Transmittal of Omaha Lead Site 

Paint Stabilization File Folder 

Said # ;Z-3P7 ^ Date: /l-C-^C ^ 

Address: ^X l 8 /^AC/^^A jf^cjy -^ jsi ~ 

Contractor: Citv of Omaha ' Year: ^Ct> p 

Paint Stabilization 

Property File Folder Documents 

j^Wor k Write Up 

Signed Access Agreement for subject property 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, ifapplicable 

jx ^ 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): Jic/Wl S 

City of Omaha Representative Signature Date 

~' Date 

30262434 

iiniiHiiii 

Superfund 
Planning Departntient 

Inspector: Bo b Pickera l Omaha/Douglas Ciwc Center 

Date: June 12,2008 ''^'^^n"'u'^Tu^t"',Zl 

Omalia, Nebraska 68183 

(402)444-5150 

Name: Gregory & Susanna Clinton TM'=f'"' (^°2) 546-07i4 

cityofomaha Addrcss: 4218 Davcnport St. ^''"'"''•^''"''"h^Z 

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 Departmerit.) 

• 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.) 

• Coriiply with the State of Nebraska 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 or approved equals prior to 

written approval of the Rehabilitation Inspector. 

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

• At all times 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 safe and presentable 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 all times until the work has been 

completed and the area has passed a visual inspection. 

Initials M^ ^ 
Address (continued) 4218 Davenport St. 

Lead Hazard Control Plan 

Interim Control of Lead based Paint Hazards 

Paint Stabilization 

• Prepa:re 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,- ^^l^^'T^-lrt'^j -^i/fwpe^ sJi 

^ (^ All paint colors to match existingjPnme 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 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 

jnlcioal solid waste landfill. 

LiAluii 

Occupant (if applicable) 

Date 

Occupant (if applicable) 

Date 
^itnej^ Date 

Exterior Lead-based Paint Stabilization Program Managed by the City of Omaha for EPA 

Region? 

Omaha Lead Site 

The purpose of this program is to prevent yards \yhere lead-contaminated soil is cleaned 

up from becoming recontaminated 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 froni the EPA. 

What work will be done? 

• Loose and flaking lead-based paint will be removed safely from exterior walls, 

-irjm. and window frames. • 

Surfaces will be primed and painted to match existing paint color as closelv as "^ 

possible. ^0-f- arei/ o-^ Z*^ nouJj jUfjp^ 

What will not be done? " i^rhL ^I'^j^up./jz.n ^ id Iny 

• Surfaces which have no lead-based paint will not be treated b7/ci<. rc a -^urm^^lon 

• Windows will not be treated ^ 

• Rotten wood will not be replaced 

• No housing repair will be done 

Who will perform the work? 

• EPA contractors will test paint on exterior hoe surfaces and give the results to the 

City of Omaha Paint Stabilization Program. 

• City Construction Specialists will prepare a work plan arid contact the property 

owner for permission to proceed. 

• Work will be competitively bid by approved,, trained contractors. 

When, will the work be dorie? 

• 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 permissiori of the owner. 

Initials CT^ 
Consent for 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: Davtime Phone: 

Owner Name(s): Gregory Clinton & Susanna Clinton 345-6867 

Addresses of Properties Covered by this Agreement . 

Property Address 

City/State/Zip Code 

4218 DAVENPORT ST 

Omaha, Ne 

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

Environmental Response and Liabilitv Act (CERCLA). 42 USC. & 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 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 responise activities. 

2. Obtaining samples from Grantor's property. 

(1) 2/12/2007 
Address: 4218 DAVENPORT 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. 

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 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: 4218 DAVENPORT ST, Omaha, Ne, 

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 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 by contractor during removal activities: 

1. . 

2. ' • 

3. 

4. 

• 5. 

ADDITIONAL COMMENTS: 

V" aeznur^-^ ^ ^ 

Ut^rrA ^r«*-. rA< Z ^ ^-..a<4!V 

I have read the foregoing document and understand that it is an agreement grantirig permission to 

the Grantee to enter the above described premises for the purpose of conducting environmental 

response activities, and I agree to its terriis and conditions. 

Grantor's Signature: ^''^^y^y'^ST^t^^^C^^^^i^^P J Date T^/ls/o S 

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

Douglas County, Nebraska Property Record - R2020760000 

Print Report 

Parcel Dimensions available 6 scale 0-50 ft wast of 144 St - VIeW On MflB Information is valid as of 2008-5-19 Treasurer's Tax Report 

New Feature ->->-> Auto Sales Search 

Owner. 

