### # 

## TRANSMITTALo f

OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R SAI D #: 2cy^?? ) Date : 

# i/: ^
Address : //^^ ^ H/^pl < Remediatio nContractor : Coasta l Environinenta i Group

_Year : _2010ARRA
_ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o ofpropert y (DVD ) 

## <y ^ Executiv e Summary EPA-provide dproperty sketc h 

# y Signe dAcces s Agreemen t for subjec t property Signe dAcces s Agreement(s ) for adjacent property <2 y Restoratio nAgreemen t

• ^'J?! ^ Settlemen t document s (i.e. , for damag e o r to replac e plants , etc. ) vS " Confirmatio ndat a



## ^y ^ Photograph s \ U t>^o>wproo ^ X (:^<%(^cn ^ y ^0\ r iR" ^ As-buil t sketc h 'Oy Satisfactory restoratio nsigne db y Property Owne r ''^y Property close-ou t chec k lis t signe db y EP A -^S ^ Descriptio no f area s no t meetin g RO D cleanu p criteri a ^y Utility clearance s B^ ' Property informatio nfro mDougla s County Assessor' s Offic e D D D 

# y Dat e

3026102 1 Superfun d

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Acces s Agreement Restoratio nAgreement Topsoil Samplin g (if applicable ) Disposa l Samplin g (i f applicable ) Garde nSamplin g (if applicable} * Utilit y Clearanc e Video/Photo s (Before) Video/Photo s (During ) Video/Photo s (After) Video/Photo s (30-Day ) Property CompletionAgreement Final Report Sent : / / Sizncd : 3 /1 $ / l l Signed : 3 /l ^ 1 \\ 1 1 1 1 1 1 Called : / / On : / / On : / / On : / / On : / / Si^ed : . / / Issued : / / By : By : By : By : By : By : By : By : By : By : By : By : By : 

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### Dougla s County Accoun t Infonnatio n Pag e 1 of 2 Tqama l
Dougla s County , Nebrask a Propert yRecor d - R174467000 0 Prin t Reoor t Vie wInteractiv e GI S Ma o Informatio n i s vali d a s o f 2010-8-3 0 Treasurer' s Ta xReoor t Ne wFeatur e r * • ^ r * Subdivisio n Sale s Searc h Owne r CUMMING S JULI A
160 7 LOCUS TS T OMAH AN E 68110-000 0 Propert yInformatio n Ke yNumber : 446 7 000 0 1 7 Accoun t Type : Residentia l Parce l Number : 174467000 0 Parce l Address : 160 8 MAPL E S T OMAH AN E 68110-000 0 Lega l Description : MILLAR D & CALDWELL' S AD D LO T2 1 BLOC K0 W 3 0 E 15 0 N 71.62 5 F T3 0 X 71.62 5 Vaiu e Informatio n
201 0 200 9 200 8 200 7 200 6 200 5 Lan d $200.0 0 $200.0 0 $200.0 0 $200.0 0 $200.0 0 $200.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $200.0 0 $200.0 0 $200.0 0 $200.0 0 $200.0 0 $200.0 0 

### Sho wAl l Transaction s

Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t O.O A 2130. 0 0. 0 71. 0 30. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/acco\mtinfo.jsp?accoiintno=R17.
. . 9/15/201 0

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.



### http://douglasne.mapping-online.eom/DouglasCoNe/static/accountinfo.jsp?accountno= R17..
. 9/15/201 04/5/201 1 www.dhon.org/irthinternet/DHONNoti c 

### Creat e Anothe rTicke t Bac k r^W l h Intemet Sen d Emai l 

# • E *

• YOU RTICKE T NUMBE RI S 2703945
. Origina l Cal l Date ; 4/05/1 1 Time : 10:0 3 a m Op : ALFONSO1879 0 Wor k t o Begi n Date ; 4/07/1 1 Time : 10:3 0 a m State : N E County : DOUGLA S Place : OMAHA Address : 160 8 Street : MAPL E S T Twp : 15 NRng : 13 E Sect-Qtr : 10-NE-NW-SE-S W 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 : FA X AL L CLEAR S TO : (402)934-281 1 : PLEAS E INCLUD E AL L EASEMENT S Company: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ALFONS O Phone : (402)934-283 7 Wor k Bein g Don e For : Coasta l Dept h o f Excavation : 4f t Corne r Lot : NFront : Y Rear ; Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCATV MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C


