## Transmitta l o f

Omah aLea dSite Pain t Stabilizatio n Fil e Folde r Said #7V/^ V Date : ^^^^'77 ? Address : c?'?^ ^ A J ^ ^ S f Contractor : Cit v o f

Omah a Year : ^^^^ ^ 

## Pain t Stabilizatio n Propert y Fil e Folde r Document s t/wor k Writ e U p Signe dAcces s Agreemen t fo r

subjec t propert y Pre-Renovation for msigne db y Propert y Owne r Pre-Renovation For mfo r

Occupant/Tenant , ifapplicabl e ^y^aintin g Agreement/Cit y o f

Omah aPurchas e Orde r Settlemen t document s (i.e. , fo r

damage or t

o replac e plants , etc. ) Renovation Recordkeeping Checklis t signedb y Certifie dRenovato r L^^ropert y informatio n fromDouglas Count y Assessor' s Offic e tether (describe) : (Tldfa J . _

I 0>*- ^ / ^ 

## 3 ^ /r--/:x . Cit y o f Omah aRepre^ntati^ ^ Si^atur e Dat e
EP A Representativ e Signatur e I Dat e 3026244 9 Superfun dPlannin g Departmen t Inspector : Stev e Zivn yOmaha/Dougla s civi c Cente r r»„4.„ . T/1/i/A n181 9 Fama mStreet , Suit e 100 3 Date . 7/14/0 9 Omaha . Nebrask a6818 3 (402 ) 444-515 0 

### Name : Josep h P . Newsom e TM''"^'" ^ '''-°'^ ' A J J or^rv ^ X T . 4 ot h o . Steve n N . Jensen , AICP , LA . CityofOmah aAddreSS : 290 2 N 4 8 St . • ' Director Ji mSuttle , Mayo r ' 

### 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 ddocument s consis t ofth e followin g sections : •General Responsibilitie s for th e Contracto r an dOccupant . •Lea dHazar dContro l Plan , Interi mContro l o f LeadBase dPain t Hazards . Th e Contracto r Shall ; •Compl y wit h HUD' s "Guideline s fo r th e Evaluatio n an dContro l o f Lead-Base d Pain t Hazard s in Housing. " (Copie s ar e availabl e a t th e Plannin g Department. ) •Compl y with Standard s calle dfor i n th e "Constructio n an dRehabilitatio n Specifications , Housin g an dCommunity Developmen t Division , Cit y o f Omaha , Nebraska. " (Copie s are availabl e at th e Plaimin g Department. ) •Compl y wit h th e Stat e o f Nebrask aHealt h an dHuma n Service s Regulatio n and Licensure , Titl e 17 8 Chapte r 2 3 LeadBaise Pain t Regulations . •Coordinat e dail y constructio n schedul e wit h th e occupant •Submi t informatio n cu t sheet s fO r al l substitution s o r approve dequal s prio r t o writte n approval ofth e Constructio n Specialist . •Repai r o r replac e al l item s damage do r disturbe ddurin g pain t stabilizatio n activities . •Kee p wor k

site andsurroundin g are afre e fromaccumulation s o f wast e niaterial s o r

rubbis h cause db y th e wor k

a

t al l times . •Upo n dail y completio n o f work : clean u p al l rubbish , exces s material , equipment , an detc. , that i s connecte dwit h th e work , an d.leav e all part s ofth e wor k

area s in a. neat , sanitary , leadsaf e an dpresentabl e condition . •Cornplei t thi s projec t withi n 3 0 calenda r days . Th e Occupant/Owne r Shal l •Remov e an dstor e av/a y an y persona l propert y withi n twent y (20 ) feet o f th e are a t o b e remediated . •Provid e acces s t o electricity an dwater throughou t th e pain t stabilizatio n process . •Ensur e tha t al l househol dmember s sta y at leas t te n fee t awa y fromal l wor k

area s andals o kee p al l pet s a t leas t ten fee t avva y a t al l time s unti l th e wor k

ha s bee n complete dan dth e are aha s passe da ' visual inspection . , Initial*^' '

### 290 2 N 48" " S t (Continued ) 

## Lea dHazar dContro l Plan Interi mContro l o f Lea dbase dPain t Hazard s Pain t Stabilizatio n •Stabiliz e al l previousl y paintedexterio r

surface s of th e dwellin g t o includ e bu t no t limitedt o th e siding , fascia , eaves , trim , window trim , gutters , doo r trim , an dfoundation . Do no t includ e door s o r windows . •Stabiliz e all previousl y paintedexterio r

surface s ofth e garage an dshed . •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 dbase dpain t stabilization . • Al l pain t color s t o matc h existin g pain tpattem . 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 ) Ruste dmeta l wil l requir e rust-inhibiting primer . • 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 mUs t b

e double bagge dfo r

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

o

f

dwelling befor e starting , during an dafte r

the project . •Al l lea dpaintedcomponents an ddebri s mus t be remove dfro mthe 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 dispose do f

i

n amunicipa l soli dwast e landfill .

