TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#:^3i23_ Date: H ' I 5 "^ I 0 

Address: c^H^c ^ ft/JLLfmn A V 

Remediation Contractor: f)?n nrPr^'f 7»/^>f4 NO<LOC) I?<J.^ IN<I.<J Year: ^( J I ( j 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

[^ Video of property (DVD) „ , J?237560, 

\S Executive Summary Superfund 

w EPA-provided property sketch 

[« Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

a Restoration Agreement 

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

0 Confirmation data 

W Photographs ' 

a As-built sketch 

w Satisfactory restoration signed by Property Owner 

0 Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

0 Utility clearances 

a Property information from Douglas County Assessor's Office 

D 

D 

D 

Signature ' Date 
PROPERTY SUMMARY 

Date: 11/15/2010 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Month of November 

Property Address; 2442 BAUMAN AV 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered NONE 

A.2 Issues Resolved NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS 

Bl = 205 PPM @ 8"; DZ = 63 PPM @ 12"; EA = 72 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 final lead levels v) Legend 

ii) Contamination left behind areas vi) Contractor identification 

111) 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 

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

photographs 

iv) Signed form veniying satisfactory restoration 

v) Description of areas not meeting Interim ROD cleanup criteria 

TECHNOLOGIES, INC. 
Find Record 

Backfill: 

Remediation Query Lead Remaining Query Property Damage Query 

Sample Area: 39979

Owner: 

­ 2442 BAUMAN AV 

User Provided Owner Information Resident: 

n Owner Occupied 

Owner Name: 

JFRAZIER ETHEL 

Owner Addressl: 

1 

Owner Address2: 

2442 BAUMAN AVE 

City: 

JOMAHA 

Owner Phone 

|C402) 453-6556 

State: Zip Code: 

|N E 168112-

Alternate Phone: 

1 

Owner Name: 

Owner Address: 

City: 

Owner Phone: 

State: Zip Code: 

Alternate Phone: 

Resident Name: 

I 

Property Address: 

12442 BAUMAN AV 

Zip Code: 

Resident Phone 

Contract: Assessment: 

Contractor: PRUDENT_2010. .S Qualifying Group J400 

Contract Option IBASE Assessment Max XRF Value 444 
• '-i.-i!\b:,;/;r,rj 

EPA Property Close Out 

Property #: ^^^T ^ Property Address: 7-^:4^2 - 8i!iAK,w\awc A*^ ^ 

Date/Time: Owner's Name: £r4fve j Fr^C^i'^l P 

Quads Excavated: t?2.1 0 1 Contractor Group: Prudent Technologies, Inc , 

Excavation General Yes No 

1. If necessary, were tlie correct quadraiit(s) excavated and restored? / 

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

Grading Sod and Vegetation Yes No 

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

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

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

day tittle period) 

4. Are sodded areas generally firm and evenly graded? 71 

5. Are the joints between the sod strips generally tiglit? (Only evaluate if inspected at a 30 day 7 

time period) 

6. Was the property graded sucli that water will not pool on the propeity? 

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

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 reinstalled? (If applicable) 7 

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

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

Foundation, Siding and Gutters Yes No 

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

2. Was damage to the foundation avoided? / 

3. Was damage to windows avoided? / 

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

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) Yes y No 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? y 
Owners comments: 

Inspection notes: 

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

EPA Representative JQJ^J ^ ; Date: lojffffo 
}IES. INC. 

AS - BUILT DRAWING 

OLS#39979 

Dite Excavated: 09/03/2010 

USEPASIgned-OirDatc OMAHA LEAD SUPERFUND SITE : 

39979 

ExtariorPant NofttiAfraw 

Site Sketch noood 

Q Poor 

Omaha Lead Site 

Sampling Address: 2442BAUMANAV • Notpsint 

Sample Number 

RYA9CPXA-3M70 F1 

Concentration 

?22 _ Bom 

Sample 

Collected LAB 

D 

Fimn:

Date:

Samples Collected 

 ftfi t I3g-Air 

 t-15-01 

RYBSCPXA-aSOTO F2 2 3 O ppm D Time: IP itO 0*1 

RYCSCPXAr3e979 

n¥DOOPXA-09Q79 

Bl 

-BaD 

D Samples Analyzed 

RDZSCPXA^OSrO DZ _lL2JL.PPm D XRF Unit: JQ^^ ^ Book: 235 - WOZOOPXA aOBTQ -ez ~ ppm a D Drte: H-iO-a^ 

nPZOOPXA-38870 -PZ- n •nme:_JBaa 

Number of Samples-I t f | | o | strtr:__caSL.i 

Legend: F1 > Front Left. F2 = Front Right. B => l Back Len. B2 » Back R^M DZ < Orip zone, GZ - Garden. PZ » Pla; 

AlflUKlrarti M9 M viMwdftmittM t0tt/t, ttfi ^ 

6-<!y?. IENTEREI) 

': APR 2 8 zoos: 

81='205 PPM® 8" mn. 

P.I. 

Vh. 5^=^ 

DZ = 63PPM@12" 

.^n^^f'i 

..tifiii»^^l>«<^.AM 

..DzilUH: 

-BE: 

.230. 

cmo 

w^^ 

^*ipi»,.Ae. Il<r3» Cnatt: OHwA 

EA= 72 PPM (9 Scrape 

CONTRAa «: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
Property Completion Agreement 

This agreement documents the completion of removal activities performed on the below listed property. 

The property ovmw'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: 

Property Addre«»; ^ M M Z , ^ r. t J tv\Ciir> ru^-t. 

Owner; 

:= Piia. ^ Fr<^^:irr 

Phone: 

Restoration Items in Question: 

Hem: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

-f^ <-€_ l O •

;? I agree restoration Is completed, except as noted above. 

L J I do not agree restoration is completed 

^t^Jt ^ /liVi^*^ ^ Jk2==- ^ - !•>-,-/g 

f OwOwner' i s Signature Date 
TWHf«)!j(»ll&rNC 

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

2-L|L4 T ^ faPrtJlVVA ^ AVThe 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 Prodent to perform activities related to the cleanup including soil sampling, removal of lead-contaminated soil, and restoration of the referenced property. 

If you have any questions about the soil cleanup planned for your property, please contact Prudent South Omaha OfRce for the Omaha 

Lead Site cleanup,^at (402) 733-1188; 733-14SS. 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 1 I i2.J ^ JBy:E , '^ h -fJ "^ \ r ^ 

(Please Print Name) 

Property Owner Signature: _^2BZL ^ v ^ ^'O-^^jUL ^ 

(Signature) > 4 (Date) 

PROPERTY INFORMATION 

iff^ob e coiiii|>lete(LI>y resident and/oi r property owner — please print)

RESIDENT NAME; Otmer J Renter 

RESIDENT ADDRESS: 3.^7ol r^acj,no^Ay^ 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS

-;3^4^^ fLu^ . M/ ^ 

OWNER'S TELEPHONE NUMBER HOME: (/^> ^^><^« S WORK: 

J I 

AGE OF HOME?:: ^ J > YEARS. HOW LONG HAVE YOU LIVED HERE? G? ^ YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 19787 YES NO 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: ^ / NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER 


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 R£SPONSE 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 960S(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 ofttietitle." 

8080 Ward Parkway, Suite 405 

Kansas City, MO 64114 

5600 S. 10'" Street 

Omaha, Nebraska 68107 

4242 Medical Drive, Suite 4250 

San Antonio, TX 78229 

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

Fax: rSISI 3S3-3707 Fax: (402)733-1883 Fax: (210) 579-6577 
TDMJDE ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address: ^ ^ y^3 [3c»^/H^/1 At/ ^ ^^^' "^'f^^/ O 

Phone: ^l'^^^ Q BVID: J'^'77 ^ 

\,0 ^ ^j/ ^ h^3,^)^ ^ k^s yio L^^^J^ ^ 

3 //y Q-?... 

r^/^^cJ 

^ r /^qc/ IKXLK^ . 

c4^^-^ ^; J ^ . b^^ 1^. / S! 

