## TRANSMITTA L o f OMAH A LEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAI D # : ^^lo ^ Date : ^\ln^or^r, ^ Address : ^fTT o gvArMj g S.' f Remediatio n Contractor : n^aPPt^i f l^nfj.I^c.. . Year : ^Q- ^ SOI L REMEDIATIO N PROPERT Y FIL E FOLDE RDOCUMENT S ^ Vide o o f propert y (DVD ) 0

^ Executiv e Summar y 0

^ EPA-providedpropert y sketch y SignedAcces s Agreemen t fo r

subject propert y D SignedAcces s Agreement(s ) fo r

adjacen t propert y {?

( Restoratio n Agreemen t D Settlemen t document s (i.e. , fo r

damag e or to replac e plants , etc. ) y Confirmation dat a 0 ^ Photograph s •__ y As-built sketch 0 ^ Satisfactor y restoratio n signedb y Propert y Owne r 0 ^ Propert y close-out chec k

lis t signedby EP A D Descriptio n o f area s no t meeting ROD cleanu p criteri a B ^ Utilit y clearance s 

# y Propert y information fromDougla s Count y Assessor' s Oflic e 

# u u n 79f.m-39a ^ 3l^i/o ± Signature s Dat e 403 1 39 9 Superfun d

### PROPERT Y SUMMAR Y 1 Date : 09/15/200 8 | Omah aLea dSit e Remedial Actio n Contrac t #EP-R7-07-06/0004 Month of : Aug/Sep t | 1 Propert y Address : 257 0 EVAN S S T I 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 Information : NON E CONFIRMATIO N SAMPLIN G DATA/RESULTS : F2=7 9 PP M @ 8" ; EA=21 9 PP M @ SCRAP E ATTACHMENT S 1 ) Propert y sketc h provide 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 dfor 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 final lea dlevel s v ) Legen d ii ) Contaminatio n lef t 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 property file, i f available , o r obtaine dinclude : i ) Pre-excavatio n agreement detail s (i f an y ar e mad e with th e property owner ) ii ) Property Statu s Formsigne db y property owne r iii ) Excavatio n digita l vide o i n MPEG , WM V (Window s Medi aVideo ) o r SWF(Flas h Player ) format and/o r photograph s iv ) Signe dfor mverifyin g satisfactory restoratio n v ) Descriptio n o f area s no t meetin g Interi mRO D cleanu p criteria .Fin d Recor d 

### Backfill :

Sampl e Area : 3210 4 - Owner : n Owne rOccupie d Owne rName : [BARFIEL D DWAYN E Owne rAddressl : Owne rAddress2 : |257 0 EVAN S S T City : [OMAH A Qea n U p Query Lea d Remainin g Query 

### 257 0 EVAN S S T Resident : Residen t Name : JBARnEL D DWAYN E Propert yAddress : [257 0 EVAN S ST Zi p Code : 6811 1 Residen t Phon e State : Zi p Code : [N E [6811 1 Owne rPhone : Alternat e Phone : 

# 1 I Propert yDamag e Quer y Clos e

Contract :

Assessment : Qualifyin g Grou p [PRIORTT Y Assessmen t XR F Date : 

# I Assessmen t Ma xXR F Value : I 671.4 1

# ^EP A EP A Propert y Clos e Ou t Propert y # : 32.J0V Propert y Address : Osl o Cwaws S h Date/Time : S/zf/o f Owner' s Name : OMtjf* ^ B^turi o Quad s Excavated : F 2- Contracto r Grou p Pruden t Technologie s Excavatio n Genera l Ye s N o 1 .Ifnecessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 

## y 2 . Ifnecessary , wer e th e correc t area s ofdri p zon e excavate dan drestored ? 

# y Gradin g So dan dVegetatio n Ye s N o 1 .Doe s th e gradin g aroun dth e perimete r ofth e house i n excavate darea s generall y slop e away fromth e house? 

## y 2 .Ha s so dbee n lai din al l area s that wer e excavated ? 

## y 3 .Doe s th e so dappear t o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte dat a3 0 day tim e period ) 

## y 4 .

Ar e sodde darea s generall y firman devenl y graded ? 

# y 5 .

Ar e th e joint s betwee n th e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte dat a3 0 day 

## y tim e period ) 6 .Wa s th e property grade dsuc h that wate r wil l no t poo l o n th e property ? 

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

# ^ y 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 ) ^ 2 .Wer e al l gate s o r fence s take n dow n durin g restoration activities reinstalled ? (I f applicable ) 

# y 3 .

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

# y 4 .

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

# y 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 ? 

# y 2 .Wa s damag e t o th e foundatio n avoided ? / 3 . Wa s damag e t o windows avoided ? / 4 . Wa s damag e t o windows o r doo r screen s avoided ? i / 5 . Wa s damag e i o downspout s o r downspou t extension s avoided ? 

