## Transmitta l o f

Omah aLea dSite Pain t Stabilizatio n Fil e Folde r Said#__,^^^*/7i " Date : 

## ^-/y-^ 7 Address : . 2 V ^ / A / ^ ^ J^I/ ^ Contractor : CityofOmah a Year : P-C7 i 9 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s (y^i . 

### Wor k

Writ e U p 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 J ^ 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. ) Renovatio n Recordkeeping Checklis t signe db y Certifie dRenovato r _^ 1 Propert y informatio n froni Dougla s Count y Assessor' s Offic e ^^Othe r (describe) : f/lCrto S ._ 

### /

e^" ^ A^* — 

### 3-/T-7 . Cit y of Omah aRepresentativ e Signatur e Dat e 

# I U a EP A Representativ e Signatur e Dat e 3026244 8 

# IHHIH i Superfun dPlannin g Departmen t Inspector : Stev e Zivn y Omaha/Dougla s Civi c Cente r Date " 1I%IQ' ^ 181 9 Fama mStreet , Suit e 1003 Omaha , Nebrask a6818 3 (402)444-515 0 Name : Harol dSchuit Z Telefa x (402)546-071 4 

### ci.yofo«>^ >Address : 2421 N 45^'A v '*"''"''•J^"''*^"'^^^'; ^ Ji mSutde , 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 ddocument s consis t

ofthe followin g sections : •General Responsibilitie s for th e Contracto r an dOccupant . •Lea dHazar dContro l Plan , Interi mContro l o f LeadBase dPain t Hazards ; Th e Contracto r Shall : •Compl y wit h HUD' s "Guideline s fo r th e Evaluatio n an dContro l o f Lead-Base d Pain t Hazard s in Housing. " (Copie s ar e availabl e at th e Plaimin g Department. ) •Compl y wit h Standard s calle dfo r i n th e "Constructio n an dRehabilitatio n Specifications , Housin g an dCommunity Developmen t Division , Cit y o f Omaiha, Nebraska. " (Copie s ar e availabl e a t th e Plannin g Department. ) •Compl y wit h th e State ofNebrask aHealt h an dHuma n Service s Regiilatio n an d Licensure , Titl e 17 8 Chapte r 2 3 LeadBas 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 or approve dequal s prio r t o writte n approval o f th 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

site ari dsuiToundin g are afre e fro maccumiilation s o f wast e material s o r

rubbis h cause dby th e wor k

a

t al l times . •Upo n dail y completio n o f work : clean u p al l rubbish , exces s material , equipment , an detc. , that i s connecte dwit h th e work , andleav e al l part s ofth e wor k

area s i n a neat , sanitary , leadsafean dpresentabl e condition . •Complet e thi s projec t withi n 3 0 calenda r days . Th e Occupant'Owne r Shal l •Remov e an dstor e awa y an y persona l property withi n twenty (20 ) feet o f th e are a t o b e remediated . •Provid e acces s t o electricity andwater throughou t th e pain t stabilizatio n process . •Ensur e tha t all househol dmember s sta y a t leas t te n fee t awa y fro mall wor k

area s an dals o kee p al l pet s a t leas t te n feet awa y at al l time s unti l th e wor k

ha s been complete dandth e are aha s passe davisual inspection . ^ ^ —. 

### Initial s J^^AJ AExterio r Lead-base dPairi t Stabilizatio n Progra mManage db y th e Cit y o f Omah afo r EP A Regio n 7 Omah aLea dSit e

Th e purpos e o f thi s programi s t o preven t yard s wher e lead-contaminate dsoi l i s cleane d u p frombecomin g re-contaminate dby deterioratin g exterio r lead-base dpaint . Tlii s i s no t ahom e repai r program . Whic h Home s Ar e 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 EP A contracto r ha s identifie ddeterioratin g exterio r lead-base dpaint . •Home s ar e eligibl e onl y b y 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 dsafel y fro mfascia , eaves , siding , trim , windo w trim , doo r tri man dfoundation . •Surface s wil l b e prime dan dpainte dt 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 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 ? •EPA contractor s wil l tes t pain t o n exterio r hous e surface s andgiv 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 in 200 7 an dwil l continu e fo r severa l years . •Th e Cit y staf f wil l prioritiz e home s baise do n th e presenc e o f childre n unde r ag e si x i f know 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 wit h permissio n ofth e owner . Initial s idi B A

