Transmittal of Oinaha Lead Site 

Paint Stabilization File Folder 

Said#_^r^9/___ _ Date: ^-4^-/ 0 

Address: cP-^V / 7^**>^/^ ^>i S f 

Contractor: Citv of Omaha Year: p-C 7 D 

Paint Stabilization 

Property File Folder Documents 

^Wor k Write Up 

l y Signed Access Agreement for subject property 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, ifapplicable 

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 

' ^ Property information^om Douglas County Assessor's Office 

Mothe r (describe): //)\Cf\^ ( S 

City of Omaha Representative Signature Date 

n^A ZllS^IOJQll. EPA Representative Signature ' Date 

30262453 

NiniHi 

Superfund 
CITY OF OMAHA 

PURCHASING - ROOM 1003 

1819 FARNAM STREET 

OMAHA, NE 68183-1003 

FAX# 402-444-5423 

MALONE PLACE LLC VENDOR: 14147 FRANCES ST 

OMAHA, NE 68144 

Purchase Order 

PURCHASE REVISION PAGE ORDER NO. 

1164759 0

SHIPTO: 

CITYOFOMAHA 

HOUSING & COMM DEV RM #1111 

1819 FARNAM STREET 

OMAHA.NE 68183 

> -< 

BILL TO: 

CITY OF OMAHA FINANCE' 

DISBURSEMENTS ROOM #1007 

1819 FARNAM STREET 

0MAHA.NE 68183 

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

CUSTOMER ACCOUNT NO. VENDOR NO. DATE OF ORDER/ BUYER REVISED DATE//BUYER 

80192 06-APR-10 HHURT 

PAYMENTTERMS SHIP VIA F.O.B. 

DESTINATION 

FREIGHT TERMS REQUESTOR/DELIVER TO CONFIRM TO /TELEPHONE 

MARUCA, T MARIE 

> • ITEM PART NUMBER /DESCRIPTION DELIVERY DATE QUANTITY UNIT UNITPRICE EXTENSION • < 

All prices and amounts on this order are express sd in : US Dollar 


NEEDED: 2,189.00 N 


07-APR-10 


EPA PAINT STABILIZATION 


PROGRAM GROUP 81 .2448 


TEMPLETON ST 


O SHIP TO: 


Address at top of page 


SHIPTO: Address shown above. Ifshipmentisdelayedorany Items not available, advise at once. Purct^ase order number must appear on all invoices, packages, packing lists, bill of lading, and conespondence. Tota 2.189:00 

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

nished witti invoice. 

TAX EXEMPTION: Ttie City of Omaha Is exempt from Federal Excise Taxes and the Nebraska and City of 

.4. On-iaha Sales Taxes. Federal I.D. 476006304; STATE I.D. 01-0316768; Fuel Dealers Uc. 91-0316768. w\: 

Cily Purchasing Mgwit / Buyer 
Planning Department 

Omaha/Douglas Civic Center 

Inspector: To m Roz a 1819 Farnam Street, Suite 1003 

r>ati»- O/^/in Omaha, Nebraska 68183 

Uate . ZO/IU (402)444-5150 

Telefax (402) 546-0714 

Name: Juan De La Cruz/'Cuadf a. Cunningham, RA, F.SAME 

jiSsu^d^M^yor Addrcss: 2448 Templeton St °''"''^' 

OMAHA EXTERIOR PAINT STABILIZATION PROGRAM 

FOR THE EPA OMAHA LEAD SITE 

The Contract hid documents consist ofthe following sections: 

• General Responsibilities for the Contractor and Occupant. 

• Lead Hazard Control Plan, Interim Control of Lead Based Paint Haziirds. 

The Contractor Shall: 

• Comply with HUD's "Guidelines for the Evaluation and Control of Lead-Based 

Paint Hazards ui Housing," (Copies are available at the Planning Department.) 

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

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

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

• Comply with the .State ofNebraska Health and Human Services Regulation and 

Licensure, Title 178 Chapter 23 Lead Base Paint Regulations. 

• Coordinate daily construction schedule with thie 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 and surrouriding areafree from accuinulations 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., thatis connected with the work, and leave all parts of the work areas in a 

neat, .sanitary, lead safe and presentable condition. 

• Complete tliis project within 30 calendar-days. 

The Occupant/Owner Shall 

• Remove and store away any personal property within twenty (20) feet ofthe area 

to be remediated. 

• Provide access to electricity and water throughout the paint stabilizatiori 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 Ail 
2448 Templeton St (Continued)' 

Lead Hazard Control Plan 

Interim Control of Lead based Paint Hazards 

Paint Stabilization 

. • Prepare and paint all previously painted exterior surfaces ofthe dwelling 

to include but not limited to the fascia, eaveSj trim, window trim, doof trim 

and foundation. Do not include doors or windows^ 

• 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 match existing paint pattern. Prime and apply two coats 

of approvedfinish 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. 

• Cleain 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 constriiction specialist. 

• All lead-based paint debris (chips and components) must be disposed of in 

. a municipal solid waste landfill. 

