TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

/*^ 

sAn)#: l^l^'5D Date: ^ ^ ^ f

 /r 

Address: ?>^S ^ ^A/)^^/! ^ ^ 

Remediatioii Contractor: Hu;ia^ f leeM - ^THt •. Year: 2X30^ 

SOBLREMEDL^TION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

y 

Executive Siimmary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

y Restoration Agreement 

D Settlement documents (i.e., for damage or to replace plants, etc.) 

Confirmation data 

Photographs 

y As-built sketch 

Satisfectory restoration signed by Property Owner 

y Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

Utility clearances 

y Property infonnationfi-om Douglas County Assessor's Of&ce 

D 

D 

D 

ISignatUTO^" 

• ^ ^ 

30054214 

•m 

Superfund 
Rnd Record Remedlatjon Query j Lead Remaining Query I Propeity Damage Query 

Backfill: 

Sample Area: 13450 - 3639 HASCALL ST 

Owner: 

D Owner Occupied 

Owner Nanie: 

|MORRTS.SEY BARNEY A 

Owner Addressl: 

Owner AddressZ: 

|3639 HASCALL ST 

City: State: Zip Code: 

[OMAHA |NE |68105 

Owner Phone: Altemate Phone: 

j(402) 553-4581 | 

Resident: 

Resident Name: 

1 

Property Address: 

[3639 HASCALL s r 

Zip Code: 

|68105 

Resident Phone 

1 

Contract: 

Contractor: 

|PRUDENT2009_S 

Contract Option 

[BASE 

Assessment: 

Qualifying Group 

(PRIORTTY 

Assessment Max XRF Value: 

1 641 
mOPEKTY SUMNIARY 

Date: 9/15/2009 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Month of: August 

Property Address: 3639 HASCALL ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A3 Unique Findings: NONE 

A.4 other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Fl = 99 PPM @, 10"; B2 = 389 PPM @, 6"; PA = 232 PPM @ 6" ; DZ = 1042 PPM @ 13"; EA = 147 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 individiial 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. 

TECHNOLOGIES, INC. 
TIBCHNOLOGIES.INC. EPA 

EPA Property Close Out 

Property #: \'^^S O Property Address: 3 fc?^ M«-S<raU "^>. 

Date/Time: S-i'-oCf Owner's Name: ^CVITCVA KorrCStf'c^ 

Quads Excavated: F/ , C?Z; PZ , B' 2 - Contractor Group Pnident Technologies 

Excavation General Yes No 

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

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

Grading Sod and Vegetation Yes No 

1. Does the grading around the 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? (Qnly evaluate if inspected at a 30 

day time period) i / 

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

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? c / 

Gates, Fences and Retaining WaOs Yes No 

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

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

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? / 

2. Was damage to the foundation avoided? / 

3. Was damage to windows avoided? / 

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

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

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? / 

2. Was damage to walkway surfaces avoided? 

/ 
0^3 ^ fecali ^t-

Owners comments: 

Inspection notes: 

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

EPA Representative f^yd y Date: S/n/oj ^ 
EPA 

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 Usted below, if any. 

Property ID: 

Property Address: 3^3 ^ \-U/ ^ r « i f 'S ; 

Owner:

Phone:

 Oj 

 <-jo2_ 

• ^ M'''/.'^-

"U ^s - ^^^3 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Hem: 

Hem: 

Required corrections to complete the property: 

^ I agree restoration is completed. 

L J I do not agree restoration Is completed at (noted deficiencies above) 

^/3( 0 ^ yjk ^ u.^a-T^^... ^ "^'^-^^yp Owner^sSi^wure Date 
Pnident Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up leadcontaminated soils at a number ofproperties located in Omaha, Nebraska, including the property located at 

. The EPA requests your pennission to allow Prudent to perform a soil cleanup at this 

property to remove lead-contaminated soil. By signing this form, tiie propeity owner giants pennission to Prudent to perform 

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

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

Omaha Lead Site cleanup. Ms. Siva S. .lampana-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 

(Please Print Njille) 

Property Owner Signature: 

^ is^b ^ J y (Date) 

