SAIDtt: 32050

TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

 DATE: 1/15 

ADDRESS: 3607 N 29 ST 

REMEDIATION CONTRACTOR: PRUDENTTECHNOLOGIES. INC. YEAR: 201^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

d PRE AND POST VIDEO OF PORPERTY (DVD) 

d EXECUTIVE SUMMARY 

[ i EPA-PROVIDED PROPERTY SKETCH 

d SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

n SIGNED ACCESS AGREEMENT{S) FOR ADJACENT PROPERTY 

El RESTORATION AGREEMENT 

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

m CONFIRMATION DATA 

Q PHOTOGRAPHS 

d AS-BUILT SKETCH 

0 SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

D / PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

[^ UTILITY CLEARANCES 

d PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

SIGNATURE DATE 

30218871 ili 

Superfund 
PROPERTY SUMMARY 

Date: /15/2010 Omaha Lead Site Reinedial Action Contract # EP-R7-07-06 TO#l Month of: 

Property Address; 3607 N 29 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 = 243 PPM @ 8"; EA = 183 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 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, ifavailable, or obtained include: 

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

ii) Property Status Form signed by property ovmer 

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. 

TECHNOLOGIES. INC. 
Rnd Record 

Backfill: 

Remediation Query j Lead Remaining Query I Property Damage Query 

Sample Area: 32050

Owner: 

­ 3607 N 29 ST 

User Provided Owner Information Resident: 

n Owner Occupied 

Owner Name: 

iJACKSON CAROL 

Owner Addressl: 

Owner AddressZ: 

J3521 N 29 ST 

City: 

JOMAHA ^ 

Owner Phone 

j(402) 455-2729 

State: Zip Code: 

^ JNE J68111-

Alternate Phone: 

Owner Name: 

Owner Address: 

Cjty: 

Owner Phone: 

r 

State: Zip Code: 

Alternate Phone: 

Resident Name: 

Property Address: 

I3607N29ST 

Zip Code: 

168111-

Resident Phone 

I 

Contract: Assessment: 

Contractor: JPRUDEMT2010_S Qualifying Group ^400 

Contract Option jOFTION 1 Assessment Max XRF Value | 520.85 
' TECHNOLOGIES, INC. 

EPA Property CJlose Out 

Property #; 3 2Jb ^ C) Property Address; ^(QC^ T ^ - ^"^^" T 

Date/Time: Owner's Name: Ci^o*^'^<2cWo tA 

Quads Excavated; \=> Z _ Contractor Group; Frudeiirt TechinioSogies, Sue, 

Excavation General 

Yc3 No 

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

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

Grading Sod and Vegetation Yes No 

1. 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 that were excavated? / 

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

day lime period) / 

4. Are sodded areas general!)' fimi and evenly graded? / 

5. Arc the joints belween tlie sod strips generally tight? (Only evaluate if inspected at a 30 day / time penod) 

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

7 Was damage lo landscaping or plant materials avoided? / 

Gates, Fences and Retaining WalSs Yes No 

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

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) / 

4. Was daniage lo retaining walls avoided? (Ifapplicable) 

y 

Foundation, Sidiing and Gutters 

Yes No 

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

Was damage to the foundation avoided? y 

Was damage lo windows avoided? 

Was damage to windows or door screens avoided? 

y 

5. Was damage lo downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Cono'ete) Ves No 

1 Was damage to driveway surfaces avoided? 

Was damage to walkway surfaces avoided? r
Owners coniments: 

Inspection notes: 

M i *

^ . W W ^^' ' 

<K> 

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

EPA Representative 6CM. ^ ^Date: i/<?/// 
mm rnNDCDGiEs. mc AS - BUILT DRAWING 

OLS # 32050 

Date Excavated: 11/02/2010 OMAHA LEAD SUPERFUND SITE I'SEPA Signed-OfT Date: 

32050 

Omaha Exterior Paint Lead Site Owner Name: CAROL JACKSON 

Site • Good Sketch Address: 3607 N 29 ST • Poor Phone: ": Wr Q-'fTot paint 

Sannple Number Lead 

Concentration 

Sample 

Coltected ^ LAB 

Firm: 

Samples Collected, 

RYASCPXA-32050 F1 ppm D Date: 

RYBSCPXA-32050 F2 ppm D Time: 

RYCSCPXA 32050

RYDSCPXA 32050

 B1 

 B2 

ppm 

ppm 

D 

D Samples Analyzed 

RDZ0CPXAO2000

RCZ6CPXA 32050

RP2SCPXA-32050

 B?-

 Gi ­

 PZ \i^ . 

ppm 

ppm 

ppm 

- B 

aQ­

-B -

n 

XRF Unit: 

" Date: 

Time: 

A I 

^ 

Bool 

i 

Number of Samples =

y > . 

