## TRANSMITTA L o f OMAH A LEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : S-^^yi
- Date : Address : rtf2^ l J>e.c.Jtu ^ Sit
Remediatio n Contractor : J^^jLu- h UJiA.J^y^,

_T^^ y ^®^ * ^^'^X l SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S [Zf

Vide o ofpropert y (DVD ) 0

^ Executiv e Summar y B EPA-provide dpropert y sketc h ^ Signe dAcces s Agreemen t fo r

subjec t propert y D Signe dAcces s Agreement(s) fo r

adjajen t propert y 0

^ Restoratio n Agreemen t [/

Settlemen t document s (i.e. , fo r

damag e o r t

o replace plants , etc. ) I ZConfirmado n dat a I FPhotograph s 1 ? As-buil t sketc h E

l Satisfactor y restoratio n signe db y Propert y Owne r [ /

Propert y close-ou t chec k

lis t signe db y EP A D Descriptio n o f

area s no t meetin g RO D cleanu p criteri a \ Z Utili't y cleartuice s 

## w Propert y informatio n fromDougla s Coimt y Assessor' s Offic e D D D 

## Signature ^ _D a >at e 4031072 1 

# liH i Superfun d

### PROPERT Y SUMMAR Y 1 Date : 01/23/200 9 Omah aLea dSite Remedial Actio n Contrac t #EP-R7-07-06/0004 Mont h of : Dec/Ja n Propert y Address : 542 1 DECATURS T A . EXECUTIV E SUMMAR Y A. 1 Issue s Encountered : NON E A. 2 Issue s Resolved : NON E A. 3 Uniqu e Findings : NON E A. 4 Oflier Relevan t Infonnation : NON E CONFIRMATIO N SAMPLIN G T>ATA/RESULTS : D Z = 6 5 PP M @ 12" ; F 2 = 4 8 PP M @ 4" ; N O EASEMENT ATTACHMENT S 1 ) Propert y sketcl i provide dby EP A pursuan t to contract specification s 2 ) SignedAcces s Agreemen t including acces s agreement s require dfo r crossra g othe r propertie s 3 ) Pre-Excavation digita l vide o clip/photograph s 4 ) Post-Excavation digita l vide o clip/photograph s 5 ) Documentation - CompletedClose-ou t Checklis t 6 ) As-Buil t sketch ­ i ) Shall include-final-lead-level s v ) Legend ii ) Contamination lef t behindarea s vi ) Contracto r identification iii ) Propert y addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s to b e includedi n the individua l propert y file, i f available , o r obtainedinclude : i ) Pre-excavation agreemen t detail s (i f an y ar e made wit h the propert y owner ) ii ) Propert y Statu s For msignedb y propert y owne r iii ) Excavation digita l vide o i n MPEG , WM V (Window s Medi aVideo ) o r SW F(Flas h Player) forma t and/o r photograph s iv ) Signedfor mverifyin g satisfactor y restoratio n v ) Descriptio n o f area s no t meeting InterimRO D cleanu p criteria .

ECHNOLOGIES , INC .Fin d Recor d Clea n U p Query 

# J Lea d Remainin g Query I Propert yDamag e Quer y Backfill :

Sampl e Area : 8497 6 - 542 1 DECATU R S T Owner : D Owne rOccupie d Owne rName : LEBED Z STEVE N R Owne rAddressl : Owne rAddressZ : 542 1 DECATU R ST City : State : Zi p Code : OMAH A [NE " )6810 4 Owne rPhone : Alternat e Phone : (402 ) 551-139 7 . |(402 ) 639-264 0 

### Resident : Residen t Name : 

# r Propert yAddress : )542 1 DECATU R ST Zi p Code : |6810 4 ' Residen t Phon e Contract : Contractor : jPRUpENT2008_ S Group : 

# I Assessment : Qualifyin g Grou p [NORT H Assessmen t XR F Date : 

# r Assessmen t MaxXR F Value : 

## I soTTBCHNQIOGIES . IN C 

# SEFV K EP A Propert y Clos e Ou t Propert y # : €4<?l 6 Propert y Address : J5^-? l L>S C fTfo/Z.s. i Date/Time : Owner' s Name : Quad s Excavated : ^'^ / ^^ f Contracto r Grou p Pruden t Technologie s Excavatio n Genera l Ye s No 1 .If necessary , wer e the correct quadrant(s ) excavatedan drestored ? / 2 .I f necessary , wer e the correct area s of dri p zone excavatedan drestored ? / Gradin g Sodan dVegetatio n Ye s N o 1 .

Doe s the grading aroundth e perimete r oflh e hous e i n excavatedarea s generall y slop e awa y fro mthe house ? / 2 .Has so dbee n lai din al l area s tha t wer e excavated ? / 3 .

