TRANSMITTA L of OMAH A LEA D SITE 

SOIL REMEDIATIO N FIL E FOLDER 

SAID#: ^^/" f Date: /^/V/^7 

Address: /3^S^ S J2^ Sf' 

Remediation Contractor: Coastal Environmental Group Year: 2007 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

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 

As-built sketch . 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description ofareas not meeting ROD cleanup criteria 

D Utility clearances 

D Property information from Douglas Coimty Assessor's Office 

D 

D , 

D 

^ ^ 

40317873 

Superfund 
Final Report Property Check List (piease place with each file) 

Hard Copy Information 

\ . Property Check List 

'Sv^ Site Working Drawing Map 

- ^ EPA originals Map 

H, Douglas County Assessor's Map 

'S. Property Contact Sheet 

Agreement 

"~i->Access Agreement 

2. Restoration Agreement 

Miscellaneous Documents 

~1^Final Map fi-om the Field 

-2^hang e Orders f^f^ 

-f^r^RFData 

-4rA.ny emails or PO correspondences r^jf^ 

Property Completion 

\l . Executive Summary 

" X AS BUILT 

" ^ Property Completion Agreement ^ 

"NyAny buyout info or reimbursement info t^/rT 

~~5: Check or money order copies y\i/A 

'&>JEPA Property Close Out Form 

"^?T-Attached Begin Video 

Electronic Documentation 

Drawings 

~T> EPA original 

"2?^ Working Drawing 

-±- AS Built.vso 

-4r-AS Built.jpg 

Photos 

~-\—., Begin Photos 

-^—^ During/Excavation Photos 

-*—' Sod Photos 

- ^ 30-Day Sod Photos 

Scanned Documents 

""^ Final Documents 

-^^^"^ Executive Summary 

Videos 

Begin Video 

2. My Movie 
Property Access Checklist 

Property ID: ^ Q ^ | ^ 

Property .\ddrcss: | ^^ 5 S 2.Q, ^j . 

n

n

 WORK STARTED

 WORKCOMPELTED

 ON: 

 ON: 

/ / 

^ ' ' "''•• 3CaMCj ^

Address:

 Ct^n^SoM 

' (J 

Renter:

Phone: 

Fax:

 1 

1 

Phone: ^5 ^

Fax: 

 3^'75^/ ^ 

Cell/Pauer: 

Additional Intormation: 

1 Cell/Pa<;er: 

D Notification Letter Sent: / / By: 

^ 

m 

u 

• 

D 

.Access .\<ireenicnt 

Restoration Ajireenient 

Topsoil Sampling (if applic able) 

Disposal Sampling (if applicahle) 

Garden Samplin" (if ap|)lic able) 

Signed: ~^ 11 ^ lO' ^ 

Signed: i / / ^7 / 0-? 

/ • / 

^y (Uu^rs 

^y-Chiz<s 

B.>: 

By: 

B\: 

- ^ 

S 

i D 

jD 

n 

D 

la 

l'tilit> Clearance 

Video/Photos (Before) 

\ ideo/Photos (During) 

Video/Photos (.\fter) 

Video/Photos (3()-Day) 

Property Completion Agreement 

Final Report 

Called: 7 . ' ^ OT 

On:3:'P-/ i0 2 

On: / 

On: / / 

On: • 

Signed: / 

Issued: / / 

B.^:/A6

B.^<lKe,:s 

B>: 

By: 

By: 

By: 

 '^\2,^7<?fir5?S 

ll 

.Air Monitoring (as applicable) 

HI! Community 

Results: 

D Crew ! On:

— 

/ B^: j 

1 1 Community 

1 Results: 

D Crew ! On: / / 1 By: I 

1 1 Community D

j Results:

 CrcM On: / ! B}: j 

1 

Omaha Lead Site 
t Square Footage to be Excavated = 919 ^/ ^ 

Property Classification: 800 ne Linear Footaqe to t)e Excavated = 112 // ^ 

/ ^ / 

O 

^"^ 

Omaha Lead Site 

Concrete Omaha, Nebraska 

Excavated Area Property Number 

Existing Structure Scale OLS-20214 

Fence 

Permanent Landscaping 

1 Inch = 20 feet or 1 grid = 5 x 5 ft Property Address 

1325 S 26 ST 

Quadrant Boundary j^n*'.' iff*. 

