### #



## TRANSMJTTA Lof OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAI D 

# .ii M Date : 

# \ < \\ o Address : Remediatio nContractor : Coasta l Environmenta l Grou p Year : 20 i SOI LREMEDIATIO N PROPERT Y nLEFOLDE RDOCUMENT S 

### / Vide o o f propert y (DVD ) 

### / Executiv e Summar y 

### / EPA-provide dpropert y sketc h Signe dAcces s Agreemen t for subjec t propert y Signe dAcces s Agreement(s ) for adjacen t propert y 

# y Restoratio nAgreemen t Settlemen t dociunent s (i.e. , for damag e o r t o replac e plants , etc. )

r—

\ 

### Confiimatio ndat a 

# y Photograph s 7( 7 ^ Wt b<CA\/<\tUK ^ V \\ { W L 

### / As-buil t sketc h Satisfactor y restoratio nsigne db y Propert y Owne r Propert y close-ou t chec k lis t signe db y EP A Descriptio no f area s no t meetin g RO D cleanu p criteri a Utilit y clearance s 

# s / Propert y infomiatio nfro mDougla s Count y Assessor s Offic e [ ' 

### D 

## n 

# \yh . Dat e 3005449 0 Superfun d

# t t

Property Acces s Checklis t Propert y ID : I< RM 2 1 nWOB K STARTE D ON : / / D WORKCOMPELTE D ON : / / Propert y Address : ^^C^ ^ l^n e S + Owvne r p^^) ^ P^Oim-el ) Rente r Address : 53/^^ ^ Phone : Fax : Cell/Pager . Additional Information : 

## Phone : ^5 2 'J:50 5 Fax : Cell/Page n^5 ^ .Z/32 ^ D Notificatio nLette r Sent : / / By : Q ^ Acces s Agreement Si^ed : * / U / o l By : • ''^Restoratio nAgreemen t Signed : 9 1 < f /

ot , By : D Topsoil Samplin g (i f applicable ) 1 1 By : D Disposa l Samplin g (if applicable ) 1 1 By : D Garde nSampUng (if applicable ) / / By : 0 ^ Utilit y Clearanc e 

## Called:2_/3L/e 3 By : ^I'z^'bicy H JB^Video/Photo s (Before ) On : ^ / 1 1 / bt By : VE,V^U.<,S ? • Video/Pboto s (During ) On : / / By : D Video/Photo s (After) On : / / By : • Vldeofl»liot0 8 (30-Day ) On : / / By : D Propert y Completio nAgreement Signed : / / By : D Final Report Issued : / / By : Ai r Monitorin e (a s aoDlicabl e GCommunit y DCrc w On : / / By :



# __J Results : 0 Communit y QCre w 

### On : / / By : Resuhs : D Communit y QCrc w On : / / By : Results : Omah a Lea d Sit e

## Pougla s Count y Accoun t Infornfl|io n Pag e 1 of 2 >rna| c • Dougla s County , Nebrask a Propert yRecor d - R103877000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f 52n d S t - VlO W O n Ma p Informatio n i s vali d a s o f 2009-6-1 6 Treasurer' s Ta xRepor t Ne wFeatur e ^ • • • • Aut o Sale s Searc h Owne r ODONNEL L PAULAN 353 3 PIN E S T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 387 7 000 0 1 0 Accoun t Type : Residentia l Parce l Number : 103877000 0 Parce l Address : 353 3 PIN E S T OMAH AN E 68105-000 0 Lega l Description : FIEL D CLU B TERRAC E LO T4 BLOC K0 4 9 X 12 9 Valu e Informatio n Lan d Improvemen t Tota l 

