PROPERTY SUMMARY

 

| Date; 09/25/2007 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: September 

| Property Address: 1622 N 29 St 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: None 

A.2 Issues Resolved: Re-Seed will occur in October/November on any dead spots to encourage spring growth 

A.3 Unique Findings: 

A.4 Other Relevant Information 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl - 181 @ 10" 

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) BV1D 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) Excavation digital video in MPEG, WMV (Windows Media Video) or SWF (Flash Player) format and/or 

photographs 

iii) Signed form verifying satisfactory restoration 

iv) Description of areas not meeting Interim ROD cleanup criteria. 

40285039 

lllilll 

Superfund 

HNOLOCIES, INC. 
• u^Kxi]• 

Omah Exterior Paint North Arrow Owne a Lead Site r Name: JOHN T MCPHATTER JR [] Good Site Sketch Address: 1622 N 29 ST Q Poor

 

Phone:

 H: LSI-S&3I W:

 Q Not paint 

Sampl Lead Samples Collected e Number Sample AR 

Concentration Collected LAB 

Firm: FDA QfTlPM 

RYASCPXA-26247 F1 •^.jfii— P pm eg/ n Date: O M 1 1 \ fo (a

 

RYBSCPXA-26247 F2 2. /ft Dom [g^ r-)

 Time: /u -!^?<O

 

RYCSCPXA-26247 B1 filO D pm G^ n

 S< amples Analyzed

 RYDSCPXA-26247 B2 293 Dpm Q}'' D 

Dpm D D XRI - Unit:

 

RC2SCPXA 36S<7 GZ Dpm a a • Date* C-i . it-l

 

BP7SCPY.A 26217 PZ Dpm n n Ti me' P M

 

Staff: MSW Number of Samples = \A\ SZ_< 

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, 82 = Back Right DZ = Drip Zone, GZ= Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

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26247 

Exterior Paint North Arrow Owner Name: JOHN T MCPHATTER JR Omah< a Lead Site

Q Good

Address: 1 622 N 29ST Site Sketch

Phone: *•LSI -&&•*! W: Q Not paint 

Lead Sample . .„ Samples Collected Sample Number Concentration Collected Firm: FQ4 CiT/fAl 

RYASCPXA-26247 F1 3(o I Dom UK' r~) Date: /I M | 1J h (n 

RYBSCPXA-26247 F2 _2. / o ppi"11 m' D Time: /U '^c) 

RYCSCPXA-26247 B1 810 com n Samples Analyzed RYDSCPXA-26247 B2 293 pom D 

rcDzoorxA-gogi? — BZ Dom D n XRF: | Init in iM Rnnlf 1 f^.r\ 

RCZSCPXiA 36217 GZ DDm D n - D,3te' i—i • 1*~] • Oto 

RPZSCPY/i PC?17 n'

7

 DDm n

 Tilne Ph\ 

Staff: MS\A/ Number of Samples = : *d 

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = BacK Right DZ = Drip Zone, GZ = Garden, PZ = Play 

AH quadrants are as viewed from the street, facing property 

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Site Remedial environrr'entsi sampling .

 A^*;—— ACliuti 

Prudent Technologies, Int. (Prudent) is under contract with tlit IT. S. Environmental PI-J^I-UUII A 

(EPA) to clean up lead-contaminated soils at a number cf properties located in Ojna.u««, N?V-:"^" 

includuig tlie propefty located at \ (^ Q.*2- K\ 

permission to allow Prudent to perform a soil cleanup at this property to remove leaH-r*)«f-wi««a*-o.-j -.-.-,<; 

By signing this form, the property owner giants peruiiSiiOii to Prudent tu peifoiiii dCuvn.*^ iddL^u ^ lu. 

cleanup including soil sampling, removal of lead-contaminated soil, and restoratipr! n^thp r« f»Ter<r-;"i 

property. After obtaining the owner's signature on uiis form, Piuilent Tet'miolugjti, IUL. \>ill -*iu.a:i ^ 

property owner (and residents) within the next few weeks to coordinate performance the work 

If you have any questions about the soil cleanup planned for your property, please lUmau Tioue^L^ 

Administrative Clerk for me Omaha Lead Site cleanup, Ms. Cyndie Hinds at (40!l) ^04-100^. Ge*1'?'?'1 

Questions about the Ouialia Lead Site cleanup can be directed to the EPA Public Informal)on CenL&is ci. 

(402) 731-3045 (south Omaha office) or (402) 991-95pjriorth Omaha office). 

PropeiLy Access Giacted 

Pi'Opeilj C-ni.it:i 

PROPERTY .'NF 

(T o Lt completed ty ifesida'A aivi'oi piopert; CWIIKC - plass piiivO 

RESiDENTF^AME: I <^ ^ _____ " 

RES'DEMT ADDRESS: \ fo o 7 ^ A ___ SJr fi.<

&\\ Q 

IF RENTAL, PROPERTY OWNED SY: 

OWNER'S MAILING ADDRESS; _.. 

OWNER'S TELEPHONE NUMBER -HO?J!E: _Lf|OZ=1_.^)5J.j: __ <S_&7i.) '.""?.:': _(___, 

AGE OF HOME?: __ YEARS. HOW L?r."T ITV Y~" '. "'T VTM-? ___ YSARS. 

