## TRANSMITTA LO FOMAH A LEA D SIT E PAIN T STABILIZATIO NFIL EFOLDE R SAID# : 32.'?<? ' Date : Oj^l ^ N%Z . ^ T Address ; LB PStabilizatio nContractor : PRUDEN T TECHNOLOGIES , INC . Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Videoo f propert y (DVD) : Pre-Stabiiizatio n& Post-Stabilizatio nVideo s / 

### Executiv e Summary / 

### SignedAcces s Agreement For m Advanc e Notic e For m 

## / Pre-Stabilizatio nVideo Agreement For m 

## 1 / Acces s Tracldn g Form 

## :

/ Property Acces s Assessmen t For m Neiglibor Acces s Agreement For m Pain t Matcl i For m 

## / Pre-Stabilizatio nPropert y Safet y Assessmen t Form Work-Site Hazard s Analysi s Checklis t Photographs : Pre-Stabilizatio nPropert v Hazar dAssessment Photograph s Dougla s Count y Assessor Property informatio n Property Completio nAgreement For mSignedb y Propert y Owne r Property Close-Out Chec k Lis t SignedBy EP A Pruden t Technologies , Inc . Sig n atur e Dat e VLA'iCcAjtsr^^fii ^ 

### Signatur e 

# 4 ^ ^ 3005513 1 

# i W Superfun d

### -IE(9INaLOGIBS,INC . 

# Propert y Summar y Date : 11/~/200 9 LB PSTABILIZATIO NEPA CONTRAC T EP-R7-08-0 7 Mont hof : No v Propert y Address : 381 8 N22 St . SAID # : 3296 1
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 : 9/23/2009 ii . Work Began : 9/29/200 9 iii . Close-Ou t Date : 10/01/2009 B . Enclosures : 1 . Pre-Stabilizatio nVide o 2 . Post-Stabilizatio nVide o 3 . Signe dAcces s Agreemen t Form 4 . Advance-Notic e Form 5 . Pre-Stabilizatio nVide o Agreemen t 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 nAgreement Form 15 . Propert y Close-Ou t Chec k Lis t Signe dB y EPA

# m. INC . Prudent Technologies , Inc . (Prudent ) is unde r contrac t (Contrac t #EP-R7-08-07 ) wit hth eU. S. Environmental Protectio n Agenc y (EPA ) to stabiliz e LeadBase dPaint (LBP ) at anumbe r ofpropertie s locate d inOmaha , Nebraska , includin g th e property locate d at "^ R}<? ! t^ ( 7_7-' ^ S f , Oyf^c^k< ^ , W£ Th e EP A request s you r permissio n to allo w Pruden t to perfor mLB PStabilizatio nat thi s property . By signin g thi s form , th e property owne r grant s permissio n to Prudent to perfor mactivitie s relate dto 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. " By signin g thi s documen t1 agre e to allo wanEP A contracto r to conduc t asoi l cleanu p at my property followin g completio nof lead-base dpain t stabilization , if th e soi l cleanu p ha s no t alread y bee nperformed . I understan dthat th e stabilizatio ncontracto r canno t provid e assurance s of whic hcontracto r wil lbe boun d to th e soi l cleanup . I further understan dthat th e soi l cleanu p contracto r wil l make al l reasonabl e effort s to addres s concern s that 1, as th e property owner , ma y hav e regardin g soi l cleanupat my property . p( j Yes , i hav e rea dan dunderstan dth e paragrap habove .

hir p n Prnnprt v Oump r ' Signatureo f f Property Owne r
Date Ifyo 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 fo r th e LeadBase dPain t Stabilization , Mrs . Shanno nHolt , at (402 ) 504-100 4 or (402>812-0223 . General question s abou t th e Omah aLeadSite cleanu p ca nbe directe dto th e EPA Publi c Informatio nCenter s at (402 ) 731
­ 304 5 (Sout hOmah aoffice ) or (402 ) 99 1 -958 3 (Nort hOmah aoffice) . Propert y Acces s Grante dBy : 

