### TRANSMITTA L of OMAHA LEA D SIT E PAIN T STABILIZATIO N FIL E FOLDE R SAID# : /nns ^ Date : Of,jfnj^cii n Address : ^fi5^ ^ ,< ? ."^ R .^T , Stabilizatio n Contractor : Pruden t Technologies , Inc . Year : 2010 _ PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S y Vide o of propert y (DVD ) DTg
- QftA , prs T 0^ Executiv e Summar y S

f

SignedAcces s Agreemen t fo r

subject propert y 5 /

Pre-Renovation For msignedb y Propert y Owne r D Pre-Renovation For mfo r

Occupant/Tenant , i f applicabl e y Painting Agreemen t D Settlemen t document s (i.e. , fo r

damag e or to replac e plants , etc. ) y Renovation Recordkeeping Checklis t signedby CertifiedRenovato r H Photograph s y Satisfactor y close-ou t chec k

lis t signedby Propert y Owne r D Propert y close-ou t chec k

lis t signedb y EP A y Propert y information fro mDougla s Count y Assessor' s Offic e t

/ Hazar danalysis , i f prepare d D Safet y Audi t 3020379 3 n Other, (describe) : . |||||| | Superfun d .Erudcn t Technology , Inc . Signatiir e I^at e ( 

## -m^^ ^ /0//3// 0 EP A CORSimatur e HDat e (afte r file folde r review )TECHNQLOGIBS. ] 

## Propert y Summar y I Date ; 6/29/201 0 | LB P STABILIZATIO N EP A CONTRAC T EP-R7-08-0 7 | Mont h of ; Jun e Propert y Address : 454 6 S 3 8 St . SAID# : 1003 5

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 : 04/06/201 0 ii . Wor k Began : 04/27/201 0 iii . Close-Ou t Date : 04/27/201 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 h For 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 Ai^w'ti *

4aLOCIBS,INC . Pruden t Technologies , Inc . (Prudent ) i s unde r

contrac t (Contrac t #EP-R7-08-07 ) wit h th e U . S . Environmenta l Protectio n Agenc y (EPA) to stabiliz e Lea dBasedPain t (LBP) a t anumbe r

o f propertie s locate di n Omaha , Nebraska , including th e propert y locate dat : 

## ^.^ ^ ^ ^r p ^- ^ Th e EP A request s you r

permissio n t o allo w Pruden t to perfor mLB P Stabilizatio n a t thi s property . B y signing thi s form, the propert y owne r

grant s permissio n to Pruden t t

o perfor mactivitie s relate dto LB P Stabilizatio n including scraping pain t an dpaintin g ofth e referencedproperty . Further , th e owner/tenan t verifie s tha t they hav e receive dthe LB P pamphle t "Renovat e Right. " B y signin g thi s documen t I agre e to allo w a n EP A contractor to conduct asoil cleanu p a t m y propert y following completio n o f

lead-base dpain t stabilization , i f th e soi l cleanu p ha s no t alread y bee n performed . I understandtha t the stabilizatio n contractor cannot provide assurance s o f which contractor vdll b e boun dt o the soil cleanup . I furthe r

imderstandtha t th e soil cleanu p contractor wil l mak e all reasonabl e efforts to addres s concem s tha t I , a s th e propert y owner , ma y hav e regardin g soi l cleanu p a t m y property . 

# f ] Yes , I hav e rea dan dunderstandthe paragraph above . Propert y Owner' s Signatur e Dat e I f

yo u hav e an y question s abou t the LB P stabilizatio n plarme dfo r

you r

property , pleas e contac t Prudent' s Custome r

Relations/Offic e Manage r

fo r

th e Lea dBasedPain t Stabilization , Mr . Chandr a Sheka r a

t 402
- 504-100 4 o r 402-889-3821 . Genera l question s abou t th e OmahaLea dSit e cleanu p ca n b e directe dt o the EP A Publi c hiformation Center s a t (402 ) 731-304 5 (Sout h Omahaoffice) or (402 ) 991-958 3 (Nort h Omahaoffice) . Propert v Acces s Grante dBv :
Propert y Owner' s Signatur e Dat e

Pleas e Prin t Nam 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 , T X 7822 9 Plione : (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 7TKCIHINOLXXSIBS . INC. ~ «£j£ » PROPERT Y INFORMATIO N (T o b e complete db y residen t and/o r propert y owne r ~ pleas e print ) RESIDEN T NAME : Owne r Tenan t RESIDEN T ADDRESS :

