TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAn)#: nSi" ) Date: 

Address: ,^ IU S 3 Sh 

Remediation Contractor: 'f^^^t ^ "JetXiJlr,.:.^ , ^Y\C,^ Year: , SD'^^a. 

SOI L REMEDIATIO N 

PROPERT Y FIL E FOLDE R DOCUMENT S 

IET Video of property (DVD) 

a Executive Sxunmary 

0 EPA-provided property sketch 

0 Signed Access Agreement for subject property 

D Sigjoed Access Agreement(s) for adjacent property 

0 Restoration Agreement 

0 Settlement documents (i.e., for damage or to replace plants, etc.) 

0 Confinnation data 

0 Photographs 

As-built sketch 

0 Satisfectory restoration signed by Property Owne r 

0 Property close-out check list signed by EP A 

• Description of areas not meeting RO D cleanup criteria 

^ Utility clearances 

[Z Property information from Douglas County Assessor's Office 

D . 

D 

D 

Signature/ ^ Date 

40310706 ill! 

Superfund 
PROPERTY SUMMARY 

Pate; 01/23/2U09 Omaha Lead Site Remedial Action Contract ff £P-R7-07-U6/U0U4 Montii of: Oec/Jan 

Property Address; 2138 S 33 ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Oflier Relevant Infonnation: AREA NOT EXCAVATED Bl LANDSCAPE, TREE 3'X26' @ 242 PPM 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 547 PPM @ 12"; B2 = 274 PPM @ 6**; PZ ^177 PPM @ 12"; Fl = 406 PPM @ 10"; DZ = 496 

PPM @ 12"; F2 = 251 PPM @ 6"; EA = 363 PPM @ SCRAPE 

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 chp/photographs 

4) Post-Excavation digital video clip/photographs 

5) Documentation - Completed Close-out Checklist 

6) As-Built sketch -

i) Shall include fmal lead levels v) Legend 

ii) Contamioation left behind areas vi) Contractor identification 

ui) 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 m MPEG, WMV (Windows Media Video) or SWF (Flash Player) format and/or 

photogr^hs 

iv) Signed form verifying satisfactoiy restoration 

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

TECHNOLOCIES, INC. 
Find Record 

Backfill: 

Sample Area: 17869 - 2138 S 33 ST 

Owner: 

Clean Up Query 

n Owner Occupied 

Owner Name: 

ICOLLETT PAMELA M 

Owner Addressl: 

I 

Owner AddressZ: 

|2138 S 33 ST 

City: 

OMAHA 

Owner Phone: 

State: Zip Code: 

[ N E [68105 

Alternate Phone: 

(402) 342-3863 

Lead Remaining Query I Property Damage Query 

Resident: 

Resident Name: 

jCGLLETT PAMELA M 

Property Address: 

)2138 S 33 ST 

Zip Code: 

[68105 

Resident Phone 

I 

Contract: 

Contractor: 

|PRUDENT2008_S 

Group: 

Assessment: 

Qualifying Group 

jPLAY ZONE 

Assessment XRF Date: 

I 

Assessment Max XRF Value: 

I 788.65 
TECHNOLOGIES, INC 

Property*: /"?$^ ^ 

Date/Time: 

Quads Excavated: %\, (^y, Pz, P', fl^ O'L. 

^ P A 

EPA Property Close Out 

Property Address: 2.)2? S "i?, S^ 

Owner's Name: 

Contractor Group Prudent Technologies 

Excavation General 

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

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

Grading 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? 

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? 

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

time period) 

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

7. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls 

1. Do gates open and close 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? (IfappUcable) 

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

Foundation, Siding and Gutters 

1. Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? 

S. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes 

y 

y 

No 

Yes No 

y 

y 

y 

y 

y 

y 

y 

Yes No 

y 

y 

y 

y 

Yes No 

y 

y 

y 

y 

y 

Yes No 

y 

y 
Owners comments: 

Inspection notes: 

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

EPA Representative 0o^: ^ ^ Date: /-2f-<>f 
TECHNOLOGIES 

PROPERTY CONTACT ATTEMPTS 

ENVIRONMENTAL & 

CONSTRUCTION 

SERVICES 

PropertgJTO: n9<f.<=\ 

Property Address: r?! ? g *^ 9.:^. j^ f 

Owner NameOwner Phone: 

-PrQfv^g/ ^—r.cfLf^rr 

Below please find a listing of unsuccessful attempts to reach the above 

property owner. 

Date 

j4QaJn^ 

Time 

^r^ n 

Initials 

_g_2L 

Result 

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Signature Date 

Prudent Technologies, Inc., 

y 

Acknowledgment signature Date 

EPA 

8080 Ward Parkway. Suite 405 

Kansas City, MO U114 

Phon*: (816) 36^703 

6007600d 11323 :E0 8003 OE 33Q 

2S0C N. 24"* Sfreet, Suite 308 

Omaha, Nebraska 68110 

Phone: (402)504-1004 

Fax: f4021 $04-1005 

4242 Medical OnVe, Suita 7250 

San Antonio, TX 78229 

Phone: (210)822-9688 

Fax: (210) 579-6577 
Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up leadcontaminated soils at a number ofproperties located in Omaha, Nebraska, including the propeity located at 

. The EPA requests your permission to allow Prudent to perform a soil cleanup at this 

property to temove 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 oflead-contaminated soil, and restoration ofthe referenced property. 

If you have any questions about the soil cleanup planned for your property, please contact Prudent's Administrative Clerk for the 

Omaha Lead Site cleanup. Ms. Madhurima Duni-at (402) 733-1188:733-1455. 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 oflice). 

Ptoperty Access Granted By: ^^/irYYtS\A [_jb i ["^J^T 

(Please Print Name) 

Property Owner Signatui 

(Signature)T (Date) 

PROPERTY INFORMATION 

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

RESIDENT NAME: filw^ei. Co((.frf Renter 

RESIDENT ADDRESS: 

<3}r (y^K^.^JUj>^ CgA^^jT 

l£RENTAL, PROPERTY OWNEp BY: 

OWNER'S MAIUNG ADDRESS; ^ , , /-

OWNER'S TELEPHONE NUMBER - HOME: (^>2.) WORK: 

AGE OF HOME?: 1 £ ^ YEARS. HOW LONG HAVE YOU LIVED HERE? I / YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? r-YE8— NO' <^Al 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: C / NUMBER OF OCCUPANTS 7 YEARS OLD AND OLOER 

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.) 

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

are pursuant to 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." 

8080 Ward ParKway, Suite 405 

Kansas City, MO 64114 

Phone: (816) 363-3703 

Fax: (816) 363-3707 

2505 N. 24'" Street, Suite 308 

Omaha, Nebraska 68110 

Phone: (402)504-1004 

Fax: (402)504-1005 

4242 Medical Drive, Suite 4250 

San Antonio, TX 78229 

Phone: (210)822-9588 

Fax: (210) 579-6577 
OLS#: 17869 

Date Excavated: 10/03/2008 

USEPA Signed-OfTDate: 

AS-BUILT DRAWING ' ! ^ 

' OMAHA LEAP SUPERFUND SITE 

•-4^ ^ Name: _ , ..— - , 

/^ddressT"777jy -Jy JTJ^, _ 

Phone: V^'a~. J-y.Z- .y^g^ ^ 

Oinaha Lead SIta Date: py/A^ ^ 

Site Sketch Time: 

North AnDW 

Team ^sr/^jZ-Lf i y^^f^ d BVID # /y^i i 9 XRF Code 5'S"<:> "^ 

Sample Number 

gy fe^tP;^ A - y7<t? 

