TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: ^«jgqq Date: o/ j .9.3.j ^fln^ 

Address: ^Ci.^6- i^M.<;A-c ^Y/T 

Remediation Contractor: fip., rfPJC^'f l^-htinftng 19JI. free. Year: 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

1^ Video of property (DVD) 

a Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

^ Restoration Agreement 

D Settlement documents (i.e., for damage or to replace plants, etc.) 

Q Confiimation data 

gf Photographs 

a As-built sketch 

Gtf Satisfactory restoration signed by Property Owner 

H Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

H Utility clearances 

^ Property information from Douglas County Assessor's Office 

D 

D 

D 

/?"* * -*T'-Iri ^/'JM 

SignatunT Tate 

40311262 

illilDHill 

Superfund 
PROPERTY SUMMARY 

Bate; QllUam 1 Qmaba UsA Site Remedial Actian Cottfract^ EP-R7-Q7-e6/QeQ4 ManthQf;Q^€^aan 

Property Address: 2435 KANSAS AV 

A. EXECUTIVE SUMMARY 

A.1 Issues Encoimtered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Infonnation: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

DZ = 225 PPM @ 12"; Fl = 132 PPM (@ 8"; EA = 134 PPM @ SCRAPE 

ATTACHMENTS 

1) Property sketch provided by EPA pursuant to contract specifications 

2) Signed Access Agreement including access agreements required for crossing other properties 

3) Pre-Excavation digital video chp/photographs 

4) Post-Excavation digital video cUp/photographs 

5) Documentation - Completed Close-out Checklist 

6) As-Built sketchi) Shall include,final lead levels, v) Legend 

ii) Contamination left betiind areas vi) Contractor identification 

iii) Property address vii) Date 

iv) BVID number 

7) Other items to be included in the mdividual property file, if available, or obtained include: 

i) Pre-excavation agreement details (if any are made with the properly owner) 

ii) Property Status Form signed by property owner 

iii) Excavation digital video in MPEG, WMV (Windows Media Video) or SWF (Flash Player) format and/or 

photographs 

iv) Signed form verifying satisfactory restoration 

v) Description of areas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES, INC. 
Rnd Record Qean Up Query Lead Remaining Query I Property Damage Query 

Backfill: , 

Sample Area : 3889 9 - 243 5 KANSAS AV 

Owner: 

n Owner Occupied 

Owner Name: 

|CAMPBELL BARBARA J 

Owner Addressl: 

r 

Owner AddrKs2: 

|6129 N 24 ST 

City: State: Zip Code: 

|OMAHA [NE" |68110 

Owner Phone: Alternate Phone: 

|(402) 312-1626 I ~ 

Resident: 

Resident Name: 

|CAMPBELL BARBARA J 

Property Address: 

2435 KANSAS AV 

Zip Code: 

168111 

Resident Phone 

Contract: 

Contractor: 

|PRUDENT2008_S 

Group: 

Assessment: 

Qualifying Group 

[PRIORITY ' 

Assessment XRF Date: 

I 

Assessment Max XRF Value: 

I 532.71 
TECHNOLOGIESi INC SERI\ 

EPA Property Close Out 

Property#: 3 8 8^ ^ Property Address: .?^3 £ ^rtro ^ Av 

Date/Time: Owner's Name: 

Quads Excavated: D^y Pl ^ ^A- Contractor Group Prudent Technologies 

Excavation General i^ 

Yes No 

1. If necessary, were the correct quadrant(s) excavated and restored? 

2. If necessary, were the correct areas of drip zone excavated and restored? ^ ^ 

Grading Sod and Vegetation 

Ye^ts /No 

1. Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from the house? 

2. Has sod been laid in all areas that were excavated? 17' 

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 y day time period)

 ._ 

4. Are sodded areas generally firm and evenly graded? 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day i / time period) 

6.

