TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 27733 DATE: 1/15 

ADDRESS: 2517 BURDETTE ST 

REMEDIATION CONTRACTOR: PRUDENT TECHNOLOGIES. INC. YEAR: 20l{) 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

0 PRE AND POST VIDEO OF PORPERTY (DVD) 

QT EXECUTIVE SUMMARY 

0 EPA-PROVIDED PROPERTY SKETCH 

0 SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

H RESTORATION AGREEMENT 

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

m CONFIRMATION DATA 

m PHOTOGRAPHS 

O^ AS-BUILT SKETCH 

G / SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

M PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

m UTILITY CLEARANCES 

Q PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

SIGNATURE DDATE 

30217584 

lllll l 

Superfund 
PROPERTY SUMMARY 

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

Property Address: 2517 BURDETTE ST 

A. EXECUTIVE SUMMARY 

A.l Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 295 PPM @ 6"; EA = 110 PPM @ 2" 

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, ifavailable, or obtained include: 

i) Pre-excavation agreement details (ifany 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. 

TECHNOLOGIES, INC. 
Find Record Remediation Query Lead Remaining Query Property Damage Query 

Backnil: 

Sampie Area: 27733 - 2517 BURDETTE ST 

Owner: 

D Owner Occupied 

Owner Name: 

JMOBECO INDUSTRIES 

Owner Addressi: 

Owner Address2: 

|ll413 HICKORY RD 

City: State: Zip Code: 

lOMAHA [NE J68144-

Owner Phone Altemate Phone: 

j(402) 342-2820 1 

Contract: 

Contractor: jPRUDEm7010_S 

contract Option foPTlONT 

User Provided Owner Information 

Owner Name: 

i 

Owner Address: 

1 

City: 

! 

State:

yi 

 Zip Code: 

Owner Phone: Alternate Phone: 

Assessment: 

Qualifying Group ^400 

Assessment Max XRF Value 520.94 

Resident: 

Resident Name: 

Property Address: 

12517 BURDETTE ST 

Zip code: 

J68111^ 

Resident Phone 

r - — 
Ymmm ;-.:-•'-

 '•f^~ CA^-\ /p . i TECHNOLCXJiife, INC; 

EPA Property Close Out 

Property #: Z77^ 3 Property Address: 251"7 '<d>ur.^^ ^ • 

Date/Time: Owner's Name: pf[ffi^£0> "^X^v^.. 

Quads Excavated: ^^ Contractor Group: Prudent Technologies, Inc., 

Excavation General Yes 

L If necessar>. were the correct qiiadrant(s) excavated and restored? / 

2. If necessary, were the conect areas of drip zone excavated aiid restored? 

/ 

Grading Sod and Vegetation Yes 

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? / 

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

4 Are sodded areas generally firm and evenly graded? A 

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

time period) A 

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

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

Gates, Fences and Retaining Walls Yes 

i. Do gates open and close freely? (Ifapplicable) / 

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

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

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

Foundation, Siding und Gutters Yes 

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

2. Was damage to the foundation avoided? y 

3. Was damage lo windows avoided? 

/ 

4. Was damage to windows or door screens avoided? 

y 

5. Was damage to downspouts or downspout extensions avoided? 

/ 

Sidewalks and Driveways (Concrete) Yes.

I Was damage lo diiveway surfaces avoided'^ 

AT 2.

 Was damage to walkway surfaces avoided? 

No 

No 

No 

No 

 No 
Owners comments: 

Inspection notes: 

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

EPA Representative a'^! ^ ^Date: M\\\[O 
ECHNOIOGIES, INC. 

AS - BUILT DRAWING 

OLS tt 27733 

Date Exca va red: 10/04/2010 OMAHA LEAD SUPERFUND SITE I SEPA Signcd-Off Date: 

zn33 

Name lV\ol>ece XAalut^-rit.i Omaha Lead Site Date •fA''*-Acs- North Arrow 

Address: Asi-ya^AtfiTre * r Site Sketch Time: \t:'hO 

Phone: 

Team csA'- ^ /fit'. y BVID# v^733 XRFCode /g3 7 Bt><}IA • 13 3 

Sample Number 

Lead Concentration Confirmation Sample 

Z-/ASCPX.A{- 2773 3 

g^g ppm F' Yes a No "^O ^ ^ 

2*70 ppm / i Yes n No 5 ^ R-<gfC/^X/^-2773? 

^2. f ppm 

^ f Yes • No CC 3?>2^ ppm j(Ji Yes n No 5^ 

5 ppm -TBS- - B - Nu P 

6 ppm ve& a Nu P 

!7 

ppm Yes • No • • 

,i^i,5^^ ^ u a 

B-NtEEEl 

] \.-..S^AlJ..^ I _.. 

-h-1 4 

1 1 

Bl = 295 PPM (o: 6" 

\ Fl \f^ \ 

T if : 

•t"+H 

ll 1 

A^dOL 

i kiu'BO£<T£ 'S.T: 

KA = IIOPPVI fl 2" 

Omaha Lead Site 46130

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

 I 
AEFA 

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, ifany. 

Property ID: 

Property Address: ^ "5 i T ^i) r At- He K\r 

Owner: 

Phone: 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

I agree restoration is completed. 

