TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: '^ie'h^ ^ Date: 

Address: Mo!^^ ^^ZX^jJ'^ 5 T 

Remediation Contractor: Envrionmental Restoration, LLC_ Year: 2010_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

r Video ofproperty (DVD) _bBefore DAfter D BasementV;, ^U) JkfSetflAyr 

N^ Executive Summary (Final Report) 

^l ^ EPA-provided property sketch 

^ ^ Signed Access Agreement for subject property 

n Signed Access Agreement(s) for adjacent property 

LK Restoration Agreement 

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

**S^ Confirmation data 

K Photographs _^Before DCrew Photos Di During Excavation D Sod 

BTSO-day Sod D 

^Ss,^ As-built sketch 

Of Completion Agreement signed by Property Owner, 

Bs. Property close-out check list signed by EPA 

D Description ofareas not meeting ROD cleanup criteria 

H, Utility clearances 

M. Property information from Douglas County Assessor's Office 

B. Property access checklist 

30260324 

\ Contact Log 

(3 Superfund 

Environmental Restoration Sisnature . Date 

^i( ^ 
^ ' Onfiaha Lead Site—EP-R7-09-05 

Environmental Restoration, LLC 

^ ..o* www.crllc.com 

EXECUTIVE SUMMARY: 

26399 - 4039 DECATUR ST 

No Issues or Concerns Q Issucs/Conccrns 

Detail Explanation: 
EPA 

EPA Property Close Out Form 

Omaha Lead Site 

Property #: 3lU^^ ^ Property Address: M D y ] ^UJ&v r •$? 

Date/Time: Owner's Name: 'V>AfiL \^"<^V\Y\ 

Quads Excavated: fe \ Contractor Group : Environmental Restoration (ER) 

Excavation General Yes No 

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

2. Ifnecessary, were the correct areas ofdrip zone excavated and restored? . A 

Grading Sod and Vegetation Yes No 

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

y ^ house? 

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

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

period). 

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

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at 30-day time period). 

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

7. Was damage to landscaping or plant materials avoided? y 

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 re-instailed? (if applicable) A 

Was damage to gates or fences avoided? (if applicable) 

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

Foundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? A2. Was damage to the foundation avoided? A 

3. Was damage to windows avoided? cV 

4. Was damage to window screens or door screens avoided? A 

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

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? A 

2. Was damage to walkway surfaces avoided? f^lk 

Inspection notes: ^ 

Remedial and restoration activities complete including 30-day sod warranty: 

EPA Remesentative:y^eJz?^^<^jZ^^^^k^'J!u:!^ Date: 
Paae 1 of 1 

"> 

I Create Another Ticket ] ( Back to Irth Intemet | Send Email 

YOUR TICKET NUMBER IS 2537858. 

Original Call Date: 7/07/10 

Work to Begin Date: 7/09/10 

Time:

Time:

 2:2 6 pm 

 3:00 pm 

Op: TRACY24136 

State: NE 

Address: 4039 

County: DOUGLAS 

Street: DECATUR ST 

Place: OMAHA 

Twp: 15N Rng: 13E 

Twp: Rng: 

Legal Given: C 

Sect-Qtr: 17-NE 

Sect-Qtr: 

Type of Work: Excavating the «"-

Location of Work: LOCATE ENTIF, 

Remarks: FAX ALL CLEARS TO: [4C IM : SAID #26399 
 r ^A\ ^ 

Company : ENVIRONMENTAL REST 

Contac t Name: TRACY BRISTOW 

Alt . Contact : 

Work Being Done For: EPA 


Depth of Excavation: 12 Corr. 
 a,j '^A^[ Involves Tunneling or Horizontal Bo. 


CXCATV MUDOl OMAHACOF DPI 


V <^^A7 %* 

Ser\'ice Area ouinber Utility Tjpe 

Day: 4029340469 

CXCATV coy. COMMUNlCAnONS. JNC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day; 4025047823 


MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 


Emerg; 4025047970 


Day: 4024447197 


OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICH/TRAFFIC Alt: 4024445161 


Emerg: 4024445160 


Day: 4067289343 


OPPDGPR5 OUAYIA PUBUC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg; 8887289343 

Day: 4067289343 


QLNNE 1C QV^TiST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemelOHONNoticeCreation/MessaKeText.asD?ret=<TiF<iTTi TQ nmi'-<r\-i r\ 
WS3MM M 

Contact Snformation Log 

SA!D# ;iL399 

rr^< 

{7.^d r PaytSmePhone: ^0Z-^3Z-~7O0 ^ \ 

Property Address: QO ^ ^ 

1 

Attempt to contact Date/time Name 

3-B-^V /7/:i 'OO 

/.7 33 D \A>-teJ-<> 

J-'^-'/^/^-Vs £j 

Hc>y70fl7Ai^' 

