TRANSMITTA L of OMAH A LEA D SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID#: 5423 Date: 

Address: 1209 S 10 St. 

Remediation Contractor: Environmental Restoration, LLC Year: 2010 

X 

D 

X 

X 

SOIL REMEDL^TION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) J35efore D After D Basement D 

Executive Summary (Final Report) 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

J^T Photographs ja^efor e DCrew Photos H^uring Excavation D Sod 

^r5b-day Sod D 

As-built sketch 

Completion Agreement signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria. Contamination left behind 

Utility clearances 

Property information from Douglas County Assessor's Office 

Property access checklist 

Contact Log 

30262329 

fenvironniental Restoration Signature 

*A COR si^iature 

Date 

Date 
# EPA 

EPA Property Close Out Form 

Omaha Lead Site 

Property #: 5423 

Date/Time: 

Quads Excavated: F2 

Excavation General 

Property Address: 1209 S 10 St. 

Owner's Name: Nancy Calinger 

Contractor Group: Environmental Restoration (ER) 

^JACAMT Lo t Yes No 

1. If necessary, were the correct quadrant(s) excavated and restored? v ^ 

2. If necessary, were the correct areas of drip zone excavated and restored? /Vio "Pgr kJj^ 

Grading Sod and Vegetation 

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 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 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? 

Yes 

w ^ 

i ^ 

w ^ 

\.^ 

t ^ 

No 

Gates, Fences and Retaining Wails Yes No 

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

2. Were all gates or fences taken down during restoration activities re-installed? (if applicable) -m 

3. Was damage to gates or fences avoided? (if applicable) 1 ^ 

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

Foundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? 

\fd^M:f lof2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

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

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfeces avoided? 

T7^ 2. Was damage to walkway surfeces avoided? 

Inspection notes:, / i 

Remedial and restoration activities complete including 30-day sod warranty: 

EPA Representative; yf2^^J7^7&J^^^.UL ^ ^ Date: /O Z^ji 2£>t( 
OMAHA LEAD SITE — EP-R7-09-05 

ENVIRONMENTAL RESTORATION, LLC 

WWW.ERLLC.COM 

< . Q 

EXECUTIVE SUMMARY 

5423 1209 S 10 ST 

NO ISSUES OR CONCERNS ISSUES/CONCERNS 

DETAIL EXPLANATION: 
IRTH One Call Page 1 of2 

Ticket Information for Ticket 2876028 

Below Is The Ticket Text Followed By A List Of Members Affected jxth 

Printer Friendly Version 

Original Call Date: 10/13/11 

Work to Begin Date: 10/17/11 

Time: 10:04 am 

Time: 10:15 am 

State: NE 

Address: 1209 

Twp: 15N Rng: 13E 

Twp: Rng: 

Legal Given: C 

County: DOUGLAS 

Street: S lOTH ST 

Sect-Qtr: 27-NE 

Sect-Qtr: 

