### SAiD# : 

### 2827 8 

### TRANSMITTA L O F OMAH ALEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R DATE : 1/1 5 ADDRESS : 223 4 N 1 8 S T REMEDIATIO N CONTRACTOR : PRUDENTTECHNOLOGIES . INC . YEAR : 

### 2011 ^ 

### SOI L REMEDIATIO N PROPERT YFIL E FOLDE R DOCUMENT S d PR E AN D POS TVIDE O O F PORPERT Y(DVD ) d EXECUTIV E SUMMAR Y d EPA-PROVIDE D PROPERT YSKETC H d SIGNE D ACCES S AGREEMEN TFOR SUBJEC TPROPERT Y D SIGNE D ACCES S AGREEMENT(S ) FOR ADJACEN TPROPERT Y d RESTORATIO N AGREEMEN T D SETTLEMEN TDOCUMENTS (I.E. , FOR DAMAG E O R TO REPLACE PLANTS , ETC. ) d CONFIRMATIO N DAT A 0 PHOTOGRAPH S d AS-BUIL TSKETC H 0 SATISFACTOR YRESTORATIO N SIGNE D B YPROPERT YOWNE R 0 PROPERT YCLOSE-OU TCHECKLIS TSIGNE D B YEP A D DESCRIPTIO N O F AREA S NO TMEETIN G RO D CLEANU P CRITERI A U

/ UTILIT YCLEARANCE S d PROPERT YINFORMATIO N FRO M DOUGUV S COUNT YASSESSOR'S OFFIC E D 

# a %\\^\\ \ -BK^JD SIGNATUR E DAT E 

### 3021841 7 

# W i Superfun d

### PROPERT Y SUMMAR Y Date : /15/201 0 Oinah aLea dSit e Remedia l Actio n Contrac t #EP-R7-07-0 6 TO# l Montl i of : Propert y Address : 223 4 N1 8 S 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 = 34 9 PP M @ 6" ; E A = 38 8 PP M @ SCRAP E(~1" ) ATTACHMENT S 1 ) Property sketc hprovide db y EPA 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 ndigita l vide o clip/photograph s 4 ) Post-Excavatio ndigita l vide o clip/photograph s 5 ) Documentatio n - Complete dClose-ou t Checklis t 6 ) As-Buil t sketc h­ i ) Shal l includ e final lea dlevel s v ) Legen d ii ) Contaminatio n lef t behin darea s vi ) Contracto r identificatio n iii ) Property addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e include dinth e individua l property file, i f available , o r obtaine dinclude : i ) Pre-excavatio n agreement detail s (i f any ar e mad e withth e property owner ) ii ) Property Statu s Formsigne db y property owne r iii ) Excavatio ndigita l vide o in MPEG , WM V (Window s Medi aVideo ) o r SWF(Flas hPlayer ) format and/o r photograph s iv ) Signe dfor mverifyin g satisfactory restoratio n v ) Descriprio nofarea s no t meetin g Interi mRO D cleanu p criteria .

TECHNOLOCIES . INC .Fin d Record 

### Backnil :

Sampl e Area : 2827 8 - 223 4 N 1 8 S T Owner : D Owne rOccupie d Owne rName : JHOUSIN G I N OMAHAIN C Owne rAddressl : 

## ] Owne rAddress2 : 52 0 S 2 7 S T City : State : Zi p Code : JOMAHA N E 68105 - Owne rPhon e Alternat e Phone :



### Contract : Contractor : JPRUDENT2010_ S Contrac t Optio n JOPTIO N 2 Remediatio n Quer y Lea d Remainin g Quer yPtx)pettyDamag e Quer y

Use rProvide d Owne rInformatio n Resident : Owne rName : Residen t Name : Owne rAddress : 

# 1 City : State : Zi p CixJe : Propert yAddress : 12234 N 1 8 S T Zi p Code : 

# lesiio - Residen t Phon e Owne rPhone : 

# 1 Alternat e Phone :

Assessment : i Qualifyin g Grou p |40 0 i j Assessmen t Ma xXR F Valu e f 482.4 7TECHNOLiOGIES , tNC . 