CLINTON GREGORY J 

ETAL 

4218DAVENPRTST 

OMAHA NE 68131-0000 

Property Information 

Key Number: 2076 0000 20 

Account Type: Residential 

Parcel Number: 2020760000 

Parcel Address: 4218 DAVENPORT ST 

OMAHA NE 68131-0000 

Legal Description: POPPLETON PARK LOT 13 BLOCK 26 50 X 128 

Value Information 

Land Improvement Total 

2008 $6,400.00 $125^200.00 $131,600.00 

2007 $6,400.00 $119,000.00 $125,400.00 

2006 $6,400.00 $119,000.00 $125,400.00 

2005 $6,400.00 $119,000.00 $125,400.00 

2004 $6,400.00 $73,000.00 $79,400.00 

2003 $6,400.00 $73,000.00 $79,400.00 

Sales Information 

Sales Date: 2001-12-12 

Deed Type: WD Book: 2199 Page: 308 

Price: $123,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Information 

Acres SF Units Depth Width Vacant 

0.14 6400.0 1.0 128.0 50.0 No 

Improvemen t Information 

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Douglas County Account Information Page 2 of 2 

Building 1 

2 1/2 story Unfin 4218 Davenport St 

:oo:qit 

*(r 

U f 

. , , Frat Floor <T 

3M.3Sq-Pl­ Wa.D&q. Fl. 

1*1 «H 

6yTi<fMle<^1 CS^'O'xi C' 

CLICK CLICK TO ENLARGE IMAGE TO ENLARGE IMAGE 

Square Footage: 1820.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Good 

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

HVAC: Central Air to Air Rooms: 9.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 2.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Gable Stories: 2.5 

Floorcover: Allow/ance Foundation: Blocl< 

Sprinl<ler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1920 0 0% 1920 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 1.0 

Basement Bsmnt Block 8 ft 952.0 

Fixture Base Fixtures 1.0 

Fixture Batti Full 

2.0 

Garage Detached 

280.0 

Porch Slab Roof Ceil 

190.0 

Porch Slab Roof Ceil 20.0 

Porch Wood Decl< 

200.0 

User Attic Full Finish 

336.0 

User Check MLS 

1.0 

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Parcel ID 

Owner Name 

Property Address 

City 

Zip 

Owner Address 

Owner Address 2 

Owner City 

Owner State 

Owner Zip 

Sec-Twn-Rng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer Website Link 

Assessor Website Link 

httD://www.doeis.ore/doffis alias/doeis/oarcelSearch.a.snx?pnvTIsp.r=falBP/«rvnliHTTcAr-fQic 

Parcel Search Page 1 of 1 

</<;/onno 

Results 1 -1 of 1 

B f^ Parcels 

^ CLINTON GREGORY J Q 

4218 DAVENPORT ST 

2020760000 # 

CLINTON GREGORY J 

4218 DAVENPORT ST 

OMAHA 

68131 

4218DAVENPRTST 

OMAHA 

NE 

68131 

20-15-13 

POPPLETON PARK 

26 

13 

50X128 

Treasurer Information 

Valuation Information 
EPA Paint Stabilization Program 

City of Omaha Planning Department 

Housing and Coinmunity Development Division 

Change Order Purchase Order 1149685 

Grdup.No. 22 

Project: Gregory Clinton & Susanna Clinton Change Order No. 1 

4218 Davenport St. Datfe: 10/17/2008 

Contractor: G. W. Tibbs Construction 

4321 N.. 56th St. 

Omaha, NE 68104 

The Contract is changed as follows: 

Lift needed, for upper dormer. Asbestos shingles and roof slope prevented workers from access. 

The original contract amount was: $3,000.00 

Net change by preyiOsuly authorized Change Orders: $0.00 

The contract amount prior to this Change Order was: $3,000.00 

The Contract will be increased by this Charige Order in the amount of: $300.00 

The nevv contract amount including this Change Order will be: $3,300.00 

The Contract time will be changed by 60 days. 

The date of substantial completion as of the date of this Change Order therefore is: 10/14/2008 

CONTRACTOR: CITY OF OMAHA 

Signature Signature 

By •) By / ­

10 iLL 

Date Date 

H 

cc: Edward Dantzler 

Marian Todd 
CITY OF OMAHA 

PURCHASING ­ ROOM 1003 Purchase Order 

1819 FARNAM STREET / 

PURCHASE ORDER NO. REVISION PAGE 

OMAHA, NE 68183-1003 

FAX# 402-444-5423 1149685 0 1 

V 

SHIPTO: 

CITY OF OMAHA 

HOUSING &COMMDEV RM#1111, 

1819 FARNAM STREET 

OMAHA.NE 68183 

G W TIBBS CONSTRUCTION VENDOR: >: - < 

ATTN BILL TO: GARRY TIBBS 

CITY OF OMAHA FINANCE 

DISBURSEMENTS ROOM #1007 4321 N 56 ST 

OMAHA. NE 68104 1819 F/\RNAM STREET 

OMAHA.NE 68183 

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

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

80190 07-AUG-08P BURKE 

PAYMENTTERMS SHIP VIA F.O.B. 

