TRANSMTTTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

sm #: 17^92- Date: 1'LJl<:fn'^ 

Address: p__Zlo ^ 2 ^ ^ 

Remediation Contractor: nwj,^ > 'lltA. Lvrc^ Year: 2^r)'=j 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOOJMENTS 

12 Video of property (DVD) 

E Executive Smnmary 

D

A 

EPA-provided property sketch 

Signed Access Agreement for subject property 

 Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

D

ID 

 Settlement docum«its(i.e., for damage or to replace plants, etc.) 

Confixmation data 

Photographs 

As-built sketch 

D

D

i 

D 

Satisfectory restoration signed by Property Owner 

Property close-out check list signed by EPA 

 Description of areas not meeting ROD cleanup criteria 

 Utility clearances 

Property information from Douglas County Assessor's Office 

D 

D 

Signature "~~" iJate 

30218252 

mi 

Superfund 
Find Record Remediation Query I Lead Remaining Query I Property Damage Query 

Backfill: 

Sample Area: 17352 ­ 2310 S 35 ST 

Owner: Resident: Contract: 

n Owner Occupied Resident Name: Contractor: 

Owner Name: |GUZMAN MAURILLIO B |PRUDENT2009_S 

|TRUSCOTT CHRISTOPHER C Property Address: Contract Option 

Owner Addressl: |2310 S 35 s r |OmON 3 

I Zip Code: 

Owner Address2: 68105 Ass^ment: 

|2310 S 35 ST Resident Phone 

City: State: Zip Code: Qualifying Group 

|OMAHA |N E |6810 5 400/CHILD 

Owner Phone: 

I 

Altemate Phone: Assessment Max XRF Value: 

I 442.15 
imBmBBmfmmBmisx 

Date: 12/15/2009 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Montli of: November 

Property Address: 2310 S 35 ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A3 Unique Findings: NONE 

A.4 Other Relevant Information: AREA NOT EXCAVATED BY PO'S REQUEST F2/LS 2'X4' 240 PPM 

@ SCRAPE 

CONFIRMATION SAMPLING DATA/RESULTS: 

F2 = 166 PPM @ 6"; EA = 77 PPM @ SCRAPE (~1) 

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 sketchi) 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) 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. 

TKSMNimmES.KNi:. 
TECHNOLOGIES. INC. 

EPA Property Close Out 

Property*: H'^SX - Property Address: 2.110 -5 3 5 2 t 

Date/Time: Owner's Name: AA.i!tttr^ll<<? Cbc«..Z,»v\<tv^ 

Quads Excavated: f-2 ^ Contractor Group Prudent Technologies 

Excavation General 

Ves 

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

2. If necessary, were the correct areas ofdrip zone excavated and restored? / 

Grading Sod and Vegetation Yes 

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

from the house? J 

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

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

day time period) / 

4. Are sodded aieas generally firm and evenly graded? J 

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

time period) • 

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

7. Was damage to landscaping or plant materials avoided? 

J 

Gates, Fences and Retaining Walls Yes 

1 Do gates open and close fi-eely? (Ifapplicable) / 

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

3 Was damage to gates or fences avoided? (Ifapplicable) J 

4 Was damage to retaining walls avoided? (Ifapplicable) / 

Foundation, Siding and Gutters Yes 

1 Was damage to the siding or trim avoided? J 

2. Was damage to the foundation avoided? / 

3, Was damage to windows avoided'? y 

4 Was damage to windows or door screens avoided? J 

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

Sidewalks and Driveways (Concrete) 

Yes

1. Was damage to driveway siirfares avoided'' 

2 Was damage to walkway surfaces avoided? 

L__ 

JNo 

No 

No 

No 

 No 
Owners comments: 

Inspection notes: 

I 

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

I 

EPA Representative Q^ £•£2. J< ^ Date: //frfcy 
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 fiiture, excluding any 

remaining warranty (30 days total) except those items hsted below, ifany. 

Property ID: 

Property Address: 9^10 $ . 16^ 5r 

Owner: 

Phone: 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

^^ 1 agree restoration is completed. 

1 I do not agree restoration is completed at (noted deficiencies above) 

13/lb>/^? 

Owner's Signature Date 

I
Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up lead­

(jDi^aminated soils ||1 a number of properties located in Omaha, Nebraska, including the property located at 

^^( O ^ . Jo A ^ r • . The EPA requests your permission to allow Prudent to perform a soil cleam^) at this 

property to remove lead-cantaminated soil. By signing this fonn, the property owner grants permission to Prudent to perform 

activities related to the cleanup including soil sampling, removal of lead-contaminated soil, and restoration ofthe referenced propeity. 

