### PROPERT Y SUMMAR Y Date : 08/21/200 7 | Omah aLea dSite Remedia l Actio nContrac t #EP-R7-07-0 6 | Mont hof : Augus t Property Address : 262 0 N1 9 Av A . EXECUTIV ESUMMARY A. I Issue s Encountered : Non e A. 2 Issue s Resolved : A. 3 Uniqu e Findings : A. 4 Othe r Relevan t Information : Vacan t Lo t CONFIRMATIO NSAMPLIN GDATA/RESULTS : 

## Fl-290@6 " F2-135@6 " Easemen t 14 1 @ Scrap e ATTACHMENT S 1 ) Propert y sketc hprovide db y EP Apursuan t t o contrac t specification s 2 ) Signe dAcces s Agreemen t includin g acces s agreement s require dTo r crossin g othe r propertie s 3 ) Pre-Excavatio ndigita l vide o clip/photograph s 4 ) Post-Excavatio ndigita 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 nlef t behin darea s vi ) Contracto r identificatio n iii ) Property addres s vii ) Dat e iv ) BV1 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 nagreemen t detail s (i f an y ar e mad e wit hth e propert y owner ) ii ) Excavatio ndigita 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 no f area s no t meetin g Interi mRO D cleanu p criteria . 4028504 3 Superfun d



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# PxEP A EP APropert y Clos e Ou t For m Property # : Property Address : Date/Time : Owner' s Name : Quad s Excavated : Contracto r Grou p Excavatio nGenera l Ye s N o 

### 1 .I f necessary , wer e th e correc t quadrants ) excavate dan drestored ? 

### / 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 nexcavate darea s generall y slop e awa y fro mth e house ? 

### i/ 2 .Ha s so dbee nlai di nal l area s that wer e excavated ? 

### S 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 ) L / 

### 4 .Are sodde darea s generall y firman devenl y graded ? I / 

### 5 .Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte dat a3 0 day tim e period ) 

# y 6 .Wa s th e property grade dsuc htha t water wil l no t poo l o nth e property ? 

# i/ 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 nan dclos e freely ? (I f applicable ) 

# s Ye s N o



### l/ 2 .

Were al l gate s o r fence s take ndow ndurin g restoratio nactivitie s reinstalled ? (I f applicable ) 

### S 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 ) Foundation , Sidin g an dGutter s 1 .Wa s damag e t o th e sidin g o r tri mavoided ? 2 .Wa s damag e to th e foundatio navoided ? 3 .Wa s damag e to window s avoided ? 4 .Wa s damag e to window s o r door screen s avoided ? 5 .Wa s damag e t o downspout s o r downspou t extension s avoided ? Sidewalk s an dDriveway s (Concrete ) 1 .Wa s damag e t o drivewa y surface s avoided ? 2 .

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

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/ Ye s N o



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## Owner s comments :

Inspectio nnotes :

Removal an drestoratio nactivate s complete includin g th e 30-day so dwarranty : EPARepresentativ e £)„ „ & . Date : sli t /a- 7Tota l Quadr a juar e Footag e t o b e Excavate d = 222 0 PropertyClassification : 80 0 Tat Footag e t o b e Excavate d = 0

Legen d Concret e 7~/ \ Excavate d Are a [ I Existin g Structure •—• —

Fence [>'.'.-

: 1 Permanen t Landscapin g

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—• Quadran t Boundar y Stree t Boundar y '~ S Tree/Shru b 

### Nort h 1 9 Avenu e

Nort h Arro w 

### Omah a Lea d Sit e Omaha , Nebrask a Scal e 1 Inc h = 2 0 fee t o r1 gri d = 5 x5 f t Propert yNumbe r OLS-2943 9 Propert yAddres s 262 0 N 1 9 AV E F2 B 1 Pos t Excavatio n Concentration s (ppm ) B 2 _Ra yAre a _ D Z _ Easemen t I ^-/ Garde n _Othe r_ Descriptio n of post excavatio n areas : F1 . fron t yar d left-han d quadrant ; F2 . fron t yar d ngtit-han d quadrant ; B1 , backyar d left-han d quadrant ; B2 . backyar d right-han d quadran t DZ . dri p zon e (1- 3 foo t are a of soi l aroun d th e foundatio n of th e house )

