## TRANSMITTALO FOMAHALEAD SIT E PAIN T STABILIZATIO NFIL EFOLDE R SAID# : %f-\^?> ^ Date : Address : 

# M'lr j N S M s Y LB PStabilizatio nContractor : PRUDEN T TECHNOLOGIES , INC . Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S B Video of property (DVD) : Pre-Stabilizatio n& Post-Stabilizatio nVideo s y Executiv e Summary V SignedAcces s Agreement Form y Advanc e Notic e For m t ^ Pre-Stabilizatio nVide o Agreement Form y Acces s Trackin g Form ^ Property Acces s Assessmen t For m y Neighbo r Acces s Agreement Form y Pain t Matc hForm y Pre-Stabilizatio nPropert y Safet y Assessmen t For m y Work-Site Hazard s Analysi s Checklis t B' Photographs : Pre-Stabilizatio nPropert v Hazar dAssessmen t Photograph s H Dougla s Count y Assessor Propert y informatio n y Propert y Completio nAgreement FormSignedb y Propert y Owner D Propert y Close-Out Chec k Lis t SignedBy EP A Pruden t Technologies , Inc . Signatur e Dat e 

# ^Mk ^

3005612 5 

# iniiM i Superfun dTECHNOLOGIES , IN C 

# Propert y Summary Date : ll/~/200 9 LB PSTABILIZATIO NEPACONTRAC T EP-R7-08-0 7 Mont hof : No v Propert y Address : 172 7 N5 4 St . SAI D # : 8493 9
A . Executiv e Summary : a . Issue s Encountered : NON E b . Issue s Resolved : NON E c . Uniqu e Findings : NON E d . Othe r Relevant Information : i . Acces s Date : 10/13/2009 ii . Work Began : 10/26/2009 iii . Close-Ou t Date : 10/27/2009 B . Enclosures : 1 . Pre-Stabilizatio nVide o 2 . Post-Stabilizatio nVide o 3 . Signe dAcces s Agreement Form 4 . Advance-Notic e Form 5 . Pre-Stabilizatio nVide o Agreement Form 6 . Acces s Trackin g Form 7 . Propert y Acces s Assessment Form 8 . Neighbo r Acces s Agreemen t Form 9 . Propert y Pain t Matc hForm 10 . Pre-Stabilizatio nPropert y Safet y Assessment Form 11 . Work-Sit e Hazard s Analysi s Checklis t 12 . Pre
- Stabilizatio nPropert y Hazar dAssessment Photograph s 13 . Dougla s County Assessor Propert y Informatio n 14 . Signe dPropert y Completio nAgreemen t Form 15 . Propert y Close-Ou t Chec k Lis t Signe dB y EPATBCaiNaLOCIBS,INC. ~ Pruden t Technologies , Inc . (Prudent ) i s unde r contrac t (Contrac t #EP-R7-08-07 ) withth e U . S . Environmenta l Protectio n Agenc y (EPA ) t o stabiliz e Lea dBase dPain t (LBP ) at anumbe r o f propertie s locate dinOmaha , Nebraska , includin g th e 

### propert v locateda t -f ^ J ? ^ /J ^ ^ ^ ^ 7^ ^ C>yy/9/yyP ^ /V ^ Th e EP Arequest s you r pennissio nt o allo w Pruden t t o performLB PStabilizatio nat thi s property . B y signin g thi s form , th e property owne r grant s permissio nt o Pruden t t o performactivitie s relate dt o LB PStabilizatio nincludin g scrapin g pain t an d paintin g ofth e reference dproperty . Further , th e owner/tenan t verifie s that the y hav e receive dth e LB Ppamphle t "Renovat e Right. " B y signin g thi s documen t I agree t o allo w a nEP Acontracto r t o conduc t asoi l cleanu p at my property followin g completio no f lead-base dpain t stabilization , i f th e soi l cleanu p ha s no t alread y bee nperformed . I understan dthat th e stabilizatio ncontracto r caimo t provid e assurance s o f whic hcontracto r wil l b e boun dt o th e soi l cleanup . I further understan dthat th e soi l cleanu p contracto r wil l mak e al l reasonabl e effort s t o addres s concem s that I , a s th e propert y owner , may hav e regardin g soi l cleanu p at m y property . { ^ YeSjJJiave,/€a9)an dunderstan dth e paragr^ habove .

