TRANSMITTA L of OMAH A LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SA1D#: ^SnM ^ Date: 

Address: ^'^'^ O Goxy A {VV"^ 

Remediation Contractor: Envrionmental Restoration, LLC_ Year: _2010_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

D Video of property (DVD) ^Before DAfter D Basement D 

i ^ Executive Summary (Final Report) 

^a.^ EPA-provided property sketch 

Ms^ Signed Access Agreemen t for subject property 

D Signed Acces s Agreement(s) for adjacent property 

Ky^ Restoration Agreemen t 

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

u\ . Confirmation data 

D Photographs jH Before DCrew Photos D During Excavation S Sod 

D 30-day Sod D 

'K ^ As-built sketch 

D Completion Agreement signed by Property Owner 

N ^ Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

^"Sv Utility clearances 

l5«^ Property information from Douglas County Assessor's Office 

'""Hv^ Property access checklist 

^ ^ 30237829 

[>-^ Contact Log 

D Superfund 

Environmental Restoration Signature Date 

t^'ZZ' / / 

Date 
\ Omaha Lead Site—EP-R7-09-05 

0 Environmental Restoration, LLC 

V- " ^ www.erilccom 

••tINWt*" 

EXECUTIVE SUMMARY: 

35749 - 2220 GRAND AV 

[~K\ NO Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
a% EPA 

EPA Property Close Out Form 

Omaha Lead Site 

Property #: VsnM^ Property Address: 9L^'^ 0 QACAM/Q, VQ/' 

Date/Time: Owner's Name: CJSTO^^ - CS"vy&Vn::>-5 

Quads Excavated: Contractor Group : Environmental Restoration (ER) 

Excavation General 

Yes No 

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

y 

2. Ifnecessary, were the correct areas of drip zone excavated and restored? 

y 

Grading Sod and Vegetation Yes No 

I. Does the grading around the perimeter of the house in excavated areas generally slope away from the U house? 

2. Has sod been laid in all areas that were excavated? 

y 

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

period). 

4. Are sodded areas generally firm and evenly graded? 

y 

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

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

7. Was damage to landscaping or plant materials avoided? 

y 

Gates, Fences and Retaining Walls 

Ves No 

1. Do gates open and close fi-eely? (ifapplicable) 

l^'h 

2. Were all gates or fences taken down during restoration activities re-installed? (ifapplicable) fJ ^ 

3. Was damage to gates or fences avoided? (ifapplicable) 

y 

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

/OAr 

Foundation, Siding and Gutters Ves No 

1. Was damage to siding or trim avoided? 

y 

2. Was damage to the foundation avoided? 

y 

3. Was damage to windows avoided? 

y 

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

t*^ 

5. Was damage to downspouts or downspout extensions avoided? 

• y 

Sidewalks and Driveways (Concrete) 

Ves No 

1. Was damage to driveway surfaces avoided? 

^^ 

2. Was damage to walkway surfaces avoided? 

<..• 

inspection notes: / 

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

EPA Representative zi^4Uiu^-JiZr£ 

Date: M^ 
1 Clll^ ^ 1 V/X 1 

"> 

[ Create Another Ticket ~ ] [ Back to Irth Internet ] [ Send Email ] 

YOUR TICKET NUMBER IS 256ieiBp 

Original Call Date: 8/05/10 Time: 9:47 am Op: TRACY24186 

Work to Begin Date: 8/09/10| Time: 10:15 a j 

State: NE County: DOUGLAS Place: OMAHA 


Address: 2220 Street: GRAND AVE 


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


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: Excavating the entire property 


Location of Work: LOCATE ENTIRE PROPERTY 


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


: SAID #35749 


Company : ENVIRONMENTAL RESTORATION 


Contact Name: TRACY BRISTOW Phone: (402)451-1314 


Alt. Contact: Phone: (314)504-4874 


Work Being Done For: EPA 

Depth of Excavation: 12 Corner Lot: N Front: Y Rear: Involves Tunneling or Horizontal Boring : N Explosives: N 

CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 

Service Area Contact Phone Nuinber Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICH/TRAFFIC Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNE 1C QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://wv^rw.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/5/2010 
:K4^gjg^^sgJB^ H 

Contact Snformation Log 

SA!D# 5^7Vf 

S'r^ • o^ o 

I Owner's Name:^QHj (^(g^ /2-M .^U^Ju^ | Daytime Phone: ^--/Q;^ ~q4X.-^^ \ \ 

I Property Address: 2ZZ O & rA^' ^ 

Attempt to contact Date/time Jame 

C^.ll^c\ i-e ^ fy).fiS'r,y^^ i-/i-i£> y /t>'6Tc..-^ 

^\)^''^*'^i ^ 

^*| l -eA /•''•W- /M •^s-5-^^L^.e. I -i3~ft / /:i\i>'s^^ . K- O*'^ "^ ' ^ 

K-*ck: i>;^ ..-tc<?i' {-f^-I-i'iI /-/6'-/o/;?;i>^^, , '/< vr ?-D. rf-xn I ^ 

C**/!-*^^ /<^ f /»ve»^«^<: 1^11-10/ 2 ' J^/'-^ 

/?. «P«-^'"'^ 

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l-S^/0 J1-3/? 

