## TRANSMITTA Lof OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAI D # : A^C aDate : SJlfp/Zpi O Address : QXPN U?S
- 

### ?)M r T^ A Remediatio nContractor : Coasta l Environmenta l Group

_Year ; 200 8 SOI LREMEDIATIO N PROPERT Y HL EFOLDE RDOCUMENT S ^ Vide o o f property (DVD ) ^ Executiv e Summar y y EPA-providedproperty sketch p f SignedAcces s Agreement fo r subject property Kil ^ Signe dAcces s Agreement(s ) fo r adjacen t propert y y Restoratio nAgreemen t ^l( S Settlemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) ^ Confirmatio ndat a D Photograph s piT e -^t -» PymMdVlOr i ?)M3y >

aAs-built sketch 7 ^ Satisfactor y restoratio nsigne db y Propert y Owner 4033386 9 j 7 Propert y close-out check lis t signedb y EP A 

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## 7 D Notificatio nLette r J ^ Acces s Agreement

^^Restoratio nAgreement D Topsoi l Samplin g (if applicable ) D Disposa l Samplin g (i f applicable ) D Garde nSamplin g (i f applicable ) D Utilit y Clearanc e • ^ Video/Photo s (Before) nVideo/Photo s (During ) D Video/Photo s (After) D Video/Photo s (30-Day ) 0 Property Completio nAgreement D Final Report Sent : / / 

## Signed ; 9_/1^/Q 9 

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### Dougla s Coimty Accovm t Iv*%w,^tion Pag e 1 of 2 Dougla s County , Nebrask a Propert yRecor d - R254119000 0 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 ROTOL ACHA D ETA L 210 4 S 3 4 S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 

### 411 9 000 0 2 5 Accoun t Type : Residentia l Parce l Number : 

### 254119000 0 Parce l Address : 210 4 3 3 4 S T OMAH AN E 68105-000 0 Lega l Description : WINDSO R PLAC E LO T6 8 BLOC K0 N 1 0 F TLT6 7 & AL L 6 0 X 13 3 Valu e Informatio n Lan d Improvemen t Tota l 

### 200 9 $7,100.0 0 $122,500.0 0 $129,600.0 0 200 8 $7,100.0 0 $122,500.0 0 $129,600.0 0 200 7 $7,100.0 0 $122,500.0 0 

### $129,600.0 0 200 6 $7,100.0 0 $112,200.0 0 $119,300.0 0 200 5 $7,100.0 0 $112,200.0 0 $119,300.0 0 200 4 $7,100.0 0 $112,200.0 0 $119,300.0 0 Sale s Informatio n Sale s Date : 2002-02-2 6 Dee d Type : W D Book : 221 0 Page : 3 5 Price : $128,000.0 0 Grantor : Grantee : 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 

### 7980. 0 1. 0 133. 0 60. 0 N o Improvement Informatio n 

### http://douglasne.mapping-online.coin/DouglasCoNe/static/accoimtinfo.jsp?accoiintno=R25. . . 9/17/200 9 imp./ / w w w.uiiuii.uig/1 1 uiiiiiciiici/x-TivyiNi-^ou^icv/icaiiuii/ivicssagi c i CAi.as p j 1 ci—^Kiioc u i o.. . - 10/\}l^\j\j y

### Dougla s County Accoun t ^^sTji^tio n 

### Pag e 2 of 2
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### TW O STOR Y

761 7 ; • • • ff 4 Fbt» ' , Sacoo d Floo r 9040S F

y r^ • CUC KT0^Et4LARG E IMA(3 E CLIC KT O tNl^KU t IMAG E Squar e Footage : 1972. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0

HVAC : Centra l Ai rt o Ai r Rooms : 8. 0 Exterior : Fram e Shingl e Units : 1. 0 Interior : Dryw/al l Baths : ! 1. 0 Roo fCover : ' Compositio n Shingl e Bedrooms : 4. 0

Roo fType : Gabl e Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinlde rSquar e Footage : 0. 0 Yea rBuil t yea r Remodele d Percen t Remodele d Adjuste d Yea r Buil t Physica l Ag e 189 5 0 % 189 5 11 4 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 f t 1068. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 480. 0 Porc h Ope n Sla b 288. 0 Porc h Sla b w/Step s 35. 0 Porc h Sla b w/Step s 134. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R25. . . 9/17/200 9

## Propert y I D # Propert y Address : Initial Contact : Secon dContact : Fina l Contact : Fina l Action :

Comment : Owner Comment (s) : Site Coordinato r Comment (s) : CONTACT FOR M IftZ^' ? Z I P M S 3 ^ S T Date : Time : Action :

