## TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R 

# [^OZ\\ l SA1D# : ^<^^ \1 > Date : Address : Ss^T. M 5 - ^ ^ Ay Remediatio nContractor : Envrionmenta l Restoration , LLC

_Year : _2010 _ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S " ^ Vide o o f property (DVD ) _XBefor e DAfte r D Basemen t \ ) A/g > ^ejnen j N

­ Executiv e Sunimary (Final Report ) N . EPA-provide dproperty sketc h " ^ Signe dAcces s Agreemen t for subjec t property D Signe dAcces s Agreement(s ) for adjacen t property ^ Restoratio nAgreeinen t

D Settlemen t document s (i.e. , for damag e or t o replac e plants , etc. ) ^ Confirmatio ndat a H- Photograph s 2 ^ Before DCre w Photo s QDurin g Excavatio nD So d ^S^30-da y So dD "S ^ As-buil t sketc h ^B ^ Completio nAgreemen t signe db y Property Owne r " ^ Property close-ou t chec k lis t signe db y EPA D Descriptio no f area s not meetin g RO D cleanu p criteri a I3 . Utility clearance s ^ Property informatio nfromDougla s County Assessor' s Offic e

B Property acces s checklis t ^ Contac t Lo g 3026065 3 D 

# l i Superfun d Environmenta l Resioratio nSignatur e Dat e Date

### iZ@Z\ Omah a Lea d Site—EP-R7-09-0 5 \ XyV U ? Environmenta l Restoration , LL C *- -- * www.crllc.co m H^o y 

# EXECUTIV ESUMMARY : 62913-242 4 S 2 0 A V "•^ ^ N o Issue s o r Concern s Q ] Issues/Concern s Detai l Explanation :

# FP A EPAProperty Clos e Ou t Form Omah aLea dSit e OU# 2 Propert y #:_lpdP\_Zh _ Propert y Address : 

# x^'^ ^ 6 ^ 0 A> ^ Date/Time : Owner' s Name : 7Sarc\1 6 'f^vC ^ Quad s Excavated : P ) | ftP^ Contracto r Grou p : Environmenta l Restoratio n(ER ) Excavatio nGenera l Ye s N o 1 . Ifnecessary , wer e th e correc t quadrant(s ) excavate dandrestored? 

## y 2 . Ifnecessary , wer e th e correc t area s ofdri p zon e excavate dandrestored? 

# Zjozyjziz y W Gradin g So dan dVegetatio n Ye s No 1 . Doe s th e gradin g aroun dth e perimete r ofth e hous e i nexcavate darea s generall y slop e away fro mth e 

# y house ? 2 . Ha s so dbee nlai di nal l area s tha t wer e excavated ? 

### y 3 . Doe s th e so dappea r t o b e generall y health y andgrowing ? (Onl y evaluat e ifinspecte dat 30-day tim e period) . 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 ifinspecte da t 30-day tim e period) . 6 . Wa s th e property grade dsuc hthat wate r will no t poo l onth e propert>' ? 

## y 7 . Wa s damag e t o landscapin g o r plan t material s avoided ? 

## y Gates , Fence s an dRetainin g Wall s Ye s No I . D o gate s ope nan dclos e freely ? (ifapplicable ) 2 . Wer e al l gate s o r fence s take ndow ndurin g restoratio nactivities re-installed ? (ifapplicable ) 3 . Wa s damag e t o gate s o r fence s avoided ? (ifapplicable ) 

# T ^ 4 . Wa s damag e t o retainin g wall s avoided ? (ifapplicable ) Foundation , Sidin g an dGutter s Ye s N o 1 . Wa s damag e t o sidin g o r tri mavoided ? 1 1 ' ^ 2 . Wa s damag e to th e foundatio navoided ? 

### r ^/I P l l 3 . Wa s damag e t o window s avoided ? 

### "/yyy^^ 

# jl M 4 . Wa s damag e to windo w screen s o r doo r screen s avoided ? 5 . Wa s damag e t o downspout s o r downspou t extension s avoided ? Sidewalk s an dDriveway s (Concrete ) Ye s No 1 . Wa s damag e t o driveway surface s avoided ? 

