### PROPERT Y SUMMAR Y fPate : 11/26/200 7 | Omah aLea dSit e Remedia l Actio n Contrac t #EP-R7-07-0 6 | Mont hof : Novembe r IPropert y Address : 432 4 Cas 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 : Mulc hare ateste da t 22 0 @ scrap e CONFIRMATIO N SAMPLIN GDATA/RESULTS : 

### B 2 - 18 9 @ 5 " Fl-171@6 " El-7 3 @ 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 ndigita l vide o clip/photograph s 4 ) Post-Excavatio ndigita 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 lef t behin darea s vi ) Contracto r identificatio n iii ) Property'addres s vii ) Dat e iv ) BV1 D numbe r 7 ) Othe r item s t o b e include di nth e individua l propert y file , i f available , o r obtaine dinclude : i ) Pre-excavatio nagreemen 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 nMPEG , 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 .

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## Omah a Lea d W / ^gfo V th e properl yi n orde rt o conduc t Site Remedia l £ 'v?P y ? environmenta l samplin g an d t o Actio n \-*m&fc-j > remove lead-contaminate d soi l • *^TM TM * ^ ^ • • ff
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### Prudent Technologies , Inc . (Prudent) i s under contrac t wid i di e U . S . Environmenta l Protectio n Agenc y (EPA) to dea n up lead-contaminate dsoil s a t anumbe r o f propertie s locate di n Omaha , Nebraska , including di e propert y locate da t y .*?<^ ? V dog ^ £> l . Th e EP A request s your permissio n In allow Prudent to performasoil cleanup a t thi s properl y to remov e lead-contaminate dsoi l B y signing du s form , th e propert y owner grant s permissio n to Prudent to perfor mactivitie s relate dto di e cleanup includin g soil sampling , removal o f lead
- contaminate dsoil , an drestoratio n o f me reference d property . Afte r obtainin g th e owner' s signature o n dii s form , Prudent Technologies , Lie . will contact di e propert y owner (an dresidents ) withi n th e nex t fe w week s t o coordinate performanc e m e wor k I f

yo u hav e any question s abou t di e soi l cleanu p planne dfor you r property , pleas e contact Prudent * s Administrativ e Cler k

for me Omah aLeadSit e cleanup , Ms . Cyndi e Hmd s a t (402) 504-1004 . General question s about di e Omah aLeadSit e cleanu p ca n b e directe dto me EPA Publi c Informatio n Center s a t (402) 731-304 5 (sout h Omah aoffice ) or (402 ) 991-9583 (nort h Omah aoffice) . Propert y Acces s Grante dBy. V D 

### A Property Owne r Signature :


### PROPERT Y INFORMATIO N (T o b e completedb y residen t aad/b r propert y owne r - pleaaprnt ) RESDENTNAME : |_ X ffl ^ ^^~\ r ^

f^pwne rQente r RESDENT ADDRESS : M ? b 2 M C &^S ^

Cf ~ f RENTAL.PROPERTYOWNE D BY : O f JM k OWN E R- S MALM G ADDRESS ; OWNER' S TELEPHON ENUMBER-HOME : P^ Q 3 5 1 " ' ^ WORK : I AG E O F HOME? : Ao L YEARS
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### AUTHORIT Y FO RENVIRONMENTA LRESPONS EACTIONS ; Di e activitie s t o b e implementedb y SP A under nil s agreemen t ar e pursuant t

o Section10 4 of CERCLA , 4 2 U.S.C . 9604 . EPA' s righ t of acces s t o the propert y i s provide dfor inSection104<e ) o f CERCLA , 4 2 U.S . C 0605(e) , whic hprovide s entr y fi r "determining the needfor response , or choosin g or takin g an y respons e actionunder thi s title , or otherwis e enforcing the provision s o f the titla "

# &EP A EP A Propert y Clos e Ou t Propert y # : 23S 3 7 Propert y Address : Vj^ y Cfts s Date/Time : / Owner' s Name : fl« M X*f» f Quad s Excavated : Contracto r Grou p Pruden t Technologie s Excavatio nGenera l Ye s N o 1 .I f necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 

### i / 2 .I f necessary , wer e th e correc t area s o f dri p zon e excavate dan drestored ? 

### , / 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 nexcavate darea s generall y slop e awa y fro mth e house ? 

# s 2 . Ha s so dbee nlai di nal 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 da y tim e period ) 

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

# s 5 . Ar e 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 tim e period ) 

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

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

# / Gates , Fence s an dRetainin g Wall s Ye s N o 1 .

D o gate s ope nan dclos e freely ? (I f applicable ) S 2 .

Wer e al l gate s o r fence s take ndow ndurin g restoratio nactivitie 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 ) 

# s 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 ? 

### J 2 .Wa s damag e t o th e foundatio navoided ? 

### / 3 .

Wa s damag e t o window s avoided ? 

### , / 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 ? 

### / 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 ? 

### i /

### Owner s comments :

Inspectio n notes :

Remova l an drestoratio nactivate s complet e includin g th e 30-da y so dwarranty : EP A Representativ e ^ ^ &+ , Date : >

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## PropertyCompletio n Agreemen t Thi s agreemen t document s th e completio n o f remova l activitie s performe do nth 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 warrant y (9 0 day s overall , 3 0 day s o nso dgrowt hguarantee ) excep t thos e item s liste dbelow , 

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## 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 201837000 0 KYE S LISBET H A 432 4 CAS S S T OMAH A 6813 1
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### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 8/1/200 7Fin d Recor d Clea n U p Quer y Lead Remainin g Quer yI Propert yDamag e Quer y Clos e

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## Dougla s County-Omaha , N E

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. 

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### Dougla s County-.. . 8/1/200 7