## TRANSMITTAL of OMAHALEA D SIT E SOILREMEDIATIO NFIL EFOLDE R


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# n 11 SA1D# : Date ; Address : foi'? WitM V t\i ^ Remediatio nContractor : Coasta l Environmenia ) Grou p Year : 2010ARR A
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### Dougla s County Accoun t In : ^Mion Pag e 1 of 2
Dougla s County , Nebrask a Propert yRecor d Informatio n i s vali d a s o f2010-8-3 0 ­ R140891000 0

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Treasurer' s Ta xReoor t Subdivisio n Sale s Searc h Owne r WITCHE R JAME S M 0/ 0 CYNTHI AWITCHE R 331 5 N 3 7 S T OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumber : 089 1 OOO O 1 4 Accoun t Type : Residentia l Parce l Number : 140891000 0 Parce l Address : Lega l Description : 221 9 WILLI S A V OMAH AN E 68110-000 0 IDLEWIL D AD D LO T1 2 BLOC K2 5 0 X 12 7 Valu e Informatio n
201 0 200 9 200 8 200 7 200 6 200 5 Lan d $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0 $500.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6350. 0 0. 0 127. 0 50. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R140.
. . 9/3/201 0" > 

### Pag e 1 o f 1

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• YOU RTICKE T NUMBERI S 2637696
. Origina l Cal l Date : 11/08/1 0 Time : 5:4 6 pmOp : ELIZABETH1879 0 Wor k t o Begi n Date : 11/10/1 0 Time : 6:1 5 pm State : N E County : DOUGLA S Place : OMAH A Address : 221 9 Street : WILLI S AV E Twp : 15 NRng : 13 E Sect-Qtr : 09-SE,10-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTAL Remarks : FA X AL L CLEAR S TO : (877)662-421 1 : UNSUR E I F CORNE R LOT . Compan y: COASTAL ENVIRONMENTAL SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : COASTAL Dept h o f Excavation : 4 F T Come r Lot : N Front : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C
Servic e Are a Contac t Phon e Numbe r Utilit y Typ e 

### Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , INC HEIDI 

### Alt : 402934046 9 Emerg : 402932975 7 Day : 402504782 3 MUDO l METROPOLITA NUTILITIE S DISTRICT SANDY 

### Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACOFCITY OFOMAHA-TRAFFIC,SEWE RRICH/TRAFFIC Alt : 402444516 1 

### Emerg : 402444516 0 Day : 406728934 3 0PPDGPR 5 OMAH APUBLIC POWE RDISTRICT EL M LOCATINGAlt : 406207149 4 

### Emerg : 888728934 3 Day : 406728934 3 QLNNEI C QWES T LOCA LNETWOR K 

### EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 11/8/201 0< ^ COASTAL 

# As-Buil t Drawin g Omah aLea dSuperfun dSit e OLS#:2824 2 Dat e Excavated : 11/11/201 0 Dat e USEP ASigne d Off : 12/14/201 0 Are a Sodden : 2300^s q f t 

### 2824 2 Exierio rPain t IvlorUi Arro w Omah a Lea d Sit e Owne rName : -iMAE& M wrrCHE R • Goo d Sit e Sketc h Address : 221 9 WIU-I S A V • Poor Phone : « 402.453-150 8 w 

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### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wit h So d Are areplace dwit h Rock/Mulc h Are alef t bar e 

### Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
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### Omah a Lea d Sit e Owne rName : JAME S M WITCHE R Q Goo d 

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### Omah a Lea d Sit e Owne rName : JAMES M yviTCHE R 

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### Omah a Lea d Sit e Owne rName : JAME S M WITCHE R 

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### Conseii l fo rAccess - \ o PropfeK y RIGH T OF ENTR YTO PREMISE S 

### Gfanto r(th e propert yowner ) consent sto an d aulhorize s th e Unite d Slate s Environmenta l Protectio n Agenc y(EPA ) oi it s aulhorize d representatives , collectivel y th e Grantee , to ente ran d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises : ^ ^ y ( j
Owner' Nam e / Daytim e Phone y ' s s Name : / 

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PURPOS E OF RESPONS E ACTIVITIE S 

### Th e EP A is requestin g acces s to collec t soi l sample s an d remov e soi l tha t contain s elevate d concentration soflea d an d ma ypos e a healt h hazard
. Th e area(s ) wil l be excavate d to remov e contaminate d soil
. Th e remove d contaminate d soi l wil l be replace d wit h clea n material s an d th e are a wili be restore d to Ks origina l condition
. Thi s wor k is bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e ofCoasta l Environmenta l Group , contracte d byUSEPA , wil l contac t th e Granto rin-perso n to discus s th e wor ktobe perfonned , th e Granto rwil l hav ean opportunit y to revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor eit begins
. Onc e th e wor k is finished , th e Granto rwil l be aske d to revie wth e wor k an d confin n tha t it is 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 y ha s bee n remediated
. ENVIRONMENTA L RESPONS E ACTION S 

### Bysignin g thi s Acces s Agreement , th e Granto r is grantin g th e EPA , it s employees , contractor s an d subcontractor s th e righ t to ente rth e property , at al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e ofperformin g th e work
. Thi s acces s shal l remai n in 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 of2