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

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

# y

### Owner s comments :

Inspectio n notes :

Remova l an drestoratio n activate s complet e includin g th e 30-day so dwarranty : EP A Representativ e ^^».J& ^ 

### Date : ff/H/of

# %EP A Propert yCompletio n Agreemen t Thi s agreemen t documents the completion o f remova l activitie s performedo n th e below listedproperty . Th e propert y owner' s signatur e indicate s tha t the propert y owne r i s satisfiedwit h the restoratio n ofth e subject property , an dtha t no item s ar e i n question , now , o r a

t an y time i n th e fiiture , excluding an y remaining warrant y (3 0 day s total ) except thos e item s listedbelow , if any . Propert y ID : 32- ) o^ ] Propert y Address : ^.^^ ^ Owner : 

# J: ^ t o 

### «^>N < Phone : <hjo.i ^ QCA'-UI' , 

### R\ r t

U Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item : I 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 . L J I d o no t agre e restoratio n i s complete d 

# lla^lo ^

Owner' s Si g latur e Dat et - * ^^^j:7 ­ f • ' '••. \ f » • • » 

# J7^ ? v ) ^-

^ --^-7\77^<-w ^ ,7 / Piud«H t T »cfan()lo9»! s Inc . (Tmd»n $ i s und»r eontiaet vibth * U . S . EawtaaasnU l Protselio n Ag«c y (P>A ) l o d»a aig * l»ad­ 5oata»iH*j dsoil s a t aniaa Wo f piop»iti»5lo5attdinOs»4ha,N*brBia,includii5th » proptit y locsls da t Th

« EP A r»qii»s! ! ycur psnaisaont o slJw r ]^d»iz t t o peifoi M asei l ebmi ^ atftn s piopnt j t o iMnov * Uad-eontawinit dsoil . B y ag^fingftiiEfoiin , th» prop»i1 y owii«i gnntspsnaissiont o Piud»atl D pcifoii n ae1ivi!i» s t»lat» dt o th * cUma p includii ^ s<» l sampliigi tnnova l ofUad-contiimiiiKt dsoil , and resloialion o f th » »f«r*nc» dproptity . I f yo u hav e airy - qusdi on s abou t th * s«i l cltaa: ^ plana« dfo r you r prop»ily,pl*as » conta aPrudtnt' s Adainistraliv * Clti k for th t OmahaLtadSit t cl tamo . Ms . Shannon Holt-a t ("402 ^ 504- 1 g)4 . Gtnti j qutflion s abou t flitOmahaLtadSit t cltais ^ caab t dirtstt dt o fc* EP A Public laforaati onCtntmS''*?? ; "'?!%^4i;5o!:{hO!nahacfS<:»)or(4Cr ! 99!-95? 3 5Jort ^ Propeit y AectssGiantt dB y Proptrty OTrnt r Signaturt . PROPERT Y MFORMATIO N RESIDEN T MAM E 

# .-^u^avAi\e-^BHva^£j ! •;-tS - RESIDENT ADDRESS : 

## -£i : aLVy.'^JU . i:>k-._£.gi l b I F RENTAL . PROPERT Y OWNE D BY : ^w^no.c ' «A1LW 6 ADDRESS : 

# 3i5.!li 3 <ljfci y\7 s ei

_nwvp^.n . K) ^ C % W b OWNER'STELEPHON E NUMBER-HOME : J _ WORK : AG E O F HOME? : \OC> f YEARS . HO W LON G HAV E YO U LIVE D HERE ? | ^ YEARS . HA S TH E EXTERIO R BEE N PAINTE D OR COX^tRE D WIT H SIDIN G SNC E 1378? ^YE S NO NUMBE R O F OCCUPAHT S UNDE R 7 YEAR S OLD : NUMBE R OF OCCUPANT S 7 YEAR S OLD AN D OLDE R NUMBE R O F CHILDRE H UHDE R 7 YEAR S OLD WH O PLA Y M TH E YAR D FO R 5 HOURS O R MOR E PE R WEEK : COiSMFMT S OR SPECffl L WSTRUCTTOMS : (I.E . DOGS . ENTR Y GATES . ETC. ) Aui-H0Rj7V-F0RENviK0NMtL«TAlHspDNSEkunUA;fTto^^^ ^ ZI^^T.fltf^l ] f^?f^- ^ « ^^•'^ ' ?«l'« - EPA' s righ t o

f accts s t o Ih t proptrt y i s pio^dt dfori n Stctio n 154<t ^ -J Lli.KS.uA, 42 LS . C 9605(t) . whichprovidt ! eaJi y fo i dtttHiinin g th t nttdfo i rtiyonst , o t chooan g o r talcin g an y rtqBons t actio actio n undtr thi s titlt , o r olhtnris e tnforcii ^ th t prevision s of th t iitlt. " 808 0 Ward Parkway . Suit s 40 5 2S0 5 N . 24 * Staa t Sult a 308 424 2 Madlca l Oriva . Sutt a 42S 0 Kanaaa C% . H O Gdt U OmAa , Mabraakacaii o Sa n Antonio . T X 7822 9 Phone : (816 ) 363-3703 Phone : <402 ^ 504-100 4 Pnone : CIO ) 822^56 8 Fa r^16 ) 363-370 7 Fax : (402)504-100 5 f-a x1210 ! 573-6577/ . ' ... . '. \