PROPERTY INFORMATION 

(To be completed by residtmt and/or property owner — pi 

RESIDENT NAME: Renter 

RESIDENT ADDRESS: 

^ v ^ ^ g 16 ^ 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

OWNER'S TELEPHONE NUMBER - HOME: _L WORK: 

AOE OF HOME?: ^ ^ YEARS. HOW LONG HAVE YOU LIVED HERE? 1 YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WTTH SIDINO SINCE 1978? . _-^«e- -N&> ^ ^ (La 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: Lx 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: 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOOS, ENTRY OATES, ETC.) 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: The activities to be implemented by EPA under this agreement 

are pursuant to Section 104 ofCERCLA, 42 U.S.C. 9604. EPA's riglit ofaccess to the property is provided for in Section 104(e) of 

CERCLA, 42 U.S. C 9605(6), \^c h 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 Fa v f9in\ R7QJiR77 
ENVERON.MEMAL 

CONSTRUCnO 

TECHNOLOGIES, mc . SERVia 

Property Status Form 

Address: '3>Q>'2>^ Uot/ac^JlL *i^ Date: 

Phone: VAOJL ^ 1>M S - 'SC''' 3 BVID: 

Plants & Permanent Landscaping To Remain In Place 

Description & Location 

]^,^^^ ^ rseea^ ^ ^ ^^ o . ^ . A\l ^os e 

Pre-Existing Condition of Structures 

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

Item NO 

On Map 

Description & Location 

Qjr^uJk^ -3 ^ 'I^t^o^coGco 

Property Owner Prudent Empl 

ignature: Signature: y ^ . 

8080 Ward Parkway, Suits 405 2505 N. 24*" Street. Suite 308 4242 Medical Drive, Suits 425C 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX7822S 

Phnnn- fA02) 504.1004 Phona: (210)822-9S8S 
3IES, INC. 

OLS#:134S0 

Date Excavated: 07/22/2009 

USEPA Signed-OfTDate: 

13450 

Omaha Exterior Paint North Arrow Lead Site 

Site • Good Sketch 

Q^Poor 

aWHl^nri'O' AddWas : 3839 M/tSCALL ST Q ' Not paint 

Sample Numtier Lesd Sample LAB Samples Collected 

Concentration Collected 

Firm 

RYASCPXA-13450 F l ppm D Date 

lO-M-d g 

RYBSCPXA-13450 F2 3gg ppm Time Qi'.toi <ki»«.. 

RYCSCPXA-13450 Bl ppm 

Samples Analyzed 

RYDSCPXA-134Sa B2 ppm D 

ROZSCPXA-13450 DZ ppm i D

n 

XRF Unit: tfSH n Book: 22. 0 

•RC26CPXA 13480 6Z - ppm D Date: IIPIO Q 

BZ6CPXA m w RZ- Too' ppm D Time: Qta 

• / ^ D staff; cast i Number of Samples " [ ( j •[ [ ( ^ [ 

Legend: Fl = Frent Left, F2 = Front Right, Bl - Back Left, B2 = Back Right DZ = Drip Zone, OZ = Garden, PZ = Pla; 

AH quaayis aro t» vlwwd Trati Bie tlreat, taehg property Allg V 

RevsTM Crood. lA-SepJH 

EA = 147 PPM @ SCRAPE (~1") 

CONTRACT #: EP - R7-07-06 T0#1 PRUDENTTECHNOLOGIES, INC. 
13450 

Omaha fcrtorisr Pant 'irrt' Anw Lead Sit» • OoorJ ^ 5 5 • H SS I Sits Skatch 

Ssmplino Addrgss: >3:-i9 HASCA^L &T Q N=t P*.Tt 

r" S'intpic \'iimtw Le3d Sample 

Sampli^s CcBetlKl 

I U 8 Cc-ncpnlraltoi Contacted Fimi 

RYASCPXA-13450 Fl V^ V POT. D Date 10-a« -0 * 

RYBSCPXA-f34M r2 D Time ^xWtfi ^.-t^ . 

