TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID.: ^ 6 ^(. Date; W'^< ^^' ^ 

Address: 1^1 i\\A^m ^i 

Remediation Contractor: Coastal Environmental Group_ Year ; _200a 

SOIL REMEDIATION 

PROPERTY HLE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

[V EPA-provided property sketch 

JS Signed Access Agreement for subject property 

-fi" Signed Access Agreement(s) for adjacent property 

u Restoration Agreement 

-9' Settlement documents (i.e., for damage or to replace plants, etc.) 

-S Confirmation data 

( / Photographs (^^^/TTW M ^ f(^-6c^^tWv-> 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

^B " Description of areas not meeting ROD cleanup criteria 

D Utility clearances 

^ Property information from Douglas County Assessor's Office 

30054853 

Illlillll I U 

Superfund 
Property Access Checklisi 

Propcrr^lD: 5t=)(^Q|j > n WORK STARTED ON: _/ /_ 

D WORK COMPELTED ON: / / Propeny Addre»:^^ p V\ riV.<V>V| f ^ • 

Owner:, Rente r \)i>Ays)-V<^ l^/^\;e.S­ Addrt.^s: 

Phone: 

FiL\: 

Cell/Pager: 

Phone: Ll Additionul Inlormntion: 

Fav 

Cell/Pager. 

D Notirication Letter 

J ^ Acctsi Agreement 

JPl RestoratioD Agreement 

D Topsoil Sampling (if applicuble) 

Q DisposAl Sampling (rf applicable) 

• Giirdcn SflinpliDg (if apr)lical>le) 

1 1 Diilily Clcsrimcc 

D Video/Photos (Before) 

• Video/Photos (During) 

D Video/Pholoi (After) 

D Video/Photos (30-Diiy) 

^e::^ Property Completion Ajjreement 

D Final Report 

Sent: / / 

Signed: 3_/^/(Designed: ^/3 _ 0 9 

/ / 

/ / 

/ / 

Called: / / 

On: / / 

On: / / 

On: / / 

Oo: / / 

Signed: ^/^/C 5 f~ 

Issued: / / 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By. 

Bv: 

By: 

By: 

By: 

By: 

Air Monitoring (*i applicable) 

n Community CD Crew 

ReiuJtv: 

On: / / By: 

D Community

Results: 

D Crew On: / / By: 

D Communin

Resulu: 

Q Crew On: / / By: 

Omaha Lead Srte 
Douglas County Account In '^•yi^ion Page 1 of2 

Douglas County, Nebraska Property Record - R1529250000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - Vie w O n Ma p Information is valid as of 2009-8-3 Treasurer's Tax Report 

New Feature -*->- > Auto Sales Search 

Owner 

REAVES JUANITA 

1817 PINKNEYST 

OMAHA NE 68110-0000 

Property Informatio n 

Key Number: 2925 0000 15 

Account Type: Residential 

Parcel Number: 1529250000 

Parcel Address: 1817 PINKNEYST 

OMAHA NE 68110-0000 

Legal Description: KOUNTZE PLACE LOT 4 BLOCK 35 50 X 124 

Value Informatio n 

Land Improvement Total 

2009 $4,800.00 $47,500.00 $52,300.00 

2008 $4,800.00 $47,500.00 $52,300.00 

2007 $4,800.00 $41,700.00 $46,500.00 

2006 $4,800.00 $41,700.00 $46,500.00 

2005 $4,800.00 $41,700.00 $46,500.00 

2004 $4,800.00 $13,900.00 $18,700.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6200.0 1.0 124.0 50.0 No 

Impro vemen t Information 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R15... 8/22/2009 
Douglas County Account I i^Hm||alio t n Page 2 of2 

1817 Plnkney 

'«• © riinr 

'" Ri«Fteo> 

I T»OS« R 4S\ 1 B0 a o 

t0 ! pmymmm »<r 

aif 

21/2 Story Unfin 

^^^HBHjflp V ^Ty:--:Z7:7;^JtL^ 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1446.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Good 

Built As: 2 1/2 Story Unfin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 8.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: \ 3.0 

