Transmittal of Omaha Lead Site 

Paint Stabilization File Folder 

Said # ;Z-gS^V Date: 6e'~f'5-/7 

Address: ^?f^ ? It -i-u^ ^j j 

Contractor: CityofOmaha Year: ^ ^ f7 

Paint. Stabilization 

Property File Folder Documents 

y. ^ork Write Up 

Signed Access Agreement for subject property 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, ifapplicable 

LXrainting Agreement/City of Omaha Purchase Order 

Settlement documents (i.e., for damage or to replace plants, ete.) 

Renovation Recordkeeping Checklist signed by Certified Renovator 

^ Property information from Douglas County Assessor's Office 

_6/C)ther(describe): fnO'i~O.S 

T^^^'^ 7^ 3 "/S"-/^^ 

City of Omaha Representative Signature Date 

_Ja}x-Q ,yM/xoix 

EPA Representative Signature 

30262498 

IIDHIIIil 

Superfund 
CITY OF OMAHA 

PURCHASING - ROOM 1003 Purchase Order 

1819 FARNAM STREET 

OMAHA. NE 68183-1003 

FAX* 402-444-5423 

PURCHASE ORDER NO. 

1174418 

REVISION 

0 

PAGE 

1 

SHIPTO: 

CITYOFOMAHA 

HOUSING & COMM OEV RM #1111 

1819 FARNAM STREET 

OMAHA,NE 68183 

VENDOR: CHEREK'S HOME REPAIR 

10224 WEIR ST 

>. BILL TO: 7 

CITY OF OMAHA FINANCE OMAHA. NE 68127 DISBURSEMENTS ROOM #1007 

1819 FARNAM STREET 

OMAHA,NE 68183 

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

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

72989 11-MAY-11 HHURT 

PAYMENTTERMS SHIP VIA F.O.B.. 

DESTINATION 

FREIGHTTERMS REQUESTOR/DELIVER TO CONFIRM TO / TELEPHONE 

MARTINEZ, MARGARET P (402)659-2004 

< rrEM PART NUMBER / DESCRIPTION DELIVERYDATE QUANTITY UNIT UNITPRICE EXTENSION 

All prices and amounts on this order are express ;d in :. US Doi: 
 ar 


NEEDElD: 2,000.00 N 


07-MAY-ll 


EPA PAINT STABILIZATIOfrl 


PROGRAM GRP #194 - 1900 


LAIRD ST • 
 C SHIP TO: • 
 Address at top of page 


:NEEDED: 2,000.00 N' 


)7-MAY-ll 


'^EPA PAINT STABILIZATION 


PROGRAM GRP' #194 - 286& 


TITUS AVE i 


O SHIP TO: ; 


Address at top of 


NEEDED: 2,262.0 0 N 

07-MAY-l l 

EPA PAINT STABILIZATION 


PROGRAM GRP #194 - 451P 


LARIMORE ST ! 


o SHIP TO: i 


Address at top of page 


SHIPTO: Address shown above. If shipinent is delayed or any Items not available, advise at onca. Purchase order number must appear on all Invoices, packages, packing lists, bill of lading, and correspondence. Tota 6.262.00 

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

nished with Irivoice. 

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

4ilM dlu,^j Omaha Sales Taxes. Federal I.D. 476006304; STATE I.D. 01-0316768; Fuel Dealers Uc. 91-0316768. Cily Puichsiing Agieij W l / Buyer 
Planning Depart>Tiant 

Omaha/Douglas Civic i-CTKr Inspector: Tom Roza !3i9 Far.-.?..Ti St-e«; Suitt aOO 

Date: 3/25/11' Oma.ha, Nebraslcj o2i83 

(402) '!44-il50 

Telefax (•'102) 44'l-i)I40 Name: Carrie Russell 

R. E. Cunningham, RA, F.SA.VtS 

Ciq'of Omaha Address DilKtOC : 2868 Titus Av 

. Jim Suttle, Mayor 

OMAHA EXTERIOR PAINT STABILIZATION PROGRAM 

FOR THE EPA OMAHA LEAD SITE 

The Contract bid documents consistof the following sections: 

• • General. Responsibilities for vl'ie Contractor and Ocoupanr. 

• Lesd Hazard Control Piaii, Interim Control of Lead Ba.sod Pairit Ha.-:ards. 

TheContractor Shall: 

• Contractor and all subcontractorfs) shall complete and submit a "Citizenship. 

