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### TRANSMITTA L O F OMAH ALEA D SIT E SOI L REMEDIATIO N FIL E FOLDE R SAID# : 28018 DATE : 12/15/201 0 ADDRESS : 262 5 Gran t St REMEDIATIO N CONTRAaOR : PRUDENTTECHNOLOGIES . INC . YEAR : 201 0 

### SOI L REMEDIATIO N PROPERT YFIL E FOLDE R DOCUMENT S [ ^

PR E AN D POS TVIDE O O F PORPERT Y(DVD ) E f EXECUTIV E SUMMARY

EPA-PROVIDE D PROPERT YSKETC H [ ^

SIGNE D ACCES S AGREEMEN TFOR SUBJEC TPROPERT Y n SIGNE D ACCES S AGREEMENT(S) FOR ADJACEN TPROPERT Y 0 RESTORATIO N AGREEMEN T D SETTLEMEN TDOCUMENTS (I.E. , FOR DAMAG E O R T O REPLACE PLANTS , ETC. ) H CONFIRMATIO N DAT A Q PHOTOGRAPH S H AS-BUIL TSKETCH m SATISFACTOR YRESTORATIO N SIGNE D B YPROPERT YOWNE R m PROPERT YCLOSE-OUTCHEC KLIS TSIGNE D B YEP A D DESCRIPTIO N O F AREA S NO TMEETIN G RO D CLEANU P CRITERI A c f UTILIT YCLEARANCE S d PROPERT YINFORMATIO N FRO M DOUGLA S COUNT YASSESSOR'S OFFIC E 

### D D D 

# »^ w «^\^^^^ ' SIGNATUR E DATE 3026075 3 

# • il l Superfun dFin d Record 

### Backfill : Remediatio n Quer y1 Lea d Remainin g Quer y Propert yDamag e Query 

# J Sampl e Area : 2801 8 ­ 262 5 GRAN TS T Owner : Use rProvide d Owne rInformatio n Resident : n OwnerOccupled Owne rName : MATLOC KRICHETT AR Owne rAddi-essl : 

# 1 Owne rAddress2 : Owne rName : 

# 1 Owne rAddress : 

# r Residen t Name : 

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" • PropertyAddress : |262 5 GRAN TS T Zi p Code : |324 2 BEDFOR D AV E |68111 - City : lOMAH A Owne rPhon e 1(402 ) 346-848 3 A l 

# r state : Zi p Code : |N E J68111 ­ ternat e Phone : City : 

# 1 Owne rPhone : 

# 1 State : ZipCode : 

# 1 1 Alternat e Phone : 

# 1 Residen t Phon e 

# 1

Contract : Assessment : Contractor : ]PRUDENT2010_S Qualifying , Grou p '[40 0 Contrac t Optio n lOPTTO N 1 Assessmen t Ma xXR F Valu e 

# 1 540.8 9

### PROPERT Y SUMMAR Y Date : 12/15/201 0 Omah aLea dSit e Remedia l Actio n Contrac t #EP-R7-07-0 6 TO# l Mont hof : Decembe r Propert y Address ; 262 5 GRAN T S T A . EXECUTIV ESUMMAR Y A. 1 Issue s Encountered : NON E A. 2 Issue s Resolved : NON E A. 3 Uniqu e Findings : NON E A. 4 Othe r Relevan t Information : NON E CONFIRMATIO NSAMPLIN GDATA/RESULTS : B 2 = 36 7 PP M @ 10" ; E A = 31 0 PP M @ SCRAP E(~1" ) ATTACHMENT S 1 ) Property sketc hprovide db y EPA pursuan t t o contrac t specification s 2 ) Signe dAcces s Agreemen t includin g acces s agreement s require dfor crossin g othe r propertie s 3 ) Pre-Excavatio ndigital vide o clip/photograph s 4 ) Post-Excavatio ndigital vide o clip/photograph s 5 ) Documentatio n - Complete dClose-ou t Checklis t 6 ) As-Built sketch
i ) Shal l includ e fma l leadlevel s v ) Legen d ii ) Contaminatio n lef t behin darea s vi ) Contracto r identificatio n iii ) Property addres s vii ) Date iv ) BVI D numbe r 7 ) Othe r item s t o b e include di n th e individual property file , i f available , o r obtaine dinclude : i ) Pre-excavatio nagreemen t detail s (ifan y ar e mad e withth e property owner ) ii ) Property Statu s For msigne dby property owne r iii ) Excavatio n digital vide o i n MPEG , WMV (Window s Medi aVideo ) o r SWF(Flas hPlayer ) forma t and/o r photograph s iv ) Signe dfor mverifyin g satisfactory restoratio n v ) Descriptio nofarea s no t meetin g Interi mRO D cleanu p criteria .