RYCSCPXA-134SD 81 

D 

Ssinpies Analyzed RYDSCPXA-13450 B2 D 

ROZSC^X;i-»3450 OZ ^ <9<i? ntyp 

n XRFUnil Ct^.^n^ ^^^'^2 ^ •RCZSCPrVA 13d 60 

•~ PCTr 

D

pgsftpy^^ ia-160 Time d m D 

; ^ Staif: nSL ^ 

Nun sor ot Sa mpiGs = I fc Lo J 

Legenil Fl -^ F/oiil Left r 2 - Fiwl Right Bl " Cac\ Lefl. BP - Qdck R'^t DZ = Onp Zone, CZ = Garden, ^Z = Pla* 

M ^.aHmti jrn m >««<«! lion in* iS\4af. *Aam t*f^M^t A l i r? ^ 

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Print Preview http://www.dogis.org/dogis_alias/dogis/printPreview.asp.x7PrintOpt.. 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

1738970000 

MORRISSEY 

BARNEY A 

3639 HASCALL 

ST 

OMAHA 

68105 

3639 HASCALL 

ST 

OMAHA 

NE 

68105 

Sec-Tv/n-Rng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website Link 

Assessor 

Website Link 

33-15-13 

MELROSE HILL 

6 

10 

50X124 

http://webapps.dotcomm.org:8080/TreasTax/faces/pages 

/taxi nfo.jsp?parc=1738970000 

http://douglasne.mapping-online.com/DouglasCoNe/static 

/accountinfo.jsp?accountno=R1738970000 

Disclaimer: Map and parcel data are believed to be accurate, but accuracy is not Map Scale 

guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 40 feet 
Pagel ofl 

"> 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2318809. 

Original Call Date: 7/15/09 Time: 6:10 pm Op: SIVA18967 


Work to Begin Date: 7/20/09 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3639 Street: HASCALL ST 


Twp: 15N Rng: 13E Sect-Qtr: 32-NE,33-NW 


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 


: FAX ALL CLEARS TO (402) 733 1883 


: UNSURE CORNERS 


Coitipany : PRUDENT TECHNOLOGIES 


Contact Name: SIVA JTiMPAMA 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 MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 


CXCATV COX COMMUNICATIONS. INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON Alt: 4024445161 

Emeig: 4024445160 

Day: 4067289343 

0PPDGPR6 OMAHA PUBLIC POWER DISTRICT NA Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIF QWEST LOCAL NETWORK NA Alt: 4062071494 

Emerg: 8887289343 

http://wvm.dhon.org/irthinteme^/DHO^^^oticeC^eation/MessageText.asp?^et==<RESULTS... 7/15/2G09 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOdlES, INC. SOLUTIONS 

Site Safety Hazard Analysis 

•Xi-of 

Address: 3(oS'^ f^^c^/f ^ ^ 

CrcH': i ^ W '. Bf. 7 -a/- <59 

Date: 4,-/7-o<i 

Corrective 

Item Condition Hazards Action 

Overhead Lines ^c ^ l-c**^ 4*»y*a u s e jarof * 

Gas Line •ht^r\.mA htnd /coH ^ 

Water Line ^yiaa ^ h^J . Uc4*a 

Sewer Line «^vr«*v< ^,»«^J lc*./H-^ 

Septic / Leech 

field ' ^ ^ 

Propane/Butane AA^ 

Sidewalk S'B L 

Foundation ^tca* 

Retaining Walls A ^ ^ 

Fences _ctegL 

. <" 

^^st6w)H^: j^ff * 

rr Structures A< 

JA> ^ 

Driveway •^At* ' 

Sprinkler System m^% _k^££ 

Other 

J? Crew Foreman Site Safety Officer Cl %i^^' " f Ql.^^ 

8080 Ward PaMAvay, Suite 405 2505 N. 24" Street. Suite 3GS 4242 i\;edlcai Drive. Suite 725G 

KansasCity. MO 6411--t Omaha, Nebraska 68110 San Anionio. T.X 78229 

Phone: (816) 363-3703 Phone: (402) 504-1004 Phone: (210) 822-9588 

Fax: MQ2) 5D4-1005 Fax; (210)579-5577 
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