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

## 223 ^ Date : 3^/l3loe > Addres s 

# 34lC ^ T\..V ^ A/g . Remediatio nContractor : Coasta l Environmenta l Group

_ Year : _2007 _ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S ^ Vide o o f propert y (DVD ) ^ Executiv e Summar y K

4 EPA-provide dpropert y sketc h ^ Signe dAcces s Agreemen t fo r subjec t propert y D Signe dAcces s Agreement(s ) fo r adjacen t propert y ^ Restoratio nAgreemen t D Settlemen t docimient s (i.e. , fo r damag e o r t o replac e plants , etc. ) I5

t Coniirmatio ndat a ^ Photograph s 1 ^ As-buil t sketc h j ^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 nofarea s no t meetin g RO D cleanu p criteri a D Utilit y clearance s D Propert y informatio nfromDougla s Coimt y Assessor' s Offic e D D .

D • • ' • . • ' 

### ^ ^ 4031775 5 

# iiiiin Superfun d

## Fina l Repor t Propert y Chec k Lis t (piease plac e wit heac hfiieX cP'p~6<^ ^ Jtar dCop y Informatio n(^^^^4j^_-p^_t^ ^ \Property Check Li.s t ^ "T N|W ^ 2 . Site Workin g Drawin g Ma p6^l U -Dx^^^ ^ " ^ ^ 3 . EP AoriginaL s Ma p v4 .Dougla s Count y Assessor' s Ma p o^

^ Property Contac t Sheet Agreemen t

J .-yX-cces s Agreement 2\R.estoratio nAgreement 1VI1S ( C 

### Miscellaneou s Document s 

## rsF i ^ina l Ma p fromth e Field V Chang e Order s VXR FData 4 . An y email s o r PO airrespondence s Propert y Completio n 1 . Executiv e Summar y 2 . A S BUILT N^Property Completio nAgreement 4 . An y buyou t inf o o r reimbursement inf o ' X Check o r money orde r copie s c V EP AProperty Clos e Out For m XAttache dBeginVide o Electroni c Documentatio n Drawing s N. ^ EP Aoriginal zs^Workin g Drawin g 3 . A S Built.vs o 4 . A S Built.jp g Photo s BeginPhoto s During/Excavatio nPhoto s So dPhoto s 30-Day So dPhoto s Scanne dDocument s * Fina l Document s 2 Executiv e Summar y 0 Video s

' BeginVide o 2 . 

### M y Movi e

## Propert yAcces s Checklis t Propert yID : 

## ^B?jy \ D WOR K STARTE D ON : Propert y Addres s nWORKCOMPELTE D ON : 

# "-•

• .3V/< ^ Diyfj j hy Renter : 

# "^''''^'••DyM M M'^ i yariaii^ \ Plione : 

# "'"^•^•^=B^A/.V^^ci/ . Fax : Cell/Pa^er : Additiona l Information : 

# ''"" - 7j7^-y/y i Fax : Ccll/Piifrer :

nNotilicatio nLette r Sent : / / By : 1^

4 Acces s Aj^rccincnt 

## Signed : ^//2/J 7 

## B.v : i2jC y rS c Restoratio nA);rccnicn t Signed : b l 1^ 1 0 1 

## y^ryVyi x nTopsoi l Samplin; ; (ifapplicable ) 1 1 By : nDisposal Samplin g (ifaiiplicable ) 1 1 By : Q Ganle nSamplin g (if applicahle ) 1 1 By : \0 1 Utility Clearanc e Called : [^ / \' ^ 1 (7 1 

## By^-^iK^ ^ ^ Vi(leo/Pliot(» s (Before ) 

## On : y i iy_i y i 

# ^T7a0 y nVidco/Photo s (During ) On : / / By : D Vidco/Photo s (After ) On : / / By : nVideo/Photo s (3()-Day ) On : / / By : Signed : / / By : 1 1 Properl y Coinplctio nAgreemen t c nFina l Repor t Issued : / / By : Ai rIVIonitorin g (a s applieahle )

n Communit yn Cre w On : / / By : Results : f~ 1 Communit y[ H Cre w On : / / By : Results : n Communit yD Cre w On : / / By : Results : Omah a Lea d Sit e / /_ / /Total ( Ifan t Square Footag e t o b e Excavate d = 1178 > PropertyClassification : 80 0 Tot ! ) Zon e Linea rFootag e t o b e Excavate d = 90( l

'&»'g ^



## Dewe yAvenue-^ s ^ 3 ^ 7 Legen d Concret e Northj^ i 

### rrow Omah a Lea d Sit e Omaha , Nebrasl o -3 -

—— , Excavate d Are a Existin g Structure Permanen t Landscapin g Fenc e Scal e 1 Inc h = 2 0 fee t o r1 gri d = 5 x5 ft Propert yNumbe r OLS-2282 1 Propert yAddres s 341 6 DEWE YAV E Quadran t Boundar y Pos t Excavatio n Concentration s (ppm ) F 1 . B 2 PlayAre a Stree t Boundar y F 2 DZ Easemen t ./PTM»* ' 

