PROPERTY SUMMARY 

Date: 12/12/2007 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 Month of: December 

Property Address; 1426 Cady Av 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: 

A.2 Issues Resolved: 

A.3 Unique Findings: 

A.4 Other Relevant Information: 

CONFIRMATION SAMPLING DATA/RESULTS: 

F2-164@8" 

Bl - 251 @ 14" B2 - 170 @ 14" 

Dl - 99 @ 8" 

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 includefinal 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. 

"/•O 

TECHNOLOGIES. INC. 





Name: /Hlf.k/J^.. Rg^K. 

Address 

Phone: : rj/a2;a jc/far ^£zj£3L 

Omaha Lead Site

Site SIcetch

 Date: 

 Time: 

7 ^ 

lAiQO 

North Arrow

/fV —i 

Team ^AdrJnd^f^/^i^J^/ ^ BVID #

Sample Number 

Lab 

RYBSCPLA-28915 

490 ppm 

 Q.^^lS ' 

Lead Concentration 

S8Z ^ t f 

ppm 

I ^2ft * » 1 ppm 

ppm 

ppm 

> : 

XRF Code _^g2l|_ 

Confimnation Sample 

f=?Yes e r 

6/Yes n 

frlYes n 

^Ye s n 

Yes n 

Yes n 

1 ^ 

>T 

No 0 

No n 

No E3 

No D 

No H 

No a 

No a 

^ 

7;z^ ^ .gs­

^ r 

\ r 

7- y 

-nz^zEjfezs: 

of<^r' 

3?'2 *!/? 

ff­

-i- ^ • ^ 

HZ^4r20 

- ^ 

X 

A-
©mate L©iid! 9 h / .&f/X the properw in order locondod 

Ss^g ^tff8@d8§8 S ':;^P; ' J environmenial sarroplins snd to

,0/ y 

^©^8@f? %j««MM&vvj.. remove 5ead-conteiminate(S soi! 

Bradsaill Tadhaiiolbgies, Ifoic. (EniMflsailSi is msader oMliracitTO&&e U. S. EaavcaroanflKiiQaltal Krolleciliffia AgGEBcy 

(EFA) to deaia u^ iead-contesiQimflied} soils ai a smaAis ofpsroiperlises 8oc&dl^ ra GKms!^^, Ndburaska, 

iffldnMfaig l&e gurojparty located at I M' 2 (^' r^^c^r-i^ ^ /V-^ v lHae EPA iraqpasHs yonsr 

jpersMSsiosa to allbw l^rwHesilh (!io jujedFbirm a sosl cSsasssu^ ailliys jpsntjperHy Iha irsaaove iead-cosatoxMiisitetil soil 

By siigffliMg tas SnisM, &Q^iro^(s^ o^ssucr garoil^ ^Giamssiiim Cm BinutdtosntlSiii ^eiSbsm acllavaliaes sreiatecil to l&e 

clQsanu^ iaicSiuHfiasiig soill snsiipfag, ceosioveiil oJFlQatil-ciMiasBmigitedl sosl, &2!uil trostoiraiiMtiiii of i&e srefsreaced 

projjterfy. AlRhsr dbtemng I&G O^MGT'S sigiaiate'G osn in}nk Hbsm, Bmsdleait TQcSramlogies, Mc. mil comtact &e 

jIHTOgierliy o^ssasr (oidl iTQsMGSilis) w^hra i&e isssJi few we ^ &> cooirdiiiiiaite ^^oirmsac e &e work. 

IfyoHs kavQ oiy (pcsliaffiisis si^oiiDt & Q sofll CEQESSQ!^ jploMO^ iPoir yam ^m^srty, jtleese coiatact Bnujdemt's 

Adsmms&aisve CI A iPoir l&e Qim&iibiaLeatS Sits deam&ip, Ms. CysiuSie Hkd s at (402) 504-1004. General 

qpesdmaiis eSjomlt & G OmAei Leed Silis clofliM!!^ casa be (ScirGclleii!toiSae EPA Biiblic laifbsrsmatniM Cealters at 

(402) 731-3045 (soufe Om^ a office) osr (402) S5>l-9583 (aiiojr& (MaUja office). 

Brojjpsrfy Access Grgaafte:!!By: W I I' - /t H ^ X \^ - he / T^ 

Rroperty OraecrSigiBataire: - Xly/ y iJ[j iAy\\JkX y ^ • ' ^i^--" ^ l " D { <y I '^ ^ (Data) 

PROPERT Y OKTOUSiflATCOKl 

(TofeecoiEi!5pfcts^ tty reHdE5i4 sjad/ci propsily IKJEET — pEsaizs priai) 

RESCDEiaTiaAC3E: {V> i r \^ ,-, t? I t ^ il: c: tX Qpwner Qenter 

RESOJEMTADDRESS: ]'^ \ Z L C' -. .-.| , . A *—<- 0-^--^^V^- A (\'y XX •• ' ^'' 

CP REMTOL.PROPERTY OOSED BY; 

OWMER'SaAaraiS ADDRESS: W-I^C- . C - c:3-cL^^ /"Vv^tsi 0''--'.<;• W . ^^^-^ . '^-cj'B i t C 

OrataER-STEHJEPMOCaE MUC3BER-MOOE: X-JI-A ':2^ ^ ^ ~ |'^~ r \ WORK: j 1. 

