### TRANSMITTA L O F OMAH ALEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SA1D# : 3377 7 DATE ; 1/1 5 ADDRESS : 191 2 SPRAGU E S T REMEDIATIO N CONTRACTOR : PRUDENTTECHNOLOGIES . INC . YEAR : 20lj > 

### SOI L REMEDIATIO N PROPERT YFIL E FOLDE R DOCUMENT S d PRE AN D POS T VIDE O O F PORPERT Y(DVD ) d EXECUTIV E SUMMAR Y d EPA-PROVIDE D PROPERT YSKETC H d SIGNE D ACCES S AGREEMEN TFOR SUBJEC TPROPERT Y D SIGNE D ACCES S AGREEMENT(S) FOR ADJACEN TPROPERT Y d RESTORATIO N AGREEMEN T D SETTLEMEN TDOCUMENTS (I.E. , FOR DAMAG E O R T O REPLACE PLANTS , ETC. )

• CONFIRMATIO N DAT A a PHOTOGRAPH S Q AS-BUIL TSKETC H E

J SATISFACTOR YRESTORATIO N SIGNE D B YPROPERT YOWNE R d PROPERT YCLOSE-OU TCHECKLIS T SIGNE D B YEP A D DESCRIPTIO N O F AREA S NO TMEETIN G RO D CLEANU P CRITERI A d UTILIT YCLEARANCE S d PROPERT YINFORMATIO N FRO M DOUGLA S COUNT YASSESSOR'S OFFIC E D D D ^A ^

3|H|l l SIGNATUR E O^j E 

### 3021840 7 

# H i Superfun d

### PROPERT Y SUMMAR Y Date : /15/201 0 Oinah aLea dSit e Remedia l Actio n Contrac t #EP-R7-07-0 6 TO# l Mont hof : Propert y Address : 191 2 SPRAGU ES T A . EXECUTIV ESUMMAR Y A. 1 Issue s Encountered : NON E A. 2 Issue s Resolved : NON E A. 3 Uniqu e Findings : NON E A. 4 Othe r Relevan t Infonnation : NON E CONFIRMATIO N SAMPLIN GDATA/RESULTS :

F 2 = 27 9 PP M @ 2" ; E A = 11 8 PP M @ SCRAP E(~1" ) ATTACHMENT S 1 ) Property sketc hprovide dby EPA pursuan t t o contrac t specification s 2 ) Signe dAcces s Agreemen t includin g acces s agreement s require dfor 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 sketc h­ 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 ) Property addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe 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 agreemen t detail s (i f any ar e mad e withth e property owner ) ii ) Property Statu s Formsigne db y property owne r iii ) Excavatio n digita l vide o in MPEG , WM V (Window s Medi aVideo ) o r SW F(Flas hPlayer ) format and/o r photograph s iv ) Signe dfor mverifyin g satisfactory restoratio n v ) Descriptio n ofarea s no t meetin g Interi mRO D cleanu p criteria .

TECHNOLOCIES , INC .Fin d Record Remediatio n Quer yI Lea d Remainin g Query| Propert yDamag e Query 

### Backfill :

Sampl e Area : 3377 7 ­ 191 2 SPRAGU E S T Owner : Use rProvide d Owne rInformatio n Resident : n Owne rOccupie d Owne rName : IFOSTERIVEA N Owne rAddressl : 

# 1 Owne rAddressZ : |410 2 N 1 9 ST City : lOMAH A Owne rPhon e 

# 1 State : Zi p Code : |N E |68110 - Alternat e Phone : 1(402 ) 706-635 0 Owne rName : 

# 1 Owne rAddress : 

# 1 City : 

# 1 Owne rPhone : 

# 1 " State : Zi p Code : 

# 1 r Alternat e Phone : 

# 1 Residen t Name : 

# I Propert yAddress : |191 2 SPRAGU E ST Zi p Code : |68110 - Residen t Phon e 

# I

Contract : Assessment : Contractor : JPRUDENT2010_ S Qualifyin g Grou p J40 0 Contrac t Optio n (OPTIO N 1 Assessmen t Ma xXR F Valu e ) 

