## TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAID# : Jl/7):7y f Date : ^?/^ ^ Address : ^O B /y^pployfOf ) RemediationContractor : _Coasta l Environmenta l Group

_Year : _2007 _ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S H Video o f propert y (DVD ) M Executiv e Summar y mEPA-providedpropert y sketch M SignedAcces s Agreemen t fo r

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

adjacen t propert y M Restoratio nAgreemen t D Settlemen t docmnent s (i.e. , fo r

damag e or t o replac e plants , etc. ) [

/ 

## Confirmationdata / 

## Photograph s M As-built sketch M Satisfactor y restoratio nsignedby Propert y Owne r M Propert y close-out check lis t signedb y EP A D Descriptio n o f area s no t meeting RO D cleanu p criteri a D Utilit y clearance s D Propert y informationfromDouglas Coimt y Assessor' s Offic e D D , 0 • • • • • . ' ' 0 • 

# • ^7jy7a d Date 4031791 2 Superfun d

## Fina l Repor t Propert y Chec k Lis t (piease plac e wit heac hfile) ^/Oyy j Har dCop y Informatio n <=y^S( ' ioppOi^t^a ^ 1 . Propert y Chec k Lis t : ! ^^ ^ ° f\\ri _ 2 . Sit e Workin g Drawin g Ma p , ' .3 . EP A original s Ma p ' 4 . Dougla s Count y Assessor' s Map ; ; 5 . Propert y Contac t Shee t ; | Agreemen t 1 . Acces s Agreemen t 2 . Restoratio nAgreemen t Miscellaneou s Document s 1 . Fina l Ma p fromth e Fiel d 2 . Chang e Order s ,1 . XR FDat a 4 . An y einail s o r P O airrespondence s Propert y Completio n 1 . Executiv e Summar y 2 . A S BUIL T 3 . Pr o pett y Completio nAgreemen t 4 . An y buyou t inf o o r reimbursemen t inf o 5 . Chec k o r mone y orde r copie s 6 . EP A Propert y Clos e Ou t Fon n 7 . Attache dBegi nVide o Electroni c Documentatio n Drawing s 1 . EP A origina l 2 . Workin g Drawin g .3 , A S Built.vs o 4 , A S Built.jp g Photo s Begi nPhoto s During/Excavatio nPhoto s 3 

### So dPhoto s 

## 4 3()-Da y So dPhoto s Scanne dDocument s Fina l Document s Executiv e Summar y Video s ' Begi nVide o 2 M y Movi eI^BB! ^ 

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# 2/0Z 7 Nanne : Tr-c-^ KCc^ft ^ yi^ O Omah a Lea d Sit e 

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### Pag e 1 of 2

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

### YOU RTICKE T NUMBE RI S 1912805 . Origina l Cal l Date : 10/12/0 7 Wor k t o Begi n Date : 10/16/0 7 Time : Time : 1:5 6 p m 2:3 0 p m Op : LORI1879 0 State : N E Address : 50 8 County : DOUGLA S Street : POPPLETO N AV E Place : OMAH A Twp : Twp : 15 NRng : 13 E Rng : Sect-Qtr : 26-NW Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : 50 4 POPPLETO NALSO . LOCAT E ENTIR E PROPERT Y Remarks : UNSUR E I F CORNE R : RESEN T DU E T O WOR K EXTENDING , REFRES H PAINT Compan y COASTA L ENVIRONMENTA L SERVIC E Contac t Name : LOR I Phone : (712)352-018 8 Alt . Contact : NON E Wor k Bein g Don e For : EP A Dept h o f Excavation : 3F T Corne r Lot : NFront : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V LEVEL S MC I MCLEODN E MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F QWEST 2

Servic e Are a Contac t Phon e Numbe r Utilit y Typ e CXCAT V CO X COMMUNICATIONS , INC HEID I 

### Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 LEVEL 3 LEVEL 3 COMMUNICATIONS , LL C NA 