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[•••J.-:jr.-T-r.s.'.i.i'^-iw*-'' - ^s•5 i l 

Property Access Checklist 

I SAID: 3^ 7

j Property Address:

 Vf 

 2^-^ D /^^/^>^ ^ 

p

G

 WPRKSTARTFD* 

 WORKCOMPELTED ON: 

_/_

/

 /_ 

/ 

Owner: ^^^/>. ^ /^/H •Ij^ i Renter: 

Address:^^^ ^ ^^^ ^ Phone: 

Fax: 

Cell/Pager: 

Phone: t^^^-^/^ -^^/ / Additional Infonnation: 

Fax: 

Cell/Pager: 

1 4'^ Access Agreement Signed: 2 / V / /?) By: tl/eJ( 

[S'^estoration Agreement Signed: ^ / V / /C? By: tiJ ^ 

\C\ Video Property Before On : ^ / 3 /("D Ey^i/k 

^ Digital Photos Before On : ^ / JT / (t> By^M 

r~] Video Property After On : / / By: 

n Digital Photos After On : / / By: 

[ 3 Property Completion Agreement Signed: <Sr' / ^7f C^ By: p p 

r~l Final Report Signed: / / By: 

.Additional Video cr Digital Photo's Take.fi: 

D Video n Digital Photo On : / / By: 

Reason: 

n Video n Digital Photo On : / / By: 1 

ReasoEi: 

D Video D Digital Photo On : / / ^ 

1 Reason: j 

n Video n Digital Photo On : / / By: 1 

Reason: 

Omaha Lead Project Work Plan Pagel of 19 
|0^lr5;^?i\va^ P I 

Consent tor Access to Property SA!D# 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner), consent.;; to and nv.^hc-nzti; Lhe 'Jniled States Environmental 

Piwicciion Agency (USEPA) or its authorized representatives, collectively the Grantee to enter 

and perform certain environmental response activities upon the following described premises.: 

I Owner's Name: (^^g/g^ t?/o4-f 

Daytime Phone: L^Q^- ^/^ - d^/ / 

Address: Izszo Gfcunf 

Address: 

Addresses of Properties 

covered by this Address: 

Agreement: 

Address: 

Address: 

PURPOSE OF INVESTIGATION 

The purpose of the remedial activities is to remove all soils at the property vviiich are 

contaminated with hazardous substances, in particular lead at concentrations greater than.or equal 

to 400 parts per million (ppm). 

REMEDIAL ACTIONS 

The environmental response actions to be perfomied on said property may include the following 

activities: 

a. Taking photographs and/or video of the propert}' before, during, and after remedial 

activities; 

b. Locating equipm.ent and machinery on-site in preparation for and in the course of the 

environmental response; 

c. Planning and implementing the removal action on or near Grantor's propeity. 

d. Obtaining samples from Grantor's propeity; 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the activities or Vv'ork 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 of the Grantees cr the environment, 

or to allow others to use the property in such 

I grant access to my properties 

n ] I do not grant access to my properties 

Signature 

Signature Date 
r

Additionsl Comments / Instructions: 

l^p Check this box if owner does not want E.R. to enter the residents to document interior 

foundation walls snd possible preexisting damage. By checking this box E.R. is not responsible 

for any damage dons to the interior of house, including foundation cracks or fissures. 

Q I do not agree Dl-g F ] I do not agree ree 

Contractor's Signatiire Date 
Restoration Agreement 

The purpose of Lhis agreement is to provide a mutual,agrep.rnent as to ccnditioris of property jaribr to 

ccntractor acuvilies.' 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: S^fV^ 

PropertyAddress: .^^^j^^^g^j^ ^ J^IZO Q-i^'/ 

Owner: (^^^/ ^ l^^/^fl^i 

fPhone: y^^.^/^.^^/ / 

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 Contrsctor snd not replaced: 

Fage 1 of 2 
SK^r^pjj^^" " " ^ 

Additional Comments / Instructions: 

I agree n I do not £gree Dis I 11 do aot agree » 

"-MA 

O^vner's Signature Ccntractor's Signature Date 

Attachments 

Page 2 of 2 
Property Compietiori Agreement 

Tliiii-agreement documents the cori'ipletion of remedial activities performed on my property. My 

signature will designate that I am satisfied with the restoration of my property, and that no items are in 

question, now, or at any time in the future, except those items listed below, if any. 