DESTINATION 

FREIGHT TERMS REQUEST0FM3ELIVER TO CONFIRM TO / TELEPHONE 

MARUCAT MARIE 

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

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


DEPARTMENT - PER GROUP! 22 BID DATED 7/30/08 


All prices and amounts! on this order are express d in : US Doi; ar 
 • NEEDED: 
 1,000.00 N
 i 08-AUG-08 


EPA PAINT STABILIZATIOiJ 


PROGRAM GROUP 22 1323 


N. 29TH ST. 
 o SHIP TO: 


Address at top of page 


* * * * * * * * * * * * * * • * . * * * * * \* *********************** * * 

NEEDED: 3,000.0 0 N 

08-AUG-08 

EPA PAINT STABILIZATION 


PROGRAM GROUP 22 4218 


DAVENPORT ST. 
 O SHIP TO: 


Address at top of page 


******************* * •^ ***************** * ****** * 

SHIPTO: Address shown above. If shipment is delayed or any items not available, advise at once. Purchase order number must appear on all Inva'ces. packages, packing lists, bill of lading, and conespondance. 

SHIPPING CHARGES TO BE PREPAID. IF APPLICABLE AND ADDED TO INVOICED, copy to be turnishedAwith invoice. 

TAX EXEMPTION: The City of Omaha is exempt firam Federal Excise Taxes and the Nebraska and City of 

Omaha Sales Taxes. Federal I.D. 476006304; STATE I.O. 01-0316768: Fuel Dealers Lie. 91-0316768. 
DOUGLAS COUNTY 

/ REQUEST FOR BIO AND BID SHEET 

ON: CITY O^ OMAHA EXTERIOR PAINT STABILIZATION PROGRAM FOR THE 

EPA OMAHA LEAD SITE - GROUP #22 

FROM: ' P.M. Burke 

Asst. Douglas County Purchasing Agent 

902 Omaha-Douglas Civic Center 

1819 Farnam Street 

Omaha, Nebraska 66183-0902 

Published 

NOT AN ORDER 

July 16, 2008 

Page 1 

Bid Closirig Time & Date: 11:00 a.m. Jiily 30. 2008 

IMPORTANT 

1. Bid must be in the office ot the CITY CLERK, LC-1, OMAHA-DOUGLAS CIVIC CENTER, 4. If Federal Excise Tax applies, show amount of same and deduct. 

1819 Famam Street, Omaha, NE 68183-0011 t>y the closing date and time Indicated Exemption certificates will be furnished. Do not include tax in bid. 

in a sealed envelope marked: 

BID ON: CITY OF OMAHA EXTERIOR PAINT STABILIZATION 5. BID MUST INCLUDE ANY DELIVERY OR SHIPPING CHARGES. 

PROGRAM FOR THE EPA OMAHA LEAD SITE - GROUP #22 

6. When submitting bid on items listed, bidder may on a separate sheet, make 

2. BID BOND: A bid bond is not required for this project. suggestions covering reduction in costs wherever this is possible through 

redesign, change ol material or utilization dt standard items or quantity change. 

3. Right is rasen/ed to accept or reject any or all bids in their.entirety and the bidders shall 

have the right to appeal any decision to the City Council, liight Is also resen/ed to 7. II you do not bid, return sheets with reason lor declining. Failure to do so will indicate 

accept or reject any part of your bid unless otherwise indicated by you. your desire to be removed Irom our mailing list. II you desire a copy ol tabulation 

checkhere f H 

PLEASE DO NOT CALL FOR THIS INFORMATION 

Quote your lowest price, best delivery and terms, F.O.B. delivery point on the item(s) listed below: 

QUANTITY DESCRIPTION. UNIT PRICE EXTENSION 

Tfie City of Omaha is seel<ing bids from pre-qualified suppliers to 

perform the scope of wori< as described in the attached. 

specifications. 

Each site is a geographically seiparate site, not dependent or 

related to any other site, and each site will be considered a 

separate award, per bid and attached specifications. 

DAVIS BACON ACT • 

For questions regarding this bid, or questions on how to qualify to 

become a' bidder for this or future bids with this scope of work, 

contact Mr. Mike Honaker at (402)444-5333. 

All contractors can obtain a current City ol Omaha Certified Protected Business Enterprise/Certified Business Enterprise (PBE/DBE) listing Irom the City ol Omaha website at 

www.ci.omaha.ne.us. Click on 'Departments, click on 'HUMAN RIGHTS & RELATIONS', click on 'PBE/DBE CERTIFIED DIRECTORY'. All bidders awarded a contract in the amount of $5,000 

or more must comply with the Contract Compliance Ordinanace and have on llie with the Human Rights and Relations Department the Contract Compliance Report (Form CC-1). This report 

shall be in effecl for 24 months from the date received by the Human Rights & Relations Department. Any questnns regarding the Contract Compliance Ordinance.or PBE/DBE Listings should 

be directed to the Human Rights & Relations Department at (402)444-5055. 

• Reler anv ouesttons reoardlng the BID or SPECIFICATIONS directly lo the Purchasing Department (402)444-7155 or as shown on bid. 

r • ' ­ ­ - (PLEASE PRINT LEGIBL V OR TYPE) 

Firm r-l U^ -T . \ i \\ 5 1 Incorporated in: 

Payment Terms % 

Name Signature 

Delivery (or completion)' 

Title Phone Fax 

calendar days followinq award 

Address 

yireeUP.U. Uox uny .State ^ip 

Email Address