# SEP A PropertyCompletio n Agreemen t Thi s agreement document s th e completio no f removal activitie s performe do nth e belo w liste dproperty . Th e property owner' s signatur e indicate s tha t th e property owne r i s satisfie dwit hth e restoratio no f th e subjec t property , an dthat n o item s ar e i nquestion , now , o r at an y tim e i nth e future , excludin g an y remainin g so dwarrant y (3 0 day s total ) excep t thos e item s liste dbelow , i f any . PropertyID : '^ \

^ ^ ^ Propert yAddress : "2-C=Z o x M l^l^A^J ^ Owner : (2p5^ O (



## 2 . H i-kX i ^ Phone : (J4&)\~t<£ "

## 5-10 ^ Restoratio n Item s i n Question :

Item : Item : Item : Item : Kern : Item : Require d correction s t o complete th e property :



### agre e restoratio n i s completed , excep t a s note d above . I d o not agre e restoratio n i s complete d

r s Signatur e Dat eFin d Recor d 

### Sampl e Area : 2943 9 - 262 0 N 19AV Owner : i_

J Owne rOccupied Owne rName : 

## (MITCHEL LROSCO E c Owne rAddres s 1: Owne rAddress2 : |243 0 EVAN SST City : State : Zi p Code : JOMAH A|N E [6811 1 Owne rPhone : Alternat e Phone : |(402 ) 453-702 9 [ 

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### Resident : Residen t Name : JVACAN TLO T Propert yAddress : ]262 0 N 19AV Zi p Code : [6811 0 Residen t Phon e 

### | Propert yDamag e Quer y

i i 1 | 1 f ; i I 

### Contract : Contractor : (PRUDENT2007 Group : j Assessment : Qualifyin g Grou p J80 0 Assessmen t XR F Date : 

### 1 Assessmen t MaxXR F Val u j 836. 9

### Dougla s Count y Pag e 1 o f 1 Dougla s County , Nebraska PropertyRecor d - R220698000 0 Informatio n i s vali d a s o f2007-5- 9 Prin t Repor t Value s no t finalize d unti l afte rBoar d o fEqualizatio n Vie wo n Ma p 

### Owne r MITCHEL L ROSCO E C ETA L 243 0 EVAN S S T OMAH AN E 6811 1 -000 0 

### PropertyInformatio n Ke yNumber : 069 8 000 0 2 2 Accoun t Type : ' Residentia l Parce l Number : 220698000 0 Parce l Address : 262 0 N 19A V O M A H AN E 68110-000 0 Lega l Description : \ SHERWOOD S SU B DI V LO T2 BLOC K3 6 0 X 8 1 

### Valu e Informatio n Lan d \ Improvement Tota l 

### 200 7 $400.0 0 $0.0 0 $400.0 0 

### 200 6 $400.0 0 $0.0 0 $400.0 0 

### 200 5 $400.0 0 $0.0 0 $400.0 0 

### 200 4 $400.0 0 $0.0 0 $400.0 0 

### 200 3 $400.0 0 $0.0 0 $400.0 0 

### 200 2 $0.0 0 $0.0 0 $0.0 0 

### Sale s Informatio n Dat e Typ e Boo k Pag e Pric e 

### Lan d Informatio n

" ~ I Acre s S F I F F Unit s Deptf i I Widt h Vacan t 0.1 1 4860. 0 

### 'I - 

### 60. 0 \ 0. 0 81. 0 ! 60. 0 Ye s 

### Lan d Attribute s Attribut e Attribut e Descriptio n 

### Improvemen t Informatio n

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22 .. . 6/22/200 7

### • evie w Pag e 1 o f 1 

## Dougla s County-Omaha , N E

Parce l I D Owne r Nam e Propert y Addres s Cit y Zi p Owne r Addres s Owne r Addres s 2 Owne rCit y Owne r Stat e Owne rZi p 220698000 0 MITCHEL L ROSCO E C 2620N19A V OMAH A 6811 0 

### 243 0 EVAN S 

### ST OMAH A N E 6811 1 Sec - Tw n -Rn g Owne r Addres s Additio n Bloc k Lo t Lega l 1 Lega l 2 Lega l 3 Lega l 4 /Assesso r Websit e Lin k 110-15-1 3 SHERWOOD S SU B DI V


### 60X8 1

http://douglasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R22C698000 0 Disclaimer: Ma p an d parce l dat a ar e believe d t o b e accurate , bu t accurac yi s no t Ma p Scal e guaranteed . Thi s i s no t a lega l documen t an d shoul d no t b e substitute d fo ra titl e search , 1 inc h = 5 2 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx'^PrintOptData=Dougla s County-.. . 6/21/200 7