## TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAID # : Date : 

# \2li k 

# ll' " Add^ss: l|^0 < ^ qO-^^ r Remediatio nContractor : Coasta l Environmenta l Grou p Year : 20 i 

## _20(|J L SOI LREMEDIATIO N PROPERT V nLEFOLDE RDOCUMENT S Vide o ofpropert y (DVD ) 

## £ / Executiv e Summary EPA-provide dproperty sketc h Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) fo r adjacent property Restoratio nAgreemen t Settlement document s (i.e. , fo r damag e o r to replac e plants , etc. ) Confinnatio ndat a Photograph s As-buil t sketc h 3021757 3 Satisfactory restoratio nsigne db y Property Owne r 

# llilii l Property close-ou t chec k lis t signe db y EPA Superfun d 

### Descriptio nofarea s no t meetin g RO D cleanu p criteri a Utility clearance s Property informatio nfromDougla s County Assessor' s Offic e 

# i " 1 Signature '5ate "#



# Propert y Acces s Checklis t PropertylD : ) ^ f^^ ^ D WOB K STARTE D ON : / / D WORKCOMPELTE D ON : / / Property Address : U,<^0, ^ ( ^ ^ 7
. ,'^ , Owne r Rente n Address : IB
. ' J Phone : Fax : Cell/Page n Additional Information : 

# "?5.VO:M5 : Fax : ^ Cell/Page n D NotificationLette r Sent : / / By : Acces s Agreement Signed ; tg/^/^ g By : j ^Restoratio nAgreement Signed^D-ZSLOS l By : Q Topsoil Samplin g (if applicable ) By ; D Disposa l Samplhi g (if applicable ) / /
. By : GGarde nSamplin g (if applicable ) By : 

# s Utilit y Clearanc e Called:/ ' / Ll< ^ 

# ^nJLiuiQ i Q^ldeo/Photo s (Before ) On : W l T- l ^ »y - /JTM/r^^y^/j^/. ^ D Video/Pboto s (During ) On : By : D Video/Photo s (After) On : / / By : D video/Photo s (30-Day ) On : / / By : 

# f Property CompletionAgreenra t 

### Signed : JL^^/.g | By : Final Report Issued : / By : Ai r Monitorin e (a s applicable ] Q Commnnit y QCrc w On : / / By : Results ; nComnmntt y DCnc w On : / / By : ResDhs : | D Commnnit y QCrc w On : / / By : Results :
Omah a Lea d Sit e

### Dougla s Cotmty Accoun t l a rfiunati io n Pag e 1 of 3
Dougla s County , Nebrask a Propert yRecor d - R143507000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e fi) scal e 0-5 0 ft wes t o f52n d S t - VlO WO n IMa p Informatio n i s vali d a s o f2009-10-1 5 Treasurer' s Ta xRepor t Ne wFeatur e ->•*- > Aut o Sale s Searc h Owne r ZARACK I RAYI^ON D ETA L 413 0 S 4 1 AV E OI^AHAN E 68107-000 0 Propert yInformatio n Ke yNumber : 350 7 OOO O 1 4 Accoun t Type : Residentia l Parce l Number : 143507000 0 Parce l Address : 450 5 S 4 2 S T OMAH AN E 68107-000 0 Lega l Description : KENT S AD D LO T8 BLOC K2 -E X IRRE G W9. 2 FT - S 5 0 F TLO T7 & S 5 0 F T Valu e Informatio n
200 9 200 8 200 7 200 6 200 5 200 4 Lan d $5,700.0 0 $5,700.0 0 $5,700.0 0 $5,700.0 0 $5,700.0 0 $5,700.0 0 Improvemen t $26,700.0 0 $26,700.0 0 $26,000.0 0 $26,000.0 0 $14,600.0 0 $13,300.0 0 Tota l $32,400.0 0 $32,400.0 0 $31,700.0 0 $31,700.0 0 $20,300.0 0 $19,000.0 0 Sale s Informatio n Sale s Date : 2007-04-2 7 Dee d Type : Price : Grantor : W D $35,000.0 0 Jankowsk i Nichola s J Book : 200 7 Page : 05165 6

Grantee : Valid/lnvalid : Zarack i Raymon d eta l Vali d Excl Reason : usio n Sale s Date : 2000-05-0 2 Dee d Type : Price : Grantor : D $19,000.0 0 Book : 215 1 Page : 20 7