### 242 1 N 45"'A v (Continued ) • 

## Lea dHazar dContro l Plan Interi mContro l of Lea dbase dPain t Hazard s Pain t Stabilizatio n •Stabiliz e al l previousl y paintedexterior surface s of th e dwellin g

to includ e

. bu t no t limited to th e fascia , eaves , trim , windo w trim , doo r

tri man d foundation .Do no t includ e door s or windows . • Stabiliz e all previousl y paintedexterio r

surface s of th e garage . • Prepar e an dpain t al l previousl y paintedsurface s by followin g th e Saf e

. Wor k

Practice s protocol fo r

EP A exterio r

lea dbase dpain t stabilization . •Al l pain t colorsto matchexistin g pain tpattern . Prim e an dappl y tw o coat s of approve dfinis h coat . (Refe r to Plannin g Dept . approve dpain t list ) •IF SPRAYED , ON E COAT SHAL L

BE BACK-BRUSHE D

OR BACK-ROLLED . Lea dBase dPain t Wast e Lead-base dpain t wast e mus t be handle d as follow s Al l pain t chip s an dcomponen t debri s must be doubl e bagge dfo r

disposa l Clea n pain t chip s fro mgroun daroun dperimete r of dwelling befor e starting , during an dafte r

the project . Al l lea dpaintedcomponents an ddebri s must be remove dfro mth e sit e dail y unles s otherwis e approved by the construction specialist . Al l lead-basedpain t debri s (chip s an dcomponents ) mus t be dispose d

of in amunicipal , so li dwast e landfill . 

# ^.A//i ? Propert y Owne r 

# ^^AJ97l4^l'(r^fytyi3S^Au ^ Owne r Mt e Propert y • ^-^-^ ^ 

# M^^y/? -^/ t Ocoupa n (if applicable ) O^<Jupant(ifapplic0!ffle ) ,/ Date , I essConsen t fo r Acces s t o Propert y RJGH T O F ENTR Y 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 , to ente r an dperfor m certai n environmenta l respons e activitie s upo n th e followin g describe dpremises : Owner' s Name : Davtim e Phone : Owne r Name(s) : Harol dSchultz 556-939 5 •

Addresse s o f Propertie s Covere db y thi s Agreemen t Property Addres s City/State/Zi p Code ' 242 1 N . 45th Ave . Omaha , N E 6810 4

Granto r undeirstand s that thi s grant doe s lio t limi t EPA' s righ t o f acces s under th e Comprehensiv e Environmenta l Respons e an dLiabilitv Ac t (CERCLA V 4 2 USC . & 9601-9675 . o r an v other law . PURPOS E O F ACCES S Th e purpos e o f th e respons e actio n i s t o stabiliz e loos e o r flaking exterio r lead-base dpain t o n residentia l properties , includin g day-care facilities , wher e rerhediatio 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 man y an dal l environmental respons e action s an dactivitie s i t deem s appropriate . FUTURE ACTIO N B y signin g thi s document , th e granto r agree s t o allo w a n EP A contracto r t

o conduc t asoi l cleanu p a

t thi s property followin g completio n o f lead-base dpain t stabilization . Th e granto r acknowledge s that th e pain t stabilizatio n contracto r canno t provid e assurance s tha t bin dth e soi l cleanup contractor . Th e granto r understand s tha t th e soi l cleanu p contracto r wil l make al l reasonabl e effort s t o addres s concem s tha t th e granto r ma y hav e regardin g soi l cleanup a t thi s property . 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 machiner y o n subjec t propert y i n preparatio n fo r an din th e cours e o f th e respons e activities . 2 .