Attestation" / "Emplovee Classification" form to the Planning Department, per 

State requirements, before final payment can be issued. 

• Comply v^^ith HUD's "Guidelines for the Evaluation and Control of Lead-Ba<?ed Paint 

Hazards in Housing." (Copies are available at the Planning Department.) 

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

Housing and Community Development.Divisionj City of Omaha, Nebraska." (Copiesare 

availabie at the Planning Department.) 

• Complywith the State of Nebraska Health and-Human Services Regulation and-• 

Licensure, Title. 1.78 Chapter 23 Lead Base Paint Regulations. 

• Coordinate daily, construction schedule .with, the occupant • 

. • .• Subrriit information cut sheets for all substitutions or approvisd equals prior to written 

approval ofthe Construction Specialist. 

• • Repair or.replace all items daniaged or disturbed during paint stabilization activities. 

• Keep work site and surrounding area free froin accumulations of waste materials or 

rubbish caused by the work at all times.­

• .Upon daily completion, of work:-clean up all nibbish, e.wess material, equipmeht, and 

etc., that is connected with the work, and leave all parts of the work areas in a neat, 

.tsanitary, lead safe and presentable condition. 

• Complete this.p.roject within 30 calendar days. 

The OccujDant-'Ownei-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 stabilization process. 

• Remove volunteer trees and vegetation from the drip line of the roof, and cut back 

shrubs and bushes at least two feet from the house. 

•. Ensure that all household members stay at least ten feet .away from all woi'k areas and 

also keep all pets at leasttsn.feet away at. all times until the work has been completed and 

the area has passed a visual inspection. / * V) 

../.- . InitiaLs • ^^I'^ y 
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-contaminaited by deteriorating e.xterior 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 hasidentified 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 cl.osely 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 ConstruGtion Specialists will prepare a work plan and contact the property 

owner for .permission to proceed, 

• Work will be competitively bid by approved, trainedcontractors; 

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 ofchildren 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 QyH^ ^ 
Address: 2868 TITUS AV 

Consent for Access to Propertv (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 conipletion 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 INTERf ERE 

Grantor agrees not to interfere with any of .the 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 manner 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.onPage 3 any 

items to be remov.ed by the Grantor before activities commence.. 

RESTORATION OF PROPERTY 

Except for the above stated paint stabilization, the Grantee agrees that said propeity 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. 
Douglas County Account Information Page 1 of3 

Douglas County, Nebraska Property Record - R1754760000 

Print Report 

Information is valid as of 2012-2-28 View Interactive GIS Map 

Treasurer's Tax Report 

- New Feature ­^ r* -> Subdivision Sales Search 

Owne r 

RUSSELL CARRIE N 

ETAL 

2868 TITUS AVE 

OMAHA NE 68112-0000 

Property Informatio n 

Key Number 5476 0000 17 

Account Type: Residential 

Parcel Number: 1754760000 

Parcel Address: 2868 TITUS AV 

OMAHA NE 68112-0000 

Legal Description: MINNE LUSA LOT 25 BLOCK 30 42 X 120 

Value Informatio n 

Land Improvement Total 

2011 $5,700.00 $63,900.00 $69,600.00 

2010 $5,700.00 $63,900.00 $69,600.00 

2009 $5,700.00 $63,900.00 $69,600.00 

2008 $5,700.00 . $63,900.00 $69,600.00 

2007 $5,700.00 $79,200.00 $84,900.00 

2006 $5,700.00 $79,200.00 $84,900.00 

Sales Informatio n 

Sales Data: 2004-04-23 

Deed Type: WD SooAr: 2004 Page: 072029 

Price: $90,000.00 

Grantor: Jon J Coan etal 

Grantee: Carrie N Russell etal 

Valld/lnvalld: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Unita Depth Widtii Vacant 

0.11 5040.0 1.0 120.0 42.0 No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accouhtno=R17... 3/14/2012 
Douglas County Account Information Page 2 of 3 

Building 1 

2«6« Trtus Ave. 1 1/2 aor/ Unlin 

£tsr u *<• swr»r «* 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 864.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Good 

Built As: 1 1/2 Story Unfin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 5.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1922 0% 1922 90 

Deta/7 Type Detail Description Units 

Add On Unfinished Attic W/floor 192.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 864.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch EncI Solid Wall 192.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl7... 3/14/2012 
Douglas County Account Information Page 3 of 3 

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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 

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http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R17... 3/14/2012