## Transmitta l o f

Oinah aLea d Sit e Pain t Stabilizatio n Fil e Folde r Said #^^7^ ' Date : ^^-^-/ 0 Address : ^^i^P- ^ 7 0 cglcS^ S 7 ^ Contractor ; Cit v o f Omah a Year : ^f l /€ > 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s Wor k

Writ e U p Signe d Acces s Agreemen t fo r

subject propert y Pre-.Renovatio n for msigne d b y Propert y Owne r Pre-Renovation For mfo r

Occupant/Tenant , ifapplicabl e jy/^Paintin g Agreement/Cit 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 signed by Certifie d Renovato r l^Propert V informatio n fi"omDougla s Count y Assessor' s Offic e j/other (describe) : {fi t 

## )0f0 3 7g>- ^ ^^» ^ 

### j'-/r-7j u Cit y o f Omah aRepresentativ e Signatur e Dat e 

# LJor v 

# 3wU o 1 ^ EP A Representativ e Signatur e 

### ~t Dat e ~ 3026245 5 

# HIHIIIIIHI i Superfun d1 

## C ; Y O F OMAH A

PURCHASIN G - ROO M 100 3 

### Purchas e Orde r 181 9 FARNA M STREE T PAG E REVISIO N PURCHAS E ORDE R NO . OMAHA . N E 68183-100 3 116475 2 FAX # 402-444-542 3 SHIPTO : CITYOFOMAHA . HOUSIN G & COM M DE V R M #111 1 131 9 F.ARNA M STREE T 0MAHA,N E 6818 3 BRA D BATE S PAINTIN G VENDOR : > . 314 1 s o 52 ST BIL L TO : • < CIT Y O F OMAH A FINANC E OMAHA , N E 6810 6 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 7299 0 05-APR-1 0 HHUR T PAYMEN T TERM S SHI P VI A F.O.B .

NE T 3 0 DAY S DESTINATIO N FREIGH T TERM S REQUESTOR/DELiVE R T O CONFIR M T O /

TELEPHON E MARUCA . T MARI E (402 ) 551-092 7 < 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 on . thi s orde r ar e expres s ; d i n : U S Doi:a r NEEDED : 1,925.0 0 N 07,-APR-l O EP APAIN T STABILIZATIO N PROGRA M GROU P 8 1 262 2 N 2 5T H S T • o SHI P TO : i . Addres s a t to p o f pag e

SHI P TO : Addres s show n above . I f shipmen t i s dielaye d o ran y item s no l available , advis e at 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 . 1,925.0 0 

## Tota l C 

# J SHIPPIN G CHARGE S T O BE-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 of.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 

### AdiL.i.-^«.N-- ^ Oniah a Saie s Taxes . Federa l I.D . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealers Lie . 91-0316768 . Cil y Piiichasin g Aar i / Buye r ^Plannin g Departmen t Omaha/Dougla s Civi c Cente r Inspector : To mRoz a181 9 Farna mStre« , Suit e 100 3 i-N„4.„ . 0/ 1 A/ 1 r \Omaha , Nebrask a6818 3 Date : .2/10/1 0 (402)444-515 0 Telefa x (402) 546-071 4 

### Name : Lucill e Wood s R.E.Gunningham,RA , F.SAM E 

### Ji mSuttle,Mayo r Address : 262 2 N 2 5 S t ''^'^ ' OMAH A EXTERIO R PAIN T STABILIZATIO N PROGRA M F O R TH E EP A OMAH A LEA D SIT E Th e Contrac t bi d document s consis t ofth e followin g sections: . • . .Genera l Responsibilitie s fo r

th e Contracto r

an d Occupant . oLea d Hazar d Contro l Plan , InterimContro l o f

Lea d Base d Pain t Hazards . 

