Transmittal of Omaha Lead Site 

Paint Stabilization File Folder 

Said #_^;?3^aZ _ Date: ^" ^ ~ ^ ^ 

Address: 3<9' 7 Aj V / S^f 

Contractor: Citv of Omaha Year: ^ O ^O 

Paint Stabilization 

Property File Folder Documents 

_j/wor k Write Up 

^•^^igned Access Agreement for subject property 

Pre-Renovation form signed by Property Owner 

Pre-Renovation Form for Occupant/Tenant, ifapplicable 

Lx-^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 

^^Property information from Douglas County Assessor's Office 

i : l Other (describe): iho-h S • 

City of Omaha Representative Signature Date 

EPA Representative Signature ( Date 

30262475 

inmi 

Superfund 
CITY OF OMAHA 

PURCHASING - ROOM 1003 Purchase Order 

1819 FARNAM STREET ' REVISION PAGE 

OMAHA, NE 68183-1003 

PURCHASE ORDER NO. 

1166798 0 1 

FAX# 402-444-5423 

SHIP TO: 

CITY 01= OMAHA 

HOUSING & COMM DEV RM #1111 

1819 FARNAM STREET 

OMAHA,NE 68183 

RON BELL BRUSH & LADDERS VENDOR: >: - < BILL TO: 

CITY OF OMAHA FINANCE 

505 LARAMIE CR 

PAPILLION, NE 68046~ 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 

99937 23-JUN-10 H HURT 

PAYMENT TERMS SHIP VIA F.O.B. 

IMMEDIATE DESTINATION 

FREIGHTTERMS REQUESTOR/DELIVER TQ-. CONFIRM TO / TELEPHONE 

MARUCA, T MARIE (Vij ^ ' (402)515-2926 

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

All prices and amounts on this order are express 5d in : US Dol'ar 


NEEDED: 1,290.00 N 


24-JUN-10 


EPA PAINT STABILIZATIOfJ 


PROGRAM GROUP 137 327 fl . 
 4iST ST 


O SHIP TO: 


Address at top of page 


NEEDED:' 625.00 N 


24-JUN-lO 


EPA PAINT STABILIZATION 


PROGRAM GROUP 137 4316i 


BURT ST 


o SHIP TO: 


Address at top of pape 


SHIPTO: Address shewn above. If shlpmenlis delayed or any Items not available, advise at once. Pur­

chase order number must appear on all invoices, packages, packing lists, bill of lading, and correspondence. Total ( ^-9^5.00 )

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

nished 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 Uc: 91-0316768. 

Clly Purchasing Agent) Buyer 
Plamiing Department 

• Omaha/Douglas Civic Center 

Inspector: Stev e Zivn y 1819 Farnam Street. Suite 1003 

Date : 5/12/1 0 Omaha, Nebraska 68183 

(402) 444-5150 

Telefax (402) 546-0714' 

Name: Jason M Caskey & Kirste%.£^eij(gh,„,, RA. RSAME 

jSfi^Mtor Address: 327 N 41 St Street 

OMAHA EXTERIOR PAINT 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 available at the Plarming Department.) ' 

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

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

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

• Comply with the State ofNebraska 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 Construction Specialist.­

• • Repair br replace all items damaged or disturbed during paint stabilization 

activities. 

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

or rubbish caused by the work at all times. 

• Upondaily completion of work: clean up all mbbish, excess material, equipment, 

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

neat, Siihitary, lead safe and presentable condition. 

• Complete this project within 30 calendar daysThe Occupant/Owner Shall 

• Remove and store away'any personal property Within twenty (20) feet ofthe area 

to be remediated. 

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

• 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 
327 N 4lst 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 ofthe dwelling to include but not limited to the siding, fascia, 

eaves, trim, window trim, shutters, gutters, railings, downspouts, door trim 

and foundation. DO NOT INCLUDE WINDOWS OR MAN DOORS. 

• 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 pattern. Prime and apply two • 

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

hst). 

• 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 must be double bagged for disposal. 

• Clean paint chipsfromground 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 be disposed of in 

a municipal solid waste landfill., 

:^|i^« -

Date 

Sfn/^o 

Date 

Witness Date 

Occupan ipant

t (i(iff applicable appncab )

 Date 

S[ii-7ni/o 

fable) Date 
Exterior Lead-based Pairit Stabilization Program Managed by the City pf 

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 leadrbased paint. 

• Homes are eligible only by referral from the EPA. 

What work will be done? • 

. • Loose andflaking lead-basedpaint wilf 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 doors will not be included. 

• Rotten ^yood 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 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 if known and the severity of the problem. 

Paint Stabilization is voluntary and will be done only with permissiori ofthe owner. 

