Transmittal of Omaha Lead Site 

Paint Stabilization File Folder 

Said# FS^6>7^ Date: ^'7^-£>f 

Address: 3/P. 9 /1/</ / SJContractor: Citv of Omaha Year: ^-^rc>*^ 

Paint Stabilization 

Property File Folder Documents 

L^or k Write Up 

^•^Signed Access Agreement for subject property 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, ifapplicable 

Ix^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 

^ Other (describe): \\\(&0 

7^w^>. /^ ^ 3-75^ 7< 

City of Omaha Representative Signature Date 

EPA Representative Signature __ _.. ---. Date 

30262450 

iiinniHiii 

Superfund 
Planning Department 

Inspector: Steve Zivn y Omahi/Douglas civic Center 

Date: 7/13/09 ' ^^^'S T ^^u'^?^".1!2^ 

Omaha, Nebraska 68183 

(402) 444-5150 

Name: KristanE Money . TeWax(402) 546-07i4 

CityofOmaha - AddreSS! 3129 N 48^^ StTcct ''^^'''''•J''^^'"'^S;i^ 

Jim Suttle, Mayor 

OMAHA EXTERIOR PAINT STABILIZATION PROGRAM 

FOR THE EPA OMAHA LEAD SITE 

The Contract bid documents consist ofthe following sections: 

• Gerieral 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 Evaluation and Control of Lead-Based 

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

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

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

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

• Comply with the State ofNebraska Health and Human Services Regulation aiid 

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 ofthe Construction Specialist. 

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

'activities.' 

• Keep work site and surrounding area free 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 connected with the work, and leave all pairts ofihe work areas in a 

neat, sanitary, lead safe and presentable condition. 

• Complete this project within 30 calendar days. 

The Occ upaiit/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 stay at least ten feet away from 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 passed a visual inspection. 

hiitiais (AflYl 
3129 N 48th St (Continued) 

Lead Hazard Control Plan 

Interim Control of Lead based Paint Hazards 

Pairit Stabilization 

• Stabilize all previously painted exterior wood or concrete surfaces ofthe 

dwelling to include but not limited to the fascia, eaves, trim, window trim, 

gutters, door trim, and foundation. Do not include doors or windows. 

INCLUDE FOUNDATION WINDOWS. 

• Stabilize all previously painted exteirior surfaces of the garage. 

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

Work Practices protocol for EPA exterior lead ba^ed paint stabiliziation. 

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

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

list) Rusted metal will require rust-inhibiting primer. 

• 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 bagged for 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 removed from- the site 

daily unless otherwise approved by the construction specialist. 

• All lead-based pairit debris (chips and components) must be disposed, of in 

a municipal solid waste landfill. 

^roperty Owner I Date 

Property Owner Date 

>JJJ 471AAIJUL^ J-l^-O'Tl 

Witness Date 

Occupant (if applicable) Date 

Occupant (ifapplicable) Date 

Witness Date 
Exterior Lead-based Paitit Stabilization Program Managed by the City of 

Omaha for EPA Region 7 

Omaha Lead Site 

The purpose of this program is to prevent 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 safelyfi-om 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 no 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 pennission 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 of children under age 

six ifknown. and the severity ofthe problem. 

Paint Stabilization is voluntary and will be done only with permission ofthe owner. 

Initials iifjff] 
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 thefollowing described premises: 

Owner's Name: 

Davtime Phone: 

Owner Name(s): Kristan Money 

98U8327 

Addresses of Properties Covered by this Agreement 

Property Address 

City/State/Zip Code 

3129 N. 48th St. 

Omaha, NE 68104 

J 

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

Environmental Response and Liabilitv Act CCERCLAl 42 USC. & 9601-9675. or anv other law. 

PURPOSE OF ACCESS 

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

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

or will take place. Sampling of soil may be conducted. This consent shall allow Grantee onto 

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

response actions and activities it deems appropriate. 

FUTURE ACTION 

By signing this document, the grantor agrees to allow an EPA contractor to conduct a soil cleanup 

at this property following completion of lead-based paint stabilization. The grantor acknowledges 

that the paint stabilization contractor caimot provide assurances that birid the soil cleanup 

contractor. The grantor understands that the soil cleanup contractor will make all reasonable efforts 

to address concems that the grantor may have regarding soil cleanup at this property. 

