### PROPERT Y SUMMARY Date : 10/26/200 7 Omah aLea dSite Remedia l Actio n Contrac t #EP-R7-07-0 6 Mont h of : Octobe r Propert y Address : 171 2 N 2 8 Stree t A . EXECUTIV E SUMMARY A. I Issue s Encountered : Non e A. 2 Issue s Resolved : Re-See dwil l occu r i n Novembe r o n an y dea dspot s t o encourag e sprin g growth . A. 3 Uniqu e Findings : A. 4 Othe r Relevan t Informatio n : Bus h i n B 2 - 33 9 @ Scrap e CONFIRMATIO N SAMPLIN G DATA/RESULTS : F2 - 15 3 @ 6 " 

### Bl-317@10 " B2 - 16 7 @ 10 " D l - 27 8 @ 13 " 

### E l - 12 3 @ Scrap e ATTACHMENT S 1 ) Propert y sketc h provide db y EP A pursuan t t o contrac t specification s 2 ) Signe dAcces s Agreemen t includin g acces s agreement s require dfo r crossin g othe r propertie s 3 ) Pre-Excavatio n digita l vide o clip/photograph s 4 ) Post-Excavatio n digita l vide o clip/photograph s 5 ) Documentatio n - Complete dClose-ou t Checklis t 6 ) As-Buil t sketch i ) Shal l includ e fina l lea dlevel s v ) Legen d ii ) Contaminatio n lef t behin darea s vi ) Contracto r identificatio n iii ) Property addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e include di n th e individua l propert y file , i f available , o r obtaine dinclude : i ) Pre-excavatio n agreemen t detail s (i f an y ar e mad e wit h th e propert y owner ) ii ) Excavatio n digita l vide o i n MPEG , WM V (Window s Medi aVideo ) o r SW F(Flas h Player ) forma t and/o r photograph s iii ) Signe dfor mverifyin g satisfactor y restoratio n iv ) Descriptio n o f area s no t meetin g Interi mRO D cleanu p criteria . Superfun d ECHNOLOCIES , INC .

# •Name : Omah a Lea d Sit e Date : Nort h Address : Site Sketc h Time : Phone : 

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### Agreement ) Allow Acces s T o Propert yJ o Conduc t Easemen t 

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# I ? W ? ' 2 Samplin g an d Cleanu p Uadte r Cossforac t EP-R7-07-OS , & e U . S . Isaviroiomeaia l Rrotectio aAgeac y (EPA) ha s Coafcractis dIftrudes t Tecbnoiogies , lac . (Ptodeot) , to cleanu p lea dcoMamijifltJcf l o n variou s residfisrtJai pfopesiie s indw&i g yous r property . Yo u ca ahel p witli iisi s activit y b y givia g pemassio ato conduc t easemeo t saoijilia g aad conduc t cleanup o n yma r property . I f yo u sign tfas s fbnn , Prudent will return i maft w week s an dperform Jkawork . We will coosri&iat e seasiiliffl g emdcleamBi ) witi i yo u gwio ? to I f

yo u hav e aaiy questioia s abou t iSiapropose dwork , pleas e cosrfatf DS Q Gesrvey , EPA' s Rejec t Office r fo r ois r Omah aLaa dSit e Contrac t Mr . G^vsy L bache da t (402 ) 731-07^ . Pi-operf y Acces s Create dBy : \ \ < J / 

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### PROPERT Y (T o b e coEiplrfe db y resfies i Eafi/o r proper^

- pleas e print ) RESIDEN T MAK E : TS^L A t W^> ~ QJw n ne r RESIDEM T ADDRESS : \ ~ ? f ^$ ? J 1 I F REMTOL . PROPERT Y OWME D BY : x i r^ j OWNER' S C3AILD1 G ADDRESS ; OWNER' S TELEPHON E NUBBER-HOdE : r^ L ^ M - ~ WORK : AG E O F HOC3E? : YEARS . HO W IQH G HAV E Y O LIVE D HERE ? YEARS . HA S TH E EXTERIO RBEE H PAIMTE O O RCOVERDE D WITH SJDB1 GSWCE1978 ? B O HA S TH E INTERIO R BEEt J PAHTE D O R COVERE D SINC E 1S78 ? K

