PROPERTY SUMMARY

 

Date: 10/03/2007 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 Month of: October 

Property Address; 1903 Laird St 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: Map Error on missed area in Bl sampled and tested at below threshold. 

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: 

Dl-110@13" 

B2 - 95 @ 4" 

F2 - 195 @ 4" 

Easement - 99 @ 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 sketchi) 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. 
• • 

33246 

On Exterio^Paint North Arrow Owne r iahe iL ead? 5i te r Name: JAMES R DORSEY 

Site SI (etch i Address: 1903 LAIRD ST n p°°r

 \y - Phone: H: 402-451-0490 W: Q Not paint 

Sampl Lead Sample Samples Collected e Number LAB Concentration Collected Firm: P £- ATT A?J l^ 

RYASCPXA-33246 F1 •2.^3 DDm n Date: la> ~1 <-/ 

RYBSCPXA-33246 F2 ^^^-* ppm R^*^ D Time: £_> ID 0^ 1 r>vr<trnvA.irvMri ni nam

 

Samples Analyzed RYDSCPXA-33246 B2 $&£> Dpm n 

RDZSCPXA-33246 DZ y ^4r~& 0am n XRFUnit: 0/*- Book: 5 **-

Pam n Date-

 ~7/Sdf/^ /" 

RPZOGPXA-30240 P2 D pm n n

 Ti nriG" r/f*j 

Staff: 'f?7??7 Number of Sai Tipk JS = 4 CM 

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Omaha Lead Site 46130 



1 

33246 

Owner Name: JAMES R DORSEY 

Address: 1903 LAIRD ST 

Phone: H: 402-451-0490

Sample Number 

RYASCPXA-33246 F1 

RYBSCPXA-33246 F2 

RYDSCPXA-33246 B2 

RDZSCPXA-33246 DZ 

'nCZCCPXA 33B16 GZ 

; 

Om aha Lead Si te

 

Site Sketch 

 W: 

Lead Sample 

Concentration Collected 

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B^^­ DI )m D ni sm 

5^^ DI 5m 

/ ^*'t£ opm 

- Dpm D 

Dpm D D 

Number of Samples = 4 Oi 

Exterio^Paint North Arrow 

Q Poor 

fj Not paint 

Samples Collected 

Firm: P- £-~ ATT" M 1 lJ 

Date: (0 ~~l <-/ 

Time: .£' 10 OW —1

 

Samples Analyzed 

XRI r

 Unit: &j*~ Book 

Date1

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Staff: s2^ 77?7

 

: i , 4ENTER] ED; 

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Omaha Lead Site 46130 
Agreement to allow access to 

Omaha Lead the property in order to conduct 

Site Remedial environmental sampling and to 

Action remove lead-contaminated soil 

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

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

including the property located at jgjft.% | otfr^ g^l- _ . The 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-contaminated soil, and restoration of me referenced 

property. After obtaining the owner's signature on this form, Prudent Technologies, Inc. will contact 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 Hinds 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). 

Property Access Granted By: ft S -^ A 

(P]»u«PiinlNHJB») 

Property Owner Signature: 

(^Signature) (Dat«) 

PROPERTY INFORMATION , (To be completed by resident and/or property owner - please print) 

RESIDENT NAME: . e-U Qenter 

RESIDENT ADDRESS: LdJVJ *" 

IF RENTAL. PROPERTY OWNED BY: 

OWNER'S HAILING ADDRESS: | ^ Q <% Q TY)^ Ufl £& \\ D 

OWNER'S TELEPHONE NUMBER-HOME: l~\*5\~ P WORK: J I 

AGE OF HOME?: ^f>"^ YEARS. HOW LONG HAVE YOU LIVED HERE? So YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1378? __\s^itS NO 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: ONUBBER OF OCCUPANTS? YEARS OLD AND OLDER 2-

NUHBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY « THE YARD FOR S HOURS OR HORE PER WEEK: O 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS. ENTRY GATES. ETC.) 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS^ The activities to be implemented by EPA under this 

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

provided fcr in Section 104(e) of CERCLA, 42 U.S. C 9605(e), which provides entry for "determining the need fa­ response, or choosing or taking any response action under this title, or otherwise enforcing the provisions of the 

titlo." 
&EPA 

EPA Property Close Out 

Property #: 5 Property Address: /903 Lf)>ff O 

Date/Time: Owner's Name: JRmes Oaxftj 

Quads Excavated: a* * Contractor Group Prudent Teonnologies 

Excavation General Yes No 

1. If necessary, were the correct quadrants) 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? >/ 

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) iS 

4. Are sodded areas generally firm and evenly graded? 

^ 5.

