SOIL REMEDIATION FILE FOLDER 

SAID#: 37044 Date: 

Address: 5325 N 18 St 

Remediation Contractor: Environmental Restoration, LLC Year: _2011 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) JSaeioxQ D After D Basement D 

Executive Summary (Final Report) 

^y f EPA-provided property sketch 

y f Signed Access Agreement for subject property 

n Signed Access Agreement(s) for adjacent property 

y y Restoration Agreement 

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

yy ^ Confirmation data 

Photographs ^ f Before DCrew Photos jzf During Excavation D Sod 

j/sO-day Sod D 

As-built sketch 

Completion Agreement signed by Property Owner 

y Property close-out check list signed by EPA 

n Description of areas not meeting ROD cleanup criteria. Contamination left behind 

y y Utility clearances 

Property information from Douglas County Assessor's Office 

Property access checklist 

30262333 

y ( Contact Log 

• Superfund 

Envirormiental RestOTation Signature Date 

PA COR signatvire y Date 
EPA 

EPA Property Close Out Form 

Omaha Lead Site 

Property #: 37044 Property Address: 5325 N 18 St 

Date/Time: Owner's Name: PBM Asset 

Quads Excavated: B2 Contractor Group: Environmental Restoration (ER) 

Excavation General Yes No 

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

2. If necessary, were the correct areas of drip zone excavated and restored? A/IT 

Grading Sod and Vegetation Yes No 

1 / house? 

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

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? •-^ 

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

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

7. Was damage to landscaping or plant materials avoided? c y 

Gates, Fences and Retaining Walls Yes No 

1. Do gates open and close freely? (if applicable) 

2. Were all gates or fences taken down during restoration activities re-installed? (if applicable) 

3. Was damage to gates or fences avoided? (if applicable) l y 

4. Was damage to retaining walls avoided? (if applicable) tJHFoundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? 

2. Was damage to the foundation avoided? Jn^jiA.^ /b4­ 3. Was damage to windows avoided? hi 

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

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? f^^ 

2. Was damage to walkway surfaces avoided? ^ 

Inspection notes: 

Ckej^ s.d "> Spnnj t^i ^ 

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

EPA Representative: .^[t^Zy^y^/s'.H^.^J^j ^ Date: 

/y^/// 
OMAHA LEAD SITE — EP-R7-09-05 

ENVIRONMENTAL RESTORATION, LLC 

WWW.ERLLC.COM 

EXECUTIVE SUMMARY: 

37044 5325 N 18 St 

NO ISSUES OR CONCERNS ISSUES/CONCERNS 

DETAIL EXPLANATION: 
Ogden St 

N 5325 N 18 St iii 

Printed: Nov 22, 2011 A www.dcgis.org/dogis 
L\. X J. 1.—KJ AXV—KJK*l.l 

Diggers Hotline 

Of 

Nebraska 

Home Ticket 

Ticket Creation 

Create Another Ticket Go to Home Page Send Email 

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• YOUR TICKET NUMBER IS 2904915. 

Origina l Cal l Date : 11/18/1 1 Time : 8:3 2 am Op: TIM2418 6 

Work t o Begi n Date : 11/22/1 1 Time : 8:4 5 am 

State : NE County : DOUGLAS Place : OMAHA 

Address : 532 5 Street : N 18TH ST 

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

Twp: 16N Rng: 13E Sect-Qtr: 34-SW 

Legal Given: C 

Type of Work: LEAD REMOVAL 

Location of Work: LOCATE ENTIRE VACANT LOT 

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

: 37044 

Company : ENVIRONMENTAL RESTORATION 

Contact Name: TIM SUTTON 

Alt. Contact: CELL 

Phone:

Phone:

 (402)451-1314 x2267 

 (402)306-2347 i 

Work Being Done For: EPA 

Depth of Excavation: 24 INCHES Corner Lot: N Front: N Rear: N 

Involves Tunneling or Horizontal Boring : N Explosives: N 

MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 

Service Area 

Utility Service Area Name Contact Phone Numbers Code 

Type 

MUDOl 

METROPOLITAN UTILITIES SANDY MUDOl Day: (402) 504 - 7823 

DISTRICT Emerg: (402) 504 - 7970 

OMAHACOF CITY OF OMAHA- RICH/TRAFFIC Day: (402) 444 - 7197 

XDACITTI " CCVA/CD / ^ M A U A 

http://www.dhon.org/IRTHOneCall/Ticket/TicketCreation.aspx?ViewTicketID=898206 11/18/2011 
ENVIRONMENTAL 

RESTORATION 

Questions to answer at the house 

1 Does the map match the property? MgjS> 

2 Is there a doR? r\c:a 

3 Is there anything that need to be moved? like a car or boat?__{jO_ 

4 Does the property have easy access? \ i ^L5=> 

5 Is the property Easy, Normal or Hard? ^OSaS i 

6 If no. is there a property we can get access from?_ 

7 Is soil going to have to be shuttled out? CN Q 

8 Is the property all hand work? CX Q 

9 Is there a retaining wail? r\ o 

l b Is it in had shape? 

11 Is there under ground line to the garage? > \ 0 

12 Is there a sewer clean out? \\o> 

13 Isthereany hazards in the yard? P\f > 

14 Is the siding old on the house? H n V^pyjl^Ty 

15 Try to leave the time frame open when we will be there? (A Q 

16 If they need a notice Mark it big on the map. Try to leave it at a 24 hournotice only? 

17 What kind materials are need for replacement?. 

18 Is there zoysia grass at the property ( Red flag this property)? (iCN 

19 Is this property boarder line on routine? (\c> 

20 (s there sentimental item be aware of? Iv O 

21 Can we use the driveway? 

22 Is the property line marked in the excavation areas?. 

5'g"—U^;^rOi^$:i^uddb^ 
Contact Information Log 

SAfD# ^104U 

Gorrtouiik- TOfY^ 

Owner's Name: ^ P ^ ^ ^ ^^ . _ Ce(i / S^Q^ H'^ l QS^ s 

j Property Address: 5*^2 8 VA • ^5 ^ '^ Z 

Attempt to contact DateAime Name 

s-n-Tow ^tj\o T S 
PI ^perty Access Checklist 

SAID: -anO^l V D WORK STARTED ON: 

Property Address: S^Tf j * ^ V^ ^ «^ \ iD WORK COLMPELTED ON: 

0>vner:pfi ^ ^ ^ f^^r,,^CjC.r ^ Renter: 

Address Phone: 

Fax: 

Cell/Pager: 

Phone: (^ J Jf? f . O 5 g T "~~ Additional Information: 

Fax: 

L

Cell/Pager: 

K T Access Agreement Signed: S Il*f I \f By M ^ Restoration Agreement Signed: 5 / /'f/ if By 1 . ^ 

^

O^

 Video Property Before 

 Digital Photos Before 

^oyTKJWiL 

On x^^^nr 

By 

By 

ffel 

KK • Video Property .\fter On By 

n Digital Photos After On By 

1 ^ Property Completion Agreement Signed: jJr/Jc/J i By S ^ 

n Final Report Signed: / ! By 

Additional Video or Digital Photo's Taken: 

n Video n Digital Photo On : / ! B Y: 

Reason: 

n Video n Digital Photo On / / By: 

Reason: 

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

Reason: 

n Video n Digital Photo On / / By: 

Reason: 
Froni:402 435 0088 05 11 10:03 #701 P.001/004 


05/1J/201 1 THU >!5 2 PAX 

B003/006 


I- •.	 ( 

Consent for Access to Property SAID^r yiO|i ^ 

RfGHT Of E^^^^<Y TO PREMISES 

Grantor (the property owner), consents to and authorizes the Ujwted States Environmental 

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

and perform certain environmental response activities upon the following described premises; 

Owner'a Name; p g /V\ / H-^ -^ MiLy\^%^i^*y*^ * ^''*>'"" ^ ^ y^< ^ ~0O K \ 

Ad«r«i: 552 5 *^ - V^'^Si V 

Address: 

Addreisea of Propertku 

Addreu: covered by this 

Agre«mept: 

Address: 

Address'. 