Lead Concentration 

^ • ^ " ppm 

"•^^» ' ppm 

ppm 

Confinnation Sample 

/2LYe5 t=3 

5^Yes a 

•^ Yes • 

No 0 ^ 

No 5 ^ 

No 0t ; 

No ^ ^ 

No 0S -

No ET 

No • 

AREA NOT EXCAVATED 

[Bl LANDSCAPE, TREE; 3'X36' @ 242 PPM] 

^ 

F1 = 406PPM@10' ' '!^r. 1 

ff-^ 

+-V 

7q-

:s^ 

r/j5N3t>A»f/^ 

5^^r/ 

J F 2 = 251 PPM ©6 " 

c5S^/-^ rr-iOmaha Lead Site 

EA » 363 PPM @ SCRAPE 

46130 

CONTRAa #: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC. 
46130 
ItUBENTL rECHNOLOGIES, INC. — 

Property Status Form 

Address: ^}><^ ^ 7;i,^4 gt 

Phone: 

Item# 

On Map 

Date: 

BVID: 

Plants & Permanent Landscapmg 

Description and Location 

9 kcuoK ^ ^(o-.v^^ €LcuJr^ , 

• r?^ 

* ^ rose _ I • ^ 

Pre-Existing Condition of Structures 

Does your Basement have a history of leaking? Yes — No •X 

Item# 

On Map 

Description & Location 

Property Owner 

Signati 

Prudent Employee 

Signature: 

8080 Ward Parkway, Suite 405 

Kansas City, MO 64114 

Phone: (816) 363-3703 

Fax: (816) 363-3707 

2505 N. 24*" Street, Suite 308 

Omaha, Nebraska 68110 

Phone: (402)504-1004 

Fax: (402)504-1005 

4242 Medical Drive, Suite 4250 

San Antonio, TX 78229 

Phone: (210)822-9588 

Fax: (210) 579-6577 
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PRUDENT TECHNOLOGIES, INC. 

- 8080 WARD PARKWAY. SUITE 405 

KANSAS CITY, MO eit114 

; (816)363-3703 I 

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TECHNOLOGIES, INC. 

ENVIRONMENTAL & 

CONSTRUCTION 

SERVICES 

REIMBERSEMENT FOR 2318 S. 33 ST. 

PLANT PRICES FROM INDIAN CREEK NURSERY 

2Clemantis 39.98 

40 Lily of the valley 40.00 

6 Climbing roses 149.94 

12 Iris 47.88 

54 Daffodils 47.94 

60 Tulips 29.94 

33 Rosebush 824.67 

4 Agastache 39.96 

2 Echinacea 19.98 

23Hasta 253.00 

5 Yucca 74.95 

18 Poppy 107.82 

2 Mums 19.98 

2 Phlox 21.98 

14 Daisy 139.86 

20 Tiger/Day Lilly 199.80 

11 Peony 219.89 

2 Lilac bush 29.98 

1 Linden tree 159.00 

2 Snowball bush 69.98 

6 Lilac bush (common white purple) 89.94 

Labor 300.00 

Water bill reimbursement 41.53 

Total 2,968.00 

Previous check - 2,368.00 

Remaining 600.00 

8080 Ward Parkway, Suite 405 

Kansas City, MO 64114 

Phone: (816) 363-3703 

Fax:(816)363-3707 

2505 N. 24*" Street, Suite 308 

Omaha, Nebraska 68110 

Phone: (402)504-1004 

Fax: (402)504-1005 

4242 Medical Drive, Suite 4250 

San Antonio, TX 78229 

Phone: (210)822-9588 

Fax: (210) 579-6577 
Page 1 of 1 

^/3 9 S 33 Jr. 

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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 

2540580000 

COLLETT 

PAMELA M 

2138 S 33 ST 

OMAHA 

68105 

2138 S 33 ST 

OMAHA 

NE 

68105 

Sec-TwnRng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

28-15-13 

WINDSOR PLACE 

0 

11 

50X140 

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp? 

parc=2540580000 

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

accountno=R2540580000 

Disclaimer: Map and parcel data are believed to be accurate, but accuracy is not 

guaranteed. This is not a legal document and should not be substituted for a title search, 

appraisal, survey, or for zoning verification. 

Map Scale 

1 inch = 62 feet 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 9/24/2008