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

time period) •s 

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

1. Was damage to landscaping or plant materials avoided? */ 

Gates, Fences and Retaining Walls Yes No 

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

• 

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) 

^ 

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? </ 

2. Was damage to the foundation avoided? iS 

3. Was damage to windows avoided? L/ 

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

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

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: 

'

; SMTV ^ rh^DK l 

5 ff 

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

EPA Representative Qn/ft ,»# Date: iolt/o-> 
33246

 

&<xcK ENTERED Omah Exteriop^aint North Arrow a Lead Site Owner Name: JAMES >EY 

Site Sketch Address: 1903 LAIRD ST Poor 

Phone: H. 402-451-0490 W: Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Rrm: 

mples Collected 

RYASCPXA-33246 D Date: 6» 1 

RYBSCPXA-33246 a Time: i?' /£> 

RYOOOPXA-03g40 

RYDSCPXA-33246 

a 

a Samples Analyzed 

RDZSCPXA-33246 a XRF Unit: 0I2

- Book:, 

D Date: 

RPZ9OPXA"OOg40 PS a Time: 

Number of Samples = L\ , Staff: 

ENTERED 

Omaha Lead Site 46130 
TECHNOLOGIES, INC.

ENVIRONMENTAL & 

CONSTRUCTION 

 SERVICES 

MAP ERROR REPORT FORM 

Property Address: 

BVTD; 

Description of the Map Error. "Tfan*, & a. jzJ-np /yf <s,r«ss an 

*? 

Date of the Report to EPA: 

Method of Reporting (circle one): Phone call E-mail 

Met with EPA PO Other Method 

Description on how the error was resolved; tiJi'{j 

if £></&S HOP 0ffrn. 

Signature of the Reporting Staff Member 

8080 Ward Parkway, Suite 405 2505 N. 2<T street. Suite 308 4242 Medical Drive, Suits 4260 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363^703 Phone: (402)604-1004 Phone: (210)8224588 r».- mini tt*.aTn7 Fax: (402) 504-1005 Fax: (210) S79-6S77 
I

SEPA 

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 (30 days total) except those items listed below, if any. 

Property ID: ^2, ^ !Zjv4'Vj' 

Property Address: \Q Q -^ N_£> -»*&. SsS- Owner: <^?Cc^vO^ C£"<-^-<H^

 

Phone:

 l-4X

^o.5 - M 5> V- O Q ^^0 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

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

LJ I do not agree restoration is completed 

7 

/Owner's Signature Date 
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 

0701990000 

DORSEY 

JAMES R 

1903 LAIRD 

ST 

OMAHA 

68110 

1903 LAIRD 

ST 

OMAHA 

NE 

68110 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Assessor 

Website Link 

03-15-13 

BOULEVARD PARK ADD 

13 

1 

N80FT 

& N 80 E 3 FT LOT 2 50 X 80 

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

accountno=R0701 990000 

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 = 24 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 8/1/2007 
Page 1 of 2 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 1871224. 

Original Call Date: 8/22/07 Time: 10:31 am Op: CYNDIE18967 

Work to Begin Date: 8/24/07 Time: 11:00 am 

State: NE County: DOUGLAS Place: OMAHA 

Address: 1903 Street: LAIRD ST 

Twp: 15N Rng: 13E Sect-Qtr: 03-SW
 

Twp: Rng: Sect-Qtr:
 

Legal Given: C
 

Type of Work: soil excavation - lead remediation
 

Location of Work: LOCATE ENTIRE PROPERTY
 

Remarks: FAX ALL CLEARS TO: (402)504-1005
 

Company : PRUDENT TECHNOLOGIES
 

Contact Name: CYNDIE Phone: (402)504-1004
 

Work Being Done For: EPA
 

Depth of Excavation: 14" Corner Lot: N Front: N Rear: N
 

Involves Tunneling or Horizontal Boring : N Explosives: N
 

CXCATV MAGELLAN MUD01 OMAHACOF OPPDGPR5 QLNNE1C
 

Service Area Contact Phone Number Utility Type 

Day: 4029340469
 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 9185747098 

MAGELLAN MAGELLAN MIDSTREAM PARTNERS LP TONYA Alt: 

Emerg: 9185747098 

Day: 4025047823
 

MUDOl METROPOLITAN UTILITIES DISTRICT EDWINA Alt: 

Emerg: 4025047946 

Day: 4024447197
 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343
 

http://vvww.dhon.org/irthintemet/DHONNoticeCreatiori/MessageText.asp?ret=<RESULTS... 8/22/2007 
Page 2 of2 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Alt: 

Emerg: 8887289343 

QLNNE1C QWEST LOCAL NETWORK NA 

Day:

Alt: 

 4067289343 

Emerg: 8887289343 

http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/22/2007 
Find Record Clean Up Query Lead Remaining Query Property Damage Query 

D Owner Occupied 

Owner Name: 

IDORSEYJAMESR 

Owner Address 1: 

Owner AddressZ 

11903 LAIRD ST 

City: State: Zip Code 

|OMAHA NE J68110 

Owner Phone: Alternate Phone: 

|(402) 451-0490 

Resident Name: 

IDORSEYJAMESR JPRUDENT2007 

Property Address: Group: 

11903 LAIRD ST 

Zip Code: 

J68110 

Resident Phone Qualifying Group 

800 

Assessment XRF Date: 

Assessment Max XRF va ue