PROPERTY SUMMARY

 

Date: 10/18/2007 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 Month of: October 

Property Address: 4234 Mason St 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: None 

A.2 Issues Resolved: Re-Seed will occur in November on any dead spots to encourage spring growth. 

A.3 Unique Findings: 

A.4 Other Relevant Information: Behind Fence in B2 - 238 @ Scrape, Flower garden in B2 - 184 @ Scrape, 

Flower garden in Fl - 312 @ Scrape 

CONFIRMATION SAMPLING DATA/RESULTS: 

Fl - 48 @ 6" 

B2-64@8" 

Easement 72 @ Scrape 

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 sketch ­

i) Shall include final 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) Excavation digital video in MPEG, WMV (Windows Media Video) or SWF (Flash Player) format and/or 

photographs 

iii) Signed form verifying satisfactory restoration 

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

IIlllll •!•[! ••!!• '-'"" I O 

Superfund 

TECHNOLOGIES, INC. 
21233 

Oma tha Lead Sit* i Exterior Paint North Arrow Owner Name: MORGAN J HELTON 

S E3 Good ite Sketch Address: 4234 MASON ST Q Poor 

Phone: H: 402-553-6702 W: 402-444-1136 [~~1 Not paint f

Sample Lead Sample . Samples Collected Number AB Concentration Collected Firm: j#5\jJ

 

RYASCPXA-21233 F1 ^/ 2^ Dom tf

 Date: 6/V/6V

 

RYBSCPXA-21233 F2 / ^^ DDm p?t l~)

 Time: $?/'%

 

RYCSCPXA-21233 B1 ^ )"2~ ppm 0 D

 Samples Analyzed

 RYDSCPXA-21233 B2 ^7.?.^ Dpm 0 D 

RDZSCPXA-21233 DZ 25^ D pm 0 D XRFUnit: ^/"z

-^ Book: &?— 

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Omaha Lead Site 46130 
07 9/27/' 
P7 /07

 
21233 

Oma ha North AITOW Lead Site Exterior Paint Owner Name: MORGANJ HELTON 

S 13 Good i te Sketch Address: 4234 MASON ST £] Poor 

Phone: H: 402-553-6702 W: 402-444-1136 Q Not paint f

Sample Number

 Leaci 

Concentration 

Sample

Collected

 „ 

 LMD 

Firm:

Samples Collected 

 /?SvJ 

RYASCPXA-21233

RYBSCPXA-21233

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Date:

Time:

 6/V/6V 

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Omaha Lead Site 46130 
Agreement to allow access to 

Omaha tV«Vt\ Lead the property in order to conduct 

Site Remedial environmental sampling and to 

Actio remove lead-contaminated soil n 

Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency 

(EPA) to clean up lead-contaminated soils at a number of properties located in Omaha, Nebraska, 

including the property located at ^/,yi3 / /'itfSA/7 •—>/ . The EPA requests your 

permission to allow Prudent to perform a soil cleanup at this property to remove lead-contaminated soil. 

By signing this form, the property owner giants permission to Prudent to perform activities related to the 

cleanup including soil sampling, removal of lead-contaminated soil, and restoration of the referenced 

property. After obtaining the owner's signature on this form, Prudent Technologies, Lie. will contact the 

property owner (and residents) within the next few weeks to coordinate performance the work. 

If you have any questions about the soil cleanup planned for your property, please contact Prudent's 

Administrative Clerk for the Omaha Lead Site cleanup, Ms. Cvndie Hinds at (402) 504-1004. General 

questions about the Omaha Lead Site cleanup can be directed to me EPA Public Information Centers at 

(402) 731-3045 (south Omaha office) or (402) 991-9583 (north Omaha office). 

Property Access Granted By: 

f fP]«K« Print Nsm») 

Property Owner Signature: 

(Signature) 

J^ i/il ~<y**) r^v' 

PROPERTY INFORMATION 

(To be completed by resident and/or property owner - please print) 

RESIDENT NAME: 

RESIDENT ADDRESS: 

IF RENTAL. PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS: 

OWNER'S TELEPHONE NUMBER - HONE: 

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

 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? YES NO

 

~r^ 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: I NUMBER OF OCCUPANTS? YEARS OLD AND OLDER C?k 

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY IN THE YARD FOR 5 HOURS OR MORE PER WEEK. _j 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS. ENTRY GATES. ETC.) 