_YE S N O NUttBE R O F OCCUPANT S UNDE R S YEAR S OLD : D NUE3BE R O F OCCUPANTS 6 YEAR S OL D AN D OLDE R MUQBE R O F CHILDREH T UNDE R 6 YEAR S OL D WH O PLA Y I N TH E YAR D FO R 5 HOUR S O R COR E PE R WEEK : 

### coaaEWT S O R SPECIAL IMSTRUCTIOMS : (I.E . DOGS . ENTRYGATES . ETC. ) _ AUTHORITY FO RENVIQRNMWrAL RESPONS E ACTION S Th e activitie s to b e implement s b y EPA unde r thi s agreement ar e pursuan t to Sectio n 10 4 o f CERCLE . 4 2 U . S.C . 9604 . EPA'sri^i t o f acces s t o the propet y i s provide dfor in Sectio n 104(e ) o f CERCLE , 4 2 U.S . C 9605(e) , whic h provide s entr y fo r "determinin g th e nee dfo r response , o r choosing o r takin g any respons e actio n unde r thi s title , o r othe'wis e enforcin g the provision s o f the title. " 

# A

# EP A Propert y Clos e Ou t Propert y # : 26V? 3 Propert y Address : /7/ 2 A/o«f* » Z8i> > Date/Time : Oc.i-23 , Owner' s Name : Ce.A/r A &A'»tJ Quad s Excavated : p . Contracto r Grou p Pruden t Technologie s Excavatio n Genera l Ye s N o 1 .I f necessary , were th e correc t quadrants ) excavate dan drestored ? 

# s 2 .

I f necessary , were th e correc t area s o f dri p zon e excavate dan drestored ? 

# s Gradin g So dan dVegetatio nYe s N o 1 . Doe s th e gradin g aroun dth e perimeter o f th e hous e i n excavate darea s generall y slop e away fro mthe house ? 

# s 2 .Ha s so dbee n lai di n al l area s that were excavated ? 

# I / 3 .Doe s th e so dappea r to b e generally health y an dgrowing ? (Only evaluate i f inspecte da t a3 0 da

y time period ) 4 .Ar e sodde darea s generall y fir mandevenl y graded ? 

# * / 5 . Are th e joint s betwee n th e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 day time period ) 

## s 6 .Wa s th e propert y grade dsuc h that wate r wil l no t poo l o n th e property ? 

## s 7 .Wa s damag e t o landscaping or plan t material s avoided ? 

# s Gates , Fence s an dRetainin g Wall s Ye s N o 1 .

D o gate s open andclos e freely ? (If applicable ) 

### / 2 .

Wer e all gate s or fence s take n dow n durin g restoration activitie s reinstalled ? (I f applicable) 

### </ 3 .Wa s damag e to gate s or fence s avoided ? (I f applicable ) 

### / 4 .Wa s damag e to retainin g wall s avoided ? (I f applicable ) 

### S Foundation , Sidin g an dGutter s Ye s N o 1 .Wa s damag e t o th e sidin g o r tri mavoided ? 

### / 2 .Wa s damag e t o the foundatio n avoided ? 

### S 3 .Wa s damag e to window s avoided ? 

### S 4 .Wa s damag e to window s o r doo r screen s avoided ? 

### / 5 .Wa s damag e to downspout s o r downspou t extension s avoided ? 

### S Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 .

Wa s damag e to drivewa y surface s avoided ? 

