TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: ^S<^ / Date: )2.l22^/^t>s 

Address: ll2. ^ Ti J2^ i\-

Remediation Contractor:' }^>J^tJ- 7^J..>t.r/i>>e»V>> 'dp^r , Year; 2o Q ^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ Video of property (DVD) 

a Executive Summary 

if EPA-provided property sketch 

0 Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adja^«nt property 

y Restoration Agreement 

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

13 Confirmation data 

[3 PhotogrJ5)hs 

y As-built sketch 

y Satisfactory restoration signed by Property Owner 

0 Property close-out check list signed by EPA 

ET Description of areas not meeting ROD cleanup criteria 

y Utility clearances 

y Property information from Douglas County Assessor's Office 

D 

40309583 D iinni 

D , Superfund 

Signati96 Date 
/ 

PROPERTY SUMMARY 

Date: 12/20/2008 Omaha Lead Site Remedial Action Contract # EP-R7-07-06/0004 Month of: Nov/Dec. 

Property Address; 392S N 24 ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encowitered: NONE 

A.2 Issues Resolved; NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Infonnation: AREA NOT EXCAVATED B2 TREE, BUSHES, 15'X5' @ 294 PPM 

CONFIRMATION SAMPLING DATA/RESULTS: 

B2 = 203 PPM @ 2"; DZ = 169 PPM @ 2"; Fl = 270 PPM @ 2'; F2 = 266 PPM @ 2"; EA = 80 PPM @ 

SCRAPE 

ATTACHMENTS 

1) Property sketch provided by EPA pursuant to contract specificatioiis 

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

3) Pre-Excavation digital video clip/photographs 

4) Post-Excavation digital video clip/photogr^hs 

5) Documentation - Completed Close-out Checklist 

6) As-Buiit sketch ­

i) Shall includefinal 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 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 

photographs 

iv) Signed form verifying satisfactory restoration 

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

TECHNOLOGIES, INC. 
Find Recnrd 

Backfill: 

Sample Area: 33421 - 3925 N 24 ST 

Owner: 

D Owner Occupied 

Owner Name: 

(DUNN RENTAL LLC 

Owner Addressl: 

|C/0 BONNIE J DUNN 

Owner AddressZ: 

19905 FLORENCE HEIGHTS BLVD 

City: ^^^^ ^ State: Zip Code: 

[OMAHA [ N E |6811 2 

Owner Phone: Alternate Phone: 

|(402) 689-4283 

Clean Up Query Lead Remaining Query I

Resident: 

Resident Name: 

Property Address: 

|3925 N 24 s r 

Zip Code: 

[68110 

Resident Phone 

I 

 Property Damage Query 

Contract: 

Contractor: 

PRUDErfT2008_S 

Group: 

Assessment: 

Qualifying Group 

(800/CHILD 

Assessment XRF Date: 

Assessment Max XRF Value: 

I '. 1137 
TECHNOLOGIBS, INC 

Property #: 2,^^^-2-1 

Date/Time: 

Quads Excavated: F^^pX^B^ 172­

^EPk 

EPA Property Close Out 

Property Address: 3^2 5 /V^2.if S»f 

Owner's Name: 

Contractor Group: Prudent Technologies, Inc., 

Excavation General 

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 

1. Does the grading around the perimeter of the 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 Walls 

1. Do gates open and close freely? (IfappUcable) 

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 

1. Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) 

1. Was damage to driveway surfeces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

/ 

/ 

Yes No 

y 

/ 

/ 

/ 

X 

/ 

X 

Yes No 

/ 

y 

y 

y 

Yes No 

y 

y 

y 

y 

y 

Yes No 
Owners comments: 

Inspection notes: 

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

EPA Representative irJ^ ^ . Date; /n/i//n-» 
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 fiiture, excluding any 

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

Property ID: 

Property Address: ^;^*cj3J5 Deo*K>x - ?4 ­ -Ih^-? . < <M P M K 5J 

'^^^''- n^rvi<fL. Phone: ' 

Restoration Kems in Question: 

Item: 

item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

L J I agree restoration is completed, except as noted above. 

L J I do not agree restoration is completed 
Prudent Technologies, Inc. (Pnident) is under contract with the U. S. Environmental Piotection Agency (EPA) to clean up leadcontaminated soils at a number of properties located in Omaha, Nebraska, including the property located at 

^9iS ~ fLj. ^H*^^-" - The EPA requests your permissbn to allow Prudent to perform a soil cleanup at this 

property to lemow lead-contaminated soil. By signing tiiis form, the property cwner grants pennission to Prudent to perform 

activities related to the cleanup including soil sampling, removal of lead«ontaminated soil, and restoration ofthe refeienced property. 

