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

# <;(i W n SAID# : ^^'? ^ Date : 

## Address : l^l ( H^HtCA . bU ^ Remediatio nContractor : Coasta l Environmenta l Group _ Year : 2010ARR A SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S 

# f Vide o ofpropert y (DVD ) Executiv e Summary EPA-provide dproperty sketc h Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) fo r adjacent property Restoratio nAgreemen t Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) Confirmatio ndat a Photograph s if ^ ^jyO^mo^ A^ t^C^^^r^y ^ y^ ^ 

# y As-buil t sketc h 

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### Descriptio nofarea s no t meetin g RO D cleanu p criteri a 

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## Propert yAcces s Checklis t Propert y D) : ^ ^ ^ D WOR K STARTE D ON : __/__/ _ Propert y Address : ^< ^ j pCtJiPMJ LUTJ ^ nWORKCOMPELTE D ON : / / Owner : Renter : 

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# m(^-^?M ^ Fax : Cell/Pager :

nNotificatio nLette r QCXcces s Agreemen t ^^Restoratio nAgreemen t r nTopsoi l Samplin g (i f applicable ) nDisposal Samplin g (i f applicable ) Q Garde nSamplin g (i f applicable ) [J UtiUt y Clearanc e 1 ^ Video/Photo s (Before ) nVideo/Photo s Puring ) nVideo/Photo s (After ) nVideo/Photo s (30-Day )

• Propert y Completio nAgreemen t

• Fina l Repor t Ai r Monitorin g (a s applicable )
• Community • Cre w On : Results : l~l Community C D Cre w On : Results : l~l Conununit y C D Cre w On : Results : Phone : Fax : Cell/Pager : Additiona l Information :

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### Dougla s County Accoimt In Pag e 1 of 2 « » - Dougla s County , Nebrask a Propert yRecor d - R140264000 0 Prin t Reoor t Vie wInteractiv e GI S Ma o Informatio n i s vali d a s o f2010-8-3 0 Treasurer' s Ta xRepor t 1 Ne wFeatur e -•-»- •Subdivisio n Sale s Searc h Owne r CIT YO F OMAH A C/

O PLANNIN G DEPARTMEN T 181 9 FARNA M ST# 1 11 1 OMAH AN E 68183-000 0 Propert yInformatio n Ke yNumtier : 026 4 000 0 1 4 Accoun t Type : E xGovernmen t Parce l Numlier : 140264000 0 Parce l Address : Lega l Description : 152 1 FLORENC OMAH AN E 681 HORBACH S 2N E BLV D 10-000 0 D AD D LO T9 BLOC K3 N 1/ 2 3 0 X 14 0 Valu e Informatio n 201 0 200 9 200 8 200 7 200 6 200 5 Lan d $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 

### Sho wAl l Transaction s

Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 9 4200. 0 0. 0 140. 0 30. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R140. . . 9/2/201 0

### 3/31/201 1 www.idhon.org/irthinternet/DHONNotic.
. 

## • ^ Creat e Anothe rTicke t 

## <^nr i Sen d Emai l Bac k TTrirt h Inteme t


## YOU RTICKE T NUMBE RI S 2699978 . Origina l Cal l Date ; 3/31/1 1 Time : 12:5 1 pm Op : ALFONSO1879 0 Wor k t o Begi n Date ; 4/04/1 1 Time : 1:1 5 pm State : N E County : DOUGLA S Place : OMAHA Address : 152 1 Street : FLORENC E BLVD Twp : 15 NRng : 13 E Sect-Qtr : 15-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 : FA X AL L CLEAR S TO : (402)934-281 1 : PLEAS E INCLUD E AL L EASEMENT S Company: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ALFONS O Phone : (402)934-283 7 Wor k Bein g Don e For : Coasta l Dept h o f Excavation : 4f t Corne r Lot : NFront : Y Rear ; Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCATV LEVEL S MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C 

