PROPERTY SUMMARY

 

I Date: 11/28/2007 \ Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: November 

fProperty Address; 4326 N 39 St ~ 

A EXECUTIVE SUMMARY 

A.I Issues Encountered: None 

A.2 Issues Resolved: Re-Seed will occur in November on any dead spots to encourage spring growth. 

A.3 Unique Findings: 

A.4 Other Relevant Information: Map Error on fence line. Marked on as built 

CONFIRMATION SAMPLING DATA/RESULTS: 

F2 - 86 @ 4" 

El - 70 @ Scrape 

Bl-150@10" 

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 clip/photographs 

4) Post-Excavation digital video clip/photographs 

5) Documentation - Completed Close-out Checklist 

6) As-Built sketch ­

i) Shall include final lead levels v) Legend 

ii) Contamination left behind areas vi) Contractor identification 

iii) Property address vii) Date 

iv) BVID number 

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

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

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

photographs 

iii) Signed form verifying satisfactory restoration 

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

40285037 

1:111! 1:1111 

Superfund 


34073 

Omah Exterior Paint North Arrow Owne i a Lea dSi te r Name: WILLIE HOLMES -

Site Ske1 ch Address: 4326 N 39 ST >, 

n Poor 

Phone: H: W: [~l Not paint 

Sample Number 

RYASCPXA-34073

RYBSCPXA-34073

RYCSCPXA-34073

RYDSCPXA-34073

RDZSCPXA-34073

 F1 

 F2 

 B1 

 B2 

 DZ 

Lead 

Concentration 

317 D. 

Sample 

Collected 

& °[ ppm [^ 

Z 2.*"? PI 

1^0? P 

5"^*^ P 

P 

Dm El 

am Q| 

am \\A 

om Q 

pm D 

Number of Samples = 5 

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v 

* 

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Q 

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wv/AL 

3-77 

VI 

Wa\y 

Samples Collected u\B 

Firm: 

[3 Date: 5?|i3|o M

 

[D Time: I't* • '15

 

CD

 Samples Analyzed [D 

[D XRFUn it: 810 Book: ^ 3> 

[D Date: ^ - ?c> - v Y 

[3 Time: 

Staff: ^ ./4 ­ j£

 

EN1 PER ED 

- AU( 1 B2 004 

•v 

14 

^ mi. ___^f^ 

1 

DZ. 

I—1 

f^ 

897 

A/3*?:51" 

Omaha Lead Site 46130 
A*vvin

 "X- Agreem? to a How access to 

Omaha Lead / ,$£&V the prope.iy in order to conduct 

Site Remedial | \jvPv ? environmental sampling and to 

Action \*fo**mr-_> remove lead-contaminated soil 

Prudent Technologies, Inc. (Prudent) is under contract with die U. S. Environmental Protection Agency 

(EPA) to dean up lead- contaminated soils at a number of properties located in Omaha, Nebraska, 

including fee properly located at H^ZA, S> 3 *T ^ The EPA requests your 

permission to allow Prudent to perform a :;oil cleanup at this properly to remove lead- contaminated soil 

By signing mis form, me property owner grants permission to Prudent to perform activities related to me 

cleanup including soil sampling, removal of lead-contaminated soil, and restoration of me referenced 

property. After obtaining me owner's signature on mis form, Prudent Technologies, Inc. will contact me 

properly owner (and residents) within me next few weeks to coordinate performance me work. 

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

Administrative Clerk for me Omaha Lead Site cleanup, Ms. Cyndie Hinds at (402) 504-1004. General 

questions about me Omaha Lead Site cleanup can be directed to me EPA Public Information Centers at 

(402) 731-3045 (south Omaha office) or ('102) 991-9583 (north Omaha office). 

Property Access Granted By: O A ^-" 

Property Owner Signature:' 

(Signature) (Date) 

PROPERTY INFORMATION 

(To be completed by resident and/v property owner - please print} 

RESBEMTHAME: Ovg-O \\o\rvN4'^ rj^wner Qenter 

RESDEHTADDRESS:

 A 2> 3.fe M _,cf ^ 6 t^ 7*Ln . ^ 9 ( \ 

f RENTAL.PROPERTY OWNED BY: "~ 

OWNER'S MAILMG ADDRESS; M ?> 2-.k KJ '3> ^ ^^ QjTA.^Xfr KK C <£ \ \ 

OWNER'S TELE PHONE NUMBER-HOME: L^&l ^ 'S 3 ~ \ 4H "f WORK: _i ^G^l 333 - ci

c

i^'i 

AGE OF HOME?:'^22__ YEARS. HOW LONG HAVE YOU LWED HERE? 1 {5 YEARS. 

