## TRANSMITTA L o f

OMAH A LEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : ^o%S J Date : ^//7/PQQ 8 

## Address : 3 '3 . ^. ^ r5?.lriARDS f Remediatio n Contractor : PQ^/:>pA\ f 19-rH . Tff^r. . Year : ci^oo- ^ SOI L REMEDIATIO N PROPERT Y FIL E FOLDE RDOCUMENT S dVide o ofpropert y (DVD ) g

f Executiv e Summai y n

f EPA-providedpropert y sketc h H Signe dAcces s Agreemen t for subjec t property D Signe dAcces s Agreement(s ) fo r adjacen t propert y s f Restoratio n Agreemen t D Settlement document s (i.e. , fo r damag e o r t o replac e plants , etc. ) y Confirmatio n dat a 0 ' Photograph s y As-buil t sketc h H' Satisfactory restoratio n signe db y Propert y Ovvne r H • Propert y close-ou t chec k lis t signe db y EP A D Descriptio n ofarea s not meetin g RO D cleanu p criteri a 0 Utilit y clearance s 0^ Propert y infonnatio n fromDougla s Coimty Assessor' s OfBc e D D D 

### signati^S ^ 7 Da t 4031138 7 

# iim n Superfun d

### PROPERT Y SUMMAR Y Date : 09/15/200 8 Oinah aLea dSite Remedial Actio n Contrac t #EP-R7-07-06/0004 Month of : Aug/Sep t Propert y Address : 332 5 SEWAR D S T A . EXECUTIV E SUMMAR 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 Infomiation : NON E CONFIRMATIO N SAMPLIN G DATA/RESULTS : B2=13 1 PP M @ 7";F2=17 9 PP M @ 6" ; DZ=147 PP M @ 12" ; EA=13 1 PP M @ SCRAPE ATTACBDMENT S 1 ) Propert y sketch providedb y EP A pursuan t t o contract specification s 2 ) SignedAcces s Agreemen t including acces s agreement s requiredfo r crossing othe r propertie s 3 ) Pre-Excavatio n digita l vide o clip/photogrq)h s 4 ) Post-Excavation digita l vide o clip/photograph s 5 ) Documentation - CompletedClose-ou t Checklis t 6 ) As-Built sketch ­ i ) Shall includ e final lea dlevel s v ) Legend ii ) Contamination lef t behindarea s vi ) Contractor identification iii ) Propert y addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e includedi n th e individua l propert y file, if available , or obtainedinclude : i ) Pre-excavation agreemen t detail s (i f an y ar e mad e wit h th e propert y owner ) ii ) Propert y Statu s For msignedby propeit y owne r iii ) Excavation digita l vide o in MPEG , WM V (Window s Medi aVideo ) or SW F(Flas h Player) forma t and/o r photograph s iv ) Signe dfor mverifying satisfactor y restoration v ) Description of area s not meeting InterimRO D cleanu p criteria .

TECHNOLOCIES , INC ,Rn d Record Qea n U p QueryI Lea d Remainin g QueryI Propert yDamag e Quer yI Clos e 

### Backfill :

Sampl e Area : 2585 1 - 332 5 SEWAR D S T Owner : Resident : Contract : D Owne rOccupie d Residen t Name : Contractor : Owne rName : )HUDSO N GLORI A Owne rAddressl : 

# 1 Owne rAddressZ : |332 5 SEWAR D S T City : [OMAH A Owne rPhone : 

# 1 State : Zi p Code : [N E [6811 1 Alternat e Phone : 

# 1 [HUDSO N GLORI A Propert yAddress : [332 5 SEWAR D ST 

### Zi

p Code : [6811 1 Residen t Phon e Group : Assessment : Qualifyin g Grou p [PRIORTT Y Assessmen t XR F Date : 

# I Assessmen t MaxXR F Value : I 537.6 4

# EP A Propert y Clos e Ou t Propert y # : A^S^" ^ Propert y Address : (g«)A 5 &«"«"= ' S h Date/Time : Of/ai/a f Owner' s Name : ^AMI M 

### Sfvo»« M Quad s Excavated : p2.,S2-,I> 2 Contracto r Grou p Pruden t Technologie s Excavatio n Genera l 1 .Ifnecessary , wer e th e correct qiiadrant(s ) excavatedan drestored ? 2 .Ifnecessary , wer e the conec t area s ofdri p zone excavatedan drestored ? GradinK Sodan dVegetatio n 1 .