Doe s the sodappea r t o b e generall y health y an dgrowing ? (Onl y evaluat e if inspecteda t a3 0 da

y tim e period) / 4 .Ar e sodde darea s generall y fir man devenl y graded ? / 5 .Ar e th e joint s betwee n the so dstrip 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 h tha t wate r will no t poo l on th e property ? / 7 .

Wa s damage t o landscaping o r plan t material s avoided ? / Gates , Fence s an dRetainin g Wall s Ye s No 1 .D o gate s ope n an dclos e freely? (I f applicable ) 

## y 2 .

Wer e al l gate s o r fence s taken dow n durin g restoratio n activitie s reinstalled ? (I f applicable ) / 3 .

Was damage to gate s o r fence s avoided ? (I f applicable ) / 4 . Wa s damage to retainin g wall s avoided ? (IfappUcable ) 

# y Foundation , Sidin g an dGutter s Ye s N o 1 .Wa s damage to the siding o r trimavoided ? / 2 .

Wa s damage t o the foundation avoided ? 

# y 3 . Wa s damage t o window s avoided ? 

# y 4 . Wa s damage t o window s or doo r screen s avoided ? 

# y 5 . Wa s damage t o downspouts o r downspou t extension s avoided ? 

# y Sidewalk s an dDriveway s (Concrete ) Ye s No 1 . Wa s damage to drivewa y surface s avoided ? 

# y 2 . Wa s damage to walkwa y surface s avoided ? 

# y

### Owner s comments :

Inspectio n notes : Sooi^' f Ccnoiriov j inpfiiHe O ^PB s c/ost'Oni


### Remova l an drestoratio n activate s complet e includin g th e 30-da y so dwarranty : EP A Representativ e <^ ^ ^^ ^ Date : //af/o ^

# <s£n H Propert yCompletio 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 signature indicate s that th e propert y owne r i s satisfie dwith th e restoratio n ofth e subjec t property , an dthat n o item s are i n question , now , o r at any tim e i n th e future , excludin g any remainin g warrant y (3 0 day s total ) excep t thos e item s Uste dbelow , i f any . Propert y ID : Propert yAddress : j ^ ^:2, \ D P rcJU ^ "KV 

### Owner; Sh\^ ^ /f . U^M- Z Phone : Qto-2-' ) ^S'l'l^' H Restoratio n tt^ns i n Question :

Item : . Kem : ^ ^ . .^'' ' Item : Item : 1 Item :

Item : Require d correction s t o complet e th e property : 

# S o d $35 " r^'^^v^^-^ejK^uivA ­ ; ^ I agre e restoratio n i s completed , excep t a s note d above .

L J I d o not agre e restoratio n i s compiete d



## /2- 2 7-^d P Dat e

### DEC . 5.200 8 3;58P M NO . 47 3 P . 2

Pruden t Tccbuoloeies , be . (Pnident ) i s unde r oontnc t vrit h Clt c U . S . BDviranmcDta l Fiotcccio aAscac y (BPA ) to clci n v p Icadr oontflmiioR droils B I t nu^sr ofpropcnie alocate di n Omaha . Nebraska , iocladin g ih e propen y loeaie dK 5^2 / O^CeifUr ' Sir-tf f Th e EP A teques B you r permissio n to allo w Proden t ^apeiform» soi l cleanu p a i thi s property T O ranov e lead-coaiaminaR dsoil . B y sigDing thi t (brm , ih e properr y owne r grant s permissio n t o Pruden t t o perfor m activide s ijelaiedi o th e cleanu p includin s soi l samplin* , leijiova i o f lead-conttmioate dsoil , an drestoratio n ofth e reftrence dpropeny . I f

yo u hav o any qaesnoo s abou t th e soi l cleanu p planne dfo r you r property , pleas e conn aPnder n /^dminigtrariv e CIcrf c fo r th e OmahaLea dSu e cleamtp . Ms . Debora h Johnso n -a t (402 ) 733-1188 . Oenoa l question s abou i th e Omah aLea dSit e cleanu p ca n b e directe dt o th e EPAPubli c tnfbtmatio n Center s a t (402 ) 731-304 S (Sout h Omah aoffice ) o r (402 ) 991-9S8 3 (Nort h Omah aoflEce) . Property Acces s Grante dBy : 

# 5"^/f ^ ^.Ui>^- ^ Properry O^mer Signature : (D«c ) PROPERTY INFORMATIO N (T o b e eomplete d byrtsidcn t and/b rpropen yowne r— pIc« Kpnof ) RESIOENTNAME : Rents r RESIDEN T ADDRESS : SS : \ i n I
I F RENTAL , PROPERT Y OWNE D BY : OWNER' S MAIUN G ADDRESS ; OWNER' S TELEPHON E NUMBER-HOME : \.4ai. \ S^S' I 'l^^ l WORK : 