^ o 

Staff: 

Omaha Lead Site EA = 183 PPM a SC RAPE (~l") 

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

46130 
%S>A 

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

Property ID: 

Property Address; 3 (^ <3^'^ (yj '2J^ ^ ^ 

Owner: Q_o^p^-)( O ^ rA<^> ^ 

Phone: ^/ ^ ^ ^^-y^)} w ^ r P J j 6^'Cf03C , 

Restoration Items In Question: 

Item: n-^ 

item: 

item: 

item: 

item: 

item: 

Required corrections to complete tlie property: 

L J I agree restoration is completed. 

^L I do not agree restoration is completed at noted deficiencies above 

/<^-y-//) 

Owner's Signature / / / / Date 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

Property Status Form . -,/_/y, 

Address: 3/ ^ D 7 jU 3^^ ^ Date: /^"<=^ ^ '^ ^ 

Phone: ^D^ ' d^ld^SOS O ^QS^-QO' ^ BVID: 

Property Owne 

Signature 

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

Kansas City, MO 64114 Omalia, Nebrasica 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 

i 
32050 

Omah Exterior Paint NorthArrow Owne a Lead Site r Name: CAROL JACKSON 

Site Slwtc h • Good Address: 3607 N 29 ST 

Phone: H: W: • Po^r x: 

Q*^ ! paint 

Sample Lead imples Collected Number 

Concentration 

RYASCPXA-32050 F1 iP^A ppm 

RYBSCPXA-32050 F2 

RYCSCPXA-32050 Bl 

mz Samples Analyzed RYDSCPXA-32050 B2 

RD20CPXA-32000 BZnOZSCPXA 32060 6Z­ %1L ^ ^ 

RPZSCPXA-32050 PZ I I J ppm 

% 

Number of Samples = j,. ^ ^ X ;>; 

?.^ : 112 

CSI 

a. 

UX 

Sal CO 

AO s3t^o"l a^ 5r 

/^?^ 

) ^ ^ \Mu 3H\ 

U^VVf^. <o ol°l a t 

Omaha Lead Site 46130 
iSfin 

H 3607 N 29 ST 

A ^Zui^F Printed: Dec 02.2010 

www.dcgis.org/dogis 
Page 1 of 1 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2628097. 

Original Call Date: 10/27/10 Time: 4:47 pm Op: SIVA18967 


Work to Begin Date: 10/29/10 Time: 5:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3607 Street: N 29TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 04-SE,09-NE 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


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 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Nuniber Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICHA-RAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNE 1C QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/27/2010 
ENGINEERING AND 

CONSTRUCTION 

SOLUTIONS 

SITE SAFETY HAZARD ANALYSIS 

 ,g&o^/t^- ;z^ Address: : Excavation Date: 

Crew; BackfiU Date: — 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining WaUs 

Fences 

Trees 

Structures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

Condition Hazards Corrective Action 

^l^L 

A uri-eP^' 

f-c-/ ^ 

Q/l ^ 

ofc^ 

— . • 

^.ei—— 

Site Safety Office 

Date: 

^ ^ 

8680 Waitf^eaitany. Suito4ie SSOOSIOSt 4242 Medical Drive, Suits 7260 

KanawC«lr/IK>«4114 Onrtta, NcbnM a 88107 San Antonio, TX 78229 

PhonK (818) 30^3103 Plaaiw: (402)733-1188 Phone: (2t0) 82Z-«588 

Fax: 018) 363ni7D7 Fiac (402) 73»*1883 Fax: (210) «7»4577 
ll ZOIO