### TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO N FIL EFOLDE R S/iID# : 

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_ Date : ^/^/^7 Address : 32S7^(i 7 }app/a^f \fh M Remediatio n Contractor : _Coasta I Environmenta l Group

_Year : _200 7 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S ^ Vide o o f property (DVD ) &

f Executiv e Summary EEPA-provide dpropert y sketc h t

/ Signe dAcces s Agreemen t for subjec t property D Signe dAcces s Agreement(s ) for adjacen t property ^ Restoratio n Agreemen t D Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) M Confirmatio n dat a M Photograph s ' As-buil t sketc h ^ Satisfactory restoratio n signe db y Propert y Owne r S

r Property close-ou t chec k Hs t signe db y EP A D Descriptiono f area s not meetin g RO D cleanu p criteri a D Utility clearance s D Propert y informatio n fromDougla s County Assessor' s Offic e D D ,

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## Phone : 34Q>-W7 I Fax : Cell/Pager : D Notificatio n Lette r [ ^ Acces s Agreemen t NLRestoratio n Agreemen t L J Topsoi l Samplin g (i f applicable ) 1 1 Disposa l Samplin g (i f applicable ) n Garde n Samplin g (if applicable ) H^Utilit y Clearanc e " ^ Video/Photo s (Before ) E l Video/Photo s (During ) [iKvideo/Photo s (After ) D Video/Photo s (30-Day )

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### ORTI Z FRANCI AM 256 6 POPPLETO N AV Parce l I D Owne rNam e PropertyAddres s Cit y Zi p Owne rAddres s Owne rAddres s 2 Owne rCity Owne rStat e Owne rZi p Sec-Twn-Rn g Owne rAddres s Additio n Bloc k Lot Lega l 1 Lega l 2 Lega l 3 Lega l 4 Ol d Assesso rSit e NewAssesso rSit e 221843000 0 ^ ORTI Z FRANCI AM 256 6 POPPLETO N A V OMAH A 6810 5 256 6 POPPLETO N AV E OMAH A N E 6810 5 27-15-1 3 SHULLS2NDAD D 8 1 8 E 2 0 FTLT1 7 & W 48. 2 FT 68. 2 X 16 8 Valuatio n Informatio n Valuatio n Informatio n



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## Consent o par a e l Acess o d e l a Propieda d DERECHO A ENTRA RLAPROPffiDA D 

### Otorgant e (dueno(a ) d e propiedad ) s e d aconsent o y autoriz alaAgend apar al a Proteccio n de l Medi o Ambient e d e Lo s Estad o Unido s (EPA ) o s u representante s autorizado , e n conjunt o e l Cesionario , aentrar y llevar acab o alguna s actividade s ambientale s acerc ad e lapropieda ddescribid o qu e sigue :

Duen o d e l aPropiedad :

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# 2 ^ Direccion : Direccion : Direccion : Direccion : Direccion : Numer o Diario :

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PROPOSIT O D EACTIVIDADE S AMBIENTALE S 

### E l EP A solicit ael acess o acollectar muestra s d e tierr ay remove r tierr aqu e tien e alt a concentracione s d e arsenic o y/ o plom o qu e podri aser peligros o as u salud . L atierr a estar aremovid o y el(los ) area(s ) excavado(s ) estar areemplazad o co n material s Hmpia s y restaurado . Est e trabaj aestar arealizad o abaj o de l Omah aLea dSit e Superfun dSit e program ad e remediacion . Un representant e d e EP A s e contactar ael Otorgant e pesonalment e adiscuti r e l trabajo estar realizado , el Otorgant e tendr alaoportunida daexaminar y sancionar e l plan d e removimient o d e tierr ay el trabajo d e restoracio n ante s d e comenzar . Cuand o el trabajo s e termina , el Otorgant e estar apedid o arevisar el trabajo , confirmar s u terminacio ny cumpli r co n s u aprobacion . Despue s d e terminacion , el Otorgant e recibir au n document o escrit o po r el EP A qu e indic al apropieda dhabi asid o remediado . ACCIONE S D ELA RESPONDENCI AAMBIENTAL . 

