TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 5^( 6 Date: //^ /^ -loo ^ 

Address: &/ ^ 5 ^ ^ <F 

Remediation Contractor: Vf2upF^jr T&CfPfyn/~o(nia iHC Year: phojf 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ Video of property (DVD) 

l?r Executive Summary 

ffl' EPA-provided property sketch 

zf Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

y Restoration Agreement 

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

B Confirmation data 

B Photographs 

ar As-built sketch 

B Satisfactory restoration signed by Property Owner 

^ Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

B Utility clearances 

B) Property informationfirom Douglas County Assessor's Office 

D 

D 

40313555 

D 

Superfund 

Bm. Signature/* ^ 'Date 
PROPERTY SUMMARY 

Date: 11/19/2008 Oinaha Lead Site Remedial Action Contract # EP-R7-07-06/0004 Month of: Oct/Nov. 

Property Address: 814 S 33 ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Infomiation; NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

B2 = 170 PPM @ 8"; DZ = 202 PPM @ 8"; Fl = 206 PPM @ 10"; F2 = 324 PPM @ 4"; EA = 242 PPM @ 

SCRAPE. 

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/photographs 

5) Documentation - Completed Close-out Checklist 

6) As-Buih sketchi) 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 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) 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 satisfactory restoration 

v) Description ofareas not meeting Interim ROD cleanup criteria. 

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

Backfill: 

Sample Area: 5610 ­ 814 S 33 ST 

Owner: Resident: Contract: 

n Owner Occupied Resident Name: Contractor: 

Owner Name: 1 |PRUDENT2008_S 

JTHOMAS CHESTER H Property Address: 1 Group: 

Owner Addressl: 

Owner Address2: 

[814 S 33 ST 

Zip Code: 

[68105 

|l 

Assessment: 

|814S33ST Resident Phone | Qualifying Group 

City: State: Zip Code: 1 [800 

[OMAHA |NE [68105 Assessment XRF Date: 

Owner Phone: Alternate Phone: 1 

[(402) 341-2043 | Assessment Max XRF Value: 

1 960.8 
TECHNOLOGIES, INC. &EPA 

EPA Property Close Out 

Property #: 5fe (Q Property Address: 8m -^2,3.^ T 

Date/Time: Owner's Name: Ctte.STTE«? t+«)MtCfcS 

Quads Excavated: ^h^^ ^ f^^ D2.y^f=> Contractor Group: Prudent Technologies, Inc., 

Excavation General Yes 

I. 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 

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

from the house? y 

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 mspected at a 30 

day time period) y 

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? 

y 

Gates, Fences and Retaining Walls Yes 

1. Do gates open and close freely? (Ifapplicable) 

y 

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

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

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

Foundation, Siding and Gutters Yes 

1. Was damage to the siding or trim avoided? y 

2. Was damage to the foundation avoided? y 

3. Was damage to windows avoided? y 

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

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

Sidewalks and Driveways (Concrete) 

Yes

1. Was damage to driveway surfaces avoided? y 

2. Was damage to walkway surfaces avoided? y

No 

No 

No 

No 

 No 
Owners comments: 

Inspection notes: 

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

EPA Representative ^ dyf . .Ati^ Date: // 'J/2J0 ? 
«EFyv 

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: 

Property Address: y^ \ ^\ ci, '^'A) ^ c\ SI 

Owner: - ^ ^ (^^^ ^^^ ^ y { _ ^ 

Phone: 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Kem: 

Item: 

Item: 

Required corrections to complete the property: 

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

L J I do not agree restoration is completed 

"lAm 

Owner's Signature "" Date 
Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up leadcontaminated soils at a number ofproperties located in Omaha, Nebraska, including the property located at 

The EPA requests your permission to allow Prudent to perform a soil cleanup at this 

property to remove lead-contaminated soil. By signing this form, the property ownafgrants permission to Prudent to perform 

activities related to the cleanup including soil sampling, removal of lead-contaminated soil, and restoration ofthe referenced property. 

