## TRANSMITTA L of OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAI D #: \lF5(c S Date : f/^/^^/ "

Address : 230 \3 S Z. Avi-^ Remediatio nContractor : Coasta l Environmenta l Group

_Year : 2007 SOILREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S 5/ Vide o of propert y (DVD ) \sZExecutiv e Summar y M EPA-provide dpropert y sketch 0 SignedAcces s Agreemen t fo r

subject propert y D Si^e dAcces s AgTeement(s ) fo r

adjacen t propert y 5/

Restoratio nAgreemen t M Settlement document s (i.e. , fo r

damag e or to replac e plants , etc. ) M Confirmationdata 

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Photograph s bdoc ^ Oannd ^ ^so d36'aa. U E^ As-buihsketch^ M Satisfactor y restoratio nsigned by Propert y Owne r M Propert y close-out check lis t signed by EP A ~^/2- / 2-£ > 0~ J D Descriptio n of area s not meeting ROD cleanu p criteri a Q^ Utilit y clearance s M Propert y informationfro mDougla s Count y Assessor' s Office 

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## Signatur e e Dat e 4031710 8 Superfun d

## Propert yAcces s Checklis t Propertyl D I 1 S " 6 S D WOR KSTARTE D O N O M / JT / & ! D WORKCOMPELTE D ON . / / Propert y Addres s ^ ^ Q ^ g ^ 3^o dfV J Rente r Owner : ^_^Vi,-;&Vx)pV\«L ^ <C-a^^U. o Phone . Address . 230 , ^ 3^rN d (^ ^ Fa x Ot^ak. 3 Me . (S,e.^ o « Cell/Page r Phon e Z102 - 3f7- - MH M | Additiona l Informatio n Fa\ : Cell/Page r Q Notificatio n Lette r Sent : By . PTAcces s Agreemen t Signed . 0* f /<P^/e>~ f 

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- V / 30 / 0 1 

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n Communit yQ Cre w On . / / By : Results : O Communit y• Cre w O n / / By : Results : n Communit yO Cre w On - / / By : Results : Omah a Lea d Sit e

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## fMAI L Prin t - Clos e Windo w Fro m "Digger' s Hotline " <info@ne-digger s com > T o trishkasl@yaho o co m Subjec t R e NE-Digger s co m - LOCAT E Contractor s Reques t For m Date : Mon , 3 0 Ap r200 7 1 3 1 4 2 6 -050 0 DIGGER' S HOTLIN E PRESENT S TH E "N O WAIT " N I TE S TICKE TENTRY ' Avoi d lenght ywai t tim e Immediat e ticke t numbe rresponse - Use rha s acces s t o al l issue d ticket s Fre e trainin g session s Contac t Conni e o rLis a a t 402-330-186 6 fo rfurthe rinformatio n Ticke t Numbe r177395 8 fi6>l93^'Z) Wor k T o Begi n Dat e 5/2/0 7 115p m Utilite s Notifie d Cityo fOmaha , traffic , sewe rcox , mud , oppd , qwes t loca l network , leve l 3 , qwes t lon g distanc e I fther e ar e an yothe rutilitie s othe rtha n thos e mentione d above , yo u wil l nee d t o notifythe m yoursel fan d pnvatel yowne d line s wil l no t b e locate d Than k Yo u Fo rUsin g E-Mai l Origina l Messag e — From : trishkasl@yaho o co m To : info@ne-digger s co m Sen t Monday , Apri l 30 , 200 7 1 2 1 4 P M Subject : NE-Digger s co m - LOCAT E Contractor s Reques t For m NE-Digger s co m - LOCAT E Contractor s Reques t For m Nam e Trishk a Simmon s Al t Nam e Phon e 402-504-219 4 Al t Phon e 706-732 2 Emai l trishkas l @yaho o co m Calle rI D 1879 0 Compan yCoasta l Environmenta l Typ e o fwor k EXCAVATIO N Fo rWho m COASTA L ENVIRONMENTA L Ho wDee p 3f t Oi n Explosive s N o Corne rLo t Ye s Fron t o fPropert yYe s Rea ro fPropert yYe s Tunneling/Bonn g Ye s Count yDOUGLA S Cit yOMAH A


