TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID Date: ^llt ? 

Address: 

Remediation Contractor: _Coastal Environmental Group_ Year: 20i T 

SOIL REMEDIATION 

PROPERTY HLE FOLDER DOCUMENTS 

Video of property (DVD) 

0^ Executive Summary 

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.) 

Confirmation data 

Photographs ^- ^ ^ h ^ y {;f'Cfi(V(X^\9n \ (^ ip,aC^fii^^-ir\^ 

ef As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property infomration from Douglas County Assessor's Office 

\ ' ^ 1^ 

T5at& 

Superfund 
vv 

Property Access Checklist 

Property m : H C^L^T^ 

Property Address: ^ylC^ 3 O^C^ /^ ^ 

n

n

 WORK STARTED

 WORKCOMPELTED

 ON:

 ON:

 /

 /

 / 

/ 

Owner: [jg ^ r^-nnAnft) l 

Address: ^ . 

I.n0[ 5 35 AVE: 

Phone: ^(^ y (^(^O^ r)^_^ \ 

Fax: fl IAOA /yrk\ . v ^ \ o 

Cell/Pa^ i 

Oj'M • \'\\ D 

Renter: 

Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

i~l Notification Letter 

M Access Agreement 

/ 3 Restoration Agreement 

Q Topsoil Sampling (if applicable) 

r~| Disposal Sampling (if appUcable) 

Q Garden Sampling (if applicable) 

n utility Clearance 

Q^ideo/Photos (Before) 

• Video/Photos (During) 

n video/Photos (After) 

D Video/Photos (30-Day) 

roperty Completion Agreement 

Final Report 

Sent: / / 

Signed:^ /)^/CP i 

Signed: g_/_!3C3 

/ / 

/ / 

/ / 

CaUed: / / 

On:_f./2^/_05 

On: / / 

On: / / 

On: / / 

Signed: 4^^ ^ 

Issued: / / 

By: 

^r-BC 

"y'F^r 

By: 

By: 

By: 

By: 

By: /^/V^/A^/i'. 

By: 

By: 

By: 

By: 

By: 

Air Monitoring (as appUcable) 

D Conimunity QCrew 

Results: 

On: / / By: 1 

n Community

Results: 

 QCrew On: / / By: 

D Community

Results: 

Q Crew On: / / By: 

Omaha Lead Site 
• • 

Douglas Coimty Accoimt I; n||k^|ipr Page 1 of3 

Douglas County, Nebraska Property Record - R2541590000 

Print Report 

NEW Feature - Parcel Dimensions avaiiabie l® scale 0-50 ft west of 52nd Sf - Vie w OH Ma p Information is valid as of 2009-9-15 Treasurer's Tax Report 

New Feature ^ "* ^ Auto Sales Search 

Owner 

ODONNELL LEE A 

2129 S 35 AVE 

OMAHA NE 68105-0000 

Property Informatio n 

Key Numtier: 4159 0000 25 

Account Type: Residential 

Parcel Number: 2541590000 

Parcel Address: 2129S35AV 

OMAHA NE 68105-0000 

Legal Description: WINDSOR PLACE LOT 104 BLOCK 0 50 X 133 

Vaiue Informatio n 

Land Improvement Total 

2009 $6,500.00 $70,600.00 $77,100.00 

2008 $6,500.00 $70,600.00 $77,100.00 

2007 $6,500.00 $70,600.00 $77,100.00 

2006 $6,500.00 $70,600.00 $77,100.00 

2005 $6,500.00 $70,600.00 $77,100.00 

2004 $6,500.00 $70,600.00 $77,100.00 

Sales Informatio n 

Sales Date: 2003-07-23 

Deed Type: WD Booilr: 2003 Page: 161230 

Price: $116,000.00 

Grantor: Vincent Heath Etal 

Grantee: Lee O'Donnell 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 2000-10-20 

Deed Type: D SooHr; 2166 Page: 366 

Price: $109,000.00 

Grantor: 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R25... 9/17/2009 
• • 

