TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 28308 DATE: 1/15 

ADDRESS: 2910 ERSKINE ST 

REMEDIATION CONTRACTOR: PRUDENT TECHNOLOGIES. INC. YEAR: 20lfe 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

I^ PRE AND POST VIDEO OF PORPERTY (DVD) 

I^ EXECUTIVE SUMMARY 

d EPA-PROVIDED PROPERTY SKETCH 

d 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.) 

EJ CONFIRMATION DATA 

d PHOTOGRAPHS 

Ca^ AS-BUILT SKETCH 

d SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

d PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

O DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

a UTILITY CLEARANCES 

DJ PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

fLr,4u^ _ illlu 

SIGNATURE DATE 

30217606 ilH 

Superfund 
PROPERTY SUMMARY 

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

Property Address; 2910 ERSKINE ST 

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: 

F2 = 343 PPM @ 6"; EA = 261 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 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 verifying satisfactory restoration 

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

TECHNOLOCIES, INC. 
Rnd Record Remediation Query Lead Remaining Query : Property Damage Query i 

Backnil: 

Sample Area: 28308 - 2910 ERSKINE ST 

Owner: User Provided Owner Information 

n Owner Occupied 

Owner Name: Owner Name: 

IWATKINS JEAN 

Owner Addressl: Owner Address: 

r 

Owner AddcessZ: 

12905 LAKE ST 

City: 

iOMAHA 

State:

NE" 

 Zip Code: 

168111 

City: 

...

State:

 ^ ,

 Zip Code: 

 ^ , 

Owner Phone Altemate Phone: Owner Phone: Alternate Phone: 

r 

Contract: Assessment: 

contractor: |PRUDEI\rT2010_S Qualifying Group }400 

Contract Option |OPTION 2 Assessment Max XRF Value f 474.87 

Resident: 

Resident Name: 

I 

Property Address: 

J291G ERSKINE ST 

Zip Code: 

J68111-

Resident Phone 

] 
TECHNOLOGIES, INC. 

EPA Property Close Out 

Property #: '^"^3^ ^ Property Address: "^A10 Br<i^< -^ -^ 

Date/Time: Owner's Name: "^.^o.. ^ 10AV^\ ^ 

Quads Excavated: ^ 'Z- Contractor Group: Prurient Technologies, Inc., 

Excavation General Yes No 

I. If necessary, were lhe correct quadrant(s) excavated and restored? ^if 

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 J from the house? 

2. Has sod been laid in aJl areas thai were excavated? / 

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

day / lime period) 

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

5, Arc the jomts between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time penod) / 

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

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

Gates, Fences and Retaining Walls Yes No 

1. Do gates open and close freely? (If apphcable) / 

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

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

4. Wasdamagetoretaining walls avoided? (If applicable) / 

Foundation, Siding and Gutters Yes No 

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

2. Was damage lo lhe foundation avoided? y 

3. Was damage lo windows avoided? / 

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

5. Was damage to downspouts or downspout extensions avoided? / 

Sideyyalks and Privcvyays (Concrete) Yes No 

 Was daiiia"e lo drivewav surfaces avoided? 

Was damage lo walkway surfaces avoided? -y 

1
Owners comments: 

Inspection notes: 

^y 

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

EPA Representative ^'^^ . ^ Date: 4i ^ 
'CIINOI.CKIinS. INC. 

AS - BUILT DRAWING 

OLS # 283()S 

Date Excavated: 10/11/2010 OMAHA LEAD SUPERFUND SITE ISEPA Signed-OIT Date: 

<f d 30<^ 

Name _ Omaha Lead Site Date ^C 6 ^> - North Arrow 

Address Site Sketch Time: 

Phone: 

Team /f/'^^ X T ^ .-^-» ' BVID)» '^^ ^ XRF Code /» 3 7 Sa.oH-13-i 

Sample Number Lead Concentration Confirmation Sample 

\^^CrSceKA- 2^/1 ?pa­

•?/fe 

V?^' 331- _2JJ2_ 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

T'Yes nVvj ' 

AZ-Yes CD 

^•.' Yes • 

..JiYes ^ 

V65 D 

No ^ 

No tS^ , 

No Q > 

No tsr 

No O -

No O' 

ppm ves n NtT'Qa i3 

• i T T s i •jr..-],; i 

-•1­

-i 

Zf/I* /f/^iy/^e. 

/f"' 

I I = 343 I'I'M a 6" /-1 ; - . I 

31/6 I ^175^ 

2. f/g c/->^i'. <^ 

LA = 261 I'I'M a S( KAI'E(~r) 

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

Dus agiftevijciu uocuiJiciUi the iotYspiiiiiou ot i'cn'towi'ii actiViues 5.)e;iv'in"ie:u oii die bcJcvi^ iisit;*:? p;''jpej'r>'. 

rhe incipeitv ovvuers signatiiie iiidi&ates iliat the pf('pe.rt;v owaer n Kalisfied with ihc rtstorHiicyn {A the 

isfthject pri.ipen-v' aad that m.) iterrv; are in qtjieslion, aow, or at an)' time in the future, e.xc.l;Ld<ng any 

remaiiiiiig warrant;/ (30 days totaj) sitcept those items listed bel.:m/, if any. 

Propsn:? ID': LDI 

^IDLZSEJMZ'SIZ 

F.ho-nc:: 

iU 

He^tOf'SiUoin K.mn^ orii Qtaesftiiorii: 

I 34it&n© ^ 

jj iltefT?: 

;! litem. 