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.
. . 10/17/200 9

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.
. . 10/17/200 9iJujnMd c Dougla s Count y Accoun t InJugMdo n Pag e 2 of 3
Grantee : Valid/Invalid : Exclusio n Reason : Vali d
Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/lnvalid : Exclusio n Reason : 1995-08-3 1 $16,000.0 0

', Vali d Book : 201 5 Page : 53 3

Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : 1995-06-1 4 I D $8,000.0 0

Invali d Invali d Sal e Book : 200 6 Pasre ; 55 9

Lan d Informatio n Acre s S F 0.1 1 5000. 0 Improvement Informatio n Buildin g 1 Unit s 1.0 Dept h 100. 0 Widt h 50. 0 Vacan t N o

Ranc h 450 5 S 4 2 S t

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. . 10/17/200 9

## Douglas Count y Accoun t In ^ iJujnMdo n Pag e 3 of3

Uni t Type :

Buil t As :

HVAC : Exterior : interior : Roo fCover :

Roo fType : Floorcover :
Yea rBuil t Remodele d Remodele d 192 5 Detai l Typ e Applianc e Basemen t Fixture Fixture Garag e Porc h Use r Ranc h Force d Ai r Fram e Viny l Drywal l Compositio n Shingl e Gabl e Allowanc e Yea r Percen t

0 0 % Detai l Descriptio n Allowanc e Bsmn t Bloc k 8 f t Bas e Fixture s Bat h Hal f Detache d Woo d Roo f Traffi c-3 0 Condition : Cond o Squar e Footage : Rooms :

Units : Baths : Bedrooms : Stories : Foundation : Sprinkle rSquar e Footage : Adjuste d Yea r Averag e 0. 0 2. 0 1. 0 0. 5 1. 0 l- O Bloc k 0. 0 Physica l Ag e Buil t 192 5 8 3 Unit s 1. 0 208. 0 1. 0 1. 0 252. 0

48. 0

1. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl..
. 10/17/2009

## Pag e 1 of 2

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

### Send Emai l 

# ] [
YOU R TICKE T NUMBE R IS 2397789 . Origina l Cal l Date : 11/02/0 9 Time : 9:5 6 a m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 11/04/0 9 Time : 10:3 0 a m State : N E County : DOUGLA S Place : OMAH A Address : 450 5 Street : S 42N D S T Twp : 14 NRng : 13 E Sect-Qtr : 05-NE-NW Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LO T Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : COASTA L Dept ho f Excavation : 4 F T Come r Lot : N Front : Y Rear : Y Involve s Turmelin g o r Horizonta l Borin g : N Explosives : N ATTNEBR l CXCAT V METR O MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F

Servic e Are a Contac t Phon e Numbe r UtiUt y Typ e
ATTNEBR l ATT/T 

### Day : 8002413624 9 Alt : Emerg : 8002413624 9

CXCAT V CO XCOMMUNICATIONS , IN C HEID I 

### Day : 402934046 9 Ah : 402934046 9 Emerg : 402932975 7

METR O METR O COMM
. COLLEG E CHRI S 

### Day : 402457230 7 Ah : 402672703 3 Emerg : 402457231 3

MUD0 2 METROPOLITA NUTILITIE S DISTRIC TSAND Y 

### Day : 402504782 3 Alt : 

## Emerg : 402504797 0

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. 11/2/2009

### Pag e 2 of 2

OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R 

### RICH/TRAFFI C Day : 402444719 7

Ah : 402444516 1 Emerg : 402444516 0

OPPDGPR 6 OMAH APUBLI C POWE RDISTRIC T 

### N A 

### Day : 406728934 3 Ah : 406207149 4 Emerg : 888728934 3
QLNNEI FQWES TLOCALNETWOR K 

### N A 

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

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 11/2/200 9OLS# : 1015 6 

# As-Buil t Drawin g Dat e Excavated:11/13/0 9 Dat e USEP ASigne d Off : 12/4/0 9 COASTA L 

# Omah aLea dSuperfun dSit e Are a Sodden : 53 1 s o f t CNVmONNINTAI
. C « O U P
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## 1015 6 Exterio rPain t Nortt i Arrow Omah a Lea d Sit e • Goo d Sit e Sketc h •Poo r Samplin g Address : 4505 S 42 S T Q No t paint Sampl e Numbe r Lea d Concentratio n Sampl e Collecte d LA B Firm : Sample s Collecte d > ^ Cft
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s viewed fro m th e street , facin g propert y



### Legen d
Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wit h So d Are a replace d wit h Rock/Mulc h Are a lef t bar e 

### Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc .

# ^ 5 

# t 5 77 *

Omah a Lea d Sit e Sit e Sketc h Samplin g Address : 450 5 S 42 S T Sampl e Numbe r RYASCPXA-1015 6 RYBSCPXA-1015 6 RYCSCPXA-101S 6 fIVDCCPX A1016 6 RDZSCPXA-101S 6 nOgSCPX A1015 6 RPZOCPXA-IOIG O Lea d Sampl e Concentratio n Collecte d F l pp m F 2 pp m 8 1 

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Re v 2(K) « Crtalcd :

## 1015 6 Omah a Lea d Sit e Exterio rPain t Nort h Ano w 

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## _liia_pp m D Date : fi r7 - o 8 RVBSCPXA-IOIS e F 2 llaffoo m 

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Re

v2008 Crated : m-Ma>-0 8 .01.23COASTA l iHVIItONHIHTA t C KO U P IH C 

## Consen t fo rAcces s T o Propeft y RIGH TO F ENTR YT O PREI^ISE S 

### Granto r(th e propert yowner ) consent s t o an d autliorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rit s authorize d 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 describe d premises : fTslc r

Owner' s Nante : Daytim e Phone : 

# ^M
. Addres s o fPropert y covere d Ii 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 soii
. 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 vi/il i 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 fCoasta l 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 perfomned , 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 wori ( 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 v^rritte n documentatio n from EP Atha t th e propert y ha s bee n remediated
.
ENVIRONMENTA L RESPONS E ACTION S 

### B ysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractor s an d subcontractor s th e righ t t o ente rth e property , a t al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e worit
. 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 f2COASTA L lNVINONH»KTA t C KO U rIN C 

### cRemov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; cRemov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma ywis h t o save ; < Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessar ysubsequen t t o a n initia l waterin g perio d b yEPA ; <Abid e b yhealt h an d safet yguidanc e provide d b yEPA ; * I fth e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propert yt o perfor m th e work
. eAllo wvideotapin g and/o rphotographin g o fth e property
. AGREEINEN TNO TT O INTERFER E 

### Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo fth e wor k activities , o rwit h an y o fth e wor k done , o rwit h th e equipmen t use d o n hi s property , o rt o undertak e an y action s regardin g th e us e o fsai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o fth e Grantee s o rth e environment , o rt o allo wother s t o us e th e propert yi n suc h a manner . Shoul d yo u hav e an yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , a t (402 ) 991-119 9
I gran t acces s t o mypropertie s D I d o no t gran t acces s t o mypropertie s 

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# RESTORATIO NCHANG EORDE R OMAH ALEA D Propert y I D #i6i^ G Propert y Addres s H5Q 5 $: > ^^ ^ AS4 Owne r Name C((^r=Hy> UgV f 

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COASTA L 

## Restoratio n Agreemen t Th e purpos e ofthi s agreemen t i s to provide amutua l agreeme ma s t o condition s ofth e propert y prior t

o romediationactivities
. Thi s will als o serv e a s documentationfo r th e purpos e of assuring tha t restoration activitie s ar e completedt o th e satisfactionofth e propert y owne r andthe UnitedState s Environmenta l Protectio nAgenc y (EPA)
. PropertylD : ]{)\^( ^ jpropert y Address : ^Q 5 ^ Jl^'^'^

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## Phone: '^'b'h-O^i' l O

nth e attacheddiagram(s ) indicat e area(s ) to excavate , surface structure s an dlandscaping feature s an d acces s location(s ) to b e use dby th e contractors . Indicat e distances , depths , materia l types , etc . Photographically an dVideographioall y documen t th e existing condition s ofthe propert y an dthe basemen t i

f necessary . 

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# z trun k diamete r Nunibe r o f tree s < = 2 inc h Eac h 

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. 