## Utilit y Servic e Are a Contac t Phon e Numbe r Typ e Day : 4029S4046 9 CXCATV CO X COMMUNICATIONS , IN C HEIDI Ai : 4029S4046 9 Emerg : 4029S2975 7 Day : 8773668S4 4 LEVEL S COMMUNICATIONS , LEVEL S N A Alt : LL C Emerg : 877S668S4 4 Day : 402504782 S 

## METROPOLITA NUTILITIES MUDO l SAND Y MUD At : 

## DISTRIC T Emerg : 402504797 0 Day : 402444719 7 

## CITY O FOMAHA
- OMAHACO F RICH/TRAFFIC Alt : 402444516 1 TRAFFICSEWE R Emerg : 402444516 0 dhon.org/irthintemet/.../MessageText.as..
. 

### 1/ 2

### 3/31/201 1 ^ ^

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## Day : 406728934 S ^T.T.r^^T,T,c OMAHAPUBLIC POWEREL M _ .«....,.. . 0PPDGPR 5 j^j^^^ ^ LOCATIN G^ ^ 406207149 4 Emerg : 888728934 3 EI M Day : 406728934 3 QLNNEI C QWES T LOCALNETWORK TM\-T^T ^ 

## AH : 406207149 4 LULAllN O Emerg : 888728934 3

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. ' i o r-io|je.i( y RIGH TO F EK'TRYT O PREMISE S 

### Granto t (th e property ' ownei ) conssnl Kt o £.n d authorise s th e Unite o Siste?
. Environmenla l Protectio n Aoenc y(f:PA ) o i it s autiiorize d representsiives , collectivel y th e Grantee , t o ente rsn d perfor m certai n environmenta l lespons e activitie s upor i th e followin g describe d premises : —7 , -; , ^



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Ownei' s Name : Da^'tim e Phone : 

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Addres s o fPropert y covere d b ythi s Agreement ; 

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fioc.^i^L^ B D PURPOS E O F RESPONS E 

### AcTivniE 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 coniain s elevate d concentration s o flea d an d ma ypos 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 fCoasta l Environmenta l Group , contracte d b yUSEPA , wil l contac t th e CBranto 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 v/or 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 v\'it 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 

### B ysignin g thi s Acces s Agreement , th e Gianto ri s grantin g th e EPA , it s employees , contractor s sn d subcontractor s th e righ t t o ente rth e properly , a t al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e wor k Thi s acces s shal l remai n i n effec t unti l th e wor k ha s bee n satisfactoril ycornpleled
. Th e Granto rals o agree s to :

Pag e 1 o f2r . cAs " I k 1



### ' Remov e obstruction s includin g boats , trailers , vehicles , pisyscfip e iiemr , woo d piles , do o houses , etc ; < F^emove fiov>'e i bulb s o i piant s tha t th e Granto i o rth e Granloi' s lenan l t o save ; rna ywis h Wate ran d maintai n leplacemen l vegetation , iricludin g fertilize rapplication , necessa0 ' subsequen i t o a n inilia l v^'aterin g perio d b yEPA ; a s
< Abid e b yhealt h an d safet yguidanc e piovide d b yEPA ; I fth e properl yi s rented , assis t EP Ai n obtainin g tenant appiovg j fo i th e propert yt o perfor m th e work , acces s l o I Allo wvideotapin g and/o rphotographin g ofth e properly
. AGREEMEN THO I T o INTERFER E 

### Th e Granto ragree s no t t o interfer e o rtampe i wit h an yofth e wor k activities , o i Vv'it h an y o fth 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 fsai d property ' whic h woul d ten d l o endange rth e healt h o r welfar e o fth e Grantee s o rth e environment , o rt o allo wother s l 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

0 1 gran t acces s t o m ypropertie s D ' d o no t grzn t access t cm ypropertie s

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## Restoratio n Agreemen t Th e purpos e ofthi s agreement is.t o provid e amutual agreement a s t o condition s ofth e property 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 are complete dt o th e satisfactio no f th e property owne r an dth e UnitedState s Environmental Protectio nAgenc y (EPA) . 

