PROPERTY SUMMARY

 

Date: 09/18/2007 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: September 

Property Address: 2502 Ames Av 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: Garden Area not sodded 

A.2 Issues Resolved: Re-Seed will occur in October/November on any dead spots to encourage spring growth 

A.3 Unique Findings: 

A.4 Other Relevant Information: 

CONFIRMATION SAMPLING DATA/RESULTS: 

YA - 167 @ 6" 

GA - 54 @ 8" 

YC - 258 @ 14" 

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) Excavation digital video in MPEG, WMV (Windows Media Video) or SWF (Flash Player) format and/or 

photographs 

iii) Signed form verifying satisfactory restoration 

iv) Description of areas not meeting Interim ROD cleanup criteria. 

40285073 

•111 

Superfund 

HNOLOCIES, INC. 
602 

te Exterior Paint North Arrow Owner Name: Omaha Lead S n Good A 

Address: 2502 AMES AV Site Sketch / \ 

Phone: H:

Sample Number 

RYASCPXA-602 

RYBSCPXA-602 

RYCSCPXA-602 

RYDSCPXA-602 

RDZSCPXA-602 

RGZSCPXA-602 

RPZSCPXA-602 

D Poor 

1 w: |~| Not paint 

Lead Sample (.„ Samples Collected 

Concentration Collected Firm: Sverdrup 

YA 430.8 ppm 0 D Date: 

YB 299.2 pom p] |~| TimeYC 806 pom p| ^ ^ Samples Analyzed YD 293.2 ppm Ivl 

DZ 385.4 ppm 0 D XRF Unit: Book: 

GZ 740.8 pcm pj (~| patp. 10/22/1999 

pz

 PPm PI PI Time: 03:46 

NumDer OT o am pies — u I i 

Legend: YA = Yard (NE), YB = Yard (SE), YC = Yard (SW), YD = Yard (NW), DZ = Drip Zone, GZ = Garden, PZ = Play 

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Rev4 . . . . . . . . . . . . . . . . . 046141.0123 

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602 

IQ Exterior Paint North Arrow owner Name:

 Omaha Lead S 

D Good A Address: 2502 AMES AV

 Site

 Sketch 

D Poor T Phone: H: w i 

FJ Not paint 

Sample Number Lead

Concentration

 Sample 

 Collected 

..0

Firm:

 Samples Collected 

 Sverdrup 

RYASCPXA-602 YA 430.8 ppm 0 D Date: 

RYBSCPXA-602 YB 299.2 pom |7| fl Time. 

RYCSCPXA-602 

RYDSCPXA-602 

YC

YD

 806

 293.2

 ppm

 ppm

 171

 Ivl 

^ 

.—, Samples Analyzed 

RDZSCPXA-602 DZ 385.4 ppm 0 D XRF Unit: Book: 

RGZSCPXA-602 GZ 740.8 ppm p| H Date 10/22/1999 

RPZSCPXA-602 PZ

 PPm l~l Fl Time: 03:46 

Legend: YA = Yard (NE), Y B = Yard (SE), YC = Yard (SW), YD = Yard (NW), DZ = Drip Zone, GZ = Garden, PZ = Play 

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Rev 4 046141.0123 
Agreem o Allow Access To

 

Omaha Lead Property To Conduct Easement

 

Site Remedial Sampling and Cleanup

 

Action 

Sh

Under Contract EP-R7-07-06, the U. S. Environmental Protection Agency (EPA) has Contracted Prudent 

Technologies, Inc. (Prudent), to cleanup lead contamination on various residential properties including 

your property. You can help with this activity by giving permission to conduct easement sampling and 

conduct cleanup on your property. If you sign this form, Prudent will return in a few weeks and perform 

the work. We will coordinate sampling and cleanup with you prior to commencement. 

If you have any questions about the proposed work, please contact Dan Garvey, EPA's Project Officer for 

our Omaha Lead Site Contract Mr. Garvey can be reached at (402) 731-0788. 

Property Access Granted By: \ ^ / < 

(Pl»a» PrintW im») 

Property Owner Signature: * V I l€U>Ua/La 7- / /- 0 

(Doit) 

PROPERTY INFORMATION 

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

RESIDENTNAME: \' 1 fV Jl^S^ t \^)n.^\-C3jP fawner Denier 

RESIDENT ADDRESS: ^2 f5 fi 9 A Tf\<? S\ P\^-P (*^W\ "^iXvni ^Xj-C V£D \ \ \ 

— ....—^ IF RENTAL. PROPERTY OWNED BY: *»^ 

OWN ER-StSAILWG ADDRESS; 0 2- YWLA A \ \-

OWNER'S TELEPHONE NUMBER -HOUSE: ( > WORK: £17 3 ^ °\ 

AGE OF HOHE?: 1 (H^ YEARS. HOW LONG HAVE YO LIVED HERE? YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERDED WITH SIDING SINCE1378? '^YES NO 

HAS THE INTERIOR BEEN PAWTED OR COVERED SINCE 1978? YES NO 

NUHBER OF OCCUPANTS UNDER C YEARS OLD: NUMBER OF OCCUPANTS 6 YEARS OLD AND OLDER __ 

NUMBER OF CHILDRENT UNDER 6 YEARS OLD WHO PLAY IN THE YARD FOR5 HOURS OR MORE PER WEEK: \ k 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS. ENTRY GATES. ETC.) j)<y<a J(A \*\ ^G CJfL. 

