TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: _Sa^^3_^ _ Date: &j^ H j oc^lr^ 

Address: ^^1 3 M lg^ S.-T. 

Stabilization Contractor: Pruden t Technologies, Inc . Year: 2010_ 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

S/ Video ofproperty (DVD) pfig­ ^Q ­ pfg l 

0 Executive Summary 

0 Signed Access Agreement for subject property 

0 Pre-Renovation Form signed by Property Owner 

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

M Painting Agreement 

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

K Renovation Recordkeeping Checklist signed by Certified Renovator 

0^ Photographs 

y Satisfactory close-out check list signed by Property Owner 

M Property close-out check list signed by EPA 

y Property information from Douglas County Assessor's Ofifice 

Sr Hazard analysis, if prepared 

n

D

 Safety Audit 

 Other (describe): 

30203955 nil 

Superfund 

PradMit Technology, Inc. Signature 

oe^in 

'A COR Signature 

(afier file folaer review) 

^^jH^t^CM-^JLcTt. lO/cJ/o 
TECHNOLOGIBS,] 

Property Summary 

Date: 6/24/2010 LBP STABILIZATION EPA CONTRACT EP-R7-08-07 Month of: June 

Property Address: 3913 N 18 St. SAID #: 33613 

A. Executive Summary; 

a. Issues Encountered: NONE 

b. Issues Resolved: NONE 

c. Unique Findings: NONE 

d. Other Relevant Information:­

i. Access Date: 03/29/2010 

ii. Work Began: 04/15/2010 

iii. Close-Out Date: 04/16/2010 

B. Enclosures: 

1. Pre-Stabilization Video 

2. Post-Stabilization Video 

3. Signed Access Agreement Form 

4. Advance-Notice Form 

5. Pre-Stabilization Video Agreement Form 

6. Access Tracking Form 

7. Property Access Assessment Form 

8. Neighbor Access Agreement Form 

9. Property Paint Match Form 

10. Pre-Stabilization Property Safety Assessment Form 

11. Work-Site Hazards Analysis Checklist 

12. Pre- Stabilization Property Hazard Assessment Photographs 

13. Douglas County Assessor Property Information 

14. Signed Property Completion Agreement Form 

15. Property Close-Out Check List Signed By EPA 
©»»«« 

40IiOCIBS> INC.' 

Prudent Technologies, Inc. (Prudent) is under contract (Contract # EP-R7-08-07) v^dth the U. S. 

Environmental Protection Agency (EPA) to stabilize Lead Based Paint (LBP) at a number of properties 

located in Omaha, Nebraska, including the property located at: "^^1 % f\i I o S ^ 

The EPA requests your permission to allow Prudent to perform LBP Stabilization at this property. By 

signing this form, the property owner grants permission to Prudent to perform activities related to LBP 

Stabilization including scraping paint and painting ofthe referenced property. Further, the 

owner/tenant verifies that they have received the LBP pamphlet "Renovate Right." 

By signing this document I agree to allow an EPA contractor to conduct a soil cleanup at my property 

following completion of lead-based paint stabilization, if the soil cleanup has not already been 

performed. I understand that the stabilization contractor cannot provide assurances of which 

contractor will be bound to the soil cleanup. Ifiirther imderstand that the soil cleanup contractor will 

make all reasonable efforts to address concerns that I, as the property owner, may have regarding soil 

cleanup at my property. 

t>^Yes, I have read and understand the paragraph above. 

XT XO^O 

Property OwneTB Signutuio Date 

If you have any questions about the LBP stabilization plaimed for your property, please contact 

Prudent's Customer Relations/Office Manager for the Lead Based Paint Stabilization, Mr. Chandra 

Shekar at 402- 504-1004 or 402-889-3821. General questions about the Omaha Lead Site cleanup can 

be directed to the EPA Public Information Centers at (402) 731-3045 (South Omaha office) or (402) 

991-9583 (North Omaha ofifice). 