## Utilit y Servic e Are a Contac t Phon e Nunibe r Typ e Day : 402934046 9 CXCATV CO X COMMUNICATIONS , IN C HEIDI Alt : 402934046 9 Emerg : 402932975 7 Day : 402504782 3 METROPOLITA NUTILITIES MUDO l SAND Y MUD Alt : DISTRIC T Emerg : 402504797 0 Day : 402444719 7 

## CITY O FOMAHA

- OMAHACO F RICH/TRAFFIC Alt : 402444516 1 TRAFFICSEWE R Emerg : 402444516 0 Day : 406728934 3 

## OMAHA PUBLIC POWER EL M 0PPDGPR 5 Ah : 406207149 4 

## DISTRIC T LOCATIN G Emerg : 888728934 3 dhon.org/irthinternet/. ../MessageText.as..
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## Conse^nvfo fAccess ^

To l^roperl y RIGH TO F ENTR YT O PREMISE S 

### Granto t (th e property ' owner) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agency(EPA ) o i it s 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 : 

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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 remove soi l tha t contain s elevate d concentration s o f lea 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 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 f Coasta l Environmenta l Group , contracte d b yUSEPA , wil l contac t th e Granto rin-perso 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 EPAtha 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 subcontractor s th e right 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 f performin 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 of2I t \y^^^^^'i COASTA L

• .X " thyHOhKlKTJ H

DfiQl V C » 0 U P t V C 

### t Remov e obstruction s includin g boats , Irailers , vehicles , playscap e ilems , woo d piles , do g houses , etc ; I
.Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma ywis h t o save ; cWate ran d maintai n leplacemen t vegetation , includin g feriilize rapplication , a s necessary ' subsequen t t o a n initia l waterin g perio d b yEPA ; 'Abid e b yhealt h an d safet yguidanc e provide d b yEPA ;

' I f th e property / i s rented , assis t EP Ai n obtainin g tenan t approva l fo i acces s t o th e property / t o perfor m th e work
. IAllo 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 o f th 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 f sai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o f th 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

M I gran t acces s t o mypropertie sQ ' d o no l gran t acces s t o mypropertie s 

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.

Pao e 2 o f2COASTA L KMViaOMHCNTA L C n O U P
. INC
. 

## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s to provid e amutual agreemen t a s to condition s o f th e property prio r t o remediatio nactivities
. Thi s wil l als o serv e a s documentatio nfo r th e purpos e o f assurin g that restoratio n activitie s are complete dt o th e satisfactio no f th e property owne r an dth e Unite dState s Environmental Protectio nAgenc y (EPA)
.

Property ID : Z^^^ 3 Property Address : y^^^ ^ A/l ^ f l ^ ^ ^ Owner : Phone : 

# 40-2.-z^n

- i^^^o Onth e attache ddiagram(s ) indicate area(s ) to excavate , surfac e structure s andlandscapin g feature s and acces s location(s ) t o b e use db y th e contractors , hidicat e distances , depths , material types , etc . Photographicall y an dVideographicall y document th e existin g condition s ofth e propert y an dth e basement if necessary . 

### Item s t o b e Remove d b yth e Owne rbefor e Star t o f Remediation : Th e removal , storage , disposal , and/o rretu m o fthes e item s i s th e Owner' s responsibility
.



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

# jv[l?^/ ^ Item : Item : Item :

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## Landscap e Inventor y Ite m Quantit y Uni t Condition/Type/Specie s Pre-existin g property area , Quadrant s tha t wil l b e excavated , tha t 

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# n ^

Numbe r o f tree s > 2 inch Eac h 

# fkvw j tnmk diamete r 

# y
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# y trunk diamete r Numbe r o f Sprinkler Zones , Contro l Valves , Eac h Timers , Heads , etc . Attac hasketc ho f th e 

### / sprinkle r layout
. Numbe r o f andsiz e o f eac hgarden/ flower be d Eac h area . Squar e Fee t 

# y Attac hasketc ho f relativ e size s an dlocations
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Not e thi s valu e wil l b e use dt o issu e aplan t vouche r t o th e propert y owner . Easemen t Area , t o b e Eac h excavate d 

