### TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAID# : n^l 2Date : "i-Z*&-\ \ Address : JJ?3 y S
- 1 ^ S ^ RemediationContractor : Environmenta l Restoration , LLC

_Year : _201 0 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S X Video o f propert y (DVD ) _^efor e DAfle r

D Basement • / « Executiv e Summar y (Final Report) / Q EPA-provide dpropert y sketc h 0 ^ Signe dAcces s Agreement fo r

subjec t propert y n 

### SignedAcces s Agreement(s ) fo r

adjacent property Restoratio nAgreement GSettiement document s (Le. , fo r

damag e o r to replac e plants , etc. ) y i Confirmatio ndat a /

/ Photograpii s J2^efor e GCrew Photo s ;?t>urin g Excavatio nQ So d >Z^ 0-da y So dD ^ As-buil t sketc h /2 ! Completio nAgreemen t signe db y Property Owner y/ ^ Propertj ' close-oir t chec k lis t signe db y EP A O Descriptio ao f area s ao t meetia g RO D cleanu p criteri a y ^ Udlirv
- clearance s JZ ^ Property informatio nfromDougJa s Coimty-Assessor' s Offic e y ^ Property acces s checklis t Contac t Loff
c-nv-ixoomenta i Restoratio nSignat^ai ?Dat e

3026239 6 

# iMplii i Superfun d

# EP A EPA Propert y Clos e Ou t For m Omah aLea dSite Propert y U : \ 1 %\ S Propert y Address : J33 7 ^ ' "7 ^ J<- . Date/Time : Owner' s Name : jCc^/ > X>U<^4A.A^4
- 

### Quad s Excavated : . tS l Contracto r Grou p : Environmenta l Restoratio n(ER ) Excavatio nGeneral 

### VAfUbo r LOT . Yes N o 1 . If necessaiy , wer e the correc t qiiadrant(5 ) exca-vate dan drestored ? 2 . Ifnecessary , wer e flie correc t area s o f dri p zone excavatedan drestored? 

# /J L Gradin g So dan dVegetatio n Ye s N o I . Doe s th e grading "-«.^ ^ A » p^^»to > » f t>.«!,»»« . inexcavate darea s generally slop e aw y fromth e w / house ? . . y 2 . Ha s so dbee n Eai dinal l area s tha t wer e excavated ? 3 . Doe s the so dappea r t o b e geuCTall y healthy andgrowing ? (Only evaluate if inspecte da t 30-day tim e y period) . 4 . Are soddedarea s generally firman devenly graded ? 5 . Ar e th e joint s betwee nth e so dstrip s generally tight ? (Onl y evaluate if niq)ecte dat 30-da y tim e period) . 6 . Wa s the proper ^ grade dsuc htha t wate r wil l no t poo l o nth e property ? 7 . Was damage to landscaping or plan t material s avoided ? Gates , fence s an dRetainin g Wall s Ye s N o 1 . D o gate s ope nan dclos e freely? (ifapplicable ) 2 . Wer e al l gate s o r fences takendow ndurin g restoration activitie s re-installed ? (ifapplicable ) 

### 7 ^ 3 . Wa s damag e to gate s or fence s avoided ? (ifapplicable ) 4 . Wa s damag e t o retainin g wall s avoided ? (ifapplicable ) Foundatiofl , Sidin g an dGutter s Ye s N o 1 . Wa s damag e to sidin g o r trimavoided ? 2 . Wa s damag e t o di e foundatio navoided ? 

# \/ArAu r ^- ^ 3 . Was danag e t o window s avoided ? 

# n 4 . Was damag e to window
- screen s or doo r screen s avoided ? 

# I 5 . ^' ^ damag e c o downspout s or downspou t extension s avoided ? Sidewalk s aa dDriveway s (Coacrete ) Ys s N o i . Was damag e t o drivewa y surfece s avoided ? 

# 3 1 2. . Wa s damag e to walkwa y surfece s avoided ? Inspectio nnot^s :



### Remedia l an drsatoratio nactM-d'e ac-omple-t? inelndin g 3€-d.a7 so dTrarranty ; EPA Repre3eaCarive>y^I/7 ^ J ^^>- , A-^^ ^ ^^' " 7/7// /^'"^"'"" ^ 

### OMAH ALEA D SIT E —EP-R7-09-0 5 

### s ENVIRONMENTA L RESTORATION , LL C WWW.ERLLC.CO M >^TT ^



# EXECUTIV E SUMMARY : t h 

# 17818-233 9 S 7' " S T

N O ISSUES OR CONCERNS ISSUES/CONCERN S DETAI L EXPLANATION :

