TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAro#: jl^)0O Date: StoJ^^^// ; J>fflQ3, 

Address: Z3>o1 Spa^ui^ x J 

Remediatioii Contractor: J^.^^J- T^^k. !I^ ^ .^ Year: j2flQ^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ Video of property (DVD) 

^ Executive Summary 

0f^ EPA-provided property sketch 

ef Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adja^ient property 

y Restoration Agreement 

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

y Confirmation data 

y Photographs 

y As-built sketch 

0^ Satisfectory restoration signed by Property Owner 

0^ Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

M Utility clearances 

y Property mformationfix>m Douglas County Assessor's Ofi&ce 

D 

D 

D 

SSat ^ I&te 

30054218 

IMllii 

Superfund 
Rnd Record Remediation Query I Lead Remaining Query I Property Damage Query 

Backfill: 

Sample Area: 14100 - 3307 SPRING ST 

Owner: Resident: Contract: 

D Owner Occupied Resident Name: Contractor: 

Owner Name: [POWERS SCOTT A |PRUDENT2009_S 

jPROSOSKI JENNIFER 

Property Address: Contract Option 

Owner Addressl: |3307 SPRING ST [BASE 

Zip Code: 

Owner AddressZ: |68105 

Assessment: 

|3307 SPRING ST Resident Phone 

City: State: Zip Code: Quaiifying Group 

I 

jOMAHA |NE |68105 pOO/CHlS 

Owner Phone: Alternate Phone: 

Assessment Max XRF Vaiue: 1 1 r 506.86 
IIHIIOIHMKIIW mw IWIMNgttfcV 

Date: 9/15/2009 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Month of: August 

Property Address: 3307 SPRING ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 204 PPM @ 4"; NO EASEMENT 

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) Dociuuentation - Completed Close-out Checklist 

6) As-Built sketch ­

i) Shall includefinal 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 satisfactoty restoration 

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

nilCHNQlOCIES:iNC: 
TECHNOLOGIES. INC. BEPA 

EPA Property Close Out 

Property #: '^'^^ ^ Property Address:'5 $0 7 SC*^^ ^ ' 

Date/Time: ,5-l>-0^ Owner's Name: S^CJ^ {^'•"^T-^*-

Quads Excavated: S' i Contractor Group Prudent Technologies 

Excavation General Yes No 

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

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

Grading Sod and Vegetation Yes No 

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

from the house? y

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

3! Does the sod appear to be generally healthy and growing? (Qnly evaluate if iiiBpected at a 30 

day time period) y

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

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

time period) y

6. • Was the property graded 3uch that water iVill not pool on the property? " y 

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 reinstalled? (If applicable) y 

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

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

Foundation, Siding and Gutters Yes No 

1. Was damage to the siding or trim avoided? y 

2. Was damage to the foundation avoided? y 

3. Was damage to windows avoided? y 

4. Was damage to windows or door screens avoided? y 

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

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? / 

2 t/ . Was damage to walkway surfaces avoided? 
30? Sf'^^ S^ 

Owners comments: 

Inspection notes: 

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

EPA Representative A A Date: s/zy/o/ 
%EPA 

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 fiiture, excluding any 

remaining warranty (30 days total) except those items listed below, if any. 

Property ID: 

Property Address: "^'^ Q -7 S J ^ 

Owner 

Phone: ^ 

Restoration Items in Question: 

item: 

Item: 

Item: 

item: 

Item: 

Item: 

Required corrections to complete the property: 

L J 1 agree restoration is completed, except as noted above. 

L J I do not agree restoration is completed 

1. 

Owner's Signaturi Date 
Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protectian Agency (EPA) to clean up leadcontaminated soils at a number ofproperties located in Omaha, Nebraska, including the property located at 

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

property to remove lead-cantaminated soil. By signing this form, the property owner grants permission to Prudent to perform 

activities related to the cleanup including soil sanpling, removal of lead-contaminated soil, mid restoration ofthe referenced property. 

If you have any questions about the soil cleani^} plaimed for your property, please contact Prudent's Administrative Clerk for the 

Omaha Lead Site cleanup. Ms. Siva S. .lampana-at (402) 733-1188. General questions about the Omaha Lead Site cleanup can be 

directed to the EPA Public hifoimation Centers at (402) 731 -3045 (South Omaha office) or (402) 991-9583 (North Omaha office). 

Propeity Access Granted By: 

(Please Print Name) 

Property Owner Signature: i£ mn 

(Si^iature) (Date) 

PROPERTY INFORMATION 

(To be completed by resMcmt and/or property owner — please prtut) 

RESIDENT NAME: Owner Renter 

RESIDENT ADDRESS: 330 1 S p ^ ' ^ 

K>^ Cy »\. 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAIUNG ADDRESS; 

OWNER'S TELEPHONE NUMBER - HOME: < 'lO ) J2.\ Z - S o V{^ WORK: 

AOE OF HOME?-.'^^H^ : . HOW LONO HAVE YOU LIVED HERE? A YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WTTH SIDINO SINCE 19787 _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 6 HOURS OR MORE PER WEEK: 


_ I _ 
 COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOOS. ENTRY OATES, ETC.) 

