TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 44773 DATE: 1/15 

ADDRESS: 2512 MONROE ST 

REMEDIATION CONTRACTOR: PRUDENT TECHNOLOGIES. INC. YEAR: 20lf 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Q PRE AND POST VIDEO OF PORPERTY (DVD) 

EXECUTIVE SUMMARY 

EPA-PROVIDED PROPERTY SKETCH 

m SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACC:ESSAGREEMENT(S) FOR ADJACENT PROPERTY 

m RESTORATION AGREEMENT 

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

EZi CONFIRMATION DATA 

0 PHOTOGRAPHS 

0 AS-BUILT SKETCH 

m SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

[^ PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

Q ' UTILITY CLEARANCES 

GJ PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

SIGNAl^RE DATE 

30217586 

mm 

Superfund 
PROPERTY SUMMARY 

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

Property Address: 2512 MONROE ST 

A. EXECUTIVE SUMMARY 

A.l Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 381 PPM @ 3"; EA = 76 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, ifavailable, or obtained include: 

i) Pre-excavation agreement details (ifany 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. 
Find Record Remediation Query I Lead Remaining Query I Property Damage Query 

Backfill: 

Sample Area: 44773 - 2512 MONROE ST 

Owner: 

n Owner Occupied 

Owner Name: 

jSVOBODA JOSEPH A 

Owner Addressi: 

1 

Owner Address2: 

)2514 MONROE ST 

City: State: Zip Code: 

lOMAHA )NE |68107-

Owner Phone Alternate Phone: 

1(402) 731-5473 1 

Contract: 

Contractor: )PRUDENT2010_S 

Contract Option |OPnON 1 

User Provided Owner Information 

Owner Name: 

1 

Owner Address: 

1 

City: 

1 

State:

1

 Zip Code: 

1 

Owner Phone: 

1 "

Alternate Phone: 

1 

Assessment: 

Qualifying Group |400 

Assessment Max XRF Value [ 528.47 

Resident: 

Resident Name: 

r 

Property Address: 

|2512 MONROE ST 

Zip Code: 

|68107-

Resident Phone 

I 
3

TECHNOUXJIBS, INC. SEm 

EPA Property Close Out 

Property #: U ^ 77 3 Property Address: '^'^(^Moi^^cx^ 

Date/Time: ^ Owner's Name: ^«fi3^*a n ^^c^rZ'^i A 

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

Excavation General 

Yes No 

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

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 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 generally fimi and evenly graded? / 

5. Are tlie joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) / 

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

7. Was damage lo landscaping or plant materials avoided? / 

Gates, Fences and Retaining Walls Yes No 

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

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

 Was damage to gates or fences avoided? (Ifapplicable) / 

4. Was damage to retaining walls avoided? (If applicable) / 

Foundation, Siding and Gutters 

Ye^ No 

1. Was damage to the siding or trim avoided? 

A 

2. Was damage to the fomidation avoided? 

A 

3. Was dainage to windows avoided? 

A 

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

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

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage lo diivewav surfaces avoided'? 

/

-A Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

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

EPA Representative Q^^^r^JL. ^Date: ipji^ftn 
UHNOLOGIES, INC, 

AS - BUILT DRAWING 

OLS # 44773 

Date Excavated: 11/15/2010 OMAHA LEAD SUPERFUND SITE I'SEPA Signed-Off Date: 

ll. miiummt^imttmmuwi^mMsamiwmttttmtr'immmmmmStmmMlflfaB'f 

44773 

J»«n>1 UJe^rziA/s Omaha Exterior Paint htorth Arrow Owne Lead Site r Name:t<e9ePfl A SVOBOOA • 

Site • Good Sketch Address: 2512 MONROE ST 4

• Poor Phorw: H: W: ^AioX paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm: 

Samples Ccllected 

RYASCPXA-44773 F1 _Jji5_PP"n D Date: 0^\i U OJ!: 

RYBSCPXA-44773 F2 ^ 7 ppm D Time: <T.-3 6 A.-w 

RYCSCPXA-44773 

RYDSCPXA-44773 

ROZSCPXA ^11773 

ReZSCPXA.1'177a 

81 

B2 

-OZ 

5Z. & ppm 

3 I (fi ppm 

~ ppm 

ppm 

""" ppm 

Numljer of Samples • 

B^ 

D 

D 

a 

q" 

