TRANSMTITAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAm #: I4bit

 Date: ^[k S 

Address: ^7^ \ \j^a<;,\- %Y 

Remediatioii Contiactor: 'PJrH/i/lri ^(h . W . Year: S n I n 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

1^ Video of property (DVD) 

Executive Summaiy 

EPA-provided property sketch 

4 

Signed Access Agreemeot for subject propeity 

D Signed Access Agreement(s) for adjacent property 

^ Restoration Agreement 

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

d Confirmation data 

Photographs 

As-built slcetch 

Satisfijctory restoration signed by Property Ovmer 

Property close-out check list signed by EPA 

• Description of areas not meeting ROD cleanup criteria 

Utility deazances 

Property information fiom Douglas County Assessor's OfG.ce 

D 

D 

D 

^ ^^^ 

Signature ' l^te" 

30262421 

lllll 

Superfund 
Find Record 

Backfill: 

Sample Area: 466

Owner: 

t D Owner Occupied 

Owner Name: 

j FLOYD DURANT 

Owner Addressl: 

Owner Address2: 

|2211 LOCUST ST 

City: 

jOMAHA 

Owner Phone: 

t 

- 2211 LOCUST ST 

State: Zip Code: 

JNE J68110 

Alternate Phone: 

1 

Remediation Query I Lead Remaining Query j Property Damage Query 

Resident: Contract: 

Resident Name: 

r 

Property Address: 

|2211 LOCUST ST 

Zip Code: 

68110 

Resident Phone 

Contractor: 

PRUDENT2009_S 

Contract Option 

OPnON3 

Assessment: 

Qualifying Group 

[400 

Assessment Max XRF Value: 

647.2 
PROPERTY SUMMARY 

Date;p/15/2010 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 T0#1 | Month of: fsc T 

Property Address: 2211 LOCUST ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: AREA NOT EXCAVATED; UC = 299 PPM @ SCRAPE 

CONFIRMATION SAMPLING DATA/RESULTS: 

YA = 237 PPM @ 8"; DZ = 252 PPM @ 10"; YC = 86 PPM @ 8"; YB = 169 PPM @ 10"; 04 = 24 PPM @ 

12"; PZ = 283 PPM @ 12"; GZ = 168 PPM @ 12"; NO EASEMENT 

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 sketch ­

i) 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. 

TEGHNOLOCIES, INC. 
Vj \j'?J) ii' 'ii'yi'h, ) 

TECHNOLOGIES, INC. 

Property #: ^(> 

Date/Time: 

Quads Excavated: 'yA,'^t;/)a-;Y8/62, cV/ = 

EPA Property Close Out 

Property Address: 22Jl /^(MJ ^ 7 h 

Owncr'sNamc: At^va.^[^ F'^O N 

Contractor Grnu|r: Prudcnl Tcchnolofiies, tne. 

Excavation General Ves No 

1. If necessary, were liie correci quadianl(s) e.\cavated and restored? / 

2. If necessan', were llie correci areas of drip zone excavated and restored? / 

Grading Sod and Vegetation Yes No 

1. Does the giading around Ihe perimeter of the house in excavated areas generally slope away 

from llic house? / 

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

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

day lime period) y" 

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

5. Are ihe joints belween the sod strips generally tighl? (Only evaluate if inspected at a 30 day 

lime period) y 

6. Was Ihe pioperly graded such tliat water will nol pool on the property? y 

7. Was damage lo landscaping or plant materials avoided? 

( / 

Gates, Fences and Retaining Walls Vcs No 

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

2. Were all gales or fences taken down during restoration activities reinstalled? (If applicable) y 

3. Was damage lo gales or fences avoided? (Ifapplicable) y 

4. Wns damage loreiaining walls avoided? (Ifapplicable) / 

Foundation, Siding and Gutters Yes No 

1. Was damage lo ihe siding or irim avoided? y 

2. Was damage lo the foundaiion avoided? y 

3. Was damage lo windows avoided? y 

4. Was damage lo windows or door screens avoided? y 

5. Was damage lo downspouts or downspout extensions avoided? y 

Sidewalks and Driveways (Concrete.) Yes No 

1. W;is (laiiiMgc lo driveway surfaces avoided? / 

2. Was damage lo walkway surfaces avoided? y 
^ ^ U ^Cubf S ^ 

Ownen comments: 

Ilnspection notes: 

.O "f. 

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

EPA Representative -a- ^ Date: l7t37'e> 
.,SSS>L 

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 future, excluding any 

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

Propert;'ID 

Propert: Address: p? 3/ / lO£4/-St^ ^* h 

Owner: Vo^^rr^ ^^ti ^ 

Phone: H^\ - glj,^t l 

Restorat on Items in Question: 

S o d jOrJ ^ ^<g>i ^ 

HMiJkilayl C4^w6he4 r&yjA ii^ AIU^I, S^/J^O 

ftpS^i' hM^ ^ ^^ ^ I^LO /Ly^^^iA-^ih /g?^5=^. 