HAS THE EXTERIOR BEEN PANTED OR COVE RED WITH SDMGSMCE 1978? _J^YES NO 

NUMBER OF OCCUPANTS UNDER? YEARS OLD: D NUMBER OF OCCUPANTS7 YEARS OLD AND OLDER _ 

NUMBER OF CHILDREN UNDER 7 YE ARS OLD WH 0 PLAY M THE YARD FOR S HOURS OR MORE PE R WEEK: _ 

COMMENTS OR SPECIALMSTRUCTiONS: (If .DGGS.ENTRY GATES.ETC.) K3 ° 

AUTHORITY FOR ENVIRONMENTAL RESPONSEACTIONS: The activities to be implemented by EPA under this 

agreement are pursuant to Section 104 of CERCLA, 42 U.S.C. 9604. HlA's right of access to the properly is 

provided for in Section 104(e) of CERCLA, 42 U.S. C 9605(e), which provides entry fer "detemiining the need for 

response, or choosing or taking any response action tinder this title, or otherwise enforcing the provisions of the 

title" 
&EPA 

EPA Property Close Out 

/V 

Date/Time: Owner's Name: £./£<, 

Quads Excavated: f 2- Contractor Group Prudent Technologies 

Property #: Property Address: 

Excavation General Yes

1 . If necessary, were the correct quadrants) excavated and restored? S 

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

/ 

Grading Sod and Vegetation Yes

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

from the house? /

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

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

day time period) / 

4. Are sodded areas generally firm and evenly graded?

 S 

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

time period) s

6. Was the property graded such that water will not pool on the property? s 

7. Was damage to landscaping or plant materials avoided? </ 

Gates, Fences and Retaining Walls Yes

1 . Do gates open and close freely? (If applicable) s 

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

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

4. Was damage to retaining walls avoided? (If applicable) s 

Foundation, Siding and Gutters Yes

1 . Was damage to the siding or trim avoided? S 

2. Was damage to the foundation avoided? s 

3. Was damage to windows avoided? J 

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

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

Sidewalks and Driveways (Concrete) Yes

1 . Was damage to driveway surfaces avoided? / 

2. Was damage to walkway surfaces avoided? S 

 No 

 No 

 No 

 No 

 No 
Owners comments: 

Inspection notes: 

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

EPA Representative ^, &~ Date:_ 
AGREEMENT AND RELEASE FOR RESTORATION OF REAL PROPERTY
 

This Agreement and Release (hereinafter Agreement) is entered into by and between, 

Cleo Holmes (hereinafter Property Owner) and the United States Environmental Protection 

Agency (hereinafter EPA). 

WHEREAS, the property located at 4326 N 39 Street (hereinafter the Property), more 

specifically described below, is owned by Cleo Holmes; 

WHEREAS, EPA through sampling and analysis has discovered the Property was 

contaminated with lead; 

WHEREAS, the EPA performed a removal action and removed the contaminated soils 

from the property and backfilled the formerly contaminated areas with clean fill then sodded 

and/or seeded the described, effected property; 

WHEREAS, the Property currently requires a limited amount of restoration work to 

return the Property to its original condition prior to initiation of EPA's response activities, or as 

nearly as possible to its original condition; 

NOW THEREFORE, in consideration of the mutual covenants, promises and conditions 

and terms to be kept and performed as recited herein, the parties hereto agree as follows: 

1. The real property which is the subject of this agreement is owned by Cleo Holmes and 

is more specifically described as follows: 

LOOMIS 2ND SUB DIV LOT 6 BLOCK 2 40 X 133 

2. The EPA will complete the following restoration items: 

Pay $220 in lieu of purchasing and replanting plants and reimbursement of water. 

3. The Property Owner acknowledges that EPA shall have no responsibility for further 

restoration work at the Property. 

4. The Property Owner releases the United States and the EPA from any and all claims 

arising out of or connected with, directly or indirectly, their ability to inhabit, occupy, use, transfer, 

or sell the real or personal property at 4326 N 39 Street and the reimbursements, compensation, 

payments, costs, expenses, and any inconveniences or damages relating to the foregoing and the 

cleanup, decontamination, disposal and restoration of the Property, including any claims under the 
Uniform Relocation Assistance and Real Property Acquisition Policies Act, 42 U.S.C., Section 4601 

et. seq. 

5. The Property Owner affirms that he/she is the legal owner of the property at 4326 N 39 

Street. 

This agreement is entered into and made effective the /9 day of flfaau»L+L 2007. 

FOR THE PROPERTY OWNER 

Date 

FOR THE UNITED STATES ENVIRONMENTAL PROTECTION AGENCY 

Date 

U.S. EPA Region VII 

naye2o<j> 2 
17132

 

PRUDENT TECHNOLOGIES, FIRST NATIONAL BAWTOF OLATHE 

83-172/1010 8080 WARD PARKWAY, SUITE 405

 

KANSAS CITY. MO 64114 

(816) 363-3703 

i:iOiODi?soi: 

PRUDENT TECHNOLOGIES, INC. 17132 

PRUDENT TECHNOLOGIES, INC. 

