TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 36021 DATE: 12/15/2010 

ADDRESS: J 2611 BROWNE ST 

REMEDIATIO N CONTRACTOR : PRUDENTTECHNOLOGIES. INC. YEAR: 2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

[^ PRE AN D POST VIDEO OF PORPERTY (DVD) 

t ^ EXECUTIVE SUMMAR Y 

d EPA-PROVIDED PROPERTY SKETCH 

c( SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

W RESTORATION AGREEMENT 

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

a CONFIRMATION DATA 

0 PHOTOGRAPHS 

[ / AS-BUILT SKETCH 

CZf SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNE R 

Iia' PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

Q UTILITY CLEARANCES 

12 PROPERTY INFORMATIO N FRO M DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

^ U\ «\\'^^^'^ 

SIGNATURE DATE 

30260755 

Superfund 
Rnd Record Remediation Query j Lead Remaining Query Property Damage Query J 

Backfill: 

Sampie Area: 36021 - 2611 BROWNE ST 

Owner: 

D Owner Oaupled 

Owner Name: 

IPARKER ALGIE L 

Owner Addressi: 

Owner Address2: 

12619 BROWNE ST 

City: State: Zip Code: 

JOMAHA JNE J68111-

Owner Phone Alternate Phone: 

j(402) 455-2054 1(402) 630-2917 

Contract: 

Contractor: PRUDENT2010 S 

Contract Option |OPTION 2 

User Provided Owner Information 

Owner Name: 

1 

Owner Address: 

City: state: Zip Code: 

r ••'••• 1 f ' ' 

Owner Phone: Alternate Phone; 

r 

Assessment: 

Qualifying Group 400 

Assessment Max XRF Value | 493 

Resident: 

Resident Name: 

Property Address: 

J2611 BROWNE ST 

Zip Code: 

iesiiiResident Phone 

I ' — 
PROPERTY SUMMARY 

Date: 12/15/2010 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Montii of: December 

Property Address: 2611 BROWNE ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A 3 Unique Findings: NONE 

A.4 Other Relevant Infonnation: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 1016 PPM @ 13"; EA = 73 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 sketchi) Shall include fmal 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 ofareas not meeting Interim ROD cleanup criteria. 

TECHNOLOGIES, INC. 
•raCHNOLOGIES, INC. 

EPA Property Close Out 

Property #: "^ ^ ^ 2_l Property Addressr'Z-tt' V V Br <?£i:)y\e 4 f ^ 

Date/Time: Owner's Name: fA^»^\W P'tirtc/' 

Quads Excavated: ($» \ Contractor Group: Pruflent Technologies, Inc., 

Excavation General Yes 

I. If necessarv. were the correct quadrant(s) excavated and restored? y 

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

Grading Sod and Vegetation Yes 

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

from the house? / 

2. Has sod been laid in all areas diat 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 tlie joints between die sod strips generally tiglit? (Only evaluate if inspected at a 30 day / time period) 

6. Was the property graded such diat water will not pool on die property? / 

7. Was damage to landscaping or plant materials avoided? 

/ 

Gates, Fences and Retaining Walls Yes 

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

2, Were all gates or fences taken down diuing restoration activities reinstalled? (If apphcable) / 

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

/ 

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

/ 

Foundation, Siding and Gutters Yes 

1. Was damage to the sidmg or trim avoided? / 

2. Was damage (o the foundation avoided? / 

3. Was dajnage to windows avoided? / 

/ 4.

 Was damage to windows or door screens avoided? 

-"5. Was damage to downspouts or dovwispout extensions avoided? / 

Sidewalks and Driveways (Concrete) 

Yes

1. Was damage lo diivewav surfaces avoided? 

7 

-t­ 2.

 Was damage to walkway surfaces avoided'.' 

No 

No 

No 

No 

 No 
Owners cbinments: 

Inspection notes: 

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

^ti ^ EPA Representative ^ Date: J ^ .vo 
•CHNULUUIES, INC. 

AS - IKMLT EOUWING 

OLS #36021 

Date Excavated: 10/25/2010 OMAHA L£AD SUPERFUND SaXE USEPA Sigaed-Orr Date: 

36021 

Omah Exterior Paint North Arrow a Lead Site 

Site • Good SIcetch 

Q Poor 

Sampling Address: 2611 BROWNE ST Q Not paint 

Sample Numt>er Lead Sample Samples Collected 

LAB Concentration Collected Firm: jF&5_fBJjl_ _ 

RYASCPXA-36021 Fl 2 2 ^ pom 

D Date: S-ll-C 8 

RYBSCPXA-36021 F2 

_2d£_Ppn> D Time: J:I0 

RYCSCPXA-36021 

B1 _iia2_ppm D Samples Anatyzed RYDSCPXA-36021 B2 7 7 5 oom D 

nOItSCP)(A-00021 -OZ "" ppn» D D

XRF Unit (o5^ Q Book: 2Q T 

RGZ60PXA-36021 -«Z " • POW D D Date: €;> - 11 - Ci& 

RPZOGPXA.'3002i 

-PZ "" Ppni D D Time: An. Stsff: Number of Samples = | V | [ Q | hsv^ 

Legend: Fl = Front Left, F2 = Front Right Bl = Back Left B2 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Play 

AD quadrants sre as viawed fio<n the stieet lacing property 

Brawias Sfc: I Res- :I»JS.N Cii:ai<.^l: ^f-Peb^W 

EA = 73 PPM @ SCRAPE (~1") 

CONTRACT*: EP-S7-10-05 PRUDENTTECHNOLOGIES, INC. 
i i ^ 

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 ofthe 

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: 30,02; 

Property Address: c-:;^) rio {. I^OOILF. Owner: 

Phone: 

Restoration Items In Question : 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

l_9n agree restoration is completed. 

