TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

L 

SAID #: \ov% 

Date: \ '^'^ 

Add,..: ten 1 yi^' w 

Remediation Contractor: Coastal Environmental Group_ Year: 200J ^ 

SOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Siunmary 

1 / 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confinnation data 

-ePhotographs t/^^rWv ^ V fPf hyC'CAVfi-V^^ 

As-built sketch 

Satisfactory restoration signed by Property Owner 40333853 

Property close-out check list signed by EPA 

Superfund 

-B- Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

L^ 

Date 
# m

Property Access Checklisl 

Propcrr^ LD: n

 WORK STARTtD ON <03^1 P 

Propcm D

 WORK COMPELTED ON AddrT>> q(^^" | 5 3 ^ 5-7 -

Rente r Q""" Oasr. peUovl 

Address: 

Phone: 

nisz UofQo sr FK.\: 

W 

Cell/Pager: 

P.on Additionu) Inlnrmnlion­ c /^|3-2Q f)/7 CP4.^ % 

FIX : 

Cclt/Tager 

D Nofiricaiion Letter Sent: 

/f Acceu Agreement 

Signed: a_/23/^ 9 Bj : 

I [ ^ Restonjtioo Agreement Signed: & /27 ' 0 ^ By: 

D Topsoil Stmplin g (if tpplicublt) / / By 

O DispoiiU SiiDplin g (rf iipplicabte) B j: 

• Gnrdcn Snmpliog (if »pplicftblf) / By: 

m 

Uiilit y Clearance Culled: ^/^/0 9 By.Hl2Cft 

/

D Video/Photos (Before) On By: 

• Video/Photos (During ) Oo Bv: 

n Video/Pholo* (After) On By: 

G .'A'itko/I'hotos (30-D*y ) O n : / / 

^ yProperty Compfelion Agreemeni Signed^/^/ ^ Jl 

O Final Report Is»ued: Bv: 

Air Monilorin); (45 jpplicabte) 

D Communtty CH Crew O D : / / By: 

Rcsuiiy 

D ComraunitA' Q C^cy^ On: / / By; 

Results: 

D Comcnuniri Q Cn;« On / / j By: 

RMUIU : 

Omaha Lead Stte 
Douglas County Account Infooa^io >a|^ n Page 1 of3 i 0 

Douglas County, Nebraska Propeity Record - R0432080000 

Print Report 

NEW Feature - Parcel Dimensions available O) scale 0-50 fi west of 52nd St - VlO W O n Ma p Information is valid as of 2009-8-3 Treasurer's Tax Report 

New Feature - • -» ^ Auto Sales Search 

Owner 

DELEON JOSE 

ETAL 

17752 MARGO ST 

OMAHA NE 68136-0000 

Property Informatio n 

Key Number: 3208 0000 04 

Account Type: Residential 

Parcel Number: 0432080000 

Parcel Address: 4607 S 32 ST 

OMAHA NE 68107-0000 

Legal Description: SOUTH OMAHA CITY LOTS LOT 13 BLOCK 357 50 X 130 

Value Informatio n 

Land Improvement Total 

2009 $11,400.00 $58,300.00 $69,700.00 

2008 $11,400.00 $58,300.00 $69,700.00 

2007 $11,400.00 $42,300.00 $53,700.00 

2006 $11,400.00 $42,300.00 $53,700.00 

2005 $11,400.00 $22,400.00 $33,800.00 

2004 $11,400.00 $20,400.00 $31,800.00 

Sales Informatio n 

Sales Date: 2006-04-13 

Deed Type: TRD Book: 2006 Page: 041839 

Price: $72,000.00 

Grantor: ROBERT J MIKLAS TR 

Grantee: JOSE DE LEON ETAL 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 2005-04-27 

Deed Type: QC Book: 2005 Page: 049720 

Price: $0.00 

Grantor: Bemice M Miklas 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R04... 8/22/2009 
Douglas County Account Inforn||^io iri|||^i< n Page 2 of3 

