TRANSMITTA L of OMAH A LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID#: 55S(j)2 . Date: U-V- W 

Address: HOXV Scxr-g-VooT)^ S^ . 

Remediation Contractor: _Environmental Restoration, LLC_ Year: _2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

J ^ Video of property (DVD) _^efor e DAfter D Basement D 

^ Executive Summary (Final Report) 

^ EPA-provided property sketch 

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.) 

Confirmation data 

^ Photographs B^efore DCrew Photos jZlDuring Excavation D Sod 

;2^0-day Sod D 

As-built sketch 

30261855 X Completion Agreement signed by Property Owner 

j X Property close-out check list signed by EPA Superfund 

D Description ofareas not meeting ROD cleanup criteria 

X^ Utility clearances 

y Property information from Douglas County Assessor's Office 

p ^ Property access checklist 

n / Contact Log 

lental Restoration Signature Date 

_^ ^ y/v^// 

COR signature" ~ / Date 
EPA 

EPA Property Close Out Form 

Omaha Lead Site 

Property #: SbbG>Z PropertyAddress: ^02-l 'SjOora.A-oy.. S-VDate/Time: Owner's Name: TWGWNOL ^ CuxAr--V'i'=^ 

Quads Excavated: F2. Contractor Group Environmental Restoration (ER) 

Excavation General Yes No 

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

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

Grading Sod and Vegetation Yes No 

sX house? 

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

3. Does the sod appear to be generally healthy and growing? (Only evaluate ifinspected at 30-day time 

period). 

4. Are sodded areas generally firm and evenly graded? y y 

5. Are the joints between the sod strips generally tight? (Only evaluate ifinspected at 30-day time period). 

6. Was the property graded such that water will not pool on the property? v^ 

7. Was damage to landscaping or plant materials avoided? . / 

Gates, Fences and Retaining Walls Yes No 

I. Do gates open and close freely? (ifapplicable) 

Were all gates or fences taken down during restoration activities re-installed? (ifapplicable) 

3. Was damage to gates or fences avoided? (ifapplicable) # 

4. Was damage to retaining walls avoided? (ifapplicable) 

Foundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? 

2. Was damage to the foundation avoided? Vfl^r^n-tr JQ-E 

Was damage to windows avoided? B 

4. Was damage to window screens or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? A/A 

2. Was damage to walkway surfaces avoided? v/ 

Inspection notes: 

5 sd< "

Remedial and restoration activities complete including 30-day sod warranty: 

EPA Representativ J,jA:>_mi^cc^-sJ:u^ Date: 4llj^H 
/^© 7 '^ Omaha Lead Site—EP-R7-09-05 

^•«B^^^^^ Environmental Restoration, LLC 

\ ^ www.crllc.com 

EXECUTIVE SUMMARY: 

35562 4021 SARATOGA ST 

No Issues or Concerns Q Issues/Concerns 

Detail Fxnlanntion­
"> 

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

• YOUR TICKET NUMBER IS 2674606. 

Original Call Date: 2/23/11 Time: 8:00 am Op: ADAM24186 


Work to Begin Date: 2/25/11 Time: 8:30 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 4021 Street: SARATOGA ST 


Twp: 15N Rng: 13E Sect-Qtr: 05-NE 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead soil removal 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)451-1069 


: 35562 


Company : ENVIRONMENTAL RESTORATION 


Contact Name: ADAM Phone: (402)451-1314 


Alt. Contact: Phone: (636)288-9616 


Work Being Done For: epa 


Depth of Excavation: 24in Corner Lot: N Front: N Rear: N 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, FNC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOr METROPOLITAN UTILITIES DISTRICT SANDY MUD 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITYOFOMAHA-TRAFFICSEWER RICH/TRAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Ait: 4062071494 

Emerg: 8887289343 

http://vA\av.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 2/23/2011 
• Contact hiformation Log 

Owner^s Name:"^ I K^f^t ^ doffi j EJayttme Phone: C^^~ 7 <ol ' 7 

Prope erty Address: ' . t-fQ^rl £'^ r •<T(i *j CK 

Attempt to contsct 

-AiCinCSS -(br/^J •>'^'^*' 
Property Access Checklist 

SAID: -ySSCs ^ D WORK STARTED ON: __/__/_ 

PropertyAddress: ^gj^ / S'^r^'fo'J ^ D WORK COMPELTED ON: / l

_ 

Owner: •• i / /^ /• Renter: 

Address: ^^3 - _p,,, ^ ^ 4 Phone: 

Fax: 

Cell/Pager: 

Phone: Additional Information: csi^- 3^nY 

Fax: 

Cell/Pager: 

S Access Agreement Signed: / 1^ ^ ll By: 'i^ d 

[S ' Restoration Agreement Signed:/ 1^ ^ K By: -po 

^ Video Property Before On -.O- / "? ll L By: ^ . J . 

