## Transmitta l o f

Omah aLea d Site Pain t Stabilizatio n Fil e Folde r Said # 7^^f^ ^ Date : ^-p-7-/ 0 Address : /f// V Ps>r^€ ^

s A , ^ Contractor : Cit v o f

Omah aYear : 9- 0 / O 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s ^Wor k Writ e U p 

### 6Xsi , 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 l y Painting 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 Recordkeeping Checklis t signedb y Certifie dRenovato r t^^ropert y informatio n fromDouglas Count y Assessor' s Offic e 

# F^< pother (describe) : T'^Q^' ^

Cit y o f Omah aRepresentati p Signatur e Dat e
EP A Representativ e Signatur e ' Date ' 3026246 4 

# mmniiiii i

Superfun d

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

### Purchas e Orde r 181 9 FARNA M STREE T PURCHAS E ORCE R NO . REVISIO N PAG E OMAHA , N E 68183-100 3 116534 1 0 1 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 MARCO S PROFESSIONA L PAINTIN G VENDOR : . 

## y 

# S BIL L TO :

CIT Y O F OMAHAFINANC E MARC O A SALAZA R 251 4 J S T DISBURSEMENT S ROO M #100 7 OMAHA , N E 6810 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 ) " A CUSTOME R ACCOUN T NO . VENDO R NO . DAT E O F ORDER/ BUYE R REVISE D DATE/./BUYE R 8156 9 28-APR-1 0 H HUR T 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 price s an d amount s o n thi s orde r ar e expres s s d ir i : U S Doi : a r NEEDED : 7,676.0 0 N 28-APR-l O EP APAIN T STABILIZATIO N PROGRA M GROU P 9 5 141 4 • DORCA S ST , 141 6 DORCAS : ST , 142 3 S 6T H ST , .193 1 S 9T H ST , & 62 4 DORCAS : S T : O SHI P TO: . i Addres s a t to p o f pag e

SHI P TO : Addres 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 . Purchas e orde rnumbe rmus t appea ro n al l invoices , packages , packin g lists , bil l o f lading , an d correspondence . SHIPPIN G CHARiSE 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 . 

## Tota l C 7,676.0 0 

# 3

TA X EXEMPTION : Th e Cit y 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 . 0V0316768 : Fue l Dealer s Lie . 91-0316768 . V ^

' • MJB I Cil y Punihasin g Ageli U Buye r

### S^ i Plannin g Department

Omaha/Dougla s Civi c Center Inspector : To mRoz a181 9 Fama mstreet , Suit e 100 3 T^-itB

- ^X'/^\I\( \Omaha,Nebrask a6818 3 i^aie . J/ll/l U (402)444-515 0 Telefa x (402 ) 546-0714 . 

### Name : Joaqui n MaIdonad o R.E . 

### Cunningham , RA,F.SAM E 

### JiSLfd^M"ayo r

Address : 141 4 Dorca s S t .Directo r OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEA D SIT E Th e Contrac t bi d document s consis t ofth e followin g sections : •Genera l Responsibilitie s fo r

th e Contracto r

an dOccupant . •Lea dHazar dControl Plan , Interi mControl 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 availabl e a t the Planning Department. ) •Compl y wit h Standard s called fo r

i

n the "Construction an dRehabilitation ,- Specifications , Housin g an dCommunit y Developmen t Division , Cit y o f

Omaha , Nebraska. " (Copie s ar e available a t th e Planning Department. ) •Compl y wit h th e Stat e ofNebraskaHealt h an dHuma n Sei^vice s Regulation an d Licensure , Titl e 17 8 Chapte r

2 3 Lea dBas e Pain t Regulations . •Coordinat e dail y construction schedule wit h th e occiipan t •Submi t infbrmatio n cu t sheets fo r

al l substitution s o r

approvedequal s prio r

t

o writte n approva l o f th e Consti-uctio n Specialist . • Repai r

o

r

replac e all item s dartiage do r

disturbeddurin g pain t stabilization activities . •Kee p wor k

sit e an dsurrounding are a free fromaccumulation s of wast e material s o

r

rubbish cause d b y th e wor k

a

t al l times . •Upo n dail y completion o f work : clea n u p al l rubbish , exces s material , equipment, an d etc. , tha t i s connectedwit h th e work , an dleave al l part s ofth e wor k

area s i n a neat , sanitary , lea d saf e an dpresentable condition . •Complet e thi s project within 3 0 calenda r

days . Th e Occupant/Ovwe r

Shal l •Remov e an dstor e awa y an y persoiiai l propert y withi n twent y (20 ) fee t o

f

th e are a to b e remediated . •Provid e acces s to electricit y an dwate r

throughout th t pain t stabilization process . •Ensur e tha t al l householdmember s sta y a t least te n tee t awa y fro mal l wor k

areas an dals o kee p al l pet s a t leas t te n fee t awa y a t al l time s until th e wor k

ha s bee n complete dan dthe are ahas passe davisua l inspection . ^<-^ y / 

# r ^

### 141 4 Dorcas S t (Continued ) 

## LeadHazar d Contro l Pla n Interi mContro l of Lea d based Pain t Hazard s Pain t Stabilizatio n •Prepar e an dpain t all previousl y painte dexterio r

surface s ofth e dwelling t o includ e bu t no t limitedt o th e fascia, eaves , trim , window trim , doo r

tri m an dfoundation . D o no t includ e door s o r windows . • Prepar e aii dpain t al l previousl y paintedsurface s b y followin g th e Saf e Wor k

