### TRANSMITTA L O F OMAH ALEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : 3602 1 DATE : 12/15/201 0 ADDRESS : J 261 1 BROWN E S T REMEDIATIO N CONTRACTOR : PRUDENTTECHNOLOGIES . INC . YEAR : 201 0 

### SOI L REMEDIATIO N PROPERT YFIL E FOLDE R DOCUMENT S [ ^

PR E AN D POS TVIDE O O F PORPERT Y(DVD ) t

^ EXECUTIV E SUMMAR Y d EPA-PROVIDE D PROPERT YSKETCH c ( SIGNE D ACCES S AGREEMEN TFO R SUBJEC TPROPERT Y D SIGNE D ACCES S AGREEMENT(S) FOR ADJACEN TPROPERT Y W RESTORATIO N AGREEMEN T D SETTLEMENTDOCUMENT S (I.E. , FOR DAMAG E OR T O REPLACE PLANTS , ETC. ) a CONFIRMATIO N DAT A 0 PHOTOGRAPH S [ / AS-BUIL TSKETCH CZ

fSATISFACTOR YRESTORATIO N SIGNE D B YPROPERT YOWNE R Iia ' PROPERT YCLOSE-OU TCHEC KLIS TSIGNE D B YEP A D DESCRIPTIO N O F AREA S NO TMEETIN G RO D CLEANU P CRITERI A Q UTILIT YCLEARANCE S 1 2 PROPERT YINFORMATIO N FRO M DOUGLA S COUNT YASSESSOR' S OFFIC E 

### D 

## D D 

# ^ U \ «\\'^^^' ^ SIGNATUR E DATE 3026075 5 Superfun dRn d Record Remediatio n Quer yj Lea d Remainin g Quer y Propert yDamag e Quer y 

# J Backfill :

Sampi e Area : 3602 1 - 261 1 BROWN E S T Owner : D Owne rOauple d Owne rName : IPARKE R ALGI E L Owne rAddressi : Owne rAddress2 : 1261 9 BROWN E S T City : State : Zi p Code : JOMAH A JN E J68111 - Owne rPhon e Alternat e Phone : j(402 ) 455-205 4 1(402 ) 630-291 7

Contract : Contractor : PRUDENT201 0 S Contrac t Optio n |OPTIO N 2 Use rProvide d Owne rInformatio n Owne rName : 

# 1 Owne rAddress : City : state : Zi p Code : r••'•• • 

# 1 

# f ' ' Owne rPhone : Alternat e Phone ; 

# r

Assessment : Qualifyin g Grou p 40 0 Assessmen t Ma xXR F Valu e | 

### 49 3 Resident : Residen t Name : Propert yAddress : J261 1 BROWN E S T Zi p Code : 

## iesiii Residen t Phon e 

# I ' —

### PROPERT Y SUMMAR Y Date : 12/15/201 0 Omah aLea dSit e Remedia l Actio n Contrac t #EP-R7-07-0 6 TO# l Monti i of : Decembe r Propert y Address : 261 1 BROWN 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 : B l = 101 6 PP M @ 13" ; E A = 7 3 PP M @ SCRAP E(~1" ) ATTACHMENT S 1 ) Property sketc hprovide db y EP A 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-Built sketch i ) Shal l includ e fma l lea dlevel s v ) Legen d ii ) Contaminatio n lef t behin darea s vi ) Contracto r identificatio n iii ) Propert y 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 agreement detail s (i f an y ar e mad e wit hth e property owner ) ii ) Property Statu s Formsigne db y property owne r iii ) Excavatio n digita l vide o i n MPEG , WM V (Window s Medi aVideo ) o r SW F(Flas hPlayer ) forma t 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 .

TECHNOLOGIES , INC .• raCHNOLOGIES , INC . 

# EP A Propert y Clos e Ou t Propert y # : " ^ ^ ^ 2_l Propert y Addressr'Z-tt ' V V B r <?£i:)y\ e 4 f ^ Date/Time : Owner' s Name : fA^»^\ WP'tirtc/ ' Quad s Excavated : ($ » \ Contracto r Group : Pruflen t Technologies , Inc. , Excavatio n Genera l Ye s I .I f necessarv . wer e th e correct quadrant(s ) excavatedandrestored ? 