Douglas County Account I iii^^tto n Page 2 of3 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.15 6650.0 1.0 133.0 50.0 No 

Improvemen t Informatio n 

Building 1 

1 1/2 STORY RNISHED 

15 IT 

f Firat Floei t « 

,„ . second Floor 

84B.0 »q. ft. 6530sq,1l ^° | 

13 ir ;^0 imaa^n 

Banm BkKk SII DaiKfad amja B*B a »a. ft. ST: siF ,.',BH»J.I,M.WIMt.«BHIimCT<tMIEeBra 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: ; 1500.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: End Condition: Good 

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

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Frame Vinyl Units: 3.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1895 0% 1895 114 

Deta/7 Type Detail Description Units 

1.0 

Appliance Allowance 

Add On Fence Chain Link 

1.0 

Basement Bsmnt Block 8 ft 

848.0 

Fixture Additional Fixtures 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R25... 9/17/2009 
• • 

.Douglas County Account InSmjMt^ i t Page 3 of3 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 672.0 

Porch Slab Roof Ceil 140.0 

Porch Wood Deck 320.0 

User 3 UNIT CONVERSION 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R25... 9/17/2009 
• • • # 

CONTACT FORM 

Property ID# \^<^^g > 

Property 

Address: -L\zq ^ , 7\^p,Kj 

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): 
Page 1 of2 

"> 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2369192. 

Original Call Date: 9/21/09 Time: 5:33 pm Op: ELIZABETH18790 

Work to Begin Date: 9/23/09 Time: 6:00 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 212 9 Street: S 3BTH AVE 

Twp: 15N Rng: 13E Sect-Qtr: 28-SW,29-SE 

Twp: Rng: Sect-Qtr: 

Legal Given: C 

Type of Work: LEAD REMEDIATION 


Location of Work: INCLUDE ALL EASEMENTS 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 Comer Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number UtiUty Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVEL3 LEVEL3 COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 

Day: 4025047823 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/21 /2009 
Page 2 of2 

OPPDGPR6 OMAHA PUBLIC POWER DISTRICT NA

Day:

 Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

QLNNEIF QWEST LOCAL NETWORK NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www;dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/21/2009 
OLS#:17943 As-Built Drawing Date Excavated:9/26/09 

Date USEPA Signed Off: 10/5/09 

COASTA L Omaha Lead Superfund Site Area Sodden: 90 so ft CNVmONHENTAL C II O U P . IN C 

Name: Omaha Lead Site Date: North Arro w 

Address: j^\X.<i S.^( ^ Site Sketch Time: 

Phone: 

Team \iA\^c\(V^\V.^^ <^.t> BVID# ]1^^3 > XRF Code 3SDZSample Number Lead Concentration Confirmation Sample 

ppm No sa ^ / ¥ Z *• Z ^ 

ppm No CS ^ 

^»Yes • No [3 ^ <e-ybScPyA-- |-7^^ 3 ppm 

ppm $V&% CD No E3^ 

3 V ^ ^ .SZ. ppm No ca ^ 

ppm Yes CD No CD 

ppm Yes • No • 

^ . 36 ef^ 

Legen d 

Concret e Dri p Zone Excavate d Quadrants Excavate d 

Are a replace d wit h Are a replace d wit h 

Are a lef t bar e Sod Rock/Mulch 

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

u

• • 

 Ih 

1—-. ^ 

— / Name: Omaha Lead Site Date: Nnrth AlTOW 

Address: ^\X ^ S. 5S(wt Site Sketch Time: 

Phone: 

Team \\A\^tV^\-^^?.t> BVID# ]1'^^3 XRF Code SSDZSample Number Lead Concentration Confirmation Sample 

n^Lf3 

ppm (^e s n No S3 ^ 

ppm ftYes n No ts- ' 3 ^ / fc 3(^ 

ppm 4lYes n No S ^ / I O * I'Z ­ ppm ^Ves 1^ No Q ^ 3V^ ^ 3z: ppm /^yes CD No ca^ 

ppm Yes CD No CD 

ppm Yes IZI No H] 

/ . ^ ^ J^!^ 
u ^ df\ 2^Mt -.. / Name: Omaha Lead Site Date: Ncirth Arrow 

Address: ^\X ^ S\ 25/Wb Site Sketch Time; 1 i-.tf p.n.. 

