## Transmitta l o f Omah aLea dSite Pain t Stabilizatio n Fil e Folde r Said#J^Srjf^ 3 Date : <^^/ 3 -7 0 Address : 3// ^ Poff/iL:k> \/41 / _ ^ Contractor : Cit

v o f Omah aYear : rP^^7 0 

## Pain t Stabilizatio n Propert y Fil e Folde r

Document s _l:^^or k Writ e U p Jx ; 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 IXraintin g Agreement/Cit y of Omah aPurchas e Orde

r Settlemen t documents (i.e. , fo

r damage o r t o replac e plants , etc. ) Renovatio n Recordkeeping Checklis t

signe db y Certifie dRenovato

r Jl/Propert y informatio

n fromDougla s Count

y Assessor' s Offic

e Othe r (describe) : V\\c/r^ 5

Cit y o f Omah aRepresentative Signatur

e Dat e EP A Representativ e Signatur

e 3026246 6 

# iimiij i Superfun d

## CITY O F OMAH A PURCHASIN G - ROO M 100 3 181 9 FARNA M STREE T OMAHA . N E 68183-100 3 FAX # 402-444-542 3 

### Purchas e Orde r

VENDOR : G & M PAINTIN G C O IN C

1370 7 CUMIN G S T • OMAHA , N E 6815 4 f PURCHAS E ORDE R NO . 116612 1 REVISIO N 0 PAG E ]

1 J SHIPTO : CITYOFOMAH A HOUSIN G & COM M DE V R M #111 1 181 9 FARNA M STREE T 0MAHA,N E 6818 3 J BIL L TO : CITY O F OMAH A FINANC E 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 . 9129 8 DAT E O F ORDER/ BUYE R 27-MAY-1 0 H HUR T REVISE D DATE//BUYE R PAYMEN T TERM S IMMEDIAT E SHI P VI A FiO.B . DESTINATIO N FREIGH T TERM S > REQUESTOR/DELIVE R MARUCA , T MARI E 

# I k CONFIR M T O / TELEPHON 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 » d i n : U S Doi:a r EP APAINT . STABILIZATIOt J PROGRA M GROU P 11 6 3116 : POPPLETO NA V

• • O SHI P TO : . i Addres s at . to p o f pag e NEEDED : 27-MAY-l O 3,130 . CO. . N

EP APAIN T STABILIZATIO N PROGRA M GROU P 11 6 3634 i S 24T H S T O SHI P TO : Addres s at to p o f pa^ e NEEDED : 27-MAY-l O 2,310.0 0 N

SHIPTO : 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 . Pur chas e orde rnumbe rmus t appea ro n al l Invoices , packages , packin g lists , bil l o f lading , an d correspondence . iSHIPPIN G CHARGE S T O B E PREPAID , I F APPLICABL E AN D ADDE D T O INVOICED , cop y t o be fur nishe d wit h invoice . TAX 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 City o f Omah a Sale s Taxes . Federa l I.D . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealers Lie . 91-0316768 . 

## Tota l C 5-^^°° ° ) 

## 4d'k;)rU-l/V 4 . • Cil y Purchasin g /nan ( / Buye r

### Plannin g Department Omaha/Dougla s Civi

c Cente r Inspector : Stev e Zivn y 181 9 Fama mStreet , Suit

e 1003 rioto

- .I'n/i n Omaha , Nebrask a6818 3 uate . 4,IJ,1 U (402)444-515 0 Telefa x (402 ) 546-071 4 

## Name : Lui s M . Baraja s R . E . 

## Cunningham

, RA , F.SAM E City o f Onnah aAJ J iii/'-r * IJ . A Director



## Ji mSuttle , Mayor

Addrcss: 311 6 Poppleto n Av 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 d Occupant : • Lea d Hazar d Control Plan , Interi

mControl o

f Lea d Base d Pain t Hazards . Th e Contracto r

Shall : • Compl y wit h HUD' s "Guideline s fo

r th e Evaluation an

d Control o

f Lead-Base

d Pain t Hazard s i n Housing. " (Copie s ar

e availabl e a

t th e Planning Department. ) • Compl y wit h Standard s called fo

r i n the "Construction an

d Rehabilitation Specifications , Housin

g an d Communit

y Developmen

t Division , Cit

y o f Omaha, Nebraska. " (Copie s ar

e availabl e a

t th e Plarmin g Departmerit. ) • Compl y wit h the Stat e of Nebrask aHealt h an d Huma n Service s Regulation an

