### TRANSMITTA L o f OMAH A LEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : ^c..a..5> ^ Date : (&:>. ] r^ ^ Address : ^U-o aN £ q ,<i- r Remediatio n Contractor : Pb.-^rN^N- / 'hr^Mafeyqi^J^r. . Year : tJVaft^JoA q SOI LREMEDIATIO N PROPERT Y FIL E FOLDE RDOCUMENT S E T Vide o o f propert y (DVD ) 0 ^ Executiv e Summar y H^ EPA-provide dpropert y sketc h [f

l Signe dAcces s Agreemen t fo r subjec t propert y D Signe dAcces s Agreement(s ) fo r adjacen t propert y 12

^ Restoratio n Agreemen t aSetdemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) S ' Confirmatio n dat a E

l Photograph s Sf

As-buil t sketc h E

l Satisfactor y restoratio n signe db y Propert y Owne r Gf

lPropert y 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 0 Utilit y clearance s \ e Propert y infonnatio n fromDougla s Count y Assessor' s OfBc e D D D

- ^ 

### )at e 4031125 4 Superfun d

### PROPERT Y SUMMAR Y Date : 01/23/200 9 Oinah aLea dSite Remedial Actio n Contrac t #EP-R7-07-06/0004 Month of : Dec/Ja n Propert y Addre88 : 240 5 N 2 9 S T A , EXECUTIV E SUMMAR Y A. 1 Issue s Encountered : NON E A. 2 Issue s Resolved : NON E A. 3 Uniqu e Findings : NON E A. 4 Othe r Relevan t Infonnation : NON E CONFIRMATIO N SAMPLIN G DATA/RESULTS : B 2 = 13 6 PP M @ 8" ; D Z = 9 6 PP M @ 4" ; F 2 = 14 5 PP M @ 4" ; E A = 21 6 PP M @ SCRAP E ATTACHMENT S 1 ) Propert y sketch provide db y EP A pursuan t to contract specification s 2 ) SignedAcces s Agreemen t including acces s agreement s require dfo r crossing othe r propertie s 3 ) Pre-Excavation digita l vide o cUp/photogr^h s 4 ) Post-Excavatio n digita l vide o clip/photograph s 5 ) Documentation - CompletedClose-ou t Checklis t 6 ) As-Buil t sketch ­ i ) Shall include finallead level s v ) Legend ii ) Contamination lef t behindarea s vi ) Contracto r identification iii ) Propert y addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e includedin th e individua l propert y file, i f available , or obtainedinclude : i ) Pre-excavatio n agreemen t detail s (i f an y ar e mad e wit h th e propert y owner ) ii ) Propert y Statu s For msignedb y propert y owne r iii ) Excavation digita l vide o in MPEG , WM V (Window s Medi aVideo ) or SW F(Flas h Player ) forma t and/or photograph s iv ) Signedfor mverifying satisfactor y restoratio n v ) Description o f area s no t meeting InterimROD cleanu p criteria .

TECHNOLOCIES , INC
.Fin d Recor d Ciea n U p Query Lea d Remainin g Quer yI Propert yDamag e Query 

### Backfill :

Sampl e Area : 2832 9 ­ 240 5 N 2 9 S T Owner : Resident : Contract : D Owne rOccupie d 

### Residen t Name : Contractor : Owne rName : [UNOCCUPIE D 

## |pRupeff2ooO " J DUN N EMMI T Owne rAddressl : 

# r Owne rAddress2 : Propert yAddress : |2405N29S T Zi p Code : |6811 1 ; Group : 

# I Assessment : 1240 5 N 2 9 S T Residen t Phon e Qualifyin g Grou p City : State : Zi p Code : 

# L 

# ­ - I PRIORIT Y [OMAH A Owne rPhone : J |N E J |6811 1 

### Alternat e Phone : Assessment XRF Date : 

# r~—-—: . 1(402)453-726 2 

### 1(402)714-715 9 Assessment Ma xXR F Value :

### 'irBGHNQEQGIES.lS<I C Property* : 5*835« 5 Date/Time : Quad s Excavated : B a/ ^"^ ^ 4^2. ^ Sft 

# EP A Propert y Clos e Ou t Propert y Address : 9^ S H 9 ^ .S T Owner' s Name : Contracto r Grou p Pruden t Technologie s Excavatio n General Ye s .N o 1 . If necessary , wer e the correc t qiiadrant(s ) excavatedan drestored ? 

