TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 26182 DATE: 1/15 

ADDRESS: 1515 N 18 ST 

REMEDIATION CONTRACTOR: PRUDENTTECHNOLOGIES. INC YEAR: 201(^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

\6 PRE AND POST VIDEO OF PORPERTY (DVD) 

m EXECUTIVE SUMMARY 

d EPA-PROVIDED PROPERTY SKETCH 

d SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

ffl RESTORATION AGREEMENT 

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

ID CONFIRMATION DATA 

di PHOTOGRAPHS 

d AS-BUILT SKETCH 

D) SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

m PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

d UTILITY CLEARANCES 

m PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

'y^ ^ ^^'^'' 

SIGNATURE DATE 

30218386 

•1 

Superfund 
PROPERTY SUMMARY 

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

Property Address: 1515 N 18 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: 

B2 = 281 PPM @ 2"; NO EASEMENT 

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 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 veriiying satisfactory restoration 

v) Description ofareas not meeting Interim ROD cleanup criteria. 

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

Backfill: 

Sample Area: 26182 -151 5 N 18 ST 

Owner: User Provided Owner Information Resident: 

D Owner Occupied 

Owner Name: Owner Name: Resident Name: 

JCARADORI TOM 1 ~~ 

Owner Addressl: Owner Address: Property Address: 

1 ^ ' J1515N18ST 

Owner Address2: Zip Code: 

13375 S 17 ST J68110 

City: State: Zip Code: City: state: Zip Code: Resident Phone 

JOMAHA JNE ]67108­ 1 

Owner Phone Altemate Phone: Owner Phone: Alternate Phone: 

] ^ " •" " 1 " 

Contract: Assessment: 

Contractor: jPRUDENT2010ls Qualifying Group |400 

Contract Option foPrfoN 1 Assessment Max XRF Value 514.4 
^MiilEMl 

TECHNOLOGIES, INC. 

EPA Property Close Out 

Property#: "Z^l^T - Property Address: l^/ ^ ^ - ^^ ^ 

Date/Time; Owner's Name:'Tom. Co-tad-^v^ 

Quads Exca>'ated: ^1 — Contractor Group: Prudent Technologies, Inc., 

Excavation General Yes No 

I. If necessarv. were the correct quadraiit(s) excavated and restored? / 

2. If necessary, were the correct areas of drip 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 that were excavated? / 

3. Does die sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day lime period) / 

4. Are sodded areas generalh' firm and evenly graded? / 

5, Are tlie joints between tlie sod strips generally tight? (Only evaluate if inspected at a 30 day 

(ime penod) y 

6. Was the property graded such tliat water will not pool on the property? / 

7. Was damage lo landscaping or plant materials avoided? y 

Gates, Fences and Retaining Walls Yes No 

1. Do gates open and close freely'^ (If applicable) y 

2. Were all gales or fences taken down during restoration artivities reinstalled? (If applicable) y 

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

4. "Was damage lo retaining walls avoided? (If applicable) J 

Foundation, Siding and Gutters Yes No 

1 Was damage to the siding or trim avoided? y 

2. Was damage lo the foundation avoided? / 

3. Was damage lo windows avoided? yl 

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

."5. Was damage lo downspouts or downspout extensions avoided? • 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided'^ / 

2 Was damage to walkway surfaces avoided? / 
Owners comments: 

Inspection notes: 

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

EPA Representative Qc-^^y Date; /g/,/,, U£L. 
CHNOLOGIES. INC 

AS - BUILT DRAWING 

OLS #26182 

Date Excavated: 11/04/2010 OMAHA LEAD SUPERFUND SITE rSKPA Signed-OffDate: 

Name: ,'/'«.*». 6:»*ctr / Oinaha Lead Site Date: f-2^-<^ f North Arrow V 

Address: i^liT AJ {ff ^ Site Sketch Time: ll-Z C 

Phone: 

