TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: l^^M U Date: 

1 Ul 

Address: \^'\^ ^H-& hit 

Remediation Contractor: _CoflstaI Environmental Group_ Year; 20i 06^ 

A 

A 

A 

-e' 

-aA 

A 

A 

lA 

SOIL REMEDIATION 

PROPERTY HLE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Stimmary 

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 

Photographs V 1 ^ W >^ (^(>T/<<1fl<yvA ^ (| ^ j^^i^-Ti- ^ 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property infonnation from Douglas County Assessor's Office 

Signature 

30054835 

Superfund 
vv 

Property Access Checklist 

Property ID: \Q3^^l f n WORKSTARTED ON: / / 

Property Address: jQ^,-) p^|-|(^4 ^ n WORK COMPELTED ON: / / 

Owner: \^'^ ^ ^e/\\rU p Renter: 

Address: Phone: 

Fax: 

Cell/Pager: 

Phone: ^^2 ^ b/I ^ '^'^.'^ r Additional Information: 

Fax: 

Ceil/Pager jer: A 

n Notification Letter 

PT Access Agreement 

Q ' Restoration Agreement 

D Topsoil SampUng (if applicable) 

G Disposal Sampiing (if applicable) 

D Garden Sampling (if applicable) 

n UtUity Clearance 

• ^ Video/Photos (Before) 

n Video/Photos (During) 

D Video/Photos (After) 

D Video/Photos (30-Day) 

•'ffl.JProperty Completion Agreement 

t l Fuial Report 

Air Monitoring (as appUcable) 

D Community QCrew On:

Results: 

n Community Q Crew On:

Results: 

• Community • Crew On:

Results: 

Sent: / / 

Signed:^ /i^/Q ^ 

Signed:^ /|3. 0 

/ / 

/ / 

/ / 

CaUed: / / 

On: 1 / 7^1 ri 

On: / / 

On: / / 

On: / /

1 

Signed: _|\/^/e g 

Issued: / / 

/ / By:

 / / By: 

/ / By: 

By: 

ByCC 

By:jrC 

By: 

By: 

By: 

By: 

By: (^^^M\^^ \ 

By: 

By: 

By: 

By: 

By: 

Omaha Lead Sits 

 1 
• • 

Douglas County Accovmt I[^||tt|io j n Page 1 of3 

Douglas County, Nebraska Property Record - R0734570002 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VJe w O n Ma p Information is valid as of 2009-9-15 Treasurer's Tax Report 

New Feature ->->• • Auto Sales Search 

Owner 

GENTRUP KEITH P 

ETAL TR 

1937 PARK AVE 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number: 3457 0002 07 

Account Type: Residential 

Parcel Number: 0734570002 

Parcel Address: 1937 PARK AV 

OMAHA NE 68105-0000 

Legal Description: BURR OAK ADD LOT 56 BLOCK 0 ALL LOTS 54-55 & 150X150 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$14,600.00 

$14,600.00 

$14,600.00 

$14,600.00 

$14,600.00 

$14,600.00 

Improvement 

$134,800.00 

$134,800.00 

$134,800.00 

$128,100.00 

$128,100.00 

$128,100.00 

Total 

$149,400.00 

$149,400.00 

$149,400.00 

$142,700.00 

$142,700.00 

$142,700.00 

Sales Informatio n 

Sales Date: 2007-12-05 

Deed Type: 

Price: 

QC 

$0.00 

Booilr: 2007 Page: 138998 

Grantor: GENTRUP KEITH P ETAL 

Grantee: GENTRUP KEITH P ETAL TR 

Valid/lnvaiid: Invalid 

Exclusion Reason: Family Sale 

Sales Date: 2000-06-09 

Deed Type: 

Price: 

Grantor: 

WD 

$141,000.00 

Book: 2155 Page: 039 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R07... 9/17/2009 
• • 

Douglas County Account I ja^^rvm^on Page 2 of 3 

Grantee: 

Valid/Invalid: \ valid 

Exclusion Reason: 

Sales Date: 1999-03-29 

Deed Type: D Book: 2117 Page: 335 

Price: $60,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.51 22500.0 1.0 150.0 150.0 No 

Improvemen t Informatio n 

Building 1 

1937 Par* «v 

Detached Second PIOOT 

Garage «„ 8840S4 Ft 

576.0 Sq.Fl 

fSL 

First Floor 884 0 Sq. Ft 2 Story •»??:'?' 

