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# y Remediatio nContractor : Coasta l Environmenta l Group _ Year : 200 1 SOI LREMEDIATIO N PROPERT Y nLEFOLDE RDOCUMENT S Vide o o f property (DVD ) Executiv e Summar y 

# el EPA-providedproperty sketch SignedAcces s Agreement fo r

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adjacen t propert y Restoratio nAgreement Settlemen t document s (i.e. , fo r damag e or to replac e plants , etc. ) Confinnatio ndata Photograph s % W ^ ^ ^CA^^iy^/y \K W{^O^^^^^^r ^ t / As-built sketc h Satisfactor y restoratio nsignedb y Propert y Owner Propert y close-out check lis t signedb y EP A J l - Descriptio no f area s no t meetin g RO D cleanup criteri a Utilit y clearance s Propert y infonnatio nfro mDougla s Count y Assessor' s Offic e

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## Slgned:^/Za<H . By : aD>|tsoilSafflpliag(tf applicable ) 

### / / By : D Disposa l Sanqtiin g O f qipHcable ) 

### / / Br . D Garde nSampUng 9 applicable ) 

### / / By : ) ^ Utilit y Clearanc e 

## Called : iL/i2/(2 9 

# ^-m/i/n q\l^'.)L1 0 13 G^deomioio s (Btfore ) 

### On : J. / :f ^ / V L *3 ^ Dtr^'^^l'- ' aYtdeamoto s (Dnring ) 

### On : / / Br D Videomiota s (After) 

### O m/ / Dy : D Vi|Jeofl%o«08 (30-Day ) 

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• Comnmnit y QCrc w | On : / / By : Results : Omah a Lea d SK e• • 

## - Dougla s Count y Accoun t Jl&inmtio n Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R221834000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f52n d S t - VieW fO H Ma p Informatio n i s vali d a s o f2009-9-1 5 Treasurer' s Ta xRepor t Nev ^

Featur e ^ ^ - • Aut o Sale s Searc h Owne r CAPPELLAN O J R LOUI S J ETA L 290 5 S 7 4 S T OMAH AN E 68124-000 0 Propert yInformatio n Ke yNumber : 183 4 000 0 2 2 Accoun t Type : Residentia l Parce l Number : 221834000 0 Parce l Address : 121 9 S 2 7 S T OMAH AN E 68105-000 0 Lega l Description : SHULL S 2N D AD D LOT1 1 BLOC K8 N 4 0 S 12 8 W 4 0 F TLT1 2 & N 4 0 S 12 8 FT 40X9 7 Valu e Informatio n Lan d Improvemen t Tota l 

### 200 9 200 8 200 7 

### 200 6 200 5 200 4 $3,900.0 0 $3,900.0 0 $3,900.0 0 $3,900.0 0 $3,900.0 0 $3,900.0 0 $51,800.0 0 $51,800.0 0 $51,800.0 0 $44,100.0 0 $44,100.0 0 $44,100.0 0 $55,700.0 0 $55,700.0 0 $55,700.0 0 $48,000.0 0 $48,000.0 0 $48,000.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 8 3880. 0 1. 0 97. 0 40. 0 N o Improvemen t Informatio n Buildin g 1



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22.. . 9/17/2009

### Dbugla s County Accoun t I^i^tion Pag e 2 of 2 • #

Hre > Floo r > sse.otait . BGinn t IMO« qI ?ir ! aaiftwC w' i

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## 2 STORY CLIC KTO ENLARG E IMAG E CUC KTO ENLARGEJMAG E Squar e Footage : 1122. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0

HVAC : Centra l Ai rt o Ai r Rooms : 4. 0 Exterior : ^ Fram e Viny l Units : 1. 0 Interior : i Plaste r Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 2. 0

Roo fType : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : ; 0. 0 Yea r Percen t Adjuste d Yea r Yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 190 2 0 0 % 190 2 10 7 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 1. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 656. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Basemen t Singl e 1. 0 Porc h Sla b Roo f Cei l 24. 0 Porc h Sla b Roo fCei l 126. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22. . . 9/17/200 9• • • • 

