## TRANSMITTA Lo f OMAH A LEA D SIT E SOI LREMEDIATIO N FIL EFOLDE R SAI D # : IP3 S 

## S9
- Date : Address : Xl?i' ^ N ) • ^ ^ ft^ Remediatio n Contractor : Envrionmenta l Restoration , LL C Year : 201 0 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S Vide o o f property (DVD ) _Sl3efor e DAfte r N Basemen t D Executiv e Summary (Final Report ) EPA-provide dproperty sketc h Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) fo r adjacent property Restoratio n Agreemen t 

## a Settlemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) Confirmatio n dat a Photograph s ^ Before DCre w Photo s N Durin g Excavatio n N So d " ^ 30-day So dD As-buil t sketc h Completio n Agreemen t signe db y Property Owne r Property close-ou t chec k lis t signe dby EP A D 

### Descriptio n o f area s no t meetin g RO D cleanu p criteri a Utility clearance s Property informatio n fromDougla s County Assessor' s Offic e Property acces s checklis t Contac t Lo g 3023780 7 D Superfun d 

### Environmenta l Restoratio n Signatur e Date 

## <^'9-t f Dat e

## \ Omah a Lea d Site—EP-R7-09-0 5 | f Envirortmenta i Restoration , LL C " ^ www.erilcco m



# EXECUTIV ESUMMARY : 6352 2 - 273 2 N 4 5 A V 

# |~x] No Issue s o r Concern s [ ^ Issues/Concern s Detai l Explanation :

# -EP A EP APropert y Clos e Ou t For m Omah aLea dSit e Propert y # : ^3>S9.Q v Propert y Address : ^n3>Q s KJ . ^ ^ \\y Date/Time : Owner' s Name : \J><NAD ^ 

### ^jQrf ^ ~ ~ Quad s Excavated : Gl" ^ Contracto r Grou p : Environmenta l Restoratio n (ER ) Excavatio n Genera l Ye s N o 1 . Ifnecessary , were th e correc t quadrant(s ) excavate dan drestored? 

## y 2 . Ifnecessary , were th e correc t area s o f dri p zon e excavate dan drestored ? . / 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 fro mth e house ? ^ 2 . Ha s so dbee n lai di n all area s that were excavated ? 

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

. ^ Gates , Fence s an dRetainin g Wall s Ye s N o 1 . D o gate s ope n an dclos e freely ? (i f applicable ) • 2 . Were all gate s o r fence s take n dow n durin g restoratio n activitie s re-installed ? (i f applicable ) 

## A/ A 3 . Wa s damag e t o gate s o r fence s avoided ? (i f applicable ) 

## y 4 . Wa s damag e t o retainin g wall s avoided ? (i f applicable ) ^ Foundation , Sidin g an dGutter s Ye s N o 1 . Wa s damag e t o sidin g o r tri mavoided ? ^ 2 . Wa s damag e t o th e foundatio n avoided ? • 3 . Wa s damag e t o windows avoided ? ^ 4 . Wa s damag e t o windo w screen s o r doo r screen s avoided ? ^ 5 . Wa s damag e t o downspout s o r downspou t extension s avoided ? >/ ' Sidewalk s an dDriveway s (Concrete ) Ye s No 1 .Wa s damag e t o driveway surface s avoided ? ,y ^ 2 . Wa s damag e t o walkway surface s avoided ? Inspectio n notes :



### Remedia l an drestoratio n activitie s complet e includin g 30-da y so dwarranty : EP ARepresentative : yT^^y/:;^ ^ 1^j£^^ . Uj^Z ^ 

# Date : ^JZS'// D

### Pag e 1 o f 1

[ Creat e Anothe rTicke t ^ [ Bac k t o Irt h Interne t ] [ Sen d Emai l ]



### • YOU RTICKE T NUMBE RI S 2559587 ; Origina l Cal l Date : 8/04/1 0 Time : 6:5 8 a mOp : TRACY2418 6 Wor k t o Begi n Date : 8/06/10. ' Time : 7;1 5 ^ ^ State : N E County : DOUGLA S Place : OMAH A Address : 273 2 Street : N45T H AV E Twp : 15 NRng : 13 E Sect-Qtr : 08-NW-S W 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 : FAX AL L CLEAR S TO : (402)451-106 9

