TRANSMITTAL of OMAH A LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID#: :^0^9LM Date: 

Address: !^3l\l VV. \i p ^ 

Remediation Contractor: _EnvrionmeiitaI Restoration, LLC_ Year: _2010_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

D Video of property (DVD) ^Before DAfter D Basement ^ ^ d J>iSe.mIiiAjh 

^ H Executive Summary (Final Report) 

' ^ EPA-provided property sketch 

S Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

^ Restoration Agreement 

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

iS Confirmation data 

D Photographs _t5 Before DCrew Photos^During Excavation D Sod 

^ 30-day Sod D 

V As-built sketch 

"^ Completion Agreement signed by Property Owner 

Q Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

^ S Utility clearances 

" ^ Property information from Douglas Coimty Assessor's Office 

^ ^ Property access checklist „„„ 

^ ^ 30237750 

O^ Contact Log 

g Superfund 

Environmental Restoration Signature Date 

xyc^j>^y:^ &-T-_U_ EPA COR signature ~ Date" 
Omaha Lead Site—EP-R7-09-05 

Environmental Restoration, LLC 

www.erllc.eofn 

EXECUTIVE SUMMARY: 

30924-3211 N16ST 

No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
-EPA 

EPA Property Close Out Form 

Omaha Lead Site 

Property #:^JoWi _ Property Address: i2\ [ V^» l U JT T 

Date/Time: Owner's Name: '\bP^ o\Wj ^a.v^ 

Quads Excavated: -^ I Contractor Group : Environmental Restoration (ER) 

Excavation General Yes No 

1. Ifnecessary, were the correct qiiadrant(s) excavated and restored? 

^ 

2. Ifnecessary, were the correct areas ofdrip zone excavated and restored? ^0 ^ (Lo4" CL«A^X-

A/ ^ 

Grading Sod and Vegetation 

Yes No 

1. Does the grading around the perimeter of the house in excavated areas generally slope awayfrom the \ y house? 

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

^ y 

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? 

i ^ 

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 wiU not pool on the property? 

*^ 

7. Was damage to landscaping or plant materials avoided? 

y ^ 

Gates, Fences and Retaining Walls 

Yes No 

I. Do gates open and closefreely? (if applicable) 

i. ^ 

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

^ 

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

- ^ 

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

Foundation, Siding and Gutters 

Yes No 

1. Was damage to siding or trim avoided? 

y ^ 

2. Was damage to the foundation avoided? _ ^ y 

3 u ^ . Was damage to windows avoided? \^ ^ dO' ' fiuiy 

4. Was damage to window screens or door screens avoided? *^ 

L ^ 

5. Was damage to downspouts or downspout extensions avoided? 

y 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? 

~w 

2. Was damage to walkway surfaces avoided? 

y " 

Inspection notes: 

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

EPA Representativj»r"'7;^. /fT^^ ^ '^A^^ ... 

Date: 3/7^^ 0 
Adam Detrich 

From: Johnson.James@epamail.epa.gov 

Sent: Thursday, August 05, 2010 3:27 PM 

To: Adam Detrich 

Subject: Re: QC properties 

Adanij here are the QA sample result s fo r today. 

3211 N 16 ST Fl = 294 +/- 33 

3220 N 24 ST Fl = 308 +/- 34; F2 = 355 +/- 38; DZ = 246 +/ - 32 

James A. Johnson, MPH 

On-Scene Coordinator 

USEPA / R7/ SUPR / ERNB 

991 N. Sth Street 

KCK, KS 66101 

913.551.7058 offic e 

913.551.9058 fax 

816.516.4954 cel l 

Johnson. 1ames(Sepa. gov 

"Today i s a good day t o live " 

I > 

I From: | 

I —­ > > 

- I 

I 

I Adam Detrich <a.detrich@erllc.com> 

> 

I 

I > 

I To : I 

I — -­ > > 

I 

I I James Johnson/R7/USEPA/US@EPA 

> 

I 

I -­ > 

i Date: | 

I — > 

> 

- - I 

I 108/05/2010 08:59 AM 

> 

- I 

I ­ > 

I Subject; | 1 
Page 1 of2 

"> 

[ Create Another Ticket ] [ Back to Irth Intemet ] I [ Send Email 

• YOUR TICKET NUMBER 18^2551812. 