Property Access Granted By: 

3 P.^ IsLO/cf 

Property uwner s Signature Date 

K)ay\(yr^ CjtnxasAo 

Please Print Name 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 lUledical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraslta 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
iiaLociBs, n^ic 

PROPERTY INFORMATION 

(To be completed by resident and/or property owner ~ please print) 

RESIDENT NAME: Tenant 

RESIDENT ADDRESS: (jW/ 3 A/ 16 ^ 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS: 

EPHONE NUMBER: 

Q.dlOM°i Cell: 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: V^^HJ ^ \ 

TOTAL NUMBER OF OCCUPANTS: 3 

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY IN THE YARD FOR 5 HOURS 

OR MORE PER WEEK: | 

COMMENTS OR SPECIAL INSTRUCTIONS (such as does, entry gates, etc.); 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: The activities to be implemented 

by EPA under this agreement are pursuant to Section 104 of CERCLA, 42 U.S.C. 9604. EPA's right 

of access to the property is provided for in Section 104(e) of CERCLA, 42 U.S. C 9605(e), which 

provides entry for "determining the need for response, or choosing or taking any response action imder 

this title, or otherwise enforcing the provisions ofthe title." 

Property Owner Signature: ^ jhy^c?^ ^ 

(Signature) Date 

8080 Ward Parkway, Suite 405 2505 N. 24*" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, IMO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
[OLOCIBS, IN C 

PRE & POST PAINT STABILIZATION VIDEO AND PICTURES 

I understand that prudent Technologies (Prudent) will be coming out to shoot a PreStabilization video and to take pictures of my property. Prudent will use the videos and 

pictures to document the current property status/condition. Also, Prudent will shoot a video 

shot following the completion of the paint stabilization. I give permission to videos and 

pictures of my property. 

Please list any special conditions that Prudent employees need to be aware of before 

shooting a video (such as pets, prior notice, etc.). 

Z3I3J/ iss-l- Property Address 

^JQ. ^ l::ioi^ 

Owner's Name Signature Date 

ADVANCE NOTICE REQUIREMENT 

After signing the access you allow Prudent to begin Lead Based Paint Stabilization. All 

Plants, weeds and any vehicles or items on open porch (enclosed porches will NOT be 

stabilized) must be removed prior to stabilization. All Pets must be out of yard during 

stabilization. Please indicate below how much advance notice you need to have the abovementioned tasks completed. If you are a landlord you will need to contact the tenant as 

Prudent will only inform the property owners. 

Do you have any pets that reside in yard: S L 

Notice needed: ^-M 

Phone number to call to give notice: ;0n^ - 0^^ ^ 

Whom we are giving notice to: ^(Lntir a C4kxv\0LcLo 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
Current Sample Pre-Renovation Form 

Effective until April 2010. 

Confirmation of Receipt of Lead Pamphlet 

t l have received a copy of the pamphlet, Renovate Right: Important Lead Hazard 

Information for Families, Child Care Providers and Schools informing me of 

the potential risl< of the lead hazard exposure from renovation activity to be 

performed in my dwelling unit. I received this pamphlet before the work began. 

Printed riamQ of recipient Date 

Signature of recipient 

Self-Certification Option (for tenant-occupied dwellings only) —-

If the lead pamphlet was delivered but a tenant signature was not obtainable, 

you may check the appropriate box below. 

• Refusal to sign — I certify that I have made a good faith effort to deliver the 

pamphlet, Renovate Right: Important Lead Hazard Infonvatlon for Families, 

Child Care Providers and Schools, to the rental dwelling unit listed below at the 

date and time indicated and that the occupant refused to sign the confirmation 

of receipt. I further certify that I have left a copy of the pamphlet at the unit with 

the occupant. 

• Unavailable for signature — I certify that I have made a good faith effort to 

deliver the pamphlet, Renovate Right: Important Leadtiazard Information for 

Families, Child Care providers and Schools, to the rental dwelling unit listed 

below and that the occupant was unavailable to sign the confirmation of receipt. 

I further certiiy that I have left a copy of the pamphlet at the unit by sliding it 

under the door. 

Printed name of person certifying Attempted delivery 

date and time 

lead pamphlet delivery 

Signature of person certifying lead pamphlet delivery 

Unit Address 

Note Regarding Mailing Option — As an alternative to delivery in person, you 

may mail the lead pamphlet to the owner and/or tenant. Pamphlet must be mailed 

at least 7 days before renovation (Document with a certificate of mailing from the 

post office). 
m 

n?er 

PAINT MATCHING FORM: 

1. TO BE FILLED OUT ONLY IF MATCHING COLOR 

PROPERTY ADDRESS: "^^/ S ^ / f ^ ^ ^ 

BVID: 33^13 

The followmg notes are for the benefit of paint crew only. 

