### PROPERT Y SUMMAR Y Date : 10/22/200 7 Omah aLea dSite Remedia l Actio nContrac t #EP-R7-07-0 6 Mont hof : Octobe r Propert y Address : 192 4 Lothro p S t A . EXECUTIV E SUMMAR Y 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: CONFIRMATIO N SAMPLIN GDATA/RESULTS : 

### F 2 - 24 9 @ 6 " B l - 20 1 @ 6 " Dl-20 1 @10 " El-12 2 @ Scrap e ATTACHMENT S 1 ) Propert y sketc hprovide 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 sketc h­ i ) Shal l includ e fina l lea dlevel s v ) Legen d ii ) Contaminatio nleft behin darea s vi ) Contracto r identificatio n iii ) Propert y addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e include di nth 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 hth e propert y owner ) ii ) Excavatio n digita l vide o i nMPEG , WM V (Window s Medi aVideo ) o r SW F(Flas hPlayer ) 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 .

ECHNOLOCIES , INC . 

# Illllllll l Superfun d 4028506 6Name : Omah a Lea d Sit e Address : p c 

### V i /OU*^L£ P Sit e Sketc h T Nort h r; / jx_ > T- | Phone : 

# Date Teamv/ , XR F Cod e Sampl e Numbe r Lea d Concentratio n Confirmatio n Sampl e pp m Ye s n 

### RY/ S pp m Ye s C H pp m Ye s ra ^ N o DZS C PXA - 5 6 y.2 . pp m Ye s " a N o pp m Ye s d N o D RYCSCPLA-562 2 La b 547pp m

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### a .- - ;<?„„, . $ ,«;£;£ . - r 

### Agreern^^l o Allo wAcces s T o

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Under Contrac t EP-R7-07-06 , th e U . S . Environmenta l Protectio n Agenc y (EPA) ha s Contracte dPruden t Technologies , Inc . (Prudent) , t o cleanu p lea dcontaminatio n o n variou s residential propertie s includin g you r property . Yo u can help wit h thi s activity b y givin g permissio n t o conduc t easement samplin g an d conduc t cleanu p o n your property . I f yo u sig n thi s form , Prudent will return i n afe w week s an dperform th e work . W e will coordinat e samplin g an dcleanup with yo u prio r t o commencement . I f

yo u hav e an y question s abou t th e propose dwork , pleas e contac t Dan Garvey , EPA' s Projec t Office r fo r our Omah aLea dSit e Contrac t Mr . Garvey ca n b e reache da t (402) 731-0788 . Property Acces s Grante dBy : (Pl»ni » Print Wa m» ) Property Owne r Signature : 

### /7 l i /^ClA ^ O — i ­ (Signature ) (Dnt« ) 

### PROPERTY INFORMATIO N (T o b e complete db y resident and/o r propert y owner - - pleas e print ) RESIDEN TNAME : c| < o 3 yxyTtvH ? M QgAfr t Qatfne rQenle r RESIDEN TADDRESS : V^ M LoVXv^ P S V < ^ rv\^V a K^ e £>_ & \ \ I F RENTAL . PROPERTY OWNE D BY : 

### OWNER' S MAILIN G ADDRESS ; \C\Q_- > LoVkro p <£> * (\ fv \ ^ L/ i ^>€

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C , 2 W O OWNER' S TELEPHON E NUMBE R -HOME : ( AG E O F HOHE7 : JO O _ YEARS . HO W LON G HAV E Y O L-WEfrHERE ? "3^5 " YEARS . O Vv ) » \ €_c l - HA S TH E EXTERIO R BEE N PAINTE D O R COV E R D E D WTT H SDW G SNCE1378 ? _YE S ^ N O HA S TH E INTERIO R BEE N PANTE D O R COVERE D SINC E 1378? ^YE S N O NUMBE R O F OCCUPANT S UNDE R 6 YEAR S OLD : f l NUMBE R O F OCCUPANT S G YEAR S OL D AN D OLDE R _O _ NUMBE R O F CHILDREN T UNDER C 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 . DOGS . ENTR Y GATES . ETC. ) 

# 0 ATTTWryRTT Y "FCIT ? KNVTOPKMgMTA L T?K.^PON5 E ACTION S The activitie s to b e implement s b y EPA under thi s agreement ar e pursuan t to Sectio n 104 o f CERCLE , 4 2 U . S.C . 9604 . EPA 1 s right o f acces s to th e property i s provide dfor i n Sectio n 104(e ) o f CERC1£ , 4 2 U.S . C 9<S05(e) , whic h provide s entr y fo r "determinin g th e nee dfo r response , o r choosin g o r takin g an y respons e actio n unde r thi s titie , o r otherwis e en f arcin g th e provision s o f th e title. "