# o Tree/Stiru b B 1 Garde n Othe r Descriptio n ofpos t excavatio n areas : Fl , fron t yar d left-han d quadrant ; F2 , fron t yar d right-hand quadrant ; Bl , backyar d left-han d quadrant ; B2 , backyar d right-hand quadrant ; D2 , dri p zon e (1- 3 foo t are a ofsoi l aroun d th e foundatio n o fth e house) .

# 0

=*?!» . . 

# % \y0 . Propert yClassification : 80 0



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Descriptio n o l pos t excavatio n area s Fl , fron t yar d left-han d quadrant ; F2 , fron t ya M rfght-han d quadrant ; Bl , backyar d lefl-+ian a quadrant ; 92 , backyar d riflht-'ian d quadrant : DZ . dri p zon e (1- 3 foo t are a o fsOi l aroun d th e foundatio n o fIh e house) , '. , - • "• 7'.' ' 7\. - •^vJ'Ti;^.:.^r»!Es^v; . _^- ^:y.y0v,^» ;

### Prin t Previe 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 211284000 0 SARTAI N DWAYN E 341 6 DEWE Y A V OMAH A 6810 5
332 5 N 4 8 S T OMAH A N E 6810 4 Sec-Twn-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 21-15-1 3
REED S 5T H AD D 4 1 5 50X103. 2

http://douglasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R211284000 0 Disclaimer : Ma p an d parce l dat a ar e believe d t o b e accurate , bu t accuracyi 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 = 8 2 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogi s alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 6/9/200 7

## CONTAC T FORM Property I D # Property Address : 

# 99?)^ ^ 3^/(/ > OiiTJUi f}\/i . Initial Contact : ^e^nrwi A^r\nfci/->t - 

## Secon dContact : Final Contact : Fina l Action : Date : t\{th T Time : /f57 > P^cito ' Tii->nc» ­ 

## Date : Time : Date : Time : Transmi t to EP AD Action : yy /^7^-,s-. ^ ? . /4(-^^ ^ ^' ^ A/-" firtt r^ ' f(Jl.< y 

## Action: _ Action ; (<4iyfuy ^ 

## Othe r Action : D

Comment : Owne r Commen t (s) : 

# \\uyy 7k.<^yyy ^
Site Coordinato r Commen t (s) :,,t o sr< . - * COASTA L ENVIRONMENTA L CROUP . INC . 

### 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 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 i respons e activitie s upo n th e followin g describe d premises :

Owner' s Name : Davtim e Phone : 

# 'T ­ ?yj'-c^f<5> 7 jyi^a/Th / i - ry/ZL^. vi^^^^ ' Addres s o fPropert y covere d b ythi s Agreement : 

# 3y/ V tVJ ^ 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 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 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 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 ivseet 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 , contractor s an d subcontractors 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 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 f2COASTA L ENVIRONMENTA L GROUP . INC . 

### Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; Remov 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 necessarysubsequen 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 byEPA ; 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 . Allo wvideotapin g and/o rphotographin g o fth e property . AGREEMEN 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 (877 ) 234-6270 . Q I d o not gran t access t o m ypropertie s ran t access t o m ypropertie s 

# Ly-o / Dat e Signatur e Dat e

n n I woul d lik e t o b e presen t durin g an ysamplin g tha t i s required .

Pag e 2 o f2, ( ^ 

## Restoratio n Agreemen t Th e purpos e o fthi s agreemen t i s t o provid e a mutua l agreemen t as t o condition s o fpropert yprio rt o remediatio n acii\iiies . Thi s wil l als o ser\ e as decontaminatio n fo rth e purpos e o fassurin g tha t restoratio n activitie s ar e complete d l o th e satisfactio n o fth e propen \ oune ran d th e L'nite d State s Environmenta l Protectio n Agenc y(EP.A) .

Propert yID : ^^^^ t Propert vAddress : ^ ^

. , V •- 3-ilL . 0?,v.\f > Owne r '- C ( ^ ASA/7-A- A I' M Phone : 

### ^[- b g-Sfe ^ O n th e attache d diagram(s ) indicai e area(s ) l o excavate d an d dept h o fexcavation , locatio n o fal l knov^i i utilities , subsurfac e features , surfac e structure s an d landscapin g features , acces s loca;ion(s ) ! o b e use d b v contractor , an d ili e directio n o fNo.nli . Indicat e distances , depths , materia l rxpes . e;: . !;i.iic;i; e ci:g:'.:-. l p' v;.- > b

vrefcrc'iC'i^ g tli e photo-lo g niiriibe rv , it h ai i nrro'^ vindicatii' g direc;ic; i c f\ iew . 

