* 

TRAKSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID . i.{n< Dale: 1 

A L 

Address. ^It> Ompu^ ^ r 

RemedJalion Contiactor: Coastal En\'ironnicnt3l Group Year: JOJOARRA 

SOIL REMEDIATION 

PROPERTV FILE FOLDER DOCUMENTS 

Video of properly (DVD) 

Executive Summary 

y EPA-piovided property sketch 

i/ Signed Access Agreement for subject propeny 

Signed Access Agreement(s) for adjacent properly 

Restoration Agreemenl 

Settlement documents (i.e., io\ damage or to replace plants, etc.) 

Confinnation data 

Photographs ffr (r)oOv^pt^ ;^ (r><:^ATl^M ^ 4- ^ 

As-buill sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

y 

Utility clearances 

Property infonnation from Douglas County Assessor's Office 

30218845 

wm 

Superfund 
# 

^v 

Property Access Checklist 

PropertylD: ^SiZS D WORK STARTED

Property Address: ^^/ ^ QJ/t^ytAr, -^ V n WORKCOMPELTED

Owner: Renter: [ ^ 

P/yi^/U 

Address: ^ ,,^ 

Phone: 

Fax: 

Cell/Pager: 

Phone: Additional Infomiation: (A^^-M?..^ ^ 

Fax: 

Cell/Pager: 

D Notification Letter Sent: / / By: 

Q f Access Agreement Signed: | (Ol llAl f C By: 

[NIL Restoration Agreement Signed:/^ H 4 l( 0 By: 

D Topsoil Sampling (if appUcable) I I By: 

G Disposal Sampling (if applicable) I I By: 

D Garden Sampling (if applicable) I I By: 

Q Utility Clearance CaUed: ^V / ':i / vo 

^y* wA^/vo

^ Video/Photos (Before) On:J(P/ imjy> By: 

ta^ Video/Photos (During) On: / / By: 

D Video/Photos (After) On: / / By: 

D Video/Photos (30-Day) On: / / By: 

l~l Property Completion Agreement Siened: / / By: 

D Final Report Issued: / / By: 

Air Monitoring (as appUcable) 

r~| Community f") Crew On: / / 

Results: 

• Community • Crew On: / / By:

Results: 

• Community • Crew On: / / By:

Results: 

Omaha Lead Site 

 ON: / / 

 ON: / / 

 U>t*-.A^ 

1 

1 

1 
Douglas County Accotmt Infiamtion 

Page 1 of2 |a|^t: 

Douglas County, Nebraska Property Record ­ R2213550000 

Print Reoort 

Information is valid as of 2010-8-30 View Interactive GIS Mao 

Treasurer's Tax Reoort 

1 New Feature ^ -^ -> Subdivision Sales Search 

Owner 

CITY OF OMAHA 

C/0 CITY FINANCE 

1819 FARNAM ST 

OMAHA NE 68183-0000 

Property Informatio n 

Key Number: 1355 0000 22 

Account Type: Ex Government 

Parcel Number: 

2213550000 

Parcel Address: 

2816 CHARLES ST 

OMAHA NE 68131-0000 

Legal Description: SHINNS 3RD ADD LOT 10 BLOCK Y E 20 FT LT 9 & W 20 FT 40 X 127.5 

Value Informatio n 

Land Improvement Total 

2010 $0.00 $0.00 $0.00 

2009 $0.00 $0.00 $0.00 

2008 $0.00 $0.00 $0.00 

2007 $0.00 $0.00 $0.00 

2006 $0.00 $0.00 $0.00 

2005 $0.00 $0.00 $0.00 

Land Informatio n 

Acres SF Units Depth Widtti Vacant 

0.11 5080.0 0.0 127.0 40.0 Yes 

http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accoimtno=R22L.. 9/2/2010 
^ As-Built Drawing 

COASTA

ENVmONHENTA

L 

L Omaha Lead Superfund Site G « O U r .

