## Transmitta l o f Omah aLea dSite Pain t Stabilizatio n Fil e Folde r Said#^-O^^ - • Date : ^" 3 /-d" ^ Address : 73>0 h S - 3d > /9l/ ^ Contractor : Cit

v o f Omah aYear : o^Cf^* ^

_f l Wor k Writ e U p 

## Pain t

Stabilizatio n Propert y Fil e Folde r

Document s

^ . . 

### gne 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 (/Paint i Painting Agreement/Cit

y of 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 signedb y Certifie dRenovato

r ^•^Property informatio

n fi-omDougla s Count

y Assessor' s Offic

e Othe r (describe) : \)f[dh 5 

## 1 . 

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# 3~7r-7 ^ Cit y of Omah aRepresentativ e Signatur

e Dat e EP A Representativ e Signatur

e _. . Dat e 3026243 8 

# iniiii D Superfun dPlannin g Departmen t Inspector : Stev e Zivn y Omaha/Dougla s CiVicCente r p . . 7/7/n n 181 9 Fama mStreet , Suit

e 1003 Uate . I I Il W Omaha,Nebrask a6818 3 (402 ) 444-515 0 

## Name : Davi dMullen Teie&x(402)546-07i 4 A J J lo/^/ r

o orvt h A StevenN.Jensen,AICP,L A CityofOmah aAddreSS : 130 6 S 3 0 A v Director Ji mSuttle , Mayo r 

## OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRAM

FO RTH E EPA OMAHA LEAD SIT E Th e Contrac t

bi ddocument s consis t ofth e followin g sections : • General Responsibilitie s fo r th e Contracto r

an dOccupant . • Lea dHazar dContro l Plan , Interi mContro l o f Lea dBase dPaint

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 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 dfo

r i n th e "Constructio n an dRehabilitatio n Specifications , Housin g aii dCommunity Developmen t Division , Cit

y o f Omaha , Nebraska. " (Copie s ar e availabl e a t th e Plannin g Department. ) • Compl y wit

h th e Stat e o f

Nebrask aHealth an dHuma n Ser\'ice 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 wit h th e occupan t • Submi t

informatio n cu t

sheet s fo r al l substitution s o

r approve dequal s prio r

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

o r replac e al l item s damage do r disturbe ddurin g pain t

stabilizatio n activities . • Kee p wor

k sit e an dsurroundin g are afre e fromaccumulation s o f waste material s o r rubbis h cause db y th e wor k a t al l times . • Upondail y completio n o f work : clean up al l rubbish , exces s material , equipment , an detc. , tha

t i s connecte dwit

h th e work , an dleav e al l part s o f the wor k area s i n a neat , sanitary , lea dsaf

e andpresentabl e condition . • Complet e thi s projec t

withi n 3 0 calendar

days . Th e Occupant/Owne r

Shal l • Remov e andstor e away an y persona l property withi n twenty (20 ) fee t ofth e are a t o b e remediated . • Provid e acces s t o electricity an dwate r throughou t

th e pain t stabilizatio n process . • Ensur e tha

t all.househol dmember s stay atleas t te n fee t awa y fro mal l wor k area s an dalsokee p al l pet s a

t leas t te n feet away a t al l time s unti l th e wor

k h^bee n complete dan dth e are aha s passe davisua l inspection . Initials ,

### 130

6 S 30 * A v (Continued

) 

## LeadHazar dContro l Plan Interi mContro l o f

Lea dbase dPain t

Hazard s Pain t Stabilizatio n • Stabiliz e al

l previousl y paintedexterior

surface s ofth e dwelling t

o includ e but.not limitedtoth e fascia , eaves , trim , windo w trim , doo

r tri man d foundation . Do no t

includ e door s o r

windows . . o Stabiliz e al

l previously paintedexterio

r surface s ofth e porch . • INCLUD E WHIT E METAL SIDIN G - US E ACRYLI C PRIME RO N METAL SIDING • D O NO T INCLUD E GREEN METAL WINDO W O RDOO RTRI M • Prepar e an dpain t al l previousl y paintedsurface s b