### Th e Contracto r Shall : •Compl y wit h HUD' s "Guideline s fo r

the Evaluation an d Control o f

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

in th e "Construction an d Rehabilitation Specifications , Housin g an d Communit y Developmen t Division , Cit y o f

Omaha, Nebraska. " (Copie s ar e availabl e a t the Plarmin g Department. ) •Compl y wit h the Stat e ofNebrask aHealt h an d Huma n 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 constructip n schedul e wit h the occupan t •Subrni t information cu t sheet s fo r

al l isubstitution s o r

approve d equal s prio r

t

o writte n approva l ofth e Constructio n Specialist . •Repai r

o

r

replac e al l item s damaged o r

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

sit e an d surrounding are a free fromaccumulation s o f

wast e material s o

r

rubbish cause d b y th e wor k

a

t all times . •Upondail 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 leav e all part s ofth e wor k

area s i n a neat , sanitary , lea d saf e an d presentabl e condition . «Coniplctethisprojec t withi n 3 0 calenda r

days . Th e Occiipant/Owne r

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

throughou t th e pain t stabilizatio n process . •Ensur e tha t al l household member s sta y a t leas t ten fee t awa y fromal l wor k

area s an d als o kee p al l pet s a t leas t ten fee t awa y a t all times unti l th e wor k

ha s bee n complete d and the are aha s passed avisua l inspection . ^ . , Initial s ^ > ^ '262 2 S f

2 5 S t (Continued) 

### Lea d Hazar d Contro l Pla n Interi mContro l o f Lea d base d Pain t Hazard s Pain t Stabilizatio n
, • Prepar e an d paint all previousl y painte d exterior surface s ofth e dwellin g to include bu t not limite d t o th e fascia , eaves , trim , windo w trim , doo r

tri m an d foundation , jncludi e al l siding . D o no t includ e door s o r windows . •Prepar e an d pain t al l previously painte d surface s b y following th e Saf e Wor k

Practice s protoco l fo r

EP A exterior lea d base d pain t stabilization , • ' Al l paint color s t o matc h existin g pain t patteim . Prim e and apply tw o coat s o f

approve d finish coat . (Refe r

t

o Plarmin g Dept . approved paint list) •I F SPRAYED , ON E COA T SHAL L B E BACK-BRUSHED O R BACK-ROLLED . 

### Lea d Base d Paint Wast e Lead-base d pain t wast e mus t b e handle d a s follow s •Al l pain t chip s an d componen t debri s mus t b e doubl e bagged fo r

disposal . •Clea n pain t chip s fro mgroun d aroun d perimete r

o f dwellin g befor e starting , during an d afte r

the project . • All lea d painte d component s an d debri s mus t b e removed fro mth e sit e daily unles s otherwis e approved b y the constructio n specialist . oAl l lead-based pairi t debri s (chip s an d components ) mus t b e dispose d o f i

n amunicipa l soli d vvast e landfill . 

### ^^^yCUi<.£A:: > /^^^zft^d^i ^ Propert y Owne r 

### J^i^-'fiS i Dat e Propert y Owne r Dat e Witnes s Dat e Occupan t (ifapplicable ) Dat e Occupan t (ifapplicable ) Dat e Witnes s Dat e

### Exterio r Lead-base d Pain t Stabilizatio n Progra mManage d b y th e Cit y o f Omah afo r

EP A Regio n 7 Omah aLea d Sit e The purpos e o f

thi s progra mi s t o preven t yard s wher e lead-contaminate d soil i s cleaned u

p frombecoming re-contaminate d b y deterioratin g exterior lead-base d paint . Thi s i s no t ahom e repai r program . Whic h Home s Ar e Eligible ? •Home s wher e soil clean-u p ha s bee n o r

will b e done and a n EP A contractor ha s identified deterioratin g exterior lead-base d paint . •Home s ar e eligible.only b y referra l fro mthe EPA . Wha t wor k

will be done ? •Loosean d flaking lead^base d paint wil l b e removed safel y fro mfascia , eaves , siding , trim , windo w trim , doo r

tri man d foundation . •iSurfaces will b e primed an d painte d t o match existin g pain t color a s closely a s possible . Wha t wil l no t b e done ? •Surface s which hav e n o pain t will no t b e treated . •Window s o r

door s will no t b e included . •Rotten wood will no t b e replaced . . •N o housing repair will be done. . Wh o wil l perfor mth e work ? •EP A contractor s wil l tes t pain t o n exterior hous e surface s and giv 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 will prepar e awork.pla n an d contac t th e propert y owne r

fo r

permissio n t o proceed . •Wor k

will b e competitivel y bid b y approved , traine d contractors . Whe n wil l th e wor k

b e done ? • Thi s progra mbega n i n 2007-an d will continu e fo r

severa l years . •Th e Cit y staf f

will prioritiz e home s base d o n th e presenc e ofchildre n unde r

ag e si x if know n an d th e severit y o f

th e problem . Pain t Stabilizatio n i s voluntar y an d will be don e onl y wit h permissio n ofth e owner . Initial s ^ ^ 'Consen t fo r

