TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: Jtil£iL _ Date: jO/(t/2>o<o 

Address] SM-^1 O Str 

Remediation Contractor: R?f ? rypp'i'j Wr-W rattxioOi i^<^^ /A;<2-'; Year: "^.rOlQ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCXOMENTS 

\/ Video of property (DVD) 

y Exectitive Stammary 

a EPA-provided property sketch 

H Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

[? Restoration Agreement 

Q Settlement doctiments (i.e., for damage or to replace plants, etc.) 

iZ Confirmation data 

a Photographs 

ta As-built sketch 

0 Satisfactory restoration signed by Property Owner 

\ j Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

ffi Utility clearances 

\£ Property information from Douglas Covmty Assessor's Office 

D '. 

D 

D 

Signature Date 

30260763 

•ill 

Superfund 
PROPERTY SUMMARY 

Date: 10/15/2010 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Month of: October 

Property Address: 3439 U 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 = 91 PPM @ 8"; DZ = 86 PPM @ 12"; EA = 118 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) Docuraentation - 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 fiie, if available, 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 

Backfill: 

Sample Area: 46904 - 3439 U ST 

Owner: 

n Owner Occupied 

Owner Name: 

JWILLIAMS KENNETH D 

Owner Addressi: 

r 

Owner Address2: 

|3439 U ST 

City: State: Zip Code: 

JOMAHA NE )68107-

Owner Phone Alternate Phone: 

j(402) 734-7169 (402) 510-9129 

Contract: 

Contractor: PRUDENT_2010_S 

Contract Option BASE 

Remediation Query j Lead Remaining Query Property Damage Query j

User Provided Owner Information 

Owner Name: 

1 

Owner Address: 

1 

City: State: Zip Code: 

1 1 1 

Owner Phone: Alternate Phone: 

' ' 

Assessment: 

Qualifying Group 400 

Assessment Max XRF Value f 477.32 

Resident: 

Resident Name: 

JWILLIAMS KENNETH D 

Property Address: 

|3439 U ST 

ZipCode: 

)68107-

Resident Phone 

1 
TECHNOLOGIES, INC. 

" 1STIFS».1 I « I 

EPA Property Close Out 

Property #: 40.^^) ^ 

Property Address: '^M^^^ 0 9VDate/Time: 

Owner'sName: |Cen*-ve4-K L0;\Ua.vA'7 

Quads Excavated: '\)'2. i ^ ^ 

Contractor Group: Prudent Technologies, Inc., 

E.vcavation General Yes No 

I. If necessary, were the correcl quadrant(s) excavated and restored? 

u^ 

2. If necessar>'. were the correct areas of drip zone excavated and restored? 

y 

Grading Sod and Vegetation 

Yes yo 

1. Does the grading around the perimeter of the house in excavated areas generally slope away 

from the house? 

y^ y . 

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

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

lime period) 

6, Was the propert},' graded such tliat water will not pool on die property? 

Was damage lo landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls 

Yes No 

1. Do gales open and close freely? (Ifapplicable) L^^ 

Were all gales or fences taken down during restoration activities reinstalled? (Ifapplicable) zzy 

Was damage to gates or fences avoided? (If applieable) 

, y ­

4. Was damage 10 retaining walls avoided? (Ifapplicable) 

Foundation, Siding and Gutters 

Yes ^ti 

1. Was damage lo the siding or trim avoided? 'zy 

Was damage lo tlie foundation avoided? 

3. Was damage to windows avoided? y 

4. Was damage lo windows or door screens avoided? 

Was damage to downspouts or downspout extensions avoided? ly 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage lo driveway surfaces avoided? y. 2.

 Was damage to walkway surfaces avoided? 
Owners comments: 1 

Inspection notes: 

Removal and restoration activates com ng the 30-day sod warranty: 

F) j^i^-mlyn 

EPA Representative K^f^t^ 
:CHNOLO(JIES. INC. 

AS - BUILT DRAWING 

OLS # 46904 

Date Excavated: 08/18/2010 

USEPA .Signed-Off Date: OMAHA LEAD SUPERFUND SITE 

Name-. Ke.-i/lfili ICJ-l ^ Omaha Lead Site Date; _f North Arrow 

Address: .3^.^ 9 Site SIcetch Time: _ 

Phone: 

u. ^ 

Omaha Lead Site 46130 E.\ = 118 PPM fa SCRAPE 

CONTRACr #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
SEPA 

Property Completion Agreement 

This agreement doctmients 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 future, excluding any 

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

Property BD: 

Property Address: " ^ y ^ c> \ J £ t— 

Owner: \c^rs^ . ^ l^^ : 11 .^^->v^^. 