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

P^ CailClil. 01 C JJLU ^UOiiL LU bTCU.lUll 1 X'~T UJ. Vj-A.'-AVXj-J^-^Y, T4/ W.u-'.V--. J \J\J~T. l^Cft. 3 1 1&11L Ul O^.\-CD2 LU U1C pi \JJJC1 LJf ii 

provided for in Section 104<e) of CERCLA,42U.S. C 9605(e), which provides entry for "determining the need for 

respoTise, ar choosing or taking any response action undgrthis title, or otherwise enforcing the provisions of th& 

titls." 
&EPA

 

EPA Property Close Out 

Property #: 2 Property Address: v23y haic<*

 

Date/Time: Owner's Name: £n^ £#nc(,

 

Quads Excavated: r/( Contractor Group Prudent Technologies

 

Excavation General Yes

\. If necessary, were the correct quadrant(s) excavated and restored? / 

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

Grading Sod and Vegetation Yes

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? i/ 

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 firm and evenly graded? s 

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 such that water will not pool on the 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) S 

2. Were all gates or fences taken down during restoration activities reinstalled? (If applicable) </ 

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

1 . Was damage to the siding or trim avoided? «/ 

2. Was damage to the foundation avoided? s 

3 . Was damage to windows avoided? c/ 

4. Was damage to windows or door screens avoided? I/ 

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

Sidewalks and Driveways (Concrete) Yes

1 . Was damage to driveway surfaces avoided? 

^ 

2. Was damage to walkway surfaces avoided? 

^ 

 No 

 No 

 No 

 No 

 No 
Owners comments: 

Inspection notes: 

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

EPA Representative &>m ^» Date: ^^ 
21233

 

Omtfha~Lea Exterior Paint North Arrow ? Owner Name: MORGAN J HELTON |g Good Site Sketch Address: 4234 MASON ST Q Poor 

Phone: H: 402-553-6702 W: 402-444-1136 Q Not paint 

0\jf>V^> Lead Sample Samples Collected Sample Number LAB Concentration Collected 

RYASCPXA-21233 $i&4 ppm £3

 

RYBSCPXA-21233 F2 ppm £3 D 3 J

 

RYCSCPXA-21233 B1 ppm 0

 

Samples Analyzed RYDSCPXA-21233 £B2 ppm 0

 

RDZSCPXA-21233 DZ ppm 0 ^/'z

-" Book: 

RGZSCPXA-21233 £6Z ppm 0

 

prt-yo/^nx/ A^QA^aQ P*T ppm D 

Number of Samples = j .5"" 

•*f>^ • -B ENTERED ^^ ^ -xF ^^ 

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JUN 0 9 2004 A <s \~­

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Omaha Lead Site 46130 
SERA

 

Property Completion Agreement 

This agreement documents the completion of removal activities perfo med on the below listed property. 

The property owner's signature indicates that the property owner if ;a isfied with the restoration of the 

subject property, and that no items are in question, now, or at ai ' i cie in the future, excluding any 

remaining warranty (30 days total) except those items listed below, i ar /. 

Property ID: 

Property Address: Q-£3<-l Al^S^-YV 

Owner: t^f\lf\ G~~\v~&ff Hv\Ji M*nfQc\^ n£ (~\~c

^\ i £

Phone: 55 3,. (p ^ 0 2-/ 2J 0 -^i.q 

Restoration Items in Question: 

Hem: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

I agree restorationjs completed, except as noted above. H-W*^­

\ do not agree restoration is completed 

Owner's Signature Date 
PRUDENT TECHNOLOGltiWC. FIRST NATIONAL^RK OF OLATHE 16534 

8080 WARD PARKWAY. SUITE 405 83-172/1010 

KANSAS CITY, MO 64114 

(816) 363-3703 

PAY TO THE 

ORDER OF 

OLLARS 

E, 5 3 UN' i:iOiOOi?BOi : "'OiU U NPRUDENT TECHNOLOGIES, INC. 16534 

PRUDENT TECHNOLOGIES, INC. 