Op: TIM24186 

Place: OMAHA 

Type of Work: LEAD REMOVAL 

Location of Work: LOCATE ENTIRE VACANT LOT 

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

: 5423 

Company : ENVIRONMENTAL RESTORATION 

Contact Name: TIM SUTTON 

Alt. Contact: CELL 

Work Being Done For: EPA 

Depth of Excavation: 24 INCHES Corner Lot: N 

Involves Tunneling or Horizontal Boring : N 

COXCATV LEVEL3 MCINEB MUD02 

Phone: (402)451-1314 x2267 

Phone: (402)306-2347 

Front: N Rear: N 

Explosives: N 

OMAHACOF 0PPDGPR6 QLNNEIF 

Service Area 

Code 

1COXCATV 

LEVEL3 

MCINEB 

MUD02 

OMAHACOF 

0PPDGPR6 

QLNNEIF 

Service Area Name 

COX COMMUNICATIONS INC 

LEVEL3 COMMUNICATIONS, 

LLC 

MCI 

METROPOLITAN UTILITIES 

DISTRICT 

CITY OF OMAHATRAFFICSEWER 

OMAHA PUBLIC POWER 

DISIRICT 

QWEST LOCAL NETWORK 

Contact 

ELMCOX ELMCOX 

LEVEL3 LEVEL3 

MCINEB MCINEB 

SANDY MUD02 

RICH/TRAFFIC OMAHA 

CONSOLIDATED 

CONSOLIDATED 

ELM QLNNEIF 

Phone Numbers 

Day: (406) 728 - 9343 

Alt: (406) 327 - 2936 

Emerg: (888)728-934 3 

Day: (877) 366 - 8344 

Emerg: (877) 366 - 8344 

Day: (800) 289 - 3427 

Emerg: (800) 289 - 3427 

Day: (402) 504 - 7823 

Emerg: (402) 504 - 7970 

Day: (402) 444 - 7197 

Alt: (402) 444 - 5161 

Emerg: (402)444-516 0 

Day: (800) 575 - 5587 

Emerg: (800) 575 - 5587 

Day: (406) 728 - 9343 

Alt: (406) 207 - 1494 

Utility 

Type 

http://www.dhon.org//IRTHOneCall/TicketA^iewTicket.aspx?ticketID=861076 1/4/2012 
Contact Information Log 

SAID# 5H^3 

Owner'': s Name: ^d/lcV Q Uj P C \ Daytime Phone: [L/^ ^ ^^ 1 P ' ^^ Q 

Property Address: /<^0* 7 Ji^- / O ^ JJAttempt to contact 

.__ 

Date/time Name 
Property Access Checklist 

SAID: ^^^ 3 

Property Address: ld<> J S. /O ^ sf . 

D WORK STARTED ON: 

D WORK COMPELTED ON: 

_/ l_ 

I I 

Owner; 

g-r 

Renter: 

Address: 

Phone: (^pp . ) S^S ' ' J^PCe f 

Fax: 

Phone: 

Fax: 

Cell/Pager: 

Cell/Pager: 

Additional Information: 

12 Access Agreement 

[ B Restoration Agreement 

E Video Property Before 

1^ Digital Photos Before 

• Video Property After 

n Digital Photos After 

^ Property Completion Agreement 

d j Final Report 

Signed: ? A ^ / '/ 

Signed: 7 /«^-'/ '^ 

On :3_/^'^/iL 

On : ^ I^Hl M 

On : / / 

On : / / 

Signed: I'^l 3^1 W 

Signed: / / 

By: ^ 0 

By: pji 

By: iCO 

By:ie^ 

By: 

By: 

By: fi> 

By: 

Additional Video or Digital Photo's Taken: 

D Video D Digital Photo 

Reason: 

n Video n Digital Photo 

Reason: 

n Video n Digital Photo 

On 

On 

On 

: / / 

: / / 

: / / 

By: 

By: 

By: 

Reason: 

n Video n Digital Photo 

Reason: 

On : / / By: 

/ 
Consent for Access to Property SAID# S^-3 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner), consents to and authorizes the United States Environmental 

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

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

Owner's Name ~R OACy ^cJi(A^-^r Daytime Phone: /Y'^^)S>7 ^ -^C g 

Addresses of Properties 

covered by this 

Agreement: 

Address: /^7 ^ - fd ^^f 

Address: 

Address: 

Address: 

Address: 1 

PURPOSE OF INVESTIGATION 

The purpose of the remedial activities is to remove all soils at the property which are 

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

to 400 parts per million (ppm). 

REMEDIAL ACTIONS 

The environmental response actions to be performed on said property may include the following 

activities: 

a. Taking photographs and/or video of the property 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. Planning and implementing the removal action on or near Grantor's property. 

d. Obtaining samples from Grantor's property; 

AGREEMENT NOT TO 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 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 

O^grai I grant access to my properties Q I do not grant access to my properties 

Signature /J Da> 

.JJL&S'/L 

Signature Date 
Check this box if owner does not want E.R. to enter the residents to document interior 

foundation walls and possible preexisting damage. By checking this box E.R. is not responsible 

for any damage done to the interior of house, including foundation cracks or fissures. 

I agree I 11 do not agree '^0 1 agree I 11 do not agree 

A/ f ^H Of: ^yj Pt^' 

Owner's Signature Date Contractor's Signature 

/^--^<--<^ 

Date 
Restoration Agreement 

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

contractor 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). 

SAID: ^ya_ 7 

Property Address: /9~Oj ^ ft> ^ M -

Owner: ^1(^0 / O^imJtT 

Phone: (t/o qj) (^"^ ^ J^< ^ f 

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. 

Items to be removed by Contractor and not replaced: 

Item: 

Item: ' ^' ^ 

t-»f-r^« a d S 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 1 of 2 
H I agree n I do not agree pT l agree Q I do not agree 

^^^^^ -^-

'sSigfiai 

/A^ CnjC'^^it^Oy . ^ 

>wner's Signature 

Attachment 

DaU Contractor's SigHiure Date 

Page 2 of2 
Property Completion Agreement 

This agreement documents the completion 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: ^</«^ 3 

Property Address: /^ j ^ /gti . ^/ . 