 Was the property graded such that water will not pool on the property? L / ' 

7. Was damage to landscaping or plant materials avoided? 

T ; ^ 

Gates, Fences and Retaining Walls 

Yes No 

1. Do gates open and close finely? (IfappUcable) y- / ­

2. Were all gates or fences taken down during restoration activities reinstalled? (If applicable) y 

3. Was damage to gates or fences avoided? (If applicable) 

4. Was damage to retaining walls avoided? (If applicable) ~y^ 

Foundation, Siding and Gutters 

Yes ^ o 

1. Was damage to the siding or trim avoided? 

\ / 

X ­

2. Was damage to the foundation avoided? 1 / 

3. Was damage to wmdows avoided? 

4. Was damage to windows or door screens avoided? y 

5. Was damage to downspouts or downspout extensions avoided? y 

Sidewalks and Driveways (Concrete) 

Yes/^ o 

1. Was damage to driveway surfaces avoided? 

! /• 2.

 Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

Removal and restoration activates comolete including the 30-day sod warranty: 

EPA Representative '^^-^CP^ <UM.Jh- ^Date: um 
&EPA 

Property Comptetion Agreement 

This agreement documents the completion of removal activities performed on the below hsted property. 

The property owner's signature indicates that the property owner is satisfied with the restoration of the 

subject property, and that no items are in question, now, or at any time in the future, excluding any 

remaining warranty (30 days total) except those items listed below, if any. 

Property ID: 

Property Address: :2j\^s k::<AVNAayN A-t.--/? " • •.;.• 

Owner: ^~ 

Phone: 

Restoration Items in Question: 

Kem: 

Item: 

Item: 

Mem: 

Item: 

Item: 

Required corrections to complete the property: 

L J I agree restoration is completed, except as noted above. 

L_l I do not agree restoration is completed 

er's Signature / Date 
Pnident Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up leadcontaminated soils at a number of properties located in Omaha, Nebraska, including the property located at 

. The EPA requests your permission to allow Prudent to perform a soil cleanup at this 

property to remove lead-contaminated soil. By signmg this form, the property owner grants permission to Prudent to perfonn 

activities related to the cleanup including soil sampling, removal oflead-contaminated soil, and restoration ofthe referenced property. 

If you have any questions about the soil cleanup planned for your property, please contact Prudent Administrative Clerk for the 

Omaha Lead Site cleanup. Ms. Deborah Johnson -at (402) 733-1188. General questions about the Omaha Lead Site cleanup can be 

directed to the EPA Publicc Informationl^nter Information (^nterss at at(402 (402))731-304 731-30455 (Souj (SouthhOmah Omahaa office office)) roor (40 (4022 ) 991-9583 (North Omaha office).

Property Access Granted 

/] ' (^(Please Print Nafce) j 

Property Owner Signatui 

7 T (Si#iature) (Date) 

PROPERTY INFORMATION 

(To be completed by resident and/or property owner - please print) 

RESIDENT NAME: OU^g*. (\,0-V^^P'^ ^ C^_0^[|fj y Renter 

RESIDENT ADDRESS: 

LVt£_ 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

OWNER'S TELEPHONE NUMBER - HOME: ('74> ^ 'TDf ' S3^ ^ WORK: 

AGE OF HOME?: j^ + YEARS. HOW LONG HAVE YOU LIVED HERE? '^Z > YEARS. 

.

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? ^ YE9 — NU 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: (_. ) NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER 

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY IN THE YARD FOR 5 HOURS OR MORE PER WEEK: 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETC.) 

AUTHORFFY FOR ENVIRONMENTAL RESPONSE ACTIONS: The activities to be implemented by EPA under this agreement 

are pursuant to Section 104 of CERCLA, 42 U.S.C. 9604. EPA'srightof access to the property is provided for in Section 104(e) of 

CERCLA, 42 U.S. C 9605(e), which provides entry for "determining the need for response, or choosing or taking any response action 

under this title, or otherwise enforcing the provisions of the title." 