Doe s the grading aroun dthe perimete r of the hous e in excavatedarea s generall y slop e awa y fromthe house ? 2 .Has so dbee n lai di n all area s tha t wer e excavated ? 3 .

Doe s the so dappea r t o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecteda t a3 0 da

y tim e period) 4 .

Ar e soddedarea s generall y fir man devenl y graded ? 5 .Ar e th e joint s betwee n the so dstrip s generall y tight ? (Onl y evaluat e i f inspecteda t a3 0 d ^ tim e period) 6 .Wa s the propert y gradedsuc h fliat wate r will no t poo l o n the property ? 7 .

Was damage t o landscaping o r plan t material s avoided ? Gates , Fence s an dRetainin g Wall s 1 .D o gate s ope n an dclos e freely? (If ^plicable ) 2 .

Wer e all gate s or fence s taken dow n durin g restoration activitie s reinstalled ? (If applicable ) 3 .

Wa s damage to gate s o r fence s avoided ? (IfappUcable) 4 .

Was damage t o retaining wall s avoided ? (IfappUcable) Foundation , Sidin g an dGutter s 1 .Wa s damage t o the siding o r trimavoided ? 2 .

Was damage t o the foundatio n avoided ? 3 .

Was damage t o window s avoided ? 4 . Was damage t o window s o r doo r screen s avoided ?

' 5 . Wa s damag e t o downspouts o r downspou t extension s avoided ? Sidewalk s an dDriveway s (Concrete ) 1 .Wa s damage to drivewa y surface s avoided ? 2 .

Wa s damage to walkwa y surface s avoided ? Ye s No 

## y J Ye s No



# • • • • / 

## y y Ye s N o y y 

## y y Ye s No 

## y y y 

## y y Ye s No



## y 

# y

## Owner s comments :

Inspectio n notes :

Remova l andrestoratio n activate s complet e including th e 30-da y so dwarranty : EP A Representativ e 7^r..j ^ Date : gftg/a *

# PHTOffl X Propert yCompletio n Agreemen t Thi s agreemen t documents th e completion o f remova l activitie s performedon the below listedproperty . The propert y owner' s signatur e indicate s tha t th e propert y owne r i s satisfiedwit h th e restoratio n ofth e subject property , an dtha t no items ar e i n question , now , or a

t an y tim e i n th e future , excludin g an y remaining warrant y (3 0 day s total ) except thos e item s listedbelow , if any . Propert y ID : Propert y Address : 3^^ ^ 3e;^OLC ^ 

## ^1 r Owner : (2:3 1 Xor " 3 U o ^ 2f c ^ Phone : Restoratio n Kem s i n Question :

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

L J I agre e restoratio n i s completed , excep t a s note d above . L J I d o no t agre e restoratio n i s compiete d 

# f /

Ji^^h i DateJ o " * * o o a. IDl . . J

rtL:<.v:i:'X^;il3cJlealcizimbocofp;op4i:tio3iOC£t»dinOisabs,N»V»is&8,iadu&^th»pi^ ^ r.fSi^ssrolaodt s th e sleasupiwiiiSsEgMi l E!r:p!!i3g.»no ^ c f l9ad-5a;;;3j5am:i9dRo3 . awiKEtoKfiiooa f iSwnfeosedpioporty . Tfjo i ^.'•.'• 9 sz y qaeEi«ss?iboattt » EC I «leEE':T5?-rEj9dfciyt"Jijispc^,pl*aB j eoiaac t gndoat' E Afeiii£ta?1v 9 C'.«! t fr i t!i o Oa£haL»adSit o dtanua . ltCs.SSEiaiflaHott-!af4"2!:554-lC04 . Gtcuo l qujEloBEB^seii^OiSBSiaLoadSit } <I«ss3 9 c mb o .T^parfj-A s Propui y OtTB w Si ^izb : (paio )

P.E5JDEI3T5s.-Af J ^"jne*^ . :=J-.-!^c r 7iES:CF:rT^5DEESS :

