TRANSMil'TA L of OMAH A LEA D SITE 

^ _ SOIL REMEDIATIO N FIL E FOLDE R 

SAID #: ^-^m ^ Date: 

Address: 'SHV l '^- "^^ "^-T 

Remediation Contractor: _Envrionmental Restoration, LLC_ Year: 2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

N;]^ Video of property (DVD) _J2Before DAfter c/Basement D 

ja Executive Summary (Final Report) 

jZf EPA-provided property sketch 

zf Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent propeity 

jzT Restoration Agreement 

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

^ Confirmation data 

^^B Photographs JZBefore DCrew Photos n During Excavaticn D Sod 

^30-da y Sod D 

y As-built sketch 

p^ Completion Agreement signed by Propeity Ov.Taer 

o / Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

j y Utilit}' clearances 

0" Property information from Douglas County A-Ssessor's Office 

f^ Property access checklist 

Zl Contact Log 

D 

Environmental Restoration Signature Date" 

Date 
EPA 

EPA Property Close Out Form 

Omaha Lead Site OU#2 

Property #: jTVM ^ Property Address: 5H3>1 -J* ^.b 6 T 

Date/Time: Owner's Name: VouC "boA-^ '^v<-^(Ni>^^ 

Quads Excavated: fe \ Contractor Group : Environmental Restoration (ER) 

Excavation General Yes No 

1. Ifnecessary, were the correct quadrant(s) excavated and restored? ^ 

2. Ifnecessary, were the correct areas ofdrip zone excavated and restored? y 

Grading Sod and Vegetation --.— Yes No 

1. Does the grading around the perimeter ofthe house in excavated areas generally slope awayfrom the . / house? 

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

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at 30-day time • period). 

4. Are sodded areas generally firm and evenly graded? y 5. Are thejoints between the sod strips generally tight? (Only evaluate if inspected at 30-day time period). 

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

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

Gates, Fences and Retaining Walls Yes No 

1. Do gates open and closefreely? (if applicable) y 

2. ^yere all gates or fences taken down during restoration activities re-installed? (if applicable) y 

3. Was damage to gates or fences avoided? (if applicable) y 

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

Foundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? ^ 

2. Was damage to the foundation avoided? y 

3. Was damage to windows avoided? y 

4. Was damage to window screens or door screens avoided? y 

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

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? /J ^ 

2. Was damage to walkway surfaces avoided? y y 

Inspection notes: 

Remedial and restoration activities complete including 30rday sod warranty: 

Li A Representative: .w^^v 1/.(^/..^.^/J./AI/:^X -JW: Date: S/^ l 10 
f^^\ Omaha Lead Site—EP-R7-09-05 * ^y^^ L * Environmental Restoration, LLC 

S^y^jf www.crllccom 

EXECUTIVE SUMMARY: 

47449-5437 S 20 ST 

No Issues or Concerns Q] Issues/Concerns 

Detail Explanation: 
Page 1 of2 

"> 

[ Create Another Ticket ] [ Back to Irth Intemet ] Send Email 

YOUR TICKET NUMBER IS 2459721. 

Original Call Date: 4/10/10 

Work to Begin Date: 4/14/10 

Time:

Time:

 1:34 pm 

 7:15 am 

Op: TRACY24186 

State: NE 

Address: 5437 

County: DOUGLAS 

Street: S 20TH ST 

Place: OMAHA 

Twp:

Twp:

 14N Rng: 13E 

 Rng: 

Sect-Qtr: 10-NW 

Sect-Qtr: 

Legal Given: C 


Type of Work: Excavating the entire property 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)451-1069 


: SAID #47449 


Company : ENVIRONMENTAL RESTORATION 


Contact Name: TRACY BRISTOW Phone: (402)451-1314 


Alt. Contact: Phone: (314)504-4874 


Work Being Done For: EPA 


Depth of Excavation: 12 Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


ALT872 ATTNEBRl CXCATV LEVEL3 MUD02 OMAHACOF 0PPDGPR6 


PAETEC QLNNEIF 


Service Area Contact Phone Number 

Utility 

Type 

ALT872 WINDSTREAM 

COMMUNICATION ELM LOCATING 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

ATTNEBRl ATT/T 

Day:

