## TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R 

## SAID# : /a^^ ? Date : __J^;^2^ Z 

# Address : CPJ ^ Lbraa s Sh

, Remediatio nContractor : _Coasta l Environmenta l Group

_Year : _2007 _ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S

. A Vide o o f propert y (DVD ) " . WExecutiv e Summar y M EPA-provide dpropert y sketch ^ SignedAcces s Agreemen t fo r

subject propert y D Si^e dAcces s Agreement(s ) fo r

adjiacen t propert y WRestoratio nAgreemen t ' ^ Settlenient document s (i.e. , fo r

damage o r

t

o replac e plants , etc. ) u Confirmationdata, 

# D Photograph s \)(<3^e^ ^ Q]iQ3am m^ ^lAjZid'/^ijl ^ fe-Scxi ^ 3o4( ^ Veso ^ A As-buil t sketch M Satisfactor y restoratio nsignedb y Propert y Owne r ty ^ Propert y close-out check lis t signedby EP A (^f^l^l^ O ' J

. D Descriptiono f area s not meeting RO D cleanu p criteri a D Utilit y clearance s '& Propert y information fi-omDougla s Count y Assessor' s Office 

# V 1^^<^|tv/bftiss v riUi^ . 8r^ ^ ^/(S:/o 7

4031714 5 

# iii l II I Superfun d• • • 

## Propert yAcces s Checklis t Propert y ID : 1^5 ^ 2 T nWOR K STARTE D Propert y Address : r ^ 9 0 D WORKCOMPELTE D r>orCeLS > St ~ Owner : \tr^o^^ H '^^S'^^ ^ Address : ^^ ^ X>OCC.o^ V S ^ OM<3W ^ M e (^^[0 % Phone : Z-jt ) "2 . - 3MT_
- 0.^ ^ 3 Fax : Cell/Pager : d l Notiflcatio nLette r 0 ^ Acces s Agreemen t [vf

Restoratio nAgreemen t 1 1 Topsoi l Samplin g (i f applicable )

• Disposa l Samplin g (ifapplicable ) Q Garde nSamplin g (if applicable ) ETUtility Clearanc e Q^Video/Photo s (Before ) 0 Video/Photo s (During ) H/Video/Photo s (After ) U

/ Video/Photo s (30-Day ) 0 Propert y Completio nAgreemen t nFina l Repor t Ai r IVIonitorin g (a s applicable ) 1 1 Communit y [I ] Cre w On : Results : 1 1 Communit y C H Cre w On : Results : nCommunit y C H Cre w On : Results : Sent : Renter : Phone : Fax : Cell/Pager : Additiona l Information :

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Omah a Lea d Sit e By : By : 

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# 'm l aa n Tota l Qu^^ n Square Footag e t o b e Excavate d = 58 2 PropertyClassification : EB L uflrZ Tota l D^rZon e Linea rFootag e t o b e Excavate d = 0

Legen d ti:.J j Concret e Nort h Arro w N Omah a Lea d Sit e Omaha , Nebraska 

## C D

- • Excavate d Are a Existin g Structur e Fenc e Permanen t Landscapin g Scal e 1 Inc h = 2 0 fee t o r1 gri d = 5 x5 ft Propert yNumbe r OLS-1852 7 Propert yAddres s 62 0 DORCA S S T 

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Stree t Boundar y Tree/Shru b F 1 . F2 B 1 Pos t Excavatio n Concentration s (ppm ) 8 2 PlayAre a DZ Easemen t Garde n Othe r Descriptio n of pos t excavatio n areas : Fl , fron t yar d left-fian d quadrant ; F2 , fron t yar d right-hand quadrant ; Bl , backyard left-han d quadrant ; B2 , bacl<yar d right-hand quadi^nt ; DZ , dri p zon e (1- 3 foo t are a of soi l aroun d th e foundatio n o f th e house) .i-ft-^t^Ai .

