TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAIDW: ^f^ D Date: 3//3/7)B 

Address: 2377b fn27)klf/-( ^ 

Remediation Contractor: Coastal Environmental Group_ Year: _2007 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

m Video of property (DVD) 

i i Executive Summary 

EI EPA-provided property sketch 

^ Signed Access Agreement for subject property 

Q Signed Access Agreement(s) for adjacent property 

Pi Restoration Agreement 

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

W.. _ Confirmation data 

m Photographs 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

D Utility clearances 

Dl Property information fi-om Douglas Coimty Assessor's Office 

D 

Q . ' 
Final Report Property Check List (piease place with each file) ^^/^T^ O 

Hard Copy Information ^^^ ^ ^aJTi. y ^ 

Property Check List 

y^. Site Working Drawing Map 

?i. EPA originals Map 

iK Douglas County Assessor's Map 

^ Property Contact Sheet 

Agreement 

y ^ Access Agreement 

y . Restoration Agreement 

Miscellaneous Documents 

.yyma \ Map from the Field 

Xchang e Orders U ^ 

jyXK V Data 

y . Any emails or PO correspondences tO y 

Property Completion 

1. Executive Summary 

2. AS BUILT 

y3^Property Completion Agreement 

.-^T'Any buyout info or reimbursement info YX/y 

y . Check or money order copies '^ y 

y>. EPA Property Close Out Fonn 

yykiVdchQd Begin Video 

Electroni c Documentatio n 

^rawing s 

^ ^ EPA original 

2N Working Drawing 

3. AS Built.vso 

V 

4. AS Built.jpg 

Photos 

Begin Photos 

2 During/Excavation Photos 

? Sod Photos 

\ 30-Day Sod Photos 

Scanned Documents 

' Final Documents 

•2 Executive Summary 

Videos 

\ Begin Video 

% My Movie 

V 
Property Access Checklist 

Property m: yZTx^y ^ _ Q WORK STARTliO 

ON: _/ /_ 

ON: / / 

Renter: 

Phone: 

/jjvv^c^iv^v y t (y'7>/n Fa\: 

Cell/Pa<«ci 

PhoiK':i Additional Information: 

y...MSy vy 

Cell/P:iwr: 

•f e ' Nofificafion Leffci 

y»^ JT!11^77^1 yiTA •iyliyy 

Access Aureenicnt 

Kcsf01 ation A<i;rccnicnt Sijine(l:/^/X/<i^ 

Top.soil Sampliiii> (if applicable) By: 

D Disposal Sampling (if applicable) Bv: 

Garden Saniplin*; (if applicable) / / Bv: 

Utilitv Clearance Callc(l:/(9 y§7icg 

^y-zBt^^jT- /ol^^t$ii3o M/^ 6 

D Video/Photos (Before) On: / / Bv: 

• - ­ Vidco/Pliofos (During) On: Bv: 

n Video/Photos (After) On: Bv: 

g Video/Photos (3()-Day) On:_ Bv: 

n'" Property Completion A}»recnieMt Signed: By: 

D Final Rc|)ort I.ssned: 

Bv: 

Air- Moniforin<> (as aj[)plical)le ) 

LJ Conuniinify LJ Crow On: / / Bv: 

Results: 

[ n Comnuinity [U CrcM' On: / / Bv: | 

1 Results: 

1 LJ Coininiinity HH Crew On: / / By: 

Resnifs: 

Omaha Lead Site 

1 
UJiyy^-^ ^^?/ y - 1919651 26400 

Owner Name: JUANITA A MORROW 

Address: 2818 FRANKLIN ST 

Phone: H

Sample Number 

RYASCPXA-26400

RYBSCPXA-26400

RYCSCPXA-26400

RYDSCPXA-26400

•ftOZSOPXA 26400

RCZSGPy^ 26'100

nnZGCPXA 26100

 F1 

 F2 

 B1 

 B2 

 BZ 

 GZ 

 P^ 

:RED 

ailfi ft 42004: 

T?3 l^Ty^-^^A i 

 W. 

