## TRANSMITTA Lof OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R 

# L SAI D # : 

# \ov % Date : \'^' ^ 

# Add,..: te n1 yi^ ' w Remediatio nContractor : Coasta l Environmenta l Group _ Year : 200 J ^ 

### SOI LREMEDIATIO N PROPERT Y nLEFOLDE RDOCUMENT S Vide o o f property (DVD ) Executiv e Siunmar y 1 / 

### EPA-providedproperty sketch SignedAcces s Agreement fo r subject property SignedAcces s Agreement(s ) fo r adjacen t propert y Restoratio nAgreement Settlement document s (i.e. , fo r damag e o r to replac e plants , etc. ) Confinnatio ndata 

## -e Photograph s t/^^rWv ^ V fP f hyC'CAVfi-V^ ^ As-built sketch Satisfactor y restoratio nsigne db y Propert y Owner 4033385 3 

### Propert y close-out check lis t signedby EP A Superfun d -B - 

### Descriptio no f area s no t meetin g RO D cleanup criteri a Utilit y clearance s Propert y informatio nfro mDougla s Count y Assessor' s Office

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## Propert yAcces s Checklis l Propcrr ^ LD : nWOR K STARTt D ON 

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## P.on c/^|3-2 Q f)/ 7 CP4.^ % FIX : Cclt/Tage r
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# / f Acce u Agreemen t Signed : a_/23/^ 9 Bj : I [ ^ Restonjtio o Agreemen t Signed : & /2 7 ' 0 ^ By : D Topsoi l Stmplin g (i f tpplicublt ) / / B y O Dispoii U SiiDplin g (r f iipplicabte ) B j : •Gnrdc n Snmplio g (i f »pplicftblf ) / By : Uiilit yClearanc e Culled : ^/^/0 9 

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DVideo/Photo s (Before ) O n By :

• Video/Photo s (During ) O o Bv : n Video/Pholo * (After ) O n By : G .'A'itko/I'hoto s (30-D*y ) O n : / / ^ y Propert yCompfelio n Agreemen i Signed^/^/ ^ 

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D Communtt yC H Cre w O D : / / By : Rcsuii y D ComraunitA ' Q C^cy ^ On : / / By ; Results : D Comcnunir i Q Cn; « O n 

## / / j By : RMUIU :

Omah a Lea d Stt e

## Douglas Count y Accoun t Infooa^io n Pag e 1 of 3 >a|^ i 

# 0 Dougla s County , Nebrask a Propeit yRecor d - R043208000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e O ) scal e 0-5 0 f i wes t o f 52n d S t - VlO W O n Ma p Informatio 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 DELEO N JOS E ETA L 1775 2 MARG O S T OMAH AN E 68136-000 0 Propert yInformatio n Ke yNumber : 320 8 000 0 0 4 Accoun t Type : Residentia l Parce l Number : 043208000 0 Parce l Address : 460 7 S 3 2 S T OMAH AN E 68107-000 0 Lega l Description : SOUT H OMAH ACITYLOT S LO T1 3 BLOC K35 7 5 0 X 13 0 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $11,400.0 0 $58,300.0 0 $69,700.0 0 200 8 $11,400.0 0 $58,300.0 0 $69,700.0 0 200 7 $11,400.0 0 $42,300.0 0 $53,700.0 0 200 6 $11,400.0 0 $42,300.0 0 $53,700.0 0 200 5 $11,400.0 0 $22,400.0 0 $33,800.0 0 200 4 $11,400.0 0 $20,400.0 0 $31,800.0 0 Sale s Informatio n Sale s Date : 2006-04-1 3 Dee d Type : TR D Book : 200 6 Page : 04183 9 Price : $72,000.0 0 Grantor : ROBER TJ MIKLA S T R Grantee : JOS E D E LEO N ETA L Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 2005-04-2 7 Dee d Type : Q C Book : 200 5 Page : 04972 0 Price : $0.0 0 Grantor : Bemic e M Mikla s 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R04.. . 8/22/2009iri|||^i < 