SAID: 3'57</ f 

Property Address: ^^ ^ C> Cri^ ^ 

0>^"^'-= Qorodt rfui-^U^ 

Phone: Qoi^^/Z- 0(^// 

Restoration Items In Question: 

Additfona! Comments: 

r agree restoration is completed, except as noted Ixl 1 agree restoration is completed, except as noted 

I I I do nat agree restoration is completed I j I do not agree restoration is completed 

tl^6 

Owner's Signature Bate 
Douglas County, Nebraska Property Record - R2004190000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - Vie W On Ma p Information is valid as of 2009-12-15 Treasurer's Tax Report 

New Feature -J' -> -> Auto Sales Search 

Owner 

JUSTUS CONCIE E M 

2220 GRAND AVE 

OMAHA NE 68110-0000 

Property Informatio n 

Key Number: 0419 0000 20 

Account Type: Residential 

Parcel Number: 2004190000 

Parcel Address: 2220 GRAND AV 

OMAHA NE 68110-0000 

Legal Description: PATRICKS SARATOGA ADD LOT 7 BLOCK 0 64 X 125 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$2,100.00 

$2,100.00 

$2,100.00 

$2,100.00 

$2,100.00 

$2,100.00 

Improvement 

$49,500.00 

$50,600.00 

$50,600.00 

$50,600.00 

$21,800.00 

$19,800.00 

Total 

$51,600.00 

$52,700.00 

$52,700.00 

$52,700.00 

$23,900.00 

$21,900.00 

Land Informatio n 

Acres 

0.18 

SF 

8000.0 

Units 

1.0 

Depth 

125.0 

Width 

64.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2... 12/22/2009 
2220 GRAND AV 

IR?/" • JlV 

J* «M,:?'~,~. 

First Floor &»coodFkior 

e84 0t<| ft ^ S2e.0»i) «. 

' ' t ^ H 

1 1/2ST0I?YFIN 

Ml!»lll;H!fclililiMiMIM|.W<tiiri!l»'#A.-Hl-Hin 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE [zzz: 

Square Footage: 1512.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Fair 

Built As: 1 1/2 Story Fin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 2.0 

Roof Type: Hip/Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1905 0% 1905 104 

Detail Type Detail Description Units 

Add On Unfinished Attic W/floor 988.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 984.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch End Solid Wall 32.0 

Porch Slab Roof Ceiling 176.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2... 12/22/2009 

B. .^^^i^'..-» . ^ 
ENVIRONMENTAL AS-BUILT DRAWING 

WA lAHA LEAD SUPERFUND SITE 

RESTORATION 

Omaha Lead Site 

Site Sketch 

Samolina Address: 2220 GRAND AV 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

RYASCPXA-35749

RYBSCPXA-35749

RYCSCPXA-35749

RYDSCPXA-35749

RDZSCPXA-35749

 F1 

 F2 

 B1 

 B2 

 DZ 

ppm 

ppm 

ppm 

ppm 

ppm I n 

n 

n 

D 

n 

nOgOCPXA-3&749

nPZSGPXA 35740

 GSP 2 -

ppm 

ppm D n 

n 

n 

Number of Samples = | ^ | | Q | 

35749 

Exterior Paint North Arrow 

• Good < 12^ Poor 

• Not paint 

Samples Collected 

Firm: ?. E- C C g-K-

Date: B-l - CH 

Time: I: i(o fA. 

Samples Analyzed 

XRF Unit: lOfiiC^I. Book; ^T 5 

Date ^-7 7 :i29 

Time 

Staff (^SW 

Legend: F1 = Front Left, F2 = Front Rigtit, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants areras viewed froni (he street facing property , <^——-—L 

Quadrant axcavalad DrIo Zona Excavated Co«ttaininatk>n l-afl Bahind 

/««^M*..M«. « « , C O o- r A A A C cr »«• aiv^w^ww^^^ai^A^^I D^^«»4 ^^ir^«^»^« *.« I t ^ 
Illlfll 35749 

Omah Exterior Paint North Arrow a Lead Site • Good Site Sketch 

[2^ Poor 

Sampling Address: 2220 GRAND AV Q Not painl 

Sample Number 

RYASCPXA-35749

RYBSCPXA-35749

RYCSCPXA-35749

RYDSCPXA-35749

 F1 

 F2 

 B1 

 B2 

Lead 

Concentration 

ppm 

ppm 

ppm 

ppm 

Sample 

Collected 

I 

LAB 

n 

n 

D 

n 

Firm: 