Team

'pwry 

'Jtltrlfitf-^'-ZWllrtm^ BVID# ZCol^ ^ XRF Code 5SD/ 

Sample Number Lead Concentration Confirmation Sampie 

3 vy^^.spy^ - yii:\%y .3'$'5- *3 } 

ppm 

ppm 

pZYes

*(Yes

STYes

t^Yes

 a 

a 

• _ 

 ET 

No ^ 

No S ^ 

No a 

No C] 

ppm Yes a No CD 

ppm Yes a No CD 

_Lab RD2SCPLA-26182 ppm Yes • No D 

Result 234 ppm No f 1 © 

3Z:l*'33.j 

I CA4r*^ai{' 

"•c" i r^i 

•UJQ = 281 PPM « 2" j [-4^ 

Omaha Lead Site 46130 

CONTRACT #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
SER^ 

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 future, excluding any 

remaining warranty (30 days total) except those items listed below, if any. 

Property ID: QMH'i- Property Address: \ S \ S / J J ^ S ^ 

I Owner: ^ /a ^ Lfi-n>-^o'f'J ^ y I Phone: <</^y^-^-y^ -t^s^^y 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

agree restoration is completed. 

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

//-;??y^ 

Owner's Signature Date 
Pnident Techuologiis. Inc. (Prudent) is under contract with the U. S. Environmental Protection Agencv CEPA) to Clean up le.aclconta.mii)atecl,Siw4f; at n nivdiber of orap^fties located inOiriaha, Nebraska, including ttie property located at 

I requests your permission to allow Prudenl lo pertorm a soil cleanup at liiis 

pr(fperty to remove lead-contaiiimated soTT "By signing this form, the property owner grants permission to Pmdent to perfortJi 

activities related to the cleanup including soil sampling, removal of Iead-contaminaled soil, aiid restoration ofthe referenced property 

Ifyou have any cjuestions about the soil cleanup planned for your property, please contact Prudent south office for the Omaha Lead 

Site cleanup-at (^02) 733-1188. General questions about the Omaha Lead Site cleanup can be directed to the EPA Public Information 

Centers at (402) 731 -3045 (South Omahao£Gce nahao£Gce) or (402) 991-958 991-9583; (North Omah^fTice).

Property .Access (jranled f.iy 

Property Own^r Signature; yuyy^ 

(Signature) (Date) 

PROPERTY IWFORIVIATIOIM 

(To be completed by resident aiid/or properly owner - please print) 

RESIDENT MAME: y ^r^ Owner Renter 

RESIDENT ADDRE

"^ /^/r ///f y / 

IF RENTAL. PROPERTV OWNED BY: 

.y ^ AyZ^^i:.^^^^ 

OWNER'S MAILING ADDRESS

• ^^-j GA...,^ y^: c.y. T ^ ^^^^ ^ 

IWNER'S TELEPHONE NUMBER - HOME:^ ^ ! "WORK:

: m jy^-yT99oyr^'~ 

AGE OF HOWIE?: VX/VEARS . HO W LONG HAVE YOU LIVED HERE? 

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

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: f ^ MUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER 

NUIVIBER OF CHILDREW UNDER 7 YEARS OLD WHO PLAY IN THE YARD FOR 6 HOURS OR MORE PER WEEKCOWIMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETC.> 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS, The activities to be implemented by EPA utider this agreement 

are pursuant lo Section J 04 ofCERCLA. 42 U.S.C. 9604. EPA's right of access to the property is provided for in Section 104(e) of 

CERCLA, 42 U..S C 9605(e), whicli provides entry for "detennining the need for response, or choosing or taking any i espouse action 

under tlus title, or otherwise enforcing the provisions ofthe title " 

e080 vVaret PaiKV/ay. Surffi • .?4?. fVi'.'iJir.nt Drivr^. Giiitri fl'/iiO 

Kansas City. MO fi41 M n:;r\ r.iwiwo. T;: /.';:>,c:« 

Phone; i816i 363-i70S ffi'ot'ii: "Jili:; V':; Pa'.M:>.\ Ci 1(1)0t2-o:ir;i; 

f^3.x: fsiGi aSo-.^'o? ;«(!:: »-i:y: !:-iio)(;/^i.i>S/'y 
KNVl.KO{^iMKiNV4L.* 

CON»TRUCTIO^: 

