## TRANSMITTALof OMAHALEAD SITE SOI LREMEDIATIO NFIL EFOLDE R
SAI D # : 2(p-gn(< 7 Date : l2/7g/l O Address : 99:10 7 fmnl\\Y ^ R\

- Remediatio nContractor : Coasta lEnvironmenta lGroup

_Year : _2010ARRA
_ SOI LREMEDIATIO N PROPERT YFIL EFOLDE RDOCUMENT S & ^ Vide o o f propert y (DVD ) t

/ Executiv eSummar y M EPA-provide dpropert y sketc h B^ ^ Signe dAcces s Agreemen t fo r subjec t propert y

• 0 " Signe dAcces s Agreement(s ) fo r adjacen t propert y B ^ Restoratio nAgreemen t -tj ~ Settlemen t document s (i.e. , fo r damag eo r t o replac eplants , etc. ) 0 ^ Confirmatio ndat a "Q

^ Photograph s V ^ As-buil t sketc h \t f Satisfactor y restoratio nsigne db y Propert y Owne r V ZPropert y close-ou t chec k lis t signe db y EP A -B ~ Descriptio nofarea s no t meetin g RO D cleanu p criteri a 10

" Utilit y clearance s QPropert y informatio nfromDougla s Coimt y Assessor' s Offic e D D



### Dat e 3021805 4 

# i Superfun d

# vv Propert yAcces s Checklis t PropertylD : -,(^2,'^( ^ nWORK STARTE D ON ; / / Property Address : 2q ^ FPri/^klMS ^ nWORKCOMPELTE D ON : / /
Renter : 

## ""^''••^rPinAf K

9P, l Address : Phone : Fax : Ceil/Pager : 

## Phone : 2,^ 4 /^g^(^^ ^ Additional Information : Fax : 

# c.u«..^ n^pp^)_a=?(pt/

r~l NotificationLette r Sent : / / 

### By : Acces s Agreement Signed; ^ 1 1 l\ Q By : Restoratio nAgreement 

### Signed ; 2 i ZI I O By : Q Topso USampling (if applicable ) / / 

### By : Q Disposa l Sampling (if applicable ) / / 

### By : Q Garde nSampling (if applicable ) / / 

### By : Coihu X»yo6/i acvef^rtd l on/i^/i o 

### ^ utility Clearanc e 

### CaUed: Q^/a^/JD
. 

# I ^ 

### Video/Photo s (Before) On : / / 

### By : D Video/Photo s (During ) On : / / 

### By : nVideo/Photo s (After) On : / / 

### By : nVideo/Photo s (30-Day ) On : / / 

### By : ropert y Completio nAgreement Signed:] ^ ;</_// ^ By-P)UJL L 

### H F i Final Report Issued : / / 

### B y Ai r Monitorin g (a s appUcable)
• Conununit y O Cre w On : / / By : Results : Q Communit y QCre w On : / / By : Results : O Communit y O Cre w On : / / By : Results :

Omah a Lea d Sit e

### • Dougla s County Accoimt Info^^^io n Pag e 1 of 2 

# w
Dougla s County , Nebrask a Propert yRecor d - R221269000 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 - VIGWO n Ma p Informatio n i s vali d a s o f2009-12-1 5 Treasurer' s Ta xRepor t Ne wFeatur e -•••••Aut o Sale s Searc h Owne r BEL LBREND AJ
280 2 FRANKLI N S T OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumber : 126 9 000 0 2 2 Accoun t Type : Residentia l Parce l Number : 221269000 0 Parce l Address : 280 2 FRANKLI N S T OMAH AN E 68111-000 0 Lega l Description : SHINN S 2N D AD D LOT1 2 BLOC KS S 6 7 1/ 2 FT6 0 X67. 5 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $1,000.0 0 $40,500.0 0 $41,500.0 0 200 8 $1,000.0 0 $40,500.0 0 $41,500.0 0 200 7 $1,000.0 0 $40,500.0 0 $41,500.0 0 200 6 $1,000.0 0 $40,500.0 0 $41,500.0 0 200 5 $1,000.0 0 $40,500.0 0 $41,500.0 0 200 4 $1,000.0 0 $31,100.0 0 $32,100.0 0 Sale s Informatio n Sale s Date : 

### 1992-12-3 1 Dee d Type : Book : 194 1 

### Page : 07 3 Price : $22,620.0 0 Grantor : 

### Grantee : Valld/lnvalld : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 9 4020. 0 1. 0 67. 0 60. 0 N o Improvemen t Informatio n


### http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accoimtno=R2.
. . 12/30/200 9

### Dougla s County Accoun t Infoj^^fio n Pag e 2 o f 2 # - Buildin g 1 Tw o Story 280 2 Frankli n S t

i M a n Sacan d Floo rK O MD.OSq.n

.

