## TRANSMITTA L o f OMAH A LEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : %S)^^ ^ Date : __Li|p|aQfi 2 Address : tAt l f^ ^ sr Remediatio n Contractor : Pl?i^ry9f.\- f lg / ^ fs|r<//^(^|gg ^ / r^. j Year : r^n ^ SOI L REMEDIATIO N PROPERT Y FIL E FOLDE RDOCUMENT S df

Vide o o f propert y (DVD ) P

j Executiv e Summar y H ' EPA-provide dpropert y sketc h B Signe dAcces s Agreemen t fo r subjec t propert y D Signe dAcces s Agreement(s ) fo r adjaijen t propert y Z ^ Restoratio n Agreemen t D Settlemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) 'I?

r Confirmatio n dat a 0 Photograph s B As-buil t sketc h D Satisfactor y restoratio n signe db y Propert y Owne r e Propert y close-ou t chec k lis t signe db y EP A D Descriptio n o f area s no t meetin g RO D cleanu p criteri a 0 Utilit y clearance s W Propert y infonnatio n fromDougla s Count y Assessor' s Offic e 

### D D 4031356 7 

### D 

# mniiii i Superfun d 

## Signature / * 

## Dat e ^

### PROPERT Y SUMMAR Y Date : 11/19/200 8 Omah aLea dSite Remedial Actio n Contrac t #EP-R7-07-06/0004 Month of : Oct/Nov . Propert y Address ; 161 7 N 2 9 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 G DATA/RESULTS : B 2 = 197 PP M @ 12" ; N O EASEMENT . ATTACHMENT S 1 ) Propert y sketch providedb y EP A pursuan t t o contrac t specification s 2 ) SignedAcces s Agreemen t including acces s agreement s require dfo r crossing othe r propertie s 3 ) Pre-Excavatio n digita l vide o clip/photogr^h s 4 ) Post-Excavatio n digita l vide o clip/photograph s 5 ) Documentation - CompletedClose-ou t Checklis t 6 ) As-Built sketch ­ i ) Shall include fina l lea dlevel s v ) Legend ii ) Contamination lef t behindarea s vi ) Contractor identification iii ) Propert y addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e mcludedi n th e individua l propert y file, if available , o r obtaine dinclude : i ) Pre-excavatio n agreemen t detail s (if an y ar e mad e wit h th e propert y owner ) ii ) Propert y Statu s For msignedby propert y owne r iii ) Excavatio n digita l vide o in MPEG , WM V (Window s Medi aVideo ) or SW F(Flas h Player) forma t and/o r photograph s iv ) Signedfor mverifying satisfactor y restoratio n v ) Descriptio n o f area s not meeting InterimRO D cleaniq ) criteria .

TECHNOLOGIES , INC .Fin d Record I Backfill :

Sampl e Area : 8242 9 - 161 7 N 2 9 S T Owner : D Owne rOccupie d Owne rName : CIT Y O F OMAH A Owne rAddressl : |ATT H JI M THEL E Owne rAddress2 : |I819FARNAMST#111 1 City : State : Zi p Code : OMAH A JN E j6818 3 Owne rPhone : Alternat e Phone : Clea n U p Quer y Lea d Remainin g Quer y

Resident : Residen t Name : 

# r Propert yAddress : [I617N29S T ZipCode : [6811 1 Residen t Phon e 

# n Propert yDamag e Quer y

Contract : Contractor : jPRUDENT2008_S Group : Assessment : Qualifyin g Grou p |80 0 Assessmen t XR F Date : Assessmen t MaxXR F Value : 82 8

### TECHNOLOGIES ^ IN C 

# SER ^ EP A Propert y Clos e Ou t Propert y # : S a.* * 2- 1 Propert y Address : Jb n A'2- 1 ^ ^ Date/Time : Owner' s Name : Quad s Excavated : B ^ Contracto r Grou p Pruden t Technologie s Excavatio n Genera l Ye s N o 1 .I f necessary , wer e th e correct quadrant(s ) excavatedan drestored ? 

# y 2 .

If necessary , wer e th e correct area s of dri p zone excavatedan drestored ? / 

### Gradin g Sodan dVegetatio n Ye s No 1 .Doe s th e grading aroundth e perimete r ofth e hous e i n excavatedarea s generall y slop e awa y fromth e house ? / 

### 2 .

Ha s sodbee n laidin al l area s tha t wer e excavated ? / 

### 3 .

Doe s th e so dappea r t o b e generall y health y andgrowing ? (Onl y evaluat e if inspecteda t a3 0 / 

### da

y tim e period) 4 .