Basement per Appraiser 364 soft 

ftVfH^Hiiiawfiiaa 

CLICK TO ENLARGE IMAGE CUCKjrOEN LARGE JMAGE 

Square Footage: 1768.0 Percent Complete: 100.0% 

Perimeter \ 0.0 Quality: I Good 

Unit Type: Condition: i Good 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 8.0 

Exterior: Masonry Common Brick Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Clay Tile Bedrooms: 4.0 

Roof Type: Hip Stories: 2.0 

Floorcover: Allowance Foundation: Block 

http://douglasne.mapping-onIine.com/DouglasCoNe/static/accountinfo.jsp?accountno=R07... 9/17/2009 
• • 

Douglas County Account I|||n|ntion Page 3 of3 

Sprinkler Square Footage: 0.0 

Year Built 

1922 

Detail Type 

Appliance 

Appliance 

Basement 

Fixture 

Fixture 

Fixture 

Garage 

Garage 

Porch 

Porch 

Porch 

Year 

Remodeled 

2001 

Percenf 

Remodeled 

0% 

Detail Description 

Allowance 

Fireplace Masonry 

Bsmnt Block 8 ft 

Additional Fixtures 

Base Fixtures 

Bath Full 

Basement Single 

Detached 

End Solid Wall 

Slab Roof Ceil 

Slab Roof Ceil 

Adjusted Year Physical Age Built 

1922 86 

Units 

1.0 

1.0 

884.0 

1.0 

1.0 

1.0 

1.0 

576.0 

28.0 

72.0 

32.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R07... 9/17/2009 
• • • • 

CONTACT FORM 

Property ID # \'^^^l o 

Property 

Address: \o^oy, Vx^Y-p.A 

Initial Contact: Date:^// ^ Time: 

Second Contact: Date: Time: 

Final Contact: Date; Time: 

Final Action: Transmit to EPA D 

. Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

Action: 

Action: 

Action: 

Other Action: D 
• • • • 

Page 1 of2 

[ Create Another Ticket | [ Back to Irth Internet [ Send Email 

• YOUR TICKET NUMBER IS 2369190. 

Original Call Date: 9/21/09 Time: 5:31 pm Op: ELIZABETH18790 

Work to Begin Date: 9/23/09 Time: 6:00 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 1937 Street: PARK AVE 

Twp: 15N Rng: 13E Sect-Qtr: 28-NE-SE 

Twp: Rng: Sect-Qtr: 

Legal Given: C 

Type of Work: LEAD REMEDIATION 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: COASTAL 


Depth of Excavation: 4 FT Comer Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVELS LEVEL3 COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 

Day: 4025047823 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.,. 9/21/2009 
Page 2 of2 

• • • • 

0PPDGPR6 OMAHA PUBLIC POWER DISTRICT NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNEIF QWEST LOCAL NETWORK NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/21/2009 
0LS#: 18346 

As-Buil Date Excavated: 10/9/09 t Drawing Date USEPA Signed Off: 11/5/09 

COASTA L Omaha Area Sodden: 9639 so ft Lead Superfund Site 

82 = 105 PPM @ 13" 

Air Conditioner 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with 

Sod 

Area replaced with 

Rock/Mulch Area left bare 

Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 

.1 ^ [^^ 

^ 'v^^ cxwe 

Name; 

Address: 

Phone: /.ILJ ­ kS'-^<r 

Omaha Lead Site 

Site Sketch 

Date:

Time:

 <^ AR/A ^ 

/ - T CTeam AYKfS,

1!>^\V \Ar­

 GorUC. BVID # \^1 h C: 

Sample Number 

gW7^.PyA-/05 ^ 
n ^ k'' 

# • • • 

Name: G^^cXr,. Omaha Lead Site Date: 4 A^ North Arrow —i 

Address: \ m PITIL 6. if ^ Site Sketcti Time: >'^< ^ 

Phone: 6.)i.\- kS""^-C ATeam A\ f S GorUL(. BVID # 1 C3Vi^ XRF Code ^^^-z. 

