## TRANSMITTA L o f OMAH A LEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : ^«jgq q Date : o / j .9.3. j ^fln ^ Address : ^Ci.^6
- i^M.<;A-c ^Y/ T Remediatio n Contractor : fip., rfPJC^' f

l^-htinftn g 19JI . free . Year : SOI L REMEDIATIO N PROPERT Y FIL E FOLDE RDOCUMENT S 1 ^ Vide o of propert y (DVD ) aExecutiv e Summar y EPA-provide dpropert y sketch SignedAcces s Agreemen t fo r

subject propert y D SignedAcces s Agreement(s ) fo r

adjacen t propert y ^ Restoratio n Agreemen t D Settlemen t document s (i.e. , fo r

damag e o r

t o replac e plants , etc. ) Q Confiimatio n data g

f

Photograph s aAs-built sketc h Gtf

Satisfactor y restoratio n signe db y Propert y Owne r H Propert y close-out chec k

lis t signe d b y EP A D Descriptio n o f area s no t meeting RO D cleanu p criteri a H Utilit y clearance s ^ Propert y information fromDougla s Count y Assessor' s Office D D D

/?"* * -*T'-Ir i 

### ^/'J M SignatunT Tat e 4031126 2 

# illilDHil l Superfun d

### PROPERT Y SUMMAR Y 

### Bate ; QllUa m1 Qmab aUs A Sit e Remedia l Actia n Cottfract^ EP-R7-Q7-e6/QeQ 4 ManthQf;Q^€^aa n Propert y Address : 243 5 KANSA S A V A . EXECUTIV E SUMMAR Y A. 1 Issue s Encoimtered : NON E A. 2 Issue s Resolved : NON E A. 3 Uniqu e Findings : NON E A. 4 Othe r Relevan t Infonnation : NON E CONFIRMATIO N SAMPLIN G DATA/RESULTS : D Z = 22 5 PP M @ 12" ; F l = 13 2 PP M ( @ 8" ; E A = 13 4 PP M @ SCRAPE ATTACHMENT S 1 ) Propert y sketch provide db y EP A pursuan t to contract specification s 2 ) SignedAcces s Agreemen t includin g acces s agreement s require dfo r crossing othe r propertie s 3 ) Pre-Excavation digita l vide o chp/photograph s 4 ) Post-Excavatio n digita l vide o cUp/photograph s 5 ) Documentation - CompletedClose-ou t Checklis t 6 ) As-Buil t sketch
i ) Shall include , final lea d levels , v ) Legend ii ) Contamination lef t betiindarea s vi ) Contracto r identificatio n iii ) Propert y addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e include di n th e mdividua l propert y file, i f available , o r obtaine dinclude : i ) Pre-excavatio n agreemen t detail s (i f an y ar e made wit h th e properly owner ) ii ) Propert y Statu s For msignedby propert y owne r iii ) Excavation digita l vide o i n MPEG , WM V (Window s Medi aVideo ) or SW F(Flas h Player ) forma t and/o r photograph s iv ) Signe dfor mverifying satisfactor y restoratio n v ) Descriptio n o f area s no t meeting InterimROD cleanu p criteria .

TECHNOLOCIES , INC
.Rn d Recor d Qea n U p Quer y Lea d Remaining Quer y I Propert y Damag e Quer y Backfill : ,

Sampl e Area : 3889 9 - 243 5 KANSA S A V Owner : n OwnerOccupie d Owne rName : |CAMPBEL L BARBAR A J Owne rAddressl : 

# r Owne rAddrKs2 : |612 9 N 2 4 ST City : State : Zi p Code : |OMAH A [NE " |6811 0 Owne rPhone : Alternat e Phone : |(402 ) 312-162 6 

# I ~ Resident : Residen t Name : |CAMPBEL L BARBAR A J Propert y Address : 243 5 KANSA S AV Zip Code : 16811 1 Residen t Phon e Contract : Contractor : |PRUDENT2008_ S Group : Assessment : Qualifyin g Grou p [PRIORIT Y ' Assessmen t XR F Date : 

# I Assessmen t Ma x XR F Value : I 532.7 1TECHNOLOGIES i IN C 

# SERI \ EP A Propert y Clos e Ou t Property# : 3 8 8^ ^ Propert y Address : .?^3 £ ^rtro ^ Av Date/Time : Owner' s Name : Quad s Excavated : D^ y Pl ^ ^A
- Contracto r Grou p Pruden t Technologie s Excavatio n Genera l i^ Ye s No 1.