Signatur e
Date I f

yo u hav e any question s abou t th e LB Pstabilizatio nplanne dfor you r property , pleas e contac t Prudent' s Custome r Relations/Offic e Manage r for th e Lea dBase dPain t Stabilization , Mrs . Shanno nHolt , at (402 ) 504-100 4 o r (402)812-0223 . General question s abou t th e Omah aLeadSite cleanu p canb e directe dt o th e EP APubli c Informatio nCenter s at (402 ) 731
­ 304 5 (Sout hOmah aoffice ) o r (402 ) 991-958 3 (NorthOmah aoffice) . Property Acces s Grante dBy : (Pleas e Prin t Name ) Property Owne r Signature : 

# 4-/% ­

(Date )

808 0 War dParkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 AAedica 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 7TBCHNCNLOGIBS . UM C PROPERT YINFORMATIO N (T o be complete d byresiden t and/o rpropert yowne r— g^s e print ) RESIDEN TNAME : K^ L ^O'V^ . \\VVCLy\ U "^ V-gAjtir vfCrnvxes ) Rente r RESIDEN T T DEN ADDRESS : V- , IA \ ^- . I

IF RENTAL , PROPERTYOWNE D BY :
OWNER' S MAILIN G ADDRESS ; 

# cel l OWNER' S TELEPHON E NUMBE R - HOME : (^Cl Z ) 5\^ ' ' ^^^^**^Q'^ = (^^ Z \ S^tM^S'S ' NUMBE R OF OCCUPANT S UNDE R 7 YEAR S OLD : 3 > NUMBE R OF OCCUPANT S 7 YEAR S OL D AN D OLDER : NUMBE R OF CHILDRE N UNDE R 7 YEAR S OL D WHO M PLA YIN TH E YAR D FO R 5 HOUR S OR MOR E PE R WEEK :
COMMENT S OR SPECIA L INSTRUCTIONS : (I.E . DOGS , ENTR YGATES , ETC. )

AUTHORIT Y FORENVIRONMENTA LRESPONS EACTIONS : Th e activitie s to be implemente d by EP Aunde r thi s agreemen t ar e pursuan t to Sectio n10 4 ofCERCLA , 42 U.S.C . 9604 . EPA' s righ t of

acces s to th e propertyis provide dfor inSectio n104(e ) ofCERCLA , 42 U.S . C 9605(e) , whic hprovide s entry fo r "determinin g th e nee dfo r response , or choosin g or takin g any respons e actio nunde r thi s title , or otherwis e enforcin g th e provision s ofth e title. " 

# /d./S-O ^ U A^•HQW ^ P/^r^ r

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

# Advance dnotic e needed . Afte r signin g th e acces s yo u 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 o n 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 o f yar ddurin g stabilization . Ho w muc hnotic e d o yo u nee dt o hav e abov e mentione dtask s completed ? I f yo 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 onl y infor myou . D o yo u hav e an y pet s tha t resid e i nyard ? ^ Q Notic e needg^ ^ \\^^^ ^ \)^^ft . 5cnip\ ^ Numbe r t o cal l t o giv e notice : Z W.Qo^ S j ^^Z''^ij^ ^ ^ Who mw e ar e givin g notic e to : 