Lead Sample Samples Collected LAB Concentration Collected Firm: V\> a \ Q& \ T^tv^ 

ppm D Date: 0~I - 5 S - o H 

ppm H^ D Time:

AC- X ^ 

ppm 

ppm 

ppm 

B" 

D 

D 

n 

n XRF Unit: 

ppm D n Date 

ppm n n Time 

Number of Samples = i ^ 

Staff: 

 "i^-. 3 S> 

Samples Analyzed 

7> \ ^ Book: D ti 

S^-^-O M 

E H 

r 

Omah a Lea d Site Exterior Paint North Arrow 

Sit e Sketc h B^oo d 

• Poor 

Q Not paint ^ 

U^ATJ (Jf l^f[ly ^07 ^ 

liof^ ^ Uy^ 

uJ.A'.^t? ^^^M i 

m^(fi^o^-Lt- ^^ m \U^^ 

Omaha Lead Site 46130 
26400 

Omaha Exterior Paint Lead Site 

Nortti Arrow Owner Name: JUANITA A MORROW 

Site Sketch Address: 2818 FRANKLIN ST 

Phone: H: 

Sample Number 

RYASCPXA-26400

RYBSCPXA-26400

RYCSCPXA-26400

RYDSCPXA-26400

nOZCCPXA 26100

RGZSGPiXA 26100 

nPZSCPXiA 26100 

ENTERED 

AUG n V2004 

W: 

Lead Sannple 

Concentratio ncentratio n Collected 

 F1 ppm 

 F2 

ppm 

 Bl on 

ppm 

 B2 rA ^ ppm 

 9Z 

ppm 

-GZ ppm 

ppm 

Number of Samples = \

0" 

B" 

D 

D 

D 

^ 

?<oe«^'^ u ^ 

I ^ : 

\ 

12-0. 

B^oo d 

• Poor 

^ [~| Not paint 

Samples Collected LAB 

Firm: VX>c \ \ ftft\ T^rv^ 

D Date: O T - a a - e> H 

a Time: •:^\3 S 

n Samples Analyzed n 

D XRF Unit ?-: \ \ Book: % % 

D Date: _ 

Time: _ n 

Staff: ^ ^ 

c 

&. 

,V ,a3 

1 3 0:)- I- QD 

0/ 

r) 

y 

. ^ 

o 

f

ib 

. \ •V

y ^ \u%..l %-].{ 

' S\ 3^CU>£<ji-gf fos\ ^ U % -

Omaha Lead Site 

46130 
Douglas County NE GIS Map 

Disclaimer: This map is not guaranteed 

to be accurate, correct, current, or 

complete and conclusions drawn 

are the responsibility of the user. 
5 f"r Douglas County Account Information io/a'6 Page 1 of 

Dougla s County , Nebrask a Propert y Recor d - R221266000 0 

Print Report Information is valid as of 2007-8-24 View on Map Values not finalized until after Board of Equalization Treasurer's Tax Report 

Owne r 

MORROW JUANITA A ,. i , . C i ,.. . 

ETAL iyrH{7Uc<-^ y / I^y7> f^^ZcUcMc.^ 

^ ji>rd f^--.y<y77ry<9/2/r& 

2816 FRANKLIN ST #'' \ 

OMAHA NE 68111-0000 ^ \ 

Propert y Informatio n \ 

Key Number: 1266 0000 22 \ 

Account Type: Residential \ 

Parcel Number: 2212660000 \ 

Parcel Address: 2818 FRANKLIN ST 

OMAHA NE 68111-0000' 

Legal Description: SHINNS 2ND ADD LOT 10 BLOCK S W 1/2 30 X 127.5 

Valu e Informatio n 

Land Improvement Total 

2007 $100.00 $0.00 $100.00 

2006 $100.00 $0.00 $100.00 

2005 $100.00 $0.00 $100.00 

2004 $0.00 $0.00 $0.00 

2003 $100.00 $0.00 $100.00 

2002 $0.00 $0.00 $0.00 

Sales Informatio n 

Lan d Informatio n 

Acres SF FF Units Depth Width Vacant 

0.08 3810.0 30.0 0.0 127.0 30.0 Yes 

Lan d Attribute s 

Attribute Attribute Description 

Improvemen t Informatio n 

httn://doue'lasne.manninf-online.cnrn/Dniif'lasCnNe/static/accnnntinfn isn'^anr.nnntno^^R? 1 0/1 9/7007 
CONTACT FORM 