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Property Access Checklist 

SAID : -zL'^i n WORK STARTRO 

\ Prnnerty Address: Uf^ U WORKCOMPELTED ON -.CAIMA 

Owner: {J^^^ 7\- HcthfO Renter: }C^ ^ kg ^ ( j loileA~ 

Address: Phone: q05'V^h ^ 

Fax: 

Cell/Pager: 

Phone Additional Information: : ^2'^3 ^ ' lOO l 

Fax: (/Cl- 93t~70^ ^ 

Cell/Pager: 

Access Agreement Signed: 3 / 101 IC> By 

0 0 ^ Restoration Agreement Signed: ' ^ H O / j Q 

Video Property Before On : S f iZLI h 

^y- M 

[ 3 Digital Photos Before On : S I2 i / tp ^y- :A 

I I Video Property .A-fter On / / 3y: 

• Digital Photas .A:fter On / / By: 

Property Completion A.greement Signed; X/Z/i£ 3y: ^ 

• Final Report SigRed: / / By: 

Additional Video cr Digital Photo's Takeri: 

Omsha Lead Project Work Plan 

Page lo f 19 
^i^:m m 

Consent tor Access to Property 3ASD# 2fo^ ^ 

RIGHT OF ENTRY TO PREMISES 

Grantor (ihe property owner), consent.'^ to and s'-'.^houzta ihe uJnite i d States Environmental 

Piuicciion Agency (USEPA) or its authorized representatives, collectively the Grantee to enter 

and perform certain environmental response activities upon the following described premises: 

PURPOSE OF INVESTIGATION 

The purpose of the remedial activities is to remove all soils at the property which are 

contaminated with hazardous substances, in particular lead at concentrations greater than.or equal 

to 4C0 parts per million (ppm). 

REMEDIAL ACTIONS 

The environmental response actions to be perfomied on said property may include the following 

activities: 

a. Taking photographs and/cr video of the propeity before, during, zrid after remedial 

activities; 

b. Locating equipment and machinery cn-site in preparation for and in the course ofthe 

environmental response; 

c. Planning and implementing the removal acticn on cr near Grantor's propeity. 

d. Obtaining sam.ples from Grantor's propeity; 

AGREEMENT NOT To INTERFERE 

The Grantor agrees not to interfere or tamper v/ith any of the activities or v.'crk done, cr the 

equipment used to perform the activities, or to undertake any actions regarding the use cf said 

property which would tend to endanger the health cr welfare ofthe Grantees cr the environment, 

or to allov/ others to use the property in such 

mg I grant access to my properties LJ I do Tiot grant access to rn-y propsities 

Signature Sig.aattire Bate 
. — A .. . ^ ..-j J 

r

Additional Comments / Instructions: 

Schec k this box if cwnsr does not want E.R. to enter the residents to document interior 

foundation walls snd possible preexisting damage. By checking this box E.R. is not .responsible 

for any damage done to the interior of house, including fcundaticn crscks cr fissurss. 

PT i agree Q I ^^o net agrse n I sgrse n J <^o '"tOt sgr-ie 

Owner's Signature Date Contrsctcr's Signsttire Date 
Restoration Agreement 

The purpose of lliis agreement is to provide a mutual agreement as tc ccnditions uf properfy prior to 

ccritrictor aiiiiviiics. Tnis 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 Environraental 

Protection Agency (EPA). 

AL.3i9 

Property Address: V^^^^ Dp^<^h^r~ 

Owner: 0<^i7 A /-li^hfl' ~ 

Phone: 

VJOV^ 

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

utilities, subsurface features, surface structures ahd 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. . 

ttems to be removed by Contractor and not repSsced: 

Faae 1 of 2 
r;''g;^rrj55?S^3 i^ ^ 

FT l agree Q I do act s.gree j i I agrea I 11 do :::!ct apree 

A.^bJiJldJ-­ Oivner's Srgnature 

Attachments 

Date Contractor's Signature Bate 

Pags 2 cf 2 
4024511059 P-02 ..o.nan a Kea^ h^state^Ca^^^ REST0H.TIO« 

JUL-29-2010 .08^38 ^ 

I 

Property Completion Agreement 

T;:I J ugrsciTteiit liocumerits tlie coiiipletion of remedial activities perfonned on my property.. My 

signature will designate thai I am satisfied wilh the restoration of my property, and that no items are in 

question, now, ot at any lime in the future, except those items listed below, ifany. 