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XL3t-3902 2 Readin g N o Mode Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 35.18 5 Supervise d By : 

## Certificat e o fVerificatio n

3 8 SOIL 2010-02-1 6 16:0 4 30.0 6 Fina l 1015 6 450 5 S 4 2 St
. D Z 1 3 O
. BARAJA S 1 1

± Erro r ± 12.85 2

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 3 9 Mod e SOI L Tim e 2010-02-1 6 16:0 5 Duratio n 30.1 3 Sequenc e Fina l Flag s BVI D 1015 6 ADDRES S 450 5 S 4 2 St
. QUADRAN T D Z DEPH T 1 3 XR F TEC H O
. BARAJA S MIS C 1 NOT E 1

pp m Erro r P b 34.35 2 ± 12.61 3 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 91 3 Mod e SOI L Tim e 2009-11-1 9 13:0 6 Duratio n 92.0 1 Sequenc e Fina l Flag s AVERAG E jAy g of.91Uj-9T2 ^ ADDRES S 450 5 s"?2 ^ QUADRAN T e m DEPH T 1 " XR F TEC H R
. VENTR Y MIS C clearenc e NOT E ngn c

pp m ± P b ± Supervise d B y 

# : ^cnrwi L

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 119.17 7 Supervise d By : 

## Certificat e o fVerificatio n

91 0 SOI L 2009-11-1 9 13:0 5 30.5 5 Fina l 1015 6 450 5 s 4 2 s t e m 1 " R
. VENTR Y clearenc e ngn c

± Erro r ± 15.58 8

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 132.42 1 Supervise d By : 

## Certificat e o fVerificatio n

91 1 SOI L 2009-11-1 9 13:0 6 30.9 2 Fina l 1015 6 450 5 s 4 2 s t e m 1 " R
. VENTR Y clearenc e ngn c

± Erro r ± 16.12 3

# Therm o SCIENTIFI C Therm o Fishe r Scientifi c 90 0 Middlese x Turnpik e Billerica , M A0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequence Flag s BVI D ADDRES S QUADRANT DEPHT XR F TEC H MIS C NOTE

pp m Pb 121.37 5 Supervise dBy : 

## Certificat e o fVerificatio n

91 2 SOIL 2009-11-1 9 13:0 6 30.5 4 Final 1015 6 450 5 s 4 2 s t e m 1 " R
. VENTR Y clearenc e ngn c

± Erro r ± 15.65 4

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 rori-lfl r XL3t-3902 2 Readin g N o 90 5 Mod e SOI L Tim e 2009-11-1 9 13:0 0 Duratio n 91.9 6 Sequenc e Fina l Flag s AVERAG E fAVg^2f902?904 — ADDRES S ^?f50 5 s 4 2 s t QUADRAN T B l DEPH T XR F TEC H R
. VENTR Y MIS C clearenc e NOT E ngn c

pp m Erro r Pb CZ7E99SL—- ^ ±Q334Q— ^ Supervise d By : ^ Q A ^ ^ J ^

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 90 2 Mod e SOI L Tim e 2009-11-1 9 12:5 9 Duratio n 30.5 7 Sequenc e Fina l Flag s BVI D 1015 6 ADDRES S 450 5 s 4 2 s t QUADRAN T B l DEPH T 8 " XR F TEC H R
. VENTR Y MIS C clearenc e NOT E ngn c

pp m ±Erro r Pb 78.87 1 d : 13.19 0 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 85.89 2 Supervise d By : 

## Certificat e o fVerificatio n

90 3 SOI L 2009-11-1 9 13:0 0 30.5 4 Fina l 1015 6 450 5 s 4 2 s t B l 8 " R
. VENTR Y clearenc e ngn c

± Erro r ± 13.65 6

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 72.23 5 Supervise d By : 

## Certificat e o fVerificatio n

90 4 SOI L 2009-11-1 9 13:0 0 30.8 5 Fina l 1015 6 450 5 s 4 2 s t B l 8 " R
. VENTR Y clearenc e ngn c

d b Erro r ± 12.87 4

# m m4 m /^A. \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 I ^^^ ^

I Coasta l Environmenta l Grou p inc
. S^^^^ ^

www.coa8taihazmat.co m '^ i PR(jtt.c ^ COASTA L INViaONHINTA L GROUP , INC
. 

# EXECUTIV ESUMMARY : BVID #10156-(450 5 S 4 2 ST ) No Issue s o r Concern s [ ^ Issues/Concern s Detail Explanation :

# EPAPropert y Clos e Ou t For m Properl y # : iOi^ p Propert y Address:

- .U.7> ^ f^^A C Datc/Tlmc : Owncr' s Name:
. ^ Quad s Excavattd : j^t ^ D g- " Contracto r Grou p (^( J Ye s N o £xcavatlai i GeHera l 1
.i f necessary , were th e connec t quadrant(s ) excavate dandrestored ? 

