## TRANSMITTA L OFOMAH ALEA D SIT E PAIN T STABILIZATIO NFIL EFOLDE R SAID# : 37^2 7 Date : Address : J257 ^ Ettf^O n A ^ LB PStabilizatio nContractor : PRUDEN T TECHNOLOGIES , INC . Year : 200 9 PAIN T STABILIZATIO N PROPERT Y FIL EFOLDE RDOCUMENT S AVide o of property (DVD) : Pre-Stabilizatio n& Post-Stabilizatio nVideo s y Executiv e Summary ASignedAcces s Agreement For m AAdvanc e Notic e For m APre-Stabilizatio nVide o Agreement Form AAcces s Trackin g Form sK Property Acces s Assessmen t Form y Neighbo r Acces s Agreement For m APain t Matc hFor m y Pre-Stabilizatio nProperty Safet y Assessmen t For m AWork-Site Hazard s Analysi s Checklis t B^ Photographs : Pre-Stabilizatio nPropert y Hazar dAssessmen t Photograph s H Dougla s Count y Assessor Propert y informatio n e^ Property Completio nAgreement For mSigned by Property Owner nProperty Close-Out Chec k Lis t Signed By EP A 'jruden Technologies Si : Pruden tTecnnologies , Inc . ignatur e Dat e

3005530 9 

# • 11 Superfun d

### TBOINaLOGIBS . IN C 

# Propert y Summar y Date : 11/~/200 9 LB PSTABILIZATIO NEPACONTRAC T EP-R7-08-0 7 Monthof : No v Propert y Address : 257 4 Elliso nAv . SAI D # : 37627 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 : 10/14/2009 ii . Wor k Began : 10/30/2009 iil . Close-Ou t Date : 11/04/2009 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 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 nAgreement Form 15 . Propert y Close-Ou t Chec k Lis t Signe dB y EPANUMBE R OF CHILDRE N UNDE R 7 YEARS OU D WHO M PLA Y

IN TH E YAR D FOR » HOUR S

OR MOR E PE R WEEK: 

# sy OCT.15.200 9 2:29P M NO.29 7 P . 4/ 7



### Pruden t Teeimolo&tes , tne . (PnidcM ) i s unde r contnc t (Contnc t #EP-RT-OS-O? ) withth eU . S . EnviiDiiinemal Protectio n Agenc y (EPA ) t o a^jijjz e Lea dBase dPain t (LBP ) a t aniunbo r o f pitipenic s locate di nOmaha , Nebraska , tncludin eth e propert y locate dat^M t ^'S?V SJAALUII^ ^ 

### Th eEP Areqtiest s you r permissio nt o allo w Ahtdcn t t o perfor mLB PStabilizatio na t thi s property . B y signin g thi s fonn , th e propert y owne r giant s peimistio ^ t o Pmden t l o perfor moetivitie s relate dt o LB PStabilizatio nincludin g scrapin g pai maq d paintin g ofth erefticnce dpropel^ . Funher , th eownerAenan t verifie s tha t the y hav ereceive dth eLB Ppamphle t ''Renovat e Right. " B y signin g thi s dacwnen t Iagre e ( o allo w a nEP Acontracto r t o conduc t asoi l cleanu p a t tn y propert y followin g completio no f lead-base dpain t stabiliation , j f th esoi l cleanu p ha s no t alread y bee s performed . Iunderstan dtha t th e stabilizatio ncontracto r canno t provid eassunnce s o f whic hoonttacio r wil l b o twun dt o th esoi l cleanup . I fuphe r understan dtha t th esoi l cleanu p contracto r wil l mak eat l reasooabl o ofToit s l o addres s concem s tha i 1 , a s th epropert y owner , ma y hav eregardin g soi l cleanu p a t in y pKipcny . 

