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### Dougla s County Accoun t Informatio n Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R200085000 0 Prin t Repor t Informatio n i s vali d a s o f2007-8-2 4 Vie wo n Ma p Value s no t finalize d unti l afte rBoar d o f Equalizatio n Treasurer' s Ta xRepor t Owne r SCOT TNANC YL 261 5 PATRIC KAV E OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumber : 008 5 000 0 2 0 Accoun t Type : Residentia l Parce l Number : 200085000 0 Parce l Address : 261 5 PATRIC KA V OMAH AN E 68111-000 0 Lega l Description : PATRICK S AD D LO T4 BLOC K4 W4 0 F T Valu e Informatio n Lan d Improvemen t Tota l 200 7 $ 1,100.0 0 $ 31,700.0 0 $ 32,800.0 0 200 6 $ 1,100.0 0 $ 31,700.0 0 $ 32,800.0 0 200 5 $ 1,100.0 0 $ 31,700.0 0 $ 32,800.0 0 260 4 $ 1,100.0 0 $ 10,200.0 0 $ 11,300.0 0 200 3 $ 1,100.0 0 $ 10,200.0 0 $ 11,300.0 0 200 2 $0.0 0 $0.0 0 $0.0 0 Sale s Informatio n Sale s Date : 2006-08-0 4 Dee d Type : W D Book : 200 6 Page : 09209 4 Price : $ 37,900.0 0 Grantor : Ric h Tamar a M Grantee : Scot t H Nanc yL Lan d Informatio n Acre s S F F F Unit s Dept h Widt h Vacan t 0.1 2 5280. 0 40. 0 1. 0 132. 0 40. 0 N o Lan dAttribute s Attribut e Attribut e Descriptio n Improvemen t Informatio n Buildin g 1 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R20. . . 10/5/200 7

### Dougla s County Accoun t Informatio n Pag e 2 o f 2

261 5 Patric k A

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### Buil t As : HVAC : Centra l Ai rt o Ai r Units : 1. 0 Exterior : Fram e Sidin g Baths : 1. 0 Interior : Drywal i Bedrooms : 2. 0 Roo fCover : Compositio n Shingl e Stories : 1. 5

Roo fType : Gabl e Foundation : 

### Bloc k Floorcover : Allowanc e Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 191 3 0 % 191 3 9 3 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Ston e Tri m 150. 0 Applianc e Allowanc e 1. 0 Applianc e Securit ySyste m 

### 1. 0 Basemen t Bsmn t Bloc k 8 f t 624. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h En d Scree n 168. 0 Porc h En d Scree n 63. 0 Use r Atti cFul l Finis h 408. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R20. . . 10/5/200 7

## Douglas 

## County 

## NE 

## GIS Map

Disclaimer: This map is not guaranteed to be accurate, correct, cunent, or complete and conclusions drawn are the responsibility of the user.

## CONTAC T FORM Propert y I D # Propert y Address : Initia l Contact : Secon dContact : Fina l Contact : Fina l Action :

Comment : Owne r Commen t (s) : Sit e 1 Coordinato r

Commen t (s) : 

# f7^9 ^ yy' ^ 

# z<yyy 7 /y^z^ccyzTk / Date : lo U Time : ^/ ^ Action : /Jr^«g>^7^^< ^ Date : A/ > Time : /^5Z ? Action : /^WT^c/^y L Date : "^ ^ Time : //< / Action : ^,4^'^/ ^ <<^^/^,g»^a4g _ Transmi t to EP A D Othe r Action : D

1

# m t

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### Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc . www.coastalhazmat.co m COASTA L ENVtRONMENTA l C N 0 U ' , IN C 

# EXECUTIV ESUMMARY : 27392—261 5 PATRIC K AV E I I N o Issue s o r Concern s X 

# Issues/Concern s Detai l Explanation : Property Owne r wa s issue dachec k #501 9 inth e amount o f $300.0 0 fo r ado g kenne l whic hwa s take n away andthrow nou t alon g withothe r debri s durin g remediatio nactivitie s a t th e property .

# As-Buil t Drawin g COASTA L 

# Oinah aLea dSuperfun dSit e
2739 2 OwrtM - Name : TAK'AR AM KIC M Omahc i Lea d Sit a txtoftc cPain t NL* U I AXTOW I Sit s Skatct i Q Goo d Address : 26 i 5 PATRIC KA V Phone : f-

__ _ ^ a Nolpair J Sarr.pl « Kijmbe r Laa d Samplo s Co l e«e d LA B ConcoTtratiOf i Coilocta d 

## tauX L RYASCr>XA-?739 2 F ' 

# n RYaSCPXA-2739' 2 F ? yL^~ 7 pp m 

## D T,rne : I U • iS^ J RYCSCHXA-2.1-39 7 H I "7*/-" 7 pp m 

## D Sampte a Analyze d RYDSCPXA-2739 2 B 2 

## n RDZSCPXA-2739 2 D Z XR t Unit ; .^/ ^ BOO K^/ ^ Re2&eP^fe«.-Z739 Z -»^ - PP* n 

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# ENTERE D durin g remediatio n activities . Remov e j u i 2 7 2au 4 

