TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

\ 0 SAID#: IM 

Date: \ U 

Address: "1 ^ fl^K^ ^ 

Remediation Contractor: Coastal Environmental Group_ Year: 20^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

/ 

Video of property (DVD) 

P Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

Photographs ^c? Vm ^<ry? \ S^^cop/^-^uy^ r i\i^ty>(^f<ri^^ 

As-built sketch 

•/ Satisfactory restoration signed by Property Owner 

« / Property close-out check list signed by EPA 

-& Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

D 

D 

D 

30054444 

Superfund 
Property Access Checklist 

Property ID: [^[^ ^ n WORK STARTED ON: 

D WORKCOMPELTED 0N:_ / / Property Address:-720 PiferT ^ ^4" 

O^vnc Renter: r Lnnl?. ^ \Jo.C^af\\'i 

Address: %arr\ t 

Phone: 

Fax: 

Cell/Pagen 

Phone: i|2 2 -n( ^ 

Additional finformation: 

Fax: 

Cell/Pagen 

1 

D Notffication Letter Sent: / / By: 

M Access Agreement Signed: 5_/i2_/£3 By= MvrDS 

SZI Restoration Agreement Signed: 3_/J2^/09 By= Dr-hAvio 

D Topsoil Sampling (if applicable) / / By: 

D Disposal Sampling (if applicable) / / By: 

0 Garden Sampling (if appliaible) / / By: 

1 ^ Utility Clearance Called:^ / G /p ^ By=^/iu>/Dq, 

Q^<leo/Pliotos (Before) On:^/£5/ ^ By: Cafiuii, PM^^^TV-^ 

D Video/Pbotos (Daring) On: / / By: 

D Videoffl»hoto8 (After) On: / / By: 

n Viileo«»hoto»(JO-D«y) On: / / By: 

D Properly Completion Agreemoit Sipncd: / / By: 

D Pinal Report Issued: / / By: 

Air Monitorine (as applicable 

D Community QCrcw On: / / By: 1 

Results: 

n Community QCrew On: / / By: , 

ResuHs: 

D Community QCrcw | On; / / |By: 

Results: 

Omaha Lead Site 
CONTACT FORM 

Property ID # 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

\5U0\ 

m o ?\CTCX j^+ — 

Date: Time; 

Date: Time: 

Date: Time: 

Transmit lo EPA D 

Action: 

Action: 

Action: 

Other Action: D 
Douglas County Account Infotn^o it||^ C n Page 1 of2 

Douglas County, Nebraska Property Record - R0321380000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VieVtf O n Ma p Information is valid as of 2009-8-3 Treasurer's Tax Report 

New Feature ^ -> •• Auto Sales Search 

Owner 

VACANT! LOUISE C 

720 PIERCE ST 

OMAHA NE 68108-0000 

Property Infornnation 

Key Number: 2138 0000 03 

Account Type: Residential 

Parcel Number: 0321380000 

Parcel Address: 720 PIERCE ST 

OI^AHANE 68108-0000 

Legal Description: CITY LOTS LOT 6 BLOCK 247 15 FT VAC PIERCE ST ADJ & E 16 FT LT 5 & W 

7.5 FT 

Value Informatio n 

Land Improvement Total 

2009 

2008 

2007 

2006 

2005 

2004 

$3,800.00 

$3,800.00 

$3,800.00 

$3,800.00 

$3,800.00 

$3,800.00 

$43,500.00 

$43,500.00 

$28,500.00 

$28,500.00 

$28,500.00 

$19,400.00 

$47,300.00 

$47,300.00 

$32,300.00 

$32,300.00 

$32,300.00 

$23,200.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.08 3528.0 1.0 147.0 24.0 No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accountno=R03... 8/22/2009 
Douglas County Account Inforn^ion Page 2 of2 rn^io 

verified ^IHCPWH'C 1*171 

XiMB 

«C 

esnicekxkvn TMOS F 

SPLIT ENTRY 

CLICK TO ENLARGE IMAGE 

Square Footage: 754.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: Split Entry Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 4.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 2.0 

Roof Type: Gable Stories: 1.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1880 0 0% 1880 129 

Detail Type Detail Description Units 

Add On Fence Chain Link 1.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 710.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch Slab Roof Ceil 101.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R03... 8/22/2009 
Page 1 of2 

"> 

Create Another Ticket 11 Back to Irth Internet [ Send Email J 

• YOUR TICKET NUMBER IS 2362515. 