Alt: 

 80024136249 

Emerg: 80024136249 

CXCATV COX COMMUNICATIONS,

INC 

 ^^j^ j 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 LEVEL3 COMMUNICATIONS, LEVEL3 NA LLC Alt: 

http://www.dhon.ore/irthmtemet/DHONNoticeCreation/MessageText.asD?ret=<RESULTS... 4/10/2010 
Page 2 of2 

MUD02 

OMAHACOF 

0PPDGPR6 

PAETEC

QLNNEIF

METROPOLITAN UTILITIES 

DISTRICT 

CITY OF OMAHATRAFFIC.SEWER 

OMAHA PUBLIC POWER 

DISTRICT 

 PAETEC COMMUNICATIONS 

 QWEST LOCAL NETWORK

SANDY 

RICH/TRAFFIC 

ELM LOCATING 

NO NEED TO CALL OUT 

EMERGENCY 

 ELM LOCATING 

Emerg: 8773668344 

Day: 4025047823 


Alt: 


Emerg: 4025047970 


Day: 4024447197 


Alt: 4024445161 


Emerg: 4024445160 


Day: 4067289343 


Alt: 4062071494 


Emerg: 8887289343 


Day: 8002891901 


Alt: 


Emerg: 8002891901 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://wvm.dhon.org/irthintemet/DHONNoticeCreation/MessaeeText.asD?ret=<RESlJLTS... 4/10/2010 
raji^^vA; 

Contact Information Log 

sAiDj^Y^yy^ 

i^td^ 

Daytime ¥hone:^ ^ .Ir-^ ? ^ / V^ 

j Property Address: ^ Lf^ *^L^ 

Attempt to contact Date/time Name 

brg/^^z-r /^r.,^ai. 

jr^y^K ^ft/f^^^y 

/--?77^ J.VX. 

l-oh/o ~ii:/o 

J:£L 

Q/ ^ 

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liaa 

Property Access Checklist 

1 SAID: ^-IJ^LJ ^ 

Property ASdrcss: • :5y?.?^ .fv?^ 

p

U

 WORKStARTF.bi

 WORK COMPELTED

 ON; 

 ON; 

Owner:.'-

Addre: •Ml. • • 

Renter: 

Phone: 

Fax: 

CeSl/Pager: 

Additional Infonnation: 

K]

n

D

n

D

I S

Access Agreement 

 Restoration Agreement 

 Video Property Before 

 Digital Photos Before 

 Video Property After 

 Digital Photos After 

 Property Completion Agreement 

Signedy>^/^2^// g

Signed:^/^// ^ 

On 

Oa 

On / / 

On ./ /

Signed: 5 F { U O 

 By;

SyBy: 

 By: 

^ 

>/ 

^ 

^ 

Additional Video or Digital Photo's Taken; 

n Video n Digital Photo ! On i

Reason: 

n Video D Digital Photo 

Reason: 

n Video n Digital Photo 

On 

On 

:.

:

 / 

/

 /

 / 

/ 

By: 

3y: ^ — • 

Reason: 

Omaha Lead Project Work Plan Page lof 19 
 1 

Consent tor Access to Property SAID# V2£?^ f 

RIGHT OF ENTRY TO PREMISES 

Grantor (iJie property owner), consents to and -authorisco ihe United States Environmental 

ciuleciion Agency (USEPA) or its authorized representatives, collectively the Grantee to enter 

and perform certain environmental response activities upon the following described premises; 

?fJp^y^ Ime Phone; 

"^"^^yri^y^o-^^

Address: 

Addresses of Properties 

Address: covered by this 

Agreement: 

Address: 

Address: 

PURPOSE OF INVESTIGATION .. 

The purpose cf the remedial activities is to remove all soils at the property v/hich are 

contaminated with hazardous substances, in particular lead at concentrations greater than.or equal 

to 400 parts per million (ppm). 