Phone: 

Restoration Items in Question: 

Item: 

item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

F 

 I I agree restoration is completed. 

do not agree restoration Is completed at (noted deficiencies above) 

Owner's Signature J 7 Date 

I
Prudeni Technologies. Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up leadcontaminated soils at a number of properties located in Omaha, Nebraska, including the property located at 

jL^^ ^ ^ .St~ • . The EPA requests your permission to allovk' Prudent to perform a soil cleanup at this 

property to remove lead-contaminated soil. By signing this form, the property owner grants permission to Prudent to perform 

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

Ifyou have any questions about the soil cleanup planned for your property, please contact Prudent Souih Oniaha Ol'ficc for the Omaha 

Lead Site cleanup,_at (402) 733-1188; 733-1455. General questions about the Omaha Lead Site cleanup can be directed to the EPA 

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

Property Access Granted By; 

1 (Pliase Print Name) 

Property Owner Signature: 

I (Signature) ( I 

PROPERTY INFORMATION 

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

RESIDENT NAME: Renter 

RESIDENT ADDRESS: 

3Ma.q— U SL y^y^^y AkjJ>. K^e _^Slo 7 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

OWNER'S TELEPHONE NUMBER - HOME: J _ WORK: _L 

AGE OF HOME?: Ifi ^ YEARS. HOW LONG HAVE YOU LIVED HERE? ^-> y YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? t^^E S NO 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: _ I NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER 

IM. 

_51 

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 under this agreement 

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

8080 Ward Parkway, Suite 405 5600 5.10'" Street 4242 Medical Drive, Suite 4250 

KansasCity, MO 64114 Omaha, Nebraska 68107 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)733-1455 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)733-1883 Fax: (210) 579-6577 
ENVIRGMMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address:

Phone: 

3 H S '^ U Sj ­ '^^*^" ^ '

BVID: 

"^ / ' ^ 

.g>^/~aJ? ^h„ ^ 

O U-A.-

o^-xi..^JI 

' ^ \ CU) 

S&u4iv 1^6 pla^^- c 

- !

WJIS^* ' 

^ 

i (,^ 

PR E ­ ByX g>h">VA

^ 

t-^e&h

 I ) QLW/Vft. ^ y

^ 

 Ul^oJUcL-tAa 

s 

LoLrqe^ dracoes ' 

Property Owner . Prudent Employee 

/signature: /(jhAjJ ^ ^/C^!^C<g»-^ Signature: 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

KansasCity, MO64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone:(816)363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fax:(210)579-6577 
Name: Ke/i/l e.iJi O u/'llic^j-ij, Omaha Lead Site Date: ^L s j Ol North Arrow —i 

Address: .iH:^9 U .^1 Site Sicetch Time: ~^nsz^^, Phone: iTeam ^AAVLfe.ljiv(^fa|(^.t;. BviD#_M ^ XRF Code ffi»Q9^ 

Sample Number Lead Concentration Confirmation Sampl 

1 f^jYes n femn ^ 2 pjYes D 

4 

3 ^S m p m TIL ^ Yes a 

5 t)'yDQiP)ci\ 

6 ppm 'es • 

7 ppm Yes • 

u. ^r-

OmaK a T PCIH ^JT P 46130 
Page 1 of 1 

in? 1 

3^3^ 0 5/­

http://douglasne.mapping-online.com/assessdoc/Photos/36/R22484000000001.jpg 6/14/2010 
Print Preview Page 1 of2 

Douglas County-Omaha, NE 

fc,.,.tUi«»4 iiSimBKH 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 

2 

Owner 

City 

Owner 

State 

Owner 

Zip 

Sec-TwnRng 

2248400000 

WILLIAMS 

KENNETH D 

3439 U ST 

OMAHA 

68107 

3439 U ST 

OMAHA 

NE 

68107 

09-14-13 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Acres 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

SU LLI VANS ADD TO SO OMAHA 

0 

45 

LTS 44 & 

80X100 

0.19 

http://webapps.dotcomm.org:8080rrreasTax/faces/pages/taxinfo.jsp? 

parc=2248400000 

http://douglasne.mappingonline.com/DouglasCoNe/static/accountinfo.jsp? 

accountno=R2248400000 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 6/15/2010 
Create Another Ticket: I: Back to^F;Internet 

YOUR TICKET NUMBER IS  2563796. 