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## v : C0AS 1 A l [NrikONhfKTi l * i pno^v* - C R 0 U r) h C 

### t Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; cRemov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t maywis h t o save ; I Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessary ' subsequen t t o a n initia l waterin g perio d b yEPA ; « Abid e b yheall h an d safet yguidanc e provide d b yEPA ; « I fth e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo i acces s t o th e propert yt o perfor m th e work
. t Allo wvideotapin g and/o rphotographin g ofth 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 wothers 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 Coastal Environmenta l Group , a t (402 ) 991-119 9

D I gran t access t o m ypropertie s D I d o not grant acces s t o m ypropertie s 

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Pag e 2 o f2C OA S T AL 

## Restoratio n Agreemen t The purpos e of thi s agreemen t i s to provide amutua l agreemen t as t o condition s of the propert y prior t

o remediationactivities
. Thi s will als o serve a s documentationfo r the purpos e of assuring tha t restoration activitie s ar e completedto the satisfactionof the propert y owne r an dthe UnitedState s Environmenta l ProtectionAgenc y (EPA)
. PropertylD : ^-/^^ C Propert y Address ; y? ZI ^ \A JU J f ^ -AxfZ Z Owner ; J c ^ , ^ .^ 3 ^ ? j- t k-^A ^ Phone : yU o f h^j^-jy ^ O

nthe attacheddiagram(s ) indicat e area(s ) t o excavate , surface structure s an dlandscapin g feature s an d acces s location(s ) t o b e use db y the contractors . Indicat e distances , depths , materia l types , etc . Photographicall y an dVideographicall y documen t the existing condition s ofth e propert y an dthe basemen t i

f necessary . 

## Item s t o b e Remove d b yth e Owne rbefor e Stert o fRemediation : Th e removal, storage , disposal , and/o rretum o fthes e item s i s th e Owner' s responsibility
. Kem : 

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. Quadrant s that wil l b e excavated , that i s covere dwit hgrass . Numbe r o f tree s > 2 inc h Eac h 

### ^ trunk diamete r Numbe r o f tree s < = 2 inc h Eac h trunk diamete r Numbe r o f Sprinkle r Zones , Contro l Valves , Eac h Timers , Heads , etc . Attac hasketc ho f th e sprinkle r layout
. Numbe r o f an dsiz e o f eac hgarden/ flower be d Eac h area . Squar e Fee t Attac hasketc ho f relativ e size s an dlocations
. Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . Not e thi s valu e will b e use dt o issu e aplan t vouche r t o th e propert y owner . Easemen t Area , t o b e excavate d 

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### AddKiona l Comment s / Instructions : Th e cit yo f Omah a ordinance s ma yprohib Kyo u fro m usin g dir t o rgrave l area s o n you rproperty as driveway s o rvehicl e parkin g areas . Th e Environmenta l Protectio n Agenc y(EPA ) ma yb e removing an d replacing soi l underlyin g a grave l o rdir t are a o n you rpropertytha t yo u ma yb e usin g a s a drivewa yo rvehicl e parkin g area . I fthi s i s th e case , yo u shoul d understan d tha t thi s removing an d replacing o fsoi l doe s no t mea n tha t an yillega l drivewa yo rparkin g are a o n you r propert yi s mad e legal
. T o th e contrary , yo u ma yb e cite d b yth e cit yi fyo u us e a grave l o rdir t are a a s a drivewa yo rparkin g area , no t wKhstandin g an yremova i o r replacement o fsoi l b yth e EPA
. I fyo u hav e an yquestio n abou t legalityo fa certai n drivewa yo rparkin g area , yo u ma ycontact th e cK yo fOmaha' s Plannin g Departmen t a t (402 ) 444-5150
. Q Pleas e chec k thi s bo xi f yo u underetan d th e informatio n outline d above
. 

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G 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
. B ycheckin 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
. 

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o f Verificatio n XL3t-3902 2 Readin g N o 4 Mod e SOI L Tim e 2011-01-1 8 16:0 6 Duratio n 90.6 7 Sequenc e Fina l Flag s AVERAG E Av g o f1- 3 ADDRES S 221 9 WILLI S AV QUADRAN T B 2 DEPH T 4 " XR F TEC H C.PADILL A MIS C CONFIRMATIO N NOT E CLEA R

pp m P b 265.03 5 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 287.38 9 Supervise d By : 

## Certificat e o f Verificatio n

1 SOI L 2011-01-1 8 16:0 4 30.1 8 Fina l 2824 2 221 9 WILLI S AV B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 25.10 5

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTumpik e Billerica , M A0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 251.48 8 Supervise d By : 

## Certificat e o f Verificatio n

2 SOI L 2011-01-1 8 16:0 5 30.2 2 Fina l 2824 2 221 9 WILLI S A V B 2 4 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 23.66 7

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o f Verificatio n XL3t-3902 2 Readin g N o 3 Mod e SOI L Tim e 2011-01-1 8 16:0 6 Duratio n 30.2 7 Sequenc e Fina l Flag s BVI D 2824 2 ADDRES S 221 9 WILLI S AV QUADRAN T B 2 DEPH T 4 " XR F TEC H C.PADILL A MIS C CONFIRMATIO N NOT E CLEA R