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### Yahoo ' Mai l - trishkasl@yaho o co mPag e 2 o f 2
Addres s 230 1 S 32N D AV E Direction s Where o n Property OVERAL L
Townshi p Rang e Eor W Sectio n 1/

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### htt p //u s 1387 mai l yaho o conVym/ShowLetter'^bo\=lnbo\&MsgId=101 3 234314 4 2736 0 4/30/200 7. » ' ••'I/ , 

## Consen t Fo rAcces s T o Propert y RIGH T O FENTR Y T O PREMISE S 

### Granto r (th e property owner ) consent s t o an dauthorize s th e Unite dState s Environmental Protectio nAgenc y (EPA ) or it s authorize drepresentatives , collectivel y th e Grantee , t o enter an dperfor mcertai nenvironmental respons e activitie s upo nth e followin g describe d premise s

Owner' s Name :

Addresse s of Propertie s covere db y thi s Agreement : Daytim e Phone : i^j-js^,^^ ^ ^ Address : 2.33 1 Address : Address : Address : Address : 

## S <y-*^'^4< ^ Ov^J ^ AJ L^<^*c^
-

PURPOS Eo r RESPONS EACTIVITIE S 

### Th e EP Ai s requestin g acces s t o collec t soil sample s an dremov e soi l tha t contain s elevate dconcentration s o f arseni c and/o r leadan dma y pos e ahealt hhazardTh e soil will b e remove dan dth e excavate darea(s ) will b e replace dwit hcleanmaterial s and restore dThi s wor k

i s bein g performe dunde r th e Omah aLeadSite Superfun dSite remediatio nprogram A

nEP Arepresentativ e wil l contac t th e Granto r in-perso nt o discus s th e wor k

t o b e performed , th e Granto r wil l hav e a nopportunity t o revie w andapprov e th e planne dsoil removal , an drestoratio nwor k

before i t begin s Onc e th e wor k

i s finished , th e Granto r will b e aske dt o revie w th e wor k

an dconfir mtha t i

t i s complet e andmeet s wit hth e Grantor' s approval Upo ncompletion , th e Granto r wil l receiv e wntte ndocumentatio n fromEP Athat th e property ha s bee nremediate d ENVIRONMENTA LRESPONS EACTION S 

### B y signin g thi s Acces s Agreement , th e Granto r i s grantin g th e EPA , it s employees , contractor s an dsubcontractor s th e righ t t o ente r th e property , a t all reasonabl e time s and wit hprio r notice , for th e sol e purpos e o f performin g th e wor k

Thi s acces s shal l remai n i neffect unti l th e wor k

ha s bee nsatisfactoril y complete dTh e Granto r als o agree s t o

«Property_ID » 

### Pag e 1 o f 2

### •Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc , •Remov e flower bulb s or plant s that th e Granto r or th e Grantor' s tenan t ma y wis h t o save , •Wate r andmaintai nreplacemen t vegetation , includin g fertilizer application , a s necessary subsequen t t o a ninitial watering perio db y EPA , •Abid e by healt handsafet y guidanc e provide dby EPA , •If th e property i s rented , assis t EP Ai nobtainin g tenan t approval for acces s t o th e property t o perfor mth e wor k

i f EP Ai s unabl e t o obtai nsuchaccess , an d •Allo w videotapin g and/o r photograph y o f th e property includin g exterio r an d interio r area s o f building s AGREEMEN T NO T T O INTERFER E 

### Th e Granto r agree s no t t o interfere o r tampe r withany o f th e activitie s or wor k

done , o r th e equipmen t use dt o perfor mth e activities , or t o undertak e an y action s regardin g th e us e o f sai dproperty whic hwoul dten dt o endange r th e healt hor welfare o f th e Grantee s or

th e environment , or to allo w other s t o us e th e property insuchamanne r Shoul dYO U hav e any questton s abou t thi s program , pleas e contac t

