## TRANSMITTA Lo f

OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAI D # : ^ ^ ^ Date : 

# \at o Address : Remediatio nContractor : Coasta l Environmenta l Grou p Year ; 200 1 SOI LREMEDIATIO N PROPERT Y nLEFOLDE RDOCUMENT S

/ 

## 5 / j ^



## t / -a 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 Restoratio nAgreemen t Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) Confirmatio ndat a 

# 1 / i / Photograph s As-buil t sketc h Satisfactory 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 Propert y infiBfinatji6 nfromDougla s Counl y Assessor' s Offic e [ I D 

## n

3005446 3 

# 1 6 Dat e Superfun d

## Propert yAcces s Checklis t Property© : 7^<5'4 q Propert y Addms : 3, ^ Ph^,4n/ \ ON : __/__/__ ON : / / 

## <>"»* ^ ?dneTA : BJA^-ii ^ Addres s 

## 3 1 mVopplt-^o O piH.«c : MAt/5'l%.\nV p Fax ; Ceil/Pager : L_

J Notificatio nLette r ^ Acces s Agreement ^ Restoratio aAgreemen t nTopsot l Samplin g (i f applicable ) D Disposa l Sanq>iing (i f applicable ) D Garde nSamplin g (i f appUcable ) ^UtiK^Ctearattc e 0 V{deQ/Pbotos(Bdbre ) 0 Video/Photo s (Dnring ) D Vldeomioto s (After) D VldeoAlioto s (30-Day ) PFinal Repor t Ai r MonitorinE(aaapplicable ] % O Comnmnit y DCre w 

### I On : Results :

• Comnmnit y •Crew r On : Resolts :

• Ctonnmnhy QCrc w I On : Resolta : D WOR K STARTED D WORKCOMPia.TE D Asft r

Sent : Sisned : Slpied ! / / / Rente r PiMme : Fax : Cell/Page n Additional Information :

/ / / / / / / / / 

## Caned: ^ /Y l /ty \

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## SigpedP ^ r/{gl(p \ Issned : / / / 

### / i By : / / By : By :

Omah a Lea d Sit e By : By : By : By : By : By : 

## By : '\\\\^\ri \ By : By : By : By : By : By :

## Dougla s Count y Accoun t I H^M^i^io n Pag e 1 of 3 Dougla s County , Nebrask a Propert yRecor d - R095726000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e (3 ) scal e 0-5 0 ft wes t o f 52n d S t - Vle W O n Ma p Infomiatio n i s vali d a s o f 2009-8- 3 Treasurer' s Ta xRepor t Ne wFeatur e • • ^ - > Aut o Sale s Searc h Owne r BLAC KROBER TJ 311 4 POPPLETO N AV E OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 572 6 OOO O 0 9 Accoun t Type : Residentia l Parce l Number : 095726000 0 Parce l Address : 311 4 POPPLETO N AV OMAH AN E 68105-000 0 Lega l Description : DUNDY- E S JR-SU B DIV(HANSCO M PLACE ) LO T4 BLOC K0 37. 5 X 10 0 & E 3 7 1/

2 S 4 0 F TL T1 5 BL K6 HANSCO M PLAC E 37. 5 X 4 0 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $5,900.0 0 $65,800.0 0 $71,700.0 0 200 8 $5,900.0 0 $65,800.0 0 $71,700.0 0 200 7 $5,900.0 0 $65,800.0 0 $71,700.0 0 200 6 $5,900.0 0 $92,400.0 0 $98,300.0 0 200 5 $5,900.0 0 $92,400.0 0 $98,300.0 0 200 4 $5,900.0 0 $92,400.0 0 $98,300.0 0 Sale s Informatio n Sale s Date : 2008-01-2 5 Dee d Type : W D Book : 200 8 Page : 00833 0 Price : $106,000.0 0 Grantor : THOMPSE N BRUC E AETA L Grantee : BLAC KROBER TJ Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 2006-03-1 0 Dee d Type : W D Book : 200 6 Page : 02775 7 Price : $21,000.0 0 Grantor : ROBER TW NOVA KETA L 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09.. . 8/22/2009

### Dougla s County Accoun t I ;

Q|Mn3|^io n 

### Pag e 2 o f 3
Grantee : BRUC E ATHOMPSE N Valid/Invalid : Exclusio n Reason : Invali d Questionabl e Sal e Lan d Informatio n Acre s 0.1 2 S F 5320. 0 Unit s 1. 0 Dept h 140. 0 Widt h 38. 0 Vacan t N o Improvement Buildin g 1 Informatio n

