TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SMDU: 27564 DATE: 1/15 

ADDRESS: 4223 GRANT ST 

REMEDIATION CONTRACTOR: PRUDENT TECHNOLOGIES. INC. YEAR: 201 ^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

El PRE AND POST VIDEO OF PORPERTV (DVD) 30237568 

d EXECUTIVE SUMMARY lilM 

Superfund 0 ' EPA-PROVIDED PROPERTY SKETCH 

t^ SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

EJ SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

d RESTORATION AGREEMENT 

D SETTLEMENT DOCUMENTS (I.E., FOR DAMAGE OR TO REPLACE PLANTS, ETC.) 

0 CONFIRMATION DATA 

Ef PHOTOGRAPHS 

Q AS-BUILT SKETCH 

D SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

EJ PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

d UTILITY CLEARANCES 

0 PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

n 

£^•1 ^ g/t8/" 

SIGNATURE DATE 
PROPERTY SUMMARY 

Date: /15/2010 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Month of: 

Propeity Address: 4223 GRANT 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 = 272 PPM @ 2"; B2 = 62 PPM @ 2"; EA = 280 PPM @ SCRAPE (~1") 

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 sketchi) 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) 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. 

TECHNOLOGIES, INC. 
Find Record 

Backfill: 

Sample Area: 27564 - 4223 GRANT ST 

Owner: 

[U Owner Occupied 

Owner Name: 

j BATTLE JR ROBERT E 

Owner Addressl: 

Owner Address2: 

|4219 GRANT ST 

City: State: Zip Code: 

jOMAHA NE )68111-

Owner Phone Alternate Phone: 

|(402) 558-1098 |f402) 551-5960 

Contract: 

Contractor: PRUDENT2010 S 

Contract Option |OPTION 1 

Remediation Query I Lead Remaining Query I Property Damage Query 

User Provided Owner Information Resident: 

Owner Name: Resident Name: 

I 

Owner Address: Property Address: 

r )4223 GRANT ST 

Zip Code: 

J68111-

City: State: Zip Code: Resident Phone 

I r 

Owner Phone: Alternate Phone: 

r " r 

Assessment: 

Qualifying Group pOO 

Assessment Max XRF Value \ ~ 508.32 
TECHNOUXJIES, INC. 

EPA Property Close Out 

Property #: '2.~l /^ ^ Property Address:l\'2JZ3> ^f*^"^ ^ ^-

Date/Time: Owner's Name: '(?*'Ur\r <S*tHe 3f , 

Quads Excavated: ^1 ,B'2^ Contractor Group: Prudent Technologies, Inc., 

Excavation General 

Yes

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

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

Grading Sod and Vegetation Yes 

1. Does tl^e grading around the perimeter of the house in excavated are.as generally slope away 

from the house? y 

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

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

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

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

6. Was the property graded sucli tliiat water will not pool on the property? / 

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

Gates, Fences and Retaining Walls Yes 

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

/ 

2. Were all gates or fences talcen 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

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

2. Was damage to Uie fomidation avoided? y 

3. Was damage to windows avoided? y 

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

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

Sidewalks and Driveways (Concrete) Yes 

1. Was damage to diiveway 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 SQ" ^ ^Date: izlisho 
;CHNOLlX;iES, INC. 

AS - BUILT DRAWING 

OLS#27564 

Date Excavated: 11/03/2010 

USEPA Signed-Off Date: OMAHA LEAD SUPERFUND SITE 

Owner Name: ROBERT E BATTIE JR 

27564 

Omaha Exterior Paint Lead Site 

Address: 4223 GRANTS! 

Phone: H:

Sample Number 

R'l'ASCPXA-aTJOa

RYBSCPXA-27564

RYCSCPXA-27564

RYDSCPXA-27564

RD/SCHAA-27564.

nczocpxA 27sax

RPZSCPXA-2756».

 H 

 F2 

 &1 

 B2 

 XIZ. 

 -ez 

P i ­

.EIS[TE.HSD 

SEP 1 ;fl ZOOV: 

B2=62PPM@2" 

 w: 

Lead 

Concentration 

ppm 

^3X a ppm 

m ppm 

^pp m 

ppm 

ppm 

ppm 

Numtier of Samples = 

Site • Good Sketch 

Sample 

Collected 

D 

O^ 

cr 

D 

D 

D 

•

Q

LAB 

Firm: 

D Date: 

D Time:

D 

D 

 Poor 

 Not paint 

Samples Collected 

m. 9/?/ry 

 /?<<;//•> 

Samples Analyzed 

D XRF Unit 

D Date: _ 

D Time: _ 

Staff: ^ 1 

mG ^ 

-^=»f- ^ 

<by 50*2 

4,^^ • ^ 

V.\ 

4.07 ;- < B1=272PPM@2" 

/ ^^;a\. 

"^wJCT 

fe«w>\ 

<')maha Lead Site 461.^0 EA = 280 PPM @ SCRAPE (-1") 

CONTRACT #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
SERA 

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 of the 

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. 

Restoration Items in Question: 

W I agree restoration is completed. 

L J I do not agree restoration is completed at (noted deficiencies above) 

/^/fC) A/) ^0 

Owner's Signature DateV, Y 
r * 

I ­

iJCH^CiiOCisis, ivj-: 

Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up leadcontaminated soils^l a number ofproperties located in Omaha, Nebraska, including the property located at 

M'^'2-' ^ MrrCMM" S V The EPA requests your permission to allow Prudent to perform a soil cleanup at this 

property to remove l4ad-contaminated soil. By signing this form, the property owner grants permission to Pru.1enl lo perform 

activities related to the cleanup including soil sampling, removal of lead-contaminated soil, and restoration of-.he referenced property. 