Original Call Date: 9/12/09 Time: 2:31 pm Op: ELIZABETH18790 


Work to Begin Date: 9/16/09 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 720 Street: PIERCE ST 


Twp: 15N Rng: 13E Sect-Qtr: 26-NW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remediation 


Location of Work: LOCATE ENTIRE PROPERTY, ALL EASEMENTS AND TO THE PEDESTAL 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: coastal 


Depth of Excavation: 4ft Corner Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVELS MUD02 OMAHACOF 0PPDGPR6 QLNNEIF QWESTNE 


Service Area Contact Phone Number UtiUty Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVELS LEVELS COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 

Day: 4025047823 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 


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


Emerg: 4024445160 


Day: 4067289343 


http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/12/2009 
Page 2 of2 

OPPDGPR6 OMAHA PUBLIC POWER DISTRICT NA 

QLNNEIF QWEST LOCAL NETWORK NA 

QWESTNE QWEST LONG DISTANCE 

Alt: 4062071494 


Emerg: 8887289343 


Day: 4067289343 


Alt: 4062071494 


Emerg: 8887289343 


Day: 8002834237 


Alt: 


Emerg: 8002834237 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/12/2009 
As-Built Drawing 

COASTA L INVIHONMINTAL Omaha Lead Superfund Site a R O U P , INC . 

1569 

Omah a Exterior Paint North Arrow Lea d Site Owner Name : Site • Good Sketc h Address : 720 PIERCE ST • Poor Phone: H: _ W: r~l Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm; 

Samples Collected 

Sverdrup 

RYASCPXA-1569 YA 665.6 ppm 0 a Date: 

RYBSCPXA-1569 YB 234.6 ppm 0 n Time: 

RYCSCPXA-1569

RYDSCPXA-1569

 YC 

 YD 

375.8

274.2

 ppm

 ppm

 0 

0 

D 

n Samples Analyzed 

RDZSCPXA-1569 DZ ppm • D XRF Unit: Book; 

RGZSCPXA-1569

RPZSCPXA-1569

 GZ 

 PZ 

PP"i

ppm

 D 

• 

a

• 

Date; 

Time; 

7/11/1999 

17;33 

Staff; Number of Samples = 

Legend; YA = Yard (NE), YB = Yard (SE), YC = Yard (SW), YD = Yard (NW), DZ = Drip Zone, GZ = Garden, PZ = Play 

OLS#: 1569 

Date Excavated :9/18/0 

Date USEPA Signed Off: 16/5/09 

Area Sodden: 1035 sa 

•Yc?-- ZM.L^ 

••r»rg:y^(i:^(5?-'-$'f'.'''l Rev 4 

Legend 

Concreize Drip Zone Excavated Quadran-ts Excavated 

Area replaced with Area replaced with 


Area left bare 
 Sod ' ' Rock/Mulch 


Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 

569 5JI 

Omah Exterior Paint North Arrow a Lead Site Owner Name: 

Sit • Good e Sketch Address: 720 PIERCE ST A • Poor 

Phone: H; W; 

Q Nol paint 

Sannpl Lead Sample Samples Collected e Number LAB Concentration Collected Firnn; Sverdrup 

RYASCPXA-1569 YA 665.6 ppm 0 D Date; 

RYBSCPXA-1569 YB 234.6 ppm 0 a Time: 

RYCSCPXA-1569 YC 375.8 ppm 0 n Samples Analyzed RYDSCPXA-1569 YD 274.2 ppm 0 a 

RDZSCPXA-1569 DZ ppm n a XRF Unit: Book: 

RGZSCPXA-1569 GZ ppm n a Date: 7/11/1999 

RPZSCPXA-1569 PZ ppm D a Time: 17:33 

Number of Samples • 

Staff: 

Legend: YA = Yard (NE), YB = Yard (SE), YC = Yard ($W), YD = Yard (NW), DZ = Drip Zone, GZ = Garden, PZ = Play 

57//^X^-'^^^'^ 

5oD 

?m^/^;i 

YD-- ZM.U. 

'^fbtwrn/t^v/yv- Rev 4 01614 1,012.'! 

