### TRANSMITTA L O F OMAH A LEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : 

### 2908 7 DATE : 12/15/201 0 ADDRESS : 151 3 OHI O S T REMEDIATIO N CONTRACTOR : PRUDEN T TECHNOLOGIES . INC . YEAR : 

### 201 0 

### SOI L REMEDIATIO N PROPERT Y FIL E FOLDE R DOCUMENT S H PRE AN D POS T VIDE O O F PORPERT Y (DVD ) M EXECUTIV E SUMMAR Y BT^EPA-PROVIDE D PROPERT Y SKETC H O^SIGNE D ACCES S AGREEMEN T FORSUBJEC T PROPERT Y D SIGNE D ACCES S AGREEMENT(S ) FOR ADJACEN T PROPERT Y

• RESTORATIO N AGREEMEN T D SETTLEMEN T DOCUMENTS (I.E. , FOR DAMAG E O R TO REPLAC E PLANTS , ETC. ) H^ONFIRMATIO N DAT A 

### S ^ PHOTOGRAPH S ^ O AXLJU A 

### <-cA , D^S-BUIL T SKETC H H SATISFACTOR Y RESTORATIO N SIGNE D B Y PROPERT Y OWNE R B^ROPERT Y CLOSE-OU T CHECKLIS T SIGNE D B Y EP A a DESCRIPTIO N O F AREA S NO T MEETIN G RO D CLEANU P CRITERI A H UTILIT Y CLEARANCE S D PROPERT Y INFORMATIO N FRO M DOUGLA S COUNT Y ASSESSOR'S OFFIC E 

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# MiDiiiini i Superfun dFin d Record 

### Backfill :

Sampl e Area : 2908 7 -151 3 OHI O S T Owner : D Owne rOccupie d Owne rName : jCrTY O F OMAH A Owne rAddressl : |C/ 0 CIT Y FINANC E Owne rAddress2 : [181 9 FARNAM S T City : State : Zi p Code : lOMAH A |N E [68183 - Owne rPhon e Alternat e Phone : [(402 ) 441-515 0 

# 1

Contract : 

### • Contractor : PRUDENT2010 . 

### . S Contrac t Optio n OPTIO N 2 Remediatio n Quer y Lea d Remainin g Quer yJ Propert yDamag e Quer y 

### Use rProvide d Owne rInformatio n Owne rName : 

# 1 Owne rAddress : 

# 1 City : 

# 1 State : Zi p Code : 

# 1— 1 Owne rPhone : 

# 1 Alternat e Phone : 

# 1

Assessment : Qualifyin g Grou p 40 0 Assessmen t Ma xXR F Valu e | 495. 8 Resident : Residen t Name : 

# I Propert yAddress : |l51 3 OHI O S T Zi p Code : [68110 - Residen t Phon e 

# I

### PROPERT Y SUMMAR Y Date : 12/15/201 0 Oniah aLea dSite Remedial Actio n Contrac t #EP-R7-07-0 6 TO# l Mont h of : Decembe r Propert y Address ; I51 3 0fflOS T A . EXECUTIV E SUMMAR Y A. I 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 Information : NON E CONFIRMATIO N SAMPLIN G DATA/RESULTS : B 2 = 38 2 PP M @ 8" ; N O EASEMEN T ATTACHMENT S 1 ) Propert y sketch providedb y EP A pursuan t t o contrac t specification s 2 ) SignedAcces s Agreemen t including acces s agreement s requiredfo r crossing othe r propertie s 3 ) Pre-Excavation digita l vide o clip/photograph s 4 ) Post-Excavation digita l vide o clip/photograph s 5 ) Documentation - CompletedClose-ou t Checklis t 6 ) As-Built sketch i ) Shall include fina l lea dlevel s v ) Legen d ii ) Contaminatio n lef t behin darea 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 , i f available , or obtainedinclude : i ) Pre-excavatio n agreemen t detail s (ifan 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(Flash Player ) forma t and/or photograph s iv ) Signedfor mverifying satisfactor y restoratio n v ) Description o f area s not meeting Interi mRO D cleanu p criteria .