TECHNOLOGIES , INC .TECHNOLOGIES , INC . 

### Propertv # : 2^0 1 S Date/Time : 10/2-^/^^l ^ Quad s Excavated : Excavatio nGenera l l.-^"3 . f f 

# EP A Propert y Clos e Ow t Propert y Address : 2-^"^ ^ S P-"^^" ^ " ^ Owner'sName : Richc-Hrc x /\AcM~locb
Contracto r CBroup : Piruiden t Technologies , Irac , 1 . If necessary , wer e th e correc l quadrant(s ) excavate dan drestored ? 2 . If necessary , wer e th e correc t area s of dri p zon e e.xcavate dan drestored ? Gradin g So dan dVegetatio n 1 . 2 . 3 . 4 5 . 6 . 7 . Gates , 1 . 2 .

. 1 4 . Doe s tli e gradin g aroun dth e perimete r of th e hous e i nexcavate darea s generall y slop e away fromth e house'. ' Ha s so dbee nhii di nal l area s tlia t vver e excavated ? Doe s Ut e so dappear t o b e generall y healdty an dgrowing ? (Onl y evaluat e if inspecte dat a3 0 da

y tim e period ) Are sodde darea s generall y fin n an devenl y graded ? Ar e th e joint s betwee n th e so dstrip s generall y tight ? (Onl y evaluat e if inspecte dat a3 0 da y tim e period ) Wa s th e property grade dsuc htitat wate r wil l no t poo l o ntlt e property ? Wa s damag e to landscapin g or plan t material s avoided ? Fence s an dRetainin g Wail s D o gate s ope nmi dclos e freely ? (I f applicable ) Wer e al l gate s o r fence s tal-ce ndow ndurin g restoratio nactivitie s reinstalled ? (I f applicable ) Wa s damag e l o gate s o r fence s avoided ? (If applicable ) Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) Foundation , Sidin g an dGutter s 1 . Wa s (iajiiag c to th e sidin g o r tri mavoided ? 2 . Wa s damag e l o th e foundatio navoided ? ?i . Wa s damag e t o window s avoided ? 4 . Wa s damag e t o window s or doo r screen s avoided ? 5 . Wa s damag e to downspout s o r downspou t extension s avoided ? Ye s N o 

## y / Ye s N o



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# y y y y Sidewalk s an dDriveway s (Concrete ) Ye s No 1 . Wa s damag e t o drivewa y surface s avoided' ' 

# y 2 . Wa s damag e t o walkwa y surface s avoided ? 

# y

## Owner s commeinits :

Inspectio nnotes :

Remova l an drestoratio n activate s complet e includin g th e 30-da y sodwarranty : EP A Representativ e 7/,.. ^ J/L. . Date ; /^/^a// ^

### 2801 8 rtCHNULOGIES . FNC . 

### A S - BUIL T DRAWIN G OL S U 2801 8 Dat e Excavated : 10/5/201 0 

### OMAH A LEA D SUPERFUN D SIT E USEP A Signed-OfTDate : 

# lil i Exterio rPain t Nort h Arro w Omah a Lea d Sit e Owne rName : RICHETT AR MATLOC K Sit e Sketc h • Goo d Address : 262 5 GRAN TS T • Poo r

Phone : H : W : 

# i Q No t pain t Lea d Sampl e 1 A P Sample s Collecte d Concentratio n Collecte d Firm : Flaft \ R s yTci j RYASCPXA-2801 8 F 1 pp m 

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# n Date : Ot - 3 o - o M RYBSCPXA-2801 8 pp m

Sampl e Numbe r F 2 

## \3 r D Time : a .3 0 RYCSCPXA-2801 8 B l 

# —35 5 pp m 

### [ T D Sample s Analyze d RYDSCPXA-2801 8 8 2 pp m 

### I T D nOZSCr'X A2801 8 B ^ pp m 

### D D XR F Unit : ^ \ \ Book : & D nczscpxA-280ie—es - pp m 

### D D Date: . riPgGCP)(A"2001 0 P2 - pp m 

### D D Time: . 

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## L Oinah aLeadSite 4613 0 EA = 31 0 PP M @ SCRAP E CONTRAC T# : EP-S7-10-0 5 PRUDENTTECHNOLOGIES , INC .