Property ID # £^7 ^ 

Property 

Address; j7B7£_^^</y7Ms7 

Initial Contact: Date yc/s Time: y^Z ! Action: /aW>? ^ ^^^/^^g^/gi 

Second Contact: Date:_^ Time Action: 

Final Contact: Date: Time Action: 

Final Action: Transmit to EPA D Other Action: D 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 
X 

• ^ ^ • Omaha Lead Site—Fixed Price EP-R7-07-05 {Ml} Coastal Environmental Group Inc. 

www. coastal hazmat. com 

COASTA L ENVIRONMENTA L \ y G H 0 U r . IN C 

EXECUTIVE SUMMARY: 

26400—2818 FRANKLIN ST 

No Issues or Concerns Issues/Concerns 

Detail Explanation: 
As-Built Drawing ^ ^ ^ 

COASTA ^^!^&^ L Oinaha Lead Superfund Site 

26400 

Omah a Extarior Pmrrl Lea d Sit s 

NMtfi Aac-w Owr>er Nomo ; JUAr«rrA A wnftRO'/; 

Sit e Sketc h 

Addra&s : i f ij . FF^NKLI N a i _ • Poor 

• Not pant 

Lead Sample 

Conoentrg^o-i 

Sannple Numt>er 

Fifm: 

KYASCPXA-2640 0 F1 

a Dale: 

RYBSi;PXA-ae*OU F2 ? : 1 \ Pom n 

Time: 

RVCSCPXA-264I>D tJI D Siintt>les Ar.'iiyjed RYDSCPXA-264CN3 B? A^ ^ pprn D 

ppm • n XR1= Unil: \ Book r .'^,^. , pl>iti D u L M e _ _ ^...H-CJ 4 

pom D D 

Time: 

Slatf: NiinKwr of Sarr^Xcs • rzrt: 

ENTERED 

41 IR n * ?fin* 

Po doesn't want any 

?(r>f*^ ^ ^ ' heavy equipment on 

the sidewalk and would 

like all work completed 

in one day. Do not 

disturb rose bush in F2 \ 

and would like for us to 

do an excellent clean \ 

up job after the work 

has been completed. 

i^ 

y 

o 

^'b' 

F2 = 43 PPM @ 6 " 

EA-s = 234 PPM 

w% iy7:<^'y<^^M 

'r>sit.yM^iU. 

•f iOX\ 5t-U*\ S*­

«61X» 

OLS# : 2640 0 

Dat e Excavated : 11/2/07 

Dat e USEP A Signe d Off: 12/3/07 

Legen d 

Area not Excavated t ^ Dripzone Excavated [SS^^ Quadrants Excavated 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
i3«, EPA 

EPA Property Close Out Form 

Property #: 7677171 . pr.p.r., K^^. yy^^^£f7/J7 , 

Date/Time: 

Quad Contractor Croup s Excavated: 

Excavation Ceneral 

1. If necessary, were the correct quadrant(s) excavated and restored? 

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

Grading Sod and Vc£etatioii 

1. Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from the house? 

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

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? 

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

time period) 

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

7. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls 

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

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

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

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

Foundation, Sidiog and Gutters 

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) 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

y 

A/A 

Yes No 

y 

Yes No 

^ ^ 

A/i 

^1^ 

A/A 

Yes No 

M-t 

iJk 

yA 

f j ^ 

7 ^ 

Yes No 

h / ^ 
Owners comments: 

Inspection notes: 

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

EPA Representative Date: /^/>7 b 7 
Property Completion Agreement 

This agreement documents the completion ol' remedial activities performed on nn property. M\ 

signature will designate thai I am satisfied with the resloration of my properly, and thai no items are in 

questions, now, or al any time in the future, except those items listed below, ifany. 

