa l I.D . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealers Lie . 91-0316768 . Cil y Puithasin g Agenlt f B uPlannin g Departmen t Omaha/Dougla s Civi c Center . Inspector : Stev e Zivn y 181 9 Farna mStreet , SuitellO O Date : 8/18/1 0 Omaha , Nebrask a6818 3 (402)444-515 0 Telefa x (402 ) 444-614 0 

## Name : Kevi n R . Snethen R . E . Cunningham , RA , F.SAM E Cit y o f Oinah a Directo r Ji mSuttle , Mayo r 

## Address : 114 1 S SS'^Street OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEA D SIT E Th e Contract bi ddocuments consis t ofth e followin g sections : •General Responsibilitie s fo r th e Contracto r an dOccupant . •Lea dilazar dContro l Plan , Inteii mContro l o f Lea dBase dPain t Hazards . Th e Contracto r Shall : •Compl y wit h HUD' s "Guideline s for th e Evaluatio n an dContro l o f Lead-Base d Paint Hazard s in Housing. " (Copie s ar e availabl e a t th e Plannin g Department. ) •Compl y wit h Standard s calle dfo r in tli e "Consfructio n an dRehabilitatio n Specifications , Housin g an dCbmmuriit y Developmen t Division , Cit y o f Omaha , Nebraska. " (Copie s are availabl e a t th e Plannin g Department. ) •Compl y wit h th e State ofNebrask aHealth Mi dHuma n Service s Regulatio n and Licensure , Titl e 17 8 Chapte r 2 3 Lea dBas e Pain t Regulations . •Coordinat e dail y constructio n schedul e w;it h th e occupan t •Submi t informatio n cu t sheet s fo r al l substitution s or approve dequal s prio r t o writte n approval o f th e Constmctio n Specialist . •Repai r b r replac e al l itein s damage do r disturbe ddurin g pain t stabilizatio n activities . •Keep wor k

sit e ari dsurtouridin g are afree fro maccumulation s o f wast e material s or

rubbis h cause db y ,th e wor k

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

area s i n a neat, , sanitary , leads.af 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 personal property withi n twenty (20 ) feet o f th e are a t o b e remediated . •Provid e acces s to electricity an dwate r throughou t the pain t stabilizatio n process . •Remov e voluntee r tree s an dvegetatio n fro mth e dri p lin e o f th e roof , an dcu t bac k shrub s an dbushe. s atleas t tw o fee t fro mth e house . •Ensure that al l househol dmember s stay , a t leas t te n feetawa y fro mal l wor k

area s an dalso.keep.al l pets.a t leas t te n feet awa y at;al l time s unti l th e wor k

ha s been coriiplete dan dth e are aha s passe davisual inspection . Initial s114 1 8 33.' " S t (Continued ) 

## Lea dHazar dContro l Pla n Interi mContro l o f

Lea dbasedPain t Hazard s Pain t Stabilizatio n •Stabiliz e al l previousl y painte dexterio r wood , brick , metal , concret e surface s o f th e dwellin g t o includ e bu t no t limite dt o th e siding , fascia , eaves , trim , windo w trim , shiitters , gutters , railings , porc h floor, downspouts , doo r tri man dfoundation . D O NO T INCLUD E MAN DOOR S O RWINDOWS . D O NO T INCLUD E CEMENTITIOU S SIDING . • Prepar e an dpain t all previousl y painte dsurface s b y followin g th e Saf e Wor k

Practice s protoco l for EP A exterio r lea dbase dpain t stabilization . • Al l pain t color s t o matc h existin g pain t pattem . Prim e an dappl y tw o coat s o f approve dfinish coat . (Refer 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 mus t b e doubl e bagge dfo r disposal . •Clean pain t chip s fro mgroun daroun dperimete r o f dwellin g befor e starting , durin g an dafte r th e project . •Al l lea dpainte dcomponent s an ddebri s mus t b e remove dfro mth e sit e dail y unles s otherwis e approve db y th e constructio n specialist . . •Al l lead-base dpain t debri s (chip s an dcomponents ) mus t b e dispose do f i n amunicipalysoli dwaste landfill . 

# D. I AUci ^ Property Owner Dat e .Propert y Owner . Dat e Witnes s Dat e Occupan t (ifapplicable ) Dat e Occupan t (i f applicable )Dat e

### Exterio r Lead-base dPain t Stabilizatio n ProgramManage db y th e Cit y o f Omah afor EP A Regio n 7 Omah aLea dSit e Th e purpos e o f thi s progra mi s t o preveri 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 wher e soi l clean-u p ha s bee n or wil l b e don e anda n EP A confractorha s identifie ddeterioratin g exterio r lead-base dpaint . •Home s are eligibl e onl y b y referral fro mtli e EPA . Wha t wor k

wil l b e done ? •Loos e an dflaking lead-base dpain t wil l b e remove dsafely fro mfascia , eaves , siding , trim , windo w trim , doo r tri man dfoundation . •Surface s wil l b e prime dan dpainte dto tnatc 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 Constructio n Specialist s wil l prepar e awor k

plan an dcontac t th e property owner fo r permissio n to 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 o f childre n under ag e si x i f 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 wit h permissio n ofth e owner . 

