TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAK) #: g.na ^ ^^^'• 

Address: /ooK ^Tlyir^^y^ flL^ 

Remediation Contractor: /^.3..,-/ - nZcl.,..A.p, . ^ r y Year: loo ^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

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 Video ofproperty (DVD) 

 Executive Stimmary 

 EPA-provided property sketch 

 Signed Access Agreement for subject property 

 Signed Access Agreement(s) for adjacent property 

 Restoration Agreement 

 Settlement documents (i.e., for damage or to replace plants, etc.) 

 Confinnation data 

 Photographs 

 As-built sketch 

 Satisfactory restoration signed by Property Owner 

 Property close-out check list signed by EPA 

 Description of areas not meetmg ROD cleanup criteria 

 Utility clearances 

 Property mformation from Douglas County Assessor's Office 

Signati ^ ilam­ )ate 

40310751 

Superfund 
PROPERTY SUMMARY 

Date: 01/23/2009 Omaha Lead Site Remedial Action Contract # £P-R7-07-0(i/0004 Mondi of: Dec/Jan 

Property Address: 1003 TURNER BD 

A. EXECUTIVE SUMMARY 

A,l, Issues Encpmitered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Otber Relevant Infonnation: AREA NOT EXCAVATED Fl LANDSCAPE 3'X20' @ 724 PPM 

CONFIRMATION SAMPLING DATA/RESULTS: 

DZ = 48 PPM @ 12"; F2 = 216 PPM @ 4"; EA = 52 PPM @ 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 chp/photographs 

4) Post-Excavation digital video clip/photogr^hs 

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 

Ui) 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 Clean Up Query I Lead Remaining Query I Propetty Damage Query I 

Backfill: 

Sample Area: 21724 - 1003 TURNER BD 

Owner: Resident: Contract: 

n Owner Occupied Resident Name: Contractor: 

Owner Name: MCGRANE RYAN K jPRUDENT2008_S 

[MCGRANE RYAN K 

Property Address: Group: 

Owner Addressl: 1003 TURNER BD 

I 

Zip Code: 

Assessment: Owner Address2: |68105 

11003 TURNER BLVD Resident Phone Qualifying Group 

City: State: Zip Code: |800/CHILD 

jOMAHA |NE |68105 

Assessment XRF Date: 

Owner Phone: Alternate Phone: I • 

|(402) 345-0775 |(402) 212-9102 Assessment Max XRF Value: 

I 1149 
TECHNOLOGIES, INC 

Property*; a?/7^ ^ 

Date/Time: 

Quads Excavated: It-Zj f2 ^ S(\ 

«EFA 

EPA Property Close Out 

Property Address: l0O3'fo«r\elS S n 

Owner's Name: 

Contractor Group Prudent Technologies 

Excavation General Yes No 

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

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 Ihe house in excavated areas generally slope away 

from the house? y 

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 time period) y

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

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

time period) y 

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

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

Gates, Fences and Retaining Walls 

Yes No 

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

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

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

4. Was damage to retaining walls avoided? (If applicable) y 

Foundation, Siding and Gutters 

Yes No 

1. Was damage to the siding or trim avoided? 

y 

2. Was damage to the foundation avoided? 

y 

3. Was damage to 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 

1. Was damage to driveway surfaces avoided? • ' 

y 2.

 Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

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

EPA Representative < ^ j ^ Date: //sp/o'; 
SEFW 

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 m the fiitiu-e, excluding any 

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

Property ID: 

Property Address: 1 r.03 T"^^^^'> foO 

Owner: 

Phone: 

Restoration Items In Question: 

Item: 

Itsm: 

Hem: 

Kem: 

Item: 

Hem: 

Required corrections to complete the property: 

» /gsfs."a Sc^. 

1 ^ I agree restoration's completed, except as noted above. 

