## TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO N FIL EFOLDE R SAID#
- 

# 1173' / Date : /<9//7/^<^ 7 Address : ^"^36 ^ /^^^^ ^ Remediatio n Contractor : Coasta l Environmenta l Group _ Year : 2007 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S 

# y Vide o o f propert y (DVD ) 

# y Executiv e Summar y EPA-provide dpropert y sketch 

# y Signe dAcces s Agreemen t fo r

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

adjacen t propert y D 

# y Restoratio n Agreemen t Settlement document s (i.e. , fo r

damage or t o replac e plants , etc ) Confirmation data Photograph s hiL^ ^ ^ So d As-buil t sketch Satisfactor y restoratio n signe dby Propert y Owne r 

# y Propert y close-out check lis t signedby EP A '^/^/^^~ 7 D 

## Descriptio n o f area s no t meetin g RO D cleanu p criteri a D 

## Utilit y clearance s 

# % y Propert y information fi-omDougla s Count y Assessor' s Office D D D



# zhJi//zy<yy/doL^}J^^ce ^ 

# lo/i^/^r . \ 

## Ignatur e 4031712 0 

# inii i Superfun d

# 7y34 " ^^'^' 5 ZWZn ^ ^Z - Fina l Repor t Propert y Chec k Lis t (Please plac e wit heac hfile) Har dCop y Informatio n lX | Property Chec k Lis t Site Workin g Drawin g Ma p EP A original s Ma p Dougla s County Assessor' s Ma p Property Contac t Sheet Agreemen t i n Acces s Agreemen t • jZjKestoratio n Agreemen t Miscellaneou s Document s '27Fina l Ma p fromth e Fiel d 2. Chang e Order s (2 1 XRFDat a 4. An y email s or PO correspondence s Propert y Completio n ^T y Executiv e Summary 2. AS BUIL T IPiProperty Completio n Agreemen t 1 ^ Any buyou t inf o or reimbursemen t inf o f5 | Chec k or mone y orde r copie s 'J6] [ EPA Property Clos e Out Fon n ^.Attache dBegi n Vide o 

## Electroni c Documentatio n Drawing s [r j EPA original |2I 7 Workin g Drawin g -m AS Buik.vs o • ^ AS Built.jp g Photo s /Begi n Photo s

During/Excavatio n Photo s • So dPhoto s vGO-Da y So dPhoto s Scanne dDocument s Z^Xid X Document s ^Executiv e Summary

)Kideo s ^Begi V

Beg n ide o yA y Movi e

## Propert yAcces s Checklis t Propert yID ; | - ] i ; ^ L j 

### n^OR K STARTE D ON : n< j U / C'- f n WORKCOMPELTE D ON : / / Propert yAddress ; 2.^3 5 H3rVU;;)<^i - Renter : Owner : J ^ ^ ^ ^ CjiSrC^lc ^ Address : 7^3 3 HS^VU^ ) S h Phone : Fax : Cell/Pager : Additiona l Information : Fax : Cell/Pagcr : Phone : ^07-
- GS O - ^ 2 M 'T i

M Notificatio n Lette r Sent ; & / | 0 / 0 7 By : 0 Acces s Agreemen t Signed : OS / \ b 1 0" ^ By : 

## 'JJaiv\ « K ^ [ ^ Restoratio n Agreemen t Sijined : HS I I t /O f By : cP<ir>fN » ^-^ ^ n Topsoi l Samplin g (i f applicable ) / / By : L J Disposa l Samplin g (ifapplicable ) / / By ; Q Garde n Samplin g (if applicable ) / / By : 0 ^ Utility Clearanc e Called;Q^ / li/O l By : 

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# r/ln c n Fina l Repor t Issued : / / 

## By : - ^ 1 Ai r Monitorin g (a s applicable ) 1 1 Communit y C H Cre w On : / / By : Results : E

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### By : 1 Results : 1 1 Communit y C H Cre w On : / / B. : Results :
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### Phon e 3??/ - ?^3 ^ Tea m V^A^^^U M 

### W I ^<< / BVID # 1773 V XR F Cod e 

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### Prm t Previe w Dougla s County-Omaha , N E

Pame 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 rStat e Owne rZi p Sec-Twn Rn g 081480000 0 GARCI A JUAN P 293 5 MARTH AS T OMAH A 6810 5
293 5 MARTH AS T OMAH A N E 6810 5 28-15-1 3 Owne r Addres s Additio n Bloc k Lo t Lega l 1 Lega l 2 Lega l 3 Lega l 4 Ol d Assesso r Sit e Ne w Assesso r Sit e I CLARK S PLAC E 0 4 3 1/