Item: 

Item: 

I corrections to complete the property: 

agr se restoration Is completed. 

n I do lot agree restoration is confipleted at (noted deficiencies above) 

\ a^. :2lU. /7-//-€> 9 

Owner' I Signature t Date 
Prudent Technologies, Inc. (Pnident) is under contract wilh the U. S. Environmental Protection Agency (EPA) to clean up leadcontainiiuted joils al a nuniber of properties located in Omaha, Nebraska, including the property located at 

iJ3/ / ufjCj^J.^' r Sj r . The EPA requests your, pemiission to allow Prudent to perform a soil cleanup at this 

property to remove lead-contaminated soil. By signing this fonn, ^ e property owner grants permission to Prudent to perform 

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

Ifyou have any questions about the soil cleanup planned for your property, please contact Prudent's Adiiiiiii.-itniiivc Clerk for the 

Omaha Lead Site cleanup. .M.s. Siv:i .S. .I;iini-):in.i-at (402) 7.13-I INS. General questions about the Omaha Lead Site cleanup can be 

directed to the EPA Public InformBtion Centers at (402) 731-304S (South Omaha office) or (402) 991-9583 (North Omaha office). 

Property Access Granted By: X J ^ ftvl5U/V F-l/O 

(Please4>rmt Name) 

Property Owner Signature: \ o - I­

(Signafjfe) (Date) 

PROPERTir INFORMATION 

(Tobee complete completedd bbyy iciiden iciidentt and/o and/orr pproperty owner — please print) 

RE8IDENT NAME: hi/K^c(r Hoyet (Owner Renter

RESIDENT ADDRESS: 

?^H l^ocrty^'t ^i -

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; Samt 

OWNER'S TELEPHONE NUMBER - HOME: (m f*^** wi-n& ) i -^J"*' 

J 1 

7 

/ / AGE OF HOME?: ' YEARS. HOW LONG HAVE YOU LIVED HERE? YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WTTH SIDING SINCE 1978? ^YES NO . 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: c7 NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER

•2? 

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.) 

(Pa^s K^? 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: The activities to be implemented by EPA under this agreement 

are pursuant lo Section 104 ofCERCLA, 42 U.S.C. 9604. EPA's right ofaccess lo llie 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 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: 1816) 363-3707 Fax: 1402)504-1005 Fax: (210) 579-6577 
ENVIROiVMENTAL & 

C0NSTRlJCT10^ 

TECHNOLOGIES, INC. SERVICES 

Property Status Form 

Address: (33/ / l^Ctfif i'^- Date: /0^7-0?' 

H09. -yr/^ S7(fi Phone: BVID: 

Item NO Plants & Permanent Landscaoine To Remain In Place 

On Map Description & Location ., ^ /^ . S..jJ 

J '^ '' ^^ 

Pre-Existing Condition of Structures 

Docs your Basement have a history of leaking? Yes No ^ 

Item NO Description & Location , , r - ,% / jk ^ j L ^ 

On Map 

Property Owner Prudent Employee 

Signature: (^Uv. ^ I^w ? Signature: J^(CL 

8080 Ward Parkway, Suite 405 5600 S 10 st 4242 Medical Drive, Suite 4250 

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

Phone: (816) 363-3703 Ohnnn - IAI\'>\ 7t 1 -flOO 
rcFlNOI/KUES. INC. 

AS - BUILT DRAWING 

t)LS#:466 

Date Kxcavatcd: 10/19/20119 

OMAHA LEAD SUPERFUND SITE 1,8KPA Signfd-Otr Diito: 

"^GC 

Oniah Extenor Paint North jUrrow a Lead Site • Good Site Sketch 

0 Poor 

Sampling Address: d. ^ 1 1 LOOUS 7 (3f - |~1 Not paint \ 

Lead Sample Samples Collected 

Concentration Collected Sample Number LAS Firm: I'^yerdn fn 

RYASCPXA- ^ Q YA Q ^ Q ppm [T n Date: 

RYBSCPXA- I.I.QQ YB D Time: 

RYCSCPXA- tf.CQ YC *fC ^ pom n Samples Analyzed RYDSCPXA- H-QC YD ^.=?0 ppm • 

RDZSCPXA- ^ Q DZ G C ^ Dom XRF Unit: Book; 

RGZSCPXA- '^G Q GZ Y^( p ppm • Date: G - fl - .9.9 

RPZSCPXA- *f(2Q PZ 7(3 d Dom Time: .9;/ / 

Staff: Number of Samples = 11 O 

Legend: YA = Yard (NE), YB = Yard (SE). YC = Yard (SW). YD = Yard (NW), DZ = Drip Zone, GZ = Garden, P2 = Play 

All quadrants are aa ucwed from the street, (aclrg property AuJB.' i 

0 4 = 24P1>M « 12" ' ^ 

\RV.\ .NOT EXC A\ .\TED; LC 

- 299 PPM fl Sf RAPF. (-1") 

LOCUST Sxr. 

