PROPERT Y SUMMAR Y Date : 12/12/200 7 Omah aLea dSit e Remedia l Actio n Contrac t #EP-R7-07-0 6 Mont hof : Decembe r Propert y Address : 243 1 Patric k Av A . EXECUTIV E SUMMAR Y A. 1 Issue s Encountered : A. 2 Issue s Resolved : A, 3 Uniqu e Findings : A. 4 Othe r Relevan t Information : CONFIRMATIO N SAMPLIN GDATA/RESULTS : F l - 18 3 @ 8 " B l - 15 5 @ 8 " B 2 - 22 2 @ 8 " E l - 19 4 @ scrap e 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 digital 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 ) Property addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e include di n th e individual property file , i f available , o r obtaine dinclude : i ) Pre-excavatio n agreemen t detail s (i f any ar e mad e wit hth e property owner ) ii ) Excavatio n digita l vide o in MPEG , WMV (Window s Medi aVideo ) o r SW F(Flas hPlayer ) forma t and/o r photograph s iii ) Signe dfor mverifyin g satisfactory restoratio n iv ) Descriptio n o f area s no t meedn g Interi mRO D cleanu p criteria .



# n- 0 4029336 0 TECHNOLOGIES , INC . Superfun d

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## 2743 1 Exterio rPain t North Arro w 

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### Bo(M:iM ^ RQZ3CPXA'g740 1 6 2 Date : fJ-IH-Q- J RPgOOPXA'g740 1 Pf - Time : Pt A Staff : MAu / Numbe ro f Sample s = | U Legend : F l = Fron t Left , F 2 = Fron t Right , B 1 = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone . G Z = Garden , P Z = Pla y A

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vth e propertyi n orde rt o conduc t Sit e Remedia l |^ \^W ? ^ environmental sampling and t o Aetio n | V«MSvwr;^ ' remove lead-contaminate d soi l Rudes t Tedmobgies , Inc . (Rndcnl ^ t s uode rconfrac t vn h At e U . S . EnvinnmeBtB l Rotedio n Agenc y (EPA ) t o dea n n p lead-coatamtiiate d soil s a t a mtoiba ro f propertie s locate d i n OknAa , Ndiraska , indndii ^ di e properl yloorte d a t O.y^'X K'PaV-nrJ f A.iiu . Th e EP Areqpiest e you r penuissio n t B dlowRudenttDperfbiiuasoildeanu p a t fliis propert yt o remov e lead-cosfaBunatedsoi L B ysignin g dn s fiiim,diepnyertyowne rgrant s penuissio n t o Audentf o perfim u adivilie s relate d t o flic deann p indudtn g soi l satipling , renrav d o f lead-oontaaunate d soil , en d resforalio n o f di e reference d property . Afla robtainin g di e owner' s signatnr e o n du s fium, Rudcn t Tedmobgies , fac. wil l contac t di e propert yowne r(an d residents ) widii n di e nex t fe ww e A s t o coordinat e perftrtnanc e di e wor k Ifyo u hav e an yqnestioti s diontdi e soi l deaim p planne d fo ryou rpnyeriy , pleas e contac t Ruden f s Adininistrtfiv e Cled cfb rdi e ObuhaLea d Sit e deanup , Ms . Cyndi e Btad s a t (402 ) 304-1004 . Genera l qjueslion s dMiu t di e Omdi a Lea d Sit e deanu p ca n b e dtrecte d to di e EP ABibli cItifoimafio n Centers a t (402 ) 731-304 5 (sond i Onuli a office ) o r(402 ) 991-958 3 (nord i Otaiah a offic^ . Rupert y Owne r Signatore :

PROPERT Y nFORMATIO N (T

o b e convkte dby restdeo t andt e propst y o«« r - pka s prnt ) X RESOENTNAME : ^/jirCA^l T Cy>J ' QJwna rQente r \ Q RESPEilTADDRESS : ^/J ^ 