 IN C 

OLS#: 25825 

Date Excavated: 11/6/2010 

Date USEPA Signed Off: 12/2/2010 

Area Sodden: 1295 so ft 

Address: :5<?/(., rio«//,><. Sf- Site SIcetch Time: .^ ^ "k

Phone: 1 

Team y^tf/*jyi,<.h^ll'j\i^'^'> BV1D# •^Jii^' ^ XRF Code 7^< ^ 

Sample Numtier 

Lead Concentration Confirmation Sample 

ppm fives CD No O-" ' gvf?gc:^l^A - ::?gggg ^ ^ Z 

ppm 6 Yes n No B ^ 

ppm 81 Yes • No C3-:: /^/K 

ppm .?^Yes n No 13 ^ 

ppm Yes n No O 

ppm Yes n No n 

ppm Yes • No • 

Name: C i k, < / [)in^i^< ^ Omalia Lead Site Date j : / -

NofthAnow 

..lb ^V4hftf<tk-S^ 

f^ fHH^ 

\ ^ \ ­ i^f 

. Hdil. 

• ^^^n ^ 

cti Iri/ IP4 

Omaha Lead Site 46130 

Legen d 

Concret e Drip Zone Excavated Quadrants Excavated 

Area replaced with Are a replace d wit h 

Sod ' ' Rock/Mulch ^ ^® ^ l^^ t ^*^ ° 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
Name: C r/v) tK (^Ji\y*i^i^ Omaha Lead Site North Arrow —i 

Address'~237kl£^S>I3!^f Site Sketch -

Phone: ___ ^ 4 

Team [\f>i^JiiL^-r?yi/'Jlii<'^^ BviD# '•AJ>7SAS" XRF Code ^^ ^ 

Sample Numt)er Lead Concentration Confirmation Sample 

FiYes CD fZv/3gc:^t^A-:?^flgg 6 Yes n •g^z 

^ ^ 

r-A 

—(.. . 

•••f i I • —-• \ 1 

- * ­

>ko Qqc.tkvi4l. • ^ y 

Ctl./fe4l' 

Omaha Lead Site 46130 
% ^ 

Name: C ' ^ ' ^ £V*^*»A<^ Omaha Lead Site Date: ^JulqH North Arrow \ 

Address: T'^//., n^arh ^ Si" Site Sketch Time: V.^ h 

1 Phone: i 

Team [{pii^J^lc-f^yi/^J/li'^i' BVID# '-AJ) D^S " XRF Code :^^< ^ 

Sample Number Lead Concentration Confinnation Sample 

ppm FiYes O No O-- ^ 

ppm fiYes 1=1 No B- ­

ppm 0(Yes a No O--^. •?^2 

^ ^ ^ ppm No Q ^ 

ppm ^ Yes • No tn 

ppm Yes • No • 

ppm Yes • No • 

j I fj^'^'' ^ 

'U 

in 

-^^•H^-^Jmi-i^-%)-. f^ fi u 

' ^ i^/" 

^dft. <rJ 

tk^t>^i?Mi 

Cll/le^0 

Omaha Lead Site 46130 
Name: C *y\*f Omaha Lead Site Date: j////o Y Noitli Arrow 

Address: SJt SitaSkstch Time: /(. - Phone: f 

Team I^P In^JicL ^•^</(^///fc'n» BVJD#_fv52.X ^ XRF Code ^ ^ ^ 

Sample Number Lead Concentration Confinmation Sample 

ppm fiYe s CD No C3­ -

-^eC2 —

^^ Z ppm 

 ppm 

fiYes

pjYes

^^Ye s

 n 

 CD 

a 

No

No

No

 Q- ^ 

 C3 ^ 

S ^ 

ppm Yes CD No D 

ppm Yes a No O 

ppm Yes • No • 

Omaha Lead Site 46130 
'':-^ / 

c 0 ;• s 1 A I 

C I C 'J I f- c 

C:oiif;eii\ ft;r Ac^coi^i-. 'lo TioiK-^iiy 

RIGHT OF ENTRY TO PREW/IISES 

Grantoi (the pfopert)' ownei) conseiit.s to and aulhorizes the United States 

Envitonmental Protection Agency (PPA) oi its aulhorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upori th£, 

following described premises: -^Z* ^ P ^C"^ 

Owners Name: Daytime Phone: 

^JyM±Lf..Ommf^ ,. 

