## Transmitta l o f

Oinah aLea d Site Pain t Stabilizatio n Fil e Folde r Said#_^r^9/___

_Date : ^-4^-/ 0 Address : cP-^V / 7^**>^/ ^ ^> i S f Contractor : Cit v o f

Omah aYear : p- C 7 D 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s ^Wor k Writ e U p l y 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 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 signe dby Certifie dRenovato r ' ^ Propert y information^o mDougla s Count y Assessor' s Offic e Mothe r (describe) : //) ( 

## \Cf\^S

Cit y o f

Omah aRepresentativ e Signatur e Dat e 

# n^ A ZllS^IOJQll . EP A Representativ e Signatur e ' Dat e 3026245 3 

# NiniH i Superfun d

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

MALON E PLAC E LL C VENDOR : 1414 7 FRANCE S S T OMAHA , N E 6814 4 

### Purchas e Orde r REVISIO N PAG E PURCHAS E ORDE R NO . 0 116475 9 SHIPTO :

CITYOFOMAH A HOUSIN G & COM M DE V R M #111 1 181 9 FARNA M STREE T OMAHA.N E 6818 3 > -<

BIL L TO :

CIT Y O F OMAH A FINANCE ' DISBURSEMENT S ROO M #100 7 181 9 FARNA M STREE T 0MAHA.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 8019 2 06-APR-1 0 HHUR T PAYMENTTERM 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

> • ITE M PAR T NUMBE R /DESCRIPTIO N DELIVER Y DAT E QUANTIT Y UNI T UNITPRIC E EXTENSIO N • < Al l price s an d amount s o n thi s orde r ar e expres s s d i n : U S Dolla r NEEDED : 2,189.0 0 N 07-APR-1 0 EP APAIN T STABILIZATIO N PROGRAM GROU P 8 1 .244 8 TEMPLETO NS T O SHI P TO : Addres s a t to p o f pag e

SHIPTO : Addres s show n above . Ifshipmentisdelayedoran y Item s no t available , advis e a t once . Pur ct^as e orde rnumbe rmus t appea ro n al l invoices , packages , packin g lists , bil l o f lading , an d conespondence . 2.189:0 0 

## Tota l C 

# J SHIPPIN G CHARGE S T O B E PREPAID , I F APPLICABL E AN D ADDE D T O INVOICED , cop y t o b e fur ­ nishe d witt i invoice . TA X EXEMPTION : Tti e Cit y o f Omah a I s exemp t from Federa l Excis e Taxe s an d th e Nebrask a an d Cit y o f 

## .4 . On-iah a Sale s Taxes . Federa l I.D . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealer s Uc . 91-0316768 . 

### w\ : Cil y Purchasin g Mgwi t / Buye r

### Plannin g Departmen t Omaha/Dougla s Civi c Cente r Inspector : To mRoz a181 9 Farna mStreet , Suit e 100 3 r>ati»

- O/^/i n Omaha , Nebrask a6818 3 Uate . ZO/I U (402)444-515 0 Telefa x (402 ) 546-071 4 

### Name : Jua n D e L aCruz/'Cuad f a . Cunningham , RA , F.SAM E 

### jiSsu^d^M^yo r

Addrcss : 244 8 Templeto n S t °''"''^ ' OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEA D SIT E Th e Contract hid document s consis t ofth e followin g sections : •Genera l Responsibilitie s fo r

th e Contracto r

an dOccupant . •Lea dHazar dControl Plan , Interi mControl o f

Lea dBase dPain t Haziirds . Th e Contracto r Shall : •Compl y wit h HUD' s "Guideline s fo r

th e Evaluation an dControl o f

Lead-Base d Pain t Hazard s u i Housing, " (Copie s ar e available a t th e Planning Department. ) •Compl y wit h Standard s calle dfo r

i

n the "Construction an dRehabilitation Specifications , Housin g an dCommunit y Developmen t Division , Cit y o f

Omaha, Nebraska. " (Copie s ar e availabl e a t the Planning Department. ) •Compl y wit h th e .Stat e ofNebraskaHealt h an dHuma n Service s Regulation an d Licensure , Titl e 17 8 Chapte r

2 3 Lea d Bas e Pain t Regulations . •Coordinat e dail y constructio n schedule wit h thi e occupan t •Submi t informatio n cu t sheet s fo r

al l substitution s o r

approve d equal s prio r

t

o writte n approva l o f

the Construction Specialist . •Repai r

o

r

replac e al l item s damage do r

disturbeddurin g pain t stabilizatio n activities . • • . . •. Kee p wor k

sit e an dsurrouridin g are a free fro maccuinulation s o f

wast e material s o

r

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 detc. , thati s connectedwit h the work, an dleave al l part s o f

the wor k

area s i n a neat , .sanitary , lea dsaf e an dpresentabl e condition . •Complet e tlii s projec t within 3 0 calendar-days . Th e Occupant/Owne r

