## TRANSMITTA Lof OMAH A LEAD SIT E SOI LREMEDIATIO N FIL EFOLDE R SAID#: ^ Date : '^tjjlJp^ B Address : ,9y)^f l MiAAi l ^" f Remediatio n Contractor : P.^on PM "T ~fe c U . Tf iM r Year : o^^-9 < SOI LREMEDIATIO N PROPERT Y FIL E FOLDE RDOCUMENT S E

f Vide o o f property (DVD ) aExecutiv e Suirmiar y \ ^ EPA-providedproperty sketc h y Signe dAcces s Agreemen t for subjec t property D Signe dAcces s Agreement(s ) for adjacen t property 0 Restoratio n Agreemen t D Settlemen t document s (i.e. , for damag e o r t o replac e plants , etc. ) [^ Confirmatio n dat a y Photograph s y As-buil t sketc h y Satisfactory restoratio n signe db y Property Owne r y Property close-ou t chec k lis t signe db y EP A n Descriptio n ofarea s no t meetin g RO D cleanu p criteri a y Utilit y clearance s y Property informatio n fi-omDougla s County Assessor' s Offic e D

Signatur ^ Dat e 403 1 38 1 Superfun dPROPERT Y SUMMAR Y Date : 09/15/200 8 Omah aLea dSit e Remedia l Actio n Contrac t #EP-R7-07-06/000 4 Mont hof : Aug/Sep t Propert y Address : 202 5 MIAM I 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 N SAMPLIN GDATA/RESULTS : Fl=19 8 PP M @ 6" ; DZ=28 8 PP M @ , 6" ; EA=10 7 PP M @ SCRAP E ATTACHMENT S 1 ) Property sketc hprovide db y EP A 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 n digital vide o clip/photograph s 4 ) Post-Excavatio n digital vide o clip/photograph s 5 ) Documentatio n - Complete dClose-ou t Checklis t 6 ) As-Built sketch i ) Shal l includ e fina l lea dlevel s v ) Legen d ii ) Contaminatio n lef t behin darea s vi ) Contracto r identificatio n iii ) Property addres s vii ) Dat e iv ) BVI D numbe r 7 ) Othe r item s t o b e include di n th e individua l property file, i f available , o r obtaine dinclude : i ) Pre-excavatio n agreemen t detail s (i f any ar e mad e wit hth e property owner ) ii ) Property Statu s Formsigne db y property owne r iii ) Excavatio n digita l vide o i n MPEG , WM V (Window s Medi aVideo ) o r SWF(Flas hPlayer ) format and/o r photograph s iv ) Signe dfor mverifyin g satisfactor y restoratio n v ) Descriptiono f area s no t meetin g Interi mRO D cleanu p criteria .

TECHNOLOCIES , INC .Rn d Record Qea n U p Quer y Lea d Remainin g Quer yI Propert yDamag e Quer y Backfill :

Sampl e Area : 2915 4 Owner : n Owne rOccupie d Owne rName : |BAS S SHAW N R Owne rAddressl : Owne rAddress2 : |202 5 MIAM I ST City : |OMAH A Owne rPhone : 1(402)341-755 7 ­ 202 5 MIAM I S T

State : Zi p Code : |N E |6811 0 Alternat e Phone : |(402 ) 351-602 3 | | | Resident : Residen t Name : BASS SHAW N R Propert yAddress : 202 5 MIAM I ST Zi p Code : 16811 0 Residen t Phon e 

# r Contract : Contractor : Group : Assessnient : Qualifyin g Grou p iPRIORm r Assessmen t XR F Date : 

# I Assessmen t Ma xXR F Value : 

### I 473. 6

# dEB V EP A Propert y Clos e Ou t Propert y # : 2.<= l ITlf . Propert y Address : 202 £rfiavvi i S h Date/Time : (a/092^/o 3 Owner' s Name : ShR** * B»t s Quad s Excavated : F j t)2 . Contracto r Grou p Pruden t Technologie s Excavatio n General 1 .

Ifnecessary , wer e the correct quadrant(s ) excavate dan drestored ? 2 .Ifnecessary , wer e the correct areas ofdri p zon e excavatedan drestored ? Gradin g So dan dVegetatio n 1 .

