0

TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAIDft: 29044 DATE: 12/15/2010 

ADDRESS: 1507 1/2 OHIO ST 

REMEDIATION CONTRACTOR: PRUDENT TECHNOLOGIES. INC. YEAR: 2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ PRE AND POST VIDEO OF PORPERTY (DVD) 

G1 EXECUTIVE SUMMARY 

• f EPA-PROVIDED PROPERTY SKETCH 

m SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

[^ RESTORATION AGREEMENT 

D SETTLEMENT DOCUMENTS (I.E., FOR DAMAGE OR TO REPLACE PLANTS, ETC.) 

(3 CONFIRMATION DATA 

a PHOTOGRAPHS 

m AS-BUILT SKETCH 

SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

d PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

n DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

 UTILITY CLEARANCES 

d PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

SIGNATURE DATE 

30260822 

Superfund 
Find Record Remediation Query Lead Remaining Query I Property Damage Query 

Backfill: 

Sampie Area: 29044 -150 7 1/2 OHIO ST 

Owner: 

n Owner Occupied 

Owner Name: 

ITHOMPSONDL 

Owner Addressl: 

I 

Owner AddressZ: 

11682 WHITMORE ST 

City: State: Zip Code: 

JOMAHA NE" 168112 

Owner Phone Alternate Phone: 

)(402) 455-7242 

Contract: 

Contractor: |PRUDENT2010. .S 

Contract Option [OPTION 2 

User Provided Owner Information 

Owner Name: 

! 

Owner Address: 

1 

City: 

1 

State:

1

 Zip Code: 

i 

Owner Phone: 

1 '

Alternate Phone; 

1 

Assessment: 

Qualifying Group |400 

Assessment Max XRF Value | 494.22 

Resident: 

Resident Name: 

I 

Property Address: 

J1507 1/2OHIOST 

Zip Code: 

J68110-

Resident Phone 
PROPERTY SUMMARY 

Date: 12/15/2010 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Month of: December 

Property Address; 1507 Vz OfflO ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Infonnation: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

F2 = 380 PPM @ 2"; B2 = 395 PPM @ 2"; NO EASEMENT 

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-Built sketch ­

i) 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 of areas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES, INC. 
TECHNDLOGDES, INC. 

EPA Property CBose Out 

Property#: 2-^b ^ Property Address: j^O T '9-0'K'^t> 

Date/Time: Owner's Name: D L '^^'"^Q^OI ^ 

Quads Excavated: ^2 . 92 ^ Contractor Group: Prudent Tedhmologies, Inc., 

Excavation General Yes No 

1. [f necessarv. were the correct qiiadrant(s) excavated and restored? / 

2, If necessary, were the conect areas of drip zone excavaled and restored? 

y 

Grading Sod and Vegetation Yes No 

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

from (he house? y

2. Has sod been laid in all areas tliat were e.xcavated? / 

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 fimi and evenly graded? 

y 

5. Are the joints between tlie sod strips generally light? (Only evaluate if inspected at a 30 day / time period) 

6. Was the property graded such tliat water will not pool on tlie property? 

/ 

7. Was dajiiage to landscaping or plant materials avoided? 

y 

Gates, Fences and Retaining Walls Yes No 

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

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

^ 

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

y 

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

Foundation, Siding and Gutters Yes No 

1. Was daniage to tlie siding or trim avoided? y 

2. Was damage to the foundation avoided? y 

3. Was damage lo windows avoided? 

y 

4. Was daniage to windows or door screens avoided? 

y 

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

Sidewallks and Driveways (Concrele) Yes No 

t. Was damage lo driveway surfaces avoided? y 

/ 2. Was damage to walkway surfaces avoided? 
Owneirs conn in ents: 

iBspectioE motes: 

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

EPA Representative Qc,„^^t^ Date: i,ji?f,, lot­
im CHNOLOGIES. INC. 

AS - BUILT DRAWING 

OLS #29044 

Date Excavated: 10/29/2010 

USEPA Signed-OfT Date: OMAHA LEAD SUPERFUND SITE 

29044 

Omah Extffriw Paint NorthAoow Owne a Lead Sita r Name; PL THOMPSON 

Sits Q Good Sketch Address: 15071/2 OHIO ST n Poor 

Phona: tt 402-455-7242 MW: 

Qnolpatn t 1

Sampl Lead Samples CoBected e I4uin ber LAB ConoenlrdtiLM \JV1 i Collected Firm: .ASkLVA^V^LE— RYASCPXAr29044 F l .ppm IT D Oate: ft«i- a.*.. Aii 

RYBSCPXA-29044 F2 .ppm 0- D Time: t:nc j .tns- RYCSCPXA-29044 B l AJU. ppm [ T D Samples Analyzed RYDSCPX/ik-29044 B2 W'* ^ .Pffi Q^ D 

nDgOOPWAgOOH Qg 

"" pom D D XRF Unit lOc n Boole i(c2 _ 

fiozoopxAgtwK ca _i: ^ ppm D D Date: _ajL21li2 i 

nPilDOPXrt £0044 M ppm 

n D Time-j^na 

Staft /i^i.. ^ Number of Samples = | Jf.. 

Legend: Fl = Front Left, F2 = Front Right 81 = Back L ^ B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants an as viowiidftom die sdcel. faong prapoty 

CONTRACT #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
%!EPA 

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; VSo ^ 1/.^ C UJ o ^j^ -

Owner: t ^ c m r^ o T U c\t.^ pRfA>^^ 

Phone: 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

^ agree restoration is completed. 