Original Call Date: 8/09/10 Time: 3:18 pm Op: SIVA18967 


Work to Begin Date; 8/11/10 Time: 3:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address : 3439 Street: U ST. 


Twp: Rng: Sect-Qtr: 


Twp: Rng; Sect-Qtr: 


Legal Given: C 


Type of Work: Lead Soil Remediation 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 E xcavation: 6 FT Corner Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


ABBBLAIR ABBOMP ALT872 ATTNEBRl ATTNEBR2 BCBSNE BELLEVUE 


BHEIC BOYSTOWN BSHPCLKS CHILHOSPP CRGHTON CXCATV DCEMA 


DIGITEL DOCOINFS ENERGY FEDAIRP GALAXCTV GPCJF GPFD 


GPFDN HITEC KIMCO LANQDEV LAVISTA LEVEL3 


MAGELLANP MCINEB METHODIS METRO MMPCAN MUDOl MUD02 


MUD03 MUD04 MUD05 MUD06 NEORTHO NNGOl OMAAIRP 


OMADl OMAHACOF OPPDGPRl 0PPDGPR2 0PPDGPR3 0PPDGPR4 


0PPDGPR5 0PPDGPR6 OWWCl PAETEC PINPOINT PMRNRDWA QLNNEIA 


QLNNEIB QLNNEIC QLNNEID QLNNEIE QLNNEIF QWESTNE RLSTNl 


ROYALOAKS SID206 SID244 SID294 SID295 SID337 SID354 


SID359 SID365 SID373 SID380 SID388 SID397 SID415 


SID421 SID422DC1 SID431 SID432 SID437 SID439 


SID460 SID482 SID494 SID504 SPRINTNE TENASKl UNITE 


UNITEOM UNO02 UNOTEL WESTCO 


Utility Service Area Contact Phone Number Type 

Day: 4024266230 


AMERICAN BROADBAND- ABBBLAIR Alt: 4024266200 NE, CATV,TELE,FIB 

Emerg: 4024498646 


Day: 4024266230 


AMERICAN BROADBAND- ABBOMP Alt: 4024266200 NE. CATV.TELE-FIB 

dhon.org/irthinternet/.../MessageTextas... 1/10 
Emerg: 4024498646 

ALT872 WINDSTREAM 

COMMUNICATION ELM LOCATING 

Day: 4067289343 

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Emerg: 8887289343 

ATTNEBRl ATT/T 

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Alt: 

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ArmEBR2 AT T 

Day: 80024136249 

Alt: 

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BCBSNE BLUE CROSS BLUE SHIELD 

OF NEBRASKA 

Day: 8888474757 

Alt: 

Emerg: 8888474757 

BELLEVUE CITY OF BELLEVUE JIM 

Day: 4022933042 

Ah: 4022933025 

Emerg: 4025934111 

BHEIC BLACK HILLS ENERGY 

Day:

Ah: 

 8006948989 

Emerg: 8006948989 

BOYSTOWN BOYS TOWN JOHN KAVA 

Day: 4029817231 

Ah: 

Emerg: 4029817211 

BSHPCLKS NEBRASKA HEALTH 

SYSTEM NA 

Day: 4025523460 

Ah: 4025523347 

Emerg: 4025595111 

CHILHOSPP CHILHOSPP Consolidated Utility 

Services 

Day: 8888474757 

Ah: 

Emerg: 8888474757 

CRGHTON CREIGHTON UNIVERSITY DAVE MCATEE 

Day: 4022802780 

Ah: 4025101995 

Emerg: 7125454616 

Day: 4029340469 

dhon.org/irthinternet/.../MessageText.as... 2/10 
8/9/2010 ^ittp://www.dhon.org/irthinternet/DHO.. 

