## Transmitta l o f

Omah aLea dSite Pain t Stabilizatio n Fil e Folde r Said#^/35> ^ Date : "^^ P 52-/ 0 Address : /^S 3 J S . 3 V Sf

Contractor : CityofOmah aYear : '^ 0 ^ O 

## Pain t Stabilizatio n Propert y Fil e Folde r Documents . l^Wor k Writ e U p \ y Signe dAcces 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 I x Painting Agreement/Cit y o f

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

dariiage o r

t

o replac e plants , etc. ) Renovation Recordkeepin g Checklis t signedb y Certifie dRenovato r f^nPropert V informatio n fro mDouglas Count y Assessor' s Offic e _U f Othe r

(describe) : nrlafa ^ 

## Jtr^* ^ 7^>i ^ 3-^^"-7:: ^ Cit y o f

Omah aRepresentativ e Signatur e Dat e EP A Representativ e Signatur e / Dat e 3026246 8 

# IHI i Superfun d

## CIT Y O F OIVIAH A PURCHASIN G - ROO M 100 3 

### Purchas e L )rae r 181 9 FARNA M STREE T REVISIO N PAG E . PURCHAS E ORDE R NO . OMAHA , N E 68183-100 3 0 1 • 11684S 7 FAX#'402-444-542 3

G& M .PAINTIN G C O IN C VENDOR : 1370 7 CUMIN G S T OMAHA , N E 6815 4 SHI P TO : CITY O F OMAH A HOUSIN G & COM M DE V R M #111 1 131 9 FARNA M STREET ' OMAHA.N E 6818 3
> .

BIL L TO :

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 INSTRUCTIONS.BELOW ) CUSTOME R ACCOUN T NO . VENDO R NO . DAT E O F ORDER/ BUYE R REVISE D DATE/7BUYE R 9129 8 07-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 CONFIR M T O / TELEPHON E ZIVNY . STEVE N D > ITE M PAR T NUMBE R / DESCRIPTIO N DELIVER Y DAT E QUANTITY UNI T Al l price s an d amount s o n thi s orde r are . expres s NEEDED : 05-SEP-l O EP APAIN T STABILIZATIOt * PROGRA M GROU P 16 6 1033 ; S 3iS T S T • O SHI P TO : i Addres s a t to p o f pag e NEEDED : 05-SEP-l O EP APAIN T STABILIZATIO N PROGRA M GROU P 16 6 90 8 B 36T H S T O SHI P TO : Addres s a t to p o f pa^ e UNI T PRIC E EXTENSIO N =d i n . - U S D.ol J a r 1,290.0 0 N

1,315.0 0 N - <



# 7

SHIPTO : Addres s show n above . I f shipmen t I s delaye d o ran y Item s no t 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 . 2,605.0 0 

## Tota l C 

# J SHIPPIN G CHARGE S T O B E PREPAID , I F APPUCABL E AN D ADDE D T O INVOICED , cop y t o b e fur ­ nishe d wit h invoice . TAX 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 Nebraska an d Cil y 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 Puichasin g Agcn/ / Buye r

### Plannin g Department Inspector : Steve Zivn y

t^J^^^^ m Date : 6/21/1 0 Omaha , Nebrask * 6818 3 (402)444-515 0 Telefa x (402 ) 546-071 4 

## Name : AlexKudenJr . _„_. . „ . PC^M P R . E . Cunningham , RA , F.aAM t CityofOmah aAddrCSS I 103 3 S 3 1 StrCC t Director Ji mSuttle , Mayo r 

## OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEA D SIT E Th e Contrac t bi d document s consis t o f th e followin g sections : •Genera l Responsibilitie s fo r

th e Contracto r

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

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

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

i

n the "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 Planning Department. ) •Compl y wit h the Stat e ofNebraskaHealt 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 th e occupan t •Submi t information cu t sheet s fo r

al l substitution s o r

approve d equal s prio r

t

o writte n approva l o f

th e Construction Specialist . •Repai r

o

r

replac e all item s damage d o r

disturbed durin g pain t stabilization activities . •Kee p wor k

sit e an d surrounding areafree fro maccumulation s o f

vvast e material s o

r

rubbis h cause d b y the wor k

a

t al l times . • Upo n dail y completion o f

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

area s i n a neat , sanitary , lea d saf e an d presentable 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 withi n twent y (20) fee t o