I gran t acces s t o my propertie s n1 d o not gran t acces s t o my propertie s 

# J M ^ ^ 

### Sisnatur e 

## r Dkt e Signatur e Dat e

I 1 1 wouldlik e to b e presen t durin g any samplin g tha t i s required .
Pag e 2 o f 2 «Property_ID »

## Restoratio n Agreemen t Th e purpos e o fthi s agreemen t i s t o pro\id e a mutua l agreemen t a s t o condition s o fpropert > prio rt o remediatio n activitie s Thi s VMI I als o serv e as decontaminatio n fo rth e purpos e o fassurin g tha t restoratio n activitie s ar e complete d t o th e satisfactio n o fth e propert vowne ran d th e Unite d State s Environmenta l Protectio n Agenc y(EP.A )

Propert vID : \ n « 5 6 % Propert yAddres s ^•2^^ AAi/ ^ 

### 2,3><? l Owner . rJU.-.5>l-pp)lv< ^ r^7^.<:\-eJ J (- , Phone : 

### -^a - ^Lo l - ^ 6 Z, v O n th e attaclie d diagraiT\(s ) indicat e area(s ) t o excavate d an d dept h o fe\cavaiion . locatio n o fai l know n utilities , subsurfac e features , surfac e structure s an d landscapin g feature s acces s location{s ) t o b e use d b v contractor , an d th e directio n o fNort h Indicat e distance s depth s materia l type s et cI;idicat e d'g'ta l photo s b yreferencin g th e piioto-io g numbe rwitl t a n arro windicatin g directio n o fvie w 

### item s T o B e Remove d B yOwne rBefor e Star t O fRemediat'on . (Us e additiona l sheet s a s necessary ) Th e removal , storage , disposal , and/o rretur n o fthes e item s i s th e GAfner' s responsibilit y Ite m Ite m Ite m Item : Ite m Item Item Ite m Pag e 1 o f ( j

# !(P ^ Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Us e additiona l sheet s a s necessary ) Item 

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## NhD-^ ^ Ite m Item . Ite m Ite m Ite m Item . Ite m Ite m Ite m Ite m Ite m Ite m Ite m Ite m
Pag e 3 

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### Ite m

Pre-evislin g propert y are a tha t I

S covere dwit hiiras s

Numbe r o f tree s ' 2 inc H

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Numbe r ot " Sprinkler Zone s Contro l VaKe s Timer s Hsad s et c Anac hasketc ho t the sprinkle r la v out
Numbe r o f an dsiz e of eac hgarde nfloue r bed are a .Anac hasketc ho f relativ e size s andlocation s 

### Landscap e Inventor y (Us e additiona l sheet s a s necessary ) 

### Quantit y 

## Unit Condition/Type/Specie s
Squar e fee t ^

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### Ite m Agree d upo n valu e o f plan t material s no t t o b e replace d b vcontracto r Not e thi s valu e VMI I b e use d t o issu e a plan t vouche rt o th e propert y owne r Agree d upo n lis t o f plan t material s tha t VMI I b e replace d b ycontracto rB e ver yspecifi can d detaile d Includ e a sketc h o f \vere eac h plan t wil l be place d b vth e contracto r Agree d upo n are a o f propert yt o b e replace d vMt h gras s so d Includ e a sketc h o f th e area(s ) t o b e replace d wit h sras s so d
Are a o f Cit vo rCount y propert yt o b e landscape d pe rthei rrequirement s Includ e a sketc h o f th e are a (s ) 

### Quantit y Uni t Condition/Type/Specie s 

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### Additional.Comment s / Instructions : 

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Chec k th e boxi fOwne rdoe s no t wan t CE G t o documen t inteno rfoundatio n wall s an d possibl e pre-existin g damag e B ycheckin g thi s bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e inteno ro fhouse , includin g foundatio n crack s o rfissure s

agre e I I I d o no t agre e 

# D i agre e 

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# 1756 5 Exteno rPain t Nort h Arro w 

### Omah a Lea d Sit e Owr,e rName : CHRI S C/^^TEU D • Goo d 

### Sit e Sketc h Address : SSllA , S£NDAV& . 

### • Poo r 

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## D Date : W1? : .-,• ? 

