TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: /PS7X ^ Date: ^/s'/^QO ^ 

Address: /l43 Hrt tJl/^^e. 

Remediation Contractor: Coastal Environmental Group_ Year: _2007_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Y Executive Summary 

M EPA-provided property sketch 

B^ Signed Access Agreement for subject property 

D Si^ed Access Agreement(s) for adjacent property 

^ Restoration Agreement 

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

"SZ Confirmation data 

W Photographs hdnyCJL ^ '^Cy^^ R6-C 

H As-built sketch 

M Satisfactory restoration signed by Property Owner 

0 Property close-out check list signed by EPA (Y> JB7t^^CO'y 

Q Descriptionof areas not meeting ROD cleanup criteria 

/ Utility clearances 

D Property information firom Douglas County Assessor's Office 

5K Ppk-[^f\e. ft^wmrlZ records 

' Ddte 

403171 49 

Superfund 
Property Access Checklist 

PropertylD: /f^7^5 ^ D WORK STARTED ON: / / 

Property Address: y -7^ 3 ^^// ^ /L|/^ . D WORKCOMPELTED ON: / / 

<^-*'^ Mariazi Pilonso 

Address: ^7^/3/)^^^/y,/^. 

Phone: g'/g'^/^/ B 

Fax: 

Cell/Pager: 

• Notification Letter 

l y Access Agreement 

[_X Restoration Agreement 

Q Topsoil Sampling (if applicable) 

Q Disposal Sampling (if applicable) 

D Garden Sampling (if applicable) 

Nyl Utility Clearance 

S i Video/Photos (Before) 

P/Video/Photos (During) 

[vf Video/Photos (After) 

C3^ Video/Photos (30-Day) 

l u Property Completion Agreement 

n Final Report 

Air Monitoring (as applicable) 

r~] Community CH Crew On: /

Results: 

n Community UD Crew On: /

Results: 

r~l Community Q Crew On: /

Results: 

Renter: 

Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

Sent: / / 

Signed: _5:/^/£2 Z 

Signed: "5 I'D lO ^ 

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1 1 

1 1 

Called: 5_/2> /^ ^ 

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Issued: / / 

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Omaha Lead Site 
Total Qua^^kquar e Footage to be Excavated = 1376 

Property Classification: 800 i1 Total Di^^Rn e Linear Footaqe to be Excavated = 14

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: Pa a rk/WenuE•* 

Legend Noilh Arrow Omaha Lead Site 

[^^^ Concrete Omalia, Nebraska 

Y Y \ Excavated Area Property Number 

OLS-18722

^ Existing Structure Scale

Property Address • Fence 1 1nch = 20 feet or 1 grid = 5 x 5 fl 

1743 PARK AVE \YY\ 

— Quadrant Boundary _vy'""., — — Post Excavation Concentrations (ppm) 

- Street Boundary o F1 B2 PlayArea 

fvrirci(irf>i.(xitc irK ^ / ? ' F? n7 Fasement

o Tree/Shrub '''^^y B1 (3a re e n_ _ Othe r 

Description of post excavation areas: F1, front yard ieft-hand quadrant; F2, front yard right-hand quadrant; Bl , bacl<yard left-hand quadrant; B2, backyard right-hand quadrant; 

DZ, dnp zone (1-3 IDOI area of soil around the foundation ofthe house). 
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1 Result matching "1743 Park Avenue, Omaha, NE" Name Age State Photo Email 

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Justin 

Lappe 32 NY :m EMAIL ME 

Lappe, Justin 

1743 Park Ave Justi n Lapp e ­ Vie w 

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provider. I Justin iLappe 

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Howr popular is the name JuSti n Lappe ? 

http://www.whitepages.com/10001 /search/ReverseAddress?housenumber= 1743&street=Par... 5/3/2007 
Yahoo! Mail - trishkasl@yahoo.com Page 1 of 2 

"S3ilK>Of MAIL Print - Close Window 

From: "NE DIGGERS" <info@ne-diggers.com> 

To: trishkasl@yahoo.com 

Subject: Re: NE-Diggers.com - LOCATE Contractors Request Form 

Date: Tue, 8 May 2007 14:10:18 -0500 

DIGGERS HOTLINE PRESENTS THE 'NO WAIT N.I.TE.S. TICKET ENTRY! 