16534 
Print Preview Page i 01 i 

Douglas County-Omaha, NE 

Parcel ID 1618430002 Sec-Twn-Rng 20-15-13 

Owner HELTON Owner 

Name MORGAN J Address 

Property 

Address 

4234 MASON 

ST Addition LEAVENWORTH HEIGHTS 

City OMAHA Block 

Zip 68105 Lot 202 

Owner 

Address Legal 1 E 30 FT LOT 201 & ALL 

Owner 

Address 2 

4234 MASON 

ST Legal 2 75 X 108 

Owner City OMAHA Legal 3 

Owner 

State 

NE Legal4 

I 

Owner Zip 68105 Assessor 

Website Link 

http://douglasne.mappingonline.com/DouglasCoNe/static/accountinfo.jsp? 

accountno=R1618430002 

Disclaimer Map and parcel data are believed to be accurate, but accuracy is not Mag Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 33 feet appraisal, survey, or for zoning verification. 

http://vvww.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 7/16/2007 
21233

 

Omaha Lead Site Owner Name: MORGAN J HELTON 

Site Sketch Address: 4234 MASON ST

 

Phone: H: 402-553-6702 W: 402-444-1136

 

Sampl Lead Sample e Number 

Concentration Collected 

RYASCPXA-21233 a

 

RYBSCPXA-21233 

RYCSCPXA-21233 

RYDSCPXA-21233 

RDZSCPXA-21233 

RGZSCPXA-21233 

*y ^ f-\ r~t y ^^-O-4-C^^ 

Number of Samples = 

ENTERED 

JUN 0 9 2004 

Exterior Paint 

Good 

Poor 

Not paint 

Samples Collected 

Samples Analyzed 

46130 
FindReccxd ! Qean Up Query I Lead Remaining Query j Property Damage Query ! Close i 

Sample Area: 21233 - 4234 MASON ST 

Owner: Resident: Contract: 

Q Owner Occupied ,. 'Resident Name: Contractor:

 

Owner Name: | HELTON MORGANT j IPRUDENT2007

 

IHELTON MORGAN j Property Address: | Group:

 

Owner Addressl: J4234 MASON ST

 

4 Zip Code: 

Assessment: Owner AddressZ: J68105 

J4234 MASON ST, Resident Phone Qualifying Group

 

City: State: Zip Code: |EBL - AGE 1.5

 

JOMAHA INF 168105

 ' Asssssment XRF Date: 

Owner Phone: Alternate Phone: : 1 

1(402) 553-6702V ](402) 444-1136 i Assessment Max XRF Value: 

! "' 7337 

L SS3­
maha Exterior Paint Lead Site Owner Name: MORGAN J HELTON Good Site Sketch Address: 4234 MASON ST Poor 

Phone: H: 402-553-6702 W: 402-444-1136 fj Not paint 

Sample Samples Collected Sample Number Collected Firm.

 

RYASCPXA-21233 ppm Date:

 

RYBSCPXA-21233 F2 ppm Time:

 

RYCSCPXA-21233 B1 ppm 0 

Samples Analyzed RYDSCPXA-21233 f"B2- *;.' ppm 

RDZSCPXA-21233 DZ ppm 0 XRFUnrt: ^/'2

-~ Book: 

RGZSCPXA-21233 IGZ ppm 0 Date:

 

Ppm D Time:

 

S*afc Number of Samples = 

ENTERED 

JUN 0 9 2004 

Omaha Lead Site 
Print Preview Page 1 of 1 

Douglas County-Omaha, NE 

Parcel ID 1618430002 Sec-Twn-Rng j 20-15-13 

Owner HELTON Owner 

Name MORGAN J Address 

Property 

Address 

4234 MASON 

ST Addition LEAVENWORTH HEIGHTS 

City OMAHA Block 

Zip 68105 Lot 202 

Owner 

Address Legal 1 E 30 FT LOT 201 & ALL 

Owner 

Address 2 

4234 MASON 

ST Legal 2 75 X 108 

Owner City OMAHA 'Legal 3 

Owner 

State 

NE Legal 4 

Owner Zip 68105 Assessor 

Website Link 

http://douglasne.mappingonline.com/DouglasCoNe/static/accountinfo.jsp? 

