TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 25147 DATE: 1/15 

ADDRESS: 2926 MYRTLE ST 

REMEDIATION CONTRACTOR: PRUDENTTECHNOLOGIES. INC. YEAR: 201(^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

BT PRE AND POST VIDEO OF PORPERTY (DVD) 

[2 ^ EXECUTIVE SUMMARY 

Q^EPA-PROVIDED PROPERTY SKETCH 

[ F SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

Q^RESTORATION AGREEMENT 

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

d CONFIRMATION DATA 

\3 PHOTOGRAPHS 

0 AS-BUILT SKETCH 

C/ SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

0 PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

Gr UTILITY CLEARANCES 

H PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

SIGNATURE DATE 

30218425 

iiiiiiniii 

Superfund 
PROPERTY SUMMARY 

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

' 

Property Address: 2926 MYRTLE AV 

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: 

Bl = 320 PPM @ 2"; EA = 215 PPM @ 2" 

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 ofareas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES. INC. 
Find Record Remediation Query | Lead Remaining Quer/ I Property Damage Query 

Backfill: 

Sample Area: 25147 - 2926 MYRTLE AV 

Owner: 

D Owner Occupied 

Owner Name: 

lOTY OF OMAHA" 

Owner Addressl: 

|C/0 nNANCE DEPARTMENT 

Owner Address2: 

11819 FARNAM ST 

City: State: Zip Code: 

lOMAHA |NE 168183-

Owner Phone Alternate Phone: 

I 

Contract: 

Contractor: |PRUDENT2010_S 

Contract Option |OPTION 1 

User Provided Owner Information 

Owner Name: 

1 

Owner Address: 

1 

City: 

1 

State: Zip Code: 

1 1 

Owner Phone: 

1 "

Alternate Phone: 

1 

Assessment: 

Qualifying Group J400 

Assessment Max XRF Value f 185 

Resident: 

Resident Name: 

[UNOCCUPIED 

Property Address: 

|2926 MYRTLE AV 

Zip Code: 

|68131-

Resident Phone 

r 
TECHNOLCX:-T.ES, INC. 

EFA ;rtv Close Oof. 

Satc/TJme; 

QiiadsExcavatci-t'B \ 

Property Address; "ZAT-^e (^.(^(rf^^ 

Owner's Name: ^ rS& o^ ^'>^avuj<^ 

Cositiractor Growp: lPriiuk>,nt Tecllmo!ogic.s, FliniK. 

E:5c:iivatioii Genera) Yes No 

I 11 necessary, were the correcl quadiaiU(s) excavated and restored? / 

2. ir necessary, were the conect areas of drip zone excava(ed and restored? / 

Grading Sod and VcgeilatioRi ¥es No 

1 Does the grading around the perijiieter of the house in excavated areas generally slope away 

from the liouse? / 

2 

Has sod been laid m ali areas tliat were excavated? / • - 1 

.1 . Does (he sod appear to be generally healthy and growing? (Only evaluate if inspected al a 30 

/ day iinie period) 

4. 

Are sodded areas generally' firm and evenly graded? / 

5 Arc tlie joints between the sod strips generaJly tight? (Only evaluate if inspected al a 30 dai>' 

tune penod) / 

0. Was the property graded such that water will not pool on tlie property? 

/ 

7. W;is damage (o landscaping or plant materials a\'oided? 

/ 

0;i!teS; Fences and RKlaiaimg Watis 

Yes ujL^Oy . No 

! Do gates open and close freely? (If applicable) 

Were all gates or fences taicen down dunng restoration activities reinstalled? (If applicable) 

7 

Was damage to gates or fences avoided? (If applicable) 7

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

FoMKidation, Stains, and Gulrtej's ''i<t% I M 

Was damage to the suiing or trim avoided? / 

Was damage to the foundation avoided? / 

W;is damage io windows a\'0Kied? 

7

/ 

4. Was dania";e to ^vindows or door screens avoided':* 

Was damage to downspouts or downspout extensions avoided? 

7 

Sidewalks %n.A pitivgways (Coni'c'e.ite) Y«a No 

!, Was da.iiiaj;e to d]"ive\va\ sisrfac;es avoided? 

2. Was damage to walkway surfaces avoided? zrj 
Owners confiimeiits: 

Inspection notes: 

y

^ r -'•> y ' y hy\ 

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

EPA Representative Q^ J H Date: i\»''W 
hTHNDrDGIES. INC. 