If you have any questions about the soil cleanif) planned for your property, please contact Prudent Administrative Clerk for the 

Oinaha Lead Site cleanup. Ms. Deborah Johnson -at (402) 733-1188. Gracral questions about the Onudia Lead Site cleanup can be 

directed to the EPA Public Infonnation Centers at (402) 731-3045 (South Omaha office) or (402) 991-9583 (North Omaha office). 

Property Access Granted By: 

Property Owner Si| /Oi=dJ3<XfX 

(Date) 

PROPERTY INFORMATION 

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

RESIDENT NAME • v>< g Owner Renter 

RESIDENT ADDRESS 


IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

•^4d> VA<»^4-tvvga.J^ 5^ ^ 

OWNER'S TELEPHONE NUMBER - HOME: (VOC^) ViT^ - 33<^ ^ WORK: 

J 1 

AGE OF HOME?: m. YEARS. HOW LONG HAVE YOU LIVED HERE? ±7 YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? 7 ^ YES NO 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: < ^ NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER 

_y 

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 providedfor in Section 104(e) of 

CERCLA, 42 U.S. C 960S(e), which provides entiy for "deteiminrngthe need for response, or choosing or tidng any response action 

under diis title, or otherwise enforcing tfaeprovisions 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 
:•:, AS-BXJOyTCKAWING 

OMAHA LEAD SUPEKFUKD SITE OLS#: 33421 

DateEicavated: 11/14/2008 

USEPA Signed-OffDate: 

)i 

!• 

t'! 

33421 

4^ Nodh ATOMF Omaha LM d SH * Extflftor Paint 

Sit* Sketch n <*«*» Lr fameUng Mdra n 3825NZ4818I 

•'Poo r 

a NptMint Sample 

SwiplMCdIwiad SwnplsNumba f GonoentnfOo) Cdlvctad FIrm:je£JiK. iai£(L RYASCPXA^34S1 F1 fLji&S . ppm QT Date: njlltlft* 

RyBSCPXAr33431 F2 fi LjJJLi L ppm H ' T!ma:lli3SJJ[ ^ 

fiweoP)(M)04< 1—Bl* -• ppm D Samplas Al atyoM) -£2£ ppm Q T 

RDZSCPXA^3421 DZ dlLk. ppm D ^ XRFUnit: /"^^VOJ Book: 2J3 _ 

ppm n Date: '7-2 y IfiS. ppm • Time: nrvt 

..jiib RYDSCFiA 33421 j j Numberof iample» «n n [ J ] Staff: _J!lSSai 

Lni">x-> •-.•J^!£!!!^'.-BFiJint Right, Bi s Back Loft, B2-0ackRi8iMDZ> Orip Zone. GZ=G^den, PZ • Ploy 

I ; ARqMAiaiimwvi*««dInmMlln«t,tM«jprapi ,-. ..........«^-......... . .&«* •-....-.,. - •|r»"p'^^'«i,*^.^wp^^^-. '• • • .. K- ^ 

• n > < 

B2=»203PPM(a2'' 

:3.<l2j5..,W. .2.M.H>.|1.V. - J 

: .1 i.Dwoct. .iLe »v.^ a..I .\.. i^Vfi-i... k . ..m^.- ,....;..^ 

AREA NOT EXCAVATED : • : : : *• : : 

[B2 TREE, BUSHES; 15'X5' @ 294 PPM] 

.: u-. i 3 ^ 

:««.< 3e' • On jCcA/'*"': ..e 

iDZ= 169 PPM ©2 " j|-^ - avj^--- ; 

in f i : : «< : J'- ­

• ;ffs r 

..•yii3M n.i..:^r^ '266 PPM® 2" 

4< F1 = 270PPM@2'' *—k — P=^. Mmi 

iRwim CM t OiMgH» 

.•.N.;w.$:b. .".:...;.;...;. (M4m.ai.23 

"H" 

EA = 80 PPM @ SCRAPE 

CONTRACT # : EP - R7-07-06 / 000 4 PRUDENT TECHNOLOGIES, IN C 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address: 21 ^ 5 ^). ^4" ^ S ^ Date: fo/^^^jo t 

Phone; ^!53 '33'^( ^ BVID: 

