## TRANSMITTALof OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDER 

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# ^ohh " SAID # : Date : Address : M \\\'\4 M'''^ h < Remediatio nContractor : Coasta l Environmenta l Grou p Year : 200 1 _200g|
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### Dougla s Coimty Accoimt Inforni^o n Pag e 1 of 2 rni^ c Dougla s County , Nebrask a Propert yRecor d - R123586000 0 Prin t Repor t NE WFeatur e - Parcs l Dimension s availabl e (3 ) scal e 0-5 0 ft wes t o f52n d S t - ViewO H Ma p Informatio n i s vali d a s o f 2009-10-1 5 Treasurer' s Ta xRepor t Ne wFeatur e - • - > ^ Aut o Sale s Searc h Owne r THOMPSE N BRUC E A ETA L 351 1 WOOLWORT H AV E OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 358 6 000 0 1 2 Accoun t Type : Residentia l Parce l Number : 123586000 0 Parce l Address : 111 9 S 3 1 S T OMAH AN E 68105-000 0 Lega l Description : HANSCO M PLAC E LOT1 9 BLOC K5 5 0 X 15 0 Valu e Informatio n Lan d Improvemen t 7ota / 200 9 $6,800.0 0 $103,800.0 0 $110,600.0 0 200 8 $6,800.0 0 $103,800.0 0 $110,600.0 0 200 7 $6,800.0 0 $103,800.0 0 $110,600.0 0 200 6 $6,800.0 0 $104,700.0 0 $111,500.0 0 200 5 $6,800.0 0 $104,700.0 0 $111,500.0 0 200 4 $6,800.0 0 $45,900.0 0 $52,700.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 7 7500. 0 1 0 150. 0 50. 0 N o Impro t vemen Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.
. . 10/21/200 9

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2 1/ 2 STOR V UNFINISHE D

1W8 D s n n CLIC KTO ENLARG E IMAG E Squar e Footage : 1 1748. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : En d Condition : Goo d

Buil t As : 2 1/ 2 Stor yUnfi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : i 8. 0 Exterior : Fram e Sidin g Units : 2. 0 Interior : Drywal l Baths : 2. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 4. 0

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### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.
. . 10/21/200 9Pag e 1 of 2

" > Great e Anothe rTicket

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• YOU RTICKE T NUMBE RI S 2403267
. Origina l Cal l Date : 11/09/0 9 Time : 2:1 3 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 11/12/0 9 Time : 2:4 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 111 9 Street : S 31S T S T Twp : 15 NRng : 13 E Sect-Qtr : 21-SW,28-N W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remediatio n Locatio n o f Work : INCLtJDE AL L EASEMENT S LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (877)662-421 1

: UNSUR E O F CORNE R LO T Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : Coasta l Environmenta l Grou p Dept h o f Excavation : 4 fee t Come r Lot : NFront : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V LEVEL 3 MUDO l MUD0 2 OMAHACO F OPPDGPR S 0PPDGPR 6 QLNNEI C QLNNEI F

Servic e Are a Contac t Phon e Number Utilit y Typ e
CXCAT V CO X COMMUNICATIONS , IN C HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7
LEVEL3 LEVEL3 COMMUNICATIONS , LL C N A Day : 877366834 4 Alt : Emerg : 877366834 4
MUDO l METROPOLITA N UTILITIES DISTRIC T SAND Y Day : 402504782 3 Alt : 

### Emerg : 402504797 0
MUD0 2 METROPOLITA N UTILITIES DISTRIC T SAND Y 

### Day : 402504782 3 Alt : Emerg : 402504797 0

http://vmvi^.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 1 1 /9/200 9

### Pag e 2 of 2

OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R 

### RICH/TRAFFI C Day : 402444719 7

Alt : 402444516 1 Emerg : 402444516 0
OPPDGPR S OMAH A PUBLI C POWE RDISTRIC T N A 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3
OPPDGPR 6 OMAH A PUBLI C POWE RDISTRIC T N A 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 QLNN E1 C QWES T LOCA LNETWOR K N A 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 QLNN E1 FQWES T LOCALNETWOR K N A 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3

http://vmvi^.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 11/9/200 9OLS# : 2082 6 Dat e Excavated:11/11/0 9 Dat e USEP ASigne d Off : 12/22/0 9 

# As-Buil t Dravi^ing COAST AL ENVIKONMCNTA L Are a Sodden : 27 0 s q f t 

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## Consen t fo rAcces s T o Propert y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propertyowner) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA) o rit s authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises :

Owner' s Name : Daytim e Phone : . 

