TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: ^ ^ ^ Date: \ a to 

Address: 

Remediation Contractor: Coastal Environmental Group Year; 2001 

SOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

/ 

5/ 

j ^ 

t/ 

-aVideo of property (DVD) ' 

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 

1/ 

i/ 

Photographs 

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 infiBfinatji6n from Douglas Counly Assessor's Office 

[I 

D 

n 

30054463 

16 

Date 

Superfund 
Property Access Checklist 

Property©: 7^<5'4 q 

Property Addms: 3, ^ Ph^,4n/ \

ON: __/__/_ _ 

ON: / / 

<>"»*^ ?dneTA: BJA^-ii^ 

Address 

31 m Vopplt-^oO 

piH.«c: MAt/5'l%.\nV p 

Fax; 

Ceil/Pager: 

L_J Notification Letter 

^ Access Agreement 

^ Restoratioa Agreement 

n Topsotl Sampling (if applicable) 

D Disposal Sanq>iing (if applicable) 

D Garden Sampling (if appUcable) 

^UtiK^Ctearattc e 

0 V{deQ/Pbotos(Bdbre) 

0 Video/Photos (Dnring) 

D Vldeomiotos (After) 

D VldeoAliotos (30-Day) 

P Final Report 

Air MonitorinE (aa applicable] 

% 

O Comnmnity DCrew I On:

Results: 

• Comnmnity •Crewr On:

Resolts: 

• Ctonnmnhy QCrcw I On: 

Resolta: 

D WORK STARTED 

D WORKCOMPia.TED Asftr 

Sent:

Sisned:

Slpied!

/

/

/

Renter 

PiMme: 

Fax: 

Cell/Pagen 

Additional Information: 

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/ / 

/ / 

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/ 

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Caned:^ /Yl /ty\ 

Oa:3_/n/Q9 

On: / / 

On: / / 

On: / / 

SigpedP^ r/{gl(p\ 

Issned: / / / 

/ i By: 

/ / By: 

By: 

Omaha Lead Site 

By: 

By: 

By: 

By: 

By: 

By: 

By: '\\\\^\ri\ 

By: 

By: 

By: 

By: 

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Douglas County Account I H^M^i^ion Page 1 of3 

Douglas County, Nebraska Property Record - R0957260000 

Print Report 

NEW Feature - Parcel Dimensions available (3) scale 0-50 ft west of 52nd St - Vle W O n Ma p Infomiation is valid as of 2009-8-3 Treasurer's Tax Report 

New Feature • • ^ -> Auto Sales Search 

Owner 

BLACK ROBERT J 

3114 POPPLETON AVE 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number: 5726 OOOO 09 

Account Type: Residential 

Parcel Number: 0957260000 

Parcel Address: 3114 POPPLETON AV 

OMAHA NE 68105-0000 

Legal Description: DUNDY-E S JR-SUB DIV(HANSCOM PLACE) LOT 4 BLOCK 0 37.5 X 100 & E 37 

1/2 S 40 FT LT 15 BLK 6 HANSCOM PLACE 37.5 X 40 

Value Informatio n 

Land Improvement Total 

2009 $5,900.00 $65,800.00 $71,700.00 

2008 $5,900.00 $65,800.00 $71,700.00 

2007 $5,900.00 $65,800.00 $71,700.00 

2006 $5,900.00 $92,400.00 $98,300.00 

2005 $5,900.00 $92,400.00 $98,300.00 

2004 $5,900.00 $92,400.00 $98,300.00 

Sales Informatio n 

Sales Date: 2008-01-25 

Deed Type: WD Book: 2008 Page: 008330 

Price: $106,000.00 

Grantor: THOMPSEN BRUCE A ETAL 

Grantee: BLACK ROBERT J 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 2006-03-10 

Deed Type: WD Book: 2006 Page: 027757 

Price: $21,000.00 

Grantor: ROBERT W NOVAK ETAL 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09... 8/22/2009 
Douglas County Account I; Q|Mn3|^ion Page 2 of 3 

Grantee: BRUCE A THOMPSEN 

Valid/Invalid: 

Exclusion Reason:

Invalid 

 Questionable Sale 

Land Information 

Acres 

0.12 

SF 

5320.0 

Units 

1.0 

Depth 

140.0 

Width 

38.0 

Vacant 

No 

Improvemen t

Building 1 

 Information 

•^0 .* RraFtair -^NKCndFkM 

1:26am t 

^„ va ntr 

JtlJ 

•Id 

2*0 

TWO STORY •j'VftitMi n 

CLICK TO ENLARGE IMAGE 

Square Footage: 2452.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Fair 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Forced Air Rooms: 8.0 

Exterior: Frame Stucco Units: 2.0 

Interior: Drywall Baths: 2.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: ,2.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1890 0% 1890 119 

Detail Type Detail Description Units 

Add On Shed 1.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 1226.0 

Fixture Additional Fixtures 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09... 8/22/2009 
Douglas County Account I: n|uiB^ion Page 3 of3 

Fixture Base Fixtures 1.0 

Fixture Bath Full 2.0 

Garage Built In 400.0 

Porch Slab Roof Ceil 216.0 

User 2 UNIT CONVERSION 1.0 

User codei 25tomodle 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09... 8/22/2009 
• • 

Property ID # 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

If^^^q 

?>UH Popp^-Von A\/C 

Date: Time: 

Date: Time: 

Date: Time: 

Transmit to EPA D 

Action: 

Action: 

Action: 

Other Action: • 
• • • • 

Page 1 of2 

"> 

Create Another Ticket Back to Irth Internet | [ Send Email ) 

• YOUR TICKET NUMBER IS 2362526. 

