### PROPERT Y SUMMARY | Date ; 10/26/2007 | Omah aLea dSite Remedia l Actio nContrac t #EP-R7-07-0 6 | Mont hof : Octobe r | Propert y Address ; 322 4 N 3 9 S t A . EXECUTIV ESUMMARY A. I Issue s Encountered : Non e A. 2 Issue s Resolved : Re-See dwil l occu r i n Novembe r o nan y dea dspot s t o encourag e sprin g growth . A. 3 Uniqu e Findings : A. 4 Othe r Relevan t Information : CONFIRMATIO N SAMPLIN GDATA/RESULTS : Fl - 8 7 @ 6 " B 2 

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### E l - 10 6 @ Scrap e 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 ndigita l vide o clip/photograph s 4 ) Post-Excavatio ndigita l vide o clip/photograph s 5 ) Documentatio n - Complete dClose-ou t Checklis t 6 ) As-Buil t sketc h­ i ) Shal l includ e fina l lea dlevel s v ) Legen d ii ) Contaminatio nlef t behin darea s vi ) Contracto r identificatio n iii ) Propert y addres s vii ) Dat e iv ) BV1 D numbe r 7 ) Othe r item s t o b e include di nth e individua l propert y file , i f available , o r obtaine dinclude : i ) Pre-excavatio nagreemen t detail s (i f an y ar e mad e wit hth e property owner ) ii ) Excavatio ndigita l vide o i nMPEG , WM V (Window s Medi aVideo ) o r SW F(Flas hPlayer ) forma t and/o r photograph s iii ) Signe dformverifyin g satisfactor y restoratio n iv ) Descriptio no f area s no t meetin g Interi mRO D cleanu p criteria .



# • 11 1 Superfun d TECHNOLOGIES , INC , 4028432 3Name : Address : Phone : Cb.vvieA

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Unde r Confrac t EP-R7-Q7-05 , & e U . S . Eavkommflafo i Protectio n Agenc y (EPA) ha s Contracte dPiruden t Technologies , Inc . (Pirudent) , to cleanup lea dcoffitaxmnsitio no n variou s residential propertie s includin g yoi H property . Yo u ca n help TO$ H iM s sdavjfi y fa y giwsi g pejmissio ato conduc t essemeoi sampEn g so d comfcc t cleamip o n you ? property . I f yo u sig atM s fofm , FkudeM will return i n afe w week s an dperfos m ihe wofk . We will coordiiaai e ssmpEui g saddesoug i witS i you pxio f t

o commeficemesiL I f yo u hav e ass yqisesisoa s abou t tSi e propose d work , pleas e coisiaci : Ds a Gasrvey , EPA' s Brojec t Office rto r ou rOmaha Lead Sit e Contrac t Mr . Garve yca n jj e reache d a t (402) 731-07^ . Propert yAcces s Graaled By : V / J A f A ^

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^ " A . f j 0 X . ' UaE»PriHtNaHC . Roperf yOwae rSignatee : ' 3 € - Q (Bigrmturj ) (Dni» )
PROPERT Y OWFOIRMATDOK I C^HET- RESIDEN TCdAClE : V CLC-^e»^ J iQ' V W>*^ L (U<Xr<x 0 Qjwne rDenie r RESIDEN TADDRESS : ^ 2 - ^- H N I F REBT&L . PROPERT YOWME D BY : OW/WER'SMAILM G ADDRESS ; llIl^CX>~i J e A \-\O \

" 1 b S WORK : J AG E O F HOME? : f^\ rYEARS . HO W LON G HAV E Y O LIVE D HERE ? 3 S YEARS . HA S TH E EXTERIO R BEE M PAIHTE D O R COVEROE D WIT H SJDIM G SITJCE^978 ? ^VE S C3 0 HA S TH E INTERIO R BEEf J PAC3TE D O R COVERE D SINC E 1978 ? YE S H O HUHBE R O F OCCUPAWT S UMDE R S YEAR S OLD : HUHBE R O F OCCUPAWTSS YEAR S OL D AM D OLDE R MUdBE R O F CHILDREfJ T UMDE R S YEAR S OL D WH O PLAYI N TH E YAR D FO R 5 HOUR S O R COR E PE R WEEK : COQDEMT S O R SPECIA L INSTRUCTIONS : (I.E . DOGS . EMTR Y GATES . ETC. ) AUTHORITY FO RENVIQRHMENTALRESPONS EACTION S The activitie s to b e implemestt s b y EPA unde r thi s ag-esmen t ar e pursuan t to Sectio n 104
- o f CERCLE . 4 2 U . S . C . 9604 . EPA ' ari^i t o f acces s to the propert y i s provide dfor in Sectio n 104(e ) o f CERCLE , 4 2 U.S . C 9605(e) , whic h provide s entr y fo r "determinin g th e nee dfo r response , o r choosing o r takin g any respons e actio n unde r thi s title , o r otherwis e enforcin g th e provision s o f th e title. "

# &EP A EP A Propert y Clos e Ou t Propert y # : 3OVf / Propert y Address : 322^* 1 3 9 H Date/Time : Qc + Owner' s Name : Onme t Hotmt s Quad s Excavated : Contracto r Grou p Pruden t Technologie s Excavatio nGenera l Ye s 1 .I f necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 

### i / 2 .I f necessary , wer e th e correc t area s o f dri p zon e excavate dan drestored ? 

### ^ Gradin g So dan dVegetatio n Ye s 

## 1 . Doe s th e gradin g aroun dth e perimete r o f th e hous e i n excavate darea s generall y slop e awa y fro mth e house ? 