Location 

Siding 

Soffit 

Fascia 

Comer Trim 

Window Trims 

Door Trims 

Front Porch Ceiling 

Front Porch Ceiling Beams 

Front Porch Floor 

Front Porch Railings 

Front Porch Steps 

Siding Baseboards 

Foundation 

L-^H^'/li^ 

t f C-Lw(^c 

N o 6^«>ro^ 

Paint Description 

fl.5k,.^Ujs/lJ^«»J' 

T{iP ^ (p^*v-Ui

\ 

<:::Aiyn.^ 

o 

Paint Yes Paint No 

xy 

ly 

\y ^ 

y 

\ / 

- • 

y 

y 

y 

y" 

y 

y 

^ 

 kCtil :sy 

y ^ 

y^ 

• I UNDERSTAND SHER\ ^IN WILLIAMS WILL MATCH MY C URRENT CO] LORS. 

Homeowner signature: Date: JIS.^/j2.CP/ ^ 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone:(816)363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
•IQLOGnSblNC. 

ACCESS ASSESSMENT FORM: 

Is the property stucco or asbestos? 

If yes, is any of the stucco or asbestos damaged or 

cracked? 

If yes, stop as we can't stabilize this property. It 

requires special preparation techniques. It will be 

returned to EPA and they will assign at a later date. 

Does this property require lots of scrapping? 

Does this property require a lift or scaffolding to reach 

upper levels? 

Does this property have lots of plants or items in areas 

where painting is required? 

Does this property have any significant structural 

damage? If yes, EXPLAIN? 

Does this property have a garage? 

If yes, describe location of garage. 

Does this property have aluminum siding? If yes, is it 

original factory finish or has it been painted over? 

Does this property have any other type of structural 

components? (I.e. roof shingles as siding)? 

If yes, EXPLAIN? 

Is this property vacant or occupied? 

Are there any pets at this property? 

Are there any low hanging power lines? 

Do we need neighbor's access? If yes please explain 

and get neighbor's property address and owner 

information. If possible, get signature from the 

neighbor. 

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8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone:(816)363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax:(210)579-6577 
TEC31NOLOGIES»1 

ACCESS INFORMATION TRACKING SHEET 

BVID: ZSSI 3 

PROPERTY ADDRESS : 3^1 3 N f^ SfProperty Owned By: 

(If new property owner) 

Owners Phone No's: 

Home: -i-?.i-'-?-^-?Vork: 

Cell: -JL0J,,.^C1±U-^ Fax: -

Access Contractor: ASW PDA MES PE Other (Prudent) 

DATE TIME ACCESSOR CONRACT DETAIL 

* zW'i \{D\0(> i^' ^ 

Comments: 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Plione: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
(effective April 2010) 

RENOVATION RECORDKEEPING CHECKLIST 

Name of Firm. i(j^0LfAl (j)' . 

Date and Location of Renovation: ^u6'// ^ S^/ 3 4 /

BriefDescriptionofRenovation: ^J^A^j/P^m ^ / f^iAjt ^ ^^EM-l/fi 

Name of Assigned Renovator: -I^LJ (^//j(^(\/p{^ / /uS^l^tj/^ /jj . 

Name(s) of Trained Workers: P/)f/if^lj- i (.^fi^/ijii d 

Name of Dust Sampling/^chnician, Inspector^ ami/or Rigk Assessor, if used: 

r0 Copies of renovator and dust sampling technician qualifications (training certificates, certifications) on file. 

y Certified renovator provided training to workers on (check all that apply): 

zTPosting warning signs ^H Setting up plastic containment barriers 

^a^aintaining containment JZ^voiding spread ofdust to adjacent areas 

JZwaste handling Q^ost-renovation cleaning 

D Test kits used by certified renovator to determine whether lead was present on components affected by 

renovation (identify kits used and describe sampling locations and results: 

/ Q Warning signs posted at entrance to work area. 

n Work area contained to prevent spread ofdust and debris. 

D Windows in and within 20 feet ofthe work area are closed 

D Doors in and within 20 feet ofthe work areas are closed and sealed 

D Doors that must be used in the work area are covered to allow passage but prevent spread ofdust. 

