## Transmitta l o f

Omah aLea dSite Pain t Stabilizatio n Fil e Folde r Said #^t?H O Date : 7^-^'^^< f Address : //^-^ ~ S • 3 J ~ j^ V Contractor : Cit v o f

Omah a Year : ^ ^ ^ 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s i l 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 o f

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 signedby Certifie dRenovato r Propert y informatio n fro mDouglas Count y Assessor' s Offic e i^Other (describe) : nCfUTk/ )



### 3 - y S~-7^ ~ 

# 7^^ ^ ^^ ^ Cit y of Omah aRepresentativ e Signatur e Dat e 

# :^IX . EP A Representativ e Signatur e ' Dat e 3026243 3 Superfun dPlannin g Departmen t Inspector : Stev e Zivn y Omaha/Dougia s ciw c Ccmc t T>

K . Aitoin o • 181 9 Fama mStreet , Suitc l 00 3 Date : 4/18/0 8 Omaha . Nebrask a6818 3 (402)444-515 0 

### Name : Raymon dKraus e^^^^' ^ ^'" ^ '''•''' ' A j j i-iieci'-icA-%T r Steve n N . Jensen , AIC P City of

Omah aAddrCSS : 111 5 8 3 5 AV E Directo r Mik e Fahey, . Mayo r 

## OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEA D SIT E Th e Ciontrac t bi ddocument s consis t of th e followin g sections : • Genera l Responsibilitie s fo r th e Contracto r an dOccupant . •Lea dHazar dContro l Plan , Interi mContro l of Lea dBase 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 of Lead-Base d Pain t Hazard s in Housing. " (Copie s ar e availabl e at th e Plannin g Department. ) •Compl y wit h Standard s calle dfo rin th e "Constructio n An dRehabilitatio n Specifications , Housin g an dCommunit y Developmen t Division , Cit y of Omaha , Nebraska. " (Copie s ar e availabl e at th e Plannin g Department. ) •Compl y wit h th e Stat e of Nebrask aHealt h an dHuma n Service s Regulatio n an d Licensure , Titl e 17 8 Chapte r 23 Lea dBas e Pain t Regulations . • ••>. •Coordinat e dail y constructio n schedul e wit h the'occupan t •Submi t informatio n cu t sheet s fo r al l substitution s or approved.equal s prio r to writte n approva l of th e Rehabilitatio n Inspector . •Repai r or replac e al l item s damage d or disturbe ddurin g construction . • At all time s kee p th e sit e of wor k an dsurroundin g are afre e fro maccumulation s of

wast e material s or rubbis h cause d by th e work . •Upo n dail y completio n of wor k clea n up all rubbish , exces s material , equipment , an detc. , tha t is connecte dwit h th e work , an dleav e all part s of th e wor k area s in a neat , sanitary , lea dsaf e an dpresentabl e condition . •Complet e thi s projec t withi n 30 calenda r days . Th e Occupan t Shal l •Remov e an dstor e awai y an y persona l propert y withi n twent y (20 ) fee t of th e are a to be remediated . •Remov e voluntee r tree s an dvegetatio n fro mth e dri p lin eof th e roof, an dcu t bac k shrub s an dbushe s at leas t tw o fee t fro mth e hous e an dgarage . •Eiisur e tha t al l househol dmember s sta y at leas t te n fee t awa y fro mal l wor k area s ari dals o kee p all pet s at leas t te n fee t awa y at al l time s unti l th e wor k ha s been . Cbrnplete dan dth e are aha s passe davisua l inspection . ^ ( • Initial s " ^111 5 S 3 5 Av e (continued ) 

## Lea dHazar dContro l Pla n InterimControl o f

Lea dbase dPain t Hazard s Pain t Stabilizatio n •Prepare an dpain t al l previousl y painte dexterio r surface s of th e dwellin g t o includ e th e fascia , eaves , siding , trim , windo w trim , doo r tri man d foundation . D o no t pain t window s o r doors . •Prepar e an dpain t al l previousl y painte dsurface s o f th e fron t porch . •Prepar e an dpain t al l previousl y painte dexterio r surface s of th e garag e if applicable . •A H pain l color s t o matc h existing . Prime an dappl y tw o coats . •Se e plannin g Department' s lis t o

f approve dpain t product s fo r lea d projects . 

