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### TRANSMITTA L O F OMAH ALEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : 2923 3 DATE : 1/1 5 ADDRESS : 161 8 OHI O S T REMEDIATIO N CONTRAaOR : PRUDENTTECHNOLOGIES . INC . YEAR : 201(> 

### SOI L REMEDIATIO N PROPERT Y FIL E FOLDE R DOCUMENT S d PR E AN D POS T VIDE O O F PORPERT V (DVD )

• EXECUTIV E SUMMAR Y Q EPA-PROVIDE D PROPERT Y SKETC H d SIGNE D ACCES S AGREEMEN T FOR SUBJEC T PROPERT Y D SIGNE D ACCES S AGREEMENT(S ) FOR ADJACEN TPROPERT Y d RESTORATIO N AGREEMEN T D SETTLEMEN T DOCUMENTS (I.E. , FOR DAMAG E O R TO REPLAC E PLANTS , ETC. ) d CONFIRMATIO N DAT A d PHOTOGRAPH S Q AS-BUIL T SKETC H d SATISFACTOR Y RESTORATIO N SIGNE D B YPROPERT YOWNE R PROPERT Y CLOSE-OU T CHECKLIS TSIGNE D B Y EP A D DESCRIPTIO N O F AREA S NO T MEETIN G RO D CLEANU P CRITERI A d UTILIT Y CLEARANCE S ra PROPERT Y INFORMATIO N FRO M DOUGLA S COUNTS ASSESSOR'S OFFIC E D 

### D D ^ ^ 3\\*b ^ SIGNATUR E DAT E 3021838 7 Superfun d

### PROPERT Y SUMMAR Y Date : /15/201 0 Oinah aLea dSit e Remedia l Actio n Contrac t #EP-R7-07-0 6 TO# l Mont hof : Propert y Address ; 161 8 OHI O S T A . EXECUTIV E SUMMAR Y A. 1 Issue s Encountered : NON E A. 2 Issue s Resolved : NON E A. 3 Uniqu e Findings : NON E A. 4 Othe r Relevan t Information : NON E CONFIRMATIO N SAMPLIN GDATA/RESULTS :

F 2 = 18 4 PP M @ 2" ; N O EASEMEN T ATTACHMENT S 1 ) Propert y sketc hprovide db y EP A pursuan t t o contrac t specification s 2 ) Signe dAcces s Agreemen t includin g acces s agreement s require dfo r crossin g othe r propertie s 3 ) Pre-Excavatio n digita l vide o clip/photograph s 4 ) Post-Excavatio n digita l vide o clip/photograph s 5 ) Documentatio n - Complete dClose-ou t Checklis t 6 ) As-Built sketc h­ i ) Shal l includ e fina l lea dlevel s v ) Legen d ii ) Contaminatio n lef t behin darea s vi ) Contracto r identificatio n iii ) Property addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e include din th e individua l property file , i f available , o r obtaine dinclude : i ) Pre-excavatio n agreemen t detail s (i f any ar e mad e withth e property owner ) ii ) Property Statu s For msigne db y property owne r iii ) Excavatio n digita l vide o i n MPEG , WM V (Window s Medi aVideo ) o r SW F(Flas hPlayer ) forma t and/o r photograph s iv ) Signe dfor mverifyin g satisfactory restoratio n v ) Descriptio n ofarea s no t meetin g Interi mRO D cleanu p criteria .

TECHNOLOCIES , INC .Fin d Record 

### Backfill :

Sampl e Area : 2923 3 -161 8 OHI O S T Owner :

• Owne rOccupie d Owne rName : AUSTO N ARCHI E L Owne rAddressl : Owne rAddress2 : fl62 0 OHI O ST City : State : Zi p Code : lOMAH A 

### JN E J681lb Owne rPhon e Alternat e Phone : 

## j

Contract : Contractor : JPRUDENT2010_ S Contrac t Optio n foPTIO N 2 Remediatio n Quer y Lea d Remainin g QueryPropert yDamag e Quer y

Use rProvide d Owne rInformatio n Owne rName : Owne rAddress : 

## J City : State : Zi p Code : Owne rPhone : Altemat e Phone :

•

Assessment : Qualifyin g Grou p j40 0 Assessmen t Ma xXR F Valu e f 473.2 7 Resident : Residen t Name : Propert yAddress : 1161 8 OHI O S T Zi p Code : 

## jeslio " Residen t Phon e 

# ITECHNOLOGIES , INC . 

# EP A Propert y Clos e Ou t Vropcrty n-.TJliyy ? Propert y Atldress : (u ? I ^Okh s ^ . Date/Time : Owner' s Name : 4<cW ^ e A lA.'^Oy q Quad s Excavated : P'Z ^ Contracto r Group ; Pruden t Technologies , tn c Excavatio n Genera ) Ye s N o I .I f necessary , wer e th e correcl quadrant(s ) excavate dandrestored ? / 