### an d replac e do g kennel . Remov e al l tree s i fpossible . Sav e pin e tree s di g aroun d the m i n F 1 an d F 2 yyy$^y^iy^>>'^^>^ ­ 

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### Legen d Are ano t Excavate d Dripzon e Excavate d Quadrant s Excavate d 

### Contrac t # : EP-R7-07-0 5 Coasta l Enviromnenta l Grou p Inc ,

### S i ^ 

# EP A

# Bt EP APropert y Clos e Ou t For m Propert y# : ^7^q ^ Propert y Address : ^ Q 6? ! 6 ) fri'hr\07^ . ANTC - Date/Time : ( i /a ^ Owner' s Name : i\T-r\^t^ i <^, n\\ ' Quad s Excavated : Contracto r Crou p C tsr , %- ^ fK \ Excavatio D Genera l Ye s No 1 . If necessary , wer e th e correc t qiiadrant(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 ? 

## y Gradin g So dan dVesetatio n Ye s No 1 1 .Doe s th e gradin g aroun dth e perimete r ofth e hous e i nexcavate darea s generall y slop e awa y ^ fromth e house ? 2 . Ha s so dbeenlai dinal l area s that were excavated ? 

### y 3 . Doe s th e sodappea r t o b e generall y healthy an dgrowing ? (Onl y evaluat e if inspecte da t a3 0 da y time^riod ) 4 . Ar e soddedarea s generall y fuman devenly graded ? y 15 . Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e if inspecte da t a3 0 da y tim e period ) 6 . Wa s th e propert y grade dsuc htha t water will no t poo l onth e property' ' 

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

# y Gates , Feoce s an d Retainin g Wall s Ye s N o I .D o gate s ope n an d clos e freely? (I f applicable ) ^ y 2 .Wer e al l gates o rfence s take n dow n durin g restoratio n activitie s reinstalled ? (I f applicable ) \ y 3 .

Wasdamag e t o gate s o rfence s avoided ? (I f applicable ) 1 ^ 4 .

Wasdamag e t o retainin g wall s avoided ? (I fapplicable ) 

# 4V Foundation , SidioKan d Cutter s Ye s N o \ . Wa s damag e t o th e sidin g o rtri m avoided ? y 2 .Wa s damag e t o th e foundatio n avoided ? 1 ^ 3 .

Wa s damag e l o window s avoided ? ^ 4 .Wa s damag e t o window s o rdoo rscreen s avoided ? y 5 .Wa s damag e t o dowTispout s o rdownspou t extension s avoided ? ^ Sidewalk s an dDriveway s (Concrete ) Ye s No 1 .Wa s damag e to drivewa y surface s avoided ? 2 .

Wa s damag e t o walkway surface s avoided ? 

### y/ 

### V 

## Owner s comments :

Inspectio nnotes :

Removal an drestoratio nactivate s complet e includin g th e 30-da y so dwarranty : EPARepresentati>^I ^ ,y0^^ , ^lyy ^ Date :

## Propert yCompletio n Agreemen t Thi s agreement document s th e completio no f remedia l activitie s performedo nm y property . M y signature wil l designate tha t I a msatisfie dwit hth e restoratio no f m y property , andtha t no item s ar c i nquestions , now , or a

t any time i nthe future , except thos e item s listedlielow , ifany . Propert yID : " 3 H O^ Q ' 1 Propert yAddress : ^^^^ ^

'Prrh cy c M AxT f Owne r 

### MIKAQV J S ( oft " 

# i Phone : 

## &17- ' C)(..uc7 i Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item :

I agre e restoratio n I s completed , excep t a s note d I I d o no l agre e restoratio n i s complete d 

# /yy^ /

yZ-T y• ,r.7rj ^ Date Contractor' s Signature Dat e I

## Propert yDamag e Settlemen t

Propert y I D 2739 2 Propert y Addres s 261 5 Patric k AV E Owne r Nanc y Scot t Phon e 402-517-066 0

I hav e receive dfro mth e contractor . Coasta l Environmental Grou p Inc . (Coastal) , asumo f $ 300.0 0 a s compensatio n fo r ado g kennel that wa s throw n away durin g th e remova l o f lead-impacte dsoi l fro mth e property .

Chec k Numbe r 501 9 Valu e of Chec k $300.0 0 Mad e Ou t T o Nanc y Scot t Descriptio n o f Miscellaneou s Propert vDamag e Coasta l accesse d th e propertyat 251 6 Patric k Av e t o complet e lea d restoratio n durin g excavatio n at th e propertya do g kenne l wa s take n awa yan d throw n ou t alon g wit h othe rwast e debris . Coasta l ha s agree d t o pa

yth e homeowne r$300.0 0 a s a buyou t fo rth e homeowne rt o replac e at he rleisure . M ysignatur e belo wi s acknowledgemen t o f th e receip t o f th e su m liste d above , whic h I furthe r acknowledg e t o b e lai rcompensatio n fo rth e miscellaneou s propert ydamag e describe d abov e an d releas e Coasta l Environmenta l Grou p In cfro m furthe robligation s o rliabilit yrelate d t o thi s propert y damage .