PURPOSE OFlNVESnOATlON 

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

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

to 400 parts per million (ppm). 

REMEDXALAC170NS 

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

activities: 

a. Taking photogtaphs and/or video of the property before, during, and after remedial 

activities; 

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

enviroiunental response; 

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

d- Obtaining samples from Gramor's property; 

^0{t£EM^Nl' NOT TO l^rERf BRE 

The Grantor agrees not to interfere or tamper with any of the activities or work done, or the 

equipment used to perform ihe activities, or to undertake any actions regarding the use of said 

property which would tend to endanger (he health or welfare ofthe Grantees or the environment, 

ot to allow others to use the property in such 

CD I do not grant access to my properties to my properties 

Sigoature 

Date 

L/oa^ - ^Sl -lOG ^ 
JXl Check this box if owner does not want E.R. to enter the residents to document interior 

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

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

.01 agree n I do not agree 0^ agree CU I do not agree 

? 0 Tonjo r f o F<v.y pAfcfe t{ y^-^-\ ^ 

Owner's Signature Date 

1/jtJ-bA.l <t3|C 
Froni:402 435 0088 

05 J[^1 1 10:03 #701 p.002/004 05A9/201.1 THU J:5 2 PAX 

SlOOd/OO S 

( • 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of property prior to 

contractor activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction of die property owner and the United States Environmental 

Protection Agency (EPA). 

SAID: 2>lO»4«4 

Property Address; 5S)2 S Kx- ty^^ . Owner: 

Phone; 

On the attached diagram(») indicate area(s) to be excavated and depth of excavation, location of all knovm 

utilities, subsurface features, sur&ce stmctures and landscaping features, access locatioa(9) to be used by 

contractor, and the direction of North, fadicate distances, depths, material types, etc. Indicate digftal photos 

by referencing the photo-log number wWi an arrow indioatmg direction of view. 

Items lo be removed by Contreetor and not f«ptac«d: 

I Item: "^ " --———^—— — 

Item: 

Item: 

litem: 

Item: 

Item: 

Item: 

Page 1 of 2 
Froiii:402 435 0088 05f[^1 1 10;03 #701 P.003/004 

OS/lJ/ZOl l THU 9'.52 ?AX E1005/00 S 

f f .^ 

Additional Comments / Inetruetiona: 

•^eyXoLC^ txa'A oy>d "^cA 

O I do not agree zri agree 

,^^ , rjfer^-n 

CoatralhfSr*s Sij^ture Date 

Page 2 ofZ 
Frora:402 435 0088 


12/0'''^011 10:14 #240 P.001/002 

12/05/201 1 MON 17iI S PAX 

h 0002/003 ' IZ^il 

PropertyCdmpletTonT^greement 

This agreement documents the completion of remedial activities performed on my property. My 

signature wid designate that I am satisfied v«th the restoration of my property, and that no Hems are in 

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

SAID: ^yoW 

Property Address: ^2J $ hi- f^tkf f 

Oyi'ner: 

Pbode; 

Restoration Items In Queetton: 

Item: 

Item: 

Item: 

Item: 

Item: 

Kem: 

Additional Comments; 

KJ^iigrw rettorktioB^b coiRplteed, except u iiot«t 

n I do not agree restoratii^ is completed 

/0 I sgrce restorative Is complet«d, except M a«t«d 

i 11 d» not agree rMtoretion to corapletcH 

^^^- w 

CoatractoPs Signature Date 
Uougia L C4.t^^ 1 Vi . ~J s uounty Account iniormaiion 