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

1} IU,llD 

Date 

I
Pnident Tectuiologies, Inc. (Prudeni) is under contraci with the U. S. Environmental Protection Agency (EPA) to clean up leadcontaminated soils at a number of properties located in Qmaha, Nebraska, including the property located at 

The EPA requests your permission lo allow Prudent to perform a soil cleanup at thii; 

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-contaminaled soil, and restoration ofthe referenced property. 

Ifyou have any questions about the soil cleanup planned for your property, please contact Prudent south office for the Omaha Lead 

Site cleanup-at (402) 733-1188. Getieral questions about the Omaha Lead Site cleanup can be directed to the EPA Public Information 

Centers al (402) 731-3045 (South Omalia coffice) or r402) 991-9583 fNorth Omaha^tfSfceT^ 

Property Access Granted By r~ 

y y (PleasePrir-"'^^ 

Property O-wner Signature /2/M/y (Signature) 

PROPERTY INFORMATION 

to 6e completed by resid<uit and/or property o-wner — please print) 

RESIDENT NAIViE: Owner Renter QLLO-^^—i^ ^ 

RESIDENT ADDRESS; 

^q)U^</\e. Q V CSiKjJi... MF 6^1 / j 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADQf^SS; 

\j^-f\ e ^ 5^v nvwdt^ fJg ^^Wj 

• • 1 I £i WORK: 

fi30 - c^'^'T 

AGE OF HOME?: YEARS. HOW LONG HAVE YOU LIVED HERE? YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? YES 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.) 


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

are pursuant to Seaion 104 ofCERCLA, 42 U.S.C. 9604. EPA's light of access tothe property is provided for in Section 104(e) of 

CERCLA, 42 U.S. C 9605(e), which provides enli-y for •"determining the need for response, or choosing or laXiug any response action 

under this title, or otherwise enforcing the provisions ofthe title." 

8080 Ward Parkway, Suite 405 5600 S 10 St 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Orr>.aTia, Nebraska 621(17 San Antonio. TX 78229 

Phone: (816) 363-3703 PS^one: (402) 733-i188 Phor.e: (210) 822-9588 

Fax; (816> 363-3707 F.=.<-. il02> "33-1883 Fax; (210)579-6577 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address: ^CP\ ^ 

0 Oti-/Vs.g ^Sd"-^ 

Phone: 

8080 Ward Parkway, Suite 405 5600 S 10 St 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68107 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)733-1188 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)733-1883 Fax: (210) 579-6577 
I l l 36021 

Omah Exterior Paint North Arrow a Lead Site • Good Site Sketch 

n Poor I Sampling Address: 2611 BROWNE ST Q Not paint 

Sannple Number Lead Sample Samples Collected LAB Concentration Collected Firm: FPft PS ,\(L 

RYASCPXA.36021 Fl ppm D Date:

 5-11't>8 

RYBSCPXA-36021 F2 2 5 A ppm D Time: i:\0 

RYCSCPXA-36021 Bl H q 3 ppm D 

Samptes Analyzed RYDSCPXA-36021 B2 7 7 5 ppm D 

RDZSCPXA-OOOZi DZ ppm n D XRF Unit: G5HC> Book: 20 1 

nO2OGPXA-06021 -6£ — ppm D D Date: C^-//-Q 8 

RPZOGPXA-30021 - -P£ ppm D D Time: A M 

E Staff: HSU / Number of Samples = ^ 

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

All quadrants are as viewed from the street, fadng property 

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Rev :008.N Cnuiled: 26-FelM)8 M4701.OI,2J 
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Printed: Nov 17,2010 

www.dcgis.org/dogis 
Page 1 of 1 

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Create Anottier Ticket Back to Irtti Internet Send Email 

• YOUR TICKET NUIVIBER IS 2622424. 

Original Call Date: 

Work to Begin Date: 

10/20/10 

10/22/10 

Time:

Time:

 5:22 pm 

 5:45 pm op: SIVA18967 

State: NE County: DOUGLAS Place: OMAHA 

Address: 2611 Street: BROWNE ST 

Twp: 15N Rng: 13E Sect-Qtr: 04-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 : 

Contact Name: 

PRUDENT TECHNOLOGIES 

SIVA JAMPAMA Phone: (402)733-1188 

Work Being Done For: EPA 

Depth of Excavation: 6 FT Corner Lot: N

Involves Tunneling or Horizontal Boring : N

 Front: Y Rear: 

 Explosives: N 

CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICHATRAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT 

Day: 4067289343 

ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/20/2010 
,llfC. CONSTRUCTION 

SOLUTIONS 

SITE SAFifcTY HAZARD ANALYSIS 

Address • ^^1 1 firnfv^^ ^ : Excavation Date: MMJL ^ 

Crew: BackfiU Date: Lem l 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees 

Stractures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

Condition Hazards Corrective Action 

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Site Safety Ofiice 

Date: 

SBOOSIOSt 4242 Medical Drive, Sufte 7250 

caisas;Clir;MO«4114 BtaHfca 48107 San Antonio, TX 78229 

V^naar. (4a2)733-i m Phone: (2t0) 822-«588 

Fax: (4a2)73»d«83 F=ax: {210)«T9-6577