# \ y 2 . Ifnecessary , wer e the correc t area s ofdri p zone excavatedandrestored ? 

# y Gradm g Sodan dVegetatio n Ye s yW o 1 .Doe s the grading aroundthe perimete r of the hous e in excavatedarea s generall y slop e awa y fiomthe house ? 2 .

Ha s sodbeen lai di n all area s tha t wer e excavated ? 3 .

Doe s the sodappea r to b e generally health y an dgrowing ? (Onl y evaluat e if inspecteda t a3 0 / 

### \ y da

y tim e period) 4 .Ar e soddedarea s generall y firman devenl y graded ? 5 .Ar e the joint s betwee n the so dstrip s generally tight ? (Onl y evaluat e i f inspecteda t a3 0 da y 

# 17 ' tim e period) 6 . Was the propert y gradedsuc h tha t wate r will no t poo l on the property ? 

### \ y 7" 

### 7 . Was damage t o landscaping o r plan t material s avoided ? 

### V Gates , Fence s an dRetainin g Wall s Ye s JN o 1 . D o gate s ope n an dclos e finely? (IfappUcable) 

# 17 1 ^ 

### 2 . Wer e all gate s o r fence s taken dow n during restoratio n activitie s reinstalled ? (I f applicable ) 

### 1 / 3 . Was damage to gate s o r fence s avoided ? (I f applicable ) 

# T7 ' 4 . Was damage t o retaining wall s avoided ? (I f applicable) 

### 1 / Foundation , Sidin g an dGutter s Ye s ^ 0 1 .Was damage t o the siding or trimavoided ? 

# 1 / /
­ 2 .Was damage t o the foundation avoided ? 

## \ y 3 .

Was damage t o window s avoided ? 4 .

Was damage to window s or doo r screen s avoided ? 

# 1 7 / 

### 5 .Was damage t o downspouts o r downspou t extension s avoided ? Sidewall u an dDriveway s (Concrete ) Ye s M o 1 .Was damage to drivewa y surface s avoided ? 

### l / / 

### 1/ ' 2 .

Was damage to walkwa y surface s avoided ?

### Owner s conunents :

Inspectio n notes :

Remova l an drestoratio n activate s complet e includin g th e 30-da y sodwarranty : EP A Representativ e LJ A ^ /X'-£^J ^ Date : / /

/ / Q f

# &EP A Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio n o f remova l activitie s performedo n th e belo w liste dproperty . The propert y owner' s signatur e indicate s tha t th e propert y owne r i s satisfiedwit h th e restoratio n ofth e subject property , an dtha t n o item s ar e i n question , now , o r a

t an y time i n th e future , excludin g an y remainin g warrant y (3 0 day s total ) except thos e item s liste dbelow , if any . Propert y ID : Propert y Address : A 4^/ 9 < ^ iJ 

## ^f ^ ,sy . Owner : ^^^^ff
- ^^ ^ Phone : Restoratio n Kem s i n Question :

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

# <,t O b^^t y H" ^ ^ ^ 

# wM^i ^

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

# i>wv^^iO>^^-. ^ ^l- ' n - 0 ^ Owner' s Signatur e Dat ePruden t Technologies , Inc . (Piudent ) i s unde r contrac t wit h th e U . S . Environmenta l Protectio n Agenc y (EPA ) t o clea n u p lead
contaminate dsoil s a t anumt>e r ofpropertie s locate di n Omaha , Nebraska , includin g di e propert y locate da t ^H^j y K ) • 0<^t ^ S4- . Th e EP A request s you r pemussb n t o allo w Pruden t t o perfor masoi l cleaniq ) a t thi s propert y t o remo w lead-contaminate dsoil . B y signin g tfai s form, th e propeit y owne r grant s peimissio n t o Piuden t t o perfoi m activitie s relate dt o th e cleani p includin g soi l sampling , remova l o f lead«>n1aminate dsoil , an drestoratio n o f th e tefeience dproperty . I f