Propert y Owne r

Dat e Witnes sDat e Occupan t (ifapplicable )Dat e Occupan t (i f

applicable )Dat e Witnes sDat e

### Exterio r

Lead-basedPain t Stabilization Progra mManagedb y th e Cit y o f Omah afo r

EP A Region 7 Omah aLea dSit e

Th e purpos e o f thi s progra mi s t o preven t "yard s wher e lead-contaminate dsoi l i s cleaned , up frombecomin g re-contaminate dby 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 da n EP A contracto r ha s identifie ddeterioratin g exterio r lead-base dpaint . •Home s are eligibl e onl y b y refeiTa l fromth e EPA . Wha t wor k

wil l b e done ? •Loos e andflaking lead-base dpain t wil l b e remove dsafel y fro mfascia , eaves , siding , triih , 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 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 d^yil l no t b e replaced . • • N o housin g repai r wil l b e done . Wh o wil l perform , th e work ? •EP A contractor 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

pla n an dcontac t th e propert y owne r fo r permissio n t o proceed . •Wor k

wil l b e comjpetitively bi db y approved , traine dcontractors . Whe n wil l th e wor k

b e done ? •Thi s programbegan i n 200 7 an dwil l continu e fo r severa l years . •Th e Cit y staf f wil l prioritiz e home s base do n th e presenc e o f childre n unde r 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 onl y wit h permissio n ofth e owner . Initials..r.^< ^Consen t fo r Acces s t o Propert y RIGH T O F ENTR Y T O PREMISE S Granto r (th e property owner ) consent s t o an dauthorize 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 environmenta l respons e activitie s upo n th e followin g describe dpremises : Owner' s Name : Davtim e Phone : Owner Name(s) : Josep h P Newsom e 451-897 7

Addresse s o f Propertie s Covere db y thi s Agreemen t Property Addres s City/State/Zi p Cod e • 290 2 N . 48ti i St . Omaha , N E 6810 4

Granto r linderstand s that thi s grant doe s no t limi t EPA' s righ t o f acces s unde r th e Comprehensiv e Environmenta l Respons e andLiabilit v Ac t (CERCLA) . 4 2 USC . & 9601-9675 . or 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 . Saniplin g o f soi l ma y b e conducted . Thi s consen t shal l allo w Grante e onto Grantor' s property an dfurther , provide s th e Grante e th e righ t to perfor man y an dal l environmental respoiis e action s an dactivitie s i t deem s appropriate . FUTUR E ACTIO N B y signin g thi s document , th e granto r agree s t o allo w a n EP A contracto r t o conduc t asoi l cleanup a

t thi s propert y followin g completio n o f lead-base dpain t stabilization . Th e granto r acknowledge s tha t th e pain t stabilizatio n contracto r carmo t provid e assurance s tha t bin dth e soi l cleanup contractor . Th e granto r understand s that th e soi l cleanu p contracto r wil l mak e al l reasonabl e effort s t o addres s concem s tha t th e granto r may hav e regardin g soi l cleanup a t thi s property . ENVIRONMENTA L RESPONS E ACTION S Th e environmenta l respons e action s t o 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 an din th e cours e o f th e respons e activities , 2 .

Obtainin g sample s fro mGrantor' s property . (1 )2/12/200 7Address : 290 2 N . 48t h St . Consen t fo r Acces s to Property (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 ) remova l o f loos e o r flaking pain t identifie db y EP A usin g lead-saf e method s i n complianc e wit h HUD/EP A regulation s an d2 ) repaintin g accordin g to th e attache dspecifications . TER M Thi s acces s agreemen t shal l b e operabl e for. th e perio do f tim e it take s t o complet e th e environmenta l respons e activities . Upo n completio n o f th e respons e actions , al l right s and privilege s give n b y th e Granto r shal l ceas e o n that 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 an y o f th e activitie s undertake n b y Grante e a t th e Property , tampe r with any o f Graiitee' s property , o r tak e an y action s regardin g th e us e ofth e Propert y whic h wil l endange r huma n healt h o r welfare o r th e envirorunent , o r allo w other s t o us e th e Propert y i n suc h manne 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 ofth e property o r any portio n o f it . Granto r agree s t o provid e 30-day notic e to EP A 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 aii y an dall samplin g and/o r analysi s resultin g fromGrantee' s respons e activitie s on.th e property . PRIO RCONDITION S AGREEMEN T Th e granto r agree s t o th e conditio n ofth e property prio r t o remediatio n an dindicate s o n Pag e 3 an y item s t o be.remove db y th e Granto r befor e 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 dproperty wil l b e restore d a s nearl y a s possibl e to it s origina l stat e an dconditio n a s foun dimmediatel 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 ) 2/12/200 7