Address of Property 

covered by this 

Agreement: 

Zi.\k-...OMRby^^ .i>J: 

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) vv'ill be 

excavated to remove contaminaled soil. The removed contaminated soil SN\\\ be 

replaced with clean materials and the area v^\\\ 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 wili 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, 

contractors snd subcontractors the right to enter the property, at all reasonable times 

and witfi 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 
c c;^S1 A I 

c t 0 u '

' Remove obstructions including boats, iiaileis, vehicles, plgyscaf)? iten-i.^, wood 

piles, doo houses, etc; 

' Remove flov/er bulbs oi piants ttist the Granloi or the GrarUci's lensnl may wish 

to save; 

' Waler and maintain replacement vegetation, including fertilizer application, as 

necessary' subsequent to an initial vv'atering period by EPA; 

< Abide by heallh and safety guidance provided by EPA; 

I If the property' is rented, assist EPA in obtaining tenant sppiovsl foi access lo 

the property' lo perform the work. 

I Allow videotaping and/or photographing of the properly. 

AGREEMENT HOT TO INTERFERE 

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

of the work done, or with the equipment used on his properly, or to undertake any 

actions regarding the use of said property' which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (402) 991-1199 

0 1 grant access to my properties D I do not grant access to my properties 

..,^yyy..y.(^.-±^-^ ^ .... .TM 

Signature Date Signature Dale 

D I would like tc be. present duririfi any tsmplirio thsl is feqi'ired. 

• »• c 

Paae 2 of 2 
J. 

C ci A. S T A. L 

Restoration Agreement 

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

remediation activities. This 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). 

PropertylD: 1,t]^h50000 — Z^^'^^ 

Property Address: -^^/ ^ ^MA/ZZ-Sf? <^. 

Owner: fjj^H Of= 0/viA^(^ 

Phone: 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access location(s) to be used by the contractors. Indicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

Items to be Removed by the Owner before Start of Remediation: 

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

Items to be Removed by the Contractor During RemecJiation and Not Replaced 

Item: ^ , 

Page 1 of. 
C O A S T /k L e N V( RON M I N TA L 

c n o u r . PN C 

Items to Be Removed By Contractor During Remediation and Replaced 

Item 

Landscape Inventory 

Quantity Unit Condition/Type/Species 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. l^y Quadrants 

Number of trees > 2 inch 

trunk diameter 

Each 

Number of trees <= 2 inch 

trunk diameter 

Each 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

•sprinkler layout. 

Each 

Number of and size of 

each garden/ flower bed 

area. 

Micicli a sketch oi' rel;ui\e 

sizes and locutions. 

Each 

Square Feel 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Not f thi s Naliif \^ill l)C 

used (0 issue a plant 

\oiiclioi Id thc proprrl\ 

()\MiC'r. 

Easement Area, to be 

excavated Each 

Page 2 of. 
»t!L. ) 

C O A S T Al L • NVtflONHENTA L 

CROUP . < N C 

The city of Omaha ordinances may prohibit you from using dirt or gravel areas on your property 

as driveways or vehicle parking areas. The Environmental Protection Agency (EPA) may be 

removing and replacing soil underlying a gravel or dirt area on your property that you may be 

using as a driveway or vehicle parking area. If this is the case, you should understand that this 

removing and replacing of soil does not mean that any illegal driveway or parking area on your 

property is made legal. To the contrary, you may be cited by the city if you use a gravel or dirt area 

as a driveway or parking area, not withstanding any removal or replacement of soil by the EPA. 

If you have any question about legality of a certain driveway or parking area, you may contact 

the city of Omaha's Planning Department at (402) 444-5150. 

Q Please check this box if you understand the information outlined above. 

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. 

01Ia agree O I do not agree 

V^/4^ 

)wner's Signature Contractor's Signature Date 

Page 3 of. 
BVID# ZS8L S 

XRF PROPERTY SAMPLE SHEET 


Date {-•LO - zo a 

Project Omaha Lead ARRA 

Z.S/6 CHA.IU,ISS 

am/pm 

30 sec 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

XRF ID# 

Shot# Reading 

5^ ^ Z ^ i z ^ 

330 zio i zy> 

331 Z^^i Z3 

Average Z^ ^ 1 Z 3

Shot# Reading 

Average 

Shot# Reading 

Average 

Shot# Reading 

^ ^ y 

7 

Average 

Signature 

jl/lnk; u^K ^ Print 

Sample area 

e>z 

Depth 

4" 