### Initial s ^j)3 >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 enter an dperform

certai n environmental respons e activitie s upo n th e followin g describe dpremises : Owner' s Name : Davtime Phone : Owner Name(s) : Kevi n RSnethe n 709-253 4

- . . . . - . • . Addresse s o f Propertie s Covere dby thi s Agreement Propert y Addres s City/State/Zi p Code 114 1 S . 33t h St . Omaha , N E 6810 5

Granto r understand s tha t thi s grant doe s no t limi t EPA' s righ t o f acces s under th e Comprehensiv e Environmenta l Respons e an dLiabilit v Ac t CCERCLA') . 4 2 USC . & 9601-9675 . o r anv 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-base dpairi t o n residentia l properties , includin g day-care facilities , where remediatio n o f leadcontaminate dsoi l ha s o r

wil l tak e place . Samplin g o f soi l ma y b e conducted . Thi s consent shal l allo w Grante e onto Grantor' s propert y andfiirther, provide s th e Grante e th e righ t t o perfor man y an dal l envirorunental respons e action s an dactivitie s i t deem s appropriate . ENVIRONMENTAL RESPONS E ACTION S Th e environmental respons e action s t o b e performe don subjec t propert y ma y includ e th e followin g activities : 1 .

Locatin g equipmen t and/o r machinery o n subjec t propert y i n preparatio n fo r an dir i th e cours e o f the respons e activities . 2 .

Obtainin g sample s fro mGrantor' s property .

2/12/200 7 (1 )Address : 114 1 S . 33t h St . Consen t fo r Acces s t o 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 wil l includ e 1 ) removal o f loos e o r flaking pain t identifie db y EPA usin g lead-saf e method s i n 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 agreement shal l b e operabl e fo r th e perio do f tim e it . take s to complete th e environmental 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 c 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 interfer e wit h any o f th e activitie s undertake n by Grante e a t th e Property , tampe r wit h an y o f Grantee' s property , o r tak e ari y action s regardin g th e us e o f th e Propert y whic h wil l endange r huma n health o r welfar e o r th e environment j o r allo w other s t o us e th e Propert y i n suc h marme r durin g th e termo f thi s consent . Granto r agree s t o provid e notic e an dacop y o f thi s agreemen t to prospectiv e purchasers , lessees , assigns , o r graritee s o f th e propert y o r any portio n p f it . Granto r agree s t o provid e 30-da y notic e t o EP A prio r to any fransfer 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 an y an dal l samplin g and/o r analysi s resultin g fro mGrantee' 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 property 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 that sai dpropert y wil l b e restore d a s nearl y a s possibl e t o it s origiria l stat e an dconditio n a s foun dimmediatel y precedin g th e begirmin g o f activitie s authorize db y thi s Agreement , followin g completio n o f th e respons e activities .

2/12/200 7 (2 )Address : 114 1 S . 33t h St. , Omaha , NE , 6810 5 CURREN T CONDITIO N / PROPOSE D RESPONS E ACTIVITIE S Th e purpos e o f thi s sectio n i s to provid e amutual agreemen t a s t o condition s o f propert y prior t o confracto 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 db v propert v owne r prio r to th e respons e activities : 1 . . 2 . 3 . 4 . 5 . Item s NO T to b e remove db v contracto r durin g removal activities : 1 . 2 . 3 . 4 . 5 . • • • ADDITIONA L COMMENTS :

I hav e readth e foregoin g documen t an dunderstan dthat i t i s a n agreement grantin g permissio n t o th e Grante e t o 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 : "^^^^^-^^/C , JTu X D^t e 2_iPi{M^\ ^

(3 ) VYi/m nDougla s Count y Accoun t Informatio n Pag e 1 of 2 Dougla s County , Nebrask a Propert y Recor d - R123637000 D Prin t Repor t NE W Featur e - Patce l Dimension s avallabi a Q scal e 0-5 0 ft wes t o f S2n d S t - VJe W O O Ma p Infonnatio n i s vali d a s o f 2010-4- 5 Treasurer' s Ta x Repor t Ne w Featur e r* : iir * si s Aut o Sale s Searc h Owne r SNETHE N KEVI N R 114 1 8 3 3 S T OMAH A N E 68105-000 0 Propert y Informatio n Ke y Number : 363 7 000 0 1 2 Accoun t Type : Residentia l Parce / Number : 123637000 0 Parce l Address : 114 1 8 3 3 S T OMAH A N E 68105-000 0 Lega l Description : HANSCO M PLAC E LO T 1 5 BLOC K7 W 168. 8 FT 5 0 X 168. 8 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $7,100.0 0 $109,800.0 0 $116,900.0 0 200 8 $7,100.0 0 $109,800.0 0 $116,900.0 0 200 7 $7,100.0 0 $109,800.0 0 $116,900.0 0 200 6 $7,100.0 0 $77,000.0 0 $84,100.0 0 200 5 $7,100.0 0 $77,000.0 0 $84,100.0 0 200 4 $7,100.0 0 $77,000.0 0 $84,100.0 0 Sale s Informatio n Sale s Date : 2006-04-1 1 Dee d Type : W D Booilr : 200 6 Page : 04089 7 Price : $119,000.0 0 Grantor - Eri c L War d ETA L Grantee : Kevi n R Snethe n Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widti i Vacan t 0.1 9 8400. 0 1. 0 168. 0 50. 0 N o Improvemen t Informatio n http://douglasne.mapping-online.corii/DouglasCoNe/static/accountinfo.jsp?accountno=Rl2. „ 4/16/201 0Dougla s County Accoun t Informatio n Pag e 2 of 2
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CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1840. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Goo d

Buil t As : 2 1/ 2 Stor y Unfi n Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 10. 0 Exterior : Fram e Shingl e Units : 1. 0 Interior : Drywal l Baths : 2. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 6. 0

Roo f Type : Gabl e Stories : 2. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle 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 189 5 0 % 189 5 11 5 Deta/ 7 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 Basemen t Bsmn t Bloc k 8 f t 904. 0 Fixtur e Additiona l Fixture s 2. 0 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 80. 0 Porc h Enc I Soli d Wal l 80. 0 Porc h Sla b Roo f Ceilin g 228. 0

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountoo=R12. . . 4/16/201 0