CH I do not agi^e restoration is completed 

al^P 

•wner's Sfgiiature Date 
Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environniental Protecticn Agency (EPA) to clean up leadcontaminated soils at a number ofproperties located in Omaha, Nebraska, including Ifae property located at 

/po 3 "TuTne-r 6ft/e f The EPA requests your permissbn to allow Prudent to perform a soil cleanup at this 

property to iemo\fe lead-contaminated soil. By signing this form, the property owner grants permission to Ptudent to perform 

activities related to the cleanup including soil sampling, removal of lead-contaminated soil, and restoration of die tefeienced property. 

If you have any questions about the soil cleanup planned for your property, please contact Pnident Administrative Clerk for the 

Omaha Lead Site cleanup. Ms. Deborali Johnson -at (402) 733-1188. General questions about the Omaha Lead Site cleanup can be 

directed to the EPA Public Infonnation Centers at (402) 731-3045 (South Omaha ofBce) or (402) 991-9583 (North Omaha ofBce). 

Property Access Granted By: Vi.s} (^-»\ 1 ^ Cj-j'rc^t\ tt.­

(Please Print Name) 

l(.l-Sr Property Owner Signature: 

(Signature) (Date) 

PROPERTY INFORMATION 

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

C 

RESIDENT NAME : ^Vrt^rv IV\^ Grec«\g . Owner, Renter 

RESIDENT ADDRESS: 

/Q0 3 "To>rnP. r (iLc J 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAIUNG ADDRESS; 

OWNER'S TELEPHONE NUMBER - HOME: l^O^ ) ,^ Vi " -ol' ^ S ^ WORK: 

J 1 

AGE OF HOME?: ^ O YEARS. HOW LONG HAVE YOU LIVED HERE? .0 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: 

0 

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, 42 U.S.C. 9604. EPA's right of access to the property is providedfor in Section 104(e) of 

CERCLA, 42 U.S. C 9605(e), which provides entry for "determiningthe need for response, or choosing or taking any response action 

under this title, or otherwise enforcing theprovisions of the title." 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San AntonicTX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
AS - BtHit:DilAWiNG 

OLS#: 21724 

Date Excavated: 11/13/2008 

USEPA Sl^ied-OfTDate: 

OMAHA LEAD SUPERFUND SITE: ^ 

21724 

CONTRACT #: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC. 
ENVIRONMENTAL! 

CONSTRUCTIO 

TECHNOLOGIES, INC. SERVICE 

Property Status Form 

Address:/<:?o3 Tort^^ r ^}^<^ Date: ///<3'/ < c^r 

Phone: 3V5'-07-75 ' BVID: 

Plants & Permanent Landscaping To Remain In Place 

Description & Location 

<3 ^ 

^ Pre-Existing Condition of Stnictnres 

DoesyourBasementhaveahistory of leaking? Yes No ^ 

Item NO 

On Map 

Description & Location 

Property Owner Prudent Employee 

Signature: Signature: Wji''-<^ 

_ 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

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

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
21724 

Omah Exterior Paint ^orth Arrow a Lead Site 

{ 3 Good Site Sketch • Poor 

samplin g Address : 1003 TURNER BD • Not paint 

Lead Sample Samples Coil icted Sample Number LAS I Concentrat on Collected Firm: P^ A ^"(j j ]iX. 

RYASCPXA.21724 Fl ppm 

D Date: 1'%'0'i 

RYBSCPXA-21724 F2 ppm Time: ^•QOp. m . 

RYCSCPXA-21724 Bl ppm

± n 

Samples Ana yzed

RYDSCPXA-21724 82 .ppm D

RDZSCPXA-2t724 DZ I^Z6 2ffe \ pom I

n XRF Unit: dSHC i ^oolc 2/ 3 

RGZ6CPXA 31724 G i ppm D Date: "7 - 3 ^ i?a. RPZOGPXA] ^724 P2- J:: ippm D D Time: Pn ^ D 

^-2172 4 Staff: n.S U) RYBSCP Number o f Samples = | ^ Lab 1

530 PPi" , I Result Front Right, 81 Back Left, 8 2 = Back Rigdji DZ = Drip Zone, GZ = Ganqen, PZ = Play 

All quadrantsi are as viewed from the aireet,

, facirg proper^ 

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R17231000000001 .jpg (JPEG Image, 640x480 pixels) http://douglasne.niapping-online.com/assessdoc/Pliotos/19/R17231000.. 