### Iterr. s T o 5 5 Ramcve d B yOwne rBefor e Sta.- t C fR i (Us e additiona l sheet s a s necessary ) 'h s rer^.ovai , storage , disposal , and/o rrstjr n c ftbes s iterr s i s :b e C^^- Item : V^-^'T^VI_ , clt-4 , lA^^y\ -O-cv-C-U - vlyQ^^ c Item : 

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

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## Uni t Condition/Type/Specie s
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I'ac h

1 iac h ;

luic h

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## Ite m

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Niinihci ' o f liec s < = 2 inc h Irun k (.liamclc r

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• • i : - 1 l l . . , 1 , 1 , l l , • ' 1 1 I.I' : , 1 . ,11, 1 \ i • > ill , •I!- . 

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

## Quantit y 

# IJo o 

# i 4

f 4

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,i!.M . .I'l' . i . |. | 1 . .i • ' ,;|i 

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A^./dt-SV^'^- ^

O Chec k th e bo xi fOwne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e pre-existin g damage . Bycheckin g thi s bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures .

n I d o no t agre e 

### imI agre e I I I d o no t agre e agre e 

# o C// 2 67 ­ 

# yiy^y ^ s i 0«<ifr"sSij>na<ur e Dat e . CtVnlrattJu-VSrgnatur c Dat e Pag e 6 o f\ /Total r 'an t S q igi^Mr - Footag e t o b e Excavate d = 1178 > PropertyClassification : 80 0 Tot , p Zon . ' rFootag e t o b e Excavate d = 9o( \

&b..UC .



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### vfiL, \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 ^^^ 7 I Coasta l Environmenta l Grou p Inc . iv^^^T ^

wvvw.coastalhazmat.co m ^"twiott ^ COASTA L ENVIRONMENTA L C R 0 U F , IN C 

# EXECUTIV ESUMMARY : 22821—341 6 DEWE Y AV E I I N o Issue s o r Concern s [ ^ Issues/Concern s Detai l Explanation: P O wa s issue dtw o mone y order s #R1006461776 4 & R1006461776 5 i nth e amount o f $500.0 0 eac h fo

r atota l amoun t o f $1000.0 0 fo r concret e driveway crack s afte r remediatio nactivitie s wer e conducted . Th e property owne r wil l repai r o r replac e a t thei r leisure .

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e itita i Quadran t Squar e Footag e I D b e Excarfated - 117 B Wniert ycnsancadon : 800 Tota l on p Zon e Linea rFixita(y e to D e Excavate d - 9 0 

### B 2 concret e wal l scra p roc k an d pu t back . F 2 ha s a ba d wal l sta y awa yfro m it . Al l plant s go , bushe s t o b e determine d b y foreman . Meta l fencin g remov e an d trash . Drivewa yan d wal l ar e

bad . Ther e i s ne wconcret e n o damag e t o sidewalk . F 1 retainin g wal l al l plan t lif e mus t go .

—tk^ftu i w iM<iiiiii»iM naa , tmi*tmt rtawjij oni w • . 

### Legen d Are ano t Excavate d Dripzon e Excavate d Quadrant s Excavate d 

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

## Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio no f remedial activitie s perfonne donm y property . M y signatur e will designat e tiia t 1 a msatisfie dwit hth e restoratio no f m y property , andthat n o ilcm s arc in questions , now . o r a

t any time i nth e future , excep t thos e item s liste dbelow , if any . 1'n.portylD : ^20^ / Property Adtlrcs.. : ^C//( ^ 7))fri^ei y AUe ^ Owner : 

## l>Li/yP7A7 y - Osyi ''"Sy^77h7y y Pho n 

# - ^/^-^^yj y Restoratio n Item s i n Question :

Item : Item : Item : item : Item : Item : Additiona l Comments :

l_r I iifirc c restofsitioi i i.s compieteil , excep t a s nntc d I I <l o no t ii(;n » I'ostorHtioi i i s complete d 

# y ^ - -y-'i-o ? /- y yyi y y,<,0G. , OwncrVsignalur c Dat e Contractor' s Stgnatur e bfit c / I

## Propert yDamag e Settlemen t

Propert y I D 2282 1 Propert y Addres s 341 6 Dewe y Av e Owne r Dwayn e Sartai n Phon e 402-813-298 7