Acces s to Propert y RIGH T O F ENTR Y T O PREMISE S Granto r

(th e propert y owner ) consent s t o an d authorize s theUnite d State s Environmenta l Protection Agenc y (USEPA ) o r

it s authorize d representatives , collectively th e Grantee , t o ente r

an d perfor m certai n environmenta l respons e activitie s upon th e followin g describe d premises : Owner' s Name : Davtim e Phone : Owne r

Name(s) : Lucill e Woods 402-714-869 9
Addresse s o f

Propertie s Covere d b y thi s Agreemen t Propert y Addres s City/State/Zi p Cod e 262 2 N . 25t h St . Omaha , N E 6811 0

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 Comprehensive Environmenta l Respons e an d Liabilit v Ac t fCERCLA l 4 2 USC . & 9601-9675 . o r

an v othe r

law . PURPOS E O F ACCES S The purpos e o f th e respons e actio n i s t o stabiliz e loos e o r

flaking exterior lead-base d pain t o n residentia l properties , includin g day-car e facilities , wher e remediatio n o f lea d contaminated soil has o

r

will tak e place . Sampling o f soi l ma y be conducted . Thi s consen t shal l allo w Grantee ont o Grantor' s propert y and fiirther, provide s th e Grante e th e righ t to perfor man y and al l environmenta l respons e action s an d activitie s i t deem s appropriate . ENVIRONMENTA L RESPONS E ACTIONS Th e environmenta l respons e action s t o b e performe d on subject propert y ma y includ e the followin g activities : 1 .

Locating equipmen t and/o r

machiner y o n subjec t propert y i n preparatio n fo r

an d i n th e cours e o f th e respons e activities . 2 .

Obtaining sample s fro mGrantor' s property .

2/12/200 7 (1 )Address : 262 2 N . 25t h St . Consen t fo r

Acces s t o Propert v (Pag e 2 ) 3 .Plarmin g an d implementing the respons e actio n o n th e Grantor' s property . Thi s will includ e 1 ) remova l o f

loos e or flaking pain t identified b y EP A usin g lead-saf e method s in cornplianc e wit h HUD/EP A regulation s an d 2 ) repainting according to th e attache d specifications . TER M Thi s acces s agreemen t shall b e operable fo r

the perio d o f tim e i t take s to complet e the 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 th e Granto r

shal l ceas e on tha t date , unles s extende d b y asubsequen t agreement . AGREEMEN T NO T TO INTERFER E Granto r

agree s not to interfer e wit h an y o f

th e activitie s undertaken b y Grantee a t th e Property , tampe r

v^t h an y o f Grantee* s property , o r

tak e an y action s regarding th e us e ofth e Propert y whic h will .endange r

huma n healt h o r

welfar e o r

the environment , o r

allo w other s to us e the Propert y i n suc h manne r

durin g the ter mo f

thi s consent . Granto r

agree s t o provide notic e an d acop y o f thi s agreemen t to prospectiv e purchasers , lessees , assigns , o r

grantee s ofth e propert y o r

an y portio n o f it . Granto r

agree s t o provide 30-da y notic e t o EP A prior t

o an y transfe r

o f ownershi p right s to the property . SAMPLIN G RESULT S Grantee agree s t o provide Granto r

wit h th e result s o f

an y an d all sampling and/or analysi s resulting fro mGrantee' s respons e activitie s on.th e property . PRIO R CONDITIONS AGREEMEN T Th e granto r

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 to be removed b y the Granto r

befor e activitie s commence . RESTORATIO N O F PROPERT Y Excep t fo r

th e abov e state d paint stabilization , th e Grantee agree s tha t sai d propert y will be restored as nearl y a s possibl e to it s origina l stat e an d conditio n as foun d immediatel y preceding th e beginning o f activitie s autiiorize d b y thi s Agreement , followin g completio n o f th e respons e activities .