D 

D 

D 

D 

D 

Samples Analyzed 

XRF Unit: /63 1 Book: /5 2 

Date: /0-£)^-OS ~ 

Time: 

Staff: 

PAT) 

L A 

.^^-t^'^-"l'»lfN'i ' I I ij^^'^' t • ^ EUTE EED 

'i:!iri 

fi> 

B 316 l =381 PPM 3 " H(SL 

<a5'iA^:'^^''^.^'^ ' 

^ 

f;/ u F-'H 

195 \ ^ 87 

±—-A.—^—^—)i c 

:_w^^._-^ 

MoMj^HT ;^ ! 

Omaha Lead Site 4613(1 EA = 76 PPM a SCIUPE t~l") 

CONTRAa #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
«ERIV 

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 fiiture, excluding any 

remaining warranty (30 days total) except those items listed below, ifany. 

Property ID: 

Property Address; ;g^5- ; ^ ^^^^^ ^ 5^ ^ 

Owner: So oiy\ lA Ihta y 

Phone: ^0^ ^ f.^ ^ 

Restoration Items in Question: 

item: 

Item: 

Item: 

item: 

Item: 

item: 

Required corrections to complete the property: 

Elagr agree e restoration is completed. 

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

(yiA^yyfyCy ^ / ^ A^ y^LyLytyty^ . — mh^L J6 

Owner's Signature Date 
Prudent Technologies, Inc (l-'iudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up lenclcoijUminated soils at a number of properties located in Omaha, Nebraska, including the property located at 

aiS l a l f^ 0/lf" Q P,,,, •^"TThe EPA requests your permission to allow Prudent to perlbrm a soil cleanup at this 

property to rerriove lead-contaminaied soil By signing this form, the property owner grants permission to Pru.lenl to perform 

activities related lo the cleanup including soil sampling, removal of lead-contaminated soil, and restoration of he referenced propeity 

If you have any questions about the soil cleanup planned for your property, please contact Prudent. • • •'. • .for the Omaha 

Lead Site cleanup, at (402)733-1188; 733-1455. General questions about the Omaha Lead Sile cleanup can b ; du-ecta1 to the EPA 

Public Information Centers af (402) 731-3045 (South Omaha office). 

Property Access Granted By J'o^M W f - [X^-gC? /"^"g-V/| ^ 

(Please PnnVSJame) / 

Property Owner Signature>^. , CAfTi^MyyL ^ . , vlA(24AlAYyiAA jjl^ l '/ O 

/ / (Signature) O Q^y (Datel 

PROPERTY INFORMATION 

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

RESIDENT NAiVlE; jTc? g|n ») ^ \X) €.0. Y" ^ V] Owner Renter 

RESIDENT ADDRESS: 

IF RENTAL, PROPERTY 0\WNED BY: 

OWNER'S MAILING ADDRESS; 

XS]"^ l^pysrof: 5+ -

OWNER'S TELEPHONE NUIWBER - HOME: ^7 1 ) '73 7 -.$"^^ 3 WORK: 

AGE ODFF HOME?: \ \f f)) YEA RSf .HOW LONG HAVE YOU LIVED HERE? 7 3 YEARS.

0 Y\ 

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

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: 0 NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER 

_JL_ 

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.) 

'X^\CL^ . oeULL UxJ^nr.^.. gjl-a.r4-i 

•-^ 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS, The activities to be implemented by EPA .indei this agreement 

are pursuant to Sectiorr 104 of CERCLA, 42 U SC. 9604. EPA's right of access to the property is provided tb in Section 104(e)or 

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." 

,-<ansa.s "ity. •'WC '-."' 
E^VIROMiV1E^\TAL& IRUDRN CONSTRLCTION 

TECHNOLOGIES, INC. SERVrCES 

Property Status Form 

Address: SLSI5- K|oAr<D<,=5 7— Date: | (-Os^—^ O 

BVID: 

I^J'A\yV^<A.^ IA Y ^y>^it ^ JS/. 