# y 2 .

I f necessary , wer e th e correct area s o f drip zone excavatedandrestored ? 

# y Gradin g Sodan dVegetatio n Ye s 1 .

Doe s the gradin g aroundthe perimete r o

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

Has sodbee n lai di n all area s dia t wer e excavated ? / 3 .

Doe s the sodappea r t

o b e generally health y andgrowing ? (Onl y evaluate i f inspecteda t a3 0 da

y tim e period) / 4 .Ar e soddedarea s generally firmandevenl y graded ? / 5 .Ar e tlie joint s between di e sodstrip s generall y tiglit ? (Onl y evaluat e i f inspecte da t a3 0 da y / tim e period) 6 .Wa s the propert y grade dsuc hdia t wate r wil l not pool o n di e property ? / 7 .

Wa s damag e t o landscapin g o r plan t material s avoided ? / Gates , Fence s an dRetainin g Wall s Ye s 1 .

Do gate s ope n andclos e freely ? (I f applicable ) / 2 ,Wer e all gate s o r fence s taken dow n diuin g restoratio n activitie s reinstalled ? (I f apphcable ) / 3 . Wa s damag e t o gate s or fence s avoided ? (Ifapplicable ) / 4 . Was damag e to retainin g wall s avoided ? (Ifapplicable ) / Foundation , Sidin g an dGutter s Ye s 1 .

Wa s damag e t o the sidm g o r tri mavoided ? / 2 .

Wa s damag e ( o th e foundation avoided ? / 3 .

Wa s dajnage t o window s avoided ? / / 4 .Wa s damag e to window s o r doo r screen s avoided ? -"5

. Wa s damag e t o downspout s or dovwispou t extension s avoided ? / Sidewalk s an dDriveway s (Concrete ) Ye s 1 . Was damag e l o diivewa v surface s avoided ? 

# 7 -t

­ 2 .

Was damag e t o walkwa y surface s avoided'. ' N o

N

o

N

o

N

o

N o

## Owner s cbinments :

Inspectio n notes :

Rempva l andrestoratio n activate s complete includin g th e 30-da y so dwarranty : ^ti ^ 

## EP A Representativ e ^ 

## Date : J ^ 

## .v o• CHNULUUIES , INC . 

## A S - IKML T EOUWIN G OL S #3602 1 Dat e Excavated : 10/25/201 0 

## OMAHA L£A D SUPERFUND SaX E USEP ASigaed-Or rDate : 3602 1 Exterio rPain t Nort h Arro w Omah a Lea d Sit e • Goo d Sit e SIcetc h Q Poo r Samplin g Address : 261 1 BROWN E S T Q No t pain t Sampl e Numt>e r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm : jF&5_fBJjl_ _ RYASCPXA-3602 1 F l 2 2 ^ po m D Date : S-ll-C 8 RYBSCPXA-3602 1 F 2 _2d£_Ppn > D Time : J:I 0 RYCSCPXA-3602 1 B 1 _iia2_pp m D Sample s Anatyze d RYDSCPXA-3602 1 B 2 7 7 5 oo m D nOItSCP)(A-0002 1 -O Z D D " " ppn » XR F Uni t (o5^ Q Book : 2QT RGZ60PXA-3602 1 -« Z " • PO W D D Date : €; > - 1 1 - Ci & RPZOGPXA.'3002 i -P Z "" Ppn i D D Time : 

# An . Stsff : Numbe ro f Sample s = | V | [ Q | 

### hsv ^ Legend : F l = Fron t Left , F2 = Fron t Righ t B l = Bac k Lef t B 2 = Bac k Righ t D Z = Dri p Zone . G Z = Garden , P Z = Play AD quadrant s sr e a s viawe d fio< n th e stiee t lacin g propert y

Brawia s Sfc : I Res - :I»JS. N Cii:ai<.^l : ^f-Peb^ W EA = 7 3 PP M @ SCRAP E(~1" ) CONTRACT* : EP-S7-10-0 5 PRUDENTTECHNOLOGIES , INC .

