SAID#: 22019

TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

 DATE: 1/15 

ADDRESS: 3608 MARCY ST 

REMEDIATION CONTRAaOR: PRUDENT TECHNOLOGIES. INC. YEAR: 2011^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

\il PRE AND POST VIDEO OF PORPERTY (DVD) 

[p EXECUTIVE SUMMARY 

EPA-PROVIDED PROPERTY SKETCH 

SIGNED ACCESS AGREEMENT FOR SUBJEa PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

El RESTORATION AGREEMENT 

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

El CONFIRMATION DATA 

• PHOTOGRAPHS 

ID AS-BUILT SKETCH 

m SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

• PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

01 UTILITY CLEARANCES 

• PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

0/y\ ^\tf>V^ 

SIGNATURE DATE 

30218574 

Superfund 
PROPERTY SUMMARY 

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

Property Address; 3608 MARCY 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: 

Fl = 112 PPM @ 9";«AHiHHai k EA = 164 PPM @ SCRAPE (~1") 

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 fmal 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 of areas not meeting Interim ROD cleanup criteria. 

TECHNOLOGIES. INC. 
Find Record 

Backfill: 

Sample Area: 22019 - 3608 MARCY ST 

Owner: 

• Owner Occupied 

Owner Name: 

lOMAHA HOUSING ALTTWORTTY 

Owner Addressl: 

I 

Owner Address2: 

|540 S 27 ST 

City: State: Zip Code: 

jOMAHA " " [NE |68105-

Owner Phone Altemate Phone: 

Contract: 

Contractor: |PRUDENT_2010_S 

Contract Option |BASE 

Remediation Query ] Lead Remaining Query I Property Damage Query 

User Provided Owner Information 

Owner Name: 

1 

Owner Address: 

1 

City: 

1 

State:

1

 Zip Code: 

1 

Owner Phone: 

1 

Alternate Phone: 

• 1 

Assessment: 

Qualifying Group J466 

Assessment Max XRF Value | 470 

Resident: 

Resident Name: 

iTtNANTS 

Property Address: 

|3608 MARCY ST 

Zip Code: 

|68105-

Resident Phone 
TECHNOUXSIES. INC. 

EPA Property Close Out 

Property #: rt^T^ ^ 2 "2 ^ I ^ Property Address: 5^^ ^ AV^tr^v^ ^"h. 

Date/rime: 

Quads Excavated: p i y-j 

Owner's Name: <5h^*<^a. HOCOT>IACJ .«4M.1V^^ v 

Contractor Group: Prudent Technologies, Bmc, Ci 

Excavation General Yes No 

1. If necessarv, were lhe correct quadrant(s) excavated and restored? / 

2, If accessary, were the correct areas ofdrip 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? / " 

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

3. 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 finn and evenly graded? / ^ 

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

lime period) / 

6. Was the property graded such tliat water will not pool on tlie property? y 

7. Was damage to landscaping or plant materials avoided? y ^ 

Gates, Fences and Retaining WalJs Yc3 No 

1 Do gates open and close freely? (Ifapplicable) / ^ 

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

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

4. Was damage lo retaining walls avoided? (Ifapplicable) ^ 

Foundation, Siding and Gutters Yes No 

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

2. Was damage lo the foundation avoided? y 

3. Was damage to windows avoided? / 

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

f>. Was damage lo downspouts or downspout extensions avoided? / 

Sidewailts and Driveways (Concrete) Yes No 

1 Was damage lo dvivcwav surfaces avoided? 

y ^ Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

y/>• " 

^y^ r 

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

EPA Representative Q^*^-^^ ^Date: tittln 
THNOLOGIES, INC. 

AS - BUILT DRAWING 

01.S# 22019 

Date KxiavaU'd: 09/03/2010 OMAHA LEAD SUPERFUND SITE I SEPA Signed-Off Date: 

Name; _ Omaha Lead Site Date: ^5 29-^'/ North Arrow f 

Address: Site Sketch Time: 2'J< ' 

Phone: 

f 1 

Team'^llnf /Ibyii-K.--^ (7ieS ) BVID# gZ^/ 9 XRF Code 3&^sSample Number Lead Concentration Confiimation Sample 

^•Yes a No

ppm 

'no ppm ^ 

•f^Yes n No 3 ' 

& ''Yes n No n ­

ppm 

ppm «Yes n No S^ 

ppm .71- Yes n No Q 

ppm Yes a No • 

ppm Ye No • s • 

Omaha Lead Site 46130 r.A= K)4I'I'M II Scrape 

CONTRACT #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
Property Completion Agreement 

This agreement documents the complelion of removal activities pertbrmed on the below listed property. 

