## Transmitta l o f Omah aLea dSit e Pain t Stabilizatio n Fil e Folde r Said #^C>2l ^ Date : 7'^-S"'C d Address : ///S " S _ 3 ^ Si ~ Contractor : Cit y o f Omah aYear : 

## g^cTb B Pain t Stabilizatio n Propert y Fil e Folde r Document s J l Wor k

Writ e U p ^ Signe dAcces s Agreemen t fo r

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

Occupant/Tenant , ifapplicabl e Painting Agreement/Cit y o f

Omah aPiirchas e Orde r Settlemen t documents (i.e. , fo r

damage o r

t

o replac e plants , etc. ) enovation Recordkeeping Checklis t signe db y Certifie dRenovato r Propert y informatio n fro mDouglas Count y Assessor' s Offic e Othe r

(describe) : Fh^ J

Cit y of Omah aRef^resentativ e Signatur e Dat e k

Representativ e Signatur e / Dat e 3026243 2 

# Illlll l Superfun d

# ¥rchwm l A ^' ' Plannin g Departmen t Omaha/Dougla s Civi c Cente r 

### Inspector : Steve Zivn y 181 9 Fama mStreet , Suit e 100 3 

### Date : 5/7/0 8 Omaha , Nebrask a6818 3 (402)444-515 0 Telefa x (402 ) 546-071 4 

## Name : Joshu a& Alethe aHay s Steve n N . Jensen , AIC P Cit y o f Omah a 

## Address : 111 5 S 36' ^ Stree t Directo r Mik e Fahey , Mayo r 

## OMAHA EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEAD SIT E Th e Contract bi d document s consis t o f

the followin g sections : •Genera l Responsibilitie s fo r

the Contracto r

an d Occupant . •.Lea dHazar dControl Plan , InterimControl o f

Lea dBase dPain t Hazards . Th e Contracto r Shall : •Compl y wit h HUD' s "Guideline s fo r

th e Evaluation an dControl o f

Lead-Base d Pain t Hazard s i n Housing. " (Copie s ar e available a t th e Planning Department. ) •Compl y wit h Standard s calle dfo r

i

n the "Construction An dRehabilitation . Specifications , Housing an dCommunit y Developmen t Division , Cit y o f

Omaha, Nebraska. " (Copie s ar e available a t the Planning Department. ) • Compl y wit h the Stat e o f

Nebrask aHealt h an dHuma n Service s Regulation an d Licensure , Titi e 17 8 Chapte r

2 3 Lea d Bas e Pain t Regulations . •Coordinat e dail y construction schedule wit h th e occupan t • .Submi t informatio n cu t sheetis fo r

al l substitution s o r

approve dequal s prio r

t

o writte n approva l o f

the Rehabilitatio n Inspector . •Repai r

o

r

replac e al l item s damage do r

disturbeddurin g construction . •A t al l times kee p th e sit e o f

wor k

an dsurroundin g areafre e fro maccumulation s o

f

wast e material s or rubbis h causedb y the work . •Upo n dail y completion o f

wor k

clea n u p al l rubbish , exces s material , equipment , an d etc. , tha t i s connectedwit h the work, an dleave al l part s o f

the wor k

area s i n a neat , sanitary , lea dsate an d presentabi- ; condition . •Complet e thi s project within 3 0 calenda r

days . Th e Occupan t Shal l •Remov e an dstor e awa y an y persona l propert y withi n twent y (20 ) fee t o

f

th e area t o be remediated . • Remov e voluntee r

tree s an dvegetation fro mth e dri p lin e o f

th e roof , an dcu t bac k shrub s an dbushe s a t leas t tw o fee t fro mth e hous e an dgarage . • Ensur e tha t all'househol dmember s sta y a t least te n fee t awa y fro mal l wor k

areas an d als o kee p al l pet s a t leas t te n fee t awa y a t al l tinies until the wor]i;-has..bee n complete dan d th e are ahas passedavisua l inspection . Initial ^

### 111 5 S 36" ^ Street (continued) 

## Lea d Hazar d Contro l Pla n Interi mContro l o f

Lea d base d Pain t Hazard s Pain t Stabilizatio n •Prepar e an dpain t al l previousl y painte dexterio r

surface s o f

th e dwellin g t o includ e th e fascia , eaves , siding , trim , windo w trim , doo r

tri man d foundation . D o no t pain t window s or doors . • Prepar e an dpain t al l previousl y painte dsurface s o f

th e fron t porch . •Prepar e an dpain t al l previousl y painte d exterio r

surface s o f

th e garage i f applicable . • All pain t color s to matc h existing . Prim e an dappl y tw o coats . •See planning Department' s lis t o

f

approvedpain t product s fo r

lea d projects . 

