SAiD#: 33801

Ti^NSIVIITTAL OF OIVIAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

 DATE: 1/15 

ADDRESS: 1618 SPRAGUE ST 

REMEDIATION CONTRACTOR: PRUDENTTECHNOLOGIES. INC. YEAR: 20lt 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

d PRE AND POST VIDEO OF PORPERTY (DVD) 

EJ EXECUTIVE SUMMARY 

d EPA-PROVIDED PROPERTY SKETCH 

d SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

d RESTORATION AGREEMENT 

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

d CONFIRMATION DATA 

PHOTOGRAPHS 

0 AS-BUILT SKETCH 

SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

^ PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

• UTILITY CLEARANCES 

ID PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

SIGNATURE DATE 

30218388 

lIHI 

Superfund 
PROPERTY SUMMARY 

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

Property Address: 1618 SPRAGUE ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Infomiation: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 247 PPM @ 2"; EA = 282 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-Buih sketchi) 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. 

TECHNOLOCIES, INC. 
Find Record Remediation Query Lead Remaining Query Propetty Damage Query 

Backfill: 

Sample Area: 33801 -161 8 SPRAGUE ST 

Owner: User Provided Owner Information 

• Owner Occupied 

Owner Name: Owner Name: 

JANDERSON JR GEORGE C 

Owner Addressl: 

r 

Owner Address: 

Owner Address2: 

J1604 SPRAGUE ST 

City: 

(OMAHA 

State:

INT 

 Zip Code: 

{68110 

City: State: Zip Code: 

1 

Owner Phone 

1(402) 453-1868 I 

Alternate Phone: Owner Phone: Alternate Phone: 

Contract: Assessment: 

Contractor: PRUDENT2010 S Qualifying Group |400 

Contract Option JOPTION 2 Assessment Max XRF Value 495.41 

Resident: 

Resident Name: 

r—TM" 

Property Address: 

J1618 SPRAGUE ST 

Zip Code: 

J68110-

Resldent Phone 
y^^,Xy\Q/0^ TECHNOIXDGIES, INC. 

EPA Property Close Out 

Property #: "^ ^ ^ ^ ^ Property Address: )^1^%^2>'^' ^ 

Date/Time: Owner's Name: ^^^Of^e^A^^d^Tf-o ^ 

Quads Excavated: B V Contractor Group: Prudent Techiniologics, Unc, 

Excavation General Yes No 

1. If necessan'. were the correct quadrant(s) excavated and restored? / 

2. If necesscirv'. were the correct areas 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 liouse? y

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

o. 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 firm and evenly graded? y 

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

time period) y 

0. Was the propertA' graded such tliat water will not pool on tlie property? y 

7. Was damage to Lindscapmg or plant materials avoided? 

y 

Gates, Fences and Retaining WalSs Yes No 

!. Do gates open and close freely? (If applicable) y 

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

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

y 

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

y 

Foundation, Siding and Gutters Yes JVo 

1. Was damage to the siding or trim avoided? 

y 

2. Was damage to the foundation avoided'' 

y y 

3 Was damage to windows avoided? 

^ 

4. Was damage to windows or door screens avoided? 

y • 

5. Was dainage to downspouts or downspout extensions avoided? 

y < • 

Sidewalks and Driveways (Concrete) Yes No 

I Was damage lo driveway surfaces avoided" 

Was damage to walkway surfaces avoided? ^ 
Owners comments: 

Inspection notes: 

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

EPA Representative "'^T ^ ^Date: \^\ '"^ '^^ 
m t'HNOLOGlES. INC. 