# 2k2 ^

Property ID : l^QV^' j 600 0 -^ 0 2^3 9 Property Address : y^^ / fjCf^ffMUf. . if^O , Owner : 6;-fV Q t d m fit AD , 

### Phone : 

## m ^ WlM^ o Onthe attache ddiagram(s ) indicate area(s ) to excavate , surfac e strucuire s an dlandscapin g feature s an d acces s location(s ) to b e usedby the contractors . Indicate distances , depths , materia l types , etc . Photographicall y andVideographically document the existin g condition s ofth e propert y andth e basemen t i

f necessary . Item s t o b e Remove d b yth e Owne rbefor e Star t o fRemediation : Th e removal , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s respon s ibility
. Item : 

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### Landscap e Inventor y Ite m Quantit y Uni t Condition/Type/Specie s Pre-existin g propert y area , Quadrant s tha t will b e excavated , tha t 

# Z f i s covere dwit hgrass . Number of tree s > 2 inch Eac h trun k

diameter Numbe r of tree s <= 2 inch Eac h 

# ^i y trun k

diameter . Numbe r of Sprinkler Zones , Contro l Valves , Eac h Timers , Heads , etc . .^iiachaskeicho'i th e .sprii-il<,lei ' layoui . Number of an dsiz e of eachgarden / flowe r be d Eac h area . Square Feet Aiiin.:! ) a.';keicl i o'i relmi'. e ^•\zt ^ ;iri dlociiiioiis .

• ^greeduponvalu e o f plant material s not t o b e replace dby contractor . Nni p thi s MiliiC ' \\-\\ \l) c :i<e( l lo i,'>sii e nplai n vouche r I

dtlu
- propen y Easemen t Area , t o b e excavate d Pag e 2 o fC O AS T/ > L

Additiona l Comment s / Instructions : Th e cit yo fOmah a ordinance s ma yprohibi t yo u fro m usin g dir t o rgrave l area s o n you rpropert y a s driveway s o rvehicl e parkin g areas . Th e Environmenta l Protectio n Agenc y(EPA) ma yb e removin g an d replacin g soi l underlyin g a grave l o rdir t are a o n you rpropert ytha t yo u ma yb e usin g a s a drivewa yo rvehicl e parkin g area . I fthi s i s th e case , yo u shoul d understan d tha t thi s removin g an d replacin g o fsoi l doe s no t mea n tha t an yillega l drivewa yo rparkin g are a o n you r propert yi s mad e legal
. T o th e contrary , yo u ma yb e cite d b yth e cit yi fyo u us e a grave l o rdir t are a a s a drivewa yo rparkin g area , no t withstandin g an yremova l o rreplacemen t o fsoi l b yth e EPA
. Ifyo u hav e an yquestio n abou t legalit yb fa certai n drivewa yo rparkin g area , yo u ma ycontac t th e cit yo fOmaha' s Plannin g Departmen t a t (402 ) 444-5150 . [~ 1 Pleas e chec k thi s bo xi fyo u understan d th e informatio n outline d above
.

Q Chec k th e bo xi fOwne 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 no t responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures
.



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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1 

## Certificat e o fVerificatio n XL3t-3902 2 Readin g N o 7 4 Mod e SOI L Tim e 2011-04-0 6 19:5 1 Duratio n 90.6 3 Sequenc e Fina l Flag s AVERAG E Av g o f71-7 3 ADDRES S 152 1 Florenc e QUADRAN T B l DEPH T 4 " XR F TEC H M
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# Therm o SCIENTIFI C Therm o Fishe r Scientifi c 90 0 Middlese x Turnpik e Billerica , M A0182 1

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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

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pp m P b 291.39 4 Supervise d By : 

## Certificat e o f Verificatio n

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. MATEU S Confirmatio n CLEA R
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# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

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. MATEU S Confirmatio n CLEA R

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Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 S J^^2 ^