I FR^MTf^L . PROPERT Y OWHE D BY : OWNER' S C^aiLCJ S fiQDRESS; 

# '3'3^ ^ ^y.Tyy^ ^ .'iiw:i.'crs;"r:L':^M*::r.iyu[::sEJi-HOcnE : fSf^ t VYcl ^ 4^ ^ 5 CTORK:

AG E <^ ? KOns? : YEARS . W.'Mfl J LOK G yi!.';f: ? Y3 U LR/E C HERE ? YEASS . ^ HA S TH E E;!TER)6! RBJiEr } PAIHTE D O RCOVERE Q WTT H SQiH G S9MC E 197C 7 YE S * ^ B O nUCi^SE R O F OCCURftUTS U»OE R 7 YEAR S ^\.^ \ KlUriEE RO FOGCyPA?!TS ? YEAJ^ S SJ.'i ] A"' n .•JJL'C''' ? tSUClBE RO FCHILDRE H UMEiE RT YEAR S OL O IWr ? P'.fl y " ' TW E YAR5 3 '^C Rf KOU.'. S O Ri^^CR E PE RWEESt : CMJCaCMT C O RSPECIA L iHSimSCTiOMS : (I.E . D«»®S , EyiR Y GATES , E71C. ) / 

## ^/lA^Ay ^ M<^.UU^ (U-^^r-^^i^yMju u ^l^i^.^f i le^ i /^,^_ )

A!J7!10K:I 7 roR.£IT7!K3NMS3tIALR£Sn7nES: A'^TKTKE ^ i; » a«ti\Jttt*Ei o b«{Eipl«Bi4lllfl<lti7EFA vill«1Usssp;«&«a t CTOSffiPW- n t « Secrlor a)C < ttf CSSCLA . 4 3 U .SJ C . 9394.7L7A'i ; slg ^ c f a^csE E t o th « piop«i ^ i s -^ami&i A fori aSot^Sio B ISI^o ) o f CERCLA , 4 2 U £ . C 960i(9) . urUcf apnmde s czrisy f w "de t sniaisr s ' ^ coe dfo r n^cnss , s x ehooBx. g c r :^sz ^ u ^ i»!^(£]s » actic n

Se n An^iiia , T S »l£2 a P{ion8:^l5i3&o<»0 3 PRttne : JS1C)822-9» 8 fer«tl8Vs78-8S7 7* «•» ' » r• » t jf s

Ptikt o To<ABdo^o^ LK . (7>ludc9i<{) isusMJ w cooenie t Ti7i&th « 11 . S . E^ ^ cosscisiBdA dSOA GdaasiWo f ga«ipg!iieBloccilodsOnsliis,HebKa&Q , iaciii^i^QtllwiBDps^locsto d& .

. ThoBPAnqm^ytwpeiaiBflatAdliRrnnidixAtoi^edwEaasialdoaB^il^ E {Bopes^'t A navr e lotsd-ecatisaiodA dGOII. S y B^iagiSa&fua , tfaopmptal y OCTBC Ef^EsztEpcEiisBeat o Ptizdaatt s pcsfts i • cti^osniotodt o th acloos 9 ioeiu& Q soi l Wy».t.ni»ni^iji«riiiiwenhmitrtiABBilrJ»iTn^pinim«i«ngymiTptB^ ^ OadbaLe&dSitf t >i'>"-n > M e aiaTM«»Hdt-stf403! ) 304-1(104 . Ccsw d4^^a(iiEdboizl&»Oni!&nLoQdSit» docso ^ se ab e diectodt o «uIP A PuUi e bAssidieBiCeBtas E il(40 ^ 731-304 5 tpoudtOoote i offico ) OT(402 ) 991-938 3 (^cuihOai& aoffico) .