Item NO Plants & Permanent Landscaping To Remain In Place 

On Map Description &. Location 

Pre-Existing Condition of Structures 

DoesyourBasementhaveahistory of leaking? Yes No ^ 

Item NO 

On Map 

Description & Location 

y j Prudent Employee 

A/.i^^'SiSature:^,^^ ^ 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street. Suite 308 4242 Medical Drive, Suits 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 
33421 

Omah Exterior Paint Nortti Arrow a Lead Site 

Site • Good Sketch 

Ea^oor 

Sampiing Address: 3925 N 24 ST 

• Notpaint 

Lead Sample Samples Cqllected Sample Num'be LAEl Concentratioh Collected Firm: P g T^e - J2£L^£^ 

RYASCPXA-33421 Fl ppm D 

Date: l/lftio 8 

RYBSCPXA-33421 F2 //J ^ ppm D 

Time: ll:%S AV\ 

RYC3CPXA-034S4 -B4- ppm 

n Samples Ar aly2ed 

Srgr«¥DSCPXA-334! i B» g;?5 ppm or 

RDZSCPXA-334S1 DZ JLLfe. ppm n XRF Unit: (^5vg Book: 2J3 

RGZOOPXA 33414 -6£ ppm a n Date: 3 _ iZ£i 

nPZCCPXA 33124 -PE- ppm 

D D Time: /|f» ^ 

RYDSCPLA 33421 Staff: i*lSuO uLab Number of Samples = | LJ | j | 

l_SRe8ult 

Lcyeiivj. , -. . Jn???.'?,"? ^ ^ Front Right, Bl = Back Left, B2 = ,Back Righjt D2 = Drip Zone, GZ = Gajrden. PZ = Play 

All quadrants ye^ s vievwd from the street, faciig )roperty^ ' * ^--••--- . - - I - - - - . -- ­

-Jtlt-HZOM 

iS.'^i-is.-.jo. 2.M.VV..<2,\^. 

:.D.ur>c\. .iCe^v.Va .\... ..Lv.<v.:. CMl.'. 

7i^y7L2ii'(e':'l)\'iis\'''i 

pe'.< 

nn 

5*25' 

7^g ^^^f 

2fc=ll«» B2O 

r*'r 

a-; :5 

in 

^ 

.f:i. t^....-.:.ll.3H f2,.; 

1*—4-H« * -»<r 

wALy> 

Re .•.N.-<^R .$:!•, v 2008 Cicated. 03-May48 044701.01.23 
Page 1 of 1 

/"» 

DECEMBER 2005 - DOUGLAS COUNTY ASSESSO fe- ?»s^.«s,sa«a.>.»!.«.»#8a& 

K/2^5/ y\^ 

http://douglasne.mapping-online.com/assessdoc/Photos/03/R20137800000001 .jpg 10/23/2008 
Print Preview Page 1 of 1 

Douglas County-Omaha, NE 

\panxllD 

Owner 

IName 

{property 

Address 

\city 

\zip 

1 Owner 

\ Address 

1 Owner 

\ Address 2 

\ Owner 

\City 

Owner 

State 

Owner 

\zip 

2013780000 

DUNN 

RENTAL LLC 

3925 N 24 

ST 

OMAHA 

68110 

POBOX 

11037 

OMAHA 

NE 

68111 

Sec-TwnRng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website 

Unk 

Assessor 

Website 

Link 

03-15-13 

PLAINVIEW 

4 

13 1 

50X124 1 

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

parc=2013780000 

littp://douglasne.mappingoniine.com/DouglasCoNe/static/accountlnfo.jsp? 

accountno=R2013780000 

Disclaimer: Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. Tiiis is not a legal document and stiould not be substituted for a title searcti, 1 inch = 25 feet appraisal, survey, or for zoning verification. 

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dido« 

fX 



Page 1 of2 

"> 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2162605. 

Original Call Date: 10/27/08 Time: 12:19 pm Op: MADHURIMA18 967 


Work to Begin Date: 10/29/08 Time: 12:45 pm 


State: NE County: DOUGLAS .Place: OMAHA 


Address: 3925 Street: N 24TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 03-SW,04-SE 


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 MADHURIMA Phone: (402)733-1188 


Alt. Contact Phone: (618)401-2223 


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 Plione 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: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 


OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON Alt: 4024445161 

Emerg: 4024445160 

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Day: 4067289343 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Ah: 8887289343 

Emerg: 4067289343 

Day: 4067289343 

QLNNE 1C QWEST LOCAL NETWORK NA Ah: 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/27/2008