## Transmitta l o f Oniah aLea d Sit e Pain t Stabilizatio n Fil e Folde r Said#cPP-/^/ ^ 

### Date : t^'^-7 0 Address : 

### ^ 0 ^ 3 . ^C r

i/ ^ Contractor : Cit v o f

Omah a Year : ^ ^ / ^ 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s V^Work Writ e U p 1^Signe d Acces s Agreemen t fo r

subject propert y Pre-Renovation for msignedby Propert y Owne r Pre-Renovation For mfo r

Occupant/Tenant , ifapplicabl e \/^aintin 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 Recordkeepin g Checklis t signe db y Certifie dRenovato r

• LXPropert y informatio n fro mDougla s Count y Assessor' s Offic e t^^the r (describe) : frjuh i 

## y^^> ^ 72y ^ 3 -iS'-7: ^ Cit y of Omah aRepresentative Signatur e Dat e 

# O^^ , EP A Representativ e Signatur e Dat e 3026247 1 Superfun d

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

### Purchas e Orde r 181 9 FARNA M STREE T OMAHA , N E 68183-100 3 F/\X # 402-444-542 3

VENDOR : M C SERVICE S 260 4 ABERDEE N D R PAPILLION , N E 6813 3 PURCHAS E CROE.= ^ NO . REVISiC N . PAG E 1 116962 7 0 1 J ^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 6813 3



## - . J BIL L TO :

CIT Y O F OMAH A FINANC E DISBURSEMENT S ROO M #100 7 181 9 FARNA M STREE T OMAHA,NE.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 DATE//BUYE R 10287 6 27-OCT-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 CONFIR M T O / TELEPHON E ZIVNY , STEVE N D > < ITE M PAR T NUMBE R / DESCRIPTIO N DELIVER Y DAT E QUANTITY UNI T UNITPRIC E EXTENSIO N Al l price s an d amount s o n thi s orde r ar e expres s 2 d i n : U S Dolla r NEEDED : 650.0 0 N 28-OCT-1 0 ER APAIN T STABILIZATIOt J PROGRA M GROU P #18 2 906 " S 2 6 S T o SHI P TO : Addres s a t to p o f pag e

SHIPTO : Addres s show n above . I f shipmen t i s delaye d o ran y item s rx> t available , advis e a l 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 cctrespondence . SHIPPING . CHARGE S T O B E PREPAID , I F APPUCABL E AN D ADDE D T O INVOICED , cop y t o b e fur ­ 

## Tota l C 650.0 0 

# J nishe d wit h invoice . TA

X EXEMPTION : Th e Cil y o f Omah a i s exemp t fro m Federa l Excis e Taxe s an d th e Nebraska an d Cit y of Omah a Sale s Taxes . Federa l I.D . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealer s Lie . 91-0316768 . 

# ^ u ^ Cil y Putthasin g Agen l / Buye r 1 ^Plannin g Departmen t Omaha/Dougja s Civi c Cente r Inspector : Stev e Zivn y 181 9 Fama mStreet , Suit e 110 0 Date : 9/22/1 0 Omaha , Ncbraska.6818 3 (402)444-515 0 Telefa x (402 ) 444-6140 

## Name : Alin aM . Ceballo s R . E . Cunningham , RA , F.SAM E Cit y o f Omah a Directo r Ji mSuttle , Mayo r 

## Address : '906 S 26^ ^ Stree t OMAH A EXTERIO RPALN T STABILIZATIO N PROGRAM FO RTH E EPA OMAHA LEA D SIT E Th e Contrac t bi ddocument s consis t ofth e followin g sections : •General Responsibilitie s fo r th e Contracto r an dOccupant . •Lea dHazar dContro l Plan , Interi mContro l o f Lea dBase d Paint Hazards . Th e Contracto r Shall : •Compl y wit h HUD' s "Guideline s fo r th e Evaluatio n an d Contro l o f Lead-Base d Pain t Hazard s i n Housing. " (Copie s ar e availabi e a t th e Plannin g Department. ) •Compl y wit h Standard s calle d fo r i n th e "Constructio n and Rehabilitatio n Specifications , Housin g an d Community Developmen t Division , Cit y o f Ornaha , Nebraska. " (Copie s ar e availabl e a t th e Plannin g Department. ) •Compl y wit h th e Stat e ofNebrask aHealth an d Huma n Sen/ice s Regulatio n an d Licensure , Titi e 17 8 Chapte r 2 3 Lea d Bas e Pain t Regulations . •Coordinat e dail y constructio n schedul e wit h th e occupant •Subrni t infcrmatior i cu t sheet s for al l substitution s o r approve d equal s prio r to writte n approval o f th e Constructio n Specialist .

