## TRANSMITTA L of OMAH A LEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SATO# : 9j/^nf . Date : lj\qo ^ Address : ^ / 5

> pnpf^oilZ . A ^ RemediationConHactor : ft..p..,^ %,A . Tonr ^ Year: . ?^(? 9 SOI L REMEDIATIO N PROPERT Y FIL E FOLDE RDOCUMENT S ^ 

# a r ^ ^ 

## D ^ 

# n d Vide o of propert y (DVD ^ Executiv e Summar y EPA-provide dpropert y sketch SignedAcces s Agreemen t fo r

subject propert y Signe dAcces s Agreement(s ) fo r

adja^ien t propert y Restoratio n Agreemen t Settlemen t documents (i.e. , fo r

damag e or t o replac e plants , etc. ) Confirmation data Q^ 

# e r 0 / Q ^ 

## D ^ 

### D D Photograph s As-built sketch Satisfector y restoratio n signedb y Propert y Owne r Propert y close-out chec k

lis t signedby EP A Descriptio n o f area s no t meeting ROD cleanu p criteri a Utilit y clearance s 

### Propert y informatio n fromDougla s Count y Assessor' s Offic e

D 

### Qc^ -4 ^ Signatur e 5////A ) 

## 15at e 3005424 8 

# MiHinM i Superfun dFROFEBT Y SUMMAR Y Date ; 9/15/200 9 | Omah aLea dSit e Remedia l Actio n Contrac t f

t EP-R7-07-0 6 TO# l | Montl i of : Augus t Propert y Address : 61 2 POPPLETO N A V A . EXECUTIV E SUMMAR Y A l Issue s Encountered : NON E A. 2 Issue s Resolved : NON E A J Uniqu e Findings : NON E A. 4 Othe r Relevan t Information : NON E CONFIRMATIO N SAMPLIN G DATA/RESULTS : F l = 29 1 PP M @ 13" ; B l = 20 0 PP M @ 13" ; N O EASEMEN T ATTACHMENT S 1 ) Propert y sketc h provide db y EP A pursuan t t o contrac t specification s 2 ) Signe dAcces s Agreemen t includin g acces s agreement s require dfo r crossin g othe r propertie s 3 ) Pre-Excavatio n digita l vide o clip/photograph s 4 ) Post-Excavatio n digita l vide o clip/photograph s 5 ) Documentatio n - Complete dClose-ou t Checklis t 6 ) As-Buil t sketch
i ) Shal l includ e final lea dlevel s v ) Legen d ii ) Contaminatio n lef t behin darea s vi ) Contracto r identificatio n iii ) Propert y addres s vii ) Dat e iv ) BVI D numbe r 7 ) Odie r item s t o b e include di n th e individua l property file, i f available , o r obtaine dinclude : i ) Pre-excavatio n agreement detail s (i f an y ar e mad e wit h th e property owner ) ii ) Propert y Statu s For msigne db y propert y owne r iii ) Excavatio n digita l vide o i n MPEG , WM V (Window s Medi aVideo ) o r SW F(Flas h Player ) format and/o r photograph s iv ) Signe dfor mverifyin g satisfactory restoratio n v ) Descriptio n o f area s no t meetin g Interi mRO D cleanu p criteria .

TECHNOLOGIES, INC .Fin d Record Remediatio n Queryj Lea d Remainin g Queryj Propert y[>amag e Query Badcfill :

Sampi e Area : 2100 6 - 61 2 POPPLETO N A V Owner :

• Owne rOocupie d Owne rName : j FERRAGi m RICHAR D Owne rAddressl : Owne rAddress2 : |61 4 POPPLETO N AV E Qty : State : Zi p Code : jOMAH A [N E |6810 8 Owne rPhone : Alternat e Phone : 

# I Resident : Residen t Name : 

# I . Propert yAddress : |61 2 POPPLETO N A V Zi p Code : |6810 8 Residen t Phon e 

# I Contract : Contractor : |PRUDENT2009_S Contrac t Optio n BAS E Assessment : Qualifyin g Grou p 

## po o Assessmen t MaxXR F Value : 

# r 405.5 8I1CHN0L0GIES,IN C Property* : 3L^^0{ f Date/Time : ^-Z)' ^ Quad s Excavated : 0>)/p- l 

# MEP A EP A Propert y Clos e Ou t Propert y Address : (»»0 . foffU ^ ^ Owner' s Name : ^»cVcw-o* . Fc*r acx< y i Contracto r Grou p Pruden t Technologie s Excavatio n Genera l Ye s N o 1 .