IZuround covered by plastic sheeting extending 10 feet from work area - plastic anchored to the 

building and weighted down by heavy objects. 

D If necessary, vertical contaimnent installed to prevent migration ofdust and debris to adjacent 

property. 

y Waste contained on-site and while being transported off-site. 

Renovation Recordkeeping Checklist Omaha Lead Site 

 /'P ^ o / 
(effective April 2010) 

y 

fLX Work site properly cleaned after renovation. 

DAI I chips and debris picked up, protective sheeting misted, folded dirty side inward, and taped for 

'Removal. 

^ZiWork area HEPA vacuimied to get paint chips from groimd surface, if necessary. 

MM Certifie^i^n^v^o post-renovatkj cleaningyverificajiy (describe results): Certified^ndva(tor

r performe performedd post-renovationn cleaning.verifica|w)nn (desj 

i/eMi'Ail aiflI certify under penalty of law that the above information is true and complete. 

Nanie and Titles Date 

Renovation Recordkeeping Checklist Omaha Lead Site 
• • 

TECHNOLOGIBS. INC 

Checklist for the Worksite Hazard Analysis 

Address: ^2 ^ I ^ 71 . i S --4=r ^ 

Crew: Date; H^l^lCi 

Item OK? Hazard Corrective Action 

Overhead Lines y In-transit Vehicle Clearance y Levels around high wires 

Vehicle Clearance around 

high wires when working / 

Phon y e lines 

Cable lines y ^ 

Gas Line y Water Line y Sewer Line y^ 

Septic Tank T 

y Propane/Butane y Access to/on Property y 

Neighbor Access Required y 

High Traffic Area y • 

Garage y 

Structures y 

Driveway y Sidewalk y Foundation y Retaining Walls y 

Fences y- Trees ^ y 

Foliage c 

General Condition of yard y

y 

Damaged Areas: sink 

holes/rotted wood y Sprinkler System y 

Pets y 

Insects -^z- Weather Conditions y 

Unsafe driving conditions ^ ^ • • 

Unsafe neighborhood ^.. •

Crew/Foremaivf Sub-Contractor 

hui^ &6 

8080 WaPd Park\f&y, 2505'N . 24'" Street, Suite 308 ! Medicalprive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402) 504-1004 Phoiie: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax:(210)579-6577 




• # 

TECHNOLOGIBS. INC 

Prudent Property Close-Out Form (Lead-Based Paint Stabilization) 

SAID: "^ZLl 3 

Property Address: S4^ 3 A/• ^ ^ ^ 

Owner's Name: 

S.NO 

Performance Standards/close-Out Criteria 

1 

Was the entire 8tructure(s) painted with the exception of the stated, 

excluded areas? This would include painting of other associated 

features including fascia, eaves, siding, all trim, porches, box 

beams, columns, rails, and exterior surfaces of garages. 

2 Was all scraping and other preparation work completed 

satisfactorily? 

3 Were all required areas of the structure(s) primed as needed and 

painted with two top coats? 

4 Are all of the areas where contaminated materials have been spilled 

thoroughly vacuumed/ cleaned? 

5 

Did the contractor collect/vacuum all falling and scraped paint chips 

on the entire property, roadways, alleyways, public access areas 

and also remove any other generated debris? 

6 Is the grass area that surrounds the structure(s) in reasonably good 

condition? 

7 Was the paint products utilized equivalent to a 30 year 

product/quality? 

8 Are all Items such as polyethylene sheeting, ladders, paint brushes, 

cones, barrier tape etc properiy removed? 

9 

Is there any evidence of property damage that was done by the 

contractor? Any properiy damage needs to be completed prior to 

the EPA Close-OuL 

10 Are there any property items that were temporarily re-located by the 

contractor that need to be moved back? 

11 Are there any (known) lingering issues with the property owner(s) 

that have been left unresolved? 

