TRANSMITTA Lo f OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL E FOLDE R SAI D # : ^^irryOi f Date : n ^ //nf> . jpni o Address : 5",^ ^ .< ? S | A < Stabilizatio n Contractor : Pruden t Technologies , Inc . Year : 2010 _ PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S y Vide o ofpropert y (DVD ) jyg

_fJAc Lprs^ f y Executiv e Summary s f

Signe dAcces s Agreemen t fo r subjec t property y Pre-Renovatio n Formsigne db y Property Ovraer D Pre-Renovatio n For mfor Occupant/Tenant , i f applicabl e y Paintin g Agreemen t D Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) [j /

Renovatio n Recordkeepin g Checklis t signe db y Certifie dRenovato r y Photograph s y Satisfactory close-ou t chec k lis t signe db y Property Owne r D Property close-ou t chec k lis t signe db y EP A y Property informatio n fi-omDougla s County Assessor' s Offic e y Hazar danalysis , i f prepare d D Safet y Audi t ^

3026014 5 D Othe r (describe) : Superfun d 

### rf)Q.4JdL^tiv^3 ^

t-4iitL i r n Lpf^j-^fr ^ Pniden t Technology , Inc . Signatur e /Date / 

# /o/z/fro lahir e Dat e (after file folae r review )TECHNOLOGIES, ] 

## Propert y Summary Date : 07/8/201 0 | LB P STABILIZATIO N EP A CONTRAC T EP-R7-08-0 7 | Mont hof ; Jul y Propert y Address ; 53 6 S 3 1 Av . SAI D # : 2260 4 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 Relevan t Information ; i . Acces s Date ; 03/30/201 0 ii . Wor k Began ; 05/14/201 0 iii . Close-Ou t Date : 05/14/201 0 B . Enclosures : 1 . Pre-Stabilizatio n Vide o 2 . Post-Stabilizatio n Vide o 3 . Signe dAcces s Agreemen t For m 4 . Advance-Notic e For m 5 . Pre-Stabilizatio n Vide 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 n Propert y Safety Assessmen t For m 11 . Work-Sit e Hazard s Analysi s Checklis t 12 . Pre - Stabilizatio n Propert y Hazar dAssessmen t Photograph s 13 . Dougla s Count y Assesso r Propert y Informatio n 14 . Signe dPropert y Completio n Agreemen t For m 15 . Propert y Close-Ou t Chec k Lis t Signe dB y EP A200V07-2 1 01:5 9 4025041005 P4/ 6 >

>

Prudent Technologies , Inc . (Prudent ) i s unde r contrac t (Contrac t #EP-R7-Og-07 ) withth e U . S . Environmental Protectio n Agenc y (EPA ) t o stabiliz e Lea dBase dPaint (LBP ) a t anumbe r ofpropertie s locate di n Omaha , Nebraska , includio g th e property locaie dat : ^ 3 Z o ^ . 3/-^/4 tr ^ 

## /)zn^/,a^.z? e z.yzz ^ Th e EP A request s you r permissio n t o allo w Pruden t t o perfor mLB P Stabilizalio n s t thi s propeity . B y signin g thi s form , th e propeity owne r gratU s pecmissio n t o Pruden t t o perfoi mactivitie s lelate dt o LB P Stabilizatio n inchidin g scrapin g pain t an dpaintin g o f th e lefeFcnce dproperty . Further , tb e owner/tenant verifie s tfiat the y hav e receive dth e LB P pamphle t ''Renovat e Right. " B y signin g thi s documen t I agre e t o allo w a n EP A contracto r t o conduc t asoi l cleanu p at my propeity foUowin g completio n o f lead^basc dpain t stabilization , i f th e soi l cleanu p ha s no t alread y bee c pef&rmed . 1 tmdeistan dtha t th e stabilizatio n contiacto r canno t provid e assurance s o f whic h contiacto r wil l b e boun dt o th e soi l cleanup . I further imdentan dthat th e soi l cleanu p contracto r wil l mak e al l reasonabl e effort s t o addres s concern s that I , a s th e property owner , ma y hav e regardin g soi l cleanu p at m y property . It/fVei) , I hav e rea dan dunderstan dth e paragrap habove . 

