## TRANSMITTALO FOMAHA LEAD SIT E PAINT STABILIZATIO NFIL EFOLDE R SAID# : 3ftqi5

_

Date : &)u|i)flfl ^ Address : SlU]- ^ kj^t^yiA- M /^ M LB PStabilizatio nContractor : PRUDEN T TECHNOLOGIES , INC . Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S y Videoo f property (DVD) : Pre-Stabilizatio n& Post-Stabilizatio nVideo s IZExecutiv e Summar y M SignedAcces s Agreement For m 

# A Advanc e Notic e Form Pre-Stabilizatio nVideo Agreement For m s /

Acces s Trackin g Form s 7 Property Acces s Assessmen t For m S /

Neighbo r Acces s Agreement For m A Pain t Matc hForm
• i ZPre-Stabilizatio nPropert y Safet y Assessmen t For m 1 /

Work-Site Hazard s Analysi s Checklis t 5 /

Photographs : Pre-Stahilizatio nPropert v Hazar dAssessment Photograph s ^ Dougla s Count y Assessor Propert y informatio n M Propert y Completio nAgreement FormSignedb y Propert y Owne r D Property Close-Out Chec k Lis t SignedB y EP A Pruden t Technologies , Inc . Signatur e Dat e 

# i//LA,^:UU£JLa ^ M^7p Ignatur e ' Dat e 3005470 3 

# ini m Superfun d1ECHNOLOGIBS , IN C 

# Propert y Summar y Date : 8/^</2009 LB PSTABILIZATIO N EP A CONTRAC T EP-R7-08-0 7 | Mont hof ; Aug. Propert y Address ; 241 5 Kansa s A v SAI D # : 3891 2
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 ; 7/16/200 9 ii . Wor k Began ; 7/24/200 9 iii . Close-Ou t Date ; 7/27/200 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 A" ^ y• " 

## 7 7 i d 

# 7 TECHNOIOCmS . INC . PROPERT YINFORMATIO N (T o b e complete d b yresiden t and/o rpropert yowne r—pleas e print ) RESIDEN TNAME : ^wnep / Rente r RESIDEN TADDRESS : 

## :^'-\\y^,^^^cK £'W ^ I F RENTAL , PROPERT YOWNE D BY :
OWNER' S MAILIN G ADDRESS ;
OWNER' S TELEPHON E NUMBER - HOME : l^ ? ) 7OO-2i^£> \ WORK : _J \ NUMBER O F OCCUPANT S UNDE R 7 YEAR S OLD : ^ NUMBER O F OCCUPANT S 7 YEAR S OL D AN D OLDER :
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. )


## — ^ t/^.s—

AUTHORIT Y FO RENVIRONMENTA LRESPONSEACTIONS : Th e activitie s t o be implemente db y EP A unde r thi s agreemen t ar

e pursuan t t

o Sectio n10 4 o f CERCLA, 42 U.S.C . 9604 . EPA' s righ t of acces s t o the propert y i s provide dfo r i

nSectio n104(e ) o

f CERCLA, 4

2 U.S . C 9605(e) , whic hprovide s entr y fo r "determining the nee dfo r response , o r choosin g o r taking an y respons e actio nunde r thi s title , o r otherwis e enforcin g the provision s ofth e title. "

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 77:«A'-i.-*i * :ti;i ^ V ^ "-^j:.. '

-HBCHNOIXXSIBS . IN C Pruden t Technologies , Inc . (Prudent ) i s unde r contract (Contract #EP-R7-08-07 ) witi i the U . S . Environmenta l Protection Agenc y (EPA ) t

o stabilize Lea dBase dPain t (LBP) a t anumbe r of propertie s locatedi n Omaha, Nebraska , including the propert y locate da t 2 . «• < / j T Keti ^ ^ €* . ^ / f V«
- Th e EP A requests you r permission to allow Pruden t to perfor mLB PStabilizationa t thi s property . By signing thi s form, th e propert y owne r grant s permission to Pruden t to perfor mactivitie s relatedto LB PStabilization including scraping pain t an d painting ofth e referencedproperty . Further, th e 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 t o allow a nEP A contracto r to conduct asoi l cleanu p a t m

y propert y followin g completionof lead-basedpain t stabilization , i f the soil cleanu p has no t alread y bee n performed . I understan d tiiatthe stabilizationcontracto r canno t provid e assurance s of whic hcontracto r wil l be boun dto the soi l cleanup . I furthe r understan dtha t the soi l cleanu p contracto r wil l mak e al l reasonable effort s to addres s concems tha t I , as th e propert y owner, ma y have regarding soi l cleanu p a t m y property . [ ] Yes , 1 hav e rea dan dunderstan dthe paragrap habove . 

