## TRANSMITTA Lof OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAID# : 22/^? . Date : 2./^!/o a Address : 

# 35-// yy.^rr l S f Remediatio nContractor : Coasta l Enyironmenta l Group

_Year : 200 7 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S s

/ Vide o o f property (DVD ) U Executiv e Stimmary 0 EPA-provide dpropert y sketc h M Signe dAcces s Agreemen t for subjec t property D Signe dAcces s Agreement(s ) for adjacen t propert y aRestoratio nAgreemen t D Settlement document s (i.e. , for damag e o r t o replac e plants , etc. ) Confirmatio ndat a Photograph s B As-buil t sketc h WSatisfactory restoratio nsigne db y Property Owne r mPropert y close-ou t chec k lis t signe db y EP A D Descriptio no f area s no t meetin g RO D cleanu p criteri a D Utility clearance s D Property informatio niro mDougla s Coimty Assessor' s Offic e D D , 

# ^i^y^^^^ ^ -^IM ^ .ignatur< ! 4031774 5 

### Superfun c

# y^<^ 3 

# / . Fina l Repor t Propert y Chec k Lis t (piease plac e wit heac hnie ) Har dCop y informatio n 1 . Propert y Chec k Lis t 2 . Sit e Workin g Drawin g Map 3 . EP A original s Map 4 . Dougla s Count y Asses.sor' s Map 5 . Propert y Contac t Shee t A}»reemen t 1 . Acces s Agreemen t 2 . Restoratio nAgreemen t Miscellaneou s Document s 1 . Fina l Ma p fromth e Fiel d 2 . Chang e Order s 3 . XR FDat a 4 . An y email s o r P O airrespondence s Propert y Completio n 1 . Executiv e Summar y 2 . A S BUFLT 3 . Propert y Completio nAgreemen t 4 . An y buyou t int o o r reimbursemen t int o 5 . Chec k o r mone y orde r copie s 6 . EP A Propert y Clos e Ou t Form 7 . Attache dBegi nVide o Electroni c Documentatio n Drawing s 1 . EP A origina l 2 . Workin g Drawin g 3 . A S Built.v.s o 4 . A S Built.jp g Photo s 1 Begi nPhoto s 2 During/Excavatio nPhoto s -5 So dPhoto s 4 30-Da y So dPhoto s Scanne dDocument s ' Fina l Document s ^ Executiv e Summar y Video s Begi nVide o 2 M y Movi e

## Propert yAcces s Checklis t PropertylD : ^7^71^0 ^ D WOR K STARTE D ON : / / Propert y Adilress : ^5"/ / ^^/^/X/fl^^/^f . D WORKCOMPELTE D ON : / / Renter : 

### 0,vner : -y^miy"/ililf^ ) Address : J f 1 Phone : Fax : Cell/Pager : Additiona l Information : 

## •''"•" - 34{D'iD9 ^ Fax : Ccll/Pager :

nNotificatio nLette r Sent : / / By : 1 ^ Acces s Agreemen t Signed : [ p I Q - l O / 

## By : /2yVi ^ r ^ Restoratio nAgreemen t Signed : ^ l 9 ' iO l 

## B.y : ^ZJci y nTopsoi l Samplin g (i f applicahle ) 1 1 By : nDisposal Samplin g (ifapplicable ) 1 1 By : C

H Carde nSamplin g (if applicahle ) 1 1 By : • ^ Utility Clearanc e Called : ^ ' 1 ±i l 0^ 1 

# ^y^rr/sht ^ tm'sm^ : % ^ Q* - Video/Photo s (Befoie ) On : U ? 1 "d- l O' l 

## By = /£/a i D Video/Photo s (During ) On : / / By : nVideo/Photo s (After ) On : / / By : D Video/Phot<» s (30-Day ) On : / / By : 1 1 Propert v Completio nAgreemen t Signed : / / By : 1 1 Fina l Repor t Issued : / / By : Ai r IVIonitoring (a s applicahle ) nCommunit y C D Cre w On: _ / / By : Results : nCommunit y • Cre w On: _ / / 

# 1 Results : nCommunit y C H Cre w On: _ / / By : Results : Omah a Lea d Sit e

# hmi- ^ 

# y1lm\^p M Tota l Q^Mttn t Squar e Footag eto be Excavate d = 433 3 Propert: y yClassiflcatiorfr^O O ' ^ ^ Tot^^B a Zon e Linea rFootag e to be Excavate d = 0



