Transmittal of Omaha Lead Site 

Paint Stabilization File Folder 

Said# ^C>2l^ Date: 7'^-S"'Cd 

Address: ///S " S _ 3 ^ Si ~ 

Contractor: City of Omaha Year: g^cTbB 

Paint Stabilization 

Property File Folder Documents 

J l Work 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 Piirchase Order 

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

enovation Recordkeeping Checklist signed by Certified Renovator 

Property information from Douglas County Assessor's Office 

Other (describe): Fh^ J 

City of Omaha Ref^resentative Signature Date 

k Representative Signature / Date 

30262432 

Illlll l 

Superfund 
¥rchwml A ^'' 

Planning Department 

Omaha/Douglas Civic Center Inspector: Steve Zivny 1819 Famam Street, Suite 1003 Date: 5/7/08 Omaha, Nebraska 68183 

(402)444-5150 

Telefax (402) 546-0714 Name: Joshua & Alethea Hays 

Steven N . Jensen, AICP 

City of Omaha Address: 1115 S 36'^ Street 

Director 

Mike Fahey, Mayor 

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 Planning Department.) 

• Comply with the State of Nebraska Health and Human Services Regulation and 

Licensure, Titie 178 Chapter 23 Lead Base Paint Regulations. 

• Coordinate daily construction schedule with the occupant 

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

written approval of the Rehabilitation Inspector. 

• Repair or replace all items damaged or disturbed during construction. 

• At alltimes keep the site of work and surrounding area free from accumulations 

of waste materials or rubbish caused by the work. 

• Upon daily completion of work clean up all rubbish, excess material, equipment, 

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

neat, sanitary, lead sate and presentabi-; condition. 

• Complete this project within 30 calendar days. 

The Occupant Shall 

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

to be remediated. 

• 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 and garage. 

• 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 alltinies until the wor]i;-has..been 

completed and the area has passed a visual inspection. 

Initial^ 
1115 S 36"^ Street (continued) 

Lead Hazard Control Plan 

Interim Control of Lead based Paint Hazards 

Paint Stabilization 

• Prepare and paint all previously painted exterior surfaces of the dwelling 

to include the fascia, eaves, siding, trim, window trim, door trim and 

foundation. Do not paint windows or doors. 

• Prepare and paint all previously painted surfaces of the front porch. 

• Prepare and paint all previously painted exterior surfaces of the garage if 

applicable. 

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

• See planning Department's list of approved paint products for lead 

projects. 

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 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 nninicipal solid waste landfill. 

Property Owner Date 

Witness Date 

Occupant (if applicable) Date 

Occupant (if applicable) 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 Constiruction 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 of children under age 

six if known and the severity of the problem. 

Paint Stabilization is voluntary and will be done only with permissiofr&ftRelJwnfer. 

Mtials M)W.^ 
Consent for Access to Property 

RIGBTT 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: 

Davtime Phone: 

Owner Name(s): Joshua Hays & Alethea Hays 342-4447 

Addresses of Properties Covered by this. Agreement 

Property Address 

City/State/Zip Code 

1115 S 36 ST 

Omaha, Ne 68105 

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

Environmental Response and Liabilitv Act (CERCLA). 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 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. 

ENVIRONMENTAL RESPONSE ACTIONS 

The environmental response actions to be perfonned 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. 

(1) 2/12/2007 
Address: 1115 S 36 ST 

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^ A-HcitiioWfrf A N 

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 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 of the property prior to remediation and indicates on Page 3 any 

items to be rem.oved 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: 1115 S 36 ST, Omaha, Ne, 68105 

CURRENT CONDITION / PROPOSED RESPONSE ACTIVrriES 

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 activitites 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: 

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 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. 

Grantor's Signature: r?- Date 05" ir 0^ 

(3) UYirimi 
Douglas County Account Information Page 1 of 2 

Douglas County, Nebraska Property Record - R1903630000 2^t\^? 

