## TRANSMITTA L of OMAHALEAD SIT E SOI LREMEDIATIO NFIL EFOLDE R 

# t: 

# i^l ^ SAID# : ^cf^l^ l Date : 

## Address : Slci ^ N . ^ 3 S f RemediationContractor : Envrionmenta l Restoration , LLC

_Year : _2010_ SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S D Video of propert y (DVD ) JtS^efore DAfte r

D Basement ^ /it i^UH£/\y ' ^S . Executive Summar y (Fina l Report ) ^ ^ EPA-providedpropert y sketch ^S ^ SignedAcces s Agreemen t fo r

subject propert y D SignedAcces s Agreement(s ) fo r

adjacen t propert y ^ RestorationAgreemen t D Settlemen t documents (i.e. , fo r

damag e or to replac e plants , etc. ) ^ Confirmationdata

D Photograph s ^^Befor e DCrewPhotosBsDuringExcavatio nD Sod ^ 30-da y SodD IS ^ As-built sketch L> Completio nAgreemen t signe d by Propert y Owne r LS Propert y close-ou t chec k lis t signe d by EP A

. D Descriptio nofarea s no t meetin g RO D cleanu p criteri a 1 ^ Utilit y clearance s L \Propert y informatio nfromDougla s Coimt y Assessor' s Offic e 

## )s ^ Propert y acces s checklis t Q Contact Log ^3023777 5 D Superfun d 

## Environmenta l Restoratio nSignatur e Dat e EP ACO R X y ZO^ signatur

signatur e T5at eI 

## Omah a Ua d Site—EP-R7-09-05 >^i^ ^

? Environmenta l Restoratiort , LL C wwMr.ernc.co m 

# EXECUTIV ESUMMARY : 32159-361 5 N 2 9 S T 

# No Issue s o r Concern s [ ^ Issues/Concern s Etetai l Explanation :

# - EPA EP APropert y Clos e Ou t For m Omah aLea dSit e Propert y #: _ 

## SPt^ltf" ) Propert y Address : 2 ^t S MSJ^ ^ SP Date/Time : Owner' s Name : . Quad s Excavated : F t & i .B z Contracto r Grou p : Environmenta l Restoratio n(ER ) Excavatio nGeneral Ye s N o I . Ifnecessary , wer e the correct quadrant(s ) excavatedan drestored ? 

## y 2 . Ifnecessary , wer e the correct area s ofdri p zon e excavatedan drestored ? 

### ^ y Gradin g So dan dVegetatio n Ye s N o 1 . Doe s th e gradin g aroun dth e perimete r o f th e hous e i nexcavate darea s generall y slop e away fromth e y house? 2 . Ha s so dbee nlai dinal l area s that wer e excavated ? 

## y 3 . Doe s th e so dappear t o b e generall y health y an dgrowing ? (Onl y evaliiat e if inspecte dat 30-day tim e period) . 4 . Are sodde darea s generall y fir man devenl y graded ? y 5 . Are th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e ifinspecte dat 30-day tim e period) . 6 . Wa s th e property grade dsuc htha t wate r wil l no t poo l o nth e property ? y 7 . Wa s damag e t o landscapin g o r plan t material s avoided ? y 

### Gates , Fience s an dRetainin g Wall s Yes N o I . D o gate s ope nan dclos e freely? (if applicable) 

# A 2 . Wer e al l gate s o r fence s take ndovr aduring restorationactivitie s re-installed ? (i f applicable ) 3 . Wa s damag e t

o gate s o r fence s avoided ? (i f applicable) 

# -pit : 4 . Wa s damage to retaining wall s avoided ? (if applicable) 

# r Foundation , Sidin g an dGutter s Ye s N o 1 . Wa s damag e t o sidin g o r tri mavoided ? y 2 . Wa s damalge t o th e foundatio navoided ? y 3 . Wa s damag e t o windows avoided ? y 4 . Wa s damag e t o windo w screen s o r doo r screen s avoided ? . ty 5 . Wa s damag e t o downspout s o r downspou t extension s avoided ? uy 

### Sidewalk s an dDriveway s (Concrete ) Ye s N o I . Wa s damage t o drivewa y surface s avoided ? 2 . Wa s damage t o walkwa y surfece s avoided ? Inspectio nnotes : Ppul w ^ Ai&tufD ^ S6 d Remedia l an drestoratio nactivitie s complet e includin g SOnday so dwarranty : EP ARepresentsitiveyyyy ^ 