Douglas County, Nebraska Property Record ­ R1203800000 

Information is valid as of 2011-3-31 

New Feature -•-•- •

Print Report 

View Interactive GIS Man 

Treasurer's Tax Report 

 Subdivision Sales Search 

Owner 

PBM ASSET MANAGEMENT INC 

1201 N ST #102 

LINCOLN NE 68508-0000 

Property Informatio n 

Key Number: 0380 0000 12 

Account Type: Residential 

Parcel Number: 1203800000 

Parcel Address: 

Legal Description: 

5325 N 18 ST 

OMAHA NE 68110-0000 

GOODLAND LOT 32 BLOCK 0 40 X 120 

Value Informatio n 

2010 

2009 

2008 

2007 

2006 

2005 

Land 

$2,300,00 

$2,300.00 

$2,300.00 

$2,300.00 

$2,300.00 

$2,300.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$2,300.00 

$2,300.00 

$2,300.00 

$2,300.00 

$2,300.00 

$2,300.00 

Sales Informatio n 

Sales Date: 2005-07-19 

Deed Type: 

Price: 

Grantor: 

WD 

$2,225.00 

INA GROUP LLC 

Book: 2005 Page: 087049 

Grantee: PBM ASSET MANAGEMENT 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 1994-07-26 

Deed Type: 

Price: 

Grantor: 

D 

$15,000.00 

Book: 1983 Page: 570 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12... 4/13/2011 
uougias L^ouniy Accoum iniormauuu 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Show All Transactions 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.11 4800.0 0.0 120.0 40.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12... 4/13/2011 
Douglas County Account Information TageToTT 

The above map is powered by Google, and is intended to provide a general idea of a property's location. If 

you require a more exact property location, you may use the Interactive GIS Maps that are maintained by our 

office. 

http://dougIasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12... 4/13/2011 
ENVIRONMENTAL AS-BUILT DRAWING 

OMAHA LEAD 3 

SUPERFUND SITE .{f 

'«< «o^' ' RESTORATIO N Contract# EP-R7-09-05 

3704 4 

Omah Exterior Pamt North Arrow a Lead Site r~| Good Site Sketch r~l Poor r 

Samolin q Address : 5325 N 18 ST F^f Not paint 

Sample Number Lead Concentration XRF LAB Samples Collected 

RYASCPXA-37044 F1 L O l • Firm PF T^C . P R KiA 

ppm 

RYBSCPXA-37044 F2 Date: 

2 2 1 ppm [ ^ • 

RYCSCPXA-37044 Bl lft6 ppm • Time I ^ ^ 5 P^^ 

RYDSCPXA-37044 82 

GiCi ppm [ y • Samples Analyzed 

RDgGCPXA-37044 BB ppm • •

RCZ6CPXA-37044 G * ppm • • XRF Unit: lo&laf a Book: 2-f^ 

RPZSCPXA 37044 PZ ppm • • Date; /2. • Qg. - /£> 

Time: AC2 

Number of Samples = | '-j | | ( ^ | Staff: M<;u/ 

Legend: Fl = Front Left, F2 = Front Rigftt, Bl = Back Left, B2 = Back Rigtit DZ = Drip Zone, GZ = Garden, PZ = Pla All quadrants are as viewed from the street, facing property 

- ^ it -

M47IM " 1 23 

LEGEND 

Quadrant Excavated Drip Zone Excavated Lead Soil Remaining Easement Excavated 
37044 

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

Q Poor 

Samolinq Address: 5325 N 18 ST Q'Not paint 

Sample Number Lead Concentration XRF LAB Samples Collected 

RYASCPXA-37044

RYBSCPXA-37044

RYCSCPXA-37044

 Fl 

 F2 

 B1 

ICi l 

J2 1 

ppm 

ppm 

n 

n 

D 

Fimi: ? f XxlC

Date; 