Shal l •Remov e an d stor e awa y an y persona l propert y withi n twent y (20 ) fee t ofth e area t o b e remediated . •Provid e acces s t o electricit y an dwate r

throughou t th e pain t stabilizatior i process . •Ensur e tha t all householdmembers sta y a t 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 te n fee t awa y a t al l time s until the wor k

has been . completedan dth e are aha s passe davisua l inspection . Initial s 

# Ai l

### 244 8 Templeto n S t (Continued) ' 

## Lea d Hazar dContro l Plan InterimControl o f

Lead basedPain t Hazard s Pain t Stabilizatio n

. • Prepar e an dpain t al l previousl y painte dexterio r

surface s ofth e dwelling t o includ e bu t no t limitedt o the fascia , eaveS j trim , window trim , doo f

tri m an dfoundation . D o no t includ e door s o r windows ^ •Prepar e an d pain t all previousl y painted surface s b y followin g th e Saf e Wor k

Practice s protoco l fo r

EP A exterio r

lea dbasedpain t stabilization . •Al l pain t color s t o matc h existing pain t pattern . Prim e an dappl y tw o coats o

f

approve d finish coat . (Refe r

t o Planning Dept . approvedpain 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 d a s follow s •Al l pain t chip s an d componen t debri s mus t b

e double bagge dfo r

disposal . •Cleai n pain t chip s fro mgroun daroun dperimete r

o

f

dwelling before . starting , during an d afte r

the 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 the constriiction specialist . •Al l lead-basedpain t debri s (chip s an dcomponents ) must be disposedo f

i

n

. amunicipa l soli dwast e landfill . Propert y Owne r Dat e 

# ^/f e /it ) ^2£0£^y Owne r Dat e Witnes s Dat e Occupan t (ifapplicable ) Dat e Occupan t (ifapplicable ) Dat e Witnes sDat e

### Exterior Lead-base dPain t Stabilizatio n Progra mManagedb y th e Cit y o f Omahafo r

EP A Regio n 7 .Omah aLea d Sit e Th e purpos e o f thi s programi 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 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 fromth e EPA . What wor k

wil l b e done ? •Loos e an dflaking lead-base d pain t wil l b e remove d safel y fromfascia , eaves , siding , trim , windo w trim , doo r tri man d foundation . •Surface s wil l b e prime dan d painte d t o matc h existin g pain t colo r a s .closely 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 not 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 an d giv e th e result 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

plan an d Contact th e property owner for permissio n t o proceed . •Wor k

vvil 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 mbegan 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 know n and . 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 with permissio n ofth e owner . 

### Initial s " ^ LConsen t fo r Acces s t o Propert y RIGH T O F ENTR Y TO.PREMISE S Granto r (th e property owner ) consent s t o an d authorize s th e Unite d State s Enviromnental Protectio n Agenc y (USEPA ) o r it s authorize drepresentatives , collectivel y th e Grantee , to ente r an d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises : Owner' s Name : Davtime Phone : Owner Name(s) : Juan DeL aCruz/Cuadr a 402-932-138 3

Addresse s o f Propertie s Covere d b y thi s Agreemen t Property Addres s City/State/Zi p Code 244 8 Templeto n St . Omaha , N E 6811 1

Granto r understand s that thi s grant doe s no t limi t EPA' s righ t o f acces s unde r th e Comprehensiv e Environmenta l Respons e an dLiabilitv Ac t fCERCLA V 4 2 USC . «f e 9601-9675 . o r anv . 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 d pain t o n residentia l properties , includin g day-care facilities , wher e remediatio n o f lead containinate d soi 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 dfurther , provide s th e Grante e th e righ t to perfor man y an d al 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 d o 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 property in preparatio n fo r an d i n th e cours e o f th e respons e activities . 2 . Obtainin g sample s fro mGrantor' s property .

