TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

sAiD« iaft2 ^ DATE: >/» /2O/2 

ADRESS: 2 ^ ZW Map(fl SJREMEDIATION CONTRACTOR: COASTAL ENVIRONMENTAL GROUP YEAR: ^.Ql ^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

/ Executive Summary 

[y EPA-provided property sketch 

DH/ Signed Access Agreement for subject property 

1 ^ Signed Access Agreement (s) for adjacent property 

n Restoration Agreement 

^{H Settlement documents (i.e., for damage or to replace plants, etc.) 

[^ Confirmation data 

D Photographs SOD 

Pre-Excavation 

Excavation 

y As-Built sketch 

^ Satisfactory restoration signed by Property Owner 

& Property close-out check list signed by EPA 

A4^ Description of areas of areas not meeting ROD cleanup criteria 

^ Utility clearances 

V^ Property Information from Douglas County Assessor's Office 

D 

H ) l 

v y 

Date 

30261364 

Superfund 
tvV ^ 

Property Access Checklist 

Property ID: XQPiP(7 \ 

Property Address: 2^^ ^ jL//Jl|)U "Sf 

n WORK STARTED 

Dl WORK COMPELTED 

ON: . 

ON:_ 

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Owner: ^p ^

Address: 

Phone: l\< q

Fax: 

CeU/Pager: 

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^27 ^ 

Renter: 

Phone: 

Fax: 

CeU/Pager: 

Additional Information: 

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: ^

Y \

O

Q

Q

D

D

D

D

n

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O

 Notification Letter 

 Access Agreement 

 Restoration Agreement 

 TopsoU SampUng (if appUcable) 

 Disposal Sampling; (if appUcable) 

 Garden SampUng (if appUcable) 

 Utility Clearance 

 Video/Photos (Before) 

 Video/Photos (During) 

 Video/Photos (After) 

 Video/Photos (30-Day) 

 Property Completion Agreement 

 Final Report 

Sent:

Signed:

Signed:

/

/

/

CaUed:

On:

On:

On:

On:

Signed:

Issued:

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 /

 / 

/ 

/ 

/

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 /

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/ 

/ 

/ 

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By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

Air Monitoring (as appUcable] 

O Commimity CU Crew 

Results: 

On: / / By: 

1 1 Commimity

Results: 

 CD Crew On: / / By: 

r~l Commimity

Results: 

Q Crew On: / / By: 

Omaha Lead Site 
Douglas Cotinty Account Infqsmation Page 1 of2 >aua 

Douglas County, Nebraska Property Record - R2002760000 

Print Report 

View Interactive GIS Map Information is valid as of 2011-10-13 Treasurer's Tax Report 

New Feature r^ -> r> Subdivision Sales Search 

Owner 

POPE BEULAH 

2909 N 25 ST 

OMAHA NE68111-0000 

Property Informatio n 

Key Number: 0276 0000 20 

Account Type: Residential 

Parcel Number: 20027iB0000 

Parcel Address: 2426 MAPLE ST 

OMAHA NE 68111-0000 

Legal DescHpt'on: PATRICKS -A S- ADD LOT 8 BLOCK 1 S 72.6 W 44 FT 44 X 72.6 

Value Informatio n 

Land //nprovemenf 7bta/ 

2011 $400.00 $0.00 $400.00 

2010 . $400.00 $0.00 $400.00 

2009 $400.00 $0.00 $400.00 

200B $400.00 $0.00 $400.00 

2007 $400.00 $0.00 $400.00 

2006 $400.00 $0.00 $400.00 

Land Informatio n 

Aeries SF Units Depth Width Vacant 

0.07 3168.0 0.0 72.0 44.0 Yes 

Hfl ny^ 

^OZhttp://douglasne.mapping-online.coni/DouglasCoN e/static/accountinfo.jsp?accountno=R2... 10/19/2011 
i 

Douglas County Account Infoagation Page 2 of2 

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Binney SI Binney St Bir»ney SI 

Locust St $ ^ 

Maple St 

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PO ! I 

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S Miami SI I Miami 54 

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Map data ©2011 Google 

The above map is powered by Google , and is intended to provide a general idea of a property's location. If 

you require a more exact property location, you may use the Interactive GIS Maps that are maintained by our 

office. 

http://douglasne.mapping-online.com/DouglasCoN e/static/accountinfo.jsp?accountno=R2... 10/19/2011 
As-Built Drawing 

0LS:29824

COASTAL DATE EXCAVATED:04/2010 Omali DATE USEPA SIGNED OFF:6/23/10

Environmenta a Lead Superfund Sitel Group, AREA SODDED: See Executive 

Summary Inc. 

