### TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO N FIL EFOLDE R SAI D # : lD5"b" 1 Date: ?)b(o/i D Address : L|^D ^ S - \^ ^ <l h Remediatio nContractor : Envrionmenta l Restoration , LLC

_Year : _2010 _ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S
^ Vide o o f propert y (DVD)^^:QBefor e DAfte r D Basement ^ X\^\yf^UinJb ^ "*"S . Executiv e Summar y (Fina l Report ) Y\A/AJi ^

"T3 NEPA-provide dpropert y sketc h """^S * Signe dAcces s Agreemen t fo r subjec t propert y D Signe dAcces s Agreement(s ) fo r adjacen t propert y ' ^ Restoratio nAgreemen t

D Settlemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) ^*B ^ Confirmatio ndat a H ^ Photograph s ^S^Befor e DCrev ^ Photo s [^Durin g Excavatio nD So d ^Ss30-da y So dD > ^ As-buil t sketc h
• ~S x Completio nAgreemen t signe db y Propert y Owne r "*S ^ Propert y close-ou t chec k lis t signe db y EP A i nDescriptio no f area s no t meetin g RO D cleanu p criteri a ''"^""Qs . Utilit y clearance s ^*S s Propert y informationfromDougla s Count y Assessor' s Office *S . Propert y acces s checklis t I 3026041 1 

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# 'Mi Environmenta l Restoratio nSignatur e . / Dat e 

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## Omah aLea dSite^EP-R7-09-0 5 

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^ Environmenta l Restoration . LLC wvAv,er(lc.co m 

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# EXECUTIVESUMMARY : 10567-450 9 S 1 9 S T 

# 3s^^ o Issue s o r Concern s Q Issues/Concern s Detai l ExDlanation :

# EP A EP A Propert y Clos e Ou t For m Omah aLea dSit e OU# 2 Propert y #: _ 

## /0SG 7 Propert y Address : 6(^ f 5/ f ^-f . Date/Time ; Owner' s Name : S«,fuctc/ o r - R6eJriq u c » Quad s Excavated : F / Contracto r Grou p : Environmenta l Res t juratio n (ER ) Excavatio nGenera l Ye s No I . If necessary , wer e th e correct quadrant{s ) excavatedan drestored ? 

# 7 " 2 . If necessary , wer e th e correct area s o f drip zone excavatedan drestored ? 

# Mk
Gradin g Sodan dVegetatio n Ye s N o 1 . Doe s the gradin g aroun dth e perimete r o f the hous e i nexcavatedarea s generally slop e awa y fro mthe ^ house ? 2 . Has sodbee nlaidi nal l area s tha t wer e excavated ? 

# y 3 . Doe s th e sodappea r to be generally health y an dgrowing ? (Onl y evaluat e i f inspecteda t 30-da y tim e period) . 4 . Ar e soddedarea s generall y finnandevenl y graded ? ^ 5 . Ar e thejoint s betwee nthe so dstrip s generall y tight ? (Onl y evaluat e i f inspecteda t 30-da y tim e period) . 6 . Was th e propert y grade dsuc htha t wate r wil l no t pool o nth e property ? ^ 7 . Wa s damage to landscaping o r plan t material s avoided ? 

## y Gates , Fence s an dRetainin g Wall s Ye s N o 1 . D o gates,ope nan dclos e freely? (i f applicable ) ^ 2 . Wer e al l gate s or fence s take ndownduring restorationactivitie s re-installed ? (i f applicable) / ^ 3 . Wa s damage t o gate s or fence s avoided ? (i f applicable ) ^ 4 . Was damage t o retaining wail s avoided ? (if applicable) 