Avoid lengthy wait time - Immediate ticket number response - User has access to all issued tickets. 

FREE training sessions. Contact Connie or Lisa at 402-330-1866 for further information. 

Ticket* 1782007 

Work Begin Date : 5-10 at 215 pm 

Utilities Notified : City of Omaha Traffic & Sewer, Cox, Mud, Oppd, Qwest Local, Level3, Mci, McLeodusa, 

QwestLong 

If There are any other utilities not mentioned above you will need to notify them yourself. Any privately owned 

lines will not be located. 

Thank You For Using Email. 

— Original Message — 

From: trishkas1@yahoo.com 

To: info@nejLdiggers.com 

Sent: Tuesday, May 08, 2007 12:47 PM 

Subject: NE-Diggers.com - LOCATE Contractors Request Form 

NE-Diggers.com - LOCATE Contractors Request Form 

Name: Trishka Simmons 

Alt. Name: 

Phone:402-504-2194 

Alt. Phone: 706-7322 

Email: trishkas1@yahoo.com 

Caller ID: 18790 

Company: Coastal Environmental 

Type of work: EXCAVATION 

For Whom: COASTAL ENVIRONMENTAL 

How Deep: 3ft. Oin. 

Explosives: No 

Corner Lot: No 

Front of Property: Yes 

Rear of Property: Yes 

Tunneling/Boring: Yes 

County: DOUGLAS 

City: OMAHA 

http://us.f387.mail.yahoo.com/ym/ShowLetter?box=lnbox&MsgId=5508_2558573_290800... 5/9/2007 
Yahoo! Mail - trishkasl@yahoo.com Page 2 of 2 

Address: 1743 PARK AVE 

Directions: 

Where on Property: 

OVERALL 

Township: 

Range: 

EorW: 

Section: 

1/4 Section: 

Township: 

Range: 

EorW: 

Section: 

1/4 Section: 

http://us.D87.mail.yahoo.com/ym/ShowLetter?box=lnbox&Msgld=5508_2558573_290800... 5/9/2007 
Results 1 - 1 of 1 

B ID Parcels 

ALONSO MARIA 

a 174J PARK AV 

Parcel ID 0734340000 # 

Owner Name ALONSO MARIA 

Property Address 1743 PARK AV 

Oily OMAi-iA 

Zip 6B105 

Owner Address 

Owner Address 2 1743 PARK AVE 

Owner City CWAHA 

Owner Slate NE 

Ow^er Zl!? 68105 

Sec-Twn-Rng 28-15^13 

Owner Address 

Addition BtJRR CAK ADD 

Bioci<L 0 1 

Let 37 

4 ,.,.^. 1 t 

Legal 2 50X10 0 

legal 3 

Legal 4 j ^ 

Old .ft.sssssc'Sits Ivaluation Information i 

iNlew Assessor Site j Valuation Information i 

liUp:/'/WVv~vV.QOgiS.org/'CiuglS aiiaS/uOgiS/ pai'CCioCmCii.aSfjX;gOVijacr--iaiafcuCvaiiuo6fcr--xaioC J/ o/Zwu / 
Property ID # 

Initial Contact:

Second Contact:

Final Contact:

Final Action:

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

\%%v 

 Date: ^f^ Time: 1^>^> Action: ^ ^ 

 Date: Time: Action: 

 Date: Time: Action: 

 Transmit to EPA D Other Action: D 

- (AI\ ^ \\\jmfy^ i^-<^ M^n^fk6. ^ 1 \^C^(^ J^ 
o 

Consent For Access To Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States Environmental 

Protection Agency (EPA) or its authorized representatives, collectively the Grantee, to 

enter and perform certain environmental response activities upon the following described 

premises: 

Owner's Name: 

Daytime Phone: 

^^ ar",ao A\O O ' ^02 - ^yS - \^) ^ 

Address: 3 pv^2 . 9..^ A U> niAA^J 6sibS. Address: 

Addresses of 

Propertie Address: s covered by 

this Agreement: Address: 

Address: 1 

PijRPosF OF RESPONSE .ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of arsenic and/or lead and may pose a health hazard. The soil 

will be removed and the excavated area(s) will be replaced with clean materials and 

restored. This work is being performed under the Omaha Lead Site Superfund Site 

remediation program. 