FINA L PLA T 1——-n- y 

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### Parce l Searc h Pag e 1 o f 1 Results 1 - 3 of 3 B Q Parcel s B CARLSO N MATTHE W J a 1620 5 DORCA S S T B KERSTE N CHARLE S A ffi 

### 1620 6 DORCA S S T REGA N TIMOTH YJ 62 0 DORCA S S T Parce l I D Owne rNam e PropertyAddres s Cit y Zi p Owne rAddres s Owne rAddres s 2 Owne rCity Owne rStat e Owne rZi p Sec-Twn-Rn g Owne rAddres s Additio n Bloc k Lot Lega l 1 Lega l 2 Lega l 3 Lega l 4 Ol d Assesso rSit e NewAssesso rSit e 

### 022233000 0 # REGA N TIMOTH YJ 62 0 DORCA S S T OMAH A 6810 8 62 0 DORCA S S T OMAH A N E 6810 8 26-15-1 3 U^ND S W 4 0 E 23 4 F TSU B L T5 LOT6 4 0 X 90. 5 Valuatio n Informatio n Valuatio n Informatio n



### http://www.dogis.org/dogis_alias/dogis/parcelSearch.aspx?govUser=false&validUser=fals e 4/19/200 7

## CONTACT FORM Property ID # 

# ie>5d- i ,0. \ u- ^ Initia l Contact : Date : ^'^^'^ ^ Time : l^."?^ PAction:jl m Secon dContact : Date : ^^3-^ 7 Time : f)!450
­ Action : appj- . ^llDp-0 \ Fina l Contact : Date : Time : Action : Fina l Action : Transmi t t o EP A D Othe r Action : D

Comment : Owne r Commen t (s) : Sit e Coordinato r Commen t (s) :\ ^ 

### / ; 

## Consen t Fo rAcces s T o Propert y

RIGH T O FENTR Y T O PREMISE S 

### Granto r (th e property owner ) consent s t o andauthorize s th e Unite dState s Environmenta l Protectio nAgenc y (EPA ) or it s authorize drepresentatives , collectivel y th e Grantee , t o ente r andperfor mcertai nenvironmental respons e activitie s upo nth e followin g describe d premises :

Owner' s Name : Daytim e Phone : 

# s # a n Mo2
- 3A-2.
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Addresse s of Propertie s covere db y thi s Agreement : Address : 

## GQj b 1:^0rcc ^ s> ^

OMak a Ni ^ Address : 

### Address : Address : Address : PURPOS EO FRESPONS EACTIVITIE S 

### Th e EP A i s requestin g acces s t o collec t soil sample s an dremov e soi l that contain s elevate dconcentration s o f arseni c and/o r leadan dma y pos e ahealt hhazard . Th e soil wil l b e remove dan dth e excavate darea(s ) wil l b e replace dwit hcleanmaterial s an d restored . Thi s wor k

i s bein g performe dunde r th e Omah aLeadSite Superfun dSite remediatio nprogram . AnEP A representativ e wil l contac t th e Granto r in-perso nt o discus s th e wor k

t o b e performed , th e Granto r wil l hav e a nopportunity t o revie w an dapprov e th e planne dsoil removal , andrestoratio nwor k

before it begins . Onc e th e wor k

i s fmished , th e Granto r wil l b e aske dt o revie w th e wor k

an dconfir mthat it i s complet e andmeet s wit hth e Grantor' s approval . Upo ncompletion , th e Granto r wil l receiv e writte ndocumentatio n fromEP A tha t th e property ha s bee nremediated . ENVIRONMENTA LRESPONS EACTION S 

### B y signin g thi s Acces s Agreement , th e Granto r i s grantin g th e EPA , it s employees, contractor s andsubcontractor s th e righ t t o ente r th e property , a t all reasonabl e time s and wit hprio r notice , for th e sol e purpos e o f performin g th e work . Thi s acces s shal l remai n ineffect unti l th e wor k

ha s bee nsatisfactoril y completed . Th e Granto r als o agree s to ; 

## ^*'° '

«Property_ID » 

