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TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 27966 DATE: fl/15 

ADDRESS: 2113 Grant St 

REMEDIATION CONTRACTOR: PRUDENT TECHNOLOGIES. INC. YEAR: 201O 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

[^ PRE AND POST VIDEO OF PORPERTY (DVD) fV\\ssir>Cj B^-vMP€^o 

• EXECUTIVE SUMMARY 

• EPA-PROVIDED PROPERTY SKETCH 

Ei SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

n SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

0 ' RESTORATION AGREEMENT 

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

izf CONFIRMATION DATA 

Q PHOTOGRAPHS 

 AS-BUILT SKETCH 

[^ SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

m PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

d UTILITY CLEARANCES 

^ PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

. ^ ^ ^iJli 

SIGNATUR GNAl E DATE 

30218585 

Superfund 
^ 

PROPERTY SUMMARY 

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

Property Address: 2113 GRANT 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: 

Bl = 1016 PPM @ 13"; EA = 73 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. 

TECHNOLOGIES. INC. 
TECHNOIOGHES. INC. 

EPA Property Close Out 

Property #: X7ACcG? Property Address: "ZJ-' 3 tiraw*- %• 

Date/Time: Owner's Name; (ZtfYv^te 3<tv*v e'5. 

Quads Excavated: ^ [ Contractor Group: Prudent Technologies, Inc., 

Excavation General Yes No 

I. If necessary, were the correci quadrant(s) excavated and restored? y 

2. If necessary, were the correct aieas of drip zone excavated and restored? y 

Grading Sod and Vegetation Yes No 

1. Does the grading around tlie 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 time period) 

4. Are sodded areas generally finn 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 tliat water will not pool on die property? y 

7. Was dainage to landscaping or plant materials avoided? / 

Gates, Fences and Retaining Walls Yes No 

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

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) y 

4. Was dainage fo retaining walls avoided? (Ifapplicable) y 

Foundation, Sidingand Gutters Yes No 

1. Was damage to the 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? / 

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

Sidewalks and Driveways (Concrete) Yes No 

1 Was damage to driveway surfaces avoided? ^ 

2 Was damage to walkway surfaces avoided? / 
Owners comments: 

Inspection notes: 

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

EPA Representative 7d<i^ ;5U Date: fijiifio 
C'HNOLOGIES. INC. 

AS - BUILT DRAWING 

OLS # 27966 

Date Excavaled: 10/25/2010 

IISEPA Signed-OfT Date: OMAHA LEAD SUPERFUND SITE 

27966 

Omaha Exterior Paint Owne Lead Site r Name: JAMES RONNIE G^ 

Site • Good Sketch Address: 2113 GRANTST • Poor Phone: H: W: ^ Not paint i 

Sample Number Lead 

Concentration 

Sample 

Collected LAB Samples Collected 

Firm: 45 w ­ fe?. ^ S 

RYASCPXA-27966 Fl / J^O ppm Q D Date: <\l'Z<fJbi 

RYBSCPXA-27966 F2 Z5 T ppm D Time: 10-10 

RYCSCPXA-27966

RYDSCPXA-27966

 Bl 

 B2 

H "1 i

P.i q

 ppm 

 ppm 

\2 

S\ 

D 

D Samples Analyzed 

fiDgocrxA-gyooo B2­ ppm a D XRF Unit: /QO V Book: /7 3 

nGZ0CrXA-2790C 62 - ppm a D Date: y o . / 9 ­ 0( „ 

RPZOCrXA-27900 P2- ppm n n Time: ^ 

Number of Samples = H Staff: rlsi ^ 

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

All qu^rants are 4S viewftd from the street, facing propeity 

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Bl = 1016 PPM « 13" L —^ 

OCT n 1 ?flD6. 

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EA = 73 PPM a S( RAPE 

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

046141 
^ R ^ 

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 proj)erty, 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: O * r 

^ O r a.Jh ^Si^ 

Owner: .(xtMLS^^K.^.^ 'VjJL'^-OvjL 

Pbone: t 

Restoration Items in Question 

Item 

[p] I agree restoration is completed. 

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

-U. P^ ( I 0 

Date 
Pnident Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up leadcontaminated soils at a number of properties located in Omaha, Nebraska, including the property located at 

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

property to remove lead-contaminated soil. By signing this form, 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 property. 