An EPA representative will contact the Grantor in-person to discuss the work to be 

performed, the Grantor will have an opportunity to review and approve the planned soil 

removal, and restoration work before it begins Once the work is fmished, the Grantor 

will be asked to review the work and confirm that it is complete and meets with the 

Grantor's approval. Upon completion, the Grantor will receive written documentation 

from EPA that the property' has been remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times and 

with prior notice, for the sole purpose of performing the work. This access shall remain 

in effect until the work has been satisfactorily completed The Grantor also agrees to: 

«Propert y ID» Paee 1 of 2 
• IMl •

 • 

\ y 

• Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

• Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

• Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

• Abide by health and safety guidance provided by EPA; 

• Ifthe property is rented, assist EPA in obtaining tenant approval for access to the 

property to perform the work if EPA is unable to obtain such access; and 

• Allow videotaping and/or photography of the property including exterior and 

interior areas ofbuildings. 

AGREEMENT NOT To INTERFERE 

The Grantor agrees not to interfere or tamper with any ofthe activities or work done, or 

the equipment used to perform the activities, or to undertake any actions regarding the 

use of said property which would tend to endanger the health or welfare ofthe Grantees 

or the environment, or to allow others to use the property in such a manner. 

Should you have any questions about this program, please contact 

0 I grant access to my properties CH I do not grant access to my properties 

sjyjy] 

'7)7 7 7A. 1 / 77nr:>c'^ 

Sig^ture Date Signature Date 

[~11 would like to be present during any sampling that is required. 

Page 2 of2 

«Property_ID» 
•m 

Restoration Agreement 

The purpose of this agreement is lo pro\ ide a mutual agreement as to conditions of propcrU prior lo 

remediation aclivilies. This will also sene as decontamination for ihe purpose of assuring thai restoration 

acli\ ities are completed lo the satisfaclion of the property owner and the United States En\ ironmenlal 

Protection Agency (EPA). 

PropertylD: \<^~1 2_ T— 

Property Address: VIM"^ QY^^WA . pcxrl c f\ ^ NJ^ (l5?\ o <? 

OK»ner: rv \ > , ' A \ nr^R tY 

Phone: Ij^ ^ _ c ; \ T ; _ 

1"M'> 

On the allached diagram(s) indicate arca(s) to c\ca\ alcd and depth of e\ca\ ation. location of all kno\vn 

ulililies. subsurface features, surface structures and landscaping features, access locaiion(s) to be used b\ 

contraclor. and the direction of Nonh. Indicate distances, depths, material t> pes. etc. Indicate digital photos 

by referencing the pholo-log number with an arrow indicating direction of \ icw. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use addrtional sheets as necessary) 

Item: 

(v\ (^'V' 

rtem: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Paae 1 of ( / 
Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

l ^ 

Item: 

As otrJrter U^inl- <h> ^ ^ tLOcCJtf.^ 

Item: 

^^ V Oirax/^ . .^.od l t/v&t<-a^di ^ 

Item: 

Item: 

Item: 

Item: 

Item: 

!tem: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 3 of i/ 
Items To Be Remove d By Contractor During Remediation An d Not Replaced 

(Use additional sheets as necessary) 

Item: 

Item: 

Item: 

Hem: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 2 of. u 
m^ 

Item 

Pre-e.xisting property area 

that is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Landscape Inventory 

(Use additional sheets as necessary) 

Quantity Unit Condition/Type/Specles 

Square feet ' L ^ 

h\\j e. loe^u^ K^^ 

^ 7 ' Y"^ Each 

Each 

D 

D Each 

D Each 

Square Feet 

Page 4 of (fi 
Item Quantity Unit Condition/Type/Species 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this value will be N>^ $ 

used to issue a plant 

voucher to the property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. (Trv Each 

Include a sketch of were 

each plant will be placed 

by the contractor. 

Agreed upon area of 

property to be replaced 

with grass sod. %V^ c 

SF 

Include a sketch of the 

area(s) to be replaced with 

grass sod. 