# 3.30./ ^ Propert y Owner' s Signamr e Date If

yo u bav e an y question s abou t th e LB P stabilizatio n planne dfor your property , pleas e contac t Prudent' s Customer Relations/OSic e Manage r for th e LeadBase dPaint Stabilization , M** ! flKIB't' * Sheka r at 402 - 504-100 4 o r 402.889-3811 . General question s abou t th e Omah aLea dSit e cleanup ca n b e directe dt o tfa e EPA Publi c ItUfonsobon Center s at (402 ) 73 1 -304 5 (SouthOmah aoffice ) o r (402 ) 991-9S8 3 (Non hOmah aofRce) . PrpDcrt v Aeccs s Craate dBv : 

# 4rri, . ./Jy^Mf f yC . £f,^^n-u ^ 3 . 2>t>iZ o P^pert y Own«r^Signatur e ' ' Dat e 

## ^/ » 2 U4 y M/ 9 y. L• S^T'er^/se s 'leas e Print Nam e tO80 W<*r dParkmy , BiiM a40 e xso » N. 14 * 8VMI . auit » so e ta n Vadica l Orlv* . 8«itt « 42S 0 Kanu s city , M O 8411 4 Omatia . NabtMk a SB11 0 8a n Antonio , 7X7922 9 piMn»:(eie>M3-sro 9 Pticra : (402 ) eO«>1Q0 4 PtwtM : (219)8»<«$s a Fu : (402)S04.1N S FIX : (210 > 979407 7 tfvt : <Bf6 ) 88S-S70 r Pase Z 200V07-2 1 01:1 5 402504100 5200V07-2 1 01:5 9 , ^

» 4G2504100 5 ^ P 5/ 6



### PROPERT Y INFORMATIO N (T o b e complete db y resJdea t and/o r propert y owne r - pleas e print ) RESIDEN T NAME : Owne r Tenan t 

### RESIDEN T ADDRESS : ^S( ^ S . 2>/^Ayc '

E

FRENTAL . PROPERT Y OWNE D BY : /^ ^ AOyi; / /DZ3 ^ P-Z . • ^ZTf^Z^rJe u OWNER' S MAILIN GADDRESS : ^- ^ - ^ / /cF/ 2 

## Ci)Ut!Z:/L . 'SycZPP^r T A ^zsr)Z - /A^z Z OWNER' S TELEPHON ENTJMBER : Home : l/Z-J/:^'3^o 9 Work : CeU : J^^Z:_^!:££^ ^ NUMBE RO FOCCUPANT S UNDE R7 YEAR S OLD : < 3 TOTA LNUMBE RO FOCCUPANTS : / S ^ NUMBE RO FCHILDRE NUNDE R7 YEAR S OL D WH O PLA Y INTH EYAR D FO R5 HOUR S O RMOREPE RWEEK : OZ ) Ajg T Pdv 4 t / t/ V TZZ ^ y j^h^.Z l COMMENT S O RSPECIA LINSTRUCTION S ftttc ha s dop , entr y mtw . ttcl :

AUTHORIT Y FO RENVIRONMENTA LRESPONS EACTIONS : Tl « acUvitie s t o b e implemente d b y EP Aunde r thi s agreemen t ar e punuan 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 d for i s Sectio n104(e ) ofCERCLA , 4 2 U.S . C 960S(e) , whic h provide s entr y fo r "determinin g th e nee dfb r response , o r choosin g o r takin g an y respons e actio nunde r tfai s thie , o r otherwis e enforcin g th e provision s o f th e title. "



# • .(^)^6 / r>^y y 1^0./ ^ Property Owne r Signature : _ \0^ ^ _ (Signature ) "^ Dat e aoe o War d Partcway , S ult a 4a s 2«0S N . 24* " ativat . Suit * 30 8 4S42 Medica l Oftva , Siril e 42 M Kiflt M Clly , M O $411 4 Omaha . Nttoraeli a M l 1 0 U n Antanlo , T X 7S2S S Phon* : (BIS ) MMTO S Phone ; (402>S04-1004 Phona ; (2l«)a2S'*B« S Fu : (816)363470 7 Fax : (402 1 Goa-ioa s Fax : <2l« ) STMs n 200V07.2 1 01:1 6 4025D4100 S P8« e 3/ 52001-07-2 1 01:59 402504100 5 P6/ 6

