PROPERTY SUMMARY

 

Date: 08/21/2007 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: August 

Property Address: 2620 N 19 Av 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: None 

A.2 Issues Resolved: 

A.3 Unique Findings: 

A.4 Other Relevant Information: Vacant Lot 

CONFIRMATION SAMPLING DATA/RESULTS: 

Fl-290@6" F2-135@6" 

Easement 141 @ Scrape 

ATTACHMENTS 

1) Property sketch provided by EPA pursuant to contract specifications 

2) Signed Access Agreement including access agreements required Tor 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 sketch ­

i) Shall include final lead levels v) Legend 

ii) Contamination left behind areas vi) Contractor identification 

iii) Property address vii) Date 

iv) BV1D 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) Excavation digital video in MPEG, WMV (Windows Media Video) or SWF (Flash Player) format and/or 

photographs 

iii) Signed form verifying satisfactory restoration 

iv) Description of areas not meeting Interim ROD cleanup criteria. 

40285043 

Superfund 

TECHNOLOGIES, INC. 
Name: 

Address:

Phone: 

/flit &/<«// 

 Z&£fl //. /f^Av 

Omaha Lead Site 

Site Sketch 

Date:

Time:

 8. £o.0'7 

 12.. iO 

North Arrow 

Team fD ft Tfc //?*,' BVID# XRFCode 

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Name: A 

Address: 

Phone: 

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Omaha Lead Site 

Site Sketch 

Date: 

Time: 

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AGE OF HOME?: YEARS. HOW LOKi, [:^-, .'.•... . L:.;.- , r.:.,' : - .i.-.- \/A <- .,;<^_ | A. 

SThf tXTERIORBEEM PAIKTED OR 

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PxEPA

 

EPA Property Close Out 

Form 

Property #: Property Address: 

Date/Time: Owner's Name: 

Quads Excavated: Contractor Group 

Excavation General

 Yes No 

1 . If necessary, were the correct quadrants) excavated and restored? / 

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

Grading Sod and Vegetation Yes No 

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

from the house? i/ 

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

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

day time period) L/ 

4. Are sodded areas generally firm and evenly graded? 

I/ 

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

time period) y 

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

7. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls 

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

s 

Yes No 

l/ 

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

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

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

Foundation, Siding 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? 

y

•/ 

Yes No 

S 

s 

y

/ 

(/ 

Yes No 

J 

I/ 
Owners comments: 

Inspection notes: 

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

EPA Representative £)„„ &. Date: slit /a -7 
Total Quadra juare Footage to be Excavated = 2220 

Property Classification: 800 Tat Footage to be Excavated = 0 

Legend 

Concrete 

7~/\ Excavated Area 

[ I Existing Structure 

•—•— Fence 

[>'.'.-:1 Permanent Landscaping 

— — • Quadrant Boundary 

Street Boundary 

'~S Tree/Shrub 

North 19 Avenue 

North Arrow Omaha Lead Site 

Omaha, Nebraska 

Scale 

1 Inch = 20 feet or 1 grid = 5 x 5 ft 

Property Number 

OLS-29439 

Property Address 

2620 N 19 AVE 

F2 

B1 

Post Excavation Concentrations (ppm) 

B2 _ Ray Area _ 

DZ _ Easement I ^-/ 

Garden _ Other _ 

Description of post excavation areas: F1. front yard left-hand quadrant; F2. front yard ngtit-hand quadrant; B1, backyard left-hand quadrant; B2. backyard right-hand quadrant 

DZ. drip zone (1-3 foot area of soil around the foundation of the house) 
SEPA

 

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 of the 

subject property, and that no items are in question, now, or at any time in the future, excluding any 

remaining sod warranty (30 days total) except those items listed below, if any. 

Property ID: '^\ ^ ^^ 

Property Address: "2-C=Zo xM l^l^A^J^

 

Owner: (2p5^O(

 2. H i-kXi ^

 

Phone: (J4&)\~t<£" 5-10^

 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Kern: 

Item: 

Required corrections to complete the property: 

agree restoration is completed, except as noted above. 

I do not agree restoration is completed 

rs Signature Date 
Find Record 

Sample Area: 29439 - 2620 N 19 AV 

Owner: 

i_J Owner Occupied 

Owner Name: 

(MITCHELL ROSCOE c 

Owner Address1: 

Owner Address2: 

|2430 EVANS ST 

City: State: Zip Code: 

JOMAHA |NE [68111 

Owner Phone: Alternate Phone: 

|(402) 453-7029 [ 

$/>»& 

«>>) 

Clean Up Query Lead Remaining Query {

Resident: 

Resident Name: 

JVACANT LOT 

Property Address: 

]2620 N 19 AV 

Zip Code: 

[68110 

Resident Phone 

| 

Property Damage Query 

i

i

1 

|

1

f 

;

i

I

Contract: 

Contractor: 

(PRUDENT2007 

Group: 

j 

Assessment: 

Qualifying Group 

J800 

Assessment XRF Date: 

1 

Assessment Max XRF Valu 

j 836.9 
Douglas County Page 1 of 1 

Douglas County, Nebraska Property Record - R2206980000 

Information is valid as of 2007-5-9 Print Report 

Values not finalized until after Board of Equalization View on Map 

Owner 

MITCHELL ROSCOE C 

ETAL 

2430 EVANS ST 

OMAHA NE 68111 -0000 

Property Information 

Key Number: 0698 0000 22 

Account Type: ' Residential 

Parcel Number: 2206980000 

Parcel Address: 2620 N 19AV 

OM AH A NE 68110-0000 

Legal Description: \ SHERWOODS SUB DIV LOT 2 BLOCK 3 60 X 81 

Value Information 

Land \ Improvement Total 

2007 $400.00 $0.00 $400.00 

2006 $400.00 $0.00 $400.00 

2005 $400.00 $0.00 $400.00 

2004 $400.00 $0.00 $400.00 

2003 $400.00 $0.00 $400.00 

2002 $0.00 $0.00 $0.00 

Sales Information 

Date Type Book Page Price 

Land Information " ~ I 

Acres SF I FF Units Deptfi I Width Vacant 

0.11 4860.0 'I- 60.0 \ 0.0 81.0 ! 60.0 Yes 

Land Attributes 

Attribute Attribute Description 

Improvement Information 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22... 6/22/2007 
•eview Page 1 of 1 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

2206980000 

MITCHELL 

ROSCOE C 

2620N19AV 

OMAHA 

68110 

2430 EVANS 

ST 

OMAHA 

NE 

68111 

Sec- Twn -Rng

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

/Assessor 

Website Link 

 110-15-13 

SHERWOODS SUB DIV 

60X81 

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

accountno=R22C6980000 

Disclaimer: 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 for a title search, 1 inch = 52 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx'^PrintOptData=Douglas County-... 6/21/2007