## Transmitta l o f

Oniah aLea d Site Pain t Stabilizatio n Fil e Folde r Sai d # .P^f// ^ Date : 

## ^^P'/ O Address : 

### 3<5d 9 /^/fV>/e4s T At / Contractor : Cit v o f

Omah a Year : ^ 6 7 0 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s O^Wor k Writ e U p __^; i Signe d Acces s Agreemen t fo r

subjec t propert y Pre-Renovation for msignedby Propert y Owne r Pre-Renovation For mfo r

Occupant/Tenant , ifapplicabl e l^Paintin g 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 Recordkeepin g Checklis t signe db y Certifie d Renovato r _J

_ Propert y informatio n fromDougla s Count y Assessor' s Offic e ^^Othe r (describe) : ]J7\ ( }(H-Q S 

# 7^- ^ ^ ^ 3 -/s-^7J~ - Cit y o f Oinah aRepresentativ e Signature , Dat e

^ 

# Ik i EP A Representativ e Signatur e Jate 3026246 5 Superfun d

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

### Purchas e Orde r 181 9 FARNA M STREE T OMAHA , N E 68183-100 3 FAX * 402-444-542 3 /

V PURCHAS E ORDE R NO . 116533 5 REVISIO N 0 PAG E 1 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 VENDOR : G& M PAINTIN G C O IN C 1370 7 CUMIN G S T OMAHA , N E 6815 4 > . BIL L TO :

CIT Y O F OMAH A FINANC E DISBURSEMENT S ROO M #100 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 . VENDO R NO . 9129 8 DAT E O F ORDER/BUYE R 28-APR-1 0 H HUR T REVISE D DATE//BUYE R PAYMEN T TERM S SHI P VI A F.O.B .

IMMEDIAT E 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 UNI T PRIC E EXTENSIO N Al l pr.ice s an d amount s o n thi s orde r ar e expres s s d i n : U S Dol : a r NEEDED : 3,960.0 0 N 28-APR-l O EP APAIN T STABILIZATIOt * PROGRA M GROU P 8 9 12 1 S ! 3 8T H AV E Ec 3 00 9 POPPLETO NAV E o SHI P TO : Addres s a t to p o f pag e

SHI P TO : Adclres s show n above . 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 rnumbe rmus t appea ro n al l invoices , packages , packin g lists , bil l o f lading , an d correspondence . 3,960.0 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 wit h invoice . TAX EXEMPTION : Th e City o f Omah a Is.exemp t fro m Federa l Excis e Taxe s an d th e Nebrask a an d City o f 

### 'nt.UL:\iiu'vi ^ Omah a Sale s Taxes . Federa l I.D . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealer s Lie . 91-0316768 . Cil y Purchasin g Agelii y Buye rPlannin g Departmen t Omaha/Dougla s Civi c Center Inspector : Stev e Zivn y 181 9 Farna mStie« , Suit e 100 3 r«ot^ . 0;'i^/ir \Omaha , Nebrask a6818 3 Date : 2/16/1 0 (402 ) 444-515 0 Telefa x (402 ) 546-071 4 

### Name : Bruc e A . Thompse n R.E . 

### Cunningham , RA,F.SAM E 

### jiSsmu^MUyo r

AddfCSS ! 300 9 Poppleto n A v ^'^'^ ' OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRA M F O RTH E EP A OMAH A LEA D SIT E Th e Contrac t bi d document s corisis t o f th e followin g sectioPxS : •General Responsibilitie s fo r th e Confracto r an d Occupant . •Lead Hazard Contro l Plan , Interi mContro l o f LeadBase d Pain t Hazards . Th e Contracto r Shall : •Compl y wit h HUD' s "Guideline s for th e Evaluatio n an d Contro l o f Lead-Base d Pain t Hazard s i n Housing. " (Copie s ar e availabl e a t th e Plannin g Department. ) •Corhpl y wit h Standard s calle d for i n th e "Constmctio n an d Rehabilitatio n Specifications , Housin g an d Community Developmen t Division , Cit y o f Omaha , Nebraska. " (Copie s ar e availabl e a t th e Plamiin g Department. ) •Compl y wit h th e Stat e ofNebrask aHealth an d Huma n Service s Regulatio n an d Licensure , Titl e 17 8 Chapter 2 3 Lea d Bas e Pain t Regulations . •Coordinat e dail y constructio n schedul e wit h th e occupan t •Submi t informatio n cu t sheet s for al l substitution s or approve d equal s prio r t o writte n approva l o f th e Constructio n Specialist . . •Repai r o r replac e al l item s damage d o r disturbed.durin g pain t stabilizatio n activities . • •Kee p wor k

