### TRANSMI I lA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO N FIL EFOLDE R SAID# : 319.95 ^ Date : Address : '^^) H ^CC^ j ^- f Remediatio n Contractor : Envrionmenta l Restoration , LL C Year : 201 0 SOI LREMEDIATIO N PROPERT Y FIL E FOLDE RDOCUMENT S N ^ Video o f

propert y (DVD ) ^Befor e DAfte r

jZfBasemen t D ^ • , . Executiv e Summar y (Fina l Report ) jZ l EPA-providedpropert y sketc h ^ SignedAcces s Agreemen t foi : subject propert y Q . . SignedAcces s Agreement(s ) fo r

adjacen t propert y v^ r

Restoration Agreemen t

. D • Settlemen t documents (i.e. , fo r

damag e o r t o replac e plants , etc. ) J S Confirmation data ''S*

- • Photograph s JZ f

Befor e DCrew Photo s 0'Durin g Excavatio n D So d 'Ss^.O-da y SodD ^ . 0 As-built sketc h ^ Completion Agreemen t signe db y Propert y Owne r n / Propert y close-ou t chec k

lis t signe dby EP A D Description o f

area s not meetin g ROD cleanup criteri a J2 f

Utilit y clearance s p r Propert y information fromDougla s Count y Assessor' s Office J2^ Propert y acces s checklis t 3023757 9 

### j y Contact Log D ' Superfun d 

### Environmenta l Restoratio n Signature "Date " 

## ""VEMTOEI S Date " signatur e

# I Omaha 

### Lead Site--EP-R7-09-05 Environmental Restoration, LLC www.edlc.com 

# EXECUTIVE SUMMARY: 22295 

# - 251 

## 4 MARCY ST



## NO 

## Issr~es 

# or Concerns Detail Explanation:

# EPA EPA Propert y Clos e Ou t Form Omah aLea dSite OU# 2 ^rw^^'m^yimm^ t • ^ ' 

### Propert y #:_33^3r£
_ Propert y Address : 7^^) ^ t^jQ j 5 T Date/Time : Owner' s Name : ^v^{h>i ^ T!1PJQ&<J^ ? 

### Quad s Excavated : JJQ
. Contracto r Grou p : Environmental^Restoratlo n (ER ) Excavatio n Genera l Ye s N o 1 . Ifnecessary , wer e the correct quadxant(s ) excavatedan drestored ? 

## y 2 . Ifnecessary , wer e the correct areas of dri p zone excavatedan drestored ? /J/ j TsP r tVi\U./. « A J Avier i JL ' Gradin g Sodan dVegetatio n -Yes—No
1 . Doe s the grading aroun dthe perimete r ofth e hous e i n excavatedarea s generall y slop e avra y fromthe house ? 

# y 2 . Ha s sodbee n laidi n al l area s tha t wer e excavated ? 

# y 3 . Doe s the sodappea r t

o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecteda t 30-da y tim e period) . 4 . Ar e soddedarea s generall y fir man devenl y graded ? 

# y 5 . Ar e thejoint s betwee n the sodstrip s generall y tight ? (Onl y evaluat e if inspecteda t 30-da y tim e period) . 6 . Was th e propert y grade dsuc htha t wate r will not pool o n th e property ? 

### y 7 . Was damage 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 n an dclos e freely? (if applicable ) / 2 . Wer e al l gate s o r fence s taken dow n during restoration activitie s re-installed ? (i f applicable ) 

### y 3 . Was damag e t o gate s o r fence s avoided ? (i f applicable ) y 4 . Was damag e t o retaining wall s avoided ? (i f applicable ) 

### y Foundation , Sidin g an dGutter s Ye s N o 1 . Was damag e t o siding o r tri mavoided ? y 1 2 . Wa s damag e t o th e foundatio n avoided ? ^ 3 . Was damag e t o window s avoided ? y 4 . Wa s damage t o windo w screen s o r doo r screen s avoided ? • 5 . Was damag e t o downspouts 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 drivewa y surface s avoided ? ^ 2 . Wa s damag e to walkwa y surface s avoided ? 