If necessary , wer e the correct qua(1rant(s) excavatedan drestored ? / 2 .

I f necessary , wer e the correct areas ofdri p zone excavatedan drestored ? 

## y Gradin g Sodan dVegetatio n Ye s N o 1 .

Doe s the grading aroun dthe perimete r ofth e hous e i n excavatedarea s generally slop e awa y / fromthe house ? 2 .Ha s sodbee n laidi n all area s tha t wer e excavated ? 

# y 3 .

Doe s th e sodappea r t o b e generall y heakh y an dgrowing ? (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 n th e sodstrip s generall y tight ? (Onl y evaluat e if inspecteda t a3 0 da y tim e period) 

# y 6 .

Wa s th e propert y gradedsuc h tha t wate r wil l not pool o n th e property ? 

# y 7 .

Was damag e t o landscaping or 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 or fence s taken dow n during restoration activitie s reinstalled ? (I f applicable ) 

## y 3 . Was damage t o gate s or fence s avoided ? (I f applicable ) 

# y 4 . Was damage t o retaining wall s avoided ? (If applicable ) 

# y Foundation , Sidin g an dGutter s Ye s No 1 , Was damag e t o the siding or trimavoided ? 

### y 2 .

Was damag e t o the foundatio n avoided ? 

### y y 3 .

Was damage t o window s avoided ? 4 .

Was damage t o window s o r doo r screen s avoided ? 

### y 5 .Was damage to downspouts or downspou t extension s avoided ? 

## y Sidewalk s an dDriveway s (Concrete ) Ye s No 1 . Was damag e t o drivewa y surface s avoided ? y 2 . Was damage t o walkwa y surface s avoided ? 

### y

## Propert yCompietio n Agreemen t Thi s agreemen t document s th e completio n o f removal activitie s performe do n th e belo w liste dproperty . Th e property owner' s signatur e indicate s tha t th e property owner i s satisfie dwith th e restoratio n ofth e subjec t property , an dtha t n o item s ar e i n question , now , o r a t an y tim e i n th e future , excludin g an y remainin g warrant y (3 0 day s total ) excep t thos e item s liste dbelow , i f any . Propert y ID : Propert y Address : /• * i <- j POPP W hv N A^^u ; Owner : 'p y c V 

# f elK.^<\r.o- V , Phone : Q ^ C 

# r^q r C^/^^ ^ Restoratio n ttem s I n Question :

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

^-Tkagre e restoratio n i s completed .

L J I d o no t agre e restoratio n i s complete d a t (note d deficiencie s above )



## SQADys^^^: ^ 

# ^ - ]^-^ ^ Owner' s Signatur e DatePruden t Technologies , Inc . (Prudent ) i s unde r contract wit h the U . S . Environmenta l Protectia n Agenc y (EPA ) to clea n u p lead
contaminate dsoil s a t anumbe r ofpropertie s locate di n Omaha, Nebiaska , includin g the propert y locate da

t i o 149 ^ ^'^P P f£'^0? ^ ' ^ ^ VS K

request s you r permissio n to allow Pruden t t o perfon n asoil cleanu p a

t thi s propert y ^ retiiove (eid^coiitafiunate dsoil . B y signin g thi s form, the propert y owne r grant s pemiission to Pruden t t o perfor m activitie s relatedto the cleaniq ) includin g soi l sampling , remova l o

f lead-contaminate dsoil , an drestoration ofth e reference dproperty . I f yo

u have an y question s abou t the soil cleanu p plannedfo r you r property , pleas e contac t Prudent' s Administrative Cler k