### Fag e 1 ot 1

" > [ Creat e Anothe rTicke t ] [ Bac k t o irt h InterneT Sen d Emai l



### • YOU RTICKE T NUMBE RI S 2707699 . Origina l Cal l Date : 4/08/1 1 Time : 6:4 0 am Op : TIM2418 6 Wor k t o Begi n Date : 4/12/1 1 Time : 7:1 5 am State : N E County : DOUGLA S Place : OMAH A Address : 233 9 Street : S 7T H S T Twp : 15 NRng : 13 E Sect-Qtr : 26-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Lea d Soi l Remova l 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 # 1781 8 Compan y: ENVIRONMENTA L RESTORATIO N Contact Name : TI M SUTTO N Phone : (402)451-131 4 x226 7 Alt . Contact : Phone : (402)306-234 7 Wor k Bein g Don e For : EP A Dept h o f Excavation : 2 4 i n Corne r Lot : NFront : NRear : Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V LEVEL 3 MUD0 2 OMAHACO F 0PPDGPR 6 QLNNEI F 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 LEVEL 3 LEVEL 3 COMMUNICATIONS , LL C N A 

### Day : 877366834 4 Alt : Emerg : 877366834 4 MUD0 2 METROPOLITA NUTILITIE S DISTRIC T SAND Y 

### Day : 402504782 3 Alt : 

### Emerg : 402504797 0 OMAHACO FCIT Y O FOiVlAHA-TRAFFICSEWE RRICH/TRAFFI C Day : 402444719 7

Alt : 402444516 1 Emerg : 402444516 0 http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 4/8/201 1

### Fag e 2 o f 2

0PPDGPR 6 OMAH A PUBLI C POWE RDISTRIC T Day :

EL M LOCATIN GAlt : 406728934 3 406207149 4 Emerg : 888728934 3 QLNNEI FQWES 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. . . 3/25/201 1

## Contac t Informatio n Lo g 

# SAID#_i2£/ £
I Owner' s Name ; Acko/ ^ -TDv ^ ^/n^/. ! I ^"V^'"" ^ ^^°'"'
- ^0 / -35^ ' nCf S I Property Address ; ^Jj j J . 7 ^ p/
- 

# H Attemp t t o contac t Date/tim e Nam e 

### faece s J -^r^ s ytj¥l J (-36'( ( 

## 7^J 9

'

## Propert yAcces s Checklis t SAID : /-7/f ^ nWOR K STARTED ON : _/ l _ 

### D WORK COIMPELTE D ON ; I I 

### Property Address ; ^?? ? 

# ^B3 ? Owner : ^|;^ ^ Address : ^^ ^ rTAU^^^^Al ^ T . J-U4 C l ( , " ^ Renter : Phone : Fax : Cell/Pager : Phone : Fax ; /" O f - J 5 /' ^ ^ ( U ? Additional Information : Cell/Pager : [ ^ [ ^ H Acces s Agreement Restoratio nAgreement Video Property Befor e Siened : / Siened: / O n: { 1 Il« l 1 1 1^ 1 l l

iJlo l 1 / By : /^ ^ 

## By:A ^ By:^ ^ 1 ^ Digita l Photo s Befor e O n: ( /Jo / / ( By:<e ^ nVide o Propert y Afte r O n: / / By : D I S

Digita l Photo s Afte r Propert y Completio nAgreement O n: Siened : ^ / / 1 Lt > 1 l ( By : By : fiO D FinalRepor t Signed : / / By : Additional Video o r Digita l Photo' s Taken : D Video nDigita l Phot o O n: Reason ; / / By ; D Video Reason : D Digita l Phot o O n; / / By : D Vide o Reason : D Digita l Phot o O n; / / By ; nVide o Reason : nDigita l Photo O n: / / By :

## Consen t fo rAcces s t o Propert y SAID # 

# 11^1 9 RIGH T O FENTR Y T O PREMISE S 

### Granto r (th e property owner) , consent s t o an dauthorize s th e Unite dState s Environmenta l Protectio nAgenc y (USEPA ) o r it s authorize drepresentatives , collectivel y th e Grante e t o ente r an dperfon ncertai nenvironmenta l respons e activitie s upo nth e followin g describe dpremises :

Owner' s Name : /\d^\ ^ 'X\\lP:^..'i h| Daytim e Phone : ^Ol^J^g-^^l ^ Address ; 

