TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: ^jD^^O ^ ^ Date: 

Address: fo&?y Ki o i| t4— 

Remediation Contractor: l^^oJrTctkM^f^ .^^?>nc,. Year: -^Qi?-

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

I2f

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a

D

B^

B^

Q^

B^

y

^

Q^

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M

\y

D 

D 

D 

 Video of property (DVD) 

 Executive Summary 

 EPA-provided property sketch 

 Signed Access Agreement for subject property 

 Sigjied Access Agreement(s) for adjacent property 

 Restoration Agreement 

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

 Confinnation data 

 Photographs , 

 As-built sketch 

 Satisfectory restoration signed by Property Owner 

 Property close-out check list signed by EPA 

 Description of areas not meeting ROD cleanup criteria 

 Utility dearasLces 

 Property informationfrom Douglas County Assessor's Office 

Signature/ 17^^ ^ D>ati S c 

40310719 

Superfund 
PROPERTY SUMMARY 

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

Property Address; 6808 N 24 ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Oflier Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 196 PPM @ 6"; DZ = 324 PPM @ 6"; EA = 244 PPM @ 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 cUp/photogr^hs 

5) Documentation - Completed Close-out Checklist 

6) As-Built sketchi) Shall include finallead 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 satisfactory restoration 

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

ECHNOLOGIES, INC. 
Rnd Record 

Backfill: 

Sample Area: 40452 - 6808 N 24 ST 

Owner: 

n Owner Occupied 

Owner Name: 

[DOUGLAS VICKIE L 

Owner Addressl: 

I 

Owner AddressZ: 

)6808JJ 24 ST 

City: State: Zip Code: 

jOMAHA^_ _ ;.|NE J |68112 _ 

Owner Phone: Alternate Phone: 

1(402)455-9739 ] [ 

Clean Up Query Lead Remaining Query i

Resident: 

Resident Name: 

[DOUGLAS VICKIE L 

Property Address: 

[6808 N 24 ^ 

Zip Code: 

|68112 i 

Resident Phone 

1 

 Property Damage Query 

ii 

Contract: 

Contractor: 

|PRUDENT2008^S _ 

Group: 

Assessment: 

Qualifying Group 

; |800 ^ 

Assessment XRF Date: 

L-,^, -^i 

/Assessment Max XRF Value: 

I 843.2 
TECHNOLOGIES. INC 

EPA Property Close Out 

Property #; Property Address: 6So 8 N ^M^"*" 

Date/Time: Owner's Name: 

Quads Excavated V Contractor Group Prudent 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? / 

Grading Sod and Vegetation 

Yes No 

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

from the house? / 

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

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 generally firm and evenly graded? / 

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 property? / 

7. Was damage to landscaping or plant materials avoided? / 

Gates, Fences and Retaining WaUs 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) / 

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

/ 

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

/ 

Foundation, Siding and Gutters Yes No 

I. Was damage to the siding or trim avoided? / 

2. Was damage to the foimdation avoided? / 

3. Was damage to windows avoided? 1 / 

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

5. Was damage to downspouts or downspout extensions avoided? 

/ 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? 

./ 

2. Was damage to walkway surfaces avoided? 

i / 
Owners comments: 

Inspection notes: 

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

EPA Representative JH^^. ^ Date: //JQ/OI 
SER^ 

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 futm-e, excluding any 

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

Property ID: 

Property Address; (^<go ^ >^-) ^M W ^.VOwner: y/V^t^r e }, T^ r.^S ^ 

Phone: ^ 0 2 " M^* ; - ^n^ ^ ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

t

item: 

Item: 

I agree restoration is completed, except as noted above. 