CXCATV INC TM^ ^ 

DCEMA 

DIGITEL 

DOUGLAS COUNTY 

EMERGENCY MGT 

AGENCY 

LIGHTCOREA 

CENTURYLINK COMPANY NA 

T^nrnnjT:<i

UUL.UIN t b

 DOUGLAS COUNTY 

 INFORMATION SERVICES ^^ ^ 

ENERGY ENERGY SYSTEMS CO DAVE WOODS 

FEDAIRP FEDERAL AIRPORT 

AUTHORITY CARL WOODS 

GALAXCTV GALAXY CABLEVISION MARSHA 

GPCJF GREAT PLAINS 

COMMUNICATION PATTY 

GPFD FIRST DATA RESOURCES 

GPFDN FIRST DATA RESOURCES 

HITEC m-TEC TOWERS, INC. RODVANSLYKE 

Ah: 4029340469 


Emerg: 4029329757 


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Ah: 


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Day: 4023469066 


Ah: 4023469128 


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Day: 4022717520 


Ah: 


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Day: 4023623334 


Ah: 4023661415 


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Ah: 


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Day: 8888474757 


Ah: 


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Day: 4027405619 


Ah: 4022506209 


Emerg: 4022506209 


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8/9/2010 ^fcittp://www.dhon.org/irthinternet/DHO.. 

KIMCO KMCO STREET LIGHTING TIM 

LANQDEV LANOHA Q 

DEVELOPEMENT INC KRIS 

LAVISTA CITY OF LAVISTA JEFF 

LEVEL3 LEVEL3 

COMMUNICATIONS, LLC NA 

,,.^^.TAXTD MAGELLANP MAGELLAN MIDSTREAM ^^^^^ ^ ^,^^0^^. ^ DEBORAH 

MCINEB MCI NO CALL PER 

MEMO 

METHODIS METHODIST HEALTH 

SYSTEMS 

METRO METRO COMM. COLLEGE CHRIS 

MMPCAN MAGELLAN MIDSTREAM MAGELLAN 

MAGELLAN 

MUDOl METROPOLITAN UTTLITTES 

DISTRICT SANDY 

MUD02 METROPOLITAN UTTLITTES 

DISTRICT 

SANDY 

Day: 4023064960 

Ah: 4028968008 

Emerg: 4023064960 

Day: 4022895528 

Ah: 

Emerg: 4023064960 


Day: 4023314343 


Ah: 4023318927 


Emerg: 4023311353 


Day: 8773668344 


Ah: 


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Day: 9185747098 


Ah: 


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Day: 8002893427 


Ah: 


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Day: 8888474757 


Ah: 


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Day: 4024572307 


Ah: 4026727033 


Emerg: 4024572313 


Day: 


Ah: 


Emerg: 


Day: 4025047823 


Ah: 


Emerg: 4025047970 


Day: 4025047823 


Ah: 


Emerg: 4025047970 

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MUD03 

MUD04 

MUD05 

MUD06 

NEORTHO 

NNGOl 

OMAAIRP 

OMADl 

OMAHACOF 

OPPDGPRl 

_ _^__ _ . 0PPDGPR2

METROPOLITAN UTTLITTES 

DISTRICT 

METROPOLITAN UTTLITTES 

DISTRICT 

METROPOLITAN UTlLmES 

DISTRICT 

METROPOLITAN UTTLITTES 

DISTRICT 

NEBRASKA 

ORTHOPAEDIC HOSPITAL 

NORTHERN NATURAL 

GAS CO 

OMAHA AIRPORT 

AUTHORITY 

OMAHA DOOR AND 

WINDOW INC 

CITY OF OMAHATRAFFICSEWER 

OMAIL\ PUBLIC POWER 

DISTRICT 

 OMAHA PUBLIC POWER

SANDY 

SANDY 

SANDY 

SANDY 

NA 

TOM SWANEK 

NA 

RICHTRAFFIC 

ELM LOCATING 

 „^. . _ n r ATTxrr^ ELM LOCATING 

Day: 4025047823 


Ah: 


Emerg: 4025047970 


Day: 4025047823 


Ah: 


Emerg: 4025047970 


Day: 4025047823 


Ah: 


Emerg: 4025047970 


Day: 4025047823 


Ah: 