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

Omaha Lead Site cleamqj. Ms. Siva S. Jampana-at (402) 733-1188. General questions about the Omaha Lead Site cleanup can be 

directed to the EPA Public Information Centers at (402) 731 -3045 (South Omaha office) or (402) 991-9583 (North Omaha office). 

Property Access Granted By: X O' T \ T \ '^' ^ '-g ^ ^ '^' J Cc y t V ^^^5 rPlRiia t Nmnel (Pleasee Prin Print Name) 

Propeity Owner Signature: y#^>^/^^ [lOckOn

(Signature) (Date) 

PROPERTY INFORMATION 

(To be completed by retidcnt and/or property owner — pkasc print) 

RESIDENT NAME: Bnl^ty Tfu^coit' Renter 

RESIDENT ADDRESS: 

^••?y/9 .^ r 35 - 9 r ' 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

SctvJA^^ 

OWNER'S TELEPHONE NUMBER - HOME:: t"^^ m,m'3^5^ \ ^ WORK: 

J \ 

AGE OF HOME?: fO? YEARS. HOW LONG HAVE YOU LIVED HERE? 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 19787 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLO: ^ NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER 

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

O 

COMMENTS OR SPECIA >ECIAL INSTRUCTIONS INSTRUCTIONS^ (I.E. DOGS, ENTRY GATES. ETC.)

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: The activities to be in^ilemented by EPA under this agreement 

arc pursuant to Section 104 of CERCLA, 42 U.S.C. 9604. EPA's right of 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 ofthe title." 

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

KansasCity, MO64114 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 
ENVIROJNMEMAI.C^ 

CON-STRUCTlOiN 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address: ^3/t > S>^ 3^^ - Date: /0-/7'd> f 

Phone: H^ ^ ' ^fS ' ' ^^^ ? BVID: / 735' ^ 

Item NO Plants & Permanent Landscaping To Remain In Place 

On Map Description & Location 

A<^: ^^ care-r^/ uj^i-l^ /le,^hof^.r ,y/an^^ 9-i^it ^ 

/I e«^A /fcy- ///ne 

Pre-Existing Condition of Structures 

Does your Basement have a history of leaking? Yes No ^ ^ 

Item NO Description & Location 

On Map 

Property Owner Prudent Employee 

Signature: Signature: j^JJ/U0yie^^^sf-~ 

8080 Ward Parkway, Suite 405 5600 S 10 St 4242 Medical Drive, Suite 4250 

KansasCity, MO 64114 Omaha. Nebraska 68107 San Antonio. TX 78229 , tOAC \ OCO OTA O 
FCtlKiMXxHFS, r\-C 

AS - BUILT DRAWING 

()r,S#:17J52 

I)rtte Evcavatfrf: 10/2S/2009 

t SEI'V Signed Off Date: OMAHA LEAD SUPERFUND SITE 

17352 

Omaha Exterior Paint Lead Site Owner Name: MAURILLIO B GUZMAN 

Site • Good Sketch Address: .2310 S 35 ST_ • Poor -^ Phone: H; W: 13 Not paint 

Lead Sample Samples Collected Sample Number 

I 

LAB Concentration Collected Firm: FOA Qc/ M 

RYASCPXA-17352 Fl g H 3 ppm D Date f/o-oH 

RYBSCPXA-17352 F2 M ^ o<. ppm D Time \5-Ho 

RYCSCPXA-17352 Bl \ ^ _^ ppm D Samples Analyzed RYDSCPXA-17352 82 -2J^2 _ ppm 

RDZSCPXA-17352 DZ n S^PPnn XRF Unit: ' ^ ^^ Book:^M _ 

-RQZSCPXA^17351? S2 - D

ppm D Date: Q\ • stn : 0. 4 ^ 

RPZ3CPXA-17362 PZ— ppm D Time: 

D 

D VM. Staff: Number of Samples = | ^ Qt,p 

ENTEi 

SEP 13 

SB 

Aa£w 

, .5M 3 

uVAU. 