Roof Type: Hip Stories: I 2.5 

Floorcover: Allowance Foundation: I Block 

Sprinkler Square Footage: ; 0.0 

year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1905 0% 1905 104 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 694.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch End Solid Wall 176.0 

Porch Wood Deck 56.0 

User See notes 1.0 

http ://douglasne.mapping-online. com/DouglasCoNe/static/accountinfo.j sp?accountno=R 15... 8/22/2009 
CONTACT FORM 

Property ID # 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

5^WI^ 

\'in 

Date: 

Date: 

Dale: 

?\r\\Lx>^\j

Time:

Time:

Time:

Transmit to EPA D

 %^ 

 Action: 

 Action: 

 Action: 

 Other Action; D 

r 
• • 

Page 1 of2 

> 

Create Another Ticket ] 1 Back to Irth Internet j Send Email 

YOUR TICKET NUMBER IS 2360351. 

Original Call Date: 9/09/09 Time: 3:55 pm Op: ELIZABETH18790 

Work to Begin Date: 9/11/09 Time: 4:30 pm 

State: NE County: DOUGLAS Place : Gtyt/mA 

Address: 1817 Street: PINKNEY ST 

Twp: 15N Rng: 13E Sect-Qtr: 10-NW 

Twp: Rng: Sect-Qtr: 

Legal Given: C 

Type of Work: LEAD REI^EDIATION 


Location of Work: INCLUDE ALL EASEI^IENTS LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 

Contact Name: ELIZABETH Phone: (877)662-4210 

Work Being Done For: COASTAL 

Depth of Excavation: 4 FT Corner Lot: N Front : Y Rear: 

Involves Tunneling or Horizontal Boring : N Explosives: N 

CXCATV I^AGELLAN I^UDOl OI^IAHACOF 0PPDGPR5 QLNNEIC 

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 DEBORAH Alt: 

Emerg: 9185747098 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 


Day: 4024447197 

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

Emerg: 4024445160 

http://www^.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/9/2009 
Page 2 of 2 

• • 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNE 1C QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/9/2009 
OLS#: 5566 

Date Excavated:9/22/09 

Date USEPA Signed Off: 10/6/09 

As-Built Drawing Wi 

C CAST A L Omaha Lead Superfund Site Area Sodden: 1836 sa ft 

Name: Omaha Lead Site 

Address: l<y<7 ArvYcrvey Site Sketch 

Phone: n w/* 17. "^aSDate 

|o/il»/c>? 

Team 

O U ; l'^e^t)ar^ 

BVID# 

S'.S'Lala XRF Code / ^• ^ y ^ 

Sample Number Lead Concentration Confirmation Sample 

^5 > 

! r ^ ^

y^/r^?kf >

^^ ^ ^ =^ ^

 ppm 

 ;^m 

 ppm 

Yes

Yes

Yes

Yes

 C3 

• 

O 

• 

No IZI 

No ^ 

No (3 

No ^ 

//^je' ^ <^ r ppn, Yes D No a . 

46904.783-01 

Quadrants Excavated 


Area replace d wit h Area replaced with 

Sod ' ' Area left bare 
 Rock/Mulch 


Contracli #: EP-R7-07-05 Coastal Environmental Group Inc. 

• • • • 

Name; Omaha Lead Site 

Address: l^i? P{r^)Frniy . Site Sketch 

Phone: t-" n ^/* n . ^aS"' 

Date Team BVID # XRF Code j^^y ^ 10/331/0 ^ 

Sample Numt}er Lead Concentration Confirmation Sample 

T . rr ppm Yes El No • 2 /zysy^r^jf^' s^s^^~Tr^' W •?.^<^j;z 7 ppm Yes • No ^

Yes • No [3 '^'^^^ ^ ppm Yes • No ^ 

5 yr^2-r<r/^.y-5-g-^ ^ ^z ^ Yes n No a . //^.^ ^ ^ ^ ppm 

Omaha Lead Site 46904.783-01 
^/AJ^AJ ^ 

Name; Omaha Lead Site 

Address; l<f/7 PSrs^^r^y Site Sketch 

Phone; 