PtoBortTOCTCTffiagauw : />/ ^ t- - t r ^ "H ^ 7~^^~ ^ '71 - ' ^ ' ^ (Peso ) PROPEK W CSFORCmimiBii a Rente r ..ig ^ - ^ 

### ^ ^ ^ 5 ^ S ^ -

f y'7y4y \ i^y ^ S ^ I F JafiHTOi . PRSPERT V ©raCffiil t KV : Ot^ER' S Cmja( £ AimSDRESS; 

## yyi^ ^ $i! f 7/y7K77i^g4L. soaErsTELEPMiEicaEauDJBER-HiaaE : <^ t 5^^ - 4^7^ ^

raoRK: A® E OP IXI0D]E7 : YEARS . MOK J LOK ©

IffiaV E VO U LIWE D HERE ? 7z / YEARS . MAS TDI E EinnSRiO R ISEEC 3 l!^llC3inS D O R dSH^ERE O OTHIK I 8I1I[3 G SICICE 1I8?8 7 VE S niuic^BE R O E eiccuip^cairs UNDE R 7 YEAR S OLD : _ caucDSE R m occuPAiairs rYEAR S i^iLin i m n OLDE R nUDSE R Ol rCtCIIILORE n UNDE R 7 VEAR S OL D Od O PLA V P TSO E YAR D FO R S IHiOUR S O R GOR E PE R VSEEd : isoc]DEi:3'ir s O R SPEGA^ L psinsiiiciniocas : (I.E . DO6S . Etam vSAIES . ETC. ) ry/ A * /^JLi - ^^^nKj^-^Ayty (E-/*->•"» • ^g^_^^'ZA4Lt' : ^ htH^uy ^

"/r i / 0 ^

< . ""^^-'<-\ y

cr

o msssiia t t o Sectio a10 4 o f CESCLA , 4 2 U JJC.9S04 . SPA' s a ^ o f sccest o ih o jinpest r isjinmded&ziiaSoctioaTo^o ) of CSHCLA , 4 2 US . C 9903(o),r7Uc!isgEmndo s CS ^ Jin''diAc8siia»3& o a»edfiK»9aas \or chooaii s oftdaia g B^n^ooE S actia n UBd«fbistiII^oKOlliu•C7il»e8A)s«ii!!3th»pw«BeBEofttut^SIe.' ' 813 ®

viasjis i poccz^ . stJiQib ds s 1:3.20* ^

stea l SlillGioSE S 

### ^SA 2 Dcm aDiiiv a3i!g|]lb<i23 i SO D ^^siteiillffl . Ti t IQ33 9 Pmm . @1l_ ^ SS3-370 3 ' PIclffiliilQ : pil)822-8Si 8 Pe c (^§si4-ie« 3 i?S!J:pillI!)S79-SS7 7V..vi'Vi.|.'. , • - la i t • T L • \

» r - r » j» X

Piudw t T »ctandog|* ^ Inc . (l*nid»B $ i s under contnc t iri & th * TJ . S . EanwBBtiot d1 ^ coatamiade dsofls a t amimoKo f |iiiopMtieElocaUdiaOaaba,)I*tirai&E , iadudiiath * pxoMitTiocab ds t

. TlwEPAr»qu»stEyo»pHSttGBontoaUovPiiuU(nttop«fiinBasailcl»aniq»BtAii s pnput f t o rcciov * lead-costaBiiade dsoil . B y a^oa g M s ftoo , th e propeit y ovn w gpmts pensiieaa u t o Pniden t t o peifon a activitie s relate dto th e desa ^ ndudin g soi l sampling reaora l o f Irad-contamimle dsoil , m drettoiatioi i ofth e reference dpropwly . I f yo u har e VK ^ quertoosabculth e scd l deas: ^ plamM dfaryompropei^ , pleas e cwtoctPnidwa' s AdaimdiafiTeCltri t fwih e OnahaLeadKtedeanug . Mt.ShaBH0iiHolt-at(4Q2!>304-lCQ4 . Genn dqoeslioasaboutflieOmahBLeBdSiitedeBCupcanb e direcUdto^EPAPiMcInfioiB^onCenteiss t 1^:5'^31-^3(J5out h Oaah aoffice ) ar(402 ) 991-938 3 (NoithOnaha^ ^ Proper ^ AccesGiaBledBy : (Pleas e Pnnt K ame ) Ptopei ^ Ovne r S^iature : :y^lcQyhy^0,uJy^^ry ^ Z^/^ / l^^uba ^ (PaU ) PROPERT Y l»F0RC3AT10 M (T

o b e coQ^bfij db y rasien t txaUerprtper ^ wva s - plea B print ) RESIDEH T MAEaE : \ l ( ^

