### PROPERT Y SUMMAR Y Date : 11/28/200 7 Omah aLea dSit e Remedia l Actio n Contrac t #EP-R7-07-0 6 Mont hof : Novembe r Propert y Address : 311 0 Charle s S t A . EXECUTIV E SUMMAR Y A. I Issue s Encountered : Non e A. 2 Issue s Resolved : Re-See dwil l occu r i n Novembe r o n an y dea dspot s t o encourag e sprin g growth . A. 3 Uniqu e Findings : A. 4 Othe r Relevan t Information : CONFIRMATIO N SAMPLIN G DATA/RESULTS : B2-221@6 " 

### D l - 8 2 @ 13 " E l - 17 6 @ scrap e ATTACHMENT S 1 ) Propert y sketc hprovide db y EP A pursuan t t o contrac t specification s 2 ) Signe dAcces s Agreemen t includin g acces s agreement s require dfo r crossin g othe r propertie s 3 ) Pre-Excavatio n digita l vide o clip/photograph s 4 ) Post-Excavatio n digita 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 n left behin darea s vi ) Contracto r identificatio n iii ) Propert y addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e include di n th e individua l propert y file , i f available , o r obtaine dinclude : i ) Pre-excavatio n agreemen t detail s (i f an y ar e mad e wit hth e propert y owner ) ii ) Excavatio n digita l vide o i n MPEG , 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 n o f area s no t meetin g Interi mRO D cleanu p criteria .

TECHNOLOGIES , INC
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## H I M Superfun dOmah aLea dSit e 4613 0 

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## ^HHHL — AUTHORIT Y FO R ENVIRONMENTA L RESPONS E AC'^^^^^ H ies t o be implemente d b yEP A underthi s provide dfor in Sectio n 104(8 ) o f CERCLA , 4 2 U.S . C IMUPHpxride s entr y for "determining the needfor response , or choosin g or takin g an y respons e actio n under thi s title , or otherwis e enforcin g the provision s o f the titla. "

## Agreement ^ atto wacces sto 

## Omah a Lead -/ Af t \ th e properf^ 

## properf^ n i 

## orde r to conduc t Site Remedia l -: • vW vyenvironmenta l samplin g an d to Actio n %£*&*.>< • remov e lead-contaminate d soi l v 

# x ••&,•••• ' Prudent Technologies , Inc . (Prudent ) is under contrac t wit h th e U. S. Environmenta l Protectio n Agenc y (EPA) to dea n

up lead-contaminate dsoil s at anumber ofpfoptrne s locate d in Omaha , Nebraska , ifirludhi f th e orooert v locate d at ^\\f i VJ^QfvvQA ^ . Th e EPA request s your permissio n to allow Prudent to performasoi l cleanupat thi s propert y

to remov e lead-contaminate dsoil . By signing thi s form , th e propert y owne r grant s permission to Prudent to peifum i activitie s relate d to th e cleanu p including soi l sampling , remova l of lead-contaminate dsoil , an drestoratio n of the reference d property . Afte r obtaining the owner' s signatur e

on mi s form , Pnia\H * Technologies , IIK . wiU ttMtac t the propert y owne r (andresidents ) withi n th e next fe w week s to coordinat e performanc e th e wor k If

you hav e any question s about the soi l cleanup planne dfor your property , pleas e contact Prudent' s Administrativ e Cler k

fo r the Omah aLea dSit e cleanup , Ms . Cyndi e Sud s at (402 ) 504-1004 . Genera l question s about the Omah aLea dSit e cleanu p ca n

be directed to the EP A Publi c Informatio n Centersat (402 ) 731-304 5 (sout h Omah aoffice )or (402 ) 991-9583 (nort h Omah aoffice) . ;A\t\f i I

