TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: Zlf-l^") Date: /O JJ9J ^n 8 

Address: 3x/j? HaJt^Z-T^yJ^ 9fRemediation Contractor: i^y^uJr lotUiAyL. jlc, . Year: 2-Dog 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video ofproperty (DVD) 

Executive Summary 

Bf EPA-provided property sketch 

Signed Access Agreement for subject property 

D 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

y 

Photographs 

As-built sketch 

y Satisfactory restoration signed by Property Owner 

y Property close-out check list signed by EPA 

D Description ofareas not meeting ROD cleanup criteria 

y Utility clearances 

y Property infonnation from Douglas County Assessor's Office 

u 

D 

D 

jk'jlo±_ SgnSte 

Date 

40311423 • 

Superfund 

V­
PROPERTY SUMMARY 

Date: 10/17/2008 Omaha Lead Site Remedial Action Contract # EP-R7-07-06/0004 Month of: Aug/Sept 

Property Address: 3218 CALIFORNIA ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NOME 

I * ' y 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Infomiation: CONTAMINATION LEFT BEHIND Fl BUSHES 2X3 FT @ 825 PPM 

CONFIRMATION SAMPLING DATA/RESULTS:' 

Bl=104 PPM @ 13"; Fl=340 PPM @ 6"; NO EASEMENT 

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/photograph's 

5) Documentation - Completed Close-out Checklist 

6) As-Built sketch ­

i) 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 incliided in the individual property file, if available, or obtained include: 

' r' 

i) Pre-excavationagreementdetails(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 satis'factory restoration 

v) Descriptionof areas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES, INC. 
Find Record Qean Up Query Lead Remaining Query I Property Damage Query Close 

Biadcnil: 

Sample Area: 24199 ­ 3218 CALIFORNIA ST 

Owner: Resident: 

n Owner Occupied 

Owner Name: 

|JAMERSON TYRONE 

Owner Addressl: 

---—-­ — ­ ­ ­ — J 

Resident Name: 

|THNANTS " 

Property Address: 

3218 CALIFORNIA ST 

Owner Address2: 

|3218 CALIFORNIA ST 

City: 

[OMAHA 

OwnerPhone: 

1(402)344-2387 

State: Zip Code: 

;|NE 1168131 

Alternate Phone: 

1(402)29072153 

Zip Code: 

68131 

Resident Phone t 

Contract: 

Assessment: 

Qualifying Group 

|1200 

Assessment XRF Date: 

Assessment Max XRF Value: 

1629.9f. 
SER/V 

EPA Property Close Out Form 

Property #: L-^:i ^ Property Address: 'g ^ 'J^'T-Xo C ^ li-^rn )ai 

Date/Time: Owner's Name: ~'inlr^if\/'. '^M0r^r \ 

Quads Excavated: \^) ^ F | Contractor Group j^tt ole.i-^-'fiQ4/i«c\Q^'iO;<, 

Excavation General 

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 Vegetation 

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 between 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? (IfappUcable) 

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

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

4. Was damage to retaining walls avoided? (IfappUcable) 

Foundation, Siding and Gutters 

1. Was daniage 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 

/ 

/ 

Yes No 

/ 

/ 

y 

y 

y 

y 

y 

Yes No 

y 

y 

y 

y 

Yes No 

y 

y 

• 

y 

y 

y 

Yes No 

y 

i? 
Owners comments: 

f 

^ 

1 

• 

- 1 

1 

Inspection notes: 

\ > 

• N '' 

' 

• 

r 

> :

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

EPA Representative Date: 9/»/o» 
%B>A 

Property Completion Agreement 

This agreement 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 ofthe 

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 ID: ^.i^ l ^ ^ 

Property Address: .;^ ^ , g ^ r^^^ l ir^r^.T ^ S\­ 1 Owner: 1) 

Phone: 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

L J I agree restoration is completed, except as noted above. 

L J I do not agree restoration is completed 

^72^/^f 

Date 
M ' ••• » * t 

i'l .VV. rt '•* tV^wy ^ • ;;-. .-s^WK-y v) 

FtudtBt Tftcfando^*^ Inc. (PludtoQ is imd« coBlnet wifli tfa* IJ. S. EnviioiiBtiii^ 

«l*iiiup atftnE 

Pmdtnt to p«f«B 

wli«iti»snlBt»<ltoth* dtas^incluiiii^Eail Bmplii^iHBOval of Iwd-coBtiniiTiiiftd Bofl, mdwdonlion of tht nfmnwd pwpwty. 

If yxmhanrv aay qiudions about tlu soil dfta^plannwl fbr yout prop wly, pltait coHtMtPnidwit''« Adminianlivt Clwkfar tht 

OaihaLtwlSitt dtanuB. Ms.ShamoinHolt-ai''Wa 304-1004. Gtnwd qutsfions about tiu Omaha Ltad Site dtanq^ cnb t 

diitcttd to flu EPA Public LafbnaationCwdMS at<40^ 731-304i (^wthOmaha offict) o((;402) 991-9383 l^oithOaiafaa offict). 

