TRANSMITTAL of OIVIAHA LEAD SL 

SOIL REMEDIATION FILE FOLDER 

SAID #: 7S\Z^ \ Date: 

Address: Z^K ^ CjOr-bx^ 'bV. 

Remediation Contractor: Environmeatal Restoration, LLC_ Year: 2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUME^^^S 

jA" Video of property (DVD) ^^??Before DAfter D Basement D 

JS Executive Summary (Final Report) 

yZ ^ EPA-provided property sketch 

z f Signed Access Agreement for subject property 

n Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

j A Photographs ydBefo re QCrewPhotosJZf During Excavation D Sod 

t/3 0-day Sod 0 

ZJ As-built sketch 

Completion Agreement signed by Property Ovvner 

CA 

Property close-out check Ust signed by EPA 

Description ofareas not meeting ROD cleanup criteria 

Utility clearances 

Property- information trom Dougias County Assessor's Office 

Property-access checklist ^Pr
p*<+>i Fofial t^«A j 

-* 30261913 

Contact L02; 

A ^ \/Aca/r h /. ^ ' f ' Superfund 

Environmental Restoration Signature Date 

Date 
EPA 

EPA Property Close Out Form 

Omaha Lead Site 

Property #: Z^2.5 \ Propertj Address: ZS\'»> Cot-\Ds^ SyV. 

Date/Time: Owner's Name: rrvoifAa. \Ai>jr\rt 

Quads Excavated: F l /"fcy Contractor Group : Environmental Restoration (ER) 

Excavation General Yes No 

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

2. Ifnecessary, were the correct areas of drip zone excavated and restored? M 

Grading Sod and Vegetation Yes No 

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

house? Z 

2. Has sod been laid in aliareas that were excavated? 

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

period). 

4. Are sodded areas generally firm and evenly graded? 

Are the Joints between the sod strips generally tight? (Only evaluate if inspected at 3Q-day time period). 

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

Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls 

Yes No 

1. Do gates open and close freely? (ifapplicable) 

Were all gates or fences taken down during restoration activities re-installed? (ifapplicable) 1 ^ 3.

 Was damage to gates or fences avoided? (ifapplicable) 

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

Foundation, Siding and Gutters 

Yes No 

1. Was damage to siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? (VA/'/r.«i \ ^ jff 

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

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Drivewavs (Coacrete) 

Yes No 

1. Was damage to driveway surfaces avoided? A/-4 

2. Was damage to walkway surfaces avoided? A/A' 

Inspection notes: . . 

Remedial and restoration activities complete including 30-day sod warrantyEPA Representative: '4/^^^ i/^i^^^Jlac73t 

Date: ^ M^/UZ 
-tO»»4, 

\ Omaha Lead Site—EP-R7-09-05 

\-««^f<te» ^ Environmental Restoration, tXC 

V ^ www.ctnc.eoin '*i.*mtKf>' 

EXECUTIVE SUMiMARY: 

29251 2513 CORBY ST 

No Issues or Concerns Q issues/Concerns 

Detai l F.xnlanflrion: 
Page I of 1 

"> 

[ Create Another Ticket ^ [ Back to Irth Intemet ] Send Email 

YOUR TICKET NUMBER IS 2707704. 

Original Call Date: 4/08/11 Time: 6:55 am Op: TIM24186 


Work to Begin Date: 4/12/11 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 

Address: 2513 Street: CORBY ST 

Twp: 15N Rng: 13E Sect-Qtr: 09-SE 

Twp: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: Lead Soil Removal 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)451-1069 


: SAID # 29251 


Company : ENVIRONMENTAL RESTORATION 


Contact Name: TIM SUTTON Phone: (402)451-1314 x2267 


Alt. Contact: Phone: (402)306-2347 


Work Being Done For: EPA 


Depth of Excavation: 24 in Corner Lot: N Front: N Rear: N 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day. 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRJCT SANDY MUD Alt; 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITYOFOMAHA-TRAFFICSEWER RICH/TRAFFIC Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING Ait: 4062071494 

Emerg: 8887289343 

;http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/8/2011 
Page 1 of 1 

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

YOUR TICKET NUMBER IS 2691589. 