•^ 0 . * RraFtai r -^NKCndFk M 1:26a mt 

## ^

„ v a nt r

Jtl J •I d 2* 0 

### TW O STORY •j'VftitM i n CLIC KTO ENLARG E IMAG E Squar e Footage : 2452. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Fai r

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 8. 0 Exterior : Fram e Stucc o Units : 2. 0 Interior : Drywal l Baths : 2. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : ,2. 0 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 189 0 0 % 189 0 11 9 Detai l Typ e Detai l Descriptio n Unit s Ad d O n She d 1. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 ft 1226. 0 Fixtur e Additiona l Fixture s 1. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09.. . 8/22/200 9

## Dougla s Count y Accoun t I:

n|uiB^io n Pag e 3 of 3
Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 2. 0 Garag e Buil t I n 400. 0 Porc h Sla b Roo f Cei l 216. 0 Use r 2 UNI TCONVERSIO N 1. 0 Use r code i 25tomodl e 1. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09.. . 8/22/2009• •



## Propert y I D # Propert y Address : Initial Contact : Secon dContact : Fina l Contact : Fina l Action :

Comment : Owner Commen t (s) : Site Coordinato r Comment (s) : CONTACT FOR M 

## If^^^ q ?>U H Popp^-Vo nA\/ C Date : Time : Date : Time : Date : Time : Transmit t

o EP A D Action : Action : Action : Other Action : •

### • • • • 

### Pag e 1 of 2

" > Creat e Anothe rTicke t Bac k t o Irt h Interne t | [ Sen d Emai l )



### • YOU RTICKE T NUMBE RI S 2362526 . Origina l Cal l Date : 9/12/0 9 Time : 6:2 8 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 9/16/0 9 Time : 7:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 311 4 Street : POPPLETO NAV E Twp : 15 NRng : 13 E Sect-Qtr : 28-N 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 : FAX 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 : 4f t Come r Lot : N Front : Y Rear : Y 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 Numbe r UtiUty Typ e 

### Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C 

### HEID I Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL 3 LEVEL S COMMUNICATIONS , LL C 

### N A Alt : Emerg : 877366834 4 Day : 402504782 3 MUD0 2 METROPOLITA NUTILITIE S 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://wvm.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 9/12/200 9

## Pag e 2 of 2 • • • •
OPPDGPR 6 OMAH A PUBLI C POWE RDISTRIC T N A 

## Day : 406728934 3 Alt : 4062071494 Emerg : 888728934 3 QLNNEI FQWES T LOCALNETWOR K N A 

## Day : 406728934 3 Alt : 4062071494 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.. . 9/12/200 9OLS# : 2054 9 

### ( ^ 

# As-Buil t Drawin g Dat e Excavated:9/220 9 Dat e USEP ASigne d Off : 10/5/0 9 COASTA L 

# Oinah aLea dSuperfun dSit e Are a Sodden : 38 0 s a f t

Name : ^i.k^rj ' AJa^u(r ~ Omah a Lea d Sit e Date : 

### !3 _ Nort hArro w Address : '^il'- i f^'of>fif>-i-o> ^ Sit e Sketc h Time : 

### /< ? J o i Phon e A^Z ) -3^S'- S<g/^ o 

# f TeawtlZ/vtiyMuJt^.t.y/nii / I

Omah aLea dSit e 4613 0 

### Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are areplace dwit h Are areplace dwit h Are alef t bar e So d Rock/Mulc h' ' 

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

# z Afic ^ Name : ^tiheT'TA/a^ei.\r ~ Address : 'M}*- t Popple+o> y Phone.^*^Z ) .y^6^ - ZK^ll T Omah a Lea d Sit e Sit e Sketc h Date : 7 Time : ~7 ^ Sl^A i Nort h Arro w ^ Team< ^

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/5/Ye s n /7i^e s n Ye s • Ye s • 

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# 311 1 

# ^(^yVW r Name : ^c^k^.r- h /Va/< i ^ Address : .5//^ / Popfle-ho n Omah a Lea d Sit e Sit e Sketc h 

### Date : Time : 

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l^BrrCrcjic^lpUfi.yyJfhu l BVI D # ^O^ f XR F Cod e 

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### ,*^^*°""« # COASTA l [HVIKOHHIhTA l '*> < PM^' ' C R 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 propertyowner) 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 followin g describe d premises :