Initials fc;gUXjmd^ 
Cohsent 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 resporise activities upon the following described premises: 

Owner's Name: Davtime Phone: 

Owner Name(s): Jason M Caskey & Kirsten Caskey 502-9865 

Addresses of Properties Covered by this Agreement 

Property Address City/State/Zip Code 

327 N. 41st St. Omaha, NE 68131 

- , 

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

Environmental Response and Liabilitv Act fCERCLAl 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 coiitaminated soil has 

or will take place. Sampling of soil may be conducted. This consent shall allow Grantee onto 

Grantor's property and fiuther, 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 respoiise activities. 

2. Obtaining samples from Grantor's property; 

2/12/2007 (1) 
Address: 327 N. 41st St. 

Consent for Access to Property ("Page 2) 

3. Plarming 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 

wdth HUD/EPA regulations and 2) repaintmg according to the attached specifications. 

TERM 

This access agreement shall be operable for the period of time it takes to complete the 

envirorunental response activities. Upon completion of the response actions, all rights and 

privileges given by the Graritor 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 ofthe 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 attivities on the property. 

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. 

2/12/2007 (2) 
Address: 327 N. 41st St. 

, Omaha, NE, 68131 

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 the 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. flfUliVe^^ Nn ^ ^ i^ lurviJ^' 

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 of 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: [^aG(Al^gVV..^^^ Date ^If//C). 

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

Douglas County, Nebraska Property Record - R1614170000 

Print Report 

NEW Feature - Parcel Dimentions available A scale 0-SO ft west of 52nd St - VIe W OH Ma p Information is valid as of 2010-4-5 Treasurer's Tax Report 

New Feature ^ . ?>' 'rlf Auto Sales Search 

Owner 

CASKEY JASON M 

ETAL 

327 N 41 ST 

OMAHA NE 68131-0000 

Property Informatio n 

Key Number 1417 0000 16 . 

Account Type: Residential 

Parcel Number: 1614170000 

Parcel Address: 327 N 41 ST 

OMAHA NE 68131-0000 

Legal Description: LA VETA PLACE LOT 7 BLOCK 1 1/2 VAC ALLEY & 40 X 116 

Value Informatio n 

Land Improvement Total 

2009 $5,500.00 $109,400.00 $114,900.00 

2008 $5,500.00 $109,400.00 $114,900.00 

2007 $5,500.00 $70,900.00 $76,400.00 

2006 $5,500.00 $70,900.00 $76,400.00 

2005 $5,500.00 $48,000.00 $53,500.00 

2004 $5,500.00 $48,000.00 , $53,500.00 

Sales Informatio n 

Sales Date: 2006-10-23 

Deed Type: WD Boofr: 2006 Page: 123418 

Price: $116,000.00 

Grantor Shurson Ellen L 

Grantee: Caskey Jason M etal 

Valid/lnvalid: Valid 

Exclusion Reason: 

.SalesDate: 1997-08-28 

Deed Type: D Book: 2073 Page: 006 

Price: $45,000.00 

Grantor: 

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Douglas County Account Information Page 2 of 3 

Grantee: 

Valid/lnvalid: Valid 

Exclusion Reason: 

Sales Date: 1993-06-26 

Deed Type: Book: 1957 Page: 672 

Price: $57,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 1991-05-28 

Deed Type: Book: 1899 Page: 082 

Price: $25,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Invalid 

Exclusion Reason: Invalid Sale 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.1 4640.0 1.0 116.0 40.0 No 

Improvemen t Informatio n 

Building 1 

327N41ST 

"H|i; 41 

Iff 

Fn« Floor ,.7«4S«»n, ri f 

S««<MKtFIIMr 

&20 O4q.lt. 

'»0 

2 1/2 STCWY UNRN V^j^^^-liL. 

Bwnm Blaek fl * i. iHA.... 

JM4.0 iq.« . mes?,"^" 

CLICK TO ENLARGE IMAGE 

Square Footage: 1284.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

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Douglas County Account Information Page 3 of3 

Unit Type: '. Conditior i: Very.Good 

Buiit As: 2 1/2 Story Unfin Condo Square Footage: 0.0 

HVAC; Central Air to Air Rooms: 6.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.5 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof type: Hip Stories: 2.5 

Floorcover: Allowance Foundation: Block 

Sprinlder Square Footage: 0.0 

year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1908 2006 0% 1957 53 

Detail Type Detail Description Units 

Add On Fence Wood 1.0 

Add On Unfinished Attic W/floor 520.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 545.0 

Fixture Base Fixtures ^1•P 

Fixture Bath Full 1.0 

Fixture Bath Half 1.0 

Porch Wood Deck 36.0 

Porch Wood Roof 130.0 

User MLS UPDATE 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountao=R16... 4/16/2010