# h ] Yes , Ihav t rea dan duiukrsian dth epangiap habove . Siffiaao cofPrapeii y



# /0~/Y - 0

Dat e Ifyo u hav ean y question s abou t th eLB Pstabilizatio nplanne dfo r you r property , pleas e contac t Prudent' s Cuaiome r Retotlonn/Offic e Mnnnae r fo r th eUa dBase dPam t Stabilization , Mri . Sha^n^f f Htft-a t (4ffiZ ) SM-IOI M o r l401W134tt23 . Genera l question s abou t tb eOmali aLea dSit e cleanu p ca nb edirecte dt o th eEP APubli c Infonnatio nCenter s a t (402 ) 73 1 ­ 304 S (SouthOmah aoOIce ) o r {fiiXL ) 991-958 3 (Nort hOmah aoffice) . l^pert y Acces s Grante dBy : 

# bojAAy. . ^ . p^ri U -Z A (Picas ePrin t Nane ) Propett y Owne r Signatur e 

# ' /^i^/^* ^ 

# JbAV-o ^ (DMe )

80 M War d Parkway . Sult a 40 6 2S0S N . Hf ^ StrMt . Suit e SO S 43« 2 Madtca l Driva ^ Suit e 426 0 Kanea a City . M O 6411 4 Omaha , NtbraaJ u SBII O Sa n Antonio , T X 7022 0 Ptu>na:(ai« ( 313470 3 Fai.(«16)M3'370 7 PHOO K(402)604100 4 Fas : {402)504.100 5 PDona : (2l0>822'«St t FfDc: (210 ) 570467 7OCT.15.200 9 2:29P M N0.297,-,-J>.7/ 7 

# Advance dnotic e needed . Afte r

signin g th e acces s yo u allo w Pruden t t o begi nLea dBase d Paint Stabilization . Ali Plants , weed s an dan y vehicle s o r item s on openporc h(enclose dporche s wil l NO T b e stabilized ) mus t b e removedprio r t o stabilization . All Pet s mus t be ou t o f yar ddurin g stabilization . How muc hnotic e d o yo u nee dt o hav e abov e mentione dtask s completed ? Ifyo u ar e alandlor dyo u wil l nee dt o contac t th e tenan t a s Pruden t Technologie s will onl y infor myou . Do you hav e an y pet s tha t resid e i nyard ? Notice needed : 1 ^ ^OO'^' f 

# Number t o cal l t o giv e notice : Whomw e ar e givin g notic e to : Hom e Owner s Signatur e ^

808 0 wan t Parkway . Suii a 40 6 2S0 » N . 24< * Straat , Sult a 30 6 424 3 Madica l Driva , Suit t 42S0 KanaacCily , M O 6411 4 Omaha , MebraskaOSII O Sa o Antorrio , 7X7822 0 Ptiora : (61 ^ 363-370 1 F«|:(0ia)363-370 7 PIMHM : (4O3)a04-ia0 4 Pax : (402 1 AM-tOO S Phone : (210 ) e22<458 a nu : (210 ) $70-667 7

## OCT.15.200 9 2:29P M^ ^'^ ^ '''J^^^ ^



## PRE-STABILIZATIO NVIDE O FORM I UNDERSTAN D THA T PRUDENT TECHNOLOGIE S WIL LB ECOMIN G OUT T O SHOO T A PRE-STABIUZATIO NVIDE O A T MY PROPERTY . THEVIDE O I S JUS T A TOO LUSE D T O DOCUMENT TH ECURRENT PROPERT Y STATUS/CONDITION . APOS T VIDE O WIL LALS O B E SHO T PRIO RT O COMPLETIO NO FSTABILIZATION . OWNERSNAME : U(Xnn y £ ' /Lrf^^i ^ J ^ PROPERTY ADDRESS : 2 5"> ^ C///JC n/fc' C BVID/SAH) : ?> ' ^ ^ 

# HOMEOWNER S SIGNATURE: 11^^,.,^/^^^^^t^i^i0 ^ PRUDEN T REPRESENTATIV ESIGNATlflRE : AN Y CONDITION S NEED T O B EAWAR EO FBEFORESHOOTIN G VIDEO : (LE . PETS r NOTIC ENEEDED) : 

# P s ^

MOOWarUPannwiy , Suit * 40 5 260 5 N . 24* " Strae t Suit e 30 8 424 2 Madica l Oriva ^ SuK e 429 0 KantaaCity.M0M11 4 Omaha , Nabraaka 6811 0 Sa n Antonio , TX7U2 0 Pbopa : 1816 ) 303-370 3 PtKme : (402)604-100 4 Phone : (210)822.068 8 Fas : (816 ) 363470 7 Fax : (403)504^00 5 Fax : (210 ) 6704S7 7TBC9INOLOGIES, ] 

