### TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAI D # : 'Tid^'Z . Date : 5-2'l-\ \ Address : f=)2D'? S ^ . Z^ r ^S T Remediatio nContractor : Envrionmenta l Restoration , LLC

_Year : _201 0 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S X ^ Vide o o f property (DVD ) J2l5efor e DAfte r D Basemen t D J aExecutiv e Summary (Fina l Report ) Q

^ EPA-provide dproperty sketc h X ^ , Signe dAcces s Agreemen t for subjec t property D Signe dAcces s Agreement(s ) for adjacent property X Restoratio nAgreemen t D Settlemen t document s (i.e. , for damag e or t

o replac e plants , etc. ) jX Confirmatio ndat a J y Photograph s JZ^efor e DCre w PhotosHlOurin g Excavatio nD So d j2^0-da y So dD . X As-buil t sketc h jX Completio nAgreemen t signe db y Property Owner X ^ Property close-ou t chec k lis t signe db y EP A D Descriptiono f area s not meetin g RO D cleanu p criteri a X Utility clearance s J2 ^ Property informatio nfromDougla s County Assessor' s Offic e X Property acces s checklis t ^ 3026187 4 

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### tnviroru n ental Restoratio nSignatur e Dat e .

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# EPA EP APropert y Clos e Ou t For m Omah aLea dSit e Propert y # : Tis^'^Z . PropertyAddress : 9;7ri ^ tv . - Z'-V ST T Date/Time : Owner'sName : -yn,rV \S>eirVio O Quad s Excavated : T ? 1 Contracto r Grou p : Environmenta l Restoratio n(ER ) Excavatio nGenera l Ye s N o 1 . Ifnecessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 

## X 2 . Ifnecessary , wer e th e correc t area s ofdri p zon e excavate dan drestored? \JCLCyfAr
­ 1 nr 

## X M Gradin g So dan dVegetatio n Ye s N o 

# X house? 2 . Ha s so dbee nlai di nal ! area s that were excavated ? 

## y 3 . Doe s th e sodappea r t o b e generall y health y andgrowing ? (Onl y evaluat e ifinspecte dat 30-day tim e period) . 4 . Are sodde darea s generaUy fir man devenl y graded ? i ^ 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 30-day tim e period) . i . ^ 6 . Wa s th e property grade dsuc hthat wate r wil l no t poo l o nth e property ? 7 . Wa s damag e f o landscapin g o r plan t material s avoided ? , ^ Gates , Fence s an dRetainin g Wall s Ye s N o 1 . D o gate s ope nandclos e fi-ee!y ? (ifapplicable ) 

## i ^ 2 . Were al l gate s o r fence s take ndow ndurin g restoratio nactivitie s re-installed ? (ifapplicable ) 

# M . 3 . Wa s damag e t o gate s o r fence s avoided ? (ifapplicable ) 

## X 4 . Wa s damag e t o retainin g wall s avoided ? (ifapplicable ) Foundation , Sidin g an dGutter s Ye s No 1 . Wa s damag e t o sidin g o r tri mavoided ? 2 . Wa s damag e t o th e foundatio navoided ? 

## \)^^fv f Wa s damag e t o window s avoided ? & • ^ 4 . Wa s damag e t o windo w screen s o r doo r screen s avoided ? 5 . Wa s damag e t o downspout s o r downspou t extension s avoided ? Sidewalk s an dDriveway s (Concrete ) Ye s N o I . Wa s damag e t o driveway surface s avoided ? 

## /JA 2 . Wa s damag e t o walkway surface s avoided ? » / Inspectio nnotes :



### Remedia l an drestoratio nactivitie s complet e includin g 30-da y so dwarranty : EP ARepresentative;^^y^77^ J 'M^^^/y,'iJs£i^ Date : 

# \/4L L

### <y^2^ % i ^s© ^ i Omah a Lea d Site—EP-R7-O9-0 5 \^* ^

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wrww.erllc.co m 

# EXECUTIV ESUMiVIARY : 3645 2 - 520 8 N24 S T

N o Issue s o r Concern s | ^ Issues/Concern s Dptai l Fxniannrinn
­rag e i ox i "> [ Creat e Anothe rTicke t ' ] [ Bac k t o Irt h Interne t ] : [ Sen d Emai l YOU RTICKE T NUMBE RI S 2669442 . Origina l Cal l Date : Wor k t o Begi n Date : 2/08/1 1 2/10/1 1 Time : Time : 8:5 1 a m 9:1 5 a m Op : ADAM2418 6 State : NE Address : 520 8 County : street : DOUGLAS N24TH S T Place : OMAH A Twp : 15 NRng : 13 E Sect-Qtr : 03-NW,04-NE Twp : 16 NRng : 13 E Sect-Qtr : 33-SE,34-S W Lega l Given : C Typ e o f Work : lead soi l remova l Locatio n o f Work : LOCAT E ENTIR E PROPERTY Remarks : FA X AL L CLEAR S TO : (402)451-106 9 : 3645 2 —: Compan y :_ENVIRONMENTAL RESTORATIO N Contac t Name : ADA M Phone : (402)451-1314 - Alt . Contact : Phone : (636)288-961 6 Wor k Being Don e For : ep a Dept h o f Excavation : 24i n Corne r Lot : NFront : NRear : N Involve s Tunneling o r Horizonta l Boring : NExplosives : N CXCAT V

MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Are a Contac t Phon e Numbe r Utilit y Typ e CXCAT V CO X COMMUNICATIONS , IN C HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 MUDO l METROPOLITA NUTILITIE S DISTRIC T SAND Y MU D Day : 402504782 3 Alt: ' Emerg : 402504797 0 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R RICH/TRAFFI C Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC T EL M LOCATIN G Day : 406728934 3

Alt : 406207149 4

Emerg : 888728934 3 QLNNEI C QWES T LOCA LNETWOR K EL M LOCATIN G Day : 406728934 3

Alt : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 2/8/201 1

## Contac t Informatio n Lo g 

## SA[D#3C>'iS'2 ~ q^^^-^^rf^ -

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## Propert yAcces s Checklis t SAID : 

### ^(p'^SZ ^ D WOR K STARTE D ON : / / Propert y Address : 5^ ^ ^ li^r^ f D WOR K COMPELTE D ON : / / Renter : Owner : 2.^; ^ S^lO//f ^ 1 Address : Phone : 

# <g002 . SJA2 7 m Fax : Cell/Pager : Additiona l Information : 

# Phone : .^-57P^Y^2 7 Fax : 4t::;z,-^^^-^x3 3 Cell/Pager :

ces s Agreemen t Signed : \ l I l<^ l I Q By : JT^ . Restoratio nAgreemen t Signed : i C I iC t I l O By : J7 ^ Vide o Propert y Befor e O n : i z U L I ' o By : J: A 0 Digita l Photo s Befor e O n t z I i LI i Q By : OTA l~ l Vide o Propert y Afte r O n By : D Digita l Photo s Afte r O n: / / By : JSr Propert y Completio nAgreemen t Signed : c P J<»^Y / K 

### By : F ^ n nFina l Repor t Signed : / / By : Additiona l Vide o o r Digita l Photo' s Taken : D Vide o nDigita l Phot o O n: / / B y Reason : nVide o nDigita l Phot o O n By : Reason : nVide o • Digita l Phot o O n Reason : nVide o D Digita l Phot o O n By : Reason :

### FRO M : Zn S CORP LLC FA X NO . 40 2 99 1 553 3 1 6 201 0 02:27PM P l



## Consen t fo rAcces s t o Propert yfiA»D#2)^^/6"2> RIGH T

### o r Emu v TO 

### PRBMrses Granto r (th e property ovvner) , cxjnsoit s to stt dauthorize s th e Unitd dState s EnvironmOTial Protectio nAgenc y (USEPA ) o r it s atihorize drqnesentativcs , collectivel y lh e Grante e to ente r an dperfon ncertai nenvironmentB l resp<Mu e actrvitie s upo nth e foUowin g desoribe dpremises : Paytime Pbont ; ^2/ - ^ 8 ' 6^2* 7 Owmr'iVamt : ZACI A

### 5£gH< ^ Addresi : 

# f^og > tf. v-ff * s r AddfMs ; Addrcn no f Propert y covere dk y W s Addren : Agrecmeat : Addmw : Addra* ; PURPOS EO F

### bJVEsnGATifl N % e purpos e o f tiie reinedia l activitie s i s t o remov e a U soil s a t th e propert y whisshar e contamlnale dwithhazar^u s substaxices , i nparticular lea da t concentration s greate r tba no r equa l t o 40 0 part s pe r millio n(ppm) . REMEDIA LACTIOSt s , Th e environmenta l respons e action s t o b e perfbtme do nsii dpropert y ma y includ e th e following activrdes : a .

Takin g photograph s and/o r vide o o f th e propeit y before , during , an dafte r remedia l activities ; b .

Locatin g equipmen t axidmwjbinery on-sit e i npreparatio nfor an di nlh e cours e o f th e enviroomenta l response ; 0 .