L J I do not agree restoration is completed at (noted deficiencies above) 

Dannil \ y

Owner' vner' ss Signatur Signaturee > ^yy^ -J ^
FCHVfilC>t;iF.\!V: 

Prudent Technologies, Inc. (Prudenl) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up Icadcontgminated soils at a number ofproperties located in Omaha, Nebraska, including the property located at 

I^^ T 1%. C3V\(o ^^T" The EPA requests your permission to allow Prudent to perform a soil cle-anup at this 

property to remove lead-contaminated soil. By signing this form, the property owner grants permission to Prudenl lo perform 

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

Ifyou have any questions about the soil cleanup planned for your property, please contact Prudent. .';:i- •. vi-:i ;• l)i: w for the Omaha 

Lead Site cleanup, at (402) 733-1188; 733-1455. General questions about the Omaha Lead Site cleanup can b; directed lo the EPA 

Public Information Centers at (402) 731 -3045 (South Omaha office). 

Property Access Granted By. ^^T^/^A 

(Please ffriul Name, ^V>- f ^ o V] 

Property Owner Signature: _ 

(Signature; ^^ 0 V ^ (Date)

PROPERTY INFORMATION 

(To be completed by resident and/or property owner - please print) 

RESIDENT NAME: Owner Renter 

RESIDENJLABDRESS:

\S o"/ Vo ok : A ^ (S^vwJ^ N>e fi^tt 

IF RENTAL, PROI^^TY OWNED BY 

v^^*^ t V ^ p ?? (?/l ^ 

OWNER'S MAILING ADDRESS; 

tr,^2 . (A_v^f-(-.v^--^ .st- o .L^,__i^lS e-^ 

OWNER'S TELEPHONE NUMBER - HOME: _L WORK: 1. 

MoL) ^<<:-T2-M7 _ 

AGE OF HOME?: 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: 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 .inder this agreemeni 

are pursuant to Section 104 ofCERCLA, 42 U.S.C. 9504. EPA's right of access to the property is provided lb' 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 re.spon.<;e action 

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

8080 Ware Parkv;ay, S." "Wciiic-.a' :'-;vi.. Suito ^2h: 

Kansas City, WIO ^i'.'^'­

ohone: (?16) 353-C""f" 
ENVIRONMENTAL & IRUDEN' CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address: I 5 O ~7 j/^ ^ OVU o ^i - Date: »o|2Lr3|(T> 

Phone: BVID: 

\r^ni^ cy^ •€.CL 

Property Owner Prudent Employee 

Signature: 

S080 Ward Partcway, Suite 405 

/7/^n Signature: 

5600 S los t 4242 Medical DTive, Suite 4250 

Kansas City, MO 64114 OMl^iJi^ Nebraska 68107 San Antonio, TX 78229 

Phone: (816) 363-3703 PhoneK (402) 733-1188 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: ^02)733-1883 Fax:(210)579-6577 
29044 

Exterior Paint North Arrow Owne Omaha Lead Site r Name: D L THOMPSON • Good Site Sketch Address: 1507 1/2 OHIO ST • Poor 

Phone: H: 402-455-7242 W: Q^Not paint 1

Sampl Lead Sample Samples Collected e Number LAB Concentration Collected Firm: As w \ R5.\N F 

RYASCPXA-29044 F1 Z5 g ppm IT D Date: r,'^-

 s.^-^ ^ 

RYBSCPXA-29044 F2 

ppm D Time: \;.HSfhft 

RYCSCPXA-29044 B1 

ppm D Samples Analyzed RYDSCPXA-29044 B2 ppm D 

RDJOOPXJ^ 20011 DJ ppm D D XRF Unit /oo l Book: llo ^ 

nogocpxj"iaoQii ppm D D Date ^'2'^-Pi n 

ppm 'D D Time UQOStaff; Number of Samples • /kij 

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

All quadrants are as viewed from the street, facing property 

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7 1/2 Ohio St. 

A Printed

: Nov 11.2010 OIS 

wvi/w.dcgis.org/dogis 
Page 1 of2 

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Create Another Ticket Back to Irth internet Send Email 

• YOUR TICKET NUMBER IS 2624626. 

Original Call Date: 10/23/10 Time: 11:40 am Op: SIVA18967 


Work to Begin Date: 10/27/10 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1507 Street: OHIO ST 


Twp: 15N Rng: 13E Sect-Qtr: 10-SE-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: SOIL LEAD REMEDIATION PROJECT 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)7-33-1883 


: UNSURE CORNERS... 1507 1/2 OHIO ST 


Company : PRUDENT TECHNOLOGIES 


Contact Name: SIVA JAMPAMA Phone: (402)733-1188 


Work Being Done For: EPA 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MCINEB MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Nuniber Utility 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MCINEB MCI NO CALL PER 

MEMO 

Day: 8002893427 

Alt: 

Emerg: 8002893427 

MUDOl METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICH/TRAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/23/2010 
Page 2 of2 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day:

 Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/23/2010 
t..wr^siKIJC'110N 

SOLUTIONS 

SITE SAFfcTY HAZARD ANALYSIS 

Address: -AL2 //^ rk i pf' Excavatioii Date: (^/^/"^( ^ 

Crew: Backfill Date: 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees 

Structures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

Condition Hazards Corrective Action 

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Site Safety Office 

Date: 

8080 Wanf^artEHay, 5iBle405 15600 SI O St 4242 Medhsil Drive, Suite 7250 

Kansas Cay; IIO««114 OmatB, Nebraska 68107 San Vkntenio,'TX 78229 

Pbone: (816) 36^3703 V^aner. (403)733-1188 Phone: (2tO) 822^588 

F^E (81S) 363-^3707 Fax: (402)733*1883 Fax: (210) S79-6577 
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