L J I do not agree restoration is completed 

i^ - 7,^1-0 

Date 
Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection 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 Ptudent 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 sampling, 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 .Administrativt: Clerk for the 

oinaha Lead Site cleanup, Ms. Madhurima Duni-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 Bv:Vl/LKif L. Qo 

Property Owner Signature: Q-\A-o3 

(Date) 

)PERTY INFORMATION 

(To be complete lident and/or property owner — please print) 

RESIDENT NAME: 1)OMIA 5 (^y^ ^ Renter 

RESIDENT ADDRESS: 

IF RENTAL, PROPERTY OWNED BY: 

\Af-fJte - \ ,T ^ n"^>~ojr\OLy\ 

OVVNER'S MAILING ADDRESS; . . a A A> 

OWNER'S TELEPHONE NUMBER-HOME: t ) WORK: 

AGE OF HOME?: \/r P ^ YEARS. HOW LONG HAVE YOU LIVED HERE? ^ I YEARS. 

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

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: vS) 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 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 the need for 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 Fax: (210) 579.6577 
.v^V '.'A-.X'i 

Jr-6M^kHA;;LEAi).'isiJT^feRE 

OLS#: 404S2 

Date Excavated: 9/19/2008 

US£PA Sigoed-OtrDate: 

UwlSlte 

lOlMteh 

Drts: 

^ iS. Nonh AiRMv * 

Phone: _iL5ir.a323 _ - ^ 

T>«, M J^tiAf^ C (Pel BVID* qc^f5Z XRFCode l?<*t 

Sample Number Lead canceramsii Conf 

avAy<Ll^cA>M-ftt»6^ r'Yet D NO 03 

avcg^j>xA - ao«t.Si. 

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No • 

Omabt Lead She 4«130 £A=244 PPM @ SCRAPE 

CONTRACT #: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC. 
Address:(^^0 Date: ^ ^J AJ 4 V V %y. 

Phone: BVID: 

n 7 1 ^ 3^ c^ 1 

Flamts & Permanent Landscaping 

Item# 

On Map Description and Location 

V/wf) u 

. ^ 

t 

y^ 

or 

Item# 

On Map 

<£-r 

Pre-Existing Condition of Stmctures 

Does your Basement have a history of leaking? Yes — No 

Description & Location 

Property Owner Vr ck,'-,fi, -D^Judlfli 

Signature: i^^lk / 1 /• 

Pmdent Emi 

Signature: 

8080 Ward Parkway, Suite 405 24* Street, Suite 308 Msditial Drive: -Suite 42S0 

Kansas City, MO 64114 lha, Nebraska 63110 San Antonio, TX. 78229 

Phone; (816) 363-3703 i8ne: (402)504-1004 Phone: (210)822-9588 

C3». I'itrvi K70..e«T7 
Name: \r,0^< . Qo^lc^S Omalia Laad Site DatB:_1^0Ji 

Address: ^go y tS 2M5\- SttsSkotch Time: \St'i ^ 

Phone: M'^e: ^ ^'1'3A 

N an st 

Omaha Lead Site 46130 
Page 1 of 1 

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http: //douglasne.mapping-online. coin/assessdoc/Photos/31 /R17490300000001 .jpg 9/15/2008 
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 

1749030000 

DOUGLAS 

VICKIE L 

6808 N 24 

ST 

OMAHA 

68112 

6808 N 24 

ST 

OMAHA 

NE 

68112 

Sec-TwnRng 

Addition 

Block 

Lot 

Legall 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website 

Link 

Assessor 

Website 

Unk 

33-16-13 

MINNE LUSA 

5 

4 

46X120 

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

parc=1749030000 

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

accountno=R1749030000 

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 = 24 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOpfData=Douglas County-... 9/15/2008 
PRUDENT tECHNOLOGIES FIRST NATIONAL BAM^O S^^O F OLATHE 

8080 WARD PARKWAY, SUITE 1^ 83-172/1 2065^:­ -': - -.KANSAS CITY, MO 64114 . •'-; ^ ;.^^;,-::.(816) 363-3703 • 

r PAY 10 THE f/T^A \y , \ y>, 

-.ORDER OF . -A y / ( ^jp-^^ \^_J>i 

i:2rmz 

$ 

DGLLARSi;/© 1 

L'MEMO 

ii'Q EOE,,5-7if .. •: 10 iGG: ; 7 2Pi:

PRUDENT TECHNOLOGIES, INC. 