sit e an dsurroundin g are afree fromaccumulation s o f wast e material s o r

rubbis h cause d b y th e wor k

at.al l times . •Upondail y completio n o f work : clean u p al l rubbish , exces s material , equipment , an d etc. , tha t i s connecte dwit h th e work , an d leav e al l part s ofth e wor k

area s i n a neat , sanitary , leadsaf e an dpresentabl e condition . •Complet e thi s projec t withi n 3 0 calenda r days . Th e Occupant/Owne r Shall . •Remov e an d stor e awa y any persorial property withi n twent y (20 ) feet o f th e are a t o b e remediated . •Provid e acces s t o electricity an d wate r throughou t th e pain t stabilizatior i process . •Ensure that all househol d meitiber 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 at leas t te n feet away a t al l time s unti l th e wor k

hasjjee n com.piete d an d th e are aha s passe d avisua l inspection . Initials ^

### 3009 Poppleton AV (Continued ) ' 

### Lea d Hazar d Contro l Pla n InterimControl of Lea d based Pain t Hazard s Pain t Stabilizatio n •Stabiliz e al l previousl y paintedexterio r

wood, brick , meta l or concret e surface s ofth e dwelling to includ e bu t no t limite d

to .th e siding , fascia , eaves , trim , window trim , shutters , gutters , railings , downspouts , doo r

tri m an d foundation . DO NO T INCLUD E WINDOW S ORMA N DOORS . •Prepar e an d pain t all previousl y painted surface s by followin g th e Saf e Wor k

Practice s protoco l fo r

EP A exterio r

lea dbase dpain t stabilization . •Al l pain t colors to matc h existing pain tpattem . Prim e an dappl y tw o coat s of approve d finish coat . (Refe r to Plannin g Dept . approve dpain t list) . • IF SPRAYED , ONE COAT SHAL L

BE BACK-BRUSHE DOR BACK-ROLLED . 

### Lea d Based Pain t Wast e Lead-base d pain t waste mus t be handle das follow s •Al l pain t chip s an d componen t debri s must be doubl e bagge d fo r

disposal . •Clea n pain t chip s fro mgroun daroun dperimete r of dwelling befor e starting , during and afte r

th e project . •Al l lea d painted component s an d debri s mus t be remove dfro mthe sit e dail y unles s otherwis e approved by the constmction specialist . •Al l lead-based pain t debri s (chip s an dcomponents ) must be disposed of in amunicipa l solid wast e landfill . Propert y Owner .Dat e np.rt v Ownft r ,/ ' e 

### Propert y Owne r

/ ' . Dat 

### Dat e 

### S LoA/ni\^hjry7)pjixi mg>^' ^ Witnes s Dat e Occupan t (ifapplicable )Dat e Occupan t (ifapplicable) .Dat e

### Exterio r Lead-base d Pain t Stabilizatio n Progra mManage db y th e Cit y o f Omah afo r EP A Regio n 7 Omah aLea dSit e The purpos e o f

thi s progra mi s t o preven t yard s wher e lead-contaminated soil i s cleane d u

p fro mbecomin g re-contaminatedb y deteriorating exterio r

lead-basedpaint . 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 has bee n o r

wil l be don e an d a n EP A contracto r

has identifie d deterioratin g exterio r

lead-basedpaint . • Home s are eligibl e onl y b y referra l fro mth e EPA . Wha t wor k

wil l be done ? •Loos e an d flaking lead-basedpain t wil l be remove dsafel y fro mfascia , eaves , siding , trim , window trim , doo r