Doe s the grading aroun dthe perimete r ofth e hous e i n excavatedareas generall y slope awa y fromth e house ? 2 .Ha s so dbee n laidi n all areas tha t wer e excavated ? 3 .

Doe s th e sodappea r to b e generall y health y an dgrowing ? (Onl y evaluat e i

f inspecteda t a3 0 da

y tim e period) 4 .

Ar e sodde dareas generall y fir man devenl y graded ? 5 .

Ar e the joint s betwee n th e sodstrip s generall y tight ? (Onl y evaluat e i

f inspecteda t a3 0 da y tim e period) 6 .Wa s the propert y gradedsuc htha t wate r wil l not pool o n the property ? 7 .

Wa s damage t o landscaping o r plan t material s avoided ? Gates , Fence s an dRetainin g Wall s I .

Do gate s ope n an dclos e freely? (I f applicable) 2 .Wer e all gate s o r fence s take n dow n durin g restoration activitie s reinstalled ? (I f applicable) 3 .

Wa s damage t o gate s o r fence s avoided ? (I f applicable) 4 .Wa s damage t o retaining wall s avoided ? (I f applicable) Foundation , Sidin g an dGutter s 1 .

Wa s damage t o the siding o r tri mavoided ? 2 .Wa s damage t o the foundatio n avoided ? 3 .

Wa s damage t o window s avoided ? 4 .Wa s damage t o window 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 ) I .

Wa s damage t o drivewa y surface s avoided ? 2 .

Wa s damage t o walkwa y surface s avoided ? Ye s N o y 

### y Ye s N o 

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### Owner s comments :

Inspectio n notes :

Remova l an drestoratio n activate s complet e includin g th e 30-day so dwarranty : EP A Representativ e SO^JSL . 

### Date : g/^t/oj tI 

# &EPA Propert yCompletio n Agreemen t Thi s agreemen t document s th e completio n o f removal activitie s performe do n th e belo w liste dproperty . Th e property owner' s signatur e indicate s tha t th e property owne r i s satisfie dwithth e restoratio n ofth e subjec t property , an dtha t n o item s ar e i n question , now , o r at an y tim e i n th e future , excludin g an y remaining warranty (3 0 day s total ) excep t thos e item s liste dbelow , i f any . Propert y ID : 2.'= ) | CZ ^ Propert y Address : X ^ o x i S 

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Item : Item : Item : Item : Item : Item : Require d correction s t o complet e th e property :

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### YOU RTICKE T NUMBE RI S  2081824 . Origina l Cal l Date : 7/14/0 8 Time : 5:2 3 p mOp : RAMITA1896 7 Wor k t o Begi n Date : 7/16/0 8 Time : 6:0 0 p m State : N E County : DOUGLA S Place : OMAH A Address : 202 5 Street : MIAM I S T Twp : 15 NRng : 13 E Sect-Qtr : 10-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remediatio n Locatio n o f Work : LOCAT E ENTIR E PROPERT Y 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 : RAMIT A Phone : (402)733-145 5 Alt . Contact : Phone : (402)733-118 8 Wor k Bein g Don e For : EP A Dept h o f Excavation : 6f t Corne r Lot : NFront : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N CXCAT V MAGELLANMUDO l OMAHACO F 0PPDGPR 5 QLNNEI C 

### Utilit y Servic e Are a Contac t Phon e Numbe r Typ e Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I Alt : 402934046 9 Emerg : 402932975 7 Day : 918574709 8 MAGELL/ ^ MIDSTREAM MAGELLA N TONYAAlt : PARTNER S LP Emerg : 918574709 8 Day : 402504782 3 METROPOLITA N UTILITIE S MUDOl EDWIN AAlt : DISTRIC T Emerg : 402504794 6 Day : 402444719 7 

### OMAHACO FCIT Y O FOMAHA-TRAFFICSEWE RRO N Alt : 402444516 1 Emerg : 402444516 0 

### OMAHA PUBLI C POWE R Day : 406728934 3 

### 0PPDGPR 5 

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