# EP A Propert y Clos e Ou t Propert y #:'Z' ^ 2-"^ ^ Propert y Address : 7'Z.> H ^ ' '^ "^ Date/Time : Owner' s Name : 0^-1^ - Quad s Excavated : X7 \ Contracto r Group : Pruden t Technologies , Inc. , Excavatio n Genera l Ye s 1. If necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? / 2. If necessary , wer e th e correc t area s of dri p zon e excavate dan drestored ? / Gradin g So dan dVegetatio n Ye s 1. Doe s th e gradin g aroun dth e perimete r of th e hous ein excavate darea s generall y slop e awa y fro mth e house ? / 2. Ha s so dbee n lai d in al l area s that wer e excavated ? / 1 J . Doe s th e so dappea r to be generall y health y an dgrowing ? (Onl y evaluat e if

inspecte d at a

30 day lim e period ) / 4. Are sodde darea s generall y fir man devenl y graded ? / 5. Ar c tli e joint s betwee n tli e so dstrip s generall y tight ? (Onl y evaluat e if

inspecte d at a

30 day / tim e penod ) 6. Wa s th e property grade dsuc htliat wate r wil l no t poo l on th e property ? / 7. Wa s damag e to landscapin g or plan t material s avoided ? / Gates , Fence s an dRetainin g Wall s Ye s 1.

Do gate s ope n an dclos e freely ? (If applicable ) / 2 Were al l gate s or fence s take n dow n durin g restoratio n activitie s reinstalled ? (I f applicable ) / 3. Wa s damag eto gate s or fence s avoided ? (I f applicable ) / 4. Wa s damag e to retainin g wall s avoided ? (I f applicable ) / Foundation , Sidin g an dGutter s Ye s 1.

Wa s damag e to th e sidin g or tri mavoided ? / 2. Wa s damag eto tli e foundatio n avoided ? / .1 . Wa s damag e to window s avoided ? / 4. Wa s damag e to window s or doo r screen s avoided ? / 5. Wa s damag eto downspout s or downspou t extension s avoided ? / Sidewallt s an dDriveway s (Concrete ) Ye Ye s s 1 Wii s d;iiiiae e lo drivewa v surface s avoided ? 

## y 2.Wa s damag e to walkwa y surface s avoided ? No

No

No

No

No

## Owner s comments :

Inspectio n notes : 

# y 

# y y y )

Remova l an drestoratio n activate s complete includin g th e 30-da y sodwarranty : EP A Representativ e 9c ^ / ^ ^Date: dul HTHNOLOGIES . INC . 

## AS - BUILT DRAWING OL S t t 2827 8 Dat e Kxcavated : 11/02/201 0 IISEP A Signed-OfTDate : 

## OMAH A LEAD SUPERFUND SIT E
Name : (^EU E R^KP , Omah a Lea d Sit e Address : 77.34 - M 1 ^'^ ^ Sit e Sketc h Phone : Team_£DA__Ga^A i BVID#^2£2l£ _ Sampl e Numbe r Lea d Concentratio n 

## 34 9 pp m Z-i?,'5CP)LA-Z.e-znP , 

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### ,//. ^ 7 Z 8 Z7 & Date : 09-W-9 5 Nort h Arro w Time : (\:U n XRFCod e /g3 7 fJooiC - IZ< f Confirmatio n Sampl e F l Ye s D N o ^ F 2 Ye s C D N o 5 , B ; Ye s • N o [2 S BZYe s <= ! N o E f C KYe s n fjo- B QZYe s Q M&-J 3 • Pi L Ye a D- N o D 

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### CONTRAC T# : EP-S7-10-0 5 PRUDEN TTECHNOLOGIES , INC .

# SERf t

• s . 

