SAID#: 29374

TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

 DATE: 12/15/2010 

ADDRESS: 2006 MIAMI ST 

REMEDIATION CONTRACTOR: PRUDENTTECHNOLOGIES. INC. YEAR: 2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

BJ PRE AND POST VIDEO OF PORPERTY (DVD) 

d EXECUTIVE SUMMARY 

lfi EPA-PROVIDED PROPERTY SKETCH 

13 SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

H RESTORATION AGREEMENT 

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

H CONFIRMATION DATA 

\£ PHOTOGRAPHS 

III AS-BUILT SKETCH 

m SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

[?f PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

d UTILITY CLEARANCES 

d PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

oy Vv ,\r.^v' ^ 

SIGNATURE DATE 

30260788 

Superfund 
Find Record Remediation Query Lead Remaining Query : Property Damage Query 

Backfill: 

Sample Area: 2937 4 - 2006 MIAM I ST 

Owner: 

n Owner Occupied 

Owner Name: 

]CAM RANH BAY INVESTMENTS 

Owner Addressi: 

Owner AddressZ: 

J3711 N 19 ST 

City: State: Zip Code: 

lOMAHA ]NE jesiio-

Owner Phone Alternate Phone: 

Contract: 

Contractor: PRUDENT2010 S 

Contract Option ^OPTION 1 •^ • 

User Provided Owner Information 

Owner Name: 

Owner Address: 

City: State: Zip Code: 

Owner Phone: Alternate Phone: 

Assessment: 

Qualifying Group MOO 

Assessment Max XRF Value f" 524.27 

Resident: 

Resident Name: 

I 

Property Address: 

|2006 MIAMI ST 

Zip Code: 

J68110-

Resident Phone 
PROPERTY SUMMARY 

Date: 12/15/2010 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Month of: December 

Property Address: 2006 MIAMI ST 

A. EXECUTIVE SUMMARY 

A.l Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 390 PPM @ 6"; B2 = 232 PPM @ 6"; EA = 357 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-E.xcavation 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 (ifany 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 verifying satisfactory restoration 

v) Description ofareas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES, INC. 
TECHNOLOGIES, INC. 

EPA Property Close Out 

^dOci- M \^«i>v. . Property #: d^iy^A Property Address: 

DiUc/Tinie: Owner'sName: ('4^rcitd(l_ G>a!y.c^ '> 

Quads ExcaA'ated:' 6l , 'S 2. ^ Contractor Gn'oup: Pn.mk'.nt Technologic.'i, Inc.. 

Excavation General Yes No 

1 If !iecessp.r>. were the correcl quadiant(s) excavated and restored'' / 

2. If necessiiry. were the correct areas of dnp zone excavated and restored? / 

Grading Sod and Vegetation Yes No 

1. Does the grading arouiTd tlie penmeter of the house in excavated areas generally slope away y from the house'? 

2 Has sod been laid in all areas lliat vvere excavated? y 

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

day lune period) y 

4 Are sodded areas generally firm and evenly graded'? y 

5. Arc the joints between the sod stnps generally light? (Only evaluate if inspected al a 30 day / time penod) y 

6 Was the property graded such tliat waler will not pool on tlie property'^ d 

7 Was damage lo landscaping or plant materials avoided? A 

1 

Gates, Fences and Retaining W.-jlLs Yes IMo 

) Do gales open and close freely''' (Ifapplicable) 

2 Were all gates or fences taken down dunng restoration activities reinstalled? (Ifapplicable) r 

3 Was damage lo gales or lences avoided? (Ifapplicable) y 

4 Was damage to retaming walls avoided? (Ifapplicable) y 

Fonindation, Sitling innd Gutters Yes No 

1 Was damage lo the siding or trun avoided? A 

Was damage lo the foundalion avoided? A 

Was damage to windows avoided? -y^ 

4, Was damage lo windows or door screens avoided? A

5 Was damage to downspouts or downspout extensions avoided? A 

Siclewallks ami Drivc^vays (Concrete) Ye.s . Wo 

1 Was damage to driveway surfaces avoided? 

2 Was damage to walkway surfaces avoided'' 
Owners comments: 

Inspectaon notes: 

Removal aiid restoratiori activates complete including the 30-day sod warranty. 

