## TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO N FIL EFOLDE R 

## SAID# : ^77 ^ Date : "^ j 1 1 [o l Address : /J3 0 S // ) S h RemediationContractor : _Coasta l Environmenta l Group

_ Year : 2007 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o o f propert y (DVD ) [j /

Executiv e Summary [1 /

EPA-provide dpropert y sketc h K

Signe dAcces s Agreemen t fo r subjec t property D Signe dAcces s Agreement(s ) for adjacent propert y M Restoratio n Agreemen t D Settlemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) ^ 

### Confirmatio n dat a Photograph s - M As-built sketc h s K Satisfactory restoratio n signe db y Property Owne r M Property close-ou t chec k lis t signe db y EP A D Descriptio n o f area s no t meetin g RO D cleanu p criteri a D Utility clearance s D Property informatio n fromDougla s Coimty Assessor' s Offic e D D .

D " • ' • • . ' • " • ' • 

# 7//1/0 7 4031790 1 

# liilil l Superfun d

## Propert yAcces s Checklis t Propert y ID : P07^5 ' Propert y Address : fQ^T^ Q J ^ /Qfi . ^ f n n WOR K STARTE D WOR K COMPELTE D ON : ON : / / / / 0>vner : [.U1 1 /fa/} ! c)0h/Wh ^ > Addre.s.s : ^^-^ ^ S./O^J f Plume : 3^5'Lpll l Fax : Cell/Pager : Renter : Phone : Fax : Cell/Paj^er : Additiona l Inlorniation :

• Notificatio n Lette r r-i

U Acces s Aj^rcemcnt [j - Restoratio n Agreemen t n Topsoi l Samplin g (i f applicable ) n Disposa l Samplin g (if applicable ) n Garde n Samplin g (if applicable ) "^/Utilit y Clearanc e S ' Video/Photo s (Before ) n Video/Photo s (During ) D Video/Photo s (After ) n Vi<leo/Plioto s (3()-Day ) 1 1 Propert y Completio n Agreemen t H

H Fina l Repor t Sent : / / Signed: ^ i'dt ) 1 O l Signed : 6 1 9-^ 1 C 7 1 1 1 1 1 / Called : 319 7 lO ^



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### X iiPm f ^ E 31 1 Gar ( Jen ot h er . Descriptio n o f pos t excavatio n areas : F1 . fron t yar d left-han d quadrant . F2 , fron t yar d right-hand quadrant ; Bl , backyard left-han d quadrant ; B2 , backyard right-hand quadrant ; DZ , dri p zon e (1- 3 foo t ars a o f soi l aroun d th e foundatio n o f th e house) .

### Prin t Previe w Pag e 1 o f 1 

# idSOS./O^S'i' . Dougla s County-Omaha , N E

Parcell 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 Sec-Twn Rn g 113330000 0 J^^^^ ^ JOHNSTO N WILLIA M J Additio n 123 0 S 1 0 S T Bloc k OMAH A Lo t 6810 8 Lega l 1 Lega l 2 P 0 BO X 387 1 Lega l 3 OMAH A Lega l 4 Ol d N E Assesso r Sit e Ne w 6810 3 Assesso r Sit e 26-15-1 3 FORES THIL L 1 2 E 16 4 S 56. 3 FT

http://webarc.co.douglas.ne.us/dcassessor/details.asp ? PARCELNB=113330000 0 http://webarc.co.douglas.ne.us:8080/RealWare1/details.do ? id= R 113330000 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 = 53 9 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 4/23/200 7Parce l Searc h Pag e 1 o f 1 Result s 1 - 3 o f 3 B ^ Parcel s Q ^ JOHNSTO N WILLIA M J 123 0 S 1 0 S T Parce l I D Owne rNam e PropertyAddres s City Zi p Owne rAddres s Owne rAddres s 2 Owne rCity Owne rStat e Owne rZi p Sec-Twn-Rn g Owne rAddres s Additio n Bloc k Lot Legal ! Lega l 2 Lega l 3 Lega l 4 Ol d Assesso rSit e NewAssesso rSit e 113330000 0 ' ^ JOHNSTO N WILLIA M J 123 0 S 1 0 S T OMAH A 6810 8 P 0 BOX 387 1 OMAH A N E 6810 3 26-15-1 3 FORES THIL L 1 2 E 16 4 8 56. 3 FT