Practice s protoco l fo r

EP A exterio r

lea dbasedpain t stabilization . •Al l pain t color s t o matc h existing pain t pattem . Prim e an dappl y tw o coat s o

f

approve dfinish coat . (Refe r

t

o Planning Dept . approve dpain t list ) •I F SPRAYED , ON E COAT SHAL L B E BACK-BRUSHE D O R BACK-ROLLED . Lea dBase dPain t Wast e Lead-base dpain t wast e mus t b e handle da s follow s •Al l pain t chip s an dcomponen t debri s mus t be doubl e bagge dfo r

disposal . •Clea n pain t chip s fromgroun daroun d perimete r

o

f

dwellin g befor e starting , during an dafte r

th e project . •Al l lea dpainted components an ddebri s must b e remove dfro mth e sit e dail y unles s otherwis e approve db y th e construction specialist . •Al l lead-basedpain t debri s (chip s an dcomponents ) must be disposedo f

i

n amunicipa l solidwast e landfill . Pro^rt y Owne r

Dat e 

# id-L^J^^/ O Dat e Witnes s Dat e Occupan t (ifapplicable ) Dat e Occupan t (ifapplicable ) Dat e Witnes sDat e

### Exterio r

Lead-base d Pain t Stabilizatio n Progra mManagedb y the Cit y o f Omahafo r

EP A Region 7 Omah aLea d Sit e Th e purpos e o f thi s progra mi s to preven t yard s wher e lead-contaminate d soi l i s cleane d up frombecomin 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 Are 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 EPA confracto r ha s identifie ddeterioratin g exterio r lead-base d paint . •Home s ar e eligibl e onl y b y referral fromth e EPA . Wha t wor k

wil l b e done ? •Loos e an dflaking lead-base d pain t wil l b e remove d safely fro mfascia , eaves , siding , frim, windo w trim , doo r friman d foundation . •Surface s wil l b e prime dan dpainte d t o ihatc 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 no t b e treated . •Window s o r dOor s wil l no t b e included . •Rotte n woo dwil 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 o n exterio r hous e surface s an d giv e th e result s t o . th e Cit y o f Omah aPain t Stabilizatio n Program . •Cit y Constructio n Specialist s wil l prepar e awor k

pla n an d contac 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 in 200 7 an d wil l continu e fo r severa l years . •Th e City staf f wil l prioritiz e home s base d o n th e presenc e ofchildre n unde r ag e si x i f know n an dth e severity o f th e problem . Pairi t Stabilizatio n i s voluntar y an d wil l b e don e onl y wit h permissio n ofth e owner .

InitialCj^i ^Consen t fo r Acces s t o Propert y RIGH 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 , colleiitivel y th e Grantee , t o ente r an dperfor m certai n environmental respons e activitie s upo n th e followin g describe d premises : Owner' s Name : Davtime Phone : Owne r Name(s) : Joaqui n Maldonad o 402-505-303 9

Addresse s o f Propertie s Covere d b y thi s Agreemen t

. Property Addres s City/State/Zi p Cod e 141 4 Dorca s St . Omaha , N E 6810 8

Granto r understand s tha t thi s grant doe s no t limi t EPA' s righ t o f acces s under th e Comprehensiv e Environmenta l Respons e an dLiabilitv Ac t f

CERCLA l 4 2 USC : & . 9601-9675 ! o r an v other 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 o n residentia l properties , includin g day-care facilities , where remediatio n o f leadcontaminate d soi l ha s o r

vyil 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 propert y an dftirther, provide s th e Grante e th e righ t to perfor many an d al l environmental respons e actions , an dactivitie s i t deem s appropriate . ENVIRONMENTA L RESPONS E ACTION S Th e envirorunental respons e action s t o b e performe d o n subjec t propert y ma y includ e th e follovrin g activities : 1 .Locatin g equipmen t and/o r machiner y o n subjec t property in 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 : 141 4 Dorca s St . Consent fo r Acces s to Propertv (Pag e 2 ) 3 .