# ACCES S INFORMATIO NTRACKIN GSHEE T BVID : 3,7^7. 7 PROPERT Y ADDRESS : '^^l U 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 AME S P EOthe r (Prudent ) DATE TIM E ACCESSO R CONRACTDETAI L /^S*-t ^ A^JUule-CA ^ 

# i ^ l^] ^ I1 '^I' n t l 

# / P U

Comments :

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica i Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omahia , Nebraslc a 8811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Plione : (402)504-100 4 Plione : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7TECHNOLOGIBS, ] 

# Acces s Assessment 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 ? 

# H 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 Aan dthe y wil l assig na t alate r date . Doe s thi s propert y requir e lot s o f scrapping ? 

# %nVi ^**^*^\A^ 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 ? a Doe s thi s propert y hav e an y significan t structura l damage ? 

# ^^A > 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 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 7TECHNOLOGIBS, ] 

## Doe s thi s propert y hav e agarage ? 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 facto ^ finisho 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 r qjccupied ? Ar e ther e an y pet s a t thi s property ? ingm s p 

## Ar e ther e an y lo w hangin g powe r 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 Oniaha , 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 7OCT . 15.2009« . 2:29PM, . 'NO.29 7 P,2'' 7 

## PAINT MATCHIN GFORM : 1 . T O B EFILLE D OU T ONL Y I FMATCHIN GCOLO R rROPERTVADDRJESS : _ 

# BVID : '5?^7 7 Th e followin g note s ar c fo r th e benefi t o f pain t cre w only . 

### Pain t Ye $ Pain t No Locatio n Pain t Deseriptio n Sidin g Alrr»\jn\orf > U Soffi t A^^V)OnlP'V ^ 

# xy ^ Fasci a '\|r>r^On ^ Or^ s Come r Tri m frjruv^ioio*^^ 

### J L ^ Windo w TYini s ^Imoo j t ^ 

### J ^ " ^ Doo r Trim s A^<Y>Oi^ » tJvvA . 

### v ^ Fron t Porc hCeilin g 

# • ^/ AC^^X^ T Fron t Porc hCeilin g Beams Ar^*viOwsOw ^ \ ^ 

### Fron t Porc hFloor Fron t Porc hRailing s Fron t Porc hStep s .Sidin g Baseboard s P\\mO, ^ jv w L / 

### Foundatio n 

## S^cK ^ (*iof-pVo-A-c J ^ looo ^ ^nnafc h / Ae €y/ihM ) \ 

# 6l^ ,^fcf4 . ^ 

### UUJ^OAU J I^HUOL J

## tvty , t>^c»<» ^ r^tXJA j fifent Jga r H)<rtA,L(ri J UJ^ A(^'\Jlci^C{^ ) I UNDERSTAN D SHERWI NWILLIAM S WIL LMA/C H M Y CURREN T COLORS , Homeowno-signature : /[l^>i^>y ^ f ^ 

# ^ i..^ - A>-Af-^' f

BOI Q Ulhr dPtitmny , Suit * 40 6 2fiOSN . 24'*Sti«ft . Suft * 30 8 434 2 Modlca i OHv ^ Sut e 4260 KancMCity,M0a«11 4 Om4>V.N«lnat a6611 0 S>nAnn>nip^ 7X76220 Pftom : (816)363.370 3 P)ioi)« : (402)504.1004 

### pxon* : (210)82^M n Fax : (816 ) 3n-370 7 Fw ; (402) 60«-100 S Pa c(210 ) 670467 7TECHNOLOGIES, ] 

## 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 ? 

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

# ^J 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 7TECHNOLOGIBS. ] . & « 

## PRE-STABILIZATIO NPROPERT Y SAFET Y ASSESSMENT FOR M PROPERT Y ADDRESS : BVID/SAID : 

# '3>7^^ ^ PRUDENT ASSESSMENT REPERSENTATIVE : 

# ^ ^ At^f y 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 , 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 7TECHNCnX3GIIS , IN C 

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

# 2>S7 V FAUSn M ^ - ?'^* ^ " Crew : 

### Date : |o|\«i| 2 ^» ^ Ite m OK ? Hazar d Correctiv e Actio n Overhea dLine s _pCUii« ^ U>YC \ « W~t W N.^* ^ '>'>^ « <4^'*^—tbbiU L pfli»* > cw u . In-transi t Vehicl e Clearanc e Level s aroun dhig hwire s 