tri man dfoundation ; •Surface s wil l b e primed an dpainted t o matc h existing pain t colo r

a s closel y a s possible . Wha t will no t be done ? •Surface s whic h hav e n o pain t wil l no t be freated, •Window s o r

door s will not b e included . •Rotte n woo d will not b e replaced . •N o housin g repai r

will be done . Wh o wil l perfor mthe work ? •EP A confractor s will tes t pain t o

n exterio r

hous e surface s an dgive the result s t o th e Cit y o f

OmahaPain t Stabilization Program . •Cit y Construction , Specialist s will prepar e awor k

pla n an dcontact th e propert y owne r

fo r

permission t o proceed . •Wor k

wil l be competitivel y bidb y approved , trainedcontractors . Whe n wil l th e wor k

b e done ? oThi s progra mbega n i n 2007 an dwil l continue fo r

severa l years . •Th e Cit y staf f

will prioritiz e home s basedo n th e presenc e o f

children imde r

age si

x i f

know n an d th e severit y o f

th e problem . Pain t Stabilization i s voluntary an dwil l be don e onl y wit h permission of the^wner . Initial sConsen t fo r Acces s t o Propert y RIGH T O F ENTRY T O PREMISE S Granto r (th e propert y owner ) consent s t o an d authorize s th e Unite d State s Environmental Protectio n Agenc y (USEPA ) o r it s authorize d representatives , collectivel y th e Grantee , t o ente r and perfor m certai n environmental respons e activitie s upo n th e followin g describe d premises : Owner' s Name : Davtim e Phone : Owne r Name(s) : Bruc e A Thompse n 346-512 0

Addresse s o f Propertie s Covere d b y thi s Agreemen t Property Addres s City/State/Zi p Code 300 9 Poppleto n Ave . Omaha , N E 6810 5 .

Granto r understand s tha t thi s gran t doe s no t limi t EPA' s righ t o f acces s under th e Comprehensiv e Environmental Respons e an d Liabilitv Ac t rCERCLA) . 4 2 USC . & 9601-9675 . o r an v other law . PURPOS E O F ACCES S Th e purpos e ofth 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 contaminate 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 d further , provide s th e Grante e th e righ t t o perfor many an d al l envirorunenta l respons e action s an d activitie s i t deem s appropriate . ENVIRONMENT/U : RESPONS E ACTION S Th e environmenta l respons e action s t o b e performe d o n subjec t propert y ma y includ e th e followin g activities : 1 .Locatin g equipmen t and/o r machiner y o n subjec t property i n preparatio n fo r an d i n th e cours e o f th e respons e activities . 2 . Obtainin g sample s fromGrantor' s property .

2/12/200 7 

### (1 )Address : 300 9 Poppleto n Ave . Consen t for Acces s t o Propert v (Pag e 2 ) 3 .

Plarmin g an d implementin 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 o r flaking pain t identifie d b y EP A usin g lead-saf e method s i n complianc e with HUD/EP A regulation s an d 2 ) repaintin g accordin g t o th e attache d specifications . TERM Thi s acces s agreemen t shal l b e operabl e fo r th e perio d o f tim e i t take s to complete the environinenta 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 b y th e Granto r shal l ceas e o n that date , unles s extende d b y asubsequent agreement . AGREEMEN T NO T T O INTERFERE Granto r agree s no t t o interfer e with aii y o f th e activitie s undertake n b y Grante e a t th e Property , tampe r with an y o f Grantee' s property , o r tak e an y action s regardin g th e us e ofth e Propert y whic h wil l endange r human healt h o r welfare o r th e environinent , o r allo w other s t o us e th e Property , i n suc h manne r durin g th e ter mo f thi s consent . Granto r agree s t o provid e notic e an d acop y o f thi s agreemen t t o prospective , purchasers , lessees , assigns , o r grantee s ofth e property o r an y portio n o f it . Granto r agree s t o provid e 30-day notic e t o EP A prio r t o an y fransfer o f ownershi p right s t o th e property . SAMPLIN G RESULT S Grante e agree s t p provide . Granto r with th e result s o f any an d al l samplin g and/o r arialysi s resultin g fro mGrantee' 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 propert y prio r t o remediatio n an d indicate s ^o n Pag e 3 an y item s t o b e remove d b y th e Granto r befor e activitie s commence . RESTORATIO N O F PROPERT Y Excep t fo r th e abov e state d pain t stabilization , th e Grante e agree s that sai dpropert 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 dimmediatel y precedin g th e beginnin g o f activitie s authorize d b y thi s Agreement , followin g completio n o f th e respons e activities .