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

# y Inspectio nnotes : 

# VACAM T L£r r

Remedia l an drestoratio nactivitie s complet e includin g 30-da y so dwarranty : L i Aiieprcsentati v ^^l^^^^^^:y^^^c^c^^Z ^ Date :

### Pag e 1 of 2
"> [ Creat e Anothe rTicke t ] [ Bac k to Irt h Interne t ] Sen d Emai l 

### YOU RTICKE T NUMBE R IS 2442644 . Origina l Cai l Date : 3/22/1 0 Time : 3:1 6 pm Op : TRACY2418 6 Wor kto Begi n Date : 3/24/1 0 Time : 3:4 5 pm State : NE County : DOUGLA S Place : OMAH A Address : 242 4 Street : S 20T H AV E Twp : 15 NRng : 13 E Sect-Qtr : 27-SW,34-N W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e of Work : Excavatin g th e entir e propert y Locatio nof Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLE.ARS TO : (402)451-106 9 : SAI D #6291 3 Compan y ENVIRONMENTA L RESTORATIO N Contac t Nam e TRAC Y BRISTO W Phone : (402)451-131 4 Alt . Contac t Phone : (402)630-838 2 Wor k Bein g Don e For : EP A Dept h of Excavation : 12 Corne r Lot : NFront : Y Rear : Y Involve s Tunnelin gor Horizonta l Borin g : NExplosives : N ALT87 2 ATTNEBR l CXCAT V LEVEL 3 MUD0 2 OMAHACO F 0PPDGFR 6 QLNNEI F

Servic e Are a Contac t Phon e Numbe r Utility Typ e ALT87 2 WINDSTREA M COMMUNICATIO N 

### EL M LOCATING Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 ATTNEBR l ATT/ T 

### Day : 8002413624 9 Alt : Emerg : 8002413624 9 CXCAT V CO X COMMUNICATIONS , INC 

### HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 LEVEL 3 LEVEL 3 COMMUNICATIONS , LLC N 

### N

A 

### A Day : Alt : 877366834 4


### http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret-<RESULTS. . . 3/22/201 0

### Pag e 2 o f 2

METROPOLITA NUTILITIE S MUD0 2 DISTRIC T

OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R

OPPDGPR 6 OMAH APUBLI C POWE RDISTRIC T
QLNNEI FQWES T LOCALNETWOR K 

### Day : 402504782 3 SAND Y 

### Alt : Emerg : 402504797 0 Day : 402444719 7 RICH/TRAFFI C Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 EL M LOCATIN G 

### Alt : 406207149 4 Emerg : 888728934 3 Day : 406728934 3 EL M LOCATIN G 

### Alt : 406207149 4 Emerg : 888728934 3

http://ww\v.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 3/22/201 0

### 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 2412542 . Origina l Cal l Date : 11/24/0 9 Time : 11:3 0 a m Op : ADAM2418 6 Wor k t o Begi n Date : 11/30/0 9 Time : 12:0 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 242 4 Street : S 20T H AV E Twp : 15 NRng : 13 E Sect-Qtr : 27-SW,34-N W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Lea d excavatio n Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (402)451-088 0 Compan y ENVIRONMENTA L RESTORATIO N Contac t Nam e ADA M Phone : (402)451-131 4 Alt . Contact Phone : (636)288-961 6 Wor k Bein g Don e For : EP A Dept h o f Excavation : 2 4 Corne r Lot : NFront : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N ALT87 2 ATTNEBR l CXCAT V LEVEL 3 MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F

Servic e Are a Contac t Phon e Nunibe r Utility Typ e 

### Day : 406728934 3 ALT87 2 WINDSTREA M COMMLTNICATIONN A 

### Alt : 406207149 4 Emerg : 888728934 3 Day : 8002413624 9 ATTNEBR l ATT/T 

### Alt : 

### Emerg : 8002413624 9 Day : 402934046 9 CXCAT V co x COMMUNICATIONS , IN C HEID I 

### Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL 3 LEVEL 3 COMMUNICATIONS , LL C NA 