# 7 Foundation , Sidin g an dGutter s Ye s N o 1 . Wa s damage to siding or trimavoided ? * > • 2 . Was damage t o the foundationavoided ? • 3 . Wa s damage t o window s avoided ? ^ 4 . Wa s damage t o windo w screen s o r door screen s avoided ? 1 ^ 5 . Wa s damage t o downspouts or downspou t extension s avoided ? * ^ Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 . Wa s damage to drivewa y surface s avoided ? • 2 . Wa s damage to walkwa y surface s avoided ? 1 ^ Inspectio nnotes :

Remedia l an drestoratio n activitie s complet e includin g 30-da y so dwarranty : EP A Representative : 

# Date: mUT ^

### Pag e 1 of 2

" > [ Creat e Anothe rTicke t " ) [ Bac k t o Irt h Interne t ] I [ Sen d Emai l 

### YOU RTICKE T NUMBE RI S 2438560 . Origina l Cal l Date : 3/15/1 0 Time : 12:2 9 p m Op : TRACY2418 6 Wor k t o Begi n Date : 3/17/1 0 Time : 1:0 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 450 9 Street : S 19T H S T Twp : 14 NRng : 13 E Sect-Qtr : 03-NW-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Excavatin g th e entir e propert y Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)451-106 9 : SAI D #1056 7 Compan y. : ENVIRONMENTA L RESTORATIO N Contact Name : TRAC Y BRISTO W Phone : (402)451-131 4 Alt . Contact : Phone : (402)630-838 2 Wor k Bein g Don e For : EP A Dept h o f Excavation : 1 2 Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V DIGITE L LEVEL 3 MUD0 2 OMAHACO F 0PPDGPR 6 PAETE C QLNNEI F
Utilit y

Servic e Are a Contac t Phon e Numbe r Typ e 

### Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I 

### Alt : 402934046 9 Emerg : 402932975 7 Day : 866562434 9 TMr^iTc . LIGHTCOR EA CENTURYLIN K ... . 

### Alt : 800850904 8 D^^'^E ^ COMPAN Y ^ ^ 

### Emerg : 866562434 9 Day : 877366834 4 LEVEL 3 LEVEL 3 COMMUNICATIONS , ^ ^ 

### Alt : 

### Emerg : 877366834 4 Day : 402504782 3 METROPOLITA NUTILITIE S MUD0 2 SAND Y DISTRIC T 

### Alt :

- A ! -. - mx_ . ..T^,. * —O..^4=^PT:?CTT TT C -^/ I s/9ni nPag e 2 of 2 Emerg : 402504797 0 OMAHACO F CIT Y O FOMAHA
TRAFFIC.SEWE R RICH/TRAFFI C Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 OPPDGPR6 OMAH A PUBLI C POWE R DISTRICT EL M LOCATIN G Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 PAETEC PAETE C COMMUNICATIONS NO NEE D TO CAL LOU T EMERGENC Y Day : 800289190 1 Alt : : Emerg : 800289190 1 QLNN EI FQWES T LOCA LNETWOR K

EL M LOCATIN G Day : Alt : 406728934 3 406207149 4 Emerg : 888728934 3

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Address : 

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# •-'Y^ i Cell/Pager : AJ~<- ^ 

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# yii i 5JIEL Renter : Phone : Fax : Cell/Pager : Additional Information :

I S 0 ly E " n n n U Acces s Agreement Restoratio nAgreement

Vide o Property Befor e Digita l Photo s Befor e Vide o Property Afte r Digita l Photo s Afte r Propert y Completio nAgreement Fina l Report 

### Siened:^;?/^^/ ^ Signed^^/^/p O n'.i^ l ^^ 1 it ^ O n: 3 / /-? / / D O n: / / O n: / / Signed : / / Signed : / 7 

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- By : • . • . By : By : Additiona l Vide o o r Digital Photo' s Take n nVide o nDigita l Phot o I O n

