PROPERTY SUMMARY

 

fPate: 11/26/2007 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: November 

I Property Address: 4324 Cass 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: Mulch area tested at 220 @ scrape 

CONFIRMATION SAMPLING DATA/RESULTS: 

B2 - 189 @ 5" 

Fl-171@6" 

El-73 @ 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) BV1D 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. 40286230 

11.1.II III III 

Superfund 
3383? 

Exterior Paint North Arrow Owner Name: LlSRETUA KYfifiT Omaha Lead Site [JpGood A 

 Sk6tCh Address: 4324 CA^RfiT *** . Q P°or / -, Phone: H: W: Q Not paint [ 

Sampl Lead Sample .,._ Samples Collected e Number Concentration Collected Firm: fA> MJ/Tti

 

RYASCPXA-3383? F1 &0fe ppm LTT' Q

 Date: (*'24-0S

 

RYBSCPXAV8383? F2 203 DPm R^ n Time: T' ^

 

RYCSCPXA-33Q3? B1 "^y 5 P pm Q*" D

 

Samples Analyzer. i RYDSCPXA-<8383? B2 5*^2 PPm CT D 

RDZSCPXA-S393? DZ "$~T.O Ppm Q" n XR F Unit: 1037 Book 

— pom n n Date: la -Z.&-& 5­ nr\**f+^r\\j JL ^^l^^^ ^^^^ ^7 

T me: AW 

Staff: Z. 4 Number of Samples = ! £ — 

Legend: F1 = Front Left, F2 = Front Right, B1 = 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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,3383? 

Omah Exterior Paint North Arrow a Le ad Site Owner Name: bl'SÐA fxYiGo f^Good A Site Sk etch Address- 4^/84- C^SS* &T 

Phone:

 H; W: 

Sampl Lead e Number 

Concentration

RYASCPXA-,3383? F1 

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RYCSCPXA-^383? B1 

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Number of Samples = £ 

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 Collected Firm: f^^- M«3/ Tti

 

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Legend: F1 = Front Left, F2 = Front Right, 81 = 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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„ .„ ..^ _^^_ allowaccessto 

Omaha Lead W / ^gfo V the properly in order to conduct 

Site Remedial £ 'v?Py ? environmental sampling and to 

Action \-*m&fc-j> remove lead-contaminated soil • *^TM TM* ^^ • • ff. _.^^ >•* _ _ 

Prudent Technologies, Inc. (Prudent) is under contract widi die U. S. Environmental Protection Agency 

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

including die property located at y .*?<^? V dog^ £>l . The EPA requests your 

permission In allow Prudent to perform a soil cleanup at this properly to remove lead-contaminated soil 

By signing dus form, the property owner grants permission to Prudent to perform activities related to die 

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

property. After obtaining the owner's signature on diis form, Prudent Technologies, Lie. will contact die 

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

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

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

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

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

Property Access Granted By.V D 

A 

Property Owner Signature: 

PROPERTY INFORMATION 

(To be completed by resident aad/br property owner - pleaa prnt) 

RESDENTNAME: |_X ffl^ ^^~\r^ f^pwner Qenter 

RESDENT ADDRESS: M ?b 2 M C &^S^ Cf~ 

f RENTAL.PROPERTY OWNED BY: Of JMk 

OWNE R-S MALMG ADDRESS; 

OWNER'S TELEPHONE NUMBER-HOME: P^Q 3 51 " ' ^ WORK: I 

AGE OF HOME?: AoL YEARS. HOW LONG HAVE YOULB/ED HERE? O YEARS. 

