### TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO N FIL EFOLDE R SAI D # : 4US^ ^ Date : Address : S^Q;\ g <, . '^ \^S T Remediation Contractor : Envrionmenta l Restoration , LLC

_Year : _2010 _ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S D Vide o o f propert y (DVD) "^^^35 ^ DAfte r

D Basement^ " /U) AlSCM^^ . ^ Executiv e Summar y (Fina l Report ) /\^££$ici
. • EPA-providedpropert y sketch ^S» ^ Signe dAcces s Agreemen t fo r subjec t propert y D Signe dAcces s Agreement(s ) for adjacen t propert y ^ Restoratio n Agreemen t

D Settlement document s (i.e. , fo r damag e o r t o replac e plants , etc. ) H Confirmatio ndat a 

### Hi ^ Photograph s _[!>^efor e DCre w Photo s DsDurin g Excavation D Sod '•S^O-da y So dD D

v As-built sketch ^ Completion Agreemen t signedb y Propert y Owne r • \Propert y close-out chec k

lis t signedby EP A D Description o f area s not meetin g ROD cleanu p criteri a 1 ^ Utilit y clearance s N ^ Propert y information from.Douglas Count y Assessor' s Office ^> D Propert y acces s checklis t ^ 3023763 5 

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### Envirormiental Restoratio nSignatur e Dat e 

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## ^'f { Dat e? tW r' ^

Omah a Lea d Site—EP-R7-09-0 5 S ^\^^ ^ S Environmental Restoration , LL C V * " V www.or1lc.con i ••«»«io*' ' 

## EXECUTIV ESUMMARY : 4655 3 - 582 6 S 2 1 S T [\^ | N o Issue s o r Concern s Q Issues/Concern s Detai l Explanation :

# EP A EP A Propert y Clos e Ou t For m Omah aLea dSite OU#2 Propert y # : v\Li^€ ^ ^ Propert y Address : ST-^'a.L g " ^ 2. ] " ^ Date/Time : Owner' s Name : £,»r>\\>'a ^ 'XtAVC ^ Quad s Excavated : Pa . Contracto r Grou p : Environmenta l Restoratio n (ER ) Excavatio n Genera l Ye s N o 1 . I f necessary , wer e the correct quadrant(s ) excavatedan drestored ? ^ 2 . If necessary , wer e the correct area s of dri p zon e excavatedan drestored ? 

### y Gradin g So dan dVegetatio n Yes N o 1 . Doe s tiie gradin g aroun dth e perimete r ofth e hous e i nexcavatedarea s generall y slop e awa y fromthe • ^ house ? 2 . Ha s so dbeen lai di n all area s tha t wer e excavated ? ^ 3 . Doe s th e so dappea r to b e generally health y an dgrowing ? (Onl y evaluat e i f inspecteda t 30-da y tim e period) . 4 . Ar e sodde darea s generall y fir mandevenl y graded ? • 5 . Ar e th e joint s betwee n the sodstrip s generall y tight ? (Onl y evaluat e i f inspecteda t 30-da y tim e period) . 6 . Wa s the propert y gradedsuc htha t wate r wil l not poo l o n the property ? • 7 . Wa s damag e t o landscapin g or plan t material s avoided ? 

### y Gates , Fence s an dRetainin g Wall s Ye s N o 1 . D o gate s ope n an dclos e fi-eely? (i f applicable) t ^ 2 . Wer e all gate s or fences take n dow n durin g restoration activitie s re-installed ? (if applicable ) \y 3 . Was damag e t o gate s o r fence s avoided ? (if applicable ) ty ^ 4 . Was damag e t o retaining wall s avoided ? (if applicable ) A M T Foundation , Sidin g andGutter s Yes N o 1 . Was damag e t o siding o r tri mavoided ? ^ 2 . Was damag e t o the foundatio n avoided ? ,y 3 . Was damag e to window s avoided ? • 4 . Was damag e t o windo w screen s or doo r screen s avoided ? y 5 . Was damag e t o downspouts o r downspou t extension s avoided ? t ^ Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 . Was damag e t o drivewa y surface s avoided ? ^ 2 . Wa s damag e t o walkwa y surface s avoided ? ^ Inspectio n notes :



### Remedia l an drestoratio n activitie s complete includin g 30-da y so dwarranty : EP A Representa j 

## ^7;:^'M/f^r.^^J ^ Date : ^p^jn Q

### Pag e 1 of 2

" > [ Creat e Anothe rTicke t J [ Bac k t o Irt h Inteme t ] 1 1 ! k Sen d Emai l 1 >