# \\C:>me.OU>rier ' ITUai^u ^ d^d ^ Hom e Owner' s Signatur e 

# ^Q^L^-Si^^ .

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 

## PRE-STABILIZATIO NVIDE O FORM I UNDERSTAN D THA T PRUDENT TECHNOLOGIE S WIL LB ECOMIN G OUT T O SHOO T APRE-STABILIZATIO NVIDE O AT MY PROPERTY . TH EVIDE O I S JUS T ATOO LUSE D T O DOCUMEN T TH ECURREN T PROPERT Y STATUS/CONDITION . APOS T VIDE O WIL LALS O B E SHO T PRIO RT O COMPLETIO NO FSTABILIZATION . OWNERSNAME : fCfQOu^^-- ' PROPERTYADDRESS : :Z^:2 ^ A y ^4 ^ S7^ ^ ^^y^^Ayy^ ^ BVID/SAID : ^^^ ^ ^c^ S



# . ,CX^..^A,(b^cy- ^ HOMEOWNER S SIGNATUR E PRUDENT REPRESENTATIV ESIGNATUR E 

# : CK^^ ^ S^^ ^
AN Y CONDITION S NEED T O B EAWAR EO FBEFORESHOOTIN G VIDEO : (LE . PETS , NOTIC ENEEDED) : 

# l\)ooe ^

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 INFORMATIO NTRACKIN GSHEE T 

# ^ ,-,2 7 

# N S^S / BVI D 

# : ^'^^J l PROPERT Y ADDRES S Propert y Owne dBy : (I f ne w propert y owner )

Owner s Phon e No's : Home : Work : Cell : - Fax : - Acces s Contractor : AS WPD AME S P EOthe r (Prudent ) DAT E TIM E ACCESSO R CONRAC T DETAI L\ A/ \1 1 O . _ ll 1 ^ , • . . , D y 

## /^*^/t^J^-<e—6 / ^ 0 f J 7 C> 1 0'\/i^' ^ -"- i 

## UJA^ ] 

# ty y ' 1 ^

v.' U 11 1 11 1 CU1 5 .

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 7TECHNOLOGIBS , IN C 

# Acces s Assessment Form : (Mus t b e complete dfor ever y property . Informatio nmus t b e obtaine dfromapropert y wal k thru , no t given b y owner )
I s th e propert y stucc o o r asbestos ? 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 Aan dthe y wil l assig na t alate r date . 

# -^^y y 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 ? 

# y O 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 ? 

# y 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 , 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 . IN C 

## Doe s thi s propert y hav e agarage ? 

# y ^ I f

yes , describ e locatio nof garage . Doe s thi s propert y hav e aluminu msiding ? 

# hy ) Ifyes , i s i t origina l factory finis ho r ha s i t bee npainte dover ? 

# r-\ ) Doe s thi s propert y hav e an y othe r typ e o f

structura l components ? (I.e . 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 ? Ar e ther e an y low hangin g power 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 , 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 740L0GIBS.IN C 

## PAINT MATCHIN GFORM : 1 . T O B EFILLE D OU T ONL Y I FMATCHIN GCOLO R PROPERTYADDRESS : JT^^^J?.: ? A, / 4"< g y y ^^/V^/J^ ^ xt^ T 

## BVID : S'^ScF. ^ Th e followin g note s ar e fo r th e benefi t o f pain t cre w only . Pain t Ye s Pain t N o Locatio n Pain t Descriptio n Sidin g A\ r^OVvvw^ - 

### Soffi t

• > I 

### Fascia I I 

### Come r Tri m 

# ±y ^ Windo w Trims Doo r Trims Fron t Porc hCeiling Fron t Porc hCeiling Beam s ^ 

## T r ^ 

# y


# - y ; ^ 

# J ^ y 

# r ,,^ Yv > 

# ,iy ^ Fron t Porc hFloo r .^ ^ - ^ :L<*1 . 

### Fron t Porc hRailing s 

# y ^ Fron t Porc hStep s Siding Baseboards Foundatio n 

# (n . W'«^< ° - ^ , 

### £ v 

# k i^ ^ tO>V g >^^ ^ 

## py?.<>^/ i P^ILJX^: ^ 

# ^oiJ rUL' U ^



### • I UNDERSTAN D SHERWI NWILLIAM S WIL LMATC H M Y CURREN T COLORS . Homeowne r signature : ^^cyV^[\c\^ ^ ^A^^^» ^ Date : (b . \2'0 ^ 