Date Team BVID# XRFCode^^^ ^ 

\of3i'^lo7 n\..^r^ fRe,lntU-\cS 6'-£'Lui 

Sample Number Lead Concentration Confirmation Sample 

2 fzys^^^^^ - ^s^^~Znu' 

3 /^r^i^^xAf ^?F 35> '^'^^^^ ^ • 7.i»i^t^ 7

5 /TJ^^^^^r^'SS-^.^yi^J /f^'f ^ "f ^

:;*ti 

2:E 

D2­

l^ip-t ^ ^ >».JJ 

tn. ^••^••••—••••»v — 

ppm 

ppm 

 ppm 

Yes

Yes

Yes

 B] 

• 

• 

 ppm Yes • 

 ppm Yes • 

t 

rTT"'-."/ 

f^ 

-^W'l-fi-

Omaha Lead Site 46904.783-01 
Name: Omaha Lead Site 

Address: 1^/7 ArvKn^ y Site Sketch 

Phone: 1 W/*17. ^25" i'^ 1

Date Team BVID# 

xo/a^lo' ^ nu»i>^ /^.aiiP>-ky J~XCi^(p 

Sample Number Lead Concentration 

2 fzy^y^j^-^ ' 5"g<^<g-""<?^' 

3 S5> 

ppm 

jey^^^^xAt-ss^n^ r&. ^ ^ ^ ^ s.j^ ppm 

5 ^f^Z^^^*^*?'^^r^ ^ 7^ ^ //^^^ ^- ^ ppm 

9ir\,\r\(ly^ 

i£^ _ei. \2.^^t^Z7 ! 

i 

D^ 

! / /^4f^t^ ^ 

—1 " b.^/?^!27 

IfiL 

1 /5/i^.5^ 

! 1-

XRF Code 

J^^'/ -

Confinnation Sample 

Yes d No • 

Yes n No ^ 

Yes • No (3 

Yes • No ^ 

Yes • No ca. 

i ^ 

it 

11 

jdLkibc^cd&k m^r^?^^^ 

M£t& 

„ .L 

Omaha Lead Site 46904.783-01 
• - * * 

COASTA l 

INVIKONK I hTA l 

••< Pno' ' C K 0 U r . IN C 

Consent fof Access To Propect^/ 

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: Daytimme Phone/Sli^l-iBH I 

' J)ula<1if.e,. Kggk.l/^^^ 

Address of Property 

covered by this 

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 
c

COASTA L 

INVIftOHHtKTi t 

C II 0 U ' IH C 

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

piles, dog houses, etc; 

e 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; 

e 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 of the 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 (402) 991-1199 

©Ig gran r t access to my properties G I do not grant access to my properties 

v^? 

ignature Date 

Q I would like to be present during any samplingi that is required. 

Page 2 of 2 
COASTA L 

Restoration Agreement 

The purpose ofthis 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 thaf restoration 

activities are completed to the saiislaction of the propert)' owner and the United States Environmental 

Protection Agency (EPA). 

S^U 

\?>\1- fin^^^py ^ h 

O^v"^'-^ ^u..rV . Re^^.< 

Phone: 

On the attached diagram(s) indicate area(s) to excavated and deplh of excavation, location of all known 

utilities, subsurface features, syrface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, 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. 
COASTA L 

c A o u r . IM C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

//K^ . L ^/i-i^l i /^/<:>«a>/^ 

Page 2 of ^0 
COASTA L 

C n O U r IN C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

-^c^ 4^>/, g^ . P^ 

Item: 

Item: 

Item: 

Item: 

Kem: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

item: 

Item: 

Item: 

Page 3 of ^ 
C O A 5 T ft L 

C « O u r IMC . 

Landscape Inventory 

(Use additional sheets as necessary) 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

tmnk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Quantity 

PZ 

4+t"^'? 

P 

/ 

V4 

Unit 

Square feel 

Each 

Each 

Each 

Each 

Square Feet 

Condltion/Type/Species 

•^ 

f^v^Aw^ 

Page 4 of. 
Item 

Agreed upon value of 

plant materials not to be 

renlaced by contractor. 

Note this >'alue will be 

used to issue a plant 

voucher to thc property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant will be placed 

by the contractor. 

Agreed upon area of 

property to be replaced 

witii grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. 