I ^ Digital Photos Before On : «=2 / ? / /r By: ^.3 . 

n Video Property After On : / / By: 

n Digital Photos After On : / / By: 

[^ Property Completion Agreement Signed: J_/:>/// ( By:ieD 

n FinalReport Signed: / / By: 

.^idditional Video or Digital Photo's Taken: 

1 

On : / / By: n Video n Digital Photo 

Reason: 

D Video n Digital Photo On : / / By: 

Reason: 

n Video n Digital Photo On : / / By: 

Reason: 

n Video n Digital Photo On : / / By: 1 

Reason: 

Omaha Lead Project Work Plan Page 1 of!9 
Property Access Checklist 

SAID: -JSSC^ ^ 

PropertyAddress: ^/gj / Str^^jo^ ^ 

D

D

 WORK STARTED

 WORKCOMPELTBD

 ON: / / 

ON:__/__/_ 

Owner: -Ti^ ^

Address: y^^ ­

^ ^ C^r-^k

 j^^^ ^

 ^ 

 j 4 

Renter: 

Phone: 

Fax: 

• •^' — ­ ....-•• — 

Phone:

Fax: 

Q,SV - ^'7 / 

Cell/Pager: 

Additional Information: 

Cell/Pager: 

S

^

S I

1 ^

n

 Access Agreement 

 Restoration Agreement 

 Video Property Before 

 Digital Photos Before 

 Video Property After 

Signed: / /«2<V (/ 

Signed:/ 1^ ^ K 

On : :X/ ?/(( 

On : «2 / ? / /r 

On : / / 

By: 7$]) 

By: 150 

By: ^ . S . 

By: (t. J . 

By: 

n

[^

n

 Digital Photos After 

 Property Completion Agreement 

 FinalReport 

On : / / 

Signed: J_/.P/// ^ 

Signed: / / 

By: 

By:'ieD 

By: 

.Additional Video or Digital Photo's Taken: 

n Video n Digital Photo On :

Reason: 

/ / By: 

n Video

Reason:

 n Digital Photo On : / / By: 

| 

n Video

Reason: 

n Digital Photo On : / / By: 

n Video

Reason: 

n Digital Photo On : / / By: 

Omaha Lead Project Work Plan Page 1 of 19 
Consent for Access to Property SAID# 5try63 

RIGHT OF ENTRY TO PREMISES 

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

Protection Agency (USEPA) or its authorized representatives, collectively the Grantee to enter 

and perfomi certain environmental response activities upon the following described premises: 

Owner'sName: "1^^ ^ j Or4( i Daytime Phone: Q^ y . ^i l ^ • ! • 1 1 — 1 -*¥ - 1 • ^ . . . ^ ^ -

Address: c/o^f S^rtK-fo fj t\ . 4 . Address: c / 

Addresses of Properties 

Address: covered by this 

Agreement: 

Address: 

Address: 

PURPOSE OF INVESTIGATION 

The purpose of the remedial activities is to remove all soils at the property which are 

contaminated with hazardous substances, in particular lead at concentrations greater than or equal 

to 400 parts per million (ppm). 

REMEDIAL ACTIONS 

The environmental response actions to be performed on said property may include the following 

activities: 

a. Taking photographs and^or video of the property before, during, and after remedial 

activities; 

b. Locating equipment and machinery on-site in preparation for and in the course of the 

environmental response; 

c. Planning and implementing the removal action on or near Grantor's property. 

d. Obtaining samples from Grantor's property; 

AGREEMENT NOT To INTERFERE 

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

equipment used to perform the activities, or to undertake any actions regarding the use of said 

property which would tend to endanger the health or welfare ofthe Grantees or the environment, 

or to allpw others to use the property in such 

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

- y ^ 

'iL 

Signature Signature Date 
n Check this box if owner does not want E.R. to enter the residents to document interior 

foundation walls and possible preexisting damage. By checking this box E.R. is not responsible 

for any damage done to the interior of house, including foundation cracks or fissures. 

D l agree d l I do not agree I 11 agree n I do not agree 

Owner's Signature Date Contractor's Signature Date 
Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of property prior to 

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

activities are completed to the satisfaction of the property owner and the United States Enviromnental 

Protection Agency (EPA). 