The property owner's signature indicates that the property owner is satislled 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 warraiity (30 days total) except those items listed below, if any. 

Property ID: 

Property Address: -^fepf t M.Q/fi^'gT T 

Owner; Q y^^ ^ Hnoflr^ ^ A-tlA^^^'.4 y 

Phone; ^ ^ ¥^^^^^0 0 % t.^ 1 ' 

' Restoration neme in Qusstion: 

Item: 

/S/AI4 

ttem: 

ttem: 

Item: 

ttem: 

Item: 

Required corrections to complete the property: 

^ ^ 1 agree restoration is completed, except as noted above. 

L H i do not agree restoration is completed 

Owner's SignaMre 
FROM OMAHA HOUSING AUTHORITV 40^^4-4238 (MOH>JUL 26 2010 10^ST . 10:20/No. 7523385188 P 4 


7 7<' 

'7.-- •s.';;':'^^^- -V 

Nl. y 

ilTiddnl T<i.iiii«liisiox, Inc. (PnidnD) in under coiilnict wiih Un,' Xj, S. Enviromnciv*! Proiection Asency (EPA) ID clean up liS4(l< 

i^O|U*minaled saij<: at a iiuntbtf orpropsiticK loc«(«<l in Onialia. Nubnska, including tiie proi>cny located al 

^66C . ^(ofLWi y . 'tlw EPA r«(|iioiix your pennissionlo iillnw Prudeiil lop«rforin * soil clMiiupal this 

|)rap«ny to n«mov« l«a<Vi/QnliuntiiM«4 tioil By ugninglhiii liMin. tlu properly ovvner (jtius permission to Piudcni to pcrrorni 

aotiv-iiicx rijbted lo the dcaiiup including soil .«Rinplin]& removal ortead-conUntinnted »iLand r«M0ratio(i ofthe rercrenccd pn>p<ny. 

It you li:iv><>aiiy qitcMions alioui ilvnoil olcaiuip plnnnod for your prop«ny, please conuct IVudisnl noiitli ofTice Jot the Omahti I^CAII 

SHo cleiiniip"iit (Mi ) 773.\ IVtl. Centfrtl qiidsnionx iiboui the Omitlv.! JycuA Silc clotuip can bc directed Ui Hie r.PA Public liir<>Tin*lioii 

CoiU«n» al Wi ) 7.11 -304 J (South Onwiha oflke) or («02) 99 > -9S«.'» {North Omaha office). 

fVop*rty.\ce<p>«C;i:ini«dHy: Of^t,^4^^_ltj>J>'S7i\K..A3k ^ t.)e^C^^/& 0\f<et!4o, 

J {Plca:ic Pifini Nun*) * 

* ^ ^ I ' TSignaluro) (Date) 

PROPeRTY INFORMATION 

(To l»c complt-tcd by ixsident imri/or propcrlj' owner • plrase prim) 

RESIDENT NAME: C»\r\^id^rx^'t^^ K Owner s^^Jf) 

RESIDENT ADDRESS: 

34o 9 t»t<ir<y ^ . ^V^mJ^^ Aj e dttOS ' 

IF RENTAL, PROPERTY OWNED BY: 

O^^Jkt>. H-^ffgfyy^ AoUt^^U ^ 

OWNER'S MAILING ADDRESS; 

OWNER'S TELEPHONE NUMBER • HOME: f N j ll ^ WORK: 

AGE OF HOME?: /Q O YEARS. HOW LONO HAVE YOU LIVED HERE? ^ if T YEARS. 

HAS TME EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE IB^S? UK*vfe * **[ N O 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: O NUMBER OF OCCUPANTS 7 YEARS OLD ANO OLDER 

-U 

NUMBER OF CHILDREN UNDER 7 YEARS OLO WHO PLAY IN THE YARD POR 9 HOURS OR MORE PER WEEK: 

COMMENTS OR SPECIAL INSTRUCTIONS: (IE. DOQS. ENTRY GATES, ETC.) 

AlJTrlOWTY I'OR I:,NVTRON.M]iS'r.\L R.ESI»(>Ni5K ACTIONSi rh* activities to be impUinenled by 1-;PA under this atrccnicnl 

nri pursuant lo Scttioii 104 oCCURCL.V 42 U S.C 'XO-l. EP.A's rigtt olacccu; lo Ihc property is pfovUlcd for in Section in<l(t)0r 

craCLA . 42 I.-..S. C i»6fi5fe). which provide* citti-y for "del<sntiinins th* need Tor rcsporiK. or isltoonlng or liikii>jt any fosponite xctirai 

under ibi^ title, or otherwise ent'orciiij the pru% ifuott* of Uu liitc." 