y followin g the Saf e Wor k Practice s protoco l fo

r EP A exterio r lea dbase dpain t stabilization . • Al l pain t colors t o matc h existing pain

t pattem . Prim

e an dappl y tw o coats , of approve dfinish coat . (Refe r t o Planning 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 must

b e doubl e bagge dfo r disposal , o Clea n pain t chip s fro mgroun daroun dperimete r o f dwelling befor

e starting , durin

g an dafte r th e project . • Al l 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 constructio

n specialist . • Al l lead-base dpain t debri s (chip s an

dcomponents ) must

be disposedo

f i n amunicipa l solidwast

e landfill . ropert y Propert y Owne r Dat e Witnes s Dat e Occupan t (ifapplicable ) Dat e Occupan t (if applicable ) Dat e Witnes s Dat e

### Exterio

r 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-cOritaminate dsoi l i s cleane d u p frombecomin g re-cbntaminate dby 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 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 are eligibl e onl y by referral fro mth e EPA . What wor k wil l b e done ? • Loos e an dflaking lead-base dpain t wil l b e remove dsafely fromfascia , eaves , siding , trim , windo w trim , doo r tri man dfoundation . • Surface s wil l b e prime dan dpainted , t 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 o pain t wil l no t b e treated . • Window s or

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 h exterio r

hous e surfaces , an dgiv e th e result s to th e Cit y o f Omah aPain t

Stabilizatio n Program . • Cit y Constructio n Specialist s wil l prepar e awor k pla n 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 progra mbegan i n 200 7 an dwil l continu e foi - severa l years . • Th e Cit

y staf f wil l prioritiz e homei s base do n th e presenc e ofchildre n unde r 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 and-wil l b e don e onl y wit h permissio n ofth e owner . Initial s / ^Consen t fo r Acces s t o Propert y RIGH T O F ENTRY T O PREMISE S Granto r (th e property 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 environmenta l respons e activitie s upo n th e followin g describe dpremises : Owner' s Name : Owne r Name(s) : Davi dMulle n Davtime Phone : 960-063 1

Addresse s o f

Propertie s Covere dby thi s Agreemen t Property Addres s 130 6 S . 30t

h Ave . City/State/Zi p Cod e Omaha , N E 6810 5 Granto r understand s tha t

thi s gran t doe s not limi t EPA' s right

o f acces s under

th e Comprehensiv e Environmenta l Respons e an dLiabilitv Ac t fCERCLA') . 4 2 USC . & 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 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 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 dfiirther, provide s th e Grante e th e righ t to perfor many an dal l environmental respons e action s an dactivitie s i t deem s appropriate . FUTUR E ACTIO N B y signin g thi s document , th e granto r agree s t o allo w a

n EPA contracto r

t o conduc t

asoi l cleanu p a t thi s propert

y followin g completio n o f lead-base dpain t

stabilization . Th e granto r acknowledge s tha t th e pairi t

stabilizatio n contracto r

canno t provid e assurance s that bin dth e soi l cleanu p contractor . Th e granto r

understand s tha

t th e soi l cleanu p contracto r wil l mak e al l reasonabl e effort s to addres s concem s tha t

th e granto r

ma y hav e regardin g soi l cleanup at thi s property . ENVIRONMENTAL RESPONS E ACTION S Th e environmenta l respons e action s t o b e performe don subjec t property ma

y includ e th e followin g activities : 1 . Locatin g equipmen t

and/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 fro mGrantor' s property . (1 ) 2/12/200 7Address : 130 6 S . 30t h Ave . Consen t fo r Acces s to Property (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 includ e 1 ) removal o f

loos e o r flaking pain t

identifie dby EP A usin g lead-saf e method s i n complianc e with HUD/EPA regulation s an d2 ) repaintin g accordin g t o th e attache dspecifications . TERM Thi s acces s agreenien t

shal l b e operabl e fo

r th e perio do f

tim e 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 an d privilege s give n by th e Granto r shal l ceas e o n tha

t date , unles s extende db y asubsequent agreement . AGREEMEN T NO T T O INTERFERE Granto r agree s no t

t o interfer e wit

h an y o f th e activitie s undertake n b y Grante e a t th e Property , tampe r with an y o f

