## TRANSMITTALO FOMAHA LEAD SIT E PAIN T STABILIZATIO NFIL EFOLDE R SAID# ; ^?>f?^ i Date : A ^ | O.Q> ) ^OQ' ) Address : ;^nU'l f -f'^r4 r € N f l

A f ^ Rr> > LB PStabilizatio nContractor : PRUDEN T TECHNOLOGIES , INC . Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S i

/ Vide o o f propert y (DVD) : Pre-Stabilizatio nA rui)t-3(aUilLi.aim u VIdw s U Executiv e Summary y Signe dAcces s Agreement Form y Advanc e Notic e Form y Pre-Stabilizatio nVide o Agreement Form y Acces s Trackin g Form y Propert y Acces s Assessmen t Form y Neighbo r Acces s Agreement Form y Pain t Matc hForm y Pre-Stabilizatio nPropert y Safet y Assessment Form y Work-Site Hazard s Analysi s Checklis t y Photographs : Pre-Stabilizatio nPropert v Hazar dAssessment Photograph s y Dougla s County Assessor Propert y informatio n y " Propert y Completio nAgreement FormSignedb y Propert y Owne r D Propert y Close-Ou t Chec k Lis t SignedB y EPA Pniden t Technologies , Inc . Signatur e Dat e 

# /"^cL^fc^J ^ __!^l/lo _ EPATSignatur e ^ ' Dat e 3005542 0 

# iiUHi l Superfun dTECHNOLOGIES , INC . 

# Propert y Summar y Date : 8/03/200 9 | LB PSTABILIZATIO NEP A CONTRAC T EP-R7-08-0 7 | Mont hof ; Au g Propert y Address ; 274 4 Fonteneli e B d SAI D # : 6354 1
A . Executiv e Summarv ; a . Issue s Encountered : NON E b . Issue s Resolved : NON E c . Uniqu e Findings ; NON E d . Othe r Relevan t Information ; i . Acces s Date : 7/09/200 9 ii . Wor k Began ; 7/15/200 9 iii . Close-Ou t Date : 7/16/200 9 B . Enclosures ; 1 . Pre-Stabilizatio nVide o 2 . Post-Stabilizatio nVide o 3 . Signe dAcces s Agreemen t For m 4 . Advance-Notic e For m 5 . Pre-Stabilizatio nVide o Agreemen t For m 6 . Acces s Trackin g For m 7 . Propert y Acces s Assessmen t For m 8 . Neighbo r Acces s Agreemen t For m 9 . Propert y Pain t Matc hFor m 10 . Pre-Stabilizatio nPropert y Safety Assessmen t For m 11 . Work-Sit e Hazard s Analysi s Checklis t 12 . Pre
- Stabilizatio nPropert y Hazar dAssessmen t Photograph s 13 . Dougla s Count y Assesso r Propert y Informatio n 14 . Signe dPropert y Completio nAgreemen t For m 15 . Propert y Close-Ou t Chec k Lis t Signe dB y EP ATECHNOIiOGnSS . IN C Pruden t Technologies , Inc . (Prudent ) i s unde r contract (Contract #EP-R7-08-07 ) wit hthe U . S . Environmenta l Protection Agenc y (EPA) to stabiliz e Lea dBase dPain t (LBP) a t anumbe r ofpropertie s locatedi nOmaha, Nebraska , including the propert y locateda t ^ILlL l fpiJtBMEU£ ^ IbLV h Th e EP A request s you r pennissio nto allow Pruden t to perfor mLB PStabilizationa t thi s property . B y signing thi s form, the propert y owne r grants permissionto Pruden t to perfor mactivitie s relatedto LB PStabilizationincluding scraping pain t an d painting ofth e referencedproperty . Further, the owner/tenan t verifie s tha t the y have receivedthe LB Ppamphle t "Renovat e Right. " B y signing thi s documen t I agree to allow a nEP A contracto r to conduc t asoil cleanu p a t m y propert y followin g completionof lead-basedpain t stabilization , ifth e soil cleanu p ha s not alread y bee nperformed . I understanddia t the stabilizationcontracto r canno t provid e assurance s of whic hcontracto r wil l b e boun dto the soil cleanup . I furthe r understandtha t the soi l cleanu p contracto r wil l mak e all reasonable effort s to addres s concems tha t I , a s the propert y owner , ma y have regarding soil cleanu p a t m y property . itan dthe paragrap habove .

