## Transmitta l o f

Omah aLea d Site Pain t Stabilizatio n Fil e Folde r Sai d #:7.-&B6 y Date : E'-^- 7 0 Address : S^S ~ A ) H 7 /^( 7 Contractor : Cit y o f

Omah aYear : '^ ^ 7 0 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s V^or k Writ e U p _^^Signe d Acces s Agreemen t fo r

subjec t propert y Pre-Renovation for msigned , b y Propert y Owne r Pre-Renovation For mfo r

OCcupantAFenant , ifapplicabl e Painting Agreement/Cit y of Omah aPurchas e Orde r Settlemen t documents (i.e. , fo r

damag e o r

t

o replac e plants , etc. ) Renovation Recordkeepin g Checklis t signed b y Certifie d Renovato r Propert y informatio n fro mDougla s Count y Assessor' s Offic e i./Othe r (describe) : fmH s

Cit y o f Omah aRepresentativ e Signatur e Dat e 

# V]r ^ f{.Ll ^ JL/XOIX . EP A Representativ e Signatur e / Date.

_• 30262477 Superfun d

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

### Purchas e Orde r

. ' 181 9 FARNA M STREE T PURCHAS E CRDE R HO . OMAHA , N E 68183-100 3 115693 9

FAX # 402-444-542 3 SHI P TO : CITYOFOMAH A HOUSIN G & COM M DE V R M #111 1 181 9 FARNA M STREE T

. 0MAHA.N E 6818 3 MARCO S PROFESSIONA L PAINTIN G VENDOR : > . BIL L TO :

CIT Y O F OMAH A FINANC E MAFiC O A SALAZA R 251 4 J ST DISBURSEMENTS ROO M #100 7 OMAHA . N E 6810 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 . VENOO R NO . DAT E O F ORDER / BUYE R REVISE D DATE//BUYE R 8156 9 29-JUN-1 0 H HUR T PAYMEN T TERM S SHI P VI A F.O.B .

IMMEDIAT E DESTINATIO N FREIGHTTERM S REQUESTOR/DELIVE R T O CONFIR M T O / TELEPHON E MARUCA , T MARI E > ITE M PAR T NUMBER/DESCRIPTIO N • DELIVER Y DAT E QUANTITY UNI T UNI T PRIC E EXTENSIO N Al l prices , and amount s o n thi s orde r ar e expres s sd.i n : U S Doi ; ar . NEEDED : 1,477.0 0 N 30-JUN-l O EP APAINT STABILIZATIO N PROGRA M GROU P 1 4 3 1006 : S 2 6T H S T o SHI P TO : Addres s a t top o f pag e NEEDED : 1,577.0 0 N 30-JUN-l O EP A.PAIN T STABILIZATION ' PROGRA M GROU P 14 3 50 5 K 41S T A V O SHI P TO : Addres s a t to p o f pag e

SHI P TO : 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 . 3,054.0 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 . . TA X EXEMPTION : Th e Cil y o f Omahai s exemp t fro m Federa l Excis e Taxe s an d th e Nebraska an d Cit y of 

# ' Lici t Alll^^.^^ ^ Omah a Sale s taxes . Federa l I.D. . 476006304 ; STAT E 1.0.01-0316768 ; Fue l Dealers Lie . 91-0316768 . Cil y Purchasin g Ajen l / Buffe r • vJ ^Plannin g Departmen t

, _, _ . Omaha/Dougla s Civi c Cente r Inspector : Stev e Zivn y . 181 9 Parna mStreet . Suit e 1003 Date : 5/12/1 0 • Omaha , Nebrask a68183 . (402)444-515 0 Telefa x (402 ) 546-071 4 

### Name : Gregor y L . Schanema n R . E : 

### Cunningham , R.^F.SAM E 

## jSaXo r Address : 50 5 N4r ^ Av e .^-

- OMAHA EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEA D SIT E The Contrac t bi d document s consis t ofth e followin g sections : •Genera l Responsibilitie s lo r tli e Contracto r an d Occupant . •Lea d Hazar d Contro l Plan , Interi mContro l o f Lea d Ease d Pain t Hazards . Th e Contracto r Shall : •Compl y wit h HUD' s "Guideline s fo r th e Evaluatio n and Contro l o f Lead-Base d Pain t Hazard s i n Housing. " (Copie s ar e availabl e a t th e Plarmin g Department. ) •Compl y wit h Standard s calle d fo r i n th e "Constructio n an d Rehabilitatio n Specifications , Housin g an d Communit y Developmen t Division , Cit y o f Omaha , Nebraska. " (Copie s are availabl e at th e Plannin g Department. ) • .Compl y wit h th e Stat e ofNebrask aHealt h an d Huma n Service s Regulatio n and Licensure , Titl e 17 8 Chapte r 2 3 Lea d Bas e Pain t Regulations . •Coordinat e dail y constructio n schedul e wit h th e occupant •Submi t informatio n cu t sheet s fo r all substitution s o r approve d equal s prio r to writte n approval o f th e Construction-Specialist . •Repai r o r replac e al l item s damage d or disturbe d durin g pain t stabilizatio n activities . •Kee p wor k