### 51 6

# 'ysiyy i TECHNOLOGIES , BMC. 

### Propert y #:'^ ? "7" ^ Date/Time : Quad s Excavated : p "^^ ^ 

# EP A Propert y CSose Ou t Propert y Address : 1^1 ^ V^,^ ^ ^t Owner' s Name:'3 ^ U^''-' ^ 'royf-eT L Contracto r Group : Pruden t Technologies , Inc. , Excavatio n Genera l Ye s N o I .if " necessarv . wer e th e correct quadrant(s ) excavatedandrestored ? 

# J 2 .

I f necessary , wer e the correct area s o f drip zon e excavatedandrestored ? / Gradin g So dan dVegetatio n Ye s N o 1 Doe s the grading aroundthe perimete r o

f th e hous e i n excavatedarea s generally slop e awa y fro mthe house ? / 2 .

Has sodbeen laidi n all area s tha t wer e excavated ? / 3 .

Doe s the sodappea r t

o be generall y health y an dgrowing ? (Onl y evaluat e i f inspecteda t a3 0 da

y lim e period) / 4Ar e sodde darea s generall y finn andevenl y graded ? / 5 .Ar e tlie jonit s betwee n the sodstrip s generall y tight ? (Onl y evaluat e i f inspecteda t a3 0 da y 

# y tim e period) 6 .

Wa s the propert y grade dsuc htlia t wate r wil l not pool o n tlie property ? 

# y 7 .

Wa s damag e t o landscaping o r plan t material s avoided ? 

## y Gates , Fence s an dRetainin g Wall s Ye s N o i .D o gate s ope n andclos e freely ? (I f apphcable ) 

## s / 2 . Wer e all gale s o r fence s talce n dow n during restoratio n activitie s reinstalled ? (I f apphcable ) 

# 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 retaining wall s avoided ? (I f applicable ) 

# y Foundation , Sidin g an dGutter sYe s N o 1 . Wa s damag e t o the siding o r trimavoided ? 

# y 2 . Wa s damag e t o tli e foundation avoided ? 

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

# y 4 . Wa s danmge t o window s o r doo r screen s avoided ? 

# y 5 . Wa s damag e t o downspout s o r downspou t extension s avoided ? 

# y Sidewalk s an dDriveway s (Concrete ) Ye s N o Wii s damag e lo drivewa y surface s avoided ? 2 . Wa s damag e to walkwa y surface s avoided ?

## Owner s comments :

Inspectio n notes :

Remova l an drestoratio n activate s complete includin g th e 30-da y sodwarranty : EP A Representativ e Qcs^^^t ^ Date : iz/nli oECHNDTDCIES , INC . 

### A S - BUIL T DRAWIN G OLS#3377 7 Dat e Excavated : 10/06/201 0 

### OMAH A LEA D SUPERFUN D SIT E I'SEP A Signed-OfTDate : 

### 3377 7 Omah a Lea d Sit e Exterio rPaint Sit e Sketc h • Good • Poo r Samplin g Address ; 191 2 SPRAGU E S T 0 No t paint Sampl e Numbe r Lea d Concentratio n Sampl e Collecte d LA B Firm : Sample s Collecte d FPAPB-A J RYASCPXA-3377 7 RYBSCPXA-3377 7 RYCSCPX A33'?7- ? RYDSCPXA-3377 7 F 1 F 2 Bl - B 2 

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### jaswi . Legend : F l = Fron t Left . F2 = Fron t Right , B l = Bac k Left . B 2 = Bac k Righ t D Z = Dn p Zone . G Z = Garden , P Z = Pla y Al l quadrant s ar e a

s viewe d fro m ttt e street , facing propert y 

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### Spra^H t S-f . kev;(»1 8 Cralcd : i : Ap r I A = 1 I S PP M aS ( RAP E(~l' ) CONTRAC T# : EP-S7-10-0 5 PRUDEN TTECHNOLOGIES , INC .