### • YOURTICKE T NUMBE RI S 2478423 . -^*«'a. - 'T "tr - I'-i' i M -1^-—r'iiTf*fti' r- Origina l Cal l Date : 4/28/1 0 Time : 5:3 8 pm Op : TRACY241 8 6 Wor k t o Begi n Date : 5/03/1 0 Time : 6:1 5 pm State: . NE County : DOUGLA S Place : OMAH A Address : 582 6 Street : S 21S T S T Twp : 14 NRng : 13 E Sect-Qtr : 10-NW-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Excavating th e entir e propert y Locatio n o f Work : LOCAT E ENTIR E PROPERTY Remarks : FA X AL L CLEAR S TO : ;402)451-106 9 : SAI D #4655 3 Compan y: ENVIRONMENTA L RESTORATIO N Contac t Name : TRACY BRISTOW Phone : (402)451-131 4 Alt . Contact : Phone : (314)504-4874 . Wor k Bein g Don e For : EPA Dept h o f Excavation : 1 2 Corne r Lot ; N. Front : Y Rear : Y Involve s Tunneling o r Horizonta l Boring ; NExplosives : N ALT87 2 ATTNEBR l CXCAT V

DIGITE L LEVEL 3 MUD0 2 OMAHACO F 0PPDGPR 6 PAETE C QLNNEI F QWESTNE SPRINTNE

Servic e Are a Contac t Phon e Numbe r Utilit y Typ e ALT87 2 WINDSTREA M COMMUNICATIO N EL M LOCATIN G 

### Day : 406728934 3 Alt : 4062071494 Emerg : 888728934 3
ATTNEBR l ATT/ T 

### Day : 80024136249 Alt : Emerg : 8002413624 9 CXCAT V CO X COMMUNICATIONS , IN C HEIDI 

### Day : 402934046 9 Ah : 402934046 9 Emerg : 402932975 7 Day : 866562434 9 LIGHTCOR EACENTURYLIN K DIGITE L N A COMPAN Y 

### Alt : 800850904 8

/ » « • , . .I" -.-O..- J ^rUTTl T T T T^ O A l^ O l^f\ ^ f \Page 2 of 2

LEVEL S LEVEL3 COMMUNICATIONS , ^ ^

MUD02

OMAHACO F

0PPDGPR 6

PAETE C METROPOLITA N UTILITIES DISTRICT
CIT Y O FOMAHA
TRAFFIC.SEWE R
OMAH A PUBLI C POWE R DISTRICT

PAETE C COMMUNICATION S SAND Y

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EL M LOCATIN G

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SPRINTN E QWESTN EQWES T LON GDISTANC E
SPRIN T COMMUNICATION S CO Emerg : 866562434 9 Day : 877366834 4 Alt : Emerg : 8773668344 Day : 402504782 3 Ah : Emerg : 402504797 0 Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 Ah : 406207149 4 Emerg : 888728934 3 Day : 800289190 1 Alt : Emerg : 800289190 1 Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 Day : 800283423 7 Alt : Emerg : 800283423 7 Day : 800521057 9 Ah : Emerg : 800521057 9

h/r»tjnxrMAtiPf.rrRatmn/MessaaeText.asp?ret=<RESULTS.. . 4/28/201 0

## Contac t Infonnatio n Lo g SAID#y^5T J Owner' s Name^pr/J^Z ^ < l j^^J j ^/ ^ | Daytim e ^^^0^^: ^ ^f^JT^-^T^-^f^Ui^ . Propert y Address ; ^^' ^ 5- 2(^ ^ Attemp t t o contac t Date/tim e Nam e 

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# V^^^ J n WOR K STARTED ON : / /_ D WOR K COMPELTE D ON : Propert y Address:^^;^ ^ ^ ^ l 

# ^r r I I Renter : 

## Om^^f-JO-LL t f,l^pl.i p Phone : . 

# ^%z&^^i^r - Fax : Cell/Pager : Piione : Additional Information : Fax : Cell/Pager :

^ Acces s Agreement Signed : _^/^/JE . 