Omah a Lea d Project Wor k Pla n Pag e I of 1 9iiLVi^SSSiiiCiSra i i^ a 

## Consen t lo r Acces s to Propert y SAID#//^ f <^ ^ RIGH T OFENTR Y TO PREMISE S 

### Granto r (lh e property ovraer) , consent< ? to an dauthorizes,ine.Uriited.State s EnvLrorurierita i PioleciioriVAgehc y (USEPA)'o r it s authorize drepreseritatives , collectivel y th e Grante e to ente r an dperfor mcertai n environmenta l respons e activitie s upo nth e followin g describe dpremises ;

PURPOS E OFINVESTIGATIO N: 

### Th e purpos e of th e remedia l activitie s is to remov e al l soil s at th e propert y whic hare contaminate dwit hhazardou s substances , in particular lea d at concentration s greate r than.o r equa l to 40 0 part s pe r millio n(ppm) . REMEDIA LACTION S Th e enviromnenta l respons e action s to be perfomie d ensai dpropert y ma y includ e th e followin g activities : a. . Takin g photograph s and/o r vide o of th e propert y before , during , an dafter remedial activities ; b. . Locatin g equipmen t and.machiner y on-sit e in preparatio nfo r an din th e cours eof the enviromnental . response ; c. Plannin g an dimplementin g th e remova l actio none r nea r Grantor' s propeity . d. . Obtainin g sample s fromGrantor' s property ; AGREEMEN T NO T To INTERFER E\. ./"•••. • Th e Granto r agree s not to interfer e or tampe r wit han y of th e activitie s or work done , or . the

. equipmen t use d to perfor mth e activities , or to undertak e any . action s regardin g th e us e of said

, propert y whic hwoul dten d to endange r th e healt hor welfar e of th e Grantee s or th e enviroimient , or to allo w other s to us e th e propert y insuc h ^..-Q I gran t acces s to my propertie s do not gran t acces s to my propertie s 

# P%.L// r ^U^f^ , ^T^/! ^ /7 ^ 7&'^^i.^'>^ : 7k7^7/ o ignatur e Signature . * Dat e PSignatur Dat ei?3giSiSK~SSS 3 SS I
Additiona l Comment s / Instructions : 

# ~ 1

JP ^ Chec k thi s bo xi f owne rdoe s no t wan t E.R . t o ente rth e resident s t o documen t interio r foundatio n wall s an d possibl e preexistin g damage . Bycheckin g thi s bo xE.R . i s not responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n cracks o rfissureis .

I agre e Q I d o EO t sgre e r~ | I agre e nI d o Ko t agre e ^
YQLP/fH / ^ 

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## Restoratio nAgreemen t Th e purpos e of Ihl s agreemen t is to provid e amutua l agreementas.to . conditioiiSu r propert y pi'ib r to cer.tr.aLCtpr.aci!V!l!es.-Th; 3 wi 11 als o serv e as'documentatio nfor th e purpos e of assurin g tha t restoration activitie s ar e complete d to th e satisfactio n of th e propert y owne r an dth e Unite dState s Environmenta l Protectio nAgency (EPA) .

SAID : ftvAddresI t Propef-tyAddress : : Lf^fi< 7 ^ / 9 ^ ^ 

## Qy^^^^'-rf^Lyrt^Jh y fiac/rf^^'^ dnth e attache ddiagram(s ) indicat e area(s ) to be excavatedan ddept h

of excavation , location of al l know n utilities , subsurfac e features , surfac e stmcture s aii dlaridscaping features , acces s location(s ) to be use dby . contractor , andthe directio n of North . Indicate , distances , depths , materia l types , etc . Indicat e digita l photo s by referencin g th e photo-lo g numbe r wit h

an arrow indicating directio n of view . item s to be remove d byContracto ran d no t replaced :

Item: . = -= 

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### Pag e 1 of 2 1

### agre e • Q I d o not agre e y^ l 

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## Did o not agre e Owner' s Signatur e . 

