Transmittal of Omaha Lead Site 

Paint Stabilization File Folder 

Said#__,^^^*/7i" Date: ^-/y-^ 7 

Address: .2 V ^ / A/ ^ ^ J^I/ ^ 

Contractor: CityofOmaha Year: P-C7i 9 

Paint Stabilization 

Property File Folder Documents 

(y^iWor . k Write Up 

Signed Access Agreement for subject property 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, ifapplicable 

J ^ 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 

_^1 Property information froni Douglas County Assessor's Office 

^^Othe r (describe): f/lCrtoS ._ 

/ e^" ^ A^* — 3-/T-7. 

City of Omaha Representative Signature Date IU a 

EPA Representative Signature Date 

30262448 

IHHIHi 

Superfund 
Planning Department 

Inspector: Stev e Zivn y Omaha/Douglas Civic Center 

Date" 1I%IQ'^ 1819 Famam Street, Suite 1003 

Omaha, Nebraska 68183 

(402)444-5150 

Name : Harol d Schuit Z Telefax (402)546-0714 

ci.yofo«>^> Address: 2421 N 45^'A v '*"''"''•J^"''*^"'^^^';^ 

Jim Sutde, Mayor -^ . 

OMAHA EXTERIOR PAINT STABILIZATION PROGRAM 

FOR THE EPA OMAHA LEAD SITE 

The Contract bid documents consist ofthe following sections: 

• General 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 Plaiming Department.) 

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

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

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

• Comply with the State ofNebraska Health and Human Services Regiilation and 

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 of the Construction Specialist. 

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

activities. 

• Keep work site arid suiTounding area free from accumiilations 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 parts ofthe work areas in a 

neat, sanitary, lead safeand presentable condition. 

• Complete this project within 30 calendar days. 

The Occupant'Owner Shall 

• Remove and store away any personal property within twenty (20) feet of the 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. ^ ^ —. 

Initials J^^AJA 
Exterior Lead-based Pairit 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. Tliis 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 safely from 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 permission 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 baised on the presence of children under age 

six if known and the severity ofthe problem. 

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

Initials idi B A 
2421 N 45"'Av (Continued) • 

Lead Hazard Control Plan 

Interim Control of Lead based Paint Hazards 

Paint Stabilization 

• Stabilize all previously painted exterior surfaces of the dwelling to include 

. but not limited to the fascia, eaves, trim, window trim, door trim and 

foundation. Do not include doors or windows. 

• Stabilize all previously painted exterior surfaces of the garage. 

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

. Work Practices protocol for EPA exterior lead based paint stabilization. 

• All paint colors to matchexisting paint pattern. Prime and apply two 

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

list) 

• 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 paint debris (chips and components) must be disposed of in 

a municipal,solid waste landfill. 

^.A//i? 

Property Owner 

^^AJ97l4^l'(r^fytyi3S^Au^ 

PropertyOwner • Mte

M^^y/? ^-^-^ ^ -^/ t 

Ocoupan (if applicable) 

O^<Jupant(ifapplic0!ffle) ,/ Date, 

I 

ess 
Consent for Access to Property 

RJGHT 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 the following described premises: 

Owner's Name: 

Davtime Phone: 

Owner Name(s): Harold Schultz 

556-9395 • 

Addresses of Properties Covered by this Agreement 

Property Address 

City/State/Zip Code' 

2421 N. 45th Ave. 

Omaha, NE 68104 

Grantor undeirstands that this grant does liot limit EPA's right of access under the Comprehensive 

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

PURPOSE OF ACCESS 

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

residential properties, including day-care facilities, where rerhediation 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 cannot provide assurances that bind 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 to 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. 

(1) 2/12/2007 
Address: 2421 N. 45th Ave. 

Consent for Access to Propertv (Page 2) 

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

1) removal of loose or flaking 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 envirorunent, or allow others to use the Property in 

such manner during the term of this consent. Grantor agrees to provide notice and a copy of this 

agreement to prospective purchasers, lessees, assigns, or grantees of the 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 sampling and/or analysis resulting 

from Grantee's response activities on the property. 

PRIOR CONDITIONS AGREEMENT 

The grantor agrees to the condition ofthe 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 

begirming of activities authorized by this Agreement, following completion of the response 

activities. 

(2) 2/12/2007 
Address: 2421 N. 45th Ave., 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 

Environmental 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: 

1. 

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 environmental 

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

pamphlet "Renovate Right". 