### AJJa*, ^ ^/Hi/ZtiiynyAL . Signatur e of Propert y Owne r 

## 7-ii > -o<\ Dat e I f yo u have an y question s abou t the LB Pstabilization plannedfo r you r property , pleas e contact Prudent' s Custome r Relations/Office Manage r fo r the Lea dBase dPain t Stabilization , Mrs . Shanno n Holt , a t (402 ) 504-100 4 o r (402)812-0223 . Genera l question s abou t the Omah aLea dSit e cleanu p ca nbe directedto the EP A Public Informatio n Centers a t (402 ) 731
­ 3045 (Sout hOmah aoffice ) o r (402 ) 991-958 3 (Nort hOmah aoffice) . Propert y Acces s Grante dBy : (Pleas e Prin t Name) Propert y Owne r Signature : 

### A^yft/u ^ y^^^^^^e.^ ^ (Signature) 

## I.IC - O ^ (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 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 

# Advance dnotic e needed . After signin g th e acces s you allo w Pruden t t o begi n Lea dBase d Pain t Stabilization . All 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 informyou . D o you hav e an y pet s tha t resid e i n yard ? Notic e needed : ^t4 - 

## h r 

# Numbe r t o cal l t o giv e notice : Who mw e ar e givin g notic e to : Oa-xs- y ^'VOIWC/A , 

# Hom e Owner' s Signatur e e&iar-..y^i£^iau^tCu. .

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 FOR M I UNDERSTAN D 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 N O FSTABILIZATION . OWNER S NAME : Rub^- O M \Yaf ^ c3 a. 

## 'X^\ S ^Caf^^a ^ ^^ ^ PROPERT Y ADDRESS : BVID/SAID : ? > ^^\^ HOMEOWNER S SIGNATURE : 

# ^J ^ 

# ma,u ^ PRUDEN T REPRESENTATIV ESIGNATURE : ]:NTATIV E

## siGr^ i 

# (7>yy 7 AN Y CONDITION S NEE D T O B EAWAR EO FBEFOR ESHOOTIN G VIDEO : (LE . PETS , NOTIC ENEEDED) :

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" ^ TECHNOLOGIES, ] .<< ^ 

## ACCES S INFORMATIO NTRACKIN GSHEE T BVID : 2^ ^ I 7
- PROPERTYADDRESS : Zl^ ^ " b Vy^r^^^^ ^ /W ^ 

# [luh^j A Ni\raroO [ _ Propert y Owne dBy : (I f new propert y owner )

Owner s Phon e No's : Home : Work : Cell : Fax : ~ 

## Acces s Contractor : AS WPDA ME S P EOthe r (Prudent ) DATE TIM E ACCESSO R CONRAC T DETAI L 

# n\s]o' ^ ^ 

## P/ M K Ar v I <I
- «- V 

### (J^>v\y-y-i j i -^ A\^.y-. y 

# J'

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 7J ,• • iT( ^ * •. .

TECHNOLOGIES ^ 1 

# 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 ? . I f

yes , i s an y ofth e stucc o o r asbesto s damage do 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 dt o EP A an dthe y wil l assig na t alate r date . 

## ry: > Doe s thi s propert y requir e lot s o f scrapping ? 

# y 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 ?
I f

yes , 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 ? I f

yes , describ e locatio nof garage . 

# We t ly j 

# k/M" ^ Doe s thi s propert y hav e aluminu msiding ? I f

yes , i s i t origina l factory finis ho r ha s i t beenpainte dover ? Doe s thi s propert y hav e an y othe r typ e of structura l components ? (I.e . roo f shingle s a s siding) ? I f

yes , EXPLAIN ? I s thi s propert y vacan t o r occupied ? 