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Print Preview http://www.dogis.org/dogis_alias/dogis/printPreview.aspx7PrintOptDa.. 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

1723100000 

MCGRANE 

RYANK 

1003 TURNER 

BD 

OMAHA 

68105 

1003 TURNER 

BLVD 

OMAHA 

NE 

68105 

Sec-Twn-Rng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website Link 

Assessor 

Website Unk 

21-15-13 

MAYNE PLACE 

4 

26 

44X125 

http://webapps.dotcomm.org:8080/TreasTax/faces/pages 

/taxinfo.jsp?parc=1723100000 

http://douglasne.mapping-online.com/DouglasCoNe/static 

/accountinfo.jsp?accountno=R1723100000 

guaranteed. This is not a legal document and should not be substituted for a title search, . .—. __ . . . , , . : , . . . 1 inch - 25 feet appraisal, survey, or for zoning verification. 

lofl 11/3/2008 10:48 AM 


http://www.dhon.org/uj^nternet/DHONNoticeCreation/MessageText.. 

Create Another Ticket ,| Back to Irth Internet Send Eniail 

YOUR TICKET NUMBER IS i 2168934. 

Original Call Date: 11/04/08 Time: 10:37 am Op: MADHURIMA18 967 


Work to Begin Date: 11/06/08 Time: 11:00 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1003 Street: TURNER BLVD 


Twp: 15N Rng: 13E Sect-Qtr: 21-SW,28-NW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remediation for soil 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)733-1883 


: UNSURE CORNERS 


Company : PRUDENT TECHNOLOGIES 


Contact Name: MADHURIMA Phone: (402)733-1188 


Alt. Contact: Phone: (618)401-2223 


Work Being Done For: epa 


Depth of Excavation: 6 ft Corner Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MCLEODNE MUDOl 
 MUD02 OMAHACOF 0PPDGPR5 


0PPDGPR6 QLNNEIC QLNNEIF 


Utility Service Area Contact Phone Number Type 

Day: 4029340469 


COX CXCATV HEIDI Alt: 4029340469 COMMUNICATIONS, INC 

Emerg: 4029329757 


Day: 8773668344 

LEVEL3 LEVEL3 NA Alt: COMMUNICATIONS, LLC 

Emerg: 8773668344 

Day: 8002891901 

NO NEED TO CALL MCLEODNE MCLEODUSA Alt: OUT EMERGENCY 

Emerg: 8002891901 

Day: 4025047823 

METROPOLITAN MUDOl SANDY Alt: UTILITIES DISTRICT 

Emerg: 4025047970 

lof2 11/4/2008 10:37 AM 
http://www.dhon.org/^intemet/DHONNoticeCreation/MessageText... 

MUD02 METROPOLITAN 

UHLITIES DISTRICT SANDY 

Day: 

Alt: 

Emerg: 

4025047823 

:4025047970 

OMAIL\COF CITY OF OMAHATRAFFICSEWER RON 

Day: 

Alt: 

4024447197 

4024445161 

Emerg: :4024445160 

0PPDGPR5 °E^T"^""°'*'^ ^ NA 

Day: 4067289343 

Alt: 8887289343 

Emerg: 4067289343 

0PPDGPR6 O; ^ PUBLIC POWER ^ ^ 

Day: 

Alt: 

4067289343 

8887289343 

Emerg: 4067289343 

QLNNEIC QWEST LOCAL 

NETWORK NA 

Day: 

Alt: 

Emerg: 

4067289343 

: 8887289343 

QLNNEIF QWEST LOCAL 

NETWORK NA 

Day: 

Alt: 

4067289343 

Emerg: :8887289343 


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