TRANSMITTA L of OMAHA LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID #: 'Tid^'Z. Date: 5-2'l-\ \ 

Address: f=)2D'?S ^ . Z^r ^ST 

Remediation Contractor: Envrionmental Restoration, LLC_ Year: _2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

X ^ Video of property (DVD) J2l5efore DAfter D Basement D 

Ja Executive Summary (Final Report) 

Q^ EPA-provided property sketch 

X^ , Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

X Restoration Agreement 

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

j X Confirmation data 

Jy Photographs JZ^efore DCrew PhotosHlOuring Excavation D Sod 

j2^0-day Sod D . 

X As-built sketch 

j X Completion Agreement signed by Property Owner 

X^ Property close-out check list signed by EPA 

D Descriptionof areas not meeting ROD cleanup criteria 

X Utility clearances 

J2^ Property information from Douglas County Assessor's Office 

X Property access checklist ^ 30261874 

j X . Contact Log llllll lllll il l llll illilll 

^ \/ary.A+- /tf t . Superfund 

tnvirorun ental Restoration Signature Date . 

PA COR signature ~j y Date" 
EPA 

EPA Property Close Out Form 

Omaha Lead Site 

Property #: Tis^'^Z . PropertyAddress: 9;7ri^ tv. - Z'-V STT 

Date/Time: Owner'sName: -yn,rV\ S>eirVioO 

Quads Excavated: T? 1 Contractor Group : Environmental Restoration (ER) 

Excavation General Yes No 

1. Ifnecessary, were the correct quadrant(s) excavated and restored? X 

2. Ifnecessary, were the correct areas ofdrip zone excavated and restored? \JCLCyfAr­ 1 n r XM 

Grading Sod and Vegetation Yes No 

house? X

2. Has sod been laid in al! areas that were excavated? y 

3. Does the sod appear to be generally healthy and growing? (Only evaluate ifinspected at 30-day time 

period). 

4. Are sodded areas generaUy firm and evenly graded? i ^ 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at 30-day time period). 

6. Was the property graded such that water will not pool on the property? i . ^

7. Was damage fo landscaping or plant materials avoided? , ^ 

Gates, Fences and Retaining Walls Yes No 

1. Do gates open and close fi-ee!y? (ifapplicable) i ^ 

2. Were all gates or fences taken down during restoration activities re-installed? (ifapplicable) M. 3. Was damage to gates or fences avoided? (ifapplicable) X 

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

Foundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? 

2. Was damage to the foundation avoided? \)^^fvf 

Was damage to windows avoided? & • 

^ 

4. Was damage to window screens or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) Yes No 

I. Was damage to driveway surfaces avoided? /JA 

2. Was damage to walkway surfaces avoided? » / 

Inspection notes: 

Remedial and restoration activities complete including 30-day sod warranty: 

EPA Representative;^^y^77^ J 'M^^^/y,'iJs£i^ Date: \/4LL 
<y^2^% 

i ^s©^ i Omaha Lead Site—EP-R7-O9-05 

\^* ^ ' Environmental Restoration. LLC 

V j ^ wrww.erllc.com 

EXECUTIVE SUMiVIARY: 

36452 - 5208 N 24 ST 

No Issues or Concerns | ^ Issues/Concerns 

Dptail Fxniannrinn­
rage i oxi 

"> 

[ Create Another Ticket '] [ Back to Irth Internet ] : [ Send Email 

YOUR TICKET NUMBER IS 2669442. 

Original Call Date: 

Work to Begin Date: 

2/08/11 

2/10/11 

Time:

Time:

 8:51 am 

 9:15 am 

Op: ADAM24186 

State: NE 

Address: 5208 

County: 

street: 

DOUGLAS 

N 24TH ST 

Place: OMAHA 

Twp: 15N Rng: 13E Sect-Qtr: 03-NW,04-NE 


Twp: 16N Rng: 13E Sect-Qtr: 33-SE,34-SW 


Legal Given: C 


Type of Work: lead soil removal 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)451-1069 


: 36452 — : 


Company :_ ENVIRONMENTAL RESTORATION 


Contact Name: ADAM Phone: (402)451-1314-


Alt. Contact: Phone: (636)288-9616 


Work Being Done For: epa 


Depth of Excavation: 24in Corner Lot: N Front: N Rear: N 


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 MUD 

Day: 4025047823 

Alt:' 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICH/TRAFFIC 

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.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 2/8/2011 
Contact Information Log 

SA[D#3C>'iS'2~ 

q^^^-^^rf^ -

Attempt to contact Date/time Name 

Ui . |/^-"5^0 pCy. 