§Wt£s « f^XS-\ei-it'«~|i 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fax:(210)579-6577 
•--•'•••••'•".'-."' ' •.V,v«;',V''•••'. • • -.••• -,''v'•••'' • i ! 

^ dMAJBLA:.i%ADMfk«E^JiMr£^ OLS#: 38899 

Date Excavated: 10/27/2008 

USEPA SIpwd-OffDate: 

38899 

Omaha Exterior Paint NorthArrow Owne Lead SRe r Name: BARBARA J CAMPBEUL 

Site Sketch 

• Good Addiws*: 243S KANSAS AV 

Ptjone:,':!: 

Sample Number 

RYASCPXA-3a899 

RYBSCPXA-38899 

Fl 

F2 

RYDSCPXA^8899 

RDZSCPXA-3e899 

nezscpxA-aBBW 

nPZOOPKA-00000

B2 

OZ 

P£ -

V^/cJh•.r^'> 

(paf64 ^ 

vt. 

Lead 

Concentration 

inceni 3 inppm 

ppm 

R Sl>ppm 

^H?t\ om 

ppm 

ppm 

Collected 

Q 

Ef 

r_i 

Q 

Ef 

n 

Numt>er of Samples = ; ^

B'Poor •V • Notpalnt 

Sample Samples Collected LAB 

.^2^....;... 

^ 

. ^ ' r '*' 

.A*^:3.f5. 

D Date:

Time: a 

D 

D 

XRFUnIt D Date: D Time: D Staff: j ^ | 

 O- l7'/y-l 

 tf\:'i ^ 

Samples Analyzed 

 '^ 1 ^,^U 

Al t P 

ENTERED 

DZ = 225 PPM (ffi 12" 

• -^ 

yN 

>k : >^i^sc^6 

hT.=^H01.; 

-J 

1 

^•ii..i» « 

a... F1 = 132PPM®8" 

' ^ \ ­ .;.p.-^.... 

Omaha Lead Site 

?JS<AMS, 

- tS)Mft-«i^ ^jg i 

EA = 134 PPM m SCRAPE 

46130 

CONTRAa #: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC. 
ENVIRONMENTAL <& 

CONSTRUCTION 

TECHNOLOGIES, INC. V SERVICES 

Property Status Form 

Phone: i. ^ BVID: 

Plant & Permanent Landscaping To Remain In Place 

Item# 

Description and Location 

On Map 

CXJiAi/^ \0o 

Pre-Existing Condition of Structures 

DoesyourBasementhaveahistory of leaking? Yes -' No 

Item# Description & Location 

On Map 

Property Owner Prudent Empioyee 

Signaturi Signature 

8080 Ward Parkway, Suite 405 'N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 maha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 

Fax: (816) 363-3707 

Phone: (402)504-1004 

Fax: (402)504-1005 

Phone: (210)822-9588 

Fax: (210) 579-6577 
38899 

Omah Exterior Paint NorthArrow Owne a Lead Site r Nanw-.BARI >ARA J CAMPBELL • Good Site Sketch AddraM:2435| KANSAS AV Ba^Poor 

Phom: H: W: ^ 

Q Not paint 

Sampl Lead Sample Samples Cdlleeied e Numb tr 

Concerttratit n Collected 

Finn: ^H A ,\^/P=f ^ 

RYASCPXA^8899 F1 Date: O-)'7'n- 4 

RYBSCPXA^8C99 F2 a £h.PPm Bf Time: IQi^fQ 

JWGOCPXA 00(99 ^^_PP m Ll 

Samples Ajtalyzed RYDSCPXAr38{99 B2 

RDZSCPXAr38i 99 DZ i;^ ppm E 1 

RGSSCPM^FW \^ PPnt D 

rtPzoopxAOoqoo P ^ - ppm D 

02./MD ^ NumberO( samples =|7[ ] [^ ^ 

ENTERED 

• *si:p'2"(i"2oa4': 

lafiSO ^ 

• 

I u. 