REMEDIAL ACTIONS 

The enviromnental re.^ponse actions to be perfomied on said.property may include the following 

activities: 

a. Taking photographs, and/or video of the propeity before, during, and after remedial 

activities; 

b. Locating equipment and machinery on-site in preparation for and in the course of the 

environmental response; 

c. Plamimg and implementing the removal action on cr near Grantor's propeily. 

. d. Obtaining samples from Grantor's property; 

AGREEMENT NOTT O INTERFERE 

The Grantor agrees not to interfere or tamper with any of the activities or work done, or the 

equipment used to perform the activities, or to imdertake any actions regarding the use of said 

. property w;hich would tend to endanger the health or welfare ofthe Grantees cr the environment, 

or to allow others to use the property in such 

I grant access to my properties 

n I do not grant access \o my properties ^ 

Signature 

Date 
. ,, r.;-,T...r.r,:-r—W,4 i-ffS 

I AdditionsI Comments / instructions 

CJ Check this box if owner does not vjanl E.R. to enter the residents to document interior 

foundation wails snd possible preexisting damage. By checl^ing this box E.R. is not responsible 

for any dam.age done to tha interior of house, including foundaticn crscks or fissures. 

f^' . D I do iiot agree Dr agree n I do not sgri: 

Contractor's Signature Date 
r~i--.n^.-..^,~.\i^yj^-i WM 

Restoratton Agreement 

Ths purpose of iiiis agreement is to provide a mutual agreement as to ccnditions uf property prior to 

contractor aclIvIiics. Tnis will also serve as documentation for the purpose of assuring that restoration 

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

Protection Agency (EPA). 

V?VY, ^ 

Property Address: ^YZ ^ </^ ^ '^/" 

A^yi^ P'^' ^ /;iy^/^y:^ ' /MH^ 

^2-^>^^^^^/^^-- ^ 

On the attached diagram(s) indicate area(s) to be excavated and depth of excavation, 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 with an arrow indicating direction of view. . 

Kents to be remcyed by Contractor snd not replaced 

Etem: 

Krg/^^Aec/.,„„,u 

Item: 

Ctem: 

Stem: 

[tem: 

ftem: 

[tem: 

Page 1 of 2 
1 

£VJiM.^:^S!5•£ 

J Ad Additiona t l Comments I Instructions: 

filagre e n I do aot agree D l agree dH I do not agree 

Owner'sjSigna Contractor's Signature Date 

Attachments 

Page 2 of 2 
Property Completion Asreement 

Tills agreement documents the compietion of remedial activities performed on my property.. My 

signature will designate that I am satisfied with the restoration of my property, and that no items are in 

question, now, or at any time in the future, except those items listed below, if any. 

SAID: 

Propertrty : yAddress Address «; ^1/^ 7 < 3 i C3 '^ '^ 

Owner; fcp/^-v^ f^i^rj-y [uf\J^uii^fiy^9^^ LLr_ 

Phone: -^((0-(fffQ 

Restcrstoon litems in Question: 

I agree restoration is completed, except as noted 

^^y^rT^ona t egree restoration is ccmpleted 

1 \ I agree restoration is completed, except as noted 

I 11 do aot agree restoration is completed 

_Z^ . /Me / Sr ^r/D 

Contractor's Signature Bate 
Douglas County, Nebraska Property Record - R0728530000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VJeW On Ma p Infomiation is valid as of 2009-12-15 Treasurer's Tax Report 