# T W REHTAL.PROPERI Y OWNE O BY : U OWMER'SIIABJIGAOORESS ; llli ^

ttl^C<^^ ^ 1 ^ V OWMER'SIELEPHOII E HIHiaER-HOIIE : jf^^SX^ A'«^^< ^

WORK: j L V AceoPHOiiET : A ) //^uaa . HOWLOM C HAV E YO U LB/E D HERE ? ^A^ ^

YEARS . yHA S TH E EXTERIOR BEE N PAM1E D O R COVERE D WIT H SDH 6 SMC E 1878 7 YE S M O Af^ ^ y ~ NUMK R O F OCCUPANT S UNDER 7 YEAR S OLD : NUMBE R O F OCCUPANT S 7 YEAR S OL D AN D OLDE R A^/ ^ yNUMKR<H>CHn.DRENUNDER7YEARSOL0WHOPLAYilTHEYAR0FORSHOURS0RII0REPER1MEER : /^ ( A yCOUKNT S O R SPECIALBISTRUCnONS : (lE.DOGS.ENTRYGATES.ETC ^

(/ACv 4 ^ T~S¥9F l AUTHC»UT 7 FO RENVIRONMENTA L RESPONS E ACTIONS ; Th e activitie s t o b e implementedb y SP A unde r dii s agreemen t ar

e pursuan t t o Section 10 4 ofCERCLA , 4 2 US.C . 9604 . EPA'sri^ofaoces&tothepicpeityi s providedfor i n Sectic n 104(e ) o f CSRCLA , 4 2 US . C 9S0S(e) ^ which provide s en& y fir "detenninin g di e needfb r re^Kuse , o r ciioasingc r takin g aiyie^ciiseaitic n under ddstid ^ or odterwiseenlbxin g di e provision s of dt e tiUa '

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V ttiepropertyi n orde rt o conduc t Sit e Remedia l \ %)^W ? $ environmenta l samplin g an d to Atflio n V*«NVw«*;/ ' remov e lead-contaminated soi l Rudcn t Tedmobgies , Inc . (Ruden ^ i s unde r ooidrac t wid i di e U . S . EnviranBenta l Rotedio n Agenc y iPfJ ^ t o dea n q p lead-amtaninatB dsoil s a t amuribc r o f pnqjiertie s locate di n OknAa , Ndua ^ indndin g di e propert y locate da t . Ih e EP A reqpes b you r penuissio n to auowRudentt o periotn i asoi l dean y a t flns propert y to raniov e lead-contaminate dsoi L B y "B*'*" c ftfs rann, tfiepraperty owne r granf e pcnnissio n to Rudentt o pcrni moctivilie s rdale dto di e deanq p todBdtu g soi l sanqibig , remov do f lead-contantDate dsoil , an drestoralio B o f di e reftrence d pfopeity . Affce r dbtanin g di e owner' s "S""'*^* * o n du s rami, RndoB t Tedmobgies , LB C wi u contac t di e propert y owne r (andresidenfe ) witfu n th e nex t fb w week s to coordbnaf e perfbrmanc e di e work . Ifyo u hov e an y (pieslioii s abou t di e soi l deanu p planne dfb r you r property , pleas e contac t Ruden f s Adninisfradv e Cled i fbr di e QnaluLea dSit e deam^ , Vs . Cyndi e EEnd s a t (402 ) S04-1004 . Genera l qiieslion s dbou t di e Omah aLea dSit e doim p ca n b e iKrecte dto di e EP A Rdilicbifeimatio n Center s a t (402 ) 731-304 5 (sond i Otauh aoffice ) o r (402 ) 991-958 3 (nord i Qnah aoffic0 . Rupert y Acces s Grante dBy : 0>lsa»MaNaw ) Ropert y Owne r Signatore : 

### PROPERTYINFORMATIO N (T

o b e caB^lBte dby Tcddn t asdt e propcity OBBO'—phB B prto Q RESOENTNAIK : V g t C r...* ^ [jo)r - QXvnt f Qente r 