2.9g>2.-«+ 

Omah a Lead Site 

NumDer oT Samples •• 

Sampling Address : Z.i\ZXe> MAF'l- E

Site

 S+ ­

Sketch • Soad 

• Poo' 

[3^0 1 paint 1 

Sample Number 

RYASCPXA-29S2 4

RYBSCPXA-Z9ez»+

 F l 

P2 

Lead 

Concentration 

13J 

<oS(fc _ ppm 

Sample 

Collected 

B' 

l«k 8 

D 

Firm

Date.

Time:

Samples Coliecied 

ASV/ , Aj/n X 

"7 / I R/g-t^^ 

o 9 : ^ O 

RYCSCFXA-Z*6Z 4

•RYDCCPXA i!9eC't

 B l 

BS 

3^ 1

—

 ppm 

ppm n 

D 

D Samples Analyzed 

f^DEGCrXA g-^BCM—BS­ — ppm D D XRF Unrt 100 7 Book. Ife* ^ 

-ReescPXA- e.ofea't oznpgcc^x ^ awam—P2­

—

—

 ppm 

ppm 

D 

D 

n 

n 

Date:

Time

 a//<y/o<f^ 

prv ) 

I Staff MS W 

Legend- F l = Front Lefl. F2 • From Right. B l = Back Left, 82 = Back Rigtit DZ " Dtip Zone, GZ •= Garden, PZ = Ra y 

RYAi;rJ>LJ^29e24 Air quadrant* »f« »m v*«w«d frofntfi*rtT»«l,tacincpfopwty 

RMun tOTppni 

Hf-w .20.1* DI t").:*«I ;*- M « .U" 

CONCRETE DRIP ZONE EXCAVATED QUADRANTS EXCAVATED 

AREA REPLACED WITH AREA REPLACED WITH SOD AREA LEFT BARE 

ROCK/MULCH 

CONTRACT #: EP-R7-09-06 COASTAL ENVIRONMENTAL GROUP, INC. 
Z9g>2.4 

Omah Exterior Paint North Arrow a Lead Site • Good Site Sketch i • Poor 

Sampling Address: Z4Z. ^ MAPL E S V Q^Not paint 

Sample Number Lead Sample Samples Collected LAB Concentration Collected Finn: ASW ^ Aj/p K 

RYASCPXA-Z9S24- Fl 131 ppm Q^ Date: -7/IR/O 6 

RYBSCPXA-Z9azH. F2 <bS(h 

ppm D Time: o9 : ^ O 

RYCSCPXA-Z9SZ4 B1 3^ 1 ppm 0 ' 

D Samples Analyzed nYDSCPXA 29gaM B2 — ppm D D nDZCCPXA'aosg'i DZ -=Z ppm D D XRF Unit: ]00~ T Book: liiZ^ 

•RGZSCPXA-iP&Z'l- CZ — ppm D D Date: f=i7l<f/o<2. 

^pzccpx.^ ^»aaM^ PZ — ppm D D Time: pm 

Numbe Staff: HSW r of Samples = 3 I 

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

PYAQrPtA-29824 * " ^'^^'^'•^"ts sre as viewed from the street, facing property 

Rev 2008 ,BL Created: 16-May-08 046141.0123 
Z9g>2_4 

Exterior Paint North Arrow Omaha Lead Site • Good Site Sketch 

• Poor 

Sampling Address: Z4Z. ^ MAPL E S+- [g^Not paint 1 

Sample Number Lead 

Concentration 

Sample 

Coiiected LAB 

Finrn:

Samples Collected 

 ASW , AJ/D K 

RYASCPXA-Z982M­ Fl 12LL ppm Q^ Date: -7/lP,f<=><2> 

RYBSCPXA-29az4

RYCSCPXA-Z9ez4

RYDC)CP^^ g>OG'l

 F2 

 B1 

 82 

<oS(S 

3^ 1

—

ppm 

 ppm 

 ppm 

QD 

D 

D 

D 

Time: o9 : M-O 

Samples Analyzed 

-RDZGCPXA- g.96g'^ DZ • 

•RGZGCPXA' 

^pzccpyo^ z9s^i- pz 

_jz:

—

—

 ppm 

 ppm 

 ppm 

a 

D 

D 

D 

D 

D 

XRF Unit: 