I hav e receive dfromth e contractor . Coasta l Environmental Grou p Ine . (Coastal) , asumo f $ 1000.0 0 a s compensatio n fo r miscellaneou s property damag e in lieu o f furthe r repair s or replacement o f th e damage d property , whic hi s describe dbelow , that occurre ddurin g th e removal o f lead-impacte dsoil s fromth e adjacent property . Mone y Orde r Numbe r 1006461776 4 & 1006461776 5 Valu e of Mone y Orde r 500.0 0 e a(tota l amoun t $1000.00 ) Mad e Ou t T o Dwayn e Sartai n Descriptio n o f Miscellaneou s Propert vDamag e Coasta l accesse d th e propertyat 341 6 DeweyAv e fro m th e publi cacces s unt o th e property' s concret e driveway , pe rowner' s writte n permission . Th e concret e drivewaydi d not hav e an ypre-existin g cracks tsefor e wor k commenced . Additiona l cracks were develope d i n smal l on e are a o f th e drivewaydu e t o excavatio n work . M ysignatur e belo wi s acknowledgemen t o f th e receip t o f th e su m liste d above , whic h I furthe r acknowledg e t o b e ^i rcompensatio n fo rth e miscellaneou s propert ydamag e describe d abov e an d releas e Coasta l Environmenta l Grou p In cfro m furthe robligation s o rliabilit yrelate d t o thi s propert y damage . 

# U yn-n-o i 

# TyTJ L Signature Date Contractor' s Signature Pag e 1 o f 1Tin- . l-RONTOI - THI ' IXK'UMl-N THA S AMICRO-PRIN TAMOUN TBO X AN D THF'iRMOCHROMK" . Ali.SiiNCI- . 01 - THIiSl i I-T;ATIIRI-;, S Wll.i . INniCATI' ; ACOPY. -r i MoneyGram. ^ -^

^ Mone yOrders ^*^ ' NATIONA L MONE Y ORDE R

KEE P ACOP YO F THI S STU B rO R YOU R RECORDS / MANTENC AUN ACOPI AO E EST E RECIB O PAR ASU S ARCHIVO S 

# •u-fi.. 0 3.^9- 1 - ' 3^i U he-^-^- t ^ ^ 0V2 1 /x>^-^ 7 ^d£J^y ^ '

# SEP A ^PAPropert y Clos e Ou t For m Propert y #: 'Z'7BZ 7 Propert y Address : 3f ^ Tj^open ^ /h y V / / ^ Dmtc/Tinc : Owner' s Name : l^y^J^Je' - l/F^yt - "^^^^he-XAiA / Quad s Excavated : Contracto r Grou p Excavatio nGenera l Ye s No 1.Ifnecessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 

## L^ ^ 2.If ncccssa-fy , wer e th e correc t a-ta s ofdri p zon e excavate dan drestored? Gradin g So d an d Vetctotio B Ye s

No 1.Doe s th e gradin g aroun dth e perimeter ofth e house inexcavate darea s generall y slop e awa y fromth e iiouse ? 2.Ha s so dbeenlai dinal l area s tha t wer e excavated ? 3.Doe s th e sodappea rtobe generall y healthy andgrowing ? (Onl y evaluat e if

inspecte d at a

30 da y tim e period ) ^^ 4.Ar e soddt darea s generall y fir man devenl y graded ? 5.

Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y e\aloat e if

inspecte d at z

30 da y tim e period ) 6.Wa s th e property grade dsuc htha t wate r will not poo l or th e prope'T > ^. i^ ' 7.^'a s damag e to landscapin g or plan t material s avoided ? 

# -y GMIC V Feocc s an aRetaipin t nali s Ve s No Do gate s openan dclos e S-eely'; ' ^I f appiicable ) 

## r\o 

# d- 7(J L £2 . 2.Wer e ail gate sor fence s lake ndow ndurin g reslorationacti \itie s .-einstanec ? .i f applicpie ) 3.

Wa s damag e to gate s or fence s avoided ? Mf appiicable ) Wa s damag e tc retainin g wall s avoided ? ^! f applicable ! Foundation , Sidii i an dGutter s >.e i Nc 1.Wa s damag e to th e sidin gor trimavoided ? L y 2.

Wa s damag e to th e foundatio navoided ? 

### L / 3.

Wa s damag e to window s avoided ? 

# y 4 Wa s damag e to window s or door screen s avoided ? 

# y 5. Wa s daraag e to downspout s or dovk-nspou t extension s avoided ?\^,, ^ Sidewalk s an dDriveway s (Concrete ) Ve sNo 1.Wa s damag e to drivewa y surface s avoided ? 

# y 2.Wa s daraag e to walkway surface s avoided ? 

# M 1

### Owner s comments :

iDjpectic nnctes : QAA/1€, 

### yCy f Q0Ui^ ^ 

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Remc\-a l andrestcraticnsacti x ate s ccrr.r l jdir. g ".h e 30-dE v ?od•>-».£rranrv': EP ARepresentativ e \J(T\/ J < , 

# Date : 7/W^ 7