### / 2
.If necessary , were th e correc l area s ofdri p zone excavaie dandrestored ? 

### y Gradin g So dan dVcgctatio a Ye s N o 1
.Doe s the gradin g aroun dth e perimeter ofth e hous e i nexcavate darea s generally slop e awa y 

### / fromth e house ?_^^_
_ 2
.Ha s so dbee nlai dinall area s tlu t wer e excavated ? 3
.

Doe s th e sodappear to b e generally health y an dgrowing ? (Only evaluate i f inspecteda t a3 0 day time period ) 4
.Are soddedarea s generally Fir man devenl y graded ? 

### ^ S
.Are th e joint s betwee nth e so dstrip s generally tight ? (Only evaluate if inspecte da t a3 0 da y 

### y tim e period) 6
.Wa s the propert y grade dsuchtha t wate r wil l no t poo l o nthe propertj' ? 

### y 7
.

Wa s damage t o landsoq>ing o r plan t material s avoided ? 

### • ' Gates , Feoce s an dRetainin g Wall s 

### Ye s N o 1
.D o gate s ope nan dclos e freely ? (Ifapplicable ) • ' 2
.Were all gate s or fence s takendow ndurin g restoraiio naclivitie s reinstalled ? (Ifapplicable ) 

### / 3
.

Wa s damage t o gate s or fence s avoided ? (If applicable ) 

### / 4
.Wa s damage t o retainin g wall s avoided ? (Ifapplicable ) 

### / Foundation , SidioK an dGnller s 

### Ye s N o 1
. Wa s damage t o th e sidin g o r trimavoided ? 

### y 2
. Wa s damage t o Ih e foundationavoided ? 

# y 3
. Wa s damage to window s avoided ? 

## y 4 Wa s damage to window s or doo r screen s avoided ? 

# y 5
. Wa s damage l o downspout s o r downspoul extension s avoided ? 

## y Sidewalk s an dDrKeway s (Concrete ) Ve s N o I
. Wa s damage l o drivewa y surface s avoided ? 

## y 2
. Wa s damage t o walkwa y surface s avoided ? 

## y

## Ovf'oer s comments :

Inspectio nnotes :

Remova l an drestorationaclivale s complete including th e 30-da y so dwan-anry : EP ARepresenialiv e ^ ^ j ±Date : /z/'//oj

## Novembe r 16 , 200 9
Octavi o Baraja s Coasta l Environmenta l Group , In c 241 1 Marth aStree t Omaha , N E6810 5
Dea r Octavio , T o refres hyou r memory , w e me t approximatel y thre e week s ag o a t m y hous e a t

413 0 Sout h41^ * Av e regardin g th e soi l remova l a t m y renta l propert y a t 450 5 Sout h42ndstreet . Firs t o f all , i t wa s ver y nic e meetin g yo u an dyou r partne r tha t day
. Ireall y enjoye dth e conversation
. Sinc e tha t meeting , you r me nhav e bee nou t t o d o th e jo b an dIjus t wante d t o sa y tha t w e wer e VER Y please dwit hth e cre w tha t yo u sent . My brothe r rent s tha t propert y an dh e sai dtha t everyon e wa s especiall y nice , an dtha t the y di dagrea t job
. W e wan t t o tak e thi s tim e t o than k yo u an dt o le t yo u kno w tha t if yo u eve r nee darecommendation , w e woul db e honore dt o giv e yo u one . You , an dyou r me nar e th e best ! Tak e car e an dGo dbles s yo u richly !

413 0 Sout h41s t Av e Omaha , N E6810 7 402-733-031 5

## Propert yCompletio n Agreemen t
I hi s agreemen l documenl s th e completio n o fremedia l aelivilie s perlbime d o n m yproperl yM ysignalur e wil l designal e Iha l I a m salisfie d wit h lh e restoratio n o fm yproperly , an d tha i n o ilem s ar e i n questions , now , o ra l an ylim e i n th e future , excep t Ihos e ilem s liste d below , i fan y

Propert yID : ^^^fj p Propert yAddress : li'VN ^ " S LJ ? *^ ­ 

# '^""' " KfAuri^nrJl ~ 1
. .. . grcuck l -^-_m r Phone : Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item :
Addttiona l Comments :

i^ I Hgrc cI'c.^taralio n u complettd , rxccp l a s notei t Jnn t ai;rc cresiomtio n i s complcle d 

# ^Jj.^^a/>^ ^ Hh'/// A nrr' s Signatiir r Dnl c