20 r M « 1 Bvmetxitft i <jDDSqF r CLIC KT O ENLARG E IMAG E Squar e Footage : 1100. 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 : 6. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 2. 0

Roo fType : Hi p Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinkle 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 188 4 0 % 188 4 12 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 520. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h Sla b Roo fCeilin g 24. 0 Porc h Sla b w/Step s 16. 0



### http ://douglasne.mapping-online
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. 12/30/200 9

### Pag e 1 of 2

" > [ jGrealg^Anothe rTicKe t | ^
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### • YOU RTICKE T NUMBE RI S 2458150
. Origina l Cal l Date : 4/08/1 0 Wor k t o Begi n Date : 4/12/1 0 Time : Time : 2:4 9 pm 3:1 5 pm Op : ELIZABETH1879 0
State : N E Address : 280 2 County : DOUGLA S Street : FRANKLI NS T Place : OMAH A
Twp : 15 NRng : 13 E 

### Twp : Rng : Lega l Given : C Sect-Qtr : 16-N E 

### Sect-Qtr : Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTA L Remarks : FAX AL L CLEAR S TO : (877)662-421 1 : UNSUR E I F CORNE R LOT . Compan y: COASTA L ENVIRONMENTA L SERVIC E 

### Contac t Name : ELIZABETH Phone : (877)662-421 0 Wor k Being Don e For : COASTA L Dept ho f Excavation : 4 F T Come r Lot : N Front : Y Rear : Involve s Tunneling o r Horizonta l Boring : N Explosives : N CXCAT V LEVEL 3 MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

Servic e Are a Contac t 

### Phon e Numbe r UtUit y Typ e
CXCAT V CO XCOMMUNICATIONS , IN C HEID I 

### Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7

LEVEL S LEVEL S COMMUNICATIONS , LL C 

### N A Day : 877366834 4 Alt : Emerg : 877366834 4

NfUDO l METROPOLITA NUTILITIE S DISTRIC TSAND Y 

### Day : 402504782 3 Alt : Emerg : 402504797 0

OMAHACO FCIT YO FOMAHA-TRAFFICSEWE RRICH/TRAFFI C 

### Day : 402444719 7 Ah : 402444516 1 Emerg : 402444516 0

http://www.dhon.org/irihintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS,.
. 4/8/201 0

## Pag e 2 of 2

OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC TELM LOCATIN G 

## Day : 406728934 3 Alt : 406207149 4 

## Emerg : 888728934 3
QLNNEI C QWES TLOCA LNETWOR K ELM LOCATIN G 

## Day : 406728934 3 Alt : 406207149 4 

## Emerg : 888728934 3

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### • YOU RTICKE TNUMBE RI S 2449545
. Origina l Cal l Date : 3/30/1 0 Time : 5:5 2 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 4/01/1 0 Time : 6:1 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 280 2 Street : FRANKLI NS T Twp : 15 NRng : 13 E Sect-Qtr : 16-N E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMEDIATIO N Locatio n o f Work : LOCAT E ENTIR E PROPERTY , AL L EASEMENT S AN D T O TH E PEDESTA L Remarks : FAX AL L CLEAR S TO : (877)662-421 1 : UNSUR E I F CORNE R LOT . Corr5)an y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : COASTA L Dept ho 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 MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

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

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

### Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL 3 LEVEL S COMMUNICATIONS , LL C N A 

### Alt : Emerg : 877366834 4 Day : 402504782 3 MUDO l METROPOLITA NUTILITIE S DISTRIC TSAND Y 

### Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRICH/TRAFFI C AU : 402444516 1 Emerg : 402444516 0

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. . 3/30/201 0

## Pag e 2 of2

OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC TEL M LOCATIN G 

## Day : 406728934 3

Alt : 406207149 4 

## Emerg : 888728934 3
QLNNEIC QWESTLOCA LNETWOR K

EL M LOCATIN G 

## Day : 406728934 3

Alt : 406207149 4 

## Emerg : 888728934 3

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### 2637 6 

# As-Buil t Drawin g COASTA L 

# Omah aLea dSuperfun dSit e OLS# : 2637 6 Dat e Excavated : 4/19/201 0 Dat e USEP ASiqne d Off : 5/6/201 0 Are a Sodden : 119 8 s o f t Exterio rPain t Nort h Arro w Omati a Lea d Sit e Owne rName : BREND AJ BEL L Sit e Sketc h QiSoo d Address : 280 2 FIRANKLIN^T •Poo r Phone : H : 402-341-890 3 W : 402-280-218 8 ^ n No t pain t Lea d Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collecte d Firm : RYASCPXA-2637 6 F l pp m 