Phone: ^er-— 

Team ^\•AV^(^V>^^| g.t> BVID# ]1^^ 3 XRF Code 5SD"Z ­

3 ^ (Pi^ 
Name: _ Omaha Lead Site Date: Nnrth Arrow 

Address: ;aL\3Lq s.isi ^ Site Sketch Time»: : nVQfp.*^. Phone: 

Team \\AV<>\ft^\U) (^>t^ BVID# ll ^ '^3 XRF Code 6>SD'Z -

Sample Numtwr Lead Concentration Confimiation Sample 

ppm «Ves a No B ^ 

ppm No C&" 32 ppm •lYes a No B ^ 

ppm No O * ^ e s ° 3^^ * SZ. ppm j^yes a No ta^ 


ppm Yes a No CD 

ppm Yes • No O 


/. ?^ #* 
»*^'^"v. 

COASTA l IHyiROHn f RTA l 

C I O t l P . IH C 

Consent fcf Access To Pfopsfty 

RIGHT OF ENTRY TO PREI^ISES 

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: . <IQI . .. 

Owner's Name: Daytime Phone: 

r^t^OA/NCil i^ ^ ^ b z ^^S-OZ'^l 

Addresa of Property 

covered by this 

Agreement: 

-^2.12-9 ^ '^'DMJl ^ 

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 perfonned, 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 confinn 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 
s^-'^"''*^ 

COASTA l tNVmONHIKTA l 

'•"I POO^*' ' C I O U '

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

piles, dog houses, etc; 

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

to save; 

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

necessary subsequent to an initial watering period by EPA; 

c Abide by health and safety guidance provided by EPA; 

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

the property to perform the work. 

6 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 

I grant access to my properties D I do not grant access to my properties 

Signature Date 

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

t •« C 

Page 2 of2 
# 

,.y 1 

iC J -

COASTA L 

Restoration Agireement 

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 of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property IP: \'^qT^g-^ 

Property Address: T^^-^A S 1\ ^ l^^/£J 

Owner; 5^y^f^g\ | ^p ^ 

Phone; 4^g>^to^ m 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access location(s) to be used by the contractors. Indicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

items to be Removed by the Owner before Start of Remediation: 

The I enoval, storage, disposal, and/or return of these itoms is the Owner's responeibility. 

Page 1of 7 
c :'i COASTA L 

Items to Be Removed By Contractor During Remediation and Repiaced 

Item: 

Item: 

Sgfe/ iF V 

Item: 

Item: 

Item Quantity 

Pre-existing property area, is that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter \ 

Number of trees <= 2 inch 

tnmk diameter \ 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. ^ 

Aiiaih ;i skeicli- oi iln? 

.".pripkloi ti;\'.uii. V 

Number of and size of 

each garden/ flower bed 

area. 

Alliith ;i skoich ol ri.-!;itivf \ 

<izi-s nnd loc;iiiivK 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

\CU- Illi" \HIII C VMII fil 

{iScC 10 li; u<' .1 ;IIHII; \ 

»(iiK-iii;r Id llif i:rii|)cri> 

iiw ner: 

Easement Area, to be 

excavated \ 

Landscape Inventory 

Unit Condition/Type/Species 

Quadrants 

Each 

Fflch 

Fach 

Fjirh 

Square Feet 

S 

Each "^bvcVorKx ^i^^^^f^^ 

Page 2 .,'V 
COASTA L 

! Additional Comments / Instnictions: 

y\pheck the box rf Owner does not want CEG to document interior foundation walls and possible 

pr&^xisting damage. By checking this t>ox CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