Date: _ 

Time: _ 

]0<D~T Book:

a7ifh<£t 

pm 

 \iiZ=) 

Number cf Samples 

Staff: MSW 

Legend: Fl = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

DVAcr-P! A 79824 *" '^'^^'^''^rUs are as viewed from the street, facing property 

R^uft 167 ppm 

ncv2008DL Crcmcd: 16-May-OS 046141.0123 
*>, .-C IHVIBOHUI KIJ.I 

' «»" • C« 0 U r > « ( 

Consenifoi Access To Property' 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property' ov^ner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmenta! response activities upon the 

following described premises: 

Ovifner's Name- Daytime Phone: 

/I Ojpe 6eu\oy\ VoZ H sulci? 

Address of Property 

covered by this 

Agreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s} V4\\\ be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, v^rill contact 

the Grantor in-person to discuss the work to be perfomied, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work 

before it begins. Once the work is finished, the Grantor will be asked to review the work 

and confirm that it is complete and meets with the Grantor's approval. Upon 

completion, the Grantor will receive written documentation from EPA that the property 

has been remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of performing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
C 0ASTA L tHVinONHhKTA l 

C « O O ' I K C 

t Remove obstructions including boats, trailers, vehicles, playscape items, wo

piles, dog houses, etc; 

od 

e Remove flower bulbs or plants that the Grantor or the Grantor's tenant may w

to save; 

ish 

c Water and maintain replacement vegetation, iricluding fertilizer application,

necessary subsequent to an initial wateririg period by EPA; 

 as 

r Abide by health and safety guidance provided by EPA; 

« If the property is rented, assist EPA in obtaining tenant approval for access

the property to perform the work. 

to 

c Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the work activities, or with any 

of the work done, or with the equipment used on his property, or to undertake any 

actions regarding the use of said property which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (402) 991-1199 

^ 1 grant access to my properties D I do not grant access to my properties 

Siigneture Date 

Q I would like to be present during any sampling! that is required. 

Page 2 of 2 
COA S T A L CNVIMOMHtNTAL C N O U P . IN C 

Restoration Agreement 

The pvupose of this agreement is to provide a mutual agreement as to conditions of the property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: Z ^ ^ Z j 

Property Address; Z 'I Z 3 Z ^ c^p \ dl S' ' 

~PhZ^: C7C7 0 ^y i HlC ' 

On the attached diagram(s) indicate aiea(s) to excavate, surface structures and landscaping features and access 

location(s) to be used by the contractors. Indicate distances, depths, material types, etc. Photographically and 

Videographically docimient the existing conditions ofthe property and the basement ifnecessary. 

Items to be Removed by the Owner before Start of Remediation: 

The removal, storaqe, disposal, and/or retum of these items is the Owner's responsibility. 

Hem: A ^\ y ypUnis y i^-e- S^^y^d 

Item: 7 17 

Ken): 

Item: 

Items to be Removed by the Contractor During Remediation and Not Replaced 

Item: 

zryiy flcAnj-j i^f-y Jz^AJn^ 

Kem: 

Item: 

Kem: 

Page 1 of. 
COA S T A L IHVinOMHTMTAL C « O U * , • H C 

Items to Be Removed By Contractor During Remediation and Replaced 

Kem: 

l o. Item: 

£nA 

Kem: 

Kem: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Agreed upon value of 

olant materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Easement Area, to be 

excavated 

Quantity 

fZ 

? 

er 

y 

0 

0 

) < > 

Landscape Inventory 

Unit 

Quadrants 

Each 

Each 

Each 

Each 

Square Feet 

$ 

Each 

Condition/Type/Species 

l?\v;^ U-r-^9 5 

fci/\<i^iv)<^ (\e)oli> 

Page 2 of. 
COASTA L CMVIHONHCNTAk c n o u p . INC . 

Additional Comments / Instructions: 

The cKy of Omaha ordinances may prohibK you from using dirt or gravel areas on your property 

as driveways or vehicle parking areas. The Environmental Protection Agency (EPA) may be 

removing and replacing soil underlying a gravel or dirt area on your property that you may be using 

as a driveway or vehicle parking area. If this is the case, you should understand that this removing 

and replacing of soil does not mean that any illegal driveway or parking area on your property is 

made legal. To the contrary, you may be cKed by the cKy if you use a gravel or dirt area as a 

driveway or parking area, not withstanding any removal or replacement of soil by the EPA. 