# Ch^ndr ^ P- Uri^Jrh^l l (Pleas e Print Name ) Propert y Owne r Signature : X 

# CAA ^



# i) . (Signature )
(Date )

808 0 War d Parkway , Suit e 40 5 2505 N. 24' " Street , Suit e 308 424 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 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657740L0GIBS . CM C PROPERT YINFORMATIO N (T o b e complete d b yresiden t and/o rpropert yowne r— pleas e print ) RESIDEN TNAME : Owne r RenterJ 

# P^jT v^^uar i 

# f RESIDEN TADDRES S 

# IFREjfTAL^^OPER^^^D^y ^

jJ^^A^^^J j ^[Jry^/^.^/ / -Jh^PT Ktjli j Ul , OWNER' S MAILIN G ADDRESS ; i _ , ^ / . ^ , n i , ^
OWNER' S TELEPHON E NUMBER - HOM E [WORK : NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OL D NUMBE R O F OCCUPANT S 7 YEAR S OL D AN D OLDER :
NUMBE R 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. )

AlJIHORIl' Y FORENVIRONMENTA LRESPONS EACTIONS : Th e activitie s l o b e implemenie db y EPA under thi s agreement arc pursuant to Sectio n10 4 ofCERCLA . 4 2 U.S.C . 9604 . EPA" s righ l ofacces s to th e property i s provide dfor i

nSectio n104(e ) ofCERCLA , 4 2 U.S . C 9605(e) , whic hprovide s entr y fo r "determinin g th e nee dfo r response , o r choosin g o r takin g any respons e actio nunder thi s title , or otherwis e enforcin g th e provision s ofth e title. "



# v : U^/V^A . ( X 

# ' e/^sh" )

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 . Afte r

signin g th e acces s you allo w Pruden t t o begi nLea dBase d Pain t Stabilization . All Plants , weed s an dan y vehicle s o r iteni s on openporc h(enclose dporche s wil l NO T b e stabilized ) mus t b e remove dprio r t o stabilization . All Pet s mus t b e ou t o f

yar ddurin g stabilization . How muc hnotic e d o you nee dt o hav e abov e mentione dtask s completed ? Ifyo u ar e alandlor dyo u wil l nee dto contac t th e tenan t a s Pruden t Technologie s wil l only infor myou . D o you hav e an y pet s tha t resid e inyard ? 

# N O Notic e needed : ^. U fjgjy^r ^ 

# Numbe r t o cal l to giv e notice : Who mw e ar e givin g notic e to : 

# Ch^ndr^ ^ iLanol/o r Hom e Owner' s Signatur e 

# > i/AxA...Kj . g|^?/^' >

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 Fax : (816 ) 363-370 7 Phone : (402)504-100 4 Fax : (402)504-100 5 Phone : (210)822-958 8 Fax : (210 ) 579-657 7IXCHNQLOGIBS, ] 

## PRE-STABILIZATIO NVIDE O FORM I UNDERSTAN D THA T PRUDENT TECHNOLOGIE S WIL LB ECOMIN G OUT T O SHOO T A PRE-STABILIZATIO NVIDE O AT MY PROPERTY . TH EVIDE O I S JUS T A TOO LUSE D T O DOCUMENT TH ECURRENT PROPERT Y STATUS/CONDITION . A POS T VIDE O WIL LALS O B E SHO T PRIO RT O COMPLETIO NO FSTABILIZATION . 

# OV/NER S NAME : U)ri^}\i^^/ I J0r\'\r^3~^^'h j L l (L . PROPERT Y ADDRESS : 3&l ^ ^ 2- ^ ^ ^ BVID/SAID : 3 ^ " ? ^ / HOMEOWNER S SIGNATURE : __K/^AA>^ ^ I V 

## . ^h/M/ \^hsjo ^ PRUDEN T REPRESENTATIY ESIGNATURE : Q I o^^i^^c t

S>h e ^c > r AN Y CONDITION S NEED T O B EAWAR EO FBEFORESHOOTIN G VIDEO : (I.E . PETS , NOTIC ENEEDED) : 

# U- ^

808 0 War d Parkway , Suit e 40 5 2S0S 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 ) 679-657 7TBCHNCnjOGIBS k IN C 

