SAID#: 28300

TRANSMITTAL OF OIVIAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

 DATE: 1/15 

ADDRESS: 2916 ERSKINE ST 

REMEDIATION CONTRAaOR: PRUDENTTECHNOLOGIES. INC YEAR: 2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

d PRE AND POSTVIDEO OF PORPERTY (DVD) 

IZ EXECUTIVE SUMMARY 

m EPA-PROVIDED PROPERTY SKETCH 

0 SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

0 RESTORATION AGREEMENT 

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

d CONFIRMATION DATA 

• PHOTOGRAPHS 

[Z AS-BUILT SKETCH 

d SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

y PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

n DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

[F UTILITY CLEARANCES 

0 PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

n 

^<y ^ \\^t>\\\. 

SIGNATURE DATE 

30218426 lliliilli 

Superfunc 
PROPERTY SUMMARY 

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

Property Address: 2916 ERSKINE ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

B2 = 290 PPM @ 4"; 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 ofareas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES. INC. 
3

TECHNOLOGIES, INC. 

Property #:Z ^ 3 <; ^ 

Date/Time: 

Quads Excavated: ^'2_­

.A'.-yryA\ 

••^•:. y^y=^\ i y y . 

EFA Property Close Out 

Property Address: 2^i ^ ^rfKl-^e S^­

Owner's Nannie: ^Tr-Hj, c^^''*^*-'^'H 

Contractor Group: Prudent Techuologics, Hwc, 

Excavation General Yes No 

I If necessary, were the correct quadraitt(s) excavated aiTd restored? / 

2. If necessim-, were tiie correct areas of drip zone excavated and restored? / 

Grading Sod and Vegetation Yes No 

1. Does the grading around tlie perimeter of the house in excavated areas generally slope away / from the house? 

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

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

day lime period) y 

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

5. Arc tlie joints between the sod stnps generally light? (Only evaluate if inspected at a 30 day — ... time penod) /

6, Was the propert>' graded such tliat water will not pool on die property? y 

7. Was daniage to landscaping or plant materials avoided? 

y 

Gates, Fences and Retaining Walis Yes No 

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

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

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

y 

4. Wasdamage to retaining walls avoided? (If applicable) 

y 

Foundation, Siding and Gutters Yes No 

1 Wcis damage to the siding or trim avoided? y 

2. Was damage lo the foundalion avoided? 

y 

3. Was damage lo windows avoided? 

y 

4. Was damage to windows or door screens avoided? 

y 

5. Was damage to downspouts or downspout extensions avoided? 

y 

Sidewalks and Driveways (Concrete) Yes No 

W;is damage lo diivewav surfaces avoided? / 

Was damage to walkway surfaces avoided? y 
Owners comments: 

Inspection notes: oyf 

/...y m 

^(^^ 

y 

y <»• A y 

^V" > , s« 

t^'" &^ 

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

EPA Representative J9e^ ^. ^ Date: i/iifil 
mm 

CUNOLtXJIES. INC f AS - BUILT DRAWING 

OLS#28J«0 

Date Excavated: 11/23/2010 

I'SEPA Signed-OfT Date: OMAHA LEAD SUPERFUND SITE 

Name: C ir>) c-f 6;»t^./.v, Omaha Lead Site 

/\cldress~~T'i7(- C,<iKini> 5 h Site SIcetch 

Phone; 

Team \^iUUlLy^'^' ' BVID. I'^iCO 

Sample Number Lead Concentration 

ppm 

ppm ll VZ)'S^>X^ c3F^ ^ ppm 

ppm 

ppm 

ppm 

ppm 

^ i 

Date l: : limy/ — North Arrow 

Time •-'• y y : 

XRF Code Q/SHJ) 

Confirmation Sample 

r< Yes a No S2^ 

Tj Yes O No B ^ 

C. Yes • No B­ -

h Yes O No 13 ^ 

Yes a No Q 

Yes O No • 

Yes n No • 

Oniaha Lead Site 46130 

CONTRACT #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
SEPA 

Property Compietion 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; ^c^i^^ fj^s^/r ^ Sdj^ y 

Owner: 

Phone: 0 /J/- . , / j/j/^i ^ Hoj- ^/(-/H- ^/p^ r 

Restoration Items in Question: 

Item: 

iv^''0^<X- prppM;/by-t.v^<.. <<S>WccX 5t'<S mAi 9 

Item: 

Item: 

item: 

Item: 

Item: 

Required corrections to complete the property: 

EH I agree restoration is completed. 

"^a^dt o not agree restoration Is completed at (noted deficiencies above) 

yi "/ ^^u..^i,yy -yoc d 

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

i^Tl(i r^fS.Lcf/'i^ • Tlie EPA 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 perform 

activities related to the cleanup including soil sampling, removal of lead-contamitiated soil, and restoration ofthe referenced property. 

