Transmittal of Oniaha Lead Site 

Paint Stabilization File Folder 

Said# cPP-/^/ ^ Date: t^'^-70 

Address: ^ 0 ^ 3. ^Cr i/^ 

Contractor: Citv of Omaha Year: ^ ^ / ^ 

Paint Stabilization 

Property File Folder Documents 

V^Work Write Up 

1^Signed Access Agreement for subject property 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, ifapplicable 

\/^ainting Agreement/City of Omaha Purchase Order 

Settlement documents (i.e., for damage or to replace plants, etc.) 

Renovation Recordkeeping Checklist signed by Certified Renovator 

•LXProperty information from Douglas County Assessor's Office 

t^^the r (describe): frjuh i 

y^^>^ 72y^ 3 -iS'-7:^ 

City of Omaha Representative Signature Date 

O^^, 

EPA Representative Signature Date 

30262471 

Superfund 
CITY OF OMAHA sViV> PURCHASING - ROOM 1003 Purchase Order 

1819 FARNAM STREET 

OMAHA, NE 68183-1003 

F/\X# 402-444-5423 

VENDOR: MC SERVICES 

2604 ABERDEEN DR 

PAPILLION, NE 68133 

PURCHASE CROE.=^ NO. REVISiCN . PAGE 1 

1169627 0 1 

J 

^SHIP TO: 

CITY OF OMAHA 

HOUSING & COMM DEV RM #1111 

1819 FARNAM STREET 

,OMAHA,NE 68133 

- . J 

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. DATE OF ORDER/BUYER REVISED DATE//BUYER 

102876 27-OCT-10 H HURT 

PAYMENT TERMS SHIP VIA F.O.B. 

IMMEDIATE DESTINATION 

FREIGHT TERMS REQUESTOR/DELIVER T CONFIRM TO / TELEPHONE 

ZIVNY, STEVEN D 

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

All prices and amounts on this order are express 2d in : US Dollar 


NEEDED: 650.00 N 


28-OCT-10 


ERA PAINT STABILIZATIOtJ 


PROGRAM GROUP #182 906" 


S 26 ST 


o SHIP TO: 


Address at top of page 


SHIPTO: Address shown above. If shipment is delayed or any items rx>t available, advise al once. Purchase order number must appear on all invoices, packages', packing lists, bill of lading, and cctrespondence. 

SHIPPING. CHARGES TO BE PREPAID, IF APPUCABLE AND ADDED TO INVOICED, copy to be fur­ Total C 650.00 J 

nished with invoice. 

TAX EXEMPTION: The Cily 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. ^u ^

Cily Putthasing Agenl / Buyer 1 ^ 
Planning Department 

Omaha/Dougjas Civic Center Inspector: Steve Zivny 1819 Famam Street, Suite 1100 

Date: 9/22/10 Omaha, Ncbraska.68183 

(402)444-5150 

Telefax (402) 444-6140 

Name: Alina M. Ceballos R. E. Cunningham, RA, F.SAME City of Omaha Director Jim Suttle, Mayor Address: '906 S 26^^ Street 

OMAHA EXTERIOR PALNT STABILIZATION PROGRAM 

FOR THE EPA OMAHA LEAD SITE 

The Contract bid documents consist ofthe 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 availabie at the Planning Department.) 

• Comply with Standards called for in the "Construction and Rehabilitation 

Specifications, Housing and Community Development Division, City of Ornaha, 

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

• Comply with the State ofNebraska Health and Human Sen/ices Regulation and 

Licensure, Titie 178 Chapter 23 Lead Base Paint Regulations. 

• Coordinate daily construction schedule with the occupant 

• Subrnit infcrmatiori cut sheets for all substitutions or approved equals prior to 

written approval of the Construction Specialist. 

. • . Repair or replace all iterhs daniaged or disttirbed during paint stabilization 

activities. 

• Keep work site and surrounding area free from accumulations of waste materials 

or j-ubbish caused by the work at all times. 

• Upondaily completion of work: clean Up all rubbish, excess material, equipment, 

and etc., tha;t is connected with the work, and leave all parts ofthe work areas in a 

neat, sanitary, lead safe and presentable condition. 

» Complete thi.«. project v/ithin 30 calendar days. 

Tlie Occupant/'Owner-Shall 

• Remove and store away any personal property vwthin twenty (20) feet of the area 

to be remediated. 

• Provide access to electricity and water throughout the paint stabilization process. 

• 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; 

• 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—-siv^. 
906 S 26"'Street (Continued) . . 

Lead Hazard Control Plan 

Interim Control of Lead based Paint Hazards 

Paint Stabilization 

. • . Stabilize, all previously painted exterior wood, brick, metal, concrete 

.. surfaces of the caUB A dwelling to. include but not limited to the siding, 

fascia, eaves,frim, window trim, shutters, gutters, railings, porch floor, 

downspouts, door trim and foundation. DO NOT INCLUDE MAN 

DOORS OR SyiNDOWS. INCLUDE METAL SIDING. 

.•. Prepare and paint all previously painted surfaces by following the Safe 

Work Practices protocol for EPA exterior lead based paint stabilization. 

• All paint colors to match existing paint pattem. Prime and apply two 

coats of approved finish coat. (Refer to Planning Dept. approved paint 

list). 

• IF SPRAYED, ONE COAT SHALL BE BACK-BRUSHED OR 

BACK-ROLLED. 

Lead Based Paint Waste 

Lead-based paint waste must be handled as follows 

• All paint chips and component debris niust be double bagged for disposal.. 