CU-J t Ttn ^ owne r Rente r RESIDEHT ADDRESS 

# Stl I F RBW5IAL . PROPERT Y OWME D BY: , OWNER' S IimiLCa G ADDRESS : ^ 2 < : ^gw^"^ ^ 4;A r OWNER'STELEPHON E HUCSBER-HOGOE : J L WORK : AG E O F H0KJE7 : YEARS . HO W LOM G HAV E YO U LWE D HERE ? YEARS . HA S TH E EXTERIO R BEE H PAIHTE D O R COVERE D WR H SIDIH G SIHC E 1378 ? ^VE S H O HUrSBE R O F OCCUPANT S UHDE R 7 YEAR S OLD : HUG3BE R O F OCCUPANTS 7 YEAR S OL D AH D OLDE R HUE3BE R O F CHILORE M UMDE R 7 YEAR S OLD WH O PLA Y 6 3 TH E YAR D FO R S HOURS O R UOR E PERWEEK : C0I£IE3EHT S OR SPECIA L INSTRUCTIOHS : (I.E . DOGS . EMTR Y GATES . ETC. )

AUIHORIi r FDREHTIR0NMEHTA L RESPOKSE ACTIONS ^ Th e activiliesto b e iBpleaeAedb y EP A unde r thi s a^eenen t ar

e puiBuntt o Sectio n 10 4 o f CEKCLA, 4 2 U5C9604 . EPA'sn^ofaccestotl!iepiopenyispnmdedf«irinSectionl04(e)o f CERCLA , 4 2 US. C 9603(e) , vUc h provide s entryfor^detenainixi g th e nee dfbrreqMose , w chooan g or taldxigai^reqyoi ^ actio n uader dn s title , o r othenris e wfbrdi ^ th e pnniBOins o f th e title. " 808 0 Wer d PatfiwE^ . Suit e W S 2S0 S H . 24'* ' strest . suit e 30 8 424 2 Qedlca l Difva , Suit e 425 0 Ctans B Cltf . (» 0 6411 4 Om^a . H{!!i(nB^.28S11 9 8s ! .AntsniQ . T X ?^ 9 Phon e ^16)363-370 3 Phone : ((02)9)4-100 4 Phone : (210 ) 822^^ 8 Fax : (Bie ) 383-970 7 Ffl K(402)804-100 6 FS K(BIO ) 67ft-fl«7 7' • a ­ lia t L J l • • a s_

1 • J • , »0 1 ^ r^ (.•

j » J t fc»« ——» » « i Ptudeo t ;»cfaado^e % lae . iTludai ^ i s unde r coadn]ctui & th e U . S . Ea«ii«sBO!^PtatectioBABC3^| ^ coB^rgiinrlftdEca Es t aaxaWo f propesfioElocEtednOaiiQ,IIetiBa&c , iadu£iB3thowoBa^M«&a)a ^ ^ . 72uEPAxo^^yoispegcuaoat adlo^nuwattopoiflan B QEoi l deca39Elfia s pnigKsfytoraaoveleQd-ceataaiazlodEail . B7agaii^fiaEfflBU,t&e]^n!^CEii y WTan^citiEpflnaiaaoDtoltedceztt ^ BctivMeEidBtedtoth e decai g Mdiniii?; ^ soi l Bapliii|<,reBovi! l o f loadrcoataEsiBilfidBaS , radrestagoiianofllunftseacedjBopoKt^. I f

yo aha n aa y qiueiotii B abou t tfa

e Ed l deazuppltsEnedfisyoispcopeity , pleas o contatitPhidaa'BAdcaiaaffifiTOCleifcfiirlh o OaahaLesdSit o dacai ^ M RShwmniBHoH-atf40Z > 304-1004 . Gwaoa l que^onEsbtnA^OciDbaLoadSit e doiai ^ cissb o directedt o t u gP A PiM c bAussSioeiiCeDlM G•t(40 ^ 731-104 3 (^ouOiOiai& i office ) o r (402 ) 991-938 3 (;HoithOai ^ office) . ttojiml y AcceEBGiQEStedBy : ~M?leQE» PnatKioe ) Ptoped ^ OfTaoc Signdsse ; 