If you have any questions about the soil cleanup planned for your property, please contact Prudent's Administrative Clerk for the 

Omaha Lead Site cleanup. Ms Madhurima Duru -at (402) 733-1188, 733-1455. General questions about the Omaha Lead Site 

cleanup can be directed to the EPA Public Information Centers at (402) 731-3045 (South Omaha office) or (402) 991-9583 (North 

Omaha office). 

Property Access Granted By: 

(Please Print Name^ I 

Property Owner Signature: _ 

gnature) wm (Date) 

PROPERTY INFORMATION 

(To be completed by resi^entayd/o si^entMd r property owner ~ plei 

RESIDENT NAME: C W^J'^V^^^V , O t«-^o>_/^ Renter 

RESIDENT ADDRESS: 

c^vw.A ^ ^ ^ ^'T i Q 5 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

^ i - (N^W^xl.^ \^K, GSV«> ^ 

OWNER'S TELEPHONE NUMBER - HOME: J L WORK: 

( ^ I ^H\ - .^C3M3 

AGE OF HOME?: ( 6 ^ YEARS. HOW LONG HAVE YOU LIVED HERE? ^ ^ YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? *• YES NO 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: L F NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER 

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY IN THE YARD FOR 5 HOURS OR MORE PER WEEK: 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETC.) 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: The activities to be implemented by EPA under this agreement 

are pursuant to Section 104 of CERCLA, 42 U.S.C. 9604. EPA's right of access to the property is provided for in Section 104(e) of 

CERCLA, 42 U.S. C 9605(e), which provides entry for "determining the need for response, or choosing or taking any response action 

under this title, or otherwise enforcing the provisions ofthe title." 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical 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 
AS - BUILT DRAWING ^ P 

OMAHA LEAD SUPERFUND SITE OLS#: 5610 

Date Excavated: 9/24/2008 

USEPA Signed-Off Date: 

Telal Quadrant Squam Footags to be Excavated = 18SS 

Aope ^ Clatafcation: 800 Total Dilp Zone IJn«ar Foolaae ^ *» Exca»^ed -118 

Post Excavation Concentrations (ppm) i3t|T HGL PI B2 PEay/Uea 

F2 DZ Eaaeowiit Tree/Slnib o Bl Garden Oflw 

EA = 242 PPM a SCRAPE 5'*^'*' ^ 

CONTRAa #: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC 
mjDM (TECHNOLOGIES, INC. 

Property Status Form 

Address: Sl M SSSr ^ <?,<^ Date: 

Phone: HoX- '^^ V - ^^H2> BVID: 

Plants & Permanent Landscaping 

Item# 

On Map Description and Location 

<>^ ' )\ep^ 

5w'^^ . So p(e-.!>-X CJL L v^-i . 

q 

Pre-Existing Condition of Structures 

Does your Basement have a history of leaking? Yes — No y* ^ 

Item# Description & Location 

On Map 

^ o C l ycK^Qji^ ^ 

Property Prudent Employe^ 

Signature Signature: 1^-^ 

8080 Ward Parkway, Suite 405 2505 N. 24"^ Street, Suite 308 4242 Medical 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 
Total QuadrJI^tuare Footage to be Excavated = 1858 

Property Classifk:ation: 800 Total Drip Zone Linear Footage to be Excavated = 118 

,SQUttL33LStEeet 

Legend North Arrow Omaha Lead Site 

Oniaha, Nebraska 1 ^ Concrete 

y / \ Excavated Area Property Number 

OLS-5610 l U Existing Structure Scale 

•—•— • Fence Property Address 1 Inch = 20 feef or 1 grid = 5 x 5 ft 

POQ Permanent Landscaping 814 S 33 ST 

— — — Quadrant Boundary oo""^'. . Post Excavation Concentrations (ppm) 

Street Boundary Fl B2 Play Area ^.\ y HGIL 

F2 DZ Easement ( y Tree/Shrub *>|< F f T r HyclruGeo!.c:gic. inc 

Bl Garden Other 

DescripUon of po« excavation anus: F1, front yard left+and quadrant F2. front yard right-hand quadrant' Bl, badtyarH left-hand quadrant B2, backyard lioht-hand quadrant 

DZ, drip zona (1-3 fbot area of soil araund the foundation of tne house). 