TECHNOLOGIES , INC .

# EMffiiM a ' TBCHNOUDCmS . INC . 

### Propert y # : '27\0^^ Date/Time : Quad s Excavated : (^2 — .••••• ' • • i?*' ^ P ^ '^'9-~^ ? » . | K 

# EP A Propert y Clos e Ou t Propert y Address : | ^|"? > 6^' C ^ ' Owner' s Name : ^:^^^ J «^f ^ ^'mak' t Contracto r Group : Pruden t Technologies , Inc. , Excavatio n Genera l Ye s N o 1 . J f necessary , wer e th e correc t quadjrant(s) excavatedandrestored ? 

## y 2 . I f necessary . wer e th e correc t area s o f drip zone excavate dandrestored ? 

# y Gradin g So dan dVegetatio n Ye s N o 1 . Doe s th e gradin g aroundth e perimete r o

f th e hous e i n excavate darea s generall y slop e awa y / fro mth e house ? 2 . Has so dbee n laidi n all area s tha t wer e excavated ? 

## y 3 . Doe s lli e sodappea r t

o b e generally health y andgrowing ? (Onl y evaluate i f inspecte dat a3 0 

## y da

y lime period) 4 . Ar e soddedarea s generally fir man devenl y graded ? 

# y 5 . Ar e th e joint s between the sodstrip s generall y tight ? (Onl y evaluate i f inspecte da t a3 0 da y / tim e period ) 6 . Wa s th e propert y grade dsuch tlia t wate r wil l not pool o n th e property ? / 7 . Wa s damag e to landscapin g o r plan t material s avoided ? 

## y Gates , Fence s an dRetainin g Wall s \k s N o 1 . D o gate s ope n andclos e freely ? (Ifapplicable ) / 2 . Wer e all gale s o r fence s taken dow n durin g restoratio n activitie s reinstalled ? (I f applicable ) 

# y 3 . Was damag e to gate s o r fence s avoided ? (Ifapplicable ) 

# y 4 . Was damag e t o reiainin g wall s avoided ? (Ifapplicable ) 

# y Foundation , Sidin g an dGutter s Ye s N o I . Was damag e t o th e sidin g or trimavoided ? / 2 . Was damag e t o th e foundatio n avoided ? 

# y 3 . Was damag e l o window s avoided ? 

# y 4 . Was damag e to window s or door screen s avoided ? 

# y 5 . Was damag e to downspout s or downspou t extension s avoided ? ^ Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 . Was damag e l o drivewa y surface s avoided ? / ^ 

## y 2 . Was damag e to walkwa y surface s avoided ?

## Owner s comments :

Inspectio n notes :

Remova l andrestoratio n activate s complete includin g th e 30-da y so dwarranty : EP A Representativ e ^'^A ^ ^Date: lol^*'!" *CHNOLOGIES , IN C 

## A S - BUIL T DRAWIN G OL S U 2908 7 Dat e Excavated : 10/08/201 0 

## OMAHA LEAD SUPERFUND SIT E liSEPASigned-OffDate :

Omah a Lea d Sit e Owne rName : OUf ^ Sit e Sketc h Ad d ress : isi 3 S I aur o S /

Phone : H : 

# I Lea d Sampl e Sample s Collecte d Sampl e Numbe r LA B Concentratio n Collecte d Firm : ^/r S RYASCPXA - F1 pp m 

### D Date ; s^-^' V RYBSCPXA - F 2 

## 27 ^ pp m 

### Q - D Time : /'i^ y RYCSCPXA - B 1 

## ^9 0 pp m 

### Q- D Sample s Analyze d RYDSCPXA - B 2 ^ '^0 ' pp m 

### Q

# n RDZSCPXA - BZ - 

### D pp m XR F Unit : ^O ^

Book : ^ C S 

### D RGZSCPXA -GZ - pp m 

### D Date : RPZSCPXA -PZ - pp m 

### D D Time : 

### D Staff : Numbe ro f Sample s = _i ^

Omah aLeadSit e N O EASEMEN T CONTRAC T # : EP-S7-10-0 5 PRUDEN T TECHNOLOGIES , INC . 4613 0

# »EPA Propert yCompletio n Agreemen t Thi s agreement document s th e completio n o f remova l activitie s performe don th e belo w liste dproperty . Th e propert y o\yiier' s signature indicate s tha t th e propert y owner i s satisfie dwit h th e restoratio n ofth e subjec t propeily , andtha t n o :item s ar e i n question , now , o r a

t any tim e i n th e future , excludin g any remainin g warrant y (3 0 day s total ) excep t thos e item s liste dbelow , ifany . Properl yID : 