### Alt : 

### Emerg : 877366834 4 http://ww\v.dhon.org/irthintemet/DHONNoticeCreation/MessaseText.asD?ret=<RESULT. . . 11/24/200 9

### Pag e 2 o f 2

Ar\ ^ £- r \ -*-Tr»'^ i MUD0 2 METROPOLITA NUTILITIE S DISTRIC T SAND Y 

### Alt : Emerg : 402504797 0 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE RRICH/TRAFFI C 

### Day : 402444719 7 Alt : 402444516 1 

### Emerg : 402444516 0 OPPDGPR 6 OMAH APUBLI C POWE RDISTRIC T N A 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 QLNNEI FQWES T LOCALNETWOR K N A 

### Day : 406728934 3 Ah : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 11/24/200 9

## Contac t Informatio n Lo g 

# SMD#(^/^fy 3 Owner' s Name ; ^/Uu:-e^' ^ 'J///£jt y DaytimePhone : ^f^-^^Aj^S'S'y Propert y Address : ^^;^ ^ -^ , Zi p / ( ( ^ Attemp t t o contac t Date/tim e Nam e 

# ^^/^y/^ f^^'^ o 

# ^ A ^3s r2yyn// ^

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# Propert y Acces s Checkiis t SAID : ^^y ^ nWOR K STARTE D ON : / / PropertyAddress; ' fi^/^i/ -^.//.T f A Y nWORKCOMPELTE D ON : / / 1 Owner : ^^ ^ ZZHZZ^l / Renter :

Address : ^^^ ^ ^ ^ ^ j ^ 5 ^ Phone : Fax :

. Cell/Pager : 

## Phone: ^^ ^ ­ 7 32-^1.^^ 2 Additiona l Information : Fax : 1 Cell/Pager :

FT i Acces s Agreemen t Signed : 4^7^7/ ^ 

## Byr^:4 _ \ ^ Restoratio nAgreemen t Signed : / / l /7 I O f By.^ ^ 1 [3^Vide o Propert y Befor e O n:j//_l7^i ^ ^T--72 ^

ro-'^igital Photos Befor e O n:/f_l/_2l ^ By:-^E ^ 1 1 Vide o Propert y Afte r O n: / / By : 1 • Digita l Photo s Afte r O n: / / By : 1 1 Propert y Completio nAgreemen t Signed : / / By : 1 • Fina l Repor t Signed : / / By : Additiona l Vide o o r Digita l Photo' s Taken : 1 nVide o nDigita l Phot o O n: / / 

## By : 

## 1 Reason : nVide o nDigita l Phot o O n: I I By : Reason :
• vide o • Digita l Phot o O n: / / 

### By : 1 Reason : j

• vide o • Digita l Phot o O n: I 1 

### By : 1 1 Reason : |

Omah a Lea d Projec t Wor k Pla n 

### Pag e lo f 1 9

# Consen t fo r Acces s t o Propert y SAID # 

# i^Ti^l S RIGH T O FENTR Y T O PREMISE S 

## Granto r (th e propert y owner) , consent s to £Ui dauthorize s th e Unite dState s Environmenta l Protectio nAgenc y (USEPA) or it s authorize drepresentatives , collectively th e Grantee to ente r an dperformcertai nenvironmenta l respons e activitie s upo nthe following describe dpremises ; Owner' s Name : H^ g '~IZ' Y 

### I DaytimePhone : 4^^-7:7/ ^ 

# Addr. . ^^^^^,j2 o AY . Address : Addresse s o f Propertie s covere db y thi s Address ; Agreement : Address : Address : PURPOS EO FINVESTIGATION 

## Th e purpos e o f th e remedia l activitie s i s to remov e all soil s at the propert y whichar e contaminate dwit hhazardou s substances , i nparticula r

leada t concentration s greater than.or equa l t o 40 0 part s pe r million(ppm) . REMEDIA LACTION S 

## Th e environmenta l respons e action s t o b e perfomiedo nsaidpropert y ma y include the followin g activities : a .Takin g photograph s and/or vide o of th e propert y before , during , andafte r

remedia l activities ; b .Locatin g equipment an dmachinei y on-sit e i npreparatio nfo r

andinth e cours e ofth e enviromnental response ; c .Plannin g an dimplementin g th e remova l actio no nor nea r

Grantor' s property . d .Obtainin g sample s fro mGrantor' s property ; A o REEMEN T NO T TO INTERFER E 