Property Owner 

Date 

^/f e /it) 

^2£0£^y Owner 

Date 

Witness 

Date 

Occupant (ifapplicable) 

Date 

Occupant (ifapplicable) 

Date 

Witness Date 
Exterior Lead-based Paint 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. This 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 vvill 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 based on the presence of children under age 

six if known and. the severity of the problem. 

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

Initials "^ L 
Consent for Access to Property 

RIGHT OF ENTRY TO.PREMISES 

Grantor (the property owner) consents to and authorizes the United States Enviromnental 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): Juan DeLa Cruz/Cuadra 402-932-1383 

Addresses of Properties Covered by this Agreement 

Property Address 

City/State/Zip Code 

2448 Templeton St. 

Omaha, NE 68111 

Grantor understands that this grant does not limit EPA's right of access under the Comprehensive 

Environmental Response and Liabilitv Act fCERCLAV 42 USC. «fe 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 remediation of lead containinated soil has 

or will take place. Sampling of soil may be conducted. This consent shall allow Grantee onto 

Grantor's property and further, provides the Grantee the right to perform any and all environmental 

response actions and activities it deems appropriate. 

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. 

2/12/2007 (1) 
Address: 2448 Templeton St. 

Consent for Access to Propertv CPage 2) 

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

1) removal of loose br 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 hot to interfere with any of the activities undertaken by Grantee at the Property, 

tarnper with any of Grantee's property, or take any actions regarding the use ofthe Property which 

will endanger human health or welfare or the environnient, or allow others to use the Property in 

such marmer 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 pairit stabilization, the Grantee agrees that said property will be restored 

as nearly as possible to its original state and condition as found iinmediately preceding the 

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

activities. . 

(2) 2/12/2007 
Address: 2448 Templeton St., Omaha, NE, 68111 

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 theresponse 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 imderstand 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: \}W^>s5Vv(X. ^^^^ "^ / T // D 

2/12/2007 (3) 
Dbugl^svGourity Account Information http://douglasne.mapping-online.conVDouglasCoNe/static/accountinfo., 

Douglas County, Nebraska Propert y Record - R1644130000 

Priht Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VJeW OH information is valid as of 

2009-12-31 

New Feature

Owne r 

DELACRUZCUADRA JUAN 

EmL 

2448 TEMPLETON ST 

OMAHA NE 68111-0000 

Propert y Informatio n 

Key Number: 

AccountType: 

Parcel Number: 

Parcel Address: 

Legal Description: 

Value Informatio n 

L:and 

2009 

2008 

2007 

2006 

2005 

2004 

Saleis Informatio n 

Sales Date: 

Deed Type: 

Price: 

Grantor 

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

Sales Date: 

Deed Type: 

Price: 

Grantor: 

Grantee: 

4413 0000 16 

Residential 

1644130000 


2448 TEMPLETON ST 

OMAHA NE 68111-0000 

LUKE & TEMPLETONS LOT 13 BLOCK 0 50 X 132 

Improvement 

$2,600.00 $57,700.00 

$2,600.00 $57,700.00 

$2,600.00 $57,700.00 

$2,600.00 $57,700.00 

$2,600.00 $11,400.00 

$2,600.00 $10,300.00 

2003-09-17 

CO SooAc: 2003 

$65,000.00 

MARAITZA BELTRAN 

JUAN DELA CRLiZ CUADROS 

Invalid 

Land Contract - Agreement 

2003-09-17 

WD SooAr;

$65,000.00 

MARITZA BELTRAN 

JUAN DELACRUZ CUADRA ETAL 

 2004 

Map 

Treasurer's Tax Report 

-• ^ •• Auto Sales Search 

Totai 

$60,300.00 

$60,300.00 

$60,300.00 

$60,300.00 

$14,000.00 

$12,900.00 

Page: 183103 

Page: 165083 

lof 3 1/25/2010 9:26 AM 
D»'jg!as Cpunty Account Information http://dougiasne.mapping-online.com/DouglasCoNe/static/accountinfo.. 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 1998-09-20 

Deed Type: 

Price: $16,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Invalid 

Exclusion Reason: Invalid Sale 

Sales Date: 1998-05-28 

Deed Type: DM 

Price: $25,000.00 

Grantor: 

Grantee: 

Valid/invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units 

0.15 6600.0 1.0 

Improvemen t Informatio n 

Building 1 

Book: 2116 

Book: 2091 

Depth 

132.0 

Width 

50.0 

Page: 607 

Page: 049 

Vacant 

No 

MiiTtMFUETQHST, 

"i 

1 m riNiSMEo ston y 

1 1/2 Story Fin 

Central Air to Air 

Frame Siding 

CLICK TO ENLARGE IMAGE 

Percent Complete: 

Quality: 

Condition: 

Condo Square Footage: 

Rooms: 

Units: 

100.0% 

Fair 

Fair 

0.0 

9.0 

1.0 

2 of 3 1/25/2010 9:26 AM