^••'j-j.' ^ Pmdtn t Ttchuolo^ti ; lae . (Tiudtm Q i s imdt i eoatiBC t wi&th * U . S . Enviion mtntal ProUctio n Agtnc y (^i ^ t o clea n 1 9 coatamin^ dsoil s a t B num Wo f pr^ertie s locate di n Omaha, N ebndca , isclui&D g th t propen y locate da t

. Th e EP A leqiieslsyouipeimisaoiiti } allon r Ptuden t t o perfoD B asoil cleanu p a t tts piopw^t o zemor e lead-eontamiiuUdsoil . B y agon g fliis fom , th e propert y o«m w grant s peaaisao n t o Ptudent t o ptrfoim • ctivitieEielaUdiD th e clesn ^ includii ^ soil simpli % lemova l s f lead-contamiaMe dsoil , mdiestontio o o f th t nfeience dpiopeity . I f yo u hav e m y quedioB E abou t th e scil cleaa: ^ planne dfo i you t piopetly , pleas e ectaaiitPlSliSrs'XdiBrniaiali'y e Cla k f

w th e OmahaLea dSit e deann> . Ms.ShaBnoinHolt-a t (403 ) 504-1004 . G eneia l (jueslion s abou t ftie OmahaLeadSite cleamipc n b e directe dt o flie EP A Publi c lafoimal i o n C entei s a t (40 ^ 731-304 3 (Pout h Omah aoffice ) o

r (402) ?91-958 3 (J l ort h O aahaoff i et) . PtopertyAeeeBjCnaiUdBy . Ij / Ji\/P/]]Cl y J~:>7i/7-Cli^Jdl ( OPIeas t Piint) ! ameV ' 

## .e

: ^M^y / i;A i JQLJIOMTIMT^U/^/ S Ptopert y Owne i Stgoabae ^T - (D.U ) ^ 

# T PROPERT Y MFORMATIO N (T t ko nayleli dky nmlaa l aal/tr p n f u ^ nrM C - |lMu»fxiat ) RESIOENT MAM E 

### Rente r 

# ^ J " u — 

# \ RESIOEN T ADDRESS : _, , , ^ \ y . 

## O 5 Mf > 9\J7^r^S . S V O'fvv'a.U A K><L / C-7l\ \^ I F REMTAL . PROPERT Y OWNE D BY : 

### ^

( . OWNER' S HAILMG ADDRESS : > , . 

## 9- 5 I D Q^fciv\7 \^^g^^,. - Qt^^A^ ^ 

# 1 —^ OWNER'STELEPHON E NUMBER HOME : J_ jWORK :

— « l l ^ 

## \0o f AG E O F HOME? : 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 ¥lfr m SUIN G SINC E 1S78 7 _ YE S N O NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OLD : NUMBE R O F OCCUPANTS ? YEAR S OL D AM D OLDE R NUMBE RO FCHILDRE N UNDE R7 YEAR S OL D WHO PLA Y M TH E YAR D FORS HOUR S O RMOR E PE RWEEK : C0P(|||)X ^ O RSPECIA L fMSTKUCnOMS : (I.E . DOGS . ENTR Y GATES . ETC. ) \ /

.- , c • w ' w 

# '' ' 

# yfj^ AufifQp y if^^u<OHMltN| ^ ^^^[i£nLi^ttii^im4s^tyAmi».]^.m..n^ ^ (•£iu<LA,4 ^ UA.C9eu5(e);w^cnpiaividestatiyfo t detenaiauigthenttdfotiei^pflnM,'0 1 fehboaagortakingaByrei^aaseaetion unde i thi s title , o r othenris t enfi»eii%th e ptovaon s ofth e title.' " '^

808 0 War d PartiMy . Sulf a 40 5 2S0 S N . 24* * Sireet . Suit e 30 8 424 2 MedlcM Olive . Suit e 425 0 Kama aCi^ . M O C411 4 Omaha . NMraeii a 6811 0 S m Antonio . T X 7822 9 PhOR C fill6)363-3703 Fax : (816)363^70 7 Phone : («02 ) S04-100 4 Fax : (402)504-100 5 Ptione : ^10 ) 822-058 8 Fax:(Z10)S79-CS7 7