### y Inspectio n notes :

(JOQ/^inB^Jo r so d


### Remedia l an drestoratio n activitie s complete includin g 30-da y so dwarranty : EP A Representatiyer/^ ^ ^^^^..jjLsfe ^ Date : fr/sj/i ^

### Ada m Detric h From : Heitman.Jason@epamail.epa.go v Sent : Wednesday , Apri l 28,201 0 2:4 7 P M To : Ada m Detric h Subject : Sampl e Results for4/28/201 0 Goo d aftemoo n Adam , Bot h QApropertie s fortoda ypasse d th e XR F screening
. Her e are th e results: 154 1 S 2 6 S t B1:37 7 251 4 Marc yS t 82:30 1 DZ:18 3 Than k you . Jaso n Heitma n On-Scen e Coordinato r U S EPARegio n 7 90 1 N
. 5t h Stree t Kansa s City , K S 6610 1 913-551-710 4

### m
Contac t Informatio n Lo g 

# U^l^f S SAID#
. Owner' s Name : jQ^^^^ ^ £lJl^ A T o I Paytim e Phone:/^^;^ ^ ^ ^ '^ J ^ 7 f H Property Address : ^ 5 /t ^ l/J^/pRCJ j ^ ^ Attemp t t o contac t Date/tim e Nam e 

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### Pag e 1 of 2
"> [ Creat e Anothe rTicke t " ) [ Bac k t o Irt h interne t ] Sen d Emai l 

### YOURTICKE T NUMBERI S 2459715 . Origina l Cal l Date : 4/10/1 0 Time : 1:2 8 p m Op : TRACY2418 6 Wor k t o Begi n Date : 4/14/1 0 Time : 7:1 5 a m State : NE County : DOUGLA S Place : OMAH A Address : 251 4 Street : MARC Y S T Twp : 15 NRng : 13 E Sect-Qtr : 21-S E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Excavatin g th e entir e propert y Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)451-106 9 : SAI D #2229 5 Compan y: ENVIRONMENTA L RESTORATIO N Contact Name : TRAC Y BRISTO W Phone : (402)451-131 4 Alt . Contact : Phone : (314)504-487 4 Wor k Bein g Don e For : EP A Dept h o f Excavation : 1 2 . Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V LEVEL 3 MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

Servic e Are a Contac t Phon e Nunibe r Utilit y Typ e 

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

### Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL S LEVEL S COMMUNICATIONS , LL C N A 

### Alt : Emerg : 877366834 4 Day : 402504782 3 MUDO l METROPOLITA N UTILITIE S DISTRICT SAND Y 

### Alt : 

### Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC.SEWE RRICH/TRAFFI C Alt : 402444516 1 

### Emerg : 4024445160
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.. . 4/10/201 0

### Pag e 2 of 2 Day : 406728934 3 OPPDGPR S OMAH A PUBLI C POWE RDISTRIC T EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3 QLNNEI C QWES T LOCA LNETWOR K

, Day : 406728934 3 EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 4/10/201 0

## Propert y Acces s Checklis t 

# MAu»^;?zf 5 j j^,.^r^,AL-^-.};I S 11 ^ ^>o^^- y



## Phone : y^ ^ J^ f fS/ ^ Fax : Cell/Pager : n WOk K STARTED aWOR K COMPELTE D ON : / / 

## ' ^ Renter : Phone : Fax : Cell/Pager : Additiona l Infonnation :

p ^ Acces s Agreement Signed : ^1^1 ^ By : 

# = 2 ^ ly

^ Restoratio n Agreement 

### Signed : J^/f^/ ^ 

## ^yiJ ^ [ 3 Vide o Property Befor e O n :ii_/i£_/lO . By : 

### AS L 1 ^ Digita l Photo s Befor e O n ^ / G/t O gy ­ :^€ > • Vide o Property Afte r O n / / By : n Digita l Photo s Afte r O n / / By : T ^ Propert y Completio n Agreemen t Signed : X I ^ l/ o 

## By = / ^ iW3r
• Fina l Report Signed : / / Additiona l Vida o o r Digita l Photo' s Taken ; D Vide o n Digita l Photo O n / / By : Reason : n Vide o n Digita l Photo I O n : / / Reason : D Vide o D Digita l Photo j O n : / / 1 B y Reason : n Video , n Digita l Photo O n By : Reason :

Omah a Lea d Projec t Wor k

Pla n Pag e I o f 1 9

### i^irss at ^ 

## Consen t ror Acces s t o Propert y SAlD#g<^^? S RIGH T O FENTR Y T O PREMISE S 

### Granto r (ih e propert y owner) , consent s t o an dauthorize s ih e Unite dState s Environmenta l Pioieciio n Agenc y (USEPA ) o r it s authorize drepresentatives , collectivel y th e Grante e t o ente r an dperfor mcertai n environmenta l respons e activitie s upo n th e followin g describe dpremises ; Owner' s Name; 

