TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 31394 DATE: 12/15/2010 

ADDRESS: 1467 E M M ET ST 

REMEDIATION CONTRACTOR: PRUDENT TECHNOLOGIES. INC. YEAR: 2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

[ / PRE AND POST VIDEO OF PORPERTY (DVD) 

d EXECUTIVE SUMMARY 

izf EPA-PROVIDED PROPERTY SKETCH 

a SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

n SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

a RESTORATION AGREEMENT 

D SETTLEMENT DOCUMENTS (I.E., FOR DAMAGE OR TO REPLACE PLANTS, ETC.) 

d CONFIRMATION DATA 

0 PHOTOGRAPHS 

[ J AS-BUILT SKETCH 

Q SATISFAaORY RESTORATION SIGNED BY PROPERTY OWNER 

0 PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

0 UTILITY CLEARANCES 

U PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

^ ^ V< 

A V 

SIGNATURE DATE 

30260823 

II 

Superfund 
Find Record Remediation Query Lead Remaining Query Property Damage Query 

Backfill: 

Sample Area: 31394 -1467 EMMET ST 

Owner: 

n Owner Occupied 

Owner Name: 

IHABITAT FOR HUMANITY OMAHA 

Owner Addressl: 

1 

Owner AddressZ: 

J2204 AMES AVE 

City: 

)OMAHA 

State:

|N E

 Zip Code: 

 J68110-

Owner Phone 

1 "1 

Alternate Phone: 

Contract: 

Contractor: JPRUDENT2010_S 

Contract Option lOPTION 2 

User Provided Owner Information 

Owner Name: 

1 

Owner Address: 

1 

City: 

1 

State:

1

 Zip Code: 

1 

Owner Phone: 

1 "

Alternate Phone: 

1 

Assessment: 

Qualifying Group 400 

Assessment Max XRF Value | 477.56 

Resident: 

Resident Name: 

I 

Property Address: 

)1467 EMMET ST 

Zip Code: 

68110-

Resident Phone 
PROPERTY SUMMARY 

Date: 12/15/2010 Omaha Lead Site Remedial Acdon Contract # EP-R7-07-06 TO#l Month of: December 

Property Address: 1467 EMMET ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

B2 = 385 PPM @ 2"; EA = 207 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 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) 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. 
' TECHNOLCXJIES, EMC. 

Property #: "^C?*^ M" 

Date/Time: 

Quads Excavated: f??"? 

EPA Property Close Out 

Property Address: \^0 7 t vnnveV >* ­

Owner's Name: rV^+^j^^-.^. tWwimHi) 

Contractor Group: Prudent Technologies, Inc, 

Excavation General Yes No 

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

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

Grading Sod and Vegetation . Yes No 

]. Does tlie grading around the perimeter of the house in excavated areas generally slope away / from the house? 

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

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

day lirae period) y 

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

5. Arc Uie joints between the sod strips generally tiglit? (Only evaluate if inspected at a 30 day y time period) 

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

/ 

7. Was damage (o landscaping or plant materials avoided? 

/ 

Gates, Fences and Retaining WalJs Yes No 

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

y 

•?. Were all gales or fences taken down diuing restoration activities reinstalled? (If applicable) y 

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

y 

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

y 

Foundation, Siding and Gutters Yes No 

1. Was damage to tlie 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 

.i. Was damage lo downspouts or downspout extensions avoided? y 

Sidewalks and Driveways (Concrete) Yes No 

1. Was dajiiage to driveway surfaces avoided? y 

2. Was damage to walkway surfaces avoided? 
Owners coiinments: 

Inspection notes: 

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

EPA Representative Q'^JU. Date: nhilio 
ECHNDEDGIES. tNC. 