Original Call Date: 7/2_4/10_^ Time: 9:07 am Op: TRACY24186 


Work to Begin Date: ^/28/107 Time: ITVlS^aiiy' 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3211 Street: N 16TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 10-NE-NW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: Excavating the entire property 


Location of Work: LOCATE ENTIRE PROPERTY 


JlemarJcs.:__FAX.,ALL CLEARS TO: (402)451-1069 


i_.SAID #30924 


Company : ENVIRONMENTAL RESTORATION 


Contact Name: TRACY BRISTOW Phone: (402)451-1314 


Alt. Contact: Phone: (314)504-4874 


Work Being Done For: EPA 


Depth of Excavation: 12 Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number 

Utility 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MAGELLAN ^^GELLAN MIDSTREAM PARTNERS DEBORAH 

Day: 9185747098 

Alt: 

Emerg: 9185747098 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RICHATIAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/24/2010 
Page 2 of2 

Day: 4067289343 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT LOCATING ^^ ' 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK

PI M 

 LOCATING

Day: 4067289343 

 ^^^' 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/24/2010 
1 

Contact Information Log SAID#3o^^^ 

Owner's Name:^^{-^-f^v y •X~^.^'T 

Property Address: 3;>(| /^ , /(^"tb j f 

Attempt to contact Date/time Name 

AcC^iJ ^rf*. s JiJA*V ^-9-( o V:' 9 n ^ 

1'iO^lO II3^ 45 

^<!»*V\^l^+« •'^ /^(7-/ 0 ff;-j^ ^ i ? 

-k 
Property Access Checklist 

n WORKStARTED., . 

j Prnn^rty Address: -351 ) K- |(#1!^3 ^ U WORKCOMPELTED ON:__/__/_

Owner: j^protk Y P^A-j- Renter: P>i y (yjjxA^ 

Address: ^^ ^ -7 ' M- ^ ^^^S-j - Phone: 

Fax: 

Cell/Pager; g ^^ - /^/S ^ 

Phone: j^/.yS3Z > Additional Information: 

Cell/Pager: 

Ip3 Access Agreement Signed: «^ / ^ / /^g By-iS/; 

S: Restoration Agreement Signed; ^ / f / / ^ By: le, ^ 

Video Property Before On : 1 / '^ 1 /-o 

^y- M 

Digital Photos Before On : ^7 iM f !'> ^y A­ n Video Property After On / / By: 

n Digital Photos After On / / By: 

( 3 Property Completion Agreement Signed: ^ / 171 fO By:</ ^ 

n Final Report Signed: / / By: 

Additional Video or Digital Photo's Taken 

n Video D Digital Photo I On : / 

Omaha Lead Project Work Plan Page I of 19 
Consent tor Access to Property SAlDuJ^^'^y 

RIGHT OF ENTRY TO PREMISES 

Grantor (Lhe property owner), consents to and avjthorizes ihe United States Erivironmentai 

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

and perform certain envirorunental response activities upon the following described premises.: 

Owner's Name: • UOro44sj>J -^A h Daytime Phone: 3^/ / •'ySJ~ t 

Addresses of Properties 

covered by this 

Address: 

Address: 

Address: 

3:?u M. ic^ikjf. q 

Agreement: 

Address: 

Address: J 

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 cn-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 samplesfrom 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 imdertake 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 

I grant access to my properties 

n I do not grant access to my properties 

2^/i^ 

^nature Date Signature 

Date 
Additional Comments / Instructions: 

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

foijn^ation 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. 

Q I do not agree CD I agree n I do not agree 

2-1^-//) 

Iwner's Signature Bate CoatrECtor's Signature Date 
Restoration Agreement 

The purpose of lIiIs agreement is to provide a rmituai_agree.rnent as-tc ccriditions of property p-ibr to 

contractor aetlvilies:' Tnis 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). 

3^:^9 

Property Address 3^i{ H- /6 til J A. 