### Address : 2902 N . 48t h St. , Omaha , NE , 6810 4 CURREN T CONDITIO N / PROPOSE D RESPONS E ACTIVITIES Th e purpos e o f

thi s section i s t o provid e amutua l agreemen t as t o condition s o f

propert y prio r

t

o contracto r

activities . Thi s will als o serve as documentation fo r

the purpos e o f

assuring tha t restoratio n activitie s ar e completedt o the satisfaction of th e propert y owne r

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

prio r

t

o th e respons e activities :

3 . 4 . 5 . Item s NO T t o b e remove db v contracto r

durin g remova l activities : ^ ' Tlo O C^TLS l ^Ton.'Lf i ^ uitfi'^^f^' ^ AO^Zf^S rog^ T stoS , Of - ^fi(7 > 

### 2 . 3.

­ 4 . 5 ' . • ' 

### ADDITIONA L COMMENTS :

I have rea dthe foregoin g documen t an dunderstan dtha t it i s a n agreemen t grantin g permissio n t o the Grantee t o ente r

th e above describedpremise s fo r

the purpos e o f

conductin g environmenta l respons e activities , an dI agre e t o it s terms ari dconditions . I acknowledg e tha t I hav e receive dthe pamphle t "Renovat e Right" . Grantor' s Signature : 

# < ^ L. A /^^ ^ ^ Dat e ijn/ ^

(3 ) 2/12/200 7Dougla s County Accoun t Informatio n Pag e 1 of 2 Dougla s County , Nebrask a Propert y Recor d - R160211000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e <B ) scal e 0-5 0 ft wes t o f 52n d S t - Vie w O H Ma P Informatio n i s vali d a s o f 2009-6-1 6 Treasurer' s Ta x Repor t Ne w Featur e -»•*- > Aut o Saie s Searc h Owne r NEWSOM E JOSEP H P ETA L 290 2 N 4 8 S T OMAH A N E 68104-000 0 Propert y Informatio n Ke y Number : 021 1 000 0 1 6 Accoun t Type : Residentia l Parce l Numbe r 160211000 0 Parce l Address : 290 2 N 4 8 S T OMAH A NB68104-000 0 Lega l Description : LAK E JAME S PAR KLOT 1 2 BLOC KD 5 0 X 140 . Valu e Informatio n Lan d Improvemen t Tota l 200 9 200 8 200 7 200 6 200 5 200 4 $7,200.00
. $7,200.0 0 $7,20.0.0 0 $7,200.0 0 $7,200.0 0 $7,200.0 0 $62,000.0 0 $62,000.0 0 $62,000.0 0 $62,000.0 0 $33,300.0 0 $33,300.0 0 $69,200.0 0 $69,200.0 0 $69,200.0 0 $69,200.0 0 $40,500.0 0 $40,500.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 6 7000. 0 1. 0 50. 0 140. 0 N o Improvemen t Informatio n Buildin g 1

•

http://douglasne.mappihg-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R160. . . 7/9/200 9Dougla s Count y Accoun t Informatio n Pag e 2 o f 2

1 1/ 2 Stor y Unfi n

i.-,ii«,-i-,v)SP7j^ * *« > iTl' ' Fir « Fto i 1C4+.0 ' l y i

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CLIC KT O ENLARG E IMAG E Squar e Footage : 1084. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : -r - Condition : Averag e Buil t As : 1 1/ 2 Stor y Unfi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 5. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Batfis : 1. 0 Roo f Cover : Slat e Bedrooms : 2. 0

Roo f Type : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 192 3 0 0 % 192 3 8 6 Detai l Typ e Oefa/7 Descriptio n Unit s Ad d O n Unfinishe d Atti c W/floo r 952. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 1260. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Basemen t Singl e