### Day : 877366834 4 Alt : Emerg : 877366834 4 MC I MC I N O CALLPE RMEM O 

### Day : Alt : 800289342 7 Emer g 800289342 7 MCLEODN EMCLEODUS A D O NO T CALLOU T EMERGENCIE S PERMEM O 

### Day : Alt : 800289190 1


### http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 10/12/200 7

### Pag e 2 of 2

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### Emerg : 800289190 1 Day : 402504782 3 Alt : Emerg : 402504794 6 Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 Alt : 

### Emerg : 888728934 3 Day : 406728934 3 Alt : Emerg : 888728934 3 Day : 800283423 7 Alt : 303992192 6 Emerg : 800283423 7

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 10/12/200 7Parcell D 032324000 0 Parce l Cit y Omah a Parce l Zi p fyHIOH-OOO O Owne r Nam e C.appellan o Fran k Owne r Addres s Owne r Addres s 2 50 4 Poppleto nAve

Owne r Cit y Omah a Owne r Stat e N e Owne r Zi p 6SI0H-()m m Additio n (UyLoi s Acre s 0.0 9 r ­

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## PropertyID # Property Address : Initial Contact : Secon dContact : Final Contact : Final Action :

Comment : Owne r Commen t (s) : Site Coordinato r Commen t (s) : CONTAC T FORM ^ \7^^S \

So? > fopp(^-h)> V A\J f Date : Time : Action: _ Date : Time : Action : Date : Time : Action : Transmi t to EP A D Othe r Action : D 

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## • Consen t Fo rAcces s T o Propert y> > RIGH TO F ENTR YT O PREMISE S 

### ;- , :.t*/4/f . Granto r(th e propert yowner ) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rit s authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises : , ­ Owner' s Name : Daytim e Phone : g , g ^ - / ^ ^ 

# 7t^j>/ t cjf^y-^ t
Addres s o f Propert y covere d b ythi s Agreement : 

# ^0 % ?on^y ys y PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EP Ai s requestin g acces s t o collec t soi l sample s an d remov e soi l tha t contain s elevate d concentration s o f lea d an d maypos e a healt h hazard . Th e area(s ) wil l b e excavate d t o remov e contaminate d soil . Th e remove d contaminate d soi l wil l b e replace d wit h clea n material s an d th e are a wil l b e restore d t o it s origina l condition . Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e o f Coastal Environmenta l Group , contracte d b yUSEPA , wil l contac t th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l hav e a n opportunit yt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e i t begins . Onc e th e wor k i s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d confir m tha t i t i s complet e an d meet s wit h th e Grantor s approval . Upo n completion , th e Granto rwil l receiv e writte n documentatio n fro m EP Atha t th e propert yha s bee n remediated . ENVIRONMENTA L RESPONS E ACTION S 

### B ysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractor s an d subcontractors th e righ t t o ente rth e property , a t al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o f performin g th e work . Thi s acces s shal l remai n i n effec t unti l th e wor k ha s bee n satisfactoril ycompleted . Th e Granto rals o agree s to :
Pag e 1 o f 2

# m•• ^

%^^*^ ^ COASTA L '*'^ , .eC''" * C ENVIRONMINTA L U , INC . ft 0 P 

### •Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; •Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma ywis h t o save ; •Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessarysubsequen t t o a n initia l waterin g perio d b yEPA ; •Abid e b yhealt h an d safet yguidanc e provide d b yEPA ; •I f th e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propert yt o perfor m th e work . •Allo wvideotapin g and/o rphotographin g o f th e property . AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo f th e wor k activities , o rwit h an y o f th e wor k done , o rwit h th e equipment use d o n hi s property , o rt o undertak e an y action s regardin g th e us e o f sai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o f th e Grantee s o rth e environment , o rt o allo wother s t o us e th e propert yi n suc h a manner . Should you hav e an yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , a t (877 ) 234-6270 . I gran t access t o m ypropertie sC U i d o not gran t access t o m ypropertie s 

# '-/ y

# ? Dat e Signatur e

Dat e G I woul d lik e t o b e presen t durin g an ysamplin g tha t i s required .

Pag e 2 o f 2COASTA L 

### Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s t o provid e amutual agreemen t a s to condition s o f th e property prio r t o remediatio nactivities . Thi s wil l als o serv e a s documentatio nfo r th e purpos e o f assurin g tha t restoratio n activitie s are complete dto th e satisfactio n o f th e propert y owne r andth e Unite dState s Environmental Protectio nAgenc y (EPA) .