Owner: 

Phone: 

39r 

On the attached diagram(s) indicate area(s) to be excavated and depth cf 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, materialtypes, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Etems to be removed by Contractor and not replaced: 

j Item: 

2^U<^ Ail U->/fA ^fcc / 

1 Item: 

Kem: 

Item: 

Page 1 of 2 
Additional Comments / Instructions: 

n I do not agree Q I agree O I do not agree 

2-^-/^ 

Owner's Signature Date Contractor's Signature Date 

Attachments 

Page 2 of 2 
I

Property Completion Agreement 

Tliis agreement dociimehts th'e" corifipletibli 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: JSOf^y 

Property Address: 3,^/ / A^. JC^-jL. S-lOwner: l\)^ c ^=^4- Phone: Jy^/ . ^^^^- Q 

Restoration Items in Question: 

>Ol agree restoration is completed, except as noted |> | I agree restoration is completed, except as noted 

I I do not agree restoration is completed I 11 do not agree restoration is completed 

Owner's Signatur iignature Date Contractor's Signature Date
Douglas Coimty Accoimt Information Page 1 of3 

Douglas County, Nebraska Property Record - R2249360000 

Print Report 

NEW Feature - Parcel Dimensions available (9 scale 0-50 ft west of 52nd St - Vie w OH Ma p Infomnation is valid as of 2009-12-15 Treasurer's Tax Report 

New Feature -*->- * Auto Sales Search 

Owner 

FANT DOROTHY M 

ETAL 

3207 N 16 ST 

OMAHA NE 68110-0000 

Property Informatio n 

Key Number 4936 0000 22 

Account Type: Residential 

Parcel Number: 2249360000 

Parcel Address: 3211 N16ST 

OMAHA NE 68110-0000 

Legal Description: SULPHUR SPRING LOT 11 BLOCK 3 52.8 X 124 

Value Informatio n 

Land /mproi^e/nent Total 

2009 

2008 

2007 

2006 

2005 

2004 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$43,100.00 

$43,100.00 

$52,200.00 

$52,200.00 

$52,200.00 

$50,900.00 

$45,700.00 

$45,700.00 

$54,800.00 

$54,800.00 

$54,800.00 

$53,500.00 

Sales Informatio n 

Sales Date: 2006-02-16 

Deed Type: WD Book: 2006 Page: 018465 

Price: $47,900.00 

Grantor: Country Home Loans 

Grantee: Dorothy M Fant eta! 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 2005-11-16 

Deed Type: WD Book: 2005 Page: 149065 

Price: $50,400.00 

Grantor CAMILLE R HAWK TR 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R2... 12/21/2009 
Douglas Coimty Account Information Page 2 of3 

Grantee: COUNTRYWIDE HOME LOANS INC 

Valid/Invalid: Invalid 

Exclusion Reason: \ Sale to Mortgage - Bank 

Land Information 

Acres SF Units Depth Width Vacant 

0.15 6572.0 1.0 124.0 53.0 No 

Land Attributes 

Attribute Attribute Description 

Negative Influence Traffic 1 

Improvemen t Informatio n 

Building 1 

321i1 N 16 

TWO STORY 

;^|is?^y" 

CLICK TO ENLARGE IMAGE CLICKJLO„ENLARGE IMAGE 

Square Footage: ; 1738.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Good 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Baths: 2.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Hip Stories: 2.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1895 1991 0% 1895 115 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

httn://dou2]asne.maDDina-online.com/DouslasCoNe/static/accountinfo.jsp?accountno=R2... 12/21/2009 
Douglas County Account Information Page 3 of3 

Basement 

Basement 

Fixture 

Fixture 

Garage 

Porch 

User 

Bsmnt Block 8 ft 

Finished 

Base Fixtures 

Bath Full 

Attached 

End Solid Wall 

MLS UPDATE 

660.0 

550.0 

1.0 

2.0 

484.0 

112.0 

1.0 

httD://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accoimtno=R2... 12/21/2009 
ENVIRONMENTAL AS-BUILT DRAWING 