# n Date ; RYBSCPXA-2637 6 F 2 pp m 

### B f 

# n Time : RYCSCPXA-2637 6 B l pp m 

### D Sample s Analyze d RYDSCPXA-2637 6 B 2 pp m 

# n D Z RDZSCPX A2637 6 pp m 

### D XR F Unit : 8 I 0 Book ; ^ 5 RGZOOrXA-g037 0 -62 - pp m 

### D 

# n Date : e //2/0 / pp m 

### D Tim e Staff :

Omah aLeadSite 4613 0 

### Legen d
Concret e Dri p Zon e Excavate d Quadrant s Excavate d 

# D 3?? ^ Are a replace d wit h Are a replace d wit h Are alef t bar e So d Rock/Mulc h 

### Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
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## Omah a Lea d Sit e Exterio rPain t Owne rName : BREND AJ BELL QfGoo d 

## Sit e SIcetc h Address : 2802 FRANKLI N S T •Poo r Phone : H : 402-341-890 3 W : 402-280-218 8 ^ •Notpain t Sampl e Numbe r RYASCPXA-2637 6 RYBSCPXA-2637 6 RYCSCPXA-2637 6 RYDSCPXA-2637 6 RDZSCPXA-2637 6 ROiI0CP)(A-£007 0 RrZOGPXA-2007 0 Lea d Sampl e Concentratio n Collecte d F 1 pp m 

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### \ - COASTA l [HVItOHH fHU l * " PRO'*' ' c* 0 u r . I I fc 

## Consen i fo fAcces s T o Propeft y RIGH TO F ENTR YT O PREMISE S 

### Granto r(th e propert yowner ) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agency(EPA ) o rit s authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta i respons e activitie s upo n th e followin g describe d premises :

Owner' s Name : Daytim e Pho n 

# 3 ^

Addres s o fPropert y 

# 290 ^ reAAy^Uy y3 ^ covere d b ythi s Agreement :
PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EP Ai s requestin g acces s t o collec t soi l sample s an d remov e soi l tha t contain s elevate d concentration s o flea d an d ma ypos 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 its 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 b yUSEPA , wil l contac t th e Granto rin-persb n t o discus s th e wor k t o b e performed , th e Granto rwil l hav e a n opportunit yt 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 propert y ha s bee n remediated

.
ENVIRONMENTA L RESPONS E ACTION S 

### Bysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractor s an d subcontractors th e righ t t o ente rth e property , a t al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e wori(

. 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 o f2

### # .*^'"'*'» ,
COASTA L tttVmONKfKTi l C t O U P IK C 

### €

Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; G Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t maywis h t o save ; e Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessarysubsequen t t o a n initia l waterin g perio d b yEPA ; cAbid 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 t o th e propert yt o perfor m th e work

. cAllo wvideotapin g and/o rphotographin g o fth e property
. AGREEMEN TNO TT o INTERFER E 

### Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo fth e wor k activities , o rwit h an y b 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 wothers t o us e th e propert yi n suc h a manner . Should you hav e an yquestion s abou t thi s program , pleas e contact Coasta l Environmenta l Group , a t (402 ) 991-119 9



# 0^ f gran t access t o m ypropertie s D I d o not gran t acces s t o m ypropertie s


# V2./XOI P Signatur e Y Dat e Signatur e 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 o f2

# f:; , 0

COA S T AL
• M V I « O M M • M TAL O n O U P

. INC

. 

## Restoratio n Agreemen t The purpos e ofthi s agreemen t i s to provide amutua l agreemen t as to condition s ofth e propert y prior to remediationactivities
. Thi s will als o serve a s documentationfo r

the purpos e of assuring tha t restoration activitie s ar e completedto the satisfactionof the propert y owne r an dthe UnitedState s Environmenta l ProtectionAgency (EPA)
.

Propert y ID : 

# ^<^5-7 ^ PropertyAddress : ZB^ 7 f^f^UM/tJi/J/ U '> J Owner : /^^^^^ ^ >f^ ; ' 

# < 4 Phone : 

# •^/•»96- ^ 0B/''32& V O

nthe attacheddiagram(s ) indicat e area(s ) t o excavate , surface structure s an dlandscapin g feature s an d acces s location(s ) to b e usedby the contractors . Indicat e distances , depths , materia l types , etc . Photographicall y an dVideographicall y documen t the existing condition s ofth e propert y an dthe basemen t i

f necessary . 