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^^r > /W^e_ : 0\^^-^>X. ^ KM . ^^1 1 O V REN1AL.PR0PER1 V OVWIE D BY : ' ' OIWIER'BMAmQADDRESS : \VV>f>.t f V U cA^U^y\j LRS ) (^•\^^^^KXU> ^ K ^ - ^ ' OWNER'SlElCPHON E NUaBSR-HOME : i 1 .^_«- . WORN : i \ AeEOrNOMET : YEARS . HOWflON G HAV E YO U UWE D HERE ? YEARS . HASn S EXIBRIORBEEMPAIITCDORGOVEReomniSDIIOSMC e 1878 ? .YE S N O NUSBE RO F0CCUMB1 8 UNDE Rr YEAR S OLD : NUME RO FOGCtVAMI S I YEAR S OL O AN D OLDE R NUHBEROFCHOJIRENUNDERTYeARSeLOWHOPLAYHIIMEYAROFORSHOURSORaORePeRWeER : CO—EN WOROTEOM.USTRUCIIDNS : (IE.D068.BNfmYeAtE8.eTC ^ AUTHCHUTYFORENVIRONIiENTALRESPONSBACTIONS : Ib e activitie s t o beinplanoitedb r SPAuodordii s agpeemen t ar e pursuan t t o Sectt m10 4 of CERCZA , 4 2 U.S. C 9d04 . EPA' s il ^ o f acces s t o dieptapeit y i s providedfor i nSeoifln 104(e) tf CERCLA , 4 2 US . C 6d05(e X whichprovide s eati y fir "detaminin g d » needfinreqpoBse^ o r duxsin g or taldn g oi ^ req^ons e action under dii s tide ^ c r odienris e enfiicin g di e p title"

## 2743 1 

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### Omah a Lea d Sit e Samplin g Address : 243 1 PATRIC KAV 

### Sit e SIcetc h • Goo d • Poo r Phone : H : (402)234-282 0 ALT : \ ^

Not pain t Sampl e Numbe r Lea d Concentratio n Sampl e Collecte d LA B Firm : Sample s Collecte d RYASCPXA-2743 1 F l pp m 

## D Date : 

### 7 -12-67 - RYBSCPXA-2743 1 F 2 

# J_a ^ pp m 

## D Time : /f).'/. ? ^uo ^ RYCSCPXA-2743 1 RYDSCPXA-2743 1 B 1 8 2 pp m pp m 

## D D Sample s Analyze d RDg9CPXA-2740 1 B Z pp m 

## D D XR F Unit : &SH2 . Book:/fi y RQZOCPXA"2743 1 Sf i pp m 

## D D Date : S-IH-0 7 RPZ0Cn)(A-2743 1 P? - pp m 

## D Time : 

### ?f A Staff : M.S W Numbe ro f Sample s = ! • Legend : F l = Fron t Left , F 2 = Fron t Right , B 1 = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Pla y Al l quadrant s ar e a&jVjew ^ fro m th e street , facin g propert y 

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# SER( V EP A Propert y Clos e Ou t Propert y #:^7yJ / P<,htcK/f»t^ , Propert y Address : 5Vj ; P,/,<tlt fl«»c Date/Time : ii/Aifo f Owner' s Name : fftammo ttoMt o Quad s Excavated : f f m . _ Contracto r Grou p Pruden t Technologie s Excavatio n Genera l 1 .

If necessary , wer e the correct qiia(irant(s ) excavatedan drestored ? 2 .

Ifnecessary , wer e the correct area s ofdri p zone excavatedandrestored ? Gradin g So dan dVegetatio n 1 .

Doe s th e grading aroundthe perimete r o f the hous e in excavatedarea s generall y slop e awa y fromthe house ? 2 .

Has so dbeen lai din all area s tha t wer e excavated ? 3 .

Doe s the so dappea r t o b e generall y heahh y andgrowing ? (Onl y evaluat e if inspecteda t a3 0 da

y tim e period) 4 .

Ar e soddedarea s generall y fir man devenl y graded ? 5 .Ar e th e joint s betwee n the sodstrip s generall y tight ? (Onl y evaluat e if inspecteda t a3 0 da y tim e period) 6 .Wa s the propert y gradedsuc htha t wate r will no t poo l o n th e property ? 7 .

Was damage to landscaping o r plan t material s avoided ? Gates , Fence s an dRetainin g Wail s 1 .D o gate s ope n andclos e freely? (If applicable ) 2 .

