### PROPERT Y SUMMAR Y Date : 10/11/2007 Omah aLea dSite Remedia l Actio nContrac t #EP-R7-07-0 6 Mont hof : Octobe r Propert y Address : 252 6 Gran t S t A . EXECUTIV ESUMMAR Y A. I Issue s Encountered : Non e A. 2 Issue s Resolved : Re-See dwil l occu r i nNovembe 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 NSAMPLIN GDATA/RESULTS : F2
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### Easemen t - 6 4 @ Scrap e ATTACHMENT S 1 ) Propert y sketc hprovide db y EP Apursuan 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 llea dlevel s v ) Legen d ii ) Contaminatio nleft behin darea s vi ) Contracto r identificatio n iii ) Property addres s vii ) Date iv ) BVI 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 propert y 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 dfor mverifyin g satisfactor y restoratio n iv ) Descriptio no f area s no t meetin g Interi mRO D cleanu p criteria . 4028439 8 Superfun d 

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### Owne rName : Omah a Lea d Sit e ^ ^ Address : 252 6 GRAN TS TSite Sketc h D ° oo d 

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## Agjeem^Pt o Allo wAcces s To Omah a Lea d ^ v$%''> , PropertyTo Conduc t Easemen t ^J\.\n-TnJ * , T , " 

## Sit e Remedia l * \>S£ y£ Samplin g an d Cleanu p Actio n ^r/svtf ^ ''« < ^ft-.tf - Under Contrac t EP-R7-07-06 , meU. S. Environmenta l Protectio nAgenc y (EPA) ha s Contracte dPrudent Technologies , Inc . (Prudent) , to cleanup lea dcontaminatio n onvariou s residentia l propertie s includin g your property . Yo u canhelp wit hthi s activityby givin g permissio nto conduc t easemen t samplin g an d conduc t cleanuponyou r property . If yo u signthi s form , Prudent will return inafe w week s an dperform th e wor k

We will coordinate samplin g an dcleanup wit hyo u prio r to commencemen t If

yo u hav e an y question s abou t me propose dwork , pleas e contac t DanGarvey , EPA' s Projec t Office r fo r our Omah aLea dSit e Contract . Mr. . Garvey ca n

be reache d at (402 ) 731-0788 . Property Acces s Grante dBy . Propert y Owner Signature fDal» )


### PROPERTYINFORMATIO N (T o be complete d by resident and/o r propert y owner - pleas e print ) RESIDEN TNAME : -Q 

### Q U 

### U C £, RESIDEN TADDRESS : .252 - C. Cj \ f A V\ V- *g > V Q tV \ ^> W K> e A ^ ' / IF RENTAL . PROPERT YOWNE D BY : OWNER' S HAILIN G ADDRESS ; £2 . S 2, L C i r a, t, N I >> T~ Q /V V

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_ !p OWNER' S TELEPHON E NUMBER-HOME : ( ; -fp^ 3^ A " ^ ^ 3 WORK : f ) AG E OF HOHE? : I Q f) YEARS . HO W LON G HAV E YO LIVE D HERE ? f££ ) YEAR S HAS TH E EXTERIO R BEE N PAINTE D OR COVERDE D WITH SIDIN G SINC E 1378? ^YE S NO HA S TH E INTERIO R BEE N PAMTE DOR COVERE D SINC E 1878 7 V" ^ YE SNO NUMBE R OF OCCUPANT S UNDE R 6 YEAR S OLD : Q NUMBE R OF OCCUPANT S 6 YEAR S OL D AN D OLDE R NUMBE ROF CHILDREN TUNDE R 6 YEAR S OL D WH O PLAY 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 YGATES . ETC. ) L^ QC\



### ' FO R EN\TORMMENTA LRESPONS EACTION S Th e activitie s to be implement s by EPA unde r thi s agreemen t are pursuan t to Sectio n10 4of CERCLE , 42U.S.C . 9604 . EPA 1 s right of acces s to the propert yis provide dfor inSectio n104(e ) of CERCLE , 42 U.S . C SX$05(e) , whic h provide s entr y fo r "determinin g th e nee dfo r response , or choosin gor takin g any respons e actio nunde r thi s title , or otherwis e enforcin g th e provision s of th e title. "

# &EP A EP APropert y Clos e Ou t Property* : Propert y Address : ^/^6 * G/?/?nr -*V
Date/Time : lO/n/ o 7 Owner' s Name : Jojc * &QC/,** , Quad s Excavated : Contracto r Grou p Truden t Technologie s Excavatio nGenera l Ye s N o 

### 1 .I f necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 

# y 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 

### N o 

## 1 . Doe s th e gradin g aroun dth e perimete r o f th e hous e i nexcavate darea s generall y slop e awa y 

# y fro mth e house ? 2 . 

### Ha s so dbee nlai di nal 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 da y tim e period ) 

# y 4 . 

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

# s 5 . 

### Ar e th e joint s betwee nth 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 hthat water wil l no t poo l o nth e property ? 