1 OoraoeSS /cisiim 0>oO. 

1 »j-/(^ -fo J-.A 
Property Access Checklist 

SAID: ^(p'^SZ^ D WORK STARTED ON: / / 

Property Address: 5^ ^ ^ li^r^ f D WORK COMPELTED ON: / / 

Renter: Owner: 2.^; ^ S^lO//f ^ 

1 Address: Phone: 

<g002. SJA27 m Fax: 

Cell/Pager: 

Additional Information: 

Phone: .^-57P^Y^27 

Fax: 4t::;z,-^^^-^x33 

Cell/Pager: 

cess Agreement Signed: \ l I l<^l IQ By: JT^ . 

Restoration Agreement Signed: iC I iCt I lO By: J7 ^ 

Video Property Before On : iz U L I ' o By: J: A 

0 Digital Photos Before On t z I iL I iQ By: OTAl~l Video Property After On By: 

D Digital Photos After On : / / By: 

JS r Property Completion Agreement Signed: cP J<»^Y/ K By: F ^ 

nn Final Report Signed: / / By: 

Additional Video or Digital Photo's Taken: 

D Video n Digital Photo On : / / By 

Reason: 

n Video n Digital Photo On By: 

Reason: 

n Video • Digital Photo On 

Reason: 

n Video D Digital Photo On By: 

Reason: 
FROM : ZnS CORP LLC 	 FAX NO. 402 991 5533 16 2010 02:27PM Pl 


Consent for Access to Property fiA»D#2)^^/6"2> 

RIGHT or Emuv TO PRBMrses 

Grantor (the property ovvner), cxjnsoits to sttd authorizes the Unitdd States EnvironmOTial 

Protection Agency (USEPA) or its atihorized rqnesentativcs, collectively lhe Grantee to enter 

and perfonn certain environmentBl resp<Mue actrvities upon the foUowing desoribed premises: 

Owmr'iVamt Paytime Pbont; ^2/ - ^ 8 ' 6^2* 7 : ZACIA 5£gH< ^ 

Addresi: f^og> tf. v-ff* sr 

AddfMs; 

Addrcnn of Property 

covered ky Ws Addren: 

Agrecmeat: 

Addmw: 

Addra*; 

PURPOSE OF bJVEsnGATiflN 

% e purpose of tiie reinedial activities is to remove aU soils at the property whissh are 

contamlnaled with hazar^us substaxices, in particular lead at concentrations greater tban or equal 

to 400 parts per million (ppm). 

REMEDIAL ACTIOSts , 

The environmental response actions to be perfbtmed on siid property may include the following 

activrdes: 

a. Taking photographs and/or video of the propeity before, during, and after remedial 

activities; 

b. Locating equipment axidmwjbinery on-site in preparation for and in lhe course of the 

enviroomental response; 

0. Planning and implementing the removal actxMi on or near Giantor's proper^, 

d. ObtaiDiQ^ samples fiom Grantor's property; 

AOREEMENTltoT Td TNTCRPBRB 

The Grantor agrees not to interfere or tamper with any of th© activities or work done, or the 

equipment used to perfcrm the activities, or to undertake any actions regarding the use of said 

property v/ticli would taid to endanger tiie health or welfere of the Grantees or the environment, 

or to allow others to use the property in such 

grant BCccsB to my properties 

(^ I do not grant access to my properties 

^ 

Jl:iMd' 

Sigtistvr Date s 

Dsts Signature 
FROM : ZflS CORP LLC FAX NO. : 402 991 5533 iec. 16 2010 02:27PM P2 


1.2/16-'2O10 THUl3i2 4 PAS 

Addtienal ConvnantB / biBtnietlona: 

3'Oteck tws box tf owner does not want E.R. to •nter the reawtents to documanl mteriof 

Ibundation wails and poaaibte prewisting damage. By checking this box E.R. is not responsible 

fcr any damage done to the irterlor of house, Including foundation cracks or fiosures. 

Q I do not agree a ^ aeree Did o not agree jai agree 

C - ^ Dste CiNitr«ctar>s^iss«t«r» ^ ^ ^ Own«r* Owner*i s Signatore 
Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of property prior to 

contractor activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction of the property ovvner and the United States Environmental 

Protection Agency (EPA). 

SAID •-^nf}< ,^, Z^^yn 3(^^5-2 

PropertyAddress: ^2,0 6 Ay. Z^ ^ ^T . 