HAS THE EXTERJOR BEEN PAINTED OR CCVERSC Wir: m.'J? "''."":' "•:<"•• Y"7" 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: ? n

NUMBER OF CHILDREN UNDER 7 YEARS OiPV'H^ r" ;"v w THE Y^»I5 POR5HOURSOR MORE PERWEEK: 

COMHENTS OR SPECW.L INSTRUCTIONS: (I.E. BOGS. ENTRY GATES, ETC } 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: The 3-;''it:?itcK? •>/.-!=rr; or-* =^ V' FP*. --.r.^'1"'­

agreernera arepiursiiBT«.toSea.ini K:4 oi C . : -; , - r - - - ,,,.-,--T -..-.,-. ,.- ­

:';sporiE5, or i'iCosir^Gk'tskirigar.yrKpcnsr ac*.:?: urdsr*?'^ '

;

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utie ' 
SEPA 

EPA Property Close Out 

Property #: 

Date/Time: 

Quads Excavated: g£ 

Property Address: l£22 ^/art/-

Owner's Name: Jch* 

Contractor Group Prudent Technologies 

Eicavation General Yes No 

\ . If necessary, were the correct quadrants) excavated and restored? ,/ 

2. If necessary, were the correct areas of drip zone excavated and restored? i/ 

Grading Sod and Vegetation Yes No 

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

from the house? S 

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) i/ 

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

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

time period) i/ 

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

7. Was damage to landscaping or plant materials avoided? 

^ 

Gates, Fences and Retaining Walls Yes No 

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

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

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

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

Foundation, Siding and Gutters Yes No 

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

2. Was damage to the foundation avoided? </ 

3. Was damage to windows avoided? ,/ 

4. Was damage to windows or door screens avoided? 

^ 

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

Sidewalks and Driveways (Concrete) Yes No 

1 . Was damage to driveway surfaces avoided? s 

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

Inspection notes: 

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

EPA Representative /5L. Jl Date: t hi lot 
26247 

Exterior Paint North Arrow Owner Name: JOHN T MCPHATTER JR Omaha Lead Site [] Good Site Sketch Address: 1622 N 29 ST 

Phone: H \.c.si -S&3/ w: r~] Not paint 

Sample Number

 Lead

 Sample ^_ Samples Collected 

Concentration Collected rm: f QA piT/fM 

RYASCPXA-26247 F1 3(ol com fft/ (~l D; lte /lUl l 1 h(r> 

RYBSCPXA-26247 F2 2 /ft PPTM EK D Time: /^.'^?<O 

RYCSCPXA-26247 B1 /ft| fr\U~ ppm fiX f~l 

Samples Analyzed RYDSCPXA-26247 B2 2^3 ppm fCK l~l 

ppm D D XRF :

 Unit: ID^H Book: 1 -SO 

Date: ^ • IH • O<^ 

RPZSCPXA 3624-7 P2 ppm Q Q ne P N1 

SI aff: MSW Number of Samples = '• A ; ' \ 

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

M M \ M \ ($**\ \ ENTESED^ 

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oEPA

 

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, if any. 

Property ID: ^ £ £ (^ ~] 

Property Address: R A^ N ^^ St 

Owner: '7 „,/ , T /W /~>/ <J»- / - /)/)-, J O^IA / • ii£l^folAgJlr>tQfi_ ~

 

Phone: (_' n ) ^ / C / — C"/7 ^ f 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

I agree restoration is completed, except as noted above. 

I do not agree restoration is completed 

^Owner's Signature Date 
Print Preview Page 1 of 1 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

2212840000 

MCPHATTER JR 

JOHNT 

1622N29ST 

OMAHA 

68111 

11710 GOLDEN 

BLVD 

OMAHA 

NE 

68123 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Assessor 

Website Link 

16-15-13 

SHINNS2NDADD 

U 

2 

S 38 E 90 FT LT 1 & 

N 8 E 90 FT - 46 X 90 

http://douglasne. mappingonline. com/DouglasCoNe/static/accountinfo.jsp? 

accountno=R221 2840000 

Disclaimer: Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 18 feet appraisal, survey, or for zoning verification. 

ittp://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 8/1/2007 
Page 1 of 2 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 1860255. 

Original Call Date: 8/07/07 Time: 5:18 pm Op: CYNDIE18967 

Work to Begin Date: 8/09/07 Time: 5:45 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 1622 Street: N 29TH ST 

Twp: 15N Rng: 13E Sect-Qtr: 16-NE 

Twp: Rng: Sect-Qtr: 

Legal Given: C
 

Type of Work: Excavation Soil - Lead Remediation
 

Location of Work: LOCATE ENTIRE PROPERTY
 

Remarks: FAX ALL CLEARS TO: (402)504-1005
 

Company : PRUDENT TECHNOLOGIES
 

Contact Name: CYNDIE Phone: (402)504-1004
 

Work Being Done For: EPA
 

Depth of Excavation: 13" Corner Lot: N Front: N Rear: N
 

Involves Tunneling or Horizontal Boring : N Explosives: N
 

CXCATV LEVEL3 MUD01 OMAHACOF OPPDGPR5 QLNNE1C
 

Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVELS LEVEL3 COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT EDWINA Alt: 

Emerg: 4025047946 

Day: 4024447197
 

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

Emerg: 4024445160 

Day: 4067289343
 

http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/7/2007 
Page 2 of 2 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Alt: 

Emerg: 8887289343 

QLNNE1C QWEST LOCAL NETWORK NA

Day:

 Alt: 

 4067289343 

Emerg: 8887289343 

http ://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESU LTS... 8/7/2007 
Find Record dean Up Query Lead Remaining Query I Property Damage Query 

Owner Occupied 

Owner Name: 

IMCPHATTERJRJOHNT 

Owner Addressl: 

Owner AddressZ: 

111710 GOLDEN BLVD 

City: State: Zip Code 

I OMAHA NE j68123 

Owner Phone: Alternate Phone: 

(402) 651-5621 

Resident Name: 

(VACANT LOT 

Property Address 

(1622N29ST 

Zip Code: 

(68111 

Resident Phone 

(PRUDENT2007 

Group: 

Qualifying Group 

|800 

Assessment XRF Date: 

Assessment Max XRF Value