Print Report 

Parcel Dimensions available O scale 0-50 tt west of 144 St - VIe W O n MaP ' information is valid as of 2008-4-17 Treasurer's Tax Report 

New Feature ->-»- » Auto Saies Searcti 

Owner 

HAYS JOSHUA iVI 

ETAL 

1115 S 36 ST Per-7^ 3^ 6") OMAHA NE 68105-1813 

Property Information 

Key Number: 0363 0000 19 

Account Type: Residential 

Parcel Number: 1903630000 

Parcel Address: 1115 S 36 ST 

0I\4AHANE 68105-0000 

Legal Description: OAKHURST PARK LOT 15 BLOCK 3 52 X 125 

Value Information 

Land Improvement Total 

2007 $13,000.00 $162,400.00 $175,400.00 

2006 $13,000.00 $107,500.00 $120,500.00 

2005 $13,000.00 $107,500.00 $120,500.00 

2004 $13,000.00 $107,500.00 $120,500.00 

2003 $13,000.00 $107,500.00 $120,500.00 

2002 $0.00 $0.00 $0.00 

Saies Information 

SalesDate: 2005-12-09 

Deed Type: WD Book: 2005 Page: 159599 

Price: $191,500.00 

Grantor: D MARC BEALS ETAL 

Grantee: JOSHUA M HAYS ETAL 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Information 

Acres SF Units Depth Width Vacant 

0.14 6500.0 1.0 125.0 52.0 NoImprovemen t Information 

Utt.^.llA^ T-fc 1 f\r . 
Douglas County Account Information Page 2 of 2 

Building 1 

9P 

111 

itfff 

« | ] 

i 

^f -.» i ; 

2 1/2 STORY UNFINISHED Ti l 0 f-<| P: 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1880.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Frame Siding Units: 1.0 

interior: Drywall Bathis: 1.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Gable Stories: 2.5 

Floorcover: Allowance Foundation: Blocl< 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1915 0 0% 1915 92 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 1.0 

Basement Bsmnt Block 8 ft 900.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch Slab Roof Ceil 168.0 

Porch Wood Deck 80.0 

Porch Wood Deck 296.0 

llftn'//Hr~l1ialnQn p mnnnino-nnlin p /-<->m/F>r>iirrlncr^r>M/a/<:-tatir>/n^/'^nT^»i"^^-^ :.,.^0„^„. ^ — .- - T~. i nr. r-1/- i^nr. n 
CITY OF OMAHA 

PURCHASING - ROOM 1003 Purchase Order 

1819 FARNAM STREET PURCHASE ORDER NO. OMAHA.NE 68183-1003 

1U8682 FAX# 402-444-5423 

SHIP TO: 

CITY OF OMAHA 

HOUSING & COMM DEV RM #1111 

1819 FARNAM STREET 

OMAHA,NE 68183 

EKG TRANSPORTATION VENDOR: >

BILL TO: 3709 NO 17 ST CITY OF OMAHA FINANCE OM/VH/V.NE 68110 DISBURSEMENTS ROOM #1007 

1819 FARNAM STREET 

OMAHA,NE 68183 

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

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

71338 27-JUN-d8P BURKE 

PAYMENT TERMS SHIP VIA F.O.B. 

DESTINATION 

FREIGHT TERMS REQUEST0RA3ELIVER TO CONFIRM TO / TELEPHONE 

KASPAR.CATHLEEN SSPURLOCK (402)30&4179 

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

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

DEPARTMENT - PER GROUP 12 BID DATED 6/11/08 . A l l price s an d amounts on thi s orde r ar e expressfe d i n US Dolla r 

NEEDED: 3,100.0 0 N 

29-JUN-0 8 

EPA PAINT STABILIZATION 


PROGRAM GROUP #12 


1034 SOUTH 30 STREET 


O SHIP TO: 


Address at top of page 


• A******************]************************* * 


NEEDED: 3,100.0 0 N 

29-JUN-0 8 

EPA PAINT STABILIZATION 


PROGRAM GROUP #12 


1115 SOUTH 36 STREET 


O SHIP TO: 


Address at top of pa^e 


It************-****** * *************************** 

SHIP TO:- Address showii above. If shipment Is delayed or any items not available, advise at once. Pur­

chase order number must appear on all invoices, packages, packing lists, bill of lading, and correspondence. Tota l ( Continued ) 

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

nished with invoice. 

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

Omaha Sales taxes. Federal I.D. 476006304; STATE I.D. 01-0316768; Fuel Dealers Uc. 91-0316768. 

Oily PuFchising Agent I Buyer