Transmittal of Omaha Lead Site 

Paint Stabilization File Folder 

Said# ;25V7 ^ Date: 6p-fd-70 

Address: 2>C>7 / J 2> <& /VC/ 

Contractor: Citv of Omaha Year: tP-(> .70 

Paint Stabilization 

Property File Folder Documents 

^MVork Write Up 

^< 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 from Douglas County Assessor's Office 

^•^Other (describe): V\\(MiS 

~Tl7y^ ^2 ^ 3'-JS'-j. City of Omaha Representative Signature Date 

Sb^jjoix.. EPA Representative Signature / Date 

30262476 illlili 

Superfund 
Ch Y OF OMAHA 

PURCHASING - ROOM 1003 • Purchase Order 

1819 FARNAM. STREET ' r 

PURCHASE ORDER NO. REVISION PAGE 

OMAHA, NE 68183-1003 

1164956 0 2 FAX* 402-444-5423 

7 

SHIP TO: 

CITYOFOMAHA 

HOUSING & COMM DEV RM #1111 

1819 FARNAM STREET 

OMAHA.NE 68183 

CHEREK'S HOME REPAIR VENDOR: kBILL TO: 10224 VVEIR ST CITY OF OMAHA FINANCE OMAHA. NE 68127 • DISBURSEMENTS ROOM #1007 

1819 FARNAM STREET 

OMAHA,NE68183 

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

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

72989 13-APR-10 HHURT 

PAYMENT TERMS SHIP VIA F.O.B. . 

DESTINATION 

FREIGHTTERMS REQUESTOR/DELIVER TO CONFIRM TO / TELEPHONE •MARUCA. T MARIE (402) 659-2004 

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

11-APR-lO 


EPA PAINT STABILIZATION 


PROGRAM GROUP 82 3022 


LAFAYETTE AVE 


O SHIP TO: 


Address at top of pafie 


SDED 3,580.0 0 N 

Lll^Pl 


JPA 
PAINT STABILIZATION 


PROGRAM GROUP 82 3 07 N^ 


3 6TH AVE 


o SHIP TO 


Address at top of page 


NEEDED: 1,980.0 0 N 

11-APR-lO 

EPA PAINT STABILIZATION 


PROGRAM GROUP 82 3510 


SEWARD ST 


O SHIP TO: 


Address at top of pa^e 


NEEDED: 2,074.0 0 N. 11-APR-lO 

EPA PAINT STABILIZATION 


SHIPTO: Address shoWn.above. If shipment is delayed or any items not available, advise at once. Purctiasc order number must appear on all invoices, packages, packing lists,.bill of lading, and. correspondence. Tota Continued )

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

nished with invoice. 

TAX EXEMPTION: The City of Omaha is exempt from Federal Excise Taxes and tfie Nebraska and City of 

Oniaha Sales Taxes. Federal I.D. 476006304; STATE I.D. 01-0316768: Fuel Dealers Lie. 91-0316768. Cily Purchasing Agenl / Buyer 
Oracle iProcurement: Receiving Page I of 1 

Shopping Cart Home LQ9.Qllt Preferences Hglp Diagnostics ORACLG " iProcurementg 

H/Confirmation 

Receipt 57756 has been created for you. 

Receive Items: Confirmation Details 

Receipt Information 

Receipt Date 18^un-2010 11:16:32 

Received item Details 

Receipt Pacldng Item Receipt 

Receipt Requisition Description Quantity:Unit WaybillSlip Comments Comments.Supplier 

i 57756 CHANGE ORDER 500iDOLLAR CHEREK'S 

#2 DATED HOME 

6/17/10 • , REPAIR 

INCREASES THIS 

. SOW BY $5100.00 ' 

EPA PAINT 

STABILIZATION 

PROGRAM 

. GROUP 82 4310 S 

21 ST ST 

57756 48509 EPA PAINT 3580 DOLLAR CHEREK'S 

STABILIZATION HOME 

jPROfiRAM ..^ ^ REPAIR 

^^--fGROUP 82 307 N^ N 

/ ^ 36TH AVE ) -

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About this Page '^ ^ 

http://pllusll3.corio.com:8000/OA_HTML/OA.jsp?page=/oracle/apps/icx/por/rcv/webui/I... 6/18/2010 
Planning Department 

• Omaha/Douglas Civic Center 

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

Dfltp- 1/'>/in Omaha, Nebraska 68183 

i^aic. .vj.i v (402)444-5150 

Tclcfa.x (402) 546-0714 

Name: Kevin Smith EL E. Cunningham,RA,F.SAME 

j£L°!i°M'^yor Address: 307 N 36 S^VeKue. °'""°' 

OMAHA EXTERIOR PAINT STABILIZATION PROGRAM 

FOR THE EPA OMAHA LEAD SITE 

The Contract bid documents consist of the 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 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 Plaiming 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 of approved equals prior to 

written approval ofthe Construction Specialist. 