^ 

Sample area 

Depth 

Sample area 

Depth 

Address 

Sample time 

sample length 

Shot# 

Average 

Shot# 

Average 

Shot# 

Average 

RETEST AREAS 

Sample area Shot# 

Depth 

Average 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

332 

SOIL 

2011-01-20 13:15 

91.30 

Final 

Avg of 329-331 

2816 CHARLES ST 

B2 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 273.543 

Supervised By: 

Certificate of Verification 

329 

SOIL 

2011-01-20 13:13 

30.26 

Final 

25825 

2816 CHARLES ST 

B2 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 25.224 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 290.641 

Supervised By: 

Certificate of Verification 

330 

SOIL 

2011-01-20 13:14 

30.66 

Final 

25825 

2816 CHARLES ST 

B2 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 23.320 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 276.189 

Supervised By: 

Certificate of Verification 

331 

SOIL 

2011-01-20 13:15 

30.38 

Final 

25825 

2816 CHARLES ST 

B2 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 23.281 
/ Q \ Omaha Lead Site—Fixed Price EP-R7-07-05 

3 ^^^ ^ I Coastal Environmentai Group Inc. 

^T^^ ^ www.coa8talhazmat.com 

Xppoit' ^ COASTA L INVIIONHENTAL 

C >0 U P, IN C 

EXECUTIVE SUMMARY: 

BVID # 25825 - (2816 CHARLES ST) 

No Issues or Concerns Issues/Concerns 

Detail Explanation 
dAL 

EPA Property Close Out Form 

Property if: Property Address: 

Date/Time: Owner's Name:. /i.. ,flt 

Quads Excavated: Contractor Group ( ^ 

Excavation Yes No General 

1. If necessaiy, were the correct quadnuit(s) excavated and restored? / 

2. If necessary, were the conrct areas ofdrip zone excavated and restored? / 

Grading Yes No Sod aad VegeUttoa 

I. Does the grading around d»e perimeter ofthe house in excavated areas generally slope away / from the house? 

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

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

day time period) .^— ^ y

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

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day /

time period) 

6. Was the propeity graded such that waier will not pool on the propeny? 

r 7. Was damage lo landscaping or plant materials avoided? y

Gates. Fences and ReUfailpg Walb VM NO 

I I. Oo gates open and close freely? (Ifapplicable) / 

2. Were all gates or fences taken down during restoration aclivilies reinsulied? (Ifapplicable) y 

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

1. Was damage to retaining walls avoided? (Ifapplicable) 7 

Foundation, SidinRand Gatters Yes No 

I. Was damage to the siding or aim avoided? y 

2. Was damage lo Ihe foundation avoided? / 

3. Was damage lo windows avoided? / 

4 Was damage to windows or door screens avoided? J 

3. Was damage io downspouts or downspoui extensions avoided? / 

Sidewalks and Driveways (Concrete) Yes No 

I. Was damage lo driveway surfaces avoided? T 

2. Was damage to walkway surfaces avoided? J 
OM'Dcrs comments: 

ninspection notes: 

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

EPA Representative 9^ ^ Date: (4?iiq_ 
# 

'Zj^ 

Property Completion Agreemenl 

\U\i agiecmcm duiuineni} (he complclton ol icmcdiitl aclivmes perloimed nn my piopeily My .Mgnaiuic 

will dCMgnaic Ihal I am salisfied wilh the icsioralion of my propeily. <tnd ih?! no iieim are in questions 

now. or ai any lime in ihe fulurr cxcepi ihosc Hems li&iec) bdoM, if any 

r^np7M;m;'^is-^Lr '" ^ '^ 

n^p.rtyAdd,»v l^j ^ „Ci3^fi^^3._> t _. - - . 

Owner: (^~ ^ S^_JCX L _.C20'>.<ah\.O_. 

!:!T1!^. ..<'Mol^.HH.H-..^LHL^. 

Resloration Items in Question: 

Item: 

Itam: 

Hem: 

Itam: 

Item: 

U I- IP J.g- l 

Hem: 

Additional Comments; 

lfii \ nfr r rrtloiDlion i« comptclrd, r>«cpl nt noiril 

I J I ilo nni ii|>i'fr ir)ioi-*ii«ii A complftrd 

o?J-A>^JU'^l( l iO l till 

Otviiri'»Sicnaitiir l)*ir Conti uriAi't SignaliHt' DAir