AGE OFMOOE?: 1 U YEARS. MOWLOWG MAVE YOU LG^D HERE? M 7 YEARS. 

HAS TWE EKTERMRBEEM PAD3TE0 OR COVE RED tSOTMSCQCaGSDlCE 13787 ____W S MO yT--, r-]^ ,,,, 

CaUCDBER OF 0CCUPAC31S UC3DER7 YEARS OLD: Cy BUOBER OF OCCUPAISTrS 7 YEARS OLD AMD OLDER \ 

taUiriBEROFCHOLDRECa UMDER7 YEARS OLD WHO PLAY C3 THE YARD FOR S HOURS ORinORE PER WEEK: y ' 

COaCDEMTSORSPECtftLDlSTWUCTKiMS: (IE.DOGS.EHTHIY GATES.ETC^ 

AUTHORITY FOR ENVIRONMENTALRKPONSE ACTIONS; The activitjes to be implensitfid by EPAunde- this 

a^eenent are putsuant to Section 104 of CERCLA, 42 U.S.C. 9604. ^A' s li ^ of access to thepn^eity is 

providedforin Section 104(e) of CSICLA, 42 U.S. C 9605(e), whidi pro(^ides ejtry fcr"detamining the need for 

response, or choosing or taking any response action unds'this title, or olher^ise sifbrdng the provisions of the 

title" 
OLu^^^^^^ijo'^ 

Name: t^xrkAtr Rg^Vv. Omaiia Lead Site Date: "JAI/Q I North Arrow -3

Address: /V:3<: CA/i'^ ^y ^ SiteSlietch Time: 

Phone: CdtaH'^S-- /'^'^I /fV 

Team •zAckfr^e^i^/r^T^/^ BVID # O-^^fS' XRF Code _2Sx l 

Sample Number Lead Concentration 

Confirmation Sample 

^ya<^.PYA_ - ::i^\s 

*^Yes n 

f^Yes ^ 

'9'r^ fan "'Yes n 

^^L^2&_*.££L ppm 

ppm 

ppm RYBSCPLA-28915 

\ * 

1^ 
^EFW 

EPA Property Close Out 

Form 

Property #: •2 H/g- Property Address: NOXjeCj^^Uj jjVCy 

Date/Time: fX/n/o-r Owner's Name: mH^- ^ XiW O 

Quads Excavated: /{t,a2.F:i*f>9 Contractor Group. Pnuetn r gOo7 

Excavation General Yes No 

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

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

Grading Sod and Vegetation Yes No 

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

from the house? y 

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

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

l y day time period) 

4. Are sodded areas generally firm and evenly graded? y 

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

time period) y 

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

7. Was damage to landscaping or plant materials avoided? y 

Gates, Fences and Retaining Walls Yes No 

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

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

Foundation, Siding and Gutters Yes No 

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

2. Was damage to the foundation avoided? 

y 

3. Was damage to windows avoided? 

y 

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

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

Sidewallis and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? / 

2. Was damage to walkway surfaces avoided? 

/ 
^^y 

Owmers commcBts: 

InspectnoE motes: 

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

EPA Representative iQOjr.. Date: /JI////G '02_ 
PRUDEfSIT TECHNOLOGIES,^ FIRST NATIONAL B;^F0 F OLATHE 17583 

8080 WARD PARKWAY, SUITE 405 83-172/1010 

KANSASCITY, MO 64114 

(816)363-3703 

^^p^n^g;;y'^"'"x--^N^^jr^^M^ ^ 

<^A).>T A v-€s-Aa.><i<x/>r-y C\A Jl y\\xiy^yysijSy ^ 

^^sa/. QixiU CW 

ii°0 1)7 5 6 311° 0° t o J,00 i ? EOio ii°0 ti .

PRUDENT TECHNOLOGIES, INC. 

 HKS Kn° 

•—frnrTARS Q 

17583 

PRUDENT TECHNOLOGIES, INC. 17583 

o o 
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 fiiture, excluding any 

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

Property DD: 9 *S"^ /S " 

Property Address: /£y2 ^ (X A D ^ 

Owner: / ^ JT ( ^ CUp-li^ 

Phone: 

Restoration Stems on Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: d 

Requoired coinrections to complete the propeirty: 

LJ I agree restoration is completed, except as noted above. 