Ar e soddedarea s generall y fir mandevenl y graded ? / 

### 5 .Ar e th e joint s betwee n th e sodstrip s generall y tight ? (Onl y evaluat e i f inspecteda t a3 0 da y / 

### tun e period) 6 .Was th e propert y gradedsuc h tha t wate r will no t poo l o n th e property ? / 

### 7 .

Was damage t o landscaping or plan t material s avoided ? / 

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

### 2 .

Wer e al l gate s o r fence s taken dow n durin g restoratio n activitie s reinstalled ? (Ifapphcable ) i / 

### 3 .

Was damag e t o gate s o r fence s avoided ? (If applicable ) / 

### 4 .Was damage t o retainin g wall s avoided ? (I f applicable ) / 

### Foundation , Sidin g an dGutter s Ye s No 1 .Wa s damag e t o th e siding or trimavoided ? 

# y 2 .

Wa s damage t o th e foundation avoided ? 

# y 3 . Was damage t o window s avoided ? i / 

### 4 . Wa s damage to window s o r doo r screen s avoided ? 

# y 5 . Was damage to downspouts o r downspou t extension s avoided ? 

# y Sidewalk s an dDriveway s (Concrete ) Ye s No 1 .Was damage t o drivewa y surface s avoided ? / 

### 2 .Wa s damage to walkwa y sur&ce s avoided ? /

## Owner s comments :

Inspectio n notes :

Remova l an drestoratio n activate s complet e including th e 30-da y so dwarranty : EP A Representativ e ^.^>a. . Date : /^fjj/o p

## Oct . 16 . 200 8 5:21P M OMAH APLANNIN G DEPT , 402-444-614 0 No . 309 8 P . 3



## Propert yCompletio n Agreemen t Thi s agieement document s th e completio n o f remova l aciivitie s perfonne do n th e belo w liste dproperty . Th e propert y owier' s signatur e indicate s tha t th e propert y owne r i s satisfie dwit h the restoratio n of th e subjec t property , andtha t n o item s are i aquestion , now , or a

t an y time in th e future , excludin g an y remainin g wairant y (3 0 day s total ) excep t thos e item s listedbelow , i f any . 1 Propert y ID : 

# 1 1 PropertyAddrew : /^/- 7 / / Z 9 ^ ^'^ • -^ . 

### Owner : ^. ^ ^ f ^^^/ L 1 Pbone : Restoratio n Item s i n Question :

Item : nam ; hem : Kern : Item : llam : Raqulre d correction s t o complst s th e property ;

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



# a . u> . <*27^-~ / ^' A r'0^^.-6J - /o > - ry- o ^ Owner' s Signatur e Dat e

### Sep . 17 . 200 8 12:13P M OMAH APLANNIN G DEPT . 402-444-6H 0 No . 105 1 P . 1

PriidailTtclinologia , Inc . (Pn>dait)i B unt o OQiit((ci<«idid M U . S.Eiv»incinGnalFn(eaiQ aAgenc y (EPA ) oclea i up lead
contvumiB dsoil s i t M. numb ao f pcopenk s locoe di aOnah v VebEislok , includki K ib c piqpcn y locae du

. TheEpAiniuctayottrpanl$sionodlowPnideatiopci£3i«icoilaUKnup«tihi ( propai y n noiov e Itad-ooimninflto dtoil . B y sieun s ^ i ^vm . D u piaiierq r owner ffwa s pcimtelo n w Pnidcatf o parfbc m acAtntie s idaic dt o di e deiBi f nchidin e toi l saagpfin c icaiMi l o f IcadkoaBrn'msKdsoil , ao dlectoralian o f ik e TcfiMice dptopcny . I f

yo u hllt « u y queraor aabou t ifa

e soi l cleatm p plane dfo r you r pi<)i>ety , pIcMc eontac c hudaBiT i »Aniniifrfiv e Clt A fer th e ftnA« Lea dSit e dewip i ^^ f yadhwii mOayf- n (401 ) 731-11M " 73j.]i M Geoen l question s abou t lh e ODah aLea dSxC e cieaai 9 cnb c djicde dloihcfiPAPublicfailbnnKio n CCMo atf (40Z)''3I-304 S (5oud | Omah aoffitt ) o r (402 ) 991-9SI 3 (Non h Oimlu i offlce) . PirepalyiweeuOimiedB\^/ \^^^t ^ (A J WjU-g^/ ^ Pte-» t t^e f X j 7 (Plea^ManVtaS ^ Pwpeit y 0«>naSIPMMIC : (—^--^A^^tofa^ ^ C.;< A (TAya-ar
- V" ^ >^ 7' " ^ ^ PROPERI Y MFONHATIO N (T B b e conplMie db y r««iim t udAi r propcrti r a«»r - pIcU e pkte O (I B t e coBpiM M V J rcaiwica i RESICNENTNAME- . \ /</. L ^'^'-^ ^ \ « rQ,„ „ R^I^^B , RESIDEN T ADCRESS :