Sampie Number Lead Concentration Confirmation Sampie 

g9As^p)c^- /g ? ^ 4/,, Yes t ^ No 121^ -a Yes n No ZAi ^fei^^ppm " I Yes n No cz' 

y/vYes [^ No [3" 

V^Yes n No IZI 

ppm Yes • No n 

Yes • PP"^ Ji ^ No • 

\ 

y 
Name: Gr^.'^sV^ Omaha Lead Site Date: u^yAi North Arrow 

Address: U^L^ Site SIcetch Time: < r c 

Phone: /.^^t - k<r-i<: 

VfSl ^fcrz: A­ rvA 

Team_A\£S_ BVID# )C3^( ^ XRF Code ^^d^-z. 

Sample Number Lead Concentration Confimnation Sample 

gyA2^p)c^- \e ? ^ Mr 

1:^ ^ 

ppm •fj Yes Zl No ^ 

-t-'ZZ­ ]^sSdPyrA-/e-5^^ ppm No g ' •zM'2±3f 

ppm No ZA 

//•/A>±'3^ ppm No [3' 

MB ±.2-7 No izr ppm 

ppm No • 

ppm No • 

^tit±3l\ ^)A>±Sf( 

4 

: ^ : 

c 

^ 0 

VOs^ K? I 

«i a ^— 

^ ^ i 

tJi^ /^«^±27 

M^crV xyA 

w ^01^22. lokt ZO- ^ i 

--^crW-^-tf t 
COASTA l 

ENvrnONM l HTA l 

C R O U r , I W C 

Coinsenl for Access To PropsFty 

RIGHT OF ENTRY TO PREMISES 

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

Environmental Protection Agency (EPA) or its authorized representati\'es, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

(VP Dd^e S^l-m 

Owner's Mame: Daytime Phone 

i-^ h^r^^p 

Address of Property 

covered by this 

Agreement: 

1^^1 VaxV- t^f^ 

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) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will 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 perfonned, 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 will 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 and subcontractors the right to enter the property, at all reasonable times 

and with 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 
Jl* *> 

1.^ \:^.-fyi^^ / COA.STA L IHYIROHMtKTl t 

CROU P IH C \ A 

i Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

e Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

« Water and maintain replacement vegetation, including fertilizer application, as 

necessary' subsequent to an initial watering period by EPA; 

c: Abide by health and safety guidance provided by EPA; 

e If the property is rented, assist EPA in obtaining tenant approval for access to 

the property to perform the work. 

c Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

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

of the work done, or with the equipment used on his property', 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 contacl Coastal 

Environmental Group, at (402) 991-1199 

I grant access to my properties Q I do not grant access to my properties 

%^ fj/yc^ 

Signature Date Signature Date 

Q I would like to be present during any samplingi that is required. 

Page 2 of 2 
COASTA L 

Restoraliisoia Agireement 

The purpose of this agreemeni is to provide a mutuaJ agreement as to conditions ofthe properly prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

fProperty ID: [ y g^4( ^ 

Property Address: ^Q•2,-7 ^^CkSc^ KJ ^ 

Owner: "^rW \ C-^^XS-W^yQ 

Phone: iaX^LZ^jh^^ .Js^JOod^^jZM^- i\ia^,..„^.^ 

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 VideographicaJly document the existing conditions of lhe property and the basement if 

necessary. 

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

The ranoval. storage, disposal, and/or return ofthese itoms Is the Owner's responEibiiity. 

UrMiL 

Item: 

Item: 

Item; 

Items to be Removed by the^ontractor During Remediation and i\}ot Repjaced^ 

Item: 

\im 

Item: 

Item: 

Item: 

^ Page 1 of 
COASTA L 

Items to Be Removed By Contractor During Remediation and Repiaced 

Item: 

s^if &-^ 

Item; 

' g ^ \^ ^ 

ttem: 

t 

* Item: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Nurnber of trees > 2 inch 

trunk diameter 

Number of trees <- 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Aiiath ;i skcicli ol the" 

•.(•rii'kloi l;!>:nii 

Number of and size of 

each garden/ flower bed 

area. 

Alli'itli ;i Nkt'icli o\ rk.-!;ilivi­

•>m-s niid loc;iiiiiiii 

Agreed upon value of plant 

materials not to be 

replaced by contractor. 

N'Cic llii' ^HlllC v\ill Hi 

i;six' 10 liiui .1 ;)lan; 

loiifSiLT lo llie i;ropci-f\ 

uii ner. 