SAID: 3S^(^ S 

PropertyAddress: y"o;t^/ J<Kr'^4x>ja, /f^ 

Owner: ^'KoMct^^ C>>Jt'4-t5 

Phone: Usy.JiyY 

On the attached diagram(s) indicate area(s) to be excavated and depth of excavation, location of all known 

utilities, subsurface features, surface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items to be removed by Contractor and not replaced: 

Hem: 

K<fl<=^<:^ AH -gK^ccUQ^ec^ ^/^ ^ ^/ M ^oJ 

Item: 

t^A^fc-/-^ "TP'" tA<( Q^l^ borc^\c) .'TprV/i/c/cn r{:^'\J. 

Item: 

Item: ^ / 

item: 

Item: 

Item: 

Page 1 of 2 
I agree Q I do not agree ^ i CU I do not agree 

Owner'ss Signatur Signaturee /Date / Contractor's Signature Date 

Attachments 

Page 2 of 2 
Property Completion Agreement 

This agreement documents the completion of remedial activities perfonned on my property. My 

signature will designate that I am satisfied with the restoration of my property, and that no items are in 

question, now, or at any time in the future, except those items listed below, ifany. 

SAID: 3SSU ^ 

PropertyAddress: Y<^f _rtr«}7^«i «\ 5i. 0^"^'-= /L^. J Cur4.A 

Phone: CcSy - J i 7 ^ 

Restoration Items in Question: 

Item: 

item: 

item: 

Item: 

Item: 

item: 

Additional Comments: 

L. 

6l9AC«f^ecl Oiho^'^X^akrinii 

lyl 1 agree restoration is completed, except as noted jyA I agree restoration is completed, e.xcept as noted 

 I r do not agree restoration is completed I I I do not agree restoration Is completed 

0^ <^0^ 

Owner's Signature Date Contractor's Signature Date 

I
Douglas Coimty Account InfoHM ji 'on 

Page 1 of2 i 

Dougias County, Nebraslta Property Record - R0804610000 

Print Report 

View Interactive GIS Map Infomriation is valid as of 2010-11-16 Treasurer's Tax Report 

New Feature "*->- > Subdivision Sales Search 

Owner 

CURTIS THOMAS R 

ETAL 

4025 SARATOGA ST 

OMAHA NE 68111-0000 

Property Informatio n 

Key Number: 0461 OOOO 08 

Account Type: Residential 

Parcel Number: 

0804610000 

Parcel Address: 

4021 SARATOGA ST 

OMAHA NE 68111-0000 

Legal Description: CENTRAL PARK LOT 5 BLOCK 17 60 X 125 

Vaiue Informatio n 

Land Improvement Total 

2010 $1,100.00 $0.00 $1,100.00 

2009 $1,100.00 $0.00 $1,100.00 

2008 $1,100.00 $0.00 $1,100.00 

2007 $1,100.00 $0.00 $1,100.00 

2006 $1,100.00 $0.00 $1,100.00 

2005 $1,100.00 $0.00 $1,100.00 

Show All Transactions 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.17 7500.0 0.0 125.0 60.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountao=RO... 11/19/2010 
Douglas County Account Inf 

'H 'on Page 2 of 2 

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iuttwrarOiurcti Fort St FortSt 

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n Z 

2 

Camden Ave ^4 

3 

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3 

M 

E. Golden HiBti i n 

Browne S« w Cemetery Brownest ., .iS2 

BrowfieSt 

Saratoga St 

Grand Ave 

Fowter Ave 

POWERED BV 

Map data @I2010 Google' 

The above map is powered by Google, and Is intended to provide a general idea of a property's location. If you 

require a more exact property location, you may use the Interactive GIS Maps that are maintained by our 

office. 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo .jsp?accountno=RO... 11/19/2010 
ENVIRONMENTAL AS-BUILT DRAWING 

I OMAHA LEAD SUPERFUND SITE ^ 

RESTORATION 

Name: t-U^| J V^ih'iUr Omaha Lead Site Date Nbrth Arrow 

Addressi 4n 7, t 5^c>^h><j^ S4- Site Sketch Time: lo t. 3^^ 

Phone: ^ V 

Team ^1g ? Ak\ (f,l4 BVID# -^'^sz^z XRF Code aa 

Sample Number Lead Concentration Confinmation Samph 

13 ppm f\ Yes CH No ^ 

ppm ^ma fZYe s a No ^

ppm £?t Yes n No gO 2SiSii*3L a a ppm No 1 ^ i 

ppm Yes a No O 

ppm Yes • No n 

ppm Yes • No a 

iNlFERlD 

SAID #35562 ii^iitrtiifle^ ^ 

DATE EXCAVATED 3-1-11 

DATE EPA SIGNED OFF 14-1-11 

AREA SODDED 940 SQ FT 

ci^f tj'-^ 

iS^ 

^^-tefk^^n-jrcj 

/T'j/' ^ •- \—Vi ­

Se^r yyofj M ^ y 

Omaha Lead Site t) 