I P RENTAI , PROPERT Y OWHE D BY :
OWNER' S MAILIN G ADDRESS : OWNER' S TEUEPHON E NUMBE R- ROME : t \WORK : 

### Mrl ) HMM ^ gy p AG E O FHOME? : YEARS . HO WUOM G HAV E YO U UMED HERE ? YEARS . HA S TH E EXTERIO RBEE N PAMTS D O RCOVERE D WT H SIDIN G &MC E 187B 7 YE S , N O NUMBE RO FOCCUPANT atJNDE R7 YEAR S OLD : _^

_ NUMBERO FOCCUPANT S 7 YEAR S OL D AND OLDE R NUMBE R O F CHILDRE N UNDE R 7 YEAR S OL D WH O PLA Y I N TH E YAR D FO R S HOUR S O R MOR E PE R WEEK : COMMENT S O RSPECIA L mSTRUCnOMS ; (LE . DOGS . ENTRY GATES . ETC. )

AUTHORTT Y FO RENVnONMOEKTA L RESPOKS E ACTIONS : T V aotititic s b b « ioiplcveoM l b y EP A wdc r thU iirccaio K • nsponuaKiaSeciMalM«fCERCLA.4ZO.S,C96M . £PA'(ri8lnoraK«>»n>tbepi«pcrtyi$piovidedliriDS«ciiotilM(e)o f CERCLA , 4 2 U.S , C 960S(e) , ttltiett provide s eotr y for "deicnniDln s lh e needta t itspouc; , o r chooein c o r (akio K

any nspoiu e iictio o imde r Otis M c o r Mhertrif c enfbrcn v lh e provixiou'o f lh e tda. ^ SO

WWin dPartoway , Suit e 40 6 2S0 S N . 24 * StfMt , Suit e 30 8 424 2 Msdica l Ditw . Suit e 42S 0 Kansu City , W O M11 4 Omahn , NtbhKk a0811 0 Sa n Antonio , T X 7B22 9 Phone : (816 ) VSUStx aPhone : (40Z ) 504^100 4 PtMite : (210 ) 422-950 8 ftO/rdw" ilBlo'^flOn Z J I da s :XB J

## AS-BUIL T DRAWIN G ^ OLS# : 8242 9 Dat e Excavated : 9/25/200 8 Dat e USEP A Signed-Off : 

## OMAHA LEA D SUPERFUND SIT E

8242 9 Ext«fia rPain t NonnAni M Omah a Lea d Sit e • Goo d Sit e Sketc h Samplin g Address : 161 7 N 2 9 S T Q No t pain t Sampl e Numbe r Lea d Sampl e Samples Collecte d lA B Concentratio n Collecte d RTT. : Pn A FfeTl ) RYASCPXA-8242 9 F 1 

### D 1-3-o 8 _fiL3___PP" i Dale : RYBSCPXA-8242 9 F 2 20 ^ Do m 

### D Time : 10-l a Al A RYCSCPXA-8242 9 B 1 _L£Ll__Pp m 

### D Samples Analyze d RYDSCPXA-e242 9 B 2 ft ?f t Po m 

# n RDZ8ePXA-0242 9 O S " OPit t 

### D 

# n XR F Uni t ^y^ O Book : 2J 3 nozoopx A 02420—e z ~ PO W 

### D D Date-. _ FlPZsePXA-a24£ g re- • ~ pp m 

### D Time; 

### D

_ Staff : 

### mst ^ Numbero(Sample s =[j ^ | Cj ] Legend : F 1 = Fron t Left , F 2 = Frot t Right , B 1 = Bac k Lett , B 2 = Bac k Rig M D Z = Dri p Zone , G Z = Garden , P 2 = Pla y A n quadrant s ar e a s viewe d rrao n th e (Mel , fadm a pnvait y ' 1 • • 1. 1 a.^...^ m B2-197PP M ii ; 12 " •"' . •.%'*>«'i-s««^ « -^;,. TM 

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## M w s t Rnn n Cmu da3M.y. « N O EASEMEN T

CONTRA a # : E P - R7-07-0 6 / 000 4 PRUDEN T TECHNOLOGIES , INC .

