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TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
\< p 

### SAI D # : 

# \S M Date : 

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# y Address : YWWpO(/U/i?P< K W Remediatio nContractor : Coasta l Environmenta l Group
_ Year : 20 i 0 6


### SOI LREMEDIATIO N PROPERT YHL EFOLDE RDOCUMENT S Vide o o f property (DVD ) Executiv e Summar y EPA-providedproperty sketch SignedAcces s Agreement fo r subject property SignedAcces s Agreement(s ) fo r adjacen t propert y iz

f Restoratio nAgreement e Settlemen t doctmient s (i.e. , fo r damag e o r to replac e plants , etc. )

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### Confiimationdata 

## Photograph s y^^'^oy i \f UW^-^^ ^ As-built sketch Satisfactor y restoratio nsignedby Propert y Owner Propert y close-out check lis t signedby EP A Descriptio no f area s no t meetin g ROD cleanup criteri a Utilit y clearance s Propert y informatio nfro mDougla s Count y Assessor' s Office



# 1 t 7 to )ate

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Property Acces s Checklis t PrepertylD ; It^l^CSp ^ Q WOR K STARTED ON : ON : Owne n 

## Pjrtj/j p 'Tfr^ow)^/ \ Address : 

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. Additional Information :

D Notificotto o Lette r [ ^ Acces s Agreement ^ Restontio aAgreement D Ttopso nSamplin g (t f applicable ) D DispottISamplin g Ci f applicable ) Q Garde nSamplin g (ffapplicfdile ) " ^ Utilit y aearanc e <E 1 VideomHrto s (Before ) aVideo«boto s (Dating ) aVideonPhoto s (After) D VIdeomioto s (30-Day )
D Final Report Sent : / / 

## Signed : i^/i^/ ^ Signed : ifi/^/ ^ / / / / / / 

## Called : KL/^S-'C S 0«:jl'iy.l12 3 O K I 1 O m/ / OB : / / Signed : / / Issued : / / By : By : By : By : By : By : 

## Br. i \Ci\;:i \ Bj^(^p<kxkAi n By : By : By : By : By : Ai r Monitorin e{a aapplicabl e DCommnnH y OCre w Results : On : / / By : 

# 1
DCommnnH y Resnits : DCrev r On : / / By :

. 1 DConmmnlt y Resnits : DCrc w On : / / By :

Omah a Lea d Sit e

## Dougla s Count y Accoim t I

i [j^iM^io n 

## Page 1 of 2
Dougla s County , Nebrask a Propert yRecor d - R122108000 2 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 - VJeWO n Ma p Informatio n i s vali d a s o f2009-9-1 5 Treasurer' s Ta xRepor t Ne wFeatur e ^ - • - •Aut o Sale s Searc h Owne r THOMPSE N BRUC E A ETA L 351 1 WOOLWORT H AV E OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 

### 210 8 000 2 1 2 Accoun t Type : Residentia l Parce l Number : 122108000 2 Parce l Address : 351 1 WOOLWORT H AV OMAH AN E 68105-000 0 Lega l Description : GRIFFI N & SMITH S 1STSU B LOT3 BLOC K6 -E XE 1 N 11 5 FT - LT3 Valu e Informatio n Lan d Improvemen t Tota l 

### 200 9 $ 7,100.0 0 $237,200.0 0 $ 244,300.0 0 200 8 $ 7,100.0 0 $237,200.0 0 $244,300.0 0 200 7 $ 7,100.0 0 $237,200.0 0 $ 244,300.0 0 

### 200 6 $ 7,100.0 0 $126,400.0 0 $ 133,500.0 0 200 5 $ 7,100.0 0 $126,400.0 0 $ 133,500.0 0 200 4 $ 7,100.0 0 $126,400.0 0 $ 133,500.0 0 Sale s Informatio n Sale s Date : 