% MAHA LEAD SUPERFUND SITE 

RESTORATION 

Name: ^'^o ^ 3<7vg ^ Omaha Lead Site Date: 1-17-0' $ North Arrow 

Address: 33 ^ ) 1 w> /6^'^A- Site Sketcli Time: ^ ^ 3(!0" 

Phone: 3'( S - ?V>'7 

< ^ 

Team 7^^*^ ^ / g^''-^-' , Sg^ ^ BVID # 3C7^,^ ^ XRF Code ~7&S 

Sample Number Lead Concentration Confirmation Sample 

gVASo.P)^ A - 3o<=r^ ^ ^ i Yes a No - ^ 

|"<5-Yes a No ^ gyg^ g - -^^^-z^ g i Yes tZl 

No S, No ta. <^? iil ^ ppm No S T 

ppm No a 

ppm Yes • No • 

SAID # 30924 

DATE EXCAVATED 8-3-10 

DATE EPA SIGNED OFF 8-18-10 

AREA SODDED 477 SQ FT 

Omaha Lead Site 

46130 

\sssm 

Quadrant excavated 

Drip Zono Excavated Contamination Left Behind 
Omaha Lead Site 46130 
7^# \^b(oyKs fgyCr^'^MLp-l/^iS 

Name: mit'CC^ ^roc S Omaha Lead Site Date: 7^17-€> S North Arrow 

( ^ 

Address: 35- 1 I -A^ /C^-^k^ Site Sketch Time: ^ i 3£ > 

Phone: 3f6 - '?V?7 ^ 

Team 7^-^f-^ /<^^r ^ j ^i­ ^ BVID # '3^CP^^ ^ XRF Code ~73S 

Sample Number Lead Concentration Confirmation Sample 

gVASc^FX A -

12-Vg-Sc:; RKA ­

 3Q^:Z ^ 

^o^PLtJ- ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

«^( Yes

p^Ye s

S i Yes

e:^Yes

Yes

 a 

a 

Q 

O 

• 

No . 

No ^ 

No ^ 

No ^ 

No E f 

No CD 

No • 

Omaha Lead Site 4613( 
ENVIRONMENIAL XRF DATA ENTRY LOG a 

RESTORATION 

SAID # '^jcfi<1j\ — 

PROPERTY ADDRE ESS 

•*,?AV I O . \ l o 

QUADRENT OR SAMPLE AREA 

redig 

D F2 

n Bl 

B2 

• DZ 

PZ 

• GZ 

• 

EZ1 

F7? 

n OTHER 

DATE %- \ H \ VO 

TIME 

XRFS/N 

DhPIH AVERAGE OF RESULTS SHOT#s 

^•^ n -i- S o S,5^2te-5.SZ-9 - ^ ^ 

SAMPLER NAME i\y^r^co^ \ :3: \trNC»\.L ^ 
Thenno Fisher Scientific Thermo 900 Middlesex Turnpike 

Billerica, MA 01821 

SCIENTIFI C 

201048-04 10:48 Avgof3826-582l3211nl6 8t EZ 

2010-08-04 10:48 3211nI6st EZ 

2010-08-04 10:47 32Ilnl6s t EZ 

2010-08-04 10:47 3211 n 1681 EZ 

2010-08-04 10:43 AvgofS818-S82(321lnl6st Fl 

2010-08-04 10:43 3211nl6st Fl 

2010-08-04 10:43 3211nl6st Fl 

2010-08-04 10:42 3211iil6st Fl 

jimmy 

jinuny 

jinuny 

jinuny 

jinuny 

jimmy 

jinuny 

jimmy 

sur&ce 

swiBce 

surface 

surface 

4 

4 

4 

4 

final cleaiance 

final clearance 30924 

final clearance 30924 

final clearance 30924 

final clearance 

final clearance 30924 

final clearance 30924 

.final clearance 30924 

355.73 ± 

357.49 ± 

333.81 ± 

333.93 ± 

379.60 ± 

382.09 ± 

390.09 ± 

366.63 ± 

29.54 

29.63 

29.38 

29.40 

30.94 

30.95 

31.27 

30.59 

08/05/1009:47:36 Page 1 of 1 
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