## Howar d Stree t Legen d Nort h Arro w Omah a Lea d Sit e Ar Concret e Omaha , Nebraska Excavate d Are a Propert yNumbe r 

## CZ ] Existin g Structure Nl OLS-2260 3 Scal e Permanen t Landscapin g Propert yAddres s 1 Inc h = 20 fee t or1 gri d = 5 x5ft 351 1 HOWAR D ST Fenc e (.••"Ste , Quadran t Boundar y Pos t Excavatio n Concentration s (ppm ) F1 . B2 PlayAre a 

# V HQ L Stree t Boundar y F2

___ _ DZ Easemen t >it., y 

# o Tree/Shru b B1 Garde n Othe r Desaiptio nof pos t excavatio n areas : F1 , fron t yar d left-han d quadrant ; F2 , fron t yard nght-han d quadrant ; 81 . backyard left-han d quadrant ; B2 , backyard right-hand quadrant ; DZ . dri p zon e (1- 3 foo t are a of soi l aroun d th e foundatio nof th e house) .

### Prin t Previe w Pag e 1 o f 1 

# ^&^0 3 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 rCit y Owne r Stat e Owne rZi p Sec-Twn Rn g 141879000 0 TIPPET S TERR YR 351 1 HOWAR D S T OMAH A 6810 5 351 1 HOWAR D S T OMAH A N E 6810 5 21-15-1 3 Owne r Addres s Additio n Bloc k Lo t Lega l 1 Lega l 2 Lega l 3 Lega l 4 Ol d Assesso r Sit e No w « ^jt l ISAAC S & SELDEN S AD D 6 2 W1/ 2 33X12 4

http://webarc.co.douglas.ne.us/dcassessor/details.asp ? PARCELNB=141879000 0 http://webarc.co.douglas.ne.us:8080/RealWare1/details.do ?

jid=R141879000 0 Disclaime rMa 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 = 17 1 fee t appraisal , survey , o rfo rzonin g verification . 

### http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Dougla s County-.. . 4/25/200 7 

# i

## Property I D # Property Address : Initial Contact : Secon dContact : Final Contact : Fina l Action :

Comment : Owne r Commen t (s) : Site Coordinato r Commen t (s) : CONTAC T FORM 99' 1^ 0 3 

# m / ymr ds-t . ''^^'^'y/P^-^ ^2^«"^^ ) Date : Time: _ Action: _

Date : Time: _ Action : Date : Time: _ Action : Transmi t to EP A D Othe r Action : D



# fl^^f. Wi S fi:3 o,-•'"""'" , 

# Consen t Fo r

Acces s T o Propert y RiciHToi ' ENTRY

### T O PRI'MISI'I S 

### (iranlo r (Ihc properly ovvner ) consent s to an dauthorize s Ih c Unitec i State s BnvironmenUi l I'rolcclio nAgency (\iPA ) or it s authorize drepiesentntives , colleclivcl y Ih c Grantee , f o cnlc r aiu l perfor mccrlai nenvironmental respons e aclivilie s uponlli e followin g describe d premises :

OWIUM' S 

### Name : Day(i«i c Phono : ^CZ'3^i-^zs t Address : _ _ /-/o^^;/1/^.J ^ ^ ^ 

### ^ S / / Address : Addresse s o f Address : ' Propertie s covere db y

thi s A<!;reeinent : Address : Address :

_.,^ , , , PlIkl'O.SI'OfRl'SPONSl'ACTIVITII' S 

### Th e BP A i s requestin g access't o collec t soil sample s an dremov e soil tha t contain s elevate dconcenlralion s o f arseni c and/o r lea dandma y pos e aheallhhazard . Th e soi l wil l he remove dandthe excavate darea(s ) will b e replace dwit helea nmaterial s an d restored . This wor k

i s bein g performe dunder the Omah aLea dSite SuperfundSite reniediaiio ni^rogram . A

niiP A rcprcsenlaliv e will contac t the Granto r in-perso nl o discus s th e wor k

l o b e performed , the Granto r will hav e a nopportunity to revie w an dapprov e th e planne d.soi l removal , andresloralio nwor k

before i t begins . Onc e th e wor k

i s Unished , th e Granto r wil l b e askedt o revie w the wor k

an dconfir mtha t i

t i s complete an dmeet s wil hIh e (iranlor' s approval . Uponcompletion , th e Granto r will receiv e writte ndocumentatio n fro mf:P A lha l lli c properly ha s beenremediated . P>JV1R()NMI':NTAI , 