If you have any questions about the soil cleanup planned for your property, please contact Prudent .••i-;i:h (. .>:ii;i:':i t )|IK\- for the Omaha 

Lead Site cleanup, at (402) 733-1188; 733-1455. General questions about the Omaha Lead Site cleanup can b ; directed lo the EPA 

Public Information Centers at (402) 731-3045 (South Omaha office). 

Property Access Granted By: 

(Please Prim Name) 

Property Owner Signature: 

(Signature) 

PROPERTY INFORMATION 

rrob [To bee ^ complete , d by . resident and/or propert ^ - y. r owner — pleas ^ e print) 

RESIDENT NAME: l/ A fCLwl " loi r UJlH ^ Rfi^fe'pfl-lUf.^tKwna^ -^ Renter 

Coo^T^ ^ 

RESIDENT ADDRESS: 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS 

OWNER'S TELEPHONE NUMBER - HOME: J _ WORK: 

AGE OF HOME?: 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 .mder 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 "determining the need for response, or choosing or taking any response action 

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

8080 Ward Parkway, Si;''!;- ••: iw&tiical Drive. 5uitB 4260 

Kansas City, MO e-i-.-'i'-. Sail AiHOiiio Xt. "822? 

"hone: (816) 363-3~f" 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address: q'X':2_' ^ CJ ^eL^^Jl— S^t" ^^^^' ^'^l^^^^ ^ 

Phone: qo2. ' 3>X - ^33- 6 BVID: 

6 

<^ ecx' 

Prudent Employee 
lirilllllllllll l 27564 

Omaha Exterior Paint North Arrow Owne Lead Site r Name: ROBERT E BATTLE JR 

Site SItetch • Good Address: 4223 GRANT ST • Poor Phone: H: W: • Not paint 

Sample Number 

ryi'A3CPXA-27004

RYBSCPXA-27564

RYCSCPXA-27564

RYDSCPXA-27564

RUZbCHXA-27664-

RGZS6PXA 2756<l

RPZSCPXA 27564­

H 

 F2 

 B1 

 B2 

 J3Z. 

 « Z 

 PZLead 

Concentration 

.31 

# 

a 

ppm 

ppm 

ppm 

£)2,ppm 

Sample 

Collected 

D 

GK 

LAB 

D 

D 

D 

a 

Firm:

Date:

Time: 

Samples Collected 

 Qjf e J^ -

^ j-jf^Y 

fit 9^ 

Samples Analyzed 

jm . 

ppm a n XRF Unit: 

ppm D n Date: _ 

ppm D D Time: _ 

Number of Samples = ^ L_j Staff: 

Omaha Lead Site 46130 
I \^M » ' . * ] 

w 

H 4223 Grant St. 

A ^ Printed: Dec 15,2010 

www.dcgis.org'dogis 
Page 1 of 1 

"> 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2628349, 

Original Call Date: 10/28/10

Work to Begin Date: 11/01/10

 Time:

 Time:

 8:48 am 

9:15 am 

Op: SIVA18967 

State: NE 

Address: 4223 

County: DOUGLAS 

Street: GRANT ST 

Place: OMAHA 

Twp: 15N Rng: 13E

Twp: Rng:

Legal Given: C 

Sect-Qtr: 08-SE-SW 

Sect-Qtr: 

Type of Work: omaha soil rememediation project 

Location of Work: LOCATE ENTIRE PROPERTY 

Remarks: FAX ALL CLEARS TO: (402)733-1883 

Company : PRUDENT TECHNOLOGIES 

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

Work Being Done For: EPA 

Depth of Excavation: 6FT Corner Lot: 

Involves Tunneling or Horizontal Boring : 

CXCATV MUDOl OMAHACOF 0PPDGPR5 

Y Front :

N Explosives :

QLNNEIC 

Y

 N 

Rear : Y 

Service Area ;;;ontact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC lElDl

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SAND ANDY

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICH/TRAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/28/2010 
TECMNOLOGtES, INC. 

ENVIRONMENTAL 

ENGINEERING AND 

CONSTRUCTION 

SOLUTIONS 

SITE SAFETY HAZARD ANALYSIS 

Address: -^^-S^..£i.tQ.t\A„.SL\. Excavation Date: ~U~^^~J P 

Crew: t^L^-O. Backfill Date: -J-^~-^~~~~. 

Item Condition Hazards Corrective Action 

Overhead Lines ho^A 4 \ ,-^t '^AJ I ^ 

Gas Line VuT^ek xo 

Water Line 

Sewer Line ^ "V^ 

Septic/Leech 

Field :UiL 

Propane/Butane -Hj^ 

Sidewalk ^p^A . ^AQ 

Foundation vJ/A 

Retaining Walls J O ^ 

Fences hn?)Xl'f^^ r y ^

Trees dniik VAO 

Structures A;/ ^ 

Driveway <Qi>^ ^ j c s •^y u/^A 

Sprinkler System U ^ 

other _m^LfMt 

Crew Foreman Site Safety Office 

Date: 

8080 Wanf Partany, Suite 405 5600 S 10 St 4242 Medical Drive, Suite 7250 

Kansas Oty, MO 64114 Omaha, Nebraska 68107 San Antonio, TX 78229 

Phone:(816)363-3703 Phone: (402)733-1188 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)733-1883 Fax: (210) 579-6577 

um r »« 

^>* ? S^y. ?»7 ^ 

-T*' * ..ii^iiie^' :•'fc'li.''WII'll»l'r*g»>-'.^<te