AS ­ BUILT DRAWING 

OLS #31394 

Date Excavated: 10/21/2010 

USEPA Signcd-Orr Date: OMAHA LEAD SUPERFUND SITE 

31394 

Omaha Exterior Paint NonhAmMi 

Owne Lead Site r Mame: ALEXANDER EASTER_ • Good 

Address: 1467 EMMET ST

Phone: Jl ; 402-345-9171

Site Sketc ^ 

 w: 

h 

D

Q

 Pot* 

 Notpaint i 

Sampte Number Lead 

Concentration Sample 

Collected lAB 

Firm:

Samples CoDected 

 r^ A MT/.^«A 1 

RYASCPXA-31394 Fl 2{?2.pp m 0 D Date; B-I1- S 

RYBSCPXA-31394 F2 Z?-*? .ppm EJ D Time; <?'- ^ C 

RYCSCPXA-31394 

RYDSCPXA.31394 

Bl 

B2 

S'J Z Dom 

H7 a -PPr" 

0 

0 

D 

D Samples Analyzed 

n7 ppm D D XRF UnH: 10^ 7 Book: '2 9 

RGZSCPXA-31394 GZ n & .ppm \H D Date: f.-/-" ^ 

pom a D Time: Z***! 

Number of Samples staff; Z.A 

1 • 

Legend: Fl = From Left, F2 = From Right, Bl = Back Left, 82 = Back Rigtit DZ = Drip Zone, GZ = Garden, PZ = Play 

AD quadrants are as viewed from the street, facing property 

AuLeV T"Tr7>"^^ "i~^ tTt": ~^' 

s m • 0 iirS 

342 B2 = 385 PPM fSJ 2' I ¥78 

32 • | - _ •• : 

td ^76! 

iGi^. 

L 

J'^.l.TfviHrr.sr 

Z.S2. I izr 

FZ a 

WALK 

Ilcv4' .£»'l.MET>r 

EA = 207 PPM @ SCRAPE (-1") 

CONTRACT #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
SEPA 

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 ofthe 

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: i4l;7 glQi/Vtr^-i- Sf. 

Owner: |^^4^.} - 4. . Hutvt^,,v;^ .f/W^k i 

Phone: ^bl-^q ^ Q^Cy-J 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

J^ l agree restoration is completed. 

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

il iU 2^1.0 

^yLy-^yny^^y^^^-^y-''*^''^ 

Date 
R P.003 X Date/Time 10/08/2J 12:30 402 457 4012 

Oct. 8. 201 I2:28PM Ha l l for Human i ty No. 1414 P. 3 

Pmdertt Teebnologies, Inc. (Pnidoii) is under contract with tlie U. S. Environmenlal Protection Agmcy (EPA) to dean op leadcontaminated soils at tJiuraber of propenies located in Omahf^ Nebraska, including the propeity located at 

|4lp 1 &tMliVltarSr . . The EPA requesu your pwraission to allow Piudent to perfonn a soU cleanup at this 

piopecty to (cmove lead-coiuaniinaied soil. By signing this form, the property ovmer giants pennission to Pnident to pcifoim 

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

Ifyou have any questions about (he soil cleanup planned fbr your property, please contact Prudenl south oHicc .for fhe Omaha Lead 

Site cleanup-at (402) 733-1183. Qeneial questions about the Om ^ Lead Site cleanup can be directed to the EPA Public Information Centen at (402) 731-3045 (South Omaha otTice) or (402) 991-9SS3 (North Omaha oilice). 

Property Access Granted ^ / \ (Please Priqit Name) 

Propeity Owner Signature: fd/e/2^id 

(Date) 

PROPERiy INFORMATION 

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

RESIDENT NAME: OwnerJ Renter 

RESIDENT ADDRESS 

lifbn (-^-ryj- J ^ 

If RUN I AL, PROPERTY OWNED BY, 

|47tfafk4--fe<- [JtlM^Vilixj (OrviA.^g^ 

OWNER'S MAILING ADDRESS; 

22M ViA^Ai/g. Qi^/iU^ Kft? UMb 

OWNER'S TELEPHONE NUMBER. HOME: (462. t 4tr7-f7Ti*f 7 WORK: 

J 1 ., 

AGE OF HOME?: n/f l YEARS. HOW LONG HAVE YOU LIVED HERE? YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 197B7 _YES NO 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: NUMBER OF OCCUPANTS 7 YEARS 0110 ANO OLDER 

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY IN THE YARD FOR 6 HOURS OR MORE PER WEEK: 

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

AinHORITY POR ENVIRONMENTAL RESPONSE ACTIONS; The activilies to be implemenled by EPA under this agreement are pursuani to Section 104 ofCERCLA, 42 tJ.S.C 9604. EPA's right of access to the properly is provided for in Section 104(e) of 

CBRCLA, 42 tJ.S. C 9£0S(e), whieli provides eniry for "determining the need for response, or choosing or taking any response action under Siis title, oi otherwise enforcing the provisions ofthe title." 