(2 )2/12/2007

### Address : 300 9 Poppleton Ave. , Omaha , NE , 68105 CURREN T CONDITIO N / PROPOSE D RESPONS E ACTIVITIE S The purpos e o f thi s sectio n i s t o provid e amutua l agreemen t as to condition s o f

propert y prio r

to contractor activities . Thi s wil l als o serve a s documentation fo r

th e purpos e o f

assurin g tha t restoratio n activitie s ar e complete d t o th e satisfaction of th e propert y owne r

an dth e Unite dState s Environmenta l Protection Agenc y (EPA) . Items t o be remove d b v propert v owne r

prio r

t

o th e respons e activities : 1 . 2 . 3 . 4 . 5 . . - Items NOT t o be remove d b y contracto r

durin g remova l activities : 1 . . 2 . • • 3 . . • • 

### 4 . 5 . 

### ADDITIONA L COMMENTS :

I hav e rea d the foregoin g documen t an d understan dtha t i

t i s a n agreemen t grantin g permissio n t o th e Grantee to ente r

th e abov e describedpremise s fo r

the purpos e o f

conductin g environmenta l respons e activities , an d I agre e t o it s term s an dconditions . I acknowledge tha t I hav e receive d th e pamphle t "Renovate " Right" . Grantor' s Signature : /z/^ ^ ^ //rUyyt./>U/\/ l . Dat e j^y^^ ^

(3 ) vnrm n

### Dougla s Count y Accoun t Information Pag e 1 of 2 Dougla s County , Nebrask a Propert y Recor d - Rl23744000 0 Prin t Repor t NE

W Faatur a - Parce l Dimsnaion s availabi e ffi scal e 0-5 0 n wes t o

f 52n d S t - Vie W O H IMa p Informatio n i s vali d a s o f 2009-12-3 1 Treasurer' s Ta x Repor t Ne w Featur e -•?•.• • Aut o Sale s Searc h Owne r THOMPSE N BRUC E A ETA L 351 1 WOOLWORT H AV E OMAH A N E 68105-000 0 Propert y Informatio n Ke y Number : 374 4 00001 2 Accoun t Type : Residentia l Parce l Number : 123744000 0 Parce l Address : 300 9 POPPLETO N A V OMAH A N E 68105-000 0 Lega l Description : HANSCO M PLAC E LO T 1 BLOC K1 0 W41. 3 E 14 2 FT 41. 3 X 5 0 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $3,700.0 0 $60,100.0 0 $63,800.0 0 200 8 $3,700.0 0 • $60,100.0 0 $63,800.0 0 200 7 $3,700.0 0 $60,100.0 0 $63,800.0 0 200 6 $3,700.0 0 $31,400.0 0 $35,100.0 0 200 5 $3,700.0 0 $31,400.0 0 $35,100.0 0 200 4 $3,700.0 0 $31,400.0 0 $35,100.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widti i Vacan t 0.0 4 2050. 0 1. 0 50. 0 41. 0 N o Improvemen t Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R123.. . 2/2/201 0Dougla s County Accoun t Informatio n Pag e 2 o f 2

1 1/ 2 STOR Y FINISHE D

1 <*«.B m 21 7 FWFtO' L.^., ^ " 330 - nr r ». ^ 1 1 r Jif f

mUm * CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1111. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor y Fi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 7. 0 Exterior : Fram e Viny l Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gambre l Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k 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 189 0 0 % 189 0 12 0 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Applianc e Fireplac e Meta l 1. 0 Basemen t Bsmn t Bloc k 8 f t 693. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h Ope n Sla b 256. 0 Porc h Sla b Roo f Ceilin g 35. 0

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountao=Rl23. . . 2/2/201 0