I F RENTAL , PROPERT Y OWNE D BY : OWNER' S MAILIN G ADDRESS :
OWNER' S TELEPHON E NUMBER : Home : Work : Cell : NUMBE RO F OCCUPANTS UNDE R7 YEAR S OLD : TOTA L NUMBE RO F OCCUPANTS : NUMBE RO F CHILDRE N UNDE R7 YEAR S OL D WH O PLA Y I N TH E YAR D FOR5 HOURS O

RMOR E PE RWEEK : " COMMENT S O RSPECIA L INSTRUCTION S (suc h a s does , entr v gates , etc.^ ;

AUTHORIT Y FO RENVIRONMENTA L RESPONS E ACTIONS : Th e activitie s t o b e implemente d by EP A unde r

thi s agreemen t ar e pursuan t to Section 10 4 o f CERCLA , 4 2 U.S.C . 9604 . EPA' s right of

acces s to the propert y i s provide dfo r

i

n Sectio n 104(e ) o f CERCLA , 4 2 U.S . C 9605(e) , which provide s entr y fo r

"determinin g the needfo r

response , or choosing or takin g an y respons e actio n unde r thi s title , o r

otherwis e enforcing th e provision s ofth e title. " Propert y Owne r

Signature : A 

# A A si5
- 

# c <^Vr ^ 

# A ^ '/—f , 't o (Signature ) Dat 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 , 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'TBCHNOLOCnSi,IN C 

### PR E & POS T PAIN T STABILIZATIO N VIDE O AN D PICTURE S I understan d tha t pruden t Technologie s (Prudent ) wil l b e comin g ou t t o shoo t a Pre Stabilizatio n vide o an d t o take picture s o f m y property . Pruden t wil l us e th e video s an d picture s t o documen t th e curren t propert y status/condition
. Also , Pruden t wil l shoo t a vide o sho t followin g th e completio n o f th e pain t stabilization
. I give permissio n t o video s an d picture s of my property . Pleas e lis t an y specia l condition s tha t Pruden t eniployee s nee d t o b e awar e o f before shootin g a vide o (suo h a s pets , prio rnotice , etc.)
.

Propert y Addres s 

# y-^-/ o Owne r er s Nam e Signature Dat e 

### ADVANC E NOTIC E REQUIREMEN T Afte rsignin g th e acces s yo u allo w Pruden t t o begi n Lead Base d Pain t Stabilization
. Al l Plants , weed s an d an y vehicle s o ritem s o n ope n porc h (enclose d porche s wil l NO T b e stabilized ) must b e remove d prio rt o stabilization
. Al l Pets mus t b e ou t o f yard durin g stabilization
. Pleas e indicat e below ho w muc h advanc e notic e yo u nee d t o hav e th e above mentione d task s completed
. I f yo u are a landlor d yo u wil l nee d t o contac t th e tenan t a s Pruden t wil l onl y infor m th e propert y owners . Do yo u have an y pet s that resid e i n yard : - Notic e needed : Phon e numbe rt o cal l t o give notice : Who m w e are givin g notic e to :

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

# S a 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 ^

I hav e receive d a copy o f th 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 m e o f th e potentia l risk o f th e lea d hazar d exposur e fro m renovatio n activit y t o b e performe d i n my dwellin g unit
. I receive d thi s pamphlet befor e th e wor k began
. Printe d nam e of recipien tDat e Signatur e of recipien t Self-Certificatio n Optio n (fo rtenant-occupie d dwelling s only ) — I f th e lea d pamphlet wa s delivere d bu t a tenan t signatur e wa s not obtainable , yo u ma y chec k th e appropriat e box below
. •Refusa l t o sig n —I certif y tha t I hav e mad e a goo d fait h effor t t o 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 , t o th e renta l dwellin g uni t liste d below at 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 rcertif y tha t I hav e lef t a cop y of th e pamphlet a t th e uni t wit h th e occupant . •Unavailabl e fo rsignatur e — I certif y that I hav e mad e a goo d fait h effor t t o delive rth e pamphlet , Renovate Right : Importan t Leadijazar 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 below an d tha t th e occupan t wa s unavailabl e t o sig n th e confirmatio n of receipt
. I furthe rcertif y tha t I hav e lef t a cop y of th e pamphlet a t th e uni t b y slidin g I t unde rth e door
. Printe d nam e of perso n certifyin g Attempte d deliver y dat e an d tim e lead pamphlet deliver y Signatur e o f perso n certifyin g lea d pamphlet deliver y