OLS #338(11 

Date Excavated: 11/02/2010 

IISEPA Signed-OffDate: 

AS - BUILT DRAWING 

OMAHA LEAD SUPERFUND SITE 

33801 

Omah a Exterior Painl North Arrow Lea d Sit e Owner Name: GEORGE C ANDERSON JR 

Sit • Good e Sketch Address: 1618 SPRAGUE ST • Poor Phone: H: V53 - /<?*& W: • Not paint i 

LeaC Sample Samples Collected Sample Number 

Concentration Collected 

LAB 

Firm f DA fiTf r Af 

RYASCPXA~33801 Fl ppm \y D Date 

RYBSCPXA-33801 F2 

ppm \y D Time 

RYCSCPXA-33aQ1 B1 _!i251ppm D 

Samples Analyzed RYDSCPXA-33801 B2 I l"7 ppm % D 

nD2CCrxA-300Q1 - 0 2 ~ ppm n D XRF Unit: Id-Zl Book; /2 ? 

nOZGCPXA-OJOOl S€ J^^ ppm D D Date: e-/i>-os- nPZSGPXA'33001 P£ _r ppm n D Time: f/IO 

Staff: Number of Samples = ^ 

MA. 

•!.!t-n't'n'•"" ; 'f'."-'' 

4 ^ 

W 

^?5 

117 

B2. 

Bl = 247 PPM (w, 2 " 

o — •—. n 

..Fl.. 

.fZ.. 

JUIS .SpRA6ucsr 

iA^i ^ 

:^R2A6.UC ^:T 

Omaha Lead Site 4613<1 

EA =282 PPM (qj. SC RAPE (~1") 

CONTRACT #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
6ERIV 

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, if any. 

Property ID: 

Property Address: // y f 2 J^J^fU- Owner: f^^^,.^^ d^tsJS-OAj 

Phone: yojL . jTg ^ ^Sf^t > 

Restoration Items in,Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

B I agree restoration is completed. 

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

yu<^c^yd^^*^-^ M ^. /^ 

Owner's^ignature Date 
T?rnvcilC>i:;3F>, !V:; 

S'rudenl Technologies, Inc. ^V'vudent) is under contract with the U. S. Environmental Protection Ageiicy (EPA) to clean up loadcontaminalgp so ^ at a number ofproperties located in Omaha, Nebraska, including the property located at 

jlOj/i D^^^QtLA't' The EPA requests your permission (o allow Prudent to pertbmi a soil cleanup at this 

prop'eriy'to remove lead-contaminated soil. By signing this form, the property owner grants permission to Prudenl to pertbrm 

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

Ifyou have any questions about the soil cleanup planned for your property, please contact Prudenl • .;: '• • Ibr the Omaha 

Lead Site cleanup, at (402) 733-1 188; 733-1455. General questions about the Omaha Lead Site cleanup can b ; directed lo the EPA 

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

Property Access Granted By ^^—^A<^*^- y>^ j ^-^/t^g/L ^ ^ ^ (Please Print Name) 

Property Owner Signature­ yLy^^^ ij^l-^ 

(Signature) (Date) 

PROPERTY INFORMATION 

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

RESIDENT NAME: Up- Ovi/ner P.enter 

RESIDENT ADDRESS 

y^rt2:±^ 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; /iffof ^ 'y^^^-'^^^yy(y— 

OWNER'S TELEPHONE NUMBER - HOME: ffePr ^f:^ 0^ 0 WORK: 

J L_ 

AGE OF HOME,..yy ? . EARS. HOW LONG HAVE YOU LIVED HERE? EARS. 

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

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD/^^Q_NUMBE R 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 .mdev this iigreemeni 

are pursuant to Section 104 ofCERCLA, 42 U S.C. 9604. EPA's right ofaccess to the property is provided tb" in Section 104(c) of 

CERCLA, 42 U.S. C 9605(e), which provides entry for "determining the need for response, or choosing or taking any response action 

under this title, or otherwise enforcing the provisions ofthe title." 

SOSO War M P.-.i:Kvv,--,y. 

