PROPERTY SUMMARY

 

Date: 09/25/2007 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: September 

Property Address: 2576 Manderson St 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: None 

A.2 Issues Resolved: Re-Seed will occur in October on any dead spots to encourage spring growth. 

A.3 Unique Findings: 

A.4 Other Relevant Information: 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl-192@6" B2-180@6" 

Easement 30 @ Scrape 

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 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) Excavation digital video in MPEG, WMV (Windows Media Video) or SWF (Flash Player) format and/or 

photographs 

iii) Signed form verifying satisfactory restoration 

iv) Description of areas not meeting Interim ROD cleanup criteria. 

40285126 

III 111 III 

Superfund 

CHNOLOCIES, INC. 

3.27 3 

Name: Omaha Lead Site Date: 1~/~S North Arrow 

Address: Site Sketch Time: 10 / <: 

Phone: 

, 

Team M-T /7h BVID# XRFCode 7037 

Sample Number 

& - 327 

Lab RYCSCPLA-32730 

:; 864 ppm: 

Lead Concentration 

ppm 

ppm 

ppm 

ppm 

Confirmation Sample 

n Yes D 

r^Yes CD. 

61 Yes S* 

62 Yes ° 

Yes CD 

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Omaha Lead Site 46130 
vv,; ."„,, Agreeraj|tto allowaccess to 

V...«..M • / $$fa V theprolBtv in order to conduct 

Site Remedial * r\fflff? * environmental sampling and to 

Action \^v>//Avtfv.^, remove lead-contaminated soil 

Prudent Technologies, Inc. (Prudent) is under contract with fhe U. S. Environmental Protection Agency 

(EPA) to clean up lead-contaminated soils at a number of properties located in Omaha, Nebraska, 

including the property located at ^)S 7£> /D^>y-/^>-j^.^ . The EPA requests your 

permission to allow 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 fhe 

cleanup including soil sampling, removal of lead-contaminated soil, and restoration of fhe referenced 

property. After obtaining the owner's signature on this form, Prudent Technologies. Inc. will contact fhe 

property owns' (and residents) within the next few weeks to coordinate performance fhe work. 

If you have any questions about fhe soil cleanup planned for your property, please contact Prudent's 

Administrative Clerk for the Omaha Lead Site cleanup, Ms. Cyndie Hinds at (402) 504-1004. Genera! 

questions about the Omaha Lead Site cleanup can be directed to fhe EPA Public Information Centers at 

(402) 731-3045 (soufh Omaha ofjic^or (402) 991-9583 (north Omaha office). 

Property Access Granted By: 

(Pit i a PriniNnm»j 

! -, / ''/» S // * / // ­

Property Owner Signatures, ^ 

(JSignatui*) /? (Date) 

PROPERTY INFORMATION 

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

RESDENTNAME: ^?j /•$- QJwner Qenter 

RESIDENT ADDRESS: 

IF RENTAL.PROPERTY OWNED BY: 

OWNE R'S HALING ADDRESS; 

OWNER-S TELEPHONE NUMBER - HOME: L\V

 ^ _\ WORK: J_ 

AGE OF HOttET: YEAR\ \OWJjMG HAVE YWtfVED HERE? YEARS. 

\ 

HAS THE EXTERIOR BEEN PAWTED OR COVERED WFTH SB3ING SWCE 1378? YES NO 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDE R 

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY M THE YARD FOR 5 HOURS OR MORE PE R WEEK: _ 

COMMENTS OR SPECIAL INSTRUCTIONS: (LE. DOGS.ENTRY GATES.ETC4 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS; The activities to be implemented by EPA under this 

agreement are pursuant to Section 104 of CERCLA, 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 y605(e), which provides entry tor "determining the need for 

response, or choosing or taking any response action under this title, or otherwise enforcing the provisions of the 

titlo." 
EPA Property Close Out

 

Property #: 33 sen Property Address: 257C 

Date/Time: spfit'jf. Owner's Name: Job* Vos<.y 

Quads Excavated: QJ_ Contractor Group Prudent Technologies 

Excavation General Yes No 

1 . If necessary, were the correct quadrants) excavated and restored? i/ 

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

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? S

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

3. Does the 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? s 

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

time period) s 

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

7. Was damage to landscaping or plant materials avoided? s 

Gates, Fences and Retaining Walls Yes No 

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

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

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

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

Foundation, Siding and Gutters Yes No 

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

2. Was damage to the foundation avoided? c/ 

3 . Was damage to windows avoided? s 

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

5. Was damage to 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 £L*yfiL+ Date: 9//?//£ 7

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rt-prr*Vt:-ri-v;-'£'j'i-s:i'. ;-T.-iTV,-v4-; 