143 

P-2-a 

mm: PATID 

pEtt 

%ip­

.mo : 

ilV: 

;2 

*r* 

^fe x iie­

•fl 

"H" 

F2- -K 12 = 166 PPM n 6 

5 35**' 

EA-77P!'\ i a S('KAFK(-r-i 

Omaha Lead Site 46130 

CONTRACT #: EP - R7-07-06 T0#1 PRUDENT TECHNOLOGIES, INC. 
17352 

Omaha Exterior Paint North Arrow Lead Site Owner Name: MAURILLIO B GUZMAN 

Site • Good Sketch f 

Address: 2310 3 35 ST n^oo r 

1

• ^ Phone: H: w: 0 Not paint 

Sample Lead Sample 

Samples Collected Number LAB Concentration Collected Firm: FQA Qd lOfi 

RYASCPXA-17352 F1 S H J ^ Dom D Date: f/Po H 

RYBSCPXA-17352 F2 M H A ppm D Time: 1.^ : VO 

RYCSCPXA-17352 B1 \ ^ ^ ppm t a Samples Analyzed RYDSCPXA-17352 82 2^i3_PPm n 

RDZSCPXA-17352 DZ ^AiLPP m D XRF Unit: ^ t \ Book:C\^^ 

•RQZ3CPXA--17302 S2 - ppm D D Date: ^ 

RPZOCPXA 17003 Pi - ppm D a 

Time: ^ ^

t Staff: 

. ^ Number of Samples = S ' 

ENTEEED 

SEP 13 mh 

ALU ^ »'••• > T 

.(A^AU. I 

pATiO; 

: \M5 D€Ct 

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Ok 

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WAL'K--­

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Omaha Lead Site 

46130 
2310 S ?5 ST 

arch 2007 DOUGLAS COUNTY ASSESSO ''ii!% aSiifl'iSH 
Print Preview Page 1 of2 

Douglas County-Omaha, NE 

Parcel 

ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 

Owner 

City 

Owner 

State 

Owner 

Zip 

0905420000 

TRUSCOTT 

CHRISTOPHER 

C 

2310 S 35 ST 

OMAHA 

68105 

2310 S 35 ST 

OMAHA 

NE 

68105 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Acres 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

CREIGHTONS 1ST ADD 

10 

3 

50X133 

0.14 

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

parc=0905420000 

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

accountno=R0905420000 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 9/17/2009 

2 
Page 1 of2 

"> 

• YOUR TICKET NUMBER IS 2389391. 

Original Call Date: 10/19/09

Work to Begin Date: 10/21/09

 Time:

 Time:

 2:28 pm 

 3:00 pm 

Op: SIVA18967 

State: NE 

Address: 2310 

County: DOUGLAS 

Street: S 35TH ST 

Place: OMAHA 

Twp: 15N Rng: 13E

Twp: Rng:

Legal Given: C 

 Sect-Qtr: 28-SW 

 Sect-Qtr: 

Type of Work: SOIL LEAD REMEDIATION PROJECT 

Location of Work: LOCATE ENTIRE PROPERTY 


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


: UNSURE CORNERS 


Company : PRUDENT TECHNOLOGIES 


Contact Name: SIVA JAMPAMA Phone: (402)733-1188 


Work Being Done For: EPA 


Depth of Excavation: 6 FT Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MUD02 OMAHACOF OPPDGPR6 QLNNEIF 


Service Area Contact 

CXCATV COX COMMUNICATIONS, INC HEIDI 

LEVELS LEVEL3 COMMUNICATIONS, LLC NA 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY 

OMAHACOF CITYOFOMAHA-TRAFFICSEWER RICH/TRAFFIC

Phone Number Utility Type 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

Day: 4025047823 


Alt: 


Emerg: 4025047970 

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SOLUTIONS 

(L 

Site Safety Hazard Analysis 

st Address: AS^^ S- 3 S — Ex. 

Crew: Bf. 

Date: ^^•^jo' ? 

Corrective 

Item Condition Hazards Action 

Overhead Lines \t>«tS> h^ufh^f ^ 

Gas Line ^'^>-igt / lv<nyJ ^^^/ ^ 

Water Line -f -f 

Sewer Line C'Ort ec / kyl^. J //g-g.^?^ 

Septic / Leech 

field / L^ 

Propane/Butane /Vv& 

Sidewalk Jtszii. t-'^g- /^^ytjJ'a.t ^ 

Foundation ^ 

Retaining Walls ^t. ^ 

Fences • T^^ ^ 

Trees/ Bushes y^-fii/ ^ 

Structures /uj ^ 

Driveway ^ L-^a. jt^lj^-f^t 

Sprinkler System / c ^ 

Other 

Crew/Eereman Safet> Officer 

• 3 

3080 Ward Parkway. Suite 'lOfi 2506 \'\. ZA Street. Suite oOS •1-.'J:4i' i'viedica! Drive. Suite "250 

KansasCity. MO 64114 Omaha, Webiaska B8110 Sail Antonio. TX 7322S 

Phone:(816)383-3703 Phone: (402) 504-1004 Phone; (210) 322-S688 

Fax: (81Si3«-;T07 Fax; (4fl:r) fi04-1nor^ 
•4" ^^'-^-^^