Dat e Ifyo u have an y question s abou t the LB Pstabilizationplannedfo r you r property , pleas e contact Prudent' s Custome r Relations/Office Manage r fo r the Lea dBasedPain t Stabilization , Mrs . Shanno nHolt , a t (402 ) 504-100 4 o r f402W12-0223 . Genera l question s abou t the Omah aLea dSit e cleanu p ca nbe directedto the EP A Public Informatio nCenters a t (402 ) 731
­ 3045 (Sout hOmahaoffice ) o r (402 ) 991-958 3 (Nort hOmah aoffice) . Propert yAccess Grante d By : 

### ht06l£LA rljL>6LA^f : Propert y Owne r Signature :

(Date )

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Oniaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7TlfCHNOLOCIBS . IN C PROPERT YINFORMATIO N (T o be complete d b yresiden t and/o rpropert yowne r—please print ) RESIDEN TNAME : A/O^/rt ^

L06LF & ner ) Rente r RESIDEN TADDRESS : 

# ^^^ ^ foo\€oe\\ e 'e>W( ) I F RENTAL , PROPERT YOWNE D BY :
OWNER' S MAILIN G ADDRESS ; OWNER' S TELEPHON E NUMBE R - HOME : l¥0 ^ 39T"/^ 3 WORK : (4^ > Cfil l 'fiCl ^ NUMBER O F OCCUPANT S UNDE R 7 YEAR S OLD : NUMBE R O F OCCUPANT S 7 YEAR S OL D AN D OLDER :



# 1

NUMBER O F CHILDRE N UNDE R 7 YEAR S OL D WHO M PLA YI N TH E YAR D FO R 5 HOUR S O R MOR E PE R WEEK :
COMMENT S O R SPECIA L INSTRUCTIONS : (I.E . DOGS , ENTR YGATES , ETC. )

AUTHORIT Y FO RENVIRONMENTA LRESPONS EACTIONS : Th e activitie s t o b e implemente db y EP A unde r thi s agreemen t ar e pursuan t t o Sectio n104 ofCERCLA , 4 2 U.S.C . 9604 . EPA' s righ t o f acces s t o th e property i s provide dfor i nSectio n104(e ) ofCERCLA , 4 2 U.S . C 9605(e) , whic hprovide s enti y for "detenninin g th e nee dfor response , o r choosin g o r takin g an y respons e actio nunde r thi s title , o r otherwis e enforcin g th e provision s ofth e title. "

8080 Ward Parkway , Suit e 40 5 2505 N . 24" * Street , Suit e 308 4242 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Phone : (816) 363-3703 Fax : (816) 363-3707 Omaha , Nebrask a 6811 0 Phone : (402)504-100 4

Fax : (402)504-100 5 Sa n Antonio , T X 7822 9 Phone : (210)822-958 8 Fax : (210 ) 579-6577TECHNOLOGIES . 1 

# Advance dnotic e needed . After signin g th e acces s you allo w Pruden t t o begi nLea dBase d Pain t Stabilization . Al l Plants , weed s an dan y vehicle s o r item s on ope nporc h(enclose dporche s wil l NO T b e stabilized ) mus t b e remove dprio r t o stabilization . Al l Pet s mus t b e ou t ofyar ddurin g stabilization . Ho w muc hnotic e d o you nee dt o hav e abov e mentione dtask s completed ? Ifyo u ar e alandlor dyo u wil l nee dt o contac t th e tenan t a s Pruden t Technologie s wil l only informyou . D o you hav e an y pet s tha t resid e i nyard ? 9^ 0 

# Notic e needed : 

# d/ ^ Numbe r t o cal l t o giv e notice : ^'/'Y
- ^ ^ ^ Who mw e ar e givin g notic e to : /i^j ^ ^ ^ U)o a^ ^ Hom e Owner' s Signatur e

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , TX 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7

