## TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAIDW: ^f^ D Date : 3//3/7) B Address : 2377 b fn27)klf/- ( ^ Remediatio nContractor : Coasta l Environmenta l Group

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i Restoratio nAgreemen t D Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) W. . _Confirmatio ndat a mPhotograph s As-buil t sketc h Satisfactor y restoratio nsigne db y Propert y Owne r Propert y close-ou t chec k lis t signe db y EP A D Descriptio no f area s no t meetin g RO D cleanu p criteri a D Utilit y clearance s D

l Propert y informatio nfi-omDougla s Coimt y Assessor' s Offic e D Q . '

# Fina l Repor t Propert y Chec k Lis t (pieas e plac e wit heac hfile) ^^/^T^ O 

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## 5 f" r Dougla s Count y Accoun t Informatio n 

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## CONTAC T FOR M Propert y I D # 

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Comment : Owne r Commen t (s) : Sit e Coordinato r Commen t (s) :X • ^ ^ • 

### Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc . 

# {Ml } www . coasta l hazmat . co m COASTA L ENVIRONMENTA L 

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y G H 0 U r. IN C 

# EXECUTIV ESUMMARY : 26400—281 8 FRANKLI NS T N o Issue s o r Concern s Issues/Concern s Detai l Explanation :

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# Oinah aLea dSuperfun dSit e
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### Legen d Are ano t Excavate d t ^ Dripzon e Excavate d[SS^ ^ Quadrant s Excavate d 

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

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# EP A EP A Propert y Clos e Ou t For m 

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Ar e th e joint s t)etwee nth e so dstrip s generall y tight ? (Onl y evaluat e if inspecte da t a3 0 da y tim e period ) 6 .Wa s th e propert y grade dsuc htha t water will not poo l o nth e property ? 7 .Wa s damag e t o landscapin g o r plan t material s avoided ? Gates , Fence s an dRetainin g Wall s 1 .D o gate s ope nandclos e freely ? (If applicable ) 2 .Wer e all gate s o r fence s take ndowndurin g restoratio nactivitie s reinstalled ? (I f applicable ) 3 .Wa s damag e f o gate s or fence s avoided ? (I f applicable ) 4 .Wa s damag e t o retainin g wall s avoided ? (I f applicable ) Foundation , Sidio g an dGutter s 1 .Wa s damag e t o th e sidin g or tri mavoided ? 2 .Wa s damag e to th e foundatio navoided ? 3 .

Wa s damag e t o window s avoided ? 4 .Wa s damag e t o windows or doo r screen s avoided ? 5 .

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## Owner s comments :

Inspectio nnotes :

Removal an drestoratio nactivate s complet e includin g th e 30-da y so dwarranty : EPA Representativ e Date : /^/>7b 7

## Propert yCompletio n Agreemen t Thi s agreement document s th e completio nol ' remedial activitie s performe do nn nproperty . M \ signature will designat e thai I a msatisfie dwit hth e resloratio no f m y properly , andtha i no item s ar e i n questions , now , or a

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## Consen t Fo rAcces s T o Propert y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propert yowner ) consent s t o an d authorize s th e Unitec 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 :

Owner' s Nam e Daytim e Phone : ^<7 1 ' ( ] ^Z ? ~ 7

Addres s o f Propert y covere d b ythi s 

# W i y&eukiiA ^ ^y Agreement : 

### PURPOS E OF 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 f lea 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 soil . 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 wil l 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 f Coastal Environmenta l Group , contracte d b yUSEPA , wil l contact th e Granto rin-perso n t o discus s th e wor k t o b e performed , 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 wor k 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 writte n documentatio n fro m EP Atha t th e propert yha s bee n remediated . ENVIRONMENTA L RESPONS E ACTION S 

### Bysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , an d wit h prio rnotice , fo rth e sol e purpos e of performin g th e work . 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 f 2COASTA L 

### Restoratio n Agreemen t Th e purpos e o f thi s agreement i s t o provid e amutual agreemen t a s t o condition s ofth e propert y prio r t o remediatio nactivities . Thi s wil l als o serv e a s documentatio n fo r th e purpos e o f assurin g tha t restoratio n activitie s are complete dt o th e satisfactio nofth e property owne r an dth e Unite dState s Environmental Protectio nAgenc y (EPA) .

Propert yID : ^^([ 9 

### Propert y Address : ^2377 FTz^lA77y7y7 U ^T ^ Owner : 

### t_777_^A7/r A y>77T7^^7 J Phone : 

# ^ ^ 7 737 f 7 O nth e attache ddiagram(s ) indicate area(s ) to e.xcavate danddept ho f e.xcavation , locatio nof al l know n utilities , subsurfac e features , surfac e structure s an dlandscapin g features , acces s location(s ) t o be usedby contractor , an dth e directio no f North . Indicate distances , depths , material types , etc . Indicate digita l photo s b

y referencin g th e photo-lo g number w it ha n arrow indicatin g directio no f view . 

### Item s T o B e Remove d B yOwne rBefor e Star t O f Remediation : (Us e additiona l sheet s a s necessary ) Th e removal , storage , disposal , and/o rretur n o f thes e item s i s th e Owner s responsibility . Item : 

# y^j y Item : Item : Item : Item : Item : Item : Item : Pag e 1 o fCOASTA L 

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Use additiona l sheet s a s necessary) 

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### Landscap e Inventor y (Us e additiona l sheet s a s necessary ) 

### Ite m Quantit y Condition/Type/Specie s

Pre-existin g property area , tha t wil l b e excavated , tha t i s covere dwit h"rass . 

# 7 o y7o y Numbe r o f tree s > 2 inch trunk diainete r 

# 7/sry^

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Numbe r o f Sprinkle r Zones . Contro l Valves . Timers . Heads , etc .

• AiUic haslxetc hu ! the --.I'lriiikle: ' !L! \out .
Numbe r o f an dsiz e o f eac hgarden, ' flowe r bed area . .•U..ivi . ; ; NKcici i y y\y\ \z

Pag e 4 of .COASTA L 

### Ite m Agree d upo n valu e o f plan t material s no t t o b e replace d b vcontractor . Not e thi s \alu e wil l b e use d t o issu e a plan t vouche rt o th e propert > o\

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n Chec k th e box if Owne rdoe s no t wan t CE G to documen t interio rfoundatio n wall s an d possibl e pre-existin g damage . Bycheckin g thi s boxCE G is no t responsibl e fo ran ydamag e don e to th e interio r of house , includin g foundatio n cracks orfissures . 

# tfia: agre e nI do no t agre e 

# (2 yjyyykWpl^ ^ OwiieP s s Signatur

Signatur e e ni^P Date / Contractor' s Signature Dat e Pag e 6 of .