Property ID : ^(G7J 7 

### Property Address : ^Cf ^ fhPT^tyTVA J Owner : -p^^^^j ^ (L^^^lCT ^ C Phone : 

# yTs O - )09 ^ On th e attache ddiagram(s ) indicate area(s ) to e.xcavate danddept ho f excavation , location o f all known utilities , subsurfac e features , surfac e structure s andlandscapin g features , acces s location(s ) t o b e use db y contractor , andthe directio no f North . Indicate distances , depths , materia l types , etc . Indicate digital photo s b

y referencin g the photo-lo g number wit ha n arro w indicatin g directio no f view . 

### Item s T o B e Remove d B yOwne rBefor e Star t O f Remediation : (Us e additiona l sheet s a s necessary ) Th e rennoval . storage , disposal , and/o rretur n o f thes e item s i s th e Owner' s responsibility . Item : 

## UC i 

# hi C Item : Item : Item : Item : Item : Item : Item : Pag e 1 o fCOASTA L 

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Us e additiona l sheet s a s necessary ) Item : 

# u o y Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item :

Pag e 2 o fCOASTA L 

### Landscap e Inventor y (Us e additiona l sheet s a s necessary ) 

## Ite m
Pre-existin g property area , tha t wil l b e excavated , tha t i s covere dwit hgrass .

Numbe r o f tree s > 2 inch trunk diamete r

Numbe r o f tree s < = 2 inch trunk diamete r

Numbe r o f Sprinkle r Zones , Contro l Valves . Timers . Heads , etc . Anac hasketc ho f th e sprinkle r la\out . Numbe r o f an d siz e o f eac hgarden/ tlo \ ver be d area .

. -\tiachasketc ho t relaii\ e size s an dlocation s 

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Pag e 4 of .COASTA L 

## Ite m Agree dupo nvalu e of plan t material s no t t o b e replace db v contractor . Not e thi s valu e wil l b e use dt o issu e aplan t xouche r t o th e propen y owner . Agree dupo nlis t of plant material s that will b e replace dby contractor . B e ver y specifi c anddetailed . Includ e asketc hof wer e eachplant will b e place d b \th e contractor . Agree duponare ao f propert> ' t o b e replace d wit hgras s sod . Includ e asketc hof the area(s ) to b e replace dwit h gras s sod . .Are ao f Cit y or Count y propert> ' t o b e landscape d per thei r requirements . Includ e asketc hol the are a(s )

Easemen t Area , t o b e excavate d 

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Pag e 5 ofCOASTA L ENVIRONMENTA L CROUP , INC . 

### Additiona l Comment s / Instructions :

• Chec k th e boxi f Owne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e pre-existin g damage . B ycheckin g thi s boxCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n cracks o rfissures .

• I d o no t agre e agre e 

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# ^\\'\oy=\'7yh , Totalll ^ nt Squar e Footag e t o b e Excavate d = 89 2 

# ( ^ r^.'/ ' 7c y Total. - .f j Zon e Linea rFootag e t o b e Excavate d = 0 PropertyClassification : 80 0

Descriptio n of pos t excavatio n areas : Fl , front yar d leB-han d quadrant : F2 . fron t yar d nght-han d quadranl : Bl , backyard left-han d quadrant : B2 . backyar d right-hand quadranl . DZ . dri p zon e (1- 3 foot are a of soi l aroun d th e foundatio n of th e house) .X 

### Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc . ^ < # www.coastalhazmat.co m COASTA L ENVIRONMENTA L 6 R O U r, IN C 

# EXECUTIV ESUMMARY : 21029—50 8 POPPLETO NAV E 

# No Issue s o r Concern s I I Issues/Concern s Detai l Explanation :

# ^ As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e
Tota l Quado m squar e lQt)eExcwiAea-89 2

iMa l Diil|)Z«i e Ln» r ftiixertyC&Bdllcaboti : 80 0 tobeExcavaiECl-a



### Slop eDZ awa yfro m th e garage .

F l = 11 £

EA-S = 19 0 PP M

M-Stt : 2102 9 r7~ \ Da|?,Ej<iCayated : 10/13/0 7 }&st e U|EPASigne d Off : 12/ 1 5/07

