PROPERTY SUMMARY

 

| Date: 11/27/2007 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: November 

| Property Address; 4222 Patrick Av 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: None 

A.2 Issues Resolved: Re-Seed will occur in November on any dead spots to encourage spring growth. 

A.3 Unique Findings: 

A.4 Other Relevant Information: 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl - 79 @ 6" B2 - 94 @ 8" 

El - 80 @ scrape 

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

photographs 

iii) Signed form verifying satisfactory restoration 

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

TECHNOLOGIES, INC. 
27203

 

O jte Exterior Paint Arrow 

Own6r Name: JAMES R MALY r naha Lead S

[] Good Site Sketch /I Address: 4222 PATRICK AV ^ Q \

 Poor 

Phone: »'• 402-345-7215 W: Q3^Not paint 

Sampl Lead Sample .. B Samples Collected e Number 

Concentration Collected Firm: KL^ /Y\T4 U&L 

RYASCPXA-27203 F1 in F>pm B" D Date: OS - t^8 • O5 

RYBSCPXA-27203 F2 }la3> ppm 03^ D Time: 1 ; tO onrx r—i ! RYCSCPXA-27203 B1 ^31 c>pm 

Samples Analyzed RYDSCPXA-27203 B2 0 1^2 t>pm D - ppm D D XRFUnit: 1037 Book: 133 

"- Pom D D Date: n-7-or 

\\f JL\j(->\ AA c. I mM<t I iL. - pom D D Time: >4 /Vf 

^T~ Staff: /./4 Number of Samples = ! *-] j 

I.egend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

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27203

 

Omat Exterior raim Owno i a Lead Site r Name: JAMES R MALY Q Good Sit e Sketch

 /j Address: 4222 PATRICK AV

 4 Q Poor

 

Phone: H. 402-345-7215 W: rjg^ot paint 

Lead Sample Samples Collected Sample Number 

Concentration Collected Firm: r£-- /nr\T^ (JL 

RYASCPXA-27203 F1 / j 7 Dom C^ D Date: Q*^ • r/-o ' O5 

RYBSCPXA-27203 F2 Jjfe3 com ^f^ D Time: \ • IO orf^ 

1 RYCSCPXA-27203 B1 L

4'3( t>pm

 D Siamptes Analyzed RYDSCPXA-27203 B2 &H^ i>pm

 D ~" i>pm D D )<R F Unit: //?a 7 Rook- / 33 

RQZSCPXA-g7203 02 ~ c>pm D D C)ate 

RPZOOP)(A'272QO PZ - c>pm D D

 Time A fV\ 

SJtaff: LA Number of Sa mples88 

1.egend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

: 

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'^ AgreemJ^to allowaccessto 

Omaha Lead / $% v the property in order to conduct 

Site Remedial * \^8Pv J environmental sampling and to 

Action \^ffrf»ffif^ remove lead-contaminated soil 

Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency 

(EPA) to clean up lead-contaminated soils at a number of properties located in Omaha, Nebraska, 

including the property located at . The EPA requests your 

permission to allow Prudent to perform a soil cleanup at this property to remove lead-contaminated soil 

By signing mis form, the property owner grants permission to Prudent to perform activities related to me 

cleanup iuduuiog Suil SSuipuflg, leuiGVai Of icdd-COutauiiuated 5uil, Sud f £iuiduuu Of uie f efef HiCed 

property. After obtaining the owner's signature on this form, Prudent Technologies, Inc. will contact the 

property owner (and residents) within the next few weeks to coordinate performance the work. 

If you have any questions about the soil cleanup planned for your property, please contact Prudenfs 

Administrative Clerk for me Omaha Lead Site cleanup, Ms. Cyndie Hinds at (402) 504-1004. General 

questions about the Omaha Lead Site cleanup can be directed to the EPA Public Information Centers at 

(402) 731-3045 (south Omaha office) or (402) 991-9583 (north Omaha office). 

^-

Property Access Granted By: *---> 

4s» PnntNun*) /yj/7 ^

 

Property Owner Signature: 

(Date) 

PROPERTY INFORMATION 

(To be completed by resident and/or property owner - pleas prmt) 

RESDENTNAME: r\l/jL—~_ ; QJwner Qenter 

RESIDENTAOORESS: 

IF RENTAL.PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS: 

OWNER'S TELEPHONE NUMBER-HOME: jj~^\

 J"$X • 3V\>°1 WORK: J L 

AGE OF HOME?: /%t""YEARS. HOWLONG HAVE YOU LWED HERE? 

HAS THE EXTERIOR BEEN PANTED OR COVERED WTTH SIDING SMCE 1378? 