If necessary , wer e th e correc t quadrant(s ) excavatedan drestored ? 2.

If necessary , wer e th e correc t area s of dri p zone excavatedan drestored ? ^ ^ Gradin g Sodan dVegetatio n Ye ^t

s /N o 1.

Doe s th e grading aroun d th e perimete r ofth e hous e in excavatedarea s generall y slop e awa y fromth e house ? 

# 17 ' 2.Ha s sodbee n lai d in all area s tha t wer e excavated ? 3.Doe s th e sodappea r tobe generall y health y andgrowing ? (Onl y evaluat e

if

inspecte d at a

30 

# y da

y tim e period) ._ 4.Ar e sodde darea s generall y fir man devenl y graded ? 5.

Ar e the joint s betwee n the sodstrip s generall y tight ? (Onl y evaluat e

if

inspecte d at a

30 da y 

### i / tim e period) 6.Wa s the propert y gradedsuc h tha t wate r will no t poo l on the property ? 

### L / ' 7. Wa s damageto landscapingor plan t material s avoided ? 

# T ; ^ Gates , Fence s an dRetainin g Wall s Ye s No 1.

Do gate s ope n an dclos e finely? (IfappUcable ) 

# y - /
­ 2.Wer e all gate sor fence s taken dow n durin g restoratio n activitie s reinstalled ? (If applicable ) 

# y 3.Was damageto gate sor fence s avoided ? (If applicable ) 4.Wa s damageto retaining wall s avoided ? (If applicable ) 

## ~y ^ Foundation , Sidin g an dGutter s Ye s ^ o 1. Was damag e to th e sidingor trimavoided ? \ / X ­ 2.Wa s damage to the foundation avoided ? 

### 1 / 3.Wa s damage to wmdow s avoided ? 4.Wa s damag eto window sor doo r screen s avoided ? 

# y 5.

Wa s damage to downspout sor downspou t extension s avoided ? 

# y Sidewalk s an dDriveway s (Concrete ) Yes/^ o 1.Was damage to drivewa y surface s avoided ?

! /	 • 2.Wa s damage to walkwa y surface s avoided ?

### Owner s comments :

Inspectio n notes :

Remova l an drestoratio n activate s comolet e including th e 30-da y so dwarranty : EP A Representativ e '^^-^CP ^ <UM.Jh
- ^Date: 

# u m

# &EP A Propert y Comptetio n Agreemen t Thi s agreement document s th e completio n o f removal activitie s performe do n th e belo w hste dproperty . Th e propert y owner' s signatur e indicate s tha t th e propert y owner i s satisfie dwith th e restoratio n o f th e subjec t property , an dtha t n o item s ar e i n question , now , o r at any tim e i n th e future , excludin g any remainin g warranty (3 0 day s total ) excep t thos e item s liste dbelow , i f any . Property ID : Property Address : 

# :2j\^ s k::<AVNAay N A-t.--/ ? " • •.;. • Owner : ^ ~ Phone : Restoratio n Item s i n Question :

Kem : Item : Item : Mem : Item : Item : Required correction s t o complet e th e property :

L J I agre e restoratio n i s completed , excep t a s note d above . L_ l I d o no t agre e restoratio n i s complete d

er' s Signature / Dat ePniden t Technologies , Inc . (Prudent ) is unde r contrac t wit h the U. S. Environmenta l Protection Agenc y (EPA )to clea n up lead
contaminate dsoil s at anumbe r of

propertie s locate d in Omaha, Nebraska, includin g th e propert y locate d at

. Th e EP A requests you r permissio n to allo w Pruden t to perfor masoil cleanu p

at

thi s propert y to remov e lead-contaminate dsoil .By signm g thi s form, th e propert y owne r grants permissio n to Pruden t to perfon n activitie s related to th e cleanu p includin g soil sampling , remova l oflead-contaminatedsoil , an drestoration ofth e reference dproperty . If

yo

u have an y question s abou t th

e soil cleanu p planne dfo r you r property , pleas e contact Pruden t Administrative Cler k

fo

r the Omah aLea dSit e cleanup . Ms . Debora h Johnso n -a t (402) 733-1188 . Genera l question s abou t th

e Omah aLea d Sit e cleanu p ca n

be directed to the EP A Public Informatio n (^nter sat ) (Sout h ) r (402) 991-958 3 (Nort h Omah aoffice) . c Informationl^nter s at (402 (402 ) 731-304