2/12/200 7 (1 )Address : 244 8 Templeto n St . Consen t for Acces s to Propertv CPag 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 ) remova l o f loos e b r flaking pain t identifie d b y 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 the attache d specifications . TERM Thi s acces s agreemen t shal l b e operabl e for th e perio d o 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 by th e Granto r shal l ceas e o n tha t date , unles s extende d by asubsequen t agreement . AGREEMEN T NO T T O INTERFERE Granto r agree s ho t t o interfere with any o f th e activitie s undertake n b y Grante e a t th e Property , tarnper with any o f Grantee' s property , o r tak e any action s regardin g th e us e ofth e Propert y whic h wil l endange r huma n health o r welfar e o r th e environnient , o r allo w other s t o us e th e Propert y i n suc h marme r durin g th e ter mo f thi s consent . Granto r agree s to- provid e notic e an d acop y o f thi s agreemen t t o prospectiv e purchasers , lessees , assigns, , o r grantee s o f th e property or an y 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 to th e property . SAMPLIN G RESULT S Grante e agree s to provid e Granto r wit h th e result s o f any ' an d al l 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 an d indicate 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 for th e abov e state dpairi t stabilization , th e Grante e agree s that sai d propert y wil l b e restore d a s nearl y a s possibl e t o it s original stat e an d conditio n a s foun diinmediatel y precedin g th e begirmin g o f activitie s authorize dby thi s Agreement , followin g completio n o f th e respons e activities . .

(2 )2/12/200 7Address : 244 8 Templeto n St. , Omaha , NE , 6811 1 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 amutual agreemen t a s t o condition s o f property prio r to 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 owner an dth e Unite d State 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 therespons e activities : 1 . . 2 . 3 . 4 . 5 . Item s NO T to b e remove db v 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 imderstan dtha t i t i s a n agreement grantin g permissio n t o th e Grante e t o ente r th e abov e describe d premise 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 d conditions . I acknowledg e tha t I hav e receive d th e pamphle t "Renovat e Right" . Grantor' s Signature : \}W^>s5Vv(X . ^^^ ^ " ^ / T // D

2/12/200 7 (3 )Dbugl^svGourit y Accoun t Informatio n http://douglasne.mapping-online.conVDouglasCoNe/static/accountinfo. , Dougla s County , Nebrask a Propert y Recor d - R164413000 0 Prih 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 S t - VJe W O H informatio n i s vali d a s o f 2009-12-3 1 Ne w Featur e Owne r DELACRUZCUADR A JUA N Em L 244 8 TEMPLETO N S T OMAH A N E 68111-000 0 Propert y Informatio n Ke y Number : AccountType : Parce l Number : Parce l Address : Lega l Description : Valu e Informatio n L:an d 200 9 200 8 200 7 200 6 200 5 200 4 Salei s Informatio n Sale s Date : Dee d Type : Price : Granto r Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : 441 3 000 0 1 6 Residentia l 164413000 0 244 8 TEMPLETO N S T OMAH A N E 68111-000 0 LUK E & TEMPLETON S LO T 1 3 BLOC K0 5 0 X 13 2 Improvemen t $2,600.0 0 $57,700.0 0 $2,600.0 0 $57,700.0 0 $2,600.0 0 $57,700.0 0 $2,600.0 0 $57,700.0 0 $2,600.0 0 $11,400.0 0 $2,600.0 0 $10,300.0 0

2003-09-1 7 C O SooAc : 200 3 $ 65,000.0 0 MARAITZ A BELTRA N JUA N DEL A CRLi Z CUADRO S Invali d Lan d Contrac t - Agreemen t 2003-09-1 7 W D SooAr ; $ 65,000.0 0 MARITZ A BELTRA N JUA N DELACRU Z CUADR A ETA L 200 4 Ma p Treasurer' s Ta x Repor t -• ^ • • Aut o Sale s Searc h

Tota i $ 60,300.0 0 $ 60,300.0 0 $ 60,300.0 0 $ 60,300.0 0 $ 14,000.0 0 $ 12,900.0 0
Page : 18310 3

Page : 16508 3

lo f 3 1/25/201 0 9:2 6 A MD»'jg!a s Cpunt y Account Informatio n http://dougiasne.mapping-online.com/DouglasCoNe/static/accountinfo. . Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1998-09-2 0 Dee d Type : Price : $16,000.0 0 Grantor : Grantee : Valid/Invalid : Invali d Exclusio n Reason : Invali d Sal e Sale s Date : 1998-05-2 8 Dee d Type : D M Price : $25,000.0 0 Grantor : Grantee : Valid/invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s 0.1 5 6600. 0 1. 0 Improvemen t Informatio n Buildin g 1 Book : 211 6

Book : 209 1

Dept h 132. 0 Widt h 50. 0 Page : 60 7

Page : 04 9

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1 1/ 2 Story Fi n Centra l Ai rt o Ai r Fram e Sidin g CLIC KT O ENLARG E IMAG E Percen t Complete : Quality : Condition : Cond o Squar e Footage : Rooms :

Units : 100.0 % Fai r Fai r 0. 0 9. 0 1. 0

2 o f 3 1/25/201 0 9:2 6 A M