## Th e Granto r agree s no t to interfer e o r

tamper wit han y o f

th e activitie s or wor k

done , or the equipmen t use dt o perfor mth e activities , or to undertak e an y action s regardin g th e use o f said property whic hwouldten dto endange r

th e healt ho r

welfar e o f the Grantee s or th e environment , o r t o allo w other s t o us e th e propert y insuc h I 1 1 gran t acces s t o m y propertie s nI d o no t gran t acces s t o m y propertie s

Signatur e Dat e

### • Chec k thi s bo xi fowne rdoe s no t wan t E.R . t o ente rth e resident s t o documen t interio r foundatio n wall s an d possibl e preexistin g damage . B ycheckin g thi s bo xE.R . i s no t responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures .

I 1 1 agre e • I d o no t agre e 

# D l agre e •1 1 d o no t agre e 

# / f l 7- ^ Contractor' s Signatur e Date Dat e

## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s t o provid e amutua l agreemen t a s t o condition s o f property prio r t o contracto r activities . Thi s wil l als o serv e a s documentatio nfor th e purpos e o f assurin g tha t restoratio n activitie s ar e complete dt o th e satisfactio nofth e propert y owne r an dth e Unite dState s Environmenta l Protectio nAgenc y (EPA) .

Propert y Address ; ^4^^g^.^ ^ /^ ^ 

# ^'^""' ' . T^g^^ C ZrU/€( y Phone : 

# ^4^ ^ ^ -y^z-^y^ y O nth e attache ddiagram(s ) indicat e area(s ) t o b e excavate dan ddeptho f excavation , locatio no f al l know n utilities , subsurfac e features , surfac e structure s ah dlandscapin g features , acces s location(s ) t o b e use dby contractor , an dth e directio no f North . Indicat e distances , depths , materia l types, etc . Indicat e digital photo s b y referencin g th e photo-lo g number wit hanarro w indicatin g directio no f view . item s t o b e remove d byContracto ran d no t replaced :

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

Pag e 1 o f2

### I 1 1 agre e ( • I d o no t agre e O I agre e O I d o no t agre e /

/ 

### j^wner' s Signatur e 

### Attachment s ( y f 

# 7/77^ 7 Date Contractor' s Signatur e Dat e



### Pag e 2 o f2

## Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio nof remedia l activitie s performe d on my property . My signatur e wil l designate tha t I

amsatisfie dwithth e restoratio nof my property , an dtha t no item s ar e in question , now ,or at an y tim e inth e future , excep t thos e item s liste dbelow , if any . I SAID : C.^^ y 3

Propert y Address ; yy/JV iZ
- J. ^ TJ iZ Z Owner : \^^^^c ; ZTZyZpi y \Phone : 

# ^^ - 7 37-.4 t .?-</ • Restoratio n item s in Question :

Item : item : Item : Item : Item : item :

2 J I agre e restoration is completed, excep t as note d \y \I agre e restoration is completed, excep t as note d ILd p no t agre e restoratio n

is complete d I 11 do not agree restoration is complete d
Contractor' Sisnatur Fiaf p Contrsctor' s s Signatur e e I

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## Jame s J Jur yI s thi s you ? Edi t 612 0 S 48t h S t Omaha , N E 68117-270 7 

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### Dougla s Count y Accoun t Informatio n Pag e 1 o f 2

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_r < ........*.. . KlnU r .f,....... , .—-— . _ Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t of 52n d S t - Vle WO H Ma p Informatio n i s vali d a s of 2009-11- 3 Treasurer' s TaxRepor t Ne wFeatur e ->->*- > Aut o Sale s Searc h Owne r JUR YJAIVIE S J ETA L 612 0 8 4 8 S T OMAH AN E 68117-000 0 Propert yInformatio n Ke yNumber : 