# f^^ ^ TECHNOLOGIES , IN C 

## PRE-STABILIZATIO NVIDE O FOR M I UNDERSTAND THA T PRUDEN T TECHNOLOGIE S WIL LB ECOMIN G OU T T O SHOO T A PRE-STABILIZATIO NVIDE O A T M Y PROPERTY . TH EVIDE O I S JUS T A TOO LUSE D T O DOCUMEN T TH ECURREN T PROPERT Y STATUS/CONDITION . A POS T VIDE O WIL LALS O B E SHO T PRIO RT O COMPLETIO NO FSTABILIZATION . OWNERSNAME : M^O ^ O^cve t PROPERTYADDRESS : O-lH^ i fcrOrBi^TX^f^^I > BVID/SAID : G'SS^ ) HOMEOWNER S SIGNATURE : PRUDEN T REPRESENTATIV ESIGNATURE : ^ 

# /^fp: ^ AN Y CONDITION S NEED T O B EAWAREO FBEFOR ESHOOTIN G VIDEO : (LE . PETS , NOTIC ENEEDED) : J\^ , ^ ^ 

# /Wfr /

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , TX 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax:(816)363-370 7 Fax : (402)504-100 5 Fax:(210)579-657 7TECHNOLOGIES , INC . • eiPRois j 

# ACCES S INFORMATIO NTRACKIN GSHEE T BVID : G2>^l:^ j PROPERT Y ADDRESS : 

## 2.7^ Aio(^kf\QJUAL iVA d Propert y Owne dBy : (I f new propert y owner )

Owner s Phon e No's : Uome : ^'^-^----?'^^
- Work : 

# Cell : A7.2:-:-l9.7^
- Fax : - Acces s Contractor : AS WPDA ME S P EOthe r (Prudent ) ACCE^^SO R CONRAC T DETAI L 

# ^hlo ^ Lf ' pr ^ ^ y ) 1 

## V o ^cJ: j x U poJickalfi^ MAA . U/ruJ f iV > -Lnn ; <^T<r^f^ ^ 

## DATE TIM E 

## ^E§sp i

Comments :

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7TECHNOLOGIES . IN C 

# Acces s Assessmen t Form : (Mus t b e complete dfo r every property . Informatio nmus t b e obtaine dfro mapropert y wal k thru , no t given b y owner )
I s th e propert y stucc o o r asbestos ? 

# Cooo a Ifyes , i s an y ofth e stucc o o r asbesto s damage do r cracked ? Ifyes , sto p a s w e can' t stabiliz e thi s property . I t require s specia l preparatio n techniques . I t wil l b e returne dt o EP A an dthe y wil l assig na t alate r date . Doe s thi s propert y requir e lot s o f scrapping ? Doe s thi s propert y requir e alif t o r scaffoldin g t o reac huppe r levels ? Doe s thi s propert y hav e lot s o f plant s o r item s i narea s wher e paintin g i s required ? Doe s thi s propert y hav e an y significan t structura l damage ? Ifyes , EXPLAIN ?

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7TECHNOLOGIES ^ IN C 

## Doe s thi s propert y hav e agarage ? Ifyes , describ e locatio no f garage . 

# ( M O Doe s thi s propert y hav e aluminu msiding ? N O Ifyes , i s i t origina l factor y finisho r ha s i t bee npainte dover ? 

# M o Doe s thi s propert y hav e an y othe r typ e o f structura l components ? (Le . roo f shingle s a s siding) ? Ifyes , EXPLAIN ? I s thi s propert y vacan t o r occupied ? Ar e ther e an y pet s a t thi s property ? 

# CJsJ h Ar e ther e an y lo w hangin g powe r lines ?

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , TX 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7TBCHNOLOGIES, ] 

## NEIGHBORHOO D PROPERT Y ACCES S FOR M I S THER EA NEIGHBORIN GPROPERT Y THA T NEED S T O B EACCESSED ALON G WIT H ASSIGNED PROPERT Y T O COMPLET ESTABILIZATIO NPROCESS ? 