### Rii.snoN.si' : ACTION S 

### By signin g thi s Acces s Agreement , the Granto r i s giantin g Ihe EPA , it s employees , conliaclor s an dsubcoiilractor s th e right to enter th e property , a l al l reasonabl e time s an d wil hprio r nolice , fo r th e .sol e purpos e o f performin g th e work . Thi s acces s shall remain n

i effec t unlil the wor k

ha s beensatisfactoril y compleled . Th e Granlo r als o agree s to :

ccPropcrl. y :I:D » 

### Pay e I of 2'imi ­



### ' Remov e obstruction s piles , do g houses , etc ; includin g boats , irailers , vehicles , playsca p e ilems , woo d

" Remov e llowe r bulb s or plant s tha t th e Granto r or Ih e (iranlor' s l lo save , enan l may wis h

• Wate r an dmainlai nreplacemen t vegetation , includin g ferlilize r necessar y subsequen t to aninitia l waterin g perio d by EPA ; application , as ••Abid e by heall han dsafel y guidanc e piovide d by EPA ; •Ifth e propert yis rented , assis t EP A inobtainin g tenan t approva l for acces s to Ih c propert yto perfor mth e work if EP A is unabl elo oblai nsuc haccess ; an d •/Mlo w videotapin g and/o r photograph y of th e properl y includin g c.xlerio r an d interio r area s ofbuilding s A(iRi:i;.M);N T No r To 1NTI:KIT;RI { 

### Th e Cjranto r agree s no t to interfer e or tampe r wil han y of th e activitie s or wor k

done , or th e et|uipmen l use dlo perfor mth e activities , orto undertak e any action s regardin g th e i.is c of sai dproperl y whic hwoul dlen dto endange r th e healthoi ' welfar e ofth e Grantee: ; (M th e enviioiimenl , or lo allo w ollier s to us e th e properl y insuc hamanne r Shoul dyu u hav e an y question s abou l Ihi s program , pleas e conlac l ( ^i an * acces s (o my propertie s f— 1 

### I I 1 do no t <jrant acces s to my ])ro!ieilie s

Signatur e ' "^ Dal e Sigiiadir e Dal e

GI wonki like tohe presen t durin g an y samplin g tha t is required . Pag e 2 of 2 «r;:opp:r . y 11

## Restoratio n Agreemen t Th e purpos e o l llii s agreemen t i s t o proxid e a mutua l agreemen t as I o condiiion s o f propert yprio rt o remediatio n aclivilies . Thi s uil l als o serv e as dcconlnininaiio n fo rth e purpos e o f assurin g ihn t restoratio n aclivilie s ar e complete d t o th e satisfactio n o f Ih e propert voune ran d th e Unite d .Stale s Environmenia l Protectio n Agenc y(liPA) .

Properl yID : £ 2 60 ^ Propert yAddress : ^^, ^ ^ U^.^^^ X 

## ^^"^'•^Y^^^ ^ x.L.y ^ ''"""^ = '63^^sH G -Vzi- 4 O n th e attache d diagrani(s ) indicai e area(s ) t o excavate d an d dept h o f excavalion . locatio n o f al l know n utilities , subsurfac e features , surfac e structure s an d landscapin g features , acces s Kication(s ) l o b e ese d b v contractor , an d th e directio n o f Nonh . Indicat e distances , depths , materia l l}pcs . etc . I:idic:!! e digita l pliot.- s h> referencin g th e photo-lo g numbe ruitl i a n arro windicatin g directio n of view . 

### Item s T o B e Ramove d B yOwne rBefor e Star t C f ReT.ediaticr: ; (Us e additiona l sheets a s necessary) Th e removal , storage , disposal , and/o rretur n o f thes e item s i s th e Owner' s rsspor.sibifty . Item : Item : 

## /Idlkv^A* ^ y ^ ^ \ Item : y ^ Item : y ^ Item : 7 Item : / Item : y ^ Item : Pag e 1 o f 

## i ^ ^---- ^ 

## y

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Us e additiona l sheet s a s necessary ) Item : Item : y Item : Item : Item : item : Item : Item : Item : Item : Item : Item : Item : Item : Item :

( , Pag e 2 o f

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d Replace d (Use additiona l sheets a s necessary) Item : Item : ^ Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item :

Pag e 3 

### o fU

# m

Ite m

I'lo-cxi.sliiij i piopcil yare a lll.l l I S co\'eic( l Will i gi'dss .

