TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAK)#: 24 1 Date: 

Address: 

Remediation Contractor: /CQ^^J H l^J.u.(Lp>. .Xvir.^ Year: Pj^bK. 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

[ ET Video ofproperty (DVD) 

y Executive Summary 

y EPA-provided property sketch 

B ' Signed Access Agreement for subject property 

n Signed Access Agreement(s) for adjacent property 

B^ Restoration Agreement 

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

0 Confirmation data 

y Photographs 

y As-buUt sketch 

0^ Satisfactory restoration signed by Property Owner 

y Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

M Utility clearances 

y Property information from Douglas County Assessor's Office 

D 

D 

D 

ate 

40310712 ii 

Superfund 
PROPERTY SUMMARY 

Date: 01/23/2009 Omaha Lead Site Remedial Action Contract ff EP-R7-07-06/0004 Month of: Dec/Jan 

Property Address: 2003 PINKNEY ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: AREA NOT EXCAVATED, YB TREE, 5'X5' @ 238 PPM 

CONFIRMATION SAMPLING DATA/RESULTS: 

UD = 124 PPM (@ 6"; YB = 82 PPM @ 6"; DZ = 204 PPM @ 12"; UD = 306 PPM @ 6"; EA = 302 PPM 

@SCRAPE 

ATTACHMENTS 

1) Property sketch provided by EPA pursuant to contract specifications 

2) Signed Access Agreement includmg access agreements required for crossing other properties 

3) Pre-Excavation digital video clip/photogr^hs 

4) Post-Excavation digital video cUp/photographs 

5) Documentation - Completed Close-out Checklist 

6) As-Built sketchi) Shall includefinallead 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 propertyfile,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 

photogr^hs 

iv) Signed form verifying satisfactory restoration 

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

TECHNOLOCIES, INC. 
Find Record 

Backfill: 

Sample Area: 361 - 2003 PINKNEY ST 

Owner: 

n Owner Occupied 

Owner Name: 

JBRUMT NAOMI V 

Owner Addressl: 

• - - -

Owner Address2: 

|2003 PINKNEY ST 

City: State: Zip Code: 

|OMAHA |NE |68110 

Owner Phone: Alternate Phone: 

' — 

Clean Up Query Lead Remaining Query I Property Damage Query 

Resident: 

Resident Name: 

Property Address: 

|2003 PINKNEY ST 

Zip Code: 

|681iq , 

Resident Phone 

Contract: 

Contractor: 

)PRUDENT2008^S 

Group: 

C 

Assessment: 

Qualifying Group 

|800 11^ 

Assessment XRF Date: 

r" ""• " 

Assessment Max XRF Value: 

I 826.4 
TECHNOLOGIES, INC &EPk 

EPA Property Close Out 

Property #: Us) Property Address: 2DO 1> nV\ k-uuzt. ^^ 

Date/Time: Owner's Name: 

Quads Excavated: Y ^^ ; ^^ ^ Contractor Group Pnident Technologies 

Excavation General Yes No 

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

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

Grading Sod and Vegetation Yes No 

1. Does the grading around the perimeter of Ihe house in excavated areas generally slope away .-^ from the house? 

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

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 generallyfirm and evenly graded? ^ 

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

6. Was the property graded sudi that water wii] not pool on the property? -^ 

7. Was damage to landscaping or plant materials avoided? 1 ^ 

Gates, Fences and Retaining Walls Yes No 

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

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

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

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

Foundation, Siding and Gutters Yes No 

1. Was damage to the siding or trim avoided? u ^ 

2. Was damage to the foundation avoided? t 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. Was damage to walkway surfaces avoided? y 
Owners comments: 

Inspection notes: 

Removal and restor; ites complete including the 30-day sod warranty: 

EPA Representative dLgf Date: /^T/^ A 
«ERIV 

Property Completion Agreement 

This agreement documents the completion of removal activhies 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, if any. 

Property ID: 

Property Address; ^^^ 3 p.^j:^^ ^ <^^ 

Owner: M^^^ ; ^^^^ ^ 

Phone: t^r ^ -//5 3 .-ppcf ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

I agree restoration is completed, except as noted above. 

L J I do not agree restoration is completed 

/bJ2/\0 f 

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

. 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 grants permission to Prudent to perform 

activities related to the cleanup including soil samplmg, removal oflead-contaminated soil, and restoration ofthe referenced property 

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 Madhunma Duru-at (402) 733-1188, 733-1455. General questions about the Omaha Lead Site 

cleanup can be directed to the EPA Public Information Centers at (402) 731-3045 (South Omaha office) or (402) 991-9583 (North 

Omaha office). 

Property Access Granted 

(Pleasfe Prinntt Name : ) 

Property Owner Signature i-f/*?^ ^ "yMxyUJQyyZyy. (Date) (SignaSne) 

PROPERTY INFORMATION 

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

RESIDENT NAME: Owner Renter 

RESIDENT ADDRESJ 

V^Ag SV fiv^^^iJi/^ ^^^^ C-.gVlD 

^ 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILIN(TMipRESS; 

' ^ Qw^^J ^ 1^,, (^<^ U t> *\^ ^ 

• ^ 

OWNER'S TELEPHONE NUMBER - HOME: _L WORK: 

AGE OF HOME?: \cro 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 Section 104 of CERCLA, 42 U S.C 9604 EPA's nght of access to the property is provided for in Section 104(e) of 

CERCLA, 42 U S C 960S(e), which provides entry for "determining the need for response, or choosing or taking any response action 