Prooer^ Owner Prudent Emplo)ree 

Si^ure : /%-aynAiyL, £ . , \Xj.^yiyiyMyiA J Signature: 

8080 Ward Parkt^ay ' . Suite 405 <7 ^ ^ 5600 S 10 St 4^ 2 Medical Drtve, £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 

C^"- I'i.itW B70.*<77 
44773 

Omaha Exterior Pab< North Amw Owne Lead SHB r Nameri*09EPi IA CVOPeBA* 

Site • Good Sketch Address: 2512 MONROE ST • Poor 

A

Phone: H; w B ^ paint 

Sample Number Lead Stsnpie LAB C<riiected 

Concentration CoBected Ftrm: 

RYASCPXA-44773 F1 n DSHBC 

RYBSCPXA-44773 F2 n Ttme: 

RYCSCPXA-44773 B1 ppm n 

Saniples An^yzed RYDSCPXA44773 B2 n 

RPZSCPXA <1<I773 DZ D n XRF Unit Id3 1 Book. /3 2 

RGZSCnXA <I1773 -ez D n Date: yg-T^V-i^S" 

RPZSCJ'XA-44y/'8 -pg- • Time: ^/» ? 

i^/4 Number of Sam;ri«' 

**^- ^ 

SEP 1 5 2085 

b3I& 

.CL S.3.. 

r 

F.I ^i f% 

lis rz 0 .;. 

m L m y /?• 

A^oi^ffu^t ;^ t 

Omaha Lead Site 4613(1 
251

2 Monroe St 40x130 

A Printed

: Nov 04, 2010 

www.dcgis.org/dogis 
Page 1 of2 

"> 

Create Anotiier Ticl<et Bacit to irtli Internet Send Email 

• YOUR TICKET NUMBER IS 2634543. 

Original Call Date: 11/04/10 Time: 10:08 am Op: SIVA18967 


Work to Begin Date: 11/08/10 Time: 10:45 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2512 Street: MONROE ST 


Twp: 14N Rng: 13E Sect-Qtr: 09-SE,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 

ATTNEBRl CXCATV LEVELS MUD02 OMAHACOF 0PPDGPR6 PAETEC 

QLNNEIF SPRINTNE 

Service Area Contact Phone Number 

Utility 

Type 

ATTNEBRl ATT/T 

Day: 80024136249 

Alt: 

Emerg: 80024136249 

CXCATV COX COMMUNICATIONS, 

INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVEL3 LEVELS COMMUNICATIONS, 

LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MUD02 METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11/4/2010 
Page 2 of2 

CITY OF OMAHA- OMAHACOF RICH/TRAFFIC TRAFFIC.SEWER 

OMAHA PUBLIC POWER 0PPDGPR6 ELM LOCATING DISTRICT 

NO NEED TO CALL OUT PAETEC PAETEC COMMUNICATIONS EMERGENCY 

QLNNE IF QWEST LOCAL NETWORK ELM LOCATING 

SPRINT COMMUNICATIONS 
 SPRINTNE 
 CO 


Day: 4024447197 


Alt: 4024445161 


Emerg: 4024445160 


Day: 4067289343 


Alt: 4062071494 


Emerg: 8887289343 


Day: 8002891901 


Alt: 


Emerg: 8002891901 


Day: 4067289343 


Alt: 4062071494 


Emerg: 8887289343 


Day: 8005210579 


Alt: 


Emerg: 8005210579 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11/4/2010 
ENVIRGNMENTAL 

ENGINEERING AND 

CONSTRUCTION iBeMwoLOttiES, mc . SOLUTIONS 

SITE SAFfeTY HAZARD ANALYSIS 

:iM 10 Address: Excavation Date 

Crew: B.ckf,nD.te:-^:^itZ£. 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees 

Structures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

Condition 

^ v ^ 

gc-vj 

l^^y ^ 

'^\y^y~ryJ 

hy/ ^ 

r^H 

^e>e? r 

^ic^^v^vrvM 

pHU/ ^ 

f«>*«-v1/^ ^ 

po^?Nr 

A^M 

Hazards Corrective Action 

Site Safety Office 

Date: 

> ^ ^ 

8080 WanHJaftasay. SuilEr 406 seoosiost 4242 Medical Drive, Suite 7250 

K»s»G«y;Ha6411 4 Omaha, Netaa^ka €8107 San Antonio, TX 78229 

Phone: (8t6)36S'3703 Ptntne: (403)733-1188 Phone: (210)822^9588 

Fax: (St«) 363-3707 Fax: (402)733^1883 Fax: (210) 579-6577