# j y

Pag e 2 of
.COASTA L IMVIROMHI M TA i. C It O U P
. INC
.
Additiona l Comment s / Instructions : Th e cit y of Omah a ordinance s ma yprohibi t yo u fro m usin g dir t orgrave l area s on you rpropert y as driveway s orvehicl e parkin g areas . Th e Environmenta l Protectio n Agenc y(EPA ) ma y be removin g an d replacin g soi l underlyin g a grave l ordir t are a on you rpropert ytha t yo u ma y be usin g as a drivewa y orvehicl e parkin g area . If thi s is th e case , yo u shoul d understan d tha t thi s removin g an d replacin g of soi l doe s no t mea n tha t an yillega l drivewa y orparkin g are a on you r propert y is mad e legal
. To th e contrary , yo u ma y be cite d byth e cit y ifyo u us e a grave l ordir t are a as a drivewa y orparkin g area , no t withstandin g an yremova l orreplacemen t of soi l byth e EPA
. if yo u hav e an yquestio n abou t legalit y ofa certai n drivewa y orparkin g area , yo u ma ycontac t th e cit y of Omaha' s Plannin g Departmen t at (402 ) 444-5150
. O Pleas e chec k thi s bo x ifyo u understan d th e informatio n outline d above
.

• Chec k th e bo xifOwne 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
.



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## Certificat e o f Verificatio n

4 SOI L 2011-04-0 6 18:2 6 91.4 6 Fina l Av g o f 1- 3 160 8 Mapl e F 2 6 " M
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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

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pp m P b 310.14 1 Supervise d By : 

## Certificat e o fVerificatio n

1 SOI L 2011-04-0 6 18:2 4 30.3 3 Fina l 2988 3 160 8 Mapl e F 2 6 " M
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± Erro r ± 25.14 9

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

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## Certificat e o fVerificatio n

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

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pp m P b 336.62 5 Supervise d By : 

## Certificat e o fVerificatio n

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

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Supervise d By : 

## Certificat e o f Verificatio n

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

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pp m P b 104.71 0 Supervise d By : 

## Certificat e o fVerificatio n

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

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pp m P b 100.58 0 Supervise d By : 

## Certificat e o fVerificatio n

6 SOI L 2011-04-0 6 18:2 9 30.2 4 Fina l 2988 3 160 8 Mapl e F l 6 " M
. MATEU S Confirmatio n CLEA R

±

Erro r ±

16.60 3

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 155.48 9 Supervise d By : 

## Certificat e o fVerificatio n

7 SOI L 2011-04-0 6 18:3 0 30.1 2 Fina l 2988 3 160 8 Mapl e F l 6 " M
. MATEU S Confirmatio n CLEA R

± Erro r ± 20.20 3

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s AVERAG E ADDRES S QUADRAN T DEPH T XRFTEC H MIS C NOT E

Supervise d By : 

## Certificat e o f Verificatio n

1 2 SOI L 2011-04-0 6 18:3 3 90.9 2 Fina l Av g o f 9-1 1 160 8 Mapl e B 2 6 " M
. MATEU S Confirmatio n CLEA R

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 371.18 4 Supervise d By : 

## Certificat e o fVerificatio n

9 SOI L 2011-04-0 6 18:3 2 30.3 1 Fina l 2988 3 160 8 Mapl e B 2 6 " M
. MATEU S Confirmatio n CLEA R

± Erro r ± 27.91 0

# Therm o SCIENTIFI C Therm o Fishe r Scientifi c 90 0 Middlese x Turnpik e Billerica , M A 0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVID ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 396.98 6 Supervise d By : 

## Certificat e o f

Verificatio n

1 0 SOIL 2011-04-0 6 18:3 2 30.3 2 Fina l 2988 3 160 8 Mapl e B 2 6 " M
. MATEU S Confirmatio n CLEA R

± Erro r ± 28.95 8

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

XL3t-3902 2 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D ADDRES S QUADRAN T DEPH T XR F TEC H MIS C NOT E

pp m P b 386.83 5 Supervise d By : 

## Certificat e o fVerificatio n

1 1 SOI L 2011-04-0 6 18:3 3 30.2 9 Fina l 2988 3 160 8 Mapl e B 2 6 " M
. MATEU S Confirmatio n CLEA R