Uni t Addres s Not e Regardin g Mailin g Optio n —As a n alternative t o deliver y i n person , yo u ma y mai l th e lea d pamphle t t o th e owne rand/o rtenant . Pamphle t must b e maile d a

t leas t 7 day s befor e renovatio n (Documen t wit h a certificat e of mailin g fro m th e pos t office)
.tMC T ACCES S ASSESSMEN T FORM : I s th e propert y stucco o rasbestos ? ^ / I f yes , i s an y o f th e stucco 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 A an d the y wil l assig n at a late rdate
. Doe s thi s propert y require lot s o f scrapping ? Doe s thi s propert y require a lif t o rscaffoldin g t o reac h uppe rlevels ? Doe s thi s propert y have lot s o f plant s o ritem s i n area s where paintin g i s required ? Doe s thi s propert y have an y significan t structura l damage ? I f yes , EXPLAIN ? Doe s thi s propert y have a garage ? I f yes , describ e locatio n o f garage . Doe s thi s propert y have aluminu m siding ? I f yes , i s i t origina l factor y finis h o rhas i t bee n painte d over ? Doe s thi s propert y have an y othe rtyp e o f structura l components ? (I.e
. roof shingle s a s siding) ? I f yes , EXPLAIN ? I s thi s propert y vacan t o roccupied ? Ar e ther e an y pet s at thi s property ? Ar e ther e an y low hangin g powe rlines ? Do w e nee d neighbor' s access ? I f ye s pleas e explai n an d ge t neighbor' s propert y addres s an d owne r information
. I f possible , ge t signature fro m th e neighbor
. 

## - p«>.*- U V f ^

T ^ <

? >J* ? 

# y ^

M P > I ^ 

# o -^r<g > 

# V' S --Yi 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 7IN C 

### PAIN T MATCHIN G FORM : I . T O B E FILLE D OU T ONL Y I F MATCHIN G COLO R PROPERT Y ADDRESS : ^ * ^ L f

A ^ ^C" ^ . ^ f BVID : Th e foUowm 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 y Soffit 

# y Fascia 

# y Come r Tri m ( / Windo w Trim s 1 / Doo r Trim s / Fron t Porc h Ceilin g fr 

# >t ^ 

# 1^-*
- s - 

# :y^^ k Fron t Porc h Ceilin g Beam s /

- Fron t Porc h Floo r / Fron t Porc h Railing s / Fron t Porc h Step s / Sidin g Baseboard s 

# y Foundatio n < • 

## ^e^ r dtfVj ^ / 

## r ^ 

## ui^ { y ^ ^". ^ 

## o ^ e .

. 

### {J o 

## Ouy)e. f ir/^ e Wj<i n 

## w^ M 4p^ r y OocO n — 

# y ^ y

• I UNDERSTAN D SHERWI N WILLIAM S WIL L MATC H M Y CURREN T COLORS .
Homeowner signature : X ,<^'VSrlC'S,' ^ ^ Qt-Vada ^ Date : ^^ ^ <^ " ^< 3 808 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 : (8l6 ) 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 G CHECKLIS T
Nam e of Finn : 

## %>{en n ^^ ^ ^ Dat e andLocation of Renovation : 7f9v7-p^'< ^ ^'yHCp'?^
- ^S > 'PJ ^ Brief Descriptio n of Renovation : (P/V'/i^-Jf /

'^Cjq^ ^ a/Af J ^{\V^€y Nam e o f AssignedRenovator : K \^g>y\>>r A fr^tA'^-.
­ Name(s ) o f TrainedWorkers : h{\\rvK< n 3r^i^. ^ (^bgc J cvrfcf ^ yl^ya t < ^ 

# / ' ^'y,us^m.\\' Q Nam e o f

Dus t Sampling Technician , Inspector , and/or Ris k Assessor , i f used : ie s of renovato r

anddus t sampling technicia n qualification s (trainin g certificates , certifications ) o n file. Certifie^^novato r provide dtrainin g t o worker s o n (check all that apply )

• Postin g waming sign s GSett i Q Setting up plasti c containmen t barrier s 

### ^

y . / DyMaintainin g contaimnen t u Avoiding sprea do f

dus t t o adjacen t area s D^amtainin g contammen t u A • W a Q Post-renovatio n cleaning Wast e handling U Tes t kit s usedb y certifiedrenovator to determine whethe r

lea dwa s present o n component s affecte dby renovatio n (identif y kit s use danddescrib e sampling location s an d results : N / / y\
g sign s posteda t entranc e to wor k

area . Wor k

are acontainedto preven t sprea dofdus t anddebris . t^^uidow s i n an dwithi n 2 0 fee t ofth e wor k

are aar e closed ^Door s in an dwithi n 2 0 fee t ofth e wor k

area s ar e closedan dsealed u Door s tha t mus t b e use di n th e wor k

are aare covere dt o allo w passag e bu t prevent sprea dofdust . I^Groim dcoveredb y plasti c sheeting extendin g 1 0 fee t fi'omwor k

are a- plasti c anchoredto th e buifidin g an dweighteddown by heav y objects . 0 I f

necessary , vertica l containmen t installe dt o preven t migratio n ofdus t anddebri s to adjacen t property . D Wast e containedon-sit e an dwhil e bein g transporte doff-site .