Obtainin g sample s fromGrantor' s property . (1 )2/12/200 7Address : 242 1 N . 45t h Ave . Consen t fo r Acces s t o Propertv (Pag e 2 ) 3 .Plarmin g an dimplementin g th e respons e actio n o n th e Grantor' s property . Thi s wil l includ e 1 ) removal o f loos e o r flaking pain t identifie db y EP A usin g lead-saf e method s in complianc e wit h HUD/EP A regulation s an d2 ) repaintin g accordin g to th e attache dspecifications . TER M Thi s acces s agreement shal l b e operabl e fo r th e perio do f tim e i t 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 b y th e Granto r shal l ceas e o n that date , unles s extende db y asubsequent agreement . AGREEMEN T NO T T O INTERFER E ' 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 wit h an y o f Grantee' s property , o r tak e an y action s regardin g th e us e o f th e Propert y whic h wil l endanger human healt h o r welfare o r th e envirorunent , or allo w other s t o us e th e Propert y i n suc h manne r 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 t o prospectiv e purchasers , lessees , assigns , o r grantee s o f th e property o r any portio n o f it . Granto r agree s t o provid e 30-day notic e t o EP A 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 t o provid e Granto r with th e result s o f an y an dall 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 andindicate s o n Pag e 3 an y item s to 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 dproperty wil l b e restore d a s nearl y a s possibl e t o it s origina l stat e an dconditio n a s foundimmediatel y precedin g th e begirmin 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 7Address : 242 1 N . 45t h Ave. , Omaha , NE , 6810 4 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 to condition s o f property 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 ar e complete dt o th e satisfactio n o f th e propert y owne r an dth e Unite dState s Environmenta l Protectio n Agenc y (EPA) . Item s t o b e remove db v propert v owne r prio r t o th e respons e activities : 1 . 2 . • 3 . 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 dthat i t i s a n agreemen t grantin g permissio n t o th e Grante e t o enter 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 t o it s term s an dconditions . I acknowledg e that I hav e receive dth e pamphle t "Renovat e Right" . Grantor' s Signature : yT^ji^^^^^^rSLyVft n Dat e 

## 02jk>ij^ _

(3 ) lIXTJim- lDougla s Count y Accoun t Informatio n Pag e 1 of2 Dougla s County , Nebrasic a Propert y Recor d - R081109000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e O scal e 0-5 0 r t wes t o r52n d S t - Vle W O n Ma R Information-i s vali d a s o f 2009-6-1 6 Treasurer' s Ta x Repor t Ne w Featur e - > - ^ - ^ Aut o Sale s Searc h Owne r SGHULT Z HAROL D D ETA L 110 1 DILLO N D R OMAH A N E 68132-000 0 Propert y Informatio n Ke y Numbe n 110 9 000 0 0 8 Accoun t Type : Residentia l Parce l Number : 081109000 0 Parce l Address : 2421N45A V OMAH A N E 68104-000 0 Lega l Description : CLAIRMON T LO T 2 8 BLOC K2 5 0 X 12 5 Valu e Informatio n Lan d /mprovemen t Tota l 200 9 $6,400.0 0 $66,100.0 0 $72,500.0 0 200 8 $6,400.0 0 • • $66,100.0 0 $72,500.0 0 200 7 $6,400.0 0 $66,100.0 0 $72,500.0 0 200 6 $6,400.0 0 $66,100.0 0 $72;500.0 0 200 5 $6,400.0 0 . $67,100.0 0 $73,500.0 0 200 4 $6,400.0 0 $61,000.0 0 $67,400.0 0 Sale s Informatio n Sale s Date : 2000-06-1 6 Dee d Type : D Book : 215 7 Page : 34 1 Price : $95,000,0 0 Grantor : Grantee :