12 Other Considerations? Property Owner Discussions? Additional 

Work that is Required 

Prudent Representative Signature m (^ii'Cii/^ 

Date: y^ i [^ 

Property Owner Signatu 

Date HIIGI^O 

Yes NO 

• 

i 

X 

i 

X 

X 

i 

X 

i 

i 

X 

X 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
ENVIRONMENTAL & CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

OMAHA LEAD BASED PAINT REMEDIATION 

EPA Close-Out Form 2010 

(Lead-Based Paint Stabilization EPA Contract EP-R7-08-07) 

SAID: 33 6|-^ 

Property Address: 3-7)3 W ^ ^

ih 3f 

Owner's Name: 

Performance Standards/Close-Out Criteria YES NO 

L Was the entire structure(s) painted with the exception ofthe stated, excluded 

areas? This would include painting of other associated features including fascia, 

eaves, siding, all trim, porches, box beams, columns, rails, and exterior surfaces of y 

garages. 

2. Was all scraping and other preparation work completed satisfactorily? y 

3. Were all required areas ofthe structure(s) primed as needed and painted with 

y two top coats? 

4. Was the paint products utilized equivalent to a 25 year product/quality? y 

5. Are all ofthe areas where contaminated materials have been spilled thoroughly 

vacuumed/ cleaned? y 

6. Did the contractor collect/vacuvmi all falling and scraped paint chips on the 

entire property, roadways, alleyways, public access areas and also remove any y 

other generated debris? 

7. Is the grass area that surrounds the structure(s) in reasonably good condition? * y 

8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, y barrier tape, etc. properly removed? 

9. Is there any evidence ofproperty damage that was done by the contractor? Any y property damage needs to be completed prior to the EPA Close-Out. 

10. Has the Property Owner signed the completion form? 

11. Are there any property items that were temporarily re-located by the contractor 

y that need to be moved back? 

12. Are there any (knovm) lingering issues with the property owner(s) that have 

y

been left unresolved? 

Other Considerations/Property Owner Discussions/Additional Work that is Required: 

EPA COR Signature 

8080 Ward Parkway, Suite 405 2505 N. 24" Street, Suite 218 4242 {Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
Douglas County Account Information 

Page 1 of2 

Douglas County, Nebraska Property Record - R0701440000 

Print Reoort 

NEW Feature - Parcel Dimensions available &. scale 0-50 ft west of 52nd St - VIe W O n Ma P Infbrmation is valid as of 2010-3-16 Treasurer's Tax Report 

New Feature -»!*• * Auto Sales Search 

Owner 

SANDERS WILLIS 

ETAL 

C/0 SANDRA CAMACHO L/C 

3911 N 18 ST 

OMAHA NE 68110-0000 

Property Informatio n 

Key Number 0144 0000 07 

Account Type: Residential 

Parcel Number 0701440000 

Parcel Address: 

3913 N 18 ST 

OMAHA NE 68110-0000 

Legal Description: BOULEVARD PARK ADD LOT 14 BLOCK 8 N 10 FT LOT 13 & S 30 FT LOT 14 40 

X125 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$7,000.00 

$7,000.00 

$7,000.00 

$7,000.00 

$7,000.00 

$7,000.00 

Improvement 

$13,200.00 

$15,800.00 

$15,800.00 

$15,800.00 

$14,000.00 

$12,700.00 

Total 

$20,200.00 

$22,800.00 

$22,800.00 

$22,800.00 

$21,000.00 

$19,700.00 

Sales Informatio n 

Sales Date: 2008-10-27 

Deed Type: QC Book: 2008 Page: 106359 

Price: $17,500.00 

Grantor SANDERS WILLIS 

Grantee: CAMACHO SANDRA 

Valid/Invalid: Invalid 

Exclusion Reason: Family Sale 

Land Informatio n 

Acres SF 

Units Deptfi Width Vacant 

0.11 5000.0 1.0 125.0 40.0 No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R0701440000 3/23/2010 
Douglas County Account Infonnation Page 2 of2 

# 

Building 1 

wr Svoond Hoof I 

7M.0sq.ft 

^ . 

"*" * I i** 

FM Floor 

734.0 n I. 

ZIQSTQimjNnN NnMBlMkl l 

nun*' 

L CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IIVIAGE 

Square Footage: 1440.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Poor 

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

HVAC: Forced Air Rooms: 8.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 2.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Hip Stories: 2.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1912 0% 1912 97 

Detail Type Detail Description Units 

Add On Unfinished Attic W/floor 672.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 724.0 

Fixture Additional Fixtures 1.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 2.0 

Garage Detached 228.0 

Porch Cvrd Wood Deck 112.0 

Porch EncI Screen 20.0 

User frame type-asbestos 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R0701440000 3/23/2010