## TRANSMITTA Lo f

OMAHA LEA D SIT E SOI LREMEDIATIO N FIL EFOLDE R SAID# : ^(-t^S'T O Date : ^-V-V V Address : 3 ^ ^ ^ ti- c c <f«f
- "SV- , Remediatio n Contractor : Envrionmenta l Restoration , LLC

_Year : _201 0 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S
^ Vide o o f propert y (DVD ) JZ^efor e DAfter D Basemen t D JZ

l Executiv e Summar y (Fina l Report ) EPA-provide dpropert y sketc h 

### J2 A Signe dAcces s Agreemen t for subjec t propert y D Signe dAcces s Agreement(s ) fo r adjacen t propert y 2 i Restoratio n Agreemen t D Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) C K Confirmatio n dat a JZ

lPhotograph s ^ j Before DCre w Photo^^0T)urin g Excavatio nD So d J^O-da y So dD ^ As-built sketc h jA ^ Completio n Agreemen t signe db y Property Owne r ^ Property close-ou t chec k lis t signe db y EP A D Descriptio n ofarea s no t meetin g RO D cleanu p criteri a j A Utility clearance s J2 [ Property informatio n fro mDougla s Count y Assessor' s Offic e JZProperty acces s checklis t tFuv aI ^po^ ) 3026190 1 

### jA ^ Contac t Lo g J ^ \JcLrQ/\- f /^ A Superfun c Envirotimenta l Restoratio nSignatur e Dat e EPA CO Rsignatur e ~y ^ Dat e

# EPA EP A Propert y Clos e Ou t For m Omah aLea dSit e OU# 2 Propert y # : ^t,sfs Propert y Address : 33a * I><a.fo r Date/Time : Owner' s Name : Loij/ s ^-f^ic j 

### Quad s Excavated : f?^,[H D P Contracto r Grou p : Environmenta l Restoratio n (ER ) Excavatio nGeneral Ye s No 1 . Ifnecessary , wer e the correct quadrant(s ) excavatedan drestored ? ^ 

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

# UI c Gradin g So dan dVegetatio n Ye s N o ^ house ? 2 . Has sodbee nlaidi nal l area s tha t wer e excavated ? 1 ^ 

### 3 . Doe s th e sodappea r to b e generall y health y an dgrowing ? (Onl y evaluat e ifinspecte da t 30-da y tim e period) . 4 . Ar e sodde darea s generall y fir man devenl y graded ? .y ^ 

### 5 . Ar e th e joint s betwee nthe sodstrip s generall y tight ? (Onl y evaluat e ifinspecte da t 30-da y time period) . 6 . Wa s th e propert y gradedsuc htha t wate r wil l no t pool o nthe property ? * y 7 . Wa s damag e t

o landscaping o r plan t material s avoided ? > y Gates , Fence s an dRetainin g Wall s Ye s N o 1 . Do gatesopenan dclos e freely? (ifapplicable ) 2 . Wer e al l gate s o r fence s take n dow nduring restorationactivitie s re-installed ? (ifapplicable ) 3 . Wa s damage t o gate s o r fence s avoided ? (ifapplicable ) 4 . Wa s damage t o retaining wall s avoided ? (ifapplicable ) 

# M Foundation , Sidin g an dGutter s Ye s N o 1 . Wa s damage to siding o r trimavoided ? 2 . Wa s damage t o the foundatio navoided ? 

## \}[}^<UiM ± I n 3 . Wa s damage to window s avoided ? 

# f ^ 4 . Wa s damage t o window screen s o r doo r screen s avoided ? 5 . Wa s damage to downspouts o r downspou t extension s avoided ? Sidewalk s an dDriveway s (Concrete ) Ye s N o 1 . Wa s damage to drivewa y surface s avoided ? 