N 

### Propert y Owne r Signature :

(T obe c(Mnplrt* d or rwidea t and/or propert y owner-pleas e prM ) RESIDEN T NAME : Qne r Q«e r RESIDEN T ADDRESS : IFRENTAL . PROPERTY OWNE D BY OWNER' S HAILIN GADDRESS ; OWNER' S TELEPHON ENUMBE R-HONE : ttO k 4^/~)O^ ^ WORK : r|fg.l3 O AC E OFHOME? : \Q ^ YEARS . HO W LON GHAV EYO U LIVE D HERE ? HA S TH EEXTERIO RME N PAINTE D ORCOVERE D WITH SIDIN GSINCE WV t NUMBE R OP OCCUPANT S UNDE R7 YEAR S OLOOC , NUMBE R Of OCCUPANT S 7 YEAR S OL D AN D OLDE R NUMBE R Of CHILDRE NUNDE R7 YEAR S OL D WH O PLA YIN TH E YARD FO RS HOUR S ORMOR EPE RWEEK : QC (OMMINI IORSPECIA LINSTRUCTIONS : fE . DOGS . ENTR Y GATES . ETC. ) 

## AUTHORITY FO R ENVIRONMENTALRESPONS EACTIONS : The activitie stobe implemented by EP A under thi s agreemen t ar e pursuant to Section104 of CERCLA , 42 U.S . C. 9604 . EPA ' sright of acces sto the propert y

is provide dfor inSection104<e ) of CERCLA , 42 U.S . C 9605(0) , whic hprovide s entr y for * determinin g the needfor response , or choosin g

or takin g an y respons e actionunder thi s title , or otherwis e enforcin g the provision sof the titla. "

# EP A Propert y Clos e Ou t Propert y # : 2576 7 Propert y Address : 311 0 Charle s S t Date/Time : Owner' s Name : Melvi aGosset t Quad s Excavated : j3i- f Contracto r Grou p Pruden t Technologie s Excavatio n Genera l Ye s N o 1 . I f necessary , wer e th e correc t quadrant(s ) 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 n excavate darea s generall y slop e awa y 

# y fro mth e house ? 

### 2 . Ha s so dbee n lai di n al l area s tha t wer e excavated ? 

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

# s da y tim e period ) 

### 4 . Ar e sodde darea s generall y fir man devenl y graded ? S' 

### 5 . Ar e th e joint s betwee n th e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 da y 

## s­ tim e period ) 

### 6 . Wa s th e propert y grade dsuc htha t wate r wil l no t poo l o n th e property ? 

### " 

### 7 . Wa s damag e t o landscapin g o r plan t material s avoided ? 

# s Gates , Fence s an dRetainin g Wall s Ye s N o 1 . D o gate s ope n an dclos e freely ? (I f applicable ) 

### S 2 . Wer e al l gate s o r fence s take n dow n durin g restoratio n activitie s reinstalled ? (I f applicable ) 

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

### S 4 . Wa s damag e t o retainin g wall s avoided ? (I f applicable ) 

### * / Foundation , Sidin g an dGutter s Ye s N o 1 . Wa s damag e t o th e sidin g o r tri mavoided ? 

### S 2 . Wa s damag e t o th e foundatio n avoided ? 

### S 3 . Wa s damag e t o window s avoided ? 

### t / 4 . Wa s damag e t o window s o r doo r screen s avoided ? 

### S 5 . Wa s damag e t o downspout s o r downspou t extension s avoided ? 

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

### «/ 2 . Wa s damag e t o walkwa y surface s avoided ? 

### ( /

### Owner s comments :

Inspectio n notes :

Remova l an drestoratio n activate s complet e includin g th e 30-da y so dwarranty : EPA Representativ e Q<* " **2

- Date : ///is/6- >M^gg
. Omah aLea dSite 4613 0

## PropertyCompletio n Agreemen t Thi s agreemen t document s th e completio n o f remova l activitie s performe do n th e belo w liste dproperty . Th e propert y owner' s signatur e indicate s tha t th e propert y owne r i s satisfie dwit hth e restoratio n o f th e subjec t property , an dtha t n o item s ar e i n question , now , o r a t an y tim e i n th 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 . Propert yID : 2576 7 Propert y Address : 311 0 Charle s S t Owner : Melvi a Gosset t Phone : 402-451-102 3 Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item : Require d correction s t o complet e th e property :



### L J I agre e restoratio n i s completed , excep t a s note d above , d o no t agre e restoratio n i s complete d



## / / Owner' s Signatur e Dat e

### Dougla s Count y Pag e 2 of 2

i n » : 3 1 1 0 CHARLE S ST i r

16

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### Clic k to Enlarg e Imag e Clic k to Enlarg e Imag e Squar e Footage : 1100. 0 Percen t Complete : 100.0 %

