TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: l41g^ Q Date: ^ | ^^T 

Address: ^6 7 <^^ ^ ' ? 7 ^ Y 

Reinediation Contractor. ?iriAAjU\i XlliW \X\L Year: ^ ^ ^ ^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

2l Video ofproperty (DVD) 

E Executive Stammary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

D Signed Access Agreeinent(s) for adjacent property 

ffl Restoration A^eemen t 

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

ffl Confirmation di^t?i 

lil Photographs 

d As-built sketch 

QD Satisfectory restoration signed by Property Owner 

IE Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleantip criteria 

Utility clearances 

Property information firom Douglas County Assessor's Office 

D 

D 

D 

\oA't­ ^ > ^ 

Signattge Date 

30260962 

Superfunci 
Find Record Remediation Query I Lead Remaining Query I Property Damage Query 

Backfill: 

Sampie Area: 14649 - 3025 S 32 ST 

Owner: Resident: Contract: 

n Owner Occupied Resident Name: Contractor: t Owner Name: [GLENN DOROTHY J [PRUDENT2009_S 

JBOSHART MATTHEW J Property Address: Contract Option 

Owner Addressi: [3025 S 32 ST OPTION 3 

Zip Code: 

Owner Address2: [68105 Assessnient: 

[3025 S 32 ST Resident Phone 

City: State: ZipCode: Qualifying Group I 

jOMAHA JNE [68105 400 •y'-^-i 

Owner Phone: Aitemate Phone: Assessment Max XRF Vaiue: 1 I 782.57 

% 
^ 

PROPERTY SUMMARY 

Date:g^/15/2010 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 T0#1 | Month of: hfa {J 

Property Address: 3025 S 32 ST 

A EXECUTIVE SUMMARY 

A.l Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: AREA NOT EXCAVATED PER P.O. REQUEST; Bl/LS (10'X200 = 60 

PPM @ SCRAPE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Fl = 80 PPM @ 6"; Bl = 82 PPM @ 6"; EA = 103 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 fmal 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 (ifany are made with the property ovvner) 

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. 
TECHNOLOGIES, INC. 

Property #: }4iD^' 7 

Date/Time: 

Quads Excavated: ^ \/ f- \ 

£ \ . 

*mmW. F ^ 

EPA Property Close Out 

Property Address: ^ChlS" ^ •^' ^ -^' 

Owner'sName: AAa."\V So'^f V 

Contractor Group: Prudent Technologies, Inc., 

Excavation General Yes No 

I. If necessary, were the correct quadrant(s) e.xcavated and reslored? / 

2, If necessary were the correct areas ofdrip 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 Vliai were excavated? ^ 

3. Does tlie sod appear to be generally healtliy and growing? (Only evaluale if inspecied at a 30 

day lime period) • 

4. Are sodded areas generally finn and evenly graded? • 

5. Are llie joints between tlie sod strips generally light? (Only evaluale if inspecied at a 30 day 

lime period) Z' 

6. Was the propert}' graded such that water will nol pool on the property? i / 

7. Was daniage lo landscaping or plant materials avoided? • 

Gates, Fences and Retaining Walls Ves No 

1. Do gates open and close freely? (If applicable) t^ 

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

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

4. Was damage to relaining walls avoided? (Ifapplicable) y 

Foundation, Siding and Gutters Yes No 

1. Was damage to the siding or uim avoided? y 

2. Was damage to the foundalion avoided? /^ 

3. Was damage to windows avoided? /" 

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

5. Was damage lo downspouts or downspout extensions avoided? 

y 

Sidewallvs and Driveways (Concrete) Yes No 

1. W;is damage lo driveway surfaces avoided? y 

2. Was damage lo walkway surfaces avoided? y 
,3o^5 5 3-^ £t 

Owners comments: 

Inspection notes: 

^ttiLeo Snou t CcnIilTIOVi f^f ' 

DuM.p ikt ePBckse-oniRemoval and restoration activates complete including the 30-day sod warranty: 

EPA Representative "'^ ^ Date: //^»/<b 
^ 

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 ofthe 

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: < Jj^ ^ 

Owner: ^/ ^ (bX^bM m, t 

Phone: '39~XS073 f^C.hA4^( (Jj-^) 2p-/>ff^^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

/ 

3 Ho6k ^m ^ ujolut-fliAJCs fr/iuliMl ^i^k / 

\X\ I agree restoration is completed. 

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

':^tl '- f7-07 

Owner's Signature Date 

I
• • 

TECHNOLOGIES, INC. 

Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up Icadajnlaminajtd .soils at a niimbM ofproperties locaied in Omaha, Nebraska, including the property located al 

ti^Siff ^ I O ^ S' ' ^ ^ ^f^ requests your pemiission to allow Prudent to perform a soil cleanup al this 

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

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

Ifyouhaveany questions about lhe soil cleanup planned for your property, please contact Prudent's ',.ir.!.i!'.'..-i'..ii-.\. ;. :.-,!. forthe 

Omaha Lead Site cleanup, .'.i^ ^.•\J > .•.:,i:;\:j.i:: at (402) '^-ll^^s. General questions aboul the Omaha Lead Site cleanup can be 

directed lo the EPA Public Information Centers at (402) 731-3045 (South Omaha otBce) or (402) 991-9583 (North Omaha office). 

Property Access Granied By 

(Please Print Name) 

Property Owner Signature: 

(Signature) Pate) 

PROPERTY INFORIVIATION 

(T property owner — please print) jToo bbcc complete completedd bbyy residen residentt and/o and/orr [ 

RESIDENT NAME: Owner Renter 

RESIDENT ADDRESS 

^o^b 6, 3 Z S^-

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

^a/Hd 

OWNER'S TELEPHONE NUMBER - HOME: l^^^ ) 7. ^^OC ^ WORK 

y 

AGE OF HOME?.31_ YEARS. HOW LONG HAVE YOU LIVED HERE? ' ^ YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978?' YES 

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


NUMBE UMI R 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.) 