## '^r^(J^S^\r^QT^ f^>f v
Addres s o f Propert y 

# iiio i ^.- yy \ covere d b ythi s Agreement : PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EPAi s requestin g acces s t o collect soi l sample s an d remove soi l tha t contain s elevate d concentration s o f lea d an d maypos e a healt h hazard
. Th e area(s ) wil l b e excavate d t o remov e contaminate d soil
. Th e remove d contaminate d soi l wil l b e replace d wit h clea n material s an d th e are a wil l b e restore d t o its origina l condition
. Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e o f Coasta l Environmenta l Group , contracte d b yUSEPA , wil l contact th e Granto rin-perso n t o discus s th e wor k t o b e perfomied , th e Granto rwil l hav e a n opportunityt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e i t begins
. Onc e th e wor k i s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d confir m tha t i t i s 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 EPAtha t th e property ha s bee n remediated
. ENVIRONMENTA L RESPONS E ACTION S 

### B

ysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractors an d subcontractors th e righ t t o ente rth e property , a t al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o f performin g th e work
. Thi s acces s shal l remai n i n effect unti l th e wor k ha s bee n satisfactoril ycompleted
. Th e Granto rals o agree s to :

Pag e 1 o f28 COASTA L HtVINONHIKTA l 

### \^o y CROU P IM 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 ma ywis h t o save ; e Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessar ysubsequen t t o a n Initia l waterin g perio d b yEPA ; cAbid e b yhealt h an d safet yguidanc e provide d b yEPA ; •I f th e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propert yt o perfor m th e work
. cAllo wvideotapin g and/o rphotographin g o fth e property
. AGREEMEN T NOTT O 

### INTERFERE Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo f th e wor k activities , o rwit h an y o f th 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 f th e Grantee s o rth e environment , o rt o allo wother s 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 Coasta l Environmenta l Group , a t (402 ) 991-119 9

ran t acces s t o mypropertie s Q I d o no t gran t acces s t o mypropertie s

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G I woul d lik e t o b e presen t durin g an ysampiin g tha t i s required
.

Page 2 o f 2c .> ^ s T> L I M r 

## RestofatEOP i Agreemen t Th e purpos e ofthi s agreement i s to provid e amutual agreement a s t o condition s ofth e propert y prior to remediatio nactivities
. Thi s will als o serv e a s documentatio nfo r th e purpos e o f assurin g that restoratio n activitie s are complete dto th e satisfactio no f th e propert y owner andthe Unite dState s Environmenta l Protectio nAgenc y (EPA)
.

PropertylD : "Z-C} ^ Z4 Propert y Address : j / /

Q S 3 / 6 ^ O^er : ^f^^ A^UoV^ ^ 5Z^\r ^ 

### Phone : ^jg. ^ , 1 / t f^(S'^ 3 

## oVW/ - 4o^-'^H(>-5'^^ Q Onth e attache ddiagram(s ) indicat e area(s ) to excavate , surfac e structure s an dlandscapin g feature s an d acces s location(s ) to b e usedb y th e contractors . Indicate distances , depths , materia) types , etc . Photographically andVideographically document the existin g condition s ofth e propert y andth e basemen t i

f necessary . 

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Pag e 1 of
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## Condttion/Type/Specie s Pre-existin g propert y area , Quadrant s tha t wil l b e excavated , tha t 

# V
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. Agree dupo nvalu e o f plao t material s no t t o b e replace db y contractor .

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# r Additional Comment s / Instructions :

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. Bycheckin g thi s boxCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n crack s o rfissures
. 

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pp m P b 39.33 8 Supervise d By : 

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± Erro r ± 12.60 8

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

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pp m P b 181.14 2 Supervise d By : 

## Certificat e o f Verificatio n

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# Therm o

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pp m Erro r Pb 166.14 0 ± 16.72 9 Supervise d By :# 

## /\,A^ \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 I Coasta l Environmenta l Grou p Inc
. M V • j ^ www.coastalhazmat.co m %p„o^<! ^ COASTA L ENVItONMEMTA L S lO U r , IN C 

# EXECUTIV ESUMMARY : BVID #20826-(111 9 S 3 1 ST ) No Issue s o r Concern s [ ^ Issues/Concern s Detai l Explanation :

## st ^ 

# EPA Propert y Clos e Ou t Form Propert y # : ^^<fJtu > Propert y Address:- J J. ) ^ ^ .. ^ )2 ^ ' Date/Time : Quad s Excavated : rowtracto r Crou p C/^'^l ^ ' ^ Ye s N o Excavatio nGenera l 1
. I f necessaiy , were th e correc t quadrant(s ) excavatedandrestored ? 

### y 2
. If necessary , were th e correc t area s ofdri p zone excavate dandrestored? t ^ GmdlB K So dan dVegetatio n Ye s N o 1
.Doe s th e gradin g aroun dth e perimeler ofth e hous e i nexcavate darea s generally slop e awa y 

### y fromth e house ?; 2
.Ha s so dbee nlai dinal l area s tha t wer e excavated ?

. y 3
.Doe s th e so dappear to b e generally health y an dgrowing ? (Only evaluate if inspecteda t a3 0 y day time period ) __^____
_ 4
.