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Name: 3V A« Moslem Omaha Lead Site Date: f-/~\5 North Arrow —

Address f 5lJe MAA**r*att ^* • Site Sketch Time: /£ • AS 

Phone : 4^-j-4£57 

Team f^A-fl M-T/jfc BVID # ^£73^> XRFCode / 037 gooK'-ftZ 

/ 

Sample Number Lead Concentration Confirmation Sample 

/^Q ~~.~ Yes O No ^ r*"" f7

I RYBi'C^XA — 927SO frS ppm /^ Yes O, No C3 ^ pVfi^C^XA- 32730 1^2, ftj» - ppm ^/ Yes Be No O^ 

^ RVDSC/>XA- -5Z-730 USD aa& — ppm 62 Yes d No ^ - -T Dom Yes D No d T " 

— ppm Yes CJ NO D ~ ppm Yes LI No D 

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Omaha Lead Site 46130 
IvEPA

 

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 properly 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 0): 

Property Address: £ <r—T/ 

Owner: 

Phone: 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

Lj I agree restoration is completed, except as noted above, 

do not agree restoration is completed 

Date 
Print Preview Page i 01 i 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

1715090000 

MOSLEY JOHN 

A 

2576 

MANDERSON 

ST 

OMAHA 

68111 

7301 N 33 ST 

OMAHA 

NE 

68112 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal3 

Legal4 

Assessor 

Website Link 

04-15-13 

MARYSVILLE ADD 

2 

18 

50X128 

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

accountno= R 1 7 1 5090000 

Disclaimer Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 39 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 7/16/2007 
Find Record 1 Clean Up Query Lead Remaining Query 1 Property Damage Quer Y Close 

ample Area: 32730 - 2576 MANDERSON ST 

Owner: Resident: Contract: 

._| Owner Occupied 

Owner Name: 

IMOSLEYJOHNA

Owner Addressl: 

> 'Owner Address2: 

J7301 N 33 ST . 

V_City:^^-^^

JOMAHA

Owner Phone:

|(402) 457-4257

*+0r I I fjfa 

­

 State: Zip Code: 

 JNE [68112 

 Alternate Phone: 

 j(402) 680-9057 

Resident Name: 

VACANT LOT 

Property Address: 

2576 MANDERSON ST 

Zip Code: 

68111 

Resident Phone 

1 

;

:

Contractor: 

PRUDENT2007 

Group: 

Assessment: 

 Qualifying Group 

j 800 

Assessment XRF Date: 

Assessment Max XRF Value: 

889.03 

0 
Page 1 of 1 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 1846661. 

Original Call Date: 7/20/07 Time: 1:52 pm Op: CYNDIE18967 

Work to Begin Date: 7/24/07 Time: 2:15 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 2576 Street: MANDERSON ST 

Twp: 15N Rng: 13E Sect-Qtr: 04-SE 

Twp: Rng: Sect-Qtr: 

Legal Given: C
 

Type of Work: Soil Excavation - Lead
 

Location of Work: LOCATE ENTIRE PROPERTY
 

Remarks: FAX ALL CLEARS TO: (402)504-1005
 

Company : PRUDENT TECHNOLOGIES
 

Contact Name: CYNDIE Phone: (402)504-1004
 

Work Being Done For: EPA
 

Depth of Excavation: 13" Max Corner Lot: N Front: N Rear:
 

Involves Tunneling or Horizontal Boring : N Explosives: N
 

CXCATV MUD01 OMAHACOF OPPDGPR5 QLNNE1C
 

Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUD01 METROPOLITAN UTILITIES DISTRICT EDWINA Alt: 

Emerg: 4025047946 

Day: 4024447197
 

OMAHACOF CITYOFOMAHA-TRAFFIC,SEWER RON Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 

Emerg: 8887289343 

Day: 4067289343 

QLNNE1C QWEST LOCAL NETWORK NA Alt: 

Emerg: 8887289343 

http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/20/2007