2 VA C ALLE YA D J & 50X8 6

htt p //webar cc o dougla s n e us/dcassessor/detail s asp" ? PARCELNB=081480000 0 htt p //webar cc o dougla s n e u s 8080/RealWarel/detail s do' ? id=R081480000 0
Disclaime rMa 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 guarantee d 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 = 17 3 fee t appraisal , survey , o rfo rzonin g venficatio n 

### http.//ww w dogi s org/dogisalias/dogis/prmtPrevie w aspx'^PrmtOptData=Dougla s County
- . 5/3/200 7

## CONTACT FOR M Propert y I D # 

# nid^ i Propert y Address : 

# 9^3 5 l\iaZhc L Initia l Contact : Date : Time : Action : Secon dContact : Date : Time : Action : Fina l Contact : Date : Time : Action : Fina l Action : Transmi t t o EP A D Othe r Action : D

Comment : Owne r Commen t (s) : Sit e Coordinato r >\ ^ 

# £ol(ip)Dpzy-hudM 5 r)otr€zmznt>^rfz) Commen t (s) :PRO t HOUS EHAL FDI RSTRct.'! ' NAME ; 'I'Yf LSUffX A At"! ' AKLA tji f COUL ADDFilS S 029S 5 MARj^ ^ 3 T OM A 6310 5 ^P-OWNE RINFORiCi.TIO N ^^
- NAM EaUAT- l P*GARCI A ETA LDATE O FLAS T CHA^ K 02-17-200 6 + 293 5 MARTH A S T EK/P GO RDOC #200 5 1505 0 ADD RHOMESTEAD DELET E CIT Y CMAH A 3 T N E SI P 6810 5 NO N NLIMERI C ai P COD E CURREN T VALU EHCS>ESTEA D YEA R DAT E LAND —IMPR- - —TOTAL —PA R R3 NNUMBE R T Y C D PC T VALU E 200 7 05-13-200 7 540 0 7480 0 8020 0 I R ADDITIO N NO . 0658 0 LO T 4 3 HAL F BLOC K 0 HAL F CLARK S PLAC E SEC T TOW N RANG EPLA T 019 9 DESCRIPTIO N

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- - " 1 1/ 2 VA C ALLE Y AD J & 2 5 0 X 8 6 3 a 5 6 7 8 PFl-ADF B PF5-PNF B PF6-PAF B

PAR C 141 3 000 0 0 8 F B 1 6 STATU S 2 CLAS S R EXEMP T 0 EXEMP T TYP E TAX DISTRIC T 010 0 SI D F - PRO P HOUS E HAL F DI R STFIEE T NAME - TYP E SUFFI X AP T ARE AZI P COD E ADDRES S 0052 7 S 02 7 S T 0>i A6810 5 -OWNE R INFORMATION ­

# o > Consen t Fo rAcces s T o Propert y RlGi n or ENrRYTOPRFMI-SF S 

### Granto r (th e propert y owner ) consent s t o andauthorize s th e Unite dState s Environmental Protectio n Agenc y (EPA ) o r it s authorize drepresentatives , collectivel y th e Grantee , to enter andperfor mcertai n environmental respons e activitie s upo n th e followin g describe d premise s

Owner^sName : ^^ ^ (^p^fa ^ Daytim e Phone :

Addresse s of Propertie s covere db y thi s Agreement : Address : Address : Address : Address : o^/3 S 

# Ha.rHv ^ S H 

# oA i 1 Address : Pi.'Rmsro i R l si>(-)Ns r .\ciiMii i s Th e EP.A I S requestin g acces s to collec t soil sample s an dremov e soil tha t contain s elevate dconcentration s of arseni c and/o r lea dandma y pos e ahealt hhazardTh e soi l will b e remove dandthe excavate darea(s ) wil l b e replace dwit hclean material s an d restore dThi s wor k

i s bein g performe dunder th e Omah aLea dSite Superfun dSite remediatio n progra m A

n EPA representativ e will contac t th e Granto r m-perso n t o discus s th e wor k

to b e performed , th e Granto r will hav e a n opportunity t o revie w andapprov e th e planne dsoil removal , andrestoratio n wor 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

andconfir mtha t i

t i s complet e andmeet s wit hthe Grantor' s approval Upon completion , th e Granto r will receiv e wntte n documentatio n fro mEPA tha t th e propert y ha s been remediate d ENVIRONM LN T A LRCSPCWS EA C I ION 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 andsubcontractor s th e right t o enter th e property , a t all reasonabl e time s an d wit hprio r notice , fo r the sol e purpos e o f performin g th e wor k