### tfL^L.^-.^ffl(ulc;.;r>v^ /^;^/<^ / iPcte ) PROPERT Y C3F®R[r3ATliaii a RESUSEKITCaAGE : oune r Rente r 

# J^=.fe ^ .•S»AiSJ 3 ." ^ e^rofioi, . 

# .S b D

F Rj^Cagn^L . PROPERTYOtli^iiaE D SV : isosER'scaAiiLcae&jteBiRiEss : '. , ia03ER'SirELEPH©Cfl E MUCDBE R - MODE : J \ _ t;;»iiRK : AS E O F DdiQinE? : YEARS , HOC; ; LOCSQJHIAVE YO U LOVE D HERE ? VEARS . MA S TIH E ElOERStSi R iSEEC a mil[3TE D O R COVERE D tiSTTN SOUCa S SKIG E HSITS ? YE S nUdiSE R O F OCCUmNTSUCaDE R 7 YEAR S OLD : D3UDSE R O F OCiQllPAi:3TS 7 VEAR S OL I At3 D OLDE R C3UC3SE R O F CMDLDREC!) UUDE R 7 VEAR S OL D l^iTIIli O PLA Y C 3 TIH E YAR D FO R S NOUR S O R DOR E PEROEEGt : COGCDEOT S O R SPCOA L ICSSTRUCTIOEas : ^.E . POCS . ECaiR V SATES . ETC. )

AUIHORIS r FOREHFmCM&IEHSA LRSSPOHS EACflOKS i !h e ostiviSioEto b e iapleeustodbyEP A tsEdKOs E^eeaoa A ae|usEuagttoSectioBl04ofCBRCLA,42U5C.9S04 . EPA'Bii|^ofccceEEtothepsopeityiEfBo^dedfisiaSectioal04(e)o f CESCLA , 4 2 U5. C 9S03(e),ti7la«bpnindesa3^fQ(''det«m]ia^thoaocdfiirxe^>oBa ^ octio B

&S9 ®

"^m ^ Poatrs^ . SGaoi b oms 2S0 S ca . 2>3< ^ S&C3it , SliSllibSS S 020 2 GcSIiBe ] DtiiVCi , Soilllib03@ 0 RiOi) ffigsCniiiiln TT f 7099 9 PGawsg : ^116 ) 3I53-Sr0 3 Fsn : anQ ) 888-970 7 Fo r{<3(DS)e3t3-'0(se s Pact ^Hffl ^ 6F0-0S7 7OLS# : 2585 1 Dat e Excavated : 7/21/200 8 Dat e USEP A Slpied-OfT :

Owne rName : CUPrri S HUDSON Address : 3325.SEWARp_8 T Phone : H : 402-551-267 2 Sampl e Numtie r RYASCPXA-2565 1 F 1 RYBSCPXA-2S85 1 F 2 RYCSCPXA-5565 1 B- t RYDSCPXA-25S6 1 B 2 RDZSCPXA-2S85 1 D Z Lab RDZSCPLA-2585 1 Resu H 1420pp m 

## r y Omah a Lea d Sit o Sit e Sketc h W . Lea d Concentratio n Sampl e Collecte d LA B ^tr 3 Do m 

### E T D S"3 6 pp m 

### D "i-^ H pp m yz ^

pp m _i2£_pp m 

### 13 ' 

### D 

# n D pp m 

### D Q pp m 

### D 

# n Numbe ro f Sample s ­ ^ 

## 2585 1 Extefio rPain t Nort h Am w 0W)o d • Poo r • Notpaln t 

# i Sample s Collecte d Firm : ^no . I'JoVg. ^ Date : Ofa-:ao--0 M Time : tv . o o Sample s Analyze d XR F Unit : g< 0 Book : ^ i