f

th e area t o b e remediated . • Provid e acces s t o electricit y an d wate r

throughou t th e pain t stabilization process . • Ehsur e tha t al l household members sta y a t leas t te n fee t awa y fro mal l wor k

areas an d als o keep"al l pet s a t leas t te n fee t awa y a t al l time s unti l th e wor k

has bee n completed ari d th e are ahas passe d avisua l inspection . sL-Z- ^ 

## Initial s ^f C

### 103 3 S 31st Stree t (Continued ) 

## Lea dHazar dContro l Plan Interi mContro l o f

Lea dbasedPain t Hazard s Pain t Stabilizatio n •Stabiliz e al l previousl y paintedexterio r

wood, brick , metal , concret e surface s o f

thi e dwelling to includ e bu t not limite dt o th e siding , fascia ,

.eaves , trim , window trim , shutters , gutters , railings , downspouts , doo r

tri m an dfoundation . D O NO T INCLUD E MA N DOOR S O RWINDOWS . D O NOT INCLUD E METAL O RCONCRETE SIDING . INCLUD E REA D DEC K AN D STAIRS . •Stabiliz e all previousl y paintedexterio r

wood, brick , metal , concret e . surface s ofth e garag e t o includ e bu t not 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 MA N DOOR S O RWINDOWS . D O INCLUD E VEHCIL E DOOR . •Prepar e an dpain t all previousl y paintedsurface s b y followin g th e Saf e Wor k

Practice s protoco l fo r

EP A exterio r

lea dbase dpain t stabilization . •All 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 . (Refe r

t

o Plannin g Dept . approve dpain t list) . •I F SPRAYED , ON E COAT 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 double bagge dfo r

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 remove dfro mth e sit e dail y unles s otherwis e approve db y th e constmction specialist .

. •Al l lead-basedpain t debri s (chip s an dcomponents ) must be dispose do f

in amunicipa l soli dwast e landfill . Propert y Owne r Dat e 

# 07/sofio Propert/Owne r Witnes s Dat e Occupan t (ifapplicable ) Dat e Occupan t (i f applicable ) Dat e

### Exterior Lead-base dPain t Stabilizatio n Progra mManagedb y the Cit y o f Omahafo r

EP A Region 7 OmahaLea dSit e Th e purpos e o f thi s progra mi s t o preven t yard s wher e lead-contamiha:te dsoi l i s cleane d u p frombecomin 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 Are 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 contracto r ha s identifie ddeterioratin g exterio r lead-base dpaint . •Home s are eligibl e onl y b y referral fro mth 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 , frim, windo w trim , doo r tri man dfoundation . •Surface s wil l b e prime dan dpainte dto 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 o pain t wil l no t b e freated. •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 t o th e Cit y o f Ornah 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 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 progra mbega 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 unde r ag e si x ifknow n an dth e severity ofth e problem . Pain t Stabilizatio n i s voluntar y an dwil l b e don e onl y with.permissio n ofth e owner . Initial s 7M ^Consen t fo r Acces s t o Propert y RIGH T O F ENTR Y 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 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) : Ale x KudenJr . 345-340 4 '

Addresse s o f Propertie s Covere db y thi s Agreement Property Addres s City/State/Zi p Cod e 103 3 S . 31s t St . Omaha , N E 6810 5 ' 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 Comprehensiv e Environmenta l Respons e an dLiabilit v Ac t fCERCLAI . 4 2 USC . «f e 9601-9675 . o r anv other law . PURPOS E OF ACCES S . Th e purpos e o f th e respons e actio n i s to stabiliz e loos e o r flaking exterio r lead-base dpain t o n residentia l properties , includin g day-car e facilities , wher e 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 consen t shal l allo w Grante e ont o Grantor' s property an dfarther , provide s th e Grante e th e righ t to perfor man y an dal l environmental respons e action s an dactivitie s i t deem s appropriate . ENVIRONMENTA L RESPONS E ACTION S Th e environmenta l respons e action s t o b e performe do n subjec t property ma y includ e th e followin g activities : 1 .

Locatin g equipmen t and/o r machinery , 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 fro mGrantor' s property .

