### TRANSMITTA L o f OMAH A LEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : ^S<^ / Date : )2.l22^/^t> s Address : ll2. ^ T i J2 ^ i\
- Remediatio nContractor: ' }^>J^tJ
- 7^J..>t.r/i>>e»V> > 'dp^ r , Year ; 2 o Q ^ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S ^ Vide o o f propert y (DVD ) aExecutiv e Summar y i f

EPA-provide dpropert y sketc h 0 Signe dAcces s Agreemen t fo r subjec t propert y D Signe dAcces s Agreement(s ) fo r adja^«n t propert y y Restoratio nAgreemen t y Settlemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) 1 3 Confirmatio ndat a [ 3 PhotogrJ5)h s y As-buil t sketc h y Satisfactor y restoratio nsigne db y Propert y Owne r 0 Propert y close-ou t chec k lis t signe db y EP A E TDescriptio no f area s no t meetin g RO D cleanu p criteri a y Utilit y clearance s y Propert y informatio nfromDougla s Count y Assessor' s Offic e D 4030958 3 

### D 

# iinn i D , Superfun d 

### Signati9 6 Dat e/ 

### PROPERT Y SUMMAR Y Date : 12/20/200 8 Omah aLea dSite Remedial Actio n Contrac t #EP-R7-07-06/0004 Month of : Nov/Dec . Propert y Address ; 392 S N 24 S T A . EXECUTIV E SUMMAR Y A. 1 Issue s Encowitered : NON E A. 2 Issue s Resolved ; NON E A. 3 Uniqu e Findings : NON E A. 4 Othe r Relevan t Infonnation : ARE A NOT EXCAVATE D B 2 TREE , BUSHES , 15'X5 ' @ 29 4 PP M CONFIRMATIO N SAMPLIN G DATA/RESULTS : B 2 = 20 3 PP M @ 2" ; D Z = 16 9 PP M @ 2" ; F l = 27 0 PP M @ 2' ; F 2 = 26 6 PP M @ 2" ; E A = 8 0 PP M @ SCRAPE ATTACHMENT S 1 ) Propert y sketch providedby EP A pursuan t t o contract specificatioii s 2 ) SignedAcces s Agreemen t includm g acces s agreement s require dfo r crossing othe r propertie s 3 ) Pre-Excavation digita l vide o clip/photograph s 4 ) Post-Excavation digita l vide o clip/photogr^h s 5 ) Documentation - CompletedClose-ou t Checklis t 6 ) As-Buiit sketch ­ i ) Shal l include final lea dlevel s v ) Legen d ii ) Contamination lef t behindarea s vi ) Contracto r identification iii ) Propert y addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s to b e includedin th e individua l propert y file, i f 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 msignedb y propert y owne r iii ) Excavation digita l vide o i n MPEG , WM V (Window s Medi aVideo ) or SW F(Flas h Player) forma t and/o r photograph s iv ) Signedfor mverifying satisfactor y restoratio n v ) Description o f area s no t meetin g InterimRO D cleanu p criteria .

TECHNOLOGIES , INC .Fin d Recnrd Backfill :

Sampl e Area : 3342 1 - 392 5 N 2 4 S T Owner : D Owne rOccupie d Owne rName : (DUN N RENTA L LLC Owne rAddressl : |C/ 0 BONNI E J DUN N Owne rAddressZ : 1990 5 FLORENC E HEIGHT S BLV D City : ^^^^ ^

State : Zi p Code : [OMAH A [ N E |6811 2 Owne rPhone : Alternat e Phone : |(402 ) 689-428 3 Clea n U p Quer y Lea d Remainin g QueryI

Resident : Residen t Name : Propert yAddress : |392 5 N 2 4 s r Zi

p Code : [6811 0 Residen t Phon e 

# I Propert yDamag e Quer y

Contract : Contractor : PRUDErfT2008_S Group : Assessment : Qualifyin g Grou p (800/CHIL D Assessmen t XR F Date : Assessmen t MaxXR F Value : 

## I '. 113 7TECHNOLOGIBS , IN C Propert y # : 2,^^^-2- 1 Date/Time : Quad s Excavated : F^^pX^B ^ 172
­ 

# ^EP k EP A Propert y Clos e Ou t Propert y Address : 3^2 5 /V^2.i f S» f Owner' s Name : Contracto r Group : Pruden t Technologies , Inc. , Excavatio n Genera l 1 .If necessary , wer e the correct quadrant(s ) excavatedan drestored ? 2 .

If necessary , wer e the correct area s of dri p zon e excavatedan drestored ? Gradin g Sodan dVegetatio n 1 .Doe s th e grading aroun dthe perimete r of th e hous e i n excavatedarea s generall y slop e awa y fromthe house ? 2 .

