PROPERTY SUMMARY

 

Date: 11/28/2007 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 Month of: November 

Property Address: 3110 Charles St 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: None 

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

A.3 Unique Findings: 

A.4 Other Relevant Information: 

CONFIRMATION SAMPLING DATA/RESULTS: 

B2-221@6" 

Dl - 82 @ 13" 

El - 176 @ scrape 

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. 

TECHNOLOGIES, INC. 

H IM 

Superfund 
Omah

a Lead Site 46130 

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Name: /r)ft-u+/i &a*s£7~ Omaha Lead Site Date: *7/^t/Q'5 North Arrow 

Address: ~3>Jl<O ctfj4£z£'£ Site Sketch Time: 

Phone: 

Team fl/tT/cH/Ui^/ /4*>l*J BV1D# 3£~>6 ? XRFCode .^S&l ' ^ 

Sample Number Lead Concentration Confirmation Sample 

1 KKM1 P Yes n NoB 

2 Q^ft*)ttj-'ir-l <&£^-fe>"7 \~-^"5 i2L n ppm /^Yes No tZ Z?,Y(? S&PfrD d2S ~j- (0( ~^>\ Uii 53 

3 ppm 0/Yes Q No C2

 

4 * Y/52>C/'X"/3 £51 &7 ZEoc )*Jfc 

ppm A3Yes D NO H

 

5 K.r&c\&{JXQ c3£~?'fo+~ 173 ppm ^Yes a NOa ^0^ 

6 ppm Yes d No d

 

7 ppm Yes D No D

 

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Omaha Lead Site 46130 

I^B ^HHHL— 

AUTHORITY FOR ENVIRONMENTAL RESPONSE AC'^^^^^H ies to be implemented by EPA under this 

provided for in Section 104(8) of CERCLA, 42 U.S. C IMUPHpxrides entry for "determining the need for 

response, or choosing or taking any response action under this title, or otherwise enforcing the provisions of the 

titla." 
Agreement^attow access to 

Omaha Lead -/ Aft \ theproperf^ properf^ni order toconduct 

Site Remedial -:•vWv y environmental sampling andto 

Action %£*&*.>< v• remove lead-contaminated soil

x ••&,••••' 

Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency 

(EPA) to dean up lead-contaminated soils at a number ofpfoptrnes located in Omaha, Nebraska, 

ifirludhif theorooertv located at ^\\fi VJ^QfvvQA^ . TheEPA requests your 

permission to allow Prudent to perform a soil cleanup at this property to remove lead-contaminated soil. 

By signing this form, the property owner grants permission to Prudent to peifumi activities related to the 

cleanup including soil sampling, removal of lead-contaminated soil, and restoration of the referenced 

property. After obtaining the owner's signature on mis form, Pnia\H* Technologies, IIK. wiU ttMtact the 

property owner (and residents) within the next few weeks to coordinate performance the work 

If you have any questions about the soil cleanup planned for your property, please contact Prudent's 

Administrative Clerk for the Omaha Lead Site cleanup, Ms. Cyndie Suds at (402) 504-1004. General 

questions about the Omaha Lead Site cleanup can be directed to the EPA Public Information Centers at 

(402) 731-3045 (south Omaha office) or (402) 991-9583 (north Omaha office). 

;A\t\fi I 

N 

Property Owner Signature: 

(To be c(Mnplrt*d or rwideatand/or property owner-please prM) 

RESIDENT NAME: Qner Q«er 

RESIDENT ADDRESS: 

IF RENTAL. PROPERTY OWNEDBY 

OWNER'S HAILING ADDRESS; 

OWNER'S TELEPHONE NUMBER -HONE: ttOk 4^/~)O^^ WORK: r|fg.l3O 

ACE OF HOME?: \Q^ YEARS. HOWLONG HAVE YOULIVED HERE? 

HAS THE EXTERIOR MEN PAINTED OR COVERED WITH SIDING SINCE WVt 

NUMBER OP OCCUPANTS UNDER 7 YEARSOLOOC, NUMBER Of OCCUPANTS 7 YEARS OLDAND OLDER 

NUMBER Of CHILDREN UNDER 7 YEARS OLD WHO PLAY INTHE YARD FOR S HOURS OR MORE PER WEEK: QC 

(OMMINII OR SPECIAL INSTRUCTIONS: fE. DOGS. ENTRY GATES.ETC.) 