Perimete r0. 0 Quality : Averag e Unit Type : Condition : | Averag e Cond o Square Footage : 0. 0 Built As : 11/ 2 Stor yFi n Rooms : 5. C) 

### HVAC : Centra l Ai rt o Ai rUnits : 1. C ) 

### Exterior : Fram e Viny l Baths : 1. ( ) 

### Interior : Drywal l Bedrooms : 2. C ) 

### Roo f Cove rCompositio n Shingl e Stories : 1
. 5 Roo f Type : Gabl e Foundation : B U

### >ck Floorcover : Allowanc e Sprinkle rSquare Footage : 0. 0 v___o,,;i « 7

9 m yea r 

### Remodele d Percen t Remodeled Adjuste d Yea r

Buil t Physica l Ag e 190 2 198 1 0 % 190 2 10 2 

### Detai l Typ e Detai l Descriptio n Unit s Ad d O n 

### Unfinishe d Atti cW/floo r 780. 0 Appliance Allowanc e 1. 0 

### Basemen t Bsmn t Bloc k 8 f t 800. 0 Fixture Bas e Fixture s 1. 0 

### Fixtur e Bat h Ful l 1. 0 

### Porc h Enc l Scree n 84. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R20 .. . 6/22/200 7

### Dougla s Count y Pag e 2 of 2

» : 3 1 1 0 CHARLE S ST ! » 

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Clic k t o Enlarg e Imag e Squar e Footage : 1 1 00. 0

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Roo f Type : Gabl e Floorcover : Allowanc e Yea rBuil t Yea r

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9 m 

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1902 v198 1 0 % 

### Detai l Typ e Detai l Descriptio n Ad d O n Unfinishe d Atti c W/floo r Applianc e Allowanc e Basemen t Bsmn t Bloc k 8 f t Fixtur e Bas e Fixture s Fixtur e Bat h Ful l Porc h Enc l Scree n »< r Tkt t

| s«w*«n « re; - 

### Clic k t o Enlarg e Imag e Percen t Complete : 100.0 % Quality : Averag e Condition : Averag e Cond o Square Footage : 0. 0 

### Rooms : 5. 0



### Units : 1. 0 

### Baths : 1. 0 

### Bedrooms : 2. 0 

### Stories : 1. 5 

### Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 

### Adjuste d Yea r Buil t Physica l Ag e 190 2 

# I g 10 2 ) 

### Unit s 780. 0 1. 0 

### 800. 0 1. 0 1. 0 84. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfojsp?accountno=R20 .. . 6/22/200 7

## Omah aLeadApplicatio n Pag e 1 of2

Ne w Searc h Logou t 

## Omah a Lea d Applicatio n Chang e P <

Summar y] Overview Propert yinf o Assessmen t CleanJ J PiaceonHol d Remov e Hol d Cal l Trackin g Propert y Google
. Map s Dougla s Count yInteractiv e EP A Ma p Image s [Sampl e Are a I D (Propert yAddres s Sampl e Addres s Zi p Owne rNam e P576 7 0 1 1 0 CHARLE S ST 3 1 1 0 CHARLE S ST 5813 1 SOSSET T MELVI A L Propert yInf o View/Edi t Existin g Propert y Douglas C O Parce l ID : Owne rName : Owne rOccupied : Address : Address2 : City : State : Zip : Owne rHom e Phone : Owne rAl t Phone : Owne rNotes :
Propert yType : Residen t Name : Residen t Phone : Propert yAddress : Addres s Notes :

Unit : OccupancyLengt h Years : Exterio rPain t Sinc e 1978 : Interio rPain t Sinc e 1978 : Tota l Occupants : Tota l Childre n Unde r7 : 202900000 0 GOSSETT MELVI A L



# r
5618N50S T OMAH A N E 6610 4 [(402)451-102 3 |(402)301-421 0

RESIDENC E RESIDEN T
311 0 CHARLE S S T 6/21/0 6 OWNE R REQUESTE D COP Y O F RESULT S LETTER , MAILE D TODAY . S W EB L Chil d Car e