PR E & POS T PAIN T STABfUZATIO N VIDE O AN D PICTURE S I understan d tha t prudan t Technologie s (Prudent) wil lbe comin g ou tto shoot a Pre Stabilizatio n vide o an d to take picture s of myproperty . Pruden t wil t us e th e video s an d picture s to documen t th e curren t propert ystatus/oondrtton . Also , Pruden t wU I shoot a vide o shot fbllowin g th e completio n ofth e pain t stabiiizatlon . I give pemnissio n to video s an d pichjre s of myproperty . Pleas e lis t an yspecia l condition s tha t Pruden t employee s need to be awar e of before shootin g a vide o (suc h as pets , prio rnotice , etc.) . 

## 3'3( ^

33/^" ^

ye . /)z:^/,u . /7 e Propert Addres propen y yAociress s 

## ^za r Owner' s Nam e Signatur e 

## Z.Jiory ^ Dat e ADVANC E NOTIC E REQUIREMEN T Afte rsignin g th e acces s yo u aNo wPruden tto t>egi n Lead Base d Pain t Stabilization . Al l PlantB , wieeds an d an yvehicle soritem son ope n porc h (endose d porche s wil l NO T

be BtabilizBd ) must be remove d prio r to stabilization . Al l Pet s must be ou t of yard durin g stafoOlzatlon . Pleas e indicat e t)elo who wmuc h advanc e notice yo u nee d to hav e th e above mentione d task s oompleted . If yo u are a landtor d yo u wil l nee d fas contac t th e tenan t as Pruden t wil l onl yInfor m th e propert yowners . Do yo u hav e an ypats that resid e in yard : 

# Jw _ Notioe needed : \JZ S Phon e numbe r to cal l to give notice : ¥0l . *=?/ / O^J ^ Who m we are givin g notic e to : H m l-Z^y< /

80BOWar 4 Partway , BiMa40 S ZBO S N. 24 * Sliaat , Suit i 30 8 4J« 2 Btadlea l Ortva , SuK o 428 0 Kan«a4City,M 0 84ll 4 Omiha , Nabraak a 8811 0 Sa n Antonio , 1X7822 0 Phona : <B16 ) 363-370 1 Phona : (402)694^100 4 Phona : (219)62^66 8 F»x:(8ie>383-J70 7 Fox : (402)604-100 8 Fax : (210)578467 7 Pag e 4/ 6 402504100 5 ?nni.n7.? i nri R200V07-2 1 01:5 9 402504100 5 P3/ 6 

# 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 hav e rece)s« d a cop yo f th e pamphlet , Renovat e Rght ; Importan t Lea d Hazar d Informatio n fo rFainiiles , OiH d Car e Provider s an d School s infomUn g m e o f th e potentia l risk o f th e lea d hazar d exposur e fro m renovatio n activit yt o b e pertomie d i n m ydwellin g unit . I receive d thi s pamphle t befor e th e woi H began . iiT|»eh!?am e o f rsdipien t • " Dat e lur e o f recipien t Seif-Certllteatto n Optto n (fo rtenant-occupie d dwelling s only ) — I f th e lea d pamphle t wa s deilvere d bu t a tenan t algnatur e wa s no t obtainable , yo u ma yoheo k th e appropriat e bo xbelow . Q Refusa l t o sig n — I certif ythe t I hav e mad e a goo d fait h effort t o deOve rth e panr^hlet , Ranovsf e Ri^t : importan t Lea d Hazar d lnfonf)atlo n lo rFamilies , Chil d Care Provlder a 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 tt woccupan t rafuse d t o sig n th e confirmatio n o f receipt . I furthe rcertif ytha t I hav e left a cop yo f th e pamphle t a t th e uni t wit h th e occupant . 0 Unavailabl e fo rsignatur e "- 1 certif ytha t I hav e mad e a goo d fait h effort t o delive rth e pamphlet . Renovat e Right : Importan t Lead-Hazar d Infonnatio n fo r Families . ChU d Car e provider s an d Schools , t o th e renta l dwellin g uni t ilete d beb wan d tha t th e occupan t wa s unavailabl e t c8jg n tti e oonflimatio n o f receipt . I furthe rcertif ytha t I hav e lef t a cop yo f th e pamphle t a t th e uni t b yslidin g I t unde rth e door , Printe d nam e o f perso n certifyin g Attenpte d defiver y dat e an d tim e lea d pamphle t deliver y Signatur e o f perso n certify ^ lea d pamphle t deliver y 