H\u Pi 
% 1569 

Omaha Lead Site Owner Name: 

Site Sketch Address: 720 PIERCE ST 

Phone: Jl; W: 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

RYASCPXA-1569 

RYBSCPXA-1569 

YA «­ 665.6 ppm 

ppm 

0 

0 

D

• 

RYCSCPXA-1569 375.8 ppm 0 a 

RYDSCPXA-1569 274,2 ppm 0 n 

RDZSCPXA-1569 ppm D a 

RGZSCPXA-1569 ppm a n 

RPZSCPXA-1569 ppm D a 

Exterior Paint North Arrow 

• Good A • Poor 

Q Not paint 

Samples Collected 

Firm: Sverdrup 

Date: 

Time: 

Samples Analyzed 

XRF Uni t: Book: 

Date: 7/11/1999 

Time: 17:33 

Staff: 

T hUP 1\ 
1569 

Omah Exterior Paint North Arrow a Lead Site Owner Name: 

Site • Good Sketch Address: 720 PIERCE ST A 

Phone:_yi W: •

Q

 Poor 

 Not paint 

Sample Numt)er Lead 

Concentration 

Sample 

Collected LAB 

Finn: _ 

Samples Collected 

Sverdrup 

RYASCPXA-1569 YA 665.6 ppm SI a Date: _ 

RYBSCPXA-1569 YB 234.6 ppm D Time: _ 

RYCSCPXA-1569

RYDSCPXA-1569

 YC 

 YD 

375.8

274.2

 ppm 

 ppm 

n 

a Samples Analyzed 

RDZSCPXA-1569 DZ ppm a a XRF Uni1 t: Book: 

RGZSCPXA-1569 GZ ppm D D Date: _ 7/11/1999 

RPZSCPXA-1569 PZ ppm D D Time: _ 17:33 

Numt>er of Samples = 4 

Staff: 

Legend: YA = Yard (NE). YB = Yard (SE). YC = Yard (SW). YD = Yard (NW). DZ = Drip Zone. GZ = Garden. PZ = Play 

Yc>-- IM- ^ 

FlB^O ^ ST Rev4 046141.0123 
COASTA L ENVIttONHENTAL " t PROtt-^ Clour , IN C 

Consent for Access To Properiy 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following describied premises: 

TOL/iS ^ \PP)0/^rO~r\ 

Owner's Name: Daytime Phone: 

C 

Address of Property •]7i> -f'^^^ 

covered by this 

Agreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Grantor in-person to discuss the work to be perfonned, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work 

before it begins. Once the work is finished, the Grantor will be asked to review the work 

and confirm that it is complete and meets with the Grantor's approval. Upon 

completion, the Grantor will receive written documentation from EPA that the property 

has been remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of perfomiing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
COASTA L >* ENVIRONHEHTA L '*>. . PROlt.^ GROUP . IM C 

«> Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

e Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

« Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

e Abide by health and safety guidance provided by EPA; 

e If the property is rented, assist EPA in obtaining tenant approval for access to 

the property to perform the work. 

• Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the work activities, or with any 

of the work done, or with the equipment used on his property, or to undertake any 

actions regarding the use of said property which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (402) 991-1199 

MI grant access to my properties D I do not grant access to my properties 

)u^'-^ 1>UJ:^- i ^ I'L, g^oo^ 

Signature Date Signature Date 

G I would like to be present during any sampling that is required. 

Page 2 of 2 
tr"t:fe COASTA L 

Restor^t30['^ AgreesnenH 

The purpose of this agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This 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 Environmental 

Protection Agency (EPA). 

Property IDT /f)b' ^ 

Property Address/>^2k> p/3/^ P 6^ ^ 

01^1 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access location(s) to be used by the contractors, indicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

items to be Removed by the Owner before Start of Remediation: 

fh e removal, storaqe. disposal, and/or reti:rn of these itoms is the Owner's responsibilrty. 

Item: 

hU^ ^ ^y>^ ^// P/^.i 

Kemi ^ /

Item: 

Item: 

items to be Removed by the Contractor During Remediation and fitot Replaced 

Kern: /?^-.. y P-^.ii ?b<^ \~-Px (PUy. Item: 

Item: 

Kern: 

1, Page 1 of 
PCP ^ COASTA L 

C K >• o t 

Items to Be Removed By Contractor During Remediation and Replaced 

Item: \i SDI ^ 

Kern: 

Sbb - 1^4 

Kem: 

\ 

\ Item: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Aii.nth ,1 ikftch ol tlie 

>.pr'i'kli.M liiv'.ni; 

Number of and size of 

each garden/ flower bed 

area. 

AlliUh ;i skctcli 1)1 rcljilivf 

?i/i-^ nnd lac;iiioiiv 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Voif ilii­ \iiiiic vs\\\ nt 

t:S('(_' 10 IMm .; ;ilaiii 

V outlier Ki I lie liroiicnx 

y\\\ ner. 