Owner: ^( ^ g ^ ^J ^ 

^ inp^ 

I Phon^y>^3 ^sr -^ s - ^^L P J 

Restoration Items in Question: 

Item: 

Item: 

item: 

Item: 

Item: 

item: 

Additional Comments: 

I IWagree restoration is completed, except as noted 

I I I do not agree restoration is completed 

l^f l agree restoration is completed, except as noted 

I I I do not agree restoration is completed 

/^-^f// 

Contractor's Signal Date 
Douglas County Account InfojaMition Page 1 of2 

Douglas County, Nebraska Property Record 

Information is valid as of 2011-8-12 

- R0322930000 

Print Report 

View Interactive GIS Map 

Treasurer's Tax Report 

New Feature -> -^ «4 Subdivision Sales Search 

Owner 

CALINGER NANCY 

1215 S 10 ST 

OMAHA NE 68108-0000 

Property Information 

Key Number: 

Account Type: 

Parcel Number: 

Parcel Address: 

Legal Description: 

2293 0000 03 

Residential 

0322930000 

1209 S 10 ST 

OMAHA NE 68108-0000 

CITY LOTS LOT 4 BLOCK 262 S 66 FT LTS 3 66 X 132 

Value Information 

2011 

2010 

2009 

2008 

2007 

2006 

Land 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

Land Information 

Acres 

- 0.23 

SF 

10032.0 

Units 

0.0 

Depth 

152.0 -

Width 

66.0 

Vacant 

- Yes 

lnttn-//Hr»iialn<:nf» mannino.nnlinp f'.nm/Dniiain<;r'n'Mp/«:tatir./nr.mnntinffS i.<;n9ap,cniintnn=Rn'^ " 8/17/901 1 
Douglas County Account InfojBation )m^ i Page 2 of2 

i:-^-

The above map is powered by Google, and is intended to provide a general idea of a property's location. If 

you require a more exact property location, you may use the Interactive GIS Maps that are maintained by our 

office. 

httn://dou&la.sne.manning-nnline.cnm/r)nnplasCnNe/static/accnimtinfn.i.«;n?accnnntnn=RO'^ 8/17/901 1 
ENVIRONMENTAL 

RESTORATIO N 

Samplins Address: /S0 3 <3 /C ' iS f 

Sampla Number 

RYASCPXA- .5V<?3 F"! 

RYBSCPXA- S'ifZ S F2 

RYCSCPXA- SfS S B1 

RYDSCPXA- if*fS 3 B2 

Lea< 

Concenti ition 

tt\£ . 

l^UL 

RDZGOPKA- -ez 

-6ZRPZSCPXA -paNumbe 

Logend: Fl - Front Left. F2 " Front Right. E 1 

SAID * 5423 

DATE EXCAVATED 10-18-11 

DATE EPA SIGNED OFF 10-27-11 

AREA SODDED 2S10 SQ FT 

AS-BUILT DRAWING 

OMAHA LEAD 

SUPERFUND SITE 

Contract* EP-R7-09-05 

^7X-:^-^^ \ 

Omah a Lea d Site 

Sit e Sketc h 

Extefior Rami 

• Cood 

f^Poor 

n Not paint 

SHS ^ 

^4ortt1 Arro w 

iffi_ 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

Sample 

Collected 

or 

or 

• 

a 

• 

LAB 

o 

n 

• 

• 

• 

ol Samp>les = 

Samples Collected 

Firm: BEJJ^C-^ PE> V4. 

Dale ikll u 

Time: 'h-Ctt>Vr\ 

Siunples Analyzed 

XRF Unit: 

Date 

Time: 

Staff 

t^nS T Book g,? / 

A M 

= Bacii Lett. B2 » Bacit Right DZ « Drip Zone. GZ *• Garden. VZ. «= Play 

\ aff« a s >WM»»el from the •InMl , «Km g propvft y 

SJTKxl Quadrant Excavated 

['V$'V$^'' 