EPA Representative Qtv ^6 ^ ^Date; ii/'7||g 
m CHNOLOGIES. INC 

AS - BUILT DRAWING 

OL.S # 29374 

Date Kxcavated: 10/07/2010 

USEP OMAHA LEAD SUPERFUND SITE A Signcd-Off Date: 

29374 

Omaha Exterior Paint Lead Site Owner Name: CAM RANH BAY INVESTMEN 

Site • Good Sketch Address: 2006 MIAMI St 

Phone: Hi w^ • Poor T

[iTf Not paint 

Lead Sample 

Concentration Collected 

RYASCPXA-29374 Fl 

Sample Number 

ppm 

RYBSCPXA-29374 F2 ii o ppm 

RYCSCPXA-29374 B1 5 ? f ppm HC 

RYDSCPXA-29374 B2 f^ ^ ppm 

RDZSCPXA-29374 —D2 UPiri — B — kijZt>(.^r AA-2 » J /4 GZ PUMI D 

1—1 

p p m U 

Numt>er of Samples = U 

Ai^L£. y 

D 

f s 9 

Bl =390PPM fl 6 

n 

^^^^jiPI 

Samples Collected LAB 

Firm: FDA •^C/^.^A 

D Date: (a/^fj/o j 

n Time: l\:n S 

D Samples Analyzed 

D 

—u XRF Unit: ^CS=( Book: ^:7 ) 

Date: _ D ilnloH­ 1—1 U Time: PJSL 

Staff: PA J 

ENTERED 

JUW 3 0 5IO04 

t<^<s B2 = 232 PPVI a 6" 

6i^ 

^ 

2-7 ^ 

^3, 

m a IK >^v^V • -f^t--

Omaha Lead Site 46130 

IA = 3.=;7 I'PM a^ S( RAPK (I" ) 

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

Property CoiiTypieto©^^ Agre®m@o'it 

I liis 5.grevVi"!-r;r_i uocuiriciiis int- coiyrplcijon oi I'OiijOval activitids peitonijeu oii uic bciow ijiic^cj properly. 

The propei't)' o>vner's signature liidicatef; thai the propeity owner a satisfied wixh ifse restoiaiion ofthe 

subject pioperry. and that no ilei.ns -jre m question, now, or at any tmie in me iittDre, iiicludiiig any 

remaining warrant}^ (30 days total, i axcepi those items listed below, if any. 

Pir.:>pe:-!:y !1B: 

Property Addrw 

.Ai/^0_Aj/17yiyriAL. 

'^yyy:/Asffrs^.AA..._AAys^^^. 

P«Km.: S^J^OQi^ l f 

ls;esitoraS:5oiSii liilems itira Qiaesitiiofb: 

•i ReQinr^di cc-rreei^5o'[ris tto compieue iiiTi^s p^^p^S-s'. 

•J 3gree restoration is completed, except as noted abovs 

I — I 

 ! \ do not agree restoration is complalec 

'/yiOwi^er' t Ss SiS-ijaiiur _,'ili::i:rJi:U-iiOe C ^/n ; . dod UJ' y ^ , py^ I" 

i
••myPiiideiit Techiinlo^jes. Inc. (Prudent) is under coniraci wiih lhe U. S. Environmenial Proieciion .'\gency (tPA ) to clean up leadeonlaminatod soils ax ;i number of properties l.^cated in Omaha, Nebraska, including the property located al 

-yOO\iiA> A^/y\ /*7 / The F.PA requests your permission to allow Pnident lo perlorm .n soil clciinup ,it tlii.s 

property lo remove lead-contaminaled soil. By signing this form, the property owner grants permission to Prudent lo perform 

activities related lo lhe cleanup including soil sampling, removal of lead-eontaminated soil, and restoration ot'the referenced property. 

Ifyou have any questions about the soil cleanup planned for your property, please conlact Prudent souih olTiee for the Omaha Lead 

Sile cleanup-at (-102) 73.V11S8. General questions aboul tlie Oniaha Lead Sile cleanup can be directed to lhe EPA Public Int'ormation 

Centers al (402) ''11 -.•;n45 (South OmaliMiffice) or (402) 991-9583 (Nortii Omaha oftice.i. 

Propertv .Access Cjianled By: 

I (Pl&se Print Name) 

Property (.)wner Signature 

(Date) 

ROPERTY INFORMAT^N 

ted by resident aiid/or property oivner — please print) 

RESIDENT NAME: Renter 

RESIDENT ADDRESS 


tJOcD (y^ d/l/d./)/) I 

IF RENTAL. PROPERTY OWNED BY: 

^i^Tyy/tpp- ^ 

p y 

OWNER'S MAILING ADDRESS; 

OWNER'S TELEPHONE NUMBER - HOME: ('VO^'V S -!? — (c> olf-S ' WORK: 

( ) . 

AGE OF HOME? YEARS. HOW LONG HAVE YOU LIVED HERE? 

HAS THE EXTERIOR BEEN PAINTED OR COVEREDD WIT WITHH SIDIN G SINCE 1978? NO

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: /yf A 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:

-M- COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETC.) 