~ SAI D #6352 2 / Compan y: ENVIRONMENTA L RESTORATIO N Contac t 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 : 12 " Corne r Lot : NFront : Y Rear : 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 Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , INC HEIDI Alt : 402934046 9 Emerg : 402932975 7 Day : 402504782 3 MUDO l METROPOLITA N UTILITIE S DISTRICT SAND Y Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRICH/TRAFFI C Alt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3 OPPDGPR 5 OMAH A PUBLIC POWE RDISTRICT EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3 Day : 406728934 3 QLNN E 1 C QWES T LOCA LNETWOR K EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3 

### http://www.dhon.org/irthintemetyT)HONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 8/4/201 0

### Pag e 1 o f 1

"> [ Creat e Anothe rTicke t " ) [ Bac k t o Irt h Interne t ] [ Sen d Emai l ] 

### YOU RTICKE T NUMBE RI S 2417776 . Origina l Cal l Date : 12/05/0 9 Time : 10:4 8 a m Op : ADAM2418 6 Wor k t o Begi n Date : 12/09/0 9 Time : 7:1 5 a m State : N E County : DOUGLA S Place : OMAH A Address : 273 2 Street : N45T H AV E Twp : 15 NRng : 13 E Sect-Qtr : 08-NW-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Lea d Excavatio n Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FAX AL L CLEAR S TO : (402)451-088 0 Compan y: ENVIRONMENTA L RESTORATIO N Contac t Name : ADA M Phone : (402)451-131 4 Alt . Contact : Phone : (636)288-961 6 Wor k Bein g Don e For : EP A Dept h o f Excavation : 2 4 Corne r Lot : NFront : Y Rear : 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 Nunibe 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 N UTILITIE S DISTRICT SAND Y 

### Day : 402504782 3 Alt : Emerg : 402504797 0
OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R RICH/TRAFFIC 

### Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0
OPPDGPR 5 OMAH A PUBLI C POWE RDISTRICT N A 

### Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3 QLNN E I C QWES 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. . . 12/5/200 9

## Contac t informatio n Lo g SAID # G35^ 3 (/D^ \ Owner' s Name : L- ) ' ^ a c ct^f ^ & ^ Daytim e Phone YJ)3 S -^ Y0~7~ 3 

### I Propert y Address : Ql3 ^ 1^
- ^5 ' h\>- ^ 

# D Attemp t t o contac t Date/tim e Nam e jf\<\od<^c d OAOfc^t^- r 

## ii/3^\/o i y,7s ' 

# R O (\/ 3 3/<s 7 /;6~ o 

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## Propert yAcces s Checlciis t SAID : 0^53 ^ D WOR K STARTED ON : / / Propert y Address : ^13 ^ l\) . '-{ S A^^- ^ D WORKCOMPELTE D ON : / / " Owner : V_

_

i Ac ^ a_(J ^ <3S_ _ Renter : Address : C ^-trV^C ^ 

### Phoiie : Fax : Cell/Pager : lone : (j/o;i ) g-5- J .')0'7 3 Additiona l Information : 

### Fax : Cell/Pager : \S ^ Acces s Agreement Signed : / / /

93 1 c/J By : ^iC ] 1 M Restoratio nAgreemen t Signed : / / 1 73 1 a l By : fi^O ( ^ Vide o Propert y Befor e On: H 1 3-^ 1 ^ 7 

## By: Ri 3 1 ^ Digital Photo s Before O n: / / /:?.3 / o l By : (0 3 [~

l Vide o Propert y After On: / / By : D Digital Photo s After O n: / / By : fT

f Property Completio nAgreement Signed : ^/pO / |C> By : /t ^ nFina l Report Signed : / / By : Additional Video o r Digital Photo' s Taken : D Vide o D Digita l Phot o 

### On / / 

### By : Reason : D Vide o D Digital Phot o O n By : Reason : nVide o D Digital Phot o On By : ; 

### Reason :

nVide o D Digital Phot o O n: / / By : 

# D

Reason :

Omah a Lead Projec t Wor k Pla n 

### Pag e lo f 1 9

## Consen t fo rAcces s t o Propert ySA1D # (r>3T^ ^ 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 , collectively th e Grante e t o ente r an dperfor mcertai nenvironmenta l respons e activitie s upo nth e followin g describe dpremises ;

Owner' s Name : /^/r\^< ^ iE-fV \CiX. _ Daytim e Phone : (ybj. ) S5~ d'7 o -7 3 Address : 

## 3-735 ! H - V 5 Av< _ Address : Ad dresse s o f Propertie s Address : covere db y thi s Agreement : Address : Address : PURPOS EO FINVESTIGATIO N 