LEGEND 

Drip Zone Excavated Lead Soil Remaining Easement Excavated 

Environmental Restoration LLC 
Omaha Lead Site 

Site Sketch 

Sampling Address: /^Q S c 5 / O <3 ^ 

Exterior Paint 

• Good 

0 Poor 

• Not paint 

North Arrow 

1 

Sample Number 

RYASCPXA- S^Z5 F1 

RYBSCPXA- 5Y2 5 "^2 

RYCSCPXA- S*f-65 B1 

RYDSCPXA- S*i.e3 B2 

fiDZSCPXARGZSCPXA-

-BZ 

-«ZRPZSGPXA- -P2-

Lead 

Concentration 

3Si4 ppm 

H-QS ppm 

( 5 7 ppm 

^C7 ppm 

ppm 

•" ppm 

ppm 

Sample 

Collected 

• 

D 

D 

LAB 

D 

n 

D 

n 

D 

n 

n 

Number of Samples = 

Samples Collected 

Firm: Pg tiAc. P& VJ^ 

Date: 'llyjlu 

Time: 3:Cx^Fl-\ 

XRF Unit: 

Date: 

Time: 

Staff: 

Samples Analyzed 

QOBiT Book: ^^ | 

A M 

Mi'ilN 

Legend: Fl = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Rigtit DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

M 

Rr.-2IJ08BL Crealad: 16-\{a\-

Jf-Jt-

^ 1 - -

n-

.§: 1 

^ 

(^.. ; 

b\ 

: I /S7 

f. 

^v^zo 

•0-

^ i en" 

.35^ . ^ 

j t — WA>_K 

5..:iP.s?r, 

..ft 

^5: 

• ;: -

_ui: 

SEP 2 i 2011 

(5 
S7r'?^<^l 

Omaha Lead Site 

Site Sketch 

Sampling Address: d /0j3f 

Exterior Paint 

• Good 

0 Poor 

• Not paint 

North Arrow 

Sample Number 

RYASCPXA- S^S 3 F1 

RYBSCPXA- 5Y2 5 "^2 

RYCSCPXA- S'^SS B1 

RYDSCPXA- 5^S 3 B2 

RDZOCPXA- B2 

RGZSCPXA- -SZRPZ6CPXA- -P2-

Lead 

Concentration 

3 3 4 ppm 

4 A S ppm 

/ 5 T ppm 

S.0 ppm 

ppm 

•" ppm 

ppm 

Number of Samples • 

Sample 

Collected 

• 

D 

D 

LAB 

D 

D 

D 

D 

D 

n 

n 

H 

Samples Collected 

Firm:BtJyi L P& W u 

Date: '\\l\\\ \ 

Time: S-QOPK 

Samples Analyzed 

XRF Unit: SO3 7 Book: g.9 / 

Date: ^^-^g-^(0/ / 

Time 

Staff: 

^^M. 

JMhL 

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

s 

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y i ] 

t i_ . ' J f 'rf -rf 

(0 

•.!... : : , 

1 

f 

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^...., - .... . . 

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Oil . 

Re\'2IXlSBL rreatod 16-Ma>--08 
ENVIRONMENTAL 

RESTORATION 

XRF DATA ENTRY LOG 

C 

SAID# 'S'^^'h 

PROPERTY ADDRESS 

QUADRENT OR SAMPLE AREA 

redig 

D 

n F2 

n B2 

• DZ 

• PZ 

n GZ 

• EZ2 

• OTHER 

DEPTH 

^ 

- ADATE 

TIME 

XRF S/N 

AVERAGE OF RESULTS 

^;?i /? 

.TfcS'-f ^ f 

lb MX \ '( 

3S730 

SHOT#s 

Cin^-'fS2 

9?3' 9 ^ 

SAMPLER NAME "T/rMn^<i li . 1 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

2011-10-18 15:24 

2011-10-18 15:24 

2011-10-18 15:24 

2011-10-18 15:23 

2011-10-18 15:20 

2011-10-18 15:20 

2011-10-18 15:19 

2011-10-18 15:18 

Avg of983-985 

Avg of 979-981 

1209 s 10 St 

1209 s 10 St 

1209 s 10 St 

1209 s 10 St 

1209 s 10 St 

1209 s 10 St 

1209 s 10 St 

1209 s 10 SI 

EZ 

EZ 

EZ 

• EZ 

. F2 

. F2 

F2 

F2 

lADDUKSS SAMI'I.K AKKA OI'KUA'I'OK DKI' 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMM^' 

surface 

surface 

surface 

surface 

4 

4 

4 

4 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

5423 

5423 

5423 

5423 

5423 

5423 

364.58 ± 28.79 

346.22 ± 28.14 

383.62 ± 29.51 

363.91 ± 28.73 

92.45 ± 17.46 

91.09 ± 17.21 

84.27 ± 16.97 

102.00 ± 18.18 

Page I of 1 10/20/11 15:09:55