### 2007-11-3 0 Dee d Type : W D Book : 200 7 Page : 13373 0 Price : $270,000.0 0 Grantor : O'Boyl e Conni e L Grantee : Thompso n Bruc e Aeta l Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 8 8178. 0 1. 0 141. 0 58. 0 N o Improvemen t Informatio n


## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12..
. 9/17/2009

### Dougla s County Accoun t Ii^^Ajji^io n Pag e 2 o f 2 j^^jl^i i

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! CLIC KT O ENLARG E IMAG E | i CLIC KT O ENLARG E IMAG E j S q uar e Footage : 2705. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Goo d Uni t Type : Condition : Averag e

Buil t As : 2 1/ 2 Stor yFi n Cond o Squar e Footage : I 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 12. 0 Exterior : Masonr yCommo n Bric k Units : •1. 0 Interior : Drywal l Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 4. 0

Roo fType : Gambre l Stories : 2. 5 Floorcover : Allowanc e Foundation : Bloc k ' Sprinkle rSquar e Footage : 0. 0

Yea rPercen t ^dyus^^dyea rp^^ysica l Ag e Yea r Buil t ^ ^ ^modele d 1 Remodele d 1 9 1 4 0 ' 0 % 191 4 9 5 Detai l T yp e Detai l Descriptio n Unit s Ad d O n Unfinishe d Atti cW/floo r 1123. 0 Applian c : e Allowanc e 1. 0 Basem e n t Bsmn t Bloc k 8 f t 1163. 0 Fixtur e Additiona l Fixture s 1. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 456. 0 Porc h Kne e Wal l 153. 0 Porc h Ope n Sla b 350. 0 Porc h Sla b Roo fCei l 154. 0 Porc h Woo d Dec k 224. 0 Use r ' Atti cFul l Finis h 1 1 375. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12.
. . 9/17/200 9

### Pag e 1 of 2

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## • YOURTICKE TNUMBE RI S 2388329
. Origina l Cal l Date : 10/17/0 9 Time : 1:1 8 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 10/21/0 9 Time : 7:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 351 1 Street : WOOLWORT H AV E Twp : 15 NRng : 13 E Sect-Qtr : 28-NW 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 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 ho f Excavation : 4f t Come r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V LEVEL 3 MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F



### Servic e Are a Contac t Phon e Number UtiUt y Typ e
CXCAT V CO XCOMMUNICATIONS , IN C HEIDI Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7
LEVEL 3 LEVEL 3 COMMUNICATIONS , LL C N A Day : 877366834 4 Alt : 

### Emerg : 877366834 4
MUD0 2 METROPOLITA NUTILITIES DISTRIC TSAND Y 

### Day : 402504782 3 Alt : Emerg : 402504797 0
OMAHACO FCIT YO FOMAHA-TRAFFICSEWE RRICH/TRAFFI C Day : 402444719 7

Alt : 402444516 1 Emerg : 402444516 0

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. . 10/17/200 9

## Page 2 of 2

0PPDGPR 6 OMAH APUBLI C POWE RDISTRIC TN A 

## Day : Alt : 406728934 3 4062071494 Emerg : 888728934 3
QLNNEI FQWES TLOCA LNETWOR K N A 

## Day : 406728934 3 Alt : 4062071494 Emerg : 888728934 3

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. 10/17/2009

# w m OLS# : 1970 8 Dat e Excavated : 10/27/0 9 

# ^As-Built Drawin g Dat e USEP ASiane d Off:11/5/0 9 COASTA L Are a Sodden : 91 8 s a f t 

# Omah aLea dSuperfun dSit e

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. Sit e Sketc h Time : Phone ; VA ? - ^Y ^ ^yfe i

Quadrant s Excavate d Are areplace d So d wit h Are areplace dwit h Rock/Mulc h Are alef t bar e Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
.• • Name : ^<**rif 7 ^'^ci^A.
. Omah a Lea d Sit e Date : 