1 

Area of City or County 

property to be landscaped 

per their requirements. 7^ 

SF 

Include a sketch of the 

area (s) 

Page 5of O' 
• Check the box if Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

0^ I agree n I do not agree d I do not agree agree 

'hh Mi^. iN^Tiry^ o e.^^(^ Sl^h-Y 

wnW's Signature Date Page 6 of _j£ _ jctor's Signature Date 
€ PROPERTY CLEARANCE WORKSHEET 

Property ID 

Property 

Address 

Measurement 

Count/Time 

Field Shots 

Shot # 

Composite 

Average 

(Bag) 

m 

' m

Composite 

Average 

(Bag) 

6q 

79

Composite 

Average 

(Bag) 

5? 

68 

\2'^22 

MA^VmA ^\/0 

Reading 

Composite 

(Dried & 

Sieved) 

• 

Composite 

(Dried & 

Sieved) 

i 

Composite 

(Dried & 

Sieved) 

Sample Area 

Pass/Fail ? 

Analytical Lab Analytical Spilt Sent Number Results •> 

Pass/Fail ? 

Analytical Lab Analytical Spilt Sent Number Results 7 

I 

Pass/Fail ? 

Analytical Lab Analytical Spilt Sent Number Results ? 

Date 

Project 

XRF ID 

Shot # 

111. .Bil 

^03 . 

^^x> 

ft5/lg/fl? 

Omaha Lead -- Fixed Price 

OlOl -5 

Reading 

IM. 

f S ^ 

.•^sa^_i^ 

SL 

Aliquot 

1 

2 

3 

/• 

5 

Aliquot 

1 

2 

3 

4 

Aliquot 

1 

2 

3 

4 

5 

Sample Area

I n Situ 

Reading 

Sample Area 

I n Situ 

Reading 

P.(^ 

f50 ^ \ 

CIS 

Z6 

Sample Area 

I n Situ 

Reading 

41 2-7 

?iA 

M 

^A 

Sample Area 

SL 

& 

 T)2 J 

Composite Readings 

(Bag) 

I20 14Z 

\b>9 

XRF Corrected Value --> 

(use calibration chart or add 

2 0 % to value) 

51 

Composite Readings 

(Bag) 

TXL 

3 S 

161 

XRF Corrected Value -- > 

(use calibration chart or add 

20<% t o value) 

V,7 

Composite Readings 

(Bag) 

Ao f72 

15 

XRF Corrected Value - > 

(use calibration chart or add 

20<Vb t o value) 

Sample Area RZ Pass/Fail ? 

I n Situ Composite Composite Analytical Aliquot Composite Readings Lab Analytical 

Reading Average (Dried & Spilt Sent Number Results 

1 1? ( Dds ; (Bag) Sieved) •> 

Confidential 5/2/07 Page 1 of 2 
2

3 

4 

5 

• ) ^ 

I B 

25? 

bS 

3 ? 

^40 

3 1 

XRF Corrected Value --> 

(use calibration chart or add 

2 0% to value) 

34 

54 

Aliquot 

1 

2 

3 

4 

5 

Sample Area 

I n Situ 

Reading Composite Readings 

(Bag) 

XRF Corrected Value - > 

(use calibration chart or add 

2 0% to value) 

Composite 

Average 

(Bag) 

Composite 

(Dried & 

Sieved) 

Pass/Fail ? 

Analytical 

Spilt Sent 

7 

Lab 

Number 

Analytical 

Results 

XRF Technician's Signiture 

Confidential 5/2/07 Page 2 of 2 
XRF DAILY CALIBRATION WORKSHEET 

Date 05-1^-0 ^ 

Project 

XRF I D 

Measurement Count/Time 

Reading 

""rue Value 

120 % 

I 80% 

i 

1 

Precision r>'ea5u'e~ie":s 

Ave-soe 

Replicate 

1 

z 

3 

4 

-

5 

7 

•"•|cc'~. Ci^.Zc^l^c'. . 0 " 