d Licensure , Titl e 17 8 Chapte r 2 3 Lea d Bas e Pain

t Regulations . • Coordinat

e dail y constructio n schedule wit h the occupan

t • Submi t informatio n cut sheet s fo r al l substitution s o

r approve d equal s prio

r t o vvritte n approva l o f th e Consfructio

n Specialist . • . Repai r o r replac e all item s damage

d o r disturbe d durin

g pain t stabilizatio n activities . • Kee p wor k sit e an d surrounding are afre

e fro maccumulation s of

wast e material s o r mbbish cause

d b y th e wor k a t al l times . • Upo n dail y completion of

work : clea

n u p all rubbish , exces s material , equipment , an d etc. , tha t i s connected wit

h th e work, an d leave al l part s ofth e wor

k area s i n a neat , sanitary , lea

d saf e an d presentable condition . • Complet

e thi s projec

t within 3 0 calenda

r days . Th e Occupant/OwTie

r Shal l • Rerhoveandstoreaway an y persona l propert y withi n twent y (20) fee t ofth e are a t o b e remediated . • Provid e acces s t o electricit y an d wate r throughou

t th e pain t stabilizatio n process . • Ensur e tha t all household member

s sta y a t leas t ter i fee t awa y fro mall wor k area s an d als o kee p al l pet s a t leas t te n fee t awa y a t al l time s unti

l th e vvor k has bee n complete d an d th e are aha s passe

d avisua l in.spection . ^



## lnitialsj^_4;^._ .

### 311 6 Poppleto n A v (Continued) 

## Lea dHazar dGontro l Plan Interi mContro l o f

Lea dbase dPain t

Hazard s Pain t Stabilizatio n • Stabiliz e all previousl

y painte dexterio

r wood , brick , meta

l o r concret e surface s ofth e dwelling t

o includ e bu t no t liniitedt o th e siding , fascia, eaves , trim , window'trim , shutters , gutters , railings , downspouts , doo r frim an dfoundation . D O NO T INCLUD E WINDOW S O RMA N DOORS . • Stabiliz e all previousl

y paintedexterio

r wood , brick , meta

l o r concret e surface s ofth e garage t

o includ e bu t no t limitedt o th e siding , fascia, eaves , frim, window frim, shutters , gutters , railings , downspouts , doo r tri m an dfoundation . D O NO T INCLUD E WINDOW S O RMA N DOORS . INCLUD E VEHICL E DOORS . • Prepar e an dpain t al l previousl y paintedsurface s b

y followin g th e Saf e Wor k Practice s protocol 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 coats o f approve dfinish coat . (Refe r t o Plarmin g Dept . approve

dpain t list) . • I F SPRAYED , ON

E COAT SHAL

L B E BACK-BRUSHE

D OR 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 must

b e double bagge

dfo r disposal . • . Clea n paint chip s fro mgroun daroun dperimete r o f dwelling befor

e starting , durin g an

dafte r th e project . • . Al l lea dpainte dcomponents an

ddebri s must

be 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

b e disposedo

f i n amunicipa l soli dwast

e landfill . 

# J v^ > i n f>(r/r^^:C

- o^J/^/7 0 Propert y Owne r Dat e Propert y Owne r Dat e Witnes s Dat e Occupan t ( i f applicabl e) Dat e Occupan t ( i f applicabl e) Dat e

### Exterior Lead-base dPain

t Stabilizatio n Progra

mManage db y the Cit y o f Omah afo r EP A Region 7 OmahaLea

dSit e Th e purpos e o f

thi s progra mi s t o preven t yard s wher e lead-contarhinate dsoi l i s cleane d u p frombecomin g re-contaminate dby deterioratin g exterio r lead-base dpairit . 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 da

