## TRANSMITTA Lo f

OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAID. : ^ 6 ^( . Date ; W'^ < ^^' ^ 

# 1^1 i\\A^ m^ i Address : Remediatio nContractor : Coasta l Environmenta l Group

_ Yea r ; _200 a SOI LREMEDIATIO N PROPERT Y HL EFOLDE RDOCUMENT S Vide o o f propert y (DVD ) Executiv e Summar y [VEPA-provide dpropert y sketc h J S Signe dAcces s Agreemen t for subjec t propert y -fi " Signe dAcces s Agreement(s ) for adjacen t propert y u Restoratio nAgreemen t -9 ' Settlemen t document s (i.e. , for damag e o r to replac e plants , etc. )

- S Confirmatio ndat a ( /

Photograph s (^^^/TTWM 

### ^ f(^-6c^^tWv- > As-buil t sketc h Satisfactory restoratio nsigne db y Propert y Owne r Propert y close-ou t chec k lis t signe db y EP A ^B " Descriptio no f area s no t meetin g RO D cleanu p criteri a D Utilit y clearance s ^ 

### Propert y informatio nfro mDougla s Count y Assessor' s Offic e

3005485 3 

# Illlillll I U Superfun d

### Propert yAcces s Checklis i Propcrr^lD : 5t=)(^Q|j > n WOR K STARTED ON : _/ /_ D WOR K COMPELTE D ON : / / Propen yAddre»:^^ p V \ riV.<V>V | f ^ • Rente r Owner: , 

### \)i>Ays)-V<^ l^/^\;e.S
­ Addrt.^s : Phone : FiL\ : Cell/Pager : Phone : L l Additionu l Inlormntion : Fa v Cell/Pager . D Notiricatio n Lette r J

^ Accts i Agreemen t JP l Restoratio D Agreemen t

D Topsoi l Samplin g (i f applicuble ) Q DisposA l Samplin g (r f applicable )
• Giirdc n SflinpliD g (i f apr)lical>le ) 1 1 Diilil yClcsrimc c D Video/Photo s (Before )
• Video/Photo s (During ) D Video/Pholo i (After ) D Video/Photo s (30-Diiy ) ^e:: ^ Propert yCompletio n Ajjreemen t D Fina l Repor t Sent : / / 

### Signed : 3_/^/(De signed : ^/3

_ 0 9 / / / / / / Called : / / On : / / On : / / On : / / Oo : / / 

### Signed : ^/^/C 5 

## f~ Issued : / / By : By : By : By : By : By : By : By . Bv : By : By : By : By : Ai rMonitorin g (* i applicable )

n Communit yC D Cre w ReiuJtv : On : / / By : D Communit y Results : D Cre w On : / / By : D Communi n Resulu : Q Cre w On : / / By :

Omah a Lea d Srt e

### Dougla s County Accoun t I

n 

## '^•yi^io n Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R152925000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f52n d S t - ViewO n Ma p Informatio n i s vali d a s o f2009-8- 3 Treasurer' s Ta xRepor t Ne wFeatur e -*->- > Aut o Sale s Searc h Owne r REAVE S JUANITA 181 7 PINKNEYS T OMAH AN E 68110-000 0 Propert yInformatio n Ke yNumber : 292 5 000 0 1 5 Accoun t Type : Residentia l Parce l Number : 152925000 0 Parce l Address : 181 7 PINKNEYS T OMAH AN E 68110-000 0 Lega l Description : KOUNTZ E PLAC E LOT4 BLOC K3 5 5 0 X 12 4 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $4,800.0 0 $47,500.0 0 $52,300.0 0 200 8 $4,800.0 0 $47,500.0 0 $52,300.0 0 200 7 $4,800.0 0 $41,700.0 0 $46,500.0 0 200 6 $4,800.0 0 $41,700.0 0 $46,500.0 0 200 5 $4,800.0 0 $41,700.0 0 $46,500.0 0 200 4 $4,800.0 0 $13,900.0 0 $18,700.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6200. 0 1. 0 124. 0 50. 0 N o Impro t vemen Informatio n Buildin g 1



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R15. . . 8/22/200 9

### Dougla s County Accoun t I i^Hm||a t lio n 

### Pag e 2 of 2

181 7 Plnkne y '« •© riin r
' " Ri«Fteo >

I T»OS « R 4S \

1 B 0 a o

t0 ! pmymm m »<r ai f 21/ 2 Stor yUnfi n ^^^HBHjflpV ^Ty:--:Z7:7;^JtL ^ CLIC KT O ENLARG E IMAG E CLIC KTO ENLARG E IMAG E Squar e Footage : 1446. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Goo d