Grantee' s property , or

tak e any action s regardin g th e us e ofth e Propert y which wil l endange r

huma n health o r

welfar e or th e environment , o r

allo w other s to us e th e Propert y in suc h manner

durin g th e termo f

thi s consent . Granto r

agree s to provid e notic e an dacop y o f thi s agreemen t to prospectiv e purchasers , lessees , assigns , or 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 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

any an dall samplin g and/o r analysi s resultin g fi-omGrantee' 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 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 state an dconditio n a s foundimmediatel y precedin g th e beginnin g o f

activitie s authorize db

y this . Agreement , followin g completio n o f th e respons e activities .

(2 ) 2/12/200 7Address : 130 6 S . 30t h Ave. , 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 amutua l 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 are 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 propertv owne r prio r to th e respons e activities :

1 . •'.•• •

Item s NO T to b e remove db v contracto r durin g removal activities : 1 . 2 . 3 . • 4 . 5 . ADDITIONAL COMMENTS :

I hav e rea dth e foregoin g documen t an dunderstan dthat

i t is . 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 fo r th e purpos e o f

conductin g environmental respons e activities , an dI agre e to it s term s an dconditions . I acknowledg e that I hav e receive dthe ' pamphle t "Renovat e Right" . Grantor' s Signature : / ^ Dat e -^-^-cD ^

(3 ) minoo iDougla s Count y Accoun t

Informatio n Pag e 1 of 3 Dougla s County , Nebrask a Propert y Recor d - R123745000 0 Informatio n i s vali d a s o f 2009-6-1 6 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 St - VJe W O H Ma B Treasurer' s Ta x Repor

t Ne w Featur e ->-»- > Aut o Sale s Searc h Owne r LEPRECHAU N PROPERTIE S IN C 90 8 LEPRECHAU N L N PAPILLIO N N E 68046-000 0 Propert y Informatio n Ke y Number : 374 5 000 0 1 2 Accoun t Type : Residentia l Parce l Number : 123745000 0 Parce l Address : 1306S30A V

OMAH A N E 68105-000 0 Lega l Description : HANSCO M PLAC E LO T 2 BLOC K1 0 E 142 F T 5 0 X 142 Valu e Informatio n

Lan d Improvemen t Tota l 200 9 $6,700.0 0 $53,700.0 0 $60,400.0 0 200 8 $6,700.0 0 $53,700.0 0 $60,400.0 0 200 7 $6,700.0 0 $53,700.0 0 $60,400.0 0 200 6 $6,700.0 0 $65,300.0 0 $72,000.0 0 200 5 $6,700.0 0 $65,300.0 0 $72,000.0 0 200 4 $6,700.0 0 $65,300.0 0 $72,000.0 0 Sale s Informatio n

Sale s Date : 2003-09-0 5 Dee d Type : W D Book : 200 3 Page : 19885 2 Price : $48,000.0 0 Grantor : Catherin e L Buenrostro eta l Grantee : Leprechau n Propertie s Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1998-12-1 7 Dee d Type : Book : 211 0 Page : 04 6 Price : $37,000.0 0 Grantor : http-//douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R123.. . 7/2/200 9Dougla s Count y Accoun t

Informatio n Pag e 2 o f 3 Grantee : Valld/lnvalld : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valld/lnvalld : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valld/lnValld : Exclusio n Reason : ,

Vali d

, 1997-03-0 1

. D Book : 205 6 Page : 56 8 $35,000.0 0

Vali d 1996-04-0 8 D Book : 203 2 Page : 66 0 • $30,000.0 0

, Vali d 1990-03-2 8 D Book : 187 3 Page : 20 5 $30,500.0 0

• Vali d Lan d Informatio n ^cre s 0.1 6 S F 7100. 0 Unit s 1. 0 Dept h 142. 0 Widt h