If you have any question about legality of a certain driveway or parking area, you may contact the 

cKy of Omaha's Planning Department at (402) 444-5150. 

CU Please check this box if you understand the information outlined above. 

Cj,^^ V/ 3 noZtcc 

n Check the box if Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

Owner's Signature 

Page 3 of. 
Oinaha Lead Application Page 1 of 1 

- ^ ' J - Omaha Lead Application \. f New Search "</' Logout •^l^ Change Password CMJ Reports 

Sumnaiy 

Property bifo Assessment Clean Up 

AOEvants Son I Paw' I "DUST I Soa I Paint I CaOtracMig 

Douglas County Interactive EPA Map Soil.Images.CZ) 

Sample Area ID perty Address ISaimple Address lOwiKler Name 

29824 P42 :4266 MAPLE ST !426 MAPLE ST 58111 POPEE BEULAH

Cleanup | SampUng I Contradtor I Remediation Events I Sidewalk Repairs (0) I 

Date Quad Parainet Xrf Resu Urats Dept h Marker Sampled PBItan u Instr_I D iQA Lab Lab Unit: 

04/12/2 0 F2 LEAD 29 mg/k g 4 0 C. Padilla N 39022 N/A 0 mg/k g 

04/12/2 0 E l ILEAD 204 mg/k g : i 0 C. Padilla N 39022 N/A 0 mg/k g 

1 

Remarks : 

A v g Residual Concentration > 1200 a t Ift , Drip Zone Concentration Av g Residual > 1 Pbppcn Concentratkin Lef t In Place 

[ Update J 

http://r7arcims.r7comp.epa.gov/ols/SoilCleanUp.cfin 10/13/2011 
Omaha Lead Application Page 1 of 1 

\. / New Search <,-• Logout Omaha Lead Application 0, 'k Change Password iS S Reports 

Sunmiafy 

Property Wa Assessmen t Clean Up Hold 

AOEvsnlB Soa I n^int~ | " Durt I "Soa I Paint I Can tracking 

GooqIe.Maps Douglas County Interactive EPA Map Soil Imagesf2) 

jSample Area ID proipert y Address Sample Address p p lOwner Name [29824 "B42!426t MAPLE ST 2426 MAPL£ ST BBIII JPOPEB BEULAH 

Cleanup 1 Sampling I Contractor Remediation Events Sidevaik Repairs (0) 

faNallon; COASTAL2010 ARRA Assnaied: 03^30011 StovevRalliia: 

Cleanup_type Contacted Ovme | Access 1 Begin Date 'En d Date CV Removed cleanup Tons | j 

400 Ol/lS/201 0 04/01/2010 04/02/2010 0 

Bd£i ^ 

Begin Date End Date 'Sod Date CVBackfiO CV Topsoil CV Total 1 

04/05/2010 04/0S/2010 04/12/2010 0 

Close Dili: 

Contractor Closeout EPA Ooseout I Sod Warrant y 

06/23/2010 06/23/2010 

Propertw Renmis: 

Comments ! 

Other Materials: 

[ l^date j 

http://r7arcims.r7comp.epa.gov/ols/SoilCleanUp.cfm 10/13/2011 
yi7Z(^ zmc^A 

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 Omaha Lead Site—Fixed Price EP-R7-09-06 

 Coastal Environmental Group Ina ,.. 

Sy^^ ^ www.coastaIhazmat.com ^ 

'""'°'* COASTAL 

EXECUTIVE SUMMARY: 

BVID #33224(4028 N 44 ST) 

X No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 

COASTAL IS UNABLE TO PROVIDE PRE-EXCAVATION AND EXCAVATION PHOTOS AS 

PART OF THIS FINAL PROPERTY FOLDER. THESE PHOTOS WERE IN THE POSSESSION OF 

A SUBCONTRACTOR THAT WAS CONTRACTED TO PERFORM ALL OF THE SITE 

COORDINATION REQUIRED BY THE SCOPE OF WORK AND THE SUBCONTRACTOR HAS 

SINCE LEFT THE PROJECT. THEREFORE, THE PHOTOS ARE NO LONGER AVAILABLE 

During an internal audit, it was discovered that this property had been excavated, backfilled, sodded, 

and signed-off by the property owner and EPA COR, but never billed. This property was initially 

excavated, backfilled, and sodded April 2010. It was signed-offby the property owner and EPA COR 

on 6/26/2010. All information associated with this property has been lost. This folder has been 

reconstructed with information we received from ORACLE. 