^^J^*;ZOH 3 
PRUDENT TECHNOLOGIES, INC FIRST NATIONAL BANK OF OLATHE 

8080 WARD PARKWAY, SUITE 405 83-172/1010 19764 

KANSAS CITY, MO 64114 

w (816)363-3703 

AFiyit 

5

i

 PAY TO THE 

 ORDER OF _ C/UJI^ TI,. T-^nn^z-A^ 

CAyyvi'ArJ^ii>.iakrJ ^y ^ yU^u^Jy^y^ JA^ ^ A<y)C f ^ DOLLARS Q g 

e MEMO 

ii'O n7E,i,ii " .«: 10 100 17 20i : "'Oil * S^ 5 »*«• 

/ 

PRUDENT TECHNOLOGIES, INC. 19764 

g/i^ ^ ?2 <i F 

PRUDENT TECHNOLOGIES, INC. 

19764 

n 
Page 1 of 1 

Sih s 3 3 s r 

http://douglasne.mapping-online.com/assessdoc/Photos/19/R17224700000001.jpg 8/8/2008 
Print Preview 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 

1722470000 

THOMAS 

CHESTER H 

814 S 33 ST 

OMAHA 

68105 

814 S 33 ST 

OMAHA 

NE 

68105 

Sec-TwnRng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

21-15-13 

MAYNE PLACE 

1 

8 

50X125 

-

http://webapps.dotconnm.org:8080/TreasTax/faces/pages/taxinfo.jsp? 

parc=1722470000 

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

accountno=R1722470000 

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 = 58 feet appraisal, survey, or for zoning verification. 

http://vvww.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 9/16/2008 
y y d ^•V ( 

• 

Indian Creek Nursery 

3 03 North Sad^ e Creek Rd 

Omaha, NE 6813 1 

Phone: 402-558-5900 Fax: 402-932-3460 


Client: ^<^ ^ 

Chester Thomas '-^A t"V^

814 South 33rd Street 

Omaha, NE 

Phone 341-2043 

Cost of a new arrangement of plant material 

Description Qty Size 

Peony 10 #2 

Van Houtte Spirea 0 #2 

Dayiily 6 #1 

Purple Coneflower 5 #1 

Butterfly Bush 1 #1 

Kari forester Grass 3 #1 

Blue Chip juniper 0 #2 

Hall's Honeysuckle 7 Qt 

Rhododendron PJM t #2 

Emerald n GoRTEuonymiiis: #2 

Magic Carpet Spicsa- #2 

Genman Bearded Iris #1 

Total Material 

Install ^.\ 

Sales Tax 

Total 

^ Sr, 0 to 

Date: October 2. 2007 

Revised: June 20, 2008 

 Revised: September 9. 2008 

Price 

19.99 

34.99 

12.99 

10.99 

19.99 

14.99 

'^M. 1^799 

Total, 

199.90 

0.00 

77.94 

54.95 

19.99 

44.97 

0.00 

41.93 

44.99 

34.99 

104.97 

65.94 

0.00 

0.00 

$ 

$ 

$ 

$ 
y 

/ 

/ 

Mr. Chester Thomas, 

This letter serves to confirm that Prudent Technologies \N\\\ provide a check in the amount of $ 1,256.15 

(one thousand tw/o hundred fifty six dollars and fifteen cents) to you for replacement and installation of 

horticultural items as agreed to on the attached sheet. No additional items or labor will be reimbursed 

under this agreement. 

This reimbursement is for the property located at 814 S. 33"* St. Omaha Ne. under contract EP-S7-07-O6 

Omaha Lead Soil Remediation. 