50. 0 Vacan t N o Improvemen t Informatio n Buildin g 1

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R123.. . 7/2/200 9Dougla s Count y Accoun t

Informatio n Pag e 3 o f 3

•]^"' ' «7 |

ft Z - JSJOT K x i r ilQO J 

### Tw o Story CLICKT O ENLARGElMAiS E Squar e Footage : j 1694. 0 Perimete r Uni t Type : Buil t As : HVAC : 0. 0

2 Stor y Force d Ai r Percen t Complete : 100.0 % Quality : \

Averag e Cond o Squar e Footage :

Condition : | Averag e

0. 0 Rooms : 10. 0 Exterior : Fram e Aluminu m Units : 3. 0 Interior : Drywal l Baths : 3. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 4. 0 Roo f Type : Floorcover : Gabl e Stories : 2. 0

Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea rBuil t 189 0 Yea r

Remodele d 0 Percen t

Remodele d Adjuste d Yea r Buil t 0 % 189 0 Physica l Ag e 11 9 Detai l Typ e Applianc e Basemen t Defa; 7 Descriptio n Allowanc e Bsmn t Bloc k

8 f t Unit s 1. 0 884. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l Porc h Sla b Roo f Cei l Use r 3 UNI T CONVERSIO N 3, 0 220. 0 1. 0 Use r code125tomode l 1. 0

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfojsp?accountno=Rl23.. . 7/2/200 9

# CIT Y O F OMAH A PURCHASIN G - ROO M 100 3 181 9 FARNA M STREE T OMAHA . N E 68183-100 3 F/\X # 402-444-542 3 

### Purchas e Orde r

VENDOR : US A CONSTRUCTIO N SERVICE S IN C

813 0 S 9 2 AV E LAVISTA . N E 6812 8 PURCHAS E ORDE R NO . 115944 0 REVI8I0 N 0 'SHI P TO : CIT Y O F OMAH A HOUSIN G & COM M DE V R M #111 1 181 9 FARNA M STREE T OMAHA.N E 6816 3 PAG E 1 J 

## J 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 . 605 7 DAT E O F ORDER / BUYE R 06-AUG-0 9 P BURK E REVISE D DATE//BUYE R PAYMEN T TERM S SHI P VI A F.O.B . DESTINATIO N FREIGH T TERM S > REQUESTOR/DELIVE R T O MARUCA. T MARI E CONFIR M T O /TELEPHON E 0214-570 0 < ITE M PAR T NUMBE R / DESCRIPTIO N DELIVER Y DAT E QUANTIT Y UNI T UNI T PRIC E EXTENSIO N IMPORTAN T - D O NO T STAR T WOR K UNTI L PROCEE D ORDE H I S ISSUE D B Y d i n : U S Dol] , DEPARTMEN T - PE R .GROU P Al l price s an d amount s 5 1 BI D DATE D 7/29/0 9 o n thi s orde r ar e expres s NEEDED : 07-AUG-0 9 TH E .PLANNIN G a r 1,890.0 0 N EP APAIN T STABILIZATIO N PROGRA M GROU P 5 1 130 6 S . 3OT H AV E o SHI P TO : Addres s a t to p o f pag e

EP APAIN T STABlLIZATIOt l PROGRA M GROU P 5 1 -

2 60 3 WOOLWORT H AV E O SHI P TO : Addres s a t to p o f pag e NEEDED : 07-AUG-0 9 4,600.0 0 N

SHIPTO : /UJdras s show n above . I f shipmen l i s delaye d o ran y Itetn s no t available , advis e a l once . Pur chas e ordt-i ' numbe rmUs t appea ro n al l invoices , packages , packin g lists , bil l o f lading , an d correspondence . SHIPPIN G CHARGE S T O B E PREPAID . I F /APPLICABL E AN D ADDE D T O INVOICED , cop y t o be.fur nishe d will , invoice . TA X EXEW.PTION : Th e Cil 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 Omah a Sa^-j s Taxes . Federa l I.D . 476006304 ; STATEI.D . 01-0316768 : Fue l Dealer s Lie . 91-0316768 . V