# ACCES S INFORMATIO NTRACKIN GSHEE T BVID : ?>%^6\ PROPERT Y ADDRES S 

# : '^<2) S ^ J 'i-'^ ^ 

# t 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 A ME S P EOthe r (Prudent ) D

>AT E TIM E

_ACCESSO R CONRAC T DETAI L 

# q a-blo- i "Tf^
- l2eM^t-^o r Vt^V-* ^ •

1 

# 0 V



## 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 , 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

### 40L0GIES,IN C PAIN T MATCHIN GFORM : 1 . T O B EFILLE D OU T ONL Y I FMATCHIN GCOLO R 

# N ^ PROPERT Y ADDRESS : •T>5R^/ ^ K TTT ^ S \Omal ^ BVID : ^ Z ^ ^ I 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 No Locatio n Pain t Descriptio n Sidin g oooo< J jiX^Wi^ t \ Soffi t 

## K£iOt di ^ 7 Fascia Come rTri m 

### Windo w Trims Doo r Trims Fron t Porc hCeiling Fron t Porc hCeiling Beam s Fron t Porc hFloo r Fron t Porc hRailing s Fron t Porc hStep s Sidin g Baseboards Foundatio n ^ ; ^ 

# &-y^AJ > J - 

# 3 ^ • ^ > ' - 

### S ^ \i C 

### s ^ q—^'v
­ 

# ¥^..^ ^ :x p N o ^r ­ 

# ^^^cfy:j'j^/^^^^e^ ' v P ^" ^ ^ ^ <r ^ iS^^t^^^< ^ ^ ^ C^ O I UNDERSTAN D SHERWINWILLIAM S WILLMATC H M Y CURREN T COLORS . Homeowne r signature : y(_}lhN ^ O J . jlh/l/l/ l y Date : gj>-?JQ 9

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 426 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 ) 679-667 7TECHNOLOGIES , IN C 

# Acces s Assessment Form : (Mus t b e complete dfor ever y property . Informatio nmus t b e obtaine dfro mapropert y wal k thru , no t given by owner )
I s th e propert y stucc o o r asbestos ?
I f

yes , i s an y o f th e stucc o o r asbesto s damage do r cracked ?
I f

yes , sto p a s w e can H 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 . \y- ^ 

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

# fAo ^ v> ^ V ^ - 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 ? 

# - Y ^ 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 . 1 

## Doe s thi s propert y hav e agarage ? rsJ O I f

yes , describ e locatio no f garage . Doe s thi s propert y hav e aluminu msiding ?
I f

yes , i s i t origina l factor y finis ho r ha s i t bee npainte dover ? 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) ?
I f

yes , EXPLAIN ?
I s thi s propert y vacan t o/occupied ?
Ar e ther e an y pet s a t thi s property ?
Ar e ther e an y lo w hangin g powe r lines ? 

# M ^

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-«57 7

### TECHNOLOGIES; ] 

## NEIGHBORHOO D PROPERT Y ACCES S FOR M I S THEREA NEIGHBORIN GPROPERT Y THA T NEED S T O B EACCESSED ALONG WIT H ASSIGNE D PROPERT Y T O COMPLET ESTABILIZATIO NPROCESS ? 

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

# rO 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

### TECHNOLOGIES , IN C 

## PRE-STABILIZATIO NPROPERT Y SAFET Y ASSESSMEN T FOR M PROPERTY ADDRESS : 3*^) 9 ' ^ *^ ^ -=*' ' BVID/SAID : ^ 2- ^ ^ I PRUDEN T ASSESSMEN T REPERSENTATIVE : 

# ^a^M - fi^^^ REPERSENTATIV EREMARKS/FINDINGS : (POWER-LINEPROXIMIT 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 , 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 7TBCHfiOLOGTBS , 

# Checklis t fo r th e Worksit e Hazar dAnalysi s 

# 3^ 1 S h) . Q^n^Jj : Address : Crew : Date : Ite m OK ? 

# TvM ^

azar d Correctiv e /Actio n ^ 

### Overhea dLine s 

## uJt^g ^ (/L^^t^ ^ Ky^Cys ^ ^ O In-transi t Vehicl e Clearanc e ^-t/yaf^<=>^- ^ LPvYt:: ^ Level s aroun dhig hwire s Vehicl e Clearanc e aroun d hig hwire s whe nworkin g Phon e line s Cabl e line s 

# OjiS k 

# i ^ Ga s Lin e Wate r Lin e Sewe r Lin e Septi c Tan k Propane/Butan e Acces s to/o nPropert y Neighbo r Acces s Require d 

# ^- /

^ S^Lil^ ^ Hig hTraffic 4^re : I C Are a <;aT5g ? 