## N O I FI T IS , GE T ACCES S FRO M ALLREQUIRE D NEIGHBORHOO D PROPERTIES . 

# t\l o

808 0 War d Parkway , Suit e 40 5 250 5 N . 24* " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , TX 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax:(210)579-657 7'nCHNOLOGIBS.IN C 

# PAIN T MATCHIN GFORM : T O B EFILLE D OUT ONL Y I FMATCHIN GCOLO R PROPERTYADDRESS : ^1^ ^ F<3o4€ne\\ ^ i^L\j£ >

I UNDERSTAN D SHERWI NWILLIAM S WIL LMATC H MY CURREN T COLORS . Homeowner signature i 

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808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , TX 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax ; (210 ) 579-657 7/^ ' (i & sr S TECHNOLOGIES , IN C 

## PRE-STABILIZATIO NPROPERT Y SAFET Y ASSESSMENT FOR M PROPERTYADDRESS : 2.1^ ^ Pon\€n€\ ^ ^^^r ^ BVID/SAID : (o?>i^^ \ PRUDENT ASSESSMENT REPERSENTATIVE : 'ScXr^^Xi V P^WxVC^xA ^ 

## ******IFSAFET Y RIS K PROPERT Y MUS T B ETURNED OVE RT O KATH Y ROTHE RBEFOR EI T CA NB EASSIGNED T O A CREW/SUB . REPERSENTATIV EREMARKS/FINDINGS : (POWER-LIN EPROXIMIT Y T O PROPERTY , SCAFFOLDING / LADDERS / LIFT S NEEDED , UNSAF EAREAS , UNSAF ENEIGHBORHOOD...ETC. )

REQUIRE S K.ROTHE RAPPROVAL YES/N O SUBMITTED T O K.ROTHE RON :

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , TX 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7# • TECHNOLOGIBS , INC . 

# Checklis t fo r th e Worksit e Hazar dAnalysi s Address : ^ 7 ^ W^rr/ct^A-^JlM ^ k^ ^ OjL ^ Crew ; Date : Ite m 

### OK ? I Hazar d/ Correctiv e Actio n Overhea dLine s LX/K-- ^ ^dl A h,.ji^J<^x ^ ^ ^' ^ ' " ^ In-transi t Vehicl e Clearanc e 

## bi U Level s aroun dhig hwire s Vehicl e Clearanc e aroun d 

## OV v hig hwire s whe nworkin g Phon e line s u ^ Cabl e line s 

## y Ga s Lin e 

# y
i Wate r Lin e Sewe r Lin e Septi c Tan k Propane/Butan e Acces s to/o nPropert y 

### -/iMJ^r< ^ G y oir ^ lA^auL ^ Neighbo r Acces s Require d /l ^ 

### 1 f ' Hig hTraffi c Are a /\J/ ^ - i Ai ^-^.-v-^rAry
- ^^CKJuA t P 

## i^^ ^ Garag e 

# [t^ 

# J y ' Structure s Sltl>f£i- ^ 

# ^sfu- i Drivewa y ^ 

# fiffhuk . Sidewal k Ms-£y ) IJ . Aye^j^-^r^- ^ Foundatio n 

## A T Retainin g Wall s 

### AJ^ A Fence s 

# Nf h Tree s [ t Foliag e }l,ij^s4-e ^ 

### S^yrJ
- .S^-^J^_ Genera l Conditio nofyar d ''^•^Tji ' Daniage dAreas : sin k ^r ' holes/rotte dwoo d Sprinkle r Systen i • — Pet s 1 Insect s 

### tiju...JA^^ ^ ^y ^JL.t> ^ pc(^— - Weathe r Condition s i ^ 

# 1 ) f Unsaf e drivin g condition s ,^ ^ Unsaf e neighborhoo d L.- ^ 

### Cre w Contracto r 

# y 250 5 N . 24' " Street , Suit e 30 8 nedica l Dryt'e , Suit e 425 0 Kansa ' Omaha , Nebrask a 6811 0 Sa n Anttnio , TX 7822 9 Phone : Phone : (402)504-100 4 Phone/(210 ) 822-958 8 Fax:(816)363-370 7 Fax : (402)504-100 5 Fa/ : (210 ) 579-657 7 808 0

## =^7 ^ ^0^^"^^^ S^^ ^Valid/Invalid : Vali d Exclusio n Reason : Multipl e 45 1 -Part i In t Vali d Sale s Date : 2001-11-1 2 Pstno - ^n 

# Curren t Sampl e Pre-Renovatio n For m Effectiv e unti l Apri l 2010 . Confirmatio n o f Receip t o f Lea d Pamphle t 1^ 1 hav e receivec i a cop yof th e pamphlet , Renovat e Right : Importan t Lea d Hazar d informatio n fo rFamilies , Chil d Car e Provider s an d School s informin g m e o f th e potentia l ris k o f th e lea d hazard exposur e fro m renovatio n activit yt o b e performe d i n m ydwellin g unit . I receive d thi s pamphle t befor e th e wor k began .