Original Call Date: 9/12/09 Time: 6:28 pm Op: ELIZABETH18790 


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


State: NE County: DOUGLAS Place: OMAHA 


Address: 3114 Street: POPPLETON AVE 


Twp: 15N Rng: 13E Sect-Qtr: 28-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 


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: coastal 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number UtiUty Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVEL3 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 


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

• • • • 

OPPDGPR6 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIF QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/12/2009 
OLS#: 20549 

( ^ As-Built Drawing Date Excavated:9/2209 

Date USEPA Signed Off: 10/5/09 

COASTA L Oinaha Lead Superfund Site Area Sodden: 380 sa ft 

Name: ^i.k^rj ' AJa^u(r ~ Omaha Lead Site Date: !3_ North Arrow 

Address: '^il'-i f^'of>fif>-i-o>^ Site Sketch Time: /<? Jo i 

Phone A^Z ) -3^S'- S<g/^o f 

TeawtlZ/vtiyMuJt^.t.y/nii/ I 

Omaha Lead Site 46130 

Legend 

Concret e Dri p Zone Excavate d Quadrants Excavate d 

Are a replace d wit h Area replace d wit h 

Are a lef t bar e Sod Rock/Mulch ' ' 

Contrac t #: EP-R7-07-05 Coastal Environmental Group Inc . 
z Afic ^ 

Name: ^tiheT' T A/a^ei.\r~ 

Address: 'M}*-t Popple+o>y 

Phone.^*^Z) .y^6^ - ZK^ll T 

Omaha Lead Site 

Site Sketch 

Date: 7 

Time: ~7 ^ Sl^A i 

North Arrow 

^ 

Team< ^ i ^ m\^fii>^jpQu I BVID # 20SH* ^ XRF Code SSi^ ^ 

Sample Number 

y 4 8<3. 

i _a2 

Lead Concentration 

^^ ^ ppm 

Confirmation Sample 

/5/Yes n 

/7i^es n 

Yes • 

Yes • 

No sr 

No R 

No lar 

No ^ 

No S 

No a 

No • 

Omaha Lead Site 46130 
3111 ^(^yVWr 

Name: ^c^k^.r-h /Va/<i ^ 

Address: .5//^/ Popfle-hon 

Omaha Lead Site 

Site Sketch 

Date:

Time:

 y//*d)3 

 I^JOS'^f^ 

North Arrow 

l^BrrCrcjic^lpUfi.yyJfhul BVID # ^O^ f XRF Code S5(9^ 

Sample Number Confinnation Sample 

Yes

'"^es

/S/yes

^^Ves

-^*es

Yes

Yes

 D 

a 

• 

a 

D 

• 

• 

No ' ^ 

No ^ 

No 1 ^ 

No ^ 

No S3 

No O 

No n 

m 

—j^ v \ ^ 

i^tr<-^;^T^­

iha Lead Site 46130 
Name: fi^i^r^ MAfo.\ ^ Omaha Lead Site 

SHa Sketch 

Ph»n« ^*<o2^^ 3^g­- ^i^lU 

Omaha Lead Site 46130 
,*^^*°""«# 

COASTA l 

[HVIKOHHIhTAl '*>< PM^' ' C R 0 U r . IN C 

Consent for Access To Property 

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 described premises: 

Owner's Name: Daytime Phone: ' ' '^P 

^<^^rf ^\ft.c-k 

Address of Property 

covered by this 

Agreement: 3/lw 

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, v\nll contact 

the Grantor in-person to discuss the woric to be performed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration worl( 

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 vinth 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 performing the work. This access shali 

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

agrees to: 

Page 1 of 2 
V^-^j f

 COASTAl tHTINONHtRTAl 

C K O t> r I f C 

* Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

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

to save; 

( Wiater 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; 

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

the property to perform the work. 

t' 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 

©<g grant access to my properties

 D I do not grant access to my properties 

^ ^ M'^ ^ 1 

Signature Date Signature Date 

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

Page 2 of 2 
COASTA L 

Restoration Agireement 

The purpose of this agreement is to provide a mutual agreemem 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 Stales Environmenta] 

Protection Agency (EPA). 