\ 'Item: 

R0qi!.?«ri*d cn>fir®cfik:'EiiS to C'Oimjplleite; tiv^ piroipeiit]/; 

\ i zci'^e ies'toiation is cornpfete'J, except as noted -dbove. 

J ! ^io v^iA ci;;jree restorsition is. coiripteted 

i^yyi 

o^v Date 

I 
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/•.:• . 

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

f(Lt w>.<_ Vr~ Tlie EPArequests your permission to allow Prudent to perform a soil cleanup at this 

properly to remove lead-contaminated soil. By signing this form, the property owner grants permission to Prudent 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 office .for the Omaha Lead 

Site cleanup-at (402) 733-1188. General questions about the Omaha Lead Site cleanup can be directed to the EPA Public Information 

Centers at (402) 731-3045 (South Omalia ofBce) or (402) 991-9583 (North Omaha office). 

Property Access Granted By 

Property Owner Signature: ^cyM%:^ /^-^-/^ 

(Signature) 

PROPERTY INFORMATION 

/(To*ie completed by resident and/or property owner — please print) 

RESIDENT NAME C^Cojf\\ [^\r Owner Renter 

(ESIDENT ADDRESSL x ^ 

IF J^NTAL, PROPERTYiOWNED BY: 

OWNER'S MAILING ADDRESS; /? , _ . . A* - /^ r-^ 

OWNER' ijS TELEPHON TELEPHI E NUMBER - HOME: J \_ WORK: 

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

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


ALrrHORFTY 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 9605(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 of the title." 

8080 Ward Parkway. Suite 405 5600 S 10 St 4242 Medical Drive, Suite 4250 

Kansas City,'MO 64114 Omaha, Nebraska 68107 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402) 733-1188 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)733-1883 Fax:(210)579-6577 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address: ^ g|l O Q , j . ,^ ; ^ e ^j(_ Date: /J ^ ^ ~ / ^ 

Phone BVID: : ^-/ - (y^SZS'S" 

8080 Ward 5600 S 10 St 4242 Medical Drive, Suite 4250 

Kansas CIM^MO 64114 Omaha, Nebraska 68107 San Antonio, TX 78229 

Phone: (81«) 363-3703 

Fax: (816) 363-3707 

Phone: (402)733-1188 

Fax: (402)733-1883 

Phone: (210)822-9588 

Fax: (210) 579-6577 
I < V &';-'* »V 'f ^iri-nii ; 

Name: _ Omaha Lead Site Date: /O '6~fi ^ North Arrow 

Address: Site Sketch Time: /, io 

Phone: 

\ 

Team ASi^ / Ti^- X4- ^ BVID# ^B}0'^ XRF Code /fi37 OoPlii i33 

Sampie Number 

Lead Concentration Confirmation Sample 

juk. ppm ;^;Yes DAf " No g ^ '^jm' 

J0^ ppm ^cZYes O No 0B\^ -33X. ppm ^ / Yes Q No raC­ gl*? ppm /?2Yes D No g' ^ 

ppm V65 D No C3 

ppm TSS-t3 N6 D 

ppm 

El B 

"smi^mn 

iia-U 53/ ^y* ? 

lUMr-^^t^ 

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r- £ 

3/6 vr 

^- y/^ ygz-iA-z^ o 
N Lega

l Description: 25 X 100 

A 

\ iumf Printed: Oct 07, 2010 

www.dcgis.org/dogis 
Page 1 of 1 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2611136. 

Original Call Date: 10/07/10 Time: 9:28 am Op: SIVA18967 


Work to Begin Date: 10/12/10 Time: 10:00 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2910 Street: ERSKINE ST 


Twp: 15N Rng: 13E Sect-Qtr: 09-SE-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)733-1188 


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 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICH/TRAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNE 1C QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/7/2010 
ENVIRONMENTAL 

ENGINEERBVG AND 

TEOHNOUieflES, INC. CONSTRUCTION 

SOLUTIONS 

SITE SAF*:TY HAZARD ANALYSIS 

Address: .^lDg^^t^^^M.^t 

Crew . jS^tEOfcL-Vfi^-kc^ 

^l'P4

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Bntane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees 

Structures 

Driveway 

Sprinkler System 

other 

Crew Foreman 

to^6 

Condition 

/1// ^ 

^/g . 

i(W. ! ^ 

J±/A. 

.44^ 

y y ^ 

_^22 ^ 

ny/y^ 

/\y/A 

A ^ ^ 

^ y y 

/ly^ 

yiy^ 

Excavation Date: /^'//"/i^-

Backfill Date: JiLMdQ-— 

Hazards Corrective Action 

^^^^^M. P/yi.Q//]l|^%^m.A' 

^yj^irvs /^>^>e^/^aea>u^ 

Site Safety Office 

Date: 

.^^n^Jdy^Ail^ y^^/y/d p^ ­

8080 Want f!artany, Sut e 405 seoosiost 4242 Medical Drive, Suite 7250 

Kansas Oity. 1IOM114 Omalia. Neteaska 68107 San Antonio, TX 78229 

Phone: (816)363-3703 Phone: (402)733-1168 Phone: (2t0) 822r.9588 

Fax:(816)363-3707 Fax: (402)733^1683 Fax:(210)579-6577 
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