• Valld/lnvalld : Vali d Exclusio n Reason ­ , Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6250. 0 1. 0 125. 0 50. 0 N o Improvenien t Informatio n

• http://douglasne.maoping-online.com/DouglasCoNe/static/accountinfo.jsp?acco,untno=R081.. . 7/2/200 9Dougla s Count y Accoun t Informatio n Pag e 2 of 2

Buildin g 1

J^; „ I * Secon dFloo r 76 a Os q 1 1 f' ' eoa.OMi . n I I "' ' a

J STOR Y

CLIC KT O ENLARG E IMAG E Squar e Footage : 1368. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0

HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : Fram e Aluminu m Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gambre l Stories : 2, 0 Floorcover : Allowanc e Foundation : Block Sprinkle 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 192 3 0 0 % 192 3 8 6 Oeta/ 7 Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 768. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1 ^ Porc h Enc I Scree n 119. 0 Porc h Ope n Sla b 119 ^ Porc h Sla b Roo f Cei l 28. 0

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R081.. . 7/2/200 9

## olT Y O F OMAH A PURCHASIN G - ROO M 100 3 181 9 FARNA M STREE T OMAHA , N E 68183-100 3 FAXi¥402-444-542 3

US A CONSTRUCTIO N SERVICE S IN C VENDOR : 813 0 8 9 2 AV E LAVISTA , N E 6812 8 

### Purchas e Orde r PURCHAS E CRCE R NO . 11595S 1 SHI P TO :

CITY O F OMAH A HOUSIN G & COM M DE V RM#111 1 181 9 FARNA M ST,REE T 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 - < 

### J ORIGINA L PURCHAS E ORDE R - VENDOR' S COP Y (SE E INSTRUCTION S BELOW ) ^CUSTOM(- R ACCOUN T NO . | VENDO R NO . DAT E O F ORDER/BUYE R REVISE D DATE//BUYE R 605 7 13-AUG-09 P BURK E PAYMEN T TERM S SHI P VI A F.O.B . DESTINATIO N FREIGH T TERM S REQUESTOR/DELIVE R T O CONFIR M T O /

TELEPHON E MARUCA . T MARI E 0 214-570 0 

# y < ITE M PAR T NUMBER/DESCRIPTIO N DELIVER Y DAT E QUANTITY UNI T UNIT-PRIC E EXTENSIO N IMPORTAN T - D O NO T STAR T WOR K UNTI L PROCEE D ORDE ^ I S ISSUE D B Y TH E PLANNIN G DEPARTMEN T - PE R GROU P 5 4 BI D DATE D 8/5/0 9 Al l price s an d amount s 2 d i n : U S Doi ; a r o n thi s orde r ar e expres s NEEDED : 12-AUG-0 9 EP APAIN T STABILIZATIO N PROGRA M GROU P 5 4 2 4 2 1 N 4 5T H A V O SHI P TO : Addres s a t top.o f pag e NEEDED : 1.2-AUG-0 9 EP APAIN T STABILIZATIOt J PROGRAM GROU P 54 . 243 1 { J 4 5T H AV O SHI P TO : . i Addres s a t to p o f pag e NEEDED : 12-AUG-0 9 EP APAIN T STABILIZATIO N PROGRA M GROU P 5 4 250 6 5 4OT H S T O SHI P TO : Addres s a t to p o f pag e 820.0 0 N ;

1,490.0 0 N

1,550.0 0 N

SHI P TO : Addres s show n above . I f shipmen t i s delaye d o ran y item s no l available , advis e at once . Pur ­ chas e orde.' ' numbe rmus t appea ro n al l invoices , packages , packin g lists , bil l o f lading , an d correspondence . Continue d 

## Tota l C SHIPPIN G CHARGE S T O B E PREPAID . I F APPLICABL E AN D ADDE D T O INVOICED , cop y l 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 Cit y o f Omah a Saiu s Taxes . Federa l I.O . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealer s Lie . 91-0316768 . Cil y Purchasin g Agenl' / Buye r 

# 3