Numhe rii\ ' Irec s ^ 2 inc h Inin k (liainclc r

Niinilu' rol ' Irec s <- - 2 inc h Inin k (liamclc r

Numbe ro f Sprinkle r /.ones . Conlid l Valves , Timeis . I leads , clc . AII.KI I . 1 :.ke U l l " I lib ­ ,^p i ink K1 la xI'li l

Niinihc ro f an d si/. e o f eac h j.iai-(len / rhnvc rbe d area . Allael l . 1 -keU h I' t iri,ili \ r sl,\' s .lll d IlKaUlMl: . 

### Landscap e Inventor y (Us e additiona l sheet s a s necessary ) 

### Quantit y Condition/Type/Specie s

.St]uai c Ice l 

# V35 3



# 3

{ac h

liac h

I'acl i S(|uar cfee l

Pag e 4 o f

# m ^

Ite m A|;iec( l upo nvalu e o f plan l malerial s no t l o l> e replace db y coniracior . N"l r llu . \alii i w il l |i r I1-.r d1. ' I . .Ill - .1 pkiii l \niulii' i 11 1 IIK ' pmpi'i u n wlu' l Aj.>ieetl upo nlis t ol ' plan l material s lha l wil l b e rc]ilace db y conlracloi' . H e ver y spceil'i c an ddelailed . Iiu liid i a.ki'l i l l i> | uci r eac hplan l wil l In ' pliirc d i' \llu ' ( I'lil l rielo i Aj.u'Lxx l upo nare ao f propeil v l o li e replace d v \il hj.;i'as s sod . Iniliuli ' .1 -.kckj i 11 1 ll u ,iH'ai:. i 1(1 1H ' ii-pk'u'i' dw Iih la'il.s ^ '.o d

Are ao f Cit v o r (.bount y propeil v l o b e landseape d pe r Ihei f rec|uiiemcnls . Iiulikk - askrUl l > A ll u .Uf a! o 

### Quantit y 

## Uni t Condition/Type/Specie s

liac h

S f 

# Yi n

S f



# IS O

Pag e 5 o f 

# t/ ­^^^ ^



# y^ B^hec k th e bo x if Owne rdoe s no t wan t CE G to documen t interio rfoundatio n wall s an d possibl e pre-existin g damage . Bycheckin g thi s bo xCE G is no t responsibl e fo ran ydamag e don e to th e interio r of house , includin g foundatio n crack s orfissures . 

### O I do no t agre e [H 1 do no t agre e agre e Dif iagre e C/ < /CT ^ hviior'. s Si);<iiitiii c Dat e Cw/ilractoi'. Dat e Cwiilractor'. s s Signatur

Signatur e e Pag e 6 of

## Punchlis t Item s ID #^^UO? ^ Date : lr//o/o1 ' Name : yj/^ ^ Jjuppef S Description : 

# \Ar^y ^ ^^. A ^ ,W l @ LTlMuy ^ IAJO A ^AO^<SJI^ ~5 PROPERT YCLEARANC E WORKSHEE T Dat e 

# y n 19 . r n Propert yI D 

# 77Cy) ^ Propert y Projec t Omah a Lea d - - Fixe d Pric e Addres s 

# 35( ( ^^fcco^ei'^'S- r Measuremen t XR F I D Count/Tim e 

# ClOl-5 1 Fiel d Shot s Sho t # Readin g Sampl e Are a Sho t # Readin g Sampl e Are a 

### _g[S _ FA-K ^ 

# 3i a

^ g q 

## .^s ± 

## R /^' ' 7?r ^ FI -Z-U­ 

## 3S 1 _SS2 L JSCL . 

## fiZ- Fr^ ­ ,^9-^¥=y^.i^^\ -2'^ " 

## 3S3 - Sampl e Are a Pass/Fai l ? 

## m-L \ I n Sit u Composit e Composit e Analytica l Aliquo t Composit e Reading s La b Analytica l Readin g Averag e (Drie d & Spil t Sen t (Bag ) Numbe r Result s 1 (Bag ) Sieved ) 7 2 