 I I do not agree restoration is completed 

y. 11.- 7 - o y • i^yt " X \V. s:^ 

Owner's Signature Date 

I
Name: •^'ickg.i^ ^K . Omaha Lead Site Date: "7/3/<37 North Arrow —i 

Address: /V^<, C/fD' ^ Site Sketch Time: 

Phone: C\jcah'^^- /T'11 ^ 

Team T^AckJof^^^^^/^T^/ ^ BVID # O-F^l ^ XRF Code '^f^?^ j 

Sample Number Lead Concentration Confirmation Sample 

^^ ^ i^270 ppm 

ppm 

ppm 

f'Yes

P?Yes

l \ Yes

^Ye s

 n 

^ 

n 

O 

No

No

No

No

 ^ 

n 

^ 

 E3 

I '^7-ft? * ^ 1 ppm ^Yes a No « 

Yes a No CD 

Yes • No • 
AGREEMENT AND RELEASE FOR RESTORATION OF REAL PROPERTY 

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

Mike Roth (hereinafter Property Owner) and the United States Environmental Protection Agency 

(hereinafter EPA). 

WHEREAS, the property located at 1426 Cady Av (hereinafter the Propert)'), more 

specifically described below, is owned by Mike Roth; 

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 

retum 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 propert>' which is the subject of this agreement is owned by Mike Roth and is 

more specifically described as follows: 

Washington Square Block 0 Lot 6 

2. The EPA will complete the following restoration items: 

Pay $2,500 to cover the cost of repairs to the siding damaged during excavation. 

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 propert>' at 1426 Cady Av 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 1426 Cady 

This agreement is entered into and made effective the / day of VCQ (y*^^ ^^ t^C. 2007. 

FOR THE PROPERTY OWNER 

"^^ • / . y • I r yi 

!!y;(it-\Aiy, ' ioyn iz-y-o-y • " >

 '• Date 

FOR THE UNITED STATES ENVIRONMENTAL PROTECTION AGENCY 

y Date 

U.S. EPA Region VII 

nays 2 ocj) 2 
^•|9/27/20(H b. r- -||^ 

«kl-< 

^ \ j /^;KC> (yc^h

F l 

1 iy< 07 

9/27/2007 
r 

Name: ^irXAe.. Kg^K. 

Address: /VJ3£ CAXtY 

Phone: CdtQ^'^T - ,<:'^I 

Team •2Ac(r/nJ>^e*-^/^^T£^S>J BVID #

Sample Number 

Omaha Lead Site 

Site Sketch 

 O-^^l ^

Lead Concentration 

5SZ ^ t ? 

ppm 

ppm '91 ^ fa n 

ppm 7gy^z ^ pp ^ m 

I^^Zfe ^ ^ 1 ppm 

ppm 

ppm 

Date: J2 j ^ North Arrow - ^ 

Time: \A «^ Ct /fV 

 XRF Code '=f^ j 

Confirmation Sample 

*^Yes n No 13 

p7Yes 0 " No n 

8/Yes a No ED 

0lYes a No ° 

0?Yes n No S 

Yes • No • 

Yes n No • 
Print Preview Page 1 of 1 

Doaglas County-Omaha, NE 

Parcel ID 2410630000 

Owner ROTH 

Name MICHAEL E 

Property 1426 CADY 

Address AV 

City OMAHA 

Zip ; 68110 

Owner . 

Address 

Owner 1426 CADY 

Address 2 AVE 

Owner City ! OMAHA 

Owner NE State 

Owner Zip 68110 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Ljot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Assessor 

Website Link 

10-15-13 

WASHINGTON SQUARE 

0 

6 

45X127 

http://douglasne.mappjngonline.corri/DouglasCoNe/static/accountinfo.jsp? 

accountno=R2410630000 

Disclaimer Map and parcel data are lielieved to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and shoukl not be substituted for a title search, 1 inch = 39 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptDat^=Douglas County-... 7/16/2007 
Find Record J Qean Up Query Lead Remaining Query j

Sample Area: 28915 - 1426 CADY AV 

Owner: Resident: 

D Owner Occupied Resident Name: 

Owner Name: JROTH MICHAEL E 

ROTH MICHAEL E Property Address: 

Owner Addressl: \ pr426 CADVAV 

Zip Code: 

Owner Address2: (68110 

1426 CADY AVE Resident Phone 

City: State: Zip Code: r 

|OMAHA |NE |68110 

Owner Phone: Alternate Phone: 

)(402) 345-1591 

 Property Damage Query Close 

Contract: 

Contractor: 

1 JPRUDENT20Q7 

1 Group: | 

Assessment: 

Qualifying Group

j800

Assessment XRF Date:

1

Assessment Max XRF Value:

j 879.71 

| 

i 

i 

i 

j