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## Consen t fo rAcces s T o Fropert y RIGH TO F ENTR YT O PREMISE S 

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

Owner' s Name : Daytim e Phone : y/y,/^^ j ^^f

Addres s o fPropert y 

# S^/ /

(Voc L£Vo/e77 f^V covere d b ythi s Agreement :
PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EP AI s requestin g acces s t o collec t soi l sample s an d remov e soi l tha t contain s elevate d concentration s o flea d an d ma ypos e a healt h hazard
. Th e area(s ) wil l b e excavate d t o remov e contaminate d soil
. Th e remove d contaminate d soi l wil l b e replace d wit h clea n material s an d th e are a wil l b e restore d t o Its origina l condition
. Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e o fCoasta l Environmenta l Group , contracte d b yUSEPA , wil l contac t th e Granto rIn-perso n t o discus s th e wor k t o b e perfonmed , th e Granto rwil l hav e a n opportunit yt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e I t begins
. Onc e th e wor k I s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d confir m tha t i t I s 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 LRESPONS E ACTION S 

### B ysignin g thi s Acces s Agreement , th e 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 rnotice , fo rth e sol e purpos e o fperformin g th e worit
. Thi s acces s shal l remai n i n effec t unti l th e wori ( ha s bee n satisfactoril ycompleted
. Th e Granto rals o agree s to :

Pag e 1 o f2

# i ^
I COkSTA L IHVmOMHtKTA t C K0 I fP IN C 

### t Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; cRemov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t maywis h t o save ; « Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , as necessar ysubsequen t t o a n initia l waterin g perio d byEPA ; < Abid e byhealt h an d safetyguidanc e provide d byEPA ; ( I fth e propertyi s rented , assis t EPAi n obtainin g tenan t approva l fo racces s t o th e propertyt o perfor m th e work
. < t 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 propertywhic 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 propertyi n suc h a manner . Shoul d yo u hav e an yquestion s abou t thi s program , pleas e contact Coasta l Environmenta l Group , at (402 ) 991-119 9
£H^nt gran t access t o m yproperties n i d o not grant acces s to nr yproperties

Signatur e / Dat e ^ Signatur e Dat e

D I woul d lik e t o b e presen t durin g anysamplin g tha t i s required
.

Pag e 2 o f2

## Restoratm nAgreemen t The puipos e ofthi s agreemen t i s to provide amutua l agreemen t a s t o condition s ofth e propert y prior to remediatio nactivities
. Thi s will ais o serv e a s documentationfb r th e puipos e of assuring tha t restoration activitie s are compietedt o th e satisfactionof th e propert y owne r andthe UnitedState s Environmenta l Protectio nAgenc y (EPA)
. Propert y IP : j^fjC ? Propert y Address : ^^/ / lJ/ja/tUai^H/ [ A J 

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f necessaiy



## Item s t o b e Remove db y th e Owner before Star t o

f

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. storase . di&posat.-and/or returno f thes e Item s i s th e Owner' s responsibility
.

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I. Additiona l Comment s / Instructions : / • .

Q Chec k th e bo xi fOwne rdoe s no t wan t CE G t o documen t interra 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 fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures
.

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3207 5 Readin g N o 85 9 Mod e SOI L Tim e 

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### 120.0 0 Sequenc e Fina l Flag s [AVE ^ 

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3207 5 Readin g N o 85 5 Mod e SOI L Tim e 2009-10-2 7 10:1 6 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 1970 8 LOCATIO N 351 1 woolwort h INSPECTO R VENTR Y COR l e m CO R 2 1 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T

i S c C a K S pp m ± Erro r 72.46 9 ± 14.25 5 < LO D 20.55 1 < LO D 15.05 7 90.03 2 ± 7.73 9 < LO D 20.78 1 45.78 8 ± 6.31 0 < LO D 12.68 8 < LO D 5.97 6 < LO D 18.38 1 < LO D 13.97 7 111.33 2 ± 21.29 0

