### TRANSMITTA L of OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R SAID# : 3308 7 Date : Address : 255 4 Spauldin g St Remediatio nContractor : Environmenta l Restoration , LLC

_Year : _201 1 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S yy ^ Vide o of propert y (DVD ) y^&K ^ DAfter D Basemen t D y y Executiv e Summary (Final Report ) EPA-providedproperty sketc h Signe dAcces s Agreemen t for subjec t property D Signe dAcces s Agreement(s ) for adjacen t propert y y y Restoratio nAgreemen t

D Settlement document s (i.e. , for damag e orto replac e plants , etc. ) y y Confirmatio ndat a Photograph s jyi^for e DCre w Photo^^B^urin g Excavatio nD So d ^,a^-da y So dD As-buil t sketc h >0 ^ Completio nAgreemen t signe dby Property Owne r y ^ Property close-ou t chec k lis t signe dby EP A D Descriptio nof area s no t meetin g RO D cleanu p criteria . Contaminatio nlef t behin d Utility clearance s Property informatio nfromDougla s County Assessor' s Offic e Propert y acces s checklis t j y Contac t Lo g i,,,, , SJSJJ,? i D 

### ErivironmentSTRpstor^tlo nSignatur e Dat e EP ACO Rsienatur e signatur y Dat e

# EPA EP APropert y Clos e Ou t For m Omah aLea dSit e Propert y # : 3308 7 Propert y Address : 255 4 Spauldin g S t Date/Time : Owner' s Name : Candic e Frank s Quad s Excavated : B l Contracto r Group : Environmenta l Restoratio n(ER ) Excavatio nGenera l 

## \f(UL6A^ it^ f Ye s N o 1 . I f necessary , wer e th e correc t quadraiit(s ) excavate dandrestored ? 

## y 2 . I f necessary , wer e th e correc t area s ofdri p zon e excavate dan drestored ? Gradin g So dan dVegetatio n Ye s N o 

### 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 evaluat e if inspecte dat 30-da y tim e period) . 4 . Ar e sodde darea s generall y firman devenl y graded ? i ^ 5 . Ar e th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte dat 30-day tim e period) . 6 . Wa s th e property grade dsuc htha t wate r will no t poo l o nth e property ? l y 7 . Wa s damag e t o landscapin g o r plan t material s avoided ? 

## y Gates , Fence s an dRetainin g Wall s Ye s N o 1 . D o gate s ope nan dclos e freely? (i f applicable ) 

## AJ A 2 . Were al l gate s o r fence s take ndow ndurin g restoratio nactivitie s re-installed ? (i f applicable ) **"*^ ^ ^ yy 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 apphcable ) 

## A;A
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 navoided ? 

# ^fitc.i\ ^ \6 V 3 . Wa s damag e t o window s avoided ? 

# yLJ 4 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 N o 1 . Wa s damag e t o drivewa y surface s avoided ? 1^
­ 2 . Wa s damag e t o walkwa y surface s avoided ? y inspectio nnotes : . / 

# code r W^^^^^rt y Sd d Remedia l an drestoratio nactivitie s complet e includin g 30-da y so dwarranty : icsiuiitiiu u aciiviuc s cuuipici c lUCIUUIU g ^ v 

### Date : / ^Z//- /

# ^^^" X OMAH ALEAD SITE —EP-R7-09-0 5 ENVIRONMENTA L RESTORATION , LL C WWW.ERLLC.CO M
'^4 no^ ^


# EXECUTIV E SUMMARY : 3308 7 255 4 Spauldin g S t


## N O ISSUE S O R CONCERN S ISSUES/CONCERN S 

# DETAI L EXPLANATION :

### IRT H On e Cal l Pag e 1 o f 1

• th ) 

### Hom e Ticket Ticke t Creatio n Creat e Anothe rTicke t G o t o Hom e Pag e

• YOU R TICKE TNUMBE R I S 2903015 . Origina l Cal l Date : 11/16/1 1 Time : 8:0 4 a m Wor k t o Begi n Date : 11/18/1 1 Time : 8:1 5 a m State : N E County: DOUGLA S Address : 255 4 Street : SPAULDIN G S T Twp : 15 NRng : 13 E Sect-Qtr : 04-S E Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : LEA D REMOVA L Locatio n o f Work : LOCAT E ENTIR E PROPERTY . Remarks : FA X AL L CLEAR S TO : (402)451-106 9 : 3308 7 Compan y: ENVIRONMENTA L RESTORATIO N Contac t Name : TI M SUTTO N Alt . Contact : CEL L Wor k Bein g Don e For : EP A Dept h o f Excavation : 2 4 INCHE S Corne r Lot : N Involve s Tunnelin g o r Horizonta l Borin g : N MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