# s 7 ^ 

# 233 ^ Address : Addresse s o f Propertie s covere db y thi s Address ; Agreement;
­ ' .. . Address : .- . • . ­ ' • 

### Address : , PURPOS EO FINVESTIGATIO N 

### Th e purpos e o f th e renaedial activitie s i s t o remov e al l soil s a t th e property whic har e contaminate dwit hhazardou s substances" ; i hparticular lea dat concentration s greate r tha no r equa l l o 40 0 part s pe r millio n(ppm) . REMEDIA L ACTION S 

### : ' ' Th e enviroripienta l respons e action s to b e performe do nsai 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> ' before , during , an dafter remedia l activities ; b .Locatin g equipmen t andmachinery on-sit e i npreparatio nfor an di nth e cours e o f th e environmenta l response ; c .Plannin g an dimplementin g th e remova l actio no no r near Grantor' s property . d .Obtainin g sample s fro mGrantor' s property ; AGREEMEN T NO T T O INTERFER E 

### Th e Granto r agree s no t t o interfere o r tampe r withan y o f th e activitie s o r wor k

done , o r th e equipmen t use dt o perfon nth 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 endange r th e healtho r welfar e o f th e Grantee s o r th e environment , o r

t o allo w other s t o us e th e property insuc h 

## ]g(lgran t acces s t o m y propertie s C H r d o no t gran t acces s t o m y propertie s 

# u Signature Dat e Signatur e Dat e

### Additiona l Comment s / Instructions :



# S^ . t/ W 

# Co( - G Chec k thi s bo xi f owne rdoe s no t 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 . B ycheckin g thi s bo xE.R . i s no t responsibl e fo ran ydamag e done t o th e interio ro f house , includin g foundatio n crack s o rfissures .

nI agre e Q I d o no t agre e I 1 1 agre e Q I d o no t agre e

Owner' s Signatur e Date Contractor' s Signatur e Date

## Restoratio n Agreenien t Th e purpos e o f thi s agreemen t i s t o provid e amutua l agreemen t a s t o condition s o f propert y prio r t o contracto r activities . Thi s wil l als o serv e a s documentatio nfor th e purpos e o f assurin g tha t restoratio n activitie s ar e complete dt o th e satisfactio no f th e property owne r an dth e Unite dState s Environmenta l Protectio nAgenc y (EPA) .

SAID : [n^l f Propert y Address : 2^'^'2 ^ C . 7^ ^ Owner : j(\^ ^

'tpt.ii»4.^,.^.r K Phone : O nth e attache ddiagram(s ) indicat e area(s ) t o b e excavate dan ddept ho f excavation , locatio no f al l know n utilities, subsurfac e features , surfac e structure s an dlandscapin g features , acces s location(s ) t o b e use db y I contractor , an dth e directio no f North . Indicate distances , depths , material types , etc . Indicat e digital photo s b y referencin g th e photo-lo g numbe r wit ha narro w indicatin g directio no f view . Item s t o b e remove d b yContracto ran d no t replaced :

Ite r 

# IC£jpUc- € rU i -Av-z^A-^ Ku^'-yt o iMeA O c<<n C I ' ^ f^J i ^

Ite m Item :

Pag e 1 o f 2

### Additiona l Comment s / Instructions :



# m agre e nI d o no t agre e -Q ^ agre e n Id o no t agre e

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# 'AL Dat e 

### O^tt^CA f Contractor' s Signatur e 

### 1-U-i l Dat e Attachmen t

Pag e 2 o f 2

## Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio n of remedia l activitie s performe d onmy property . My signatur e will designat e tha t Iamsatisfie dwithth e restoration of my property , an dtha t no item s ar e in question , now , or at

an y tim e inth e future , excep t thos e item s liste dbelow , ifany . SAID : 

# JUli l Propert y Address : ^J ^ J j . y ^ S\ . Owner : ^^ck; ^ IDvV«.5.4/n4,/J . Phone ; jp^ ^ . j f y-//0 3 Restoratio n ttem s in Question :

Item : Item : Item : Item : Item : ttem: Additiona l Comments :

K ] I agre e restoratio n is completed , excep t as note d .^•PTTagre e restoratio n ii completed , excep t as note d |__ | I do no t agre e restoratio n is complete d [_ | I do no t agre e restoratio n b complete d 

