TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAE)#: __££Di^i_ _ Date: 

Address: ?.\5U KJ ^ ^ AVP 

Remediation Contractor: A^-Tft.J<i^^4 "H^U/K^VT"'*- ,±-r\r. . Year: —^-po ^ 

SOIL REMEDIATION 

PROPERT Y FILE FOLDER DOCUMENT S 

^ Video ofproperty (DVD) 

[?f Executive Summary 

S' EPA-provided property sketch 

\2 Signed Access Agreement for subject property 

B Signed Access Agreement(s) for adjacent property 

0 Restoration Agreement 

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

0 Confinnation data 

H Photographs 

B As-built sketch 

& Satisfectory restoration signed by Property Owner 

H Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

IB Utility clearances 

W Property information from Douglas County Assessor's Office 

D 

D 

D 

SigiStu ^ Date 

40310747 

HHimii 

Superfund 
PROPERTY SUMMARY 

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

Property Address: 3156 N 47 AVE 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 329 PPM @ 12'; B2 = 71 PPM @ SCRAPE; DZ = 94 PPM @ 4"; F2 = 28 PPM @ 10"; EA = 179 

PPM @ SCRAPE 

ATTACHMENTS 

1) Property sketch provided by EPA pursuant to contract specifications 

2) Signed Access Agreement including access agreements required for crossing odier properties 

3) Pre-Excavation digital video clip/photographs 

4) Post-Excavation digital video clip/photographs 

5) Documentation - Completed Close-out Checklist 

6) As-Built 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 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 

ui) Excavation digital video in MPEG, WMV (Windows Media Video) or SWF (Flash Player) format and/or 

photographs 

iv) Signed form verifying satisfactoiy restoration 

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

TECHNOLOGIES, INC. 
Find Record Clean Up Query Lead Remaining Query I Property Damage Query 

Backfill: 

Sample Area: 85048 ­ 3156 N 47 AV 

Owner: Resident: Contract: 

n Owner Occupied Resident Name: Contractor: 

Owner Name: r |PRUDENT2008_S 

LOWE MATTHEW Property Address: Group: 

Owner Addressl: |3156 N 47 AV 

Owner AddressZ: 

Zip Code: 

[68104 Assessment: 

3156 N 47 AVE Resident Phone Qualifying Group 

City: State: Zip Code: I INORTH 

OMAHA [N E |68104 Assessment XRF Date: 

Owner Phone: Alternate Phone: I 

(402) 321-5754 j(402) 850-4212 /tosessment Max XRF Value: 

1012 
TECHNOLOGIES, INC 

Property*: %^0^• ^ 

Date/Time: 

Quads Excavated: g) , a:^,/r^^ ^ ^ 

EPA Property Close Out 

Property Address: '^^Si /\/ W^ ^" ^ 

Owner's Name: 

Contractor Group Prudent Technologies 

Excavation General Yes No 

I. 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 of the house in excavated areas generally slope away / from the house? 

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

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? y 

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

time period) y 

6. Was the property graded such that water will not pool on the property? y 

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

Gates, Fences and Retaining Walls 

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 

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? y 

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

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? 

y 

2. Was damage to walkway surfaces avoided? 

y 
Owners comments: 

Inspection notes: 

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

EPA Representative ^^:)SL^ Date: //^^Jo? 
ENVIRONMENTAL & 

CONSTRUCTION 

inCHNOLGGIES SERVICES 

PROPERT Y CONTAC T ATTEMPT S 

Propert y ID : 

Propert y Address; d^SQ> K^ Ml*"^ Ao*>^ 

Owne r Name : ^A a fi^ U ' "^ ^ , 

Owner Phone: y^ •) \ - <^'i_L^ 

Below please find a listing of unsuccessful attempts to reach the above 

property owner. 

Date Time Initials Result 

a|L 3 ijN! n ) I X \ \ 

tk^ ^ ^f ^ AcVtl^ vOa.^V^fe^3|^Jg ^ 

r^^p^U- Ao.iyy. • TL L le.^i h> 

^ej-^rr ^ ^ 6Oc t ^* ^ p* ^ <:U*^-^ 

loUtL-t-^ ^ii /j^ U '^ol- JCixc^ i 4 ­

nvJ^ Ivjix.' 

^ ^ Jli/A f r ;^ rv-e-ft-^rt . 

. .^i- ^ ^alo? 

Signatur e Dat e 

Pruden t Technologies, Inc., / i t , fi t i , 

•<r 

and if,'I' n*r reivM'' Hf. 

>*igtfM ^ ^ /k/o? 

