# • 0• • TRANSMITTA L o f OMAH A LEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : r^C^n ^ Date : ) ^ l<^t ^ ^ Address : Z^2. h lL^\I fcjH ^ Remediatio n Contractor : fmAJij . rj
- ^i U Tgn c Year : ^-^r^ ^ SOI L REMEDIATIO N PROPERTYFILEFOLDERDOCUMENT S IE TVide o o f property (DVD ) mExecutiv e Summar y aEPA-provide dproperty sketc h 0 Signe dAcces s Agreemen t fo r

subjec t property D Signe dAcces s Agreement(s ) for adjacent property 0

Restoratio n Agreemen t 0 Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) [ /

Confinnatio n dat a 0 Photograph s As-buil t sketc h Satisfector y restoratio n signe db y Property Owne r ' ^ 

## Property close-ou t chec k lis t signe db y EP A •Descriptio n o f area s no t meetin g RO D cleanu p criteri a Utilit y clearance s 

## Property informatio n fromDougla s County Assessor' s Offic e D D D 

## SiSatuS
- ' ^^^TO T 3005412 2 

# IHNi i Superfun dFin d Recor d Remediatio n Query I Lea d Remainin g Query I Propert y Damag e Query Backfill :

Sampl e Area : 2550 9 Owner : D Ovme rOccupie d Owne rName : jWA U LUTBJLLA H Owne rAddressl : 

# I Owne rAddress2 : |332 4 HAMILTO N ST aty : |OMAH A Owne rPhone : |(402 ) 99 1 889 2 - 332 4 HAMILTO N S T

State : Zi p Code : [N E |6813 1 Alternat e Phon e [ 

### Resident : Residen t Name : )WAL I LUTFULLA H Propert y Address : )332 4 HAMILTO N S T Zi p Code : |6813 1 Residen t Phon e 

# I Contract : Contractor : )PRUDEMT2009_ S contrac t Optio n lOPnON 2 Assessment : Qualifyin g Grou p 

## po o Assessmen t Ma xXR F Value : 

# r 438.4 8

### miwnmmiBiwamtmBBMg y Date : 12/15/200 9 Omah aLea dSite Remedial Actio n Contrac t #EP-R7-07-0 6 TO# l Month of : November Propert y Address : 3324 HAMILTO N S T A . EXECUTIV E SUMMAR Y A. 1 Issue s Encountered : NON E A 2 Issue s Resolved : NON E A J Uniqu e Findings : NON E A 4 Othe r Relevan t Infonnation : NON E CONFIRMATIO N SAMPLIN G DATA/RESULTS : B l = 2 2 PP M @ 6" ; F 2 = 53 1 PP M @ 13" ; D Z = 6 9 PP M @ 12" ; E A = 22 6 PP M @ 2 " ATTACHMENT S 1 ) Propert y sketch providedb y EP A pixrsuan t t o contrac t specification s 2 ) SignedAcces s Agreemen t including acces s agreement s require dfo r crossing othe r propertie s 3 ) Pre-Excavation digita l vide o clip/photograph s 4 ) Post-Excavatio n digita l vide o clip/photograph s 5 ) Documentation - CompletedClose-ou t Checklis t 6 ) As-Built sketch ­ i ) Shall includ e final lea dlevel s v ) Legen d ii ) Contamination lef t behindarea s vi ) Contractor identification iii ) Propert y addres s vii ) Dat e iv ) BVI D numbe r 7 ) othe r item s t o b e includedin th e individua l propert y file, if available , o r obtainedinclude : i ) Pre-excavatio n agreemen t detail s (i f an y ar e mad e wit h th e propert y owner ) ii ) Propert y Statu s For msignedby propert y owne r iii ) Excavation digita l vide o i n MPEG , WM V (Window s Medi aVideo ) or SW F(Flas h Player ) forma t and/or photograph s iv ) Signedfor mverifying satisfactor y restoratio n v ) Descriptio n o f area s not meeting InterimROD cleanu p criteria .

# miDENT^fe - ^COi l EP A Propert y Clos e Ou t Propert y # : ^S^O ^ Propert y Address : Ji3^ ^ )4r^ynJt£l ^ Date/Time : Owner' s Name : Lc ^ V.^ . w] U k if^j c Quad s Excavated : /2>l , F^ y 'i>2- ^ ^2 - Contracto r Grou p Fuden t Technologie s Excavatio n Genera lYe s N o 1 .

If necessary , wer e th e correct quadrant(s ) excavatedan drestored ? / 2 .

If necessary , wer e th e correct area s of dri p zone excavatedan drestored ? / Gradin g So dan dVegetatio n Ye s No 1 .

Doe s th e grading aroun dth e perimete r ofth e hous e i n excavatedarea s gener Jl

y slop e awa y fromth e house ? / 2 .Ha s sodbee n lai di n al l area s tha t wer e excavated ? / 3 .

Doe s th e sodappea r t o b e generall y health y an dgrowing ? (Onl y evaluat e i f i ispecte da t a3 0 

## y da

y tim e period) 4 .

Ar e sodde darea s generall y firman devenl y graded ? 