Servic e Are a Servic e Are a Nam e Contac t Cod e MUDO l METROPOLITA N UTILITIE S DISTRIC T SAND YMUDO l
OMAHACO F CIT YO F OMAHA - RICH/TRAFFI C /-> M AUft Digger s Hotlin » O f N«brask a
Logou t A Sen d Emai l

Op : TIM2418 6 

## • A Place : OMAH A

Phone : (402)451-131 4 x226 7 Phone : (402)306-234 7 

### Br
Front : Rear : Explosives : Utilit y Phon e Number s Typ e Day : (402 ) 50 4 - 782 3 Emerg : (402 ) 50 4 - 797 0 Day : (402 ) 44 4 - 719 7



### http://www.dhon.org/IRTHOneCall/Ticket/TicketCreation.aspx?ViewTicketID=89580 5 11/16/201 1

## Contac t Informatio n Lo g SAID # ^3-6 3 7 Owner' s Name : Q «^./vo < / s i- r i/\^ J " Daytim e Phone : ^bj " S^ ^ S ~ j Propert y Address : Pi'S'V Sfi^Ut'n ^ S f Attemp t t o contac t Date/tim e Nam e

## Propert yAcces s Checklis t SAID : 3 Jo ? 7 nWOR K STARTE D ON : / / D WOR K COMPELTE D ON: _ / / Propert y Address : J>55 / J>pa.wl<^i/^ 3 j / Owner : C'^^4y S p'rcA./^L s Renter : 1 Address : ^^^ ^ JV^M/MIA ^ -f/ « Phone : Fax : Cell/Pager : Phone : "JOS
­ SC^^ST Additiona l Information : 

# ^^^'Siyrr^Akj
- V 6 (g ) Y«^o . cc ^ Cell/Pager : 'Q ] Acces s Agreemen t Siened : \\/ 11 > / V f By:vt ^ ly

Q Restoratio nAgreemen t Signed : \ \/ (

S" / U By : ^ ^ P(| ^ Vide o Propert y Befor e O n:l » /fd»/u 

## By:f A B ' Digita l Photo s Befor e O n:fi_/^/lA_ 

### By:f= ^ nVide o Propert y Afte r O n: / / By : nDigita l Photo s Afte r O n: / / By : I w Propert y Completio nAgreemen t Signed : U/33/* ^ 

## By:qi 5 D Fina l Repor t Signed : / / By : Additiona l Vide o o r Digita l Photo' s Taken : ] nVide o D Digita l Phot o O n: / / By : Reason : | D Vide o nDigita l Phot o O n: / / 

### By : 1 Reason : | nVide o nDigita l Phot o O n: / / By : Reason : D Vide o nDigita l Phot o O n: / / By : Reason :

## Consen t fo rAcces s t o Propert y 

# SAID#3>? Z RIGH T O FENTR Y TO 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 dperformcertai nenvironmenta l respons e activitie s upo nth e followin g describe dpremises :

Owner' s Name : C*'A<^i ^ ProiA| ^ Daytim e Phone : r/o^ J ^6 S • S^^ 5 Address : 

# J55 Y Sfp^ojJ'ia i 

# s i 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 remedia l activitie s i s t o remov e all soil s at th e property whic har e contaminate dwit hhazardou s substances , i nparticular leadat concentration s greate r tha no r equal t o 40 0 part s pe r millio n(ppm) . REMEDIA LACTION S 

### Th e environmenta l respons e action s t o b e performe do nsai dpropert y 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 dafte r remedia l activities ; b .Locatin g equipmen t an dmachinery on-sit e inpreparatio 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 nea r Grantor' s property . d .Obtainin g sample s fromGrantor' 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 wit hany o f th e activitie s o r work done , o r th e equipmen t use dto performth e activities , o r t o undertak e an y action s regardin g th e us e o f sai d property whic hwoul dten dt o endange r th e healtho r welfare 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 propert y i nsuc h 

## [p^ J I gran t acces s to m y propertie s nI d o not gran t acces s t o m y propertie s
Signatur e Dat e Signatur e Dat e

### C&^he i 'Chc k thi s bo xi fowne rdoe s no t wan t E.R . t o ente rth e residents 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 don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures .

• I agre e nI d o no t agre e ITT i agre e nI d o no t agre e

UrtV-i b 

### Owner' s Signatlir e Date Contractor*Ssignatur e Date

## Restoratio n Agreemen 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 property 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 that 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 : 

## 33o^- 7 Propert y Address : y^^S Y S^^Uj/y ^ ^ f Owner : C<Ki^Jl ) ^ ^nK/ykL s Phone : 

## ^Y^ ) }>o ^ • Si^<P S O nth e attache ddiagram(s ) indicate area(s ) t o b e excavate dan ddeptho 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 contractor , an dth e directio no f North . Indicat e distances , depths , materia l types , etc . Indicat e digital photo s b y referencin g th e photo-lo g number withanarro w indicatin g directio no f view . Item s t o b e remove d b yContracto ran d no t replaced :

Item : 

## /^j^fe- g ^ / <y<:ocvccfrLc7 gg<"^ i '^'i' k SoJ Item : Item : Item : Item :

Ite m

Pag e 1 o f2

### I agre e nI do no t agre e 

# zTi agre e nI do no t agre e 

# H y/^'^S^-t i Owner' s s Signatur

Signatur e e Date Contractor' s Signatur e Date Attachmen t

Pag e 2 of 2

## Propert yCompletio n Agreemen t Thi s agreemen t documents th e completiono f remedia l activitie s performe do nmy property . My signatur e wil l designat e tha t I a msatisfie dwit hth e restoratio no f m y property , an dtha t n o item s ar e in question , now , o r at an y tim e inth e fiature, excep t thos e item s liste dbelow , if any . SAID : 33Q@ 7 Propert y Address : J^$S/^ . ^*t^/g/z^ q,^
- Owner : jfg^^,;^^l ^ k g Phon e 

# /^^ ) 3<^s-sces ^ Restoratio n Item s i n Question :

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

\ y \I agre e restoratio ni s completed , excep t a s note d J^T l agre e restoratio ni s completed , excep t a s note d I I { d o no t agre e restoratio ni s complete d I I I d o no t agre e restoratio ni s complete d


### Owner' s Signatur e Dat e Contractor' s Signature Dat e

# a(l)^ftOQD 0 0 Q
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# 255 4 Spauldin g S t .^fflM ^ 

# A Printed : Nov 14,201 1 www.dcgis.org/dogi s 

# y.s^^- ^i 

### uougia s Lounty Accoun t intormatio n rag e i or i
i Dougla s County , Nebrask a Propert yRecor d - R020452000 0 Prin t ReDort Vie wInteractiv e GI S Ma o Informatio n i s vali d a s o f2011-11- 2 Treasurer' s Ta xReDort Ne wFeatur e ->->- > Subdivisio n Sale s Searc h Owne r FRANK S CANDI S Y 255 2 SPAULDIN G S T OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumber : 045 2 000 0 0 2 Accoun t Type : Residentia l Parce l Number : 020452000 0 Parce l Address : 255 4 SPAULDIN G S T OMAH AN E 68111-000 0 Lega l Description : LAND S SEC-TWN-RG E 04-15-1 3 -E X ST - SU B L T2 LO T2 9 - 4 0 X 12 5 Valu e Informatio n Lan d Improvemen t Tota l 201 1 $400.0 0 $0.0 0 $400.0 0 201 0 $400.0 0 $0.0 0 $400.0 0 200 9 $400.0 0 $0.0 0 $400.0 0 200 8 $400.0 0 $0.0 0 $400.0 0 200 7 $400.0 0 $0.0 0 $400.0 0 200 6 $400.0 0 $0.0 0 $400.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 2 5400. 0 0. 0 135. 0 40. 0 Ye s



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO. . . 11/14/201 1

# • • ENVIRONMENTA L AS-BUIL TDRAWIN G J***""'** , OMAH ALEA D 

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# 33 0 S 7 Exterio rPain t Nort h Arro w Omah a Lea d Sit e |~ | Goo d Sit e Sketc h 

# i n Poo r Samplin g Address : Z.S& ^

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# n Date : <=>^oS/g=> ^ nYBSCPX A33CS 7 r 2 _pp m 

## D 

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# n Sample s Analyze d • RYDSCPX A3.30g 76 3 _pp m 

## D D RDZGCPX AJ'SOQ TD^ - _pp m 

## D D XR F Unit : Book : RGZSCPX AJ206 7 G Z _pp m 

## D D Date : _ • RPZSCPX A3308 1 Pg - _pp m 

## D Time : _ 

# a Staff : 

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inde x lim e AVKR.\€ K ADDKhS S ISAMPL K ARKA OPERAIO R UKPT H NOTK S Hag s SAI D Pl > I 2011-11-1 6 15:0 0 Av g o f 283-28 5 255 4 spauldin g stB l JIMMY 4 fina l clearanc e 188.7 7 ± 22.5 5 2 2011-11-1 6 15:0 0 255 4 spauldin g stB l JIMM Y 4 final clearanc e 3308 7 203.4 1 ± 23.2 2 3 2011-11-1 6 14:5 9 255 4 spauldin g StB l JIMMY 4 final clearanc e 3308 7 189.4 3 ± 22.5 9 4 2011-11-1 6 14:5 9 255 4 spauldin g StB l JIMM Y 4 final clearanc e 3308 7 173.4 6 ± 21.8 5

Pag e I o f I 11/16/1 1 14:52:07

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