(1 ) 2/12/200 7Address : 103 3 S . 31s t St . Consen t fo r Acces s t o Propertv (Pag e 2 ) 3 .Plannin g an dimplementin g th e respons e actio n on th e Grantor' s property . Thi s wil l include 1 ) remova l o f loos e o r flaking pain t identifie db y EPA usin g lead-saf e method s in complianc e wit h HUD/EP A regulation s and2 ) repaintin g accordin g t o th e attache dspecifications . TER M 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 complete th e environmenta l respons e activities . Upo n completio n o f th e respons e actions , al l right s and privilege s give n by th e Granto r shal l ceas e on that date , unles s extende db y asubsequent agreement . AGREEMEN T NO T T O INTERFERE Granto r agree s no t t o interfere wit h an y o f th e activitie s undertake n b y Grante e a t th e Property , tampe r with any o f Grantee' s property , or tak e any action s regardin g th e us e ofth e Propert y whic h wil l endange r human health or welfar e o r th e envirormient , 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 an dacop 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 to 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 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 property prio r t o remediatio n an dindicate s o n Pag e 3 any item s t o b e remove db y th e Granto r before activitie s commence . RESTORATIO N O F PROPERT Y Excep t fo r 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 stat e an dconditio n a s foun dimmediatel y precedin g th e beginnin g o f activitie s authorize db y thi s Agreement , followin g completio n o f th e respons e activities .

^2 )2/12/200 7

### Address : 103 3 S . 3ls t 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 t o provid e amutual 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 serv e a s documentatio n fo r th e purpos e o f assurin g that restoratio n activitie s ar e complete dt o th e satisfactio n o f th e property owne r an dth e Unite dState s Enviromnenta l Protectio n Agenc y (EPA) . item s t o b e remove db v property owne r prio r t o th e respons e activities : I .

.4 . 5 . 

### Item s NO T t o b e remove db v contracto r durin g remova l activities : 1 . 2 . 3 : « 4 . 5 . . 

### ADDITIONA L COMMENTS :

I hav e rea dth e foregoin g documen t an dunderstan dtha t i t i s a n agreemen t grantin g permissio n t o th e Grante e t o ente r th e abov e describe dpremise s for th e purpos e o f conductin g environmenta l 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^^ ^ Dat e 07p/ ) 1 0

2/12/200 7 (3)

### Dougla s Count y Accoun t Infomiatio n Pag e 1 of 2 Pougla s County , Nebrask a Propert y Recor d - R131858000 0 Prin t Repor t NE W Featur e - Parce l Dimension t availalil e Q ical e 0-5 0 n wea t o f S2n d S t - Vle W O H Ma p Infbrmatio n i s vali d a s o f 2010-4- 5 Treasurer' s Ta x Repor t Ne w Featur e ^i^^M ! Aut o Sale s Searc h Owne r KUDE N J R ALE X 103 3 S 3 1 S T OMAH A N E 68105-000 0 Propert y Informatio n Ke y Number : 185 8 00001 3 Accoun t Type : Multipl e Re s Parce l Numbe r 131858000 0 Parce l Address : 103 3 S 3 1 S T OMAH A N E 68105-000 0 Lega l Description : HIMEBAUG H PLAC E LO T 3 0 BLOC K0 S 2 5 F T L T 2 9 & N 2 0 W 12 8 F T 25 X 16 0 20X12 8 Valu e Informatio n 200 9 200 8 200 7 200 6 200 5 200 4 Lan d $6,400.00
. $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 Improvemen t $35,000.0 0 $35,200.0 0 $35,200.0 0 $33,600.0 0 $33,600.0 0 $32,500.0 0 Tota l $41,400.0 0 $41,600.0 0 $41,600.0 0 $40,000.0 0 $40,000.0 0 $38,900.0 0 Lan d Informatio n Acre s 0.1 4 S F 6480. 0 Unit s 1. 0 Dept h 144. 0 Widti i 45. 0 Vacan t N o Improvemen t Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountao=R13.. . 4/16/201 0

### Dougla s Count y Accoun t Information Pag e 2 o f

2

jl^miiMs M ^ i f

-aiL . 

### i f

1 I G STOR Y FIMSHE 0 CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1065. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Poo r

Buil t As : 1 1/ 2 Stor y Unfi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : Fram e Aluminu m Units : 2. 0 interior : Drywal l Baths : 1. 5 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinl<ie 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 188 5 0 % 188 5 12 5 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 1065. 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 336. 0 Porc h Enc I Soli d Wal l 108. 0 Porc h Sla b Roo f Ceilin g 245. 0 Porc h Sla b Roo f Ceilin g 32. 0 Porc h Woo d Dec k 50. 0 Use r 2 UNI T CONVERSION ? 1. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp7accountno-R13.. . 4/16/201 0