Kansas City .ViC P;.J' 
ENVrRONMENTAL \ 

CONSTRLfCTlON 

TECHNOLOGIES, INC. SKRVI(i:S 

Property Status Form 

Address: /^/ / "GfK/^G^^ Date:/^^/^ 7/^ 0 

Phone: ^^^ . ^^^ Q BVID: ggJ^Q / 

' O y::X/n^y>/A^ yA/2-e/i ^^ fe-/ 

£". x^.^ \//? r £ C 2^o ^5 o 

Prudent Employee 

Signature: 

8080 Ward Parkway, syite 40S 5600 S 10 St 4242 Medical Drive. Suite 4250 

Kansas City, MO 641 Omaha, Nebraska 68107 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402) 733-1188 Phone: (210)822-9588 
33801 

Omah Exterior Paint North Arrow Owne a Lead SKe r Name: GEORGE C ANDERSON JR 

Site • Good Sketch Address: 1618 SPRAGUE ST • Poor Pho^B^^S^^JA 

Q Not paint i 

Sample Number 

RYASCPXA-33801

RYBSCPXA-33801

RYCSCPXA-33801

RYDSCPXA-33801

nDZCCP)(A 33001 

ROZOCPXA-33001 

RPZSCPXA 33001 

 Fl 

 F2 

 Bl 

 B2 

-PZ 

Lead Sample Samples Coifected LAB Concentration Collected Firm: ffiA ftTff C:\y^ 

ppm \y n Date: OpJ!0[d5 

ppm n Time: ^'.J5 

in 

ppm 

% 

D Samples Analyzed 

ppm n 

ppm XRF Unit: ICi l Book: /Z ? D 

ppm n Date: D 

n 

ppm D Time: 

Staff: LA Number of Samples = . ^ 

pt^AGiUg 

Omaha Lead Site 46130 
N 161

8 SPRAGUE ST: 50.33 X 90 

A &UI Printed: Dec 10.2010 

www.dcgis.org/dogis 

 i 
i'age 1 ot 1 

Create Another Ticket Back to Irth Internet 

Send Email 

YOUR TICKET NUMBER IS 2628305. 

Original Call Date: 10/28/10 Time: 8:30 am Op: SIVA18967 


Work to Begin Date: 11/01/10 Time: 9:00 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1618 Street: SPRAGUE ST 


Twp: 15N Rng: 13E Sect-Qtr: 03-SE-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: omaha soil rememediation project 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)733-1883 


Company : PRUDENT TECHNOLOGIES 


Contact Name: SIVA JAMPAMA Phone: (402)733-1188 


Work Being Done For: EPA 

Depth of Excavation: 6FT Corner Lot: Y Front: Y Rear: Y 

Involves Tunneling or Horizontal Boring : N Explosives: N 

CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 

Service Area 

Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC lElDl Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY

Alt: 

Emerg: 4025047970 

Day: 4024447197 


OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER 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://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/28/2010 
TEOHN l,INC CONSTHUCTION l lOLoams, SOLUTIONS 

SITE SAFETY HAZARD ANALYSIS 

Address: --../^L-^-v:«L-^>.ltl Excavation Date: 

Crew: Backfill Date: 

Item Condition Hazards Corrective Action 

Overhead Lines CP(<-

Gas Line e^ 

Water Line (h^' Sewer Line y j 

Septic/Leech 

Field 

Propane/Butane - — 

Sidewalk ore-

Foundation a/'^ 

Retaining Walls —— 

Fences pcc ^ 

Trees CP«^ 

Structures tr ^ 

Driveway o^— 

Sprinkler System 

Other ____ ^ 

Crew Foreman Site Safety Office 

Date: 

o n VtfaRfVarfcany. St«to4(» seoosiost 4242 Medical Drive, Suit* 7250 

lama* Gtty; M044114 Ontitek NelifaAka «8t07 San Antonio, TX 78229 

iKMia; (81<) 363i^37B3 Phono: {402)733-1138 Phone: (2t0) 82Z-«588 

ax: (Vn) 363-4T07 i=te: 4402)733^1083 Fax: (210) «T«-65n 
IU)lO e^PRAaue Sr 

IZ/9/2oio