### By
- 2icKfv>>t/> . {7 1 Restoratio n Agreemen t Signed : V i It 1 i b 

### By = L^^' ^ 0 . Vide o Property Befor e 

## O n:Jj_lll'lj2 _ By = ^-,0 . f^<s.u? . ^ Digital Photo s Befor e O n : < / /

Zf l I ' 

### By = tg,cJ LPii.WL . n Vide o Property Afte r O n : / / By : n Digital Photo s Afte r O n : / / By : ^ Propert y Completio n Agreemen t Signed : $ 1 1^ 1 { 0 

### By : '^ D n Fina l Report Signed : / / By : Additiona l Video o r Digita l Photo' s Taken : n Vide o n Digita l Photo O n : / / 

### By : 1 Reason : 1 n Vide o D Digita l Photo O n: / / 

## By : 1 Reason : n Vide o D Digita l Phot o O n / / By : H Keason :

D Vide o D Digital Photo O n : / / By : 1 Reason :

Omah a Lea d Projec t Wor k Pla n Pag e I o f 1 9

## Consen t fo rAcces s t o Propert y 

# SAID#V( ^ 5 5 J RIGH T O FENTR Y T O PREMISE S 

### Granto r (th e propert y owner) , consent s t o an dauthorize s th e Unite dState s Environmenta l Protectio nAgenc y (USEPA ) o r it s authorize drepresentatives , collectivel y th e Grante e t o ente r an dperformcertai n envirormienta l respons e activitie s upo nth e followin g describe dpremises ;

Owner' s Name : Y ^ //,£7 ^ / ^ m^f ^ Daytim e Phone : Address: ^ ^^^

_ ^ ^ f ^ ^ Address : 

### Addresse s o f Propertie s Address : 

### covere db y thi s Agreement : Address : Address : PURPOS EO FINVESTIGATIO N 

### Th e purpos e o f th e remedia l activitie s i s t o remov e al l soil s at th e property whic har e contaminate dwithhazardou s substances , i nparticular lea dat concentration s greater than , o r equal t o 40 0 part s pe r millio n (ppm) . REMEDIA LACTION S Th e environmenta l respons e action s t o b e performe do nsai dproperty may includ e th e followin g activities : a .Takin g photograph s and/o r vide o o f th e propert y before , during , an dafter remedial activities ; b .Locatm g equipmen t an dmachinery on-sit e i npreparatio nfor an di nth e cours e ofth e environmenta l response ; c .Plannin g an dimplementin g th e remova l actio no no r near Grantor' s property . d .Obtainin g sample s fro mGrantor' s property ; AGREEMEN T NO T T O INTERFER E 

### Th e Granto r agree s not t o interfer e o r tampe r withany o f th e activitie s o r wor k

done , o r th e equipmen t use dt o performth e activities , o r t o undertake an y action s regardin g th e us e o f sai d propert y whic hwoul dten dt o endange r th e healtho r welfar e ofth 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
^ I gran t acces s t o m y propertie s Q I d o no t gran t acces s to m y propertie s 

## "i/A^ ^ f ^ Signatur e Dat e Signatur e Dat e 

# 1Additiona l Comment s / Instructions :



### ^Chec k thi s bo xi f owne rdoe s not wan t E.R
. t o ente rth e resident s t o documen t interio r foundatio n wall s an d possibl e preexistin g damage
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. i s no t responsibl e fo ran ydamag e don e t o th e interio rof house , includin g foundatio n crack s o rfissures
.

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## ^^L
. Owner' s Signatur e Dat e Contractor' s Signatur e ifat e

## Restoratio n Agreemen t Th e puipos e of thi s agreement i s t o provid e amutua l agreemen t a s t o condition s o f propert y prio r t o contractor activities . Thi s will als o serve as documentationfo r th e purpos e of assuring tha t restoratio n activitie s ar e completedt o th e satisfactionof th e propert y owne r andth e UnitedState s Environmenta l Protection Agenc y (EPA) . 

## ^•" ^ ijC.S' i ? propmyAdaigsijyg;^^ S ${ l sr - Owner : 

## JhLLe ^ ^ i^& l t^ A Phone : Onthe attacheddiagram(s ) indicat e area(s ) t o b e excavatedan ddept hof excavation , locationof al l know n utilities , subsurface features , surface structure s an dlandscaping features , acces s location(s ) to b e usedb y contractor, an dthe directio n o f North . Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s b

y referencin g th e photo-lo g numbe r wit ha narrow indicating directio no f view . Item s t o b e remove dby Contracto r an dno t replaced : Item : |-^;r^ € 

# u F l d> z Item : item : Item : Item : Item : 

### item :

Pag e 1 o f 2Sketc h o f additiona l instmctions
.