### Th e purpos e o f th e remedia l activitie s i s t o remov e al l soil s a t th e propert y whic hare contaminate dwithhazardou s substances , i nparticular lea dat concentration s greate r thano r equal t o 40 0 part s pe r millio n(ppm) . REMEDIA LACTION S Th e envirormienta l respons e action s t o b e performe do nsai dproperty may includ e th e followin g activities : a .Takin g photograph s and/o r vide o o f th e property before , during , an dafter remedia l activities ; b .Locatin g equipmen t an dmachiner y on-sit e i npreparatio nfor an di nth e cours e o f th e envirormienta 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 fromGrantor' s property ; AGREEMENTNO T T O INTERFER E 

### Th e Granto r agree s no t t o interfere o r tampe r wit han y o f th e activitie s o r work done , o r th e equipmen t use dt o performth e activities , o r t o imdertak 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 Grrantee s o r th e environment , o r

t o allo w other s t o us e th e property i nsuc h I gran t acces s t o my propertie s Q I d o no t gran t acces s t o my propertie s

VX^.'^N ^ Dat e Dat e 

### Signature Signatur e 

# 1

### n Chec k thi s bo x

if owne rdoes no t wan t E.R . to ente rth e residentsto documen t interio r foundatio n wall s an d possibl e preexistin g damage .Bycheckin g thi s bo xE.R . Is no t responsibl e fo ran ydamag e don e to th e Interio r of house , Includin g foundatio n crack s

orfissures .



# 01 agre e nI do no t agre e 

# Di agre e nI do no t agre e

ivner' ^ Dat e Owner' s s Signatur

Signatur e e Contractor' s Signatur e Date

## Restoratio n Agreemen t Th e purpos e of thi s agreemen t i s t o provide amutua l agreemen t a s t o condition s of propert y prior t o contracto r activities . Thi s will als o serv e a s documentationfo r the purpos e of assuring tha t restoratio n activitie s ar e complete dto th e satisfactionof the propert y owne r an dth e Unite dState s Environmenta l Protectio nAgency (EPA) .

SAID : 035.? a Propert y Address : P73 PM S(5 ' A-^ ^ Owner : j^i^JI ^ ^^y H 

### Phone:(^O^J gj- j 7oV j 

### Onthe attacheddiagrain(s ) indicat e area(s ) to be excavatedan ddept hof excayation , locationo f all know n utilities , subsurface features , surface structure s aii dlandscaping features , acces s location(s ) t o b e use db y contractor , an dth e directiono f North . Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s by referencing th e photo-log numbe r wit ha narrow indicating directionof view . Item s t o b e remove d b yContracto ran d no t replaced :

» Item : ^,r^ ^ SI/AC^I I ^WA-V ^ ^ i ^ -^o^- ^ f> ^ oirJ i S<^<^ ^ t W ^i< ^ ^^ 1 Item : f^c^ ^ ,\ ^

^^ ^

U^et ^ 0 ^

-^^Wrc , c<r ^ -\rv»io(v P ) \oostc i -V^V ^ 'v* ^ ^/^'' YVisi k ^W 4 c=.<vvc s \^& - ^^v f Y ^ soK ^ be4 k c ^ U<* ^ Item:-^(j^ ^ ^^ ^ ()iU- t s-Kvw ^ o rkrorA-Ji ^ ~VU.«- V s4«c^ ^ "^ f i-v/kr- e ^o< A 

### Item : Item : Kem : item :

Pag e 1 o f 2

# L Additiona l Comment s / Instructions :

nI d o no t agre e \Z\I agre e Q I d o no t agre e agre e 

## fj\^. > 

# I/-22:P ^ Owner' s Signatur e Date Contractor' s Signatur e Dat e Attachment s

Pag e 2 o f 2

## Propert yCompietio n Agreemen t Thi s agreement documents th e completiono f remedia l activitie s performedo nm y property . M y signatur e wil l designat e tha t I a msatisfiedwit hthe restoratio nof m y property , an dtha t n o items ar e i n question , now , o r a

t an y time i nthe future , excep t thos e item s liste dbelow , if any . SAID : 

# uys^- ^ Propert y Address : ^ 7 5 ^ / / . 

# f^J ^ yV w Owner : 

## Lt(\<li , &t o p Phone : 

# SS3 ' 7<^7j Restoratio n Item s i n Question :

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

IW i agre e restoratio nis completed , except as note dr\ I agre e restoratio ni s completed , excep t as noted ^J-d o no t agre e restoratio ni s complete dL_ l I do not agre e restoratio ni s complete d