ENVIRONMENTAL RESPONSE ACTIONS 

The environmental response actions tp be performed on subject property may include the following. 

activities: 

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

the response activities. 

2. Obtaining samples.from Grantor's property. 
Address: 3129 N. 48th St. 

Consent for Access to Propertv (Page 2) 

3. Plaiming and implementing the response action on the Grantor's property. This will include 

1) removal of loose orflaking 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 

environmental 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 of the activities undertaken by Grantee at the Property, 

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

will endanger human health or welfare or the environmentj or allow others to use the Property in. 

such maimer during the teimi of this consent. Grantor agrees to provide notice and a copy of this 

agreement to prospective purchasers, lessees, assigns, or grantees ofthe 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 samphng and/or analysis resulting 

from Grantee's response activities on the property. 

PRIOR CONDITIONS AGREEMENT 

The grantor agrees to the condition .of the 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, following completion of the response. 

activities. 
Address: 3129 N. 48th St., Omaha, NE, 68104 

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 

Enviromnental Protection Agency (EPA). 

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

1. " . 

2. 

3. 

4. 

• 5 . 

Items NOT to be removed bv contractor during removal activities: 

L , 

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 envirormiental 

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

pamphlet "Renovate Right". 

Grantor's Signature: '^'^'^jTo^/C^f jl(y\jiij Date 2/2^ 2 

i'k\ vwmn 
CITY OF OIVIAHA 

PURCHASING - ROOM 1003 Purchase Order 

1819 FARNAM STREET 

PURCHASE ORDER NO. 

OMAHA, NE 68183-1003 

1159764 FAX# 402-444-5423 

SHIP TO: 

CITY OF OMAHA 

HOUSING & COMM DEV RM »1111 

.1819 FARNAM STREET 

OMAHA.NE 68183 

VENDOR BRAD BATES PAINTING : >. < BILL TO: 3141 s o 52 ST CITY OF OMAHA FINANCE OMAHA, NE 68106 DISBURSEMENTS ROOM #1007 

1819 FARNAM STREET 

OMAHA.NE 68183 • 

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

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

72990 21-AUG-09 J ROBBIN 21-AUG-09 J ROBBINS 

PAYMENT TERMS SHIP VIA F.O.B. 

FREIGHT rERMS REQUESTOR/DELIVER TO CONFIRM TO / TELEPHONE 

MARUCA, T MARIE • (402) 551-0927 

^ -< ITEM PART NUMBER / DESCRIPTION DELIVERY DATE QUANTITY UNIT UNIT PRICE EXTENSION 

PROGRAM GROUP 56 2 902 N 


048 ST 


O SHIP TO: j 


Address :at top of page 


1,925.0 0 N 

EPA PAINT STABILIZATION 


PROGRAM GROUP .56 3115 U 

04 7 AV : 


O SHIP TO: . i 


Address at top of pa^e 


575.0 0 N 

EPA PAINT STABILIZATION 


PROGRAM GROUP .56-3129 N 


.043 ST 


O SHIP TO: ••• 
 Address at top of page 


750.0 0 N 

EPA PAINT STABILIZATION. 
 PROGRAM GROUP 56 4516 : 


MAYBERRY ST i 


O SHIP TO: 


Address at top of page 


SHIPTO: Address Shown above. II shipment is delayed or any items not available, advise at once. Pur­

chase ord(.':' number must appear on. all invoices, packages, packing lists, bill of lading, and correspondence. Tota l ( Conlinued ) 

SHIPPING CHARGES TO BE PREPAID, IF APPLICABLE AND ADDED TO INVOICED, copy to be lur- • 

nished will; invoice. 

TAX EXENiPTION: The City of Omaha is exempt from Federal Excise Taxes and the Nebraska and Cily of 

Omaha Sa! ;s Taxes. Federal I.D. 476006304; STATE I.D. 01-0316768: Fuel Dealers Lie. 91-0316768. 

Cily Purchasing Agent / Buyer V '