.• . Repai r o r replac e al l iterh s daniage d o r disttirbe d durin g paint stabilizatio n activities . •Keep wor k

sit e an dsurroundin g are afre e fromaccumulation s o f wast e material s or

j-ubbis h cause db y th e wor k

a t al l times . •Upondail y completio n o f work : clea n U p al l rubbish , exces s material , equipment , an detc. , tha; t i s connecte dwith th e work , an d leav e al l part s ofth e wor k

area s i n a neat , sanitary , leadsaf e an dpresentabl e condition . »Complet e thi.« . projec t v/ithi n 3 0 calenda r days . Tli e Occupant/'Owner-Shal l •Remov e an dstor e awa y any persona l property vwthi n twent y (20 ) feet o f th e are a t o b e remediated . •Provid e acces s t o electricity an d wate r throughou t th e paint stabilizatio n process . •Remov e voluntee r tree s an d vegetatio n fro mth e dri p lin e of th e roof , an d cu t bac k shrub s an dbushe s a t leas t tw o fee t fro mth e house ; •Ensure tha t all househol dmember s sta y a t leas t te n fee t awa y fromal l wor k

area s an dals o kee p al l pet s a t leas t te n feet awa y at al l times unti l th e wor k

ha s been complete dan dth e are aha s passe d avisual inspection . . Initials—-siv^ .

### 90 6 S 26"'Street (Continued ) . . 

## Lea d Hazar dContro l Plan InterimControl o f

Lea dbased Pain t Hazard s Pain t Stabilizatio n

. • . Stabilize , al l previousl y paintedexterio r

wood, brick , metal , concret e

. . surface s o f th e caUB A dwelling to . includ e bu t no t limite dt o th e siding , fascia, eaves , frim, window trim , shutters , gutters , railings , porch floor, downspouts , doo r

tri man dfoundation . D O NO T INCLUDE MA N DOOR S O RSyiNDOWS . INCLUD E META L SIDING . .• . Prepar e an d pain 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 dbase dpain t stabilization . •All 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 Plannin g Dept . approve dpain t list) . •I F SPRAYED , ON E COA T SHAL L B E BACK-BRUSHE D OR BACK-ROLLED . Lea dBase dPain t Wast e Lead-base d pain t wast e mus t b e handle da s follow s •Al l pain t chip s an d componen t debri s nius t b

e double bagge dfo r

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

o

f

dwellin g befor e starting , during an dafte r

the project . •Al l lea dpainte dcomponents an ddebri s mus t b e remove dfro mth e sit e dail y unles s otherwis e approvedb y th e construction specialist . Al l lead-base dpain t debri s (chip s an dcomponents ) mus t bedispose dof i

n

. municipa l solid>wast e landfill . 

# o^'XI-xX ) Propert y Owne r

Dat e Witnes s Dat e Occupan t (if applicable)Dat e Occupan t (if applicable)Dat e

### Exterior Lead-base dPain t Stabilizatio n Progra mManage d b y the Cit y o f Omahafo r

EP A Regio n 7 Omah aLea d Sit e Th e purpos e o f thi s program , i s t o preven t yard s where lead-contaminate d soi l i s cleane d u p frombecomin g re-contaminate db y deterioratin g exterio r lead-base dpaint . 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 ar e eligibl e onl y by referral fro mth e EPA . What wor k