### Propert y Address : \c,i h OK o ^c A Owner : Phone : Restoratio n Item s I n Question :

item : Item : Item : Item : Item : Item : Require d correction s t o comptet e th e property :

^

I agre e restoratio n i s completed . E H I d o no t agre e restoratio n I s complete d a t (note d deficiencie s above )



### <i?J > - QcJrA^-^O/ O Dat ePruden t IVchnologlcs , Inc . (Prudent ) i s unde rconirnc i wit h ihcU . S . Rnvironmcniii l Proleclio n Agenc y(IZPA ) l o clean u p lead coiilaininiiie d soil s n l a numbe rol'properlics Incalcdi n Omalia . Nebraska , includin g ih c properl yIcicaic d a l 1 5 I ^ '/^^B " f^'"*" ^

Sli/cJ.,! " . Th e HP A request s j-oii rpennissio n l o allow Pruden t l o pcrroin i a soil.clcanu p n l Ihi s pmpert yto remov e Icnd-comaminMc d soil . B ysignin g ihisrorm . ih c proiieil yowne rgiani s pemiissio n t o Pruden t t o pcifor m aclivitie s related l o ih e cleanu p includin g soi l sampling , remova l orieud-cunlnmiiiaie d soil , and resioralio n ol'lh e relerencc d property . Ifyn u hav e an yquestion s abou t th e soi l cleanu p planne d fo ryou rproperty , pleas e contac t Piiidci u soutlioiric c .Ib rth e Omali a Len d Site cleanup-a l (-102 ) 733-1188 . Genera l queslion s abou t ihe.Omali a Lea d Site cleanu p can b e directe d l o ih e liP A Publi c Inrormatio n Center s a

t (402 ) 731-304 S (South Omaha oFTice ) o r(402 ) 99 l -938 3 (Non h Omaha office) . Propert yAcces s Granted By ; ly/'lli'/ i I'l ^ L.Lr/)jl j (Pleas e Prin t Name ) Propert y0«n e rSignaiurc : 'Tz/t^'r^ / ^^..^^^7^^ . J>C^ f /

-.JOi O (Signaiure) (D.-ite ) PROPERT Y INFORMATIO N (T o b e enmplftc d b yreiidcn l and/o rproperl yowne r- pleas e print ) RESIDEN T NAME : Owne r Rente r RESIDEN T ADDRESS : . » . 

# ^ A^^ ^ kIC ? CS^f / D I F RENTAL , PROPERT Y OWNE D BY : OWNER' S MAILIN G ADDRESS ;

/jt^- l ]W^/i,y , SV. , ^i./,L/ll i 7^7.v/il-t \ .V6 : 6i'l\ \ OWNER' S TELEPHON E NUMBE R • HOME : J _ WORK :

i^/tfA i ^/v^/ - vyy r AG E O F HOME? : YEARS . HOW LON G HAV E YO U LIVE D HERE ? YEARS . HA S TH E EXTERIO R BEE N PAINTE D O R COVERE D WIT H SIDIN G SINC E 1978 ? 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 NUMBE R O F CHILDRE NUNDE R 7 YEAR S OL D WH O PLA Y I NTH 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. )