Ar e soddedarea s generall y Ar man devenl y graded ? y 5
.Ar e th e joint s betwee nth e so dstrip s generally tight ? (Only evaluate if inspecteda t a3 0 da y tim e period) y 6 .Wa s the propert y grade dsuchtha t wate r will no t poo l o nth e property ? y 7 .

Wa s damag e t o landscapin g o r plan t material s avoided ? y Gates , Fence s ani l Retainin g Wall s Ye s N o 1
.D o gate s ope nan dclos e fteely? (If applicable ) 

## y 2
.Were all gate s o r fence s takendow nduring restoraiion aclivitie s reinstalled ? (If applicable ) 

### y 3
.Wa s damag e t o gate s or fence s avoided ? (If applicable ) ^
1 / ' 4
.Wa s damag e t o relaining wall s avoided ? (Ifapplicable ) Foundation,SidlnKan dGutter s Ye s N o 1
.Wa s damage l o th e sidin g o r trimavoided ? ^ 2
.Wa s damag e t o th e foundationavoided ? y 3
.Wa s damag e t o window s avoided ? ^ 4 Wa s damag e to window s o r doo r screen s avoided ? , ^ 5
.Wa s damage t o downspout s or downspou t extension s avoided ? • Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 Wa s damag e to driveway surface s avoided ? • " 2
.Wa s damag e t o walkwa y surface s avoided ?

## owner s comments :

Inspectio nnotes :

Remova l an drestoratio nactivate s complet e includin g the 30-day so dwarranry : EP A Representativ e ^< ^ j( U Date : 'Jt/lf/.'T L

## Propert yCompletio n Agreemen t 1 In s agreemen t documenl s th e complclio n o fremedia l activitie s perionne d o n m yproperl yM ysignatur e wil l designal e iha l 1 a m satisfie d wit h lh e restoratio n o fm yproperly , an d tha i n o item s ar e m queslions
. now , o ra l an ytun e i n th e fijture, excep i Ihos e item s liste d below , i f an y

PropertylD : JQ'^IX ^ Propert y Address : . ^ i ^ Q ' S yb { ^ . Owner : 

# )O L "TVSorfi^^c n Phone : 

# o Q m\{yS?j: ) '^^(MoQl/^-IS' ^ Restoratio n Item s i n Question :

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

1

^ 1 Ryrc cI'C.ttarfllio n i % completed , excep t a s note d [_ J I d o no t ai;re crestorntin n i s complete d

Owner' s Signatin f Dat e r' s Signatur e Dal e

# ®

Propert yOwne rSstisfactio n Surve y Omah a Lea d Superfun d Si t 

### 200 8 

# NO V 2 3 200 9 Remediatio n Contractor : Coasta l Environmenta l Grou p Propert yIdentifie rNumber ; 

# ZOhlK o SUPERFUN D OIVISIO N Propert yAddress : i 1 1 Q 

# ^ ,?) 1 (S t Propert yOwner' s Name : ftnKX lWnnn^;^r i (abov e informatio n t o be fille d ou t b yremediatio n contracto rprio rt o deliver voffor m l o PropertyOwner )
Instruction s t o Propert yOwner : Thi s for m i s provide d t o yo u as a mean s o ftryin g t o captur e you rleve l o f satisfactio n wit h th e wor k o f th e above-identifie d remediatio n contractor , as applicabl e t o th e soi l cleanu p actio n a t you r property
. Th e U.S
. Environmenta l Protectio n Agenc y(EPA) i s ver yintereste d i n you ropinio n regardin g lh e wor k performe d b yit s contractors
. Thi s for m i s intende d t o provid e a n eas ymean s fo ryo u t o expres s you ropinio n abou t th e wor k performe d o n you rproperty
. Pleas e indicat e you rleve l o fsatisfactio n wit h th e contractor' s worl cb yselectin g a numerica l ratin g (rangin g fro m 1 t o 10 ) usin g th e followin g ratin g scale , the n pleas e sig n an d dat e th e for m an d retur n I t t o th e USEP Ai n th e attache d self-addresse d & stampe d envelope , (additiona l comment s ma y als o b e provide d i n th e spac e below , a t th e optio n o f th e propert yowner. ) 9-1 0 "excellent " ^ ^ "ver ygood "

5- 6 "acceptable " 3- 4 "poor " 1-2 "ver ypoor " Propert yOwner s Satisfactio n Ratin g Reeardin £ Contractor' s Wor k 5 _9

_ 4 8 3 7 2 6 1 Additiona l Comment s fro m Propert yOwne r(optional : continu e t o bac k o f pag e i f needed l

Propert yOwner' s Signatur e 

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