Owner' s Name : Daytim e Phone : ' ' '^ P 

### ^<^^r f ^\ft.c- k Addres s o f Propert y covere d b ythi s Agreement : 

# 3/l w PURPOS E O F RESPONS E ACTIVITIE S 

### Th e EP Ai s requestin g acces s t o collect soi l sample s an d remove 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 ) 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 its 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 , v\nl l contact th e Granto rin-perso n t o discus s th e wori ct o b e performed , th e Granto rwil l hav e a n opportunityt o revie wan d approv e th e planne d soi l removal , an d restoratio n worl ( 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 vinth 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 property ha s bee n remediated . ENVIRONMENTA L RESPONS E ACTION S 

### B

ysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractors an d subcontractors 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 performin g th e work . Thi s acces s shal i remai n i n effect 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 2V^-^j fCOASTA l tHTINONHtRTA l C KO t > rI f C 

### *Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; cRemov 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 ; ( Wiate 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 ; eAbid 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 . t '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 Coasta l Environmenta l Group , a t (402 ) 991-119 9 ©< g gran t acces s t o mypropertie sD I d o no t gran t acces s t o mypropertie s



# ^ ^ M' ^ 

# ^ 1 Signature Date SignatureDate
Q I woul d lik e t o b e presen t durin g an ysamplin g tha t i s required .

Page 2 o f 2COASTA L 

## Restoratio n Agireemen t Th e purpos e o f thi s agreemen t i s t o provid e amutua l agreeme ma s t o condition s ofth e propert y 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 tha t restoratio n activitie s ar e complete dt o th e satisfactio no f th e propert y owne r an dth e Unite dStale s Environmenta ] Protectio nAgenc y (EPA) .

Propert y ID : 2-6SH ^ Propert y Address : 

# 1 ^ ] I H 

### fepple-4<^ Owner : 

### f\^L^4 - R\r.cie i Phone : -^M^^^-^T ^ 

# h?^"<gfrir t

hi^r k

?^' ^ ^ n O nth e attache ddiagram(s ) indicat e aiea(s ) t o excavate , surfac e structure s an dlandscapin g feature s an d acces s location(s ) t o b e use db y th e contractors . Indicat e distances , depths , materia l types , etc . Photographicall y an dVideographicall y documen t th e existin g condhion s ofth e propert y an dth e basemen t i f necessary . ^ 

### Item s t o b e Remove d b yth e Owne rbefor e Star t o f Remediation : Th e (enoval
. storafie
. disposal , and/o rretur n o f thes e itom s i s th e Owner' s responEibiiity . ttem: ^ ^V*-o<-^ 

# P (e»«- ^ 

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Pag e 

# 1.1 k

### Kern s t o B e Remove d B yContracto rDurin g Remediatio n and^Replaced _ Item : 

# ^c. A.^^- A ttem: Item : item :



### Ite m Pre-existin g propert y area , tha t wil l b e excavated , tha t i s covere dwithgrass . Numbe r o f tree s > 2 inc h trun k diamete r Numbe r o f tree s < = 2 inc h trun k diamete r Numbe r o f Sprinkle r Zones , Contro l Valves , Timers , Heads , etc . Aiiat hnsketc ho l ihi ? ^rrifklo i iiiV'.ui ; Numbe r o f an dsiz e o f eac hgarden / flower be d area . Atuiti i ; i skc'ic ho l rclntivi ' • iV/K S nn dloc;llil'iM ^ Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . Vol e llii " NHIU C «il l h i i;sr C 1 0 i>:u i . i |)IHII ; \oiicIic. ' K J lli e |)roi)cil \ U M ner . Easemen t Area , t o b e excavate d 

### Quantit y 

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Eac h Eac h

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Eacf a Squar e Fee t

S

P.ac h Pag e 2 o f fC O AS 1 AL
\Additiona l Comment s / Instructions : 

# ^^[ 1 2 ^^^U^ ^"iv\ ^c=LA/z:<^'-ce.- ^

Q Chec k th e bo xi 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 t>o xCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatio n crack s o rfissures
.