O I do not agree 

ti^ ^ i^ H 
BVID#_lJiM3 

XRF PROPERTY SAMPLE SHEET 

Date 

Project 

XRFID# 

Shot# 

US fu^ rni. Average

Shot # 

Average 

Shot# 

Average 

Shot# 

Average 

lab sample # 

tl^Jrlm 

Omaha feed I^P 2nd year opilon 

h^^^ ^ 

Reading 

/^rj ^ /t^ 

 /^Ij -J^l

Reading 

Reading 

Reading 

Lab result 

Sample area 

^)epth 

 5^ 

Sample area 

Depth 

Sample area 

Depth 

Address 

Sample time 

sample length 

Shot# 

V3>T 

7 3 ^ 

Average

Shot# 

Average 

Shot# 

Average 

RETEST AREAS 

Samplearea Shot# 

Depth 

Average 

Sample area XRF Avg. 

n^X-x ^ <; ^<>~ A0I 5 

am/pm 

30 sec 

Reading Sample area 

/ / ^ -^ /.^ 

/g^-^fc 13 £L 

Depth '?2^l /V 

\ "Z-l — / 7 

Reading Samplearea 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Signature F^itui ^SA. 

Print P^U^he^ Or/r^_s 
iysAJ\ Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^^ ^ I

ST^^T ^

 Coastal Environmental Group Inc.

 www.coa8talhazmat.com 

V ^ 

^•'tpfia^^ COASTAL 

mVltOIIHIIITAl CIOUP , IN C 

EXECUTIVE SUMMARY: 

BVID #17943-(2129 S 35 AVE) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 
4

m 

EPA Property Close Out Form 

Property #:_QaH2i- _ 

DatcHlroc: Owner's Name:..j)^^^. < ^ WHTI^ ^ ^ -• ^\ ^ \ 

Quads Excavated: ^ \ Contractor Croupf ^T^r^A^ yjCWiX^tjtMrCC^^ • 

Yes No Excavation General 

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

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

Gradin Yes No g Sod and Vegetation 

I. 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? tr 

3. Does die 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 twtween the sod strips generally tight? (Only evaluate if inspected at a 30 day i:;^ 

time period) 

6, Was the property graded such that water will not pool on the property? T 7 ^ 

7. Was damage to landscaping or plant malerials avoided? 

Gates, Fences and Rciatoing Walb 

Ves No 

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

Were all gales or fences taken down during restoration activities reinstalled? (Ifapplicable) y 

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

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

Foundation, Siding and Gmiers 

Yes ..No 

1. Was damage lo the siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? -^r 

 Was damage to windows or door screens avoided? 

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

Sidewalks and Drh-eways (Concrete) 

1.

 Was damage to driveway surfaces avoided? ^ 

2. Was damage to walkway surfaces avoided? U-" 
Ch^'Ders comments: - # 

Inspection notes: 

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

EPA Representative L JcSK. jj> aJi\jL^ Date: jt)j5^ 0^ 
^ 

Property Completion Agreement 

I his agreement documenls the completion of remedial activities perroimed on my properly My signalure 

will designate thai I am satisfied with the restoration of my properly, and thai no items are in queslions. 

now, or al any tune in the future, except Ihose ilems listed below, ifany 

Property ID: \" ^ C| L^ ^ 

Property Address: ^^^-^^^ 5 3 5

Owner: ^ p Q'Aor\r\P. \ \ 

Phone: ^O^MOi?, . Om l

Restoration Items in Question: 

Item: 

Ilem: 

Item: 

Item: 

Item: 

Item: 

Additional Comments 

 A/^ . 

 PA^' . MQ2 . QQl . l^l D 

^5 LOM^ rvi? i§ ^c^D TH>^'^ -^^' ^ w//7/c ^ 

^ p^TsI «t!rcc r cstoraiion i% complded, cxccpl as noted 

[_J I do nnf aurtc rcsforfltion in eompleled 

^ 

Owner'.* Signariirr Date Conti artoi's Signature On(c 

h\o^f\