## ?..//7t ^ y7/&^. , A.rt ^ , Date : //^^ i 

# 'lo .

### Pag e 1 o f 1

[ Creat e Anothe rTicke t j [ Backt o Irt h Interne t ] [ Sen d Emai l ]



### . YOU RTICKE T NUMBE RI S 255433 % Origina l Cal l Date : 7/27/1 0 Time : 5:1 2 p m Op : TRACY2418 6 Wor k t o Begi n Date : 7/29/1 0 Time : 5:4 5 pit State : N E County : DOUGLA S Place : OMAH A Address : 361 5 Street : N29T H S T Twp : 15 NRng : 13 E Sect-Qtr : 04-SE,09-N 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 #3215 9 Compan y ENVIRONMENTA L RESTORATIO N Contac t Nam e TRAC Y BRISTO W Phone : (402)451-131 4 Alt . Contac t Phone : (314)504-487 4 Wor k Bein g Don e For : EP A Dept h o f Excavation : 12 " Corne r Lot : NFront : Y Rear : Y Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Are a 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 MUDO l METROPOLITA NUTILITIE S DISTRIC T SAND Y 

### Day : 402504782 3 

### Ate : Emerg : 402504797 0 OMAHACO FCIT Y O FOMAHA-TRAFFIC.SEWE R RICH/TRAFFI C 

### Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 0PPDGPR 5 OMAH APUBLI C POWE RDISTRIC T 

### EL M LOCATIN G Day : 406728934 3

Alt : 406207149 4

Emerg : 888728934 3 QLNN E1 C QWES T LOCA LNETWOR K 

### EL M LOCATIN G Day : 406728934 3

Alt : 406207149 4

Emerg : 888728934 3
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 7/27/201 0

## Contac t Informatio n Lo g 

# SAID#3ll£ l
I Owner^sName : •f\\^vCse ^ ^>^o>l\a.Cr ^ Daytim e Phone : ^"hl i SS7 7 |

Propert y Address : ^4 ? I 5 " [ J I^ K 

## Attemp t t o contac t DateAJme Nam e yiAcf CVuptye ^

(j^ ^ t c< ; /<:>/^^- 5 ;?/ — 

# y7Ai^ / t<LJoekrt:i ) o> o S>eto; ^ (fp2/O f P?i^ O 

# "F- 4 

# vW-^^^^ ^ /P'ZJO-O ? /ZC^P ^ 

## eVCAllcJ->'ty \

. 

# t'ly o 

# k > -jn^ n CAcr-< 4

<

# Propert y Acces s Checklis t

Additiona l Vidaoc r Bigjtal Photo' s Takers :

Omah aLea dProjec t Wor k

Pla n Pag e I o f 1 9

# Consen t to r Acces s t o Propert y SASD #3- ^ ^ ^ ' RIGH T O FENTR Y T O PREMISE S 

## Granto r (lh e propert y 6^yner) , consent s to andcuthr-rize s ihe Unite dState s Environmenta l ?i-.jt:;ciion . Agedc y (USEPA ) or it s aiithorize drepresentatives , collectively tli e Grante e to enter an dperfor mceitm nenvironmenta l respons e activitie s upo nth e followin g describe dpremises ; Owner' s Name : Af t C- C UJkli«lC< _ Daytim e ghona : ^3 3 ' SS 7 7 

# 3(^ ^ M- ^T ^ ^

PURPOS EO FINVESTIGATIO N.' . 

## Th e .purpos e o f

the remedial activitie s i s to reriiov e al l soil s at th e propert y Vt-'hic har e contaminate dvrit hhazardou s substances , i nparticula r

leadat concentration s greater tlian.or equa l • t o 40 0 part s permiilio n(ppm) .

REMEDIA LACTION S Th e eayirorimental respons e action s t o b e perfomiedo nsai dpropert y ma y include thefoJIovviG g activities : a . Taking photographs , and/cr vide o o f

tli e property before , during , audafte r

remedia l activities ; b . Locatin g equipmen t an dmachiner y on-site i npreparatio nfo r

andinth e cquis e of th e environmenta l response ; c . Planfliiig an dimplern&ntin g fn e lemova l actio no nor nea r

Grantor' s propeity . • • d . . Obtaining sample s fro mGrantor' s propeity ; AGREEMEN T NO T T O INTERFER E• 

## • Th e Granto r agree s no t t o interfer e or tamper '.vit han y o f th e activitie s or v/or k

done , c r th e

. equipmen t use dt o perfor mth e activities , o r

to undertake an y action s regardin g the . us e c f sai d propert y whic h"woul dten dto endange r

th e healt ho r

W'-elfar e o f th e Grantee s o r

th e environment , o r t o allov/ether s t o us e th e propert y i nsuch I gran t acces s t o a y propertie s nI ^ Q no t gran t acces s t o m y properi'ie s 