### Po r s u firm ad e est e Acuerd o d e Acceso , e l Otorgant e conced e e l EPA , su s empleos , contractor s y subcontractor s el derech o aentrar l apropiedad , e n tiempo s razonabl e y si n noticiaanterior , par ael unic o proposit o arealizar trabajo . Est e acces o deberi apersisti r e n efect o hast aqu e e l trabaj o habi asid o terminad o e n u n estad o aceptado . E l Ortogant e tamibe n est ad e acuerd o con : Pagin a1 o f 2 «Property_ID »

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•Remove r obstrucione s qu e incluy e botes , ranolque , vehiculos , jugete s d e nino s montone s d e madera , casa s d e perros , etc . •Remove r d e bulbo s d e flores, o otra s planta s qu e e l Otorgant e o inquilin o de l Otorgant e quisier aguardar , •Rega r y mantene r reemplaz o d e vegetacion , inclus o l aaplicado n d e fertilizant e com o e s necesan o subsecuent e d e l ariegainida l pea - dEPA ; •Permanece r po r l agui ad e Salu dy Segurida dprovdd o po r e l EPA ; •S i l apropieda dest arentado , asist e dEP A aobtene r l aaprobado n d dinquilin o par aacces o al apropieda dallevar acab o e l trabajo , s i dEP A est ainhabi l a obtene r acceso ; y • Permiti r ahace r u n vide o y/ o toma r foto s d e l apropieda dinduyend o lo s area s exterio r y interio r d e edifidos . ACTJERDOAN O INTERFERI R 

### E l Otorgant e est ad e acuerd o an o interferi r o meters e e n cualquie r actividade s o trab^ o hecho , o e l equip o usad o allevar d e cab o lo s actividades , o hace r cualquie r acdone s e n respect o d e l aus ad e dich o propieda dqu e podri aarriesga r l asalu do bienesta r d e lo s Cesionario s o e l medi o ambiente , o permiti r otra s persona s ausa r l apropieda de n algun a manera. S i tien e pregunta s sobr e est e programa , po r favo r contact a 

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• Propert y ID »

## Restoratio n Agreemen t Th e purpos e o f thi s agreement i s t o provid e amutual agreemen t as t o condition s o f propert > prio r t o remediatio n activities . Thi s wil l als o sen e as decontaminatio n fo r th e purpos e o f assurin g tha t restoratio n activitie s are complete dt o the satisfactio n o f th e property owne r an dth e Unite dState s En \ironmental Protectio n Agenc y (EPA) .

Propert y ID : 2 H ^ . Propert y Address : ^U \\}H\3Ad A M Ov»ner : 

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# m ^ Item s T o B e Remove d B yContracto rDurin g Remediatio n An d Replace d (Us e additiona l sheet s a s necessary )

# w ^ Landscap e Inventor y (Us e additiona l sheet s as necessary) 

## Ite m Pre-e.\istin g propert y are a tha t i s covere dwit hgrass .

Number of tree s > 2 inc h trunk diamete r

Number o f tree s < = 2 inch trunk diamete r

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# EXECUTIV ESUMMARY : 20688—256 6 POPPLETO N AV E N o Issue s o r Concern s | ^ Issues/Concern s Detai l Explanation :

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# Omah aLea dSuperfun dSit e
Tota l Quadran t Squar e Footag e t o b e Excavate d = 311 6 Propert yClassificatio n EB L Tota l Dri p Zon e Linea rFootag e t o b e Excavate d = 8 0

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Pennanen l Landscapin g Quadran t Boundar y 1 Inc h = 3 0 feet o r1 gri d = 5 xS ft .y^'-". . Propert yAddres s 256 6 POPPLETO N AV E Pos t Excavatio n Concentration s (ppm ) cQ ) Straa l Boundar y Troe/Shru b ^ ^ ^ ^•ty^imf^•^^ l nrj»r . Irt r F 1 . F 2 B 1 8 2 D Z Garde n Pla yAre a Easemen t Othe r DaiLiUjau n o l fiottt axcavMn n «*a a n fron t yar d l«f l -han d quadrant : r 2 from yar d nght-han d quadran t B 1 backyar d lafl-han d quadran t B? . backyar d nght-han d c OZ . dripxanm^t-3loa%mwm0 t wo t arawi d llwfoiffidaIM n oltti e house) . Legen d Are ano t Excavate d Dripzon e Excavate d Quadrant s Excavate d Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc .

# m ^ Propert yCompletio n Agreemen t Thi s agreement document s th e completio no f remedial activitie s perfonne do n m y property . M y signatur e wil l designat e tha t I a msatisfie dwit hth e restoratio n o f m y property , andthat n o item s arc i n questions , now . o r a

t an y tim e i n th e future , excep t thos e item s liste dbelow , i f any . Pn>pert y ID : 

# c^^i^m Propert y Addrcs.s : ^^^^ ^ PDl)t] M fV PPV t Owner : 

# ni7}if3r/0'W/a<^a/Jl7 ^ Phone : 

# <^3b-ioQ7 / Restoratio n Item s i n Question :

Hem : Item : Item : Item : Item : Item : Additiona l Comments :

I \I iif;rc e restnrjttlu n I s coinplrtrd , excep t a s note d I I I <l o no t »Crc c restoi-Htio n i s complete d 

# 323 7 

# TiL: ^ Owner' s Signatur e Dat e Contractor' s Signatur e Dat e

# ^ 

# SEP A EP EP A Propert y Clos e Ou t Fo r

# f Propert y #: Propert yAddress ; 9'5lj>(T ^ fhpplth p /?/€ . Datc/Tinc : Owner' s Naaie:/}^/??^/// ^ \/-P7aSqijPr ^ Quad s Excavated : Contracto rGrou p ^ Excavatio aGenera l Ye s No 1. If necessary , wer e th e correc t quadrant($ ) excavate dan drestored ? (- ^ 2. If ncccssa'v , wer e th e correc t area s of drip zon e excavate dan drestored ? L ^ Gnidin t So d an d Vetetatto n Ye s No 1.Doe s th e gradin g aroun dth e perimeter of th e hous e in excav ate darea s generall y slop e away fromth e bouse ? 2.Ha s so dbee nlai din al l area s tha t wer e excavated ? ^Jce^ T 3h€/t , /? / ^^J A'7uJf*i7' 3.Doe s th e sodappea rto be generall y health y an dgrowing ? (Onl y evaluat e if

inspecte d at a

30 da y tim e period ) 4.

.\r e sodde darea s generall y fui n an devenl y graded ? i ^ 5.Ar e th e joint s betwee n th e so dstrip s generall y tight ? {Only e\aloat e if inspecte d at a

30 da y tim e period ) 6.Wa s th e property grade dsuc htha t wate r w ill no t poo l on th e properr\ ' 7.

Wa s damag e to landscapin g or plan t material sa\oided ? 

# T^ . Gales , Peace s aa c Rciainin t Wail s Ye s No \. Do gate s open a.n dclos e freely'? (I f applicable ) y.. ^ 1. . Wer e all gate s or fence s take ndow ndurin g restoratio n activ tie s re>.s'_a!ie-c ? .i f apr'-icabie ) \ y 3. Wa s damag e to gate s or fence s avoided ? (I f applicable ) ^ 4. Wa s damag e tc retainin g wall s avoided ? (I f applicable ) 

# p7 ^ . ^ Foundation , Sidia f an d Gutter s Yes No 1. Wa s damag e to th e sidin gor tri mavoided ? 2. Wa s damag e to th e foundatio navoided ? 3. Wa s damag e to window s avoided ? 4 Wa s damag e to window s or door screen s avoided ? 5. Wa s damag e to downspout s or dcwTispou t extension s avoided ? Sidewalk s an d Driveway s (Concrete ) Ye s No 1. Wa s damag eto drivewa ysurfaces avoided ? ^ 2. Was damag e to walkwavsurface s avoided ? ^

# T ^Owner s comments : 

# .

Inspectio n Dctes :

Remc\'a l andrestoratio n acti \ate s complet e includin g th e 30-da> ' so dwarrantv' : EP A Representative;^^^;^^^^^!;^^^^^^/!? ^ Date : y/py^- y