### 200 9 $ 6,300.0 0 $107,300.0 0 $ 113,600.0 0 200 8 $ 6,300.0 0 $107,300.0 0 $ 113,600.0 0 200 7 $6,300.0 0 $107,300.0 0 $ 113,600.0 0 200 6 $ 6,300.0 0 $100,500.0 0 $ 106,800.0 0 200 5 $ 6,300.0 0 $100,500.0 0 $ 106,800.0 0 200 4 $ 6,300.0 0 $100,500.0 0 $ 106,800.0 0 Sale s Informatio n Sale s Date : 1990-05-0 9 Dee d Type : Book : 187 7 Pago : 53 8 Price : $57,500.0 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 6076. 0 1. 0 124. 0 49. 0 N o Improvemen t Informatio n 

### 0.1 3


## http://douglasne.mapping-online.coin/DouglasCoNe/static/accotmtinfo.jsp?accountno=R l 03.. . 7/7/200 9

### Dougla s County Accoun t InforM«|io n Pag e 2 of 2 

# V # Buildin g 1

tnns F «mos f

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Dmctat f Oaiii i OTSOS f 

## TW O STOR Y CLIC KTO E N LARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1352. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : | Averag e Uni t Type : Condition : Fai r

Buil t As : 2 1/ 2 Stor yUnfi n 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 f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Hi p Stories : ! 2. 5 Floorcover : Allowanc e Foundation : Bloc k Sprinkle 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 192 5 0 0 % 192 5 8 3 Detai l Typ e Detai l Descriptio n Unit s Ad d O n Unfinishe d Atti cW/floo r 676. 0 Applianc e Allowanc e 1. 0 Applianc e Fireplac e Masonr y 1. 0 Basemen t Bsmn t Bloc k 8 f t 676. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 324. 0 Porc h Sla b Roo f Cei l 208. 0 Use r Need s TL C 1. 0



### http://douglasne.mapping-online.eom/DouglasCoNe/static/accountinfo.jsp?accountno= R103.. . 7/7/200 9

## Propett y ID # Propert y Address : Initia l Contact : Secon dContact : Fina l Contac t Fina l Actio n

Comment : Owne r Commen t (s) : Sit e Coordinato r Commen t (s) : CONTAC T FOR M |qm.\ 

# ^f)l Z?in f S­ ^ Date : '7J\'?J< ^ Time : ty.f ^ Pate : i[->iJy/ Time : 7'\ o Action : U-^ r fiyfryi Z Dale : Time ; Aciion ; Transmi t l o EP A D Othe r Action : D• • Pag e 1 of 2

" > Creat e Anothe rTiclce t ] [ • Bac k t o Irt h Interne t , , Sen d Email , ]

• YOU RTICKE T NUMBE RI S 2373175 . Origina l Cal l Date : 9/25/0 9 Time : 4:5 5 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 9/29/0 9 Time : 5:3 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 353 3 Street : PIN E S T Twp : 15 NRng : 13 E Sect-Qtr : 28-NW,29-N E 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 Contac t 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 COMNfUNICATIONS , IN C HEIDI Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL 3 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 NAlt : 402444516 1 Emerg : 402444516 0

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/25/200 9

### Pag e 2 of 2 • • 

### 0PPDGPR 6 OMAH A PUBLI C POWE RDISTRIC T N A Day : 406728934 3

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

N A Day : 406728934 3

Alt : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/25/200 9OLS# : 1942 1 

# ^ As-Buil t Drawin g flt Dat e Excavated:9/30/0 9 Dat e USEP ASigne d Off : 10/13/0 9 COASTA L 

# Oinah aLea dSuperfun dSit e Are a Sodden : 360 9 s a f t

Name : ypOfJ/J^Jt Address : "^^^T'^x>ygr ^ Phone : vfeja-<y7^? - eygj T Omatt a Lea d Sit e Sit e Sketc h
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Omah aLea dSit e 4613 0 

### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are areplace d So d wit h Are a replace d wit h Rock/Mulc h Are aleft bar e 

### Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc .

# LLW Name : QDa^jJTf O Omah a Lea d Sit e 

## Date : 7/^V^ T Address Phone : •?5^% 7 Tg/^^g r" *fo^-'CT> ' g/o$ ' Sit e Sketc h Time : ^.'VS^s^ i 

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# i
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### Address : t?^ ? 7^<rg r Sit e Sketc h Time : Phone : */ofi^€^T:^^fo T 

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Omah aLeadSit e 4613 0.s*^'"""* . COASTA L ENVIHONHENTA L VpROrt.^" ^ C « 0 U r, IN C 

## Consen t fo rAcces s T o Propert 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 Agenc y(EPA ) o rit 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 follovi/in g describe d premises : ^ Daytim e Phone : (HoX ) 3 ^ H ' '^'5^ ^

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 f lea d an d maypos e a healt h hazard . Th e area(s ) vi/il 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 Coastal 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 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 subcontractor s 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 f perfomnin 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 o f 2COASTA L ENVIKONMENTA l *^'»tpno^ ^ CROUP . IN C 

### •Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; •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 ; • Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessar ysubsequen 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 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 . •Allo wvideotapin g and/o rphotographin g o f th 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 f th 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 Coastal Environmenta l Group , a t (402 ) 991-119 9 I gran t acces s t o m ypropertie s D I d o no t gran t access t o m ypropertie s 

# ^r^^ A &i±:£ l Signnu£e_-—- ^ Dat e Signatur e Dat e
DI woul d lik e t o b e presen t durin g an ysamplin g tha t i s required .

Pag e 2 o f 2C 0 d s • T > I ,


### Th e purpos e o f thi s agreement i s t o provid e amutual agreement a s t o condition s ofth e propert y prio r to remediatio nactivities . Thi s will als o serv e a s documentatio nfo r th e purpos e of assurin g that restoratio n activitie s ar e complete dt o th e satisfactio no f th e propert y owner andthe UnitedState s Environmenta l Protectio nAgency (EPA) .

Property ID : jdu j Property Address : l,^}, ^ f>;^ ^ S f

O nth e attache ddiagram(s ) indicat e area(s ) l o excavate , surfac e structure s an dlandscapin g feature s an d acces s location(s ) to b e usedby th e contractors . Indicat e distances , depths , materia l types , etc . Photographicall y andVideographically document the existin g condition s ofthe propert y andth e basemen t i

f necessary . 

## Btom s t o b aRemovedby th e Ot^ne r

befor e Stsr C o f

Remediation : ii 3 :c- f iovc.i . siotece , c-ispjfcg.1 , fcno/ot :et.;i: t o' , thLK t itfcr/i S i.*
- iu'- . Uwtt^ i ? ii:£f.L'i({:li>,!i:iy . Keim : 

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Pag e 1 of- ^i C ^ U S T M L* 

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## I I 

### Landscap e Inventory 

## ite m Quantity ' Uni t Condction/Type/Specte s Pre-existin g propert y area , Quadrant s that wil l b e excavated , tha t i s covere dwit hgrass . Number of tree s > 2 inch Each trun k

diameter Number o f tree s <= 2 inch Each trunk diameter Number o f Sprinkler Zones , Contro l Valves , Each Timers , Heads , etc . 

# 'r

Attachnskeirli u \th f Number o f andsiz e of eac hgarden / flower bed Each area . Square Fee t Aiiach. 1 skcicli 11 1 rt-laiiM
iizcf
- an dli>c;iiii)ii ^ Agree dupo nvalu e of plant material s no t t o b e replace db v contractor . $
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# \ b V'-evA^^ ^ 

# 0 Pag e 2 of .I - \ s 1 rL , ( Additiona. 1 Comment e / Instructions : j i 

## o ^ 1 , \5* ^ S^CrT(C< S J (2on-f(fV/v ^ Vn'^S T ^y^^O- ^ 'T-^A^e-^ c "^c * '?'^' ^ iV ^ I S OK . 1 THfe^P- ^ a>ATr<^C-TrO» ^ Ot ^ +4oc^<,i $ . ^ ^ v&..v5s£~, ^ 