# h

X •Jti o Signature Dat e Signatur e Dat e

### Addttiana l Commant s / Enstructfons :



## 0 3 Chec k thi s bo x i f

cwns r doe s no t want E.R. to ente r th aresident s to documsnt interio r foundstic nVv'all s sndpossibl e prssxfstin g damage . 3 y cbecking thi s bo x E.R . i s not rssponsibl e for an y damsg e clon e to th e intsricr o

f

house , iridudirig foundationcrack s o r

fissures .

j i 1 agre e J21 1 d o ne t sgrs aQ ^ ^g^fs - dI '^ aso t sgre e 

# /^AJ^:I'X)KMI'^S.//JI: > • Owrser^ s Signatisr e Dat e • . • ConfrECfcr' s Slgnat-^re Bate

## RestorstEc nAgrees-kien t T h s purpos e o f iSiI s agreemen t i s t o provid e amutua l agreernen t ="c , f

^ ccnditioii i vj i piypen y prio r t o r-.-T.ntractc-r acliviiies . Tiii s wii i als o serv e a s documentatio nfo r th e purpos e o f assurin g that restoratio n activitie s ar e complete dt o th e satisfactio no f tli e propert y owne r an dth e Unite dState s Environmenta l Protectio nAgenc y (EPA) .

O nth e attache ddiagram(s ) indicat e area(s ) t o b e excavate dan ddept hc f excavation , location.o f al l known utilities , subsurfac e features , surfac e structure s an dlandscaping , features , acces s location(s ) t o b e use dby . ' contractor , an dth e directio no f North . Indicate 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 narrov/indicatin g directio no f view . . . Etem s ^ o b arsrrscys dfcy Ccntractes ; sn dno t rsp'aced :

Fag s 1 o f 2

### AddttJona l Comtnent s / Instructions :

i agree ' nI do no t £gre e • I agre e nidonctagrs a 

# ^j^ljf-/ i Owner' s Signature Dat3 Contrsctor' s Signatur e Dat e 

## Attachment s

• P3S 3 2of 2

## Propert y CompJstio nAgreesrtei^ ' T'«. b ?.greeir.er. t dccumcrit s Lli c completio no f remedia l activitie s performe do nm y property, . M y signatur e wil l designate tha t I a msatisfie dwit hth e restoratio no f my property , an dtha t n o item s ar e i n question , now , o r at

an y tim e i nth e future , excep t thos e item s liste dbelov/ , i f any . 

## SAID; 3PIS J Propert y Address : 3 (_ p ) ^ ^ . .^"fib^ S^ - Owner : A^Kl ^ «>^X/kG ? Phone : 

## 7S?-S>S7 7 Restoratio nJtsni s i nQuestion :

; JS ^ I sgrs s restoratic s is corap'etsd , excep t a

s Kote d

. LJ Ed o no t sgre e restoratio n! s ccnspfete d 

# /XtiytY^UYiMryy u ihyji ^ Owaer' s SESitatut s • oS e ' PS l I agre e restcrationi s coartpfsted, ezcep t a

s note d I 1 1 d o ne t £gr£ e restorstic nI s ccrapJete d 

# 3'^^SY ^ Contractor' s SEgnatur e Dst eDougla s County , NebrasksrPropert yRecor d sk! ^ - R054457000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s avaUaU e ( g scal e 0^ 0 I t wes t o f52n d S t - Vie wOf l Ma p infonnatio n i s vali d a s o f2009-8- 3 Treasurer' s Ta xRepor t Ne wFeatur e -•-•- > Aut o Sale s Searc h Owne r WALLAC E ALIC E ETA L 361 5 N 2 9 S T OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumbe r 445 7 OOO O 0 5 Accoun t Type : Residentia l Parce l Numbe r 054457000 0 Parce l Address : 361 5 N 2 9 S T OMAH AN E 68111-000 0 Lega l Description : BEDFOR D PLAC E LO T2 BLOC K1 7 N 1/ 2 24. 5 X 12 5 Valu e Informatio n Lan d Improvemen t Tota l 200 9 $1,800.0 0 $21,200.0 0 $23,000.0 0 200 8 $1,800.0 0 $21,200.0 0 $23,000.0 0 200 7 $1,800.0 0 $22,800.0 0 $24,600.0 0 200 6 $1,800.0 0 $22,800.0 0 $24,600.0 0 200 5 $1,800.0 0 $22,800.0 0 $24,600.0 0 200 4 $1,800.0 0 $10,200.0 0 $12,000.0 0 Sale s Informatio n Sale s Date : 2006-05-0 8 Dee d Type : Q C Book : 200 6 Page : 05111 4 