Q^""^= Z/^^// ^^/eMA/X" 

Phone: ^oi'€-?e>XoS27^ 

On the attached diagram(s) indicate area(s) to be excavated and depth of excavation, location of all known 

utilities, subsurface features, surface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items to be removed by Contractor and not replaced: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 1 of 2 
FROM : ZPS CORP LLC FAX NQ. : 402 991 5533 pec. IS 2010 02:2SPM P3 


i2;i6/Z«10 THU 13:23 PAX 


Additional Comments / instructions: 

ltoU> ^9lMJ e ^^cw^n^l ^ ffC&tS i^S^P^ 5DD 

Mi«e« «

Owaer'a Sioiature 

Attachfnent 

 Dldoaotsgree Qiagre e

/ 

Date 

Ufclt^ 

Contrsctor's sagutare 

 Pidonolagree 

3.-\-\ \ 

Page 2 of2 

6 
FROM : ZPS CORP LLC 
 FAX NO. : 402 991 5533 
 'eb. 24 2011 ll:54flM Pl 


02/33/2011 WBDlSiOS PA.X 

Property Completion Agreoment 

This agteement documents die conpletioQ of remedial activities performed cn my properry. My 

aignAtuio ^iii dm^iftt* tkai I am tmftafiMi winh the restorstioa Of nay properly, atMl that no itsma are in 

qoe3tio&, now, or at any time in tite future, except those items listsd IRIOW, ifany. 

SMD; ^f^^ a 

Property Addreui 5^^ g A,. ti T ^r . 

OWBWJ^ 

Phaaet 

{ ^fnft-rrfgn>^ 

Rsetoraiien itoms in QueaDon: 

itwn: 

Itsmj 

Item: 

ham: 

Item: 

AddiOonBl Coraneite: 

^ @ f igTMrtnomiM !»conpletcit,nnptas noted J3Xvn * rsst«rMloe * <«aiFlttad. tseapt ti Boietf 

Q {do Mt «gr«« rettsrilim b enapleM CJ (tfo Mt agTM r«ator«t(Mi d cQBipietcd 

O:IIT.HJT^\I 

Ownflr'B S^BHture Oats Ceii<nclor*9 Sigsature DKHI 
Douglas County Accoimt Inforr ^^ n 

Page 1 of2 

Douglas County, Nebraska Property Record - R l 144590000 

Print Report 

VI ew Interactive GIS Map Information is valid as of 2010-11-16 Treasurer's Tax Report 

New Feature -»-»- » Su bdivision Sales Search 

Owner 

ZAS CORP LLC 

C/O NABUSLI & SERHAN LLC 

8002 N 127 AVE 

OMAHA NE 68142-0000 

Property Informatio n 

Key Number- 4459 OOOO 11 

Account Type: Residential 

Parcel Number: 

1144590000 

Parcel Address: 

5208 N 24 ST 

OMAHA NE 68110-0000 

Legal Description: GLENCOE PLACE LOT 27 BLOCK 1 40 X 113 

Vaiue Informatio n 

Land Improvement Total 

2010 $500.00 $0.00 $500.00 

2009 

2008 

2007 

2006 

2005 

$500.00 

$500.00 

$500,00 

$500.00 

$500,00 

$0.00 

$0,00 

$0.00 

$0,00 

$0.00 

$500.00 

$500.00 

$500,00 

$500.00 

$500,00 

Show All Transactions 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.1 4520,0 0.0 113.0 40.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoiintno=Rl... 11/19/2010 
Douglas County Account Inforr ion Page 2 of 2 

fipogic Map pti'S&cKt^Voogle 

The above map is powered by Google, and is intended to provide a general idea of a property's location. If you 

require a more exact property location, you may use the Interactive GIS Maps that are maintained by our 

office. 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 11/19/2010 
ENVIRONMENTAL AS-BUILT DRAWING 

« MAHA LEAD SUPERFUND SITE 

RESTORATION 

Owne Omah a Lea d Sit e r Name: TODD A RAYMOND 

A Sit e Sketc h ddress: 5208 N 24 ST _ 

Phone: H; W: 

Sample Number Lead Sample LAB Concentration Collected 

RYASCPXA-36452 Fl 1^1 ppm n 

RYBSCPXA-36452 F2 lal ^ ppm ET D 

RYCSCPXA-36452 B1 517 ppm 0" D 

RYDSCPXA-36452 B2 ±hj- ppm 0 ' D

RDZ3CPXA-3G452 B£ ppm D D 

ROJ;ocPXJ^ 00402—s^ - ppm D D 

nPgOCPXA-3G4ri2 PS- ppm D D 

Number of Samples A36452 

Exterior Paint North Arrow 

• Good 

(~~| Poor 

[g^o f paint 

Samples Collected 

Firm 'Ft>-f\\ R.g.\ Cr^J 

Date: c A- - 7 .L - o fe 

Time: \2 - 5^3 9fv^ 

Samples Analyzed 

XRF Unit: QO Z Book. W ^ 

Date •S -Q'-i - OL , 

Time A M 

Staff: KS W 

Omaha Lead Site 46130 

L£SEH£ 

Qv»tf'^'nw«v8f«^ Dflo Zone Excavated Cootamination UW Behind ^ 
Omaha Lead Site Owner Name: TODD A RAYMOND 

Site Sketch A ddress: 5208 N 24 ST 

Phone: H: W: 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

RYASCPXA-36452 Fl /5 7 ppm D 

RYBSCPXA-36462

RYCSCPXA-36452

 F2 

 Bl 

UiLi... 