wil l b e done ? •Loos e an dflaking lead-base d pain t wil l b e remove d safely fromfascia,,eaves , siding , trim , windo w trim , doo r tri man d foundation . •Surface s wil l b e prirne dan d painte d to 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 no t b e treated . •Window s o r door s wil l no t b e included ; •Rotte n woo dwil l not b e replaced . •N o housin g repai r wil l b e done . Wh o wil l perfor mth e work ? • EP A confractor 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 Consfructio n Specialist s wil l prepar e awor k

plan an d contac t th e property owne r fo r permissio n to proceed . •Wor k

wil l b e competitivel y bi db 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 Cit y staf f wil l prioritiz e home s base d on th e presenc e o f childre n under ag e si x ifknow n an dth e severity ofth e problem . Pain t Stabilizatio n i s Voluntar y an dwil l b e don e only with permissio n ofth e owner . Initials "Consen t fo r Acces s t o Propert y RIGH T O F ENTR Y T O PREMISE S Granto r (th e propert y owner ) consent s to and authorize s th e Unite d State s Environmental Protectio n Agenc y (USEPA ) o r it s authorize drepresentatives , collectivel y tiie Grantee , to enter an d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises : Owner' s Name : Davtime Phone : ^ 

# 4\\ ^ Owner Name(s) : Alin aM Ceballo s 

### 50 2 997 1 - 3(9-^ 1 ^ ^^'''^ ' 

# qi/>?-u^i 4 0^-^ ^ Addresse s o f Propertie s Covere d by thi s Agreement Property Addres s City/State/Zi p Code 906S . 26tiiSt . Omaha , N E 6810 5 \ Granto r understand s that thi s grant doe s no t limi t EPA' s righ t o f acces s under th e Comprehensiv e Environmental Respons e an dLiabilit v Ac t fCERCLA) . 4 2 USC . & . 9601-9675 . o r anv other law . PURPOS E OF 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 lea d contaminate d soi 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 ont o Grantor' s property an dfurther , provide s th e Grante e th e righ t 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 envirormiental respons e action s t o b e performe 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 fo r an di 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 : 90 6 S . 26ti i St . Consen t fo r Acces s to Propertv CPag e 2 ) 3 .

Plannin g andimplementin g th e respons e actio n on th e Grantor's,property . Thi s wil l includ e 1 ) removal o f loos e o r flaking pain t identifie d b y EP A usin g lead-saf e method s in complianc e wit h HUD/EP A regulation s an d2 ) repaintin g accordin g t o th e attache d specifications . TER M Thi s acces s agreemen t shal l b e operabl e fo r th e perio d of , time i t take s t o complete the environrhenta l 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 that date , unles s extende d b y asubsequent agreement . AGREEMEN T NO T T O INTERFERE Granto r .agree s no t to . interfere vWt h any o f th e activitie s undertake n by Grante e a t th e Property , tampe r wit h an y o f Grantee' s property , o r tak e an y action s regardin g th e us e ofth e Property whic h wil l endange r human healt h o r welfar e or 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 ter mo f thi s consent . Granto r agree s t o 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 ofth e propert y o r any portio n o f it . Granto r agree s t o provid e 30-da y notic e t o EPA prio r t o any transfer 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 al l samplin g and/o r analysi s resultin g fromGrantee' s respons e activitie s o n th e property . PRIO RCONDITION S AGREEMENT Th e granto r agree s t o th e conditio n ofth e properi y prio r t o remediatio n an d indicate s on Pag e 3 an y item s t o b e rernove 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 that sai d propert y will b e restore d a s nearl y a s possibl e t o it s original state an d conditio n a s found immediatel 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 .

(2 )2/12/2007

### Address : 90 6 S . 26t h St. , Omaha, NE , 68105 CURREN T CONDITIO N /PROPOSE D RESPONS E ACTIVITIE S Th e purpos e o f

thi s section i s t o provid e amutua l agreemen t a

s t o condition s o f

propert y prio r

t

o contractor activities . Thi s wil l als o serve as documentatio n fo r

tiie 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 owne r

an dth e Unite dState s Environmenta l Protection Agenc y (EPA) . Item s t o be remove db v propert v owne r

prio r

t

o th e respons e activities : 1 . 2. 3. 4.