# * / 1 . 

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

# i / Gates , Fence s an dRetainin g Wall s Ye s 

### N o 

### 1 .D o gate s ope nan dclos e freely ? (I f applicable ) ^ / 

### 2 .

Wer e al l gate s o r fence s take ndow ndurin g restoratio nactivitie s reinstalled ? (I f applicable ) S 

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

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

### Foundation , Sidin g an dGutter s Ye s N o 

### 1 .Wa s damag e t o th e sidin g o r tri mavoided ? / 

### 2 .

Wa s damag e t o th e foundatio navoided ? i / 

### 3 .

Wa s damag e t o window s avoided ? 

# y 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 ? 

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

### N o 

### 1 .Wa s damag e t o drivewa y surface s avoided ? 6 / 

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

### Owner s comments :

Inspectio nnotes :

Remova l an drestoratio nactivate s complet e includin g th e 30-day so dwarranty : EP ARepresentativ e jQc ^ >£L ^ Date : /o////?- > * < - * * ­

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## 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 propert y owner' s signatur e indicate s tha t th e propert y 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 : 1 A 5 " Propert y Address : ' ^ v - q/ •£ > 1 C J'/ , Owner : '^KL/ t o R p 4 ^ /wv _ Phone : ^ Q ; _^ (. f /- , - 

# 1^ 3 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 . IT I I d o no t agre e restoratio n i s complete d

Owner' s Signatur e Dat e /

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

## Dougla s County-Omaha , N E

Parce l I D Owne r Nam e Propert y Addres s Cit y Zi p Owne r Addres s Owne r Addres s 2 Owne rCit y Owne r Stat e Owne rZi p 200212000 0 BEACHA M JOYC E 252 6 GRAN T S T OMAH A 6811 1 252 6 GRAN T S T OMAH A N E 6811 1 Sec-Twn-Rn g Owne r Addres s Additio n Bloc k Lo t Lega l 1 Lega l 2 Lega l 3 Lega l 4 Assesso r Websit e Lin k 09-15-1 3
PATRICK S 2N D AD D 1 1 1 0 1/ 2 VA C ALLE YA D J & LTS9&1 0 96X12 8 http://douglasne . mapping online . com/DouglasCoNe/static/accountinfo.jsp ? accountno=R2002 1 2000 0 Disclaimer : Ma p an d parce l dat a ar e believe d t o b e accurate , bu t accurac yi 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 = 3 8 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 8/1/200 7

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

## Dougla s County-Omaha , N E

Parce l I D Owne r Nam e Propert y Addres s Cit y Zi p Owne r Addres s Owne r Addres s 2 Owne rCit y Owne r Stat e Owne rZi p 200210000 0 DAVI S MILDRE D 2319N26S T OMAH A 6811 1 262 3 IZAR D CT# D OMAH A N E 6813 1 Sec-Twn-Rn g Owne r Addres s Additio n Bloc k Lo t Lega l 1 Lega l 2 Lega l 3 Lega l 4 Assesso r Websit e Lin k 09-15-1 3
PATRICK S 2N D AD D 1 1 8 1/2 VAC ALLE YADJ & AL L LT S 7 & 8 128X9 6 http://douglasne . mapping online . com/DouglasCoNe/static/accountinfo.jsp ? accountno=R2002 1 0000 0 Disclaimer : Ma p an d parce l dat a ar e believe d t o b e accurate , bu t accurac yi 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 = 4 4 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 8/1/200 7Fin d Record Clea n U p Quer yLea d Remainin g Quer yPropertyDamag e Quer yClos e 

### .ampl e Area : 64 5 - 252 6 GRAN TS T

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### Owner : D Owne rOccupie d Owne rName : BEACHA M JOYC E Owne rAddressl : .

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### Resident : Residen t Name : Propert yAddress : 252 6 GRAN TS T 1
! i Contract : Contractor : PRUDENT200 7 Group : 

# > 'Owne rAddress2 : 252 6 GRAN TS T City : iOMAH A Owne rPhone : State : Zi p Code : JN E |6811 1 Alternat e Phone : j I'•Zi p Code : 16811 1 Residen t Phon e i i Assessment : Qualifyin g Grou p 80 0 Assessmen t XR F Date : Assessmen t Ma xXR F Val u 877. 6