## Item s t o b e Remove d b yth e Owne rbefor e Start o fRemediation : Th e removal , storage , disposai , and/o rretu m o fthes e item s i s th e Owner' s responsibility

. 

### Item :

# 9^ 1 ?Lu^ r Kem : 

# M i Kem :
Kem :



## Item s t o b e Remove d b yth e Contracto rDurin g Remediatio n an d No t Replace d Kem : 

# %.^^ y^/, i ui v!)<Uw j item :
Kem :
Kem :



### Page t of

.COA S T AL •MVinONMBMTA L O I I O U P , INC

. 

## Item s t o B e Remove d B yContracto rDurin g Remediatio n an d Replace d Kem : 

# s ^ 1 Kem : 

# <O b Kem :
Kem :



## Item Pre-existing propert y area , tha t wil l b e excavated , tha t i s coveredwit hgrass . Numbe r of tree s > 2 inc h tnm k

diamete r Numbe r of tree s < = 2 inc h trun k

diamete r Numbe r of Sprinkle r Zones , Control Valves , Timers , Heads , etc . Attac hasketc ho f th e sprinkle r layout
. Numbe r of an dsize of eac hgarden / flower bed area . Attac hasketc ho f relative size s an dlocations
. Agree duponvalue of plan t material s not t o b e replacedbv contractor . Not e thi s valu e wil l b e usedto issue aplan t voucher to th e property owner . Easemen t Area , t o b e excavated 

## Quantity 

# V 2 1


# r , ( \ 

# s
/ 

# f- ^

^ 6 Landscap e inventory Unit Quadrants

Eac h
Eac h

Eac h

Eac h Squar e Fee t

$

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## Condition/Type/Specie s



# ftl^PJl^ ^

Pag e 2 of

.

### V 5 COA S T AL o a o u p , INC

.

Additiona l Comment s / Instructions : Th e cit yo fOmah a ordinance s ma yprohib Kyo u fro m usin g dir t o rgrave l area s o n you rpropert y a s driveway s o rvehicl e parkin g areas . Th e Environmenta l Protectio n Agenc y(EPA ) ma yb e removin g an d replacin g soi l underlyin g a grave l o rdir t are a 6 n you rpropert ytha t yo u ma yb e usin g a s a drivewa yo rvehicl e parkin g area . I fthi s i s th e case , yo u shoul d understan d tha t thi s removing an d replacing o fsoi l doe s no t mea n tha t an yiiiega i drivewa yo rparkin g are a o n you r propert yi s mad e legal

. T o th e contrary , yo u ma yb e cite d b yth e cit yi fyo u us e a grave l o rdir t are a a s a drivewa yo rparkin g area , no t wKhstandin g an yremovai o rreplacement o fsoi l b yth e EP A I fyo u hav e an yquestio n abou t legalit yo fa certai n drivewa yo rparkin g area , yo u ma ycontac t th e cit yo fOmaha' s Plannin g Departmen t a t (402 ) 444-5150

. [Z l Pleas e chec k thi s bo xi fyo u understan d th e informatio n outline d above

.



# i ^ Abo YM>t O Ufi! ^ •s^^'^- y.

D Chec k th e bo xi fOwne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e pre-existin g damage

. B ycheckin g thi s bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures

. 

### O Id o no t agre e 

# ^/^^^ ^ ^rrrrj^y/jf ^

yzh ^ Owner' s Signature Date Contractor' s Signature Date Pag e 3 o f

## BviD # ^(>3n Q XR F PROPERT Y SAMPL E SHEE T Dat e Projec t XR F ID #

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Averag e Signatur e Prin t ^ Addres s Omah a Lea d ARR A Sampl e tim e sampl e lengt h 

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/ ' I > ^ s

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Readin g Sampl e are a Dept h

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# ^ / / \ ^
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Sampl e are a Dept h

RETES TAREA S Sampl e are a
7 Dept h 

# y Averag e

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blilerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 45 0 Mod e SOI L Tim e 2010-05-0 4 15:4 4 Duratio n 90.3 3 Sequenc e Fina l Flag s AVERAG E ^—Av§-oM47-449 = ADDRES S 280 2 Frankli n s t QUADRAN T D Z DEPT H 13 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D 8.12 5 Z r 420.84 3 ± 15.59 5 S r 180.15 7 ± 9.35 7 U < LO D 15.30 3 R b 70.87 2 ± 6.82 6 T h 18.29 9 ± 10.52 2 D h •^«)R II R 4 2 6 70 8 

### c i -

S e < LO D 5:931 - A s < LO D 34.77 2 H g < LO D 13.97 2 Z n 307.85 8 ± ^,,..-^.80 9 W < LO D /^^y96.33 5 C u < LO D y " X32.24 4 N i < LO D y / 77.77 9 

## y C o < LO D / y204.75 9 Fe 22379.94 /
- 7 440.32 7 

# ^ A M n / ^ 109.85 7 

# "Ty ^ '';

. 