## • ^/tf(jt>^7i3)Q O Cr yicxsidk . uJ^ ^ Structure s \;L)cy^ ^ 

# OM^f^sj^J A i^5 ^ Drivewa y 

### * A - Sidewal k }jytJ?y^^) ^ 

### Foundatio n 

### hXj^ ' Retainin g Wall s VA^L/:j2n7^ ^ Uyc^r^JioC ^ 

### Fence s 

### ^f^\jJ ^ <L,JU ^ Tree s 

### Foliag e Genera l ConOitio no f yar d Damage dAreas : sin k 

# A holes/rotte dwoo d 

### iai7\JUM^4-r^ Wefi^^^ . cJ^ > 

# r Sprinkle r Syste m Pet s Insect s ^Lfit i 

# I S? ^ ,cipA3 ^ ^ 

### Weathe r Condition s Unsaf e drivin g condition s Unsaf e neighborhoo d 

# ^^id ^ \jD^d ^ b^V£ ^ ^re^ ^ b(^ ^

Cre w Foreman / Sub-Contracto r

808 0 War d Parkw i 250 5 N . 24' " Street , Suit e 30 8 Sica l Drive , Suit e 425 0 Kansa s City , MOW411 1 Omaha , Nebrask a 6811 0 &a n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 'hone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7"" . * 

# 9i

JF'/'^/S^^^^^^^^^^^^^H B 1

# 1 .^^ ^ 

# ^''^f^-''''^iKIKK k 

# c \

# 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 receive d a copyo 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 infoimin g m e o f th e potentia l ris k of th e lead hazar d exposur e fro m renovatio n activit yt o be performe d i n m ydwellin g unit . I receive d thi s pamphlet befor e th e wor k began , Priate d nam e o f r^iplenj , ;— ^ Date Signatur e o f recipien t Self-Certificatio n Optio n (fo rtenant-occupie d dwelling s only ) — If th e lead pamphlet wa s 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 t o sig n —I certif ythat 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 Schoois , t o th e renta l dwellin g uni t liste d belowa t th e dat e an d tim e indicate d an d that th e occupan t refuse d t o sig n th e confirmatio n o

f receipt . I furthe rcertif ythat I hav e lef t a copyo f th e pamphlet a t th e uni t wit h th e occupant . ijH^navailabl e fo rsignatur e — I certif ythat 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 r Families , Chil d Car e provider s an d Schools , t o th e renta l dwellin g uni t liste d belowan d that th e occupan t wa s unavailabl e t o sig n th e confirmatio n o f receipt . I furthe rcertif ythat I hav e lef t a copyo f th e pamphlet 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 Attempte d deliver y dat e an d tim e lead pamphlet deliver y Signatur e of perso n certifyin g lead pamphlet deliver y

Unit Addres s Not e Regardin g Mailin g Optio n —A s a n alternative t o deliver yi n person , yo u ma ymai l th e lead pamphlet t o th e owne rand/o rtenant . Pamphle t must be 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 post office) .Dougla s County Accoun t Informatio n Pag e 1 of 3 Dougla s County , Nebrask a Propert yRecor d - R201404000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e & . scal e 0-5 0 f t wes t of 52n d S t - VIG WO H MS D Informatio n i s vali d a s o f 2009-9-1 5 Treasurer' s Ta xRepor t Ne wFeatur e -^rtr * Aut o Sale s Searc h Owne r WRIGHTSEL L INVESTMENT S LL C C/

