### PROPERT Y SUMMARY Date : 10/30/200 7 Omah aLea dSite Remedia l Actio n Contrac t #EP-R7-07-0 6 Mont h of : Octobe r Propert y Address : 161 8 Manderso n 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 Informatio n : Brick s i n F l - 25 5 @ scrap e CONFIRMATIO N SAMPLIN G DATA/RESULTS : Fl-55@6 " E l - 4 7 @ 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 lef t behin darea s vi ) Contracto r identificatio n iii ) Propert y addres s vii ) Date 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 . 4028437 4 

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## 3273 8 Extertb rPaint Nort h Arro w 

### Omah a Lead Sit e Owne rName : CHARLE S STEWAR T Q Goo d 

### Sit e Sketc h Address : 161 9 MANDERSO N S T

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### Lea d Sit e Exterfo rPain t Nort h Arro w Owne rName : CHARLE S STEWAR T f j Goo d 

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## environmenta l samplin g an d to remov e lead-contaminate d soi l ProtJea i Tec&aoiogies , Lac . (Pradlegrf ) is uada r contrac t wis h til e U. S. Eavkoajmaaslial ProtedioE i Ageac y (EPA) to des s ug > lead-coatamaaste dsoil s at amember of propertie s iocate d iaOmaha , Nebraska , kdudsffl g {foe property loceds d at ) ^V^ iVlAK^,^ . c» ^ SU-- . Hi e EPA request s you ? pemnSSiOff iiS aliu w rsuuau : tu jpedbm S aSoi l CiSeSis p at {Jg S pfufJEst yto femOV e iead-COmamb^tfi dSuil . By sigaiffl g (Sa s fbi-m . &ae a-oaen faai s i y owiaa

owiaaf gfa a easissioff l to Pmcles t to jparfoinz H aciaviiie s relate d to cleaai^ ) iiidu^ia g soi l saasoifflg , s-ee&ova l of iead!-co2Hi£inras!atedsoil , sa drestmrs&o a of &e refercsice d isafl g iJo e o'^saeir'ii sigfijate e oaSias fosiaj , PiiMJaa t Tecfcaologies , lac . wai l cmiiac t &e owssc ? (ea dresidaate ) wstia aife s aex * fe w week s to coorfeaft e perforasEsic e fe e work . If

yo u hav e any ojjestiojs s abou i lia e soi l deaTM^ » gjlaamie d fiis r you ? p'operiy , pleas e cosaiac t Pmdast' s AdSmanisteativ e Cler k

for &aOaasfe s Lea dSit e deasm^ , Ms . Cwdi c Hkid sat (402 ) 504-1004 . Genera l question s abou i Jii e Osmih aLea dSiie deaiaaig * cts a be sSffecSad l to &e EPA (402 ) 731-304 5 (sou & OmE^i aoffice ) oi r (402 ) ^91-958 3 (aiosA Ornat e Propsr4 y Acces s 

### Owoe r SigBatase : (Dnte )

8T V DKKFORGflATBOK I (T obe coEijplcAe a &y reads ds^ifl/o r prffigisi j JCTIIET- QJwna r RESIOEMTfiDDRESS : IF REMTOL . PROPERT Y O^tJE D BY : OTHER' S OAILCJ GADDRESS ; OWMER'STELEPHOMEtJUnBER-HOdE : f^tTl i ^-f.f l '" AG E OF (J\ l YEARS . HO W LOM S MA»J E HERE ? HAS TH E EKTERIO R SEE M PAINTE D OR COVERE D WJT H SOJIM G SStJC E 1S78 7 HO HUC31SE R ©F OCCUPANT S UMDE R 7 YEAR S OLD : /^) HUKBEC l ©rOCCUPAMTS 7 YEAtl S OL D ACJ O OLDE R { MUC3BE R OF CHILDRE N UCJDE R 7 YEAR S OL D WH O PLA Y

C3 TH E YAR D FO R 5 HOUR SOR COR E PE R WEEK : COC3UEMT S OR SPECIA L IHSTRUCT10MS : (I.E . DOGS . EMTR Y GATES . ETC. )
AUTHORIT Y FO R ENVIRONMENTA LRESPONS E ACTIONS : Th e activitie s to be implernerte d by EP A under thi s agreemen t ar e pursuan t to Sectis i 104 of CERCLA,42U.S.C . 9504 . EPA'srighic f acces s to th e propert y

is provide dfo r in Sectio n 104(e ) of CERCLA , 42 U.S . C 9605(e) , whic h provide s entr y fear "deteminin g th e nes dfo r response , cr choosin gor tailin g any respons e actio n unde r thi s title , or cIh£T,?is s enforcin g th e provision s of th e title. "