Buil t As : 2 1/ 2 Stor yUnfi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 8. 0 Exterior : Fram e Viny l Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : \ 3. 0 Roo fType : Hi p Stories : I 2. 5 Floorcover : Allowanc e Foundation : I Bloc k Sprinkle rSquar e Footage : ; 0. 0 yea rBuil t Yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 190 5 0 % 190 5 10 4 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 694. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h En d Soli d Wal l 176. 0 Porc h Woo d Dec k 56. 0 Use r Se e note s 1. 0



### htt p ://douglasne.mapping-online . com/DouglasCoNe/static/accountinfo. j sp?accountno= R15.. . 8/22/200 9

## CONTAC T FOR M Propert y I D # Propert y Address : Initia l Contact : Secon dContact : Fina l Contact : Fina l Action :

Comment : Owne r Commen t (s) : Sit e Coordinato r Commen t (s) : 

# 5^WI ^ 

# \'i n Date : Date : Dale : ?\r\\Lx>^\ j Time : Time : Time : Transmi t to EP AD % ^ Action : Action : Action : Othe r Action ; D

r• • 

### Pag e 1 of 2

> Creat e Anothe rTicke t ] 1 Bac k t o Irt h Interne t j Sen d Emai l 

### YOU RTICKE T NUMBE RI S 2360351 . Origina l Cal l Date : 9/09/0 9 Time : 3:5 5 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 9/11/0 9 Time : 4:3 0 p m State : N E County : DOUGLA S Place : Gtyt/m A Address : 181 7 Street : PINKNE Y S T Twp : 15 NRng : 13 E Sect-Qtr : 10-NW Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REI^EDIATIO N Locatio n o f Work : INCLUD E AL L EASEI^IENT S LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (877)662-421 1 : UNSUR E O F CORNE R LO T Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : COASTA L Dept h o f Excavation : 4 F T Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V I^AGELLA N I^UDO l OI^IAHACO F0PPDGPR 5 QLNNEIC Servic e Are a Contac 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 MAGELLANMAGELLA NMIDSTREA M PARTNER S LPDEBORA H Alt : 

### Emerg : 918574709 8 Day : 402504782 3 MUDOl METROPOLITA NUTILITIE S DISTRIC T SAND Y 

### Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R RON 

### Alt : 402444516 1 Emerg : 402444516 0


### http://www^.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/9/200 9

### Pag e 2 o f 2 • • 0PPDGPR 5 OMAH APUBLI C POWE RDISTRIC T NA 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 QLNNE1 C QWES T LOCA LNETWOR K N A 

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

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/9/200 9OLS# : 556 6 Dat e Excavated:9/22/0 9 Dat e USEP ASigne d Off : 10/6/0 9 

# As-Buil t Drawin g W i C CAST AL Are a Sodden : 183 6 s a f t 

# Omah aLea dSuperfun dSit e

Name : Omah a Lea d Sit e Address : l<y< 7 ArvYcrve y Sit e Sketc h Phone : 

### n w/ * 17 . "^aS Dat e |o/il»/c> ? Tea m O U ; l'^e^t)ar ^ BVID # S'.S'Lal a XR F Cod e / ^• ^ y ^ Sampl e Numbe r Lea d Concentratio n Confirmatio n Sampl e 

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46904.783-0 1
Quadrant s Excavate d Are areplace dwit h Are a replace d wit h Are a lef t bar e So d ' ' Rock/Mulc h 

### Contracl i # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc .• • • • Name ; Omah a Lea d Sit e Address : l^i ? P{r^)Frni y. Sit e Sketc h 

# t- " Phone : 

## n ^/ * 

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OmahaLeadSit e 46904.783-0 1

# ^/AJ^AJ ^ Name ; Omah aLea dSit e Address ; l<f/ 7 PSrs^^r^ y Sit e Sketc h Phone ; Dat e Tea m BVID # XRFCode^^^ ^ 

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COASTA l INVIKONK I hTA l •• < Pno' ' C K0 U r. IN C 

## Consen t fofAcces s To Propect^ / RIGH T OF ENTR Y TO PREMISE S 

### Granto r(th e propert yowner ) consent s to an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) orit s authorize d representatives , collectivel y th e Grantee , to ente ran d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises :

m e

Owner' s Name : Daytim Phone/ S 

### li^l-iBH I

' J)ula<1if.e, . Kggk.l/^^ ^ Addres s ofPropert y covere d bythi s Agreement : PURPOS E OF RESPONS E ACTIVITIE S 

