Transmittal of Omaha Lead Site 

Paint Stabilization File Folder 

Said # 35 2 6^0 Date: 7f-^l-) / 

Address: "V/^ i C>^^^-f^U 

Contractor: CityofOmaha Year: &-b t7 

Paint Stabilization 

Property File Folder Documents 

tXwor k Write UP 

Z-^Signe P d Access Agreement for subject property , 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant,.if applicable 

Painting Agreeinent/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): XuOfV^i.S •. . 

CityofOmaha Representative Signature Date 

EPA Representative Signature / /Date 

30262509 

lllll 

Superfund 
CITY OF OMAHA 

PURCHASING - ROOM 1003 Purchase Order 

1819 FARNAM STREET 

REVISION PAGE 

OMAHA. NE 68183-1003 

1174402 • 

PURCHASE ORDER NO. 

0 FAX1» 402-444-5423 

SHIPTO: 

CITY OF OMAHA 

HOUSING & COMM DEV RM #1111 

1819 FARNAM STREET 

OMAHA,NE 68163 

M S SERVICES INC VENDOR: > • <

8943 J ST BILL TO: 

CITY OF OMAHA FINANCE OMAHA, NE 68127 DISBURSEMENTS ROOM #1007 

1819 FARNAM STREET 

OMAHA.NE 68183 

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

/^CUSTOMER ACCOUNT NO. I VENDORNO. DATE OF ORDER/BUYER REVISED DATE//BUYER 

92665 11-MAY-11 HHURT 

PAYMENTTERMS SHIPVIA F.O.B. 

DESTINATION 

FREIGHTTERMS REQUEST0RA3ELIVER TO CONFIRM TO / TELEPHONE 

MARTINEZ, MARGARET P 

> < ITEM PART NUMBER / DESCRIPTION DELIVERYDATE QUANTITY UNIT UNITPRICE EXTENSION 

All prices and amounts on this order are express ;d iri ; US Dol: ar 


NEEDED: 3,675.0 0 N 

12-MAY/-11 

EPA PAINT STABILIZATION 


PROGRAM GRP #198 - 4103 


GRAND AVE i 


O SHIP TO: 


Address at top of page 


SHIP TO: Address shown atx>ve. If shipment Is delayed or any Items not available, advise at once. Pur^ 

chase order number must appear on all Invoices, packagesi packing lists, bill of lading, and correspondence. Total ( 3-«75 0° )

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

nished Witt) Invoice. 

TAX EXEMPTION: The City of Omaha 13 exempt from Federal Excise Taxes and the Nebraska and City of 

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

ly PurehKlng Agj(il| Buyw 
Planning Department 

Omiha,/Dou.g!as Civic Onict 

Inspector: Chris Grummons 

1819 Fir-nam Street, Suite MOO 

Dat- 4/7/11 

Om-iha, Ncbrssb 63133 

(402)444-5150 

Tcicfix (402) 444-6140 

Name: LaRon Green R. E. Gunnaxigham, RA, F.SAME 

Gey of Oinaha DirtCtor 

Jim Sutde, Mayor Address: 4103 Grand Ave 

OMAHA EXTERIOR PAINT STABILIZATION PROGRAM 

FOR THE EPA OMAHA LEAD SITE 

The Contract bid documents consist ofthe following sections: 

• General Responsibilities for the Contractor atid Occupant. 

•

 Lead. Hazard Control-Plan, Interim Control of Lead Ba-sed Paint Hazards. 

The Contractor Shall; 

• CJontractor and all subcontractorfs) shall complete and submit a "Citizenship 

Attestation" / "Emplf>vee Clasjification" form to the Planning Department, per 

State requirements, before final payment ean be issued. 

• . Comply with HUD's "Guidelines'for.the Evaluation and Control of Lead-Based Paint 

- Hazards in Housing." (Copies are ayallablsat the Planning Department.) 

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

Housing and Community Deyelcpment Division, City of Oniaha, Nebraska." (Copies are 

available at the-Planning Department.)- ' 

•». Comply \yith the State ofNebraska Health and Humaii Services Regulation and 

Licensure,-Title 178 Chapter 23 Lead Base Paint Regulations. • • . 

» Coordinatedaily construction'schedule with the occupant 

.-. ; • •, Subniit information ciit.sheet.s for all substitutions pr approved equals pirior to written \ • ' 

approval ofthe Ccinstmction Specialist. •...;. : 

• '.

 Repair or replace all item's damaged Or disturbedduring.paint stabilization activities.' 

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

, • rubbishcaused bythe.work atall.times. 

« Upondaily completion of work: clean up all rubbish, excess material, equipment, and • 

etc.j.that is cotinected wjth the work,and leave all.parts ofthe vyork' areas in a neat, 

sanitary, lead safe and pre.sentable condition. 

• Complete this project within 30 calendar days. 