# 

Grantee: Bernice M Miklas Trustee 

Valid/Invalid: invalid 

Exclusion Reason: Family Sale 

Land Informatio n 

Acres ! SF Units Depth Width Vacant 

0.14 6500.0 1.0 130.0 50.0 No 

Improvemen t Informatio n 

Building 1 

1 1/2 Story Fm 4e07 S 32 St 

l«fl 

ftslFlur 

8MI194 Ft I d 

t I 

i IS 

eosaR 

e«rttfffEKKk8R IT?4a?0 ^ 

CLICK TO ENLARGE IMAGE CLICK TO ENtj\RGE IMAGE 

Square Footage: 1024.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Good 

Built As: 1 1/2 Story Fin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 5.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1900 0% 1900 108 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 624.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch End Solid Wall 80.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R04... 8/22/2009 
Douglas County Account InfoMMtion ^ ^ Page 3 of 3 i^a^on ^ ^ 

Porch End Solid Wall 108.0 

User MLS UPDATE 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R04... 8/22/2009 
Property ID # 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

# # 

CONTACT FORM 

lOO^l^, 

HloDT 'b -KL SV 

Date: Time: Action: 

Date: Time: Action: 

Date: Time: Action: 

Transmit to EPA D Other Action: D 
 I 

Page 1 of2 

# 

"> 

fe ..^Greate^Another Tjcjcet^,: J l c.^:i Back to irth Internet I Send Email

• YOUR TICKET NUMBER IS 2353593. 

Original Call Date: 8/31/09 Time: 4:17 pm Op: ELIZABETH18790 


Work to Begin Date: 9/02/09 Time: 4:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 4607 Street: S 32ND ST 


Twp: 14N Rng: 13E Sect-Qtr: 04-NW-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remediation 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: coastal 


Depth of Excavation: 4ft Comer Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV METRO MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number UtiUty Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4024572307 

METRO METRO COMM. COLLEGE CHRIS Alt: 4026727033 

Emerg: 4024572313 

Day: 4025047823 

MUD02 

METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/31/2009 
Page 2 of2 

# 

0PPDGPR6 OMAHA PUBLIC POWER DISTRICT NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNEIF QWEST LOCAL NETWORK NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/31/2009 
OLS#: 10096 As-Built Drawing € | Date Excavated:9/9/09 

Date USEPA Signed Off: 10/7/09 

COAST A L Omaha Lead Superfund Site Area Sodden: 810 so ft ENVIRONMENTAL GROUP , IN C 

Name: Omaha Lead Site 

Address: Site SItetch ' u^on <>.' ?^ ^ r 

Phone; _ 

Team AL/ f^^- BVID# lCC^.(: 

Sample Number 

Lead Concentration 

2 5'-^; ^ 2- ^ 

K•/&^^^:y•<y? ~ /c^'^ ^ ppm 

/?yy:^y/^j<r^ - j^>£:-9-4^ ppm 

ppm 

ppm 

ppm 

pprr. 

ppm 

Date: ulK^/o l North Arrow 

Time: S". 5i» /5»-, 

'?:^ 

^^^y ^ XRF Code 

Confirmation Sample 

f I Yes CD No 1^3^ 


t^Z Yes a No CJ^­

»5« Yes • No CZk-
 Yes '-J 
 No CD--
 Yes CD 
 No Cil-^ 
 0^ 

Yes CD No CD 

Yes • No • 


Legen d 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with 

Sod 

Area replaced with 

Rock/Mulch Area left bare 

Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc . 
U/if^ -IjrcU^ y z 

Name:

Address:

Phone: 

'

 ... ^ 

 yfog ? ^, ' ^J^ ^T ^ 

Omaha Lead Site 

Site Sketch 

Date:

Time: 

^ North Arrow 

Team U;1^UIAL/ ^ S BVID# /r<r9^ XRF Code ^<^ ^ 

Sample Number Lead Concentration Confirmation Sample 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

f I Yes

(^i Yes

,,31 Yes

/2^ Yes

«>^'Yes

l? ^ I Yes

Yes

 1^

 n

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 ^

 n

 n

 •

 No f*3^ 

 No I^J^­

 No n ^ 

 No ^^3^ 

 No O ^ 

 No O 

 No • 

-?. ^^ !;r ^YV^n^- ^ 
^ 

Name: Omaha Lead Site Date: ip//(*U ^ North Arrow 

Address: ijlnOl ^ ! -^j i ^r ^ Site Sketch Time: y,' 5 5 />»-, 

Phone: _ '<: " 