### Th e EP A is requestin g acces s to collec t soi l sample s an d remov e soi l tha t contain s elevate d concentration s oflea d an d ma ypos e a healt h hazard . Th e area(s ) wil l be excavate d to remov e contaminate d soil . Th e remove d contaminate d soi l wil l be replace d wit h clea n material s an d th e are a wil l be restore d to it s origina l condition . Thi s wor k is bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e ofCoasta l Environmenta l Group , contracte d byUSEPA , wil l contac t th e Granto rin-perso n to discus s th e wor kto be performed , th e Granto rwil l hav e an opportunit y to revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e it begins . Onc e th e wor k is finished , th e Granto rwil l be aske d to revie wth e wor k an d confir m tha t it is 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 y ha s bee n remediated . ENVIRONMENTA L RESPONS E ACTION S 

### Bysignin g thi s Acces s Agreement , th e Granto r is grantin g th e EPA , it s employees , contractor s an d subcontractor s th e righ t to ente rth e property , at al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e ofperformin g th e work . Thi s acces s shal l remai n in 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 of2

### c COASTA L INVIftOHHtKTi t C I I 0 U ' IH C 

### « Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; e 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 necessary ' subsequen t t o a n initia l waterin g perio d b yEPA ; e Abid e b yhealt h an d safet yguidanc e provide d b yEPA ; « I fth 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 fth 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 fth e wor k activities , o rwit h an y o fth e wor k done , o rwit h th e equipmen t use d o n hi s property' , o rt o undertak e an y action s regardin g th e us e o fsai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o fth 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 . Shoul d yo u hav e an yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , a t (402 ) 991-119 9 ©Ig r gran t acces s t o m ypropertie s G I d o no t gran t access t o mypropertie s 

# v^ ?

ignature Dat e Q I woul d lik e t o b e presen t durin g an ysampling i tha t i s required .

Pag e 2 o f2COASTA L 

## Restoratio n Agreemen t Th e purpos e ofthi s agreemen t i

s t

o provide amutua l agreemen t as t o condition s ofth e propert y prio r t

o remediationactivities . Thi s wil l als o serv e as documentationfo r th e purpos e of assurin g tha f restoration activitie s ar e completedt o th e saiislactio nof the propert) ' owne r an dth e UnitedState s Environmenta l ProtectionAgenc y (EPA) . 

# S^ U \?>\1 - fin^^^p y^ h 

### O^v"^'- ^ ^u..rV . Re^^. < Phone : O

nthe attache ddiagram(s ) indicat e area(s ) t o excavatedan ddepl hof excavation , locatio nof al l know n utilities , subsurface features , syrface structure s an dlandscaping features , acces s location(s ) t o be use db y contractor , an dth e directionof North . Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s b

y referencin g th e photo-lo g numbe r wit ha narrow indicating directiono f view . Item s T o B e Remove d B yOwne rBefor e Star t O fRemediation : (Us e additiona l sheet s a s necessary ) Th e removal , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s responsibility .COASTA L cAo u r. IM C 

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

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### Item s To B e Remove d B yContracto rDurin g Remediatio n An d Replace d (Us e additiona l sheet s as necessary ) 

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

### Ite m
Pre-existin g propert y area , tha t will b e excavated , tha t is covere dwit hgrass .

Number o

f tree s > 2 inch tmnk diamete r

Number of tree s < = 2 inc h trunk diamete r

Number of Sprinkle r Zones , Control Valves , Timers , Heads , etc . Attachasketc ho f the sprinkler layout . Number of an dsize o f eachgarden / flowe r bed area . Attac hasketcho f relativ e size s an dlocations . 

### Quantit y 

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Pag e 4 of .

### Ite m Agree d upo n valu e o f plan t material s no t t o b e renlace d b ycontractor . Not e thi s >'alu e wil l b e use d t o issu e a plan t vouche rt o th cpropert y owner . Agree d upo n lis t o fplan t material s tha t wil l b e replace d b ycontractor . B e ver yspecifi can d detailed . Includ e a sketc h o fwer e eac h plan t wil l b e place d b yth e contractor . Agree d upo n are a o f propert yt o b e replace d witi i gras s sod . Includ e a sketc h o fth e area(s ) t o b e replace d wit h gras s sod . Are a o fCit yo rCount y propert yt o b e landscape d pe rthei rrequirements . Includ e a sketc h o fth e aie a (s )

Easemen t Area , t o b e excavate d 

### Quantit y Uni t Condition/Type/Specie s

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Page s 

### o fPC O A£ T Ai . Additbna l Comment s / Irtstructions : 

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D Chec k th e bo xi fOwne 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 bo xCE G i s no t responsibl e fb ran ydamag e don e t o th e inteno ro fhouse , includin g foundatio n cradc s o rfissures . 