8080 Ward Parkway, Suite 405 5600 SI O St 4242 Medical Drive, Suite 4260 

Kansas City, MO 64114 Omaha, Nebraska 68107 San Antonio, TX 76228 

Phone:(816)363.3703 Phono : (402)733-1168 Phone: (210)822-9588 

Pax: (816) 363-3707 Fax: (402)733-1883 Fax: (210) S7S-6S77 
ENVIRONMENTAL & 

CONSTRUCTION 

SERVICES 

Property Status Form 

Address: JLfL' l 

ofVf 

Phone: BVID: 

\M'J ^ luvfc cl 

IAJ c r \c (X^vouvV 

(^ ^ ^ l-^'^^ ^^iJ-^J. 

^ = ^ ^ ^ cH 

•jy ii: 0 tC -

Property Owner Prudent Employee 

Signature: Signature: 

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

Kansas City, MO 64114 Omaha, Nebraska 68107 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)733-1188 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)733-1883 Fax: (210) 579-6577 
31394 

Exterior Paint North Arrow Ovme Omaha Lead Site r Name: ALEXANDER EASTER • Good Site Sketch Address: 1467 EMMET ST • Poor 

Phone: H 402-345-9171 Vll: i Q Notpaint 

Sample Number Lead Sample Samples Ck5llected LAB Concentration Collected Firm: ri\ A U.T//ZU U 

RYASCPXA-31394 Fl ZSZ ppm Ef n 

Date: &-i' l -- 5 

RYBSCPXA-31394 F2 

IZ±. ppm 0 Time: D ^--S<?

RYCSCPXA-31394 B1 ppm IZf n Samples Analyzed RYDSCPXA-31394 B2 H7S ppm 0 n 

RDZSCPXA 31301 92 ppm D n XRF Unit 103 7 Book:: I Z 9

RGZSCPXA-31394 GZ 113- ppm m D Date: _ ±LL 

RP7SCPXA^1301 Pf- ppm 

D Time: _ /»/»> 

Staff: Number of Samples = j -5" _4A 

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

All quadrants are as viewed from tt« street, facing property 

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AUG 1 s 2m 

3HZ V78 

3Z 

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A i i 

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j^.iti.rviHer.^ 

ZS2. iZf 

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WALK 

Rev 4' £MKBT in 0J6I4I.0I2J 
mt 

N 50 X 124 

A Printed: Nov 16,2010 CIS 

www. dcgis. org/dogis 
cuwsiKliCriON 

SOLUTIONS 

SITE SAFfcTY HAZARD ANALYSIS 

Address: 

. /44 7 ^yyiyy^y f f Excavation Date: ^^./^/^'l. 

Crew: BackfiU Date: —f'/^-lJuiv 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees 

Structures 

Driveway 

Sprinkler System 

Otlier 

Crew Foreman 

Condition 

CP^ ^ 

e^ 

h^' \ j 

ofi^ 

dy*­

m 

^C£ ^ 

CE«^ 

l?< ­

o*-— 

Hazards Corrective Action 

/.jcy^ i AM^-Mbr.^ O C (» / P ire-O 

Site Safety Office 

Date: 

8080 WanfBaftany. Sute 405 5600 SI O St 4242 Medical Drive, Suite 7250 

Kansas G«y; 11064114 OotidB, Netaasfca 68107 San Antonio, TX 78229 

Phone: (S16) 36S'3703 nwne : (4a2)73»-11S8 Phone: (2t0)822-«588 

|^9C (816) 363.4707 Fac (402) TS^-ISSS Fax: {210)«T»<577 
'/%7 '^mer 

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