## Propert yCompletio n Agreemen t Thi s agreement document s th e completio no f removal activitie s performe do n th e belo w liste dproperrv . Th e propert) ' owner' s signatur e indicate s tha t th e propertj
- owne r i s satisfie dvnt hth e restoratio no f th e subjec t property , an dtha t n o item s ar e i n question , uow , o r a

t an y tim e in th e future , exchadin g any remainin g warrant y (3 0 day s total ) excep t thos e item s liste dbelow , ifany . Property ' Propert yAddress : ,j(p^f ^ Oimr\ f "^iJ^ O J t ' 

### Owner : 

# p^o--yf07j-<y^^L\^nn \ Restoratoo n litem s im i Qyestiora :
Item : Itere : Item :

ReqiLsire d correcteoin s t o complet e th e piropertj n

i agre e restoratio n i s completed , excep t a s note d abov e [_ ] I d o no t agre e restoratio n i s complete d 

# lD-2i'/ o

Owner s Sigmater e''^^ -
Pnidcn t Technologies , Inc . (Prudent ) i s unde r contrac t witi i th e U . S . Environmenta l Protectio nAgenc y (EPA ) t o cleanu p lead
contaminated^ojk ; a t anumbe r o f

propertie s locate di n Omaha , Nebraslia , includin g th e propert y locate dat ..I . A * \ . ^ C n..^..m . .*. ' Tl.. . n ' o A . „ , :~~ : ._ _1 1 n_ , j * * - j :
- . Th e EPA reque,>:t. s you r permissio n to allo w Pruden t t o performasoi l cleanu p a 1 Ihi. s 

### i^_

_ propeity / t o remov e lead-contamuiale dsoil . B y signin g thi s form , th e property owne r grant s permissio nt o Pruden i t o perform activitie s relate dl o th e cleanu p includin g soi l sampling , remova l o f lead-contaminate dsoil , an drestoratio nofth e reference dproperty . Ifyo u hav e an y question s abou t th e soi l cleanu p planne dfor you r property , pleas e contac t Pruden i southoffic e for th e Omah aLea d Site cleanup-a l (402 ) 733-1188 . Genera l question s abou t Ui

e Omah aLea dSite cleanu p ca nb e directe dt o th e EPA . Publi c Informatio n Center s ai (402 ) 7 3 1-304 3 (Sout hOmah aoffice ) or (402 ) 991-958 3 (Nort hOmah aoffice) . Property .Acces s Grante dBy: ( ' ^ ' ^ (fleas e Prin t Name ) Property Owne r %\?p2.v.iriJ/y.fyl^.zyyZ/'- ^ / W/^/F^^^^JjCr a1/ 7 ' ^ (Date ) PROPERT Y INFORMATIO N (T o b e complete db y residen t andi'o r propert y OAvne r—pleas e piint ) RESIDEN TNAME : (/.l^JjyT^nkediot : f - T y yRente r RESIDEN TADDRES S 

## ^.(^X ^ l^^gy/U ^ I F RENTAL , PROPERT YOWNE D BY : OWNER' S MAILIN G ADDRESS ; OWNER' S TELEPHON E NUMBE R - HOME : (f/2 ^ ) PLII J ~ l o ^ ^ WORK:-- . _ J L AG E O F HOME? : 

# y YEARS . HO W LON G HAV E YO U LIVE D HERE? ; YEARS . HA S TH E EXTERIO R BEE N PAINTE D O R COVERE D WIT H SIDIN G SINC E 1978 ? YE S N O ^ NLIMBE R O F OCCUPANT S UNDE R 7 YEAR S OL D NUMBE R O F OCCUPANT S 7 YEAR S OL D AN D OLDE R |jl|lMBE R O F CHILDRE N UNDE R 7 YEAR S OL D WH O PLA YI N TH E YAR D FO R 5 HOUR S O R MOR E PE R WEEK :

MniENT S O R SPECIA L INSTRUCTIONS : (I.E . DOGS , ENTR YGATES , ETC. )