# m 2 . Wa s damage to walkwa y surface s avoided ? 

## A ^ Inspectio n notes :

Remedia l an drestoratio n activitie s complet e includin g 30-da y so dwarranty : EP A Representative : ^^JAJ^JL

### AA/d^yW^^JLy ^ ' Date : ^-^/j . 

# '^a A

## \ Omah a Lea d Site—EP.R7-09-0 5 t^H^tf ^

' Environmenta l Restoration . Lt, C V ^ www.erllcco m



# EXECUTIV ESUMMARY : 2659 0 332 0 DECATU R S T



# No Issue s o r Concern s Q ] Issues/Concern s

### rag e i o t z

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

### YOU RTICKE T NUMBE RI S 2678075 . Origina l Cal l Date : 3/03/1 1 Time : 7:5 0 a m Op : ADAM2418 6 Wor k t o Begi n Date : 3/07/1 1 Time : 8:1 5 am State : N E County : DOUGLA S Place : OMAH A Address : 332 0 Street : DECATU R S T Twp : 15 NRng : 13 E Sect-Qtr : 16-NW 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 : 2659 0 Compan y: ENVIRONMENTA L RESTORATIO N Contac t Name : ADA M Alt . Contact : Phone : Phone : (402)451-131 4 (636)288-961 6 Wor k Bein g Don e For : ep a Dept h o f Excavation : 24i n Corne r Lot : Involve s Tunnelin g o r Horizonta l Borin g : CXCAT V LEVEL 3 MUDO l OMAHACO F NFront : N NExplosives : N

0PPDGPR 5 QLNNEI C 

### Rear ;

Servic e Are a Contac t Phon e Numbe r Utilit y Typ e 

### Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I 

### Alt : 402934046 9 Emerg : 402932975 7 Day : 877366834 4 LEVEL 3 LEVEL 3 COMMUNICATIONS , LL C N A 

### Ah : Emerg : 877366834 4 Day ; 402504782 3 MUDOl METROPOLITA N UTILITIE S DISTRIC T SAND Y MU D Alt : 

### Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCITYOFOMAHA-TRAFFICSEWE RRICH/TRAFFI C Alt : 402444516 1 

### Emerg : 402444516 0
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 3/3/201 1

### rag e zoi z

0PPDGPR 5 OMAH A PUBLI C POWE RDISTRIC T EL M LOCATIN G Day :

Alt : 406728934 3 406207149 4 Emerg : 888728934 3 QLNNEI C QWES T LOCA LNETWOR K Day : 406728934 3

EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3

http://vvww.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 3/3/201 1

## Contac t Informatio n Lo g SAID#^^'5'? o

Owner' s Name 

## = Lo^i s Kc,r.k s PropertyAddress : JfJJ^ O ib^cft-ft^ r-T/ - 

## Attemp t t o contac t Date/tim e Nam e 5/^n^c^ /^r7-/ o ^

## Propert yFina l Repor t SAID : J)CfiS'? 0 D WOR K STARTED ON :l_ Propert y Address : J? ^ J o ^^^^^^ ^ j-f ' n WOR K COMPELTE D ON : /_ Owne r • C-aoi s ?<TK < 5 Renter : Address : 3^0 5 P<^r)c-fr Phone : Fax : Cell/Pager : Phone : SS3'UU ^ Additional Information : Fax : Cell/Pager : I B Acces s Agreemen t Signed : ////7 / ' C > 

## Byil^ O [y Restoratio n Agreemen t Signed : / ^ / /

7 / ' o By = ^ 0 ^\Vide o Prbpert y Befor e 

# O n -.IL/K/I Q By : J 6 i ^ Digita l Photo s Befor e 

# O n :iL/l^/iI I By : J 6 n Vide o Propert y Afte r O n:_/_/ _ By : N/A [ D Digita l Photo s Afte r O n : / / By : L0Property Completio n Agreemen t Signed:- ^ iJj A 1 I f By: ^

n FinalRepor t Signed : / / By : 