# y Supervise d By : / / y

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blilerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 44 7 Mod e SOI L Tim e 2010-05-0 4 15:4 3 Duratio n 30.1 1 Sequenc e Fina l Flag s BVI D 2637 6 ADDRES S 280 2 Frankli n s t QUADRAN T D Z DEPT H 13 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D I 8.09 3 Z r 423.83 0 ± 15.61 6 S r 184.62 5 ± 9.44 5 U < LO D : 14.95 2 R b 75.61 8 ± 6.93 9 T h 17.86 2 ± 10.38 2 P b 383.84 9 ± 26.17 6 S e < LO D 5.67 5 A s < LO D 34.44 1 H g < LO D 13.58 0 Z n 326.50 4 ± 30.44 3 W < LO D 92.74 1 C u 32.41 2 ± 21.51 2 N i < LO D I 78.33 5 C o < LO D I 198.38 3 F e 21417.72 1 ± 429.87 0 M n 666.90 7 ± 109.30 2 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Biilerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 44 8 Mod e SOI L Tim e 2010-05-0 4 15:4 3 Duratio n 30.1 1 Sequenc e Fina l Flag s BVI D 2637 6 ADDRES S 280 2 Frankli n s t QUADRAN T D Z DEPT H 13 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m M o < LO D Z r 423.44 4 S r 179.90 9 U < LO D R b 68.48 7 T h 19.09 7 P b 390.23 2 S e < LO D A s < LO D H g < LO D Z n 289.19 0 W < LO D C u < LO D N l < LO D C o < LO D Fe 22859.86 3 M n 597.77 6 Supervise d By : Erro r 8.14 8 ± 15.62 9 ± 9.34 5 15.76 7

•± 6.79 2 ± 10.50 6 ± 26.41 9 5.72 5 34.85 2 13.99 2 ± 29.02 1 97.78 1 31.62 3 78.50 3 207.68 8 ± 444.70 6 ± 105.25 5

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 44 9 Mod e SOI L Tim e 2010-05-0 4 15:4 4 Duratio n 30.1 1 Sequenc e Fina l Flag s BVI D 2637 6 ADDRES S 280 2 Frankli n s t QUADRAN T D Z DEPT H 13 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D : 8.13 5 Z r 415.25 5 ± 15.54 1 S r 175.93 6 ± 9.28 1 U < LO D : 15.19 1 R b 68.51 0 ± 6.74 7 T h 17.93 8 ± 10.67 8 P b 421.26 2 ± 27.52 8 S e < LO D 6.39 3 A s < LO D 35.02 3 H g < LO D 14.34 5 Z n 307.88 1 ± 29.96 5 W < LO D J 98.48 2 C u 35.84 8 ± 21.89 3 N l < LO D J 76.49 8 C o < LO D 208.20 6 Fe 22862.25 8 ± 446.40 6 M n 761.82 8 ± 115.01 4 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blilerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E ADDRES S QUADRAN T DEPT H TYP E INSPECTO R

M o Z r S r U R b T h rPtr- i

S e A s H g Z n W C u N i C o Fe 20941.56 8 / M n 627.074 / ^ Supervise d By : /^ ^ 

## Certificat e o fVerificatio n

44 6 SOI L 2010-05-0 4 15:4 0 90.3 5 Fina l

^

" '^^^^^^02Frankli n s t EA 1 " CONFIRMATIO N N

. LOPE Z

pp m < LO D 415.35 6 180.79 3

< LO D 70.53 5 < LO D 37 7 73 4 '. —

< LO D < LO D < LO D 279.48 9

< LO D 51.86 0 < LO D / < LO D / ± ±1 ±
±

; I ±

I 

# x '

:

• 

# y

. Erro r 7.96 3 15.36 8

9.30 3 15.64 0 6.80 3 14.21 1 —^-25.83 0 6.06 6 33.08 3 13.60 8 28.28 7 .^'-91.46 5 722.73 8 / 76.91 4
/ y195.87 7 422.88 8 105.57 3