New Feature -•->- > Auto Sales Search 

Owner 

FOUR DUDZ INVESTMENTS LLC 

915 S 205 ST 

OMAHA NE 68022-0000 

Property Informatio n 

Key Number: 2853 0000 07 

Account Type: Residential 

Parcel Number: 0728530000 

Parcel Address: 5437 S 20 ST 

OMAHA NE 68107-0000 

Legal Description: BROWN PARK LOT 15 BLOCK 11 50 X 130 

Value Informatio n 

Land Improvement Total 

2009 $6,400.00 $43,000.00 $49,400.00 

2008 $6,400.00 $43,000:00 $49,400.00 

2007 $6,400.00 $40,900.00 $47,300.00 

2006 $6,400.00 $40,900.00 $47,300.00 

2005 $6,400.00 $40,900.00 $47,300.00 

2004 $6,400.00 $22,500.00 $28,900.00 

Sales Informatio n 

Sales Date: 2009-11-13 

Deed Type: QC Book: 2009 Page: 123832 

Price: $0.00 

Grantor: Dudzinski Michael J etal 

Grantee: Four Dudz Investments LLC 

Valid/lnvalid: Invalid 

Exclusion Reason: Family Sale 

Sales Date: 2006-10-17 

Deed Type: WD Book: 2005 Page: 119654 

Price: $0.00 

Grantor: TD Investments 

http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 12/22/2009 
Grantee: Dudzinski Michael J 

Valid/lnvalid: Invalid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6500.0 1.0 130.0 50.0 No 

Improvemen t Informatio n 

Building 1 

t-si 

?» , 3iJ 

5it»? 11/2 Story Unfin 

Ffl«B<K» S437 S 2 a 

903.0 S^.Fl 

'Xi^ 

•4iifCLICK TO ENLARGE IMAGE 

Square Footage: 903.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Fair 

Built As: 1 1/2 Story Unfin Condo Square Footage: 0.0 

HVAC: Forced Air Rooms: 6.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

RoofType: Gable Stories: 1.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Yiear Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1900 0% 1900 110 

Detail Type Detail Description Units 

Add On Fence Chain Link 1.0 

Add On Fence Wrought Iron 1.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 760.0 

Fixture Additional Fixtures 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 12/22/2009 

. •a..l.'i"i\_ir«uJikSai#':'ii.'.';. 
Fixture ^ ^ Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch End Screen 143.0 

Porch Slab w/Steps 24.0 

Porch Wood Deck 48.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accountno=RO... 12/22/2009 
ENVIRONMENTAL AS-BUILT DRAWING 

OMAHA LEAD SUPERFUND SIT 0 

RESTORATION 

\ Name: T O I n Omaha Lead Site Date: /f'-,y,-~^ North Arrow -> 

Acidress: 5^:^? - 'XO s t Site Sketch Time: iS-:^*^ Q7^i% 

Phone: 

Team jiuyyilyL-i± ^ BviD# !-i7HH9 XRF Code ' ^ 

Satnple Number Lead Concentration Confirmation Sample 

/<fy/4 f^/^Xt 4 

KV^^^f^X/ l " 

•3^ ^ 

ppm 

ppm 

ppm 

/C Yes 

.'V Yes 

tf.' Yes 

-.T.' Yes 

• 

• 

No

No

No

No

 El 

 E l 

 ED 

E 

Lab RYBSCPLA-47449~ 

/ / -^- Z ppm 

ppm 

ppm 

-^'sYes 

Yes 

Yes 

• No

No

No

 g l 

a 

• 

Result 89.1 ppm 

t) \. A 

SAID #47449 

DATE EXCAVATED 4-20-10 

DATE EPA SIGNED OFF 5-5-10 

L..... \y 5^-! ^ 

R.X 

AREA SODDED 438 SQ FT -L4 

Af <-f ^ 

Omaha Lead Site 46130 

I ) 1 i r 

Quadrant excavated Dflp Zone Excavated Contamination Lgft Behind I ! I M 

Ca^i.(ii^,^^»%MAyv»«««kl Oj%^*^^v^#i^«.r>» 11 ^ 
Name; 7 O i n 'v?.si y>ien-ii. Omaha Lead Site Dale: If-/yC' ^ North Arrow 

Address: !^H:^1 ,<; ?.0 Si SHe Sketch Time: i^^A. Q9H \ / —- Phone: 

Team ^^^ ^ "Ai /uif!!, ^ (tf Q BVID# m HH 9 XRF Code 

Sample Number Lead Concentration Confirmation Sample 

^Y^^ f 

ppm //Yes ^ No ^ flV&iC/^XJ ^ ^'T*^' ^ 

ppm /^Yes D No S jzv^:icfK> ^ ' V^T^ f 

ppm ^/Yes a No S '3'B*F 

ppm <J<Yes Q No ta J^'^'S ppm ^eYes n No g

ppm Yes n No L l — ^ RYBSCPl-A-47449- ppm Yes • No • Result 89.1 ppm , OdK 

p-:^-yi^'.3^ li 

"^<y: !.'<. 