Ptoowt^Acct^GxanttdBv: YV^^^ST/^ ^ t^f^^^^^^ ^ 

(Pitast PnntH amt) 

Ptoptity OvnwSi^iaiBit: / 7 ^ (PaU) 

PROPERIY MFORMATION 

(Tt W nrnflttod ¥y znlont Ksl/irpnf ntf awnBr - ploutpiint) 

RESIDENT NABE: Tv * Cvif\ 0 3~0c»v>gX-Sc^f\ (^wneT) Renter 

RESIDENT ADDRESS: 

IF RENTAL. PROPERTY OWNED BY: 

OWNER'S HAILMG ADDRESS: 

^:i7\9. CaH^onrN; ^ 'S^r HYVS^^ U h ^ C.*^\-\ ( 

OWNER'STELEPHONE NUMBER - HOME: { \ WORK: 

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

^o s\lx HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SDING SINCE 19787 YES NO v ^ 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: •5 ^ NUMBER OF OCCUPANTS? YEARS OLD AHD OLDER 

NUMBER OF CHILDREN UHDER 7 YEARS OLD WWD PLAY H THE YARD FOR 5 HOURS OR HORE PER WEEK: 

COMMENTS OR SPBCIAL INSTRUCTIONS: (IE. OOGS. ENTRY GATES. ETCJ 

AUTHORITr FORENTIRiaNMENTAL RESPONSE ACTIONS; Tht octintitEtohtimpltmwitdbyEFAuuiHtfaisaffttmtnt 

]ni!3m"i4tt4^;S4<)ftlA1 gfCEJtCLA,43USjC.9!S04. EPA's jigbt of KC«B to tht propwix is Kpvidtdfiirin Stction 104(t) of 

CERCLA. 42 Ua. C 96Qj(t), ymchpnmdts tnlij lui dttwrninuaBtht nttdror rtyonstTor thooHng oftaanB gyrtyonst fctiflp undtr tUs titlt, or othmrist tsfoiciiQ tfat pnniBons of tht tidt.'' 

8080 Wanl Parkwy- Sulfa 405 2505 N. 24* Sfreet. Sulfa 308 4242 MedlcM Drtve, Sulfa 42S0 

KonflBCl^. MO 64114 Omitta. Nebraska 68110 San Anfonio. TX 7822a 

PhonK ^16) 363-3703 Phonei ^Q2)9!4-1QS4 PiiSRS: ^1S}SZZ-9KS 

rac ^tS) 3S3-37G7 Fac (402)504-1005 Fax: ^10) 579-6577 
.\- rV-V, A 

ll- r-iWflfry ..:•} 

Piudti* T tchndo^ti^ Inc. (Ptudt^ is nndw coiriiBct wifli th« U. S. Exmianmtntd Ptcttctian Agtncy 1^ ^ to d* ^ 

contamimud softs at anumbw of pnpwtitsloc8t»dmOmalu,N tbiadca, iadudiig tfat prapw^locattd at 

"7.'!^ t ^ T^n $ iLT'rvL^A ^j^^^'^^itqiMdByourpwmisBoato dlowPtudtnttopafoim a soil dtanqp atfliis 

fu^mftaxnmmiiiifrnmSmiaiaS. BysiBmaBflBsftim.thtp»pwtyownwgnntspMaiisBoatoPnid«ttti>pMfbim 

•cdvilitExdaltdlD tht cwanip inchiiit^ soil "T*" ^ i«mo«d of Itad-contaaiaittd soil, anditOontian of iht Itfwalc•dpIOlp«tty• 

Ifyouhnr» aoy qntsfioosabouttht scil dtamf plaaud fat yam piopwly, pitast«ontatt Pnidaat's A<hunitfialiTt Cltdc fm tht 

OmduLtadSiu dtanua. Ms. Sh«BflBHolt-«ti;402) 304-1004. Gwuid quesiioasiiboutflu Omda Ltad SiU dtau p caubt 

dtitcUdto^EPAPiMc&ifbnaaiioaCtiAas at (40^731-3043 (^ouih Omaha offict) €((402)991-9383 91 oithOmda offict^ 

PtoBwtvAccssGiaHUdBv: T^EOf<y t ' 7f/i'/U)C^<yT ^ 

Ptopicty OwBttc Siyirtuto: 

RESIOENTNAME: Tv U O fV g 

/ / (^gnaluw) 

PROPERTY MFORMATION 

(Tt ¥• coafktot hy iwleataalAirf n f «ctf •waw - plMKByiiat) 

RESIDENT ADDRESS: 

! 