< LO D 80.82 0 47.66 8 • ± 23.08 8 < LO D 70.17 1 < LO D 164.83 0 14080.21 9 ± 392.43 3

398.25 7 ± 100.03 5

< LO D 114.05 9 < LO D 207.76 6 < LO D 435.44 2 < LO D 14.62 8 < LO D 590.11 2 < LO D 1634.26 5 < LO D 968.58 0 Supervise d By : V

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3207 5 Readin g N o 85 6 Mod e SOI L Tim e 2009-10-2 7 10:1 6 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 1970 8 LOCATIO N 351 1 woolwort h INSPECTO R VENTR Y CO R 1 e m CO R 2 1 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

P b C d A g S r U R b T h S e A s H g Z n W C u N i C o F e M n C r T i S c C a K S pp m ± Erro r 81.12 2 ± 15.37 5 < LO D 21.42 3 < LO D 14.94 3 94.64 9 ± 8.15 4 < LO D 21.83 5 51.65 2 ± 6.82 2 < LO D 13.91 4 < LO D 5.93 5 < LO D 19.04 6 < LO D 14.33 9 118.07 1 22.44 0

< LO D 83.47 2 < LO D 32.78 8 < LO D 72.31 5 < LO D 173.88 9 15209.25 7 420.84 3

359.85 4 100.74 2

< LO D 138.26 5 < LO D 302.94 9 < LO D 777.06 8 < LO D 25.69 1 < LO D 991.80 1 < LO D 2309.94 6 < LO D 1340.27 1 Supervise d By : V

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3207 5 Readin g N o 85 7 Mod e SOI L Tim e 2009-10-2 7 10:1 8 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 1970 8 LOCATIO N 351 1 woolwort h INSPECTO R VENTR Y CO R1 e m CO R 2 1 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

pp m ± Erro r P b 53.74 5 ± 12.85 0 C d < LO D 20.67 3 A g < LO D 15.14 2 S r 86.74 9 ± 7.65 7 U < LO D 19.78 3 R b 36.91 6 5.80 4 T h < LO D 12.01 8 S e < LO D 6.24 3 A s < LO D 16.84 9 H g < LO D 14.12 6 Z n 83.91 8 ± 19.08 3 W < LO D 76.92 2 C u 43.77 2 ± 22.74 7 N i < LO D 66.94 0 C o < LO D 158.56 6 F e 13614.11 9 387.60 1 M n 376.27 5 ± 98.69 9 C r < LO D 153.63 5 < LO D 285.63 6 T

i < LO D 697.88 2 S c < LO D 21.40 9 C a < LO D 825.48 5 K < LO D 31.63 2 S < LO D 686.88 1 Supervise d By : V

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3207 5 Readin g N o 85 8 Mod e SOI L tim e 2009-10-2 7 10:1 9 Duratio n 30.0 0 Sequenc e Fina l Flag s SAMPL E 1970 8 LOCATIO N 351 1 woolwort h INSPECTO R VENTR Y CO R1 e m CO R 2 1 MIS C clearenc e NOT E ep a gu n Use rLogi n EP A

pp m ± Erro r P b 53.55 7 ± 14.68 8 C d < LO D 22.59 7 A g < LO D 16.76 8 S r 82.79 4 8.53 0 U < LO D 23.42 5 R b 42.19 2 ± 6.98 4 T h 17.17 6 ± 11.08 5 S e < LO D 7.17 8 A s < LO D 19.24 5 H g < LO D 16.19 1 Z n 98.81 5 23.22 1 W < LO D 96.37 2 C u < LO D 39.43 9 N

i < LO D 82.58 3 C o < LO D 173.42 9 Fe 12846.68 2 ± 427.27 0 M n 271.08 0 ± 101.28 9 C r < LO D 163.88 6 < LO D 228.87 8 Ti < LO D 487.28 0 S c < LO D 105.81 4 C a < LO D 886.88 6 K < LO D 1271.16 3 S < LO D 965.05 6 Supervise d By : V