Has sodbee n laidi n all area s tha t wer e excavated ? 3 .

Doe s the sodappea r t o b e generall y health y an dgrowing ? (Onl y evaluat e if inspecteda t a3 0 da

y tim e period) 4 .

Ar e soddedarea s generall y fir mandevenl y graded ? 5 .Ar e the joint s betwee n the so dstrip s generall y tight ? (Onl y evaluat e i f inspecteda t a3 0 da y tim e period) 6 .Was the propert y gradedsuc h tha t wate r will not poo l on 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? (IfappUcable ) 2 .

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

Wa s damage t o gate s o r fence s avoided ? (If applicable) 4 .Was damage to retaining wall s avoided ? (If applicable ) Foundation , Sidin g an dGutter s 1 .

Wa s damage to the siding or trimavoided ? 2 .

Wa s damage to the foundatio n avoided ? 3 .

Wa s damage to window s avoided ? 4 .

Was damage to window s o r doo r screen s avoided ? 5 .Wa s damage to downspouts o r downspou t extension s avoided ? Sidewalk s an dDriveway s (Concrete ) 1 .Wa s damage to drivewa y surfece s avoided ? 2 .

Wa s damage to walkwa y surface s avoided ? Ye s N o / / Ye s No



# y / / / 

## X / 

# X Ye s N o / 

# y y 

# y Ye s N o 

# y y y y y Ye s No

### Owner s comments :

Inspectio n notes :

Remova l andrestoratio n activate s complet e including th e 30-da y sodwarranty : EP A Representativ e irJ ^ ^ . Date ; /n/i//n- »

## Propert yCompletio n Agreemen t Thi s agreemen t documents th e completion of remova l activitie s performedon th e belo w liste dproperty . 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 n o item s ar e i n question , now , or a

t an y time i n th e fiiture, excluding an y remaining warrant y (3 0 day s total ) except thos e item s listedbelow , if any . Propert y ID : Propert y Address : ^;^*cj3J 5 Deo*K>x
- ?4
­ 

## -Ih^-? . < < M P M K 5 J 

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- n^rvi<fL . 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 complete dPruden t Technologies , Inc . (Pnident ) i s unde r contrac t wit h th e U . S . Environmenta l Piotectio n Agenc y (EPA ) t o clea n up lead
contaminate dsoil s a t anumbe r o f

propertie s locate di n Omaha , Nebraska , includin g th e propert y locate da t ^9iS ~ fLj . ^H*^^-"
- Th e EP A request s you r permissb n t o allo w Pruden t t o performasoi l cleanu p a t thi s propert y t o lemo w lead-contaminate dsoil . B y signin g tiiis form, th e propert y cwne r grant s pennissio n t o Pruden t t o perform activitie s relate dt o th e cleanu p includin g soi l sampling , remova l o f lead«ontaminate dsoil , an drestoratio n ofth e refeience dproperty . I f

yo u hav e any question s abou t th e soi l cleanif ) planne dfor you r property , pleas e contac t Pruden t Administrativ e Cler k for th e Oinah aLea dSit e cleanup . Ms . Deborah Johnso n -a t (402 ) 733-1188 . Gracra l question s abou t th e Onudi aLea dSit e cleanu p ca n b e directe dt o th e EP A Publi c Infonnatio n Center s a t (402 ) 731-304 5 (South Omah aoffice ) o r (402 ) 991-958 3 (North Omah aoffice) . Propert y Acces s Grante dBy : Property Owne r Si | 

### /Oi=dJ3<Xf X (Date ) PROPERT Y INFORMATIO N (T o b e complete db y residen t and/o r propert y owne r - pleas e print )

• v>< g RESIDEN T NAM E Owne r Rente r RESIDEN T ADDRES S
I F RENTAL , PROPERT Y OWNED BY :
OWNER' S MAILIN G ADDRESS ; • ^4d > VA<»^4-tvvga.J ^ 5^ ^ OWNER' S TELEPHON E NUMBE R - HOME : (VOC^ ) ViT^ - 33<^ ^ WORK : 

### J 1 AG E O F HOME? : 

# m . YEARS . HO W LON G HAV E YO U LIVE D HERE ? 

# ± 7 YEARS . HA S TH E EXTERIO R BEE N PAINTE D O R COVERE D WIT H SIDIN G SINC E 1978 ? 7 ^ YE S N O NUMBE R O F OCCUPANT S UNDE R 7 YEAR S OLD : < ^ NUMBE R O F OCCUPANT S 7 YEAR S OL D AN D OLDE R 

## _y NUMBE R O F CHILDRE N UNDE R 7 YEAR S OL D WH O PLA Y I N TH E YAR D FO R 5 HOUR S O R MOR E PE R WEEK : ^ - COMMENT S O R SPECIA L INSTRUCTIONS : (I.E . DOGS , ENTR Y GATES , ETC. )