Acknowledgmen t signatur e Dat e 

E P A 

8080 Ward Parkway, Suite 405 250S N. 24'" Street, Suite 308 4242 Medical Drive, Suite 7250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San AntonicTX 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 
Nov 26 2008 1:41PM Bemj-s Center 4023.^.973 3 ^ S 1 p . 3 

.. •MU(itaBiuBtear(niMialaeu«dtaOnA*,N*iMlB^inclH«n(dB|raeMy'lec«MdM 

fBOfiBiiyieicBDTBlMiKoaiiiiiin^MiL By ri|aiBKdAfthikdi(i)nvcn>o*na'pHl*pemiiiianttPmdnit(ovsfbmi 

wOvitlet HiMKlioik*clHJBiplncludUg iail MBplin(,itBMTal oriMd4eotMintMMil;tattt«oiaulcB(«rike aAHoeeil fnptQr. 

OmUiaLciiiakfc damp. •Mi. PApwiilntM.i^-of^tm 73^-1 laa OnndtiBcUiMUiiMiMteOmilikLeUSIieciMupeMib* 

diiMKd wtta EPA KUte hftoMliaB Coinn U<4(I2) 731-304S (SntkQMht cfficB) cr (40^991-MM (NoMk QiiahaoC^ 

a>iM) 

mofCRTir MFonumoN 

Cti»b»«Mnfcf*byfiil«M»ai<iiiiw|ietiyewi ( ^ ) 

RESIDSMrNAMI: M a-t ^ V B L.^ ^ 

REHOENT ADDRESS: Wv A-v^. Onr\j^>^ 0 ^ 

IP REHTAL, PROPOITT OWNCD tV : 

OWNER'SMMLMQ AODRUSf . 

OWNin'ITSLSPHONCJjUHBER'HOIIi: X WORK: 

AOEOPHOHET: /fM' ' YEARS. HOW tOIMI HAVE VOUUVBD HERE? 4 YEARS. 

HAS TME BXTEmOR BEEN PAINTED OR COVERE^DWjgtlMOINOBMCBIITfl D W m MOWO BMCE ItTI T jdCjTE S NO 

NUMBER O^OOCUPANTB UNDBR7 VBAM OU At _Z_/I>1UMBER0P OeOUPANTBrVEARB OLD AHD OLDER 

NWIB M OF CmiDHBI UNDER 7 VEARt OLD WHO flA Y IN THE YARD FOR I HOURS OM NRME PCR WEEK: 

OOMMBNTSORSKCIALINBmUCTIONS: (|.E. DOOB, ENTRY OATES, BTO.) 

AUIBOWnr POft HNVmONMEiaAL RBSrONSE ACmNS; The Kiivitfci tobe iispkamlal by ETA i 

H»piiiWMitttSM(iooX)4o(CBXCLA.42UiS.C9fiU. EPV«n|l>tofMC<«toa»pMpMjriiiMMiADdiorl»S«cllaiil04(ei>of 

CSSCL^ 41 U.S.CM03(A. wMehpiCF<MM any Ibr "dclPBiUainsiheMed teievsu*. KdMoniii or Mk ^ 

uidir tUc Mk; or oAowiaicaibcdiB dM pnwiitaM tf the tido.' 

tSK W«4 Nrtvay , SuRa 406 

iMM«eily,M0««114 

IPhaiM: (016)n3-S7in 

2S0« N. W* Elnet, Bulle SOS 

Omaha. (MratlnMIIO 

Phaaei (402)a04-10G4 

4t a MMltetl OtIvi, «««• 4M0 

SEniMORiOiTXTtttf 

PIMM! (atO^OMfM 

!iax:4«1l>9B»470r Fax: (40E)SO4-10M Fte:(t10Vl7»«7r 

e-«i SOO1V0S30V S3ISOT0NH331 iNSanUd NdIQ:3I 8003 93 AO N 
AS ^ iBtM;f'ji)RAWlNG 

OMAHA LEAD SUPERFIIND SITE. OLS#: 8S048 

nate Excavated: 12/05/2008 

USEPA Signed-OfTDate: 

85048 

Omaha EilartorMit HoilhAinM LMd Site 

Sit»Ske(di • Good 

E J Poor 

SMmiHng Addncc slSNilw . • Notpaiil 

SanvO Sample BMwieeCallecM Number LAB OaaoBrtfayoa CoSecM Rmi: Bg. fl.g, g.lt . 

nv^ttartmtxa—» > n 

RYB8CPXA85048 F2 D 

RYCaCPXA«S04a Bl D 

Samples AnalysMt 

RYOaCPXArS^MB. B2 D 

RDZSCFXASSOM DZ l</6 > nwri D XRFUW: g.5H0 Boole 11 1 

rtnnwBPir* Mnii o D Die: ^-«-<> 6 

a Timo: On— 

NMBtwrofSamplea-l H | \ Q \ aaifc fOSU 

a 

UgeMt Fl « Fnmt Lril. F2 > FrartRigIC Bl - Back Left. B2 IF Back ragM OZ * Oi«> 2ione. GZ = Ganion. PZ=P ^ 

i BNtERiBDi 

r."(^^:'s-.•^"'J•^i;i 

•-'^ ^ B2 = 71PP1 M @ SCRAPE 

. ^- ^ 

DZ = 94PPM@4" 

- ^ 

o 

F2 = 28PPM @10» 

3nar: 

r^.io.^f .:. 