### Pag e 1 o f 2

# M L

Remov e obstruction s includin g boats , trailers , vehicles, playscap e items , woo d piles , do g houses , etc ; Remov e flower bulb s o r plant s that th e Granto r or th e Grantor' s tenan t ma y wis h t o save ; Wate r andmaintai nreplacemen t vegetation , includin g fertilizer application , a s necessary subsequen t t o a ninitial waterin g perio db y EPA ; Abid e by healt handsafet y guidanc e provide db y EPA ; Ifth e property i s rented , assis t EP A inobtainin g tenan t approval for acces s t o th e property t o perfor mth e wor k

i f EP A i s unabl e t o obtai nsuc haccess ; and Allo w videotapin g and/o r photograph y o f th e property includin g exterio r an d interio r area s ofbuildings . AGREEMEN T NO T T O INTERFERE 

### Th e Granto r agree s no t t o interfer e or tampe r wit han y ofth e activitie s or wor k

done , o r th e equipmen t use dt o perfor mth e activities , or t o undertak e an y action s regardin g th e us e o f sai dproperty whic hwoul dten dt o endange r th e healt ho r welfare ofth e Grantee s or

th e environment , or t o allo w other s t o us e th e property insuc hamanner . Shoul dyo u hav e any question s abou t thi s program , pleas e contac t

RT I I gran t acces s t o my propertie s opertie s 

# ZAy^yH-2^^0 7 £d^£ . Ignatur e Dat e Signatur e Dat e

I 1 1 wouldlik e to b e presen t durin g any samplin g tha t i s required .
Pag e 2 o f 2 «Property_ID »

# ( i Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s t o provid e amutual agreemen t a s to condition s o f propert\prio r to remediatio nactivities . Thi s wil l als o scr v e a s decontaminatio nfo r th e purpos e o f assurin g tha t resloratio n activitie s are complete dto th e satisfactio no f th e propert } owne r an dth e Unite dState s Environmental Protectio nAgenc y (EPA) .

PropertylD : \f^5*Z'= f Propert y Address : ^ ^. o T^orc

_ O - ^ SJ
­ Qt ^ S V^ ^ 

## K e (L«si b 9 O^ner : V.'^ohKv ^ L^ f CL t V.CK_^a aO Phone : ^p 2.
- 3M2_
- ;i-lC= 3 ^ 

### Onth e attache ddiagram(s ) indicate area(s ) to c\ca\ate danddept ho f excavation , locatio no f all know n utilities , subsurfac e features , surfac e structure s andlandscapin g features , acces s location(s ) to b e use db \ contractor , andth e directio no f North . Indicate distances , depths , material types , etc . Indicate digital photo s b

y referencin g the photo-lo g number wilha narro w indicatmg directio no f \iew . 

### Item s T o B e Remove d B yOwne rBefor e Star t O f Remediation : (Us e addftiona l sheet s a s necessary ) Th e removal , storage , disposal , and/o rretur n o f thes e Wfm s i s th e Owner' s responsibility . item : 

# r/ J Item : Item : Item : Item : Item : Item : Item :

# (p > Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Us e additiona l sheet s a s necessary ) Item : 

## \vAor\e _ Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item :

Pag e 2 o f (/ ^

# m > Item s T o B e Remove d B yContracto rDurin g Remediatio n An d Replace d (Us e addrtiona l sheet s a s necessary ) Item : Item : y^^jno o <>€-£ { Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item : Item :

Pag e 3 o f { ^

### Ite m Quantit y Uni t 

## Conditlon/Type/Specie s Agree dupo n\alu e plant material s no t to replace db v contractor . of b e Nol c ilii s \alii c u.-<c dlo issu e \oi.icher lo ihe O Wner wil l b e a planl pioperl \ $

Agree dupo nlis t o f plan t material s that wil l b e replace db y contractor . B e ver y specifi c anddetailed . 

# 3 Eac h Inelude askeic hi.i\ ' were eae hpUin t will h e place d I nthe eonlj-aelo r Agree dupo nare aof propert) ' to b e replace d wit hgras s sod . InekiJ e askeieh.'[ ' ilie areais i i nhe replaeeJ . willi j^ras s sod . 