Date: 

Time; 

Samples Collected 

T>.E. c-c . etcS-\-o H 

Samples Analyzed 

RDZSCPXA-35749 DZ ppm n XRF Unit: lof^l . Book: ^."^ ^ 

r^OZOCPXyi 3G740 G«­ ppm n n Date; ^-7 7 ­ ^ 

RPZOCPXA-35740 Pi ­ ppm n n Time Ti3a_ 

Number of Samples = | ^ | | 0 \ Staff; ^S W 

Legend: F1 = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

Allquadrantsarelas viewed from the street, facing property "iSo^ra-AaOtCi. ^>i^ 

G.rAio<i ^ v ; Rev 2008 Created-. 12-Apr-08 044701.01 2.1 
ENVIRONMENTAL XRF DATA ENTRY LOG 

RESTORATION 

(L 

SAID#;2ATA S DATE ^ \N^ \ V Q 

PROPERTYADDRESS 

2-7-7 ^ Pit-rxnn l ftM 

QUADRENT OR SAMPLE AREA 

redig 

DEPTH .

TIME 

XRF S/N 

 AVERAGE OF RESULTS 

3^^ Q 

SHOT#s 

D

n

•

D

•

n

n

D

n

 F2 

 Bl 

 B2 

 DZ 

 PZ 

 GZ 

 EZ1 

 EZ2 

 OTHER 

4 

-t-

^ 

CP 

^ 

w^--- \S 

r,»^-t V^^) 

4la t V?> 

2-1 \ ­ 2-1 

v?,m:\«. 

tfl^V-C^<g-tA 

fc»q"l -TOD 

SAMPLER NAME O^cr\0r\^^y:^ . 
Themio Fisher Scientific Thermo 900 Middlesex Turnpike 

Billerica, MA 01821 

SCIENTIFI C 

lAMKACi; IVDDKISS I'll; Aki:v|()i'i;uAi()K 1)11'II I NOU S SMI ) ll'l ) 

1 2010-08-14 10:44 Avg of 697-699 2220 grand av EZ jimmy surface final clearance 133.57 ± 19.08 

2 2010-08-14 10:44 2220 grand av EZ jimmy surface final clearance 35749 132.98 ± 19.06 

3 2010-08-14 10;43 2220 grand av EZ jiimny surface final clearance 35749 134.51 ± 19.10 

4 2010-08-14 10;43 2220 grand av EZ jiimny surface final clearance 35749 133.23 ± 19,08 

5 2010-08-14 10:39 Avg of 693-695 2220 grand av DZ jimmy 6 final clearance 271.39 ± 26.90 

6 2010-08-14 10:39 2220 grand av DZ jmiiny 6 final clearance 35749 283.20 ± 27.33 

7 2010-08-14 10:39 2220 grand av DZ jimmy 6 fmal clearance 35749 256.14 ± 26.31 

8 2010-08-14 10:38 2220 grand av DZ jimmy 6 final clearance 35749 274.84 ± 27.07 

9 2010-08-14 10:36 Avg of 689-691 2220 grand av B2 jimmy final clearance 45.56 ± 13.40 

10 2010-08-14 10:36 2220 grand av B2 jimmy final clearance 35749 37.62 ± 12.68 

U 2010-08-14 10:36 2220 grand av B2 jimmy final clearance 35749 40.61 ± 12.90 

12 2010-08-14 10:35 2220 grand av 82 jimmy final clearance 35749 58.44 ± 14,61 

13 2010-08-14 10:34 Avg of 685-687 2220 grand av Bl jimmy final clearance 69.14 ± 15.26 

14 2010-08-14 10:34 2220 grand av Bl jimmy final clearance 35749 76.35 ± 15.78 

15 2010-08-14 10:33 2220 grand av Bl jimmy final clearance 35749 65.38 ± 15.01 

16 2010-08-14 10:33 2220 grand av Bl jimmy final clearance 35749 65.68 ± 15.00 

17 2010-08-14 10:31 Avg of 681-683 2220 grand av F2 jimmy final clearance 125.31 ± 19.23 

18 2010-08-14 10:31 2220 grand av F2 jimmy final clearance 35749 135.00 ± 20.05 

19 2010-08-14 10:31 2220 grand av F2 jimmy final clearance 35749 124.74 ± 18.95 

20 2010-08-14 10:30 2220 grand av F2 jimmy final clearance 35749 116.19 ± 18.68 

Page 1 of 1 08/14/10 13:23:37 
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