•

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Blilerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 44 3 Mod e SOI L Tim e 2010-05-0 4 15:3 7 Duratio n 30.1 2 Sequenc e Fina l Flag s BVI D 2637 6 ADDRES S 280 2 Frankli n s t QUADRAN T E A DEPT H 1 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r

• M o < LO D 7.93 8 Z r 423.69 5 ± 15.56 9 S r 184.28 6 ± 9.43 0 U < LO D : 15.53 8 R b 68.00 7 ± 6.71 8 T h < LO D I 14.47 8 P b 384.59 8 ± 26.17 1 S e < LO D [ 6.06 4 A s < LO D ; 33.36 8 H g 14.91 3 ± 9.16 6 Z n 272.58 4 ± 27.99 1 W < LO D \ 86.86 4 C u 54.55 2 ± 23.04 3 N i < LO D I 77.78 4 C o < LO D I 195.26 2 F e 21229.42 2 ± 427.38 3 M n 627.31 7 ± 106.16 6 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Biilerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 44 4 Mod e SOI L Tim e 2010-05-0 4 15:3 8 Duratio n 30.1 2 Sequenc e Fina l Flag s BVI D 2637 6 ADDRES S 280 2 Frankli n s t QUADRAN T E A DEPT H 1 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D : 7.85 4 Z r 410.99 3 ± 15.28 9 S r 181.85 1 ± 9.31 1 U < LO D J 15.37 9 R b 70.40 6 ± 6.76 9 T h < LO D : 14.43 2 P b 360.94 2 ± 25.24 3 S e < LO D * 5.99 8 A s < LO D J 32.22 8 H g < LO D : 13.60 5 Z n 265.12 5 ± 27.71 8 W < LO D : 96.51 7 C u 55.01 3 ± 23.07 6 N i < LO D : 80.39 1 C o 212.79 2 ± 133.09 8 F e 21084.46 5 ± 423.74 5 M n 622.31 7 ± 105.04 5 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 44 5 Mod e SOI L Tim e 2010-05-0 4 15:4 0 Duratio n 30.1 1 Sequenc e Fina l Flag s BVI D 2637 6 ADDRES S 280 2 Frankli n s t QUADRAN T EA DEPT H 1 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D : 8.09 8 Z r 411.37 9 ± 15.24 4 S r 176.24 0 ± 9.16 9 U < LO D : 16.00 4 R b 73.19 1 ± 6.92 3 T h < LO D * 13.72 2 P b 387.66 0 ± 26.07 5 S e < LO D : 6.13 5 A s < LO D : 33.65 2 H g < LO D : 13.47 0 Z n 300.75 9 ± 29.15 0 W < LO D : 91.01 4 C u 46.01 6 ± 22.09 7 N i < LO D 72.56 8 •

• C o < LO D 192.72 2 Fe 20510.81 6 ± 417.53 5 M n 631.58 8 ± 105.50 6 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 43 8 Mod e SOIL Tim e 2010-05-0 4 15:3 2 Duratio n 90.6 4 Sequenc e Fina l Flag s AVERAG E v g o f435-43 7 ADDRES S 280 2 Frankli n s t QUADRAN T B l DEPT H 6 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D : 7.95 6 Z r 396.64 9 ± 15.08 8 S r 186.91 5 ± 9.43 1 U < LO D : 14.71 2 R b 71.13 3 ± 6.72 0 T h < LO D • 14.15 3 -Pb - 320.84 6 ±— -23:51 3 S e < LO D I 6.23 1 A s < LO D : 30.73 9 H g < LO D : 12.91 4 Z n 275.03 3 ± 27.99 6 W < LO D • ^ ^ 7 90.15 8 C u 52.15 6 / 22.67 3 y ^ y N i < LO D y : / 75.60 8 C o < LOp ^ 

# y 196.46 5 F e 21237.85 9 425.30 6 

## y ± M n 60074 4 ^ 104.54 0 

# /

y ^ ^ Supervise d By : ""/ ^ 

# y

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 43 5 Mod e SOI L Tim e 2010-05-0 4 15:2 9 Duratio n 30.1 1 Sequenc e Fina l Flag s BVI D 2637 6 ADDRES S 280 2 Frankli n s t QUADRAN T B l DEPT H 6 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