yo u hav e any question s abou t th e soi l cleanu p planne dfo r you r propeity , pleas e contac t Pruden t Administrativ e Clerk for th e Omah aLea dSit e cleanup . Ms . Deborah Johnso n -a t (402 ) 733-1188 . Genera l question s abou t di e Omah aLea dSit e cleam p cai l b e directe dt o th e EP A Publi c Infonnatio n Center s a t (402 ) 731-304 5 (South Oinah aofBce ) o r (402 ) 991-958 3 (NoUf aOmah ao£5ce) .

"•"-•3*^',
. Propert y Acces s Grante dBy : fc. r o r^gJ " g W
- V \K T r^r \ (Pleas e Prin t Name ) 

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- i^iit ' o g Propert y Owne r Signature : (Signatuie ) (Date ) PROPERT Y INFORMATIO N (T o b e complete db y residen t and/o r propert y owne r - pleas e print ) RESIDEN T NAME ; ^<!6wner ^ Rente r RESIDEN T ADDRESS : 4 ^ '^•i r I F RENTAL , PROPERT Y OWNE D BY : ^ ^ OWNER' S MAILIN G ADDRESS ;
OWNER' S TELEPHON E NUMBER-HOME : JJ^^X. ) I H - 7/5 9 WORK :

( > AG E O F HOME? : b6 ' YEARS
. HO W LON G HAV E YO U LIVE D HERE ? ' YEARS
. HA S TH E EXTERIO R BEE N PAINTE D O R COVERE D WIT H SIDIN G SINC E 1978 ? ^YE S 

## X N O NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OLD : _^ NUMBE R O F OCCUPANT S 7 YEAR S OL D AN D OLDE R NUMBE R O F CHILDRENUNDE R 7 YEAR S OL D WH O PLA Y I NTH E YAR D FO R 5 HOUR S O R MOR E PE R WEEK : 

# JL
. COMMENT S O R SPECIA L INSTRUCTIONS : (I.E
. DOGS , ENTR Y GATES , ETC. )

AUTHORIT Y FO RENVIRONMENTA L RESPONS E ACTIONS : Th e activitie s t o b e in^lemente db y EP A unde r thi s agreemen t ar e pursuantt o Sectio n 10 4 o f CERCLA , 4 2 U.S.C . 9604 . EPA' s tigh t o f

acces s t o tiie propert y i s providedfo r i n Sectio n 104(e ) o f CERCLA , 4 2 U.S . C 9605(e) , whic h provide s entr y for "deteiminingth e nee dfor response , o r choosin g o r takin g an y respons e acdo n unde r thi s titie, o r otherwis e enforcin g theprovision s o f Ifa

e tide. "

808 0 War d Parkway , Suit e 40 5 250 5 N
. 24* ^ Street , Suit e 30 8 424 2 Medica l Drive , Suit s 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (818 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7iiiSTw^J^'. * ',' , .^(•••••••: ; -; . -'V•:'f(^^-V:'.•^'^••• ; ^- -. f .^-^ M OLSH : 2832 9 Dat e Excavated : 11/06/200 8 USEP A Si^ied-OfTDate : 

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CONTIMC T #: EP - R7-07-0 6 / 000 4 PRUDEN T TECHNOLOGIES , INC
.ENVIRONMENTAL , CONSTRUCTI O 

### TECHNOLOGIES , INC . SERVIC E 

# Propert y Statu s For m Address : ^^O ^ JO
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## Date : /0/3//0 S Phone : ^ I * ^ ""^'^'' ^ BVID : 