n EP A contracto r

ha s identified , deterioratin g exterio r lead-base dpaint . • Home s ar e eligibl e onl y b y referral fromth e EPA . What wor k wil l b e done ? • Loos e an dflaking lead-base dpain t wil l b e remove dsafely fro mfascia , eaves , siding , trim , windo w trim , doo r tri man dfoundation . • Surface s wil l b e prime dan dpainte dt o matc h existin g pain t colo r a s closel y a s possible . What v/il l no t b e done ? • Surface s whic h hav e n o pain t wil l no t b e freated. • 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 ? • EPA confractor s wil l tes t pain t o n exterio r

hous e surface s an dgiv 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 plan an dcontac t

th e property owne r for permissio n t o proceed . • Wor k wil l b e competitivel y bi db y approved , traine dconfractors . Whe n wil l th e wor

k b e done ? • Thi s progra mbegan i n 200 7 an dwil l continu e for several years . • Th e Cit

y staf f wil l prioritiz e home s base do n th e presenc e o f childre n under

ag e si x i f know n an dth e severity o f the.problem . Pain t Stabilizatio n i s voluntar y an dwil l b e don e onl y with permissio n ofth e owner . 

### Initialsi-, ^ 0 ?Consen t fo r Accesiis t o Propert y RIGH T O F ENTR Y T O PREMISE S Granto r (th e property owner ) consent s t o andauthorize s th e Unite dState s Environmental Protectio n Agenc y (USEPA ) o r

it s authorize drepresentatives , collectivel y th e Grantee , to enter an dperfor

m certai n environmental respons e activitie s upon.th e followin g describe dpremises : Owner' s Name : Owne r Name(s) : Lui s M Baraja s Davtime Phone : 342-499 4

Addresse s o f

Propertie s Covere db y thi s Agreemen t Property Addres s 311 6 Poppleto n Ave . City/State/Zi p Code Omaha , N E 6810 5

Granto r imderstand s that

thi s grant

doe s no t limi t EPA' s righ t

of acces s unde r

th e Comprehensiv e Environmenta l Respons e an dLiabilitv Ac t fCERCLA 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 dpain t

o n residentia l properties , includin g day-care facilities , wher e remediatio n o f leadcontaminate dsoi l ha s o r wil 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 orit o Grantor' s property an dfiulher, provide s th e Grante e th e righ t t o perfor man y an dal l enviromnental 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 performe do n subjec t property 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 fo

r andin th e cours e o f th e respons e activities . 2 . Obtainin g sample s fromGrantor' s property .

tmnn mAddress : 311 6 Poppleto n Ave .

Consen t for Acces s t o Propertv ("Pag

e 2 ) 3 . Plarmin g an dimplementin g th e respons e actio n o n th e Grantor' s property . Thi s wil l includ e 1 ) removal o f

loos e o r flaking pain t

identifie db y EP A usin g lead-saf e method s in complianc e wit h HUD/EPA regulation s an d2 ) repaintin g accordin g t o the attache dspecifications . TER M Thi s acces s agreemen t

shal l b e operabl e fo

r th e perio do f

tim e i t take s t o complete th e envirorunental respons e activities . Upo n completio n o f th e respons 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 db y asubsequent agreement . AGREEMEN T NO T T O INTERFERE Granto r agree s no t

t o interfere wit

h any o f th e activitie s undertake n by Grante e a t th e Property , tampe r yvit h an y o f Grantee' s property , o r

tak e any action s regardin g th e us e ofth e Propert y whic h wil l endange r

huma n health or

welfare o r

th e environment , 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 dacop 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 transfer o f ownershi p right s to th e property . SAMPLIN G RESULT S Grante e agree s to provid e Granto r with , 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 o f th e property prio r

t o remediatio n andindicate s o n Pag e 3 an y item s t o b e remove db

y th e Granto r

befor e 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 that sai dpropert

y 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 foundimmediatel y precedin g th e beginnin g o f

activitie s authorize db y thi s Agreement , followin g completio n o f th e respons e activities .

n \2/12/200 7Address : 311 6 Poppleto n Ave. , Omaha , NE , 6810 5

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 prio r to contracto r activities . Thi s wil l als o serv e a s documentatio n fo r th e purpos e o f

assurin g tha

t restoratio n activitie s ar

e complete dt o th e satisfactio n o f th e propert

y owner an dth e Unite dState s Envirorunental Protectio n Agenc y (EPA) . Item s t o b e remove db v propertv owner prio r t o th e respons e activities : I . 2 . • 3 . 4 . 5 . . • Item s NO T to bi

s remove db v confractor

durin g removal activities : 1 . 2 . 3 . 4 . 5 . ADDITIONA L COMMENTS :