### RYBSCPXA - f'f'SC S P 2 

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## D Tim e Staf f 

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# m L Legen d F l = Fron t Left , F 2 = Fron t Right . B l = Bac k Left , B 2 = Bac k Rigti t D Z = Dri p Zone , G Z = Garden , P Z = Play A H quadrant s ar e a s viewe d fro m th e street , facirt g propert y 

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# ^ As-Buil t Drawin g Omah aLea dSuperfun dSit e COASTA L OLS#:1756 8 Dat e Excavated:6/22/0 7 Dat e USEP ASigne d Off:7/2/0 7 

# iTS(be > Exlerk xPaiii t t4o(t h Arro w Omati a Lea d Sit e Owne rName : CHRJ S C^^TBLL O • Goo d Sit e Sketc h Address : ,330/^ . SSNDA)^ . r~ | Poo r

Phone : »j301 - 7G1 1 ^^^ ^ _ f~ l No t pain t Lea d Sampl e Sample s Collecte d SamF>l e Numtie r LA B Concentratio n Collecte d Fir m ocr O RYASCPXA - JT-SO S F l • Q 

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# KE L Legen d F l = Fron l Left , F 2 = Fron t Right , B l = Bac k Left . B 2 = Bac k Righ t D Z = Dri p Zone . G Z = Garden . P Z ~ P(a y A M quadrant s ar e a s viewe d fro m tt> e street , facin g propert y 

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04614 1 012 1 Legen d Quadrant s Excavate d Are ano t Excavate d Dripzon e Excavate d Contract , # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc .

### .•ff ¥



# RESTORATIO NCHANG EORDE R OMAH ALEA D Propert y I D # 

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# I D # : l^SUfe Date : ^[v,\o ^ Naine : r\ \C-> \ Description :



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### i^J^ \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 ° ^^^ ^

I Coasta l Environmenta l Grou p Inc . V^^^^ ^

www.coastalhazmat.co m ^wo-i*^" ^ COASTA L ENVIRONMENTA L CROUP . IN C 

# EXECUTIV ESUMMARY : 17568—23 0 IS . Bl"" * AV E 

# n N o issue s o r concern s X 

### Issue s o r concern s


# Detai l Explanation : P O was compensate dfo r shrub s andbushe s remove ddurin g excavatio nwithagif t certificate from IndianCree k Nursery inth e amoun t o f $550.00 . Coastal als o repaire dsidewal k o nth e wes t andth e cur b o nth e northwhic hoccurre ddurin g excavation .

# m ^ Propert yCompletio n Agreemen t Thi s agreement document s th e coniplclio no f remedial activitie s performe do nm y properly . M y signatur e wil l designat e that I a msatisfie dwit hth e restoratio no f m y properly , andthai n o item s arc i n qucslions . now . o r a

t any lim e i nih c future , excep t thos e item s liste dbelow , if any . Propert vID : 

# r/^// ^ Propert yAddress : 

# ^30 / %Zd^^A\/t - Owner : 

# (Ihri^tom rCosUl/ o Plione : 

# 3^ ^ -'^HH I Restoratio n Item s i n Question :

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

II I iisrc o restoratio ni s completed , excep t a s note d I I <l o no t iimc e restoratio ni s complete d

wner' s Signatur e Dat e Contractor' s Signatur e Dat e I

## Omah aLea dSuperfun dSit e Miscellaneou s Landscapin g Replacemen t Certificat e Propert y Owne r 

# ChnZcfhi r

CosZll o Propert y Addres s 

# &30 I S . 39'^'Ai^i . Propert y Identificatio nNumbe r 

# n5bf )
Materia l Remove d Replacemen t Valu e Flowe r be dare a
Tree s Itemize d shrubs/bushe s 

# /55Z), ^ Tota l Th e acceptanc e o f th e replaceinen t certificat e an dth e signatur e belo w i s full acknowledgemen t b y th e propert y owne r tha t thi s i s afair an dreasonabl e compensatio n for plan t material s remove ddurin g remediatio nactivities , bu t no t plante do r installe db y th e governmen t o r it' s contractors . Th e tota l amoun t o f % "000 ^ ha s bee nreceive db y th e owne r i nth e for mo f agif t certificate , #Z'lZ^ . t o b e utilize dat "7^^v^^ ^ ZZ/ft^ ^ /Uuirst^ y • d-^ZZ ^ 1 '2--- ? 