Post Excavation Concentrations (ppm) 

Street Boundary Fl . B2 Play Area 

Tree/Shrub PPP^^ ^ F2 

61 

DZ

Garden 

 Easement 

Other 

Description of post excavation areas Fl. front yard ieft-fiand quadrant; F2, front yard right-fiand quadrant; Bl, bacityard ieft-fiand quadrant; B2, backyard nght-hand quadrant; 

DZ, drip zone (1-3 foot area of soii around the foundation of the house) 
Douglas Coimty Page 1 of2 

Douglas County, Nebraska Property Record ­ R2218900000 

Information Is valid as of 2007-5-9 

Values not finalized until after Board of Equalization 

Print Report 

View on Map 

Owner 

CAMPSEY FRANCES 

ETAL 

1325 S 26 ST 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number: 1890 0000 22 

Account Type: Residential 

Parcel Number:

Parcel Address: 

Legal Description:

 2218900000 

1325 8 26 ST 

OMAHA NE 68105-0000 

 SHULLS 2ND ADD LOT 16 BLOCK 10 50 X 127 

Value Informatio n 

2007 

2006 

2005 

2004 

2003 

2002 

Land 

$4,900.00 

$4,900.00 

$4,900.00 

$4,900.00 

$4,900.00 

$0.00 

Improvement 

$83,700.00 

$63,600.00 

$63,600.00 

$63,600.00 

$63,600.00 

$0.00 

Total 

$88,600.00 

$68,500.00 

$68,500.00 

$68,500.00 

$68,500.00 

$0.00 

Sales Informatio n 

Date Type Book Page Price 

Land Informatio n 

Acres

0.14 

 I SF 

6350,0 

FF 

50.0 

Units 

1.0 

Depth 

127.0 

Width 

50.0 

Vacant 

No 

Land Attributes 

Attribute Attribute Description 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=R22... 7/25/2007 
Douglas County Page 2 of2 

1730 SI O ST 

Erv:l 3Cfft«fi 

r s 0 S-3 Fl II J 

SM:cri]Ftoc< 

JWidSfl ft s u BU 

»W 0 So R 

•3(1 n a 

Jiff 

E*-i &£Twn 

" M 0 SH ». 1 1.'2 Story Bnrr t B*>zk 9 ft 

»67 0S<i R 

elicit to Enlarge Image 

Click to Enlarge Image 

Square Footage: ! 1359.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Condo Square Footage: 0.0 

Built As: 1 1/2 Story Fin Rooms: 5.0 

HVAC: Central Air to Air Units: 1.0 

Exterior: Frame Siding Baths: 1.0 

Interior: Drywall Bedrooms: 2.0 

Roof Cover: Composition Shingle Stories: 1.5 

Roof Type: Gable Foundation: Block 

Floorcover: Allowance Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1920 0% 1920 87 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 967.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 180.0 

Garage Detached 160.0 

Porch End Screen 25.0 

Porch End Screen 154.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R15... 7/25/2007 
20214 

Omaha Lead Site 46130 
CONTACT FORM 

Property ID # (^^/ / 

Property 

Address: P 7 K S Pf ^ 

Initial Contact: Date: Time: Action: 

Second Contact: Date: Time: Action: 

Final Contact: Date: Time: Action: 

Final Action: Transmit to EPA D Other Action: D 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 
• * 

COASTA L FNVinONMENTA L 

CROUP . IN C 

Consent For Access To Propeity 

RIGHT OF ENTRY TO PREMISES 

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

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

Owner's Name: ffiAJUCe' ^ CAITIPS ^ Daytime Phone: 'g^S'' 151 6 

Address of Property 

covered by this I3>Z65> Z^s r 

Agreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Grantor in-person to discuss the work to be performed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work before 

it begins. Once the work is finished, the Grantor will be asked to review the work and 

confirm that it is complete and meets with the Grantor's approval. Upon completion, the 

Grantor will receive written documentation from EPA that the property has been 

remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of performing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
'^••-:im^ 

V^^J^ , 

- * ^ \ * <.v 

COASTA L 

ENVIRONMENTA L 

CROUP . INC . 

• Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

• Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

• Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; ,. .. . 

• Abide by health and safety guidance provided by EPA; " 

• If the property is rented, assist EPA in obtaining tenant approval for access to the 

property to perform the work. 

• Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any ofthe work activities, or with any 

of the work done, or with the equipment used on his property, or to undertake any 

actions regarding the use of said property which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (877) 234-6270. 

[?f I grant access to my properties 

D I do not grant access to my properties 

4.^HC.e^>^ '^y'^^aT e '/'^/'' Signature 

Date 

CH I would like to be present during any sampling that is required. 

!f.-ci ­

; • ( 

Page 2 of 2 
Restoration Agreement 

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

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

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

PropertylD: ^d2/<7^ " 

Property Address: /- ^ ^ ^ J ^7/^P^ T 

Owner: /^^^^^ ^ /^,^MP<. ^ 

Phone: ?^?7T/SOn the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of all known 

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

contractor, and the direction of North. Indicate distances, depths, material t>pes, etc. Indicate digital photos 

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

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

The removal, storage, disposal, and/or return of these items is the Owner's responsibility. 

Item: 

K)ON € 

Item: 

Item: 

Kem: 

Item: 

ttem: 

Item: 

Item: 

Page 1 of. ^ 
COASTA L • MVtMOMM C MTA l 

G « O U P IM C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

Mrr^^'^r ^ ^cPo ^ i ^ bZ -

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 2 of & 
COASTA L flMVinOMMIMTAt. 

C « O W » IM C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

Item: 

3 o I (• 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

item: 

Item: 

Item: 

Page 3 of ^ 
COASTA L 

Landscape Inventory 

(Use addftional sheets as necessary) 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, 

that will be excavated, that /O^t­ Square feet 

is covered with grass. 

Number of trees > 2 inch Each trunk diameter 

Number of trees <= 2 inch Each trunk diameter 

/ 

Number of Sprinkler 

Zones. Control Valves, 

Timers. Heads, etc. 

Each 

.^nach a sketch of the ^ 

sprinkler lavout. 

Number of and size of 

each garden/ flower bed 

area. Each 

Square Feet 

^ .•\nach a skeich of relative 

sizes and locations. 

Page 4 of 6 
COASTA L ENVIRONMENTA L 

CROUP . INC . 

Item - Quantity 

Agreed upon value of 

plant inaterials not to be 

replaced bv contractor. 

Not

used

e

 t

 thi

o issu

s \alu

e a

e wil

 plan

l be 

t 

A

voucher to the property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

0

each plant will be placed 

b\ the contractor. 

Agreed upon area of 

property to be replaced 

witii grass sod. 

Include a skeich of :!ie lOil^ 

area(s) lo be replaced \Mih 

grass sod. 

Area of City or Count\' 

property to be landscaped 

per their requirements. 

Include a sketch ot ilie / 

area (^ i 

Easement Area, to be 

excavated 

^ 

Unit Condition/Type/Species 

$ 

Each 

SF 

SF 

SF 

Page 5 of. / 
COASTA L 

Additional Comments / Instructions: 

.-7^Jj//^ /Uinic ^ ^ ; / ^ ^ 

• Check the box if Owner does not want CEG to docLjment intenor foundation wails and possible 

pre-existing darrage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

PtTagre e i i I do not agree 

Contractor's Signature Date ' I 

Page 6 of ^ 
PROPERTY CLEARANCE WORKSHEET 

Date O't^llllO Property ID l <^o:i/^l 

Property Project Omaha Lead ~ Fixed Price //^> ^ Address /.li s .<^ £/. Measurement 