[^ 4 agre e C D I d o no t agre e

Owner' s Signatur e Dat e Contractor' s Signatur r Dat e Pag e 3 o f \ /BVID # ^toS"Mc ^ 

### XR F PROPERTY SAMPL E SHEE T Dat e Projec t 

# ^Wg f Omah a lea d FP 2nd yea roption Addres s Sampl e tim e 

### •3HM rP-^fpiOfl- ^ A^ - am/p m XRFID # sampl e lengt h 

### 3 0 se c ^Shot # 

# m r Readin g 

# a 

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Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a Dept h Dept h Averag e Averag e
RETES TAREA S Shot # Readin g Sampl e are a Shot # Readin g Sampl e are a Dept h Dept h Averag e Averag e la b sampl e # La b resul t Sampl e are a XR F Avg . Signatur e (^Cfl/^J? m 

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### Omah a a Lea d Site—Fixe d Pric e EP-R7-07-0 5 I .. . .. ._

Coasta l Environmenta i Grou p Inc . www.coastalhazmat.co m



# EXECUTIV ESUMMARY : BVID #20549-(311 4 POPPLETO NAVE ) No Issue s or Concern s Q Issues/Concern s Detail Explanation ^v.. ^ ^ 7 "^^ ^ COASTA L mVliOMHINTA l G IO U P. IN C4 

# 0 St9
. 

# EP A EP A Propert y Clos e Ou t For m 

# U

M •yh(ioy \hi t Propert y # : 

# : iO^^ ^

• - - - ' Datc/Tlne : Quad s Excavated : ft ^ > V' ^ Contracto rGrou p <^.g>A^lTt«- ^ Ye s No Excavatio n Genera l 1 .If necessary , were th e correc t quadrant(s ) excavate dan drestored ? 

# 1/ : 2 .If necessary , were th e correc t area s o f drip zone excavate dan drestored ? 

# K J Ye s JNo Gradin g So d an d Vcgctetio a I .Doe s the gradin g aroun dth e perimeter ofth e hous e i nexcavate darea s generally slop e awa y fromth e house ? 2 .Ha s so dbee nlai dinall area s tha t wer e excavated ? 

# r ? ^ 3 .Doe s th e sodappear to b e generally healthy an dgrowing ? (Only evaluate if inspecte da t a3 0 da y time period ) 

# r 7 4 .Ai « soddedarea s generall y Ar man devenly graded ? 

# r y 5 .

Ar e th e joint s betwee nth e so dstrip s generally tight ? (Only evaluate if inspecte da t a3 0 da y tim e period ) 6 .Wa s the propert y grade dsuchtha t wate r wil l no t poo l o nth e propert}** ! 

# r/ ' 7 . Wa s damage t o landscapin g o r plan t material s avoided ? ^ ^ Gates , Fence s an dRclatnlB g Wall s Ve s lyo I .D o gate s ope nan dclos e freely? (Ifapplicable ) 2 .Wer e all gate s or fence s lakendow ndurin g restoratio nactivitie s reinstalled ? (Ifapplicable ) ^ ^ 3 .Wa s damage t o gate s or fence s avoided ? (Ifapplicable ) 

# r^ ^ 4 . Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) ^ ^ FoundatloB , Sidtn g an dGutter s 1 .Wa s damag e t o th e sidin g o r tri mavoided ? ^ 2 .Wa s damag e t o th e foundationavoided ? 

# i : 3 .Wa s damag e t o window s avoided ?

Wa s danug e t o window s or doo r screen s avoided ? 5 . Wa s damage t o downspout s o r downspoul extension s avoided ? 

# T:^ ^ Sidewalk s an dDrHeway i (Concrete ) Ye s N o 1 .Wa s damag e l o drivewa y surface s avoided ? 2 .Wa s damage t o walkwa y surface s avoided ?

### Owner s comments :



## Inspectio nnotes :

Remova l an dresloratio naclivale s complet e includin g th e 30-da y so dvyarranty : EP A Represenlaliv e LJo K jjC^/l/p,//- ^ Dale:/ O /^/ ^ 7# 

### #



## Propert yCompletio n Agreemen t Thi s agreemen t documenl s th e completio n of remedia l acliviiie s perlorme d o n m ypropertyM ysignatur e wil l designat e iha l 1 a m satisfie d wit h th e restoralio n o f m ypropeity , an d Iha l n o item s are m questions , now , o ra l an ylim e i n (h e ftjlure, excep t ihos e ilem s liste d below , ifan y Propert yID : ^^t \ PropcrtyAddrm:3H q popp^^ ^

|)Wf t 

## O""*^ ' RnVxy- V ftln 

# r Phone : ^O?
. 5^A . ^ 4 7 ^ Restoratio n Item s i n Question :

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

ttmplcied , rxccp t a s naitr i i s complcler i 

## 09-7M.9 ^

' s Signatiir f Cvnrartor' s Signatur e