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Pag e 2 o f 2

## Propert y Completio nAgreemen t This ; agreemen t dccumcrit s th e compietioi i o f rerhedia i activitie s performe do nmy property. . My signatur e wil l designat e tha t I a msatisfie dwithth e restoratio no f my property , an dtha t n o item s are i n question , now , o r at

an y tim e i nth e future , excep t thos e item s liste dbelow , i f any .

Restoratio nItem s i nQuestion :

Item : item : Item : Item : Item :

Addltions l Cornm&nts :

[_J I agre e restoratio ni s completed , except a s noted I agre e restoratio ni s completed , excep t a s note d I I I d o no t agre e restoratio ni s completed I 1 1 d o no t agre e restoratio ni s complete d
Owner' s Signatur e * ' r»«*« ^ Dat e Contractor' s Signatur e

### Dougla s Count y Accoun t Information Page 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R175572000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 ft wes t o f 52n d S t - Vle W O n IVIa p Informatio n 1 $ vali d a s o f 2009-12-1 5 Treasurer' s Ta xRepor t Ne wFeatur e ->•*• * Aut o Sale s Searc h Owne r RODRIGUE Z SALVADO R ETA L 450 9 8 1 9 S T OMAH AN E 68107-000 0 Propert yInformatio n Ke yNumber : 557 2 000 0 1 7 Accoun t Type : Residentia l Parce l Number : 175572000 0 Parce l Address : Lega l Description : 450 9 8 1 9 S T OMAH AN E 68107-000 0 MISSOUR I AV E PAR KLO T2 0 BLOC K1 4 0 X 13 0 Valu e Informatio n 200 9 200 8 200 7 200 6 200 5 200 4 Lan d $5,800.0 0 $5,800.0 0 $5,800.0 0 $5,800.0 0 $5,800.0 0 $5,800.0 0 Improvemen t $73,900.0 0 $73,900.0 0 $73,900.0 0 $67,800.0 0 $67,800.0 0 $67,800.0 0 Tota l $79,700.0 0 $79,700.0 0 $79,700.0 0 $73,600.0 0 $73,600.0 0 $73,600.0 0 Sale s Informatio n Sale s Date : 2001-09-2 8 Dee d Type : Price : Grantor : W D $73,500.0 0 Boo/f; 219 3 Page : 53 6

Grantee : Valid/Invalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s 0.1 1 S F 5200. 0 Unit s 1. 0 Dept h 130. 0 Widt h 40. 0 Vacan t N o Improvement Informatio n

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### «.« i ^ , 0 1 M p 5! ) n . FIISFMS * i |*>r ' «f f Ef f j s y 1 1/ 2 Stoi y * lj*<ia^fl«i n; Eirm t BSoci : 9 ft m

a CLIC KT O ENLARG E IMAG E CLIC KTO ENLARG E IMAG E Squar e Footage : 

### 1227. 0 Percen t Complete : 

### 100.0% Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Goo d

Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 6. 0 Exterior : Fram e Sidin g Units : 

### 1. 0 Interior : Drywal l Baths : 

### 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : 

### 1.5 Floorcover : Allowanc e Foundation : Bloc k Sprinlde 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 6 0 0 % 

### 1906 10 4 Deta; 7 Typ e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Linl < 

### 1. 0 Applianc e Allowanc e 

### 1. 0 Basemen t Bsmn t Bloc k 8 ft 880. 0 Fixtur e Bas e Fixture s 

### 1. 0 Fixtur e Bat h Ful l 

### 1. 0 Garag e Detache d 280. 0 Porc h En d Scree n 160. 0 Porc h En d Scree n 

### 120. 0 Use r Atti cFul l Finis h 352. 0

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### ENViRONMENTA L AS-BUIL TDRAWIN G 'OMAH ALEA D SUPERFUN D SITE ^ RESTORATIO N 

### 1056 7 Exterio rPain t Nort h Arro w Omah a Lea d Sit e Owne rName : SALVADO R RODRIGUE Z • Good Sit e Sketcl i Address : 450 9 S 1 9 S T

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