Signatur e o f recipien t Self-Certificatio n Optio n (fo rtenant-occupie d dwelling s only ) — I f th e lea d pamphle t wa s delivere d bu t a tenan t signatur e wa s no t obtainable , yo u maychec k th e appropriat e bo xbelow . •Refusa l t o sig n — I certifytha t I hav e mad e a goo d fait h effor t t o delive rth e pamphlet , Renovat e Right : Importan t Lea d Hazar d Informatio n fo rFamiiies , Chil d Car e Provider s an d Schools , t o th e renta l dwellin g uni t liste d belo wa t th e dat e an d tim e indicate d an d tha t th e occupan t refuse d t o sig n th e confirmatio n o f receipt . I furthe rcertifytha t I hav e lef t a cop yof th e pamphle t at th e uni t wit h th e occupant . 1

^

Unavailabl e fo rsignatur e —I certifytha t I hav e mad e a goo d fait h effor t t o delive rth e pamphlet , Renovat e Right : Importan t Lea d Hazar d Informatio n fo r Families , Chil d Car e provider s an d Schools , t o th e renta l dwellin g uni t liste d belo wan d tha t th e occupan t wa s unavailabl e t o sig n th e confirmatio n o f receipt . I furthe rcertifytha t I hav e lef t a cop yo f th e pamphle t at th e uni t b yslidin g i t unde rth e doo r 

### ^Hj^p V fi^^K<\:joJ^ Printe d nam e o f perso n certifyin g Attempte d deliver y dat e an d tim e lea d pamphle t deliver y Signatur e o f perso n certifyin g lea d pamphle t deliver y

Uni t Addres s Not e Regardin g Mailin g Optio n —A s a n alternativ e t o deliver yi n person , yo u maymai l th e lea d pamphle t t o th e owne rand/o rtenant . Pamphle t mus t b e maile d a t leas t 7 day s befor e renovatio n (Documen t wit h a certificat e o f mailin g fro m th e pos t office) .

### Douglas County Account Infoly-tion A; 

### Page 

### 1 of 3 Douglas County, Nebraska Property Record 

# - R0811830000 Print Report NEW Feature Parcel Dmens~ons available @ scale 0 50R west of 52nd St - View On Map nformation IS vahd as of 2009-6-16 Treasurer's Tax Report New Feature 3 3 3 Auto Sales Search Dwner NOLFE JULIUS L !TAL 2744 FONTENELLE BLVD 3MAHA NE 681 04-0000 Property Information Key Number: 11 83 0000 08 Account Type: Residential Parcel Number: 081 1830000 Parcel Address: 2744 FONTENELLE BD OMAHA NE 681 04-0000 Legal Description: CLAIRMONT LOT 3 BLOCK 5 50 X 125 Value Information Land improvement 2009 $6,400 00 $83,000 00 2008 $6,400 00 $83.000 00 2007 $6,400 00 $83.000 00 2006 $6,400 00 $83.000 00 2005 $6,400 00 $77,000 00 2004 $6,400 00 $70,000 00 Sales Information Sales Date: 2001 -1 1-12 Deed Type: WD Book: 2197 Price: $87,000 00 Grantor: Grantee: Valid/lnvalid: Valid Exclusion Reason: Multtple 451-Partl lnt Valtd Sales Date: 2001 -1 1-1 2 Deed Type: WD Book: 2197 Price: $1 00 Grantor: 

# 63541

Total $89,400 00 $89.400 00 $89,400 00 $89.400 00 $83,400 00 $76.400 00
Page: 18

Page: 19

### I «^Jy|•7Jfcrt*fc^•ww^'j:^^^l|*54 ^ ? ••• ; s' " ' 

### Dougla s Couni y Accoun t Infon«|tio n Pag e 2 o f 3 

# V Grantee : Valid/Invalid : > invali d Exclusio n Reason : Multipl e 45 1 Part i In t Invali d Sale s Date : 2000-09-0 5 Dee d Type : D Book : 216 2 19 3 