ALITHORITY FO RENVIRONMENTA LRESPONS EACTIONS : Th e activitie s t o b e Implemente dby EP A unde r thi s agreemai t are pursuan t l o Sectio n10 4 ofCERCLA , 4 2 U.S.C . 9604 . EPA' s righ t ofacces s t o th e propert y i s provide dFo r in Sectio n 104(e ) o f CERCLA , 4 2 U.S . C &605(e) . whic hprovide s entry fo r "detenninin g th e nee dfo r response , o r choo.sin g or takin g an y respons e actio n under tlii s title , or otherwis e enforcin g th e provision s ofth e title. " 808 0 Warrf Part.vray . Suit e 40 5 560 S s •;-: - s t 424 2 Wectica l Drive , Suit e 425 0 Kansa s City , 'M O 64t f 4 OrriEna . ?igDi2.sfe a 5310 7 Sa n Antonio . T X 7822 S Photie : ^SIS ) 363-370 3 Phone : ;432i . 7i3-'it£ t Phorie : /210 ) 322-S58 8 Fax ; (S1S> 363-370 7 Fax : {432 ; '-^^AfS^ -Pax ; i213 ) 57S«57 7ENVTRO.NMEiMALJ i COiNSTRLiCTIOi S SERVrCE. S 

### TECHNOLOGIES , INC . 

# Propert y Statu s For m^ , . Address : ^^ 5 f/^^/J-^T ^ Date : ^ ^^^ T " / ^ Phone f /

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= 308 0 War d Pa i 560 0 S 1 0 S t 424 2 S/ledrca ! Drive . Suit e 425 0 Kansa s Ciiy , M O S411 4 Phone : (816 ) 363-370 3 r-.. . /o.«e i ne n ^TAT Ortsaha . Nebrask a S815 7 Phone : (40Z)733-11S S

c..» ­ ttni x -Ji n ico n Sa n Antonio , TX 7322 9 Phorte ; (210)322-958 3 C..V ­ ntl\ \ B7a.J!ST 7

# 2801 8 Exteriai rPain t Nort h Arro w 

### Omah a Lea d Sit e Owne rName : RICHETTAR MATLOC K Q Goo d 

### Sit e Sketc h Address : 262 5 GRAN TST 

### • Poo r Phone : H : W : 

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# n Date : Ot- ^ 3 o -O M RYBSCPXA-2801 8 F 2 pp m 

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# A Printed : Oc t 21 . 201 0 -A'".'.^v.(JcEf e 'WS * de"f ^http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=%3CRESU . creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l



### • YOU RTICKE T NUMBE RI S  2605487 . Origina l Cal l Date : 9/30/1 0 Time : 12:3 7 pm Op : SIVA1896 7 Wor k t o Begi n Date : 10/04/1 0 Time : 1:0 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 262 5 Street : GRAN T S T Twp : 15 NRng : 13 E Sect-Qtr : 09-S E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : soi l lea d remediatio n projec t Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : (402)733-188 3 : UNSUR E CORNER S Compan y: PRUDEN T TECHNOLOGIE S Contac t Name : SIV AJAMPAM A Phone : (402)733-118 8 Wor k Bein g Don e For : ep a Dept h o f Excavation : 6 f t Corne r Lot ; NFront : Y Rear ; Involve s Tunnelin g o r Horizonta l Borin g ; NExplosives : N CXCATV 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 S/iND Y Day : 4025047823 Alt : 

### Emerg : 402504797 0

I o f 2 9/30/201 0 12:3 8 P M

### http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=%3CRESU. .

OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R RICH/TRAFFI C Day : 402444719 7 Alt : 402444516 1 Emerg : 402444516 0 0PPDGPR 5 OMAH A PUBLI C POWE RDISTRIC T E L M LOCATIN G Day : Alt : 406728934 3 406207149 4 Emerg : 888728934 3 QLNNEI C QWES T LOCALNETWOR K ELM LOCATIN G Day : 406728934 3 Alt : 406207149 4 Emerg : 888728934 3

2 of 2 9/30/201 0 12:3 8 P M

### SOtUTION S 

## SIT ESAFET Y HAZAR D ANALYSI S

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## Excavatio nDate : -MsUZ L Address : Crew : Backfi U Date : 'jdMlSL .

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## Drivewa y Sprinkle r Syste m Othe r Cre w Forema n Sit e Safet y Offic e Date :

\ Wai d ParioMay , Sul e 40 5 SSOOSIOS t 424 2 Medica l Drive , Suit e 725 0

;Cify;Ma^li 4 Omataa , Webrask a 6810 7 Sa n Antonio , TX 7822 9 Tone : (ffW ) 3CT<mi 3 Plwna : (402)733-118 8 Phone : (2t0 ) 822:^58 8 n c(8t6 ) 363-370 7 Fax : (402)733^188 3 Fax ; (210)«T9-657 7

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