 "'O I U Rl, 5

COPY NOT NEGOTIABLE 

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2d6;5:7- ~Si 

: y->.-. -.?^--. 

PRUDENT TECHNOLOGIES, INC 

I V «;!>Q7R(i/nftr 
09/17/2008 10:38 FAA iUZ l I i^ia a cur . I.X-.JH.IM ixx^^.^ 

^^^i^ S ^ P.O. Box 27477 

Omaha. NE 68127 m^ Phone: 402.738.1718 

Fax: 402.614.2771 

wftA/w.cmscustomlav^m.com 

Recipient oftlte Sarp y Counly HnuMRusineHH of flie Yea r ^war d 

LANDSCAPE PROPOSAL 

Name: Vicki Douglas

Addre88:^6808 North 24th Street

City. St^Zipjpmaha.NE 68112-.

Email:

 . ­

 Home: (402)455.9739 

 Wodc (402)290.1721 

 Celt 

 Fax: 

Referral: Robin Bruck Salesperson: Boblsy Byers 

OI^}aetivtt: Renovate entire landscape by adding multi-«easonai color and texture through the use of new plant 

material that compliments existing plants. 

Install landscape per design by completing the following: 

CM's mil arrange for locating services to locate buried municipalities etc... 

it i$ the owrters responsibility to infonm contractor of any private lines. (Dog fences, Outdoor lighting, etc.) 

Determine shape of bed lines 

Remove any pre-detenmined materials (plant or other) from existing landscape 

Remove enstii^ sod from determined planting beds as necessary 

Move and reset sprinkler heads as needed (if applicable) 

Install drainage tile and connectors to down spouts as needed and daylight at t>ed edge 

Install (12) solar landscape lights in areas specified by customer 

Install paver edging on end in trouble area along North skle 

install approximately (1.5) yards of soil mix to planting beds and shape accordingly 

Install approximately (4 ) granite ix>ulders witii an approximate total weight of 750 lbs. 

Plant (11) shrubs, (52) perennials and (22) ornamental grasses per design 

Plait mateilatused In construction wHl consist of the tbnowtng^izesT^ -_ -

Shrubs - two. three and / or five gallon 

Perennials - one galton 

Ornamental grasses - one and / or two gallon 

Cut in natural bed line to newly installed beds 

Install approximately (7.5) yards of hardwood mulch to newly planted area 

Apply granular Pre-Emergent and Fertilizer to newly consbucted beds 

Water in newly planted material 

Eight Bed Maintenance visits to include weeding, pruning, plant replacement and fell or spring bed clean up. 

Clean up woilc site of any remaining or discarded plant or construction material etc... and property dispose * 

Does not include any other clean up or removal of soil, trash, or debris left on site by otiier contractors. 

Sub-Total $5,315.81 

Sales Tax $185.67 

Total $5,501.48 

>\\U. tvv^Jl-e CX Sjui ^ ^-^VU ^'^2_ o <xvi^t>v^ 
09/17/2008 10:38 hAA 4U2///oioo r us \ Cjiy 1 £JI\L I \ J. LJAJU 

CM'S Custom Lawn & Landscape Guarantee 

CM'S Custom Lawn & Landscape guarantees trees, shrubs and perennials installed for one (1) year, from the date of 

irtstall and will replace nursery stock one (1) time with same size and variety, providing death occurs within one year. The 

consumer shall provide reasonable and proper care. "Excludes tropical, annuals, damage by an act of God and vandalism, 

or any animal damage. **This guarantee is void if terms or payments are not fulfilled. 

An initial down payment of 50% is due upon aoceptance of proposal. 1 agree to pay progress payments equal to the percent of 

completed constructton if my project last more than five days. Contractor may withdraw proposal if not accepted within 30 days. 

[ rj</ diertinaals 

Owner is responsible for deariy and accurately marking property lines. 