• Repair or replace all items damaged.or disturbed during paint stabilization 

activities. 

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

or rubbish caused by the work at all times. 

• Upondaily 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. 

• Complete this project within 30 calendar days. 

The Occupant/'Owner Shall 

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

to be remediated. . 

• Provide access to electricity and water throughout the paint 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 paissed a visual inspection. _^ ' 

Initials'^ 
307 N 36 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 

and garage to include but not limited to the fascia, eaves, trim, window 

trim, door trim and foundation. Do not include doors, windows or 

gutters/downspouts. 

• Include all stucco and foundation surfaces. 

• Prepare and pairit 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 approved finish 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. 

Clean paint chips from ground around perimeter of dwelling before 

starting, during and after the project. 

All lead painted components emd 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. 

3-i>-/^ 

Property 0 

Witness 

Date 

Occupant (if applicable) 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 Constmction Specialists will prepare a work plan and contact the property 

owner for permission to 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 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 
Consent.fpr Access to Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States Environmental 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: Daytime Phone: 

Owner Name(s): Kevin Smith 402-344-3953 

Addresses of Properties Covered by this Agreement 

Property Address 

City/State/Zip Code . 

307 N. 36th Ave. Omaha, NE 68131 

. ' 

Grantor understands that this grant does hot limit EPA's right of access under the Comprehensive 

Environmental Response and Liabilitv Act (CERCLA'). 42 USC. «S: 9601-9675. or any 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 envirorunental 

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: 307 N. 36th Ave. 

Consent for Access to Propertv fPaee 2) 

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

1) removal of loose or flaking paint ideritified by EPA using lead-safe methods in compliance 

with HUD/EPA regulations and 2) repainting according tothe 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 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 of the Property which 

will endanger human health or welfare or the envirormient, 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 

frorn Graiitee'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) 2/12/2007 
Address: 307 N. 36th Ave., Omaha, NE, 68131 

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 the response activities: 

I . . . • ' ' 

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 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; ^''!^^^^:., <pStc<J ^ Date 3-Ci>-7 0 

(•y^ 1/17/7.007 
Douglas Coimty Account Information Page 1 of3 

Douglas County, Nebraska Property Record - R0911390000 

Print Report 

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

New Feature -* -* r*. Subdivision Sales Search 

Owner 

SMITH KEVIN C 

ETAL 

307 N 36 AVE 

OMAHA NE 68131-0000 

Property Informatio n 

Key Number: 1139 0000 09 

Account Type: Residential 

Parcel Number: 0911390000 

Parcel Address: 307 N 36 AV 

OMAHA NE 68131-0000 

Legal Description: CRESTON ANNEX LOT 4 BLOCK 0 -EX S 11 E 65 FT- LT 4 IRREG 

Value Informatio n 

Land Improvement Total 

2011 $6,400.00 $82,900.00 $89,300.00 

2010 $6,400.00 $82,900.00 $89,300.00 

2009 $6,400.00 $76,200.00 $82,600.00 

2008 $6,400.00 $76,200.00 $82,600.00 

2007 $6,400.00 $83,700.00 $90,100.00 

2006 $6,400.00 $83,700.00 $90,100.00 

Sales Informatio n 

Sales Date: 1998-04-29 

Deed Type: D Book: 2093 Page: 057 

Price: $64,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

i.and Informatio n 

Acres SF Units Depth Widtii Vacant 

0.14 6380.0 1.0 145.0 44.0 No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DougIasCoNe/static/accountinfo.jsp?accountno=R09... 3/14/2012 
Douglas County Account Information Page 2 of 3 

Building 1 

til 

man * ^ 

...a v 

t i a TWO STORY 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1386.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Stucco Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 2.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1923 0% 1923 87 

Detail Type Detail Description Units 

Add On Unfinished Attic W/floor 598.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 598.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 

520.0 

Garage Detached 

200.0 

Porch Cvrd Wood Deck 

55.0 

Porch Slab Roof Ceiling 

120.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09... 3/14/2012 
Douglas County Account Information Page 3 of 3 

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 rhaintained by our 

office. 

http://douglasne.mapping-online.corn/DouglasCoNe/static/accountinfo.jsp?accountao=R09... 3/14/2012