s^^p^ 2r.^^fT'^~ 

Property AddfCK ^^^j ^ O^Ca^H^i r 

Ov.-.er; f)J ^ J^ ^ ^ ^ 

!5HI^^ZHiZ2^x 

Restoration Itfims in Qu<sation: 

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Item: 

Item: 

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Ajida'cnst Cr:-u"-;n\s.: 

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•Cc-i'.tr.'.ivor's.^iisnr.'.t'.re rii:» 

1 
45ias v^uuncy Account Information Page 2 of 2 

Building 1 

No 

Sketch 

Available 

Square Footage: 560.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Good 

BuiltAs : 1 1/2 Story Unfin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 5.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0,0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1905 0 0% 1905 105 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 280.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch EncI Solid Wall 240.0 

Porch Slab Roof Ceiling 108.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/apnoiir.+i"C. 
ENVIRONMENTAL AS-BUILT DRAWING 

^MAHA LEAD SUPERFUND SITE 

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Name: ^il 3 "Tni/^S-WVTt^ Omaha Lead Site Date: p/67/7<. North Arrow —i 

Site Sketch Time: ll-lfb -ml^rf!' Phone: ^S2S!^^ ^ "^ 

TeamT-i^v/e-^/T. A/o ^Oi4\ ­ BVID # Q^72^3 - XRF Code 3SH^ 

Sample Number Lead Concentration Confirmation Sample 

RY Dgc:S/^x/i ~ Zfe3 9 9 "^^^'^ ^ ppm -4^1 ^ pm "¥^-^^ppm 

ppm 

ppm 

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la Lead Site 
Name: .Vg.S'Jhl/^S-WTi ^ Omaha Lead Site Date: 0^f^ North Arrow 

Address: ^(O.'^f A^f^-\m L Site Sketch Time: //-/ S 

Phone; //rjb) ^ 1 

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TeamT^Uv^e./•• A/o^QJ4 ^ BVID# QGT^^ ^ XRF Code "jSR ^ 

Sample Number Lead Concentration Confirmation Sample 

RyA'5c:PX/\~ 2 63'? 9 

ppm ^lye s n No g^ RVBS^/>X A -^^39' ^ No ^ 

gN g ^C?^X A -7639 9 ;^^^pp m t)Yes n No^ ^ 

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"OiTOih; a Lead Site 46130 
Name: !^tl ^ iJfWG&^i^A^ Omaha Lead Site Date: [P^/JTZ North Arrcw —i 

Address, ^t^.^ f r>(prkj^it ^ Site Sketch Time: l/'/f5 

Phone: /^Sea^^^J^^N 1 

TeamT^Ux/e^^/T. A/og^Q/t^ BVID # ^ ^(^.S^ ^ XRF Code 3^*=}' 

Sampie Number I .ead Concentration Confirmation Sample 

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ENV8RONIVIENTAL XRF DATA ENTRY LOG 

DATE L "^ 1 \ '' ^ 

PROPERTY ADDRESS TIME 

^03^ OecccL 

XRF S/N 3^730 

QUADRENT OR SAI VIPLE ARE/ 

DEPTH AVERAGE OF RESULTS SHOT#s 

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n F2 

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SAMPLER NAME ii £i^ 
Thermo Fisher Scientific 

900 Middlesex Turnpike Thermo Billerica, MA 01821 

SCIENTIFI C 

A\r.u.AGK ,M)i)in;ss .AKK.VOI'l'UATOU DKIMIl NOIliS ,S,.\ll) l>l) 

1 2010.07-19 16:26 Avg of 4682-468' 4039 Decatur DZ jinuny 13 final clearance 268,01 ± 26.86 

2 2010.07-19 16:26 4039 Decaliir DZ iiinmy 13 final clearance 26399 278.39 ± 27.36 

3 2010-07-19 16:25 4039 Decatur DZ jiinmy 13 final clearance 26399 267.11 ± 26.86 

4 2010-07-19 16:24 4039 Decatur DZ jiinmy 13 final clearance 26399 258.55 ± 26.35 

5 2010-07-19 16:22 Avg of 4678-(68( 4039 Decatur Bl jimmy 6 final clearance 398.62 ± 32.53 

6 2010-07-19 16:22 4039 Decatur Bl jimmy 6 final clearance 26399 398.19 ± 32.47 

7 2010-07-19 16:22 4039 Decatur Bl jimmy 6 final clearance 26399 382,43 ± 31.92 

8 2010-07-19 16:21 4039 Decatur Bl jiminy 6 final clearance 26399 415.25 ± 33.21 

Page 1 of I 07/21/10 10:53:08 
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