# r. G^^i^^ y

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 

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

## pJ O I FI T IS , GE T ACCES S FRO M AL LREQUIRE D NEIGHBORHOO D PROPERTIES .



# i^ 

# 0

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 7TECHNOLOGIBS . IN C 

## PRE-STABILIZATIO NPROPERT Y SAFET Y ASSESSMENT FOR M 

# rjx' ^ 

# N J ^ M si " PROPERTYADDRESS : i
- / • - ^ BVID/SAID : ^ \\- ^ f PRUDEN T ASSESSMEN T REPERSENTATIVE : 

# g^ 4 ¥^ ^
REPERSENTATIV EREMARKS/FINDINGS : (POWER-LIN EPROXIMIT Y T O PROPERTY , SCAFFOLDING / LADDERS / LIFT S NEEDED , UNSAF EAREAS , UNSAF ENEIGHBORHOOD...ETC. )

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

# Curren t Sampl e Pre-Renovatio n For m Effectiv e unti l Apri l 2010 . Confirmatio n ofReceip tofLea d Pamphle t ijj [ I hav e receive d a copy ofth e pamphlet , Renovate Right : Importan t Lea d Hazar d Informatio n fo rFamilies , Chil d Car e Provider s an d School s informin g me of th e potentia l ris k ofth e lead hazar d exposur e fro m renovatio n activit y

to be performe din mydwellin g unit . I receive d thi s pamphlet befor e th e wor k began . 

# '^ean ^ lO l3|o q :)ien O i ( n ^

^^^ ® Dat e ' ^cipien t ^ ^ i Signatur eof 

# ^^ u IT Self-Certificatio n Optio n (fo rtenant-occupie d dwelling s only ) — Ifth e lead pamphlet was delivere d bu t a tenan t signatur e wa s not obtainable , yo u ma ychec k th e appropriat e boxbelow . •Refusa l to sig n — I certif ythat I hav e mad e a goo d fait h effor tto delive rth e pamphlet , Renovate Right : Importan t Lea d Hazar d Informatio n fo rFamilies , Chil d Car e Provider s an d Schools , to th e renta l dwellin g uni t liste d below at th e dat e an d tim e indicate d an d that th e occupan t refuse d to sig n th e confirmatio n ofreceipt . I furthe rcertif ythat I hav e lef t a cop y ofth e pamphlet at th e uni t wit h th e occupant . O/^navailabl e fo rsignatur e —I certif ythat I hav e mad e a goo d fait h effor tto delive rth e pamphlet . Renovate Right : Importan t Lea d Hazar d Informatio n fo r Families , Chil d Car e provider s an d Schools , to th e renta l dwellin g uni t liste d belowan d that th e occupan t wa s unavailabl e to sig n th e confirmatio nofreceipt . I furthe rcertif ythat I hav e left ^ copy ofth e pamphlet at th e uni t byslidin git undei^h e door . Printe d namqjofperso n certifyir^ g Jj Attempte d deliver y dat e an d tim e lead pamphlet deliver y Signatur e

ofperso n certifying ^

lead pamphlet deliver y

Uni t Addres s Not e Regardin g Mailin g Optio n — As an alternative to deliver y

in person , yo u ma ymai l th e lead pamphlet to th e owne rand/o rtenant . Pamphlet must be maile d at leas t 7 day s befor e renovatio n (Documen t wit h a certificat e ofmailin g fro m th e post office) .