AS - BUILT DRAWING 

OLS#25147 

Date Excavated: 10/06/2010 

t'SEPA Signed-Off Date: OMAHA LEAD SUPERFUND SITE 

ZSIUT 

Omaha Exterior Paint Nortti Anow Lead Site 

Site • Good Sketch 

• Poor 

Sampling Address: z'?2fe KWRTl- g AV 

Q'^Not paint 

Sample Numtjer Lead Sample Samples Collected LAB Concentration Collected Firm: fijjsj. PS M 

f^YASCPXA-ZSWT Fl Z12^ ppm D Date: llll^ll O 

RYBSCPXA-25)H7 F2 _a5_ ppm n Time: q:MOA>A 

RYCSCPXA-25147 Bl Jil l ppm D Samples Analyzed RYDSCPXA-25147 B2 K^»l ppm n 

fajzscpxA u5wn oz — ppm n n XRF Unit: toa/'/ ^ Book: 24B& nozscr^xAZBi't? ez - ppm a D Date: _ 

npgccpxA.asmT pz ppm n n Time: 

-EtL 

Staff: M^W Number of Sannples = >-\ \ Q 

Legend: Fl = Front Left, F2 = Front Rigtit. Bl = Back Left, B2 = Back Rigtit DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facinc property 

- * « * . • I*. . »t •i X 

£'JVT'JE'AfX> e NOV 1 9 2010 

^ 

CD 

B2.-

H73f J.i«l 

BI=320 PPM a 2" 

:r-i -(£ ­

2.12c 85.. 

•>l <l 

© 

(^;' 

EA = 215PP!M'S 2" VlfkLVi 

.iA^?rni. Av. )irv-Jim.w. CfKiaexi )6-Ma>--')M 

CONTRACT #: EP-S7-10-05 PRUDENTTECHNOLOGIES, INC. 
SEFW 

Property Completion Agreement 

This agreeinent 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 tP; ^ ^ ^ : ^ 

Property Address; ^9p( ^ ^^ ^

Pk AJCAUC ^ 

^!! ^ CiJA C.4 "r^^/. ^ 

P"""'' ^^ H0^~ ^^H-^JtUk' 

Restoration items in Question: 

Item: 

item: 

Item: 

item: 

item: 

item: 

1^ 1 agree restoration is completed. 

[ U I do not agree restoration is completed at (noted deficiencies above) 

^^yyyyyy 'f-ji^.^y^A<y-;po/Ci 

Owner's Signature ^ Date 
(FAX) P.002/003 09/10/2010 16:01 

Pradeat Technologies, Ine. (Pnuient) Is under eontrect witb the U, S. Bnvironmeote) Protectioo Ageney (EPA) to clean up lead­ contamintTwi lolli at a wamiba ofproperties located In Omaha, Nebnika,faiclnding the propetty located at 

J<^J<. /r\-y4W wc ^ __. The EPA requetu your peimisiioa to allow I^an t ta perfbnn a aoil cleanup at this 

propeny to leiAbve lead-contaminated aoil. By f Igning thia tbnn, dte property owner gtanti permiMion to Pnident to perfonn 

activltiei related to the clunup Inoluding soil Mmpliog, removil of lead-conlaminated soil, and rcstoran'on ofthe leArenced propeny. 

Ifyou have any questions about the aolt cleanup ptansed fbr your propeny, pleaie contaot Prudent Somh Qmnliii nmee fer the Oroafaa 

Lead Site cleanup jit (402) 733-lUS; 733-145S. Oeneial queitions about the Omaha Lead Site cleanup can be directed to the EPA 

Public Infbrmatlon Centen at (402) 73I-304S (South Omaha oflFice). 

Property Access Granted By: LjilliAi ^ Li^UAj^ h 

(Please Print Name) 

Property Owner Signamuren : ^jC^ y^yAAA /^'VA^/Q 

^:^igmture) (Date) 

PROPERTY INFORIMATION 

(To be completed by resident and/or propeny owner - pleaM print) 

RESIDENT NAME: <w / q y Ot^nj^l^ Ranter 

RESIDENT ADDRESS: 

S^'=fi(o m^r-^U. Ay^^ 

^ 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING AODRBSS; 

i^[\ ykrAi^rA ^^.^yy nu o^i ^ 6Mh 

OWNER'S TELEPHONE NUMBER - HOME: J L WORK: 

i'/(}M vy^-v^c/ ^ 

AOEOFHOME?! YEARS. HOW LONG HAVE YOU LIVED HERB? .YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDINO SINCE 19787 _YE8 .NO 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD:. . NUMBER OF OCCUPANTS 7 YEARS OLO AND OLDER 

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PU Y IN THE YARD FOR 6 HOURS OR MORE PER WEEK: 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOOS, ENTRY GATES, ETC,) 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: The activities n> be implemented by EPA under this agreement 

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

CERCLA, 42 U.S. C 9603(e), whid) provides entry Jbr "determming the need ibr response, or ehoosing oruking any rcaponse action 

under Ais title, or otiierwjsa enfbrcing the provisions ofthe title." 