### 2 .

I f necessary , weir e th e correct area s o f drip zone excavatedandrestored ? / 

### Gradin g Sodan dVegetatio n Ye s N o 1 .

Doe s the gradin g aroundthe perimete r o

f the hous e in excavatedarea s generally slop e awa y fro mthe house ? / 2 .Has sodbee n laidi n all area s tha t wer e excavated ? / ?i

. Doe s the sodappea r to b e generall y health y andgrowing ? (Onl y evaluate i f inspecte da t a3 0 da

y lim e period) 

# y 4 .

Ar e sodde darea s generally finn an devenl y graded ? 

# y 5 .

Ar c the joint s between the sodstrip s generall y tight ? (Onl y evaluat e i

f inspecte da t a3 0 da y tim e penod ) 

## y 6 .Wa s the propert y grade dsuc htlta t wate r will not pool o n tli e property ? 

# y 7 .

Wa s dainag e lo landscaping o r plan t material s avoided ? 

# y Gates , Fence s an dRetainin g Wall s Ye s N o 1 .

D o gate s ope n andclos e freely ? (I f apphcable ) 

## y 2 .

Wer e all gale s o r fence s taken dow n durin g restoratio n activitie s reinstalled ? (I f applicable ) / 3 . Wa s damag e t o gate s or fence s avoided ? (I f applicable ) / 4 . Wa s damag e l o retainin g wall s avoided ? (I f applicable ) ^ Foundation , Sidin g an dGutter s Ye s N o 1 Wa s damag e t o the sidm g o r tri mavoided ? / 2 .

Wa s damag e lo the foundation avoided ? 

# X 3 . Wa s dajnage lo window s avoided ? 

## y 4 . Wa s damag e t o window s o r doo r screen s avoided ? 

# X 5 . Wa s damag e l o downspout s o r downspou t extension s avoided ? 

# y Sidewalk s an dDriveway s (Concrete ) Ye s N o I . Wa s damag e t o diivewa v surface s avoided ? 

## y ^ 2 . Wa s damag e t o walkwa y surface s avoided ?

## Owner s comments :

Inspectao n motes :

Remova l andrestoratio n activate s complete includin g th e 30-da y so dwarranty : EP A Representativ e dc< m^^su j ^Date: ii)3hc ?

# IRI l CHNOLOGIES . INC 

### A S - BUIL T DRAWIN G OL S # 2923 3 Dat e Excavated : I0/2.S/20I 0 I'SEP ASigned-Of f Date : 

### OMAH A LEA D SUPERFUN D SIT E

Omah a Lea d Sit e Owne rName : ARCHI E L AUSTO N Address : 161BOHIOS T

Phone : H ; Sampl e Numbe r RYASCPX A2923 3 RYBSCPXA-2923 3 RYCSCPXA-2923 3 RYDSCPXA-2923 3 RDZSCPXA-8e33 3 RCZ0CrXA-a!)23 3 • RPZSCP,Y. A2023 3 F l F 2 B l 8 2 B2 ­ G Z 9 t 

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# M S'ia^^l'K . Omah aLeadSite N O E.4SEMEN T CONTRAC Ttt : EP-S7-10-0 5 PRUDENTTECHNOLOGIES , INC . 4613 0

# «EF ^ Propert yCompletio n Agreemen t Thi s agreement document s th e completio n o f remova l activitie s performe do n th e belo w liste dproperty . Th e property owner' s signatur e indicate s tha t th e property owne r i s satisfie dwithth 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 an y remaining warrant y (3 0 day s total ) excep t thos e item s liste dbelow , i f any . Propert y ID : 2 ^ 2-^' ^ Propert yAddress : | ^ j 9 ^ ^ ^ <^p ^ 

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)I O I agre e restoratio n i s completed .