### Pag e 1 of 2

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### Creat e Anothe rTicke t __ ; ] [iy^ i Backtojrt h jntarne t \^ | [i . Sen d Eniai | ]



### • YOU RTICKE T NUMBE RI S 2382689 . Origina l Cal l Date : 10/08/0 9 Time : 11:1 1 a m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 10/13/0 9 Time : 11:4 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 121 9 Street : S 27T H S T Twp : 15 NRng : 13 E Sect-Qtr : 28-N E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (877)662-421 1 UNSUR E O F CORNE R LOT S RESEN T Dtra : T O WOR K EXTENDING . REFRES H PAIN T AN D FLAG S 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 Come r Lot : NFront : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V LEVEL S MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F 

### Service Area Contact Phon e Numbe r UtiUt y Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL S LEVEL S COMMUNICATIONS , LL C N A Alt : Emerg : 877366834 4 Day : 402504782 3 MUD0 2 METROPOLITA NUTILITIE S DISTRIC T SAND Y Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFnC.SEWE RRO NAlt : 402444516 1 Emerg : 402444516 0 http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 10/8/200 9

### Pag e 2 of 2 • • • # 

### 0PPDGPR 6 OMAH A PUBLI C POWE RDISTRIC T N A Day : 406728934 3

Alt : 406207149 4 Emerg : 888728934 3 QLNNEI FQWES T LOCA LNETWOR K

N A Day : 406728934 3

Alt : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreationyMessageText.asp?ret=<RESULTS. . . 10/8/200 9

# 0#As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e

Omah a Lea d Sit e Owne rName : LOUI S J CAPPELLAN O J R E T Sit e Sketc h Address : 121 9 S 2 7 S T

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## D RYBSCPXA-2069 1 F 2 

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

# 2069 1 Omah a Lea d Sit e Owne rName : LOUI S J CAPPELLAN O J R E T 

### Sit e Sketc h Address : 121 9 8 27 S T Phone : H : W : Sampl e Numbe r RYASCPXA-2069 1 RYBSCPXA-2069 1 RYCSCPXA-2069 1 RYDSCPXA-2069 1 EST "

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RIGH TO F ENTR YT O PREMISE S Granto r(th a propert yowner ) consent s t o an d authorize a th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rit s authodze d repreaentatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l respons e activttie s upo n th e fDllowin g descriije d premises ; 

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# \l\( \5 2 T 3\ t Asreement ; PURPOS E O F RESPONS E ACTryiTiE S Th e EP Ai s requestin g acces s t o collec t soi l sample s an d remov e soi l the t contain s elevate d concentration s o fkra d en d ma ypos e a healt h hazard . Th e 8reB(& ) wil i b e excavate d t o remov e contaminate d soil . Th e remove d ctmtaminate d soi l wil l b e replace d wit h dea n rnatenal s an d th e are a wil l b e restore d t o Its odgina l condition . Thi s wod t i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatm n program . Arepresentativ e o fCoasta l Environmenta l Group , contracte d b yUSEPA , wil l contac t th e Granto rin^erso 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 pienne d soi l removal , an d restoratio n wori c befor e i t begins . Onc e th e wori t i s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d conflm n tha t i t i s complet e an d meet s wit h th e Grantor' s approval . Upo n completion , th e Grsnto rwil l receiv e vwtlte 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 o Granto ri s grantin g th e EPA . it s employees , contractor s an d subcontractor s th e righ t t o ente rth e property , a t al l reasonabl e time s an d wit h prio rnotioe , fo rth e sol e purpos e o fperformin g th e wod( . Thi s acces s shal l remai n i n effec t unti l th e wor k ha s tne n satisfactoril ycompleted . Th e Granto rals o agree s to : Psg e 1 o f ?