Easement Area, to be 

excavated 

Quantity 

y^ 

1 

y^ 

1 

y 

Landscape Inventory 

Unit Conditlon/Type/Species 

Quadrants 

Each 

F,aRh 

Each 

Fflch 

SquareFeet 

S 

Each 

Page 2 ^ ^ 
COASTA L 

I M vinOMM I NTA t 

< Additional Comments / Instructions: 

M Check the box if Owner does not want CEG to document interior foundation walls and possible 

prB-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house. Including foundation cracks or fissures. 

p } I agree Q 1 do not agree 

fi^fflMa 

Owner's Signature Date Confractor' (tractor'ss Signatur Sienature r Date 

Page 3 o,' ^ 
BVID# Md- XRF PROPERTY SAMPLE SHEET 

Date ml ^ Address '/ ^ yie^yy^ ^ 

Proiect Omafia lead FP 2ncl year option Sample tinrte am/pm 

XRFID# :\70?PA sample length 30 sec 

Shot# Reading 

^ 2 . 

:^2 : /7 ^ ^l(ff 

fe 7/0^ r^ 

-f Average ^ :!^ ) 

Shot# Reading 

Average 

Shot# Reading 

Average 

Shot# Reading 

Average 

lab sample # Lab result 

Sampl )amplee are ar a Shot# Reading Sample area

M 

Depth Depth 

^ Average 

Sample area Shot# Reading Sample area 

Depth Depth 

Average 

Sample area Shot# Reading Sample area 

Depth Depth 

Average 

RETEST AREAS 

Sampie area Shot# Reading Sample area 

Depth Depth 

Average 

Sample area XRF Avg. 

Sianatureg)L>art ho\\/ \ Cf ) Q^foA^ 

Print Fl< Ar^o4^0i}^orp^ 
• • 

/ ^^ A Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

^ www.coastalhazmat.com 

^tpRoT**^ COASTA L ENVItONHENTAL 

CROUP , IN C 

EXECUTIVE SUMMARY: 

BVID # 1569- (720 PIERCE ST) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 
4

m 

r r ^ 

EPA Property Close Out Form 

Property Addr.«:- "^ y O ^^^'^^^^ 6 U Property #: \0(QP 1 .r 

Date/Tlne 0«nier's Name:. J g1.1\1f ._V^ W O^^' . • , : 

Quads Excavated: ^t \ Contractor Group Pm5^v\\ Fn>(^cnnmrrU€L\ 

Excavatio Yes No n CeBcral 

I. If necessaiy, were the correct quadrant(s) excavated and restored? 

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

Gradin Yes No g Sod and Vegetation 

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

fiom the house? __^__^ _ 

y^ 

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

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

day time period) y 

4. Are sodded areas generally fum and evenly graded? 

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

 ___^ 

6. Was the property graded such that water will not pool on the propert>'? t/^ 

7. Was danuge to landscaping or plant materials avoided? l^ ' 

Gates, Fences and Retaining Walls 

Yes No 

1. Do gates open and close finely? (If applicable) t^ ^ 

Were all gates or fences taken down during restoration activities reinstalled? (If applicable) I/' 

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

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

Foundation, Siding and Gutters Yes No 

t. Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? y 

Was damage to windows avoided? y 

 Was damage to windows or door screens avoided? y 

5. Was damage to downspouts or downspout extensions avoided? ^ ' 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? ^ 
Ovf'ners comments: -% m

Inspection notes: 

Removal and restoration activates comp^etejncluding the 30-day sod warranty: 

EPA Representative Og^ boij^ Date: /D/T/Q ? 
% « 

Property Completion Agreement 

This agreement documenls the completion of remedial acliviiies perloimed on my properly My signaluie 

will designate Ihal I am satisfied with the restoration of my propeily, and ihai no items are in queslions. 

now, or al any lime in the future; except ihose ilems listed below, if any 

Property ID: \^^^C ^ 

Prapcrty Addrcsv - ] y Q P ; fip^^^ ^f . 

O""^'^ iQufse, Vnf/i/vl--. Phone: ^n^.^^^.6^^ Q 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

P^l 1 ;i(,'rcr icsroralion it completed, rxccpl as nnlcrl 

[_J I (to not ai;rec rcsroration is complcleri 

Owner's Sicnatiur Date Contiactor's Sicnaiiirc Dale