Transmittal of Omaha Lead Site 

Paint Stabilization File Folder 

Said#__3^AS3_ Date:_^r^3jl^^ 

Address: 3^7( r A^ ^' ^ S-fContractor: Citv of Omaha Year: ^~ ^ *7 

Paint Stabilization 

Property File Folder Documents 

Work Write Up 

/ 

Sighed Access Agreement for subject property 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, ifapplicable 

J^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 from Douglas County Assessor's Office 

^ Other (describe): / /lofOS 

City of Omaha Representative Signature Date 

EPA Representative Signature _ Date 

30262445 

iHRMI 

Superfund 
CITY OF OMAHA 

PURCHASING - ROOM 1003 ' Purchase Order 

1819 FARNAM STREET 

.aURCriASE ORDER NO, REVISION P.AGE 

OMAHA, NE 68183-1003 

115S851 0 1, •FAX# 402-444-5423 

SHIP TO: 

CITY CF OMAHA 

HOUSING A COMM OEV RM #1111 

1319 FARNAM STREET 

OMAHA.NE 68183 

USA CONS.TRUCTION SERVICES INC VENDOR: k - < BILL TO: 8130 3 92 AVE CITY OF OMAHA FINANCE LAVISTA, NE 68128 DISBURSEMENTS ROOM #1007 

1819 FARNAM STREET , 

OMAHA.NE 68183 

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

CUSTOM ; IT ACCOUNT NO. VENDOR NO. DATE OF ORDER/ BUYER REVISED DATE//BUYER 

6057 25-AUG-09 P BURKE 

PAYMENT TERMS SHIP VIA F.O.B. 

DESTINATION 

FREIGHT "ERMS REQUESTOR/DELIVER TO CONFIRM TO / TELEPHONE 

MARUCA, T MARIE 0 214-5700 

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

IMPORTANT DO NOT START WORK UNTIL PROCEED ORDEfl IS ISSUED BY THE PLANNING 

DEPARTMENT - PER GROUP 57 BID DATED 8/19/0'9 

A l l price s an d amounts on thi s orde r ar e express =d in US DoHa r 

NEEDED: 650.0 0 N 

23-AUG-09 

EPA PAINT STABILIZATION 


PROGRAM GROUP 57 - 24 0 


EMMET ST 


O SHIP TO: 


Address ab top of page 


NEEDED: 1, 190.00 ' N 

23-AUG-09 

EPA PAINT STABILIZATION! 


PROGRAM GROUP 57 - 3615 


N 2 9TH ST. 
 O SHIP TO: 


Address at top of page 


SHIP TO: Address shown above. If shipment is delayed or any items nol available, advise at once. Purchase orde:' number .must appear on all invoices, packages, packing lists, bill of lading, and correspondence. 

SHIPPING CHARGES TO BE PREPAID, IF APPLICABLE AND ADDED TO INVOICED, copy to be furnished will-invoice. 

Total ( ^•8^°°° ) 

TAX EXErpTION: The City of.Omaha Is exempt from Federal Excise Taxes and the Nebraska and.City of 

Omaha Sa :is Taxes. Federal I.D. 476006304; STATE I.D. 01-0316768; Fuel Dealers Lie. 91-03,16768. Clly Purciiasing Agenl / Buyer 
Planning Department 

Inspector: Tom Roza Omaha/Douglas civic Center 

Date: 7/14/09 • '^'^^^"^^T^^f'iZi 

Omahi, Nebraska 68183 

. (402)444-5150 

Name: Alice Wallace Telefax (402) 546-07i4 

CityofOmaha- AddreSS" . 361 5 N 2 9 S t StcvcnN.Jensen.AICP. LA 

Jim Suttle, Mayor 

OMAHA EXTERIOR PAINT STABILIZATION PROGRAM 

FOR TH £ EPA OMAHA LEAD SITE 

The Contract bid documents consist ofthe following sections: 

• General Responsibilities for the Contractor and Occupant. 

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

The Contractor Shall: 

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

Paint Hazards in Housing." (Copies are available at the Plaiming 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 Plarming 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 the occupant 

• Submit information cut sheets for all substitutions or approved equals prior to 

vvritten approval of the Construction Specialist. 

• Repair or replace all items damaged or distiorbed during paint stabilization 

. activities. 

• Keep work site and surrounding area free from accurtiulatipns 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., that is connected with the work, and leave all parts ofthe work areas in a 

neat, sanitary, lead safe and presentable condition. 

• Comptete this project within 30 calehda'-days. 

The Occupant/Owner Shall 

• Remove arid store away any personal property within twenty (20) feet of the area 

to be remediated. 

• Provide access to electricity and water throughout tfie pairit stabilization 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 inspectionInitials Gb 1^7 
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 andflaking lead-based paint will be removed safely frorri 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 v/ill 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 vnll prepare a work plan and contact the property 

owner for permissionto proceed. 

• Work will 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 (X-Uj 
3615 N 29 St (Continued) 

Lead Hazard Control Plan 

Interim Control of Lead based Paint Hazards 

Paint Stabilization 

1. Stabilize all previously painted exterior surfaces of the house. Include 

windows @ front porch and upper rear of house. Do not include 

doors. 

2. Prepare and paint all previously painted surfaces by following the Safe 

Work Practices protocol for EPA exterior lead based paint stabilization. 

3. All paint colors to match existing paint pattern. Prime and apply two coats 

of approved finish coat. (Refer to Planning Dept. approved paint list) 

4. IF SPRAYED, ONE COAT SHALL BE BACK-BRUSHED OR 

BACK-ROLLED. 