Quadrant axcavatad ^^^^^ H Drip Zorta Excavatod i^^^:- Contamination LaW Bahlod H 

r>A«*,^.»« U. C O D T AA n c C*%««ll«»^«»^a-w«M M*««l DA««4#«iF'%4i^% w« 11 ^ 

46130 
] Name: HJi.i^j rJ V'^ik-Tc/ Omaha Lead Site Date: Njjrth Arrow \ -I'l '^ 

Address: •io Z t %-XY-ii.\~Cii^il„ Vf Site Sketch Time: h:.l>^ 

Phone: 1 

4' 1 

Team Wf ^ Afrf/fefJ BVID# •Z'^'^LZ XRF Code m 

Sample Number Lead Concentration Confirmation Sample 

35^ua 3 • 

ppm f l Yes n No g ^ 

^- -^^^^gO ­

^i^ ppm fTYes a No ^ 

'^Ifl ^ ^ Srt Yes n No ^ ^ 35SiipX ppm 

521'es CD No l^* -2-aa ppm 

ppm Yes n No Q

Yes n No CD ppm 

ppm Yes • No •

^ • 7J 

( ^ ^ 

ryiu.\yJx=^ 'y<Sy 

SyxiiiE..::^.. ^y>^< ^ 

jai^^ftii-i -'vm 

M ^ TdtJ ^?^~i9<^^ r^. / i i -U^ -K/o-rk-^-^ \ ^ 

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4 

tr 

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C 

,1^! - 1^- S 

bW-^^-

Omaha Lead Site 46130 
] Name: _ Omaha Lead Site Date: <^/^/ W Nbrth Arrow \ 

Address: Site Sketch Time: 10 t M 

Phone: 

Team /rigb AH/fi ^ BVID# -^^gZ/Z XRF Code au 

Sample Number Lead Concentration Confirmation Sample 

"

13

m 

• 

ppm f\ Yes CD No 5 ^ 

ppm F^e s O No S ^ 

ppm B"! Yes n No gO 

a ^ l ppm F^i'es ^ No ^ 

ppm Yes 1=1 No n

ppm Yes n No O

ppm Yes • No •

Omaha Lead Site 0 46130 
EKJVtRONMENTAL XRF DATA ENTRY LOG 

3 

RESTORATION G

SAID # i^?^ ^ DATE •s \ \ \ \ \ . 

PROPERTY ADl DRESS TIME 

XRF S/N 

QUADRENT OR SAMPLE AREA 

DEPTH AVERAGE OF RESULTS SHOT#s 

redig 

D F1 

D F2 ^ . ?.TS \1> -IS--1 ? 

D

• 

Bl 

82 

D DZ 

n PZ 

n GZ 

a EZl -^ — TfhX \3 -r'^-8 ^ 

n F7? 

n OTHER 

SAMPLER NAME ~^.<ix^<<K\c^ 
Thermo Fisher Scienlific Thermo 900 Middlesex Turnpike 

Billerica, MA 01821 

SCIENTIFI C 

1 2011-03-0109:45 

2 2011-03-0109:45 

3 2011-03-0109:44 

4 2011-03-0109:44 

5 2011-03-0109:40 

6 2011-03-01 09:40 

7 2011-03-0109:39 

8 2011-03-0109:38 

,VVKK.VC;i:

Avg of 79-81 

AvB of 75-77 

 ADDKKSS 

4021 Saratoga st HZ 

4021 Saratoga st EZ 

4021 Saratoga st EZ 

4021 Saratoga st EZ 

4021 Saratoga st F2 

4021 Saratoga st F2 

4021 Saratoga st F2 

4021 Saratoga st F2 

.AKKA ()l'i:i{ATOU

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

 DKI' I 

surface 

surface 

suiface 

surface 

4 

4 

4 

4 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

35562 

35562 

35562 

35562 

35562 

35562 

35.19 

36.04 

29.07 

40.45 

36,78 

33.82 

29.19 

47.34 

± 

± 

± 

± 

± 

± 

± 

•± 

12.71 

12.87 

12.09 

13.17 

13.11 

12.82 

12.56 

13.95 

Pag 03/01/1109:52:13 e 1 of 1 
• vliJ.'f . 

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