### PROPERT Y SUMMARY Date : 10/03/2007 Omah aLea dSite Remedia l Actio n Contrac t #EP-R7-07-0 6 Mont hof : Octobe r Propert y Address ; 190 3 Lair dS t A . EXECUTIV E SUMMARY A. I Issue s Encountered : Ma p Erro r o n misse dare ai n B l sample dan dteste da t belo w threshold . 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 : CONFIRMATIO N SAMPLIN G DATA/RESULTS : Dl-110@13 " 

### B 2 - 9 5 @ 4 " F 2 - 19 5 @ 4 " Easemen t - 9 9 @ 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 sketch
i ) Shal l includ e fina l lea dlevel s v ) Legen d ii ) Contaminatio n left 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 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 .

TECHNOLOGIES , INC .•• 

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### t e Owne rName : JAME S R DORSE Y 

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## Agreemen t t o allo wacces s t o Omah a Lea d th e propertyi n orde rt o conduct Sit e Remedia l environmenta l samplin g an d t o 

## Actio n remov e lead-contaminate d soi l Prudent Technologies , Inc . (Prudent ) i s under contrac t wit hth e U . S . Environmenta l Protectio n Agenc y (EPA) to dean up lead-contaminate dsoil s a t anumber o f propertie s locate di n Omaha , Nebraska , including th e property locate da t jgjft. % | otfr ^ g^l
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_ . Th e EP A request s you r permission to allo w Prudent to performasoi l cleanup a t thi s propert y to remov e lead-contaminate dsoil . B y signing thi s form , th e propert y owner grant s permissio n t o Prudent t o performactivitie s relate dt o th e cleanu p includin g soi l sampling , removal o f lead-contaminate dsoil , an drestoratio n o f me reference d property . Afte r obtainin g th e owner' s signatur e o n thi s form , Prudent Technologies , Inc . will contac t th e propert y owne r (an dresidents ) withi n th e next fe w week s to coordinat e performanc e th e work . I f

yo u hav e an y question s abou t th e soi l cleanup planne dfo r you r property , pleas e contac t Prudent ' s Administrativ e Cler k

for th e Omah aLeadSit e cleanup , Ms . Cyndi e Hind s a t (402) 504-1004 . General question s abou t th e Omah aLea dSit e cleanu p can b e directe dto th e EPA Publi c Informatio n Center s at (402 ) 731-3045 (sout hOmah aoffice ) or (402 ) 991-958 3 (nort hOmah aoffice) . Propert y Acces s Grante dBy : f t S - ^ A (P]»u«PiinlNHJB» ) 

### Propert y Owner Signature : (^Signature ) (Dat« ) 

### PROPERT Y INFORMATIO N
, (T o b e completedb y resident and/o r property owner - pleas e print) RESIDEN TNAME : . 

### e- U Qente r RESIDEN T ADDRESS : LdJV J * " I F RENTAL . PROPERTY OWNE D BY : OWNER' S HAILIN G ADDRESS : | ^ Q < % Q TY) ^ Uf l £ & \ \ D OWNER' S TELEPHON E NUMBER-HOME : l~\*5\ ~ P WORK : J I AG E O F HOME? : ^f>" ^ YEARS . HO W LON G HAV E YO U LIVE D HERE ? S o YEARS . HAS TH E EXTERIO R BEE N PAINTE D O R COVERE D WITH SIDIN G SINC E 1378 ? __\s^it S N O NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OLD : ONUBBE R O F OCCUPANTS ? YEAR S OL D AN D OLDE R 2 - NUHBE R O F CHILDRE N UNDE R 7 YEAR S OL D WH O PLA Y « TH E YAR D FO R S HOUR S O R HOR E PE R WEEK : O COMMENT S O R SPECIA L INSTRUCTIONS : (I.E . DOGS . ENTR Y GATES . ETC. ) 

### AUTHORIT Y FO RENVIRONMENTA LRESPONS EACTIONS ^ Th e activitie s to b e implemente db y EPA unde r thi s agreemen t ar e pursuant t

o Section 104 o f CERCLA , 42U.S.C . 9604 . EPA'srigh t o f acces s t o the propert y i s provide dfc r i nSectio n104(e) o f CERCLA , 4 2 U.S . C 9605(e) , whic hprovide s entr y fo r "determinin g th e nee dfa
­ response , o r choosing o r takin g any respons e actio nunde r thi s title , o r otherwis e enforcin g th e provision s o f th e titlo. "

# &EP A EP A Propert y Clos e Ou t Propert y # : 5 Propert y Address : /90 3 Lf)>ff O Date/Time : Owner' s Name : JRme s Oaxft j Quad s Excavated : 

### a * * Contracto r Grou p Pruden t Teonnologie s Excavatio n Genera l Ye s N o 1 .

I f necessary , wer e th e correc t quadrants ) 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 awa y fro mth e house ? 

### >/ 2 . Ha s so dbee n lai di n al 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 dat a3 0 da y tim e period ) iS 

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

## ^ 5 . Ar e th e joint s betwee n th e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 da y tim e period ) 

## • s 6 . Wa s th e propert y grade dsuc hthat water wil l no t poo l o n th e property ? 

## S 1 . 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 .Wer e 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 to 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 ? 