Wer e all gate s or fence s taken dow n during restoration activitie s reinstalled ? (If applicable ) 3 .

Wa s damage t o gate s o r fence s avoided ? (If applicable ) 4 .

Wa s damage to retaining wall s avoided ? (If applicable ) Foundation , Sidin g an dGutter s 1 .Was damag e to the siding o r tri mavoided ? 2 .

Wa s damage to the foundation avoided ? 3 .

Wa s damage t o window s avoided ? 4 .

Was damage t o window s o r doo r screen s avoided ? 5 .Wa s damage t o downspouts o r downspou t extension s avoided ? Sidewalk s an dDriveway s (Concrete ) 1 .

Wa s damage t o drivewa y surface s avoided ? 2 .

Wa s damage t o walkwa y surface s a;Voided ? Ye s No • 

### J Ye s N o 

### y y / • y t / 

### • Ye s N o / 

### y • 

## y Ye s No



## y 

# y / 

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### Owner s comments :

Inspectio n notes :

Remova l andrestoratio n activate s complet e including th e 30-da y sodwarranty : EP A Representativ e J^JL ^ Date : iilxifp y y

# «ER \ Propert yCompletio n Agreemen t Thi s agreemen t document s th e completion of remova l activitie s performed on th e belo w liste dproperty . Th e propert y owner' s signatur e indicate s tha t th e propert y owne r is satisfiedwit hth e restoratio n of th e subject property , an dtha t no item s ar e

in question , now , or at an y time in th e future , excluding an y remainin g warrant y (3 0 day s total ) except thos e item s liste dbelow , if any . Propert y ID : "^J^f - i/ 5 / Propert y Address

Address : : "yiy

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Item : Hem : Hem : Hem : Item : Hem : Require d correction s to complet e th e property :

L J I agre e restoratio n is completed , excep t as note d above . L J I do no t agre e restoratio n is complete d



### Owner' s Signatur e Dat eENVIRONMENTA L & CONSTRUCTIO N TECHNOLOGIES , INC . SOLUTION S 

# Propert y Contac t Attempt s Propert y ID : <Sl" ) t- f

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808 0 War d Parkway , Suit e 40 5 250 5 N . 24 TM street , Suit e 30 8 891 8 Tesor o Drive , Suit e 10 9 Kansa s City , M O 6411 4 Omaha , Nebrasl o Sa n Antonio , T X 7821 7 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 (210 ) 822-958 8 Fax : (816 ) 363-370 7 Fax : (402 ) 504-100 5 Fax : (210 ) 579-657 7Name : 

## k)/\j>n\ . Date: U Il k 

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## Dougla s County-Omaha , N E

c n voi-CfH, . Sdl l P AI Hi' . REYNOLD S NEA L R -'

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• . CIT Y O F OMAH A *. ' ::01 1 N 2 i S I • HO B EC O I N DU l .•UU S N .f l i ^ DAVI S BOBBI E A " 2da i &LCNDOS T > .!UU / N 2 5 S T 2"»2 « BLONDOS r Parce/ / D 200107000 0 Sec-Twn-Rn g 09-15-1 3 Owne r MORELL O Additio n PATRICK S AD D Nam e BERNAR D J Propert y 243 1 PATRIC K Bloc k 6 Addres s A V City OMAH A Lo t 6 Zi p 6811 1 Legal 1 El/ 2 Owne r Legal 2 Addres s Owne r 1141 3 Legal 3 Addres s 2 HICKOR Y R D Owne rCit y OMAH A Legal 4 http://douglasne.mapping - Owne r Assesso r N E online.com/DouglasCoNe/statlc/accountinfo.jsp ? Stat e Websit e Lin k accountno=R200107000 0 Owne rZi p 6814 4 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 . 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 = 7 7 fee t appraisal , survey , o rfo rzonin g verification . 

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• ^ - - Patric k *v e

241 5 PATRIC KJ ClTVOi-OMArt A ! 1 PATRIC KA V OTYOFOMAH A 2 4 S I PA T RIC KAV > 1 S / P ArRIC KA' . .?<Jl b N .-' 4 i l

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### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s Count.. . 10/10/200 7