Area of City or County 

property to be landscaped 

per their requirements. 

Include a sketch of the 

aiea (s) 

Easement Area, to be 

excavated 

Quantity Unit Condition/Type/Species 

$ 

Each 

SF 

SF 

SF 

Pages of P 
C O A £ T A i. 

Additbnal Comments / Irtstructions: 

6-ti a-3c{ '^< . ]v\ c^cXxjcti-i-eJ 1 ^ 

D Check the box if Owner does not want CEG to document interior foundation walls and possible 

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

intenor of house, including foundation cradcs or fissures. 

Q I do not agree 

^i^lM. 

Date 
BviD# <riri^{f, XRF PROPERTY SAMPLE SHEET 

Date 

Project 

^5^^ 

Omaha lead FP 2ncl year option 

Address 

Sample time 

mil ­ Pr-i^jr^^q^^ 

O ' am/o; ' am/pm 

XRFID# 3-i>o <b^ sample length 30 sec 

Shot# Reading Sample area Shol# Reading Sample area 

/^S" ^ lto 

?^f) ^( ^ . ^ I Z. ^ ^ ^ i ^ h^ 

m^ -z^T^ M y Depth ms- ^^it Depth 

3 J S 7/)'bMl- aj^- ^ J^i ^ 7 ^ 

Average 2 ^ '^ ^ "?"' Average ^7^J^I? ^ 

Shot# Reading Sample area Shot# Reading Sample area 

^ 

i z^. m. 

\ Depth Depth /2- 7H2. -^ I • 

33 S 

Average T^gjp J^ ^ Average 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

lab sample # Lab result Sample area XRF Avg. 

Slgnature_L^CM M 

printyliAabP>\h Cac^xe^ 
l-tO^' o Omaha Lead Site—Fixed Price EP-R7-07-05 

o ^^^^L I Coastal Environmental Group Inc. 

^^^^^^o * wvvw.coastalhazmat.com 

XpRO-it^' I PRO' ^ COASTA L ENVIRONMENTA L 

G H O U P , IN C 

EXECUTIVE SUMMARY: 

BVID #5566- (1817 PINKNEY ST) 

X No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 
^^dljrT i 

EPA Property Close Out Form 

#. b s 1^ ^ Prniwrtv Ai1HrM<r- A. . ;•• : LJ — /) , . .,x^' - Property 

Date/Tlnie 

Quads Excavated: %\ Y V'5 ' Contractor Group Uflkhrf^ 

Excavatio Yes No n General 

I.

 If necessBO', were the correct quadrant(s) excavated and restored? ^ 

2. If necessary, were the correct areas ofdrip zone excavated and restored? 

Grading Yes No Sod and Vegetation 

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

from the house? 

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

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

L^­ day time period) 

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) 

6. Was the property graded such that waler will not pool on the property? ^ " 

7. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls 

Vcs No 

I. Do gates open and clo.se freely? (If applicable) ^ ' 

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

' 

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

i / 

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

u^' 

Foundation, SidiPKand Gutlcrs Yes No 

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

2. Was damage to the foundation avoided? T ^ ' 

3. Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? T7' 

5. Was damage to downspouts or downspoul extensions avoided? 

Sidewalks and Driveways (Concrete) Yes ^ 0 

1 Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

Removal and restoration activates compiele including the 30-day sod warranry: 

EPA Representative JJ ) (Kf). / i ^ Date: M //) ^ 
Property Completion Agreement 

This agreement documents the completion ol remedial activmes peribimed on my properly. My signature 

will desfgnate Iliai I am satisfied with the resioralion ofmy properly, and (hai no items are in queslion.s. 

now, or al any time in ihe future, except ihose Hems listed below, if any 

Property ID: 55(p( p 

Property Address: \9>\l 7m/6^tj sV. Owner: ^QQ^ftfy^Vg^ ZttWi S 

Phone: LQ^.^^y/ . /fl^ / 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

QJ^yr cc res tora I ion in completed, cxccpl as nnterl 

I rto nol a^rec restoration 

/^(UIUA^A ji-^'^/m T/tJ^ 

ci' s Signamr e Condaclo i 's Signalure Dale