### rsiD-^-^ ^ 

## S F

Are aof Cit\ ' o r Count v propertv - to b e landscape d per thei r requirements . Ineliul e askeleh'^ \ih c areais ) 

# /^l A S F

Pag e 5 

## ofj j

### Landscap e Inventor y (Us e additiona l sheet s a s necessary ) 

## Ite m pre-existin g property are a that i s covere dwit hgrass .

Number o f tree s > 2 inch trunk diamete r

Numbe r o f tree s < = 2 inch trunk diamete r

Numbe r o f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Attac hasketc ho f th e sprinkle r layout . Numbe r o f an dsiz e o f eac hgarden/ flowe r be d area . Attac hasketc ho f relativ e size s an dlocations . 

## Quantit y



## N o

14 ^ 

## V ^

U D 

## Uni t
Square fee t 

## Condition/Type/Specie s

Each

1 Eac h 

### ^lo' ^ t

Eac h

- Eac h

Squar e Feet

Pag e 4 o f i o

# ( i

Additiona l Comment s / Instructions :



### ^

Chec k th e boxi f Owne rdoe s not 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 boxCE G i s no t responsibl e fo ran ydamag e don e t o th e interio rof house , includin g foundatio n cracks o rfissures .

agre e O I d o no t agre e "^3 ^ agre e / [ 3 r^dcTlTot^agre e / 

# AAA. . (Xf..^"i-M- m/^w^%^^ ^ Owne^r s Signatur e ^" / Dat e Co^rn^actor' s Signatur e / Dat e Pag e 6 o f { j /a 

# RESTORATIO NCHANG EORDE R OMAH A LEA D Propert y I D #l?)59' l Propert y Addres s f^S^ ^ Oo/toA S Owne r Nam e | I' m^ L^<-Qu ^/f.^^r^r x 

# Dat e S-l ^ ^^ 7 Comment s .

Owne r Signatu r Contracto r Signatur e

## ygp . PROPERT YCLEARANC E WORKSHEE T 

# 1

Dat e Ol-May-0 7 Propert yI D 1852 7 Propert y Projec ± Omah a Lea d — Fixe d Pric e 6 2 0 DORCA S S T Addres s Measureme n XR F I D 0107-5 1 t Count/Tim e Fiel d Shot s Shot # Readin g Sampl e Are a Shot # Readin g Sampl e Are a 10 3 18 6 EA- S 16 7 2 5 F2 17 6 1 9 F l

Sampl e Are a EA- S Pass/Fai l ? I n Sit u Composit e Composit e Analyti c La b Aliquo t Composit e Reading s Analytica l Readin g Averag e (Drie d & a l Spil t Numb e (Bag ) Result s 1 (Bag ) Sieved ) Sent ? r * 2 19 8 pp m +/ - 8 pp m

3 17 6 pp m -f-/ - 7 pp m 18 6 pp m 4 18 5 pp m -1-/ - 8 pp m XR F Correcte d Valu e -- > 5 (us e calibratio n char t o rad d 22 3 pp m 20 % t o value ) Sampl e Are a F 2 Pass/Fai l ? I n Sit u Composit e Composit e Analyti c La b Aliquo t Composit e Reading s Analytica l Readin g Averag e (Drie d & a l Spil t Numb e (Bag ) Result s 1 (Bag ) Sieved ) Sent ? r 2 2 0 pp m -f-/ - 1 pp m 3 2 4 pp m -)-/ - 1 pp m 2 5 pp m 4 3 1 pp m +/ - 1 pp m XR F Correcte d Valu e -- > 5 (us e calibratio n char t o rad d 3 0 pp m 20 % t o value ) Sampl e Are a F l Pass/Fai l ? I n Sit u Composit e Composit e Analyti c La b Aliquo t Composit e Reading s Analytica l Readin g Averag e (Drie d & a l Spil t Numb e (Bag ) Result s 1 (Bag ) Sieved ) Sent ? r 2 1 3 pp m -f/ - 1 pp m 3 2 1 pp m -H/ - 1 pp m 1 9 pp m 4 2 4 pp m -1-/ - 1 pp m XR F Correcte d Valu e- > 5 (us e calibratio n char t o rad d 2 3 pp m 20 % t o value ) Confidentia l 