The ORACLE information received included the XRF readings and the initial sign-off date by the 

property owner and EPA COR. Because COASTAL did not re-excavate the property, no additional 

XRF readings were needed or obtained. 

The property owner resigned the access agreement, restoration agreement, and property completion 

agreement with current dates. The property owner also received a check in the amount of $200.00 for 

damages done during initial remediation work. 

COASTAL has taken and included pictures ofthe F2 quadrant which was initially excavated. 
4

EPA Property Close Out Form 

Property Addr«r. ^a%-^^=^^-S ^ Property ff: SlQ(rb,Ql H.. 

Date/Time: 

Owner's Name:./j^.. gjejL|>\9:.V' •. 

Quads Excavated: ^' ^ Contractor Group ( /bgL«a.\cu V

Excavation Yes No General 

1. If necessaiy, were the conect quadranKs) excavated and restored? y 

2. If necessary, were the correcl areas of drip zone excavaied and restored? 

y 

Grading Sod and Vcgetaiion 

Yes No 

1. Does the grading around ihe perimeter ofthe 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 mspecied at a 30 / day time period)

 . 

4. Arc sodded areas generally (inn and evenly graded? 

y ^ 

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

 ,_ 

6. Was the property graded such that water will not pool on the propertj"' 

y 

7. Was damage to landscaping or plant materials avoided? 

/ 

Gates, Feoccs and Rctainins Walb Yes No 

/ 1. Do gates open and close freely? (Ifapplicable) 

2. Wisre all gates or fences taken down during restoration activiiies reinstalled? (If appiicablc) y 

3. Was damage to gates or fences avoided? (Ifapplicable) y • 

 Was damage to reiaining walls avoided? (Ifapplicable) 

y 

f ouDdatioa, SidinKand Gutters Yes No 

1. Wias damage to the siding or trim avoided? 

y 

2. Was damage to the foundation avoided? y 1 

3. Was damage to w indows avoided? 

' y 

4 Was daraage to windovvs or door screens avoided? / 

5. Was damage to downspouts or downspoui exlensions avoided? y ' 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Wias damage to driveway surfaces avoided? 

/ 

2. Was damage to waDcway surfaces avoided? 

y 
I 

Ort'Dcr^ conunents: 

jlnspection no<es: 

Removal and resioration activates complele including the 30-day sod warranry: 

EPA Representative S,. ^ Date: ,,/.,/,, 
COASTAL 

Property Completion Agreement 

This agreement documents the completion of remedial activities performed on my property. My signature will 

designate that I ain satisfied with the restoration of rtiy property, and that no items are in question, now or at ariy 

time in the future, except those items listed below, if any 

Property ID: Z,'^ KZ H 

Property Address: Z -V 2-^ XA oy? le^ S 

Ov^er. f a jc>& y A,yi y 

Phone: C^oz:) H T 7 H'LA.Al 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

JS^I I agree restoration in completed, except as noted 

\ZZ1 I do not agree restoration is corhpleted 

z /yyz A^-Z7'3 

Date Contractor's Signature 
Coasta l Environmenta l Grou p 

2411 Martha Street 

Omaha, NE 68105 

Phone: 402.991.1199 

Toll Free: 877.662.4210 

Fax: 877.662.4211 

Property Damage Settlement 

Date: October 27. 2011 

Property ID 29824 

Property Address 2426 Maple St 

Owner Pope Beulah 

Phone Number 402-457-4263 

I received from the contractor, Coastal Environmental Group, Inc. (Coastal), the sum of S200.00 to 

compensate for properaty damage done during the remediation of lead impacted soil from the property 

identified above. 

Compensation Type Check #2391 

Value of Check $200.00 

Pay to the Order of: Pope Beulah 

Description of Damage 

Damaged tress during excavation/restoration of property at 2426 Maple St. 

My signature below acknowledges the presumed damage; further, 1 acknowledge that this work 

was completed satisfactory and release Coastal Environmental Group, Inc. from further obligations 

or liability to this property. 

yA^ZyZZpA ZAyyiAr /o'Z7'-n 

Owner sr's Signature { Date Contractor's Si 

COASTA 2391 L ENVIRONMENTAL GROUP INC. 

2411 MARTHA STREET 27-5/1040 003 

OMAHA, NE 68105 

6247372904 

Qc,VaS^^2^•^0'\ 

DATE 

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