.£1 

34^ 4^ 

-Hi 

)I 

F^ 

3^ ^ 

AC-' <r-f 

Omaha Lead Site 4613 
Name: T O I n i^e <; i f^enic Omaha Lead Site 

Address: S^7,l ,<; ?^0 s^ Site SIfetch 

Phone: 

Team A) /^J/fl v (CF Q BVID#_Ji7JtL2 . 

Sample Number Lead Concentration 

ppm Kv&fcr'x/ 3y:t . i - ppm 

ppm :?g ^ 

ppm J¥-3^S ppm 

ppm RYBSCPLA-47449" Lab ppm Result 89.1 ppm " \^'.\K 

K­ $/d 

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Date:if'-/y/y^ Nortti Arrow h 

Time: ^7^*W. 0^'V^ 

XRF Code ^^^ / 

Confirmation Sample 

//Yes 3 ' No El 

/^Yes lp No S 

^/Yes n No ^ 

^<Yes n No ^ 

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Yes • No a 

Yes • No • 

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Omaha Lead Site 46130 
ENViRONMENTAL XRF DATA ENTRY LOG 

RESTORATBO^S 

SAID#jrHMl _ DATE ^1 \2.1 \(o 

PROPERTY ADDRESS TIME 

5^:^-7 S. 2-0 ST 

XRF S/N "L-A-rxo 

QUADRENT OR SAMPLE AREA 

DEPTH AVERAGE OF RESULTS SHOT #s 

redig 

a F1 

n F2 

a Bl Al S^ f 1^1 iV9«?fl- ^'??3 

n B2 

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SAMPLER NAME \VW,»V\. dl \x^C^ra.l -=^3 
Thermo Fisher Scientific Thermo 900 Middlesex Tumpike 

Billerica, MA 01821 

SCIENTIFI C 

2 

3 

4 

5 

6 

7 

8 

9 

10 

ll 

12 

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2010.04-21 08:31 

2010.04-21 08:31 

2010-04-21 08:30 

2010-04-2108:30 

2010-04-21 08:26 

2010-04-2108:26 

2010-04-2108:26 

2010-04-21 08:25 

2010-04-2108:21 

2010-04-2108:21 

20104)4.21 08.20 

2010-04-21 08:20 

.A\ i:K.\(ii: ADDKI'.SS 

Avg of4998-300( 5437 s 20 «t 

5437 s 20 st 

5437 8 20 st 

5437 8 20 st 

Avgor4994-»99(34376 20st 

.5437 8 20 st 

5437 > 20 st 

5437 8 20 st 

Avgof4990-»99;5437 8 20Bl 

5437 9 20 st 

5437 s 20 st 

5437 s 20 SI 

,SA 

EZ 

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DZ 

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Bl 

Bl 

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Jim 

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surface 

surface 

surface 

sur&ce 

10 

10 

10 

10 

6 

6 

6 

6 

final clearance 

final clearance 47449 

final clearance 47449 

final clearance 47449 

final clearance 

Bnal clearance 47449 

final clearance 47449 

final clearance 47449 . 

final cleanmce 

final clearance 47449 

final clearance 47449 

final clearance 47449 

106.79 ± 

101.60 i 

115.37 ± 

103.41 ± 

162.71 ± 

151.67 ± 

165.59 ± 

170.87 ± 

153.68 ± 

148.04 ± 

157.62 ± 

155.39 ± 

17.60 

17.13 

18.11 

17.53 

21.53 

21.01 

21.76 

21.81 

19.05 

18.78 

19.30 

19.09 

Page I of I 04/21/10 10:09:56 
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