### Dougla s County Accoun t Inforn||^io n Pag e 2 of 3 # Grantee : Bernic e M Mikla s Truste e Valid/Invalid : invali d Exclusio n Reason : Famil ySal e Lan d Informatio n Acre s ! S F Unit s Dept h Widt h Vacan t 0.1 4 6500. 0 1. 0 130. 0 50. 0 N o Improvemen t Informatio n Buildin g 1 1 1/ 2 Stor yF m 4e0 7 S 32 S t

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## t I i I S

eosa R e«rttfffEKKk8 R IT?4a? 0 ^ CLIC KT O ENLARG E IMAG E CLIC KT O ENtj\RG E IMAG E Squar e Footage : 1024. 0 Percen t Complete : 100.0 % Perimete r0. 0 Quality : Fai r Uni t Type : Condition : Goo d

Buil t As : 1 1/ 2 Stor yFi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 5. 0 

### Exterior : Fram e Sidin g Units : 1. 0 

### Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : 1. 5 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 190 0 0 % 190 0 10 8 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 ft 624. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Porc h En d Soli d Wal l 80. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R04. . . 8/22/200 9

## Dougla s Count y Accoun t InfoMMtio n^ ^ Pag e 3 o f 3 i^a^o n^ ^ Porc h En d Soli d Wal l 108. 0 Use rML S UPDAT E 1. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R04.. . 8/22/2009

## Propert y ID # Propert y Address : Initia l Contact : Secon dContact : Fina l Contact : Fina l Action :

Comment : Owne r Commen t (s) : Sit e Coordinato r Commen t (s) : # 

### #


## CONTAC T FOR M lOO^l^ , HloD T'b -K LS V Date : Time : Action : Date : Time : Action : Date : Time : Action : Transmi t t o EP A D Othe r Action : DI 

### Pag e 1 of 2 #

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### c.^: i Bac k t o irth Interne t I Sen d Emai l



### • YOU RTICKE T NUMBE RI S 2353593 . Origina l Cal l Date : 8/31/0 9 Time : 4:1 7 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 9/02/0 9 Time : 4:4 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 460 7 Street : S 32N D S T Twp : 14 NRng : 13 E Sect-Qtr : 04-NW-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remediatio n Locatio n o f Work : INCLUD E AL L EASEMENT S LOCAT E ENTIR E PROPERT Y Remarks : FA X 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 : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V METR O MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F



### Servic e Area Contac t Phon e Numbe r UtiUt y Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 Day : 402457230 7 METR O METR O COMM . COLLEG E CHRI S Alt : 402672703 3 Emerg : 402457231 3 Day : 402504782 3 MUD0 2 METROPOLITA NUTILITIE S DISTRIC T SAND Y Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO N Alt : 402444516 1 Emerg : 402444516 0
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 8/31/200 9

### Pag e 2 of 2 # 

### 0PPDGPR 6 OMAH A PUBLI C POWE RDISTRIC T N A Day : 406728934 3

Alt : 406207149 4 Emerg : 888728934 3 QLNNEI FQWES T LOCA LNETWOR K

N A Day : 406728934 3

Alt : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 8/31/200 9OLS# : 1009 6 

# As-Buil t Drawin g € | Dat e Excavated:9/9/0 9 Dat e USEP ASigne d Off : 10/7/0 9 COAST AL 

# Omah aLea dSuperfun dSit e Are a Sodden : 81 0 s o f t ENVIRONMENTA L GROUP , IN C

Name : Omah a Lea d Sit e Address : Sit e SItetc h 

## ' u^o n <>. ' 

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­ »5 « Ye s • N o CZk - Ye s '- J N o CD- - Ye s CD N o Cil- ^ 

## 0 ^ Ye s CD N o C D Ye s • N o •

Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wit h So d Are areplace dwit h Rock/Mulc h Are alef t bar e Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc .

# U/if ^ -IjrcU ^ y z Name : Address : Phone : ' ... ^ yfog ? ^, ' ^J ^ ^T ^ Omah a Lea d Sit e Sit e Sketc h Date : Time : ^ Nort h Arro w

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COASTA I iltVIRONnlltlA t **• ! PBO'*'^^ C K0 U r. IH C 

## Consen t fo F Acces s T o Fropeft 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 : 51T ' ^ ^ ^ %

Addres s o fPropert y covere d b ythi s 

# ^(o<^ y 6 . h 2 5 + Agreement : PURPOS E O F RESPOJ^S E ACTIVITIE S 

### Th e EPAi 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 , wil l contact th e Granto rin-perso n t o discus s th e wor k t o b e perfonned , 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 wor 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 wit h 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 perfonnin g th e work . Thi s acces s shal l 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 f2V^-^^f^ / COASTA L INVIflOHKtKTA L C « O U rIN C 

### €

Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; G Remov 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 ; e Wate 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 . cAllo 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 I gran t acces s t o mypropertie sD I d o no t gran t acces s t o mypropertie s

Signatur e Dat e I ' SignatureDate
D 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 2

# p

Th e purpos e ofthi s agreement i s to provid e amutual agreement a s t o condition s ofth e propert y prio r to remediatio nactivities . Thi s wil l als o serv e a s documentatio nfor th e purpos e o f assurin g that restoratio n activitie s ar e complete dt o th e satisfactio no f th e propert y owner andth e Unite dState s Environmental Protectio nAgenc y (EPA) .

Propert yID : 100^^ 4 

### Property Address : H4<5 f <> . '^' X S4
­ Oyf^f^r : "S^^ ^ r)e\e< ^ 

### Phone : O nth e attache ddiagram(s ) indicate area(s ) t o excavate , surfac e structure s an dlandscapin g feature s an d acces s location(s ) to b e usedb y th e contractors . Indicate distances , depths , material types , etc . Photographicall y andVideographically document th e existin g condition s ofth e propert y an dth e basement if necessary . 

### Itenn s t o b e Remove d b yth e Owne rbefor e Star t o f Remediation : Th e removal : storage , disposal , and/o rretur n o f thes e Item s i s th e Owner' s responsibility . i item : T 

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### item s t o b e Remove d b yth e Contracto rDurin g Remediatio n an d No t Replaced _

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### Item s t o B e Remove d B yContracto rDurin g Remediatio n an d Replace d Item : 

# ^ 1 - Kem : Item : Item :



## Ite m Pre-existin g propert y area , tha t wil l b e excavated , tha t i s covere dwit hgrass . 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 . Attac hr . sketcli u t th e .i^prinklcr lavcut . Numbe r o f an dsiz e o f eac hgarden / flowe r be d area . Attac hasketc ho f relativ e size s an dloc;itions . Agree dupo nvalu e o f plan t material s no t t o b e replace db v contractor . PJo! c tlii s Milli e (>ii i h- j • js?i- ' '. c issu e H j)l«n ' \cin.'I:t i 10 i!) e prr,pcr; \ o«ntr . Easemen t Area , t o b e excavate d 

# ^ti. l

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# f Landscap e Inventory Uni t Condition/Type/Specie s Quadrant s

Eac h Eac h

Eac h

Eac h Squar e Fee t

$

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# ^Iffifc C * " 'S S T /• L O H tf W» . IN C 

### I Additional Comment s / Instructions : i 

# Qx_[ \

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# ^vr s

\A

# <X^^ ^

Q Chec k th e box if Owne rdoe s not wan t CE G to documen t interio rfoundatio n wall s an d possibl e pre-existin g damage . Bycheckin g thi s boxCE G is no t responsibl e fo ran ydamag e don e to th e interio r ofhouse , includin g foundatio n crack s orfissures . Q I do no t agre e

Contractor' s Sitniator Dat e Signatur e e Page s

# • I

BVI D # i 0 Q <i | f g 

## XR F PROPERT Y SAMPL E 

## SHEET L /

/ Dat e Addres s 

## MfeO'7 - S ^ 7 ^T 

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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 . Signature j 

# 'M m Prin t rtLuOV ^

C/»C£X ^« 

## ijQL \ Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 ^^^ ^

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^

• ^ Coasta l Environmenta l Grou p Inc . ­ f www.coastalhazmat.co m v %PRoT« ^ COASTA L ENVIIONHENTA L CI O U r . IN C 