### Lea dBase dPain t Wast e Lead-base dpain t waste mus t b e handle da s follow s , •Al l pain t chip s an dcomponen t debri s mus t b e doubl e bagge dfor disposal . •Clea n pain t chip s fromgroun daroun dperimete r o

f dwellin g before starting , durin g an dafte r th e project . •Al l leadpainte dcomponent s 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 ) mus t b e dispose do f in rXmunicipa l soli dwast e landfill . & ' 

# . 9 , 4-^-08 "

• ::£SH ^ Occupan t (i f applicable ) Dat e Occupan t (i f applicable ) Dat e Witnes s Dat e

### Exterior Lead-basedPain t Stabilizatio n Progra mManagedb y the Cit y o f Omahafo r

EP A Region 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 decontaminate db y 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 where soi l clean-u p ha s been o r v/il 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 referra l fromth e EPA . What wor k

wil l b e done ? •Loos e an dflakin g lead-base dpain t wil l b e remove dsafely 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 ? •EP A contractor s wil l tes t pain t on exterio r hous e surface s an dgiv e th e result s t o th e City of Omah aPain t Stabilizatio n Program . •City Constructio n Specialist s wil l prepar e awor k

pla n an dcontac t th e propert y owne r for permissio n t o proceed . •Wor k

will , b e competitivel y bi db y approved , traine dcontractors . Whe n wil l th e wor k

b e done ? •Thi s programbega n in 200 7 an dwil l continu e for severa l years . •Th e Cit y staf f wil l prioritiz e home s base do n th e presenc e o f childre n under ag e si x if know n an dth e severity of th e problem . Pain t Stabilizatio n i s voluntar y an dwil l b e don e onl y wit h permissio n of th e owner . 

### Initial s Wp >Consen t fo r Acces s t o Propert y RIGHT O F ENTRY T O PREMISE S Granto r (th e propert y owner ) consent s t o an dauthorizes , th e Unite diState s Environmental Protectio n Agenac y (USEPA ) o r it s authorize drepresentativeS j collectivel y th e Grantee , t o ente r an dperfor m certai n environmental respons e activitie s upo n th e followin g describe dpreniises ; Owner' s Name : Davtim e Phone : Owner Name(s) : Ra y Kraus e

Addresse s of Propertie s Covere db y this-Agreement Property Addres s City/State/Zi p Cod e 1115S35AV . 

### Omaha, N e (ipSlO^-no S

Granto r understand s that thi s grant , doe s no t limi t EPA' s right o

f acces s under th e Comprehensiv e Environmenta l Respons e an dLiabilitv Ac t (CERCLA) . 4 2 USC . & 9601-9675 . o r anv 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 flakin g exterio r lead-base dpain t o

n residentia l properties , includin g day-care facilities , where remediatio n of leadcontaminate dsoi l ha s 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 property andfurther , provide s th e Grante e th e right t o perfor many an dal l environmental respons e action s an dactivitie s i t deem s appropriate . ENVIRONMENTA L 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 on subjec t propert y 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 fromGrantor' s property .