Team vJ;l\.^:^lAl/ f.t BVID # /Cc9 ^ XRF Code ^<^ ^ 

Sample Number Lead Concentration Confirmation Sample 

f l Yes n No ra^ 

(*Z Yes n No D- -

No tU ^ ppm 

ppm / J . Yes >=] No D ^ 

ppm r^ Yes • No O- ^ 

ppm Yes • No tZI 

ppm Yes • No • 

'^^ ^/ "^r VVVt)'^'\?A'^ 
Name - I : , - . , _ , __^ Omaha Lead Site Date: NoithAiTOw

Address Site Sketch : IfkQj ^ } JSl ^f^ Time: 

Phone: 

^^^ ^ Team BVID# /<?<?*?^ XRF Code 

Sample Number Lead Concentration Confirmation Sample 

f l Yes ^ No ta ^ 

f J Yes CD No 1*3-^ 

i9« Yes • No D ^ 

- Yes CD No D- ^ 

^t'^'ye s • No O ^ 

6 ppm P^ ) Yes a No t n 

• ppm Yes • No • 

^. 3^ $r 
# 

f,to sr,. 

COASTA I 

iltVIRONnlltlAt **• ! PBO'*'^^ C K 0 U r . IH C 

Consent foF Access To Fropefty 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

Owner's Name: — Daytime Phone: 51T ' ^ ^ ^ % 

Address of Property 

covered by this ^(o<^y 6. h 2 5+ 

Agreement: 

PURPOSE OF RESPOJ^SE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Grantor in-person to discuss the work to be perfonned, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work 

before it begins. Once the work is finished, the Grantor will be asked to review the work 

and confirm that it is complete and meets with the Grantor's approval. Upon 

completion, the Grantor will receive written documentation from EPA that the property 

has been remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of perfonning the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
V^-^^f^ / COASTAL INVIflOHKtKTAL 

C « O U r IN C 

€ Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

G Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

e Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

e Abide by health and safety guidance provided by EPA; 

• If the property is rented, assist EPA in obtaining tenant approval for access to 

the property to perform the work. 

c Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the work activities, or with any 

of the work done, or with the equipment used on his property, or to undertake any 

actions regarding the use of said property which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (402) 991-1199 

I grant access to my properties D I do not grant access to my properties 

Signature Date I ' Signature Date 

D I would like to be present during any sampling that is required. 

Page 2 of 2 
p 

The purpose ofthis agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: 100^^4 

Property Address: H4<5f <>. '^'X S4­

Oyf^f^r: "S^^ ^ r)e\e< ^ 

Phone: 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access location(s) to be used by the contractors. Indicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

Itenns to be Removed by the Owner before Start of Remediation: 

The removal: storage, disposal, and/or return of these Items is the Owner's responsibility. 

i item: T i n i 5\K^\ +^ u^r^ 

item: -

Item: 

item: 

items to be Removed by the Contractor During Remediation and Not Replaced_ 

Page 1of_ ^ 
«A 

C .J J4 S T A L 

Items to Be Removed By Contractor During Remediation and Replaced 

Item: ^1 -

Kem: 

Item: 

Item: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach r. sketcli ut the 

.i^prinklcr lavcut. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and loc;itions. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

PJo!c tliis Millie (>iii h-j 

•js?i-' '.c issue H j)l«n' 

\cin.'I:ti 10 i!)e prr,pcr;\ 

o«ntr. 