### Price ; $0.0 0 Granto r JESSI E M TURNE R Grantee : JOH N TURNE R SR . Valid/Invalid : Invali d Exclusio n Reason : Famil ySal e Sale s Date : 2006-05-0 8 

### Dee dType : Q C Sooir : 200 6 Page : 05111 5 Price : $25,000.0 0 Granto r JOH N TURNE R SR . 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R05. . . 8/31/200 9Grantee : \ ALIC E WALLAC E ETA L Valid/Invalid : ] Vali d Exclusio n Reason : No n Bon o wit h Do cStamp s Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 7 

### 3125. 0 1.0 125. 0 25. 0 N o Improvemen t Informatio n Buildin g 1 RANC H 361 5 N 2 9 S T

^1 ^ "te; r

R./!r!fiir . i . rTfi: ; if -. ; - t CLICK^TO iNUARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : | 636. 0 Percen t Complete : 100.0 % Perimete rI 0. 0 Quality : Fai r Uni t Type : 

### Condition : Averag e

Buil t As : Ranc h Cond o Squar e Footage : 0. 0

HVAC : Force d Ai r Rooms : 4. 0 Exterior : i Fram e Sidin g Units : 

### 1. 0 Interior : i Drywal l Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 1. 0

Roo fType : I Gabl e Stories : 1. 0 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 

### 191 5 0 % 191 5 9 4 Detai l Typ e Detai l Descriptio n Unit s Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 ft 

### 612. 0 Fixtur e Bas e Fixture s 1. 0 Fixtur e Bat h Ful l 1. 0 Garag e Detache d 264. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R05. . . 8/31/200 9

### Porch En d Soli d Wal l " 126. 0 Porch Sla b Roo f Cei l 28. 0



## http://douglasne.mapping-onUne.com/DouglasCoNe/static/accountinfo.jsp?accountno=R05.. . 8/31/2009

## Dougla s Count y Accoun t Inlormatio n rag e J \j i J 

### Porc h En d Soli d Wal l 126. 0 Porc h Sla b Roo fCei l 28. 0



## http://douglasne.mapping-online.eom/DougIasCoNe/static/accountinfo. j sp?accountno=R05.. . 8/3 1 /200 9

### ENVIRONMENTA L AS-BUILTDRAWIN G JMAHALEA D SUPERFUN D SITE ' RESTORATIO N 

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## a Time : RYCSCPXA-3215 9 8 1 

### QI O pp m 

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## n Sample s Analyze d RYDSCPXA-3215 9 B 2 pp m 

## Q n RDZSCPXA-3215 9 D Z pp m 

# \ S u XR F Un i t : Pcif^H C Book : 

### 2Q B pp m Date : _ -7-O-Z - O S nPZSCPXA-3215 9 PZ - pp m 

# n n Time : _ 

### A M Staf f. MSu y Numbe ro f5 Sample s = 

### 5 

# 0 Legend : F 1 = Fron t Left , F 2 = Fron t Right . B 1 = Bac k Left , 8 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden . P Z = Pla y AM

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## D Sample s Analyze d RYDSCPXA-3215 9 B 2 

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## )Z5 H pp m XR F Unit : PnfiH b Book : 26 B 

## D RGZGCPXA-3215 9 6 * pp m 

## D Date : "7-OZ-Q 8 

## D nPZCCPXA3215 0 P2 - pp m 

### Time : ftM 

# n D Staff : nSU y Numbe ro fSample s = 5 Legend : F 1 = Fron t Left , F2 = Fron t Right , B l = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden , P Z = Play Al l quadrant s are a s viewe d fro m th e street , facin g propert y 

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### Omah a Lea d Sit e • Goo d 

# ^^-'551' ) Sit e Sketc h 0 Poo r Samplin g Address : 361 5 N 2 9 S T Q No t pain t Sampl e Numbe r RYASCPXA-3215 9 RYBSCPXA-3215 9 RYCSCPXA-3215 9 RYDSCPXA-3215 9 RDZSCPXA-3215 9 RGZGCPXA-321G 9 RPZCGrX; ^ 3215 0 Lea d Concentratio n Sampl e Collecte d LA B Firm : Sample s Collecte d F 1 

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# Therm o BUlerica , M A 0182 1

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