## ^^t2,^ 2^^-408 0 

# au AG E O F HOME? : 

## . 6> 1

t J ' YEARS . HO W LON G HAV E YO U UVE D HERE ? '^ ^ YEARS . HA S TH E EXTERIO R BEE N PAINTE D O R COVERE D WIT H SIDIN G SINC E 1978 ? )( , YE S N O NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OLD : Q NUMBE R O F OCCUPANT S 7 YEAR S OL D AN D OLDE R NUMBE R O F CHILDRE N UNDE R 7 YEAR S OL D WH O PLAY I N TH E YAR D FO R 5 HOUR S O R MOR E PE R WEEK :

O COMMENT S O R SPECIA L INSTRUCTIONS : (l- E DOGS , ENTR Y GATES , ETC. )

KiSvykOVXmPO RENVIRONMENTA L RESPONS E ACTIONS ; TTi e activitie s t o b e implemente db y EPA unde r thi s agreemen t • r e pursuan t t o Sectio n 10 4 o f CERCLA , 4 2 U.S.C . 9604 . EPA' s tigW o f acces s t o th e propcit y i s provide d(b r i n Sectio n 104(e ) o f CERCLA , 4 2 U.S . C 960S(e) . whic h provide s entry fbr "determinin g th e nee dfo r response , o r choosin g o r likin g an y respons e actio n unde r thi s title , o r otherwis e enforcin g th e provision s ofth e trtle." '

B08 0 War d Parlcway , Suit e 40 5 250 5 N . 24* * Street , Suit e 30 8 42a 2 Modica l Drive , Suit e 425 0 Sa n Antonio , T X 7822 9 Kansa s City , M O fi4l14 Omaha , Nabrask a 6811 0 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 3eM70 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7.».* ' i * •*.'. ' 

## '•' :6MAI^X6ii^iSJb?ERE OLS# : 8497 6 Dat e Excavated : 12/09/200 8 USEP A Signed-OfTDate : 

### 8497 6 

# (1 racioecAnjRg r Oimh aLM dsit e SUaakMcl i D OHe t RYASCPXArftMT O F l Colattai l LA B 

### D nmi:je£^JL£&_£J L RYBSCPKA«l« n KtcecpxMts m RVDecn(M497 8 M)iZBCPXA4«a7 B F 2 s i B 2 O Z .JLfta_PP m 

# i a a a a a Tane : lOMf e A.»t . Oeinpta s Amrtj^a d XR F Una : 65¥ ^ Book : 213 . -pa - 

### D 

## a ^ 

## a Niwherofaw<fc»»r5 ^ (QT I .^r&ia2
-

N O EASEMEN T

CONTRAC T # : E P - R7-07-0 6 / 000 4 PRUDEN T TECHNOLOGIES , INC .—-•^fc i &W . lJ!iiOP|lW!HVlf.-V L i * t'OiVa'lfftiLiCTIlOiN 

# 'jm m V TECHNOLOGIES , MC . SERVS'C'Ei S 

# Propert y Stoto s Wm m Address : 5Y^ ' 'DeC/Xh-^^^ ^ ©ate : (^^/ ^ 

# Phone ; <$^ H 13^ 7 BVID ; i^y^7 ^ Ite mN O Plant s & Permanen t Landscapin g T o Remai n I n Plac e O n Ma p Descriptio n & Locatio n

Pre-Existin g Conditio n o f Structure s DoesyourBasementhaveahistor y o f

leaking ? Ye s No Ite mN O Descriptio n & Locatio n O n Ma p

Propert y Owne r Pruden t Employe e Signature : Signature :

803 0 War d Partway , Suit e 40 S 2S0 S N . 2 4 Street , Suit e 30 8 424 2 MedltM l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n AntonicT X 7822 9 Phone : (816 ) 36S-370 3 Phone : (402)504-100 4 Phone : (210 ) 822-S58 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 576-657 7

## 8497 6 Exterio rPain t Nort h AncM f Omah a Lea d Sit e Sit e Sketc h Q'Poo f Samplin g Aildra««;S42 1 DECATU R S T O No t pain t 

# J Sampl e Number Lead Sample Sample s Collecte d U B Concentratio n Colle ^ Fjmi : PE . Q,, C £,K ' RYASCPXA^497 B F l pp m 