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

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Supervise d By : 

## Certificat e o f Verificatio n

8 SOIL 2011-01

- 1 8 16:0 9 90.7 8 Fina l Av g o f 5- 7 221 9 WILLI S A V F2 4 " C.PADILL A CONFIRMATIO N CLEA R

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 304.85 6 Supervise d By : 

## Certificat e o f Verificatio n

5 SOI L 2011-01-1 8 16:0 7 30.2 4 Fina l 2824 2 221 9 WILU S AV F 2 4 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 26.10 0

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

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## Certificat e o fVerificatio n

6 SOI L 2011-01

- 1 8 16:0 8 30.2 8 Fina l 2824 2 221 9 WILLI S AV F 2 4 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 25.59 5

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 268.08 1 Supervise d By : 

## Certificat e o fVerificatio n

7 SOI L 2011-01-1 8 16:0 9 30.2 6 Fina l 2824 2 221 9 WILLI S AV F 2 4 " C.PADILL A CONFIRMATIO N CLEA R

± Erro r ± 25.04 4.*'^* % 

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

www.coastalhazmat.co m '"tPHOi* * COASTA L • NVIIONHINTA l e n o u r , IN C 

# EXECUTIV ESUMMARY : BVID #2824 2 - (221 9 WILLI S AVE ) No Issue s o r Concern s | ^ Issues/Concern s Detail Explanation : __ ^

### % 

## EP APropert y Clos e Ou t For m g^ ^ Wjitii. ^ Propert y # ; Propert yAddrcss: v 

# 2#Af/^

- Date/Tine ; OwDcr' a Nane:
. / ^ uuj v I line :/• Contracto r Grou p (^ > Quad s Excavated ; 1^ 1 \ r Y ^ Yes N o Excavatio D Genen l 1
.i r necessuy , wer e th e correc t quadi3nt(s ) excavate dan dreslored ? 

## J 2
.I f necessary , wer e th e correc i area s o f dri p zon e excavate dao drestored ? / Gradin g So d an d VcKctotki B Yes No I
.Doe s th e gradin g aroun dth e perimete r oftti e hous e inexcavate darea s generall y slop e away 

# z y fix>ni th e house ? / 2
.Ha s so dbeenlai di nal l area s that wer e excavated ? 3
.Doc s th e so di^ipcar t o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte da i a3 0 

# ~ 7 da y tim e period ) 4
.Ar e sodde darea s generall y flmt an devenl y graded ? 

# ~ 7 5
.

Ar c th e Joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 da y tini e period )



# -y 6
.Wa s th e propeit y grade dsuc hthat wate r wil l no t poo l o nth e propern* ? 7
.Wa s damag e l o landscapin g o r plan t material s avoided ? 

# y Gates , Fence s an dRctainlo s Wal b Ve s N o 1
. D o gate s ope nan dclos e freely ? (I f applicable ) / 2
. Wer e al l gate s o r fence s take ndow ndurin g restoratio nactivitie s reinsulied ? (I f applicabk ) 

# y 3
. Wa s damag e t o gate s o r fence s avoided ? (I f applicable ) 

## y
^
. Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) 

# y Foundation , Sidio K an dGntler s I
. Wa s damag e l o th e sidin g o r tri mavoided ? Ye s / .N o
2
. Wa s damag e t o th e foundatio navoided ? ?
. Wa s damag e t o window s avoided ? 

# y y 4 Wa s damag e t o window s o r doo r screen s avoided ? 5
. Wa s damag e t o downspout s o r downspou i extension s avoided ? 

# y y 1 Sidewalk s an dDriveway s (Coacretc ) Ye s N o I
. Wa s damag e t o drivewa y surface s avoided ? 

## y y - ^ 2
. Wa s damag e t o walkwa y surface s avoided ?

### % 

## Ort'ner s comments :

[inspectio nnotes :

Removal andresloratio nactivate s complete includin g the 30-da y so dwarranry : EP ARepresenlaiiv e ^ ^ )S< ^ Date : iliHl!o
_

# t

Propert yCompletio n Agreen^ien t Ihi s agreemen t documenl s th e tomplcho n o l remedia l aclivme s perloime d o n myproperl yM ysignature wil l designat e that i a m satisfie d wit h th e restoratio n o fm yproperly , an d tha i n o item s ar e i n questions , now , o ra l an ylim e i n th e fulure , excep l ihos e item s liste d below , i fan y

Propert yFD : jg^ ^ ^ Propert yAddress : 2^Z \ (JJf(ll'^'5 > /h ^ Owne r 

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Ufi-hcJAM ^ Phone : 

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. tJury-JL ^ Restoratio n Item s i n Question :

Item : ttem : Item : Item : Item : =, = Item :

l|r i I Agre e restoralio n i s completed , excep t a s note d [_ J I rto no l aifre crestoratio n i s complete d

iwner' s Signatur e Dat e Cunt i arlor' s Signatur e Dal e