SAID# : 2201 9 

### TRANSMITTA L O F OMAH ALEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R DATE : 1/1 5 ADDRESS : 360 8 MARC YS T REMEDIATIO N CONTRAaOR : PRUDEN T TECHNOLOGIES . INC . YEAR : 2011 ^ 

### SOI L REMEDIATIO N PROPERT YFIL E FOLDE R DOCUMENT S \i l PR E AN D POS T VIDE O O F PORPERT Y(DVD ) [ p EXECUTIV E SUMMAR Y EPA-PROVIDE D PROPERT YSKETC H SIGNE D ACCES S AGREEMEN TFOR SUBJE a PROPERT Y D SIGNE D ACCES S AGREEMENT(S ) FOR ADJACEN TPROPERT Y E l RESTORATIO N AGREEMEN T D SETTLEMEN TDOCUMENTS (I.E. , FOR DAMAG E O R TO REPLACE PLANTS , ETC. ) E l CONFIRMATIO N DAT A

• PHOTOGRAPH S I D AS-BUIL TSKETC H m SATISFACTOR YRESTORATIO N SIGNE D B YPROPERT YOWNE R

• PROPERT YCLOSE-OU TCHECKLIS T SIGNE D B YEP A D DESCRIPTIO N O F AREA S NOTMEETIN G RO D CLEANU P CRITERI A 0 1 UTILIT YCLEARANCE S

• PROPERT YINFORMATIO N FRO M DOUGLA S COUNT YASSESSOR'S OFFIC E D D D 

## 0/y \

^\tf>V ^ SIGNATUR E DAT E 3021857 4 Superfun dPROPERT Y SUMMAR Y Date : /15/201 0 Omah aLea dSit e Remedia l Actio n Contrac t U EP-R7-07-0 6 TO# l Mont hof : Propert y Address ; 360 8 MARC Y S T A . EXECUTIV ESUMMAR 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 GDATA/RESULTS : F l = 11 2 PP M @ 9";«AHiHHai k E A = 16 4 PP M @ SCRAP E(~1" ) ATTACHMENT S 1 ) Property 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 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 fma 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 ) BVI D numbe r 7 ) Othe r item s t o b e include din th e individua l property file , i f available , o r obtainedinclude : i ) Pre-excavatio n agreemen t detail s (i f an y ar e mad e withth e property owner ) ii ) Propert y Statu s For msigne db y property owne r iii ) Excavatio n digita l vide o in MPEG , WM V (Window s Medi aVideo ) o r SW F(Flas hPlayer ) forma t 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 .

TECHNOLOGIES . INC .Fin d Record Backfill :

Sampl e Area : 2201 9 - 360 8 MARC YS T Owner :

• Owne rOccupie d Owne rName : lOMAH AHOUSIN G ALTTWORTT Y Owne rAddressl : 

# I Owne rAddress2 : |54 0 S 2 7 S T City : State : Zi p Code : jOMAH A " " [N E |68105 - Owne rPhon e Altemat e Phone :

Contract : Contractor : |PRUDENT_2010_S Contrac t Optio n |BAS E Remediatio n Quer y] Lea d Remainin g Quer yI Propert yDamag e Quer y

Use rProvide d Owne rInformatio n Owne rName : 

# 1 Owne rAddress : 

# 1 City : 

# 1 State : 

# 1 Zi p Code : 

# 1 Owne rPhone : 

# 1 Alternat e Phone : 

## • 1

Assessment : Qualifyin g Grou p J46 6 Assessmen t Ma xXR F Valu e | 47 0 Resident : Residen t Name : iTtNANT S Propert yAddress : |360 8 MARC YST Zi p Code : |68105 - Residen t Phon eTECHNOUXSIES . INC . 

# EP A Propert y Clos e Ou t Propert y # : rt^T^ ^ 2 " 2 ^ I ^ Propert y Address : 5^^ ^ AV^tr^v ^ ^"h . Date/rime : Quad s Excavated : p i y- j Owner' s Name : <5h^*<^a . HOCOT>IAC J .«4M.1V^ ^ v Contracto r Group : Pruden t Technologies , Bmc , C i Excavatio n Genera l Ye s N o 1 .

I f necessarv , wer e lh e correct quadrant(s ) excavatedandrestored ? / 2 , I f accessary , wer e th e correct area s ofdri p zone excavate dan drestored ? / Gradin g Sodan dVegetatio n Ye s N o 1 .

Doe s the gradin g aroundthe perimete r o

f the hous e in excavate darea s generall y slop e awa y fro mth e house ? / " 2 .

Has sodbee n lai di n all area s tha t wer e excavated ? 