### EXECUTIV ESUMIVIAR Y

Omah a Lea d Projec t Work Pla n 

### Pag e 1 of 1 9

### % 

# Consen t fo r Acces s t o Propert y SAID # DO£J O 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 n Agenc y (USEPA ) o r it s authorize drepresentatives , collectivel y th e Grante e t o ente r an dperformcertai n environmenta l respons e activitie s upo n th e followin g describe dpremises :

Owner'sName : Loui s B<i/\I< S Daytim e Phone : S S 3Of0>y Address : 

## 3JP O OccJ^r 

# .r/
- Address : Addresse s o f Propertie s covere dby thi s Address : Agreement : Address : Address : PURPOS EOFINVESTIGATION 

### Th e purpos e o f th e remedia l activitie s i s t o remov e al l soil s at th e property whic har e contaminate dv^dt hhazardou s substances , i n particular lea dat concentration s greate r tha n o r equa l 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 n sai 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 remedial activities ; b .

Locatin g equipmen t an dmachinery on-sit e i n preparatio n for an di n th e cours e o f th e environmental response ; c .Plannin g an dimplementin g th e remova l actio n o n o r near 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 interfer e 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 performth 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 ofth e Grantee s o r th e environment , o r

t o allo w other s t o us e th e property i n suc h I S I gran t acces s to m y propertie s Q I d o no t gran t acces s t o m y propertie s

VAAIA A 

# JB^^^^^/^ ^ Dat e ll- * f^^ 0 Signatur e Dat e

### Additiona l Comment s / Instructions :



# gpAff+ y LJ O ^



### • 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 don e t o th e interio ro f house , includin g foundatio n crack s o rfissures .

I 1 1 agre e nI d o no t agre e [~1 1 agre e n1 d o no t agre e

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

### % 

## Restoratio n Agreemen t The purpos e o f thi s agreetnen t i s t o provid e amutua l agreemen t a s t o condition s o f propert y prior t

o contractor activities . Thi s will als o serve as documentationfo r the purpos e of assuring tha t restoration activitie s ar e completedto the satisfaction of the propert y owne r an dthe UnitedState s Environmenta l Protectio n Agency (EPA) .

SAID : ^QS7 0 PropertyAddress : 3:^S> 0 b<(<fhr M - Owner : ^^^; ^ l^c^^ks r Phone : S^S-J'OfC ^ O

n th e attacheddiagram(s ) indicat e area(s ) to b e excavatedan ddept hof excavation , locationof all know n utilities , subsurfac e features , surface structure s an dlandscaping features , acces s location(s ) t o be use db y contractor , an dth e direction of North . Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s b

y referencing the photo-log numbe r wit ha n arrow indicating directiono f view . Item s t o b e remove d b yContracto ran d no t replaced :



### Item : 

# 2al^c ^ u^(4 K

# S o J Kem : Item : Item : Item : Item : Item :

Pag e 1 o f 2

### %
Additiona l Comment s / Instructions :

5 ^ I agre e n I d o no t agre e f/T l agre e C H I d o no t agre e ^/^iZ^L.,^»^ggy^}^^^^- ^ ^^i>uc^dbb w^-2^-1C\ V Owner' s Signatur e Date / I —/7
- / O Contractor' s Signatur e Dat e Attachmen t

Pag e 2 o f 2% % 

## Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio no f remedia l activitie s performe do n my property . My signatur e wil l designat e tha t I a msatisfie dwithth e restoratio n o f m y property , an dtha t n o item s ar e i n question , now , o r at any tim e in th e future , excep t thos e item s liste dbelow , ifany . 