8060 Ward Parkway, Suite 405 5600 S.10"> Street 4242 Medical Drive, Suits 4250 

Kansas City, MO Q4114 OmahB, Nabraeka 66107 San Antonio, TX7B22S 

Pfione: (816) 363-3703 

Fax: (B16) 393-3707 

Phone; (402)733-1466 

Fax: (403)733-1663 

Phone: (210)822-9686 

Fax: (210) 679-6S77 
ENVrRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address: Oada^ U\- Dare: ^ I \ ^ ^ \ D 

Phone: BVID: 

(fi^f^ ^ 

g: M4 

^ ^.^ 3 5 Bl^^rftp TW)^g ai i cy^y^-^ 

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g ^ iMir^ N:^ t n ^ SU- V/ac^ ^ [; 

(g) 14 I ^ QU-A^O S H 

(^ ^.-^15 ^rct^^t: c ^ 

(^ Qsoa .filc^^.L-. 

g^ ^ l<r^q l^lareuc^ 

) S H 3 F 1Q r et^ 

g^-^i-/ 

Property Owner Prudent Employee 

Signature: Signature: (jL^ _ 

8080 Ward Parkway, Suite 405 5600 S 10 St ledical 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 Civ . /4AOI 7^ ^ •lOO^ C o v III M C70J«77 
*vi--,-^«-Vs»"i^- ri-i-vt-iii-rir; V 

Omah Exterior Paint North Arrow a Lead Site Owner Name: LQU/' S E . ThCimaS • Good Site Sketch Addrass: 9 ^ » 4 ^rt^/tTi.£A'y 

Phone; H: Vgvr-,?/»3fl W: 

Q^Poo

Q Not pain

r 

t 1

Sample Number Lead Sample 

Samples Collected LAB Concentration (^llected Firm: /S^«^ g J 

RYASCPXA-^^/^T" Fl ZZ5 

D Date: f/r/t>6 Aufi^ jf/a/tiF 

RYBSCPXA-£^/Vr F2 D Time: /fi'T f 

K<CSCPXA-Sff/*^7 B1 

D 

RYDSCPXA-^^/ Samples Analyzed y 7 B2 D 

RDZSCPXA-gj^/i^jr D2 

a" D XRF Unit 103 7 Book: / W 

RGZSCPXA— 62. a D Date: I-lB-i?i. 

nPZSGPXA- -PZ­ a D 

Time: f\n\ 

Staff: L A Number of Samples = jP ; 

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

All quadrants arenas viewpd ftotn the street, fedng propefty 

\.i.^: ENTERED 

SHd 

..5l3..x...TlCi 

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rr?n 

r PZ''<fZCf 

l[3LlJtt,: 

Zzi: 

4 

^ 

J ^ 

fi-= : F2.: -< Q 30^ 

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enifin e vfi/ ; ; : ; : 

fav» -. <• : 1 -. -. -. 1 ': . . • 1 t ': OteUlMO 
ton ^B ' ^ ' fs^af 

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• aa© 

2926 Myrtle 

A Printed: Dec 08, 2010 

www.dcgis.org/dogis 
Page 1 of2 

"> 

Create Another Ticket Back to Irth Intemet Send Email 

YOUR TICKET NUMBER IS 2592069. 

Original Call Date: 9/14/10 Time: 5:18 pm Op: SIVA18967 


Work to Begin Date: 9/16/10 Time: 5:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2926 Street: MYRTLE AVE 


Twp: 15N Rng: 13E Sect-Qtr: 16-NE-NW-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 LEVEL3 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVELS LEVEL3 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... 9/14/2010 
Page 2 of2 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT Alt: 4062071494 ELM LOCATING 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK

Day:

 ELM LOCATING Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/14/2010 
ISOHNOLOMS, CONSTRUCTION 

mc. SOLUTIONS 

SITE SAFETY HAZARD ANALYSIS 

Address: -.-2mJ!ri^^i^^=Jt ^ 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 

Stmctures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

Condition Hazards Corrective Action 

CPT ^ 

e^ 

h^' 

v^ 

' 

ore 

ar^ 

m 

PC^>C, 

a y ^ 

1 ^ ^ 

C7^ — 

-

Site Safety Office 

Date: 

W n WwfVoriony . SiMe4(W S600S10at 4242 Medical Drive, Suite 7260 

Ciu M C^ , Ma«4114 Omliia, NctaaMa 48107 San Antonio, TX 78228 

ihone: {SIS) sas-aTOS VlMatmr. (402) 733-1 ISS Phone: {21t>) 822-i9688 

Fac (402)733^1S83 Fax: (210) S70-6577 
^9^^/1 iRTH Mi. 

010