### <;i 9 3 

## (n- z Q ^ ^ ( o 

### T D 

## ! XR F Correcte d Valu e - > (us e calibratio n char t o rad d 

# ' u q 

# ' l20<% > t o value ) Sampl e Are a 

# ra ^^a - Pass/Fai l ? I n Sit u Composit e Composit e Analytica l Aliquo t Composit e Reading s La b Analytica l Readin g Averag e (Drie d & Spil t Sen t (Bag ) Numbe r Result s 1 

### ^ 1 (Bag ) Sieved ) ? 

### 2- 7 2 

# ^ 1 3 

### 12 . 

# z 4 

# s g 4 

### f^C ) 7 ^ -y M XR F Correcte d Valu e -- > 5 ' (us e calibratio n char t o rad d 20< ^ t o value ) 

# : ^3 ' Sampl e Are a Pass/Fai l ? 

## P I cQ-^' ^ I n Sit u Composit e Composit e Analytica l Aliquo t Composit e Reading s La b Analytica l Readin g Averag e (Drie d & Spil t Sen t (Bag ) • > Numbe r Result s 1 (Bag ) Sieved ) 2 

# 7 ^ ^ ? t 3 

### 3^ ' 4 

# 4 3 i 

# . 0 ^ n XR F Correcte d Valu e -- > (us e calibratio n char t o rad d 201 % t o value ) 

# J^ S Sampl e Are a 

# B Z 2-U - Pass/Fai l ? I n Sit u Composit e Composit e Analytica l Aliquo t Composit e Reading s La b Analytica l Readin g Averag e (Drie d & Spil t Sen t Numbe r Result s ( oay ; (Bag ) Sieved ) 1 

# r l Confidentia l 5/2/0 7 Pag e 1 o f 2

52 

### -ztt ­ 

# -r^ ^ 3 

### ^ q 

## 7 d ^ 

# - S 3 4 

### }(=: ' t ^ ^ XR F Correcte d Valu e - > 5 

### ~7 b (us e calibratio n char t o rad d 2 0 % t o value ) 

# 6 3 Sampl e Are a 

## ^ l 77-^^' ^ Pass/Fai l ? -Aliquo t 1 I n Sit u Readin g



### s:- ? Composit e Reading s (Bag ) Composit e Averag e

(Bag ) Composit e (Drie d & Sieved ) Analytica l Spil t Sen t La b Numbe r Analytica l Result s 2 

### ^ i 

## 1 3 4 ^ ^ 

## 4 ^ Cfi Z 

### Z7 . 

# 2 ^ 5 

## 2 2 XR F Correcte d Valu e - > (us e calibratio n char t o rad d 2 0 % t o value ) 

# n

US E ADDITIOHA L SHEET S I F HEEDE D XR F Technician' s Signitur e 

# JQh l L\^ M LjLX^y- ^

Confidentia l 5/2/0 7 Pag e 2 o f 2Tota l Qu a quar e Footag e t o b e Excavate( J = 433 3 <:cifiraMnn' - ftHfl ^^ ^ P'ipert yClassification : 80 0 Tota l 0 on e Linea rFootag e to b e E)(cavate( j = 0 

## Alle y

I;. : - ( .

. I

:J '

\,,T\.xA'^^y

L 1.' ^ '- C .7L



## Howar d Stree t Legen d 

## Z Z 

# • Concret e Excavate d Are a Existin g Structure Nort h Arro w 

# f

N Scal e Omah a Lea d Sit e Omaha , Nebraska Propert y Numbe r OLS-2260 3 Propert yA(d d res s Permanen t Landscapin g 1 Inc h = 2 0 feet o r1 gri d = 5 x5 f t 351 1 HOWAR D S T Fence Ouadran t Boundar y Pos t Excavatio n Concentration s (ppm ) Stree t Boundar y 

## •,^0.' V V HG L F t _ B2 Pla yAre a F 2 D Z Easemen t 

# o Tree/Shru b B 1 Garde n Othe r Desaiptio n o f post excavatio n area s Fl . fron t yafc j left-fianc i cjuadrant . F2 . fron t yard nght-han d quadrant . Bl . backyar d left-han d quadrant . B2 . backyard nght-han d quadrant . D Z dn p zon e (1- 3 foot are a o f soi l aroun d th e foundatio n o f th e house )Tota l Qi^vit Squar e Footag e t o b e Excavate d = 433 3 PropertyClassification^80 0 Tot^^ j Zon e Linea rFootag e t o b e Excavate d = 0

Legen d 

# iz z 

# • o Concret e Excavate d Are a Existin g Structur e Permanen t Landscapin g Fenc e Quadran t Boundar y Stree t Boundar y Tree/Shru b Nort h Arro w Ar r

M Scal e 1 Inc h = 2 0 fee t o r1 gri d = 5 x5 ft F 1 . 