### < / 2 .Wa s damag e t o th e foundatio n avoided ? 

### i S 3 .Wa s damag e to window s avoided ? L / 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 ? 

### tX 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 to walkway surface s avoided ? 

### I /

## Owner s comments :

Inspectio n notes :



# ' ; SMT V ^ rh ^ D K l 5 ff



## Remova l an drestoratio n activate s complet e includin g th e 30-day so dwarranty : EP A Representativ e Q n/f t 

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### Omah a Lea d Site Owne rName : JAME S >E Y 

### Site Sketc h Address : 190 3 LAIR D S T Poo r Phone : H . 402-451-0490 W : No t paint Sampl e Numbe r Lea d Concentratio n Sampl e Collecte d LA B Rrm : mple s Collected RYASCPXA-3324 6 D Date : 6 » 1 RYBSCPXA-33246 

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Omah aLea dSit e 4613 0

### TECHNOLOGIES , INC . ENVIRONMENTA L& CONSTRUCTIO N 

### SERVICE S 

# MAP ERRO RREPOR T FOR M Propert y Address :

BVTD ; Description o f th e Ma p Error . "Tfan* , & a . jzJ-n p /y f <s,r«s s a n

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## Date o f th e Repor t to EPA : Metho do f Reportin g (circle one) : Phon e cal l E-mai l Met wit hEPA P O Other Metho d Description o n ho w the erro r wa s resolved ; tiJi'{ j i f

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Member 808 0 War dParkway , Suite 40 5 250 5 N . 2< T street . Suit e 30 8 424 2 Medical Drive , Suit s 4260 Kansa s City , M O 6411 4 Omaha , Nebrask a6811 0 Sa n Antonio , TX 78229 Phone : (816 ) 363^70 3 Phone : (402)604-1004 Phone : (210)822458 8 r». - min i tt*.aTn7 Fax : (402 ) 504-100 5 Fax : (210 ) S79-6S77

### I 

# SEP A 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 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 warranty (3 0 day s total ) excep t thos e item s liste dbelow , i f any . Propert y ID : ^2 , ^ !Zj v 4'Vj ' Propert y Address : \ Q Q - ^ N_£ > 

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### I I agre e restoratio n i s completed , excep t a s note d above . LJ I d o no t agre e restoratio n i s complete d


# 7 /Owner' s Signatur e Dat e

### Prin t Previe w Pag e 1 o f 1 

## 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 070199000 0 DORSE Y JAME S R 190 3 LAIR D S T OMAH A 6811 0 190 3 LAIR D S T OMAH A N E 6811 0 Sec-Twn-Rn g Owne r Addres s Additio n Bloc k Lo t Lega l 1 Lega l 2 Lega l 3 Lega l 4 Assesso r Websit e Lin k 03-15-1 3
BOULEVAR D PAR KAD D 1 3 1 N80F T & N 8 0 E 3 F TLO T2 5 0 X 8 0
http://douglasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R070 1 99000 0 Disclaimer . Ma p an d parce l dat a ar e believe d t o b e accurate , bu t accurac yi s no t Ma p Scal e guaranteed . Thi 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 inc h = 2 4 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 8/1/200 7

### Pag e 1 o f 2

Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l 

### YOU RTICKE T NUMBE RI S 1871224 . Origina l Cal l Date : 8/22/0 7 Time : 10:3 1 amOp : CYNDIE1896 7 Wor k t o Begi n Date : 8/24/0 7 Time : 11:0 0 a m State : NE County : DOUGLAS Place : OMAH A Address : 190 3 Street : LAIRD S T Twp : 15 NRng : 13 E Sect-Qtr : 03-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : soi l excavatio n - lea d remediatio n Locatio n o f Work : LOCAT E ENTIRE PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)504-100 5 Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : CYNDI E Phone : (402)504-100 4 Wor k Bein g Don e For : EPA Dept h o f Excavation : 14 " Corne r Lot : NFront : NRear : N Involve s Tunneling o r Horizonta l Borin g : NExplosives : N CXCAT V

MAGELLA NMUD0 1 OMAHACO F OPPDGPR 5 QLNNE1 C Servic e Are aContac t Phon e Numbe r Utilit y Typ e 

### Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 

### Emerg : 402932975 7 Day : 918574709 8 MAGELLA N MAGELLA N MIDSTREA M PARTNER S L P TONY A Alt : 

### Emerg : 918574709 8 Day : 402504782 3 MUDO l METROPOLITA N UTILITIE S DISTRIC T EDWIN A Alt : 

### Emerg : 402504794 6 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE RRO N Alt : 402444516 1 

### Emerg : 402444516 0 Day : 406728934 3 http://vvww.dhon.org/irthintemet/DHONNoticeCreatiori/MessageText.asp?ret=<RESULTS .. . 8/22/200 7

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OPPDGPR 5 OMAH A PUBLI C POWE RDISTRIC T N A 

### Alt : Emerg : 888728934 3 QLNNE1 C QWES T LOCA LNETWOR K N A 

## Day : 

## Alt : 406728934 3 Emerg : 888728934 3

http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS .. . 8/22/200 7Fin d Recor d Clea n U p Quer y Lead Remainin g Quer yPropert yDamag e Quer y

D Owne rOccupie d Owne rName : 

## IDORSEYJAMES R Owne rAddres s 1 : Owne rAddress Z 1190 3 LAIR D S T City : State : Zi p Cod e |OMAH A N E J6811 0 Owne rPhone : Alternat e Phone : 

### |(402 ) 451-049 0 Residen t Name : 

## IDORSEYJAMES R JPRUDENT200 7 Propert yAddress : Group : 1190 3 LAIR D S T Zi p Code : J6811 0 Residen t Phon e Qualifyin g Grou p 80 0 Assessmen t XR F Date : Assessmen t MaxXR F va u e