# / 2 .Wa s damag e t o walkway surface s avoided ? 

# J

### Owner s comments :

Inspectio n notes : H DtR O GH O NttO S T O 8 t fiepkcee t o/ » /* « Soi+H nee , O F-fh e Qfiiptotc ,



## Removal an drestoratio n activate s complete includin g th e 30-da y so dwarranty : EP A Representativ e £-_A - Date :Omah a Lea d Site Sit e Sketc h



### Omah aLeadSit e 4613 0

## Property Completio n Agreemen t Thi s agreemen t document s th e completio n o f remova l activitie s performe do n th e belo w liste dproperty . Th e property owner' s signatur e indicate s tha t th e property owne r i s satisfie dwit h th e restoratio n o f th e subjec t property , an dtha t n o item s ar e i n question , now , o r a t an y tim e i n th e future , excludin g an y remainin g warranty (30 day s total ) excep t thos e item s liste dbelow , if any . Propert y ID : £

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### o > ,- j ^ Phone : ~ " Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item : Require d correction s t o complet e th e property :

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

Owner' s Signatur e Dat e

### Prin t Previe w Pag e 1 o f 1 

## Dougla s County-Omaha , N E

Parce l I D Owne r Name Propert y Addres s Cit y Zi p Owne r Addres s Owne r Addres s 2 Owne rCit y Owne r Stat e Owne rZi p 221268000 0 GAINE S CERIT A L 1712N28S T OMAH A 6811 1 1712N28S T OMAH A N E 6811 1 Sec-Twn-Rn g Owne r Address Additio n Block Lot Lega l 1 Legal 2 Lega l 3 Lega l 4 Assesso r Websit e Lin k 16-15-1 3 SHINN S 2N D AD D S 1 2 N60F T 60X6 0 http.Y/douglasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R221268000 0 Disclaime rMa p an d parce l data ar e believed t o b e accurate , bu t accurac yi s no t 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 , 1 inc h = 2 0 fee t appraisal , survey , o rfo rzonin g verification . 

### http://vvww.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 7/16/2007Fin d Recor d Clea n U p Quer y Lea d Remainin g Quer yPropert y Damag e Quer y Clos e 

### ampl e Area : 2644 3 - 171 2 N 2 8 S T Owner : Resident : Contract : n Owne rOccupie d Residen t Name : Contractor : Owne rName : 

## [GAINE S CERIT AL JPRUDENT200 7 JGAINE S CERTT A L Propert yAddress : Group : Owne rAddressl : J171 2 N 2 8 S T k

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# i P j Zi p Code : Assessment : Owne rAddress2 : J6811 1 j 171 2 N 2 8 S T Residen t Phon e Qualifyin g Grou p City : State : Zi p Code : ]80 0 

# i JOMAH A JN E J6811 1 Assessmen t XR F Date : ] Owne rPhone : Alternat e Phone : 1 |(402 ) 346-153 0 j(402 ) 345-568 3 Assessmen t MaxXR F Value : j 903. 2

### Pag e 1 of 2

Creat e Anothe rTicke t Bac k t o Irt h Interne t 

### Sen d Emai l YOU R TICKE T NUMBE R I S 1864705 . Origina l Cal l Date : 8/14/0 7 Time : 9:4 9 a mOp : CYNDIE1896 7 Wor k t o Begi n Date : 8/16/0 7 Time : 10:1 5 a m State : N E County : DOUGLAS Place : OMAH A Address : 171 2 Street : N28T 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 : Soi l Remediatio n - Lead - Excavatio n Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)504-100 5 Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : CYNDI E Phone : (402)504-100 4 Work Bein g Don e For : EP A Dept h o f Excavation : 14 " Corne r Lot : N Front : NRear : N Involve s Tunnelin g o r Horizonta l Boring : N Explosives : N CXCAT V LEVEL 3 MUD0 1 OMAHACO F OPPDGPR 5 QLNNE1 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 Day : 8773668344 LEVEL S LEVEL S COMMUNICATIONS , LL C 

### N A 

### Alt : 

### Emerg : 877366834 4 Day : 402504782 3 MUD0 1 METROPOLITA N UTILITIE S DISTRIC T EDWIN A Alt : 

### Emerg : 402504794 6 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R 

### RO NAlt : 402444516 1 

## Emerg : 402444516 0 Day : 406728934 3 http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS .. . 8/14/200 7

### Pag e 2 of 2

OPPDGPR 5 OMAH A PUBLI C POWE RDISTRIC T N A 

### Alt : Emerg : 888728934 3 QLNNE1 C QWES T LOCA L NETWOR K N A 

## Day : 

## Alt : 406728934 3 Emerg : 888728934 3

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