• Clean paint chips from ground around perimeter of dwelling 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 bedisposed of in 

. municipal solid>waste landfill. 

o^'XI-xX) 

Property Owner Date 

Witness Date 

Occupant (if applicable) Date 

Occupant (if applicable) Date 
Exterior Lead-based Paint Stabilization Program Managed by the City of 

Omaha for EPA Region 7 

Omaha Lead Site 

The purpose of this program, is to prevent yards where lead-contaminated soil is cleaned 

up from becoming re-contaminated 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 from the EPA. 

What work will be done? 

• Loose and flaking lead-based paint will be removed safely from fascia,,eaves, 

siding, trim, window trim, door trim and foundation. 

• Surfaces will be prirned and painted to match existing paint color as closely as 

possible. 

What will not be done? ' 

• Surfaces which have no paint will not be treated. 

• Windows or doors will not be included; 

• Rotten wood will not be replaced. 

• No housing repair will be done. 

Who will perform the work? 

•

 EP A confractors will test paint on exterior house surfaces and give the results to 

the City of Omaha Paint Stabilization Program. 

• • City Consfruction Specialists will prepare a work plan and contact the property 

owner for permission to proceed. 

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

When will the work be done? 

• 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 ifknown and the severity ofthe problem. 

Paint Stabilization is Voluntary and will be done only with permission ofthe owner. 

Initials" 
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 tiie Grantee, to enter and perform 

certain environmental response activities upon the following described premises: 

Owner's Name: Davtime Phone: 

^ 

4\\^ 

Owner Name(s): Alina M Ceballos 

502 9971 - 3(9-^ 1 ^ ^^'''^' 

qi/>?-u^i4 0^-^^ 

Addresses of Properties Covered by this Agreement 

Property Address 

City/State/Zip Code 

906S. 26tiiSt. 

Omaha, NE 68105 

\ 

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

Environmental Response and Liabilitv Act fCERCLA). 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 envirormiental 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. 

2/12/2007 (1) 
Address: 906 S. 26tii St. 

Consent for Access to Propertv CPage 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 

environrhental 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 vWth any of the activities undertaken by Grantee at the Property, 

tamper with any of Grantee's property, or take any actions regarding the use ofthe Property which 

will endanger human health or welfare or the environment, or allow others to use the Property in 

such marmer during the term of this consent. Grantor agrees to provide notice and a copy of this 

agreement to prospective purchasers, lessees,, assigns, or grantees ofthe 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 ofthe properiy prior to remediation and indicates on Page 3 any 

items to be rernoved 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: 906 S. 26th St., Omaha, NE, 68105 

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 tiie purpose of assuring that 

restoration activities 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: 

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 pf conducting environmental 

response activities, and I agree to its terms and conditions. I acknowledge that I have received the 

pamphlet "Renovate Right". 

Grantor's Signature: i.A^:U ^ \..^^X^<L . ^'' ' 0-^7-f? ) 

(3) 2/12/2007 
Douglas County Account Information Page 1 of3 

Douglas County, Nebraska Property Record - R1713320000 

Print Report 

NEW Feature - Parcel DImensloni available Q icale 0-50 ft vrast of 52nd iSt - VJeW OH Ma p Information is valid as of 2010-4-5 Treasurers Tax Report 

New Feature rtf'^lirif; Auto Sales Search 

Owner 

CEBALLOS ALINA M 

906 S 26 ST 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number: 1332 0000 17 

Account Type: Residential 

Parcel Number: 1713320000 

Parcel Address: 906 S 26 ST 

OMAHA NE 68105-0000 

Legal Description: MARSHS ADD LOT 2 BLOCK 4 50 X 124 

Value Informatio n 

LMnd Improvement Total 

2009 $4,800.00 $69,300.00 $74,100.00 

2008 $4,800.00 $69,300.00 $74,100.00 

2007 $4,800.00 $69,300.00 $74,100.00 

2006 $4,800.00 $57,800.00 $62,600.00 

2005 $4,800.00 $57,800.00 $62,600.00 

2004 $4,800.00 $57,800.00 $62,600.00 

Sales Informatio n 

Sales Date: 2005-05-27 

Deed Type: WD Book: 2005 Page: 063197 

Price: $75,000.00 

Grantor: FREDERICK JACKSON ETAL 

Grantsie: ALINA M CEBALLOS 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 1946-03-13 

Oeeof Type: WD Book: 2005 Page: 063196 

Price: $2,950.00 

Grantor: EFFIE ANDERSON ETAL 

http://douglasne.mappirig-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R17... 4/16/2010 
Douglas County Account Information Page 2 of 3 

Grantee: JOSEPHINE JACKSON ETAL 

Valid/lnvalid: Invalid 

Exclusion Reason: Land Contract - Agreement 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6200.0 1.0 124.0 50.0 No 

Improvemen t Informatio n 

Building 1 

.^i?::h^ ^ 

^ll& ) Ft tamtnH 

,,.t»«it Ids 

1 1/2 STORY FINISHED 

CLICK TO ENLARGE IMAGE 

Square Footage: 1144.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Good 

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

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Aluminum Units: 1.0 

Interior: Drywall Baths: 1.5 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1910 0% 1910 100 

Detail Type Detail Description Units 

Add On Fence Chain Link 1.0 

Appliance Allowance 1.0 

Appliance Security System 1.0 

Basement Bsmnt Block 8 ft 726.0 

http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountao=Rl 7... 4/16/2010 
Douglas Coimty Account Information Page 3 of3 

Basement 

Basement 

Fixture 

Fixture 

Fixture 

Porch 

Porch 

User 

Finished 

Walkout 

Base Fixtures 

Bath Full 

Bath Half 

Slab Roof Ceiling 

Slab w/Steps 

MLS UPDATE 

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... 4/16/2010