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< Remov e obstmction s includin g boats , trailers , vehicles , plej'scap e Items , wo piles , do g houses , etc ; o d fRemov e flowerbulb s o rplant s tha t th e Granto ro rth e Granlcr' s tenan t ma yw t o save ; is h < Wate ran d msintai n replacemen t vegetation , Indudin g fedllize rapplication , necessar ysubsequen t t o a n initia l waterin g perio d b yEPA ; a s < 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 i acces s th e propert yt o perfor m th e woric . t o t Allo wvkl«>tap<n g wixUo t photographin g o fth e property . AGF^EEMEN TNO TT O INTERFER E Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo fth e wori ( activities , o rwit h an y o fth e wori ^ 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 prapert 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 . 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 (4Q2 ) 991-t19 9 j C WJi ^ 

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## Refitoratsc n AgrBsmsn l Th e purpos e o f thi s agreeme mi s t o provid e • mutua l Bgrceme ma s T O condition s ofth e propert y prio r l o rctnediatio D EctivKies . Thi s -will als o serv e u documentttio nfo r th e purpoi B o f tsiurin g tiiat reitoiatio n Bcrivitie i ar e complete dl o th e Mtisfhctio no f th e propen y owne r an dth s Unite dSiaie s EnviTonmental Protectio nAgenc y (EPA) . 

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\ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 I Coasta l Environmenta l Grou p Inc . v i \ _' ^ www.coa8talhazmat.co m ^^tpRoT*" ^ COASTA L (•VltONHIilTA L Clo u r . IN C 

# EXECUTIV ESUMMARY : BVID #20691-(121 9 S 2 7 ST ) No Issue s o r Concern s [ ^ Issues/Concern s Detail Explanation :

# EP A EP APropert y Clos e Ou t For m 7 . ^ S T Propert y AddresstV J 'i ^ Propert y # : 2,C>6 > ? / . . Date/Time : Ow«r' . Name: . .iL.Cl«-tbj 3 'T !'3 y ^ ' ^•'" f f

^ "'^" ^ Quad s Excavated : 1 ^ t Q Z r Contracto r Grou p C»«w<-ht - f e ^ r-«»u>. p Ye s N o Excavatio nGenera l I . If necessary , were th e conec t quadrant(s ) excavate dandrestored ? 2 . If necessary , were th e correc t area s ofdri p zone excavate dandrestored ? - ^ ^ Gmdln g So d an d Vegetatio a I . Doe s the gradin g aroun dth e perimeter ofth e hous e i nexcavate darea s generall y slop e awa y 

# T fromth e house ? 2 . Ha s so dbee nlai dinal l area s tha t wer e excavated ? 

# ly ^ 3 . Doe s th e sodappear to b e generally healthy an dgrowing ? (Onl y evaluat e if inspecte da t a3 0 

### \ ^ ' day time period ) 4 . Ar e soddedarea s generall y fir man devenly graded ? t / " 5 . Ar c th e joint s betwee nth e so dstrip s generally tight ? (Only evaluate i f inspecte da t a3 0 da y 

### 1 / ' tim e period) 6 . Wa s the propert y grade dsuchtha t wate r will nol poo l o nth e propert>' ' 

# i; ^ 7 . Wa s danug e t o landscapin g o r plan t material s avoided ? 

## 'ty ^ Gates , Fence s an dRetataIn K Wal b VC 5 > 0 I . D o gate s ope nan dclos e freely? (Ifapplicable ) 2 . Wer e all gate s or fence s takendow ndurin g restoralio nactivitie s reinstalled ? (Ifapplicable ) 

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

# y 4 . Wa s damag e t o retainm g wall s avoided ? (Ifapplicable ) Foundation , SidiB K an dGuHer s Ye s N o I . Wa s damag e t o th e sidin g o r tri mavoided ? 

# IZ . 2 . Wa s damag e t o the foundationavoided ? c X ^ 3 . Wa s damag e to window s avoided ? 4 Wa s damag e to window s o r doo r screen s avoided ? t y ^ 5 . Wa s damage to downspout s o r downspoul extension s avoided ? 

# l y ' Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 . Wa s damag e l o drivewa y surface s avoided ? t ^ 2 . Wa s damage t o walkwa y surface s avoided ? 

# ly "

## Ovi'ner s comments :

iDSpectio nnotes :

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# Date : /d/^/s f

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