# y 3 .

Doe s th e sodappea r t

o be generally health y andgrowing ? (Onl y evaluat e i f inspecteda t a3 0 

# y da

y lime period) 4 .

Ar e soddedarea s generally finn an devenl y graded ? / ^ 5 .Ar c th e joint s betwee n the sodstrip s generall y tight ? (Onl y evaluat e i

f inspecte da t a3 0 da y lim e period) / 6 .Was the propert y grade dsuc htlia t wate r wil l no t pool o n tlie property ? 

# y 7 .

Wa s damag e t o landscaping or plan t material s avoided ? y ^ Gates , Fence s an dRetainin g WalJ s Yc 3 N o 1 D o gate s ope n an dclos e freely ? (Ifapplicable ) / ^ 2 .

Wer e al l gate s o r fence s taken down durin g restoratio n activitie s reinstalled ? (I f applicable ) 

# y 3 .

Was daiiiag e t o gate s or fence s avoided ? (I f applicable ) / 4 .Was damag e l o retainin g wall s avoided ? (Ifapplicable ) ^ Foundation , Sidin g an dGutter s Ye s N o 1 .

Wa s damag e t o th e siding o r trimavoided ? / 2 .Wa s damag e lo th e foundation avoided ? 

# y 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 ? 

# y f>

. Wa s damag e l o downspout s or downspou t extension s avoided ? / Sidewailt s an dDriveway s (Concrete ) Ye s N o 1 Wa s damag e l o dvivcwav surface s avoided ? 

### y ^ Wa s damag e t o walkwa y surface s avoided ?

### Owner s comments :

Inspectio n notes : 

# y />• " 

### ^y^ r



### Remova l andrestoratio n activate s complete includin g th e 30-da y so dwarranty : EP A Representativ e Q^*^-^ ^ ^Date: tittl nTHNOLOGIES , INC . 

### A S - BUIL T DRAWIN G 01.S # 2201 9 Dat e KxiavaU'd : 09/03/201 0 

### OMAH A LEA D SUPERFUN D SIT E I SEP A Signed-Of f Date :

Name ; _ Omah a Lea d Sit e Date : ^ 5 29-^' / Nort h Arro wf Address : Sit e Sketc h Time : 2'J< ' Phone : 

# f1

Team'^lln f /Ibyii-K.-- ^ (7ieS ) BVID #gZ^/ 9 XR F Cod e 

# 3&^s Sampl e Numbe r Lea d Concentratio n Confiimatio n Sampl e ^•Ye s a N o pp m 

# 'n o ^ pp m •f^Ye s n N o 3 ' & ''Ye s n N o n ­ pp m pp m «Ye s n N o S ^ pp m .71 - Ye s n N o Q pp m Ye s a N o • pp m N o • Ye s •

OmahaLea dSit e 4613 0 r.A = K)4I'I' M I I Scrap e CONTRAC T# : EP-S7-10-0 5 PRUDEN TTECHNOLOGIES , INC .

## Propert yCompletio n Agreemen t Thi s agreemen t document s th e complelio n o f removal activitie s pertbrme do n th e belo w liste dproperty . Th e property owner' s signatur e indicate s that th e property owne r i s satislle dwit hth e restoration o f th e subjec t property , an dthat n o item s ar e i n question , now , o r at an y tim e i n th e future , excludin g an y remainin g warraiity (3 0 day s total ) excep t thos e item s liste dbelow , i f any . Property ID : Propert yAddress : -^fepf t M.Q/fi^'gT T Owner ; Q y^^ ^

Hnoflr^ ^ A-tlA^^^'.4 y Phone ; ^ ^ ¥^^^^^0 0 % t.^ 1 '

' Restoratio n nem e i n Qusstion :

Item : /S/AI 4 ttem: ttem: Item : ttem: Item : Require d correction s t o complet e th e property :

^

^

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

Owner' s SignaMr eFRO M OMAH AHOUSIN G AUTHORIT V

40^^4-423 8 (MOH>JU L 2 6 201 0 10^ST . 10:20/No . 752338518 8 P 4 

# 7 7< '

'7.- - •s.';;':'^^^ - -V 

## Nl . y ilTiddnl T<i.iiii«liisiox , Inc . (PnidnD ) i n unde r coiilnic t wii hUn, ' Xj , S . Enviromnciv* ! Proiectio n Asenc y (EPA ) ID clea n u p liS4(l < i^O|U*minale dsaij< : a t aiiuntbt f orpropsitic K loc«(«< l i n Onialia . Nubnska , includin g tii e proi>cny locate da l ^66C . ^(ofLWiy . 'tl w EPA r«(|iioii x you r pennissionl o iillnw Prudeii l lop«rfori n * soi l clMiiupa l thi s |)rap«n y t o n«mov « l«a<Vi/QnliuntiiM«4 tioil B y ugninglhii i liMin . tl u properl y ovvne r (jtiu s permissio n t o Piudcn i t o pcrrorn i aotiv-iiic x rijbte dl o th e dcaiiu p includin g soi l .«Rinplin] & remova l ortead-conUntinnte d»iLan dr«M0ratio( i ofth e rercrencc dpn>p<ny . I t