# y 5 .Ar e the joint s betwee n th e sodstrip s generall y tight ? (Onl y evaluat e if inspe c te da t a3 0 da y 

# y tim e period) 6 . Wa s th e propert y gradedsuc h tha t wate r wil l not pool o n th e property ? 

# y 7 . Wa s damag e t o landscaping o r plan t naterial s avoided ? 

# y Gates , Fence s an dRetainin g WaU s Ye s N o 1 . D o gate s ope n an dclos e freely? (If applicable ) 

# y 2 . Wer e al l gate s o r fence s taken dow n during restoratio n activitie s reinstalled ? (I f applicable ) 

# y 3 . Wa s damage t o gate s o r fence s avoided ? (If applicable ) 

# y 4 . Wa s damage t o retaining wall s avoided ? (I f applicable ) 

# y Foundation , Sidin g an dGutter s Ye s N o 1 . Wa s damag e t o th e siding or trimavoided ? / 2 . Was damag e t o th e foundatio n avoided ? 

# y 3 . Was damage to window s avoided ? 

# y 4 . Was damage to window s o r doo r screen s avoided ? / 5 . Was damage t o dovraspouts or downspou t extension s avoided ? / Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 . Was damage t o drivewa y surface s avoided ? / 2 . Was damage t o walkwa y surface s avoided ? 

# y

### Owner s comments :

Inspectio n notes :

Remova l andrestoratio n activate s complet e includin g th e 30-da y so dwarant y EP A Representativ e Date : jtj i •/0 9 ^ c .

## Propert y 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 propert y owner' s signatur e indicate s tha t th e property owne r i s satisfie dwith 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 fiiture, excludin g an y remainin g warrant y (3 0 day s total ) excep t thos e item s liste dbelow , i f any . Propert y ID : Propert y Address : 

## 3 3 £ H |-\-^L^^^ 1 W S ^ Owner : 

# VTJF , 

# pg ^ V._i . 3 ^ . V-J L Phone : Restoratio n Item s i n Question : 

## rz

Item : Item : item : Item : Item : Item :

I agre e restoratio n i s completed . I d o no t agre e restoratio n i s complete d a t (note d deficiende s above ) 

# wy^- ^ Owne r Dat i : e

### TECHNOLOGIES . INC . Pruden t Technologies , Inc . (Prudent ) i s unde r contrac t wit h th e U . S . Enviromnenta l Protection Agenc y (EPA) t o clea n u p lead
contaminate dsoil s a t anumbe r ofpropertie s locate din Omaha, Nebraska , includin g the propert y locate da

t

. Th e EP A request s you r permission t o allow Pruden t t o perfor masoi l cleanu p a

t thi s propert y t o remove lead-contaminate dsoil . B y signin g thi s form, di e propert y owne r grant s pennissio n t o Pruden t t o perfon n activitie s relatedt o th e cleasaq ) includin g soi l sampling , remova l o

f lead-contaminate dsoil , an drestoration o f the reference dproperty . I f yo

u hav e an y question s abou t the soil cleanu p plannedfo r you r property , pleas e contac t Prudent' s Administrative Cler k

fo

r the Omah aLea dSit e cleanup . Ms . Siv aS . Jampana-a t (402) 733-1188 . Genera l question s abou t the Omah aLea dSit e cleanu p ca n b e directedt o the EP A Public Infomiatio n Center s a

t (402) 731-304 5 (Sout h Omah aoffice ) o

r (402 ) 991-958 3 (Nort h Omah aofBce) , Propert y Acces s Grante d 

## Bv : li^rPOUAItW/il i pleas e Prin t Name ) Propert y Owne r Signature : 

# ^^i^f^i'^< ^ ^MA' ^ (Date ) ^ PROPERT Y INFORMATIO N (To b e compkte dby residen t and/o r property owner — PjHilf \i^* \ RESIDEN T NAME : RESIDEN T ADDRESS : . . A ^ I F RENTAL , PROPERT Y OWNE D BY : OWNER' S RmiN Q ADDRESS ; OWNER' S TELEPHON E NUMBE R - HOME : J L WORK : 

# S a 

# f AO E O F HOME ? : /O D ^ARS . HO W LON O HAV E YO U LIVE D HERE ? YEARS . HA S TH E EXTERIO R BEE N PAINTE D O R COVERE D WTT H SIDIN O SINC E 1978 ? VE 8 W O Qr< ^ 

# T NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OLD : ^ ^

NUMBE R O F OCCUPANT S 7 YEAR S OL D AN D OLDE R NUMBE R O F CHILDRE N UNDE R 7 YEAR S OL D WH O PLA Y I N TH E YAR D FO R 5 HOUR S O R MOR E PE R WEEK : COMMENT S O R SPECIA L INSTRUCTIONS : (I.E . DOOS , ENTR Y OATES , ETC. )

AUTHORIT Y FO RENVIRONMENTA L RESPONS E ACTIONS : Th e activitie s t o b e implemente db y EP A unde r thi s agreemen t ar

e pursuan t to Sectio n 10 4 ofCERCLA , 4 2 U.S.C . 9604 . EPA' s rightof acces s t o the propert y i s provide dfo r in Sectio n 104(e ) o

f CERCLA, 4 2 U.S . C 9605(e) , whic h provide s entr y fo r "determining th e needfo r response , or choosin g o r taking an y respons e action unde r thi s title , o r otherwis e enforcin g the provision s ofth e title. "