Valuatio n Informatio n Valuatio n Informatio n ffi MARLOW E CAROLY N A 123 0 S 10 8 S T © SPEC KALICI A 123 0 S 11 0 S T

http://www.dogis.org/dogis_alias/dogis/parceiSearch.aspx?govUser=false&validUser=fals e 4/18/200 7

# ¥^" 7 (^ ^ CONTAC T FOR M Property I D # A.c^R-S ' 

## Property Address : \^2> ^ <; . \P ^ gj . 

## Initial Contact : Date : ^ j l o IQ^ . Time : A/y p Action : O-IIL^ S 

## /]t > A/M,i:icj\ Secon dContact : Date : ,'i\yA[<r > Time : 113. 0 Action : L^ qPr^n7^o.c^ic^y , Final Contact : Date : cf/e^jo ^ Time : /c>3c Action : 5,Vr.L- ^ ../vt^ v o^c>^^ ^ (Lit^ i Grt . 

## Final Action : Transmi t t o EP A D Othe r Action : D ^/V "

Comment : Owne r Commen t (s) : Site ii> n 'Soh^sJ^j ^ /Z3 M S . lo** ^ 

## Coordinato r Commen t (s) : 

# I'.y i PA . \CC^ ^ [,H^rk ­

## £ % Consen t Fo rAcces s T o Propert y RIGH T O FENTR Y T O PRFMLSI- S 

### Granto r (th e propert y owner ) consent s t o an dauthorize s th e Unite dState s Environmental Protectio n Agenc y (EPA ) or it s authorize drepresentatives , collectivel y th e Grantee , t o enter andperfor mcertai n environmental respons e activitie s upo n th e followin g describe d premises :

Owner' s Name : ^ ^-^ ^ 

### Daytim e Phon e 

# r ^ [pyPyy^y/ /

Address : \Vi o 

## f . ( ^ ^ ^ 

### Address : Addresse s of Address : Propertie s covere dby thi s Agreement : Address : 1 

### Address : PURPOS FOFRFSPONSFACTIVITIF S 

### Th e EP.A i s requestin g acces s t o collec t soil sample s andremov e soil tha t contain s elevate dconcentration s of arseni c and/o r lea dan dma y pos e ahealt hhazardTh e soil will b e remove dandth e excavate darea(s ) will b e replace dwit hclea nmaterial s an d restore dThi s wor k

i s bein g performe dunder th e Omah aLea dSite Superfun dSite remediatio n program . A

n EPA representativ e will contac t th e Granto r in-perso n t o discus s th e wor k

to b e performed , th e Granto r will hav e a n opportunity t o revie w andapprov e th e planne dsoil removal , andrestoratio n wor k

before i t begin s Onc e th e wor k

i s finished, th e Granto r will b e aske dt o revie w th e wor k

andconfir mtha t i

t i s complet e andmeet s wit hth e Grantor' s approval . Upon completion , th e Granto r will receiv e writte n documentatio n fro mEP A tha t th e propert y ha s been remediated . ENVIRONMI-:NTA LRI^SPONS EACTION. S 

### B y signin g thi s Acces s Agreement , th e Granto r i s grantin g th e EPA , it s employees , contractor s andsubcontractor s th e right t o enter th e property , a t al l reasonabl e time s an d wit hprio r notice , fo r th e sol e purpos e o f performin g th e work . Thi s acces s shall remai n i n effect unti l th e wor k

ha s been satisfactoril y completed . Th e Granto r als o agree s to :

«Property_ID » 

### Pae e 1 of 2

### lt %

• Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; • Remov e flower bulb s o r plant s that th e Granto r o r th e Grantor' s tenan t ma y wis h t o save ; • Wate r andmaintai n replacemen t vegetation , includin g fertilizer application , a s necessar y subsequen t t o a n initial waterin g perio db y EPA , • Abid e by healt handsafet y guidanc e provide db y EPA ; •I f th e property i s rented , assis t EPA i n obtainin g tenan t approval fo r acces s t o th e property to perfor mth e wor k

i f EP A i s unabl e t o obtai n suchaccess ; and •Allo w videotapin g and/o r photograph y o f th e property includin g exterio r and interio r area s o f buildings . AORFFM[;N T NO T T O INTFRFFRF- : 