fo

r the Omah aLea dSit e cleaniy . Ms . Siv aS Jampana-a t (402) 733-1188 . OeiierB l question s abou t the Omah aLea dSit e cleanu p ca n b e directedto the EP A Public Informatio n Centers a t (402) 73 1 -304 5 (Sout h Omah aofBce ) o

r (402) 991-958 3 (Nort h Omah aoffice) . Propert y Acces s Grante dBy : R\ C V l ^ V ^Q.C^/^GC.nr < (Pleas e Prin t Naide) Propert y Owne r Signature : 

# m ^

PROPERT Y INFORIMATIO N (T o b e complete db y residen t and/o r properl y owner — pleas e print ) RESIDEN T NAME : Rente r RESIDEN T ADDRESS : ^

_y\^ , ^ , t I F RENTAL , PROPERT Y OWNE D BY : OWNER' S MAILIN G ADDRESS ; 

# 6/Jlp^pp><4^< ^ OWNER' S TELEPHON E NUMBE R - HOME : 

# t(,(fl . ^W^i^9l5.K . 

# 2.( 5 AO E O F HOME? : lo O YEARS . HO W LON O HAV E YO U LIVE D HERE ? YEARS . HAS TH E EXTERIO R BEE N PAINTE D O R COVERE D Wrr H SIDIN G SINC E 197 8 YE S N O NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OLO : . 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 PLA Y I N TH E YAR D FO R S HOUR S O R MOR E PE R WEEK : COMMENT S O R SPECIA L INSTRUCTIONS : (I.E . DOGS , ENTR Y GATES , ETC. ) 

# AUU/^?vCL . 7 w c Q/ p AUTHORIT Y FO RENVIRONMENTA L RESPONS E ACTIONS : Th e activifie s to'b e in^dnente db y EP A unde r thi s agreemen t ar

e pursuan t to Sectio n 10 4 ofCERCLA , 42 U.S.C . 9604 . EPA' s righ t ofacces s t o the propert y i s provide dfo r i

n Sectio n 104(e ) o

f CERCLA, 4 2 U.S . C 9605(e) , whic h provide s entr y fo r "determining the nee dfo rresponse, o r choosin g o r takin g an y respons e actio n uiule r thi s title , o r otherwis e enforcin g the provision s ofth e title. " TOes to'b B ir^emente db y 1

808 0 Ward Parkway , Suit e 40 5 2505 N . 24* ^ Street , Suit e 30 8 424 2 Medica l Drive , Suit e 426 0 KansasCity , MO6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Fax : (816 ) 363-370 7 ( Phone : (402)504-1004 , Fax : (402)604-100 5 ' Phone : (210)822-968 8 Fax : (210 ) 679.«S77ENVIRONMENTA L & CONSTRUCTIO N 

### TECHNOLOGIES , INC . SERVICE S 

# Propert y Statu s For m Address : Date : L l'2L ^ ( o ^ Phone : ^VlT ^ BVID : 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

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808 0 War d Parkwav . Suit e 40 S 2S0 S N . 24' ^ Street . Suit e 30 8 424 2 Medica l Drive . Suit e 42S 0% rCHNolOniKS . IN C 

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### OMAH A LEA D SUPERFUN D SIT E 2100 6 Nort h Arro w Omah a Lea d Sit e Exterio rPain t Owne rName : RICHAR D FERRAGUTI Sit e Sketc h • Good AddrBSs : 61 2 POPPLETO N A V DyPoo r Phone : H : w . ^4o t pain t Q 

# i Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm : •mg b Br f /s W RYASCPXA-2100 6 F 1 \4r>l^Po m D Date : (^lH^lo ^ RYDOOPXA-glOO O F2 - pp m D Time : 2-'. m RyCSCPXA-2100 6 B l Di^PP m D Sample s Analyze d RYDCGPXA-2100 6 B2 - pp m D D RDZSCPXA-ZIOO e BZ - .pp m D D XR F Unit : ^\ \ Book : \j • WGZ6OPXA-2100 6 62
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CONTRA a # : E P - R7-07-0 6 T0# 1 PRUDENTTECHNOLOGIES , INC .% 