## Propert yCompletio n Agreemen t Thi s agreement document s th e completio n o f removal activitie s perfonne do n th e belo w liste dproperty . Th e property owner' s signature indicate s that th e property owner i s satisfie dwithth e restoratio n o f th e subjec t property , an d(ha t n o item s ar e i n question , now , o r at an y tim e i n th e future , excludin g an y remainin g warranty (3 0 day s total ) excep t thos e itemi s liste dbelow , i f any . Property ID : Property Address : 223 4 N 1 8 S t Owner : Omah a Housin g Authorit y 

### Phone : 402-444-6900x25 1 Restoratio n Item s i n Question :

Item : Th e sit e i s sno wcovere d a t thi s tim e an d th e so d i s domfiant . Bein g unabl e t o Item : inspec t th e sod ; OH Acanno t b e certai n o f satisfaction . Pruden t agree s tha t Item : warrant yo f wor k i s extende d durin g winte rmonth s throug h spring . I f so d doe s no t Kem : tak e roo t an d becom e health yb yth e en d b f spring , Pruden t t o b e responsibl e fo r Hem : replacin g so d a t tha t time . Kem : Require d correction s t o complet e th e property :

I I I agre e restoratio n i s completed .

X I d o no t agre e restoratio n i s complete d a t (note d deficiencie s above ) 

## y&y/^//£ > Dat ePnideni Technologies . Inc . (Pnident ) i s under conliac t wit hIhe U . S . Envinmmcnla l Protectio n Agency (EPA ) t o clea nu p lead conlaminate dsoil s at anumber ofpropertie s locate di n Omaha . Nebiaska . includin g th e propert y locate dal 223 4 N . 18" * Street . Th e EP

A request s your permissio n t o allo w Pniden t t o perfor masoi l cleanup a t thi s propert y t o remov e lead-contaminate dsoil . B y signmg thi s form , th e propert y owner grant s permissio n t o Pmdent t o pofor maciivttie s relate dt o th e cleanup includin g soi l sampling , remova l o f lead^ontanunate dsoil , an drestoratio n ofth e reference dproperty . Ifyo u hav e an y question s abou t Ihe soi l cleanup planne dfor-you r property , pleas e contac t Prudent sout hoffic e .for th e Omah aLea d Site cleanup-e t (402 ) 733-1188 . General question s about th e Omah aLea dSit e cleanup can b e directe dt o th e EP A Publi c hfbrmatio n Center s a t (402 ) 73i-304 S (SoulhOmah aoflice ) o r (402 ) 991-958 3 (Nort hOmah aofTice) . Propen y Acces s Grante dBy : Stanle y Tinun , Executiv e Directo r fo r Omah aHousin g Authorit y (Pleas e Print Name ) Propert y Owne r Signature : vyyAyiUr/.lj f y/yytfiy*'^ ^ ^ ^ l^*\>O\ 0

(Signature ) (Date ) 

# f

PROPERT Y INFORMATIO N (T o b e complete db y residen t and/o r propert y owne r — plcat e print ) RESIDEN TNAME : Vacan t lo t Owne rRente r RESIDEN TADDRESS : 223 4 N 1 8 S t Omaha , N E I F RENTAL . PROPERT YOWNE D BY : Th e Omah a Housin g Authorit y OWNER' S MAILIN G ADDRESS ; 54 0 S . 27* " Street , Omaha , N E 6810 5 OWNER' S TELEPHON E NUMBER-Work : (402 > 444-690 0 x25 1 AG E O F HOME? : N/ AYEARS . HOW LON G HAV E YO U LIVE D HERE ? N/A

_YEARS . HA S TH E EXTERIO R BEE N PAINTE D O R COVERE D WIT H SIDIN G SINC E 1978 ? ^YES N O N/ A NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OLD : _N/A