AUTHOkl'f Y I'OR ENVERONMBN'l'AL RliSPONSE 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(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 otiierwise enforcing the provisions ofthe title." 

8080 Ward Parkway. Suite 406 5600 S i[)'" Streel 4242 Wledic.Tl Drive, Suite 4250 

Kansas City. MO 64114 0~aha. 'Mobraska 58107 S.^n Antonio. TX 78229 

Phone; (816)363-3703 Phono: ••4021733 -i^SS Phone: (210) 822-9588 

ra.v: (816) 363-.'?707 (-".IX (402'i ~33 -'.an.-'. Fax: (210) 579-6577 
• • 

• •-,!" , 

TECHNOLOGIES, SNC. 

Property Status Form 

Address: 3^36 ' £, Z d^ ^/ - Date: /^/PL^/^ 9 

Phone: ^^^ ^ ^97 " Q<Po>6> BVID: /J/^^ 9 

Plants & Permanent Landscaping 

Item # 

On Map Description and Location 

Z^,^ reiMioiy/se.J^^^^' 

Pre-Existing Condition of Structures 

Does yeur Basement have a history of leaking? Yes — No 

Item# 

On Map 

Description & Location 

ff?. ­ Urcicks //i^ dtii^uOctjy Cs£>iyM) 

Property Ovvner Prudent Emploj^ee 

Signature: X^J IL . ff Signature: trt^/^/l26^^'0/V.^ 
# 

rUHMilXKHES. INC, 

AS - BUILT DRAWING 

()1,.S#: 14649 

Date KMiivuUd: M/(J3/2(Mt9 

l8EI>.\Siam(l-01TI)atci OMAHA LEAD SUPERFUND SITE 

14649 

Omaha Exterior Paint Nortti Arrow Lead Site Owner Name: DOf=tOTHY J GLENN • Good 

Address: 3025 8 32 ST Site Sketch ^ • Poor Phone: H: 402-341-2011 W; [3^0 1 paint 

Lead Sample Samples Collected Sample Number LAB Concentration Collected Firm: a J Jt^ - Ty^' i 

RYASCPXA-14649 F1 •7^3 ppm D Date: 4 / S-'^'H 

RYBSCPXA-14649 F2 ppm a Time: Of^l -

RYCSCPXA-14649 81 j-^ - ppm n Samples Analyzed RYDSCPXA-14649 82 ppm n 

RDZSCPXA-U649 DZ 3 7 ^ ppm D XRF Unit: ^''^- ' Book: ^"^ ^ 

Ra2SGPXA=t462ra- ppm D D Date: 7/^-^^ ^

RP2SePXA^T2re?S •PT^ ppm D D Time: 4 ^ 

Staff: ^PsT'yyp Number of Samples = S ~ O 

ENTERED • ^ < -

JUN I 6 p i 

ii i - S2 I'l'M a 6" L-a.i^ ; 

Omaha I.,ead Site 45130 

CONTRACT #: EP - R7-07-06 T0#1 PRUDENTTECHNOLOGIES, INC. 
14649 

Omaha Lead Site 46130 
?02^S 32 ST 

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• • • • 

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Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 

2 

Owner 

City 

Owner 

State 

Owner 

Zip 

Sec-TwnRng 

1410080000 

BOSHART 

MAI IHEWJ 

3025 S 32 ST 

OMAHA 

68105 

3025 S 32 ST 

OMAHA 

NE 

68105 

33-15-13 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Acres 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

ILER ADD 

8 

6 

S 42.3 FT 

42.3X115.4 

0.1 

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

parc=1410080000 

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

accountno=R1410080000 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 9/17/2009 
• • 

Page 1 of 2 

"> 

E ae 

. YOUR TICKET NUMBER IS 2394405. 

Original Call Date: 10/27/09 Time: 9:19 am Op: SIVA18967 


Work to Begin Date: 10/29/09 Time: 9:45 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3025 Street: S 32ND ST 


Twp: 15N Rng: 13E Sect-Qtr: 33-NW 


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 


CXCATV MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITYOFOMAHA-TRAFFICSEWER RICH/TRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

0PPDGPR6 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 
• • 

Page 2 of 2 

Day: 4067289343 

QLNNE 1F QWEST LOCAL NETWORK NA Alt: 4062071494 

Emerg: 8887289343 
TECHNOLOGiES, iNC. 

(1) 

.Add ress: ^oA S S 3; i ^sf- Lx. 

L-rew: 8f. 

Date: / c ^50 ^ 

••:. . . . . l : 

0\erhead LB nes - ^ C^OCJ P i^o/J>/>J^ 

Gas Line Ax j>-'e J f-l/f^J /ef^:y~>e 

\\ ater Line 4­ .Sewer Line •O^r. e\J :/^»»^/^gv^ ^ 

Septic / Leech 

field yu- ^ 

Propane/Butane _^ld_ 

Sidewalk Cc i 05"'=' p/yc*A:>-^ 

Foundation r-C'iA 

Retaining W aiSs -/•c-j* ^ 

Fences 4L 

Trees Bushes ^li.y ^ 

Struciuies y> 

Drivewav b - ^ L^S^ _^i/c=.^^ 

St)finkler Systeni : /C^ 

Other 

Crew ForernrsJi Site S/)fer\- Officer 

yyyyL^y.. 

:!0;-;! v\;a:;; ••r^<\ 

i;;;nss3 C;iy. i.'' 

"lions : : 3 li-, :••. 


• ^3U ^