## AS - BUILT DRAWIN G Jl ^ OMAHA LEAD SUPERFUND SITE OLS# : 3210 4 Dat e Excavated : 7/1S/20O S Dat e USEP A Signed-Off :

Name : .X>wu,v^^. . ^<iVV[^l< i Address : <2s^ h ^^c.^\ v Phone : /^n i - ^•^^-S.t^ q Tea mf Jl>.o t A | QVvvtAtt. ^ Sampl e Numbe r |gVP^S6p>c4-^zin M

6 7 Omah a Lea d SK e Sit e Sketc h

BVI D #J2l2l£> L Lea d Concentratio n .2f t D 

# I ^ '- J ppm ppm 11- 7 f l 3 ppm ppm ppm ppm ppm Date ; OT-lc-0 3 Nort h Ano w I K • nme:\^vnr ?

XR FCod e _^^DJ _ Conllrmatio n Sampl e f'Ye s a No t P PlYe s a No 9 1 <}(Ye s O No @ ftiYes a N o P CWe s Ye

s a • N o N

o g • Ye

s • N o •

E A = 21 9 PP M aSCRAP E Omah aLea dSite 4613 0 CONTRAC T # : E P - R7-07-0 6 / 000 4 PRUDEN T TECHNOLOGIES , INC .

# IRUDE K rECHNOLOGIES , mc . — 

# Propert y Statu s For m Address : 2.57 ^ Ej/ni^ ^ S f Date : 

## Phone : BVID : 32-10 ^ Plant s & Permanen t Landscapin g Item # O n Map Descriptio n an dLocatio n

Pre-Existin g Conditio n o f Structure s Does you r Basemen t hav e ahistory o f leaking ? Ye s —N o . . / 

### Item # Descriptio n & Locatio n O n Ma p tv\o^ ^ O^ULl( ^ C ^ A^evO ? w>a9JtLv^:A ^ ^t^ v l- o $>^, s 4 TOrv V ^Wt P , -

Property Owne r Pruden t Employe e Signature : Signature : ^ 808 0 War d Parkway , Suit e 40 5 5 N . 24' " Street , Suit e 30 8 424 2 IViedica l Drive , Suit e 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:(816)363-370 7 Fax : (402)504-100 5 Fax : (210)579-657 7Name : Dyjuyx ^ Pavwe^ U Omali a Lea d Sit e Adclress : cSS'^ D S-A/tw x"sV - Sit e SIcetc h Phone : ^r. 1 - M?;^-^Cq Q ^

^ J ) (Woua-'t-t: ^ Tea m ^>'^oU ^ ^Vvre^H ^ BVI D # Ti^H& M Sampl e Numbe r Lea d Concentratio n pp m (fl / * Z Z pp m pp m 1 1 1 ^ 1 3 pp m pp m pp m pp m Date : £l-tO-o 3 Nort h Arro w Time : \(f.'.a Q 

### < N

XR F Cod e 

# ^5D I Confirmatio n Sampl e ^'Ye s n N o ? 3 PiYe s n N o ^ 

### (J^Ye s • 

### N o g Stye s O N o P 

### O^ye s n N o [ ^ 

### Ye s • N o • 

### Yes • N o D

OmahaLea dSite 46130

## Prin t Preview Pag e 1 o f 1 Dougla s County-Omaha , N E

Pame l I D Owne r Nam e Pmpert y Addms s Cit y Zi p Owne r Addms s Owne r Addms s 2 Owne r City Owne r Stat e Owne r Zi p 210059000 0 BARFIEL D DWAYN E 257 0 EVAN S S T OMAH A 6811 1 257 0 EVAN S S T OtAAH A N E 6811 1 Sec-Twn Rn g Additio n Bloc k Lo t Lega l 1 Legal 2 Lega l 3 Legal 4 Tmasum r Websit e Un k Assesso r Websit e Lin k 09-15-1 3 REDICKS-CLARK-AD D 2 2 2 46.23X12 4

http://webapps.dotcomm.org:8080n"reasTax/faces/pages/taxinfo.jsp ? parc=210059000 0 htt p ://douglasne . mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R210059000 0 Disclaime rMa p an d parce l dat a ar e believe d t o b e accurate , bu t accuracyi s no t Ma p Scal e guaranteed . Tiii 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 inct i = 4 2 fee t appraisal , survey , o rfo rzonin g verification . 

## http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas%20County-Omah.. . 6/12/200 8

### R2100590000000 Ljp g (JPE G Image , 640x48 0 pixels ) http://douglasne.mapping-online.coin/assessdoc/Photos/29/R210059.. .



# £y/i^N ^ -^ f 

# ^55-7 0

lof l 7/2/200 8 9:3 1 A M

# ^w ^

^..-5gj5^3 ^ p*!^ } 7 7 

### '': ­ \\X \ V \\\• 

# il£-D I 

# iiiiiil j