Ifyou have any questions about the soil cleanup planned for your property, please contact Prudent south office _for the Omaha Lead 

Site cleanup-at (402) 733-1188. 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). 

Property Access Granted By: //////>o^v) yui^ h 

(Please Print Name) 

Property Owner Signature: '^/l y ^7^y/i y { ly^yyOl Q 

J 7^ (Signature) (Date) 

PROPERTY INFORMATION 

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

RESIDENT NAME: A/ITflff ^ -^L^U/j^y] yiLo4<yA1hh { (Owner) Renter 

^ 

RESIDENT ADDRESS: 

<Q^\L ^x^vy^ ^ iii . 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; ^ ^ - , 

///^ ^AA ^ C)-. S^ y ni l . Qyyyha^ Ur tr/&^ 

OWNER'S TELEPHONE NUMBER - HOME: ( \ WORK: 

(Va> ^ y y?^}" 

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 fo be implemented by EPA under this agreement 

are pursuant to Section 104 ofCERCLA, 42 U.S.C. 9604. EPA's right ofaccess to the property is provided for 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 response action 

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

8080 Ward Parkway, Suite 405 5600 S 10 St 4242 Medical Drive, Suite 4250 

Kansas City.'MO 64114 Omaha. NetKaska 68107 San Antonio, TX 78229 

Phone:(816)363-3703 Phone: (402)733-1188 Phone: (210)822-9688 

Fax:(816)363-3707 Fax: (402t 733-1883 Fax; (210) 579-6677 
1 

ENV[RO.NME^TAL& 

CONSTRUCTION 

TECHNOLOGIES, INC. SJERVICE.S 

Property Status Form 

Address: CX(yx^' U ^ """• '^\\y\ ^ 

Phone: 

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BVID: 

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Property Owner Prudent Employee 

Signature: Signature: 

8080 Ward Parkway, Suite 405 5600 S 10 St edical Drive, Suite 4250 

Kansas City, MO 64114 Onnaha, Nebraska 68107 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)733-1188 Phone: (210)822-9588 
Name: C < fy <:< OtAc^Lu\ Omaha Lead Site Date: Ml^hfL. Ntorth Airow —i 

Address"i~^>/r, G^'Ky^va SK Site Sketcli Time: 'f.'/,^ 

Phone: t 

Team MMJM/yiL.f^' A ' BviD# 3y3(96> XRFCode ^5-^^ 

Sample Number Lead Concentration Confirmalion Sample 

,y^.<s m&: ^ Ft Yes a No Ba ^ ppm T2r w ^ ppm No B ^ ...^.SCJfX/4 <£ll^„. 11 ppm (?. Yes a No E3 ^ 

^ ^ 

ppm ^ j . Yes n No B" ^ 

ppm Yes C3 No a 

ppm Yes O No OLi 

ppm Yes. D No a

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Li'i>iOiipi Sf' 

Omaha Lead Site 46130 
291

6 Erskine 

A Printed

: Dec 08. 2010 

www.dcgis.org/dogis 
Page 1 of 1 

Create Another Ticket Back to Irth Intemet Send Email 

YOUR TICKET NUMBER IS 2592088. 

Original Call Date: 

Work to Begin Date: 

9/14/10 

9/16/10 

Time: 5 

Time: 6 

2 8 pm 

00 pm 

Op: SIVA18967 

State: NE 

Address: 2916 

County: 

Street: 

DOUGLAS 

ERSKINE ST 

Place: OMAHA 

Twp: 15N Rng: 13E Sect-Qtr: 09-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)733-1883 


: UNSURE CORNERS 


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 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RICHnTRAFFIC Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/14/2010 
ENVIRONMENTAL 

ENGINEERING AND 

CONSTRUCTION TDDHMflLOOaSB, m c 

SOLUTIONS 

SITE SAFfeTY HAZARD ANALYSIS 

Address: 

Crew: K ^ ^yJUlLtlOJ^ 

Item 

Overliead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Bntane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees 

Stmctures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

1 

y^^.M 

L e e l^i^eK\5 

iC«y.MO«4114 

Phons: fSIt) 36S4703 

Condition 

MA 

hJA 

hlf\ Wk 

Hh 

K ll 

Poo r 

. f/n//o Excavation Date: 

Backfill Date: 

Hazards Corrective Action 

rrcict< Ply/, j^n^l 

Ufi, 

A/4 

m 

fa;r 

A/A 

A//A 

A//t 

/VA 

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ebatfa«8107 

Pfione: |402)733-11S8 

Fax: HO^TSS^iaSS 

i'­

:..'"• ' 

Site Safety OfBce 

Date: 

4242 Medical Drive, Suite 7250 

San Afltenio, 7X78229 

Phone: (210) 822.«588 

Fax: (240)679-6577 
m