### _ AgreenAH o allowaccesst o ©mah a Lea d ~ / $fif a vth e proWty i n orde rt o conduc t Sit e Remedia l */\?K ? ? environmenta l samplin g an d t o remov e lead-contaminate d soi l Pruden t Technologies , Inc . (Prudent ) i s unde r contrac t wit h & e U . S . Environmental Rotedso aAgenc y (EPA) t o clea n up lead-contaminate dsoil s a t anumber , o f propertie s locate di n Omeha , Nebraska , includin g fo e property locate dat /%/ y /fletir\<J&rSor t ST T Th e EP A request s you r permissio n t o allo w Pruden t t o performasoi l cleanu p a t thi s properl y t o remov e lead-contaminate dsoi l B y signin g Shi s form , th e property owne r grant s permissio n t o Pruden t t o perfor mactivitie s relate dt o th e cleanu p iadudiag soi l s&npliag , \emov& I o f lead-cGiitamiQated ! soil , ga df esto f atio s o f fe e f efereoce d property . Afte r obtainin g th e owner' s signatur e o n thi s form , Pruden t Technologies . Inc . will contac t (h e property owae r (eadresioeife ) vnmmm anex t fe w week s i n cooromar apeibfoaeac e m awork . I f

yo u hav e an y question s abou t di e soi l cleanup planne dfo r you ? property , pleas e contac t Rudent' s Admiuisfrativ e Cl&r k

fo r fo e Omah aLea dSit e cleanup , Ms . Cyndi e Hind s a t (402 ) 504-1004 . General question s abou t th e Omah aLeadSit e cleanup ca n b e directe di n th e EPA Publi c Informatio n Center s a t (402) 731-3045 (souf e Omah aoffice ) or (402 ) 991-958 3 (norf e Omah aoffice) . Property Acces s Grante dBy : C L (Phaa ? PriniNnm» ) 

### r

# n / ^r i Property Owner Signature: ( (Date ) 

### PROPERT Y (T o b e complete db y readent and/o r property osaa " - plea s priat ) RESQEMTNAOE : _ gpwne f Qente r RESDEN T ADDRESS :

R E WTOL . PROPERT Y OWNE D BY : 0^ 1

GOFER' S TELEPHON E NUMBE R -KOBE : fe ? \ 4(5^ " ^^- ^ WORK : j j 

### AGEOFHOHET : < YEARS . HOWLOM G HAV E YO U LIVE D H E RE ?

_YEARS . HA S TH E EXTERtORBEEHPAMTEDORCOVEREDWfTHStDMGSIHC E 1978 ? _ YE S NUC3BE R O F OCCUPANT S UND E R 7 YEAR S OLD : % Q MUC3BE R O F OCCUPANT S 7 YEAR S OL D AM D OLD E R c3 . 

### MUC33E R O F CHILDRE N UMDE R 7 YEAR S OL D WH O PLAYM TH E YAR D FO R 5 HOUR S O R HOR E PE R WSEK : COE3t3EMT S O R SPECIA L CdSTRUCTOMS : (LE.OOGS.EHTR YGATES . AUTHORIT Y FO RENVIRONMENTA LRESPONS EACTIONS : Th e activitie s to b e implemente db y EP A under thi s agreemen t ar e pursuant t

o Sectio n 104 o f CERCLA , 4 2 U.S.C . 9604 . EPA' s righ t o f acces s t o the propert y i s provide dfo r in Section 104<e ) o f CERCLA , 4 2 U.S . C 9o"05(e) , whic hprovide s entr y fo r "determinin g the needfo r response , or choosin g or takin g any respons e actio n unde r thi s title , or otherwis e enforcin g the provision s o f the title "

# &EHV EP A Propert y Clos e Ou t Propert y # : 3273 9 Propert y Address : /f/ 9 f1<**oe*s<>» Date/Time : /O/3O/O ? Owner' s Name : Chntte t s-H*t**r Quad s Excavated : 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 away fro mth e house ? 

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

### * / 3 .

Doe s th e so dappea r to b e generall y healthy an dgrowing ? (Onl y evaluate i f inspecte da t a3 0 day tim e period ) * * 4 .Ar e sodde darea s generall y firman devenl y graded ? IS 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 tim e period ) , / 6 .

Wa s th e property grade dsuc h tha t wate r wil l no t poo l o n th e property ? S 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 n an dclos e freely ? (I f applicable ) 

### •­ 2 .

Were 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 ) •" 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 ? 

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

### S 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 ? 

### ^ 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 ? 

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

### Owner s comments :

Inspectio n notes :



## Removal an drestoratio n activate s complete includin g th e 30-day so dwarranty : EP A Representativ e fl** . & ~ Date :

## 3273 8 

## A J Omah a Lea d Site Exteifo rPain t Nort h Arro w Ovu.e rName : CHARLE S STEWAR T Q Goo d / 

### Sit e Sketc h Address : 161 9 MANDERSO N S T Phone : H : W : 

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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 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 h th 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 n so dgrowthguarantee ) excep t thos e item s liste dbelow , 

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