Plannin g an dimplementin g th e remova l actxM i o no r near Giantor' s proper^ , d .ObtaiDiQ^ sample s fiomGrantor' s property ; AOREEMENTlto T T dTNTCRPBR B 

### Th e Granto r agree s no t t o interfer e o r tampe r wit han y o f th © activitie s o r wor k done , o r th e equipmen t use dt o perfcr mth e activities , o r t o undertak e an y action s regardin g th e us e o f sai d property v/ticl i woul dtai dt o endange r tii e healt ho r welfer e o f th e Grantee s o r th e environment , o r

t o allo w other s t o us e th e propert y i nsuc h gran t BCccs B t o my propertie s ( ^ I d o no t gran t acces s to my propertie s ^ 

# Jl:iMd ' Dat e Sigtistvr s Dst s Signatur eFRO M : Zfl S COR P LL C FA X NO . : 40 2 99 1 553 3 iec . 1 6 201 0 02:27P M P 2 1.2/16-'2O1 0 THUl3i2 4 PA S

Addtiena l Convnant B / biBtnietlona :

3'Otec k tw s bo xtfowne rdoe s no t wan t E.R . t o •nte rth e reawtent s t o documan l mterio f Ibundatio n wail s an d poaaibt e prewistin g damage . B ycheckin g thi s bo xE.R . i s no t responsible fc ran ydamag e don e t o th e irterlo ro f house , Includin g foundation crack s o rfiosures .



### Q I do no t agre e 

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Dst e CiNitr«ctar>s^iss«t«r » ^ ^ C - ^ Own«r* i Owner* s Signator e

## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s to provid e amutual agreemen t a s t o condition s o f propert y prio r t o contracto r activities . Thi s wil l als o serv e a s documentatio nfor th e purpos e o f assurin g that restoratio n activitie s are complete dto th e satisfactio no f th e property ovvne r an dth e Unite dState s Environmenta l Protectio nAgenc y (EPA) .

SAI D 

## •-^nf}< ,^ , Z^^y n 3(^^5- 2 PropertyAddress : ^2,0 6 Ay . Z^ ^ ^T . 

## Q^""^ = Z/^^/ / ^^/eMA/X " Phone : 

## ^oi'€-?e>XoS27 ^ O

nth e attache ddiagram(s ) indicate area(s ) t o b e excavate dan ddept ho f excavation , locatio no f al l know n utilities , subsurfac e features , surfac e structure s an dlandscapin g features , acces s location(s ) t o b e use db y contractor , an dth e directio no f North . Indicate distances , depths , material types , etc . Indicat e digital photo s b

y referencin g th e photo-lo g number wit ha narro w indicatin g directio no f view . Item s t o b e remove d b yContracto ran d no t replaced :

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

Pag e 1 o f2FRO M : ZP S COR P LL C FA X NQ . : 40 2 99 1 553 3 pec . I S 201 0 02:2SP M P 3 i2;i6/Z«1 0 TH U 13:2 3 PA X

Additiona l Comment s / instructions :



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Pag e 2 of 2 6FRO M : ZP S COR P LL C FA X NO . : 40 2 99 1 553 3 'eb . 24 201 1 ll:54flM P l 02/33/201 1 WBDlSiO S PA. X 

## Propert y Completio nAgreomen t Thi s agteemen t document s di e conpletio Q o f remedial activitie s performe dc nm y properry . M y aignAtuio ^ii i dm^iftt * tka i I a mtmftafiM i win hth e restorstio aO f na

y properly , atM l tha t n o itsm aar e i n qoe3tio& , now , o r a t an y tim e i ntite future , excep t thos e item s lists dIRIOW , ifany . SMD ; 

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# { ^fnft-rrfgn> ^ Rsetoraiie nitom s i nQueaDon :

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### O:IIT.HJT^\ I Ownflr' B S^BHtur e Oat s Ceii<nclor* 9 Sigsatur e DKH I

### Dougla s County Accoimt Inforr ^^n Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R l 14459000 0 Prin t Repor t V I e wInteractiv e GI S Ma p Informatio n i s vali d a s o f2010-11-1 6 Treasurer' s Ta xRepor t Ne wFeatur e -»-»- » S u bdivisio n Sale s Searc h Owne r ZA S COR P LL C C/

O NABUSL I & SERHA N LLC 800 2 N 12 7 AV E OMAH AN E 68142-000 0 Propert yInformatio n Ke yNumber - 445 9 OOO O 1 1 Accoun t Type : Residentia l Parce l Number : 114459000 0 Parce l Address : 520 8 N 2 4 S T OMAH AN E 68110-000 0 Lega l Description : GLENCO E PLAC E LO T2 7 BLOC K1 4 0 X 11 3 Vaiu e Informatio n Lan d Improvemen t Tota l 201 0 $500.0 0 $0.0 0 $500.0 0 200 9 200 8 200 7 200 6 200 5 $500.0 0 $500.0 0 $500,0 0 $500.0 0 $500,0 0 $0.0 0 $0,0 0 $0.0 0 $0,0 0 $0.0 0 $500.0 0 $500.0 0 $500,0 0 $500.0 0 $500,0 0 

### Sho wAl l Transaction s

Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0. 1 4520, 0 0. 0 113. 0 40. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoiintno=Rl. . . 11/19/201 0

### Dougla s Count y Accoun t Infor r io n Pag e 2 o f 2



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### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl. . . 11/19/201 0

### ENVIRONMENTA L AS-BUILTDRAWIN G « MAH ALEA D SUPERFUN D SIT E RESTORATIO N

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