<080 Ward Pflrkw;iy. suite 405 5600 S 10 Sl 4242 M«<iical Drive, Suite 4250 

Kjinias City. MO 64114 OmiiJi.i. NtibrASka 68107 S«n Anionio, TX 78229 

PliQne; (816) 363-3703 Phone: (402) 723-1188 Phone: rz 10) 822-9588 

FM : (S1«| 363.3707 Hox: (402) 733-1883 Fnx: (210) 679-$577 
FROM OMAHA H0USIH(3 AUTHORITV 402^4-4238 (FRI) JUL 30 2010 8^fST. 8:58/No. 7523385211 P 3 


FROM OMAHA HOUSIHe AUTHORITV 402-444-4239 (MON)JUL 28 2010 1O:21/$T.10:20/No.7523385189 P 5 


TECHNOLOGIES, TNC 

EN VIHO.N'M H.V IA L & 

CO^$TR^; CTION 

5ERVIC£.S 

1 Address: J^ o 5

Property Status Form 

 M^-^Cw ­ ^ 

Date: ^ ­ Z-^^^ ^ 

Phone: 

BVID: 

^fe^-tr^wr. ^ CLy^^ -p^ ,£.J 

g j^»g ^ ._ 

.<syftyi^. "tV lae elrsrfuir^U^^ .^•mt^imv^^m^m 

P/ti^ t a^cfVise ^ihra^^ t Z<r«U ^rii j cM.yhSs^/-6797 . 

I Ui^ prT^y^ -H \^A-rk. ^tv <c//*iu J-'liHC /» ^ AJoJ-^ff Vo />e 

g Wcw. ^^^ '/yKiiUtV. 

^>»wfnM.i*^n»iii*o.*»ejj;'&«aar.<avai^sg'Jl-«^ NP 

DOSa iNarct P>irhiv«y, Suite 56C0 5 10 S: 4242 M»<liCAl OriVA. Suite 42S0 

Kiintat Ciiy, tdO<4114 Omaha. NebraslnSSiD? San An(«ni», TX 78229 

•••TwitK: |81«]36«'37»3 Phonn: <402| 733.tiaR Phoni:; 1210) 822<>S88 

r;ix:r8l6>J63-J707 P,V>: {402 i 733.188^ Fax:(3l0t57»-I577 
r-l Name; n/4A^ 

Omaha Lead Site Date: ^-2»-g / North Arrow 

Address: Korf^ /C/fcycy sK Site Sketch Time: Z'2- ^ " 

Phone: • f 

Teamg-/W//W.^^ (MS ^ BVID # 2:ZC/<^ XRF Code 35'^sSample Number 

Lead Concentration 

1= 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

Conf 

^'Yes 

•f^Yes 

?* Yes 

szYes 

^"'Yes 

Yes 

Yes 

rma 

• 

No ^ 

• 

No ^ 

No D­ • No Q­ • 

No 0 • 

No • • 

No • • 

ftvcy S4 

Omaha Lead Site 

46130 
Page 1 of 1 

3^6Z /Ylxruf Sf 

http://douglasne.mapping-online.com/assessdoc/Photos/20/R16445900000001.jpg 6/11/2010 
Print Preview Page 1 of2 

« % 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 

Owner 

City 

Owner 

State 

Owner 

Zip 

1644590000 

OMAHA 

HOUSING 

AUTHORITY 

3608 MARCY 

ST 

OMAHA 

68105 

540 S 27 ST 

OMAHA 

NE 

68105 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Acres 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

LUNA PARK 

0 

4 

W45FTLTS3& 

45X100 

0.1 

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp? 

parc=1644590000 

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

accountno=R1644590000 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 6/14/2010 

2 
8/17/2010 ittp://www.dhon.org/irthinternet/DHO... 

Create Another Ticket Back to Irth Intemet Send Email 

YOUR TICKET NUMBER IS  2569423. 