### Th e Granto r agree s not t o interfere o r tampe r wit han y o f th e activitie s o r wor k

done , or th e equipmen t use dt o perfor mth e activities , or t o undertak e an y action s regardin g th e us e of sai dproperty whic hwoul dten dt o endange r th e healt ho r welfare o f th e Grantee s o

r th e environment , or to allo w other s to us e th e propen y i n suchamanner . Shoul dyou hav e an y question s about thi s program , pleas e contac t [ ^

I gran t acces s t o m y propertie s 3 ] 1 d o no t gran t acces s t o m y propertie s 

# yy.y3P.3 ^ rr/^r/ y Signatur eDat e Signatur e Dat e

I 1 1 wouldlik e t o b e presen t durin g any samplin g tha t i s required . Pag e 2 o f 2 «Property_ID> :

## Restoratio n Agreemen t Th e purpos e o f thi s agreement i s t o provid e amutual agreement as to condition s o f propcrt > prio r t o remediatio n activities . Thi s will als o sen e a s decontaminatio n fo r th e purpos e o f assurin g tha t restoratio n activitie s are complete dto the satisfactio n o f th e property owne r an dth e Unite dSlate s En \ironmental Protectio n Agenc y (EPA) .

Propert y ID : 

# T?K ^ Propert y Address : (f^"3t » ^ ' I «^ ^ 1 ^ 0>>ner : \^(a[/ ^ J^Tni^f ^ Phone : 

## Qoi - 

# -yn c b n O

n the attache ddiagram(s ) indicate arca(s ) t o c\ca\alc dan ddep A o f e\ca \ation . location o f al ! known utilities , subsurfac e features , surfac e sU^cture s an dlandscapin g features , acces s location(s ) l o be usedb \ contractor , an dthe directio n of North . Indicat e distances , depths , maieria l t

> pes . et c Indicat e digita l photo s b\ ' referencin g th e photo-lo g number w it ha n arrow indicatin g directio n of \icw . 

### 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 ) Item : 

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Pag e 2 o fif ?

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d Replace d (Us e additiona l sheet s a s necessary )

## 1 ^ ^

Ite m

Pre-e.xistin g propert yare a tha t i s covere d wit h grass .

Numbe ro f tree s > 2 inc h trun k diamete r

Numbe ro f tree s < = 2 inc h trun k diamete r

Numbe ro f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Attac h a sketc h o f th e sprinkle rlayout . Numbe ro f an d siz e o f eac h garden / flowe rbe d area . Attac h a sketc h o f relativ e size s an d locations . Landscap e Inventor y (Us e additiona l sheet s a s necessary) 

### Quantit y Uni t Condition/Type/Specle s

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### Ite m Agree dupon valu e o f plant material s not t o b e replace db y contractor . Note thi s valu e will b e usedto issu e aplant voucher t o th e property owner . Agree dupo n lis t o f plant material s tha t will b e replace dby contractor . B e ver y specifi c anddetailed . Include asketc ho f were eac hplant will b e place d b

y th e contractor . Agree dupon are ao f propen y to b e replace d wit hgras s sod . Include asketc ho f th e area(s ) t o b e replace dwit h gras s sod . Are ao f Cit y or Countv ' propert y to b e landscape d per their requirements . Includ e asketc ho f the are a(s )

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# Owne r Signatur e //y . Contracto r Signatur eX 

### iyML\ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 ° J^^^L l Coasta l Environmenta l Grou p Inc . Sy^^ ^

vwww.coastalhazmat.co m %«,att ^ COASTA L ENVmONHENTA l C H 0 U P , INC . 

## EXECUTIV ESUMMARY : 20688—123 0 s . 10^ " S T N o Issue s o r Concern s | ^ Issues/Concern s Detai l Explanatio n

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# 3 Legen d OLS#:2077 5 { NorthArro w Omah a Lea d Sit e Omaha . Nebrask a '7 - Dat e Excavated:6/9/0 7 i • ^

Da l e U S EPASigft e dOff:7/2/0 7 ^ ^ Propert yNumbe r OLS - 2077 5 existin g Stru c L _J ur e Scal e Propert yAddres s 1 Inc h = 3 0 ifee t o r1 gri d = 5 X 5 n ' ^ 123 0 S 1 0 S T 6 ? g<Qj j ,=...«.. = .. . ,.=..>.^=p,.. M