## tJ^^J > J^UXir/cYe f I Daytim e Phone: Y^p; ? '^f^SS/ ^ 

# r^— — Address : 

# • 2.$i H t*^/?/z^ V Address : Addresse s o f Propertie s covere db y thi s Address : Agreement : Address : Address : PURPOS E O FINVESTIGATIO N 

### Th e purpos e o f th e remedia l activitie s i s t o remov e al l soil s at th e propert y whic har e contaminate dwit hhazardou s substances , i n particular lea dat concentration s greate r than.o r equal t o 40 0 part s pe r millio n (ppm) . REMEDIA L ACTION S 

### Th e envirorunenta l respons e action s t o b e perfomie do n sai dproperty ma y includ e th e followin g activities : a .Takin g photograph s and/o r vide o o f th e propert y before , during , an dafter remedia l activities ; b .

Locatin g equipmen t andmachinery on-sit e i n preparatio n fo r an di n th e cours e o f th e enviromnenta l response ; c .Plannin g an dimplementin g th e removal actio n o n o r near Grantor' s property . d .Obtainin g sample s fromGrantor' s property ; AGREEMEN T NO T T O INTERFER E 

### Th e Granto r agree s not t o interfere o r tampe r withan y o f th e activitie s o r work done , o r th e equipmen t use dt o perfor mth e activities , o r t o undertak e an y action s regardin g th e us e o f sai d propert y whic hwoul dten dt o endanger th e healtho r welfar e ofth e Grantee s o r th e environment , o r

t o allo w other s t o us e th e property i n suc h H I gran t acces s t o m y propertie s n I d o no t gran t acces s t o m y propertie s 

# y . ^ ^ ^ 

# y-2 . / ^ 

### Signature Dat e Signature Dat ecaEg'^iS-.a^ffiS a SiS l


### Additiona l Comment s / Instructions :

• Chec k thi s bo xi f owne rdoe s not wan t E.R
. t o ente rth e resident s t o documen t interio r foundatio n wall s an d possibl e preexistin g damage
. Bycheckin g thi s bo xE.R
. i s not responsibl e fo ran ydamag e don e t o th e interio ro f house , includin g foundatic n crack s o rfissures
.

I agre e Old o no t agre e 

## D l agre e Q I do no t agre e 

# fc^^V^ ^ - 2 . - / Owner' s Signatur e Dat e Contractor' s Signatur e Dat e

## Restoratio n Agreemen t Th e purpos e o f ilii s agreemen t i s t o provid e amutua l agreement a s t c ccndition s of propert y prio r to contracto r activiiies . Thi s wil l als o serv e a s documentatio n for th e purpos e o f assurin g tha t restoratio n activitie s are complete dt o th e satisfactio n o f th e propert y owne r an dth e Unite dState s Environmenta l Protectio n Agenc y (EPA) , SAID : 

## ^yj^Cf S Propert y Address : ^i^ l L j yi^Tj^J ^ ^ V 

# -:r r Owner:^^

­ ^^^^ ' (j^tj^^/JT ^ Phone ; 

# ~^f^ f O n th e attache ddiagram(s ) indicat e area(s ) to b e excavatedanddept hof excavation , locatio n of al l know n utilities , subsurface features , surfac e structure s an dlandscaping features , acces s location(s ) t o b e usedb y contractor , an dth e directio n o f North . Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s b y referencin g th e photo-lo g numbe r wit ha n arrow indicating directio n of view .
ttem s t o b e remove db y Contracto r an dno t replaced : Item :

Pag e 1 o f 2

### Additiona l Comment s / Instructions :

filagre e D I do no t agre e [Dlagre e Q Ido not agre e 

# 'i^^*^y-^\z.-y Signatur e Dat e Owner' Owner' s s Signat u Contractor' s Signatur e Dat e 

## Attachments

Pag e 2 of 2e'^^Ss p 

## Propert y Completio n Agreemen t Tlii s agreement dociihient s the completio n of remedia l activitie s performedo n m y property . M y signatur e wil l designat e that I a msatisfie dwit hthe restoratio n o f m y property , an dtha t no items ar e i n question , now , o r a

t an y time i n the future , excep t thos e item s liste dbelow , i f any . Property Address:^5/ y j^*-y/^/?< ^ > V ^ " ^ Owner:^^ ^ -^^ ^ f^l^/ST^ ^ Phone : y Restoratio n Items i n Question : Item : Item : Item : Item : item : Item : Additiona l Comments :

I agre e restoratio n i s completed , except a s note d r\I agre e restoratio n i s completed , except as note d I I I d o no t agre e restoratio n i s completed I 1 1 d o no t agre e restoratio n i s completed 