IF REHIAL. PROPERTY OWHED BY: 

OTV^y ^ 

,...;*'••* 

Mc 

(PaU) 

Renter 

^^^^ 1 

• \ 

OWNER'S MAILMG ADDRESS; 

OWNER'STELEPHONE NUMBER-HOME: j \ Y WORK: 

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

HAS THE EXTERIOR BEEH PAINTED OR COVERED WIUI SBIING SINCE 19787 YES NO sy^x 

• ^ 

NUMBER OF OCCUPANTS UHDER 7 YEARS OLD: '*3 NUMBER DF OCCUPANTS 7 YEARS OLD AHD OLDER 

NUHBER OF CHILDREN UNDER 7 YEARS OLO WHO PLAY H THE YARD FOR 5 HOURS OR QORE PER WEEK: 

COUMENTS OR SPECIAL INSTRUCTIOliS: (I.E. OOGS. ENTRY GATES. ETC.! 

AUTHORITY F0REN7IR0KMENTAL RESPONSE ACTIONS Tht acti^1i«stobtimpItm«BtodhyEPAundiithisa9«tm«Bt 

UnfffiPIB^it^^.S'lMl^lQ,') {fCU!CLA,^2 U5C.9|{04. EPA's jid^ of acctss to tht pcop«itvisp^dtdftvisStctiaal04C») of 

undwfUstitl*, otothwwist wnfonJmtht pnmaont of tht titlt." •V V 

8080 Ward Parkwar. Sulfa t 2905 N. 24* Sfreet, SuHe 306 4242 HadlGH OrtVBL Suit* 4250 

RanBaiCi^.H064il4 omahfli Nebraska 68110 SanADtonlo.TX78£{9 

Phone (816) 3G3-V03 PnORflC ^0Z)SQ4-1904 . «! hflntf* Ai m 1199JI'WII ,1SWUW- f k SWI WiU* www v Kimr- «M m •^ O ' FSSC: (402)504-1805 '•y fac ^10)573-6577 

n^'y/ y • 

.•,-;.,.-;'r;v. 

.:7-n^4 •'­
iii 

Bii!5iiM:MwSii^^ OLS#: 24199 

Date Excavated: 8/13/2008 

Date USEPA .Signed-OfT: 

24199 

Owner Name:OTMCO.nQDItjjg. .Ti:ftssm..k!*d«<w»*'"|?.!|'* ^^^ ^ ®'** 

Address: 3218 CALIFORNIA ST . Site Sketch 

Phone: H^OL-C^yloii «• 

Sample Number Lead 

Concentration 

•Sample 

Collecteil LAB 

RYASCPXA-24199 F1 \P^ \ ppm D 

•BvescpxA aiiQO—E2 — ppm D 

RYCSCPXA-2419fl Bl , 

RYDOCPXA 24100 B3. 

ROSSCPJOrarreB 02 

RdZBCPXAanaa—GZ 

. RPZ6ePXA-244«0 BZ. 

,

lU'^.Qpom 

 ppm 

Pf>m 

PPm 

ppm .

D 

D 

D 

D 

a 

D 

D 

D 

D 

Number of Samples = '2 ' 

^vVV*- • 

P\ lUdCt 

^T 

3^l^al^fnaSl. ^- . 

"T 1 

I ; ;. K 

FI=340PPM@6" 

i r;c 

.i>ukvM.\i 

•--.- Ck\.^nvL9t. 

Oinaha I jead Site 

lor Paint 

Good 

ExMfor North Anow 

• Poor 

• Notpalnt t

Samples Collected 

Jim: _m^.MlAlL 

Date- lOjlljO-i 

Time: •^\'b'K 

Samples Analyzed 

XRF Unit: " ^ \ \ Book: \\j'iX. 

Date:. 

Time:. ^ = 

Staff. 

^ 

ENTERED i 

• m 7 9Z884 : 

CONTAMINATION LEFI' BEHIND 

|F-I BUSHES 2X3 FT @ 825 PPM| 

NO EASEMENT 

'tftl.'lG 

CONTRACT #: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC. 
>RUDE] rECHNOLOGIES, INC. 

Property Status Form 

Address: 'az\ 8 CoiUa-orM^a Sl-- Date: Tu ne. U W^ 2crog 

Phone: BVID: 5i q ^ ^ <^ 

C'\-^ ' -1043 

Plants & Permanent Landscaping 

Item# 

On Map Description and Location 

? ' » ­ re,i»vov<g- So^v^« 

«rn».jOL-gTf7i»j 

^<^ 

'T'CCV/ ^ 

p - 3 - Sao e 

p-\N ^^ ^ 

Pre-Existing Condition of Structures 

DoesyourBasementhaveahistory of leaking? Yes -v- No ~ 

Item# Description & Location 

On Map 

t OA\S\eAe-

ci-ae\ceJi VOa^Ku^*^^ ^' 