EA = 179 PPM @ SCRAPE 

CONTRAa »: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC. 
Nov 26 2008 1:41PM Bemis Center 4023.^979 1 1 p . 2 

rNVIAONMfiMTAL« 

coNsmiticriOK 

TBCHNOLOGIBB, INC. SCKVICB8 

Property Status Form 

I 

Addrolr -5>1 St . ^ ^ 4T<^ ^ A^--< ^ Date:/t^/7; ^-^b / LJISZ^—2iJ_:L_£2-^ ^ HVID: 

J>«Bcrl|itlon A LoeslloB 

Doas yeiir BsicnMBA hsvs B hlrtray of Isakk^i? Yes No ^ 

NO DiseriptlOB A LocsttoB 

OnMsjp 

FnidcBt Emplosrc 

SifDBtwB: Sipuitiire: 

aiO« N. ^ SfeMl, 8««e 30S 4M2 MBdkal Ortw.S«n»^n MM W M PaitaNVi aOM 409 

KaiiMS-Cliy,M0M114 Om^Ntbrukt 18110 

Ptwn*:t(tl«)aa-3T0 PhOM: (»0)O3MB0a 3 Phbm; {402)004.1004 Fn:(M0)«7»4«r7 F«i:M>iaSBMTIV FM : (402)004^009 

3«l SOOIVOSZO^ S3I90-I0MH33J. INBanad UdlQtSI 8003 93 AOM 
Page 1 of 1 

AY 2005 - DOUGLAS COUNTY ASSESSO 

31 So P V7 4^ 

http://douglasne.mapping-online.com/assessdoc/Photos/04/R24146800000001.jpg 12/2/2008 
Print Preview Page 1 of 1 

Douglas County-Omaha, NE 

I 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner 

City 

Owner 

State 

Owner 

Zip 

2414680000 

LOWE 

MATTHEW 

3156 N 47 

AV 

OMAHA 

68104 

3156 N 47 

AVE 

OMAHA 

NE 

68104 

Sec-TwnRng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

08-15-13 

WAVERLY PARK 

3 

2 

40X125 

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

parc=2414680000 

httpV/dougiasne.mappingonline.com/DouglasCoNe/static/accountinfo.jsp? 

accountno=R2414680000 

Disclaimer: Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. Tliis is not a legal document and should not be substituted for a title search, 1 inch = 26 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 12/2/2008 


...»n 
85048 

Omaha Extarior Paint North Arraw Lead Site 

Q Good Site SIcetch 

g j Poor 

Sampling Address: 31 SB N 47 A V Q Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Finn:

Samples Collected 

 P£ . g-C » E,lC . 

RYASCPXA 86048

RYBSCPXA-8504d

 F* -

 F2 _f±fLO_ppm 

D D 

D 

Date:

Time:

 <»'<t-6g : 

 *^:5 7 K.i»>>. 

RYCSCPXA-8S048

RYDSCPXA-85048

 B l 

 B2 ppm 

D 

D Samples Analyzed 

RDZSCPXA-«5043 DZ 

ncaBCPXA giio«n—ez 

.ppm 

ppm D 

a 

a 

XRF Unit:

Date:

 6>5HQ Book: 2/ 9 

 ^i'Z3-0& 

RPZ8CPXA 8W48 PZ ppm D D Time: FV^ 

Number of Samples g I * ! ) | ^ | Staff: fOSO : 

Legend: F l = Front Left. F2 = Front Right, B i = Back Left, B2 = Back Right DZ = Drip Zone, GZ » Ganlen, PZ - Pla; 

AU quaiftanta are aa vieMod ton ffie 

ENfBBlD z\­ •••(^iroCx**^ ^ 1 2 2DD3 

* 

y 

im { H : | 

W.-:? 

« A 

u*. 

I £32? 

.SlSli fiV hv 

'fit I J 

t^ 

HBP 

sasnc 

MM7 A< Kcr^OOl Oiwd: l9.Ai«0( M47aij)l.23 
Page 1 of 1 

"> 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2184414. 

Original Call Date: 12/02/08 Time: 8:24 am Op: MADHURIMA18967 


Work to Begin Date: 12/04/08 Time: 9:00 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3156 Street: N 47TH AVE 


Twp: 15N Rng: 13E Sect-Qtr: 08-NW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: soil remediation work 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: 6ft Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 


CXCATV COX COMMUNICATIONS. INC HEIDI Alt: 4029340469 


Emerg: 4029329757 


Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON 

Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 4062071494 

Emerg: 4065237717 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK NA Alt: 40620714S>4 

Emerg: 4065237717 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 12/2/2008