# Si£jlM ^ Owner' s Signatur e 

### Dat e Contractor' s Signatur e Dat e

### uougia s uoimt y Accoun t Intormatio n Pag e 1 01 3 Dougla s County , Nebrask a Propert yRecor d - R171310000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e O-S O ft wes t o f S2n d S t - Vie W O n Ma p informatio n i s vali d a s o f 2009-12-1 5 Treasurer' s Ta xRepor t Ne wFeatur e ->->- > Aut o Sale s Searc h Owne r DELGAD O EVARIST O ETA L 2521 MARC YS T OMAH AN E 68105-000 0 Propert yInformatio n Ke yNumber : 131 0 000 0 1 7 Accoun t Type : Residentia l Parce l Number : 171310000 0 Parce l Address : 251 4 MARC YS T OMAH AN E 68105-000 0 Lega l Description : MARSH S AD D LO T8 BLOC K1 E 1/ 2 LT7 & AL L 79. 5 X 12 0 Valu e Informatio n 

### 2009 200 8 200 7 

### 200 6 200 5 200 4 Lan d $9,000.0 0 $9,000.0 0

$0.0 0 $6,200.0 0 $6,200.0 0 $6,200.0 0 Improvemen t 

### $46,600.00 $46,600.00 $0.0 0 $62,400.0 0 $62,400.0 0 $62,400.0 0 Tota l $55,600.0 0 $55,600.0 0 $0.0 0 $68,600.0 0 $68,600.0 0 $68,600.0 0 Sale s Informatio n Sale s Date : 2008-03-2 8 

### Dee dType : Price : W D $25,000.0 0 Book : 200 8 Page : 03073 8 Grantor : SECRETAR YO F VETERAN S AFFAIR S Grantee : DELGAD O EVAREST O ETA L Valid/Invalid : Invali d £xc/us/o n Reason : Sal e b yGovt Agency Sale s Date : 2007-06-0 7 Deec f Type : TR D Soofr : 200 7 Page : 06687 8



### Price : $0.0 0 Grantor : LINDQUIS TERI C H


### http://douglasne.mapping-online.com/DouglasCoNe/static/accountiiifo.jsp?accountoo=Rl. . . 12/21/200 9

### uougia s County Accoun t Intormatio n Pag e 2 o f 3

Grantee : DEPARTMEN TO F SECRETAR Y O F VETERAN S AFFAI R Valid/Invalid : Invali d Exclusio n Reason : Sal e t o Govt Agenc y Sale s Date : 1997-04-2 2 Dee d Type : Book : 205 9 Page : 62 6 Price : $36,000.0 0 Grantor : Grantee : Valid/lnvalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.2 2 9600. 0 1. 0 120. 0 80. 0 N o Improvemen t Informatio n Buildin g 1

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HVAC : 1460. 0 0. 0 1 1/ 2 Stor yFi n Force d Ai r Percen t Complete : Quality : 

### Condition : Cond o Squar e Footage : Rooms : 100.0 % Averag e Fai r 0. 0 9. 0 Exterior : Interior : Roo f Cover :

Roo f Type : Floorcover : Fram e Viny l Drywal l Compositio n Shingl e Gabl e Allowanc e Units : Baths : Bedrooms : 

### Stories : Foundation : 1. 0 1. 0 4. 0 1. 5 Bloc k


### http://douglasne.mapping-online.com/DougIasCoNe/static/accountinfo.js p ?accountno=Rl.. . 12/21/200 9

### uougia s v^ount y Accoun t intormatio n Fag e 3 of 3 Sprinkle rSquar e Footage : 0. 0 YearBuil t Yea r Remodele d 188 8 0 Detai l Typ e Applianc e Basemen t Fixtur e Fixtur e Porc h Porc h Porc h Percen t Remodele d 0 % Detai l Descriptio n Allowanc e Bsmn t Bloc k 8 ft Bas e Fixture s Bat h Ful l Sla b Roo f Ceilin g Sla b Roo f Ceilin g Woo d Dec k Adjuste d Yea r Buil t 188 8 PhysicalAg e 12 1 Unit s 1. 0 900. 0 1. 0 1. 0 160. 0 40. 0 168. 0



### http://douglasne.mapping-onlme.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl.. . 12/21/2009

### ENVIRONMENTA L AS-BUILT DRAWIN G 'OMAH ALEA D SUPERFUN D SITE ' RESTORATIO N 

### 2229 5 Omah a Lea d Sit e Exterio cPain t Nort h Arrow Owne rName : DANIE L RANDOLP H Sit e Sketc h Address : 2514^MARCY_S T • Poo r

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