## ^ r^rp ^ Vehicl e Clearanc e aroun d hig hwire s whe nworkin g VII V Phon e line s fiQ-4 pl>p>>l . lu»M . Hft^rU Q fAHajJln,—A<>><\Oif| / , Cabl e line s 

## -Ufe ^ Ga s Lin e 

### J^J L Wate r Lin e 

## _HA . Sewe r Lin e 

## ^Hk . Septi c Tan k 

### JU L Propane/Butan e 

## JiO - Acces s to/o nPropert y 

### JOJ L Neighbo r Acces s Require d 

### AU L Hig hTraffi c Are a 

## JiA . Garag e 

# j ^lUa . V> 3^W S ^ loft s *»''t^4 ^*>< V ^« ^ Structure s -hU ^ Drivewa y 

### .fclA . •Mu A"t e b l ni»»6V H A^^ i k'K'o^ 

# H*H ^ Sidewal k -MJL . Foundatio n 

### J4A - Retainin g Wall s M K Fence s M K Tree s 

## -*it . Foliag e Genera l Conditio no f yar d Daniage dAreas : sin k holes/rotte dwoo d Sprinkle r Syste m Pet s 3-3>fay ) JinV^) . Insect s Weathe r Condition s Unsaf e drivin g condition s Unsaf e neighborhoo d Cre w Foreman / Sub-Contracto r Sit e Safet y Office r 

## / ^ J-^O-^dffi x ^hU^^z^ " 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 7i. m*»yi«i T



# ^?p pNO.29 7 P . 3/ 7 OCT.1$.280 9 2:29P M 

# Curren t Sampl e Pre-Renovatio n For m

I { I Effectiv e ur?li i Apri l aoiQ . confirmatio n o fReceip t c fLen d Pamphle t Q ) I hav e received a cop yo fth e pamphlet , Ficnovat e fVght : Importan t Lea d Hasa d rIntonnatio n fo rFomifies , Ctul d Car e Providor s an d School s informin g m e o f th e potentia l ris k o fth e lea d hazar d exposur e fro m renovatio n activit yt o b e perfonrne d I n m ydweilin g unit . I rpc^h/e d thi s pamphle t befor e th e wor k began . 

### CAAA ^ 

# h^N ­ ^ 

# L Printe d nam e qfrecipien t Dat e 

### Signatur e o f lecipion t Self-Certificatio nOptio n9o r tenant-occupie ddweWno e only ) — I fth e lea d pamphle t wa s delivere d hu t a tenan t signatur e wa s no t obtainable , yo u ma ychec k th e appropriat e bo xbelow . a ftefusa l t o sig n —I certi ^ tha t I hav e mad e a goo d fait h eifor t t o delive rth e pamphlet , FWiovat e plgtit : Importan t Lea d Hazar d Inforwatio n fo rFamriffes . C^iT d Car e Pro\rider $ jn d SOiools , t o th e mnta 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 confinnatto n Q i receipt . I funhe rcertif ytha t I hav e lef t a cop yo fth e pamphle t a t th e uni t wit h th o oocupant . Q4Jnavailabl a fb rsignatur e —I certif ytha t I hav e mad e a goo d fait h effor t t o delive rth o pamphlet , Renovat e Right : Importan t Lea d Hazar d (nfbrmatior ) fo r FamHias . CNi d Cor e provider s an d Schools , t o th e renta l dv\«llin 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 freceipt . I furthe rcertif / tha t I hav e lef t a cop yo fth e pamphle t a t th e uni t b yslidin g i t unde rth e door . . . l^nted^fam e o fperso n certifyin g Attempte d delivery dat e an d tim e lea d pamphle t delivery Signatur e o fperso n cortliyin g lea d pamphle t delivery

UnttAddres s Not e flegaidin o Mailin g Optio n —A s a n altemativ e t o deliveryi n person , yo u ma ymai l th e loa d pamphle t t o th e owve rand^o rtenant . Pamphle t mus t b e maile d a t leas t 7 day s befor e renovatio n Pocumen t wit h a certificat e o fmailin g fro m th e pos t off ice) .Dougla s Count y Account Infonnatio n http://douglasne.n]affljing-online.conVDougiasCoNe/static/accountinfo. . i.n^m i Dougla s County , Nebrask a Propert yRecor d - R l 13478000 0 Prin t Repor t NE