# • ^ in :
^^A^' l Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 I ^^^^ ^

I Coasta l Environmenta l Grou p Inc
. v l ^ ^^T^^jfwww.coastalhazmatco m

^^ipno ^ COASTA L ENVItONNIIITA l C lO U r . I U C 

# EXECUTIV ESUMMARY : BVID #19708-(351 1 WOOLWORT H AVE )
No Issue s o r Concern s [ ^ Issues/Concern s Detail Explanation :

# p »	 • 

## EP APropert y Clos e Ou t For m 

# 3S/ rvjAo)w^>^k ^ Property# : I0[ln %
. . Propert y Address : Date/Time : Owner' s Nam e Quad s Excavated : pi ^ |^ ^ Contracto r Grou p Yes N o Excavatio nGenera l 1
.

I f necessary , wer eth e correc t quadrant(s ) excavate dan drestored ? 2
.I f necessary , wer eth e correc t area s ofdri p zon e excavate dan drestored ? 

## 1., /
Ye s N o Gradin g So d an d Vcgctatio B I
.Doe s di e gradin g aroun dth eperimete r ofth e hous e inexcavaie darea s generall y slop e away 

# 'yy fromth e house ?
_______ _ 

# y ^ 2
.Ha s so dt>ee nlai di nal l area s tha t wer e excavated ? 3
.Doe s th e so dappea r t o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte da t a3 0 da y tim e period ) 4
.Ar e sodde darea s generall y fu man devenl y graded ? 

# y 5 Ar e th ejoint 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 ) 

# y 6
.Wa s th e propert y grade dsuc hthat wate r wil l no t poo l o nth e propeny ? 7
.Wa s damag e t o landscapin g o r plan t material s avoided ? Gates
. Fence s an dRetainin g Wall s 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 nactivilie s reinsulled ? (I f applicable ) 

# y ^ 3
.

Wa s damag e t o gate s o r fence s avoided ? (Ifapplicable ) 

# -7 4
.Wa s damag et o retainin g wall s avoided ? (Ifapplicable ) Foupdation , Sidin K an dGuHer s Yes No t .Wa s damag e t o th e sidin g o r tri mavoided ? 

### W ^ 2
.Wa s damag e t o th e foundatio navoided ? 

### L ^ ^ 3
. Wa s damag e t o window s avoided ? 

### IX " 4 Wa s damag e t o window 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 d Driveway s (Concrete ) Ye s No 1
.Wa s damag e t o drivewa y surface s avoided ? 2
.Wa s damag e t o walkwa y surface s avoided ? 

# -z? ^

## 0>»'ncr s comments :

Inspectio nnotes :

Remova l an dreslorationactivate s complele ineluding th e 30-da y sodwarranry : EP ARepresenlaliv e j )(V ^ IjCtyfiiJ LDale : If/^/O f

## Propert yCompletio n Agreemen t Ihi s agreement documenl s th e completio n o fremedia l acliviiie s perloime d o n m yproperl yM ysignalure wil l designate tha t F am satisfie d wit h th e resloratio n o fm yproperly , an d tha t n o Hem s are i n questions , now , o ra t an ylim e i n th e future , excep l those ilem s liste d below , ifan y PropertylD : \0t~tOP ) Propert yAddress : 3^ 1 | )A/nn ) lA/Tirfi ^ 

### Phone : /goD\^-Lj( o - BI? D C ^ l l im ' 15^ 3 Restoratio n Item s i n Question :

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

7

^ ' nyrc cI'Mtoralio n i t compleled , excep t a s note d [ I I d o no l if,rt e re«lorfltin n i s complete d 

# JA^^ /Ari^/7 ^ ^mny^ ^ ii/q/r; ^ Owner' s Signatiir r/ / Dat e Cont i actor' s Signatur b Dal e