Erro r 

### ppm M o < LO D J 7.90 7 Z r 397.72 1 ± 15.15 8 S r 194.47 7 ± 9.62 8 U < LO D : 14.76 9 R b 66.94 7 ± 6.58 7 T h 14.55 0 ± 9.56 0 P b 315.33 6 ± 23.75 0 S e < LO D 6.01 8 A s < LO D 30.70 8 H g < LO D 13.33 8 Z n 262.14 6 ± 27.61 1 W < LO D 93.72 1 C u 62.98 4 ± 23.43 0 N i < LO D : 73.48 9 C o < LO D : 194.96 2 Fe 20303.54 7 ± 416.72 9 M n 584.78 0 ± 103.36 4 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPT H TYP E INSPECTO R

M o Z r S r U R b T h P b S e A s H g Z n W C u N i C o F e M n C r V T l S c C a K S pp m < LO D 389.12 6 194.70 7

< LO D 69.83 3 < LO D 298.26 4

< LO D < LO D < LO D 242.40 7

< LO D 39.03 5 < LO D < LO D 20786.61 3 583.55 1

< LO D < LO D 4230.45 0 < LO D 12665.78 2 17839.47 1 < LO D Supervise d By : 

## Certificat e o fVerificatio n

43 6 SOI L 2010-05-0 4 15:3 1 30.4 2 Fina l 2637 6 280 2 Frankli n s t B l 6 " CONFIRMATIO N N

. LOPE Z

: ± ± : ±1 ± :

: : ± J ±

: : ± ±

• J ±

J ± ±

: Erro r 7.96 0 14.95 2

9.60 0 14.50 0 6.64 0 13.17 9 23.03 5

5.86 1 28.96 7 12.58 8 26.43 6 88.88 1 21.74 0 77.11 4 193.07 2 420.19 7 102.72 6 297.27 3 607.15 2 1992.75 6

289.85 4 5174.10 6 8691.24 4 11018.56 3

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Bilierica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 43 7 Mod e SOI L Tim e 2010-05-0 4 15:3 2 Duratio n 30.1 1 Sequenc e Fina l Flag s BVI D 2637 6 ADDRES S 280 2 Frankli n s t QUADRAN T B l DEPT H 6 " TYP E CONFIRMATIO N INSPECTO R N

. LOPE Z

pp m Erro r M o < LO D : 8.00 1 Z r 403.10 0 ± 15.15 4 S r 171.56 0 ± 9.06 6 U < LO D : 14.86 8 R b 76.61 9 ± 6.93 2 T h 16.28 8 ± 9.96 0 P b 348.93 7 ± 24.95 4 S e < LO D 6.81 5 A s < LO D 32.54 3 H g < LO D 12.81 5 Z n 320.54 7 ± 29.94 2 W < LO D 87.87 1 C u 54.44 9 ± 22.84 8 N i < LO D : 76.22 1 C o < LO D : 201.36 3 F e 22623.41 6 ± 438.99 1 M n 651.90 1 ± 107.53 1 Supervise d By :

## iJOk^\ E. a t
. .„_._ Omah 

## a Lea d Site—Fixe d Pric e EP-R7-07-0 5

_ Coasta l Environmenta l Grou p Inc

. vl V •" ^ www.coastalhazmat.co m Xp„oit< ^ COASTA L INVIIONNiNTA l SIO U P. IN C 

# EXECUTIV ESUMMARY : BVID #26376-(280 2 FRANKLI NST )
px] No Issue s or Concern s [^ Issues/Concern s
Detail Explanation : DA NGARVE YWALKE D TH EPROPERT Y

ON5/6/1 04 

## EP APropert y Clos e Ou t For m Propert y « : "LUyXL Propert y Add i Date/Time ; Owner' s Nam e 

### L L Quad s Excavated : Contracto r Grou p ^flg-^V^ N
Excavatio nGenera l 1
.

I f neccssmy , wer e th e correc i quadrant(s ) exc avate dan drestored ? 2
.I f necessary , wer e th e correc t area s ofdri p zon e excavale dan drestored ? Gradln e So dan dVegctatk m I
.Doe s th e {TBdin g aroim dth e perimete r ofth e hous e i nexcavate darea s generall y slop e away fromth e house ? 2
.Ha s so dbeenlai di nal l area s that wer e excavated ? J
.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 da y tim e period ) 4
.Ar e sodde darea s generall y firman devenl y graded ? S
.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 tb e properl y grade dsuc hthat wate r wil l not poo l onth e pmperry' ' 7
.

Wa s dainag e t o landscapin g o r plan t material s avoided ? Gates , Fence s an dReutBlp g Wal b i
.D o gate s openan dclos e freely? (I f applicable ) 2
.Wer e al l gate s o r fence s talcendow ndurin g restoratio nactivitie s reinstalled ? (I f applicable ) 3
.