Dat e 1i/ii/e y Time : /^/ K Staff : C.Jf OmahaLeadSite 4613 0

CONTRAC T# : E P - R7-07-0 6 / 000 4 PRUDEN TTECHNOLOGIES , IN C

# tUDEM I rECHNOLOGIES , MC . 

# Propert y Statu s For m Address : 33>J^ aSeLCc^'r i Si - Date : juA e ^t. ' ^ * Phone : BVID : 

## ^ k i :X't3Z - c?^58^' j 

## Plant s & Permanen t Landscapm g Item# On Ma p Descriptio n andLocatio n

Pre-Existin g Conditio n o f

Structure s DoesyourBasementhaveahistor y of leaking ? Ye s — N o y ^ 

## Item# O

n Ma p 

# V i - f Description & Locatio n SWw.wi , ( • t t'. r "u • > ''<• > '{.1 . L>"^ i C^... A '• .-" • < • * tv•._'1 - 1



## Propert y Owne r Pruden t Employee ^ / Signature : K^^Js^y^M - Signatur e 

# •<y^7^^^ ^ 808 0 War d Parkway , Suit e 40 5 2S0 5 N . 24* " Strset , Suit s 30 8 4242 Medica l Drivs , Suit e 42S 0 Kansa s City . M O 6411 4 Oinaha . Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phons : (816 ) 365-3703 Fax : (816 ) 363-3707 Phone : (402)504-100 4 Fax : (402)504-100 5 Phon^ : (210)822-958 8 Fax : (210 ) 579-6577

# 2585 1 Exteijo rPain t NorthArrow 

### Owne rName : CURTI S HUDSO N Omah a Lea d Sit e 0i3oo d Address : 332 5 SEWAR D S T *'" ® Sketc h • Poo r Phone : H : 402-551-267 2 W : • No t pain t Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Coilecte d Firm : t::p p \-7a\fc ^ RYASCPXA-2585 1 F 1 ^6> 3 pp m 

## D Date : Ofa - '^^• - Q M RYBSCPXA-2585 1 F2 5*3 6 pp m 

## D Time : w . o o RYCSCPXA-2585 1 B 1 "Z-S H pp m 

# \ y n Sample s Analyze d RYDSCPXA'2585 1 B 2 

# Tilk . pp m 

## D RDZSCPXA-2585 1 D Z 

## _22£_pp m D XR F Uni t ; 8/ 0 Bool< : ^ 3

La

b RDZSCPLA-2585 1 pp m 

## D 

# n Date : _ 

# ^/i^/o y Resul t 142 0 pp m pp m 

## D 

# n Time : _ 

# AT I Staff : Numbe ro f Sample s = M I \ 

# A ^ 

# ENTERiED JUN : 

# 3 0 i m

- 1­ 

# v ^ ^ • >r

- 

## 2^ H 

# ni ^ -.:; c

• cjc - ;c ­ ^ 

# y
. ^ . 

# 4' . E Y

^ • P

i V . cie«- 3 O-UJ I S'^Seo**"* ­ ^e*»>j>. f i 

# s» - Omah aLeadSite 4613 0

# c 2585 1 

# f Owne rName : CURTI S HUDSON Address : 332 5 SEWAR D S T Phone : H : 402-551-267 2 Sampl e Numbe r RYASCPXA-2585 1 F l RYBSCPXA-2585 1 F2 RYCSCPXA-2585 1 B l RYDSCPXA-2585 1 B2 RDZSCPXA-2585 1 D Z

Lab RDZSCPLA-2585 1 Resul t 142 0 pp m 

### Omah a Lea d Sit e Sit e Sketc h W : Lea d Sampl e LA B Concentratio n Collecte d 1^' h pp m 

## D S"3 6 pp m 

# \y D 'Z-'S n pp m 

## D ^ 2 ^ pp m 

## D __i2£Lpp m 

# n pp m 

# n U pp m 

# U D Numbe ro f Sample s = ^ Extepo rPain t NorthArro w igfGoo d • Poo r • Notpaln t 

# i Sample s Collecte d Firm : PPf t \1SCJI\^ ^ Date : ftfa- 'ao - O H Time : w . o o Sample s Analyze d XR F Unit : 

### g/ 0 Book : 5^ 3 Date : _ 

# ^/li/6} < Time : _ 

# A/ t Staff : 

# AA i 

# ENTERE D 3 0 i m

Omah aLea dSite 4613 0 

# c

## Print Preview Pag e 1 of 1 Dougla s County-Omaha , N E

• ^fcili*ii"'tiji w

Parce l I D Owne r Nam e PnDpert y Addres s Cit y Zi p Owne r Addres s Owne r Addres s 2 Owne r Cit y Owne r Stat e Owne r Zi p 164182000 0 HUDSO N GLORI A 332 5 SEWAR D S T OMAH A 6811 1 332 5 SEWAR D S T OMAH A N E 6811 1 Sec-Twn Rn g Additio n Bloc k Lo t Legal 1 Lega l 2 Legal 3 Legal 4 Treasure r Websit e Un k Assesso r Websit e Lin k . * 