## ^.^t^sr^z^'kiz s A'Z T f ^ ,1. 3 9 . r ^ /P^^.iZ,^ y? z /./zc r Uni t Addrea s Not a Regardin g Mailin g Optio n —A s a n altenretiv d t o deliver yi n per^n , yo u maymal 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 matin g fro m th a pos t office) .

2001-07-2 1 01:1 9 402504100 5 Page 5/ 6200V07-2 1 01:5 8 4025041005 P2/ 6 PAIN T MATCHIN GFORM : 1 . T O B RFILLE D OU T ONL Y I FMATCIMN GCOLO R 

### PROPERT Y ADDRESS : 3t36 > S-^Z^r^/ l yt 

# pm±£j^jUB'h^/G r BVD) : Th e foDowio g note s ar c fo r tb e benefi t o f paia t cre w only . Locatio n Pain t Descriptio n FaintYe s Pain t N o Siding Soffi t 

# 7ri^f^\ F F 

# iZ . 

# 1 / Fasci a ^ Come r Tri m y " Windo w Trims 

# S^2!l ^ \y Doo r Trims 

### iX Fron t Porc hCeiling 

## ^ ^ fl^^r' i y Fron t Porc hCeiling Beams 

### t / Fron t Poic hFloo r Fron t Porcl i Railing s 

# v/ y y Fron t Porcl i Step s 

## Ce^rynP-z} ^ [y ^ Siding Baseboards 

# r^^\-o. \ y Foundatio n 

# T?rrcr ^ y " p (fnetti . ( S^/c/fHt ^ i>/ea.i e deci z U / i it/cup a/ yfc ^

J^\r € ^ ; 

### IrO^oA ­ 

## v X 

## Y"- ^ 

# \ X B ^ ^ < ^ P«^g' < 

# L W^^A . ^>Vv'y t I UNDERSTAN D SHERWI N WILLIAM S WK LMATC H MY CURREN T COLOR S 

# 2 •7L Homeowne r signal 

# y ^ / Ky ^ Date i

# . i . To.i o 80& 0 War d Partiany , Strit a BO B 2605 N . 24**atnat , Sull a 308 424 2 Madlea l Oflve . Suli a 426 0 KaiMo a city , M O 8411 4 Omaha . Nabraaka 6811 0 SsnAmon(o.TX7St2 « Phona ; (BtB ) 363-3703 FaK:(81B)Sa3>370 7 Phona : (402 ) 8O4-i0O 4 Fax ; (402)804.100 8 PhOfw : (210)822-« m Fax : (310 ) S7»4S7 7 7nm.n7.7 i ni'j n xn-jcn^inn c'TECHNOUX}IES,IN C ACCES S ASSESSMEN T FORM : 

# 53Z . s I s th e propert ystucc o o rasbestos ? 

### Y^€ > I f yes , I s an yo f th e stucc o o rasbesto s damage d o r cracked ? I f yes , 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 d t o EP Aan d the ywil l assig n a t a late rdate . Doe s thi s propert yrequir e lot s o f scrapping ? Doe s thi s propert yrequir e a lift o rscaffoldin g t o reac h uppe rlevels ? Doe s thi s propert yhav e lot s o f plant s o ritem s i n area s wher e paintin g i s required ? Doe s thi s propert yhav e an ysignifican t structura l damage ? I f yes , EXPLAIN ? Doe s thi s propert yhav e a garage ? I f yes , describ e locatio n o f garage . Doe s thi s propert yhav e aluminu m siding ? I f yes , i s i t origina l factoryfinis h o rha s i t bee n painte d over ? Doe s thi s propert yhav e an yothe rtyp e o f structura l components ? (I.e . roo f shingle s a s siding) ? Ifyes , EXPLAIN ? I s thi s propert yvacan t o roccupied ? Ar e ther e an ypet s a t thi s property ? Ar e ther e an ylo whangin g powe rlines ? D o w e nee d neighbor' s access ? I f ye s pleas e explai n an d ge t neighbor' s propert yaddres s an d owne r information . I f possible , ge t signatur e fro m th e neighbor . 

