TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAiD#: 19637 DATE: 1/15 

ADDRESS: 1459 S 11 ST 

REMEDIATION CONTRACTOR: PRUDENTTECHNOLOGIES. INC. YEAR: 20l() 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ PRE AND POST VIDEO OF PORPERTY (DVD) 

d EXECUTIVE SUMMARY 

m EPA-PROVIDED PROPERTY SKETCH 

d SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTV 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

Q RESTORATION AGREEMENT 

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

m CONFIRMATION DATA 

ID PHOTOGRAPHS 

ID AS-BUILT SKETCH 

D SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

CD PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

dl UTILITY CLEARANCES 

• PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

SIGNATURE DATE 

30218262 

Superfund 
PROPERTY SUMMARY 

Date: 715/2010 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Month of: 

Property Address: 1459 S 11 ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

y Fl = ^PP M @/" ; B2 = 76 PPM @ 4"; EA = 62 

^ ^ PPM @ SCRAPE (~1") 

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, if available, or obtained include: 

i) Pre-excavation agreement details (if any 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 of areas not meeting Interim ROD cleanup criteria. 

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

Backfill: 

Sample Area: 19637 -145 9 S 11 ST 

Owner: User Provided Owner Information Resident: 

D Owner Occupied 

Owner Name: Owner Name: Resident Name: 

ICASaOLARRYT 

Owner Addressl: Owner Address: Property Address: 

11459 Sl l ST 

Owner AddressZ: Zip Code: 

11620 SIO ST 168108-

City: State: Zip Code: City: State: Zip Code: Resident Phone 

lOMAHA INE [68108­ " I I 

Owner Phone Alternate Phone: Owner Phone: Alternate Phone: 

1(402) 345-8313 1(402) 345-8315 

Contract: Assessment: 

Contractor: PRUDENT2010 S Qualifying Group 400 

Contract Option OPTION 1 Assessment Max XRF Value 536.96 
TECH^30LCX;I1ES, INC. 

EPA Property C^ose Out 

Property #:' l'^(^5 7 Property Address; IH^" ^ 5 - 1^ "7"^-

Date/Time: Owner'sName: l~cccCo^ C a "v i" o 

Quads Excavated: p | ^ 2 _ Contractor Group: Pondi'ifit Teclliir»o(ogic.<i, Inc., 

Excavation General Yes No 

I li neccssarv. were the correci quadrant(s) excavated aiid restored? y 

2. If nccess<)r\-, were the correct areas ofdrip zone e.xcavated and restored? 

/ 

Grading Sod and Vegetation 

Yes No 

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

from the house? / 

2. Has sod been Uud m all areas tJiat were e.xcavated? 

/ 

.1. 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? / 

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

lune penod) / 

(>. Was the property graded such tliat water will not pool on llie property'!' / 

7. Was dani.ige lo landscaping or plant materials avoided? / 

Gates, Fences and Retaining WaiJis Yes No 

!. Do gales open and close freely? (Ifapplicable) / 

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

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

-1 Was damage to retaining walls avoided? (Ifapplicable) / 

Foundation, Sadini^ smdi Gutters Tes No 

1 Was damage lo the siding or trim avoided? y 

2 Was damage lo (he foundation avoided? 

y 

3 Was damage lo windows avoided? 

y 

4, Was damage lo windows or door screens avoided'' y ^' 

5 Was damage to downspouts or downspoul extensions avoided? y 

lidewalks and Di-iivcway<i (Concrete) Yes 

! Was dama-ie (o diivewa\ surfaces a\'0ided'" y 

Was damage to walkway surfaces avoided'' 

y 
Owners connments: 

Inspection notes: 

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

EPA Representative A^j ^ Date: ///2//^ 
(-•HNOLOC;IF:S. INC. 

AS - BUILT DRAWING 

OLS#l%37 

Date Excavated: 10/04/2010 OMAHA LEAD SUPERFUND SITE I'SEPA Signcd-OfTDate: 

19637 

Exterior Paint North Arrow Owne Omaha Lead Site r Name: LARRY T CASCIO 

Sit Q Good e Sketch Address: 1459 S 11 ST _ QRoo r Pfione: « w [ 3 Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected Firm: 

Samples Collected 

RY/\SCPXA-19637 

RYBSCPXA-19637 

RYCSCPXA-19637 

RYDSCPXA-196.37 

HZ . 

-2H1 

'^o<o 

ppm 

pprr 

ppm 

ppm 

D 

D 

D 

D 

Date; 

Time: 

XlS- JiS_ 0 5 

i3.-J^O 0^-^ _ ^ 

Samples Analyzed 

ppm D D XRF Unit: I0?>1 Book; /3 2 

ppm n D Date: _ 

HEZSCP, ppm D D Time. P f ^ 

Numtier of Samples = 14 Staff: LJ ^ 

Legend; Ft -- Front Left, F2 = Front Right, Bl = Back Left. B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ - Play 

Alt quadrants are as viewed from the street, facing property 

A Wi­

^^TMmij 

;SEP J 5 ; 

B2 = 76 PPM «' 4" 

i'A^:}. 5..\\. 

h^ 

t

J. 

F l fix 

F1=68PPM*8"' y 5 3 1 nz 

\«'AI!c. 

•~t> i l sr' 

E.\ = 62 PPM a Sf RAPE (1" ) 

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

Property Completion Agreement 

This agreenient 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; | L^ ^ q c^^ |( <;^.y^ 

Owner: LoLtr u CouU^O -

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

L—l I agree restoration is completed. 

