Transmittal of Oinaha Lead Site 

Paint Stabilization File Folder 

Said# S^?h Date: ^"r^^ - C ^ 

Address: P^^ 3 /y^^h^CA^C^ t>f 

Contractor: City of Omaha Year: ^CrO<? 

Paint Stabilization 

Property File Folder Documents 

ty^oxV. Write Up 

L'"'^igned Access Agreement for subject property 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, ifapplicable 

t ^ 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 

t y Other (describe): _JJM2 5 

T^M ^ ' ^ ^ 

City of Omaha Representative Signature 

EPA Representative Signature _ 

30262430 

Superfund 

3 '-/S~-7>-

Date 

/ Dke 
Planning Department 

Inspector: Bo b Pickera l Omaha/Douglas Civic Center 

1-4* \>f -7 inn o 1819 Famam Street, Suite 1003 

Date : Ma y 7 ,200 8 ^ ^^^ ^ Nebraska 68183 

0*^*^ (402) 444-5150 

Name: Mary Brown Joy^on g,^ J;J"111'''^°CP 

City of Omaha AddTCSS : 244 3 ManderSO R St . '*''^" ''"""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 Coinmunity Development Division, City of Omaha, 

Nebraska:" (Copies are available at the Planning Department.) 

• Comply with the State of Nebrasjka 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 atid bushes at least two feet from the house and garage. 

• Ensure that all household membiers stay at least ten feet away from all work areas 

and also keep all pets at leaist ten feet away at all times until the work has been 

completed and the area has passed a visual inspection. ^ 

Initials AiO£> 
Address (continued) 2443 Manderson St. 

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 pairit 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 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 municipal solid waste landfill. 

Property (>vner 

Property Owner Date 

Witness Date 

Occupant (if applicable) Date 

Occupant (if applicable) Date 
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: 

Owner Name(s): Mary Brown-Jbh^son 

Davtime Phone: 

763-9252 

Addresses of Properties Covered by this Agreement 

Property Address 

2443 MANDERSON ST 

City/State/Zip Code 

Omaha, Ne 

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

Environmental Response and Liability 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 response activities. 

2. Obtaining samples from Grantor's property. 

m 2/12/2007 
Address: 2443 MANDERSON ST 

Consent for Access to Property (Page 2) 

3. Planning and iniplementing 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) 2/12^007 
Address: 2443 MANDERSON ST, Omaha, Ne, 

CURRENT CONDITION / PROPOSED RESPONSE ACTIVmES 

The puipose 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 by 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. 

ADDI riONAL COMMENTS: 

1.x ^•^V, • -^ il : 7.y'i:. . . 

:' •'•' ) J 

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: ^^^JVl Q^^^jA Q . f TW^-O X Date "j j f jCS 

(3) • '2J\2n001 
Douglas County Account Information Page 1 of 2 

Douglas County, Nebraska Property Record - R1715440000 

Information is valid as of 2008-4-17 

Print Report 

Parcel Dimensions availabie 6 scale 0-SO ft wiest of 144 St - Vie w OH MSP 

Treasurer's Tax Report 

New Feature ->->- • Auto Sales Search 

Owner 

BROWN-JOHNSON MARY 0 

2443 MANDERSON ST 

OMAHA NE 68111-0000 

Property Information 

Key Number: 1544 0000 17 

Account Type: Residential 

Parcel Number: 1715440000 

Parcel Address: 2443 MANDERSON ST 

OMAHA NE 68111-0000 

Legal Description: MARYSVILLE ADD LOT 5 BLOCK 4 50 X 128 

Value Information 

Land Improvement Total 

2007 $2,600.00 •$51,700.00 $54,300.00 

2006 $2,600.00 $51,700.00 $54,300.00 

2005 •$2,600.00 $19,200.00 $21.800.00 

2004 $2,600.00 $17,400.00 $20,000.00 

2003 $2,600.00 $17,400.00 $20,000.00 

2002 $0.00 $0.00 $0.00 

Sales Information 

Sales Date: 2003-04-16 

Deed Type: WD Book: 2003 Page: 114538 

Price: $58,000.00 

Grantor: BONITA WALKER 

Grantee: MARY BROWN-JOHNSON 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Information 

Acres SF Units Depth Width Vacant 

0.14 6400.0 1.0 128.0 50.0 No 

Improvement Information 

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Douglas County Account Information Page 2 of 2 

Building 1 

CLICK TO ENLARGE IMAGE 

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First Floor 

iWO^ q tl ">' 

;443MiU£eR'SChSr 

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• Scccn-J Floor „, / 

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2 STORY 

CLICK TO ENLARGE IMAGE 

Square Footage: 1654.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Fair 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Forced Air Rooms: 8.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 2.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Hip Stories: 2.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1912 0 0% 1912 96 

Detail Type Detail Description Units 

Add On Fence Chain Link 1.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 884.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 2.0 

Porch Cvrd Wood Deck 78.0 

Porch EncI Solid Wall 216.0 

Porch EncI Solid Wall 243.0 

User SOURCE 2 1.0 

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CITY OF OMAHA 

PURCHASING - ROOM 1003 

1819 FARNAM STREET 

OMAHA, NE 68183-1003 

FAX* 402-444-5423 

Purchase Order 

PURCHASE ORDER NO. 

1148653 

REVISION 

0 

PAGE 

4' 

SHIP TO: 

CrtY OR OMAHA 

HOUSING & COMM DEV RM #1111 

1819 FARNAM STREET 

OMAHA,NE 68183 

VENDOR: G BENVIRO SERVICES 

%GARY JENKINS 

4302 MAPLE ST 

OMAHA, NE 68111 

y BILL TO: 

CITY OF OMAHA FINANCE 

DISBURSEMENTS ROOM #1007 

1819 FARNAM STREET 

OMAHA,NE 68183 

-< 

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

CUSTOMER ACCOUNT NO. VENDOR NO. 

77408 

DATE OF ORDER/BUYER 

26-JUN-08.P BURKE 

REVISED DATE//BUYER 

PAYMENT TERMS SHIP VIA F.O.B. 

DESTINATION' 

FREIGHT TERMS 

> 

REQUESTOR/DELIVER TO 

KASPAR. CATHLEEN 

CONFIRM TO / TELEPHONE 

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

10 

! NEEDED: 

i 29-JUN-0 8 

EPA PAINT STABILIZATIO^J 

PROGRAM .GR0tJP#9 

2443 MANDERSON STREET 

O SHIP TO: 

Address at.to p of page 

****ilr4r***tlr**********tl:**'**Vlr****ilr*)l:*4rir******ilr*** 

i NEEDED: 

i 29-JUN-08 

EPA PAINT STABILIZATION 

PROGRAM GR0UP#9 

3206 MYRTLE AVE 

O SHIP TO: 

Address a t top of page 

3,260.0 0 N 

1,980.0 0 N 

******************* * jk************ * *********** * 

NEEDED: 

29-JUN-0 8 

1,800.0 0 N 

SHIP TO: Address shown above. If shipment is delayed pr ariy items not availat>le, advise at once. Purctiase order numt)er must appear on all Invoices, packages, packing lists, bill of lading, and correspondence. 

SHIPPING CHARGES TO BE PREPAID. IF APPLICABLE AND ADDED TO INVOICED, copy to be furnished 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.Lie. 91-0316768. 

Tota l ( Continued ) 

City Purchasins AgenI / Buyer