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808 0 Ward Parkway , Suit e 40 5 2505 N
. 24* ^

Street , Suit e 30 8 4242 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebraska 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-3703 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-3707 Fax : (402)504-100 5 Fax : (210 ) 579-6577

## 2832 9 y Omah a Lea d Sit f Sit e Sketc h Samplin g Addiie s s : 240 5 N 2 9 S T Sampl e Niimhe r RYASCPXA-i28329 F 1 RYBSCPXA-?832 9 F 2 RYCSCPXA-28B29 B 1 RYDSCPXA-|28B2 9 B 2 RDZSCPXA-28J2 9 D Z RGZSCPX A liagaao—GS - RPZSCPXA-28&2 9 PZ Lea d Sampl e Concentratio n Collecte d 

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## 223 . pp m 442 . pp m 

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Parce l I D Owne r Nam e Property Addres s Cit y Zi p Owne r Addres s Owne r Addres s 2 Owne r City Owne r Stat e Owne rZi p 103579000 0 DUN N EMMI T 240 5 N 2 9 ST OMAH A 6811 1
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### Pag e 1 o f 1

" > Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l 

### YOURTICKE T NUMBE RI S 2166799 . Origina l Cal l Date : 10/31/0 8 Time : 10:4 6 a m Op : MADHURIMA1 8 96 7 Wor k t o Begi n Date : 11/04/0 8 Time : 11:1 5 a m .State : N E County : DOUGLA S Place : OMAH A Address : 240 5 Street : N29TH S T Twp : 15 NRng : 13 E Sect-Qtr : 09-S E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remediatio n wor k fo r soi l Locatio n o f Work : LOCAT E ENTIR E PROPERTY Remarks : FA X AL L CLEAR S TO : (402)733-188 3 : UNSUR E CORNER S Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : MADHURIM A Phone : (402)733-118 8 Alt . Contact : Phone : (618)401-222 3 Wor k Being Don e For : ep a Dept h o f Excavation : 6 f t Corne r Lot : NFront : Y Rear : Involve s Tunnelin g o r Horizonta l Boring : NExplosives : 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 , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 

### Day : 402504782 3 MUDO l METROPOLITA N UTILITIE S DISTRICT SAND Y Alt : 

### Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO N 

### Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 0PPDGPR 5 OMAH A PUBLI C POWE RDISTRICT N A 

### Alt : 888728934 3 Emerg : 406728934 3 Day : 406728934 3 QLNNEI C QWES T LOCA L NETWOR K

N A 

### Alt : 

### Emerg : 888728934 3 http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 10/31/200 8

### Pag e 1 o f 1
"> Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l 

### YOURTICKE T NUMBE RI S 2166799 . Origina l Cal l Date : 10/31/0 8 Time : 10:4 6 am Op : MADHURIMA1896 7 Wor k t o Begi n Date : 11/04/0 8 Time : 11:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 2 4 0 5 Street : N29T H S T Twp : 15 NRng : 13 E Sect-Qtr : 09-S E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remediatio n wor k fo r soi l Locatio n o f Work : LOCAT E ENTIR E PROPERTY Remarks : FA X AL L CLEAR S TO : (402)733-188 3 : UNSUR E CORNER S Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : MADHURIM A Phone : (402)733-118 8 Alt . Contact : Phone : (618)401-222 3 Wor k Being Don e For : ep a Dept h o f Excavation : 6 f t Corne r Lot : NFront : Y Rear : Involve s Tunnelin g o r Horizonta l Boring : NExplosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Are a Contac t Phon e Nuinbe r Utilit y Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 

### Day : 402504782 3 MUDO l METROPOLITA N UTILITIE S DISTRICT SAND Y Alt : 

### Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO N Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 0PPDGPR 5 OMAH A PUBLI C POWE RDISTRIC T N A Alt : 888728934 3 Emerg : 406728934 3 Day : 406728934 3 QLNN E I C QWES T LOCA L NETWOR K N A Alt : 

### Emerg : 888728934 3 http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 10/3 1 /200 8