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

8080 Ward Partway, 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 Fax: (210) 579-6577 V 
AS - BUILT DRAWING 

OMAHA LEAD SUPERFUND SITE OLS#: 361 

Date Excavated: 9/23/2008 

Date USEPA Signed-OfT: 

361 

Omaha Lead Site Owner Name: Site Sketch Address: 2003^P1NKNEYJT_ _ 

Phone: H

Sample Number 

RYASCPXA-361 YA 

RYBSCPXA-361 YB 

RYCSCPXA-361 YC 

RYDSCPXA-361 YD 

RDZSCPXA-361 DZ 

RGZSCPXA-361 G2 

RPZSCPXA-361 PZ 

 w: 

Lead Sample LAB Concentration Collected 

2702 ppm 

826.4 ppm 

ppm n 

331.2 ppm 

401.6 ppm 

ppm 

ppm 

0

•

• 

Number of Samples = : 4 

D 

a 

a 

D 

n

•

• 

Exterior Paint North Arrow 

• Good 

• Poor 

Q] Not paint 

Samples Collecled 

Firm: _ Sverdrup 

Date:. 

Time: . 

Samples Analyzed 

XRF Um t: Book: 

Date:. 6/8/1999 

Time:. 11:26 

Staff: 

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

UD=124PPM o 6" 

AREA NOT EXCAVATED 

|YB TREE, SX-S Sq. Ft :ff 238 PPMj 

DZ = 204PPMC«!12" 

MAP ERROR 

SIDE WALK 

CONTRACT #: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC. 
MODE •nn 

ECHNOLOGIES, INC. 

Property Status Form 

Address: e?l6cs3 T ? t\ Vl4/v^<»-*.j C( Date: 

Phone: BVID: 

^5'2.-10<\ ^ 

Plants & Pernianent Landscapmg 

Item# 

On Map Description and Location 

Pre-Existing Condition of Structures 

Does your Basement have a history of leaking? Yes No 

Item# Description & Location 

On Map 

Property Owner Prudent E: 

Signalun K 

4y.9^ 

8080 Ward Parlcway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive. Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 ^ "San ArtlDniDrTX^82-29 

Phone:(816)363-3703 

Fax: (816) 363-3707 

Phone: (402)504-1004 

Fax: (402)504-1005 

Phone: (210)822-9588 

Fax: (210) 579-6577 
361 

Omah Exterior Paint NorthArrow a Lead Site Owner Name:. • Good Site Sketch Address: 2003 PINKNEY ST • Poor 

Phone: ^ W: • Not paint 

Sample Number 

RYASCPXA-361 YA 

Lead 

Concentration 

270.2 ppm 

Sample 

Collected 

0 

LAB 

D 

Finn: 

Date: 

Samples Collected 

Sverdrup 

RYBSCPXA-361 YB lflP^ ppm 0 D Time: 

RYCSCPXA-361 

RYDSCPXA-361 

YC 

YD 331.2 

ppm 

.ppm 

D 

0 

a 

a Samples Analyzed 

RDZSCPXA-361 

RGZSCPXA-361 

RPZSCPXA-361 

DZ 

GZ 

PZ 

^^^ ^ .ppm 

. ppm 

.ppm 

Q 

a

D 

D 

n

D 

XRF Unit: 

Date:

Time: 

 6/8/1999 

11:26 

Book: 

Staff: Number of Samples = I 4 

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

; P/NKMCY-. ST ; 

Rev 4* 046141.0123 
.I15288900000001.jpg (JPEG Image, 640x480 pixels) http://douglasne.mapping-online.com/assessdoc/Photos/06/R15288900., 

«?oo3 pn^f'^^y ^'^' 

lof l 9/9/2008 11:27 AlV 
Print Preview Page 1 of 1 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner 

City 

Owner 

State 

Owner 

Zip 

1528890000 

BRUNT 

NAOMI V 

2003 

PINKNEY ST 

OMAHA 

68110 

2003 

PINKNEY ST 

OMAHA 

NE 

68110 

Sec-TwnRng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

10-15-13 

KOUNTZE PLACE 

33 

1 

N1/2 

62 X 74 

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp? 

parc=1528890000 

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

accountno=R1528890000 

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 = 42 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 9/9/2008 
12/04/2008 

OO 

.yiNKNty, 






Page 1 of 2 

"> 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2132416. 

Original Call Date: 9/16/08 Time: 11:12 am Op: RAMITA18967 

Work to Begin Date: 9/18/08 Time: 11:45 am 

State: NE County: DOUGLAS Place: OMAHA 

Address: 2003 Street: PINKNEY ST 

Twp: 15N Rng: 13E Sect-Qtr: 10-NW 

Twp: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: LEAD REMEDIATION PROJECT FOR SOIL 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: [402)733-1883 : UNSURE CORNERS 

Company : PRUDENT TECHNOLOGIES 


Contact Name: RAMITA Phone: {402)733-1455 


Alt. Contact: 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 MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emerg: 4029329757 

MAGELLAN MAGELLAN MIDSTREAM PARTNERS LP TONYA

Day: 9185747098 

 Alt: 

Emerg: 9185747098 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY

Day: 4025047823 

 AU: 

Emerg: 4025047946 

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RON

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/16/2008 
Page 2 of2 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA

Day: 4067289343 

 Alt: 8887289343 

Emerg: 4067289343 

QLNNEl C QWEST LOCAL NETWORK NA

Day: 4067289343 

 Alt: 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/16/2008