# 7 ) U^^ ^ 

# "-^^^ 

# y A M 7 

# y^^ ^ 

# r Ar e ther e an y pet s a t thi s property ? Ar e ther e an y low hangin g powe r lines ?

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Stree t 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 

## 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 ? 

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

# K) 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 , 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 

# PAIN T MATCHIN GFORM : T O B EFILLE D OU T ONLY I FMATCHIN GCOLO R PROPERTYADDRESS ; :^C\\ S NCCV^SJC ^ 

### £(\\ l < L BVID ; •3>e.O\' X
I UNDERSTAN D SHERWINWILLIAM S WIL LMATC H MY CURRENT COLORS . Homeowner signature ; 

## \f\30jA)j s jj: ^

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

# 7 7 TECHNOLOGIES . IN C 

## PRE-STABILIZATIO NPROPERT Y SAFET Y ASSESSMENT FOR M PROPERT Y ADDRESS : 'X^ \S K<\^^CKC , 

### P[^f <

L 

### BVID/SAID : S ^ ^ \X PRUDENT ASSESSMENT REPERSENTATIVE :



## ******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 7TECHNOLOGIES . IN C % ^ 

## Checklis t for th e Worksit e Hazar dAnalysi s Address ; ^ ^ ^ ^ ^^7^^^ ^ Crew : Date : Ite m ^ OK ? I J Hazar do Correctiv e Actio n Overhea dLine s A3& ^ U^^)7H < 

### - \Jy(\G:t^Le f UJtyj ^ f~ ­ ( J \y^A\JL o 'd^-^^AiT ^ ^fv,rrT*,;.-t5t-t > <jy^lhi9 ^ In-transi t Vehicl e Clearanc e Level s aroun dhig hwire s Vehicl e Clearanc e aroun d hig hwire s whe n workin g Phon e line s Cabl e line s 

## <i:s.k-ti, l Ga s Lin e Wate r Lin e Sewe r Lin e Septi c Tan k Propane/Butan e Acces s to/o n Propert y l\Ci/y i H' S 

# t r ^

, , \ /

. / ^ ^ ^ Neighbo r Acces s Require d Hig hTraffi c Are a Garag e 

## ^^2y^LxtA^^ ^ (Utyy^ ^ h^> ^ Structure s 

## sj^^^y^^^ ^ c: c inrjf-» < Drivewa y c M O GiTK s Sidewal k Foundatio n (VvA^^^j L <5>/, , 

### ^ •-\y>jy}77^^juX'U/-{yA>Jru ^ 

# ~^^^^27 ^ Retainin g Wall s 

## ^-1—7) . ty' . o i y-^0, . Fence s 

## : (>y<^^^^ErPaJ yi.(hp M 

# "E^m^^ ^ Tree s AAt ^ Foliag e Genera l Conditio n o f yar d 

## hjiyjy7ry\ K Damage dAreas : sin k holes/rotte dwoo d OAjtrlyy/ L Sprinlde r Syste m Pet s Insect s Weathe r Condition s Unsaf e drivin g condition s Unsaf e neighborhoo d Cre w F o b-Contracto r fet y Office r

808 0 War d WrkwayTSuit e 40 5 250 5 N . 24' " street . Suit e 30 8 4X4 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6311 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 o f Receip t o f Lea d Pamphle t a I hav e receive d a cop yo f 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 hazar d 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 . 

# Rjf , e # \ 

# A l iils\vidt^ . 

# 7»l(,'0 ^ Printe d nam e o f recipien t Dat e 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 rFamilies , 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 yo f th e pamphle t at th e uni t wit h th e occupant . Q - 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 door . 

### 1'Vt'<? ^ 

## 6-9 ^ Printe d nam e o f perso n certifyin g Attempte d deliver y 

### (y ^ 

# i
­ 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) .

### Dougla s Count y Accoun t In|Bmatio n

n|Bm a Page 1 of3 Dougla s County , Nebrask a Propert yRecor d - R060072000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t ot 52n d S t - Vle W O n Ma p Informatio n i s vali d a s o f 2009-6-1 6 Treasurer' s Ta xRepor t Ne wFeatur e - > - » - ^ Aut o Sale s Searc h Owne r MIRAND ARUBE N ETA L 241 5 KANSA S AV E OMAH AN E 68111-000 0 

# ph-J^m^. S Qj)h^/f<n/ ) Mfc^/-I3 ^ Propert yInformatio n Ke yNumbe r007 2 000 0 0 6 Accoun t Type : Residentia l Parce l Numbe r060072000 0 Parce l Address : 241 5 KANSA S A V OMAH AN E 68111-000 0 Lega l Description : BELL E ISL E LO T5 BLOC K1 E 1/ 2 L T6 & AL L 67. 5 X 136.4 9 Valu e Informatio n 200 9 200 8 200 7 200 6 200 5 200 4 Lan d