Easement Area, to be 

excavated 

_—. 

Landscape Inventory 

Quantity Unit Condition/Type/Species 

Quadrants 

^ ^ 

b Each 

Each 

\ 

Each \\o 

Each 

Square Feet 

\ 

\ $

Each \^jrClu\a ^€ajV\s 

Page 2 of • > 
. V»>^_;<^S5£^' 

COASTA L 

f Additional Comments / Instructions; j 

L. 

^^Chec k the box if Owner does not want CEG to document interior foundation walls and possible 

preexisting damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

y i I agree Q I do not agree 

Owner'ss Signatur Sienaturee '' Dat Datee Cbntractor' Cbntractor'ss Signatur Sienaturee • Date 

Page 3 of /_ 
BVID# /^3V^ 

XRF PROPERTY SAMPLE SHEET 


Date Address l^^ > po^tAA-Ch^ 

Project Omaha lead FP 2nd year opilon Sample time am/pm 

XRFID# sample length 30 sec 

Shot# Reading Sample area Shot# Reading Sample area 

:^Z3 6 ^ ^ \{ /DP ^( ^ 

-ZA % Sr'Z^.J>IO AA ^ a^^^ir . 

^S m nZr ^l? i / 3 ^ 

Depth ^ Depth (12^ ^ ^ tSh &7 ^i- ? 

TATR % ^( { ^/gy n l - d^lfj HI 

Average S' ^ ^ f O Average //OS J - 12> 

Shot # Reading Sample area Shot# Reading Sample area 

Depth Deplh 

Average Average 

.Shot.# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

lab sample # Lab result Sample area XRF Avg. 

Signature^CflM y 

Print 'PlMfllnp^ CjtOAes 
m L 

\QL\ Omaha Lead Site—Fixed Price EP-R7-07-05 

^^^v ' I Coastal Environmental Group inc. vJ ^ ^ %. ­ -o* www.coastalhazmat.com 

^•tPf.oit'^ COASTA L ENVIRONHENTAL C R O U r. IN C 

EXECUTIVE SUMMARY: 

BVID #18346-(1937 PARK AVE) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 
0 

^ 1 

EPA Property Close Out Form 

Property #: \<?l?Pr{LQ. 

Date/Time: Owner's Name;..^.,K.t)M .nvAr ^ f ' 

Quads Excavattd: [32. Contractor Group PnQ'^/ l \ 

Yes No Excavation General 

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

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

Grading Yes No Sod and Vegetation 

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

from the house? 

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

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

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 y ^ 

time period) 

6, Was the property graded such that water will not pool on the property? y^ 

7. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls 

Yes No 

1. Do gates open and close freely? (Ifappiicable) y' 

Were all gates or fences taken down during restoration activities reinstalled? (Ifappiicable) y^ 

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

4. Was damage to retaining walls avoided? (Ifappiicable) -y

Foundation, Siding and Cutlers Yes No 

I. Was damage to the siding or trim avoided? ^ ^ 

2. Was damage to Ihe foundation avoided? 

Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? ly- ^ 

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

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? y ^ 

2. Was damage to walkway surfaces avoided? 
Ort'ners comments: 

Inspection notes: 

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

EPA Represenlalive Ud> i J% A I L Dale: / / SA O ? 
Property Completion Agreenfient 

This ajireement documenis lhe compielion of remedial aclivmes perioimed on my properly. My signature 

will designale thai I am satisfied wilh the restoration of iny properly, and thai no items are in questions, 

now. or al any lime in the future, excepl those ilems hsled below, ifany 

Property m : \ <g)^<-.\V^ 

Property Address: \ (\ -^- ^ Pgr R /V ^ 

Phone: {. ^ ^^^ ^ ^MPDnA ^ •' 3^^.11 1 ft 

Restoration Items in Question: 

'^*^"': / Colo ^pdC ^f/tyyyjAfU'^P/ii-i^} f.i-if cf lyn,Ai^ A'^^r/'-'PiAa-. 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

lAii^iy LyAlF A>A f/t/iA/^ ^ ^/ / 

L_ 

I ajjrcc I cstoralion i« completed, cxccpi as noleri 

[ I I rto not aurec rcsioratmr is compleleri 

Owiin' s Signature Date Contracioi's Siqnaiurc ' Dale