## Propert yCompletio n Agreemen t Thi s agreemen t documents th e completion o f remova l 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 owne r i s satisfie dwithth e restoratio n ofth e subjec t property , an dtha t n o item s ar e i n question , now , o r at an y tim e in 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 ^ | ^ r^HA^,, ^ Owner : Phone : Restoratio n Item s i n Question :

Item : item : item : item : item : item : Require d correction s t o complet e tti e property :

L J I agre 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 )



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# /g^/j-/-. ) Owner' s Signatu n Dat ePruden t Technologies . Inc . (Prudetit ) is unde r contrac t withth eU. S. Enviromnenta l Protectio n Agenc y (EPA ) to clea n up lead contaminate dsojl sat anumbe r of

propertie s locate d in Omaha , Nebraska , includin g th e propert y locate dat 1*^12. . .fr RACOLA] ^ ST" ^ • Tli e EP A request s you r permissio n to allo w Pniden t to performasoi l cleanu pat tlii s property to remove lead-contammate dsoil . By signin g thi s form , th e property owne r grant s permissio n to Pruden t to perform activitie s relate d to th e cleanu p includin g soi l sampling , remova l of lead-contaminate dsoil , an drestoratio n ofth e reference dproperty . Ifyo u hav e an y question s abou t th e soi l cleanu p plamie dfor you r property , pleas e contac t Pruden t southoffic e for th e Omah aLea d Site cleanup-a t (402 ) 733-1188 . Genera l question s abou t tlieOmah aLea dSite cleanu p ca nbe directe d to th e EP A Publi c Informatio n Center sat (402 ) 73 1 -304 5 (Soutt^mali } r f402 9/V958 3 (NortlSOmah aoffice) . •Omali a a office

office ) o or

(402 ) ) 9/1/9 5 Propert y Acces s Grante dBy> Prin t Name ) Property Owne r Signature : ^ 1 (Sign4fu/e ) ( "(Date ) PROPERT Y INFORMATIO N (T o be complete dby residen t and/o r propert y owne r —pleas e print ) RESIDEN TNAME : 

### \/ArCA/^- ^ C o ? Owne r Rente r RESIDEN TADDRESS : 

## ( ^ (Z - Sf^iy{Qo i C _ IF RENTAL , PROPERT YOWNE D BY : 

# s. y\ ' ^ OWNER' S MAILIN G ADDRESS ; 

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# y/^ ^ /^/ f •t?r OWNER' S TELEPHON E NUMBE R - HOME : \.H'^ \ 70(e>- ^ '^SC J WORK : ( ) AG E OF HOME? : YEARS . HO W LON G HAV E YO U LIVE D HERE ? 

### ^ ^ HA S TH E EXTERIO R BEE N PAINTE D OR COVERE D WIT H SIDIN G SINC E 1978 ? 

# _...yyy OCCUPANT S UNDE R 7 YEAR S OL D MBE R OF OCCUPANT S 7 YEAR S OL D AN D OLDE R NUMBER-O F CHILDRE N UNDE R 7 YEAR S OL D WH O PLA Y IN TH E YAR D FO R 5 HOUR S OR MOR E PE R WEEK : COMMENT S OR SPECIA L INSTRUCTIONS : (I-E . DOGS , ENTR YGATES , ETC. )

AUTHORIT Y FO RENVIRONMENTA LRESPONS EACTIONS : Th e activitie s to be implemente d by EPA unde r this agreemen t are pursuan t to Sectio n 10 4 ofCERCLA , 42 U.S.C . 9604 . EPA' s righ t ofacces s to th e propert yis provide dfor mSectio n 104(e ) of CERCLA , 42 U.S . C 9605(e) , whic hprovide s entr y fo r "detenninin g th e nee dfor response ,or choosin g or

takin g an y respons e aclio n unde r tlii s title , or otherwis e enforcin g th e provision s ofth e title. " 808 0 War d Parkway . Suit e 40 5 580 0 '>