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

are pursuant to Section 104 ofCERCLA, 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 "detennining tbe need fbr response, or choosing or taking any response action 

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

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fa v n-\n \ K7Q-fiS77 
ENVlRONM£.MAL 

CONSTRLCnC 

TECHNOLOGIES, INC. SERVICI 

Property Status Form 

Address: ^HglB^o^^i!tiilA^&^B&^ ^ Date: '^\ i^ ' °' ' 

Phone: ^t i 2. - a^\'2 - gf ^2^1 ^ BVID: 

Item NO Plants «& Permanent Landscaping To Remain In Place 

On Map Description & Location 

it^i?­

p 

1 5 o 

U (J 

Pre-Existing Condition of Structures 

Does your Basement have a history of leaking*! Yes No 

Description «& Location 

Prudent Employee /, 0 

Signature 

S080 Ward Parkway, Suite 405 2505 N. 24"^ Street, Suite 308 4242 iMedical Drive, Suits 42S0 

Kansas City, MO 64114 Omaha, Nebraska S8110 San Antonio, TX 78229 

PhrtPiO' Ii07 \ .<;0-J.100d Phone: (210)822-9588 
PRUDENT TECHNOLOGIES, INT ^T FIRST NATIONA NATIONAL BAfJPf WW F OLATHE

8080 WARD PARKWAY, SUITE 405 83-172/1010 

KANSASCITY, MO 64114 

(816)363-3703 

PAY TO THE 

ORDER OF _ -y J 

(yj-^Hj? ^'l.yWJ^y^A^UiA^ jyyjyf ^ /C^AD DOLLARS Q '.-

-^y. NhGOTiABLt ^ 

ii'O EEO 2 511' «: ID;00l7E0i : ii'Olt . qi, 5U"' 

PRUDENTTECHNOLOGIES, INC. 2202 5 

/ ^V_ _ ^ 7 ^ 7 C^>^2^a.-/ ^^ykr . 

PRUDENTTECHNOLOGIES, INC. 2 POP' S 
•IT 

2226A PRUDENT TECHNOLOGIES, INC. FIRST NATIONAL BANK OF OLATHE 

8080 WARD PARKWAY. SUITE 405 63-172/1010 

KANSAS CiTY, MO 64114 

(816)363-3703 g--g-oQ( 

B PAY TO THE 

? ORDER OF _ •-ClA^vUi h. ^ ^AyyJ^ ; $ 

^--^o^^ Xdx.<a^ 0. rA. J^yty/LAA/ DOLLARS |?1 

COPY NOT NEGOTIABLE ^ 'A't'fi-Ci 

H'0BE2Ei»*ii« «:i0l00l7E0i : ii'O m 1if 5 »,»' 

PRUDENT TECHNOLOGIES. INC. 22264 

(ujrs<r^v^«^ ,-fPRUDENTTECHNOLOGIES. INC. 22264 

^W«m«,~+- CUd(^ ^ 

f^ 
EiWTRONJVIEiVrAL 

CONSTRUCnO 

TECHNOLOGIES, INC. SERVICI 

Property Status Form 

Address: Date: 

Phone: Ho?^ - a\: i - Q n7y\" \ BVID: 

Plants & Permanent Landscaping To Remain In Place 

Description & Location 

% I b o 

^ U UJ 3 C 

Pre-Existing Condition of Structures 

Does your Basement have a history of leaking? Yes No J^ 

Item NO Description & Location 

On Map 

Prudent Employee 

Signature: 

8080 Ward Parltway, Suite 405 2505 N. 24" Street. Suite 308 4242 IMedical Drive, Suite 4250 

KansasCity, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phnn»! r402) 504-1004 Phona: (210)822-9586 
PRUDENT TECHNOLOGIES, INC. 22025 

568919 (8/08) 
JES, INC. 