A U 1 1 lOKIT Y FOKENVIKONMBNTA L RL'SPONSI Z ACTIONS ; Th e aciiviiie s l o b e implcnienle d byl-P A unde rIhi s agreemen l ar

c pursiinn i to iJcclio n 10 4 o f CERCLA . 4 2 U.S.C . 9604 . (iPA' s righ t o f acces s l o th e piopen yi s provided'lb ri n Sectio n 104(c ) o f CliKCLA , 4 2 U.S . C 960S(e) . whic h provides enir> ' fo r"deienninin g ih e nee d fo rresponse , u rchoosin g u rtakin g an yrespons e aclio n unde rihi s title , u ruihcrwis e enlorcin g th e provisiun s oflh e liile. " 80B 0 War d Parkway , Suit e 40 S 5600 S los t 424 2 Medica l Drive , Suit e 426 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6810 7 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)733-118 8 Phone : (210)822-968 8 Fax:(816)363-370 7 Fax : (402)733-188 3 Fax : (210 ) 579-657 7

# E IP * 2:^03* 7

Omah aLea dSite 4613 0

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Creat e Anothe rTicke t Bac k t o Irt h Inteme t 

### Sen d Emai l 

### YOU RTICKE T NUMBE RI S 2609471 . Origina l Cal l Date : 10/05/1 0 Time : 4:3 6 p m Op : SIVA1896 7 Wor k t o Begi n Date : 10/07/1 0 Time : 5:0 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 151 3 Street : OHI O S T Twp : 15 NRng : 13 E Sect-Qtr : 10-SE-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : SOI L LEA D REMEDIATIO NPROJEC T Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (402)733-188 3 : UNSUR E CORNER S Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : SIV AJAMPAM A Phone : (402)733-118 8 Wor k Bein g Don e For : EP A Dept h o f Excavation : 6 F T Corne r Lot : NFront : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V MCINE B MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Area . Contac t Phon e Numbe r Utilit y Typ e CXCAT V CO X COMMUNICATIONS , IN C HEID I 

### Day : 402934046 9 Alt : 402934046 9 Emerg : 402932975 7 MCINE B MC I N O CAL L PER MEMO 

### Day : 800289342 7 Alt : Emerg : 800289342 7 MUDO l METROPOLITA N UTILITIE S DISTRIC T SAND Y 

### Day : 402504782 3 Alt : Emerg : 402504797 0 OMAHACO FCIT Y O FOMAHA-TRAFFIC.SEWE RRICH/TRAFFI C 

### Day : Alt : 402444719 7 402444516 1 Emerg : 402444516 0 

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0PPDGPR 5 OMAH A PUBLI C POWE RDISTRICT EL M LOCATIN G 

## Day : 406728934 3

Alt : 406207149 4 

## Emerg : 888728934 3 QLNNEI C QWES T LOCA L NETWOR K

EL M LOCATIN G 

## Day : 406728934 3

Alt : .406207149 4 

## Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.. . 10/5/201 0

### ENVIRONMENTAL ENGINEERm G AN D CONSTRUCTIO N iceHNouwies , INC . SOLUTION S 

## SIT E SAFET Y HAZAR D ANALYSI S 

# -y-z o Addr».,:/ 5 / ^ Ohl ^ r/ " Excavatio n Date : j^- y 

# Crew : T^-^l-- ^ ' f/^^.^ ^ Backfil l Date :

Ite m Conditio n Hazard s Correctiv e Actio n Overliea dLine s Septic/Leec h Fiel d Propane/Butan e Sidewal k ^ 

## Foundatio n 

## Retainin g Wall s 

# 2^ ^ / - 

## Fence s Tree s ^ 

## Structure s ^ ^ ^ 

## Driveway Sprinkle r Syste m 

# othe r 

# 2 © / " ^ 

# ^7 7 " 

# 5ftC T y ^ ^ " ^ 

# 1 - Cre w Forema n Sit e Safet y Offic e

. Date :

,Suto40 5 StOOSIOS t 424 2 Medica l Drive , Suit e 72S 0 tGHy . M O 6411 4 Minika<810 7 Sa n Antonio , T X 7B22 9 Pfiane:f8i6)363^aT0 3 Phom : (402)733-11t 8 Phone : (210 ) 822^958 8 Fax:(B16)36»470 7 ^ZOL : (402)733^1tt 3 Tax : (210)570-657 7is?^: ­ 

# 75/ 3 Ol i t o s f VACA/^ T^- r 

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