yo

u li:iv><>aii y qitcMion s aliou i ilvnoi l olcaiui p plnnno dfor you r prop«ny , pleas e conuc t IVudisn l noiitli ofTice Jo t th e Omahti I^CAI I SH

o cleiiniip"ii t (Mi ) 773. \IVtl . Centfrt l qiidsnionx iibou i th e Omitlv. ! Jycu A Sil c clotui p ca n b c directe dU i Hi e r.P A Publi c liir<>Tin*lioi i CoiU«n » a l Wi ) 7.1 1 -30 4 J (SouthOnwih aoflke ) o r («02 ) 9 9 > -9S«.'» {Nort hOmah aoffice) . fVop*rty.\ce<p>«C;i:ini«dHy : Of^t,^4^^_ltj>J>'S7i\K..A3k ^ t.)e^C^^/ & 0\f<et!4o , J {Plca:i c Pifin i Nun* ) *

* ^ ^ I ' TSignaluro ) (Date ) PROPeRT YINFORMATIO N (T o l» ccomplt-tc d b yixsiden t imri/o rpropcrlj ' owne r• plras e prim ) RESIDEN T NAME : C»\r\^id^rx^'t^^ K Owne r s^^Jf ) RESIDEN TADDRESS : 

## 34o 9 t»t<ir< y ^ . ^V^mJ^ ^ Aj e dttOS ' I F RENTAL , PROPERT YOWNE D BY : O^^Jkt> . H-^ffgfyy ^ AoUt^^U ^ OWNER' S MAILIN G ADDRESS ; OWNER' S TELEPHON E NUMBE R • HOME : f N j ll ^

WORK : AG E O F HOME? : /Q O YEARS . HO W LON O HAV E YO U LIVE D HERE ? ^ if T YEARS . HA S TM E EXTERIO R BEE N PAINTE D O R COVERE D WIT H SIDIN G SINC E IB^S ? UK*vfe * ** [ N O NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OLD : O NUMBE R O F OCCUPANT S 7 YEAR S OL D AN O OLDE R



# - U NUMBE R O F CHILDRE N UNDE R 7 YEAR S OL O WH O PLA YI N TH E YAR D PO R 9 HOUR S O R MOR E PE R WEEK : COMMENT S O R SPECIA L INSTRUCTIONS : (IE . DOQS . ENTR YGATES , ETC. ) AlJTrlOWT Y I'O RI:,NVTRON.M]iS'r.\LR.ESI»(>Ni5K ACTIONS i rh * activitie s t o b e impUinenle db y 1-;P A unde r thi s atrccnicn l nr i pursuan t l o Scttioi i 10 4 oCCURCL. V 4 2 U S. C 'XO-l . EP.A' s rigt t olacccu ; l o Ih c propert y i s pfovUlc dfo r i n Sectio n in<l(t)0 r craCLA . 4 2 I.-..S . C i»6fi5fe) . whic hprovide * citti-y for "del<sntiinin s th * nee dTo r rcsporiK . o r isltoonlng o r liikii>j t an y fosponit e xctirai unde r ibi ^ title , o r otherwis e ent'orciii j th e pru % ifuott* o f U u liitc. " <08 0 War d Pflrkw;iy . suit e 40 5 560 0 S 1 0 S l 424 2 M«<iica l Drive , Suit e 425 0 Kjinia s City . M O 6411 4 OmiiJi.i . NtibrASk a 6810 7 S« n Anionio , T X 7822 9 PliQne ; (816 ) 363-370 3 Phone : (402 ) 723-118 8 Phone : rz 10 ) 822-958 8 FM : (S1« | 363.370 7 Hox : (402 ) 733-188 3 Fnx : (210 ) 679-$57 7FRO M OMAHAH0USIH( 3 AUTHORIT V

402^4-423 8 (FRI ) JU L 3 0 201 0 8^fST . 8:58/No . 752338521 1 P 3 FROM OMAH AHOUSIH e AUTHORITV 402-444-423 9 (MON)JU L 2 8 201 0 1O:21/$T.10:20/No.752338518 9 P 5



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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 Owne r City Owne r Stat e Owne r Zi p 164459000 0 OMAH A HOUSIN G AUTHORITY 360 8 MARC Y S T OMAH A 6810 5