### Lea dBased Paint Wast e Lead-base dpain t waste mus t b e handle d a s follow s •All pain t chip s an dcomponen t debri s mus t be double bagge dfo r

disposal . •Clea n pain t chip s fro mgroun d arOun dperimete r

o

f

dwelling befor e starting , during an d afte r

the project . •Al l lea dpaintedcomponents an ddebri s mus t b e remove dfro mth e sit e dail y unles s otherwis e approve dby the construction specialist . •Al l lead-basedpain t debri s (chip s an dcomponents ) must b e dispose do f

i

n anninicipa l soli dwast e landfill .

Propert y Owne r

Dat e Witnes s Dat e Occupan t (i

f

applicable )Dat e Occupan t (i

f

applicable )Dat e Witnes sDat e

### Exterior Lead-base d Pain t Stabilizatio n Progra mManagedb y the Cit y o f Omah afo r

EP A Region 7 OmahaLea d Sit e

Th e purpos e of thi s progra mi s t o preven t yard s wher e lead-contaminate d soi l i s cleane d u p fro mbecomin g re-contaminate d b y deterioratin g exterio r lead-base d paint . 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 ha s bee n o r wil l b e don e an d a n EP A contracto r ha s identifie ddeterioratin g exterio r lead-base d paint . •Home s are eligibl e onl y b y referral fro mth e EPA . What wor k

wil l b e done ? •Loos e an dflakin g lead-base d pain t wil l b e remove d safel y fromfascia , eaves , siding , trim , windo w trim , doo r tri man d foundation . •Surface s wil l b e prime dan d painte d t o matc h existin g pain t colo r a s closel y a s possible . What wil l no t b e done ? •Surface s whic h hav e n o pain t wil l not b e treated . •Window s o r door s wil l no t b e included . •Rotte n woo d wil l no t b e replaced . •N o housin g repai r wil l b e done , Wh o wil l perfor mth e work ? •EP A contractor s wil l tes t pain t on exterio r hous e surface s an d giv e th e result s t o th e City o f Omah aPain t Stabilizatio n Program . •Cit y Constiructio n Specialist s wil l prepar e awor k

pla n an dcontac t th e property owne r for permissio n t o proceed . •Wor k

wil l b e competitivel y bi d b y approved , traine d contractors . Whe n wil l th e wor k

b e done ? •Thi s progra mbegan i n 200 7 an d wil l continu e for several years . •Th e City staf f wil l prioritiz e home s base don th e presenc e of childre n unde r ag e si x if know n an dth e severit y o f th e problem . Pain t Stabilizatio n i s voluntar y an d wil l b e don e onl y wit h permissiofr&ftRelJwnfer . 

## Mtial s M)W. ^Consen t fo r Acces s t o Propert y RIGBT T O F ENTR Y T O PREMISE S Granto r (th e property 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 drepresentatives , collectivel y th e Grantee , t o ente r and perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises : Owner' s Name : Davtime Phone : Owne r Name(s) : Joshu aHay s & Alethe aHay s 342-444 7

Addresse s o f Propertie s Covere d b y this . Agreement Property Addres s City/State/Zi p Cod e 111 5 S 3 6 S T Omaha , N e 6810 5

Granto r understand s tha t thi s grant doe s no t limi t EPA' s right o

f acces s unde r th e Comprehensiv e Environmenta l Respons e andLiabilitv Ac t (CERCLA) . 4 2 USC . «f e 9601-9675 . o r anv othe r law . PURPOS E O F ACCES S Th e purpos e o f th e respons e actio n i s t o stabiliz e loos e o r flaking exterio r lead-base d pain t on residentia l properties , includin g day-care facilities , wher e remediatio n o f lea d contaminate d soi l ha s O

r wil l tak e place . Samplin g of soi l ma y b e conducted . Thi s consen t shal l allo w Grante e ont o Grantor' s property an dfurther , provide s th e Grante e th e right t o perfor man y an d al l environmental respons e action s an dactivitie s i t deem s appropriate . ENVIRONMENTA L RESPONS E ACTION S Th e environmenta l respons e action s to b e perfonne 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 for an d i n th e cours e o f th e respons e activities . 2 .