sit e an d surroundin g are afree fro maccumulation s o f waste material s or

rubbis h cause d b y th e wor k

a

t al l times . • • Upo n dail y completio n o f work : clea n u p al l rubbish , exces s material , equipment , an d etc. , that i s connecte d v/it h th e v/ork , and leav e al l part s o f the-wor k

area s i n a

. neat , sanitary , lea d saf e an d presentabl e condition . •Complet e thi s projec t withi n 3 0 caleiida r days, . Th e Occupant/Owne r Shal l •Remov e an d store awa y an y personal property withi n twent y (20 ) fee t o f th e are a t o b e remediated . •Provid e acces s t o electricity and water throughou t th e paint stabilizatio n process . •Ensure ' tha t al l househol d member s sta y at leas t te n fee t awa y fro mal l wor k

area s an d als o kee p al l pet s a t leas t ten fee t awa y a t al l time s unti l th e wor k

ha s bee n complete d an d th e are aha s passe d avisua l inspection . . .

.• . . Initial s QL S •

### 505 N 4 1 s t Ave (Continued ) 

## Lea d Hazar d Contro l Pla n InterimContro l of Lea d based Pain t Hazard s Pain t Stabilizatio n •Stabiliz e al l previousl y painte d exterior wood , brick , metal , concret e surface s ofth e dwelling t o includ e bu t no t limited to th e siding , fascia , eaves , trim , window trim , shutters , gutters , railings , downspouts , doo r

tri m an d foundation . D O NO T INCLUD E WINDOW S O RMA N DOORS . D O NO T INCLUD E STUCC O SIDING . •Prepar e an d pain t al l previousl y painted surface s b y followin g the Saf e Wor k

Practice s protoco l fo r

EP A exterio r

lea d based pain t stabilization . • Al l paint coloir s t o matc h existin g pain l pattern . Prim e an d appl y tw o . coat s o f approve d finish coat . (Refe r

t

o Planning Dept . approve d pain t list) . •I F SPRAYED , ON E COA T SHAL L B E BACK-BRUSHE D O R BACK-ROLLED . Lea d Base d Pain t Wast e Lead-base d pain t wast e mus t b e handle d a s follow s •Al l pain t chip s an d componen t debri s mus tbe double bagge d fo r

disposal . •Clea n pain t chip s fromgroun d aroun d perimete r

o

f

dwelling befor e starting , durin g an d afte r

th e project . •Al l lea d painted component s an d debri s must b e removed fro mth e sit e dail y unles s otherwis e approved b y th e construction specialist . •Al l lead-based pain t debri s (chip s an d components ) mus t b e disposed o f

i

n amunicipa l soli d wast e laridfill . Propert y Ovrae r

Dat e Propert y Owne r

Dat e Witnes s -Dat e Occupan t (ifapplicable )Date Occupan t (i f applicable )Dat e

### Exterior Lead-base d Pain t Stabilizatio n Progra mManage d b y the Cit y o f Omahafo r

EP A Region 7 Omah aLea d Sit e Th e purpos e o f thi s progra mi s t o preven t yard s wher e lead-contaminate d soi l i s cleane d u p frombecomin g re-contaminate d b y deterioratin g exterio r lead-base d paint . Thi 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 d a n EP A contracto r ha s identifie d deterioratin g exterio r lead-base d paint . •Home s ar e eligibl e onl y b y referra l fromth e EPA . Wha t wor k

wil l b e done ? •Loos e an d flaking lead-base d pain t wil l b e remove d safel y fro mfascia , eaves , siding , trim , windo w trim , doo r trii h an d foundation . •Surface s wil l b e prime d an d painte d 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 not b e treated . •Window s o r door s wil l no t b e included . •Rotte n woo d wil l no t b e replaced , •N o housin g repai r wil l b e done . Wh o wil l performth e work ? •EP A contractor s wil l tes t pain t o n exterio r hous e surface s an d giv e th e resiilt s t o 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 d contac t th e property owne r fo r permissio n to proceed . •Wor k

wil l b e competitivel y bi d b y approved , traine d contractors . Whe n wil l th e wor k

b e done ? •Thi s progra mbega n i n 200 7 an d wil l continu e for several years . •Th e Cit y staf f wil l prioritiz e home s base d o n th e presenc e o f childre n unde r ag e si x i f known'an d th e severity o f th e problem . Pain t Stabilizatio n i s voluntar y an d wil l b e don e onl y wit h permissio n ofth e owner . 