## 7 ' O - // KHcr' Sienatur Owner' s s Signature e Dat e Contractor' s Signatur e Dat e

### Dougla s Coimt y Accoun t Information Pag e 1 of 3 Dougla s County , Nebrask a Propert yRecor d - R053540000 0 Prin t Repor t Vie wInteractiv e GI S Ma p Informatio n i s vali d a s o f 2010-7-3 0 Treasurer' s Ta xRepor t Ne wFeatur e - > * > - ^ Subdivisio n Sale s Searc h Owne r ACTIO N F INVESTMEN TALL C 10 5 8 STAT E S T#40 7 ORE M U T84058-000 0 Propert yInformatio n Ke yNumber : 354 0 000 0 0 5 Accoun t Type : Residentia l Parce l Number : 053540000 0 Parce l Address : 233 9 S 7 S T OMAHAN E 68108-000 0 Lega l Description : BARKER S ALLOTMEN TLO T 1 BLOC K0 -E X P TFO R S T& N 4 2 FT - S 14 3 E 11 4 FT Valu e Inforniatio n 

### 201 0 200 9 200 8 200 7 200 6 200 5 Lan d $100.0 0 $100.0 0 $100.0 0 $100.0 0 $100.0 0 $100.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $100.0 0 $100.0 0 $100.0 0 $100.0 0 $100.0 0 $100.0 0 Sale s Informatio n Sale s Date : 2008-09-0 1 Vie wDocumen t Dee d Type : Price : SW D $600.0 0 Bo ok : 200 8 P age : 08985 0 Grantor : Redwoo d Rea l Estat e Developmen t LL C Grantee : Empowe rGrou p LL C Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 

### 2006-10-3 0 Dee d Type : W D Book : 200 6 Page : 12873 2 

### Price : $500.0 0 Grantor : Wood s Ja yAeta l 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R05.. . 8/17/201 0

### Dougla s Count y Accoun t Information Pag e 2 of 3
Grantee : Redwoo d Rea l Estat e Developmen t Valid/Invalid : Vali d Exclusio n Reason : 

### Sho wAl l Transaction s

Lan d Informatio n Acre s S F Unlt a Dept h Widti i Vacan t 0.2 6 11514. 0 0. 0 114. 0 101. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R05.. . 8/17/201 0

### Dougla s County Accoun t Informatio n Pag e 3 o f 3

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### ENVIRONMENTA L AS-BUIL TDRAWIN G OMAH ALEA D SUPERFUN D Sif E RESTORATIO N 

### 1781 8 Exterio rPaint Nortt i Arro w Omah a Lea d Sit e Owne rName : JAY AWooDS^ • Goo d Sit e Sketc h Address:2339S7^ T • Poo r

Phone : H 402-932.6083 Q No t paint Sampl e Numbe r RYASCPXA-1781 8 F l Lead Concentratio n 

### 9

^ pp m Sampl e Collecte d LA B 

### D Firm : Date : Sample s Collecte d rP/ l ­ 7~i . 7r£ ? RYBSCPXA-1781 8 F2 

### 6 0 pp m 

### D Time : RYCSCPXA-1781 8 RYDSCPXA-1781 8 B 1 B 2 

### A37 L L4 S pp m pp m 

### D D Sample s Analyze d RD2SOPXA-170 ^ D2 ­ pp m 

### D D XR F Unit : / 0 3 7 Book : 1/ 1 ROZOGrXA-1701 0 G ^ pp m 

### D D Date : 1 -I Z -tfS " RPZOCrXA-1701 0 P2 ­ pp m 

### D D Time : staff : 

### /' ^ £. ^ Numbe ro f Sample s = W Legend : F l = Fron t Left , F 2 = Fron t Right , B l = Bac k Lett , 8 2 = Bac k Rlgfi t DZ = Dri p Zone , G Z = Garden , PZ = Pla y Al l quadrant s ar e a s viewe d fro m tti e street , facin g propert y SAI D #1781 8 DAT E EXCAVATE D 4-29-1 1 DAT E EP ASIGNE D OF F 7-7-1 1

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# iiiiiiiiiiiliiiili i 1781 8 Exterio rPain t Nort h Arro w 

### Omah a Lea d Sit e Owne rName : JA YAWOOD S 

### • Goo d Sit e Sketc h Address : 233 9 S 7 S T 

### • Poo r Phone : H : 402-932-608 3 W ; Q Not pain t Lea d Sampl e Sample s Coilecte d Sampl e Numbe r Concentratio n Collecte d LA B 

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## D D Time . 

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### £-/ i Numbe ro f Sample s = H Legend ; F 1 = Fron t Left , F 2 = Fron t Rigtit , 8 1 = Bac k Left , B 2 = Bac k Righ t D Z = Dri p Zone , G Z = Garden . P Z = Pla y Al l quadrant s are a s viewe d fro m th e street , facin g property 

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