—— Quadran t Boundar y Pos t Excavatio n Concentration s (ppm ) F 1 R ? Pla vAre a - Stree t Boundar y '•*yd.r.*:«.r.inO'f . ''' ' 

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# - 1 < > B 1 _ C >ar c e n o t h e r Descriplia n a l pos t excavabo n area % F 1 . fron t yar d left-han d quadran t F2 . front yar d nght-han d quadrant , Bl , backyar d ien-har> d quadran t B 2 backyar d nghl-harx l quadran t 

# J OZ . dri p ztxi e (1- 3 tool are a o f so i anMjn d th e (oufKlatio n o f Ihehouae ) Legen d Are ano t Excavate d 'y j Dripzon e Excavate d Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Quadrant s Excavate d Grou p Inc .

## Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio n o f remedial activitie s performe do nmy properly . My signatur e wil l designat e that 1 a msatisfie dwit hth e restoratio n o f m y property , andtha t n o item s are i n questions , now , o r a

t an y tim e in th e future , excep t thos e item s liste dbelow , i f any . Propert y ID : 

# ^0^^ 6 Propert y Address : 

# 19-^ 3 SP0\^^P . Owner : 

# UJillian i dohpsivy j Phone : 

## ^P5-(j?7/ l Restoratio n Item s i n Question :

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

I M l agre e restoratio n i s completed , excep t a s note d I I d o no t agre e restoratio n i s complete d

Owner' s Signatur e Dat e I

# SEP A• EP A Propert y Clos e Ou t For m Propert y # : 

# 9377' 5 Propert yAddress : /^i 3 0 ^./O^^- h Date/Time : Owner' s Name : / J ) I /117/17 1 J O h /idl ) n Quad s Excavated : Contracto rGrou p Excavatio n General Ye s N o 1 .

I f necessary , wer e th e correct quadrant(s ) excavatedan drestored ? y ' 2 .If necessary , wer e th e correct area s of dri p zon e excavatedan drestored ? ^ ^ Gradin g So dan dVesetatio n Ye s N o 1 . Doe s the grading aroim dthe perimete r of the hous e i n excavatedarea s generall y slope awa y 

# y fromthe house ? 2 . Ha s sodbee n laidin ail area s tha t wer e excavated ? 

# 3 3 . Doe s the so dappea r t o be generall y health y an dgrowing ? (Onl y evaluat e i f inspecteda t a3 0 y da

y tim e period) 4 . Ar e sodde darea s generally fir man devenl y graded ? 

### y 5 . Ar e th e joint s between the sodstrip s generall y tight ? fOnl v evaluat e i f inspecteda t a3 0 da y time period ) -S^TYV..* . "Sr^x-^ j tT k

^ II' ^ A-OTI*- ^ 0 \0 6 . Wa s the propert y gradedsuc htha t wate r wil l no t pool o n the property ? y » 7 . Wa s damag e t o landscaping or plan t material s avoided ? ^j ^ Gates , Fence s andRetainin g Wall s Yes N o I .

D o gate s ope n an dclos e freely ? (I f applicable ) fJk 2 .Wer e all gate s o r fence s take n dow n during restorationactivitie s reinstalled ? (If applicable)y(;A 3 .

Wa s damag e t o gate s o r fence s avoided ? (I f applicable ) i / J A 4 .

Was damag e t o retainin g wall s avoided ? (If applicable ) nJ L Foundation , Siding an dGutter s Yes N o 1 .Wa s damag e t o th e sidin g o r tri mavoided ? f) ^ 2 .Wa s damag e to the foundatio n avoided ? |JA 3 .

Wa s damag e to window s avoided ? \ f^ 4 .

Wa s damag e to window s o r doo r screen s avoided ? tJ V 5 .Was damag e to downspout s o r downspou t extension s avoided ? A K Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 .

Wa s damag e to drivewa y surface s avoided ? ^ ^ 2 .

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

### Owner s comments :

Inspectio n notes :



# iJ ^ ^/lihu- ^ ^ ^

Remova l an drestQralion_activate s complet e including the 30-da y so dwarranty : EP A ^t^xQstmi>iyy>7jAz7.^^^Jiajuh^^^ ^ Date : 77^/ 6 J