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

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

A «Property_^D.. : 

### Pag e 1 o f 2^isfi '



### •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 tenant ma y wis h t o save , •Wate r andmaintai n replacemen t vegetation , includin g fertilizer application , a s necessar y subsequen t to a n initial waterin g perio db y EPA , •Abid e by healt handsafet y guidanc e provide db y EPA , •I f th e property i s rented , assis t EPA i n obtainin g tenan t approval fo r acces s to th e property to perfor mth e wor k

if EP A i s unabl e to obtai n suchaccess , an d •Allo w videotapin g and/o r photograph y o f th e property includm g exterio r and interio r area s ofbuilding s AGRFTM I N T No r T O INI I R M R F 

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

done , or th e equipmen t use dt o perfor mth e activities , or t o undertake an y action s regardin g th e us e of sai dpropert y whic hwoul dten dt o endange r th e healt ho r welfare ofth e Grantee s o

r th e environment , or to allo w other s to us e th e propert y i n suchamanner Shoul dyou hav e an y question s abou t thi s program , pleas e contac t Q ^ gran t acces s t o m y propertie s[ H • d o no t gran t acces s t o m y propertie s 

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### Pag e 2 o f 2 «PropeiC/_I D

## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s t o pro\id e a mutua l agreemen t a s t o condition s o f propert yprio rt o remediatio n aclivilie s Thi s wil l als o serv e as decontaminatio n fo rth e purpos e o f asburin g tha t restoratio n activitie s ar e complete d t o th e satisfactio n o f th e propert voune ran d th e Unite d State s En \ ironnienta l Protectio n Acenc v(EPA ) Propert yI D Propert yAddres s -^. ^ 3 , 3 fV S S THvi X 

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### Ite m

Pre-e\istin g propert yare a tlia t I S co\ere d uit h urass

Numbe ro f tree s > 2 inc h tiim k duinieie r

Nun^bcr o f lioo i inc h Irun k

diamete r

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### Ite m Agree d upo n valu e o f plan t material s no t t o be replace d b vcontracto r Not e thi s valu e v\il l be use d t o issu e a plan t vouche rt o th e property owne r Agree d upo n lis t o f plan t material s tha t uil l be replace d b > contracto rB e ver yspecifi can d detaile d Includ e a sketc h o f were eac h plan t VMI I b e place d b vth e contracto r Agree d upo n area o f properr vt o b e replace d VMt h gras s so d Includ e a sketc h o f th e area(s ) t o be rcpLice d \Mt h gras s so d
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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 . >TT^^TP * www.coastalhazmat.co m

"tPBoit ^ COASTA L ENVIRONMENTA L C I t O U P , IN C 

# EXECUTIV ESUMMARY : 17734—293 5 MARTH A S T

^ No Issue s o r Concern s | ^ Issues/Concern s Detai l Explanation :

# t As-Buil t Drawin g ^ COASTA L 

# ah aLea dSuperfun dST O i ao u r IM C

Name : ^••-<r - C.'..< S Omah a Lea d Sit e 

### Dale : thljl/ ^ No.-". h Arro w[ • Address : J ^s'- , i^,..,1kcr . Sit e Sketc h Tim e U'.i'ifi.— . Ptx>n e 

# ^ 1

OLS# : 1773 4 Dat e Excavated : 6/19/0 7 

# fYlHrii ^ Dat e USEP ASigne d Off : 7/6/0 7 

### Legen d Are ano t Excavate d ^ Dripzon e Excavate d Quadrant s Excavate d Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc .

# t •


## Propert yCompletio n Agreemen t Thi. s agreement document s tli c completio n o f remedial aclivilie s performe don m y pioperty . M y siyiialiirc will designat e tha t I a msalisfic dwit hth e restoratio n o f m y properly , andtha i n o item s arc i n questions , now . o r a

t an y time i n th e fulurc . excep t thos e item s liste dbelow , if any . Propi'rt yID : 

# /77:^ V Propert yAd«lrcss : 

# f^^3 6 lUar-tlir i Sf . Owner : 

## KJLI/II I 

# ('iciifi a Phone : 

# uP)0'&&-^- ^ Restoratio n Item s i n Question :

Item : Item : Item : 

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

I M I iiRiT c iTstorntioi i i.> i complctinl , excep t H S note d I I d o iio f iicrc e restoi-Htio n i s complete d