### Additiona l Comment s / Instructions :

R I I agre e n I d o no t agre e 0 - 1 agre e CH I d o not agre e

Owner' s Signanir e ' Dat e ntractor' s Signatur e Dat e Attachment s

Pag e 2 o f 2

## Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio n of remedia l activitie s performe donmy property . My signatur e wil l designat e tha t Iamsatisfie dwithth e restoratio n of my property , an dtha tno item s ar ein question , now , orat an y tim e in th e future , excep t thos e item s liste dbelow , if any . SAID : 

# "/(SS^ J Propert y Address : f^^/C ^ S ^ / ^ ^ Owner : ^^^g ^ f y^ S I f/ 9 Phone : Restoratio n Item s in Question :

Kem : Item : Item : Item : Item : Item : Additiona l Comments :

IX l I agre e restoratio n is completed , except as note d r \I agre e restoratio n is completed , except as noted 1 1 Ido no t agree restoratio n is complete d L J I do no t agre e restoratio n is completed 

# /^J.-.^ A c.KJ/QJ,r > flLM?/' . V ^ ^-'^1-/ 0 Owner' s Signature"- ^ Date Contractor' s s Signatur

Signatur e e Date

### Dougla s Count y Accoun t Infornjation Pag e 1 of3 m^t r Dougla s County , Nebrask a Propert yRecor d - R202653000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-S O ft wes t o f 52n d S t - VieW O n Ma p infomiatio n i s vali d a s o f 2009-12- 1 Treasurer' s Ta xRepor t Ne wFeatur e ->••- > Aut o Sale s Searc h Owne r TELLE Z EMELI A 582 6 S 2 1 S T OMAH AN E 68107-000 0 Propert yInformatio n Ke yNumber : 265 3 000 0 2 0 Accoun t Type : Residentia l Parce l Number : 202653000 0 Parce l Address : 582 6 S 2 1 S T OMAH AN E 68107-000 0 Lega l Description : POTTE R & COBB S 2N D AD D LO T7 BLOC K7 5 0 X 13 0 Valu e Informatio n 200 9 200 8 200 7 200 6 200 5 200 4 Lan d Improvemen t $4,900.0 0 $84,500.0 0 $4,900.0 0 $84,500.0 0 $4,900.0 0 $71,900.0 0 $4,900.0 0 $71,900.0 0 $4,900.0 0 $71,900.0 0 $4,900.0 0 $54,500.0 0 Tota l $89,400.0 0 $89,400.0 0 $76,800.0 0 $76,800.0 0 $76,800.0 0 $59,400.0 0 Sale s Informatio n Sale s Date : 2004-03-3 0 Dee d Type : Price : Grantor : Q C $45,000.0 0 DANEI L TELLE Z Book : 200 4 Page : 04329 9

Grantee : EMELI ATELLE Z Valid/Invalid : Invali d Excl Reason : usio n Famil ySal e Sale s Date : 1998-04-0 2 Dee d Type : Price : Grantor : $49,500.0 0 Book : 208 6 Page : 45 5

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. 12/17/200 9

### Dougla s Count y Accoun t Inforn^io n rn^^ o 

### Pag e 2 o f 3

Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6500. 0 1. 0 130. 0 50. 0 N o Improvemen t Informatio n Buildin g 1 1 1/ 2 STOR YFI N £a2SS2 1 S T MItBMXM Ktj x n w » , . C P t ; » ' " > fte - 1 i3C ' 

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Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 7. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Stiingl e Bedrooms : 2. 0

Roo f Type : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Sprinkle rSquar e Footage : 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 191 8 0 0 % 191 8 9 2 Detai l Typ e Detai l Descriptio n Unit s 1. 0 Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1003. 0 Basemen t Bsmn t Bloc k 8 f t 300. 0 Basemen t Finishe d 1. 0 Fixtur e Bas e Fixture s
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. 12/17/200 9

### Dougla s County Accoun t Inforn^o n Pag e 3 of 3 irn^ o
Fixtur e Bat h Ful l 1. 0 Garag e Detache d 220. 0 Porc h En d Soli d Wal l 48. 0 Porc h En d Soli d Wal l 176. 0

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

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# n Date : ^ ^^^o 8 RYBSCPXA-4655 3 F 2 S 3 0 pp m 

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