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

fX 

. ^ 

Date 
Pmdent Technologies, Inc. (Prudent) is under contraci with the U. S. Enviromnental Protection Agency (EPA) to clean up leadcontaminated soils at a numher of properties located in Omaha, Nebraska, including the property located at 

ICj^r l ^ /y ^ j"^" ^ Tl^e 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 planned for your property, please contact Prudent soutli office for the Omaha Lead 

Site cleanup~at (402) 733-1188. General questions about tlie 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 CJranted By: 

(Please Print Name) 

Property Owner Signature 

(Date) 

PROPERTY INFORMATION 

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

RESIDENT NAME: yyf^T^y ^ ^^j T Cj ^ Owner 

RESIDENT ADDRESS: /^/^C ? -X'Vv^/ ^ /^ ^ 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; y<^<^3 y^^.^ v ^^^>^/^4 ^'^ 

OWNER'S TELEPHONE NUMBER -IWWET Vl6^-^/C^JCj/C ^ (^""IAIORK: 

J 1 

AGE OF HOME?: -.<ir ^ YEARS. HOW LONG HAVE YOU LIVED HERE? S,^ e^

n YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? YES <2^ _ 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: 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETC.) 

/;r/g-f-cr. T^TTT 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS^ The activities to be implemented by EPA under this agreemeni 

are pursuant lo Section 104 of CERCLA, 42 U.S.C. 9604. EPA's right 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." 

3080 Ward Parkway, Suite 40i3 5600 S ^:{> St 'slVL Medical ^ma , Suite 42S0 

Kansas City.'MO 641 Ii4 Crnaha, l\ietorasIis6S1ii? I5an Antortio, TX 78229 

Phone:(816)363-3703 Photie: ;402; 733..t1P;g Phofn>; (210)822.9688 

Fax: (816) 363-3707 f^si; i40'i!'•7,3.-i88:; FHX: (210) 679-6677 
ENVFROINMENTAL& 

CONSTRtCTION 

TECHNOLOGIES, INC. SERVICES 

, Property Status Form 

Address i^('^ ^ ^ I I n:^*>> T Date: 7ofi / ZO I O 

Phone 

• 3^^-S5/ ^ CCA^CIOS sTi^^ //g^^h 

(\fj^ U? ^ 

BVID: 

'/n^y)iy^ /fee^r An^/c P ^ ^ ^ ^ 

l^ycfKy/^^n f TZ^^ys'^y^ 

Property Owner Prudent Employee 

Signature: Signature: ./^^l'*^^ ^ 

8080 Ward Paj>^ay. 3Blte405 5600 S 10 st 4242 Medical Drive, Suite 4250 

KansasCity, MO 64114 Omaha, Nebraska 68107 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone; (402)733-1188 Phone: (210)822-9688 

/o^e * ifr i ^TAT Cmv. iAnn \ ft' y ^oo•^ C v i'^MW B70JSUT7 
145

9 S 11 ST 

A Printed

: Dec 10.2010 

www.dcgis.org/dogis 
^o"^ sr Oujm^^j0(l^ U ^ "^ /^^ % 1Q^^7 ­ • "•••" •""-"•v^y^B*""* - C^^^y. Omah Exlerior Paint i Noiij': /vrtow Owne a L^alS Sjte r Hum^^ LARRY T CASCiO i > Good j Address Site Sketch ,,„.,.. • ! ; 1459 S 11 ST 1

0 Phone: ^^Sy^^J/3 "^ ^Y5-^3/5 / I OJ Not paim 

Ssrnple Number Lead ;>arriDiss t-cfiecteo LAB 

Cot^csfitraticn Collected 1-::;--: N^-. ; i htrrn -4- u-R. RYASCPXA-1Q637 F1 D t 

I Date • 0 5 t *' ! • ''i .'• ' RYSSCPXA:-19637 F2 ppm • -: J t t RYCSCP.XA-19637 Bl ppm D ! i 

Sampies AnSiVzefi ii RYDSCPXA-'96.3? ppm • 

ppm n n XRP Unit: 103. 1 Book; /3 2 

Pprn Q n ••..'-- . .f .• /. . ..•• <r~­

.&£ZSCP>;.A.-j..!;^is:A.-.—gg- Time p'ni 

Staff .A Number of Sarnpies 

Legend: Fl •- Front Left. F2 = Front Right, B1 •- Back Left, B2 == Sack Rigtit UL = Orip Zone. GZ. = Garden, F2 

Aii quaesrariis are as viev«c* from m-s atfeet, facing .property 

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Page 1 of2 

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Create Another Ticket Back to Irth Internet ] Send Email 

YOUR TICKET NUMBER IS 2602930. 

Original Call Date: 9/28/10 Time: 11:23 am Op: SIVA18967 


Work to Begin Date: 9/30/10 Time: 12:00 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1459 Street: S IITH ST 


Twp: 15N Rng: 13E Sect-Qtr: 27-NE 


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-llE 


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 LEVEL3 MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVELS LEVELS COMMUNICATIONS, LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICH/TRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/28/2010 
Page 2 of2 

OPPDGPR6 OMAHA PUBLIC POWER DISTRICT ELM LOCATING 

Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIF QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/28/2010 
TCOHMi lOUkCHB, mc. CONSTTRUCTION 

SOLUTIONS 

SITE SAFfeTY HAZARD ANALYSIS 

Address: --4^-^l-Jn±Z^ Excavation Date: 

Crew: Bacldili 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 

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6**^ 

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Site Safety Office 

Date: 

SfiMSIoa t 4242 Medical Diiva, Sutta 72S0 

:«iaa*C<Ny;llO«4114 OmAiia, NaboAka «8107 San Antonio, TX 78229 

fioaa: (SM) 382<37D3 Phone: (402) 733-1 ISS Phone: (2tO) 8224688 

ai(:(»1S)J63^37U7 Fax: (f402) TSS^ISSS Fax: (210) «r».6577