CountyPropertyType : RES I

Addres s Inf o Provider : B&v Inf

o Date : 08/19/200 3



## http://r7arcims.r7comp.epa.gov/ols / Access_Info.cf m 5/21/200 7

### Omah aLeadApplicatio n Pag e 2 o f 2

Younges t Chil d DOB : j Chil d Info Date : Younges t Chil d i n Months : Addres s Info Provider : B&V Chil d Info Provider : Update I



### http://r7arcims.r7comp.epa.gov/ols/Access_Info.cf m5/2 1 /200 7

### Dougla s Count y Pag e 1 o f 2
Dougla s County , Nebrask a Propert y Record - R202900000 0 Informatio n i s vali d a s of 2007-5- 9 Value s no t finalize d unti l afte rBoar d o f Equalizatio n Prin t Repor t Vie w o n Ma p Owne r GOSSET T MELVI A L 5618N50S T OMAH AN E 68104-183 3 Property Informatio n Ke yNumber : 290 0 000 0 2 0 Accoun t Type : Residentia l Parce l Number : 202900000 0 Parce l Address : Lega l Description : 311 0 CHARLE S S T OMAH A N E 68131-000 0 PROSPEC T PLAC E LO T 1 2 BLOC KD 5 0 X 127. 5 Valu e Informatio n
2007 200 6 200 5 200 4 200 3 200 2 Lan d $2,600.0 0 $2,600.0 0 $2,600.0 0 $2,600.0 0 $2,600.0 0

$0.0 0 Improvement $37,500.0 0 $37,500.0 0 $37,500.0 0 $29,600.0 0 $29,600.0 0 $0.0 0 Tota l $40,100.0 0 $40,100.0 0 $40,100.0 0 $32,200.0 0 $32,200.0 0 $0.0 0 Sale s Informatio n Dat e Typ e Boo k Pag e Pric e Lan d Informatio n Acre s 0.1 4 S F 6350. 0 FF 50. 0 Unit s



### 1. 0 Dept h 

### 127. 0 Widt h 50. 0 Vacan t N o Lan d Attribute s Attribut e Attribute Descriptio n Improvemen t Informatio n Buildin g 1



### http://douglasne.mapping-online.eom/DouglasCoNe/static/accountinfo.jsp?accounmo=R20 .. . 6/22/200 7Dougla s County Pag e 1 o f 2
Dougla s County , Nebrask a Propert y Recor d - R202900000 0 Informatio n i s vali d a s o f 2007-5- 9 Value s no t finalize d unti l afte rBoar d o f Equalizatio n Prin t Repor t Vie w o n Ma p Owne r GOSSET T MELVI A L 5618N50S T OMAH AN E 68104-183 3 Propert y Informatio n Ke yNumber : 290 0 000 0 2 0 Accoun t Type : Residentia l Parce l Number : 202900000 0 Parce l Address : 311 0 CHARLE S S T OMAH A N E 68131-000 0 Lega l Description : PROSPEC T PLAC E LO T 1 2 BLOC KD 5 0 X 127. 5 Valu e Informatio n 200 7 200 6 200 5 200 4 200 3 200 2 Lan d $2,600.0 0 $2,600.0 0 $2,600.0 0 $2,600.0 0 $2,600.0 0

$0.0 0 Improvemen t $37,500.0 0 $37,500.0 0 $37,500.0 0 $29,600.0 0 $29,600.0 0 $0.0 0 Tota l $40,100.0 0 $40,100.0 0 $40,100.0 0 $32,200.0 0 $32,200.0 0 $0.0 0 Sale s Informatio n Date Typ e Boo k Pag e Pric e Lan d Informatio n Acre s 0.1 4 S F 6350. 0 FF 50. 0 Unit s

1. 0 Dept h 127. 0 Widt h 50. 0 Vacan t N o Lan d Attribute s Attribut e Attribut e Descriptio n Improvemen t Informatio n Buildin g 1

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R20 .. . 6/22/200 7

### 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 202900000 0 GOSSETT MELVI AL 311 0 CHARLE S S T OMAH A 6813 1 • 5618N50S 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 16-15-1 3

. . .

' " PROSPEC T PLAC E D 

## [7T 50X127. 5

http://douglasne
. mapping online
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. 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData-Dougla s County-.. . 6/22/200 7

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