I__ l I d o no t agre e restoratio n i s complete d a t (note d deficiencie s above )

Owner' s Signatur e Date 1Pruden t Tficlinologi^s , !n c (l-'rudeiit) is unde r contrac t wit hth e IJ .S. Environment.i l .Protectio n Agenc v (EFA ) lo clea nup loAclcontaitiinate dsoil s at

;i numbe r of

propertie s locate d in Omaha , Nebra.$ka , includin g th e property locate d at Th

e KP A request: ; you r permis.sio n to allo w Pruden t to pertor masoi l cleanu pal tJii.' ; properl y lo remov e lead-contaminate dsoil . By signin g thi s .ibrm , th e property owne r grant s permissio n lo Pruden tto perfon n aaivitie s relate dlo th e cleanu p includin g soi l sampling , remova l of

lead-contaminate dsoil , an drestoratio n ofth e reference dpropert y Ifyo u hav e any question s abou t th e soi l cleanu p planne dfo r you r properly , pleas e contac t Pruden t southoffic e fo r th e Omah aLea d Site cleauup-a t (^02 ) 733-11S8 . Genera l question s abou t th e Omah aLea dSite cleanu p ca nbe directe d to th e EPA Publi c Informatio n Center s at (402 ) 73 1 -304 5 (SouthOinah aoffice ) or (402 ) ^91-958 3 (North(^mah aofftce1 _ Properl y Acce.s s darne dlH y v /_ / 

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# (W 3^ - ^^ ^ ^ AG E OF HOME? : YEARS . HO W LON G HAV E YO U LIVE D HERE ? YEARS , HA S TH E EXTERIO R BEE N PAINTE D OR COVERE D WIT H SIDIN G SINC E 1978 ? YE S NO 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 PLA Y IN TH E YAR D FO R 5 HOUR S OR MOR E PE R WEEK : COMMENT SOR SPECIA L INSTRUCTIONS : (I.E . DOGS , ENTR Y GATES , ETC. )

AUTHORIT Y FO RENVIRONMENTA LRESPONS E ACTIONS ^ Th e activitie s to be implemente d by EP A unde r thi s agreemen t ar

e pursuan t io Sectio n 104 of CERCLA , 42 U S. C 9604 . EP.A' s righ t of

acces s to th e propert yis provide dfor in Sectio n 104(e ) of CERCLA , 42 U. S C 960i^e) , whic hprovide s entr y for "detenninin g th e nee dfo r response ,or choosing , or tiikiii g an y respons e actio n under tlu s title , or otherwis e enforcin g th e provision s ofth e titl e " 808 0 vrVare t Paikway . Sair<^ • • ''.i? . lyi'r-ijif.n l Orivf; , ;JIJ« R^'i'.if i Kansa s Cirv . MO 64 f M Phone ; f816 J 363-370 5 f*ii'j!i:. : ('i1l))Cl2'i.t»ft:;i < -3.< . (816: - 3S3-.T7!l ­ENVIRONMENTA L& CONSTRUCTIO N SERVICE S

808 0 War d Parkway , Suit e 40 5 

### seoosios t 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Oinaha , Nebrask a 6810 7 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)733-118 8 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)733-188 3 Fax : (210 ) 579-657 7

# 2923 3 Owne rName : ARCHI E L AUSTO N Address : 161 8 OHI O S T Phone : H : Sampl e Numbe r RYASCPXA-2923 3 RYBSCPXA.2923 3 RYCSCPXA-2923 3 RYDSCPXA-2923 3 nDZGCPX A30233 ­ nOgOCPX A2923 3 RPZSCPX A2033 3 F l F 2 B 1 B 2 -BZ ­ G Z P S 

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### Pag e 1 o f 1

" > Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l



### • YOURTICKE T NUMBERI S 2622426 . Origina l Cal l Date : 10/20/1 0 Time : 5:2 4 p m Op : SIVA1896 7 Wor k t o Begi n Date : 10/22/1 0 Time : 6:0 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 161 8 Street : OHI O S T Twp : 15 NRng : 13 E Sect-Qtr : 10-SE-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : soi l lea d remediatio n projec t Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)733-188 3 : UNSUR E CORNER S Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : SIV AJAMPAM A Phone : (402)733-118 8 Wor k Bein g Don e For : EPA Dept h o f Excavation : 6 F T Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Are a Contac t Phon e Numbe r utilit y Typ e CXCAT V CO X COMMUNICATIONS , INC HEID I 

### Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 MUDO l METROPOLITA N UTILITIE S DISTRIC T SANDY 

### Day : 402504782 3 Alt : Emerg : 402504797 0 OMAHACOFCITY OFOMAHA-TRAFFICSEWERRICH/TRAFFIC 

### Day : 402444719 7 Alt : 402444516 1 

### Emerg : 402444516 0 0PPDGPR 5 OMAH A PUBLIC POWE RDISTRICT EL M LOCATING 

### Day : 406728934 3 Alt : 406207149 4 

### Emerg : 888728934 3 QLNNEI C QWES T LOCA LNETWOR K EL M LOCATING 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 

### http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 10/20/201 0ENVIRONMENTA L & CONSTRUCTIO N 

### TECHNOLOGIES , INC . SOLUTION S 

# Sit e Safet yHazar d Analysi s Address : f b /^O^^'O^i Crew : P\^->v^V J^'V ^ 

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