(1 ) 2/12/200 7Address : 1115S35A V Consen t for Acces s t o Propertv (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 of loos e o r flakin g pain t identifie db y EP A usin g lead-saf e method s i n complianc e wit h HUD/EP A regulations an d2 ) repaintin g accordin g t o th e attache dspecifications . TERM Thi s acces s agreemen t shal l b e operabl e fo r th e perio do f tim e i t take s t o complet e th e environmenta l respons e activities . Upo n completio n of th e respons e actions , al l rights an d privilege s give n b y th e Granto r shal l ceas e on that date , unles s extende db y a ' subsequent agreement . AGREEMEN T NO T T O INTERFERE Granto r agree s no t t o interfere wit h any o f th e activitie s undertake n b y Grante e a t th e Property , tampe r wit h any of Grantee' s property , o r take an y action s regardin g th e us e o f th e Propert y which wil l endange r huma n healt h o r welfar e o r th e environment , o r allo w other s t o .use,th e Propert y i n suc h manne r durin g th e termof thi s consent . Granto r agree s t o provid e notic e an dacop y o f thi s agreemen t t o prospectiv e purchasers , lessees , assigns , o r grantee s of 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 to EP A prio r t o an y transfer of ownership.right s to th e property . SAMPLIN G RESULT S Grante e agree s t o pr o vide . Gra n to r wit h th e result s o f an y an dall samplin g and/o r analysi s resultin g fro mGrantee' s respons e activitie s on th e property . PRIO RCONDITION S AGREEMEN T Th e granto r agree s to th e conditio n o f th e property prio r t o riemediation an dindicaite s on 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 for th e abov e state dpain t stabilization , th e Grante e agree s that said , propert y wil l b e restore d a s nearl y a s possibl e t o it s original stat e an dconditio n a s foun dimmediatel y precedin g th e beginnin g of activitie s authorized , b y thi s Agreement , following , completio n of th e respons e activities .

(2 ) 2/12/200 7Address : 111 5 S 3 5 AV , Omaha , Ne , CURREN T CONDITIO N / PROPOSE D RESPONS E ACTTVITIES Th e purpos e o f thi s sectio n i s t o provid e amutual agreemen t a s t o condition s o f propert y prio r to contracto r activities . Thi s wil l als o serv e a s documentatio n fo r

th e purpos e of assurin g tha t restoratio n activitite s ar e complete dt o th e satisfactio n of th e propert y owne r an d th e Unite dState s Environmenta l Protectio n Agenc y (EPA) . Item s t o b e remove db v propertv owne r prio r t o th e response activities : 1 Moy/E ^ S7D7^tf/Z , Sf7£ 0 7^ 9 i^/9l/^<^ ^ ti^eTi C S7>/Sc e /^^UA/i P OA£^ibr C



### ^ \/6(7/coe s (KJ/L O 

### 7 ^ T^y/^^ o T O srr4££:<r . ' 4- . 5 . Item s NO T t o b e remove db v contracto r durin g removal activities :

^ ^h7^7 ^ 7i r 7>77 S r7/i^i^ ^ 2 . • 3 . 4 . 5 . ADDITIONA L COMMENTS :

I hav e rea dth e foregoin g documen t an d understan dthat i t i s ar i agreement grantin g permissio n t o th e Grante e t o ente r th e abov e describe dpremise s for th e purpos e o f

conductin g environmental respons e activities ^ an d I agre e t o it s term s an dconditions . Grantor' s Signature^ , ryix^\/ C . j^Qjjufjf J Dat e _9^^^/^ ^ 

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(3 ) 2/12/200 7Dougla s Count y Accoun t Informatio n Pag e I o f 2 Dougla s County , Nebrask a Propert y Recor d - R190344000 0 ( T pf ^ -4 ^ Z034t > Prin t Repor t Parce l Dimension s availabi e 0 scal e 0-S O f

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### H -^^i'^U^•o ^ 111 5 8 3 5 AV E 

# 'pio-f^n ^ OfVlAHAN E 68105-000 0 Propert y Informatio n Ke y Numtier : 034 4 000 0 1 9 Accoun t Type : Residentia l Parce l Number : 190344000 0 Parce l Address : 1115&35A V OMAH A N E 68105-000 0 Lega l Description : OAKHURS T PAR KLOT 2 1 BLOC K2 N 3 6 F T L T 2 0 & S 5 F T 4 1 X14 1 Valu e Informatio n Lan d Improvemen t Tota l 200 7 $11.,60d.0 0 $103,900.0 0 $115,500.0 0 200 6 $11,600.0 0 $67,300.0 0 $78,900.0 0 200 5 $11,600.0 0 $67,300.0 0 $78,900.0 0 200 4 $11,600.0 0 $67,300.0 0 $78,900.0 0 200 3 $11,600.0 0 $62,300.0 0 $73,900.0 0 200 2 $0.0 0 $0.0 0 $0.0 0 Sale s Informatio n Sale s Date : 1995-11-1 2 Dee d Type : Book : 202 4 Page : 08 4 Price : $65,000.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 3 5781. 0 1. 0 141. 0 41. 0 N o Improvemen t Informatio n