Property ID: ^^^/^ Q 

Property Ad.lrc.s.s= ^^^ Q 7='£/JAy/Z07Ay 5 ^ 

Owner: ^^^^ z 7 ^ /^^^.^ ^ 

Phone: ^^^ ^ J) ^yy_ 0-79 ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

_J 

lyi I agioe restoration is completed, except as noted 

 I I <lo not iiRiee restoration is completed 

'^ i/7f/y '^'^TTy T Contractor's^ignature 

I
PROPERTY Cl EARANCF WOKKSHfET 

Date Property I D //-oz-ol l&yyz 

Property ProjecL Omah a Lead - Fixed Pntrt.- Zi7J6 T^^^/cj;^ s — Address 

Measurement XRF ID 0107 ';i Count/Tim e 

'ield Sliots 

Readin g Sampl e Are a Shot * Readin g Sampl e Are a Sho t # 

/=2 y- 6 

-ym-M ^ZJT e^A'S 

Sampl e Are a FZ ^-G 

Aliquo t 

I 

2 

3 

'1 

', 

I n Sit u 

Readin q 

9V ft— /df. 9(> 

O f 

Composit e Reading s 

(Bag ) 

b f 

V 

XRF Corrected Value —> 

(use calibration chart or add 

Composit e 

Averag e 

(Baq ) 

n 

^ 

Composit e 

(Drie d & 

Sieved ) 

Analytica l 

Spil t Sen t 

7 

L a b 

Numbe r 

Analytica l 

Result s 

2 0 % to ualue) 

Sampl e Are a ;^'i > Pass/Fai l ? 

Aliquo t 

.1 

I n Sit u 

Readin q Composit e Reading s 

(Bag ) 

Composit e 

Averag e 

(Baq ) 

Composit e 

(Drie d & 

Sieved ) 

Analytica l 

Spil t Sen t 

? 

L a b 

Numbe r 

Analytica l 

Result s 

2 

3 

"•1 97 XRF Corrected Value ­ > 

li (use calibration chart oi- add 

20»/o to ualue) y)2> <y 

Sampl e Are a Pass/Fai l ? 

Aliquo t 

i 

I n Sit u 

Readin q Composit e Reading s 

(Bag ) 

Composit e 

Averag e 

(Bag ) 

Composit e 

(Drie d & 

Sieved ) 

Analytica l 

Spil t Sen t 

7 

L a b 

Numbe r 

Analytica l 

Result s 

2 

3 

A 

') XRF Corrected Value —> 

(use calibration chart or add 

2 0 % to ualue) 

Sampl e Are a Pass/Fai l ? 

Aliquo t I n Sit u Composit e Composit e Analytica l Composit e Reading s L a b Analytica l Readin q Averag e (Drie d & Spil t Sen t (Bag ) Numbe r Result s LB„ai) Sieved ) 

XRF Corrected Value --> 

(use calibration chart or add 

2 0 % to value) 

Sampl e Are a Pass/Fai l ? I n Sit u Aliquo t Composit e Composit e Analytica l Composit e Reading s Readin q L a b Analytica l Averag e (Drie d & Spil t Sen t (Bag ) Numbe r Result s _ (BagJ ^ Sieved ] _ 7 

XRF Corrected Value - > 

(use calibration chart or add 

2 0 % to ualue) 

n i l .lllll l I innAi :. Xl' l lei hiiiri.Tii'v, Siqiiiturp 7^^ ^ 7y/7C^.*^^7~77C HI ti n II 

1 
26400 I quoA: 6> ' ' PZ-y7yyy7y^ 

Owner Name: JUANJJAj^MORROW 

Address: 2818 FRANKLIN ST 

Phone: H:

Sample Number 

RYASCPXA-26400 Ft 

RYBSCPXA-26400 F2 

RYCSCPXA-26400 B1 

RYDSCPXA-26400 B2 

nDZSCPXA 26400 BZ 

nczscpyvA 26^00—GZ 

nrzscpxA 26100—P^ 

ENTERED 

mm (1^ 2004; 

 W: 

Lead 

Concentration 

yh ppm 

^ i l \ ppm 

I ^C ) ppm 

_A2)_Ppm 

ppm 

ppm 

ppm 

Omaha Lead Site 

Site Sketch 

Sample 

Collected 

D 

D 

D 

Number of Samples = i ^ 

LAB 

D 

D 

D 

n 

n 

n 

n 

Exterior Paint Nortn Arrow 

[3^oo d 

• Poor 

03 Not paint %

Samples Collected 

Firm: T=t>Q \ Qa \ T^tv^ 

Date: 0~I - 2 8 - O-H 

Time:

XRF Unit: 

Date 

Time 

Staff: 

 3' . 3 5 

Samples Analyzed 

?•) \ ^ Book: h \

^•^•ou 

E ^ 

^i&^cjflmiy^a^ 

Vcof'^' ^ ^ ^ l^.y/<^.-/^.7 

j ! ^ i7>y^7=7y7 ; 

j-- ^ l« ^ \^if. 