## i i ^ Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio n o f removal activitie s performe don th e belo w liste dproperty . Th e property owner' s signatur e indicate s that th e property owne r i s satisfie dwit hth e restoratio n ofth e subjec t property , an dthat n o item s are i n question , now , o r at any tim e in th e future , excludin g any remainin g warranty (3 0 day s total ) excep t thos e item s liste dbelow , ifany . Propert yID : 

# 30,02 ; Propert yAddress : c-:;^ ) 

# ri o { . I^OOILF . Owner : Phone : Restoratio n Item s I n Questio n :

Item : Item : Item : Item : Item : Item : 

### Require d correction s t o complet e th e property :

l_9 n agre e restoratio n i s completed . I I d o not agre e restoratio n i s complete d a t (note d deficiencie s above )



# 1 } IU,ll D Dat e 

### IPniden t Tectuiologies , Inc . (Prudeni ) i s unde r contrac i withth e U . S . Environmenta l Protectio n Agenc y (EPA ) t o clea n u p lead contaminate dsoil s at anumbe r o f

propertie s locate di n Qmaha , Nebraska , includin g th e property locate dat Th e EP A request s you r permissio n l o allo w Pruden t t o performasoi l cleanu p a t thii ; property t o remov e lead-contaminate dsoil . B y signin g thi s form , th e propert y owne r grant s permissio n t o Pruden t t o perfor m activitie s relate dt o th e cleanu p includin g soi l sampling , remova l o f lead-contaminale dsoil , an drestoratio n ofth e reference dproperty . Ifyo u hav e any question s abou t th e soi l cleanu p planne 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 . Getiera l question s abou t th e Omah aLea dSit e cleanu p can b e directe dt o th e EP A Publi c Informatio n Center s a l (402 ) 731-304 5 (SouthOmali ac office ) or r402 ) 991-958 3 fNort hOmaha^tfSfceT ^ Property Acces s Grante dB y 

# r ~ yy (PleasePrir-"'^ ^ Property O-wne r Signatur e 

# /2/M/ y (Signature ) PROPERT Y INFORMATIO N t o 6 e complete db y resid<ui t and/o r propert y o-wne r —pleas e print ) RESIDEN TNAIViE : Owne r Rente r 

# QLLO-^^—i^ ^ RESIDEN TADDRESS ; 

### ^q)U^</\e . 

# Q V CSiKjJi.. . M F6^1 / j I F RENTAL , PROPERT YOWNE D BY : OWNER' S MAILIN G ADQf^SS ; 

# 5^ vnvwdt ^ fJ g ^^W j \j^-f\ e ^

• • 1 I £ i WORK : 

# fi30 - c^'^' T AG E O F HOME? : YEARS . HO W LON G HAV E YO U LIVE D HERE ? YEARS . HA S TH E EXTERIO R BEE N PAINTE D O R COVERE D WIT H SIDIN G SINC E 1978 ? YE S N O NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OLD : NUMBE R O F OCCUPANT S 7 YEAR S OL D AN D OLDE R NUMBE R O F CHILDRE NUNDE R 7 YEAR S OL D WH O PLA Y I NTH E YAR D FO R 5 HOUR S O R MOR E PE R WEEK : COMMENT S O R SPECIA L INSTRUCTIONS : (I.E . DOGS , ENTRY GATES , ETC. )

AUTHORIT Y FO RENVIRONMENTA LRESPONS EACTIONS , Th e activitie s t o b e implemente dby EP A unde r this agreemen t are pursuan t t o Seaio n 10 4 ofCERCLA , 4 2 U.S.C . 9604 . EPA' s ligh t o f

acces s toth e propert y i s provide dfor i n Sectio n 104(e ) o f CERCLA , 4 2 U.S . C 9605(e) , whic hprovide s enli-y for •"determinin g th e nee dfor response , or choosin g or laXiu g an y respons e actio n unde r thi s title , o r otherwis e enforcin g th e provision s ofth e title. " 808 0 War d Parkway , Suit e 40 5 560 0 S 1 0 S t 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Orr>.aTia , Nebrask a 621(1 7 Sa n Antonio . TX 7822 9 Phone : (816 ) 363-370 3 PS^one : (402 ) 733-i18 8 Phor.e : (210 ) 822-958 8 Fax ; (816 > 363-370 7 F.=.<-. il02 > "33-188 3 Fax ; (210)579-657 7ENVIRONMENTA L & CONSTRUCTIO N 