# -7 - 

# ^•^ 7 Propert y Owner' s Signatur e Dat e Contractor' s Signatur e Dat e^ 

## INDIA NCREEK NURSER Y 

# 252 6 Omaha' s Bes t Kep t Gardenin g Secre t 30 3 Nort hSaddl e Cree k Roa d Omaha , Nebrask a68131-222 9 (402 ) 558-590 0 

# Gif t

Certificate

INTH EAMOUN T OF : 

## ISSUE D TO : (^)MfiHiUk > (J^^XJJL O 

## COMPLIMENT S OF : A^g^pfe ^ <?W r >^>L^y * EXPIRATIONDATE : 

## a? '^^S-gg " nze Si i Authorize d dSignatur e

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# APropert y Clos e Ou t Fo 

# TM Propert y*f' . 

# I15l£? ) Propert y Addre« = ^^{) / S,69^^AZ< ^ Datc/TInc : 

### Owner' s N.me : {Zl/iZiSfr)phfJ COSfpJi o Quad s Excavated : Contracto r Grou p / Eicavatlo B Gencn l Ye s No 1 If necessary , wer e th e correc t quadrant(s ) excavate dan drestored' ' 1 ^ 2 If neccssa^ , wer e th e correc t area sof dn p zon e excavate dan drestored' ' 

# y Gr«d>n £ So d an d Vetetatio a Ye s No Doe s th e gradin g aroun dth e perunete r of th e house mexcavate darea s generall y slop e aN\a y fromth e bouse ? 

### oJf{ ^ e-)uu.fh-o ^ c( ^ COLAS. {SL ) 2 Ha s so dbeenlai d in al l area s tha t were excavated' ' / 

### :^>£xt/?t4 b^ ?<g ' J ^ kndscAJi'ir ^ 3 Doe s th e » dappea r to t) e generall y healthy an dgrowing' owinc' ' ' v Evaluat ^ ?6

(Onl (Onl y evaluate e i

i f f inspecte inspecte d d a

a f a a

j^ : da y tim e period ) 4 Ar e sodde darea s generall y fir man devenl y graded' ' 

# z 5 Ar c th e joint s btetwee nth e so dstnp s generall y tight' ' (Onl> ev aluat e if inspecte d at z ?0 da\ titn e period ) 6 Wa s th e property grade dsuc htha t wate r w

lU no t poo l on th e propc^ ' \ y 7 Wa s damag e to landscapm g or pla.n t matenal s avoided' ' 

# z Guic v Fence s an dRcUinin t ^all s \e s No 1 Do gate s openan dclos e freeh'' (!* • applicable ) 

## v 2 Wer e all gate s or fence s take ndow ndurin g Tsioratio nact n"'t s •-eipsiailed' ' •,.l f applicable ) / 3 Wa s damag e to gate s or fence s avoided' ' (I f applicable ) A) A 4 Wa s damag e to retainin g wall s avoided' ' (I f applicable ) 

# ^1 Foundation , Sidinsan dGutter s \e s No 1 Wa s damag e lo th e sidu\ g or tn mavoided' ' ^y 2 Wa s damag e to th e foundatio navoided' ' 

## y 3 Wa s damag e to window s avoided' ' y 4 Wa s damag e to window s or door screen s avoided' ' , / 5 Wa s damag e to downspout s or downspout extension s avoided' ' */ Sidewalk s an d Drtvewiy s (Concrete ) Ye sNo 1 Wa s damag e to dnvev^ay surface s avoided' ' A^ A 2 Wa s damag e to wallcwa ) surface s avoided' ' 

# Z^ ^ '-'Z^tZ^tJz* l^A ^

## • Owner s comments :

Inspectio nnotes : , ^ ^ , 

# I pressur e LO^^ U 4t ^ f^ft^r x ^i ^ axx^fJ^r^iZ s

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