# 5 1 S^ A

• \yn^c d Vv f C ^

" ^ £ > 

# V

^ J £ P 

### >> J 

### a



# *fN: ^ 

# O A ^ V 

# TT t 

# yi s

f^ 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(effectiv e Apri l 2010 ) RENOVATIO N RECORDKEEPIN GCHECKLIS T Nam e o f Firm : 

# Pnulm ^ ^ ^ Dat e an dLocatio n o f Renovation : ^ -/ ^ '/z D 3~J ^ S J? / A'lyzS ' Brie f Descriptio n o f Renovation : pi^CJ^^^

_^ yayAi/-/'/P f Nam e o f Assigne dRenovator : , ^^ ^ , -.,..j ^ ,,^^.^y^ . Name(s ) o f Traine dWorkers : yr^r aCzl v (fV Ci > J> Z ^p/ d/ . Jgz n o ^ ^ u/ L Nam e o f Dus t Samplin g Technician , Inspector , and/o r Risk Assessor , i f used : D Copie s o f renovato r an ddus t samplin g technicia n qualification s (trainin g certificates , certifications ) o n file . Q'<^rtifie drenovato r provide dtrainin g t o worker s o n (chec k al l tha t apply) : Gl-Posting warnin g sign s O-Settin g u p plasti c containmen t barrier s B^aintainin g containmen t S3'-Avoidin g sprea do f dus t t o adjacent area s ^..JW^ e handlin g H-'Post-renovatio n cleanin g D Tes t kit s use db y certifie drenovato r t o determin e whethe r leadwas presen t o n component s affecte db y renovatio n (identif y kit s use dan ddescrib e samplin g location s an dresults : Q-^Wmiin g sign s poste da t entranc e t o wor k

area . B^ork are acontaine dt o preven t sprea do f dus t an ddebris . B'Window s i n an dwithi n 2 0 feet ofth e wor k

are aare close d CfUoor s i n an dwithi n 2 0 feet ofth e wor k

area s ar e close dan dseale d fcTDoors that mus t b e use di n th e wor k

are aar e covere dt o allo w passag e bu t preven t sprea do f dust . Buroun dcovere db y plasti c sheetin g extendin g 1 0 feet Jfro mwork are a- plasti c anchore dt o th e buildin g an dweighte ddow n b y heav y objects . fflnf necessary , vertica l containmen t installe dt o preven t migratio n o f dus t an ddebri s t o adjacent property . ast e containe don-sit e an dwhil e bein g transporte doff-site .

Renovatio n Recordkeepin g Checklis t Omah a Lea d Sit e(effectiv e Apri l 2010 ) B'^ork sit e properl y cleane dafter renovation . tUAJfchip s an ddebri s picke dup , protectiv e sheetin g misted , folde ddirty sid e inward , an dtape dfor removal . B''Wor k

are aHEP A vacuume dt o ge t pain t chip s fromgroun dsurface , i f necessary . n Certifie drenovato r performe dpost-renovatio n cleanin g verificatio n (describ e results) : LtrTcertif y unde r penalt y of la w tha t the above informatio n i s true an dcomplete .

Nam e an dTitle Dat e

Renovatio n Recordkeepin g Checklis t Omah a Lea d Sit eTECHNQIJOGI ^ IINC . 

## Checklis t for th e Worksit e Hazar dAnalysi s Address : K "^^ 5 ^ 1 ^ V Crew : Pr^,^^_K f Date : H- f^ " l O Ite m OK? / Hazar d Correctiv e Actio n Overhea dLine s 