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### v^ 0 Chec k th e boxi f Owne 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 not responsibl e fo ranydamag e don e t o th e interio ro f house , includin g foundatio n crack s o rfissures .
^,0 1 agre e Q I d o no t agre e

r e —Dat e Contractor' s Signatur e Dat e 

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

I Coasta l Environmenta l Grou p Inc . ^^^9S^ ^ \!^^yywwifw.coastalhazmat.co m ^^^ ^ ^"tPBO^' ^ COASTA L iNVIIONNENTA l C lour . IN C 

# EXECUTIV ESUMMARY : BVID #19421-(353 3 PIN EST ) ~y | No Issue s o r Concern s [] ] Issues/Concern s Detail Explanation :

# EP A # ^ 

# EP A Propert y Clos e Ou t For m Propert y # : Propert y DatcH'Intc : , Owner * Quad i Eicavated ; y \:(-y; \r ^ ^ Contracto r Grou p Excavatioi i Geaera l 1 .If necessary , were th e correc t quadrants ) excavate dandrestored ? ^ 

# X 2 .If necessary , were th e correc t area s ofdri p zone excavate dandrestored ? Ye s N o GradlDg So dan dVegetatio n 1 .Doe s the gradin g aroun dth e perimeter of th e hous e i nexcavate darea s generally slop e awa y 

# X ^ fromth e house ?, 2 .Ha s so dbee nlai dinali area s tha t wer e excavated ? 

# X 3 .

Doe s th e sodappear to b e generally healthy an dgrowing ? (Onl y evaluate if inspecte da t a3 0 day time period ) 4 .Ar e soddedarea s generall y Tin nan devenly graded ? S .Ar e th e joint s betwee nth e so dsnip s generally tight ? (Only evaluate if inspecte da t a3 0 da y 

# y tim e period) 6 . Wa s the propert y grade dsuchtha t wate r will not poo l o nth e propert>' ? 

# ~ y



# -y 7 .Wa s danug e t o landscapin g o r plan t material s avoided ? Gates , Fence aan dRctatnln g Wall s Ye s N o 

### V 1 .D o gate s ope nan dclos e freely? (Ifapplicable ) 

# X ^ 2 .Wer e all gate s or fence s takendow ndurin g restoratio nactivitie s reinstalled ? (Ifapplicable ) 

# y 3 .

Wa s damag e t o gate s or fence s avoided ? (Ifapplicable ) 

### l y 4 .Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) 

# y ^ FouDdation , Sidin g an dGutter s I . Wa s damage t o th e sidin g o r tri mavoided ? ^ 

# X 2 .Wa s damag e t o th e foundationavoided ? 3 .

Wa s damag e t o window s avoided ? 4 .Wa s damage t o window s or doo r screen s avoided ? 

# X 5 .Wa s damage t o downspout s or downspoul extension s avoided ? 

# x \ Sidewalk s an dDrh-cway t (Concrete ) Ye s N o 1 .Wa s damage l o drivewa y surface s avoided ? 

# X 2 .Wa s danmge t o walkwa y surface s avoided ? 

# X

## Owner s comments :

Inspectio nnotes :

Remova l an drestoratio nactivate s complet e indudin g th e BOrda y so dwarranty : J OV/ M VTUilUlIlJ . 

## EP A Representativ e L^J:P' ^ f j/^M^A^ ^ Date :

## Propert yCompletio n Agreemen t Thi s agreemen t documenl s th e complclio no l remedial acliviiies perlbime do nm y properl y M y signalur e will designat e lha t I a msatisfie dwit hth e restoralio no f m y property , an dlha t n o ileiti s ar e mqueslions . now , o r a l an y Dm e i

nih e fiituie , excep l thos e ilem s lisle dbelow , ifan y Propert y ID : | ^ q^ I Propert y Addrcus : ^^T, ^ Pl^ e S t 

## Q"'"''-^Pa^r . O' O C-At^g ^ 

# L L Phone : M b^- ^ ^p . - ^g^S " Restoratio n Item s i n Question :

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

\X ' "(.''•c e Jc.sfor«(ioni s complcitd , cxccp l a > nole d I I d o no l i|;re c resloratio nii ; complete d 

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# \Ax\ X Dat e (^ntia r Dal e ont i arlor' s Signatur e l