Emerg: 4025047970 


Day: 4028815784 


Ah: 3214464828 


Emerg: 3214464828 


Day: 8883676671 


Ah: 4023987773 


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Day: 4026618050 


Ah: 4024228100 


Emerg: 4026618200 


Day: 4027336440 


Ah: 4027342148 


Emerg: 4025586304 


Day: 4024447197 


Ah: 4024445161 


Emerg: 4024445160 


Day: 4067289343 


Ah: 4062071494 


Emerg: 8887289343 


Day: 4067289343 


Ah: 4062071494 


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Emerg: 8887289343 

0PPDGPR3 0'^P"«" C

DIS IRIC 1 

 POWER ^L M LOCATING 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

0PPDGPR4 0'^;^"C''0* ^

DIS IKIC 1 

 ELM LOCATING 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

0PPDGPR5 O'^.,^TM"^''^ ^

DIS IRIC 1 

 ELM LOCATING 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

0PPDGPR6 OMAHA PUBLIC POWER 

DISTRICT ELM LOCATING 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

OWWCl OMAHA WORLD HERALD 

COMPANY 

Day: 4024443169 

Ah: 

Emerg: 4024443169 

PAETEC PAETEC 

COMMUNICAHONS 

NO NEED TO CALL 

OUT EMERGENCY 

Day: 8002891901 

Ah: 

Emerg: 8002891901 

PINPOINT PINPOINT 

COMMUNICAHONS INC 

Day: 8888474757 

Ah: 

Emerg: 8888474757 

PMRNRDWA PAPIO-MISSOURI NRD MARTY THIEMAN 

Day: 4024446222 

Ah: 4026694826 

Emerg: 4024969026 

QLNNEIA QWEST LOCAL NETWORK ELM LOCATING 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

QLNNEIB QWEST LOCAL NETWORK ELM LOCATING 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

dhon.org/irthinternet/.../MessageText.as.. 6/10 
8/9/2010 

QLNNEIC 

(ittp://www.dhon.org/irthinternet/DHO... 

QWEST LOCATNETWOR N K ELM LOCATING Ah: 4062071494 

Emerg: 8887289343 

QLNNEID QWEST LOCAL NETWORK ELM LOC ATTN G 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

QLNNEIE QWEST LOCAL NETWORK ELM LOCATING 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

QLNNEIF QWEST LOCAL NETWORK ELM LOCATING 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

QWESTNE QWEST LONG DISTANCE 

Day: 8002834237 

Ah: 

Emerg: 8002834237 

RLSTNl CITY OF RALSTON DAN 

Day: 4023314118 

Ah: 4026992774 

Emerg: 4026573551 

ROYALOAKS ROYAL OAKS/HOUSE OF 

HOPE 

Day: 4028276000 

Ah: 4028276060 

Emerg: 4028276019 

SID206 SID206 DOUGLAS 

COUNTY 

LAMP RYNEARSON 

OETKEN 

Day: 

Ah: 

4024962498 

Emerg: 4026726070 

SID244 

SID 244 CHIMNEY 

RIDGETLAKEVIEW 

HEIGHTS 

LAMP RYNEARSON 

OETXEN 

Day: 4024962498 

Ah: 

Emerg: 4026726070 

SID294 SID 294 BROOKHAVEN LARRY DENTON 

Day: 4028954700 

Ah: 4026908304 

Emerg: 4025103436 

SID295 SED 295 TURTLE CREEK CHARLIE RIGGS 

Day: 4023308860 

Ah: 4026775204 

Emerg: 4026775204 

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SID337 

SID354 

SID359 

SID365 

SID373 

SID380 

SID388 

SID397 

SID415 

SID421 

SID422DC1 

SID 337 NELSONS CREEK 

SID 354 AUTUMN RIDGE 

SID 359 OAKBROOK 

MEADOWS 

SID 365 EAGLE RUN WEST 

SID 373 WOODBRIDGE 

SID 380 CHERRY RIDGE 

SID388 DOUGLAS 

COUNTY 

SID 397 LINDEN ESTATES 

2ND ADDIHON 

SID 415 WESTTN HILLS 

SID421 HILLSBOROUGH 

ESTATES 

SID 422 OF DOUGLAS 

COUNTY 

LAMP RYNEARSON 

OETKEN 

LAMP RYNEARSON 

OETKEN 

LARRY DENTON 

LAMP RYNEARSON 

OETKEN 

LAMP RYNEARSON 

OETXEN 

LARRY DENTON 

CHARLIE RIGGS 

LAMP RYNEARSON 

OETKEN 

LARRY DENTON 

DOUGLAS 

DREESSEN 

' Day: 4024962498 


Ah: 


Emerg: 4026726070 


Day: 4024962498 


Ah: 


Emerg: 4026726070 


Day: 4028954700 


Ah: 4026908304 


Emerg: 4025103436 


Day: 4024962498 


Ah: 