XRF ID 0107-51 Count/Time 

Field Shots 

Shot # Reading Sample Area Shot # Reading Sample Area 

Z 3 ^ P ^ 

/i^T ^ = ^ 

Sample Area /PZ /^'/ y I n Situ Composite Composite Analytical Aliquot Composite Readings Lab Analytical Reading Average (Dried & Spilt Sent (Bag) Number Results 1 (Baq) Sieved) 7 

2 J 

3 2.6. 4 ' ^ I 56 

XRF Corrected Value ~> 

5 (use calibration chart or add 

20% to value) 

4S 

Sample Area Pass/Fai l ? 

I n Situ A^^-V Composite Composite Analytical Aliquot Composite Readings Lab Analytical Reading Average (Dried & Spilt Sent (Bag) Number Results 1 (Bag) Sieved) 7

i "ZL. 

MSm - XRF Correcte

M nSd Valu L e —>

m

" 3 (use calibration chart or add 

20% to value) 

IP± 

Sample Area P Pass/Fai l ? I up^- I n Situ Composite Composite Analytical Aliquot Composite Readings Lab Analytical Reading Average (Dried & Spilt Sent (Bag) Number Results 1 ? ^ 3 (Bag) Sieved) 7 

2 ~7t3 7 ^ 

3 

4 

a ^ J i &2 ZS 7o7 

XRF Corrected Value —> 

5 63 (use calibration chart or add 

20% to value) 13 L 

Sample Area Pass/Fai l ? 

I n Situ Composite Composite Analytical 

Aliquot Composite Readings Lab Analytical Readinq Average (Dried & Spilt Sent (Bag) Number Results 1 (Bag) Sieved) 7 

2 

3 

4 

XRF Corrected Value - > 

5 (use calibration chart or add 

20% to value) 

Sample Area Pass/Fai l ? 

I n Situ Composite Composite Analytical 

Aliquot Composite Readings Lab Analytical Readinq Average (Dried & Spilt Sent (Bag) Number Results 1 (Bag) Sieved) 7 

2 

3 

4 

XRF Corrected Value - > 

5 (use calibration chart or add 

20% to value) 

USE ADDIIIOHAL SHEETS IF 

XRF Technician's Signiture HEEDED yCf^<'(P^^^^-^rz:^ 
'• nt Square Footage to be Excavated = 919 ^/ ^ 

one Linear Footage to be Excavated = 112 tli . 

Description of post excavation areas Fl, frontyard left-hand quadrant. F2, front yard right-hand quadrant; Bl, backyard left-hand quadrant; B2, backyard right-hand quadrant; 

DZ, drip zone (1-3 foot area of soil around the foundation of the house) 
/,^D^ \ Omaha Lead Site—Fixed Price EP-R7-07-05 

I J^^v f I Coastal Environmental Group Inc. 

V <^ www.coastalhazmat.com 

%PRoi«^ COASTA L ENVIKONMENTAL 

C K O U P , IN C 

EXECUTIVE SUMMARY: 

20214—1325 S 26 ST 

~x\ No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 
f^ As-Built Drawing 

COASTA L Omaha Lead Superfund^ite 

Total Quadrant Square Footage to be Excavated = 919 

Property Classification: 800 Total Drip Zone Linear Footaae to be Excavated = 112 

1 \ \ \ 1 Alley j i 1 1 . •- - ^ -

OLS#- 20214 1 ^ 1 ^ ^ 

^ "^at e Excavated: 8/11/07 "1 " 

nat o 1 IQPP A Qinnor i Dff - 0/7/0 7 I 

\ ' . ] • • • • • \ \ ^ > f 

• P' • 1 1 • 

P—.J 

< " ••'• _ 4 • { 

< • i • J I

« • ' - • • 

)• X . « •."•' . 