The Occiipant/Gwiier iShall-' 

• Remove tind. -Store away aiiy personal property within Iwcn'cy (20) feet of the area to -be 

rerncdiaied. •'-..•---•- ­

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

• Remove, volunteer treesand vegetation from the drip line of the roof, .<ind cut back 

shrubs and bushes at least two feet froni the house. 

«' Ensurethatali household members stay at least ten feetaway 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. I /^ 

Initials u.Ls> 
Exterior Lead-based Paint Stabilization Program Vlanaged by the City of 

Omaha for EPA Region 7 

Omaha Lead Site 

The purpose of this program is toprevent 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 primed 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 doorswill not be included. 

. • Rotten wood will not be'replaced. ­

• No housing repair will be done. 

Who will perform the work? 

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

the City of Omaha Paint .Stabilization Program. 

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

. owner for permission to proceed. 

•. Work will be competitively bid by approved, trained contj-actors, 

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 if known and the severity of the problem. 

Paint Stabilization is voluntaiy and will be done only with permission of the owner.' 

Initials U ^ 
Address: 4103 GR.AND.A.V 

Consent for Access to Propertv fPage 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 EP.A. iising lead-safe methods in compliance 

• • with HUD/EP.A 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 

enviromnental 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 NOTTO INTERFERE 

Graij-tor agrees not to interfere with any.of the activities undertaken by Grantee at the Property, 

' tamper withany 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 lise 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 theproperty. 

PRIOR CONDITIONS AGREEMENT' 

The grantor agrees to the condition ofthe 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. 
Douglas County Account Infomiation 

Page 1 of4 

pouglas County, Nebraska Property Record - R1302860000 

Print Report 

View. Interactive GIS Map Information is valid as of 2012-2-28 Treasurer's Tax Report 

New Feature - • -> ^ Subdivision Sales Search 

Owner 

GREEN LERON D 

ETAL 

4103 GRAND AVE 

OMAHA.NE 68111-0000 

Property Informatio n 

Key Number: 0286 0000 13 

Account Type: Residential 

Parcel Number: 

1302860000 

Parcel Address: 4103 GRAND AV 

OMAHANE 68111-0000 

Legal Description: HASTINGS & HEYDENS SUB DIV LOT 1 BLOCK 0 40 X 125 

Value Informatio n 

Land Improvement Total 

2011 

2010 

2009 

2008 

2007 

2006 

$4,300.00 

$4,300.00 

$4,300.00 

$4,300.00 

$4,300.00 

$4,300.00 

$73,700.00 

$81,000.00 

$65,300.00 

$65,300.00 

$65,300.00 

$65,300.00 

$78,000.00 

$85,300.00 

$69,600.00 

$69,600.00 

$69,600.00 

$69,600.00 

Sales Informatio n 

SalesDate: 2004-03-25 

Deed Type: WD Book: 2004 Page: 056257 

Price: $82,875.00 

Grantor: BEN UVMPMAN ETAL 

Grantee: LERON D GREEN ETAL 

Valid/invalid: Valid 

Exclusion Reason: 

Sales Date: 2001-03-30 

Deed Type: WD Book: 2177 Page: 83 

Price: $50,000.00 

Grantor: 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R13... 3/15/2012 
Douglas County Account Information Page 2 of4 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Sates Date: 1996-03-24 

Deed Type: D Book: 2033 Page: 380 

Price: $51,500.00 

Grantor: 

Grantee: 

Valld/lnvalld: Valid 

Exclusion Reason: 

Show All Transactions 

Land Informatio n 

Acres SF Unita Depth Width Vacant 

0.11 5000.0 1.0 125.0 40.0 No 

Improvemen t Informatio n 

Building 1 

1 1/2 FIN 

— —J I —— 

CLICK TO ENLARGE IMAGE 

Square Footage: 1690.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 9.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl3... 3/15/2012 
Douglas County Account Information Page 3 of4 

Sprinkler Square Footage: 0.0 

Year Built 

1916 

Detail Type 

Add On 

Appliance 

Basement 

Fixture 

Fixture 

Garage 

Porch 

Porch 

year 

Remodeled 

0 

Percenf 

Remodeled 

0% 

Detail Description 

Fence Wood 

Allowance 

Bsmnt Block 8 fl 

Base Fixtures 

Bath Full 

Detached 

Slab Roof Ceiling 

Wood Deck 

Adjusted Year Physical Age Built 

1916 96 

Unlta 

1.0 

1.0 

720.0 

1.0 

1.0 

336.0 

224.0 

100.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R13... 3/15/20.12 
Douglas County Account Infonnation Page 4 of 4 

The above rnap is powered by Google, and is intended to provide a general idea of a property's location. If 

you require a more exact property location, you may use the Interactive GIS Maps that are maintained by our 

office. 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl 3... 3/15/2012