/ 

/ 

..VI ITl-IORITY FOR ENVIRONMENT,AL RESPONSE ACTIONS: The activities to be implemented by EPA under this .agreement 

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

CERCL.A,, 42 U.S. C 9603(e). which provides entry for "delcniiiiiing tlie need for respi.^nse, oj choosing or taking any response aclion 

under tills lille, or otherwise eni^orcingthe provisions of the title.'' 

8080 Ward Parkv/ay, Suite 405 5600 S 10 3t 4242 Medical Drive, Suite 4250 

Kansas City.'MO 64114 Omaha. Tilebraska 62107 San Antonio. TX 7S229 

Phone: (816) 363-3703 Phcjne: (402; 733..11S8 Phone: (210)822-9688 

Fax: (316) 363-3707 F<1>:: (402) 7?.3-18Sri Fax: (210)679-6677 
mmm ENVlROiNMEiVTALJi 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address: ^^^ ^ /y)l,A)/yj/ Date: lO/^//2ci)io 

Phone: ^cPZ.. ^^ ^ ' fyPZ 13 ^"^^' ' ^ q ^ 7 ^ 

^dyy/y.'T~^iy<L A77^.y^ ./UE ^ 6 | ^ g "^ 

ksy(7y\wA. -r-JL i ^TSAAy ^ 

Property Ownery^ Prudent 

Signature: Signature: /xA/^. 

8080 Ward Par-kyifay. Su/e 40 

KansasCity, rJlO 6411 

Ptione: (816) 363-370 

5600 S 10 St 

Onnatia. Nebraska 68107 

Phone; (402) 733-1188 

4242 Medical Drive, Suite 4250 

San Antonio, TX 78229 

Phone; (210)822-9588 

c.>v. lOinv e70j!«77 
29374 

Omaha Lead Site Owner Name: _CAN/LRANH BAY INVESTMEN 

Site Sketch Address: 2006 MIAMI ST 

Phone: H: W: 

Sample Number Lead 

Concentration 

Sample 

Coltected LAB 

RYASCPXA-29374 Fl 3>2 Ca» ppm D 

RYBSCPXA-29374 F2 ZSJO ppm D 

RYCSCPXA-29374 Bl 5? ^ ppm D 

RYDSCPXA-29374

RDZSCPXA-29374

RGZSCPXA-29374

RPZ0Cr)(A"29374

 B2 

 02 " 

 GZ" 

 PZ­

^/p > ppm 

-pprn­

-ppmppm 

-B­ -B­

-Bn 

-B 

- &

-B 

Number of Samples = U 

AM-^ y 

Exterior Paint North Anrow 

• Good 

• Poor f 

[ul Not paint 

Samples Collected 

Firm: ^X/^^_^Sf^dlL17S. Date: Jnl/yR/cy j 

Tirne: W'.n S 

Samptes Analyzed 

XRF Unit 3(S ^ Book: ^ ^ 

Date: _ ilnhH- Tim«: _ PJSL 

Staff: PAJ 

ENTERED 

•A^talK 

f n f g rin t t/TcOmaha Lead Site 46139^ 
N 200

6 Miami 

A Printed

: Nov 16,2010 

www.dcgis.org/dogis 
Page 1 of 1 

"> 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2609449. 

Original Call Date: 

Work to Begin Date: 

10/05/10 

10/07/10 

Time: 

Time: 

4:27 

5:00 

pm 

pm 

Op: SIVA18967 

State: NE 

Address: 2006 

County: 

Street: 

DOUGLAS 

MIAMI ST 

Place: OMAHA 

Twp: 15N Rng: 13E Sect-Qtr: 10-SW 


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)733-11! 


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 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Nuniber Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITYOFOMAHA-TRAFFICSEWER RICH/TRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

 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... 10/5/2010 
TECHNOUmiES, INC. 

ENVIRONMENTAL 

ENGINEERING AND 

CONSTRUCTION 

SOLUTIONS 

SITE SAFETY HAZARD ANALYSIS 

Address: Excavation Date: -dJ7s3sdfd^ 

Crew: — 3. Backfill 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 

Condition 

Ot 

c?c 

r)\/­ ny 

y^n^ 

A)ryM 

XjSil^ 

fOpM' 

UsyL 

AdotxH^ 

L>ytip_ 

XdoyM(^ 

X}.r^ 

Jspyi 

Hazards r •• 

Corrective Action 

Crew Foreman 

Site Safety Office 

Date: 

^fy - /<^- 1 • y ^ 

8080 Want Parioiiay, Suite 405 5600 S 10 St 4242 Medical Drive, Suite 7250 

Kansas Gity. MO 64114 Oinaha, Nebiaska 68107 San Antonio, TX 78229 

Phone: (816) 362^3703 Phone: (402)733-1188 Phone: (210) 822-9588 

Pax: (816) 363^3707 Fax: (402)733-1883 Fax: (210) 579-6577 
31,15/ 

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^