17132 
oEPA

 

Property Completion Agreement 

This agreement documents the completion of removal activities performed on the below listed 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 (90 days overall, 30 days on sod growth guarantee) except those items listed below, 

if any. 

Property ED: 3VO") $ 

Property Address: Uja ^ t\i - 3 ^ ~ (9/yW^A . A^if

 

Owner: (J^ ^/Mg^ 

Phone: (-L/Q^) ^^3 -/(o^ ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

I do not agree restoration is completed 

Owner's Signature Date 
Find Record j dean Up Query Lead Remaining Query { Property Damage Query Close j 

ample Area: 34073 - 4326 N 39 ST 

Owner: Resident: Contract: 

n Owner Occupied 

Owner Name: 

HOLMES WILLIE 

Owner Addressl: 

Owner Address2: 

4326 N 39 ST 

City:

OMAHA

Owner Phone:

|(402) 453-1649

 State: Zip Code: 

 |NE |68111 

 Alternate Phone: 

 |(402) 829-4524 

Resident Name: 

[HOLMES WILLIE 

Property Address: 

J4326 N 39 ST 

Zip Code: 

J68111 

Resident Phone 

1 

I 

;

'•

i

;

1

Contractor: 

 PRUDENT2007 

 Group: 

Assessment: 

 Qualifying Group 

 SOD 

 Assessment XRF Date: 

Assessment Max XRF Value: 

890.94 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC SERVICES 

MAP ERROR REPORT FORM 

Property Address: 

A/-

BVID: 

Description of the Map Error: <,)>}& sio f 

J.5~ -fa 2- -/V.. s>>-h> 

Date of the Report to EPA: 

Method of Reporting (circle one): Phone call E-mail 

(Jfetwith EPAPO^pther Method. 

Description on how the error was resolved: / ? 

/te/7 

Signature of the Reporting Staff Member 

80BO Ward Parkway, Suite 405 2505 N. 24* Streot, 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 

Co.- (Aid Fax: (402)504-1005 Fax: (210) 579-6677 
1 

ENTERED 34073 

Omaha Exterior Paint North Arrow Lead Site Owner Name: WILLIE HOLMES Sit [^Good e Sketch Address: 4326 N 39 ST r • • • ^ fj Poor

Phone: H. W: fj Not paint 

Sample Lead Sample . AR Number 

Concentration Collected 

RYASCPXA-34073 F1 3 1 7 ppm pf PI 

RYBSCPXA-34073 F2 86 ffiTM ppm GJ D 

RYCSCPXA-34073 B1 2. 2. *i com ^7\ [~J 

RYDSCPXA-34073 B2 I *•/ (^? ppm r^r n 

RDZSCPXA-34073 DZ / 60 *££&• ppm rw n 

DDm 1 1 1 1 

rcrZOCPXA-94073 P2- com n n 

Number ot oamples - _S 1 yJ \ 

Samples Collected 

Firm: FDA P^l £>* 

Date: ^J»3loM 

Time- ld> ' IS~ 

Samples Analyzed 

XRFUnit: 5/0 Book: ^>"3 

Date: 0 - 3<3 -<9y 

Time: /^/^7 

Staff: <!l./^. 

ENTERED 

Omaha Lead Site 46130 
Print Preview Page I oi I 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

1636690000 

HOLMES 

WILLIE 

4326 N 39 ST 

OMAHA 

68111 

4326 N 39 ST 

OMAHA 

NE 

68111 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal3 

Legal4 

Assessor 

Website Link 

05-15-13 

LOOMIS 2ND SUB DIV 

2 

6 

40X133 

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

accountno=R1 636690000 

Disclaimer. Map 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 = 27 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/'printPreview.aspx?PrintOptData=Douglas County-... 7/16/2007 
34073

 

Omah Exterior Paint North Arrow i i Lead Site Owner Name: WILLIE HOLMES • 

Sit fy] Good e Sketch Address: 4326 N 39 ST Q Poor 

Phone: H: W: [3 Not paint 

Lead Sample ..„ Samples Collected Sample Number 

Concentration Collected C"p A pc J 0^ Firm: 

RYASCPXA-34073 F1 3 "7 7 isom n/f Fl Date: 5?|i3)c> M 

RYBSCPXA-34073 F2 8 °l Dom & D Time: l(t> '• /,5 

RYCSCPXA-34073 B1 c Z. ^ IDI am Ef D Samples Analyzed RYDSCPXA-34073 B2 H (^> Dam 

RDZSCPXA-34073 DZ f

5~°lc) opm L^ n XRFUnit: 3(0 Book: ^"3 

RGZSCPXA 34073 GZ- Ppm D D Date: fl 3d -O V 

RPZOCPXA-34073 PZ- Dpm n n Time: /># 

Staff: L./l . Number of Sar nples = 

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