AUTHORITY FORENVIRONMENTAL RESPONSE ACTIONS: The activities to be implemented by EPA under this 

agreement are pursuantto Section 104of CERCLA, 42 U.S. C. 9604. EPA' sright of access to the property is 

provided for in Section 104<e) of CERCLA, 42 U.S. C 9605(0), which provides entry for * determining the need for 

response, or choosing or taking anyresponse action under this title, or otherwise enforcing the provisions of the 

titla." 
EPA Property Close Out 

Property #: 25767 Property Address: 3110 Charles St 

Date/Time: Owner's Name: Melvia Gossett 

Quads Excavated: j3i-f Contractor Group Prudent Technologies 

Excavation General Yes No 

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

^ 

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

Grading Sod and Vegetation Yes No 

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

from the house? y

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

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

day time period) s

4. Are sodded areas generally firm and evenly graded? S' 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day s­ 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? s 

Gates, Fences and Retaining Walls Yes No 

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

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

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

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

Foundation, Siding and Gutters Yes No 

1 . Was damage to the siding or trim avoided? S 

2. Was damage to the foundation avoided? S 

3. Was damage to windows avoided? t/ 

4. Was damage to windows or door screens avoided? S 

5. Was damage to downspouts or downspout extensions avoided? s 

Sidewalks and Driveways (Concrete) Yes No 

1 . Was damage to driveway surfaces avoided? «/ 

2. Was damage to walkway surfaces avoided? (/ 
Owners comments: 

Inspection notes: 

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

EPA Representative Q<*" **2- Date: ///is/6-> 
M^gg. 

Omaha Lead Site 46130 
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 sod warranty (30 days total) except those items listed below, if any. 

Property ID: 25767 

Property Address: 3110 Charles St 

Owner: Melvia Gossett 

Phone: 402-451-1023 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

LJ I agree restoration is completed, except as noted above, 

do not agree restoration is completed 

// 

Owner's Signature Date 
Douglas County Page 2 of2 

in »: 31 10 CHARLES ST 

ir 

160 

MTU 

ill 

.» 

»n. 

Click to Enlarge Image 

Click to Enlarge Image 

Square Footage: 1100.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: | Average 

Condo Square Footage: 0.0 

Built As: 11/2 Story Fin Rooms: 5.C ) 

HVAC: Central Air to Air Units: 1.C ) 

Exterior: Frame Vinyl Baths: 1.( ) 

Interior: Drywall Bedrooms: 2.C ) 

Roof Cover Composition Shingle Stories: 1 .5 

Roof Type: Gable Foundation: BU >ck 

Floorcover: Allowance Sprinkler Square Footage: 0.0 

v___o,,;i« 79 m

 year

 Remodeled

 Percent

 Remodeled

 Adjusted Year 

 Built Physical Age 

1902 1981 0% 1902 102 

Detail Type Detail Description Units 

Add On Unfinished Attic W/floor 780.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 800.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch Encl Screen 84.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R20... 6/22/2007 
Douglas County Page 2 of2 

»: 31 10 CHARLES ST !» Iktfex i \ FnFbn 

j

i*- .J­

* 

Click to Enlarge Image 

Square Footage: 1 1 00.0 

Perimeter 0.0 

Unit Type: 

Built As: 11/2 Story Fin 

HVAC: Central Air to Air 

Exterior: Frame Vinyl 

Interior: Drywall 

Roof Cover: Composition Shingle 

Roof Type: Gable 

Floorcover: Allowance 

Year Built

 Year

 Percent T9 m Remodeled Remodeled 

1902 v 1981 0% 

Detail Type Detail Description 

Add On Unfinished Attic W/floor 

Appliance Allowance 

Basement Bsmnt Block 8 ft 

Fixture Base Fixtures 

Fixture Bath Full 

Porch Encl Screen 

»<r 

Tktt 

| 

s«w*«n« re;-

Click to Enlarge Image 

Percent Complete: 100.0% 

Quality: Average 

Condition: Average 

Condo Square Footage: 0.0 

Rooms: 5.0 

Units: 1.0 

Baths: 1.0 

Bedrooms: 2.0 

Stories: 1.5 

Foundation: Block 

Sprinkler Square Footage: 0.0 

Adjusted Year 

Built Physical Age 

1902 Ig102 ) 

Units 

780.0 

1.0 

800.0 

1.0 

1.0 

84.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfojsp?accountno=R20... 6/22/2007 
Omaha Lead Application Page 1 of2 

New Search Logout Omaha Lead Application Change P< 

Summary ] Overview 

Property info Assessment CleanJJ PiaceonHold Remove Hold 

Call Tracking 

Property Google. Maps Douglas County Interactive EPA Map Images 

[Sample Area ID (Property Address Sample Address Zip Owner Name 

P5767 01 10 CHARLES ST 31 10 CHARLES ST 58131 SOSSETT MELVIA L 

Property Info 

View/Edit Existing Property 

Douglas CO Parcel ID:

 

Owner Name: 

Owner Occupied: 

Address: 

Address2: 

City: 

State: 

Zip: 

Owner Home Phone: 

Owner Alt Phone: 

Owner Notes: 

Property Type: 

Resident Name: 

Resident Phone: 

Property Address: 

Address Notes: 

Unit: 

Occupancy Length Years: 

Exterior Paint Since 1978: 

Interior Paint Since 1978: 

Total Occupants: 

Total Children Under 7: 

2029000000 

GOSSETT MELVIA L 

r 

5618N50ST 

OMAHA 

NE 

66104 

[(402)451-1023 

|(402)301-4210 

RESIDENCE 

RESIDENT 

3110 CHARLES ST 

6/21/06 OWNER REQUESTED COPY
 

OF RESULTS LETTER, MAILED
 

TODAY. SW
 

EBL 

Child Care 

County Property Type: RESI 

Address Info Provider: B&v 

Info Date: 08/19/2003 

http://r7arcims.r7comp.epa.gov/ols/ Access_Info.cfm 5/21/2007 
Omaha Lead Application Page 2 of 2 

Youngest Child DOB: j Child Info Date: 

Youngest Child in Months: Address Info Provider: B&V Child Info Provider: 

Update I 

http://r7arcims.r7comp.epa.gov/ols/Access_Info.cfm 5/21 /2007 
Douglas County Page 1 of 2 

Douglas County, Nebraska Property Record - R2029000000 

Information is valid as of 2007-5-9 

Values not finalized until after Board of Equalization 

Print Report 

View on Map 

Owner 

GOSSETT MELVIA L 

5618N50ST 

OMAHA NE 68104-1833 

Property Information 

Key Number: 2900 0000 20 

Account Type: Residential 

Parcel Number: 2029000000 

Parcel Address: 

Legal Description: 

3110 CHARLES ST 

OMAHA NE 68131-0000 

PROSPECT PLACE LOT 12 BLOCK D 50 X 127.5 

Value Information 

2007 

2006 

2005 

2004 

2003 

2002 

Land 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$0.00 

Improvement 

$37,500.00 

$37,500.00 

$37,500.00 

$29,600.00 

$29,600.00 

$0.00 

Total 

$40,100.00 

$40,100.00 

$40,100.00 

$32,200.00 

$32,200.00 

$0.00 

Sales Information 

Date Type Book Page Price 

Land Information 

Acres 

0.14 

SF 

6350.0 

FF 

50.0 

Units 

1.0 

Depth 

127.0 

Width 

50.0 

Vacant 

No 

Land Attributes 

Attribute Attribute Description 

Improvement Information 

Building 1 

http://douglasne.mapping-online.eom/DouglasCoNe/static/accountinfo.jsp?accounmo=R20... 6/22/2007 
Douglas County Page 1 of 2 

Douglas County, Nebraska Property Record - R2029000000 

Information is valid as of 2007-5-9 

Values not finalized until after Board of Equalization 

Print Report 

View on Map 

Owner 

GOSSETT MELVIA L 

5618N50ST 

OMAHA NE 68104-1833 

Property Information 

Key Number: 2900 0000 20 

Account Type: Residential 

Parcel Number: 2029000000 

Parcel Address: 3110 CHARLES ST 

OMAHA NE 68131-0000 

Legal Description: PROSPECT PLACE LOT 12 BLOCK D 50 X 127.5 

Value Information 

2007 

2006 

2005 

2004 

2003 

2002 

Land 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$0.00 

Improvement 

$37,500.00 

$37,500.00 

$37,500.00 

$29,600.00 

$29,600.00 

$0.00 

Total 

$40,100.00 

$40,100.00 

$40,100.00 

$32,200.00 

$32,200.00 

$0.00 

Sales Information 

Date Type Book Page Price 

Land Information 

Acres 

0.14 

SF 

6350.0 

FF 

50.0 

Units 

1.0 

Depth 

127.0 

Width 

50.0 

Vacant 

No 

Land Attributes 

Attribute Attribute Description 

Improvement Information 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R20... 6/22/2007 
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 

2029000000 

GOSSETT 

MELVIA L 

3110 

CHARLES ST 

OMAHA 

68131 

• 

5618N50ST 

OMAHA 

NE 

68104 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Assessor 

Website Link 

16-15-13 . . . 

' " 

PROSPECT PLACE 

D 

[7T 

50X127.5 

http://douglasne. mappingonline. com/DouglasCoNe/static/accountinfo.jsp? 

accountno=R2029000000 

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 = 108 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData-Douglas County-... 6/22/2007 

Building 1