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o EP A D Other Action : D

### Pag e 1 of 2

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## • YOURTICKE T NUMBE RI S 2380545 . Origina l Cal l Date : 10/06/0 9 Time : 10:5 3 a m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 10/08/0 9 Time : 11:3 0 a m State : N E County : DOUGLA S Place : OMAH A Address : 210 4 Street : S 34T H S T Twp : 15 NRng : 13 E Sect-Qtr : 28-S W 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 Contact Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : COASTA L Dept h o f Excavation : 4 F 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 Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL3 LEVEL3 COMMUNICATIONS , LL C N AAlt : Emerg : 877366834 4 Day : 402504782 3 MUD0 2 METROPOLITANUTILrnE S DISTRICT SAND Y Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO N Alt : 402444516 1 Emerg : 402444516 0

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 10/6/200 9

### Pag e 2 of 2

0PPDGPR 6 OMAH A PUBLI C POWE RDISTRIC T N A Day :

Alt : 406728934 3 406207149 4 Emerg : 888728934 3 QLNNEI FQWES T LOCA LNETWOR K

N A Day : 406728934 3

Alt : 406207149 4 Emerg : 888728934 3

http://www.dlioii.org/irthiiiteniet/DHONNoticeCreatioii/Message'llxt.asp?ret=<RESULTS. . . 10/6/200 9Pag e 1 of 2

Creat e Anothe rTicke t Bac k t o Irt h Inteme t • Sen d Eniai l J
YOU RTICKE T NUMBE RI S 2369051 . Origina l Cal l Date : 9/21/0 9 Time : 3:4 2 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 9/23/0 9 Time : 4:1 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 210 4 Street : S 34T H S T Twp : 15 NRng : 13 E Sect-Qtr : 28-S W 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 : FA X 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 Contact Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : COASTA L Dept h o f Excavation : 4 F 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 Utilit y Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL3 LEVEL3 COMMUNICATIONS , LL C N A Alt : Emerg : 877366834 4 Day : 402504782 3 MUD0 2 METROPOLITA N UTILITIES DISTRIC T SAND Y Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R RO N Alt : 402444516 1 Emerg : 402444516 0

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/21/200 9

## Pag e 2 of 2

0PPDGPR 6 OMAH APUBLI C POWE RDISTRIC T N A 

## Day : 406728934 3

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## Emerg : 888728934 3 QLNNEI FQWES T LOCA LNETWOR K

N A 

## Day : 406728934 3

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## Consen t forAcccis s T o Properl y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propertyowner) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rits 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 : DaytJme Phone : (l/C^y{/''^// ^ fft A

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# 5/^ ^ Agreement : PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EPAI s requestin g acces s t o collect soi l sample s an d remove soi l tha t contain s elevate d concentration s o flea d an d maypos 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 It s 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 byUSEPA , wil l contact th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l have a n opportunityt 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 property has bee n remediated . ENVIRONMENTA L RESPONS E ACTION S 

### B

ysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractors an d subcontractors th e righ t t o ente rth e property , at al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e work . Thi s acces s shal l remai n i n effec t unti l th e wor k ha s bee n satisfactoril ycompleted . Th e Granto rals o agree s to :
Pag e 1 of2OW>«»4 f COASTA L tNVfROHHfKTA l C R O U » IH C 

### cRemov e obstruction s includin g boats , trailers , vehicles , playscap e items , wo piles , do g houses , etc ; o d
< Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma yw t o save ; is h i Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , necessary ' subsequen t t o a n initia l waterin g perio d b yEPA ; a s fAbid e b yhealt h an d safet yguidanc e provide d b yEPA ; ' I fth e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s th e propert yt o perfor m th e work . t o < Allo wvideotapin g and/o rphotographin g o fth e property . AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s no l 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 propert ywhic 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 propert yI n suc h a manner . Shoul d yo u hav e an yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , a t (402 ) 991-119 9 1 1 gran t acces s t o mypropertie s Q I d o no t gran t access t o mypropertie s
^-V.^-O' ^ Signature Dat e Signature Dat e G I woul d lik e t o b e presen t durin g an ysamplin g tha t i s required .