731-304 5 5 (Souj h Omah Omah a a office

office ) o

o r (40 2 Propert y Acces s Grante d /] ' (^(Pleas e Prin t Nafce ) j Propert y Owne r Signatu i 7 T (Si#iature ) (Date ) PROPERTY INFORMATIO N (T o be complete d by residen t and/o r property owne r - pleas e print ) RESIDEN T NAME : OU^g*
. (\,0-V^^P'^ ^ C^_0^[|fj y Rente r RESIDEN T ADDRESS : LVt£ _ IF RENTAL , PROPERT Y OWNE D BY :
OWNER' S MAILIN G ADDRESS ;
OWNER' S TELEPHON E NUMBE R - HOME : ('74> ^ 'TDf ' S3^ ^ WORK :
AG E OF HOME? : j^ + YEARS
. HO W LON G HAV E YO U LIVE D HERE ? '^Z > YEARS
.



### . HA S TH E EXTERIO R BEE N PAINTE D OR COVERE D WIT H SIDIN G SINC E 1978? ^ YE9— NU NUMBE R OF OCCUPANT S UNDE R 7 YEAR S OLD : (_. ) NUMBE R OF OCCUPANT S 7 YEAR S OL D AN D OLDE R NUMBE R OF CHILDRE N UNDE R 7 YEAR S OL D WH O PLAYIN TH E YAR D FO R 5 HOUR S OR MOR E PE R WEEK : COMMENT S OR SPECIA L INSTRUCTIONS : (I.E
. DOGS , ENTR Y GATES , ETC. )

AUTHORFF Y FO RENVIRONMENTA L RESPONSE ACTIONS : Th e activitie sto be implemente d by EP A unde r thi s agreemen t ar

e pursuan t to Sectio n 10 4 of

CERCLA, 42 U.S.C . 9604 . EPA' s right of acces sto th e propert y

is providedfo r in Sectio n 104(e ) of CERCLA , 42 U.S . C 9605(e) , whic h provide s entr y fo r "determinin g th e nee dfo r response , or

choosin g or

takin g an y respons e actio n unde r thi s title ,or otherwis e enforcin g the provision s of

th

e title. " 

### §Wt£ s « f^X S-\ei-it'«~| 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 , 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)579-657 7•--•'•••••'•".'-."' ' •.V,v«;',V''•••'. • • -.•• • -,''v'•••'' • i ! 

## ^ dMAJBLA:.i%ADMfk«E^JiMr£ ^ OLS# : 3889 9 Dat e Excavated : 10/27/200 8 USEP A SIpwd-OffDate : 

### 3889 9 Exterio rPain t NorthArro w Omah a Lea d SR e Owne rName : BARBAR A J CAMPBEU L Sit e Sketc h • Good Addiws* : 243 S KANSA S A V Ptjone:,':! : Sampl e Numbe r RYASCPXA-3a89 9 RYBSCPXA-3889 9 F l F2 RYDSCPXA^889 9 RDZSCPXA-3e89 9 nezscpxA-aBB W nPZOOPKA-0000 0 B 2 O

Z P£ - 

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- tS)Mft-«i ^ ^jg i E A = 13 4 PP M mSCRAP E 4613 0

CONTRA a # : E P - R7-07-0 6 / 000 4 PRUDEN T TECHNOLOGIES , INC
.ENVIRONMENTA L < & CONSTRUCTIO N 

### TECHNOLOGIES , INC . 

# V SERVICE S 

# Propert y Statu s For m Phone : i . ^ BVID : Plan t & Permanen t Landscaping To Remain I n Plac e Item # Descriptio n an dLocatio n O n Ma p
CXJiAi/ ^ 

# \0 o

Pre-Existin g Conditio n of Structure s DoesyourBasementhaveahistor y of leaking ? Ye s -' N o Item # Descriptio n & Locatio n O

n Ma p

Propert y Owne r Pruden t Empioyee Signatur i Signatur e 808 0 War d Parkway , Suit e 40 5 'N . 24* ^

Street , Suit e 30 8 4242 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 maha , Nebraska 6811 0 Sa n Antonio , T X 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 ) 579-6577