± Erro r ± 29.87 0

## "" " " * Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
. V " ' -^ ^

www.coastalhazmat.co m ^Pfloi* ^ COASTA L ENVIRONHENTA L GROUP , IN C 

# EXECUTIV ESUMMARY : BVID #29883-(180 8 MAPLEST )

X 

# No Issue s o r Concern s [ ^ Issues/Concern s
Detai l Explanation : -DANGARVE Y WALKE D THEPROPERT Y ON4/21/1 1

# L Propert yCompletio n Agreemen t
Thi s agreemen l document s th e completio n o f remedia l aciivme s perroime d o n m yproperty
. M ysignatur e wil l designal e tha i I a m satisfie d wit h th e rtsioralio n ofm yproperly , an d tha i n o item s ar e i n questions , now , o ra t an ylim e i n Ih e fuluie , excep i thos e ilem s lisle d below , ifan y

Propert yID : 2^<^gg; ^ Propert yAddress : \^,QC ^ \\f\C\j p \ & 9{-
. 

# o>v»«='- ^ Oa.li( ^ CuynynlAa c ^ Phone : ^Q ^ ^

^ ^

^ ^^AZ ? Restoratio n Item s i n Question :

Item : Ilem : Item : Item : Item : Item : Additiona l Comments :

I /

Q ) xfirc cicstorgtio n i t completed , exccp l a i nnlcr i [ I I ri o no t a^re crcstornrini i i s compielc d QLI

- 

## i^~l ( 

# ^ m Owner' s Signatnr e

# P A EP A Propcrt> ' Clos e Ou t For m \\oO'B fWX f

j g ^- ^ Propert y # : M^'d S
. . Propert y Address:

­ Datc/Tirae : Quad s Excavaied : Contracto r Crou p COA^-t^^ l
Ve s >' o Excavatio nGenera l I
. If neccssao' , ^'cr e th e correc t quadrantfs ) excavaie dan dresiored ? 

### y 2
. I f necessary , wer e th e correa l area s ofdri p zon e excavaie dan drestored ? 

### y Gradin g So dao dVegcUtio n Ve s N o Doe s th e gradin g aroun dth e perimeie r ofth e hous e i nexcavate darea s generall y slop e away 

## y fromth e house ? 2
.Ha s so dbeenlai dinall area s tha t wer e excavated ? 

## y 3
.Doe s th e so dappea r to 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
..\r c sodde darea s generall y firman devenl y graded ? / 5
.Ar e thejoint s betwee nth e so dscrip s generall y tight ? (Onl y evaluat e ifinspecte da t a3 0 da y tim e period ) 6
.Wa s th e propert y grade dsuc htha t waie r wil l no t poo l onth e property ? 

# y_ 7
.Wa s damag e t o landscapin g o r plan t material s avoided ? 

# y Gales
. Fence s an dRcUipJii t Wall s Ve s N u D o gate s ope nan dclos e freely? (Ifapplicable ) 

## y 2
.Wer e al l gaie s o r fence s lake ndow ndurin g resloratio nacliviiie s reinstalled ? (Ifapplicable ) 

## y Wa s damag e t o gate s o r fence s avoided ? (Ifapplicable ) 

# y 

# y 4
.

Wa s damag e l o retainin g wall s avoided ? (Ifapplicable ) Foundation , Sidiagan dCuller ? Ye s N e 1
.

Wa s damag e l o th c sidi/i g o r tri mavoided ? 

# y 2
.Wa s damag e l o th e foundatio navoided ? 

### / W'as damag e to window s avoided ? 

# y Wa s damag e t o window s or doo r screen s avoided ? 4 

# y 5
.

Wa s damag e l o downspout s o r downspou l extension s avoided ? 

### / Sidt>valk 5 an dDriveway s (Copcretc ) Ve s N o Wa s damag e l o drivewa y surface s avoided' ' 

### / 2
. Wa s damag e l o walkwa y surface s avoided ? 

# T

## Owner s comments :

Inspectio nno<es :

Remova ! an drestoratio nactivate s complet e includin g the 30-day so dwarranty : EPA Representativ e _ ^ Date : Hjti/f l