Original Call Date: 3/22/11 Time: 10:01 am Op: ADAM24186 


Work to Begin Date: 3/24/11 Time: 10:30 am 


State: NE Coimty: DOUGLAS Place: OMAHA 


Address: 2513 Street: CORBY ST 


Twp: 15N Rng: 13E Sect-Qtr: 09-SE 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: Lead Soil Removal 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)451-1069 


: SAID # 29251 


Company : ENVIRONMENTAL RESTORATION 


Contact Name: ADAM Phone: (402)451-1314 


Alt. Contact: Phone: (636)288-9616 


Work Being Done For: EPA 


Depth of Excavation: 24 in Corner Lot: N Front: N Rear: N 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Pbone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRJCT SANDY MUD 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICH/TRAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPRf OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNE 1C QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://vmw.dhon.org/irthinteraet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 3/22/2011 
» 

Contact Information Log 

SAID#2'?^S7 

(^tfop.) u^' i -^C,S7 

/^. /t;^ W I p^y*'"^ ''''""<^= ygg- - "^7 

^5-/5 drr^cT^r u 

Attempt to contact Date/time Name 

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mcM^fe (3^/ /2-/«/^o/9;5c> m 

^ 

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% % 

Property Final Report 

SAID: ^^Ji ^ n WORK STARTED ON: / / 

PropertyAddress: ^<^/-: ^ f^^^^i A n WORK COMPELTED ON: / / 

Owner; /^^^^^/ ^ ^ UAif fjl A A Renter: 

" Address: r Phone: 

Fax: 

Cell/Pager: ^ 0 ^ CA3t- 1G>^ 1 

Phone: ^OZ^ SlI " ^6 7(^ Additional Information: 

Fax: 

Cell/Pager: 

Q'^ccsss Agreeinent Signed: " ^ 1 2 1 11 By: ^ 

[Q«estoration Agreement Signed:"^ 12- 1 K By: l g 

[g/<ideo Property Before On : ^ it- l / / By: ^ ^ 

g>^igital Photos Before On :3./Z-/ '^ By: Vjt ^ 

n Video Property After On '._IJ _ By: N/A 

D Digital Photos After On : / / By: 

I3r Property Completion Agreement Siened: 5"/ ^ /!( By:(e<^ 

n Final Report Signed: / / By: 

EXECUTIVE SUMMARY 

Omaha Lead Project Work Plan Page 1 of 19 
Consent for Access to Property SAID# 2^^ I 

RIGHT OF ENTRY TO PREMISES 

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

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

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

I Owner-s Name: /^^/ ^ AiA Ifi/V/i/fU | Paytime Phone: ^Z'J^ A ^ ^ 7 ^ 1 

Address: 

Addresses of Properties 

Address: covered by this 

Agreement: Address: 

Address: L 

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 400 parts per million (ppm). 

REMEDIAL ACTIONS 

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

activities: 

a. Taking photographs and/or video of the property before, during, and after remedial 

activities; 

b. Locating equipment and machinery on-site in preparation for and in the course of the 

environmental response; 

c. Planning and implementing the removal action on or near Grantor's property. 

d. Obtaining samples from Grantor's property; 

AGREEMENT NOT To INTERFERE 

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

equipment used to perform the activities, 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 

r] I grant access to my properties 

O I do not grant access to my properties K '^ « 

X (^MIUS% ^ ^J^/A' l 

Signature 

Signature Date 
n Check this box if owner does not want E.R. to enter the residents to document interior 

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

for any damage done to the interior of house, including foundation cracks or fissures. 

pA i agree CH I do not agree j^ I agree CH I do not agree 

Owner's Signature [j Date Contractor'^ Signature Date 
Restoration Agreement 

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

contractor 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). 

s^jp^ a ^^5 1 

PropertyAddress: ^$7 3 (^[^^^>. gf -

Owner: ^^/ ^ j ^ WynZl 

Phone; L/(^2.'Snh <^ CP ^ I 

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

utilities, subsurface features, surface structures and 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. 

Items to be removed by Contractor and not replaced: 

"1 Sl\^t c.\[ (^t(/i 5 LOAL tJEM So^'l ^ t>^J . Item: 

Item: 

Item: 

Item: 

item: 

Item: 

Page 1 of 2 
Additional Comments / Instructions: 

V,.a<^. • I do not agree ^ I agree cn I do not agree agree 

SuuOC**^ 5-a,-\\ - / 

Owner's Signature Date Contractor'3 Signature Date 

Attachment 

Page 2 of2 
% % 

Property Completion Agreement 

This agreement documents the compietion of remedial activities performed on my property. My 

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

question, now, or at any time in the future, except those items listed below, ifany. 

Property Ad'gress daress:: _J ^S/ g {.^Q^ ^ 

r/lj^^lii^ j/A H^/v/A 

HOZ-^^F qumz> 

Restoration Items in Question: 

'' JL^uJi/ ^ Hen/JUUy^i c JtJuu. A ^ 

'J2/ ^ jJAtAAt^ouAl \J^ lo^tiM. 