### TECHNOLOGIES , IN C 

# Checklis t for th e Worksit e Hazar dAnalysi s Address : 

# y \ Crew : Date : ^0[2,t|zJUo ^ Ite m OK ? Hazar d Correctiv e Actio n Overliea dLine s 

## » u 3 I^ ^ aiw>ft^V e 3pfti<^/ ^ ^ftVL^ i H "fc i Wu . ol-tb t ^U K In-transi t Veliicl e Clearanc e Level s aroun dhig hwire s 

## _kk . Vehicl e Clearanc e aroun d hig hwire s whe nworkin g lOft ^ 

### Phon e line s N ^ Cabl e line s JSU L 

### Ga s Lin e JLlr _ Wate r Lin e JLfe - Sewe r Lin e -Ki L Septi c Tan k -Hi L Propane/Butan e 

## w A Acces s to/o nPropert y _MA _ 

### Neighbo r Acces s Require d _ii* L Hig hTraffi c Are a - H ^ Garag e 

## J ^ .AMsolxui . 

# • t''-- f Structure s JHA - 

### Drivewa y J!4i ^ 

### Sidewal k _kA L 

### Foundatio n Retainin g Wall s Fence s Tree s Foliag e Genera l Conditio no f yar d Damage dAreas : sin k holes/rotte dwoo d Sprinkle r Syste m Pet s Insect s Weathe r Condition s Unsaf e drivin g condition s 

# ^ ^

cSx^^e^fe ' ?re w Foreman / Sub-Cdtatractor' ' Sit e Safet y Office r 

# yeyoi/ i ^

Qohy,Wf?D(a{yL( 7 808 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 lone : (402)504-100 4 Phone : (210)822-958 8 Fax:(816)363-370 7 ax : (402)504-100 5 Fax : (210 ) 579-657 7

# ^IJ I

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# I

### Dougla s Count y Accoun t Informatio n http://douglasne.nianDing-online.com/DouglasCoNe/static/accountinfo. . :.n^v3 ] Dougla s County , Nebrask a Propert yRecor d - R240979000 0 Prin t Repor t NE

WFeatur e - Parce l Dimension s availabl e @ scal e 0-50 f t wes t o

f 52n d S t - Vle WO n Ma p Informatio n i s vali d a s o f2009-9-2 9 Treasurer' s Ta xRepor t Ne wFeatur e ^ ^ • * Aut o Sale s Searc h Owne r REGA N KEVI N M ETA L 

# 8H9^ 1 172 7 N 5 4 S T OMAH AN E 68104-000 0 Propert yInformatio n Ke yNumtyer : 

### 097 9 000 0 2 4 Accoun t Type : Residentia l Parce l Number : 240979000 0 Parce l Address : 172 7 N 5 4 S T OMAH AN E 68104-000 0 Lega l Description : WASHINGTO N H I L L LO T6 BLOC K2 N 63. 5 W13 6 F T63. 5 X 13 6 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $ 13,700.0 0 $ 224,700.0 0 $ 238,400.0 0 200 8 $ 13,700.0 0 $ 224,700.0 0 $ 238,400.0 0 200 7 $ 13,700.0 0 $ 224,700.0 0 $ 238,400.0 0 

### 200 6 $ 13,700.0 0 $ 169,800.0 0 $ 183,500.0 0 200 5 $ 13,700.0 0 $ 169,800.0 0 $ 183,500.0 0 200 4 $ 13,700.0 0 $ 169,800.0 0 $ 183,500.0 0 Sale s Informatio n Sale s Date : 2008-10-1 7 Dee d Type : 

### W D SooAr ; 200 8 Page : 10414 1 

### Price : $ 250,000.0 0 Grantor : Genobl e Bret t Josep h Eta l Grantee : Rega n Kevi n M Eta l Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 2006-09-0 1 Dee d Type : W D Book : 

### 200 6 Page : 10513 1 Price : $ 247,500.0 0 Grantor : Sawye rTravi s R eta l Grantee : Genobl e Bret t J eta l Valid/Invalid : Vali d


### lof 4 10/9/2009 10:16A MDougla s Count y Account Informatio n http://douglasne.rnj«Bing-online.coni/DouglasCoNe/static/accountinfo. . i.n^B| i Exclusio n Reason : Sale s Date : Dee d Type : Price : Granto r Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : 