Property ID: 2-6SH ^ 

Property Address: ^ ] IH fepple-4<^ 1

Owner: f\^L^4- R\r.ciei 

Phone: -^M^^^-^T^ 

h?^"<gfrirt hi^rk ?^'^ ^ n 

On the attached diagram(s) indicate aiea(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 condhions ofthe property and the basement if 

necessary. ^ 

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

The (enoval. storafie. disposal, and/or return of these itoms is the Owner's responEibiiity. 

ttem: 

^ ^V*-o<-^ P(e»«- ^ - Item: 

ttem: 

ttem: 

Page 1.1k 
Kerns to Be Removed By Contractor During Remediation and^Replaced_ 

Item: 

^c.A .^^-A

ttem: 

Item: 

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. 

Aiiath n sketch ol ihi? 

^rrifkloi iiiV'.ui; 

Number of and size of 

each garden/ flower bed 

area. 

Atuitii ;i skc'ich ol rclntivi' 

•iV/KS nnd loc;llil'iM^ 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Vole llii" NHIUC «ill hi 

i;srC 10 i>:ui .i |)IHII; 

\oiicIic.' KJ llie |)roi)cil\ 

UM ner. 

Easement Area, to be 

excavated 

Quantity 

n 

\ 

¥ 

^ 

v^ 

/ ^ 

f 

 P:z vz 

r 

Landscape Inventory 

Unit Condition/Type/Specles 

Quadrants 

Each 

Each 

Each 

Eacfa 

Square Feet 

S 

P.ach 

Page 2 of f 
C O A S 1 A L 

\ Additional Comments / Instructions: 

^^[ 1 2 ^^^U^^ "iv\^ c=LA/z:<^'-ce.-^ 

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

pre-existing damage. By checking this t>ox CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

[^4 agree CD I do not agree 

Owner's Signature Date Contractor's Signaturr Date 

Page 3 of \ / 
BVID# ^toS"Mc ^ 

XRF PROPERTY SAMPLE SHEET 


Date 

Project ^Wgf 

Omaha lead FP 2nd year option 

Address 

Sample time 

•3HMr P-^fpiOfl-^ A^ - am/pm 

XRFID# sample length 30 sec 

^Shot # 

mr 

Reading 

ara 

77 ^ ± I >• i • 

Sample area 

£2=1 

Depth 

Shot# Reading S Sample area 

b ^ 

Depth 

^ 

Average / ^ I J P /Q> Average ^ Q ^ o 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

lab sample # Lab result Sample area XRF Avg. 

Signature (^Cfl/^J? m 

Print g.UAp>J[m Qames, 
• • #ii 

^ — ^ 

/ jOk^ \

^^^^ ^

W ' j f

NpHoT*"^

Omahaa Lea I .. d Site—Fixed Price EP-R7-07-0 . .. ._ 5

Coastal Environmentai Group Inc.

 www.coastalhazmat.com

EXECUTIVE SUMMARY: 

BVID #20549-(3114 POPPLETON AVE) 

No Issues or Concerns Q Issues/Concerns 

Detail Explanation 

^v..^ 7 ^

"^^^ mVliOMHINTA COASTA Ll 

G IO U P. IN C 
4

0 

St9. EPA 

EPA Property Close Out Form 

UM •yh(ioy\ hit 

Property #: : iO^^^ • - - - ' 

Datc/Tlne: 

Quads Excavated: ft ^ > V'^ Contractor Group <^.g>A^lTt«-^ 

Excavation Yes No General 

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

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

Gradin Yes JNo g Sod and Vcgctetioa 

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

from the house? 

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

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

day time period) 

r7 

4. Ai« sodded areas generally Arm and evenly graded? ry 

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

time period) 

6. Was the property graded such that water will not pool on the propert}**! r/' 

7. Was damage to landscaping or plant materials avoided? 

^ ^ 

Gates, Fences and RclatnlBg Walls 

Ves lyo 

I. Do gates open and close freely? (Ifapplicable) 

2. Were all gates or fences laken down during restoration activities reinstalled? (Ifapplicable) ^ ^ 

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

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

^ ^ 

FoundatloB, Sidtng and Gutters 

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

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? i: 

 Was danuge to windows or door screens avoided? 

5. Was damage to downspouts or downspoul extensions avoided? 

T:^^ 

Sidewalks and DrHewayi (Concrete) 

Yes No 

1. Was damage lo driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

Removal and resloration aclivales complete including the 30-day sod vyarranty: 

EPA Represenlalive LJo K jjC^/l/p,//-^ Dale:/O /^/ ^ 7 
# # 

Property Completion Agreement 

This agreement documenls the completion of remedial acliviiies perlormed on my property My signature 

will designate ihal 1 am satisfied with the restoralion of my propeity, and Ihal no items are m questions, 

now, or al any lime in (he ftjlure, except ihose ilems listed below, ifany 

Property ID: ^^t \ 

PropcrtyAddrm:3H q popp^^ ^ |)Wft 

O""*^' RnVxy-V ftlnr 

Phone: ^O?. 5^A. ^4 7 ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

ttmplcied, rxccpt as naitri 

is complcleri 

09-7M.9^ 's Signatiirf Cvnrartor' s Signature