•—•— • Ftn x 1 we n - 

## O 

# ;5 t

Are a no t Excavatet i ^'' •

- : >f -y. ­ 

### oppi<3ton/ivenui j
NorflYAncN t Omah a Lea d Srt e 

# A Phip«rt yNumbe r OLS-2102 9 sei M Praperl yAddres s 20 TBe t or1 j M - 5 1 5 It 50 8 POPPLETO N AV E Ptis t Excauate n Concentration s tpfxn ] 

# HG L Fl B2 PlayAre a 

# • 

# • H e F2 DZ &»anen t Bl Garte n Otie r »iiw < 1 , >^e^t|l•<al^iM>l^^^ll^lHC6^«>»M^^^»»^«l>a^pllll^i^ 

### Legen d ^ Dripzon e Excavatet i w^ Quadrant s Excavatet i 

### Contrac t #: EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc ,

### S ) ^ 

# EPA EP A Propert y Clos e Ou t For m Propert y # : o^ * 0 ^ ^ Propert y Address : t-,o9 , pr^pplfJx) A Date/Time : t | /^J Chvner' s Name : ^ro^Y^ k 'r i [^p- ^ "AYIO Contracto r Grou p Cs^'at' ^ Quad s Excavated : Ye s Excavatio nGenera l I . I f necessary , wer e th e correc t quadrant(s ) excavate dan drestored? 

## y 2 . I f necessary , wer e th e connec t area s o f dri p zon e excavate dan drestored? 

## A/A
Gradin e So dan dVecetatio n Ye s 1 . Doe s th e gradin g aroun dth e perimete r o f th e hous e i nexcavate darea s generall y slop e awa y y fromth e house ? 2 . Ha s so dbeenlai dinal l area s that were excavated ? 

### y 3 . Doe s th e sodappea r t o b e generall y healthy andgrowing ? (Onl y evaluat e if inspecte da t a3 0 da y tim e period ) y 4 . Ar e sodde darea s generall y fir man devenl y graded ? 

### y 5 . Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e if inspecte da t a3 0 da y y ^ tim e period ) 6 . Wa s th e propert y grade dsuc htha t water will not poo l o nth e property ? y 7 . Wa s damag e t o landscapin g o r plant material s avoided ? ^ Gates , Fence s an dReUinin g Wall s Ye s 1 . D o gate s openan dclos e freely? (If applicable ) 

## y 2 . Wer e al l gate s o r fence s take ndowndurin g restorationactivitie s reinstalled ? (I f applicable ) 

## y 3 . Wa s damag e t o gate s or fence s avoided ? (I f applicable ) 

## y 4 . Wa s damag e t o retainin g wall s avoided ? (I f applicable ) 

## y Foundation , SidinK an dGutter s Ye s 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 navoided ? 

## y 3 .Wa s damag e t o window s avoided ? 

# y 4 .Wa s damag e t o window s or doo r screen s avoided ? y 5 .Wa s damag e t o downspout s o r downspou t extension s avoided ? 

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

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

### y No

No

N

o

No

N o

## Owner s comments :

Inspectio nnotes :

Remova l an drestoratio nactivate s complet e includin g th e 30-day so dwarranty : EPA Representati v;&-7::^^£^:3•^^^£..<^:^yX ^ Date : /^j^T "> < ^ 

## Propert yCompletio n Agreemen t This agreemen t document s the completio n o f remedia l activitie s performe do n m y property . M y .signatur e wil] designate tha t 1 a msatisfie dwit hthe restoratio n o f m y property , andtha t no item s ar e i n questions , now , o r a

t any tim e i n th e future , except thos e item s liste dbelow , i f any . I Propert y ID : ^ | 6^C (

Propert y Address : ^(-VG L 

# g

> p6pp'-cit>r \hr c Owner : :f^, ^ t < Cc^pp^Wcun n 

## Phone : g g) 0 - 1 O q^ Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item :

^ I aure e restoratio n i. s completed , excep t a s note d I I d o no t agre e restoratio n i s complete d 

# yy%yyy7o) > Owner' s Signatur e 

### Dat e I