Additional Comments: 

^^•fxl I agree restoration is conipleted, except as noted 1/^1 agree restoration is completed, except as noted 

1 do not agree restoration is completed I 11 do not agree restoration is completed 

u^3ui. . 6f^h^ II 

Owner's Signature Date Contractor's Signature Date 
Free People Search | WhitePages Page 1 of 1 

WhitePages 

Find People | Find a Business 

Or search: 

• Last name only 

• I Metro area 

Maria W Wynn Is this you? Edit 

6244 Read St 

Omaha, NE 68152-2233 

(402) 571-4676 

Age: 50-54 

•J I. IJ Kenneth N Wray, Household: , ,,, " Lynn Wray, 

Know me? Ask me to update my listing.11 

Potter SI 

\ z 

i £ a 

>¥ K ! i 2. . 

Read s 

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*> m^j„^2Sy,9, Microsoft Corporation © 2010 NAVTEQ © AND 

Name popularity and name meaning for first name Maria and last name Wynn. 

m 

WhitePages PRO 

Professloria^ tools 

for business users 

http://www.whitepages.com/search/FindPerson7firstname begins with=l&firstname=marl... 8/20/2010 
Douglas County Account Information Page 1 of2 

Douglas County, Nebraska Property Record - R2539010000 

Print Reoort 

View Interactive GIS Mao Information is valid as of 2010-8-16 Treasurer's Tax Report 

New Feature ->->*> Subdivision Sales Search 

Owner 

WYNN MARLA M 

6244 READ ST 

OMAHA NE 68152-0000 

Property Informatio n 

Key Number 3901 OOOO 25 

Account Type: Residential 

Parcel Number: 2539010000 

Parcel Address: 2513 CORBY ST 

OMAHA NE 68111-0000 

Legal Description: WILSONS ADD TO KOUNTZE LOT 6 BLOCK 0 40 X 160 

Value Informatio n 

Land Improvement Total 

2010 $200.00 $0.00 $200.00 

2009 $200.00 $0.00 $200.00 

2008 $200.00 $0.00 $200.00 

2007 $200.00 $0.00 $200.00 

2006 $200.00 $0.00 $200.00 

2005 $200.00 $0.00 $200.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6400.0 0.0 160.0 40.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R25... 8/20/2010 
Douglas County Account Information Page 2 of2 

• 

SrJohri 

A-'nft Church ^mffsspBi Willis Ave " Willis Ave Gocigfe I Map data ©2010 Google 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R25... 8/20/2010 
ENVIRONMENTAL AS-BUILT DRAWING 

OMAHA LEAD SUPERFUND Sf 

RESTORATION 

29251 

Omah Exterior Paint North Arrow a Lead Site Owner Name: MARLA M WYNN 

Site Sketch 

• Good 

Address: 2513 CORBY ST • Poor Phone: H W: [T T Not paint 

Lead Sample Samples Collected Sample Number LAB Concentration Collected Firm: 

RYASCPXA-29251 Fl / 9 0 ppm D Date: ^ - 3-\ - C ^ 

RYBSCPXA-29251 F2 Hei ppm Ef n Time: T.'; * C< fL 

RYCSCPXA-29251 B1 672L ppm B' n Samples Analyzed RYDSCPXA-29251 B2 Z-H"^ ppm M n 

RPigSCr)(A-292S1 BZ ppm D n XRF Unit: /QQ7 Bool<: yfc9 

ROZOCPXA-292G1 6 2 ppm D n Date: g. . Z ^ 

RPZSCPXA 30261 PZ ppm n n Time: A^ COStaff: •^^^ r Number of Samples = 

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

All quadrants are as viewed from the street, facing property 

ENTERED 

^ 

SAID #29251 

DATE EXCAVATED 4-18-11 

cca^Y 

DATE EPA SIGNED OFF 5-4-11 5.. AREA SODDED 2459 SQ FT 

046141 0123 

LfGENO 

Quadrant axcavated Drio Zona Excavatad Contamination Lett Bahind 

/«AM*^A«« « . C D D T riA n e :»..). 
29251 

Omah Exterior Paint North Arrow Owne a Lead Site r Name: MARLA M WYNN • Good Site Sketch Address: 2513 CORBY ST • Poor 

Phone: H: W: 

[3^Not paint 

Sampie Number 

RYASCPXA-29251 F1 

Lead 

Concentration 

ppm 

Sample 

Collected LAB 

D 

Firm:

Date:

Samples Collected 

 /\?>\ ,A 

 "TS-Q-V-QCn 

9 VA,^ tCfVV 

RYBSCPXA-29251

RYCSCPXA-29251

RYDSCPXA-29251

 F2 

 Bl 

 B2 

67 2, 

z.^ ^ 

ppm 

ppm 

ppm 

D 

D 

D 

Time: ^'a^Opm 

Samples Analyzed 

RDZQCPXA-ZeZGI

ROZ0CPXA-292G1 

 BZ 

-e2 

ppm 

ppm 

D 

D 

D 

D 

XRF Unit 

Date: R 

/QQ7 

2 ^ 

Book: 

DC? 

i^^ 

nnzscpx/'i 20261 -PZ ppm D D Time: Anx. 