Original Call Date: 8/17/10 Time: 8:26 am op: SIVA18967 


Work to Begin Date: 8/19/10 Time: 9:00 am 


State: NE County: DOUGLAS 

Address: 3608 Street: MARCY ST 

Twp: 15N Rng: 13E Sect-Qtr: 20-SE,21-SW 

Twp: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: Lead Soil 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 


Work Being Done For: EPA 


Depth of Excavation: 6 FT Corner Lot: N


Involves Tunneling or Horizontal Boring : N


BSHPCLKS CXCATV LEVEL3 MUDOl


Service Area 

BSHPCLKS NEBRASKA HEALTH SYSTEM

CXCATV COX COMMUNICATIONS, INC

LEVELS COMMUNICATIONS, LEVELS LLC 

Place: OMAHA 


Phone: (402)733-1188 


 Front: Y Rear: Y 


 Explosives: N 


 OMAHACOF 0PPDGPR5 QLNNEIC 


Utility Contact Phone Number Type 

Day: 4025523460 


 NA AH: 4025523347 


Emerg: 4025595111 


Day: 4029340469 


 HEIDI Ak: 4029340469 


Emerg: 4029329757 


Day: 8773668344 


NA Alt: 


Emerg: 8773668344 


Day: 4025047823 


METROPOUTAN UTILITIES MUDOl SANDY Ak: DISTRICT 

Emerg: 4025047970 

dhon.org/irthinternet/.../MessageText.as.. 1/2 
8/17/2010 ttp://www.dhon.org/irthinternet/DHO., 

OMAHACOF CITY OF OMAHA 

TRAFFICSEWER 

^Day : 4024447197 

RICH/TRAFFIC Ak: 4024445161 

Emerg: 4024445160 

0PPDGPR5 OMAHA PUBLIC POWER 

DISTRICT 

ELM 

LOCATING 

Day: 4067289343 

Ak: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM 

LOCATING 

Day: 4067289343 

AH: 4062071494 

Emerg: 8887289343 

dhon.org/irthinternet/.../MessageText.as... 2/2 
ENVIRONMENTAL 

ENGINEERING AND 

CONSTRUCTION TEOHMOuiens, m c 

SOLUTIONS 

SITE SAFT^TY HAZARD ANALYSIS 

^-D^/C J .3(PC)S /^y^rc y Address Excavation Date.7-7 : V 

<y-y a 6-^^ Crew: —^ Backfill Date: 

Item Condition Hazards Corrective Action 

Overhead Lines 0 ^ k y £AJ1£A . [:^fl'^foP (y^^\s/^o/ 

Gas Line y^nr^/^ 

Water Line 

Sewer Line ^rj ^ r-^-^r p/^os, ^

Septic/Leech 

Field 

Propane^ntane 

Sidewalk 

Foundation 

Retaining Walls 

7 ^ 

n.<y^^ 

cr^c.K 

h '"c ^r K 

^lY(y^kKJ-/\^ ^ i ^ 

^

CT/5^/ ,v^Ax^> -

Z 

Fences 

Trees 

Structures 

£J3MJU 

rr/n^M-A^r^f^ ^ 

M y

^^^

 ^'9/^^ ' 

 Ai/^^yf- / 

Driveway 

Sprinkler System ^ 

Other 

Crew Foreman Site Safety Office 

Date: 

Gr^'^ 9-y- y a 

5600S108t 4Z«2 Medical Drive, Suite 7250 

iGay;Ma64ii4 eiMa9lcae8107 San Antonio, TX 78229 

Phone: (81Q 363^3703 Phone: (402) 733-1188 Phone: (2t0) 822-<9588 

I^K^IC) 363^3707 ^ x : (4a2)733'1S83 l=ax: (210) 579-6577 

Find Record Remediation Query ] Lead Remaining Query | Property Damage Query | 

Backfill: 

Sample Area: 22019 - 3608 MARCY ST 

Owner: 

D Owner Omipied 

Owner Name: 

lOMAHA HOUSING AUTHORTTY 

Owner Addressl: 

1 

Owner AddressZ: 

j540 S 27 ST 

City: State: Zip Code: 

JOMAHA |NE [68105-

Owner Phone Alternate Phone: 

1C402) 444-6900 

Contract: 

Contractor: JPRUDENT_2010_S 

Contract Option [BASI 

User Provided Owner Information 

Owner Name: 

! 

Owner Address: 

r 

City: State: Zip Code: 

'!— I 

Owner Phone: Alternate Phone: 

Assessment: 

Qualifying Group |400 

Assessment Max XRF Value if 470 

Resident: 

Resident Name: 

JTENANTS ' " 

Property Address: 

{3608 MARCTST" 

Zip Code: 

J68105-

Resident Phone 

I