Time: 

nlllli n 

1.-?>'>PK 

 P 5 KA 

RYDSCPXA-37044 B2 _65il__pp m D Samples Analyzed 

nDZCCr'XA-37044 B2 — ppm a D 

RGZSCPXA-37044 S i ppm D n XRF Unit: ta&tafo Book; 275 

RPZSCPXA 3704 < PZ ~ ppm a n Date:

Time: 

 I Z ­ 02 . • 1 

A/-1 

Numt)er of Samples = | ^ | | Q | Staff: nsw 

Legend; Fl = Front Left, F2 = Front Right, B1 = Back Lett, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Pla 

AU quadraiTts are as viewed from the street, facing propeity 

T 

KJITT'IS'JRJSJO 

: NOV 19 2010 

E>\ .B.I. c3^ e'2.: 

y..lSB (^o 

[ SocL^i^sfB 

•2. 

7^-fa/;£^-/39^ 4­ S" 

i 

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00 

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<\p 

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lilHHliiilllli 37044 

Omah Exterior Paint North An-ow a Lead Site 

Sit • Good e Sketch • Poor 

Sampling Address: 5325 N 18 ST 

Q'Not fjaint 

Sample Number Lead Concentration XRF LAB Samples Collected 

RYASCPXA-37044 Fimi: PF XM L P & KA  Fl —-IDX—PPm D 

RYBSCPXA-37044 F2 2 2 7 ppm D Date:ilj IhliO 

RYCSCPXA-37044 B1 |ftfi ppm D Time: |-^*>F K 

RYDSCPXA-37044 B2 

C^t^ ppm D Samples Analyzed 

RDZGCPXA-37044 BE *• ppm D 

D

RGZSGPXA 37044 G i 

XRF Unit: JnhMi . Book: 2-?^ 

ppm D D 

Date: /Z -02.-1 0 nPZSCPXA 37014 PZ ~ ppm D D 

Time: M L 

Number of Samples = | ^ | [ ( ^ \ Staff: MSIA/ 

Legend; F1 = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Rigtit DZ = Drip Zone, GZ = Garden, PZ = Pla 

All quadrants are as viewed from the street, facing propeity 

. . . * •*• ' " * - ^ 

' 1 

• B:N I -HTJRJETJD 1 1 ;, 

: NOV ; 19 2010 .» 

. !/ i - - - J !. 

i

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\ 630. 

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U.-IB St-. Rev2i»8 Creaed i>»-Nov-10 
ENVIRONMENTAL XRF DATA ENTRY LOG 

C 

RESTORATION 

SAID # .^O^' A DATE }l \SO\ 11 

PROPERTY ADDRESS TIME 

XRF S/N i?5730 

QUADRENT OR SAMPLE AREA 

DEPTH AVERAGE OF RESULTS SHOT#s 

redig 

n 

n F2 

n Bl 

n B2 4 3^0^-=^^ L>31-L.V^ 

• DZ 

• PZ 

• GZ 

• EZ1 rJ'orei 

n EZ2 

n OTHER 

SAMPLER J/Vrtv ^ (5 c^ p^ / a j NAME 

^ 
Thermo Fisher Scientific Thermo 900 Middlesex Tumpilce 

Billerica, MA 01821 

SCIENTIFI C 

\VKR.\Ol<: ADRRKS S ISAMPi.K ARKAIOPKR A lO R IDKI'III jNOIK S 

2011-11-30 11:48 Avg of 633-635 5325 n 18 st B2 JIMMY 4 final clearance 340.20 ± 26.07 

2011-11-30 11:48 5325 n 18 st B2 JIMMY 4 final clearance 37044 347.17 ± 26.19 

2011-11-30 11:48 5325 n 18 st B2 JIMMY 4 final clearance 37044 339.79 ± 26.14 

2011-11-30 11:47 5325 n 18 st B2 JIMMY 4 final clearance 37044 333.64 ± 25.89 

Page I of 1 11/30/11 15:44:44 
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