If you have any questions about the soil cleanup planned for your property, please contact Prudent south office for the Omaha Lead 

Site cleanup-at (402) 733-1188. General questions about the Omaha Lead Site cleanup can be directed to the EPA Public Infonnation 

Centers at (402) 731-3045 (South Omalia office) or (402) 991-9583 (North Omaha office). \ 

Property Access Granted By: \ \ 7 ) Ov ^ Y\ \ l 7/L^w^sLy^ 3 : ^

(Please Print Name) 

Property Owner iligruiture: y tSfihwu JW) ^ /g/V^^^ 

e) ^ ' (Signature) ' (Date 

PROPERTY INFORMATION 

o be completed by resident and/or property owner — please print) 

RESIDENT NAME: £^4 Owner Renter - RESIDENT ADDRESS: 

t^'l^ ) Onaj^Jh ^ (^>^^^JJLix toe Q.^\\\ 

IFB^ENTAL, PROPERTY OWNEMY : II- KCfM I AL, KKUfC K I 

OWNER'S MAILING ADDRESS; 

70\<sL{ ^O^ICJU^ ^ X)r j y tA-/^-»—^1-^^-^ ] ^ ^S(( f 

OWNER'S TELEPHONE NUMBER - HOME: I WORK: 

X _L 

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

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? YES NO 

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

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY IN THE YARD FOR 5 HOURS OR MORE PER WEEK: 

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

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

are pursuant lo Seaion 104 of CERCLA, 42 US.C. 9604. EPA's light of access to the property is provided for in Section 104(e) of 

CERCLA, 42 U.S, C 9605(e), which provides entry for "detennining 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 5600 S 10 St 4242 Medical Drive, Suite 42S0 

Kansas City.'MO 64114 O.maha, Nebraska 6Sl 07 San Antonio, TX 78229 

Phone: (816) 363-3703 PhOfie: (4.02) 733-i1S8 Phone: (210)822-9588 

Fax; (816) 363-3707 fs r (402)733-1883 Fax: (210)579-6577 
ENVIRONMENTAL & 

CONSTRUCTION 

SERVICES 

Property Status Form 

Address: g^ \ \ ^ C\ T C^t^^J ^ H Date: 

Phone: BVID: 

Prudent Employee 

8080 Ward Parkway, SuKe 405 5600 SIO 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 
- 27966 

Omah Exterior Paint North Arrow 

Owne a Lead Site r Name: JAMES RONNIE G 

Sit • Good e Sketch Addre8s:2113 GRANT ST • Poor 

Phone: « W: 1 g . Not paint ^ 1 

Sample Number Lead 

Concentration 

Sample 

Collected LAB Samples Collected 

Firm; /45 w ­ fe?, ^ S 

RYASCPXA-27966 F1 /3 0 ppm Q D Date; ^f'Z'klU 

RYBSCPXA-27966 F2 ppm El D Time; 10-'IQ 

RYCSCPXA-27966

RYDSCPXA-27966

 B1 

 82 

H1 i 

^1<^ 

ppm 

ppm EH 

D 

D Samples Analyzed 

fiDZOGPXA-2790G

RGZ0CPKA-279G0

RPZGCPXA-279GG

 B2­

 G2­

 P2­

ppm 

ppm 

ppm 

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XRF Unit; /OQ-? Book;

Date; / O ^ / 9 ­ 06 , 

Time; / ^ 

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Number of Samples = ^ Staff; j^isi ^ 

Legend; F1 = Front Left, F2 = Front Right, B1 = Back Left, 82 - Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are 4S viewed from the street, facing property 

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A Qii Printed: Nov 11,2010 

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Create Another Ticket Back to Irth Internet Send..EmaiL. 

YOUR TICKET NUMBER IS 2622431. 

Original Call Date: 10/20/10 Time: 5:27 pm Op: SIVA18967 


Work to Begin Date: 10/22/10 Time: 6:00 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2113 Street: GRANT ST 


Twp: 15N Rng: 13E Sect-Qtr: 10-SW 


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 Number 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 RICHAFRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhoii.org/irthinteniet/DHONNoticeCreatioii/MessageText.asp?ret=<RESULT... 10/20/2010 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SOLUTIONS 

Site Safety Hazard Analysis 

Address: ^ll'^/jr^u^V 5^- Ex._ 

Bf. 

Date: jO^ZC^iQ 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic / Leech 

field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees/ Bushes 

Structures 

Driveway 

Sprinkler Systeni 

Other 

CrewEoreman 

Condition 

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Corrective 

Hazards Action 

1 

Site Safety Officer 

8080 Wa(H Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 IVIedical Drive, Suite 7250 

Kansas City, MO 64114 Omaln. 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 
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