O LATREL L WRIGHTSEL L 1265 7 DEE R CREE KD R OMAH AN E 68142-000 0 Propert yInformatio n Ke yNumbe r 140 4 000 0 2 0 Accoun t Type : Residentia l Parce l Numbe r 201404000 0 Parce l Address : 381 8 N 2 2 S T OMAH AN E 68110-000 0 Lega l Description : PLAINVIE W LO T4 BLOC K6 S 2 5 F T2 5 X 12 4 Valu e Informatio n 200 9 200 8 200 7 200 6 200 5 200 4 Lan d $7,000.0 0 $7,000.0 0 $7,000.0 0 $7,000.0 0 $7,000.0 0 $7,000.0 0 Improvemen t $28,900.0 0 $28,900.0 0 $28,900.0 0 $28,900.0 0 $5,800.0 0 $5,300.0 0 Tota l $35,900.0 0 $35,900.0 0 $35,900.0 0 $35,900.0 0 $12,800.0 0 $12,300.0 0 Sale s Informatio n Sale s Date : 2006-01-2 3 Dee d Type : Price : QC M $0.0 0 Book : 200 6 Page : 00779 6 Granto r Grantee : Valld/lnvalld : Latrel l Wrightsel l eta l Wrightsel l Investment s Invali d Excl Reason : usio n Famil ySal e Sale s Date : 2006-01-1 1 Dee d Type : Price : W D $0.0 0 Book : 200 6 Page : 00453 7 Granto r GILBER TL CAI N
http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R201404000 0 9/16/200 9Dougla s Count y Accoun t Informatio n Pag e 2 of 3 latio n Grantee : LATREL L WRIGHTSEL L ETA L Valid/Invalid : Exclusio n Reason : Invali d Correctiv e Dee d Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : 2006-01-0 9 QC M $0.0 0 Wrightsel l Investment s Latrel l Wrightsel l eta l Invali d Correctiv e Dee d Book : 200 6 Page : 00269 4

Lan d Informatio n Acre s 0.0 7 S F 3100. 0 Unit s 1. 0 Dept h 124. 0 Widt h 25. 0 Vacan t N o Improvement Buildin g 1 Informatio n

3»18N22a .

MtiM n CLIC KTO ENLARG E IMAG E CLIC KTO ENLARG E IMAG E Squar e Footage : 1127. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Poo r

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 6. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinlde rSquar e Footage : 0. 0
http;//douglasne.mapping-online.com/DouglasCoNe/static/accountmfo.jsp?accountno=R201404000 0 9/16/200 9Dougla s County Accoun t Informatio Pag e 3 of 3 latio n n
Yea rBuil t Yea r Remodele d 192 5 0 Detai l Typ e Applianc e Basemen t Fixtur e Fixtur e Garag e Porc h Porc h Percen t Remodele d 0% Detai l Descriptio n Allowanc e Bsmn t Bloc k 8 ft Bas e Fixture s Bat h Ful l Detache d En d Scree n En d Scree n Adjuste d Yea r Buil t 192 5 Physica l Ag e 84 Unit s 1. 0 684. 0 1. 0 1. 0 440. 0

25. 0 144. 0

http://douglasne.mapping-onlme.com/DouglasCoNe/static/accountinfo.jsp?accountno=R201404000 0 9/16/200 9

## Pruden t Propert yClose-Ou t For m (Lead-Base d Pain t StabiJ.ization ) SAID : <B^96 / Propert yAddress : v3g/ 8 A / ;22/7o^ S h Ov^ner' s Name : '^^VW ^

[mve^U^ersH ^ U c \ S.N O 

# 1 "* 1 ! 2 ! 3 i : 4 

### i ! 5
1 ; 6

• 7 | 8 1 ! 9

1 1 |1 0 1 1 1 ! ,1 2 i 1 Perfonnanc e Standards/close-Ou t Criteri a Ye s LN O ; Wa s tt» 9 entir e structure(s ) painte d wit h th e exceptio n c 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 

# A beams , columns , rails , an d exterio rsurface s o f garages . 

### y Wa s al l scrapin g an d othe rpreparatio n wor k complete d satisfactorily ? 

# i/ ^ Wer e al l require d area s o f th e structure(s ) prime d a s neede d an d 

# y painte d wit h tw o to p coats ? 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 ? 

## i / 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 ? 

# c / I s th e gras s are a tha t surround s th e structure(s ) i n reasonabl ygoo d condition ? Wa s 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 ? 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-Ou L 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 t)ack ? / 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 ? 

### ^ \ Othe rConsiderations ? Propert yOwne rDiscussions ? Additiona l Wor k tha t i s Require d 

### Pruden t Representativ e Signatur e Date : Propert yOwne rSignature : C/frv ^ ^ " 'f^rtJI r 

# ^^•10/1/C M 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 San 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