Grantor's Signature: yT^ji^^^^^^rSLyVft n Date 02jk>ij^_ 

(3) lIXTJim-l 
Douglas County Account Information Page 1 of2 

Douglas County, Nebrasica Property Record - R0811090000 

Print Report 

NEW Feature - Parcel Dimensions available O scale 0-50 rt west or 52nd St - Vle W O n Ma R Information-is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature -> -^ -^ Auto Sales Search 

Owner 

SGHULTZ HAROLD D 

ETAL 

1101 DILLON DR 

OMAHA NE 68132-0000 

Property Information 

Key Numben 1109 0000 08 

Account Type: Residential 

Parcel Number: 0811090000 

Parcel Address: 2421N45AV 

OMAHA NE 68104-0000 

Legal Description: CLAIRMONT LOT 28 BLOCK 2 50 X 125 

Value Information 

Land /mprovement Total 

2009 $6,400.00 $66,100.00 $72,500.00 

2008 $6,400.00 • • $66,100.00 $72,500.00 

2007 $6,400.00 $66,100.00 $72,500.00 

2006 $6,400.00 $66,100.00 $72;500.00 

2005 $6,400.00 . $67,100.00 $73,500.00 

2004 $6,400.00 $61,000.00 $67,400.00 

Sales Informatio n 

Sales Date: 2000-06-16 

Deed Type: D Book: 2157 Page: 341 

Price: $95,000,00 

Grantor: 

Grantee: • 

Valld/lnvalld: Valid 

Exclusion Reason­ , 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6250.0 1.0 125.0 50.0 No 

Improvenient Information 

• 

http://douglasne.maoping-online.com/DouglasCoNe/static/accountinfo.jsp?acco,untno=R081... 7/2/2009 
Douglas County Account Information Page 2 of 2 

Building 1 

J^; „ 

I * Second Floor 

76a Osq 11 f' ' eoa.OMi. n I I

 "'' 

a 

J STORY 

CLICK TO ENLARGE IMAGE 

Square Footage: 1368.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Aluminum Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gambrel Stories: 2,0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1923 0 0% 1923 86 

Oeta/7 Type Detail Description Units 

Add On Fence Chain Link 1.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 768.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1 ^ 

Porch EncI Screen 119.0 

Porch Open Slab 119 ^ 

Porch Slab Roof Ceil 28.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R081... 7/2/2009 
olTY OF OMAHA 

PURCHASING - ROOM 1003 

1819 FARNAM STREET 

OMAHA, NE 68183-1003 

FAXi¥ 402-444-5423 

VENDOR USA CONSTRUCTION SERVICES INC : 8130 8 92 AVE 

LAVISTA, NE 68128 

Purchase Order 

PURCHASE CRCER NO. 

11595S1 

SHIP TO: 

CITY OF OMAHA 

HOUSING & COMM DEV RM#1111 

1819 FARNAM ST,REET 

OMAHA.NE 68183 

> 

BILL TO: 

• CITY OF OMAHA FINANCE 

DISBURSEMENTS ROOM #1007 

1819 FARNAM STREET 

OMAHA.NE 68183 

- < 

J 

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

^CUSTOM(-R ACCOUNT NO. | VENDOR NO. DATE OF ORDER/BUYER REVISED DATE//BUYER 

6057 13-AUG-09P BURKE 

PAYMENT TERMS SHIP VIA F.O.B. 

DESTINATION 

FREIGHT TERMS REQUESTOR/DELIVER TO CONFIRM TO / TELEPHONE 

MARUCA. T MARIE 0 214-5700 

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

IMPORTANT - DO NOT START WORK UNTIL PROCEED ORDE^ IS ISSUED BY THE PLANNING 


DEPARTMENT - PER GROUP 54 BID DATED 8/5/09 


All prices and amounts 2d in : US Doi; ar 
 on this order are express 


NEEDED: 


12-AUG-09 


EPA PAINT STABILIZATION 


PROGRAM GROUP 54 24 21 N 


4 5TH AV 


O SHIP TO: 


Address at top.of page 


NEEDED: 


1.2-AUG-09 


EPA PAINT STABILIZATIOtJ 


PROGRAM GROUP 54. 2431 {J 


4 5TH AV 


O SHIP TO: . i 


Address at top of page 


NEEDED: 


12-AUG-09 


EPA PAINT STABILIZATION 


PROGRAM GROUP 54 2506 5 


4OTH ST 


O SHIP TO: 


Address at top of page 


820.00 N; 


1,490.0 0 N 

1,550.0 0 N 

SHIP TO: Address shown above. If shipment is delayed or any items nol available, advise at once. Pur­

chase orde.'' number must appear on all invoices, packages, packing lists, bill of lading, and correspondence. Tota Continued 

SHIPPING CHARGES TO BE PREPAID. IF APPLICABLE AND ADDED TO INVOICED, copy lo be fur­ l C

nished with invoice. 

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

Omaha Saius Taxes. Federal I.O. 476006304; STATE I.D. 01-0316768; Fuel Dealers Lie. 91-0316768. Cily Purchasing Agenl'/ Buyer 

3