Easement Area, to be 

excavated 

 ^ti.l 

Quantity 

% \ 

^ 

f 

f 

Landscape Inventory 

Unit Condition/Type/Species 

Quadrants 

Each 

Each 

Each 

Each 

Square Feet 

$ 

Each 

yn 

Page 2 o, > 
^Iffifc 

C * " 'S S T /• L 

O H tf W » . IN C 

I Additional Comments / Instructions: 

i 

Qx_[\ ^H ^vrs \A <X^^ ^ 

Q Check the box if Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

Q I do not agree 

Contractor's Sitniator Signature e Date

Pages 
•I 

BVID # i 0 Q <i| fg 

XRF PROPERTY SAMPLE SHEET 


L / / 

Date Address MfeO'7- S ^ 7 ^ T i(^fof Project Omaha lead FP 2nd year option Sample time am/pm 

XRFID# ?>2^o?^o sample length 30 sec 

Shot# Reading Sample area Shot# P<eaoinQ Sample area 

^ ^ /^3t./f/ J ^ 

Depth Depth ^ M . s?7^; . mTF: 

Average 1*^/ ^ X^ / ^ Average ^ ^ 3- ^ / ^ 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

lab sample # Lab result Sample area XRF Avg. 

Signaturej 'Mm 

Print rtLuOV ^ C/»C£X^ 
« 

ijQL\ Omaha Lead Site—Fixed Price EP-R7-07-05 

%^gij^^ ^^^ ^ IT

\ ^ • ^

 Coastal Environmenta ­ l Groupf Inc. www.coastalhazmat.com v 

%PRoT« ^ COASTA L ENVIIONHENTAL 

CI O U r . IN C 

EXECUTIVE SUMMARY: 

BVID #10096-(4607 S 32 ST) 

No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
 1 

m EPA 

EPA Property Close Out Form 

Property #:J£X::Q\Q_ Property Address: M l 

Datc/Tlmc: Owner's Name:./jj ijOtt^l^. JL^"Lffi) . • .1 — .

Quads Excavated: fit Contractor Group fcW^/J S bV\\H<nr^/^/YfiWkU 

Eicavatloi Yes No i Gcaenil 

I. If necessaiy, were the coirect quadiant(s) excavated and restored? 

2. If necessary, were the correct areas ofdrip zone excavated and restored? U^ 

Grading Yes No Sod and VeaetatioB 

1. Does the gmding around the perimeter ofthe house in excavated areas generally slope away 

from the house? 

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

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 fum and evenly graded? ^ ' 

S. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 17" 

time period) ^ 

6. Was the property graded such that water will not pool on (he properT>'? - ^ ^ 

7. Was damage to landscqiing or plant materials avoided? w^ 

Gates, Fences and Retaining Waib 

Ves No 

1. Do gates open and close freely? (Ifapplicable) U^ 

2. Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) U' 

3. Was danuge to gates or fences avoided? (Ifapplicable) 

4. Was damage to retaining walls avoided? (Ifapplicable) 

Foundation, Siding and GuHers 

Yes rjo 

1. Was danwge to the siding or trim avoided? U4 

2. Was damage to the foundation avoided? u ' 

3. Was damage to windows avoided? T ; ^ 

4 Was damage to windows or door screens avoided? I . ' 

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

Sidewallcs and Driveways (Concrete) 

Yes N 

1. Was damage 10 driveway surfaces avoided? tt 

2. Was damage to walkway surfaces avoided? ^

^ 
Owners comments: 

Inspection notes: 

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

EPA Representative / JcTW IkL/L ^ Date: /O [l/o ^ 
Propeiiy Completion Agreement 

ihis agreement documenls the complelion of remedial acliviiies perloimed on my properly My signaiuie 

will designate that I am satisfied with Ihe restoralion of my propeily. and ihai no items are in queslions. 

now, or al any lime in the future, excepl those ilems listed below, ifany 

Property IP: jQ^q ^ 

Propcrty Addrcss: q^- f <g '^ f ^4 . 

Owner: ^^^ ^ Q^f^^ ^ 

^"""-CnO^^^n 'ifli?)?^ 

Restoration Items in Question: 

Item: 

llem: 

Item: 

Item: 

Item: 

Item: 

L 

P(l 1 Jijjrcr I r.ttoralion K complcltd, except as noted 

I do not a|>rec re$(or«tinn is compleled 

net's Signahire Date Contrarloi' Contrarloi '$s Si cnatiir g c Date