Obtainin g sample s fromGrantor' s property .

(1 ) 2/12/200 7Address : 111 5 S 3 6 S T Consen t fo r Acces s to Propertv (Pag e 2 ) 3 .

Plannin g an dimplementin 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 wit h HUD/EP A regulation s an d2 ) repaintin g accordin g t o th e attache d specifications ^ A-HcitiioWfr f A N TER M Thi s acces s agreemen t shal l b e operabl e fo r th e perio do f time i t take s t o complete th e environmenta l respons e activities . Upo n completio n of th e respons e actions , all rights 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 asubsequen t agreement . AGREEMEN T NO T T O INTERFERE Granto r agree s no t t o interfere wit h any of th e activitie s undertake n b y Grante e a t th e Property , tampe r wit h any o f Grantee' s property , o r tak e an y action s regardin g th e us e of th e Propert y whic h wil l endange r human healt h o r welfare o r th e environment , o r allo w other s t o us e th e Propert y i n suc h manne r durin g th e termo f thi s consent . Granto r agree s to provid e notic e an d acop y o f thi s agreemen t t o prospectiv e purchasers , lessees , assigns , o r grantee s of th e property o r an y portio n of it . Granto r agree s t o provid e 30-day notic e t o EP A prio r t o any transfe r o f ownershi p rights t o th e property . SAMPLIN G RESULT S Grante e agree s t o provid e Granto r wit h th e result s o f an y an dal l samplin g and/o r analysi s resultin g fromGrantee' 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 of th 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 rem.ovedb y th e Granto r before activitie s commence . RESTORATIO N O F PROPERT Y Excep t for th e abov e state dpain t stabilization , th e Grante e agree s tha t sai d propert y wil l b e restore d a s nearl y a s possibl e to . it s origina l stat e an d conditio n a s foun d immediatel y precedin g th e beginnin g of activitie s authorize db y thi s Agreement , followin g completio n of th e respons e activities .

(2 )2/12/200 7Address : 111 5 S 3 6 ST , Omaha , Ne , 6810 5 CURREN T CONDITIO N / PROPOSED RESPONS E ACTIVrriE S Th e purpos e of thi s sectio n i s to provid e amutual agreemen t a s t o condition s of property prio r t o contracto r activities . Thi s wil l als o serv e a s documentatio n fo r th e purpos e of assurin g tha t restoratio n activitite s ar e complete dt o th e satisfactio n o f th e property owner an d th e Unite d State s Environmenta l Protectio n Agenc y (EPA) , Item s t o b e remove db v propert v owne r prio r t o th e respons e activities : 1 . 2 . .3 . 4 . 5 . Item s NO T t o b e remove db v contracto r durin g removal activities : 1 . 2 . 3 . 4 . 5 . ADDITIONA L COMMENTS :

I hav e rea dth e foregoin g documen t an d understan d that i t i s a n agreemen t grantin g permissio n t o th e Grante e to ente r th e abov e describe d premise s for th e purpos e o f conductin g environmental respons e activities , an dI agre e t o it s term s an d conditions . Grantor' s Signature : 

# r? - Dat e 

# 05 " i r 0 ^

(3

) UYirim iDougla s Count y Accoun t Informatio n Pag e 1 o f 2 Dougla s County , Nebrask a Propert y Recor d - R190363000 0 

## 2^t\^ ? Prin t Repor t Parce l Dimension s availabl e O scal e 0-5 0 t t wes t o f 14 4 S t - VIe W O n MaP ' informatio n i s vali d a s o f 2008-4-1 7 Treasurer' s Tax Repor t Ne w Featur e ->-»- » Aut o Saie s Searct i Owne r HAY S JOSHU A iV I ETA L 111 5 S 3 6 S T 