T\Dat e Contractor' s Signatur e Dat e

## Dougla s Count y Accoim t Intbrmation fag e 1 OI I Dougla s County , Nebrask a Propert yRecor d - R081160000 0 Prin t Repor t NE W Featur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f S2n d S t - Vle W O H Ma p Informatio n i s vali d a s o f 2009-11- 3 Treasurer' s Ta xRepor t Ne wFeatur e -•-•- • Aut o Sale s Searc h Owne r EMG E LIND A 273 2 N 4 5 AV E OMAH AN E 68104-000 0 Propert yInformatio n Ke yNumber : 

### 116 0 000 0 0 8 Accoun t Type : Residentia l Parce l Number : 081160000 0 Parce l Address : Lega l Description : 273 2 N 4 5 A V OMAH AN E 68104-000 0 CLAIRMON TLO T6 BLOC K4 5 0 X 12 5 Valu e Informatio n 

### 200 9 200 8 200 7 

### 200 6 200 5 200 4 Lan d $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 $6,400.0 0 Improvemen t $66,000.0 0 $66,000.0 0 $66,000.0 0 $66,000.0 0 $56,200.0 0 $51,100.0 0 Tota l $72,400.0 0 $72,400.0 0 $72,400.0 0 $72,400.0 0 $62,600.0 0 $57,500.0 0 Lan d Informatio n Acre s 0.1 4 S F 

### 6250. 0 Unit s 1. 0 Dept h 

### 125. 0 Widt h 50. 0 Vacan t N o Improvement Informatio n Buildin g 1



## http://dougIasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO.. . 11/13/2009

### Dougla s Count y Accoun t Informatio n Pag e 2 of 2

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### 1368. 0 Percen t Complete : 

### 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

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 : 7. 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 r Percen t Adjuste d Yea r yea rBuil t Physica l Ag e Remodele d Remodele d Buil t 

### 191 6 0 % 191 6 

### 9 4 Oetai YTyp e Detai l Descriptio n Unit s Ad d O n Fenc e Chai n Lin k 

### 1. 0 Applianc e Allowanc e 1. 0 Basemen t Bsmn t Bloc k 8 ft 832. 0 Fixtur e Bas e Fixture s 

### 1. 0 Fixtur e Bat h Ful l 

### 1. 0 Garag e Detache d 360. 0 Porc h Sla b Roo f Ceilin g 45. 0 Porc h Sla b Roo f Ceilin g 

### 184. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO. . . 11/13/200 9

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### 273 2 N 45t h Av e Omaha , N E 68104-452 7 Age : 65-1 - Prin t holida ycar d labe l

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# r \K I A(>l> l UMO U 1 2010-08-1 2 10:0 8 Avg of417-41 9 273 2 n4 5 a v E Z junm y surfac e fina l clearanc e 128,0 4 ± 19,2 2 2 2010-08-1 2 10:0 8 273 2 n4 5 a v E Z siufac e final clearanc e 6352 2 130.00 ± 19.3 2 3 2010-08-1 2 10:0 7 273 2 n4 5 a v E Z ^oung r surfac e final clearanc e 6352 2 138.0 3 ± 198 2 4 2010-08-1 2 10:0 7 273 2 n4 5 a v E Z surfac e final clearanc e 6352 2 116,1 0 ± 18,54 5 2010-08-1 2 10:0 4 Av g of413-41 5 273 2 n4 5 a v D Z jiimny final clearanc e 79,0 6 ± 16,05 6 2010-08-1 2 10:0 4 273 2 n4 5 a v D Z final clearanc e 6352 2 83,9 0 ± 16.2 3 7 2010-08-1 2 10:0 4 273 2 n4 5 a v D Z jminn r final clearanc e 6352 2 80.0 9 ± 16,29 8 2010-08-1 2 10:0 3 2732n45a v D Z jmnQ T final clearanc e 6352 2 73.1 8 ± 15,6 4 9 2010-08-1 2 10:0 1 Avg of 409-41 1 273 2 n4 5 a v GZ nnnii y final clearanc e 81.2 5 ± 16,4 6 1 0 2010-08-1 2 10:0 1 273 2 n4 5 a v G Z jirmny final clearanc e 6352 2 79.6 3 ± 16,25 I I 2010-08-1 2 10:0 0 273 2 n4 5 a v G Z itomiy final clearanc e 6352 2 84.8 8 ± 16,7 6 1 2 2010-08-1 2 10:0 0 273 2 n4 5 a v G Z junoE y final clearanc e 6352 2 79.24 ± 16,3 8 

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