### 5/10/200 7 Pag e 1 o f 2

# 1 Sampl e Are a Pass/Fai l ? I n Sit u Aliquo t Readin g 1 2 3 4 5 Sampl e Are a I n Sit u Aliquo t Readin g 1 2 3 4 5 XR F Technician' s Signitur e Composit e Reading s (Bag ) -1-/ - 0 pp m -1-/ - 0 pp m -vj - 0 pp m XR F Correcte d Valu e - > (us e calibratio n char t o rad d 2 0 % t o value )

Composit e Reading s (Bag ) -H/ - 0 pp m • vj - 0 pp m -1-/ - 0 pp m XR F Correcte d Valu e - > (us e calibratio n char t o rad d 2 0 % t o value ) Composit e Averag e

(Bag )

0 pp m Composit e

Averag e

(Bag ) #DIV/0 ! #DIV/0 ! Composit e (Drie d & Sieved )

Composit e

(Drie d & Sieved ) Analyti c La b Analytica l a l Spil t Numb e Result s Sent ? r

Pass/Fai l ? Analyti c La b Analytica l a l Spil t Numb e Result s Sent ? r

US E ADDITIONA L SHEET S I F NEEDE D 

## /v\)_.V\p >

Confidentia l 

### 5/10/200 7 Pag e 2 o f 2PROPERT YCLEARANC E WORKSHEE T # Dat e 02-May-0 7 Propert yI D 1852 7 Propert y Projec t Omah a Lea d - Fixe d Pric e 6 2 0 DORCA S S T Addres s Measureme n XR F I D 0107-5 1 t Count/Tim e Fiel d Shot s Shot # Readin g Sampl e Are a Shot # Readin g Sampl e Are a

Sampl e Are a F l 6- 8 Pass/Fai l ? Aliquo t 1 I n Sit u Readin g 5 8 Composit e Reading s (Bag ) Composit e Averag e

(Bag ) Composit e (Drie d & Sieved ) Analyti c a l Spil t Sent ? La b Numb e r Analytica l Result s 2 3 0 1 3 pp m +/ - 1 pp m 3 3 4 2 1 pp m +/ - 1 pp m 1 9 pp m 4 2 1 2 4 pp m -1-/ - 2 pp m XR F Correcte d Valu e — > 5 3 0 (us e calibratio n char t o rad d 20 % t o value ) 2 3 pp m Sampl e Are a Pass/Fai l ? I n Sit u Composit e Composit e Analyti c La b Aliquo t Composit e Reading s Analytica l Readin g Averag e (Drie d & a l Spil t Numb e (Bag ) Result s 1 (Bag ) Sieved ) Sent ? r 2 •Vj - 0 pp m 3 -1-/ - 0 pp m 4 -H/ - 0 pp m XR F Correcte d Valu e - > 5 (us e calibratio n char t o rad d 0 pp m 20 % t o value ) Sampl e Are a F 2 6- 8 Pass/Fai l ? I n Sit u Composit e Composit e Analyti c La b Aliquo t Composit e Reading s Analytica l Readin g Averag e (Drie d & a l Spil t Numb e (Bag ) Result s 1 1 (Bag ) Sieved ) Sent ? r 2 3 2 0 pp m -(-/ - 1 pp m 3 9 2 4 pp m -H/ - 2 pp m 2 5 pp m 4 4 3 3 1 pp m -1-/ - 2 pp m XR F Correcte d Valu e - > 5 7 (us e calibratio n char t o rad d 3 0 pp m 20 % t o value ) Confidentia l 

### 5/10/200 7 Pag e 1 o f 2Sampl e Are a Pass/Fai l ? I n Sit u Aliquo t Readin g 1 2 3 4 5 Sampl e Are a I n Sit u Aliquo t Readin g 1 2 3 4 5 XR F Technician' s Signitur e Analyti c La b Analytica l a l Spil t Numb e Result s Sen t ? r