1. e St i:lV l r/ieciica l Drive , Guit e 426 0 Kansa s City . MO 6411 4 Oinsna. . !v.e«;rjt£.. « ft'il'. r^y n AriloiHO , TX 7822 9 Phone : (816 ) 363-370 3 Phone : ;«.(12 f IZZ.-^-^ . Pfiorift : r210)022.M8 8 Fax : (816' , 363-370 7 i^ax ; (210 ) 076-667 7ILNVfRONMENTAL A CONSTRLlCTIO N 

### TECHNOLOGIES , INC . SERVICE. S 

# Propert y Statu s For m, Address : 1^1 ^ ^fff^^OM V Date : /O/j/jlO/ O Phone : 

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Propert y Ow n Pruden t E i ie e Signature : 808 0 War d PifrKfci/ay'Suit e 40 S 560 0 S 1 0 S I 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrasic a 6&10 7 Sa n Antonio , T X 7822 9 Phone : (816 ) 383-370 3 Phone : (402)733-118 8 Phone : (210)822-968 8 mne * '>fr'» ^TA T C'.v . tAf\'i \ 11 1 HOO- *

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# n D Sample s Analyzed : RYDSCPXA-3377 7 B 2 

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# n. 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 = Play Al l quadrant s ar e as . viewie d feDfrr th e street , facin g property ; '.'.. ' 

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" > Creat e Anothe rTicke t Bac k t o irt h Inteme t Sen d Emai l
YOU RTICKE T NUMBE RI S 2608873 . Origina l Cal l Date : 10/05/1 0 Time : 10:4 0 a m Op : SIVA1896 7 Wor k t o Begi n Date : 10/07/1 0 Time : 11:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 191 2 Street : SPRAGU E S T Twp : 15 NRng : 13 E Sect-Qtr : 03-S W Twp : Rng : Sect-Qtr. : Lega l Given : C Typ e o f Work : SOI L LEA D REMEDIATIO NPROJEC T Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)733-188 3 : UNSUR E CORNER S Compan y: PRUDEN T TECHNOLOGIE 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 F T Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Are a Contac t Phon e Nunibe r Utility Typ e Day : 402934046 9 CXCAT V COX COMMLINICATIONS , INC HEIDI Alt : 402934046 9 Emerg : 402932975 7 Day : 402504782 3 MUDO l METROPOLITA N UTILITIE S DISTRIC T SANDY Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACOFCITY O FOMAHA-TRAFFIC.SEWE R RICH/TRAFFIC Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 OPPDGPR 5 OMAH A PUBLIC POWE RDISTRIC T EL M LOCATIN G Alt : 406207149 4 Emerg : 888728934 3 Day : 406728934 3 QLNNEl C QWES T LOCA L NETWOR K EL M LOCATIN G Alt : 406207149 4 Emerg : 888728934 3
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## mc . CONSTRUCTIO N SOLUTION S 

## SIT ESAFfeT Y HAZAR D ANALYSI S Address : --J^'2Z:L~-^t:^^3^^-Ji2l l 

## Excavatio n Date : Crew : 

## BackfiU Date : —

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08 0 VMwfBwleMtay , iiat a 40 5 >S10S t 424 2 H«dica l Drive , Suit e 72fi O xma t GDly ; aiO«411 4 Oiirtla , ll«hf*it o 0810 7 Sa n Antonio , T X 7822 9 none : (810 ) 30^370 3 PlMfw : (402 ) 733-110 8 Phone : (2t0 ) 822-068 8 ax : {SIS ) SOS.'STfl T Fax : (402)733^108 3 Fax : (210 ) «79-65 n

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