## Q I d o no t agre e 

# ^i^lM . Date

## BviD # <riri^{f , XR F PROPERTY SAMPL E SHEE T Dat e Project 

# ^5^^ Omah a lead F P 2nc l yea roptio n Addres s Sampl e tim e 

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### l-tO^' o Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 o ^^^^L I Coasta l Environmenta l Grou p Inc . ^^^^^^o * wvvw.coastalhazmat.co m I PRO ' XpRO-it^' ^ COASTA L ENVIRONMENTA L G H O U P , IN C 

# EXECUTIV ESUMMARY : BVI D #5566 - (181 7 PINKNE Y ST ) X 

# N o Issue s o r Concern s | ^ Issues/Concern s Detai l Explanation :

## ^^dljrT i 

## EP APropert y Clos e Ou t For m # .b s 1^ ^ Prniwrt v Ai1HrM<r
- A. . ;• • : LJ

—/ ) , . .,x^' - Propert y Date/Tlni e Quad s Excavated : % \Y V'5 ' Contracto r Grou p Uflkhrf ^ Ye s N o Excavatio nGenera l I .I f necessBO' , wer e th e correc t quadrant(s ) excavate dan drestored ? ^ 2 .I f necessary , wer e th e correc t area s ofdri p zon e excavate dan drestored ? Ye s N o Gradin g So d an d Vegetatio n 1 .Doe s th e gradin g aroun dth e perimete r ofth e hous e inexcavate darea s generall y slop e away fromth e house ? 2 .Ha s so dbee nlai di n al l area s tha t wer e excavated ? 

# W " 3 .Doe s th e so dappea r to b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte da t a3 0 L^ ­ da y tim e period ) 4 .Ar e sodde darea s generall y firman devenl y graded ? ^ ' 5 .

Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 day ^ ' tim e period ) 6 .Wa s th e propert y grade dsuc hthat wale r wil l no t poo l o nth e property ? ^ " 7 .Wa s damag e t o landscapin g o r plan t material s avoided ? Gates , Fence s an dRetainin g Wall s Vc s No I .D o gate s ope nan dclo.s e freely ? (I f applicable ) ^ ' 2 .Wer e al l gate s o r fence s take ndow ndurin g restoratio nactivitie s reinstalled ? (I f applicable ) 

### ./ ' 3 . Wa s damag e t o gate s o r fence s avoided ? (I f applicable ) i / 4 . Wa s damag e t o retainin g wall s avoided ? (I f applicable ) 

# u^ ' Foundation , SidiPKan dGutlcr s Yes No 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 navoided ? 

# T ^ ' 3 .

Wa s damag e t o window s avoided ? 4 .Wa s damag e t o window s o r doo r screen s avoided ? 

# T7 ' 5 .

Wa s damag e t o downspout s o r downspou l extension s avoided ? Sidewalk s an dDriveway s (Concrete ) Yes ^ 0 1 Wa s damag e t o drivewa y surface s avoided ? 2 .Wa s damag e t o walkwa y surface s avoided ?

## Owner s comments :

Inspectio nnotes :

Remova l an drestorationactivate s compiel e including th e 30-da y sodwarranry : EP ARepresentativ e JJ ) (Kf). / i ^ Date : M //) ^

### Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio n o l remedia l activme s peribime d o n m yproperly . M ysignatur e wil l desfgnat e Ilia i I a m satisfie d wit h th e resioralio n ofm yproperly , an d (ha i n o item s ar e i n queslion.s . now , o ra l an ytim e i n ih e future , excep t ihos e Hem s liste d below , i fan y

Propert y ID : 55(p( p Propert yAddress : 

# \9>\l 7m/6^t j sV . Owner : ^QQ^ftfy^Vg ^ ZttWi S 

### Phone : LQ^.^^y/ . /fl^ / Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item : Additiona l Comments :



### QJ^y r c cre s tor a I io n i n completed , cxccp l as nnter l I rto no l a^re crestoratio n



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