Contractor will arrange for locating sennces to kxate any public buried cable and/or municipalities; it is the owner's responsibility 

to make contractor aware of any private lines on property t>efore contract is executed. If private lines are damaged, It is the owners 

responsibility to arrange for repaur and payment for repair of private lines. Private lines include, but are not limited to, buried drain tile 

outioor lighting, buried gas lines and pool lines. Private lines are not located by One-Call. A publk; utility line that is damaged beyor 

woridng condition by the contractor will be repaired at the contractor's expense, unless that line is buried less than 4" 

or improperiy kxated. The cost of damage for any improperiy kxated lines or lines that are buried less than 4 ' will be 

at the expense of the pubfic ciuiity orowfier. "^ ' "^G c(i<nt Mtbls 

Any alteration or deviation from atiove specifications invohring extra costs will become an extra charge over 

and above the contract price. These alterations and deviations virill be billed at 60.00 per hour per person 

plus materials, equipment, disposal fses and applicable taxes. Should the contract be terminated for any reason 

whatsoever before completion of the wortc as specified herein, the owner (s) agree to pay in full for all labor and 

materials furnished up to the date of such termination at the rate and price herein above specified. Any tools or 

equipment and unused materials left on the premises by the contractor shall, under any condittons, remain the 

property of the contractor. All tools, equipment and materials delivered for this job by the contractor shall be y\ 

stored by the owner and no rental or storage charge shall be made or assessed by the owner. | '^ ^ j 

diertlnttiaU 

Any buried debris that obstructs the contractor^ wori(. whether the debris needsto berennoved or not, will be charged to the owner 

at $60.00 per person per hour plus equipment and disposal fees. Unsuitable sub-grade material will be removed and replaced with 

suitable sub-grade material and billedto the owner at $100 per cubic yard of material removed and replaced. The owner must 

provide a signed document stating ttiat he/she does not wishto have unsuitable sut>-grade replaced. All wan:anties areVoid if 

unsuitable sub-grade material is discovered and rrat replaced. InHials 

Client will alk>w CM's Custom Lawn & Landscapeto place yard sign on property during construction and for a short ^..^^ 

period after completkjn of project | y^j ^ J 

eUentinllials 

Contract Price $ 5.501.48 

50% Down payment •i^'/'l^^ ^ 

Balance Paid in Full at Completion $ 2,750.74 

ACCEPTANCE OF PROPOSAL 

The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to 

do the woric as specified, ^a^inen t will be made as outiined above. 

Signature "^^^^^fBlY l /(^^ ^ Date accepted ^'^^"'O^-A ' 

Phone order authorizfed bv / H to Date Time AM/PM. ( 

Acknowledqement copy senMo \ bv Date 

FflrOfficaUw ttae vwoai 

Sal* c%\ fol^of 

T.S. \ » 1 J ^ PBM 
fl'a 

Page 1 of2 

"> 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2132434. 

Original Call Date: 9/16/08 Time: 11:22 am Op: RAMITA18967 


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


State: NE County: DOUGLAS Place: OMAHA 


Address: 6808 Street: N 24TH ST 


Twp: 16N Rng: 13E Sect-Qtr: 27-SW,28-SE,33-NE,34-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 

Alt. Contact: 

Phone:

Phone:

 (402)733-1455 

 (402)733-1188 

Work Being Done For: EPA 

Depth of Excavation: 6 FT Corner Lo

Involves Tunneling or Horizontal Boring

CXCATV MAGELLAN METRO MUDOl 

SPRNTPCS 

t: 

: 

N

N

OM

 Front: Y Rear:

 Explosives: N 

AHACOF 0PPDGPR5 QLN

 Y 

NEIC 

Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 9185747098 

MAGELLAN MAGELLAN MIDSTREAM PARTNERS LP TONYA Alt: 

Emerg: 9185747098 

Day: 4024572307 

METRO METRO COMM. COLLEGE CHRIS Alt: 4026727033 

Emerg: 4024572313 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047946 

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

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RON

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT NA

Day: 4067289343 

 Alt: 8887289343 

Emerg: 4067289343 

QLNNE 1C QWEST LOCAL NETWORK NA

Day: 4067289343 

 Alt: 

Emerg: 8887289343 

SPRNTPCS SPRINT SPECTRUM L P 

Day: 4025371800 

Alt: 4025371810 

Emerg: 8005210579 

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