## Jo. 105 1 P . 2 Sep . 1/ . 200 8 12:rJP M OMAH APLANNIN G DtPl" . 402-444-614 0 

## CHNOLOGIES,INC . — 

# Propert y Statu s For m 

# n Address : lU I' A N ^ 1,*^^ ^ Si
- Date : D'llltf o ^ Phone : BVID : H e 2-
- V^i^^ ' Soo " Plant s & , PerBunea t Landbcapin e Item# O

n Ma p Desciiplion an dLocation 

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leaking ? Ye s —No Item# Description & Location OnMi^ )

Propert y Ovnc r Prudeao t Employe e Signature : c/t^'^'y^ , O U ( ^ Jignattue : 

# -^ y S08 D War dt>ar4(way , Suit e 40 6 2S0 « N . 24 ^ Smei , Suit e 39 d I 424 2 m«(HcB ! Driy€ , Suit s 425 0 Kansa s Ci^.M 0 641i 4 Omaha , Nebrask Q GBII O ^ Sa n Antonio , T X 7822 9 PhoiTKlBIO ) 303-^70 3 rnn/cnn j (littcn'i i onn ? i i na c

## 8242 9 Exterio rPain t Nort h Arrow Omah a Lea d Sit e • Goo d Sit e Sketc h n,Poo r Samplin g Address : 161 7 N 2 9 ST Q No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d 

### Fimi : FDI ^ FfeT D RYASCPXA-8242 9 F l Q* ^ pp m 

## D Date : l-S-o 8 RYBSCPXA-8242 9 F 2 2Q* ^ Do m Time : lOWc i flM 

## D RYCSCPXA-8242 9 B 1 _jL^_L_Pp m Sample s Analyze d RYDSCPXA-8242 9 8 2 

# n ft ?f t pp m RDZSCPXA-0242 9 B 2 ~ pp m 

## D D XR F Unit : 6f^ 0 Book : Z/ 3 R023CPXA-B242 9 6 Z r___pp m 

## D D Date : l-/g-0 8 RPZSePXA-0242 9 PZ- •" pp m 

## D D Time:,., ^ flilQ 

# n Staff : /nSU ) Numbe ro f Sample s = | 4 [ | ( ^ | Legend : F 1 = Fron t Left , F2 = Fron t Right , B 1 = Bac k Lett . B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden . P Z = Play A

B quadrant s ar e a s viewe d ftom th e ^treet , facing propert y »street, l 

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## Print Preview 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 r Cit y Owne r Stat e Owne r Zi p 221279000 0 CIT Y O F OMAH A 161 7 N 2 9 S T OMAH A 6811 1 ATT H JI M THEL E 181 9 FARNA M S T #111 1 OMAH A N E 6818 3 Sec-Twn Rn g Additio n Boc k Lo t bega n Lega l 2 Lega l 3 Lega l 4 Treasure r Websit e Un k Assesso r Websit e Un k 16-15-1 3 SHINNS2NDAD D T 6 S 24. 5 N 86. 5 F T 60X24. 5

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp ? parc=221279000 0 http://douglasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R221279000 0 Disclaime rMa p an d parce l dat a ar e believe d to b e accurate , bu t accurac y i s not 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 , 11nc h = 1 3 fee t appraisal , survey , o rfo rzonin g verification . 

## http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 9/18/200 8

### Pag e 1 of 2

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



## • YOURTICKE T NUMBE RI S 2134551 . Origina l Cal l Date : 9/18/0 8 Time : 10:2 4 a m Op : RAMITA1896 7 Wor k t o Begi n Date : 9/22/0 8 Time : 11:0 0 a m State : "N E County : DOUGLA S Place : OMAH A Address : 161 7 Street : N29T H S T Twp : 15 NRng : 13 E Sect-Qtr : 16-N E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remediatio n projec t fo r soi l 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 : RAMIT A Phone : (402)733-145 5 Alt . Contact : Phone : (402)733-118 8 Wor k Bein g Don e For : ep a Dept h o f Excavation : 6 f t Corne r Lot : NFront : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V LEVEL 3 MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C 

### Servic e Are a Contac t Phon e Number Utilit y Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL 3 LEVEL S COMMUNICATIONS , LL C N AAlt : Emerg : 877366834 4 Day : 402504782 3 MUDO l METROPOLITA N UTILITIES DISTRIC T SAND Y Alt : Emerg : 402504794 6 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE RRO N Alt : 402444516 1 Emerg : 402444516 0 http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/18/200 8

## Pag e 2 of 2 Day : 406728934 3 OPPDGPR 5 OMAH A PUBLI C POWE RDISTRIC T N A 

### Alt : 888728934 3 Emerg : 406728934 3 Day : 406728934 3 N A QLNN E 1 C QWES T LOCA L NETWOR K 

### Alt : 

## Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.. . 9/18/200 8