0(\'^il^(y^^i^ i3>. ­

jj l?'X/Z; 

. \ 

^ 

\\^%\ . 

f rar^ ysx 

Omaha Lead Site 46130 
,^tDsr< 

COASTA L 

. Q^•^ f NVIBONMENTA L 

' '* PRO^ ^ C « 0 U P . IN C 

Consent For Access To Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the Unitecd States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

Owner's Name Daytime Phone: ^<7 1 ' ( ] ^Z ? ~ 7 

Address of Property 

covered by this W i y&eukiiA^ ^ y Agreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Grantor in-person to discuss the work to be performed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work before 

it begins. Once the work is finished, the Grantor will be asked to review the work and 

confirm that it is complete and meets with the Grantor's approval. Upon completion, the 

Grantor will receive written documentation from EPA that the property has been 

remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

and with prior notice, for the sole purpose of performing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
COASTA L 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: ^^([ 9 

Property Address: ^2377 FTz^lA77y7y7U ^T ^ 

Owner: t_777_^A7/rA y>77T7^^7 J 

Phone: 

^ ^ 7 737f 7 

On the attached diagram(s) indicate area(s) to e.xcavated and depth of e.xcavation, location of all known 

utilities, subsurface features, surface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log number w ith an arrow indicating direction of view. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

The removal, storage, disposal, and/or return of these items is the Owners responsibility. 

Item: 

y^jy 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 1 of 
COASTA L 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

AJ777U ^ 

Item: 

1 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 2 of 
COASTA L ENVINOMMCKTA L 

C •> O U » . IM C 

Item:

Item:

Item:

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

_ 

5^> 

 ^ ^ 

^7)77 

1 

Item: 

Item: 

Item: 

Item: 

Item: , 

Item: 

1 

Item: 

Item: 

Item: 

Item: 

Item: li 

Item: j 

; 1 

Paqe 3 of 
''^tMfCOASTA L 

Landscape Inventory 

(Use additional sheets as necessary) 

Item Quantity Condition/Type/Species 

Pre-existing property area, 

that will be excavated, that 

is covered with "rass. 

7o y7oy 

Number of trees > 2 inch 

trunk diaineter 7/sry^ 

Number of trees • = 2 inch 

trunk diameter 

Number of Sprinkler 

Zones. Control Valves. 

Timers. Heads, etc. 

•AiUich a slxetch u! the 

--.I'lriiikle:' !L!\ out. 

Number of and size of 

each garden,' flower bed 

area. 

.•U..ivi. ;; NKcicii y y\y\\ z 

Page 4 of. 
COASTA L 

Item 

Agreed upon value of 

plant materials not to be 

replaced bv contractor. 

Note this \alue will be 

used to issue a plant 

voucher to the propert> 

o\N ner. 

Agreed upon list of plant 

materials that wil l be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch ot" v\ei'e 

each plant wil l be placed 

by the coniracioi'. 

Agreed upon area of 

propert)' to be replaced 

with grass sod. 

':ii.'l;:de a skeich .)\' ihc 

;irea(s.> u-. he repi'.iccd '.^'ih 

ii'-ass >0(.l. 

.Area of Ciry or Counts' 

property- to be landscaped 

per their requirements. 

include ••, -keu-i! ..;' rr.c 

Easement .Area, to be 

excavated 

Quantity Unit Condition/Type/Species 

! 

$ 

^ 

7 Each 

SF 

SF 

^ 

SF 

Page 5of. 
COASTA L CNVinONHtNTA L c n o u p . INC . 

Additional Comments / Instructions: 

- 'y/y7y7 yi^y­

^ 7yyA77 o y yyy y T^oo. ^ fo yy^yy U/y'^ He^^y y<^uy 

77/ny^y- /^L£yy7>t/yi^A(y^. 

y / 

n Check the box if Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

tfia:agree n I do not agree 

(2 yjyyykWpl^ ^ 

OwiieP ni^Pss Signatur Signaturee Date / Contractor's Signature Date 

Page 6 of.