HAS THE EXTERIOR BEEN PANTED OR COVERED WITH SDMGSMCE 1978? ^XYES NO 

NUMBER OF OCCUPANTS UNDE R 7 YEARS OLD: 'Q NUMBER OF OCCUPANTS 7 YE ARS OLD AND OLDER 

NUMBER OF CHILDREN UNDER 7 YE ARS OLD WHO PLAY M THE YARD FOR S HOURS OR MORE PE R WEEK: 

COMMENTS OR SPECIAL INSTRUCTIONS: (LE. DOGS.ENTRY GATES.ETC^

 CJA^<£|' / \, 

,-J f\ Jrt^, ; k-1 \n • CJ -^ 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS; Die activities to be implemented by SPA under nils 

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

provided for in Section 104<e) of CERCLA, 42 U.S. C 0605(e), which provides entry fir "determining the need for 

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

titla" 
&EPA 

EPA Property Close Out 

Property #: 23S37 Property Address: Vj^y Cftss 

Date/Time: / Owner's Name: fl«M X*f»f 

Quads Excavated: Contractor Group Prudent Technologies 

Excavation General Yes No 

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

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

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? s 

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 

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 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) s 

Foundation, Siding and Gutters Yes No 

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

2. Was damage to the foundation avoided? / 

3. Was damage to windows avoided? ,/ 

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

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

Sidewalks and Driveways (Concrete) Yes No 

1 . Was damage to driveway surfaces avoided? «/ 

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

Inspection notes: 

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

EPA Representative ^^ &+, Date: > 
3383? 

Exterior Paint North A/row Omaha Lead Site 

(J^-Good Site Sketch Address: Q Poor 

Phone W: :

 H: 

Q Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm: 

Samples Collected 

ppm EZT D Date: (,'2.4-Q^ 

RYBSCPXA-,3383? F2 ppm' n Time: t- $5 

RYCSCPXA-J33Q3? B1 

~ 335 ppm 

ppm Samples Analyzed 

RDZSCPXA-&3937 D2 ppm n XRF Unit: 1037 Book: //? 

Pom D n Date: £ 

RPZOCPXA pz D n Time: 

Staff: Number of Samples = ! 

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right 02 = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 
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 (90 days overall, 30 days on sod growth guarantee) except those items listed below, 

if any. 

Property ID: ;} 3 £ 3 7 

Property Address: L /) 55 ( 'A/n ^ /-I ja , A/ (.'

 

Owner: /^^ 

Phone: (y0£) ^ 

v 3As 

S1? l-QIQj 

Restoration Items in Question: 

Item: 

Itenfi f I IN ,l 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

e Q kc (/•*. 

I do not agree restoration is completed 

'Owner's Signature Date 
£383? 

Exterior Paint North Arrow Omaha Lead Site Owner Name:

 

Site Sketch Address:

 

Phone: H: W: Q Not paint 1 1 

Sample Lead Sample Samples Collected Number . AR

 

Concentration Collected Firm: f^bs4- lA3~ / Tt±

 

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Staff: Z /4 Number of Samples = i *5 — 

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, 82 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

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Print Preview Page I 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 

2018370000 

KYES 

LISBETH A 

4324 CASS 

ST 

OMAHA 

68131 

4324 CASS 

ST 

OMAHA 

NE 

68131 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Assessor 

Website Link 

20-15-13 

POPPLETON PARK 

12 

15 

50X122.69 

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

accountno=R201 8370000 

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 = 36 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 8/1/2007 
Find Record Clean Up Query Lead Remaining Query I Property Damage Query Close 

Owner Occupied 

Owner Name: 

JKYES LISBETH A 

Owner Addressl: 

Owner AddressZ 

J4324 CASS ST 

City: 

Owner Phone: 

Resident Name: 

IKYES LISBETH A 

Property Address 

|4324 CASS ST 

Zip Code: 

I68131 

Resident Phone 

State: Zip Code 

NE 168131 

Alternate Phone: 

JPRUDENT2007 

Group: 

Qualifying Group 

|800 

Assessment XRF Date: 

Assessment Max XRF Value 

Lt^^Z^G^rf^ 
''review Page 1 of 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

2018370000 

KYES 

LISBETH A 

4324 CASS 

ST 

OMAHA 

68131 

4324 CASS 

ST 

OMAHA 

NE 

68131 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Assessor 

Website Link 

20-15-13 

POPPLETON PARK 

12 

15 

50X122.69 

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

accountno=R201 8370000 

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 = 36 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=:Douglas County-... 8/1/2007