ClhO J 0.. v^ilV Vsee^L Iro 

AUTHORITY FOR ENVIQRNMENTAL RESPONSE ACTIONS ^^<d>/^_^)LAu>C . 

U^2 J-X&-VJL& <-<^ i^\ 

TheacUvitiestobeirr4)lementsbyEPAimderthisagrecrnerlarepursuai^toSectimlC4 , , 0"? v 9604. EPA'sri§htof access to the pr^erty is provided for in Sedicsn 104(e) of CERCLE, 42U.S. C 9605(e), which &r- X4tu3,4^ 

provides aitry for "determining the need for response, or choosing or taking any response acticn under this title, or ' 

otherwise enf orting the provisions of the title." 
&EPA

 

EPA Property Close Out 

Property #: Property Address:

 

Date/Time: Owner's Name:-v^

 

Quads Excavated: Contractor Group Prudent Technologies 

Excavation General 

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

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

Grading Sod and Vegetation 

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

from the 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 a 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 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? 

Gates, Fences and Retaining Walls 

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

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

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

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

Foundation, Siding and Gutters 

1 . Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete)

1 . Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

/ 

/ 

Yes No 

/ 

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/ 

/ 

/ 

/ 

/ 

Yes No 

/ 

S 

S 

/ 

Yes No 

s 

y 

/ 

,/ 

,/ 

 Yes No 

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Owners comments: 

Inspection notes: 

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

EPA Representative x£L ^7.u Date: 
602 

1 

t 

Exterior Paint North Arrow Owner Name: Omaha LeadJSite 

D Good

i A Address: 2502 AMES AV Site

 Sketch Q Poor | 

Phone: H: W: [] Not paint 

Sample Number

 Lead

Concentration

 Sample 

 Collected LAB 

Firm:

Samples Collected 

 Sverdruo 

RYASCPXA-602 CYA> 4M& \rf ppm p) D Date: 

RYBSCPXA-602 YB 299.2 DDm p] Time: 

RYCSCPXA-602

RYDSCPXA-602

 CYC")

 YD

 MB 3Q

 293.2

 PPm

 oom

 p| 

 p] a Samples Analyzed 

RDZSCPXA-602 DZ 385.4 ppm p) a XRF Unit: Book 

RGZSCPXA-602 (<3?) W*« 5^. ppm p) a Date: 10/22/1999 

RPZSCPXA-602 PZ opm fl a Time: 03:46 

Number of Samples = 6 1 , Staff: 

Legend. YA = Yard (NE), YB = Yard (SE), YC = Yard (SW), YD = Yard (NW), DZ = Drip Zone, GZ = Garden, PZ = Play 
IS

 
SEPA

 

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 of the 

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: [^ Q £ 

Property Address: QrC ' Q 5 A/n^j yl v*s 

Owner: /"Vl •f 1 1 \ "vO hy) y -h f (2-

Phone: L/^T / ^ ~7 S^ tPRestoration Kerns in Question: 

Hem: 

Hem: 

Hem: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

OWrte.r VOOu^j A JL-i" He. ^° &&- "&-^-* & Soc.P 

C* 

L_l I agree restoration is completed, except as noted above. 

LJ I do not agree restoration is completed 

** /. ^ aJ^ %-Jit-67 

Owner's Signature Date 
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 

1222570000 

BARTEE 

MELISSA L 

2502 AMES AV 

OMAHA 

68111 

2502 AMES 

AVE 

OMAHA 

NE 

68111 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal3 

Legal4 

Assessor 

Website Link 

04-15-13 

GRUENIGADD 

3 

15 

,54X106) 

http://douglasne. mappingonline. com/DouglasCoNe/static/accountinfojsp? 

accountno=R1 222570000 

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 = 32 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 7/16/2007 
.

 

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Scale " 1

Sofl Analysis Project l£.-*.^:.l 1inch= 3O feet s [ 

-SnapicA ica- rVmfirrarim aSan^de 

DA QB DC DD DE Date: /o/z-2-/97 Time: On ^•) A: ppm 

1 2. 3. Team: Zone: Distance." B: ppm QC Duplicate S?rlir Collected' 

Address: 3^02 A/nr\ C: ppm 

Sample f No " Comi itS . D: ppm ( .'1 

z'. ppm Record Number 
Find Record Clean Up Query Lead Remaining Query Property Damage Query 

Sample Area: 602 - 2502 AMES AV 

Owner: Resident: Contract: 

._; Owner Occupied Resident Name: Contractor:

 

Owner Name: [PRUDENT2007

 

BARTEE MELISSA L Property Address: Group:

 

Owner Addressl: 2502 AMES AV

 

r Zip Code:

 

Assessment: Owner Address2: J68111

 

J2502 AMES AVE Resident Phone Qualifying Group

 

City: State: ZipCode: [800

 

OMAHA Assessment XRF Date: 

Owner Phone: Alternate Phone: I 

Assessment Max XRF Value: 

I 878~