_ NUMBE R O F OCCUPANT S 7 YEAR S OL D AN D OLDE R _N/A NUMBE R O F CHILDRE N UNDE R 7 YEAR S OL D WH O PLAYI N TH E YAR D FO R 3 HOUR S O R MOR E PE R WEEK : _N/A COMMENT S O R SPECIA L INSTRUCTIONS : (I.E . DOGS , ENTR YGATES,.ETC. ) AUTHORrr Y FORENVIRONMENTALRESPONS EACTIONS : Th e activitie s t o b e implemente db y EP A under thi s agreeinent ar e pursuant t o Sectio n10 4 ofCERCLA . 4 2 U.S.C . 9604 . EPA'srightofaccesstothepropeit y i s provide dfo r i

n Sectio n I04(e)o f CERCLA . 4 2 U.S . C 9605(e) . whic hprovide s entr y fo r "detemiinin g th e needfo r lesponse . o r choosin g o r takin g an y respons e actio n under 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 0411 4 Omaha , Nebrask a 6810 7 San/Vntonio , T X 7822 9 Phone:(816)363-370 3 Phone : (402)733-118 8 Phone : (210)822-058 8 Fax:(816)363-370 7 Fax : (402)733-188 3 Fax:(210)579-657 7ENVIRONMENTA L & CONSTRUCTIO N 

### TECHNOLOGIES , INC . SERVICE S 

# Propert y Statu s For m Address : 35L'3> 4 M ( ? K v $[ ^ Date : Phone : BVID :



## JB T A

# 5 0 \ Propert y Owne r Pruden t Emp Signature : Signature : 

## .^a ^ 808 0 War d Parkway , Suit e 40 5 250 5 N . 24" * Street , Suj i 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , TX 7822 9 Phone:(816)363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7

### Z8Z1 B Name : feMg ^C^i . Address : 77.^4 . K l \9.+^ ~ Omah a Lea d Sit e Sit e Sketc h Date : O^-IQ-^ ^ Time : il-U Q Nort h Arro w—i 

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# A 223 4 N18ST:60 X 14 0 Printed : De c 10.201 0 '" 1

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### Pag e 1 o f 1

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### • YOURTICKE T NUMBERI S 2628942 . Origina l Cal l Date : 10/28/1 0 Time : 2:0 4 pm Op : SIVA1896 7 Wor k t o Begi n Date : 11/01/1 0 Time : 2:3 0 pm State : N E County : DOUGLA S Place : OMAH A Address : 223 4 Street : N18TH S T Twp : 15 NRng : 13 E Sect-Qtr : 10-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : soi l lea d remediatio n projec t Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)733-188 3 Compan y: PRUDENT TECHNOLOGIE S Contac t Name : SIV AJAMPAM A Phone : (402)733-118 8 Wor k Bein g Don e For : EP A Dept h o f Excavation : 6F T Corne r Lot : Y Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Are a Contac t Phon e Numbe r Utility Typ e CXCAT V COX COMMUNICATIONS , INC HEIDI 

### 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 OMAHACOFCITY OFOMAHA-TRAFFIC,SEWE R RICH/TRAFFIC 

### Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 OPPDGPR5 OMAH A PUBLIC POWE RDISTRIC T EL M LOCATING Day : 406728934 3 Alt : 406207149 4 

### Emerg : 888728934 3 QLNNEI C QWES T LOCA LNETWOR K EL M LOCATING 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 

### http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT. . . 10/28/201 0

### CONSTRUCTIO N 

## wc . SOLUTION S 

## SIT ESAFfeT Y HAZAR D ANALYSI S Address : J^^Sy^M—ti^LU t Excavatio n Date : Crew : BackfiU Date :

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## Sit e Safet y Offic e Date :

«0W!an»«aftany.SataF4 « SSMSIOS t 424 2 Medica l Drive , Suit e 726 0 gnwC«r/Ma«411 4 14810 7 Sa n Antonio , T X 7822 9 lona : (SIS ) SaSsSf U (402)733-118 8 Phone : (2t0 ) 8Z2-«68 8 Fax : |4a2)733<1«S 3 Fax : (210 ) CT9-6577