# &EP A EP A Propert y Clos e Ou t Propert y # : 5€3 2 Property Address : /f a y i^ a Date/Time : /o/^/, - Owner' s Name : Rea w f^r ^ Quad s Excavated : Contracto r Grou p Pruden t Technologie s 

### ' j Excavatio n Genera l Ye s N o 1 .I f necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 

# s 2 .I f necessary, wer e th e correc t area s o f dri p zon e excavate dan drestored ? 

### S Gradin g So dan dVegetatio n Ye s N o 

## 1 . Doe s th e gradin g aroun dth e perimete r o f th e hous e i n excavate darea s generall y slop e awa y fro mth e house ? 

### «/ " 

### 2 . Ha s so dbee n lai di n al l area s tha t wer e excavated ? 

### / 3 . Doe s th e so dappear t o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte dat a3 0 da y tim e period ) 

### i / 4 . Ar e sodde darea s generall y firman devenl y graded ? c / 

### 5 . Ar e 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 da y tim e period ) 

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

## I / 7 . Wa s damag e t o landscapin g o r plan t material s avoided ? 

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

D o gate s ope n an dclos e freely ? (I f applicable ) 

### / 2 .Wer e al l gate s o r fence s take n dow n durin g restoratio n activitie s reinstalled ? (I f applicable ) 

### i/ 3 .

Wa s damag e t o gate s o r fence s avoided ? (I f applicable ) 

### -. / 4 .Wa s damag e t o 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 th e foundatio n avoided ?



### . / 3 .Wa s damag e t o window s avoided ? 

### • J 4 .Wa s damag e t o window s o r doo r screen s avoided ? 

# • y 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 1 .Wa s damag e t o drivewa y surface s avoided ? 

### \ s 2 .

Wa s damag e t o walkwa y surface s avoided ? 

### i /

### Owner s comments :

Inspectio n notes :

Remova l an drestoratio n activate s complet e includin g th e 30-day so dwarranty : EP A Representativ e fl ^ j £Date : /(.yaWp?



## - "Omah a Lea d Site Sit e Sketc h

46904.783-0 1 

### iah aLea dSit e 

# \\o\o 1

# oEP A PropertyCompletio n Agreemen t Thi s agreement document s th e completio n o f removal 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 dwit hth 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 warrant y (3 0 day s total ) excep t thos e item s liste dbelow , i f any . Propert y ED : <^£5 . "2 _ Propert y Address : i*V> ^

### <L O 

### (-Lr o o ^ k Owner : Q C V , ° ( X o r~ . =- ^ C JL ^ i t < i r 

### Phone : Restoratio n Item s i n Question :

Kern : Item : Item : Item : Item : Hem : 

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

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

## Dougla s County-Omaha , NE

Parce l I D Owne r Name Propert y Address Cit y 

### Zi p Owne r Address Owne r Address 2 Owne rCit y Owne r State Owne rZi p 1528370000 SCOT T REANNI E M 192 4 LOTHRO P S T OMAH A 6811 0 192 2 LOTHRO P S T OMAH A N E 6811 0 Sec-Twn-Rn g Owne r Address Additio n Bloc k 

### Lo t Legal 1 Legal 2 Legal 3 Legal 4 Assesso r Websit e Lin k 10-15-1 3 KOUNTZ E PLAC E 2 7 8 74 X 12 4

http://douglasne.mapping online.com/DouglasCoNe/static/accountinfb.jsp ? accountno=R 1 528370000 Disclaime rMa p an d parce l data ar e believed t o b e accurate , bu t accurac yi s no t Map Scal e guaranteed . Thi s i s no t a legal documen t an d shoul d no t b e substituted fo ra titl e search , 1 inc h = 3 7 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogis_aUWdogi^ ^ County-.. . 7/16/2007Fin d Recor d Clea n U p Quer y Lead Remainin g Quer yPropert yDamag e Quer y Clos e 

### Sampl e Area : 562 2 - 1924 LOTHRO P S T Owner : Resident : Contract : [ j Owne rOccupie d Owne rName : (SCOT TREANNI E M Owne rAddres s 1 : Residen t Name : MILTO N CURTI S PropertyAddress : 192 4 LOTHRO P ST Contractor : JPRUDENT200 7 Group : Owne rAddress2 : 1 192 2 LOTHRO P S T City : JOMAH A Owne rPhone : State : JN E Alternat e P Zi p Code : 6811 0 none : Zi p Code : (6811 0 Residen t Phon e Assessment : Qualifyin g Grou p 180 0 Assessmen t XR F Date : Assessmen t Ma xXR F Value : 1 889. 6