## Per-7 ^ 3 ^ 6" ) OMAH A N E 68105-181 3 Propert y Informatio n Ke y Number : 036 3 000 0 1 9 Accoun t Type : Residentia l Parce l Number : 190363000 0 Parce l Address : 111 5 S 3 6 S T 0I\4AHAN E 68105-000 0 Lega l Description : OAKHURS T PAR KLO T 1 5 BLOC K3 5 2 X 12 5 Valu e Informatio n Lan d Improvemen t Tota l 200 7 $13,000.0 0 $162,400.0 0 $175,400.0 0 200 6 $13,000.0 0 $107,500.0 0 $120,500.0 0 200 5 $13,000.0 0 $107,500.0 0 $120,500.0 0 200 4 $13,000.0 0 $107,500.0 0 $120,500.0 0 200 3 $13,000.0 0 $107,500.0 0 $120,500.0 0 200 2 $0.0 0 $0.0 0 $0.0 0 Saie s Informatio n SalesDate : 2005-12-0 9 Dee d Type : W D Book : 200 5 Page : 15959 9 Price : $191,500.0 0 Grantor : D MAR C BEAL S ETA L Grantee : JOSHU A M HAY S ETA L Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6500. 0 1. 0 125. 0 52. 0 No Improvemen t Informatio n

Utt.^.llA ^ T-f c 1 f\r .Dougla s Count y Accoun t Informatio n Pag e 2 o f 2

Buildin g 1

9 P

11 1 itff f

« | ] i



## ^

f -.» i ; 2 1/ 2 STOR Y UNFINISHE D Ti l 0 f-< | P : CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1880. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 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 Sidin g Units : 1. 0 interior : Drywal l Bathis : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 4. 0

Roo f Type : Gabl e Stories : 2. 5 Floorcover : Allowanc e Foundation : Blocl < 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 191 5 0 0 % 191 5 9 2 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Applianc e Fireplac e Masonr y 1. 0 Basemen t Bsmn t Bloc k 8 f t 900. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h Sla b Roo f Cei l 168. 0 Porc h Woo d Dec k 80. 0 Porc h Woo d Dec k 296. 0

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

### Purchas e Orde r

181 9 FARNA M STREE T PURCHAS E ORDE R NO . OMAHA.N E 68183-100 3 1U868 2 FAX # 402-444-542 3 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 EK G TRANSPORTATIO N VENDOR : > BIL L TO : 370 9 N O 1 7 S T CIT Y O F OMAH A FINANC E OM/VH/V.N E 6811 0 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 . DAT E O F ORDER / BUYE R REVISE D DATB/BUYE R 7133 8 27-JUN-d8 P BURK E PAYMEN T TERM S SHI P VI A F.O.B . DESTINATIO N FREIGH T TERM S REQUEST0RA3ELIVE R T O CONFIR M T O / TELEPHON E KASPAR.CATHLEE N SSPURLOC K(402)30&417 9 > < PAR T NUMBE R / DESCRIPTIO N DELIVER Y DAT E QUANTIT Y UNI T UNI T PRIC E EXTENSIO N rrE M IMPORTANT D O NO T STAR T WOR K

UNTI L PROCEE D ORDE I I S ISSUE D B Y TH E PLANNIN G DEPARTMEN T - PE RGROU P 1 2 BI D DATE D 6/11/08 . A l l price s an d amount s o n thi s orde r ar e expressfe di n U S Dolla r NEEDED : 3,100.0 0 N 29-JUN-0 8 EP APAIN T STABILIZATIO N PROGRA M GROU P #1 2 103 4 SOUT H 3 0 STREE T O SHI P TO : Addres s a t to p o f pag e

• A******************]************************* * NEEDED : 3,100.0 0 N 29-JUN-0 8 EP APAIN T STABILIZATIO N PROGRA M GROU P #1 2 111 5 SOUT H 3 6 STREE T O SHI P TO : Addres s a t to p o f pa^ e

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

SHI P TO: - Addres s showi i 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 all invoices , packages , packin g lists , bil l o f lading , an d correspondence . Tota l ( Continue d ) 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 . TA X EXEMPTION : Th e City o f Omah a I s exemp t fro m Federa l Excis e Taxe s an d th e Nebrask a an d Cit y o f Omah a Sale s taxes . Federa l I.D . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealer s Uc . 91-0316768 . Oil y PuFchisin g Agen t I Buye r