### 431 4 000 0 0 7 Accoun t Type : Residentia l Parce l Number : 074314000 0 Parce l Address : 242 4 S 2 0 A V OMAH AN E 68108-000 0 Lega l Description : CAMPBELL S AD D LO T1 2 BLOC K4 S 2 5 W 9 9 E 11 1 F T2 5 X 9 9 Valu e Informatio n Lan d Improvemen t Tota l 200 9 200 8 200 7 200 6 200 5 200 4 $3,200.0 0 $3,200.0 0 $3,200.0 0 $3,200.0 0 $3,200.0 0 $3,200.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $3,200.0 0 $3,200.0 0 $3,200.0 0 $3,200.0 0 $3,200.0 0 $3,200.0 0 Sale s Informatio n Sale s Date : 2004-02-2 0 Dee d Type : SW D Book : 200 4 Page : 06592 7 I Price : $100.0 0 Grantor : LAN D REUTILIZATIO N COMMISSIO N Grantee : JAME S J JUR YJ TWRO S Valid/Invalid : Invali d Exclusio n Reason : Sal e b yGovt Agency Sale s Date : 1997-06-2 4 Dee d Type : SH D Book : 200 4 Page : 06592 6 Price : $0.0 0 Grantor : DOUGLA S COUNTYSHERIF F 

### http://douglasne.mapping-online.eom/DouglasCoNe/static/accountinfo.j sp?accountno=RO.. . 1 1 /17/200 9

### Dougla s County Accoun t Informatio n Pag e 2 o f 2
Gr a nfoo Valid/Invalid : Exclusio n Reason : 1 AKir * o m Invali d IT H i-7ATir\ M r^rwinuniocyIr\K i

Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 5 2475. 0 0. 0 99. 0 25. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO. . . 11/17/200 9

### ENVIRONMENTA L AS-BUIL TDRAWIN G • . 

### MAH ALEA D SUPERFUN D SITf c RESTORATIO N 6291 3 Exterio rPain t North Arro w Omah a Lea d Sit e • Goo d Sit e Sketc h • Poo r Samplin g Address : 242 4 S 2 0 A V [ 2 No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm ; f M pft-J D RYASCPXA-6291 3 F 1 pp m 

### D Date : f!>-/S-^ A RYBSCPXA-6291 3 F 2 pp m 

# a Time : 2 • 3 0 pr m RYCSCPXA-6291 3 B 1 pp m 

# n 

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### H5 f pp m 

# n RDZOCrXA-6291 3 & 2 pp m 

### D D XR F Unit ; CeSH O Book ; Zi ^ RGZSCPX A6201 3 S2 ­ pp m 

# n n Dale ; '= 1 -IS-0 & Rrzscpx/'> 6201 3 e z pp m 

# n Time ; 

# a rrr- , Staff ; Numbe ro f Sample s = | If - [ 

# msu > Legend ; F l = Fron t Left , F 2 = Fron t Right , B l = 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

s viewe d fro m Ih e street , facin g properl y )f cy - . •» < y ^ •

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# RicV / dVeA^^r yThenn o Fisher Scientifi c 90 0 Middlese. x Tumpik e Billerica , M/ . 0182 1 SCIENTIFI C
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- AyER.\Gli : AODRESS ^^ ^ SAMPCEvAREA i OPER A FO ROKI'I H 1- NOIE S 1 2010-04-0 6 07:0 5 Avg of 3439-344 . 242 4 s 20 ave B 2 VENTR Y 4 fina l clearanc e 175.6 1 ± 19.6 3 2 2010-04-0 6 07:0 5 2424 s 20 av e B 2 VENTR Y • 4 fina l clearanc e 6291 3 173.0 6 ± 19.6 8 3 2010-04-0 6 07:04 242 4 s 20 ave B 2 VENTR Y 4 final clearanc e 6291 3 173.8 5 ± 19.49 4 2010-04-0 6 07:0 3 242 4 s 2 0 av e B 2 VENTR Y 4 final clearanc e 6291 3 179.9 2 ± 19.7 3 5 2010-04-0 6 07:0 2 .Av g o f 3435-343 ' 2424 s 2 0 ave B l VENTR Y 4 fina! clearanc e 188.05 ± 20.2 0 6 2010-04-0 6 07:0 2 242 4 s 20 av e B l VENTR Y 4 final clearanc e 6291 3 191.9 3 ± 20.3 5 7 2010-04-0 6 07:0 1 242 4 s 20 av e B l VENTR Y 4 final clearanc e 6291 3 197.7 1 ± 20.5 5 8 2010-04-0 6 07.0 0 2424 s 2 0 av e B l VENTR Y 4 final clearanc e 6291 3 174.5 0 ± 19.69

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