### Price : $6,506.0 0 Granto r Grantee : Valid/Invalid : invali d Exclusio n Reason : Sal e byGov t Agency Sale s Date : 2000-08-2 9 Dee d Type : D Book : 216 2 Page : 04 7 Price : $29,000.0 0 Grantor : Grantee : Valid/Invalid : ! invali d Exclusio n Reason : Foreclosur e Lan d Informatio n Acre s S F Writ s Dept h Widt h Vacan t 0.1 4 6250. 0 1. 0 125. 0 50. 0 N o Improvemen t Informatio n Buildin g 1

i^WFDWENiL.EK l

- -'L^A ' Tire l Floo r Secon d Flco r „,c | 83 6 Os q * . 74 6 3 v q R
2 STOR Y 9S6Cm. a

CLIC KT O ENLARG E IMAG E Squar e Footage : 1584. 0 Percen t Complete : 100.0 % Perimete r: 0. 0 Quality : Averag e 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R081. . . 7/7/200 9

### Dougla s Count y Accoun t Infooagio n Page 3 of 3 Uni t Type : Condition : Fai r

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 7. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 4. 0

Roo f Type : Gabl e Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 ^^^'•S"' " RemTJele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 191 8 200 1 0 % 198 0 2 9 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Applianc e Fireplac e Masonr y 1. 0 Basemen t Bsmn t Bloc k 8 ft 836. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 192. 0 Porc h Enc I Scree n 42. 0 Porc h Sla b Roo f Cei l 162. 0



### http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=R081.. . 7/7/2009# • 

# mi l TECHNOLOGIES , INC . 

## Pruden t Propert yClose-Ou t For m (Lead-Base d Pain t Stabilization ) SAID : Ar06gcA-ixVU^ ^ Propert yAddress : .^7^ ^

fhAjf^/Ul^ti e feU/b Owner' s Name : ^\)(nCVf r UOQUA' ^ S.N O Performanc e Standards/close-Ou t Criteri a Ye s N O 1 Wa s th e entir e structure(s ) painte d wit h th e exceptio n ofth e stated , exclude d areas ? Thi s woul d includ e paintin g o f othe rassociate d feature s includin g fascia , eaves , siding , al l trim , porches , bo x beams , columns , rails , an d exterio rsurface s o f garages . 

# y 2 Wa s al l scrapin g an d othe rpreparatio n wor k complete d satisfactorily ? 

# y 3 Were al l require d area s o f th e structure(s ) prime d a s neede d an d painte d wit h tw o to p coats ? 

# y 4 Ar e al l o f th e area s wher e contaminate d material s hav e bee n spille d thoroughl yvacuumed / cleaned ? 

# y 5 Di d th e contracto rcollect/vacuu m al l fallin g an d scrape d pain t chip s o n th e entir e property , roadways , alleyways , publi cacces s area s an d als o remov e an yothe rgenerate d debris? 

# y 6 I s th e gras s are a tha t surround s th e structure(s ) i n reasonabl ygoo d condition ? 

# y 7 8 Wa s th e pain t product s utilize d equivalen t t o a 3 0 yea r product/quality ? Ar e al l item s suc h a s polyethylen e sheeting , ladders , pain t brushes , cones , barrie rtap e et cproperl yremoved ? 

# y i/

^ 9 I s ther e an yevidenc e o f propert ydamag e tha t wa s don e b yth e contractor ? An ypropert ydamag e need s t o b e complete d prio rt o ^ th e EP AClose-Out . 1 0 Ar e ther e an ypropert yitem s tha t wer e temporaril yre-locate d b yth e contracto rtha t nee d t o b e move d back ? y ^ 1 1 Ar e ther e an y(known ) lingerin g issue s wit h th e propert yowner(s ) tha t hav e bee n lef t unresolved ? 

### ^y 1 2 Othe rConsiderations ? Propert yOwne rDiscussions ? Additiona l Wor k tha t i s Require d 

# ^ y Pruden t Representativ e Signatur e Date : Propert yOwne rSignature^ Date : 

## \ b s^UUl'O ^ 808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone:(816)363-370 3 Phone : (402 ) 504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210)579-657 7