Wa s damag e t o gate s o r fence s avoided ? (Ifappiicable ) 4
.Wa s dainag e t o retainbg wall s avoided ? (Ifappiicable ) FouDdatioa , SidiORao dGnUer s t .Wa s danng e t o th e sidin g o r tri mavoided ? 2
.Wa s damag e t o th e foundatio navoided ? ? •Wa s damag e t o window s avoided ? Wa s damag e t o window s o r doo r screen s avoided ? 5
.

Wa s daimtg e t o downspout s o r downspou l extension s avoided ? Sidewalk s an dDriveway s (Concrete ) I
.Wa s damag e t o drivewa y surface s avoiikd ? 2
.Wa s damag e t o walkwa y surface s avoided ? Ye s N o / / Ye s No /

i / 

# y y 

# y . 

# J 

# y

^ Ye s N o 

# Z / / / Ye s N o / / 

# y 

# y y Ye s N o / 

# y

## OM'oer s comments :

I

_ _ 

## [In.spectio nnotes :

Remova l an dreslorationactivate s complet e includin g th e 30-da y so dwarranry : EP ARepresentalive Pes_^ L_Dale : £/f/'?
_

## Propert yCompletio n Agreemen t
ihi s agreeme mdocumenl s ih e complclio n ol remedia l acliviiie s perloime d on my propert y My signalui e wil l designat e Ihal I amsatisfie dwit h(h e restoralio n of my propeily , an dthai no item s ar e inquestions , nov^ , oral an y lime inth e future , excep t Ihos e ilem s liste dbelow , if an y Properr y tP : ^( ^ 3' ^ ^ PropertyAddress : v^j^O2
. F<(>V\i<^ i iV N A - 

# Q""*^'brf.MeK.XV M Phonev^t ^ I- 5 ^ q0-2> ^ -

— Ufe l -3^C M Restoratior t Item s in Question :

item : Item : Item :
- = Item : Item : Item :
Additiona l Comments :


# Z­ \y \IRgrc c I iCKtoralio n is completed , rxccp i aj note d [_ J I rio no t «i;rt crcstorfltio n » complete d

i Dat e Sienatur Dal e Owner' s Signatnr r Contrarlor' Contrarlor' s Signature D

# Propert y Owne r Assessment o f

Performanc e For m AmericanRecovery an dReinvestmen t Ac t (ARRA ) Omah aLeadSuperftin dSite 2009/201 0 Remediatio nContractor : Coasta i Environmenta l Grou p - EP-R7-09-0 6 Propert y Identifie r Number : 2»C'3 n Propert y Address : "^^O ^ frcNy^yClly^ 

## ^{r s * 

## ^.l ^ Propert y Owner' s Name ; ^r^iyNtAf K khoK K
Instruction s t o tli e Propert v Owner : Thi s for mserve s t o recor dth e Property Owner' s assessmen t o f performanc e (Incentiv e 1

- Quality Assuranc e Surveillanc e Plan ) involvin g th e liste dremediatio ncontractor , a s applicabl e t o th e Omah aLeadSite
. Thi s for mdocument s th e timelines s o f punc hlis t resolution , busines s relations , complain t resolutio nan dth e overal l quality o f work
. I f nee dbe , th e Property Owner may utiliz e thi s for mt o recor dproblem s and/o r issue s no t specificall y tie dt o a nassigne d address , for example , busines s relation s that generall y don' t follo w th e guideline s set fort hinth e Performanc e Wor k

Statement
. Th e Property Owne r wil l indicate his/he r assessmen t o f performanc e wit hth e contractor' s wor k

b y checkin g anumerica l ratin g o nth e tabl e belo w usin g th e nu^^m^-^e^Mtiej u from th e ratin g scal e below , the nsig n& dat e th e form
. »-CiV^ll X V Es U 

## JU L1 9 201 0 9-1 0 "excellent " Ju u l acuiu 7- 8 "very good " SUPERFUN D DIVISIO N 5- 6 "acceptable " 3- 4 "poor " 1-

2 "very poor " Propert v Owner' s Assessmen t of Performanc e Regardin g th e Contractor' s Wor k 1 0 / 5 9 y 4 8 3 7 2 6 1 Propert v Owne r Additiona l Comment s fro m(optional ; continu e o nbiack pag e i f needed )
Propert y Owne r Signature : ^^^'fikj^M.^ ^ ^^ ^ Date : ^ / HIJiO^ ^