• 5 - ' • 

### Item s NOT t o b e remove db y contracto r

durin g remova l activities : • 1 . . 2 . . . . • • 

### 3

­ 4 . 5 . ADDITIONA L COMMENTS :

I hav e rea d th e foregoin g documen t an dunderstan dtha t i t i s a n agreemen t grantin g permissio n t o th e Grantee t o ente r

the abov e describe dpremise s fo r

th e purpos e p f

conductin g environmenta l respons e activities , an dI agre e t o it s terms an dconditions . I acknowledge tha t I hav e receive d th e pamphle t "Renovat e Right" . Grantor' s Signature : i.A^:U ^ \..^^X^<L . ^'' ' 0-^7-f? )

(3 ) 2/12/200 7

### Dougla s Count y Accoun t Information Pag e 1 of 3 Dougla s County , Nebrask a Propert y Recor d - R171332000 0 Prin t Repor t NE W Featur e - Parce l DImenslon i availabl e Q ical e 0-5 0 f t vras t o f 52n d iS t - VJe W O H Ma p Informatio n i s vali d a s o f 2010-4- 5 Treasurer s Ta x Repor t Ne w Featur e rtf'^lirif ; Aut o Sale s Searc h Owne r CEBALLO S ALIN A M 90 6 S 2 6 S T OMAH A N E 68105-000 0 Propert y Informatio n Ke y Number : 133 2 000 0 1 7 Accoun t Type : Residentia l Parce l Number : 171332000 0 Parce l Address : 90 6 S 2 6 S T OMAH A N E 68105-000 0 Lega l Description : MARSH S AD D LO T 2 BLOC K4 5 0 X 12 4 Valu e Informatio n LMn d Improvemen t Tota l 200 9 $4,800.0 0 $69,300.0 0 $74,100.0 0 200 8 $4,800.0 0 $69,300.0 0 $74,100.0 0 200 7 $4,800.0 0 $69,300.0 0 $74,100.0 0 200 6 $4,800.0 0 $57,800.0 0 $62,600.0 0 200 5 $4,800.0 0 $57,800.0 0 $62,600.0 0 200 4 $4,800.0 0 $57,800.0 0 $62,600.0 0 Sale s Informatio n Sale s Date : 2005-05-2 7 Dee d Type : W D Book : 200 5 Page : 06319 7 Price : $75,000.0 0 Grantor : FREDERIC KJACKSO N ETA L Grantsie : ALIN A M CEBALLO S Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1946-03-1 3 Oeeo f Type : W D Book : 200 5 Page : 06319 6

Price : $ 2,950.0 0 

### Grantor : EFFI E ANDERSO N ETA L 

### http://douglasne.mappirig-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R17.. . 4/16/201 0Dougla s County Accoun t Informatio n Pag e 2 o f 3
Grantee : JOSEPHIN E JACKSO N ETA L Valid/lnvalid : Invali d Exclusio n Reason : Lan d Contract - Agreemen t Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6200. 0 1. 0 124. 0 50. 0 N o Improvemen t Informatio n Buildin g 1 

### .^i?::h^ ^

^ll& ) F t tamtn H

,,.t»«i t

Id s 1 1/ 2 STOR Y FINISHE D CLIC KT O ENLARG E IMAG E Squar e Footage : 1144. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Goo d

Buil t As : 1 1/ 2 Stor y Fi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : Fram e Aluminu m Units : 1. 0 Interior : Drywal l Baths : 1. 5 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 191 0 0 % 191 0 10 0 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1. 0 Applianc e Security Syste m 1. 0 Basemen t Bsmn t Bloc k 8 f t 726. 0 http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountao=R l 7.. . 4/16/201 0

### Dougla s Coimt y Accoun t Information Pag e 3 of 3

Basemen t Basemen t Fixtur e Fixtur e Fixtur e Porc h Porc h Use r Finishe d Walkou t Bas e Fixture s Bat h Ful l Bat h Hal f Sla b Roo f Ceilin g Sla b w/Step s ML S UPDAT E 400. 0 2. 0 1. 0 1. 0 1. 0 168. 0

60. 0

1. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R17.. . 4/16/201 0