••-S*­

>jOfVV <3f tcuoV -5>*<J^eoaJU<J^ Cro,cJlW» ^n 

^^^^l,' ^ C^cxe.v.>. " ^ ConctveK ^\ov>^ NJorVU -|ovv,a.,^?6 ^ 

Property Owner Prudent Employee 

SignatureOy^t.^''^<_J^^«^rv-#ct- Signature: 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 iMedicai Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 / Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
24199 

Owner Hame:m^OngD»^JXjej^_^t^ts^^"*^^^^^ f Site 

Addr«8»;^18 CALIFORNIA, ST * TM SkfttCh 

Omaha Lead Site 46130 
24199 

C J Owner Name:.?«yiifr«©B«^ Jt_^ge*.. ^ 

Address;^! ? CALfFORNLA. ST ^" ® &K©tcn 

(1. 

OmahaLeadSite 46130 
Print Preview Page 1 of 1 

Douglas CouDty-Omaha, NE 

Parcel ID 

Owner 

Name 

Pmperty 

Addmss 

City 

Zip 

Owner 

Address 

Owner 

Address 

2 

Owner 

City 

Owner 

State 

Owner 

Zip 

1939920000 

JAMERSON 

TYRONE 

3218 

CALIFORNIA 

ST 

OMAHA 

68131 

3218 

CALIFORNIA 

ST 

OMAHA 

NE 

68131 j l 

Sec-TwnRng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Tmasumr 

Website 

Unk 

Assessor 

Website 

Unk 

17-15-13 

PARK PLACE 

2 

30 

W27.5E55S174.25FT 

27.5X174.25 

http7/webapps.dotcomm.org:8080/TreasTax/bces/pages/taxinfb.jsp? 

parc=1939920000 

http://dougiasne.mappingonline.com/DouglasCoNe/static/accountinfo.jsp? 

accountno=R1939920000 

Disdainker Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed^ This is not a legal document and should not be substituted fbr a title search, 1 inch = 57 feet appraisal, survey, or for zoning verification. 
Rl 939920000000 Ljpg (JPEG Image, 640x480 pixels) http://douglasne.mapping-online.com/assessdoc/Photos/11/R193992., 

' ^ ^ ^ ' • • ' ^ 

s f. ^ I % C-A-UAWA £ ^ 

lofl 7/2/2008 10:14 AM 






^y'^ ' '•»- Page 1 of2 

"> 

jj^^GreaW/Anothertiriclwtarvj, J .^/«jp.Back to.lrlh Internet- > ^i v;;Send EmailYOUR TICKET NUMBER IS 2099317. 

Original Call Date: 8/05/08 

Work to Begin Date: 8/07/08 

Time:

Time:

 1:20 pm 

 1:45 pm 

Op: RAMITA18 967 

State: NE County: DOUGLAS Place: OMAHA 


Address: 3218 Street: CALIFORNIA ST 


Twp: 15N Rng: 13E Sect-Qtr: 16-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: LEAD REMEDIATION WORK 


Location of Work: LOCATE"ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: [402)733--1883 


: UNSURE CORNERS 


Company : PRUDENT TECHNOLOGIES 


Contact Name: RAMITA Phone: (402)733-1455 


Alt. Contact: Pnone: (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 


CRGHTON CXCATV LEVEL3 MCLEODNE MUDOl OMAHACOF 0PPDGPR5 


QLNNEIC 


Utility Service Area Contact Phone Number Type 

Day: 4022802780 

CRGHTON CREIGHTON UNIVERSITY DAVE MCATEE Alt: 4025101995 

Emerg: 7125454616 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, ^p,^^, 

Ah: 4029340469 

Emerg: 4029329757 

Day: 8773668344 


LEVEL3 LEVEL3 COMMUNICATIONS, ^ ^ Ah: 


Emerg: 8773668344 

NO Day: 8002891901 NEED TO CALL OUT MCLEODNE MCLEODUSA EMERGENCY Alt: 

http://www.dhon.org/irthintemet/DHON>]oticeCreation/MessageText.asp?ret=<RESULTS... 8/5/2008 
f NS f Page 2 of2 

MUDOl 

OMAHACOF 

OPPDGPR5 

QLNNEIC

METROPOLITAN UTILITIES 

DISTRICT 

CITY OF OMAHATRAFFICSEWER 

OMAHA PUBLIC POWER 

DISTRICT 

 QWEST LOCAL NETWORK

EDWINA 

RON 

NA 

 NA 

Emerg: 8002891901 


Day: 4025047823 


Alt: 


Emerg: 4025047946 


Day: 4024447197 


Alt: 4024445161 


Emerg: 4024445160 


Day: 4067289343 


Ah: 8887289343 


Emerg: 4067289343 


Day: 4067289343 


Alt: 


Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... .8/5/2008