### , / 2 . Ha s so dbee n lai di n al l area s tha t wer e excavated ? S 

### 3 . Doe s th e so dappear t o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte da t a3 0 day tim e period ) S 

### 4 . Ar e sodde darea s generall y fir man devenl y graded ? S 

### 5 . Ar e th e joint s betwee n th e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 da y tim e period ) 

### S 6 . Wa s th e propert y grade dsuc htha t wate r wil l no t poo l o nth e property ? 

### S 7 . Wa s damag e t o landscapin g o r plan t material s avoided ? 

### </ Gates , Fence s an dRetainin g Wall s Ye s 1 .D o gate s ope n an dclos e freely ? (I f applicable ) 

### i / 2 .Wer e al l gate s o r fence s take n dow n durin g restoratio n activitie s reinstalled ? (I f applicable ) 

### * / 3 .Wa s damag e t o gate s o r fence s avoided ? (I f applicable ) 

### / 4 . Wa s damag e t o retainin g wall s avoided ? (I f applicable ) 

### </ Foundation , Sidin g an dGutter s Ye s 1 .Wa s damag e t o th e sidin g o r tri mavoided ? 

# s 2 . Wa s damag e t o th e foundatio navoided ? t / 3 . Wa s damag e t o window s avoided ? 

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

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

# / Sidewalk s an dDriveway s (Concrete ) Ye s 

### 1 .Wa s damag e t o drivewa y surface s avoided ? / 2 . Wa s damag e t o walkwa y surface s avoided ? 4 / N o

N o

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### Owner s comments :



### Inspectio n notes :

Remova l an drestoratio nactivate s complet e includin g th e 30-day so dwarranty : EPA Representativ e Jd,^ , £L * Date : 

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### Omah aLea dSit e 4613 0

### Prin t Previe w Pag e 1 o f 1 

## Dougla s County-Omaha , N E

Parce l I D 251910000 0 Sec-Twn-Rn g 08-15-1 3 Owne r HOLME S Owne r Nam e DANIE L Addres s Propert y Addres s 322 4 N 3 9 S T Additio n WESTMORELAN D Cit y OMAH A Bloc k Zi p 

### 6811 1 Lo t 

### 19 3 Owne r Addres s Lega l 1 1/ 2 VA C ALLE YAD J & L T19 3 Owne r Addres s 2 322 3 N 4 0 S T Lega l 2 40X140.5 6 Owne rCit y OMAH A Lega l 3 Owne r Stat e N E Legal 4 Owne rZi p 

### 6811 1 /Assesso r Websit e Lin k http://douglasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R251910000 0 Disclaime rMa p an d parce l dat a ar e believe d to b e accurate , bu t accurac yi s no t Ma p Scal e guaranteed . Thi s i s not a lega l documen t an d shoul d not b e substitute d fo ra titl e search , 1 inc h = 2 8 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 7/16/200 7

# SER A PropertyCompletio n Agreemen t Thi s agreemen t document s th e completio no f remova l activitie s performe do nth e belo w liste dproperty . Th e property owner' s signatur e indicate s tha t th e property owne r i s satisfie dwit hth e restoratio no f th e subjec t property , an dtha t n o item s ar e i nquestion , now , o r a t an y tim e i nth e future , excludin g an y remainin g warrant y (3 0 day s total ) excep t thos e item s liste dbelow , i f any . Propert y ID : Propert y Address : ^ ^ ^ <- | r\ j Owner : Phone : Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item : Require d correction s t o complet e th e property :



### LJ I agre e restoratio n i s completed , excep t a s note d above . LJ I d o no t agre e restoratio n i s complete d

Owner' s Signatur e Dat eFin d Recor d 

### Sampl e Area : 3041 1 Owner : D Owne rOccupie d 

### Owne rName : JHOLME S DANIE L 

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### Owne rAddress2 :

J322 3 N 4 0 S T 

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## IOMAH A Owne rPhone : |(402 ) 451-870 5 

### - 322 4 N 3 9 S T

State : Zi p Code : 

## |N E Jesn i Alternat e Phone : | 

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### Resident : Residen t Name : 

## IVACAN TLO T Propert yAddress : 11322 4 N 3 9 S T Zi p Code : J6811 1 

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### Contract : Contractor : JPRUDENT2007 

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# ! Assessment : Qualifyin g Grou p 

## jso o Assessmen t XR F Date : 

### » Assessmen t MaxXR F Value : | 902.8 1ENVIRONMENTA L& CONSTRUCTIO N 

### TECHNOLOGIES , INC . SERVICE S 

# MAP ERRO RREPOR T FOR M Property Address :

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o EPA: , Metho do f Reportin g (circl e one) : Phon e call E-mai l Othe r Metho d Descriptio n o n ho w th e erro r wa s resolved :

Signature o f th e Reportin g Staf f

Member 808 0 War dParkway , Suite 40 5 250 5 N . 24 t hStreet . Suit s 30 8 424 2 Madlca l Drive , Suite 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)504-1004 Phone : (210)822-958 8 Fax : (4021504-100 5 Fax : (210) 579-6677