## D Date : <^'IO-O t RYBSCPXA-84976 F 2 pp m 

## D Time : 10'I U A.IM. . RYCSCPXA-8497 B B l pp m 

## D Sample s Analyze d RYD8CPXA^97 6 B 2 

# n o pp m 

# n RDZSCPXA-84S7 6 D Z pp m XR F Unit : ^5V 0 Book: 2J3

_ 

## D ngMCPX A 9i9 n 62 - pp m 

# a Date : ^ -22.'0 8 

## D nrgOCPX A 8*07 6 RZ- ppm Time : iRr> \ 

## D Staff : <nS U Ntwibe ro f Sample s =|5 i \ 0 j Legend : F l = Fron t Left . F 2 = Fron t Right , B l = Bat * Left . 6 2 = Bac k

Rigli t O Z = Ori p Zone . G Z = Ganlen , P Z - Pla ^ A l qudrertf t ttv tt vtaMn d froni th s ibMt , bdn g prapirty i e i n V • • • m ) t • - y

### Pag e 1 o f 1

lun e 199 9 - Dougla s Count yAssesso r «6»,i wriffrmi^-'wi.
- ".}' : "••?M


# 5i^ l lyc.c^K' ^ s- K

http://douglasne.mapping-online.comyassessdoc/Photos/42/R2410440000000 1 .jp g 12/5/200 8

### 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 r Cit y Owne r Stat e Owne r Zi p 241044000 0 LEBED Z STEVE N R 542 1 DECATU R S T OMAH A 6810 4 542 1 DECATU R S T OMAH A N E 6810 4 Sec-Twn Rn g Additio n Bloc k Lo t Lega l 1 Lega l 2 Lega l 3 Lega l 4 Treasure r Websit e Lin k Assesso r Websit e Lin k 18-15-1 3 WASHINGTO N HIL L SU B 0 6 W51F T 5 1 X 12 7

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp ? parc=241044000 0 http://douglasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? accountno=R241044000 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 = 4 3 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 12/5/200 8. 

## I.i^o.2DE.R7" " :wt:iciiodi ? so. : n-o4,1, : q C ^]^^ylS^i^^^;- ; ::^j,j:/; . ^.^•^-::3i^V^^;^i;• ; :.- ^ 

# Wt^WMM^h .

• J^'ii^X^'.:i^^l--~-'-::^--..
- ••^•-• ^ .

'•• •

i*>v^iK-- : vj-i-a. , ^ r ,••'•- 1 TECHNOi^OQIE a R/gRKWA;*;viSuiT i 

# w

•^>-\.'.'. . '• • ^S-Uil^s^^^^^^f e S r V T ; • , i .-jiHffif i

• ^!&>j^>i*

•••: • -t ­ f^J .,562We.(3«6)V.- . jrf-r . •.?r-\-.> «" > 

### Pag e 1 of 2

Creat e Anothe rTicket , ^ . - , Bac k t o irt h Interne t Sen d Emai l

< . f. . I h. ' 

### YOURTICKE T NUMBE RI S 2186970 . origina l Cal l Date : 12/06/0 8 Wor k t o Begi n Date : 12/10,/0 8 Time : Time ; 8:5 8 p m 7: , 1 5 a m Op : MADHURIMA1896 7 State : N E Address : 542 1 County : DOUGLA S Street : DECATU R S T Place : OMAH A Twp : 15 NRng : 13 E Twp : Rng : Lega l Given : C Sect-Qtr : 18-N W Sect-Qtr ; Typ e o f Work : lead remediatio n wor k fo r soi l Locatio n o f Work : LOCAT E ENTIR E PROPERTY Remarks : FA X AL L CLEAR S TO : (402)733-188 3 : UNSUR E CORNER S Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : MADHURIM A Phone : (402)733-118 8 Alt . Contact : Phone : (618)401-222 3 Wor k Bein g Don e For : ep a Dept h o f Excavation : 6 f t Corne r Lot : NFront : Y Rear : Involve s Tunneling o r Horizonta l Boring NExplosives : N CXCAT V

MCLEODN E MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Are a Contac t Phon e Numbe r Utilit y Typ e CXCAT V CO X COMMUNICATIONS , IN C HEID I 

### Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 MCLEODN E MCLEODUS A NO NEE D T O CAL L OU T EMERGENC Y 

### Day : 800289190 1 Alt : Emerg : 800289190 1 MUDO l METROPOLITA N UTILITIE S DISTRICT SAND Y 

### Day : 402504782 3 Alt : Emerg : 402504797 0 OMAHACO F CIT Y O FOMAHA
TRAFFICSEWE R RO N 

### Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 

### http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT S l7/6/9no »

### Pag e 2 of 2 

### Day : 406728934 3 0PPDGPR5 g^^LICPO^ ^ N A Alt : 406207149 4 Emerg : 406523771 7 Day : 406728934 3 QLNNEI C QWES T LOCAL NETWOR K N A 

### Alt : 406207149 4 Emerg : 406523771 7

http://www.dhon.org/irthintemet/DHONNFoticeCreation/MessageText.asp?ret=<RESULT S 17/fi/7nf^ »