# V HG L F2 ii'. y B l Omah a Lea d Sit e Omaha , Nebraska Propert yNumbe r OLS-2260 3 Propert yAddres s 351 1 HOWAR D S T Pos t Excavatio n Concentration s (ppm ) B 2 PlayAre a D Z Easemen t Garde n Othe r Desaiplio n o f pos t excavatio n areas : Fl . fron t yar d left-han d quadrant : F2 . fron t yar d right-han d quadrant , 81 , backyan l left-han d quadrant : B2 , backyar d right-han d quadrant ; DZ , dripzon e (1- 3 foo t are a o f soi l around tfi e foundatio n o f th e house )X 

### /\^D^' o Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 itt ^ S ,^^^ , ° Coasta l Environmenta l Grou p Inc . ^V^^^ r \^^^p * www.coastalhazmat.co m

%PBoTe.'i ^ COASTA L ENVIItONnENTA L GROUP , INC . 

# EXECUTIV ESUMMARY : 22603—351 1 HOWAR D S T N o Issue s o r Concern s Issues/Concern s Detai l Explanation:

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e

Tota l Quadran t Squ s re Footag e to be Excavate d - 433 3 Propert yClaastficatio n 80 0 Tota l Dri p Zon e Linea rFootaq e to be Excavate d = 0 

# 1 1 1 ' 1 1 1 1 : 1 ! • 1 1 l i l 

### Alle y 1 1

. . ^ 

## ?m ^ ; 1 1

—- 1 B2 = 50 PP M — —­ i ^ ®^^ i 

# y7 . ^^^^^ ) ^ I Bl = 28 PP M t ^ USOL.; ' "^. \ 

## ^^^ ® ! ~ " ^ 

# ^^ S

— }-- - —— —­

• - ­ t- z - 5( 3 rnv i •^y^^^ . Fl = 22 =P M ~ ^ :i; ^ 1 i wS?0v'w5v*v^ ^ ! • 

### ^ d ; ^ 

# g

1 - • — 1 EA- N = =95 PP M - • i 

### SSc^' ' / » . •. • •• • '-:' . • i •;- - , « - u . ' 1

, • •-'.'••• , •' • ; ' : ':.'y:::,t'' - /, - ••"v-' i -- : r^ ;• " y' :

_ y y•'.. . l' ' .' : -.••1 , X • J • - ^- -.' _•••j' ? , .- -i'. ' i • . , 1 • • - • •_ • , - • . ^ . ^ j - y ^^..-,, . 

### .•-1-^7^ ' 

## 7. ••:•. • 

### ! ' A i 1 1 1 1 1 ! '

.. 1 

# ... J

—

-• ^ y. 

### loward Stree t • • 1 1 1 Legen d ^^_^^ . 2260 3 NorthArro w Omah a Lea d Sit e Omafia . Nebrask a y ~ Dat e Excavated - 6/18/0 7 • Propert yNumbe r Pat e USEP ASigne d Off : 7/10/0 7 OLS-2260 3

_ ; L.^-:. - ^ .--. ­ i^.- . Scal e 2 Permanen t Landscapin g Propert yAddres s 

# s 1 In t ;h = 20 fee tor1 gri d ' 5 x5 ft 351 1 HOWAR D ST Quadran t Boundar y Pos t Excavatio n Concentration s (ppm ) Fl B2 Pla yAre ! joi y 

# ;,0/ . 

# • HGL . 

# V k 4 4 / T — F2 _ DZ Eas€ me n t T I ee/ S w j b Bl Gar < ten_ a h e r Ocvatnba nof pea t evcavatio n w«a s F1 tron t yar d teft-t>aiK t quadran t t- 2 Iron t yard rigtit-han d quadran t Bl bac^ar d left-ruin d quadrant . t}l \ backyar d ng m han d quadrant . OZ , dr ^ zon e (1 -3 foo t aiM i of BO H aroun d tt w foundabon of th e tiouav ) 