Pass/Fai l ? Analyti c a l Spil t Sent ? La b Numb e r Anaiytica l Result s 

## 1

US E ADDITIONA L SHEET S I F NEEDE D Composit e Reading s (Bag ) 9 5 pp m +/ - 6 pp m 12 4 pp m -H/ - 8 pp m 10 3 pp m -H/ - 7 pp m XR F Correcte d Valu e - > (us e calibratio n char t o rad d 2 0 % t o value )

Composit e Reading s (Bag ) +/ - 0 pp m -1-/ - 0 pp m -1-/ - 0 pp m XR F Correcte d Valu e -- > (us e calibratio n char t o rad d 2 0 % t o value ) Composit e Averag e

(Bag ) 10 7 pp m 12 8 pp m Composit e

Averag e

(Bag ) #DIV/0 ! #DIV/0 ! Composit e (Drie d & Sieved )

Composit e

(Drie d & Sieved ) 

# \J\[\)\k k C^m L x£ ^

Confidentia l 

### 5/10/200 7 Pag e 2 o f 2XR F DAILYCALIBRATIO N WORKSHEE T 

# t# ^

Dat e Projec t XR F I D Measuremen t Count/Tim e 02-May-0 7 Omah a Lea d —Fixe d Pric e 0107-5 1

3 0 se c Calibratio n Verificatio n Check s Readin q Tru e Valu e 120 % 80 %

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

# SEPA f Propert yCompletio n Agreemen t Thi s agreemen t documents th e completio no f removal activitie s perfonne donth e belo w liste dproperty . Th e property owner' s signatur e indicate s that th e property owne r i s satisfie dwit hth e restoratio nofth e subjec t property , an dthat n o item s ar e i nquestion , now , o r at any tim e i nth e future , excludin g any remainin g so dwarranty (3 0 day s total ) excep t thos e item s liste dbelow , i f any . Property ID : Property Address : 

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Date/Time : Afay:2.1l,.S0 0 7 

### Owner' s Name : math u ti'Sf i 

### Quad s Excavated : Contracto r Grou p Excavatio nGenera l Ye s N o 1 .If necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 

# y 2 .If necessary , wer e th e correc t area s o f dri p zon e excavate dan drestored ? 

## t y Gradin g So dan dVegetatio n Ye s N o 1 .Doe s th e gradin g aroun dth e perimete r ofth e house inexcavate darea s generall y slop e away fromth e house ? 

## y 2 .

Ha s so dbee nlai dinal l area s tha t wer e excavated ? 

## y 3 .

Doe s th e so dappear t o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte dat a3 0 day tim e period ) 

## y 4 .

Ar e sodde darea s generall y fir man devenl y graded ? 

# y 5 .Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte dat a3 0 day tim e period ) i / 6 .Wa s th e property grade dsuc hthat wate r wil l no t poo l o nth e property ? 

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

# y Gates , Fence s an dRetainin g Wall s Ye s N o 1 .D o gate s ope nan dclos e freely? (Ifapplicable ) 

# y 2 .Were al l gate s o r fence s take ndow ndurin g restoratio nactivities reinstalled ? (Ifapplicable ) 

## y 3 .

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

## y 4 . Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) i ^ Foundation , Sidin g an dGutter s Ye s N o 1 .Wa s damag e t o th e sidin g o r tri mavoided ? 

# y 2 .Wa s damag e t o th e foundatio navoided ? < / 3 .Wa s damag e t o window s avoided ? 

## y 4 .

Wa s damag e t o windows o r doo r screen s avoided ? 

## y 5 .

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

## y Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 .Wa s damag e t o driveway surface s avoided ? 

## y 2 . Wa s damag e t o walkway surface s avoided ? 

# y

# f
Owner s comments :

Inspectio nnotes :

Remova l an drestoratio nactivate s complet e includin g th e 30-day so dwarranty : EP A Representativ e .Pc^yg ^ Date : s/^3/o- p