accountno=R1618430002 

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 appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_aUas/dogis/printPreview.aspx?PrintOptData=Douglas County-... 7/16/2007 
AGREEMENT AND RELEASE FOR RESTORATION OF REAL PROPERTY 

This Agreement and Release (hereinafter "Agreement") is entered into by and between, 

Erin Grace (hereinafter "Property Owner") and the United States Environmental Protection 

Agency (hereinafter "EPA"). 

WHEREAS, the property located a^4234 Mason Street (hereinafter "the Property"), more 

specifically described below, is owned by Erin Grace; 

WHEREAS, EPA through sampling and analysis has discovered the Property was 

contaminated with lead; 

WHEREAS, the EPA performed a removal action and removed the contaminated soils 

from the property and backfilled the formerly contaminated areas with clean fill then sodded 

and/or seeded the described, effected property; 

WHEREAS, the Property currently requires a limited amount of restoration work to 

return the Property to its original condition prior to initiation of EPA's response activities, or as 

nearly as possible to its original condition; 

NOW THEREFORE, in consideration of the mutual covenants, promises and conditions 

and terms to be kept and performed as recited herein, the parties hereto agree as follows: 

1. The real Property which is the subject of this agreement is owned by 

and is more specifically described as follows: 

LEAVENWORTH HEIGHTS LOT 202 BLOCK 0 E 30 FT LOT 201 & ALL 75 X 108 

2. The EPA will complete the following restoration items: 

Pay $120 in lieu of replacing some plants that EPA damaged during the remedial action. 

3. The Property Owner acknowledges that EPA shall have no responsibility for further 

restoration work at the Property. 

4. The Property Owner releases the United States and the EPA from any and all claims 

arising out of or connected with, directly or indirectly, their ability to inhabit, occupy, use, transfer, 

or sell the real or personal property at 4234 Mason Street and the reimbursements, compensation, 

payments, costs, expenses, and any inconveniences or damages relating to the foregoing and the 

cleanup, decontamination, disposal and restoration of the Property, including any claims under the 
Uniform Relocation Assistance and Real Property Acquisition Policies Act, 42 U.S.C., Section 4601 

et. seq. 

5. The Property Owner affirms that she is the legal owner of the Property at 4234 Mason 

Street. '2 

This agreement is entered into and made effective the & day of_ Oc-k^-i_ , 2007. 

FOR THE PROPERTY OWNER 

Date A * 

FOR THE UNITED STATES ENVIRONMENTAL PROTECTION AGENCY 

o 7 

Date 

U.S. EPA, Region VII 
SEP-28-2007 10:05 LJORLD-HERRLD NEWSROOM ^ 402 345 0183 P.02 

Erin Grace and Morgan Helton

 

4234 Mason St. 

Omaha, NE 68105 

(402) 553-6702 

emg2@cox.net 

Dan. 

Here is the list Morgan came up with. Let me know if you need more detail or explanation. 

Thanks for all your help! 

Erin 

List: 

4 existing and 10 new perennials 

4 annuals 

10+ iris plants 

1 mature boston ivy 

1 fully mature day lillly 

I estimate that this is about $120 dollars. 

TOTRL P.02 
SEP-28-2007 10=05 UORLD-HERRLD NEWSROOM 402 345 0183 P. 01
 

Omaha World-Herald 

Fax Cover Sheet 

Date: Time: 

Name 

Company 

7 

Fax number 

page(s) to follow 

Special instructions: 

From: IvVl/vOmaha WorM-Herald 

1314 Douglas Street Suite 700 

Omaha, NE 68102 

Phone: (402) 444-1000 ext. MS k 

Fax: (402) 345-0183 

Please call phone number above if problems occur during transmission.