### SAID : J^OS? 0 PropertyAddress : -p^^ p ^c«t4o r s 4 Owner : 

## <^qw. r "go^id- S Phone : XTj?- ^ C^ ^ Restoratio n Item s i n Question :

Item : Item : Item : Item : Kem : Kem : AddKiona l Comments :

I agre e restoratio n i s completed , excep t a s noted jA\\agre e restoratio n i s completed , except a s noted I I I do no t agre e restoratio n i s complete d L J I d o no t agre e restoratio ni s completed

ner' s Signatur e 

# SAy^^nMl-^.zi/:^../ / Dat e Contractor' s Signatur e "»• " Dat e^.'''isSf'iJT'-;^ " 

### bre e Peopl e Searc h| WhitePage s Fag e I o t Z 

# WhitePage s Fin d Peopl e | Fin d a Busines s O rsearch :
• Las t nam e onl y • I Metr o are a 

## Lewi s Bank s I s thi s you ? Edi t
332 5 Parke rS t Omaha , N E 68111-415 2 

### (402 ) 553-616 3 Age : 65 + Mar yJ Banks , Household : Brigitt e L Baskin , Cod yBanks , Kno wme ? As k m e t o updat e m ylistin g 

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201 0 Microsof t Corporatio n © 201 0 NAVTE Q © AN D Nam e popularit yan d nam e meanin g fo rfirs t nam e Lewi s an d las t nam e Banks .



### http://www.whitepages.com/search/FindPerson7firstnam e begin s with=l&firstname=loui.. . 8/20/201 0

### uougla s i.;ount y Accoun t iniormatio n rag e i oi z Dougla s County , Nebrask a Propert yRecor d - R164004000 0 Informatio n i s vali d a s o f 2010-8-1 6 Ne wFeatur e ->->- > Prin t Reoor t Vie wInteractiv e GI S Ma o

Treasurer' s Ta xRepor t Subdivisio n Sale s Searc h Owne r BANK S LOUI S ETA L 332 5 PARKE R S T OMAH AN E 68111-000 0 Propert yInformatio n Ke yNumbe r 400 4 OOO O 1 6 Accoun t Type : Residentia l Parce l Number . 164004000 0 Parce l Address : Lega l Description : 332 0 DECATU R S T OMAH AN E 68111-000 0 LOWE S AD D LO T8 BLOC KG E 4 0 F T4 0 X 127. 5 Valu e Informatio n 201 0 200 9 200 8 200 7 200 6 200 5 Lan d $800.0 0 $800.0 0 $800.0 0 $800.0 0 $800.0 0 $800.0 0 Improvemen t $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 $0.0 0 Tota l $800.0 0 $800.0 0 $800.0 0 $800.0 0 $800.0 0 $800.0 0 Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 1 5080. 0 0. 0 127. 0 40. 0 Ye s



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### ENVIRONMENTA L AS-BUILTDRAWIN G I OMAH ALEA D SUPERFUN D SITB ^ RESTORATIO N 

## 2659 0 Exterio rPain t Nort h Arro w Omah a Lea d Sit e Owne rName : LOUI S BANK S • Goo d Sit e Sketc h Address : 332 0 DECATU R ST • Poo r

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# I Fir m RYASCPXA-2659 0 F1 pp m 

# n Dat e RYBSCPXA-2659 0 F2 

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## D Tim e RYCSCPXA-2659 0 B l pp m 

# n Sample s Analyze d RYDSCPXA-2659 0 B2 

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# n .Tim e ^y n Staff : Numbe r of Sample s •• 

## D ^- A Legend : F l = Fron t Left , F2 Fron t Right , B l = Bac k Left , B2 = Bac k Righ t DZ = Dri p Zone , GZ = Garden , PZ = Pla y Al l quadrant s ar e as viewe d fro m th e street , facin g propert y 

# ENTERE D s;r P t 8 289 5

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### • Goo d Ad d ress : 3320 DECATU R S T • Poo r Phone : ^ 402-553-6153 W : 

# f [^''^Not paint Sampl e Numbe r Lea d Sampi e Sample s Collecte d LA B Concentratio n Collecte d Firm . //^t. ^ < i Ac** ^ RYASCPXA-2659 0 F 1 29 / pp m 

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# i