AS - BUILT DRAWING 

OLS#:14100 

Date Excavated: 07/14/2009 OMAHA LEAD SUPERFUND SITE USEPA Signed-OfTDate: 

Name: ^rr. H ft Oyjars . Oinaha Lead SRe Date: t>^-V^"t> ^ Amw -1 

Address: -a.'ao-=< o»yVTi ^ SV Site Sketch Time: ir.Opec»<\ 

Phone: iJra^^ ^fZA - 4-^>i S i 

^"STS 

Team ^ i ft o \ J \ <LVyiP,AVt«. BV1D# VM\ b ^, XRF Code A-.^nP 

Sample Number Lead Conoentratton Confimnation Sample 

ppm fiYes « No a /^YsacpXA - /y/Qg ppm fives C3 No $3 

ppm eiYes O No B 

ppm etVea C3 No CH 

RYO'SQ/'JCA - /V/C?r/ ppm SRYes (=> No P 

ppm pYes a No ^ 

ppm Yes ID No • 

^eL , ''^^«=P'^-14100 

37.5ppn, _ 

.iSft ^SSSL*.S^ 

^^ >«->< • -)« ^ 

^^C2£. i^J ^ -zaa 

- L T ^ ) 

Bl = 204 PPM fir; 4" 

%' 

SZ ' 75 i a/ . ^ 

"e.^ ^---- 4 

tl 3^ -

J .Aa m/jSL, ZaL£££ T •V 

0 

U 

UXklllL «2;d-eM3Q^JW^ feiAe 

IpYpY\|\f t l S^ 

NO EASEMENT 

Omaha Lead Site 46130 

CONTRACT #: EP - R7-07-06 T0#1 PRUDENTTECHNOLOGIES, INC. 
JP t 

Omaha Lead Sito Dale: r>'X- VH-fc'^ 

SHs SKstth 

Oinuhs Leud Sclc ;6130 
March 2007 DOUGLAS COUNTY ASSESSO 

'y y o. "1 Qo^n ^' 

http://douglasne.mapping-online.comyassessdoc/Photos/21/R23244000000001 .jpg 6/12/2009 
Print Preview htlp://www.dogis.org/dogis_alias/dogis/prinlPreview.aspx?PrinlOpt.. 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

2324400000 

PROSOSKI 

JENNIFER 

3307 SPRING 

ST 

OMAHA 

68105 

3307 SPRING 

ST 

OMAHA 

NE 

68105 

Sec-Twn-Rng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website Link 

Assessor 

Website Link 

33-15-13 

THOMASON & GOOS ADD 

RESV 

1/2 VAC ALLEY & 

W 50 E 380 FT OF N 

RESERVE W OF 32 AVE , 

50 X 87.8 

http;//webapps.dotcomm.org:8080/TreasTax/faces/pages 

/taxinfo.jsp?parc=2324400000 

http://douglasne.mapping-online.com/DouglasCoNe/statiG 

/accountinfo.jsp?accountno=R2324400000 

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

guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 33 feet 
Page 1 of 1 

"> 

• YOUR TICKET NUMBER IS 2302335. 

Original Call Date: 6/24/09 Time: 11:48 am Op: SIVA18967 

Work to Begin Date: 6/26/09 Time: 12:30 pm 

State : NE County: DOUGLAS Place: OMAHA 

Aciciress: 3307 Street: SPRING ST 

Twp: 15N Rng: 13E Sect-Qtr: 33-NW 


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 


: FAX ALL CLEARS TO (402) 733 1883 


: UNSURE CORNERS 


Company : PRUDENT TECHNOLOGIES 


Contact Name: SIVA JAMPAMA Phone: (402)733-1188 


Work Being Done For: EPA 

Depth of Excavation: 6 FT Corner Lot: N Front: Y Rear: 

Involves Tunneling or Horizontal Boring : N Explosives: N 

CXCATV MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 

Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emeig: 4029329757 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY

Day: 4025047823 

 Alt: 

Emeig: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON 

Day: 4024447197 

Alt: 4024445161 

Emeig: 4024445160 

OPPDGPR6 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emeig: 8887289343 

QLNNEIF QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emeig: 8887289343 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SOLUTIONS 

Site Safety Hazard Analysis ^ 

Address: 32o" ) Sp^/y,e, 

Crew: ( p AK$vt6^//v f^x/f/^ Bf. T/jT-c/y 

Date: <^ -^5"» <:? 5 

Corrective 

Item Condition Hazards Action 

Overhead Lines ^*!ycJ 1 ^ us e A^ ^ 

Gas Line J?01-1 * J Ka^J /oc^'h^ 

Water Line 

Sewer Line 

( 

Muv^t&J 

{ 

I 

Septic / Leech 

field ^ A 

Propane/Butane AyA 

Sidewalk «e««/ 

Foundation • i T — •'• ' 

Retaining Walls 

Fences y 

Trees 

Structures /C»i^ 

Driveway a^</i^ use­ pyt^c^^ ^ 

Sprinkler System /tyiOther 

Crew Foreman Site Safety Officer 

8080 Ward Parkway, Suite 405 2505 N. 24*" Street, Suite 308 4242 Medical Drive, Suite 7250 

KansasCity, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

cav fRis\r<Ba-:i7n7 Fax: (402)504-1005 Fax: (210) 579-6577 
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