808 0 Ward Parkway , Suit e 40S 560 0 S 10* ^ Stree t 4242 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Oniaha , Nebrask a 6810 7 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)733-118 8 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)733-188 3 Fax : (210 ) 579-657 7ENVIRONMENTA L & CONSTRUCTIO N 

### TECHNOLOGIES , D^C . SERVICE S



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- Omaha , Nebrask a6810 7 Sa n Antonio , T X 7822 9 'hone : (816 ) 363-370 3 '­ - ' Phone : (402)733-118 8 Phone : (210)822-958 8 •an : (816 ) 363-370 7 Fax : (402)733-188 3 Fax : (210 ) 579-657 7nKCHNOlXKilES . INC . 

### A S - BUIL T DRAWIN G Ol,S#:2550 9 Dat e KxtavaU'ii : 09/1K/2U0 9 

### OMAHA LEA D SUPERFUND SIT E l,SKP. \Siencd-OI T Dote :

Name : Ljir:>^/^LA-f & Omah a Lea d Sit e Date : JT/Z^ ? Nort h Arro w Address : .?S2. ^ ^x'/zdePtJ- W SiteSketc h Time : /sf^ l Phone : Tea m ^JiZyTr ^ *i/yfT^f/'T ' BVID # ^S'^<^ f XR F Cod e 

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CONTRAC T » : E P - R7-07-0 6 T0# 1 PRUDENTTECHNOLOGIES , INC .Mfirt^ H /. v^J^/.jLA-if f Omah a LH d Sit e S»t e SkvtG^D 

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## Dougla s County-Omaha , NE

Parce l I D Owne r Nam e Pmpert y Addres s Cit y Zi p Owne r Addres s Owne r Addres s Owne r Cit y Owne r Stat e Owne r Zi p 164209000 0 WAL I LUTFULLA H 332 4 HAMILTO N S T OMAH A 6813 1 332 4 HAMILTO N S T OMAH A N E 6813 1 Additio n Bloc k Lo t Lega l 1 Legal 2 Legal 3 Lega l 4 Acre s Treasure r Websit e Lin k Assesso r Websit e Lin k LOWE S AD D T 6 W40S107F T 40X10 7

0.0 9 http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp ? parc=164209000 0 http://douglasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R164209000 0 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 9/3/200 9

2

### Pag e 1 of 2 "> ( Creat e Anothe rTicke t \ [ Bac k t o Irt h Interne t J Sen d Emai l



### • YOU RTICKE T NUMBE RI S 2361715 . Origina l Cal l Date : 9/11/0 9 Time : 8:3 9 a m Op : SIVA1896 7 Wor k t o Begi n Date : 9/15/0 9 Time : 9:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 332 4 Street : HAMILTO NS T Twp : 15 NRng : 13 E Sect-Qtr : 16-NW Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : SOI L LEA D REMEDIATIO NPROJEC T Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)733-188 3 : FA X AL L CLEAR S T O (402 ) 73 3 188 3 : UNSUR E CORNER S Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : SIV AJAMPAM A Phone : (402)733-118 8 Wor k Bein g Don e For : EP A Dept h o f Excavation : 6 F T Corne r Lot : b Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : ^ Explosives : N CXCAT V LEVEL 3 MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Are a Contac t Phon e Nunibe r Utilit y Typ e CXCAT V CO X COMMUNICATIONS , IN C HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 LEVEL S LEVEL S COMMUNICATIONS , LL C N A Day : 877366834 4 Alt : Emerg : 877366834 4 MUDO l METROPOLITA N UTILITIE S DISTRIC T SAND Y 

### Day : 402504782 3 Alt : 

### Emerg : 402504797 0 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO N Day : 402444719 7

Alt : 402444516 1 Emerg : 402444516 0 http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/11/200 9

### Pag e 2 of 2

OPPDGPR 5 OMAH A PUBLI C POWE RDISTRIC T N A 

### Day : Alt : 406728934 3 406207149 4 Emerg : 888728934 3 QLNN E 1 C QWES T LOCA L NETWOR K N A 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3



### http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.. . 9/11/2009ENVIRONMENTA L & CONSTRUCTIO N TECHNOLOGIES . INC . SOLUTION S 

# Sit e Safet y Hazar d Analysi s Address : 3-J>? V /y^A^,y^i> ^ Crew : '^V^»VM^ 5 

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## Retainin g Wall s A ^ 

## Fence s y^ ^ 

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## Sit e Safet > Office r

308 0 War d Parkway . Suit e 40 6 2.50 5 iV . 24 ' -Street . Suit e 30 8 424 2 Medica i Orr/e . Suit e 725 0 KansasCity . M O 6411 4 Omaha , Nebrask a 8S11 0 Sa n Antonio . T X 7822 S Phone : (316 ) 363-370 3 Phone ; (402 ) 504-100 4 Flione : (210 ; 822-958 8