L J I do not agree restoration is completed at (noted deficiencies above) 

Owner's Signature / Dati 
- \ 

Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up leadconlaminated soils at a number of tj^operties located in Omaha, Nebraska, including the property located at 

^ O i"T f^a'J^^Cie.TT^ -^r " 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 ofthe referenced property. 

If you have any questions about the soil cleanup plaimed 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: IdSkt^^IlD YV^OdBLAUfi 

(Please Print Name) 

Property Owner Signal ^QjtlA/^ 

PROPERTY INFORMATION 

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

RESIDENT NAME: Renter 

RESIDENT ADDRESS: 

Qyvv^U^ y09 (S^S^luy 

IF RENTAL, PROPERTY OWNED BY: , ^ . 

OWNER'S MAILING ADDRESS; 

Rfs r\i,^,^A.^ to p &«\U tf H

OWNER'S TELEPHONE NUMBER - HOME: l^f^ ) 3l^ ' 2.^^- ^ WORK: 

J » 

AJ/A AGE OF HOME?: YEARS. HOW LONG HAVE YOU LIVED HERE? AJA. 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 : W ^ 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETC.] AJ/A 

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

are pursuantto Section 104 of CERCLA, 42 U.S.C. 9604. EPA'sright of access 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 S600 S 10 St 4242 Medical 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 

Fax: (816) 363-3707 Fax: (4021733-1883 Fax: (210) 579-5577 
ENVfRONMEiVTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

^2^P gurdeioProperty Status Form 

Address: Date ..'^1^ 

Phone: Ho;^-3H2_-;?^2^< ^ BVID 

A)i>o^ t/ftc ^ (c,(r 

Property Owner Prudent Employee 

Signature: Signature: 

8080 Ward Parkway, Suite 405 5600 S 10 St 4242 nOedft^l Drive, Suite 4250 

KansasCity, MO 64114 

Phone: (816) 363-3703 

... /0<ie% IC-t OTAT 

l^ - "^jzl Omaha, Nebraska 68107 

Phone: (402)733-1188 

San Antonio, TX 78229 

Phone: (210)822-9588 
, . 27733 

Name: Mokoao XKJ/W*-frit s Omaha Lead Site Date. »/^»-/i ^ 

Address: ^<n'^A>M0fi7re^T- Site Sketch Time: /^'SO 

Phone: T 

3-05 : Tim*'-Ain

Team C^A^^ ^ Aftfu/ BVID#. yn35 XRF Code !0'h l 

Sample Number Lead Concentration CkHifirmation Sample 

^63 ppm ^ ' Yes D5 No ii 3 ^ ^ 

2 ^ g /"J Yes D No 5 ^ 

/Jf Yes D No D!0^ 

^ "^ ppm i 5 i Yes O No 21 

—IL ppm fea D Nu ^ ­

—r— _ ppm -Yes-S- Nu D 

ppm Ves O Ne D 

ibcxmi- <^ Q B 

+-^ fSNtERlEnD­ T 

t I >

- • » ­

i .4J--VJi 

l^idmi 

— 1 — 

i ^f j^i s 

1^. w 

Fa j ^ 

26? '25^' 

rrr il 

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j i&tfko^itr<.7\ 

Omaha Lead Site 46130 
H 2517BurdetteS

t 33x126 

A Printed

: Nov 30, 2010 

www.dcgis.org/dogis 
iittp://www.dlion.org/irtiiintemet/DHONNoticeCreation/MessageText.asp?ret=%3CRESU.. 

Create Another Ticket 11 Back to Irth Internet | Send Email 

• YOUR TICKET NUMBER IS  2605480. 

Original Call Date: 9/30/10 Time: 12:34 pm Op: SIVA18967 


Work to Begin Date: 10/04/10 Time: 1:00 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2517 Street: BURDETTE ST 


Twp: 15N Rng: 13E Sect-Qtr: 09-SE 


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 OPPDGPRS QLNNEIC 


Service Area Contact Phone Number UtiUty Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

lof 2 9/30/2010 12:34 PM 
http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=%3CRESU.. 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICH/TRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNE 1C QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

2 of 2 9/30/2010 12:34 PM 
INC. CONSTRUCTION 

SOLUTIONS 

SITE SAJtTY HAZARD ANALYSIS 

 /JvuJ?^ A K Address : 7AA}'? Excavation Date: 

Crew: Backfill Date: 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees 

Structures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

Condition Hazards Corrective Action 

c A^ 

e^ 

P h^' 

- - — 

Olc~ 

A/y^ 

« — 

pC£yL^ 

cs«^ 

t r ^ 

0 ^— 

-

Site Safety Office 

Date: 

n o WanfVaftany. Suto 405 seoosiost 4242 Medical Drive, Stdte 72S0 

• III!mt y nn t 1111 Onrtha, Mihi Ml f 010 7 San Antonio, TX 78229 

iKne: (8fS) 363*37V3 Phone: (402)733-1188 Phone: (2tO) fl22-«588 

BCfSIO 363^3707 Fax: (402)733^883 Fax: (210) 679-6577 
^KCKur Lt>r 

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