Plannin g an dimplemeiitin g th e respons e actio n ot i th e Grantor' s property . Thi s wil l includ e 1 ) reitioval o f loos e o r flaking pain t identifie d by 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 . TERM Thi s acces s agreemen t shal l b e operabl e fo r th e perio d o f time i t take s to complete th e envirorunental respons e activities . Upo n completio n o f th e resporis e actions , al l right s an d privilege s give n b y th e Granto r shal l ceas e o n tha t date , unles s extende d b y asubsequent agreement . AGREEMEN T NO T T O INTERFERE Granto r agree s no t to interfere wit h an y ofth e activitie s undertake n by Grante e at th e Property , tampe r wit h an y o f Grantee' s property , o r take an y action s regardin g th e us e ofth e Propert y whic h wil l endeuige r huma n healt h or welfare o r th e envirorunent , o r allo w other s t o us e th e Propert y i n suc h marme r durin g th e termo f thi s consent . Granto r agree s t o provid e notic e an d a" cop y o f thi s agreemen t t o prospectiv e purchasers , lessees , assigns , o r grantee s o f th e property o r an y portio n o f it . Granto r agree s t o provid e 30-da y notic e t o EP A prio r t o an y transfe r o f ownershi p right s 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 d all saniplin 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 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 db y th e Granto r before activitie s commence . RESTORATIO N O F PROPERT Y Excep t fo r th e abov e state dpain t stabilization , th e Grante e agree s tha t sai d property wil l b e restore d a s nearl y a s possibl e t o it s original stat e an dconditio n a s found immediatel y precedin g th e begirmin g o f activitie s authorize db y thi s Agreement , followin g completio n o f th e respons e activities .

(2 )2/12/200 7Address : 141 4 Dorca s St. , Omaha , NE , 6810 8 CURREN T CONDITIO N /.PROPOSE D RESPONS E ACTIVITIE S Th e purpos e o f thi s sectio n i s t o provid e amutual agreemen t a s t o condition s o f propert y prior t o (contracto r activities . Thi s wil l als o serv e a s documentatio n for th e purpos e o f assurin g tha t restoratio n activitie s are complete dt o th e satisfactio n o f th e property owner an dth e Unite d State s Environmental Protectio n Agenc y (EPA) . Item s t o b e remove db v propert v owner 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 tha t i t i s a n agreemen t graritin g permissio n to th e Grante e t o enter th e abov e describe d premise s fo r th e purpos e o f conductin g envirorunenta l respons e activities , an dI agre e to it s term s an d conditions . I acknowledg e tha t I hav e receive d th e pamphle t "Renovat e Right" . Grantor' s Signatur e 

### '•^Jc ^ 

# j/MlJa^( ^ P^^^3//5/^/ ^

(3 ) 2/12/200 7Dougla s Count y Accoun t Informatio n http://dougIasne.mapping-onlihe.com/DouglasCoNe/static/accountinfo. , Dougla s County , Nebrask a Propert y Recor d - R213512000 0 Prin t Repor t NE W Featur e - Parce l Qlmension s availabl e Q scal e 0-5 0 ft wes t o f 52n d S t - VJC W O H Ma P Informatio n I s vali d as of 2010-2-1 6 Treasurer' s Ta x Repor t Ne w Featur e r * .T # S * Aut o Sale s Searc h Owne r MALDONAD O JOAQUI N ETA L • 141 4 DORCA S S T OMAH A N E 68108-000 0 Propert y Informatio n Ke y Number : 351 2 000 0 2 1 Accoun t Type : Residentia l Parce l Number : 213512000 0 Parce l Address : 141 4 DORCA S S T OMAH A N E 68108-000 0 Lega l Description : ROGER S - S E-AD D LO T 2 BLOC K1 8 E 3 3 F T 3 3 X 100. 4 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $3,600.0 0 $67,600.0 0 $71,200.0 0 200 8 $3,600.0 0 $63,100.0 0 $66,700.0 0 200 7 $3,600.0 0 $63,100.0 0 $66,700.0 0 200 6 $3,600.0 0 $51,900.0 0 $55,500.0 0 200 5 $3,600.0 0 $51,900.0 0 $55,500.0 0 200 4 $3,600.0 0 $51,900.0 0 $55,500.0 0 Sale s Informatio n Sale s Date : 2000-06-1 9 Dee d Type : Book : 215 7 Page : 47 7 Price ; $56,000.0 0 Granto r Grantee : Valld/lnvalld : Vali d Exclusio n Reason : Sale s Date : 2000-03-1 0 Dee d Type : W D Soofr ; 214 7 Page : 11 5 Price : $18,000.0 0 Grantor - Grantee : Valid/Invalid : Invali d

lo f 3 3/2/201 0 9:1 9 A MDougla s Count y Accoun t Informatio n http://douglasne.mapping-onIine.com/DougiasCoNe/static/accountinfo. , Exclusio n Reason : Financin g Sellor/Specia l Sale s Date : 1999-10-2 6 Dee d Type : Price : Grantor ­ $19,900.0 0 Book : 213 8 Page : 63 0

Grantee : Valid/Invalid : Exclusio n Reason : Vali d Lan d Informatio n Acre s S F 0.0 7 3300. 0 Unit s 1. 0 Dept h 100. 0 Widt h 33. 0 Vacan t N o Improvemen t Buildin g 1 Informatio n

141 4 Oorca s S t RANC H

fmtr^i r •» • 311 9 i7|-»-;,r ^ 'iT f Bnmetsoti t 9I:DH I I CLIC KT O ENLARG E IMAG E Squar e Footage : 939. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Averag e

Buil t As : Ranc h Cond o Squar e Footage : 0. 0

HVAC : Centra l Ai rt o Ai r Rooms : 5. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 2. 0

Roo f Type : Hi p Stories : 1. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinl<ie 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 3 0 % 191 3 9 7 2 o f 3 3/2/201 0 9:1 9 A M