Renovatio n Recordkeepin g Checklis t Omah aLea dSite(effectiv e Apri l 2010 )
0 Wor k

sit e properly cleanedafte r

renovation . £f All chip s an ddebri s picke dup , protectiv e sheeting misted , foldeddirt y sid e inward , andtape dfo r renipval . [/Wor k

are aHEP A vacuumed to ge t paint chip s fro mgroim dsurface , if necessary . D Certifiedrenovator performed n eleanin verificatio n (describ e results) : •a post-renovatio post-renovatio n eieamn g g v 

# • :-^-zi>e< ? ,yr j S^ I certif y unde r

penalt y

of la w tha t th e abov e informatio n

is tru e an dcomplete .

Nam e an dTitl e Dat e

Renovatio n Recordkeepin g Checklis t Omah a Lea d Sit eTECHNC»X)GI1S . INC . 

## Checklis t fo r th e Worksit e Hazar dAnalysi s Address : A'P^l p ! S 5 ? ^a t Crew : Date : 01)4 ^ A^'\ 0 Ite m OK? / Hazar d Correctiv e Actio n y Overhea dLine s In-transi t Vehicl e Clearanc e ^ Level s aroun dhig h wire s Vehicl e Clearanc e aroun d ^ hig h wire s whe n workin g y Phon e line s Cabl e line s 

# y Ga s Lin e 

### y ^ Wate r Lin e 

## y . Sewe r Lin e 

### y . Septi c Tan k 

# y ^ Propane/Butan e 

### y ^ Acces s to/o n Propert y 

### ^^z - Neighbo r Acces s Require d 

### y ^ Hig h Traffi c Are a 

### y ^ Garag e 

## y ^ structure s 

## y ^ Drivewa y 

## y ^ Sidewal k 

### y ^ Foundatio n 

## y ^ Retainin g Wall s 

## y . Fence s 

# y. - Tree s 

## y Foliag e 

## y ^ Genera l Conditio n o f yar d y Damage dAreas : sin k 

# y ^ holes/rotte dwoo d Sprinkle r Syste m y Pet s 

### •^y . Insect s 

## y ^ Weathe r Condition s 

### y ^ Unsaf e drivin g condition s 

### y ^ Unsaf e neighborhoo d y Sub-Contracto r

808 0 Warij^arkway , Suit e 40 5 250 5 N
. 24' " Street , Suit e 30 8 424 2 Medica l Drive , Sulte.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 ) 679-657 7

# 0
ENVIRONMENTA L & CONSTRUCTIO N TECHNOLOGIES , INC . SERVICE S OMAH A LEA D BASE D PAIN T REMEDIATIO N Propert y Owne r Close-Ou t For m 201 0 (Lead-BasedPain t Stabilizatio n EP A Contract EP-R7-08-07 ) SAID : 

### l6c ) 3:?
. Propert y Address : ^X-^J^ ^ ^ j y ,*^ y Owner' s Name : ^Ay^j^/^/ ^ ^ ^ iyjy?j: ^ Performanc e Standards/Close-Ou t Criteri a VE S N O 1 . Was the entir e structure(s ) painte dwit h the exception ofth e stated , excludedareas ? Thi s woul dinclud e painting of othe r

associate dfeature s including fascia , eaves , siding , all trim , porches , box beams , colunms , rails , an dexterior surface s o f garages . 2 . Wa s all scraping an dothe r

preparatio n wor k

completedsatisfactorily* / 

# y 3 . Wer e al l require darea s ofth e structure(s ) primeda s neededan dpaintedwit h tw o top coats ? 4 . Wa s the pain t product s utilize dequivalen t to a2 5 yea r

product/quality ? 5 . Ar e all ofth e area s wher e contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? 6 . Didth e contractor collect/vacuumall falling an dscrapedpain t chip s on th e entir e property , roadways , alleyways , publi c acces s area s an dals o remove an y othe r

generateddebris ? 7 . I s the gras s are atha t surround s the structure(s ) i n reasonabl y goodcondition ? 