(2 )2/12/200 7Address : 262 2 N . 25t h St. , Omaha , NE , 6811 0 CURREN T CONDITIO N / PROPOSE D 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 contractor activities . Thi s wal l als o serv e a s documentation fo r

the purpos e o f assurin g tha t restoratio n activitie s ar e completed t o th e satisfactio n o f the propert y owne r

and the Unite d State s Environmenta l Protectio n Agenc y (EPA) , Item s t o b e removed b v propert y owne r

prio r

t

o the respons e activities : 1 . 2 . 3 . . • 4 . 5 . , • • Item s NO T t o b e removed b v contracto r

durin g remova l activities : 1 . 2 . 3 . • . 4 . • 5 . , • ADDITIONA L COMMENTS : ^KCiu/t ^ Cux^raAf ^ / H t>^ k

I have rea d the foregoin g documen t an d understand tha t i t i s a n agreemen t grantin g permissio n t o the.Grante e t o ente r

the abov e describe d premise s fo r

the purpos e o f

conductin g environmenta l respons e activities , an d I agree t o it s term s an d conditions . I acknowledg e tha t I hav e receive d th e pamphle t "Renovat e Right" . Grantor' s Signature : 

## k/^gn^^i_ ^ Dat e ^-/S^/ 0

n,) . mmoo iDougla s Coiuit y Accoun t Informatio n http://douglasne.mapping-online.conVDouglasCoNe/static/accountinfo. , Doijglai s County , Nebrask a Propert y Recor d - R200368000 2 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f 52n d S t - VIC W O H Informatio n i s vali d a s o f Ma p 2009-12-3 1 Treasurer' s Ta x Repor t Ne w Featur e • * -• . ^ Aut o Sale s Searc h OWne r WOOD S LUCILL E 262 2 N 2 5 S T OMAH A N E 68110-000 0 Propert y Informatio n Ke y Numbe r 036 8 000 2 2 0 Accoun t Type : Residentia l Parce l Number : 200368000 2 Parce l Address : 262 2 N 2 5 S T OMAH A N E 68110-000 0 Lega l Description : PATRIC KPLAC E LO T 2 BLOC K2 AL L LT S 1 & 2 9 0 X 11 0 Vcilu e 200 9 200 8 200 7 200 6 200 5 200 4 Informatio n Lan d $2,800.0 0 $2,800.0 0 $2,800:0 0 $2,800.0 0 $2,800.0 0 $2,800.0 0 Impro vemen t $60,300.0 0 $60,300.0 0 $60,300.0 0 $60,300.0 0 $60,300.0 0 $14,700.0 0 Tota l $63,100.0 0 $63,100.0 0 $63,100.0 0 $63,100.0 0 $63,100.0 0 $17,500.0 0 Lan d Informatio n Acre s S F U 0.2 2 9900. 0 nit s Dept h 1. 0 110. 0 Widt h 90. 0 Vacan t N o Iniprovemen t Buildin g 1 Informatio n

I o f 2 1/25/201 0 9:2 8 A MDoygla s Count y Account Informatio n http://douglasne.mapping-oniine.com/DouglasCoNe/static/accountinfo. .

2eG2N25S T Roo f OMacIl M 312. 0 Sq . Ft . 

# t i r »

t 1/ 2 STOR Y FI N anrnn t Bloc k 9 1 864. D S q Ft . CLIC KT O ENI.ARG E IMAG E Squar e Footage : 1760. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Fai r

Buil t As : 1 1/ 2 Stor y Fi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 7. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 5 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Hip/Gabl e Stories : 1. 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 190 8 198 8 0 % 190 8 10 2 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Bric k Venee r 200. 0 Applianc e Allowanc e 1. 0 Applianc e Securit y Syste m 1. 0 Basemen t Bsmn t Bloc k 8 f t 864. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Fixtur e Bat h Hal f 1. 0 Garag e Detache d 312. 0 Porc h Enc I Scree n 176. 0 Use r ASBESTO S 1. 0

2 o f 2 1/25/201 0 9:2 8 AM