Number of Samples = 4- Staff: n<iW 

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

All quadrants are as viewed from the street, facing property 

(f\}j\CM~g; ENTERED ^ocK-'(^ S AUG 2 I Bm ..SoiL'-on/.U J.-A; L>T2i 

n 2lQ^' 

.e?\ b-Z ^ 

^or^<^i!..^? .3y^^v. a5>is. p.q<^y. 

Fl FZ 

.110 He.z 

WAL! ^ 

CoRby Sv 

kl 046141013;; 
29251 

Owner Name: MARLA M WYNN 

Address: 2513 CORBY ST 

Phone: ^'• 

Sample Number 

RYASCPXA-29251 

RYBSCPXA-29251 

RYCSCPXA-29251 

RYDSCPXA-29251 

RDZOCr)(A"202G1 

ROZOCPXA-292G1 

RPZSCPXi^i 20261 

Fl 

F2 

Bl 

B2 

-&Z 

-ez 

-PZ 

W: 

Lead 

Concentration 

Sample 

Collected LAB 

ppm D 

ppm Ef D 

ppm D 

2.^ ^ ppm 0" D 

ppm D D 

ppm D D 

ppm D D 

Number of Samples = LjExterior Paint North Arrow 

• Good 

• Poor 

[3^Not paint 

Samples Collected 

Firm: A5,\ .> ? V^,>C>^V 

Date: %-3L\-a ^ 

Time: ^-^(^pfYs 

Samples Analyzed 

XRF Unit: /on? Book: 2h± 

Date: R-?_ 3 

Time: /I m 

Staff: n<:u r 

Omaha Lead Site 

Site Sketch 

Legend: Fl = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

ENTEBED 

e AUG 2 I i m 

6»Z7l 

.b\ T 

Fl f l 

.m. He.z 

Vv'AL\< v 

CDResyS^ v 

Rev 4 046141 0123 
ENVIRONMENTAL XRF DATA ENTRY LOG 

O 

RESTORATION 

SAID # 292.^ 1 DATE <\ \2JD \ U 

PROPERTYADDRESS TIME 

___2Si3__c-orJ(a/ s-v 

XRF S/N 

QUADRENT OR SAMPLE AREA 

DEPTH AVERAGE OF RESULTS SHOT#s 

redig 

n F1 

D F2 

n 81 Jo­

• 82 

D DZ 

n PZ 

n GZ 

D EZ1 Ji­ 7^ i i ^ HH'^7 

n EZ2 

n OTHER 

SAMPLER NAME .2:^ ^ 
Thermo Fisher Scientific Thermo 900 Middlesex Tumpike 

Billerica, MA 01821 

SCIENTIFI C 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

II 

12 

2011.04-20 08:42 

2011-04.20 08:42 

2011.04-20 08:43 

2011-04-20 08:43 

2011-04-20 09:00 

2011-04-20 09:00 

2011-04-20 09:01 

2011-04-20 09:01 

2011-04-20 09:03 

2011-04-20 09.03 

2011-04-20 09:04 

2011-04-20 09:04 

SAM)

29251 

29251 

29251 

29251 

29251 

29251 

29251 

29251 

29251 

 ADDUKSS

2513 corby st 

2513cort)ysl 

2513 corby SI 

2513 corby st 

2513 corby st 

2S13coibyst 

2513 corby st 

2513 corby st 

2513 corby st 

2513 corby sl 

2513 corby sl 

2513 corby SI 

 SA.MIM.K AKKA

F2 

F2 

F2 

F2 

Bl 

Bl 

Bl 

Bl 

EZ 

E2 

EZ 

EZ 

 0I'I:K A

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMY 

JIMMV 

JIMMY 

JIMMY 

JIMMY 

 i:()K: 

4 

4 

4 

4 

6 

6 

6 

6 

surface 

surface 

surface 

surface 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

final ctearance 

final clearance 

final clearance 

final clearance 

final clearance 

final clearance 

363,03 ± 30.46 

370.21 ± 30.40 

359.21 ± 30.15 

Avg of 35-37 364.15 ± 30.34 

80.88 ± 16.07 

79.46 ± 16.08 

89.13 ± 16.64 

Avg of 40-42 83.16 ± 16.26 

86.94 ± 17.01 

89.57 ± 16.98 .. 

60.37 ± 15.03 ^ 

I 

AvB of 44-46 78:96 ± 16.34 * 

Page I of 1 04/28/11 15:04:05 
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