54 0 S 2 7 S T OMAH A N E 6810 5 Additio n Bloc k Lo t Legal 1 Legal 2 Lega l 3 Legal 4 Acre s Treasure r Websit e Lin k Assesso r Websit e Lin k LUN APAR K 0 4 W45FTLTS3 & 45X10 0

0. 1 http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp ? parc=164459000 0 http://douglasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R164459000 0 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 6/14/201 0

28/17/201 0 ittp://www.dhon.org/irthinternet/DHO. . . Creat e Anothe rTicke t Bac k t o Irt h Inteme t Sen d Emai l 

### YOURTICKE T NUMBE RI S  2569423 . Origina l Cal l Date : 8/17/1 0 Time : 8:2 6 a m 

### op : SIVA1896 7 Wor k t o Begi n Date : 8/19/1 0 Time : 9:0 0 am State : N E County : DOUGLA S Address : 360 8 Street : MARC Y S T Twp : 15 NRng : 13 E Sect-Qtr : 20-SE,21-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Lea d Soi l Remediatio n Projec t Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)733-188 3 : UNSUR E CORNER S Company: PRUDEN T TECHNOLOGIE S Contac t Name : SIV AJAMPAM A Wor k Bein g Don e For : EP A Dept h o f Excavation : 6 F T Corne r Lot : N Involve s Tunnelin g o r Horizonta l Borin g : N BSHPCLK S CXCATV LEVEL 3 MUDO l 

### Servic e Are a BSHPCLK S NEBRASK A HEALT H SYSTE M

CXCATV CO X COMMUNICATIONS , IN C
LEVEL S COMMUNICATIONS , LEVEL S LL C Place : OMAHA

Phone : (402)733-118 8 Front : Y Rear : Y Explosives : N OMAHACO F 0PPDGPR 5 QLNNEI C 

### Utilit y Contac t Phon e Numbe r Typ e Day : 402552346 0 N A AH : 402552334 7 Emerg : 402559511 1 Day : 402934046 9 HEID I Ak : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 

## N A Alt : Emerg : 877366834 4 Day : 402504782 3 METROPOUTA N UTILITIE S MUDOl 

## SAND Y Ak : DISTRIC T Emerg : 402504797 0 dhon.org/irthinternet/.../MessageText.as. . 1/ 28/17/201 0 ttp:// www.dhon.org/irthinternet/DHO. , 

### OMAHACO F CIT Y O FOMAHA TRAFFICSEWE R ^Day : 402444719 7 RICH/TRAFFI C Ak : 402444516 1 Emerg : 402444516 0 0PPDGPR 5 OMAHA PUBLIC POWE R DISTRIC T EL M LOCATIN G Day : 406728934 3 Ak : 406207149 4 Emerg : 888728934 3 QLNNEI C QWES T LOCALNETWOR K EL M LOCATIN G Day : 406728934 3 AH : 406207149 4 Emerg : 888728934 3

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### ENVIRONMENTAL ENGINEERIN GAN D CONSTRUCTIO N TEOHMOuiens , m c 

### SOLUTION S 

## SIT E SAFT^T Y HAZAR D ANALYSI S ^-D^/C J 

# .3(PC) S 

# /^y^rc y 

# .7-7 V Addres s Excavatio n Date : 

# <y-y a 6-^ ^ Crew : — ^ Backfil l Date :



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## Driveway Sprinkle r Syste m ^ 

## Othe r Cre w Forema n Sit e Safet y Offic e Date : 

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5600S108 t 4Z« 2 Medica l Drive , Suit e 7250 iGay;Ma64ii 4 eiMa9lcae810 7 Sa n Antonio , T X 7822 9 Phone : (81 Q 363^3703 Phone : (402 ) 733-118 8 Phone : (2t0 ) 822-<958 8 I^K^IC ) 363^3707 ^ x : (4a2)733'1S8 3 l=ax : (210) 579-6577Fin d Recor d Remediatio n Quer y] Lea d Remainin g Query| Propert yDamag e Query| Backfill :

Sampl e Area : 2201 9 - 360 8 MARC YS T Owner : D Owne rOmipie d Owne rName : lOMAH AHOUSIN G AUTHORTT Y Owne rAddressl : 

# 1 Owne rAddressZ : j54 0 S 2 7 S T City : State : Zi p Code : JOMAH A |N E [68105 - Owne rPhon e Alternat e Phone : 1C402 ) 444-690 0
Contract : Contractor : JPRUDENT_2010_ S Contrac t Optio n [BAS I Use rProvide d Owne rInformatio n Owne rName : ! Owne rAddress : 

# r City : State : Zi p Code : 

# '!— I Owne rPhone : Alternat e Phone :

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# I