Property Owner Prudent Employe 

Signature;^^^;^:^^^ ^ J ./^ gL>yULa Signature: 

8080 Wmd Pailcwav. Sulfa MS 2505 N. 7A^ Straat. Siiila 308 4242 Madlcal Drive. Suite 4260 
39979 

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

Gd Poor 

Sampling Address: 2442 BAUMAN AV Q Not paint 

Sample Number Lead Sample Samples Collected 

i 

LAB Concentration Collected Flmi: fPfirtSAT 

RYASCPXA-39979 F1 

ppm n Date: H'l5-& ^ 

RYBSCPXA-39979 F2 

23 O ppm D Time: ta ••&) a*» 

RYCSCPXA-39979 B1 ppm 

n Samples Analyzed R¥DOOPXA"39979 D2 — ppm n 

RDZSCPXA-39979 DZ \12.H ppm s- n XRF Unit: /aHAA. Book: ITKfk 

ROgOCPXA-30070 OZ "* ppm n Date: H -^O -O ^ 

RPZOCPXA'39979 PZ- a — ppm n D Time: Boa 

Staff: COSLi Number of Samples = { 4" I | Q | 

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

Ajlguadrentaare as vimwd frem the siratt, (adng property 

w^s^ BICTERE D 

\ APR 2 8 2009 \ m^ 

P.l 

5 

L M 

R?-. 

. -. t*^''.; N 

Wffi.R^*»ii«..Av ft . 

.PZ= .11.2/*;.. 

,.Z3lO. 

B . . ..f.2:. :.c<?A^ 

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Print Preview Page 1 of2 

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 

1749660000 

FRAZIER 

ETHEL 

2442 

BAUMAN AV 

OMAHA 

68112 

2442 

BAUMAN 

AVE 

OMAHA 

NE 

68112 

33-16-13 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Acres 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

MINNE LUSA 

7 

13 

44X120 

• - v "'- ' .. **" 

0.12 

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

parc=1749660000 

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

accountno=R1749660000 

v ' - " • 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 6/15/2010 
8/9/2010 ittp://www.dhon.org/irtliinternet/DHO.., 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS  2563504. 

Original Call Date: 8/09/10 Time: 1:12 pm Op: SIVA18967 


Work to Begin Date: 8/11/10 Time: 1:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2442 Street: BAUMAN AVE 


Twp: 16N Rng: 13E Sect-Qtr: 33-NE,34-NW 


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 Excavation: 6 FT Corner Lot: N Front: Y Rear; 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV METRO MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number 

UtiUty 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day:

Alt:

 4029340469 

 4029340469 

Emerg: 4029329757 

METRO METRO COMM. COLLEGE CHRIS 

Day:

Alt:

 4024572307 

 4026727033 

Emerg: 4024572313 

MUDOl 

METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF 

CITYOFOMAHATRAFFIC,SEWER 

RICH/TRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

dhon.org/irthinternet/.../MessageTextas... 1/2 
8/9/2010 ^nttp://www.dhon.org/irthinternet/DHO... ^ 

W ^ay : 4067289343 

r»DDT^r-TJD^ OMAHA PUBLIC POWER ELM ,^ .n^^n^,.,^. 

0PPDGPR5 j^j^^^ ^ LOCATING ^^-^ ^062071494 

Emerg: 8887289343 

FTM Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK TMA^T ^ Alt: 4062071494 

LULAllNG 

Emerg: 8887289343 

dhon.org/irthinternet/.../MessageText.as... 2/2 
ENVIRONMENTAL 

ENGINEERING AND 

TEBHNOUMWS, mC. CONSTRUCTION 

SOLUTIONS 

SITE SAFfeTY HAZARD ANALYSIS 

Address: --^^'^--^^Ji^^tifc--u^., Excavation Date: 

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 

Backfill Date: 

Condition Hazards Corrective Action 

<sre^^ l^S-<^ /?A«y<3 

t ^ 

^ 

-.^' " HP 

- — 

— 

ey- USV* Pf-fi^-^a-^^ 

cy 

- ^ 

— ­

***­

— t_t/«_ J>f)r U.'C^fi, 

Site Safety Office 

Date: 

SMOWmFBukMay. SutB405 i9600S10St 4242 Medical Drive.Suite 7250 

Kanos G«yi IK>«4114 Omaha, Nebnik a 68107 San Afltonio, TX 78229 

Phone: 1816)36^3703 Phone: (402)733-1168 Phone: (2t0)822!«588 

Fsc (816) 3633707 Fax: (402)733^1683 Fax: (210) 579-«577 
•/^f...;A.t,<..;