Pag e 2 of 2' -v»., •

COASTA L 

## Restoratiic n Agreemen t Th e purpos e ofthi s agreemen i i s to provide amutua l agreeme mas to condition s ofth e propeny prior t

o remediatio nactivities . Thi s will als o serv e a s documentationfo r th e purpos e of assuring tha t restoratio n activitie s are completedt o th e satisfactio no f th e propert y owne r andthe UnitedState s Environmenta l Protectio nAgenc y (EPA) . i Propert y Address : Z//] ^ '5 3^5 T ~_ \ I Owne r Phoae : O

nth e attacheddiagram(s ) indicat e area(s ) to excavate , surface structure s an dlandscaping feature s an d acces s location(s ) to be use dby th e contractors . Indicat e distances , depths , materia l types , etc . Photographically an dVideographic^ly documen t th e existing condition s ofthe propert y an dth e basemen t i

f necessary . Item s t o b e Remove d b yth e Owne rbefor e Star t o fRemediation : Th e lanoval . storacje , dispobal , and/o rrely m o f thes e item s i s th e Owner' s responEibilit y ^_



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Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 I ^^^^ ^

o Coasta l Environmenta l Grou p inc . \7^^c P www.coa8taihazmat.co m '"t-ntT ^ COASTA L INVIiONHIIITA l G • 0 U r , IH C 

# EXECUTIV ESUMMARY : BVID #18207-(2104 S 3 4 ST ) No Issue s o r Concern s ]~ \Issues/Concern s Detail Explanation : -DA NBAHNK EWALKE D TH EPROPERT Y AN D SIGNE D OF FO N3/4/1 0

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## EP APropert y Clos e Ou t For m Proptrty # : \^0 ^ . r Propert y Addrcsai-j^.• ' • • > ^ i Owner' s Name : .^^^y^r.bU LK Datc/Tlme : ^ ^ Quad s Excavattd ; ^\p? . Contracto rCroap^OQIj^ n Yes No Excavatio nGenera l 1 .I f necessaiy , wer e th e correc t quadrantCs ) excavate dan drestored ? 

# o ­ 2 . I f necessary , wer e th e correc t area s oFdri p zon e excavaie dao drestored ? 

## [7 ^ Ye s N o Grsdin g So dan dVmetetto B I .Doe s (h e gradin g aroun dth e perimne r ofth e hous e i nexcavaie darea s generall y slop e away 

## U ^ fix>mtb e house ? ^	 ^ 2 .Ha s so dbee nlai di nal l area s that 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 v ^ ' da y tim e period ) 4 .Ar e sodde darea s generall y (im t an devenl y graded ? 

### { 7 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 a3 0 da y tim e period ) 6 . Wa s th e property grade dsuc hthat wate r wil l not poo l onth e property ^ L y 

# r ? . Wa s dBRiig e t o landscapin g o r plan t material s avoided ? Gates . Fence s an dRematn g Wall s Ye s N o I 1 . D o gate s ope nan dcloii e fteely? (Ifapplicable ) 

# y 2 .Wer e al l gate s o r fence s take ndow ndurin g restoratio nactivitie s reinsulled ? (I f applicable ) K 7 3 .Wa s damag e t o gate s o r fence s avoided ? (Ifapplicable ) \ y 4 .Wa s damag e t o reiabiin g wall s avoided ? (I f applicable ) ( ^ ' Foundatiott , Sidtn g an dGaMer s Ye s N o t .Wa s damag e t o th e sidin g o r tri mavoided ? l y ' 2 .Wa s damag e t o Ih e foundatio navoided ? K 7 Wa s damag e t o window s avoided ? t x ' 4 Wa s damag e 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 ? Sidewalk s an dDrKeway s (Concrete ) Vc s N o 1 .Wa s damag e t o drivewa y surface s avoided ? 

# y 2 ,

Wa i damag e t o walkwa y surface s avoided ? 

# -z. 'I 

## Ort'Ders comments :

ninspectio nnotes :

Remova l an drestorationactivate s complele includin g th e 30-da y so dwarrmiry : EP ARepresentative Li^T njj/yXxA ^ Duleij^A^Oj/ ^

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Propert yCompletio n Agreemen t I In s agreeme m documenl s th e completio n o t remedia l activitie s perloime d o n m yproperl yM ysignatur e wil l designat e tha t I a m satisfie d wit h th e restoralio n o fm ypropeily , an d tha i n o Hems ar e i n question s now , o ra l an ylim e m th e future , excep t ihos e ilem s liste d below , ifan y

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# • {^a Q m\-fs\\ ^ Restoratio n Item s i n Question :

item : Item : Item : Item : Item : Item : Additiona l Cornmcnts :

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I c.ttorjilio n t. < comptcltd , excep t a s noter i [ I I rio no l »\^rt. e restoratio n i s complele d 

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