' $3,200.0 0 $3,200.0 0 $3,200.0 0 $3,200.0 0 $3,200.0 0 $3,200.0 0 Improvemen t $56,500.0 0 $56,500.0 0 $49,900.0 0 $49,900.0 0 $49,900.0 0 $44,900.0 0 Tota l $59,700.0 0 $59,700.0 0 $53,100.0 0 $53,100.0 0 $53,100.0 0 $48,100.0 0 Sale s Informatio n Sale s Date : 2009-02-1 8 Dee d Type : Price : W D $45,000.0 0 Book : 200 9 Page : 01519 0 Grantor : K H INVESTMEN TPROPERTIE S IN C ETA L Grantee : MIRAND ARUBE N ETA L Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1997-06-3 0 Dee d Type : D SooAr : 206 4 Page : 42 3 Price : $ 46,000.0 0 Grantor : 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountiiifo.jsp?accountno=R060.. . 7/7/2009

### Dougla s County Accoun t InjjBiatio n Pag e 2 of 3 Grantee : Valid/Invalid : vali d Exclusio n Reason : Sale s Date : 1997-04-1 1 Dee d Type : D j Book : 206 1 Page : 50 7 Price : $37,000.0 0 Grantor : Grantee : Valid/Invalid : Invali d Exclusio n Reason : Invali d Sal e Lan d Informatio n Acre s j .SF ' Unit s Dept h Widt h Vacan t 0.2 1 9248. 0 1. 0 136 0 68. 0 N o Improvemen t Informatio n Buildin g 1 TW O STOR Y En d &Dl-3l;'i)all4( y 2 4 0 o i a 1 2 0 ' 1 4 0 ' J , Firs : FK-n f i o S5 2 0 " ^ & 12.0 ' 1 0 I i«. e 26,0­ 2 6 0 f . : (-.SecondFbDt 6nc l Scr M Wal l 13

2 0 : 6 0 '

CLIC KT O ENLARG E IMAG E Squar e Footage : 1704. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Fai r

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

HVAC : Force d Ai r Rooms : 6. 0 Exterior : 1 Fram e Sidin g Units : 1, 0 i- Baths : 1. 0 Interior : Drywal l Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : 2. 5 Floorcover : Allowanc e Foundation : Bloc k 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R060. . . 7/7/200 9

### Dougla s Count y Accoun t Ini^aiatio n Page 3 of3

ni^ai s

Yea rBuil t 191 5 Detai l Typ e Applianc e Applianc e Basemen t Fixtur e Fixtur e Fixtur e Garag e Porc h Porc h Yea r Remodele d 0 Percen t Remodele d 0 % 1 Detai l Descriptio n Allowanc e Fireplac e Masonr y Bsmn t Bloc k 8 ft Additiona l Fixture s Bas e Fixture s Bat h Ful l Detache d En d Scree n En d Scree n Sprinkle rSquar e Footage : 0. 0 AdjustedYea rp,ys,calAg e 191 5 9 3 Unit s 1. 0 1. 0 852. 0 1. 0 1. 0 1. 0 440. 0 182. 0

24. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accoiintinfo.jsp?accountno=R060.. . 7/7/2009TECHNOLOGIES . IN C !j't.,o<' ^ 

## Pruden t Propert yClose-Ou t For m (Lead-Base d Pain t Stabilization ) SAID :i^"^! ^ Propert yAddress : /T' 3 7^r\ricx ^ ^A'C ^ J — Owner' s Name : piiCxf A/A^IThVldi ^

S.N O Performanc e Standards/close-Ou t Criteri a Ye s N O Wa s th e entir e structure(s ) painte d wit h th e exceptio n o f th 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 / . 

## t ^ beams , columns , rails , an d exterio rsurface s o f garages . Wa s al l scrapin g an d othe rpreparatio n wor k complete d satisfactorily ? % ^ 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 ? 

# M 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 ? % ^ 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? 

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

# J ^ Was 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 ? 

# j ^ 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 . 

# m 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 ? 

# iQ _ 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 ? 

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

# m. Pruden t Representativ e Signature : Date : Propert yOwne rSignature : /''Ajbt&sy i rUytgi^Jt'^ ' 

## Date: 9^Z9''0< i 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