## _^: 1 Porc h Enc I Soli d Wal l 108. 0

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl60. . . 7/9/200 9

## CIT Y OF OMAH A PURCHASIN G - ROO M 100 3 ' 

### Purchas e Orde r 181 9 FARNA M STREE T PURCHAS E ORDE R NO . OMAHA , NE 58183-100 3 115S76 4

FAXi ¥402-444-542 3 SHI P TO : CITY OF OMAH A HOUSIN G & COM M DE V RM S111 1 181 9 FARNA M STREE T OMAHA.N E 6818 3 BRA D BATE S PAINTIN G VENDOR : >. < BIL L TO : 314 1 s o 52ST CITY OF OMAH A FINANC E OMAHA . NE 6810 6 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 ) 'CUSTOMfi R ACCOUN T NO . VENDO R NO . DAT E OF ORDER / BUYE R REVISE D DATE//BUYE R 7299 0 21-AUG-0 9 J ROBBI N 21-AUG-0 9 J R08BIN S PAYMEN T TERM S SHI P VI A F.O.B. ' FREIGH T FERM S REQUESTOR/DELIVE R TO CONFIR M TO / TELEPHON E MARUCA , T MARI E (402 ) 551-092 7 > ITE M PAR T NUMBE R / DESCRIPTIO N DELIVER Y DAT E QUANTITY UNI T UNI T PRIC E EXTENSIO N • < PROGRA M GROU P 56 2 90 2 N' 04 8 ST O SHI P TO : Addres s at to p of pag e 5 ' 1,925.0 0 N EP APAIN T STABILIZATIO N PROGRA M GROU P 56 311 5 N 04 7 Av i o SHI P TO : i Addres s at to p of pa^ e 575.0 0 N EP APAIM T STABILIZATIO K PROGRA M GROUP ' 56 312 9 N 04 8 iS T o SHI P TO : •• Addres s at to p of pag e 750.0 0 N EP APAIN T STABILIZATIO N PROGRA M GROU P 56 4 51 6 MAYBERR YST O SHI P TO : Addres s at to p of pag e

SHIPTO : .Addres s show n above . If shipmen t Is delaye d oran y ilem s not available , advis e al once . Pur­ chas e ordc. ' numbe rmus t appea r on al l invoices , packages , packin g lists , bil l of lading , an d correspondence . Tota l C Continue d ) SHIPPIN G CHARGE S TO BE PREPAID , IF APPLICABL E AN D ADDE DTO INVOICED , cop y to

be fur ­ nishe d wit h invoice . TA X EXEN^PTION : Th e Cit y of Omah a is exemp t fro m Federa l Excis e Taxe s an d th e Nebraska an d Cil y of Omah a Sa i is Taxes . Federa l I.D . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealers Lie . 91-0316768 . Cil y Purchasin g Agen l / Buye r

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

### Purchas e Ortje r

181 9 FARNA M STREE T PURCHAS E ORDE H NO . ' . OMAHA , N E 68183-100 3 '1159754 FAX * 402-444.-542 3 • SHIPTO : 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 6818 3 BRA D BATE S PAINTIN G

• VENDOR : < 

## k

BIL L TO : 314 1 S O 5 2 S T CIT Y O F OMAH A FINANC E OMAHA , N E 6810 6 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 . DAT E O F ORDER / BUYE R REVISE D DATE//BUYE R 7299 0 21-AUG-09JROBBI N 21-AUG-0 9 J ROBBIN S PAYMEN T TERMS ' SHI P VI A F.O.B . FREIGH T TERM S REQUESTOR/DELIVE R T O CONFIR M T O /

TELEPHON E MARUCA , rMARI E (402 ) 551-092 7 

# 7 ITE M PAR T NUMBE R / DESCRIPTIO N DELIVER Y DAT E QUANTITY UNI T UNI T PRIC E EXTENSIO N MAIL-IMPOR-TANT-D O NO T STAR T WOR K UNTI L PROCEE D OpOE R I S ISSUE D B Y TH E PLANNIN G DEPARTMEN T All ' price s and amount s o n thi s orde r ar e expressfe d i n : U S Dol ! a r 1,450.0 0 N EPA - PAIN T STABILIZATIO N PROGRA M GROU P 5 6 12 2 N i 04 9 S T O SHI P TO : Addres s a t to p o f pag e 1,250.0 0 N EPAPAIN T STABILIZATIO N • PROGRA M GROU P 5 6 220 8 N 04 8 S T : O SHI P TO: - i Addres s a t top o f pag e 400.0 0 N EP APAIN T STABILIZATIO N PROGRA M GROU P 5 6 2 53 3 [ REE S S T O SHI P TO : i Addres s a t to p o f pag e 1,725.0 0 N EP APAIN T STABILIZATIO N

SHI P TO: . Addres s show n above . I f shipmen t i s delaye d o ran y item s no t available , advis e at once . Purchas e orde rnumbe rmus t appea ro n al l invoices , packages , packin g lists , bil l of lading , an d correspondence . Continue d 

# J Tota l C SHIPPIN 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 . TA X EXEV.PTION : Th e Cit y 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 Sa:; s Taxes . Federa l I.D . 476006304 ; STAT E I.Q . 01-0316768 ; Fue l Dealer s Lie . 91-0316768 . Cil y Purchasin g Agen l / Buye r