NO KASKMEN 1 

CONTRACT #: EP - R7-07-06 T0#1 PRUDENT TECHNOLOGIES, INC. 
^G C 

Omaha Lead Site 

Site Sketch 

Exterior Paint 

• Good 

0 Poor 

NorthArrow 

Sampling Address: ^^1 7 L-C^dUT^l (37" Q Not paint \ 

Sample Number 

RYASCPXA- *^ Q YA 

Lead 

Concentration 

Sample 

Collected LAB 

D 

Fimi:

Date: 

Samples Collected 

 t^\/&rcfrt/n 

/ 

RYBSCPXA- ^CC YB D Time: 

RYCSCPXA- ^ Q

RYDSCPXA- H-GC

 YC 

 YD 

*^ ^ DPTl 

___^3Q.PP m 

n 

n Samples Analyzed 

RDZSCPXA- ^(^ ^ DZ (2G.^ ppm n XRF Unit Book: 

RGZSCPXA- *^ Q Gl *f'Ho ppm D Date: G-a - .9.9 

RPZSCPXA- *fC(^ PZ 7Q d ppm D Time: Q:/ / 

Staff: Number of Samples = II 

Legend: YA = Yard (NE), YB = Yard (SE),'YC = Yard (SW). YD = Yard (NW). DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from tfie street,facing property^ hjjJa ^ 

Print Preview Page 1 of2 

'.•>5ii> ' 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 

2 

Owner 

City 

Owner 

State 

Owner 

Zip 

Sec-TwnRng 

0735840002 

FLOYD 

DURANT 

2211 

LOCUST ST 

OMAHA 

68110 

2211 

LOCUST ST 

OMAHA 

NE 

68110 

10-15-13 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Acres 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

CAIN PLACE 

0 

13 

LOTS 11-12 & 

120X146.75 

0.38 

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

parc=0735840002 

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

accountno=R0735840002 

http://\vww.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 9/16/2009 
Page 1 of2 

"> 

[ Create Another Ticket ~~] [ Back to Irth Internet ] Send Email 

YOUR TICKET NUMBER IS 2379835. 

Original Call Date: 10/05/09 Time: 1:58 pm Op: SIVA18967 


Work to Begin Date: 10/07/09 Time: 2:30 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2211 Street: LOCUST ST 


Twp: 15N Rng: 13E Sect-Qtr: 09-NE-SE,10-NW-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: SOIL LEAD REMEDIATION PROJECT 


Location of Work: LOCATE ENTIRE PROPERTY 


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


: FAX ALL CLEARS TO (402) 733 1883 


: UNSURE CORNERS 


Company : PRUDENT TECHNOLOGIES 


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


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 Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emerg: 4029329757 

MAGELLAN MAGELLAN MIDSTREAM PARTNERS LP DEBORAH

Day: 9185747098 

 Alt: 

Emerg: 9185747098 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY

Day: 4025047823 

 Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RON

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/5/2009 
Page 2 of2 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNE 1C QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/5/2009 
ENVIRONMENTAL S. 

CONSTRUCTION 

TECHNOLOGIES. INC. SOLUTIONS 

Site Safety Hazard Analysis (b 

Address: J2Jli7 y:ocu%7 

Crew::^t^<N<> UJ ^JJ'^^O'VJ Bf. 

Date: y«c? 5 o *> 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic / Leech 

field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees/ Bushes 

Structures 

Driveway 

Sprinkler System 

Other 

Cre;><T"oreman 

Condition 

'SfCe^ ^ 

1 

\ 

^ ^ 

n/-t 

•T^c-if. 

-r^i 4 

^ c ^ 

•fL^d^ 

y}iiL^ 

• ht^l- ^ 

A . 

^ y 

Corrective 

Hazards Action 

hntjeit/J^e 

hyrv J locjfi^ 

i 

A>H-J /ceWr 

t^StS y^^*t,<i* ^ 

lyS-e joAyctfc^*^ y f • •• ... . 

Site S*at>t> Officer 

8080 Wfh^ Parkway. Sii:-& 4P5 2Sf/5 W. 34'" Street, 5,-uite .JOE ^Z'l? iWdica! Drive. Suite 7255 

Kansas City. r/iC 54:11* Cmaha. Nstsiashp. e81lo S.^n A.'ifcnlo. TX 73i25 

Phone: (816) 363-:'/"0:, Pfione: (40?:! SCi-S.-JOP^ 


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