# IT/ZZ A 2 2 Contractor' s Signature Dkt e

Pag e 1 o f 1

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/ COASTA L tNVlRONMfNTA L C H C U P , IN C 

## Consen t Fo rAcces s T o Propert y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propert yowner ) consent s t o anc i authorize s th e Unitet d State s Environmenta l Protectio n Agenc y(EPA ) o rit s authorizec J representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l respons e activitie s upo n th e followin g cJescribe d premises : 

# lUAy y Owner' s Name : _ y Daytim e Phone : /--/"/ / < 3 ^j' ^

Addres s o fPropert y 

# -zd^/^ 77^^"^ ^ -^ ^ covere d b ythi s Agreement : , PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EP Ai s requestin g acces s t o collec t soi l sample s an d remov e soi l tha t contain s elevate d concentration s o flea d an d ma ypos e a healt h hazard . Th e area(s ) wil l b e excavate d t o remov e contaminate d soil . Th e remove d contaminate d soi l wil l b e replace d wit h clea n material s an d th e are a wil l b e restore d t o it s origina l condition . Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e o fCoastal Environmenta l Group , contracte d b yUSEPA , wil l contac t th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l hav e a n opportunit yt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e i t begins . Onc e th e wor k i s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d confir m tha t i t i s complet e an d meet s wit h th e Grantor s approval . Upo n completion , th e Granto rwil l receiv e writte n documentatio n fro m EP Atha t th e propert yha s bee n remediated . ENVIRONMENTA L RESPONS E ACTION S 

### Bysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , an d wit h prio rnotice , fo rth e sol e purpos e o f performin g th e work . Thi s acces s shal l remai n i n effec t unti l th e wor k ha s bee n satisfactoril ycompleted . Th e Granto rals o agree s to :
Pag e 1 o f2

## Restoratio n Agreemen t Th e purpos e ofthi s agreemen t is to provid e a mutua l agreemen tas to condition s ofth e propert yprio r to remediatio n activities . Thi s wil l als o sen e as documentatio n fo rth e purpos e of assurin g tha t restoratio n activitie s ar e complete d to th e satisfactio n ofth e propert yowne ran d th e Unite d Slate s Environmenta l Protectio n Agenc y(EPA) .

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# ^^y77a^7 ) ^^^.</fr z On th e attache d diagram(s ) indicat e area(s ) to excavate d an d dept h of e.\ca\ation . locatio n ofal l know n utilities , subsurfac e features , surfac e structure s an d landscapin g features , acces s location(s ) tobe use d by contractor , an d th e directio n o f North . Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s byreferencin g th e phoio-lo g numbe rwit h an arro windicatin g directio n of\ iew . 

### Item s To Be Remove d ByOwne rBefor e Star t Of Remediation : (Us e additiona l sheet s as necessary ) ". e remcve! . storage , cisposa! , ar.d.c r-etL-rr . cftnes e item s is th e 'Owrie' s respcr.sibi'ity . Item : 

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### 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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Pag e 2 o fCOASTA L 

### 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 ) Item : 

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Pag e 3 of .COASTA L



### Ite m

Pre-existin g property area , tha t wil l b e excavated , tha t i s covere dwit h"rass .

Numbe r o f tree s > 2 inch trunk diainete r

Numbe r of tree s =2 inch trunk diamete r

Numbe r o f Sprinkle r Zones . Contro l X'a.hes . rimers . Heads . e;c . ;.'v-;,.ts;- r ;a' v om
Numbe r o f an dsiz e o f eac hgarde nflower bed area .
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### Landscap e Inventor y (Us e additiona l sheet s a s necessary ) 

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

Squar e fee t 

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Pag e 4 o fCOASTA L 

### Ite m Quantit y Uni t Condition/Type/Specie s Agree d upo n valu e o f plan t material s no t t o b e replace d b vcontractor . Not e thi s \alu e wil l b e use dt o issu e aplan t >ouche r to th e propert ) o>

Nner . Agree dupo nlis t o

f plant material s that will b e replace dby contractor . B e \er\ ' specifi c anddetailed . Eac h Includ e r i sketc hn f wer e ciicli plant ^'

v il l b e pi:;ced b \ib. e connacio! . .Agreedupo nareaof prope mto b e replace d H it hgras s sod . SF ^ t

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# 'ryi^ ri ! .'Are aof Cir \or Counr \ .nicaoii..ii \orv.uuni \i I propertx to b e landscape ay^^'T^^^i^^/^ h per thei r ••equiremenis . y i S F

Easemen t .Area, t o be SF e\ca\ate d

Pag e 5 o fCOASTA L • NVIRONHINTA L C • O U r. INC . 

### Additiona l Comment s / Instructions : 

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• Chec k th e bo xi f Owne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e pre-existin g damage . Bycheckin g thi s bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e interio rofhouse , includin g foundatio n cracks o rfissures .

nI d o no t agre e 

# yy/ ^ 7^ 7 /c//aZ7 ^ Da w Contractor' s Signature Dat e