.^i 

ppm 

ppm 

ET D 

D 

RYDSCPXA-36452 B2 iiX ppm D 

RDZ3CPXA-3Q452

RGZSGrXA-36452

 BZ 

 SZppm 

ppm 

D D 

D 

RPZGCPXA-364S2 P * ppm a D 

Number of Samples • D

^o-asD^ & 

-^VoJi £y h. 577 Y^-^SICJiQN 

\i^ i 9i .62.. 

•5,2-CS,. tsl.z.4-

I ­ -%r: 

*=^, .FI. 

15 7 

t-l'^^Vs 

.M14- '^ . 

36452 

Exterior Paint North Arrow 

• Good 

• Poor 

[g^o t paint 

Samples Collected 

Firm: Ft>ft\ R.s\ CrO 

Date: oA - l..u - o fc 

Time: \2: S-otpm 

Samples Analyzed 

XRF Unit: QQ Z Book, j/ft 

Date: ^'0 4 OL, 

Time A n 

Staff: KS W 

•EMT-IRE-B 

HAV 0 2 VM 

Omaha Lead Site 461.^0 
Owner Name: TODD A RAYMOND Omaha Lead Site 

A ddress: 5208 N 24 ST Site Sketch 

Phone: H; W: 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

RYASCPXA-36452 Fl /$ 7 ppm 0- n 

RYBSCPXA-36452 F2 Ui L ppm Ei D 

RYCSCPXA-36452 81 577 ppm 0" D 

RYDSCPXA-36452

RDZ3CPXA-3Q452

ROZ0CrXA-3G452

RPZOCPXA 3G4S2

 B2 

 BZ 

SZ-

 F * 

m ppm 

ppm 

ppm 

ppm 

0' 

D 

D 

D 

D 

n 

D 

D 

Number of Samples • 

577 

2\ ,62. 

.5.: o%.m .-i-. ' sv 

-tti - ^ - • -

F' ^ . . .F Z. 

15 7 te(p. 

I 

wfos^y-. 

.tsll4-. .'^. 

Illiilllllllll l 36452 

Exterior Paint North Arrow 

• Good 1^ 

[ 2 Poor 

Q^o t paint 

Samples Collected 

Firm: Ffc>ft\ R.'^\ CfO 

Date: o A-- X.L - o (. 

Time: \2: Sxipm 

Samples Analyzed 

XRF Unit: QQ 2 Book, Ji^ . 

Date: f?-Q^' - Q ^ 

Time: An 

Staff: KSW 

ENTIRE-B 

^Y 0 2 2s39g 

Omaha Lead Site 46130 
ENVIRONMENTAL XRF DATA ENTRY LOG 

RESTORATION 

SAID # ^4^)2 - DATE Z \VA\\ \ 

PROPERTYADDRESS TIME 

XRF S/N 

QUADRENT OR SAMPLE AREA 

DEPTH AVERAGE OF RESULTS SHOT#s 

redig 

• F2 

• B1 4 "T^M^ U^q - UJCA-Z­

• 82 

n DZ 

• PZ 

• GZ 

n EZ1 Z?,V- ?-H OsU'S-toCaCo '/ ^ T^ 

n EZ2 

n OTHER 

SAMPLER NAME T 
Thermo Fisher Scienlific Thermo 900 Middlesex Turnpike 

Billerica, MA 01821 

SCIENTIFI C 

ADDKKSS SAMIMi; AKt.A OI'KUA lOU UKl'lll NOIK.S LSAII) I'h 

2011-02-14 10:48 Avg or663-665 5208II 24 SI EZ Jimmy surface final clearance 238,47 ± 24,48 

2011-02-14 10:48 5208 n 24 st 1 EZ jimmy surface final clearance 36452 238,94 ± 24.34 

2011-02.14 10:48 5208 n 24 sl EZ jimmy surface final clearance 36452 219,73 ± 23,92 

2011-02-14 10:47 5208 n 24 sl , EZ jimmy surface final clearance 36432 256,75 ± 25.19 

2011-02-14 10:36 Avg of 659-661 5208 n 24 st Bl jimmy 4 final clearance 73,60 ± 16.11 

2011-02-14 10:36 5208 n 24 st Bl jimmy 4 final clearance 36452 67,02 ± 15,60 

2011-02-14 10:36 5208 n 24 sl Bl jimmy 4 final clearance 36452 77,30 ± 16.41 

2011-02-14 10:35 5208 n 24 st Bl jimmy 4 final clearance 36432 76,49 ± 16,32 

Page I of 1 02/15/1108:55:49 
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