# EXECUTIV ESUMMARY : BVID #10096-(460 7 S 3 2 ST ) No Issue s o r Concern s Q Issues/Concern s Detail Explanation :1 

# m EP A EP A Propert y Clos e Ou t For m Propert y#:J£X::Q\Q _ Propert y Address : 

# M l Datc/Tlmc : Owner' s Name:./j j ijOtt^l^ . JL^"Lffi ) . • .1

—. Quad s Excavated : fit Contracto r Grou p fcW^/J S bV\\H<nr^/^/YfiWk U Ye s N o Eicavatloi i Gcaeni l I .I f necessaiy , were th e coirec t quadiant(s ) excavate dandrestored ? 2 .If necessary , were th e correc t area s ofdri p zone excavate dandrestored ? 

# U ^ Ye s N o Gradin g So dan dVeaetatio B 1 .Doe s th e gmdin g aroun dth e perimeter ofth e hous e i nexcavate darea s generall y slop e awa y fromth e house ? 

# V ^ 2 .Ha s so dbee nlai dinal l area s tha t wer e excavated ? 3 .Doe s th e sodappear to b e generally healthy an dgrowing ? (Onl y evaluat e if inspecte da t a3 0 ^	 ^ day time period ) 4 .Ar e soddedarea s generally fuman devenly graded ? ^ ' S .Ar e th e joint s betwee nth e so dstrip s generally tight ? (Only evaluate if inspecte da t a3 0 da y 

# 17 " tim e period) ^ 6 .Wa s the propert y grade dsuchtha t wate r will no t poo l o n(h e properT>' ? - ^ ^ 7 .

Wa s damage t o landscqiin g o r plan t material s avoided ? 

# w ^ Gates , Fence s an dRetainin g Wai b Ve s N o 1 .D o gate s ope nan dclos e freely? (Ifapplicable ) 

# U ^ 2 .Were all gate s or fence s takendow ndurin g restoratio nactivitie s reinstalled ? (Ifapplicable ) 

# U ' 3 .Wa s danug e t o gate s o r fence s avoided ? (Ifapplicable ) 4 .Wa s damage t o retainin g wall s avoided ? (Ifapplicable ) Foundation , Sidin g an dGuHer s Ye s rj o 1 .Wa s danwg e t o th e sidin g o r tri mavoided ? U 4 2 .Wa s damag e t o the foundationavoided ? 

# u ' 3 .

Wa s damag e to window s avoided ? 

# T ; ^ Wa s damag e to window s or doo r screen s avoided ? 4 

# I . ' 5 .Wa s damag e t o downspout s o r downspout extension s avoided ? ^ ^ Sidewallc s an dDriveway s (Concrete ) Ye s N 1 .Wa s damag e 1 0 driveway surface s avoided ? 

# t t 2 .Wa s damage t o walkwa y surface s avoided ? ^	 ^

## Owner s comments :

Inspectio nnotes :

Remova l an drestorationactivate s comolete including the 30-da y so dwarranty : EP A Representativ e / JcT WIkL/L ^ Date : /

O [l/o ^

## Propeii yCompletio n Agreemen t ihi s agreemen t documenl s th e complelio n o f remedia l acliviiie s perloime d o n m yproperl yM ysignaiui e wil l designat e tha t I a m satisfie d wit h Ih e restoralio n o f m ypropeily . an d iha i n o item s ar e i n queslions . now , o ra l an ylim e i n th e future , excep l thos e ilem s liste d below , ifan y

Propert yIP : jQ^q ^ Propcrt yAddrcss : q^- f < g '^ f ^4 . Owner : ^^^ ^ Q^f^^ ^ 

# ^"""-CnO^^^ n 'ifli?)? ^ Restoratio n Item s i n Question :

Item : llem : Item : Item : Item : Item : 

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P( l 1 Jijjrc rI r.ttoralio n Kcomplcltd , excep t a s note d I d o no t a|>recre$(or«tin n i s complele d

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