z • . . Y'^^ \ - ­ 1 ^ 1 1 ' - ^ 

, • • i ^ r Window Wells 'i > 

DZ y DZ = 36 PPM . _^_ 809 PF 

:== 1 -U 1-ul­

^ 

^ ^ ... \ 

. , • ; ^ • R - . i t 1

1 

. ^ / ^ 

A 7>/ . /

^ />x — '.X. Y 

/ ^^S^^-i^Pt^ i< I1 F2 = 106PPM F1 = 58 PPM ^^pi^ > 1 

^ 1 1 • li Vr ^ ^^^^ ^ ^ 4 Pl- . ••"•••-».' ••. •: ' .. • k iP, 

••<»••'.;. • •»:-' • '''•;•.'•• ' • ' ' • ^ . ' ••••,:;:.,•;<.•:.. : 

•:'."• . - '• ' P :* 

^ _ , South 26 street[ 1

Legend North Arrows Omaha Lead Site 

^^ ^ Concrete 

Omaha. Nebraslo 

k'/ l Excavated Area Property Number 

OLS- 20214 Existing Structure

H Scale 

Property Address

• Fence 1 Inch = 20 feet or 1 grid = 5 x 5 ft 

t«Vil 1325 S 26 ST 

• Quadrant Boundary Post Excavation Concentrations (ppm) 

- Street Boundary Fl B2 Plav Area 

HyrttdGt-oL.oqi'', Int

i^i I ) Tree/Slirub \-fel/FWW^ B1 Garde n_ __ a h e r 

Description of post excavation areas Fl. (ront yard lett-hand quadrant. F2, front yard nghl-hand quadrant, Bl, bacfcyard lett-liand quadrant; B2, backyard nght-haiid quadrant. 

02, dripzone {1-3 foot area of soil around the foundation ofthe house) 

Legen d 

1 

Area not Excavated Dripzone Excavated Quadrants Excavated 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
sm. EPA 

EPA Property Close Out Form 

Property #: fjO'/l/ f Property Address: f^ZP Q <f-^^^^ 7 

Date/Time: Owner's Name: PPtA^O^ ^ (CAt^yP^e^ 

Quads Excavated: Contractor Group 

Excavatioii General 

Yes No 

1. If necessary, 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 

1. Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from the house? i / 

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

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

day time period) 1 ^ 

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 

u ^ time period) 

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

7. Was damage to landscaping or plant materials avoided? 

Gates, FcDces and Retaining Walls Yes No 

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

2. Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) j^/> 

3. Was damage to gates or fences avoided? (Ifapplicable) i ^ 

4. Wasdamagetoretaining walls avoided? (Ifapplicable) ^^ 

Foundation, Siding and Gutters Yes No 

1. Was damage to the siding or trim avoided? i ^

2. Was damage to the foundation avoided? u^ 

3. Was damage to windows avoided? t ^ 

4. Was damage to windows or door screens avoided? i ^ 

5. Was daraage to dowTispouts or downspout extensions avoided? 

t ^ 

Sidewallu and Driveways (Concrete) Yes No ' 

1. Was damage to driveway surfaces avoided? (^ 

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^j^^ ^ yC_^/^i^.JU^ Date: f' 7 -0-7 
Property Completion Agreement 

This agrccnicnl documents the completion of remedial activities performed on my property. My 

signature will dcsignalc lhal I am satisfied with Ihc restoration of my properly, and that no ilcms arc in 

questions, now, or al any time in the future, except those items listed below, if any. 

Property ID: ^^^2-1 4 

Property Addrcs.s: ^^2. b S LC^^S T 

Ovvner: 

Fi^AKJgje'b CA<wP5gij 

Phone •• 5^5'-15\«D 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Hem; 

Item: 

Item: 

l*IS I agicc restoration i.s compirtrd, except as noted 

1 1 I <lo not apree re.stoiation is compictetl 

. - ,,.tfT& v y.-ao? /p ^ I fip P Ij 2g-(y 

'^Owner's Signature / Dat ^ Contractor'.s Sij;naturc Date