Lead Based Paint Waste 

Lead-based paint H'aste must be handled as follows 

• All paint chips and component debris must be double bagged for disposal. 

• Clean 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 construction specialist. 

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

a municipal solid waste landfill. 

Property Owner Date 

Property Owner Date 

Witness Date 

Occupant (ifapplicable) Date 

Occupant (ifapplicable) Dafe t 

Witness Date 
Consent for Access to Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States Envirorunental 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): ALLICE WALLACE 

402-933-5577 

Addresses of Properties Covered by this Agreement 

Property Address 

City/State/Zip Code 

3615 N. 29th St. Omaha, NE 

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

Environmental Response and Liabilitv Act fCERCLAI. 42 USC. & 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 contaminated 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. 

FUTURE ACTION 

By signing this document, the grantor agrees to allow an EPA contractor to conduct a soil cleanup 

at this property following completion of lead-based paint stabilization. The grantor acknowledges 

that the paint stabilization contractor cannot provide assurances that bind the soil cleanup 

contractor. The grantor understands that the soil cleanup contractor will make all reasonable efforts 

to address cohceriis that the grantor may have regarding soil cleanup at this property. 

ENVIRONMENTAL RESPONSE ACTIONS • 

The envirorunental response actions to be performed on subject property may include tlie 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. 

(1) 2/12/2007 
Address: 3615 N. 29th St. 

Consent for Access to Propert\' (Page 2) • 

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

1) removal of loose or 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 subsiequeiit 

agreement. 

AGREEMENT NOT TO INTERFERE 

Grantor, agrees not to interfere with any ofthe activities undertaken by Grantee at the Property, 

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

will endanger human health or welfare or the environment, 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 

agreenient 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 

frohi Grantee's response activities on the property; 

PRIOR CONDITIONS AGREEMENT 

The grantor agrees to the condition of the 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 paint stabilization, the Grantee agrees that said property will be restored 

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

beginning of activities authorized by this' Agreement, following completion of the response 

activities. 

2/12/2007 (2) 
Address: 3615 N. 29th St., Omaha, NE,. 

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 ofthe property owner and the'United States 

Environmental Protection Agency (EPA). 

Items to be removed bv propertv owner prior to the response activities: 

1. 

2 . • 

3. ' 

4. 

5. 

Items NOT to be removed by contractor during removal activities: 

1. 

2. 

. 3. • 

4. 

5 . • • • 

ADDITIONAL COMMENTS: 

I have read the foregoing document and understand 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: fUL.", . ^^)^^Q^^c ^ Date %J^_jQ . 

(3) iinmi^i 
Douglas County Account Information htlp://douglasne.niapping-online.coin/DouglasCoNe/static/accoiintinfo., 

Douglas County, Nebraska Propert y Record - R0544570000 

Print Report 

View Interactive GIS Map Information is valid as of 2012-2-28 Treasurer's Tax Report 

New Feature •* ^ ^ Subdivision Sales Search 

Owne r 

WALLACE ALICE 

ETAL 

3615 N 29 ST 

OMAHA NE 68111-0000 

Propert y Informatio n 

Key Number: 4457 0000 05 

Account Type: Residential 

Parcel Number: 0544570000 

Parcel Address: 3615 N 29 ST 

OMAHA NE 68111-0000 

Legal Description: BEDFORD PLACE LOT 2 BLOCK 17 N 1/2 24.5 X 125 

Value Infbrmatio n 

Land Improvement Total 

2011 $1,800.00 $10,600.00 $12,400.00 

2010 $1,800.00 ' $21,200.00 $23,000.00 

2009 $1,800.00 $21,200.00 $23,000.00 

2008 $1,800.00 $21,200.00 $23,000.00 

2007 $1,800.00 $22,800.00 $24,600.00 

2006 $1,800.00 $22,800.00 $24,600.00 

Sales Inforniatio n 

Sales Date: 2006-05-08 

Deed Type: QC SooIr; 2006 Page: 051115 

Price: $25,000.00 

Grantor: JOHN TURNER SR. 

Grantee: ALICE WALLACE ETAL 

Valld/lnvalld: Valid 

Exclusion Reason: Non Bono with Doc Stamps 

Show All Transactions 

Land Infbrmatio n 

Acres SF Units Depth Width Vacant 

0.07 3125.0 125.0 25.0 No 1-0 

Improvemen t Informatio n 

Building 1 

1 of 3 3/14/2012 2:29 PM 
Douglas Counly Account Infonnalion littp://douglasne.niapping-oni ine.coin/DouglasCoNe/static/accountinro. 

n?NCH 

-Wt" 

.f!" 

asm4MKk«t$UI>«an 

CLICK TO ENLARGE IMAGE 

Square Footage: 636.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Fair 

Built As: Ranch Condo Square Footage: 0.0 

HVAC: Forced Air Rooms: 4.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 1.0 

Roof Type: Gable Stories: 1.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1915 0% 1915 96 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 612.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch EncI Solid Wall 126.0 

Porch Slab Roof Ceiling 28.0 

2 of 3 3/14/2012 2:29 PM 
Douglas County Account Infonnation liUp://douglasne.niappi ng-oni ine.coin/DouglasCoNe/static/accountinlb, 

Map data ©2012 Google 

The above map is powered by Google, and is intended to provide a general idea of a property's location. If 

you require a more exact property location, you may use the Interactive GIS Maps that are maintained by 

our office. 

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