### Initial s G t ^

### Consen t fo r

Acces s t o Propert y RIGH T O F ENTR Y T O PREMISES Granto r

(the propert y owner ) consent s t o an d autiiorize s th e Unite d State s Environmenta l Protection Agenc y (USEPA ) o r

it s authorize d representatives , collectivel y th e Grantee , to ente r

an d perfor m certain environmenta l respons e activitie s upo n th e followin g described premises : Owner' s Name : Daytim e Phone : Owne r

Name(s) : Gregor y L Schanema n 850-035 0

Addresse s of Propertie s Covere d b y thi s Agreemen t Propert y Addres s City/State/Zi p Cod e • 50 5 N . 41s t Av . Omaha, N E 6813 1

, 

### Granto r

understand s tha t thi s gran t doe s not limit EPA' s righ t o

f

acces s unde r

the Comprehensive Environmenta l Respons e an d Liabilit v Ac t (CERCLA \4 2 USC . & 9601-9675 . o r

an v othe r

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 exterior lead-based pain t o n residentia l properties , including day-car e facilities , wher e remediation o f

lea d contaminated soil has o

r

wil l tak e place . Samplin g of soi l ma y b e conducted . Thi s consen t shal l allo w Grante e ont o Grantor' s propert y an d fiirther, provide s the Grantee th e righ t t

o perfor man y an d al l environmenta l respons e action s an d activitie s i t deems appropriate . ENVIRONMENTA L RESPONS E ACTION S Th e environmenta l respons e action s t o be performe d o n subject propert y ma y includ e the followin g activities : 1 , Locating equipmeh t and/o r

machiner y on subject propert y i n preparatio n fo r

an d i n th e cours e o f th

e respons e activities . 2 . Obtaining sample s fro mGraiitor' s property .

2/12/200 7 (1 )

### Address : 505N . 4lstAv . Consen t fo r

Acces s t o Propert v (Tage 2 ) 3 .Plaiming an d implementin g th e respons e action o h th e Grantor' s property . Thi s wil l includ e 1 ) remova l o f

loos e o r flaking pain t identified b y EP A usin g lead-saf e method s i n compliance wit h HUD/EP A regulation s an d 2 ) repainting according t o th e attache d specifications . TER M Thi s acces s agreemen t shal l b e operable fo r

th e perio d o f

tim e i t take s t o complet e th e environmenta l riesponse activities . Upo n completion of th e respons e actions , al l right s an d privilege s give n b y th e Granto r

shall ceas e on tha t date , unles s extended b y asubsequen t agreement . AGREEMEN T NOT TO INTERFER E Granto r

agree s no t t

o interfer e vyit h an y of the activitie s undertake n b y Grantee a t the Property , tampe r

wit h an y o f

Grantee' s property , o r

tak e an y action s regarding th e us e of th e Propert y whic h will endange r

huma n healt h o r

welfar e o r

th e environment , o r

allo w others t o us e the Propert y i n suc h maime r

during th e ter mo f

thi s consent . Granto r

agree s t o provid e notic e and acop 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

an y portio n o f it : Granto r

agree s t o provid e 30-da y notic e t o EP A prio r

t

o an y transfe r

o f

ownershi p right s to th e property . SAMPLIN G RESULTS Grantee agree s t o provid e Granto r

wit h th e result s o f

an y an d all-samplin g and/o r

analysi s resulting fro mGrantee' s respons e activitie s b n the property . PRIO RCONDITIONS AGREEMEN T Th e grantor agree s t o the condition ofth e propert y prio r

t

o remediation an d indicate s o n Pag e 3 an y items t o b e removed b y th e Granto r

befor e activitie s commence . RESTORATIO N O F PROPERT Y Except fo r

tiie above stated pain t stabilization , th e Grantee agree s tiiat sai d propert y wil l b e restored as nearl y a s possibl e t o it s origina l stat e an d conditio n as foun d immediatel y preceding the beginning of activitie s authorize d b y thi s Agreement , followin g completion of th e respons e activities .

2/12/200 7 (2 )Address : 50 5 N . 41s t Av. , Omaha , NE , 6813 1 CURREN T CONDITIO N / PROPOSE D RESPONS E ACTIVTTIE S Th e purpos e o f thi s sectio n i s t o provid e amutual agreement a

s t d 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 ar e complete d t o th e satisfactio n o f th e propert y owne r and th e Unite d State s Environmenta l Protectio n Agenc y (EPA) . Item s t o b e remove d b 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 d bv contracto r durin g removal activities : 1­ 2 . ' 3 . .4 . 5 . ADDITIONA L COMMENTS :

I hav e rea d th e foregoin g documen t an d understan d tha t i t i s a n agreenient grantin g permissior i to th e Grante e t o enter th e abov e describe d premise s fo r th e purpos e o f conductin g environmental respons e activities , an d I agre e t o it s term s an d conditions . I acknowledg e tha t I hav e receive d th e pamphle t ."Renovat e Right" . Grantor' s Signature : vH-lr.Ac^*o2.^->nxv ^ . Dat e ^-^^I Q

(3 ^ 2/12/200 7