Chester Thomas, Property Owner Danny Snow, Prudent Technologies 

Date Date 
Mr. Chester Thomas, 

This letter serves to confirm that Prudent Technologies will provide a check in the amount of $ 1,256.15 

{one thousand two hundred fifty six dollars and fifteen cents) to you for replacement and installation of 

horticultural items as agreed to on the attached sheet. No additional items or labor will be reimbursed 

under this agreement. 

This reimbursement is for the property located at 814 S. 33"^^ St. Omaha Ne. under contract EP-S7-07-06 

Omaha Lead Soil Remediation. 

o y ^ 

Chester TI)omas, Property Owner Danny Snow, Prudent Technologies 

Date 
0^•V i

" j Sko .O 

Indian Cieek NuTseiy 

303 North Saddle Creek B 

Omaha, NE 6813 1 

Ld 

Phone: 402-558-5900 Fax: 402-932-3460 Date: October 2. 2007 

" 

Revised: June 20, 2008 

Client: /y ^ - S<^'^ 

Chester Thomas . \ \y^F\ y^A\F^ Revised: September 9. 2008 

81

Omaha

4 Sout

, NE 

h 33rd Street 

X/w ^ 

^ yy^ Fy ­

Phone ' 341-2043 

Cos • t of a new arrangement of plant material 

/Descriptio n Qty Size Price Total, 

Peony 10 #2 19.99 199.90 

Van Houtte Spirea 0 #2 34.99 0.00 

/Dayiil y 6 #1 12.99 77.94 

. Purple Coneflower 5 #1 10.99 54.95 

Butterfly Bush 1 #1 19.99 19.99 

Kari forester Grass 3 #1 14.99 44.97 

Blue Chip juniper 0 #2 34^9-Z'"" 0.00

Hall's Honeysuckle 7 Qt 5.99 41.93 

Rhododendron PJM 1 #2 44.99 44.99 

~ -

Emerald n GolcT&Jonyi

TlUSts: #2 iM.yy 34.99 

Magic Carpet Sgi^g^.' #2 104.97 

( ^ .its,i) Genman Bearded IriV #1 fo:99 65.94 

0.00 . . 

0.00 

r\ r\r\ .. ,"' 

Total Material $ rv . ^05 7 ~I> 

Installatirjn 1 aho r ^ , $ 4 ^ ^

\ ' "\i i r

Sales Tax '* > $ 82.18 - A 

Total $ 1.256.15 





Page 1 of2 

"> 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2129830. 

Original Call Date: 9/12/08 Time: 9:26 am Op: RAMITA18967 


Work to Begin Date: 9/16/08 Time: 10:00 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 814 Street: S 33RD ST 


Twp: 15N Rng: 13E Sect-Qtr: 21-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remediation work 


Location of Work: LOCATE ENTIRE PROPERTY 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 Phone: (402)733-1188 


Work Being Done For: epa 


Depth of Excavation: 6ft Corner Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MCLEODNE MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility 

Type 

CXCATV c o x COMMUNICATIONS, 

INC HEIDI 

Day: 4029340469 

Ah: 4029340469 

Emerg: 4029329757 

LEVEL3 LEVEL3 COMMUNICATIONS, 

LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MCLEODNE MCLEODUSA NO NEED TO CALL OUT 

EMERGENCY 

Day: 8002891901 

Ah: 

Emerg: 8002891901 

MUDOl METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Ah: 

Emerg: 4025047946 

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Page 2 of2 

OMAHACOF 

0PPDGPR5 

QLNNEIC


CITY OF OMAHATRAFFICSEWER 

OMAHA PUBLIC POWER 

DISTRICT 

 QWEST LOCAL NETWORK


RON 


NA 


 NA 


Day: 4024447197 


Ah: 4024445161 


Emerg: 4024445160 


Day: 4067289343 


Ah: 8887289343 


Emerg: 4067289343 


Day: 4067289343 


Ait: 


Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/12/2008