S:='-ca': Zevia: z ' 

jRe.:.E£-er-C5-c:..c:c ' 

p^V':^-='-='=-'•-"" -"-

Omaha Lead -- Fixed Price 

nioi'^^ 

Calibration Verification Checks 

Blank Low Med 

0.0 DPm 18.9 ppm 1162.0 ppm 

22.7 ppm 1394.4 ppnn 

15.1 Dpm 929. 6 oom 

Q(o7 

UrVl 

1 

i 

1 

p reciSic n y.e£SLrerr,ent I'-.e CK 

Blank j Low ^'ed 

1^70 

1110 

1120 

ioo?0 

oao 

q?o 

mo 

1 

High 

5532.0 ppm 

5538.4 ppm 

4425.5 Dpm 

sn^P) §q?n 

! 

I 

1 

H-qn 

4?70 

53^) 

^\90 

5nn 

56^n 

CT^rt 

6350 

Confidence Interval a; .95 --> V.A. = VA1 

Method Detection Limit LVALUE' 

Average Confidence Interval cVALUEI 
\ _ • ^

^"ij-Rot*^

Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

 www.coastalhazmat.com 

 COASTA L ENVIRONKENTA L 

CROUP , IN C 

EXECUTIVE SUMMARY: 

18722—1743 Park Ave 

X No issues or concems Issues or concems 

Detail Explanation: 
A As-Built Drawing 

COASTA L Omaha Lead Superfund Sfte 

Total Quadrant Square Footage to be Excavated = 1376 

Property Classification 800 Total Dnp Zone Linear Footage to be Excavated - 14 

Legend OLS#: 18722 North Arrow Omaha Lead Site 

Date Excavated:5/18/07 Onriaha. Nebraska 

Date U^P A Signed Off:6/8/07 Property Number 

Extsttng Structure Scale OLS-1872 2 

Fence 

Permanent Landscapmg 

1 Inch = 20 feet or 1 grid = 5 x 5 ft Property Address 

1743 PARK AVE 

O 

Quadrant Boundary 

Street Boundary 

Troo/Shrub 

"A vdrrrfjtfULfXJK I'X. 

F1 . 

F2 

Bl 

Post Excavation Concentrations (ppm) 

B2 Play Area 

D2 Easement 

Garden Other 

Description of post excavation areas F 1. front yard left l^and quadrant. F2 tront yard nght tiarKI quadrant B1 t}aciryard lett-Mand quadrant. B2 bacKyard ngtit hand quadrant 

OZ dnp zona (1-3 loot aiea of &o*l around tt>a fourxlalian of tlia tiousa). 

Legend 


Area not Excavated Dripzone Excavated m Quadrants Excavated 

Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p 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 sod warranty (30 days total) except those items listed below, if any. 

PropertylD: ldl90-

Property Address: jlH ^ 7Z7^ fWt 

Owner: MdriaYl ^^0^50 

Phone: 6/5^/3/^ 

Restoration Items in Question: 

Item: 

M n J {-T.Tn. <. /•V^ fy^^i-j^^Gv^ ] 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

I agree restoration is completed, except as noted above. 

I I do not agree restoration is completed 

'Zl7l^&4^ '(^^ 

Own^f^ Signature Date 

I
SEPA 

EPA Property Close Out Form 

Property #: _ im^9 Property Address: /7V 5 QXZIZAH -

Date/Time: Owner's Name: fUYlYZfjyl hlOY^O 

Quads Excavated: 

Contractor Group 

Excavation General 

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 Vecetation 

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? (Only evaluate if inspected at a 30 

day time period) 

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? 

Gates, Fences and Retaining Walls 

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

2. Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) 1^''' 

3. Was damage to gates or fences avoided? (Ifapplicable) iJ-^ 

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

Foundation, Siding and Gutters 

1. Was daraage to the sidmg 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 daraage to downspouts or downspout extensions avoided? 

Sidewallu and Driveways (Concrete) 

1. Was dam^e to driveway surfaces avoided? 

2. Was daraage to walkway surfaces avoided? 

Yes No 

y 

y 

Yes No 

^ 

y 

y 

y 

^ 

^ 

^ 

Yes No 

y 

Yes No 

y 

u^ 

y 

y 

y 

Yes No 

y 

y 
Owners comments: 

Inspection notes: 

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

EPA Representative 

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