Emerg: 4026726070 


Day: 4024962498 


Ah: 


Emerg: 4026726070 


Day: 4028954700 


Ah: 4026908304 


Emerg: 4025103436 


Day: 4023308860 


Ah: 4026775204 


Emerg: 4026775204 


Day: 4024962498 


Ah: 


Emerg: 4026726070 


Day: 4028954700 


Ah: 4026908304 


Emerg: 4025103436 


Day: 


Ah: 


Emerg: 


Day: 4023342400 


Ah: 


Emerg: 4029600603 


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SID431 

SID432 

SID437 

SID439 

SID460 

SID482 

SID494 

SID504 

SPRINTNE 

TEN ASK 1

UNITE 

SID 431 AUTUMN GROVE

SID432 DOUGLAS 

COUNTY 

SID 437 QUAIL HOLLOW

SID 439 WEST BAY 

WOODS 

SED 460 WHISPERING 

HILLS 

SID 482 STANDING BEAR 

WEST 

SID494 GREEN MEADOWS 

ADDIHON 

SID 504 SPRINGBROOK 

SPRINT 

COMMUNICAHONS CO 

 TEN ASKA INC 

UNITE PRFVATE 

NETWORK 

 LARRY DENTON 

CHARLIE RIGGS 

 CHARLIE RIGGS 

LARRY DENTON 

CHARLIE RIGGS 

LARRY DENTON 

GERALD 

LARRY DENTON 

Day: 4028954700 


Ah: 4026908304 


Emerg: 4025103436 


Day: 4023308860 


Ah: 4026775204 


Emerg: 4026775204 


Day: 4023308860 


Ah: 4026775204 


Emerg: 4026775204 


Day: 4028954700 


Ah: 4026908304 


Emerg: 4025103436 


Day: 4023308860 


Ah: 4026775204 


Emerg: 4026775204 


Day: 4028954700 


Ah: 4026908304 


Emerg: 4025103436 


Day: 4024933378 


Ah: 4026508900 


Emerg: 4024969160 


Day: 4028954700 


Ah: 4026908304 


Emerg: 4025103436 


Day: 8005210579 


Ah: 


Emerg: 8005210579 


Day: 8888474757 


Ah: 


Emerg: 8888474757 


Day: 4023040237 


RICH HESTER 
 Ah: 4026174787 


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UNITEOM 

UNO02 

UNOTEL 

WESTCO 

UNITE PRIVATE 

NETWORKS LLC - OMAHA 

UNrVERSITY OF 

NEBRASKA AT OMAHA 

UNIVERSITY OF 

NEBR/OMAHA 

WEST CORPORAHON 

ELM LOCATING 

URSULA 

ANDREW TAYLOR 

Emerg: 4023040237 


Day: 4067289343 


Ah; 4062071494 


Emerg: 8887289343 


Day: 4025543600 


Ah: 


Emerg: 4025543739 


Day: 4025543599 


Ah: 4025543036 


Emerg: 4025542648 


Day: 8888474757 


Ah: 


Emerg: 8888474757 

dhon.org/irthinternet/.../MessageText.as... 10/10 
TEBHNOLOOIES, INC 

ENVIRONMENTAL 

ENGINEERING AND 

CONSTRUCTION 

SOLUTIONS 

SITE SAFETY HAZARD ANALYSIS 

Address: yjy.J - — 

J>\owv'^^^ Crew: 

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 

T^fr 

^(^ ^ 

•\aJ 

aoo<7 

lyj/h 

IV//1 

%HSlk<r^ 

I S 

^ / A 

Cj00<7 

C.tPcx) 

^-^ ^ 

"^^ ^ ^ToA-*^' 

i^ZA 

Excavation Date: -^J~LJf^ 

Backfill Date: 

Hazards Corrective Action 

Site Safety Office 

Date: 

.,^^^„..£^.e. . 

8080 VWaid l?ariany, Suile 405 5600 SIO St 4242 Medical Drive, Suite 7250 

Kansas City, MO 64114 Oniaha, Nebraska 68107 San Antonio, TX 78229 

Ptione: (816) 363-3703 

Fax: (816) 363-3707 

Phone: (402)733-1188 

Fax: (402)733-1883 

Phone: (210) 822r9588 

Fax:(210)579-6577 
61, D^ 

10- 9--a«/<5 ^