### Lan d Informatio n Acre s S F 2005-07-2 9 W D BooAr ; 200 5 Page : 09329 1 $239,750.0 0 Jeffre yMetzne reta l Travi s R Sawye reta l Vali d 2002-05-1 5 W D Book : 221 1 Page : 44 1 $195,000.0 0

Vali d 1999-02-2 0 D Book : 211 9 Page : 74 2 $180,000.0 0

Vali d 1996-11-2 1 D Book : 205 0 Page : 32 6 $139,500.0 0

Vali d 1995-04-2 3 D Book : 200 3 Page : 29 7 $118,500.0 0

Vali d

Unit s Dept h Widt h Vacan t
2 o f 4 10/9/200 9 10:1 6 A MDougla s Count y Account Information http://douglasne.maMaing-online.com/DouglasCoNe/static/accountinfo. . rn^Ma i Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 9 8704. 0 

### 1. 0 

### 136. 0 64. 0 N o Improvemen t Informatio n Buildin g 1 -m r 

## Verifie d
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# TW O STORY 10090 F T CLIC KT O ENLARG E IMAG E Squar e Footage : 1994. 0 Percen t Complete : ! 10 0 0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 Story Cond o Squar e Footage : 0. 0

HVAC : Centra l Ai rt o Ai r Rooms : 7. 0 Exterior : Masonr yCommo n Bric k Units : 1. 0 Interior : Drywal l Baths : 3. 5 Roo fCover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : Hi p Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k 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 193 8 

### 193 8 7 1 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1. 0 Applianc e Fireplac e Masonr y 1. 0 Basemen t Bsmn t Bloc k 8 f t 1069. 0 Basemen t Finishe d 445. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 3. 0

3 o f4 10/9/200 9 10:16A MDougla s Count y Account Informatio n http://douglasne.maii3ing-online.com/DouglasCoNe/static/accountinfo. . i.m^mi ] Fixtur e Bat h Half 1. 0 Garag e Attache d 240. 0 Porc h En d Scree n 96. 0 Porc h Sla b Roo f Cei l 96. 0

4 o f 4 10/9/200 9 10:1 6 A M

# sss^iffis r Pruden t Propert yClose-Ou t For m (Lead-Base d Pain t Stabilization ) SAID : ^^-^J ^ Propert yAddress : ^-^^I? - x / .^^ X S 7 ^ Owner' s Name : 

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S.N O Performanc e Standards/close-Ou t Criteri a 1 Wa s th e entir e structure(s ) painte d wit h th e exceptio n o fth e stated , exclude d areas ? Thi s woul d includ e paintin g o fothe rassociate d feature s includin g fascia , eaves , siding , al l trim , porches , bo x beams , columns , rails , an d exterio rsurface s o fgarages . 2 Wa s al l scrapin g an d othe rpreparatio n wor k complete d satisfactorily ? 3 Wer e al l require d area s o fth e structure(s ) prime d a s neede d an d painte d wit h tw o to p coats ? 4 Ar e al l o fth e area s wher e contaminate d material s hav e bee n spille d thoroughl yvacuumed/cleaned ? 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 ? 6 I s th e gras s are a tha t surround s th e structure(s ) i n reasonabl ygoo d condition ? 7 Wa s th e pain t product s utilize d equivalen t t o a 3 0 yea r product/quality ? 8 Ar e al l item s suc h a s polyethylen e sheeting , ladders , pain t brushes , cones , barrie rtap e et cproperi yremoved ? 9 I s ther e an yevidenc e o fpropert 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 ACiose-Ou t 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 ? 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 ? 1 2 Othe rConsiderations ? Propert yOwne rDiscussions ? Additiona l Wor k tha t i s Require d 

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808 0 War d Parkway , Suit e 40 5 250 S N . 24 " street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City ; fM O 6411 4 Omatia , 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