## 2100 6 Exterio rPain t Omah a Lea d Sit e hkxihAiTo w Owne rName : RICHAR D FERRAGUT I n Goo d Sit e Sketc h Acidress : 61 2 POPPLETO N A V n^Poo r Phone : H ? v; ^ Q Notpain t 

# 1 Sampl e Numbe r RYASCPXA-2100 6 nYDGCPXA--eiOO O RYCSCPXA-2100 6 RYDCGPXA-glOO G RD2.&UPXA-2IOe O • RCZCCPX A 2100 6 RPgOOP)( A a100 0 Lea d Sampl e Sample s Collecte d LA B Concentratio n Colle^fe d Firm : j21^__Qd_/5i4«i . F 1 

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### 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 194383000 0 FERRAGUT I RICHAR D 61 2 POPPLETO N A V OMAH A 6810 8 61 4 POPPLETO N AV E OMAH A N E 6810 8 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 26-15-1 3 PAR KWIL D AD D 1 5 36X16 0

http://webapps.dotcomm.org:8080/TreasTaxyfaces/pages/taxinfo.jsp ? parc=194383000 0 http://douglasne.mapping online.com/DouglasCoNe/statlc/accountinfo.jsp ? accountno=R194383000 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 = 7 4 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogi s alias/dogis/printPreview.asDX?PrintODtData=Douff]a s r,nimtv
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" > Creat e Anothe rTicke t Bac k t o in h Inteme t Sen d Emai l 

### YOU RTICKE T NUMBE RI S 2309014 . Origina l Cal l Date : 7/02/0 9 Time : 1:0 6 p m Op : SIVA1896 7 Wor k t o Begi n Date : 7/07/0 9 Time : 1:4 5 pm State : N E UGLA S Place : OMAH A Address : 61 2 Street : POPPLETO NAV E Twp : 15 NRng : 13 E Sect-Qtr : 26-N W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : SOI L LEA D REMEDIATONPROJEC T Locatio n o f Work : LOCAT E ENTIR E PROPERTY Remarks : FA X AL L CLEAR S TO : (402)733-188 3 : FA X AL L CLEAR S T O (402)73 3 188 3 : UNSUR E CORNER S Compan y: PRUDEN T TECHiJOLOGTE S Contac t Name : SIV AJAMPAM A Phone : (402)733-118 8 Wor k Bein g Don e For : EP A Dept h o f Excavation : 6 FT Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V LEVEL3
- MUD0 2 G»lAHACO FOPPDGPR 6 QLNNEI F QWESTN E Servic e Are a Contac t Phon e Numbe r Utilit y Typ e CXCAT V CO X COMMUNICATIONS , DST C 

### HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 LEVEL3 LEVEL S COMMUNICATIONS . LL C N A 

### Day : 877366834 4 Alt : Emerg : 877366834 4 MUD02 METROPOLITA N UTILrriE S DISTRICT SAND Y Day : 402504782 3

Alt :

Emerg : 4^2504797 0 OMAHACO FCIT Y O FOMAHA-TRAFFIC.SEWE RRO N Day : 402444719 7

Alt : 402444516 1 Emerg : 402444516 0

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### Pag e 2 of 2

OPPDGPR 6 OMAH A PUBLI C POWE RDISTRIC T N A 

### Day : Alt : 406728934 3 406207149 4 Emerg : 888728934 3 QLNNEI FQWES T LOCA L NETWOR K 

### N A Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 QWESTN E QWES T LON G DISTANC E 

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### TECHNOLOGIES , INC . SOLUTION S



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# y^= ­ 308 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 725 0 KansasCity , M O 6411 4 Omaha , Nebrask a 6811 0 San Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210 ) 822-958 8 Fax : (402)504-100 5 Fax : (210 ) 579-657 7/ /