I hav e readth e foregoin g documen t an dunderstan dtha t

i t i s a n agreement

grantin g permissio n t o th e Grante e t

O ente r th e abov e describe dpremise 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 dconditions . I acknowledg e that I hav e receive dth e pamphle t "Renovat e Right" . Grantor' s Signature : Jgr^ ^ . ^ 0rrpk^(?-I ^ ^^' ^ n%//^/7( P

('>,\. 2I\2I200 1

### Dougla s Count

y Accoun t Information Pag e 1 of 2 Dougla s County , Nebrask a Propert y Recor d - R095725000 0 Informatio n i s vali d a s o f 2009-12-3 1 Prin t Repor t NE W Featur e - Parce l Dimension s svailabl e ffl) scal e 0-5 0 ft wes t o f 52n d S t - Vie W O H Ma p Treasurer' s Ta x Repor t Ne w Featur e ->-•- > Aut o Sale s Searc h Owne r BARAJA S LUI S M blA L 311 6 POPPLETO N AV E OMAH A N E 68105-000 0 Propert y Informatio n Ke y Number : Accoun t Type : Parce l Number : Parce l Address : Lega l Description : 572 5 000 0 0 9

Residentia l 095725000 0 311 6 POPPLETO N A V OMAH A N E 68105-000 0 DUNDY- E S JR-SU B DIV(HANSCO M PLACE ) LO T 3 BLOC K0 37. 5 X 10 0 .Valu e Informatio n 200 9 200 8 200 7 200 6 200 5 200 4 Lan d $5,100.0 0 $5,100.0 0 $5,100.0 0 $5,100.0 0 $5,100.0 0 . $5,100.0 0 Improvemen t $82,000.0 0 $82,000.0 0 $82,000.0 0 $88,400.0 0 $88,400.0 0 $88,400.0 0 Tota l

. $87,100.0 0 • $87,100.0 0 $87,100.0 0 $93,500.0 0 $93,500.0 0 $93,500.0 0 Sale s Informatio n

Sale s Date : Dee d Type : Price : Grantor : Grantee : Valld/lnvalld : Exclusio n Reason : 1993-03-1 6 D Book : 195 0 Page ; .51 0 $37,000.0 0

Vali d Lan d Informatio n Acre s 0.0 8 S F 3800. 0 Unit s 1. 0 Dept h 100. 0 Widt h

38. 0 Vacan t N o Improvemen t Informatio n 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accounmo=R09.. . 1/25/201 0Dougla s Count y Accoun t Informatio n Pag e 2 of 2

Buildin g 1 2 1/ 2 STOR Y UNFINtSME D

'MOK n

%.^—n^ ' j3 ^ I

9S48K t t lat-iiT"' "

CLIC KT O ENLARG E IMAG E Squar e Footage : 1905. 0 Perimete r 0. 0 Percen t Complete : 100.0 % Quality : Goo d Uni t Type : En d Condition : Averag e Buil t As : HVAC : 2 1/

2 Stor y Unfi n Force d Ai r Cond o Squar e Footage : 0. 0 Rooms : 6. 0 Exterior : Interior : Roo f Cover : Roo f Type : Fram e Sidin g

Drywal l Units : 1. 0 Baths : 2. 0

Floorcover : Compositio n Shingl e

Gabl e Bedrooms : Stories : 3. 0

2. 5 Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea rBuil t Yea r

Remodele d 189 0 Percen t Remodele d Adjuste d Yea r Buil t 0 % 189 0 Physica l Ag e 11 8 Detai l Typ e Ad d O n Applianc e Basemen t Fixtur e Detai l Descriptio n Unfinishe d Atti c W/floo r Allowanc e Bsmn t Bloc k

8 ft Unit s 939. 0 1. 0 939. 0 Fixtur e Additiona l Fixture s Bas e Fixture s 1. 0 1. 0 Fixtur e Bat h Ful l 2. 0 308. 0 193. 0 Garag e Porc h Detache d Sla b Roo f Ceilin g

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09.. . 1/25/201 0