### TECHNOLOGIES , INC . SERVICE S 

# Propert y Statu s For m Address : ^CP\ ^ 0 Oti-/Vs. g ^Sd"- ^ Phone :

808 0 War d Parkway , Suit e 40 5 560 0 S 1 0 S t 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6810 7 Sa n Antonio , TX 7822 9 Phone : (816 ) 363-370 3 Phone : (402)733-118 8 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)733-188 3 Fax : (210 ) 579-657 7

# I l l 3602 1 Exterio rPain t Nort h Arro w 

### Omah a Lea d Sit e • Good 

### Sit e Sketc h n Poo r 

# I Samplin g Address : 261 1 BROWN E S T Q No t pain t 

### Sannpl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm : FPf t P S ,\( L RYASCPXA.3602 1 F l 

# D 5-11't> 8 pp m Date : RYBSCPXA-3602 1 F 2 

## 2 5 A pp m 

# D Time : i:\ 0 RYCSCPXA-3602 1 B l 

## H q 3 pp m 

# D Sampte s Analyze d RYDSCPXA-3602 1 B 2 

## 7 7 5 pp m 

# D RDZSCPXA-OOOZ i D Z 

# n Book : 20 1 pp m 

# D XR F Unit: G5HC >

— nO2OGPXA-0602 1 -6 £ pp m 

# D D Date: C^-//-Q 8

- RPZOGPXA-3002 1 -P £ pp m 

# D D Time : A M 

# E Staff : HSU / Numbe ro f Sample s = ^ Legend : F 1 = Fron t Left . F 2 = Fron t Rigtit , B l = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone . G Z = Garden , P Z = Pla y Al l quadrant s ar e as viewed fro m th e street , fadn g propert y

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• YOU RTICKE T NUIVIBE RI S 2622424 . Origina l Cal l Date : Wor k t o Begi n Date : 10/20/1 0 10/22/1 0 Time : Time : 5:2 2 pm 5:4 5 pm op : SIVA1896 7 State : N E County : DOUGLA S Place : OMAH A Address : 261 1 Street : BROWN E S T Twp : 15 NRng : 13 E Sect-Qtr : 04-NE Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : SOI L LEA D REMEDIATIONPROJEC 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: Contac t Name : PRUDENT TECHNOLOGIE S 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 Involve s Tunnelin g o r Horizonta l Borin g : NFront : Y Rear : Explosives : N CXCAT V

MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Are a Contac t Phon e Numbe r Utilit y Typ e CXCAT V CO X COMMUNICATIONS , INC HEID I Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 MUDO l METROPOLITA N UTILITIE S DISTRIC T SANDY Day : 402504782 3 Alt : Emerg : 402504797 0 OMAHACO FCITY O FOMAHA-TRAFFIC,SEWE R RICHATRAFFI C Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 0PPDGPR 5 OMAH A PUBLIC POWE RDISTRICT Day : 406728934 3 EL M LOCATIN G Alt : 406207149 4 Emerg : 888728934 3 QLNNEI C QWES T LOCA LNETWOR K EL M LOCATIN G Day : 406728934 3

Alt : 406207149 4

Emerg : 888728934 3 http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 10/20/201 0,llfC . 

### CONSTRUCTIO N SOLUTION S 

## SIT ESAFifcT Y HAZAR D ANALYSI S

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## Address : Excavatio n Date : MMJL ^ 

## Crew : Backfi U Date : Lem l

Ite m Overhea dLine s Ga s Lin e Wate r Lin e Sewe r Lin e Septic/Leec h Fiel d Propane/Butan e Sidewal k Foundatio n Retainin g Wall s Fence s Tree s Stracture s Driveway Sprinkle r Syste m Othe r Cre w Forema n Conditio n Hazard s Correctiv e Actio n c ^ ^ ^ 5 • " / PTTf/ ? 

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## Sit e Safety Ofiic e Date :

SBOOSIOS t 424 2 Medica l Drive , Suft e 725 0 caisas;Clir;MO«411 4 BtaHfc a 4810 7 Sa n Antonio , T X 7822 9 V^naar . (4a2)733-i m Phone : (2t0 ) 822-«58 8

Fax : (4a2)73»d«8 3 F=ax: {210)«T9-657 7