AUTHORIT Y FO RENVIRONMENTA L RESPONS E ACTIONS ; Th e activitie s t o b e implemente db y EP A unde r this agreemen t ar e pursuan t t o Sectio n 10 4 o f CERCLA , 4 2 U.S.C . 9604 . EPA' s righ t o f

acces s t o th e propert y i s providedfo r i n Sectio n 104(e ) o f CERCLA , 4 2 U.S . C 960S(e) , whic h provide s enti y for "deteiminrngth e nee dfor response , o r choosin g o r tidng an y respons e actio n unde r diis title , o r otherwis e enforcin g tfaeprovision s ofth e title. "

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7

### :•: , AS-BXJOyTCKAWIN G OMAH A LEA D SUPEKFUK D SIT E OLS# : 3342 1 DateEicavated : 11/14/200 8 USEP A Signed-OffDate : ) i ! • t' ! 

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## -£2 £ pp m Q T RDZSCPXA^342 1 D Z 

### dlLk . pp m D ^ XRFUnit : /"^^VO J Book : 2J3 _ pp m n Date : '7-2 y IfiS . pp m • Time : nrv t ..jii b RYDSCFi A3342 1 j j Numbero f iample » «n n [ J ] Staff : _J!lSSa i Lni">x- > •-.•J^!£!!!^'.-BFiJin t Right , Bi s Bac k Loft , B2-0ackRi8iMDZ > Ori p Zone . GZ=G^den , PZ • Plo y I ; ARqMAiaiimwvi*««dInmMlln«t,tM«jprap i ,- . ..........«^-......... . .&« * •-....-.,. - •|r»"p'^^'«i,*^.^wp^^^- . '• • • . . K- ^

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### TECHNOLOGIES , INC . SERVICE S 

# Propert y Statu s For m Address : 21 ^ 5 ^) . ^4" ^ S ^ Date : fo/^^^jo t Phone ; ^!5 3 '33'^( ^ BVID : Ite mN O Plant s & Permanen t Landscapin g T o Remai n I n Plac e O n Ma p Descriptio n & . Locatio n

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808 0 War d Parkway , Suit e 40 5 250 5 N . 24* ^ Street . Suit e 30 8 4242 Medica l Drive , Suit s 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816) 363-3703 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-6577

## 3342 1 Exterio rPain t Nortt i Arro w 

### Omah a Lea d Sit e • Goo d Sit e Sketc h Ea^oo r Sampiin g Address : 392 5 N 2 4 S T • Notpain t Lea d Sampl e Sample s Cqllecte d Sampl e Num'b e LAE l Concentratio h Collecte d Firm : P g T^e - 

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### • YOURTICKE T NUMBE RI S 2162605 . Origina l Cal l Date : 10/27/0 8 Time : 12:1 9 p m Op : MADHURIMA1 8 96 7 Wor k t o Begi n Date : 10/29/0 8 Time : 12:4 5 p m State : NE County : DOUGLAS .Place : OMAH A Address : 392 5 Street : N24T H S T Twp : 15 NRng : 13 E Sect-Qtr : 03-SW,04-S E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lead remediatio n projec t fo r soi l Locatio n o f Work : LOCAT E ENTIR E PROPERTY Remarks : FA X AL L CLEAR S TO : [402)733-188 3 : UNSUR E CORNER S Compan y PRUDEN T TECHNOLOGIE S Contac t Name MADHURIM A Phone : (402)733-118 8 Alt . Contac t Phone : (618)401-222 3 Wor k Being Don e For : ep a Dept h o f Excavation : 6 f t Corne r Lot : NFront : Y Rear : Involve s Tunneling o r Horizonta l Boring : NExplosives : N CXCAT V

MAGELLA NMUDO l OMAHACO F 0PPDGPR 5 ^ QLNNEI C Servic e Are a Contac t Plion e Numbe r Utilit y Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 

### Day : 918574709 8 MAGELLA N MAGELLA N MIDSTREA M PARTNER S L P TONY A Alt : 

### Emerg : 918574709 8 Day : 402504782 3 MUDO l METROPOLITA N UTILITIE S DISTRIC T SAND Y Alt : 

### Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R 

### RO N Alt : 402444516 1 Emerg : 402444516 0 http://wvm.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT.. . 10/27/200 8

### Pag e 2 of 2 Day : 406728934 3 0PPDGPR5 OMAH A PUBLI C POWE RDISTRIC T N A 

### Ah : 888728934 3 Emerg : 406728934 3 Day : 406728934 3 QLNN E 1 C QWES T LOCA L NETWOR K

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### Ah : Emerg : 888728934 3

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