° Coasta l Environmenta l Grou p Inc
. V^*^^ * www.coastalhazmat.co m —

^"tPHo-it' ' COASTA L ENVIIONHENTA L GROUP , IN C 

# EXECUTIV ESUMMARY : BVID #26239-(152 1 FLORENC EBLVD ) No Issue s o r Concern s | ^ Issues/Concern s Detail Explanation : -DANGARVE Y WALKE D TH EPROPERT Y O N04/19/201 1

### Front : EN V

I ROWORK S LLC . 40 2 93 4 281 1 

## 04 1 1201 1 14:4 2 #13 9 P.010/01 1



## Propert yCompietlo n Agreemen t Ihi s agreemen l {k^culTlenI ^ th e completio n o l remedia l aciivme s perloime d o n m ypropert yM ysignatur e wil l dcMgiiai cIha l I a m salisrie d wit h th e restoratio n o fm yproperty , an d Iha l n o item s ar e m queslions
. now , o ra l an ylim e m th e future , excep t thos e ilem s liste d below , ifan y

Propert y 

## ''' • yu^^^n . Propcrf yAddress : t CZ^ { 

## P(.p-,M:£ - /^W ^ Owner : 

## CA M 

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. Phone : 

## J 0 ^ L^L{-li2.H9 > Restoratio n Ilem s I n Question :

Ilem : Ilem : Item : item : Item : Item : Additiona l CommenIs :

nd i nyrc rrutoralio n n complcttd , rxnp t M nolti f [ I I ft o nn t aurc crctloratin n i t roniplclcr i

littl e

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# ^ 1 EP APropert y Clos e Ou t For m Propert y tf : ^1^3^^^ / Propert y Address:,— ^ DBtc/Tirae : Owner' s Name: . / ^ L< i Quad s Excavated : Confracto r Crou p (Itn . Ye s N o Excavatio nGenera l 1 . If necessaiy , wer e th e correc t qtiadrant($ ) excavate dan drestored ? / 2 . If necessary , wer e th e correc t area s ofdri p zone excavaie dan drestored ? / Ye s N o Gradin e So dan dVcKctatio n I . Doe s th e gradin g aroun dth e perimete r ofth e hous e inexcavaie darea s generall y slop e away / fromtb e house ? 1 . Ha s so dbeenlai di nal l area s tha t wer e excavated ? / 3 . Doe s th e so dappea r to b e generBlt y health y andgrowing ? (Onl y evaluat e if inspecte da t a3 0 / da y tim e period ) 4 . Ar e sodde darea s generall y furnan devenl y graded ? / 5 . Ar e thejoint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e if inspecte da t a3 0 da y / tim e period ) 6 . Wa s th e property grade dsuc htha t wate r will no t poo l onth e propeny ? 

## y 7 . Wa s damag e t o landscapin g o r plant material s avoided ? / Gates , Fence s an dRctainlo e Wall s Ve s N u 1 . D o gate s openandclo.s e freely? (I f applicable ) / 2 . Wer e all gate s or fence s take ndow ndurin g restoratio nactivitie s reinstalled ? (If applicable ) 

# y 3 , Wa s damag e t o gate s or fence s avoided ? (Ifapplicable ) 

## y 4 . Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) ^ Foundation , SidioKan dGuder s Ye s N o I . Wa s damag e t o th e sidin g o r tri mavoided ? / 2 . Wa s damag e t o th e foundatio navoided ? 

# J 3 . Wa s damag e to window s avoided ? 

# f

^ Wa s damag e t o window s or doo r screen s avoided ? 

# J 5 . Wa s damag e t o downspout s o r downspou t extension s avoided ? 

# y Sidewali u an dDriveway s (Concrete ) Vc v N o 1 . Wa s damag e t o drivewa y surface s avoided ? 

# I 2 . Wa. s damag e t o walkwa y surface s avoided ? 1

# * m Orf'ner s comments :

JFnspectio nno<es :

Removal andrestoratio naclivate s complete includin g the 30-da y so dwarranry ; HP ARepresentativ e Q- ^ ^ Date : M\\*tV ^