# 1 16-15-1 3 LOWE S AD D S 6 W20FTLT5&E20F T 4 0 X 127. 5

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp ? parc=164182000 0 http://dougiasne.mapping online.com/DouglasCoNe/static/accountinfo.jsp ? acco u ntno= R 164182000 0 Disclaime rMa p an d parce l dat a ar e believe d t o b e accurate , bu t accuracyi s no t Ma p Scal e guaranteed . Thi s i s no t a lega l documen t an d shoul d no t b e substitute d fo ra titl e search , 1 inc h = 4 0 fee t appraisal , sun/ey , o rfo rzonin g verification . 

## http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas%20County-Omah . 6/12/200 8

### R1641820000000 1 ,jpg (JPE G Image , 640x48 0 pixels ) http://douglasne.mapping-online.com/assessdoc/Photos/09/R l 64182. ,

MARC H 200 4 - DOUGLA S COUNT Y ASSESSO R 

## S3« 3 5 c^fcWARl ^ <S T

lof l 7/2/200 8 10:2 0 A Mys^ia ^.^5Sli; «

### '•7'''''-'77 ' -^•7.7 . a v>.».'. . ^. i 

### / ^n?* ­ 

# i-^^^m '



# 08/25/200 8 \ AJ 1 

### http://www.dhon.or^jtinternet/DHONNoticeCreation/MessageText. . I f C reateArioth'erTicke t '••' \' . Bac k t o Irt h fntemet'. ; Sen d Emai l 

## YOURTICKE T NUMBE RI S i 2083488 . Origina l Cal l Date : 7/16/0 8 Time : 11:0 6 a m Op : RAMITA1896 7 Wor k t o Begi n Date : 7/18/0 8 Time : 11:3 0 a m State : N E Address : 332 5 County : DOUGLA S Street : SEWAR D S T Place : OMAH A Twp : 15 NRng : 13 E Twp : Rng : Lega l Given : C Sect-Qtr : 16-NW Sect-Qtr : Typ e o f Work : lea d remediatio n Locatio n o f Work : LOCAT E ENTIR E PROPERT Y LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)733-188 3 : UNSUR E CORNE R Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : RAMIT A Alt . Contact : Phone : Phone : (402)733-145 5 (402)733-118 8 Wor k Bein g Don e For : EP A Dept h o f Excavation : 6f t Corne r Lot : NFront : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V LEVEL 3 MCLEODN E 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 , IN C ^^^^ ^ Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 LEVEL3 COMMUNICATIONS , LL C ^ ^ Day : 877366834 4 Alt : 

## Emerg : 8773668344 MCLEODN E MCLEODUS A NO NEE D T O CAL L OU T EMERGENCY Day : 800289190 1 Alt : Emerg : 800289190 1 MUDO l MEmOPOLITA N UnLITIE S DISTRIC T EDWIN A Day : 402504782 3 Alt : Emerg : 402504794 6 OMAHACO F CIT Y O FOMAHATRAFFIC,SEWE R RO N Day : 402444719 7

lo f 2 7/16/200 8 11:06 A M

### http://www.dhon.or^igkintemet/DHONNoticeCreation/MessageText... . 

## Alt : 402444516 1 Emerg : 4024445160 0PPDGPR 5 OMAH A PUBLIC POWE R DISTRIC T N A Day : Alt : Emerg : 406728934 3 888728934 3 :406728934 3 

## QLNNEI C QWES T LOCA L NETWOR K N A Day : Alt : Emerg : 406728934 3 :888728934 3

2 of 2 7/16/200 8 11:06 A M