# o — 

### Legen d Are ano t Excavate dyyy ] Dripzon e Excavate dQQQ ^ Quadrant s Excavate d 

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

# SEP A ^ 

# W r P A Propert y Clos e Ou t FiTf m Propert y# : 77<^<^ 3 Propert yAddress : 357 7 77v<yJ/^1^ ASf ^ Datc/Tlmc : Owaer' t Name : y7yj^ 7 y?/^/^yX S Quad s Excavated : Contracto rGrou p Excavatlo aGcBcra l Ye s N o 1 .Ifnecessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 

### y 2 .I f nccessa.7 , wer e th e correc t area s ofdri p zon e excavate dan drestored ? 

# y GradlD f So daa dVctcUtio BYe s No 1 .Doe s th e gradin g aroun dth e perimeter ofth e house inexcavate darea s generall y slop e away fromth e house ? l y 2 .Ha s so dbeenlai di nal l area s tha t wer e excavated ? y 3 .

Doe s th e sodappea r t o b e generall y healthy an dgrowing ? (Onl v evaluat e . f '.nspecte da t a3 0 da y tin w period ) c ^ 4 .

.\r « sodde darea s gcnerall v fuman devenl y graded ? 

## y 5 .Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a5 0 da y y tim e period ) 6 .Wa s th e property grade dsuc htha t wate r wil ! no t poo ! o nth e prope'ry ? y ^ 1 .Wa s damag e l o landscapin g or pla-i t material s a v cided ? y \ Gaicv , FCDCC S aa dRcuiaiD t '^aii s Ve s No I ! . E> o gate s openan dclos e freely'' I f applicable ) fjj i i i 2 . Wer e al ! gate s or fence s take ndow ndurin g resioratior , aci: \i'.ie s .-einsiallec ? .i f applicable ) f} ^ 1 3 .

Wa s damag e t o gate s o r fence s avoided ? 'Ifapplicable ) AM \ 4Wa s damag e t c retainin g wall s avoided ? (;i f applicable ) y ^ .^oundatioB , Sidii t an dGutter s > es N o 1 .Wa s damag e t o th e sidin g or tri ma v oided ? A ^ 2 .W' ^ damagf e t o th e foundatio navoided ? /J ^ 3 .

Wa s damag e t o window s avoided ? fi ^ 1 4Wa s damag e t o window s o r door screen s avoided ? r 1 5 .Wa s damag e t o downspout s or dov^Tispou t extension s Evoided ? f} ^ ! Sidewalk s an dDriveway s (Concrete )Ve s No 1 . Wa s damag e t o drivewa y surface s avoided ? ty ^ 2 . Wa s daraag e t o walkway surface s avoided ? y ^c—• * 

### Owner s comments :

I I Injpectic Injpectic n nnctes nctes : :

Remc\E l andrestcratio nactixate s corr.p'et e includin g th e 30-da> ' so d'- v arrant) : EP A Represe•ntati\5,.^/^^X^^^^:;VA>C'^cvJL€Z5 ^ Date : y^/c ) — /) y

## Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio no f remedial activitie s performe do ni-n y properly . M y signatur e wil l designat e that 1 a msatisfie dwit hth e resloratio no f m y properly , andtha t n o ilcnt s are i n questions , now , o r a

t an y tim e i nthe future , excep t thos e item s liste dbelow , i f any . PropertylD : T^^^^C S Propert y Address : 35-^^^^,^;^ ^ 5 ^ Owner : 

# -777)2^1 / 71py^yr< . Phone : ^^ ^ ' , ^^^ ^ Restoratio n Item s i n Question :

Item : .'\ n . -^va c \ ' ^ T^.ix-c^Ud. ^ Item : Item : Item : Item : Item : 1

\/^\;if;rc c restoratio ni s completed , excep t a s note d I I I (J o no t agre e restoratio ni s complete d 

# Vjyvu ^ I i I AyyjJ ^ -7-7- 7 '^^^^^^k/r l 2y. ^ 71?/) ? Owner' s Sif^natur c '^^ ^ Dat e Contractor' s Signatur e Dat e '