# y 8 . Ar e all item s suc h a s polyethylene sheeting , ladders , pain t brushes , cones , barrie r

tape , etc . 

# y properl y removed ? 9 . I s ther e an y evidenc e of propert y damag e tha t wa s don e by the contractor ? An y propert y damage need s to b e completedprior t

o the EP A Close-Out . 10 . Ar e yo u satisfiedwit h the wor k

performed ? 

### T y 11 . Ar e ther e an y propert y item s tha t wer e temporaril y re-locate db y the contractor tha t nee d 

# y t o b e move dback ? 12 . Ar e ther e an y (known) lingering issue s wit h th e propert y owner(s ) tha t hav e been lef t unresolved ? Othe r

Considerations/Propert y Owne r

Discussions/Additiona l Wor k

tha t i s Required :



## < f j-X- ^ />o^< ^ Propert y O atur e Dat e Pruden t Ted , Inc . Signatur e 

# ^4^ ^

808 0 War d Parkway , Suit e 40 5 250 5 N
. 24' " Street , Suit e 21 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 7Dougla s Count y Accoun t Informatio n Pag e 1 of 3 Dougla s County , Nebrask a Propert y Recor d - R073124000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e ( 3 scal e 0-5 0 ft wes t o f 52n d S t - VJe W O H Ma O Informatio n i s vali d a s o f 2010-3-1 6 Treasurer' s Ta x Repor t Ne w Featur e • * • • ? * Aut o Sale s Searc h Owne r CAVAD A ANDRE S ETA L 442 4 S 2 6 S T OMAH A N E 68107-000 0 Propert y Informatio n Ke y Numbe r 312 4 OOO O 0 7 Accoun t Type : Multipl e Re s Parce l Numbe r 073124000 0 Parce l Address : 454 6 S 3 8 S T OMAH A N E 68107-000 0 Lega l Description : BURLINGTO N CENTE R LO T 1 9 BLOC K1 LT S 1 8 & 1 9 8 0 X 12 0 Valu e Informatio n 200 9 200 8 200 7 200 6 200 5 200 4 Lan d $8,000.0 0 $8,000.0 0 $8,000.0 0 $8,000.0 0 $8,000.0 0 $8,000.0 0 Improvemen t $40,700.0 0 $40,700.0 0 $43,700.0 0 $43,700.0 0 $37,600.0 0 $34,200.0 0 Tota l $48,700.0 0 $48,700.0 0 $51,700.0 0 $51,700.0 0 $45,600.0 0 $42,200.0 0 Sale s Informatio n Sale s Date : 2003-12-0 4 Dee d Type : Price : Granto r W D $38,000.0 0 HOMEBUYER S IN C Book : 200 3 Page : 23962 8

Grantee : ADRE S CAVAD A ETA L Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 2003-11-2 1 Dee d Type : TR D Book : 200 3 Page : 22812 1 Price : $0.0 0 Granto r THOMA S OSTDIE K
http://douglasne.niapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R073124000 0 3/23/201 0Dougla s Count y Accoun t Informatio n Pag e 2 o f 3
Grantee : HOMEBUYER S IN C Valid/Invalid : Invali d Exclusio n Reason : Foreclosur e Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.2 2 9600. 0 1. 0 120. 0 80. 0 N o Improvemen t Informatio n Buildin g 1 1 1/ 2 Stor y Unn n 454 6 S 3 8 S t tnalDea
. IrcliuMVKa l Odtq R

1?4lHl l IBS ' -UB _ J2? > 

# 1
tSiql t ---ISa^SftfiL*jnQpiw«rM*iliawl>iLw—JU — CLIC KT O ENLARG E IMAG E Squar e Footage : 1023. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : En d Condition : Fai r

Buil t As : 1 1/ 2 Stor y Unfi n Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 7. 0 Exterior : Fram e Sidin g Units : 2. 0 Interior : Drywal l Baths : 2. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 5. 0

Roo f Type : Gabl e Stories : 1. 5 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 190 5 0 % 190 5 10 5 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fram e Utilit y 21. 0 Ad d O n Unfinishe d Atti c W/floo r 882. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 1023. 0 850. 0 Basemen t Minima l Finis h http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp7accou n tno=R073124000 0 3/23/201 0Douglas Count y Accoun t Informatio n Pag e 3 of3
Basemen t Fixtur e Fixtur e Porc h Porc h Porc h Use r Outsid e Entranc e Bas e Fixture s Bat h Ful l En d Soli d Wal l Sla b Roo f Ceilin g Woo d Dec k 2 UNI T CONVERSIO N 1. 0 1. 0 2. 0 124. 0 132. 0 64. 0

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