## 3889 9 Exterio rPaint NorthArro w Omah a Lea d Sit e Owne rNanw-.BAR I >AR A J CAMPBEL L • Goo d Sit e Sketc h AddraM:2435 | KANSA S A V Ba^Poo r Phom : H : W : ^ Q No t pain t Lea d Sampl e Sample s Cdlleeie d Sampl e Num b t r Concerttrati t n Collecte d Finn : ^H A ,\^/P=f ^ RYASCPXA^889 9 F 1 Date : O-)'7'n- 4 RYBSCPXA^8C9 9 F 2 

### £h.PP m B f 

# a Time : IQi^f Q JWGOCPX A 00(9 9 ^^_PP m L l Sample s Ajtalyze d RYDSCPXAr38{9 9 B 2 RDZSCPXAr38 i 9 9 DZ 

# i; ^ pp m E 1 \ RGSSCPM^FW ^ PPn t D 

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### Pag e 1 o f 1

Marc h 200 4 - Douqia s Count y Assesso r 

# ^H 3 5 kANSA S A y

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### Prin t Preview Pag e 1 o f 1 Dougla s County-Omaha , N E

Pame l I D 060077000 0 Sec-Twn Rn g 33-16-1 3 Owne r Nam e CAMPBEL L BARBAR A J Additio n BELL E ISL E Propert y Addres s 243 5 KANSA S A V Bloc k Cit y OIVIAH A Lo t 1 0 Zi p 6811 1 Lega l 1 45X136.4 9 Owne r Addres s Lega l 2 Owne r Addres s 2 612 9 N 2 4 S T Lega l 3 Owne r Cit y OIV ! AH A Lega l 4 Owne r Stat e N E Treasure r Websit e Lin k http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp ? parc=060077000 0 Owne r Zi p 6811 0 Assesso r Websit e Lin k http://douglasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R060077000 0 Disclaimer : i\/la p an d parce l dat a ar e believe d t o b e accurate , bu t accurac y i s no t Ma p Scal e guaranteed . Thi s i s no t a lega l documen t an d shoul d no t b e substitute d fo ra titl e search , 1 inc h = 8 0 fee t appraisal , survey , o rfo rzonin g verification
. 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 10/1/200 8Pag e 1 of 2

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## YOU RTICKE T NUMBE RI S 2147525 . Origina l Cal l Date : Wor k t o Begi n Date : 10/03/0 8 10/07/0 8 Time : Time : 4:1 3 pm 4:4 5 pm Op : RAMITA l State : N E Address : 243 5 County : Street : DOUGLA S KANSA S AV E Place : Twp : 16 N Rng : 13 E 

## Sect-Qtr : 33-NE-SE,34-NW-S W Twp : Rng : 

## Sect-Qtr : Lega l Given : C 

## Typ e o f Work : lea d remediatio n wor k fo r soi l Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (402)733-188 3

: UNSUR E CORNER S Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : RAMIT A Phone : (402) 7 Alt . Contact : Phone : (402) 7 Wor k Bein g Don e For : ep a Dept h o f Excavation : 6 f t Corne r Lot : NFront : Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : CXCAT V MAGELLA NMETR O MUDO l OMAHACO F OPPD G SPRNTPC S
utilit y Servic e Are a Contac t Phon e Number Typ e 

## Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , l>i C 

## HEID I Alt : 402934046 9 Emerg : 402932975 7
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### Pag e 2 of 2

MAGELLA N MAGELLA N MIDSTREA M PARTNER S L

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METR O METR O COMM . COLLEG E

MUDO l METROPOLITA N UTILITIE S DISTRICT

OMAHACO F CIT Y O F OMAHA-TRAFFIC.SEWE R

OPPDGPR 5 OMAH A PUBLI C POWE RDISTRICT

QLNNEI C QWES T LOCA L NETWOR K

SPRNTPC S SPRIN T SPECTRU M L P ^^^^ A



## CHRI S

SAND Y



## RO N

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A

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A Day : 918574709 8 Alt : 

## Emerg : 918574709 8 Day : 402457230 7 Alt : 402672703 3 Emerg : 402457231 3 Day : 402504782 3 Alt : 

# Emerg : 402504794 6 Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 Alt : 888728934 3 Emerg : 406728934 3 Day : 406728934 3 Alt : Emerg : 888728934 3 Day : 402537180 0 Alt : 402537181 0 Emerg : 800521057 9

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