## y . In-transi t Vehicl e Clearanc e (y ^ Level s aroun dhig hwire s Vehicl e Clearanc e aroun d 

# y hig hwire s whe n workin g Phon e line s 

# /y . Cabl e line s 

# z . Ga s Lin e ^ . Wate r Lin e 

## y Sewe r Lin e 

# /z . Septi c Tan k L^"""' ^^ y Propane/Butan e 

# / Z ^ Acces s to/o n Propert y L^ . Neighbo r Acces s Require d Hig hTraffi c Are a 

## LZ^ ^ t " i r * Garag e iZ y 

### /-^4 s 'Cr\iMf'<r>5 o ^ ^W<?i* ^ ' i -I ^ Structure s 

### iZ . Drivewa y ^ ^ l y Sidewal k Foundatio n ^ y Retainin g Wall s Fence s y ^ ^ Tree s 

## ly y Foliag e 

### y y Genera l Conditio n o f yar d 

## y . Damage dAreas : sin k holes/rotte dwoo d ^ Sprinkle r Syste m ^ . Pet s .y^ ^ Insect s y ^ y Weathe r Condition s 

### yy Unsaf e drivin g condition s 

## ^ y Unsaf e neighborhoo d 

# ^ y Cre w Foreman/ Sub-Contracto r

8080'War d Parkway , Suit e 40 5 250 5 N . 24^ " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 42 5 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 7200V09-0 8 06:5 2 4025041005 P2/ 2 >

> V^ - V, - ENVIRONMENTA L A CONSTRUCTION TECHNOLOGI ^ INC . SERVICE S OMAH A LEA D BASE D PAIN T itF^jvyf^DIATIO N Propert y Owne r Close-Ou t For m 201 0 (Lead-Base dPain t Stabilization EP A Contnc t EP-R7-08-07 ) SAID : Propert y Address : ^« f ^ .T'Y^ ^ ^ty . 

### Owner'sName : AfTj^ ^ j ^ /'.^»J > Ptttonaanc e Standards/Close'OB t Criteri a YE S N O 1 . Wa s the entir e structure(s ) paintedwit hthe exception o f th e stated , excludedateas ? Thi s woul dinclud e painting o f othe r associatedfeature s includin g fascia, eaves , siding , ai l trim , porches , bo x beama, columns , rails , an dexterio r surface s of garat^es . 2 . Wa s all swapin g an dothe r preparation wor k

complete daatisfaetorUy ? • y ^ 3 . Wer e all requiredareas ofth e staiKtuic(s ) primeda s neede dan dpaintedwit htw o top coals ? 4 . Wa s the pain t products utilizedequivalen t t

o a25 yea r product^quality ? t 

### Z ­ 5 . Ar e all of th e area s wher e contaminatedmalerial s have bee n spilledthoroughl y vacuumed ^ cleaned ? 

## v ^ 6 . Di dthe contiacto r coUect/vacuu mall falling an dscrape dpain t chip s o n th e entir e property , roadways , alleyways , public acces s area s an dals o remov e an y otho r generateddebris ? 7 . I s the gras s areatha t surround s the 8tiucture(s ) i n reasotiably goodcondition ? 

# i ^ 8 . Ar e al l items suc ha s polyethylene sheeting , ladders , pain t bmshes , cones , barrie r tape , etc . proiierl y removed ? ; 9 , b ther e an y evidenc e ofpropert y damage tiiat was don e b y the comiBctor? An y piopert y / 

# 7 damage need s t o b e completedprior t o th e EP A Close-Out . 

# 7 / . 10

, Ar e yo u satisfie dwit hth e wor k

perfoimed ? 11 . Ar e Iher e an y propert y item s tha t wer e temporaril y re-locatedb y the contracto r tha t nee d 

# - y 

# 7 t o b e move dback ? 12 . Ar e ther e an y (known ) lingering issue s wit hthe propoty owiiei(8 ) tha t hav e been lef l unresolved ? othe r Considentians/Propert y Owne r Discussions/Additiona l Wor k

tha t i s Required : 

# <A . 

# ,^^ / Pio j e r Signatur e Dat e Dat e BOB O War d Psftargy . $ult « 40 S 2S0 6 N . 24' ^ StrMt , Suit e 21 B 424 2 Mtdloi l Drive , 8( M 428 0 KansMaty . M06411 4 0«n*M . Ntbrtth a8811 0 tan Antonio . t X 7S22 9 Phor wilHW s Ses-3T0 S Pheiw : ^2 > 804-100 4 Ptwm ; l21O)a22-088 e F«x : <81«) 3SM70 7 ^n : (402)S04.1p« e FaK:(210)B7B-<«Tr