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CLIC KT O ENLARG E IIVIAG E CLICKJj O ENLARG E IMAG E Squar e Footage : 1196. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/2Stoi7Fi n Cond o Squar e Footage : 0. 0

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

Roo f Type : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Blocl < 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 0 0 0 % 192 0 8 7 Oe(a/ 7 Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Blocl < 8 f t 672. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bati i Ful l 1. 0 Garag e Detache d 216. 0 Porc h Sla b Roo f Cei l 144. 0 Porc h Sla b Roo f Cei l 48. 0

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## i :iT Y O F OMAH A PURCHASIN G ­ ROO M 100 3 

### Purchas e Orde r

181 9 FARNA M STREE T PURCHAS E ORDE R NO . REVISIO N PAG E •OMAHA , N E 68183-100 3 FAX#402-444-542 3 114800 4 1

. J 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 6818 3 G B ENVIR O SERVICE S VENDOR : > < BIL L TO :

CIT Y O F OMAH A FIN/^C E %GAR Y JENKIN S 430 2 MAPL E S T DISBURSEMENT S ROO M #100 7 OMAHA . N E 6811 1 181 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 . DAT E O F ORDER/ BUYE R REVISE D DATE//BUYE R 7740 8 30-MAY-0 8 P BURK E PAYMENTTERM S SHI P VI A F.O.B . DESTINATIO N FREIGH T TERM S REQUESTORrtJELIVE R T O CONFIR M T O / TELEPHON E KASPAR . CATHLEE N > - < ITE M PAR T NUMBE R / DESCRIPTIO N DELIVER Y DAT E QUANTIT Y UNI T UNI T PRIC E EXTENSIO N INPORTANT-D O NO T STAR T WOR K UNTI L PROCEE D ORDE R I S ISSUE D B Y TI E PLANNING DEPARTMENT . PE R GROU P 3 BI D DATE D 5/21/0 8 Al l price s an d amount s o n thi s orde r ar e expres s 2 d i n : U S Dol]a r NEEDED: 2,800.0 0 N 08-JUN-0 8 EP APAIN T STABILIZATIO N PROJEC T 111 5 SOtJT H 3 5 AVENU E GROU P # 3 o SHI P TO : Addres s a t to p o f pa^ e

****** * * l l * i t ****. * a* * -kV i *********** * -k ********** * * \NEEDED : 3,050.0 0 N i 08-JUN-0 8 EP APAIN T STABILIZATIO N PROJEC T 54 4 SOUT H 3 0 STREE T GR0UP# 3 GROU P # 3 o SHI P TO : Addres s a t to p o f pag e

SHI P TO : Addres s stiow n atxwe . I f shipmen t I s delaye d o ran y item s no t available , advis e a t once . Pur ­ chas e orde rnunnbe rnxjs t appea ro n all invoices , packages , packin g lists , bil l o f lading , an d correspondence . Continue d 

## Tota l C 

# D SHIPPIN G CHARGE S T O B E PREPAID . I F APPLICABLE AN D ADDE D T O INVOICED , cop y t o b e fur ­ nishe d wit h invoice . TA X EXEMPTION : Th e Cit y o f Omah a i s exempt fro m Federa l Excise'Taxe s an d th e Nebrask a an d Cit y o f Omah a Sale s Taxes . Federa l I.O . 476006304 ; STAT E I.D : 01-0316768 ; Fue l Dealer s Lie . 91-0316768 . Cii y Purchaiin g Asen I / Buye r