WFeatur e - Parce l Dimension s availabl e @ scal e 0-50 f t v«s t o f 52n d S t - Vie 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 - ^ r) * <r ^

Aut o Sale s Searc h Owne r PARRIS H DANN Y 1511 2 MARTI N AV E w / * *^ ^

1 OMAH AN E 68116-000 0 Propert yInformatio n Ke yNumbe r 347 8 000 0 1 1 Accoun t Type : Residentia l Parce l Numbe r 113478000 0 Parce l Address : 257 4 ELLISO N A V OMAH AN E 68111-000 0 Lega l Description : FOR TVIE WAD D LO T7 BLOC K0 5 0 X 133. 7 Valu e Informatio n Lan d Improvemen t Tota i 200 9 $2,600.0 0 $29,900.0 0 $32,500.0 0 200 8 $2,600.0 0 $29,900.0 0 $32,500.0 0 200 7 $2,600.0 0 $23,100.0 0 $25,700.0 0 200 6 $2,600.0 0 $23,100.0 0 $25,700.0 0 200 5 $2,600.0 0 $23,100.0 0 $25,700.0 0 200 4 $2,600.0 0 $10,200.0 0 $12,800.0 0 Sale s Informatio n Sale s Date : 2006-12-0 1 Dee d Type : QC M Book : 200 7 Page : 01465 7 Price : $0.0 0 Granto r PARRIS H DANN YETA L Grantee : PARRIS H DANN YETA L Valid/invalid : Invali d Exclusio n Reason : Multipl e Parce l Sal e Sale s Date : 2006-10-2 0 Dee d Type : WD M Book : 200 6 Page : 12172 0 Price : $ 36,000.0 0 Granto r Baye rHele n G Estat e o f Grantee : Parris h Dann yeta l Vaiid/invaiid : Invali d

lo f 3 10/9/200 9 10:0 5 A MDougla s Count y Accoun t Information http://douglasne.manning-online.coni/DouglasCoNe/static/accountinfo. . Exclusio n Reason : Multipl e Parce l Sal e Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 5 6650. 0 1. 0 133. 0 50. 0 N o Improvemen t Informatio n Buildin g 1 2874ELUSONA V OHIKU M fl«rao» lEn d Sd u v>w i Jilt , t ! HBOKH I

|Br«3Se««W4 » ,_ ' 

## RANC H CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 960. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Fai r

Buil t As : Ranc h Cond o Squar e Footage : 0. 0

HVAC : Force d Ai r Rooms : 5. 0 Exterior : Fram e Viny l Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 2. 0

Roo fType : Hi p Stories : 1. 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 Buii t 190 7 0 0 % 190 7 10 1 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 960. 0 Fixtur e Bas e Fixture s 1. 0 Fixture Bat h Ful l 1. 0 Garag e Detache d 216. 0 Porc h Enc I Soli d Wal l 120. 0

2 o f 3 10/9/200 9 10:0 5 A M

### Dougla s Count y Accoun t Informatio n http://douglasne.manDing-online.com/DouglasCoNe/static/accoiintinfo. . :.m^|)l l Porc h Enc I Soli d Wal l 

### 165. 0

3 o f 3 10/9/2009 10:0 5 A M

## Pruden t Propert yClose-Ou t For m (Lead-Base d Pain t Stabilization ) SAID : 'hIGiy j Propert yAddress : p.- S J ^ ^ fL i cQ// [ f\y~ C Owner' s Name : d/< ^ vCvMV ^ j S.N O 1 1 

### 1 2 : 3 i 

### i 4 ! 5 1 1 i 6 1 7

1 1 8 1 9 ; 1 0 1 11 1 j ; •' 2 Performanc e Standards/close-Ou t Criteri a 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 , ai l trim , porches , bo x beams , columns , rails , an d exterio rsurface s o fgarages . Wa s al l scrapin g an d othe rpreparatio n wor k complete d satisfactorily ? Wer e al i 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 ? Ar e al l ofth 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 i 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 ? 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 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 AClose-Out . 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 ? 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 Ye s N O 

# y c y 

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## y Pruden t Representativ e Signature : / ^ Propert yOwne rSignature : 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 : 1816 ) 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