2D0V09-0 4 07:4 9 402504100 5 Pag e 2/ 3Dougla s Count y Accoun t Informatio n Pag e 1 of 3 Dougla s County , Nebrask a Propert yRecor d - R210143000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e & . scal e 0-5 0 ft wes t o f 52n d S t - VJe W O O Ma p Infonmatio n i s vali d a s o f 2010-3-1 6 Treasurer' s Ta xRepor t Ne wFeatur e ->-»- > Aut o Sale s Searc h Owne r L^DDPETRA R \J(>'^ \ -3^^ ^ C/

O DB AP L ENTERPRISE S K^ ' CN^\ ' ^tb ^ P O BO X 181 2 ^Y^- ^

VV^^ ' ^«1^ ' COUNCI L BLUFF S I A51502-181 2 \ * ^ - ^ * ^ Propert yInformatio n Ke yNumber : 014 3 OOO O 2 1 Accoun t Type : Multipl e Re s Parce l Numbe r 210143000 0 Parce l Address : 53 6 S 3 1 A V OMAH AN E 68105-000 0 Lega l Description : REDICK S - E S - AD D LO T 4 BLOC K2 S 5 F T L T 3 & N 4 0 FT 4 5 X 13 0 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $12,000.0 0 $63,000.0 0 $75,000.0 0 200 8 $12,000.0 0 $63,000.0 0 $75,000.0 0 200 7 $12,000.0 0 $63,000.0 0 $76,000.0 0 200 6 $12,000.0 0 $63,000.0 0 $75,000.0 0 200 5 $12,000.0 0 $63,000.0 0 $75,000.0 0 200 4 $12,000.0 0 $63,000.0 0 $75,000.0 0 Sale s Informatio n Sale s Date : 2000-07-1 2 Dee d Type : D Book : 215 7 Page : 25 9 Price : $ 73,000.0 0 Grantor : Grantee : Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1997-07-0 7 Dee d Type : D Book : 206 5 Page : 68 7 Price : $ 65,000.0 0 Grantor : http://douglasne.niapping-online.com/DouglasCoNe/static/accountinfo.jsp7accou n tno=R210143000 0 3/23/201 0Dougla s Count y Accoun t Informatio n Pag e 2 of 3 Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 3 5850. 0 1. 0 0. 0 0. 0 N o Improvemen t Informatio n Buildin g 1 

# I B 

# I n ^^ 1 ^^^^ 1 

# PH B t .^TH - Kv~<£ ~ 

### ••il^^^^v^^^?^ ! 

# |f c

# IT^ ^ ^^^pUHBH j U L ai^li;.<^^^^B^B B 

# P^BkS^E^i^ S

. *i*-^i^^i3a'-~l(^^^j-iV.Miajia^^^|P j 

# ^31; ' _ 

# •

hT^^HM^ H 

# H H 

# ^ 1 ^C"::sl^ H 

# y ^ Jn r LuCZ U iJU r I * M , 1 Saoandnoo r a t ^t , smo n n K 

### » J u rar r

I3 0 TvmMer y BxnrtBloclig i ItlO.Oiq. t 1 CLIC KT O ENLARG E IMAG E | CLIC KT O ENLARG E IMAG E Squar e Footage : 1950. 0 Percen t Complete : 100.0 % Perimete r 154. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : Apartmen t < = 3 Storie s Cond o Squar e Footage : 0. 0

HVAC : Centra l Ai rt o Ai r Rooms : 10. 0 Exterior : Fram e Aluminu m Units : 6. 0 Interior : Drywal l Baths : 6. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 5. 0

Roo f Type : i Gabl e Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 192 0 0 % 192 0 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 1110. 0 Basemen t Finishe d 960. 0 Fixtur e Additiona l Fixture s 1. 0 http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R210143000 0 3/23/201 0Dougla s Count y Accoun t Informatio n Pag e 3 of 3 Fixtur e Fixtur e Garag e Porc h Porc h Bas e Fixture s Bat h Ful l Detache d Enc l Scree n Enc l Scree n 1. 0 5. 0 216. 0 200. 0

25. 0

http://douglasne.mapping-onIine.com/DougIasCoNe/static/accountinfo.jsp?accountno=R210143000 0 3/23/201 0