TECHNOLOGIES, mC. SEKVJCKfj 

, Property Status Form 

Address: Date: // - / ^ 3^/ O 

Phone: 

f^r-JiJ Aee/i /-s gZ 

 2e s:<p D 

. ^ ^c/<\ v//f '^d f^. /' 

Property Owner Prudent Em 

Signature: Signature: /yf.'^^ty 

SnSfl Ward Pari<wBy, Suitf 40.S SGOfl a -111 St. 

Kansa.? City, iWO 64114 

Phone: (S'lfi) 365-'l70:> l'0^^ i •^c^-^ '>'*i^T 

Ortiariii, i'^ebrastt-s o810'i 

"^^horie; i'40Zi 7;i;;-M3'o M^'t'lX t*i- i iiSO'^ 

San Anionic, TX /a229 

Phone: |i:iO) «2a-J>60fl 

C-jv­ *^nn \ c-;a t:oi''r 
Name: /At ^ CcMr^diri 

Address: /gV r A) ff ^ 

Phone 

Omaha Lead Site 

Site Sketch 

Date:

Time:

 f'^-'^' ? 

 H'-Z^Cfi 

•^^ — ^ .1 i»— — 

Team ^&fr(f^tf^'^/bi/,Ifrot*^ BVID # 26/ ^ XRF Code 5SD 1 

Sample Number Lead Concentration Confirmation Sample 

ppm PZYes O No ^ 

ppm ftfYes a No E ^ 

.255- ^3/ ' ppm 

ppm 

tJZYes

CJiyes

 • _ 

 2 r 

No

No

 t 3 

 CD 

ppm Yes O No n 

ppm Yes Q No CD 

-Lab RDZSCPLA-26182 . ppm Yes • No a 

,..———'—rresui KHsmi _iX r _ Mo f^ I y WsiF [\lijiy^%y^C 

bll> ZS'k^Bj 

H 1­

\y. l^iD p wKaaaAWMUHi H U 

slet^lf 

t?^ if^ -c^^ 

46 
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http://douglasne.mapping-online.com/assessdoc/Photos/07/R14044500000001.jpg 9/13/2010 
Douglas County Page 1 of 1 

http://www.dcgis.org/dogis/ 11/2/2010 
Page 1 of2 

" > 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2631586. 

Original Call Date: 11/01/10 Time: 4:40 pm Op: SIVA18967 


Work to Begin Date: 11/03/10 Time: 5:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1515 Street: N 18TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 15-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 LEVELS MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVELS LEVELS COMMUNICATIONS, LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICH/TRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11/1/2010 
Page 2 of2 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret-<RESULTS... 11/1/2010 
mc. CONSTRUCTION 

SOLUTIONS 

SITE SAFfeTY HAZARD ANALYSIS 

,or N ir/r Address: Excavation Date: 

Crew: BackfiU Date: 

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 Hazards Corrective Action 

c ^ ^ /lov J ly^^.... O C i» / P KcvO 

e^ 

h^' \D 

' 

ore 

a^"^ 

Pc^>*-

C3« ^ 

t r ^ 

a*— 

-

Site Safety Office 

Date: 

MO Wutf«arteway, Sute 4«s seoosios 4242 Medical Drivo, Stdte 7260 t 

;a»a«GiDr;lM>«4114 San Antonio, TX 78229 fMMadkaCS107 

tKMis: fSfC) 3^^3703 Phone: (2t0> 822-i9S88 t402)733-1iaS «x: fSIC) 363>37II7 Fax: (210) «79-<577 F s c (402) 733<1S83 

K 0