> i k J 

4^ i>T.-'^0 \ . "7 

a. 

uo: 

Xb2Au4. 

t^fcA^^V•^^e^ 

Omaha Letd Site 46130 
Page 1 of 1 

March 2004 - Douqias County Assessor 

^H 3 5 kANSAS Ay 

http://douglasne.mapping-online.coin/assessdoc/Photos/31/R06007700000001.jpg 10/2/2008 
Print Preview Page 1 of 1 

Douglas County-Omaha, NE 

Pamel ID 0600770000 Sec-TwnRng 33-16-13 

Owner 

Name 

CAMPBELL 

BARBARA J Addition BELLE ISLE 

Property 

Address 

2435 

KANSAS AV Block 

City OIVIAHA Lot 10 

Zip 68111 Legal 1 45X136.49 

Owner 

Address Legal 2 

Owner 

Address 2 6129 N 24 ST Legal 3 

Owner 

City 

OIV! AHA Legal 4 

Owner 

State 

NE 

Treasurer 

Website 

Link 

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp? 

parc=0600770000 

Owner 

Zip 

68110 

Assessor 

Website 

Link 

http://douglasne.mappingonline.com/DouglasCoNe/static/accountinfo.jsp? 

accountno=R0600770000 

Disclaimer: i\/lap and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 80 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 10/1/2008 



Page 1 of2 

" > 

[ •.r-.'nGreat^Anoth.e5>Ticket.'•«(;») j-^ , Backito^lrthiintemet^v^^,'] ^SendJErnaJ! ;^ 

YOUR TICKET NUMBER IS 2147525. 

Original Call Date: 

Work to Begin Date: 

10/03/08 

10/07/08 

Time: 

Time: 

4:13 pm 

4:45 pm 

Op: RAMITAl 

State: NE 

Address: 2435 

County: 

Street: 

DOUGLAS 

KANSAS AVE 

Place: 

Twp: 16N Rng: 13E Sect-Qtr: 33-NE-SE,34-NW-SW 

Twp: Rng: Sect-Qtr: 

Lega l Given : C 

Type of Work: lead remediation work for soil 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)733-1883 


: UNSURE CORNERS 


Company : PRUDENT TECHNOLOGIES 


Contact Name: RAMITA Phone: (402)7 


Alt. Contact: Phone: (402)7 


Work Being Done For: epa 


Depth of Excavation: 6 ft Corner Lot: N Front: 

Involves Tunneling or Horizontal Boring : N Explosives: 


CXCATV MAGELLAN METRO MUDOl 
OMAHACOF OPPDG 


SPRNTPCS 


utility Service Area Contact Phone Number Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, l>iC HEIDI Alt: 4029340469 

Emerg: 4029329757 

http://www.dhon.org/irthintemeVDHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/3/2008 
Page 2 of2 

MAGELLAN MAGELLAN MIDSTREAM PARTNERS

LP 

METRO METRO COMM. COLLEGE 

MUDOl METROPOLITAN UTILITIES DISTRICT

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT 

QLNNEIC QWEST LOCAL NETWORK 

SPRNTPCS SPRINT SPECTRUM L P 

 ^^^^A

CHRIS


 SANDY

RON


NA


NA


Day: 9185747098 


 Alt : 

Emerg: 9185747098 


Day: 4024572307 


 Alt: 4026727033 


Emerg: 4024572313 


Day: 4025047823 


 Alt : 

Emerg: 4025047946 

Day: 4024447197 


 Alt: 4024445161 


Emerg: 4024445160 


Day: 4067289343 


 Alt: 8887289343 


Emerg: 4067289343 


Day: 4067289343 


 Alt: 


Emerg: 8887289343 


Day: 4025371800 


Alt: 4025371810 


Emerg: 8005210579 


http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText,asp?ret=<RESULTS... 10/3/2008