^An ^ ^^SrlKyuri^. ^ 

# k 7'(-0 l 

## v/c y wncr' s Signatur e 

### Dat e C«inlractor'j i Signatur e Date I

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

# Jua nQiardci Propert y Addres s 

# ^li^j lliarHigy . Propert y Identificatio n Numbe r 

# m y
Materia l Remove d Replacemen t Valu e Flowe r be dare a 

# \<?> ^

Tree s , Itemize d shrubs/bushe s Tota l 

# k p ' Th e acceptanc e o f th e replacemen t certificat e an dth e signatur e belo w i s full acknowledgemen t by th e property owne r that thi s i s afai r an dreasonabl e compensatio n for plan t material s remove ddurin g remediatio n activities , 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 $ idQZ^ ha s bee n receive dby th e owne r i n th e for mo f agif t certificate , #9%3 . t o b e utilize dat hXilCi ZCZ'fZ t NLiZSZZ l I •

^ ^ ^ A^ - ( S I Cc^ C 

### y-i'-Q i ^ 1 ' /•o 7 

### Property Owner' s Signatur e Dat e Contractor' s Signatur e Dat e 

# 4

## INDIA N CREEK NURSER Y 

# 248 3 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

Certificat e .<r'3o-o 7 DATE : INTH EAMOUN T O F 

## 4^n £.Jla^ryJAjes^ ^ 

# ^ l^/^OZ'" ' ISSUE D TO : 

### (l/i m^J/iAec^C ^ COMPLIMENT S OF : C^ibdH l CZvi^t A - ^^.i ^ EXPIRATION I^ATE : S "-^ ^ "0 ^ S-U > Authorize dSigjiatiire

# ^tK A ^P A Propert y Clos e Ou t FW m Propert y W : Datc/TInc : Quad s Excavated : Propert yAddrc« : ^"^3 ^

/l/fo/f^ ^ Owner' s Name : dUm Z ^^aiTja - Contracto rGrou p ^/ ^

Excavatlo B Genera l Ye s N o 1 If necessary , wer e th e correc t quadrant(s ) excavate dan drestored''-.g^j~r^ ^ Cu* . M-U-S. ) ly 2 If necessa7 , wer e th e correc t area s o f dn p zon e excavate dan drestored' ' 

# y Gradin g So dan dVcftctatlo B Ye s No 1 Doe s th e gradin g aroun dth e perunete r ofth e hous e mexcavate darea s generall y slop e away 

# y fromth e bouse ? 2 Ha s so dbeen lai di n al l area s tha t were excavated' ' 

# y 3 Doc s th e sodappea r t o b e generall y healthy andgrowing' ' (Onl v evaluat e i f inspecte da t a3 0 da y tim e penod ) 4 Ar e sodde darea s gcnerall v fir man devenl y graded' ' 

## y 5 Ar e thejouit s betwee n th e so dstnp s generall y tigh f (Orl > evaluat e i f inspecte da t a2- 0 da v tim e period ) 6 Wa s th e property grade dsuc htha t wate r wil l not poo l on th e propei } "> y y 7 Wa s damag e t o landscapm g or plan t matenal s avoided' ' 

## y Gi9in s Fence s an dRctainin t ^alb 1 D o gate s open an dclos e frrelv'' (!•" applicable ) 2 Wer e all gate s or fence s take n dow n durin g restoratio n acti \'"le s reinsulied " ;I f applicable ) Ye s 

## y ^ No

3 Wa s damag e t o gate s o r fence s avoided' ' (Ifapplicable ) L ^ 4 Wa s damag e t o retamin g wall s avoided " (I f applicable" ! U ^ Foundation , SidiiKan dGutter s 1 Wa s damag e t o th e sidin g or tn ma v oided' ' \e s •» — N o 2 Wa s damag e t o th e foundatio n avoided* ' i ^ 3 Wa s damag e t o window s avoided' ' 

## y 4 5 Wa s damag e t o window s o r door screen s avoided' ' Wa s damag e t o dowTispout s or dovmspout extension s avoided' ' ^ 

## ^ y Sidewalk s an d Driveway s (Concrete ) Ve s N o I Was damag e t o dnvewa ysurface s avoided' ' ^ 2 Was damag e t o walkwavsurface s avoided' ' ^

### Owner s comments :

Inspectio n notes : / / / /



# ' y Sa duea f d p dec LJtlN^s^yl . LLL/ ^ ^ MMu/d y 

# al l ^^
-

Remova l andrestoratio n acti \a^es coT'c'e^ e inc'udin e th e 30-i:!a \so d"vA.'ar^n n EP A Representative^-7V^^.i:^/<t^;^^^^_^^ ^ ^/^/W7