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

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY H THE YARD FOR S HOURS OR MORE PER WEEK: 

COMMENTS OR SPECIAL INSTRUCTIONS: (LE. DOGS. E NTRY 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'srigtt of access to the property is 

provided for in Section 104(e) of CERCLA, 42 U.S. C °605(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 

titla" 
£EPA 

EPA Property Close Out 

Property #: Property Address: 

Date/Time: ///»»/» Owner's Name: 

Quads Excavated: Contractor Group Prudent Technologies 

Excavation General Yes No 

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

2. If necessary, were the correct areas of drip zone excavated and restored? S 

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? / 

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

day time period) s 

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) S

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

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

Gates, Fences and Retaining Walls Yes No 

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

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

3. Was damage to gates or fences avoided? (If applicable) s 

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? S 

3. Was damage to windows avoided? </ 

4. Was damage to windows or door screens avoided? S 

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

Sidewalks and Driveways (Concrete) Yes No 

1 . Was damage to driveway surfaces avoided? S 

2. Was damage to walkway surfaces avoided? J 
Owners comments: 

Inspection notes: 

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

EPA Representative _ &*, jGL~_ Date: — TM 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SOLUTIONS 

Property Contact Attempts 

Property ID: SL ~"\ 3^ o ^ 

Property Address: <-A9<cSi^^ ^ci"5T"j ^3^ ( l^V 0 

Owner Name: W^C) Juy-—?

 

Owner Phone: \AOA- — ^=>^ ) *-^l 3^"*^~^ 

Below please find a listing of unsuccessful attempts to 

reach the above property owner. 

Date Time Initials Result 

/ ; / 

f 0 

Signature Date 

Prudent Technologies, Inc. 

Acknowledgement Signature Date 

EPA 

8080 Ward Parkway, Suite 405 2505 N. 24TM Street, Suite 308 8918 Tesoro Drive, Suite 109 

Kansas City, MO 64114 Omaha, Nebraska San Antonio, TX 78217 

Phone:(816)363-3703 Phone: (402)504-1004 (210)822-9588 

Fax:(816)363-3707 Fax:(402)504-1005 Fax:(210)579-6577 
/ r 27203 AJ -

Exterior Paint North Arrow 

Owner Name: JAMES R MALY [] Good Site Sketch Address: 4222 PATRICK AV Poor 

Phone:

 H:

 402-345-7215 W: ol paint 

Lead Sample Samples Collected Sample Number LAB Concentration Collected Firm: _ 

RYASCPXA-27203 F1 ppm 0" D Date: O°l . O5 

RY8SCPXA-27203 F2 ppm GK" D Time: I .' IP 

RYCSCPXA-27203 B1 ppm D Samples Analyzed RYDSCPXA-27203 B2 ppm D 

RDZOOPXA 27203- 9Z D D XRF Unit: /<P37 Book: < 

7200 0£! D D Date: tl-7-Qf

 

RfZQOPXA"g72Q3- PZ D Time:4/> f

 

Staff: Number of Samples -

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden. PZ = Play 

All quadrants are as viewed from the street, facing property 
Print Preview Page 1 of 1 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

0817960000 

MALY JAMES 

R 

4222 PATRICK 

AV 

OMAHA 

68111 

14505N156ST 

BENNINGTON 

NE 

68007 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Assessor 

Website Link 

08-15-13 

CLIFTON HILL 

7 

20 

50X120 

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

accountno=R081 7960000 

Disclaimer Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 37 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 8/1/2007 
203 

Exterior Paint Nonn «,,„., Owner Name: JAMES R MALY Omaha Lead Site D Good A Address: -»222 PATRICK AV Site Sketch fj Poor ^ 

Phone: H: 402-345-7215 W: fj3^Not paint 

Sampl Lead Sample ... , Samples Collected e Number Concentration Collected Firm: »C—• /^TV-A (^2^. 

RYASCPXA-27203 F1 /J7 Dom W D Date: O^ - rXS • O5 

RYBSCPXA-27203 F2 \b?> ppm Ifl^ D Time: I : tO nrrx 

RYCSCPXA-27203 B1 *-(3l ppm (UK D 

Samples Analyzed RYDSCPXA-27203 B2 

nDJOCrXA 27203 B2 ppm n r~ VDIT iini»­ If) Hi a^ni,­ 1 ^1 

~ ppm |~1 D Date: //-7-0.T 

~ Ppm D D Time: A/Vl 

Number of Samples

-j-':

 = ; H ^

 ! 

'• ~ ~~ Staff: L<4. 

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

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Page 1 of2 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 1885652. 

Original Call Date: 9/10/07 Time: 3:12 pm Op: CYNDIE18967
 

Work to Begin Date: 9/12/07 Time: 3:45 pm
 

State: NE County: DOUGLAS Place: OMAHA
 

Address: 4222 Street: PATRICK AVE
 

Twp: 15N Rng: 13E Sect-Qtr: 08-SE-SW,17-NE-NW
 

Twp: Rng: Sect-Qtr:
 

Legal Given: C
 

Type of Work: Lead Remediation - excavation
 

Location of Work: LOCATE ENTIRE PROPERTY
 

Remarks: FAX ALL CLEARS TO: (402)504-1005
 

Company : PRUDENT TECHNOLOGIES
 

Contact Name: CYNDIE Phone: (402)504-1004
 

Work Being Done For: EPA
 

Depth of Excavation: 14" Corner Lot: N Front: N Rear: N
 

Involves Tunneling or Horizontal Boring : N Explosives: N
 

CXCATV MCLEODNE MUD01 OMAHACOF OPPDGPR5 QLNNE1C
 

Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emerg: 4029329757 

MCLEODNE MCLEODUSA NA

Day: 8002891901 

 Alt: 

Emerg: 8002891901 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT EDWINA Alt: 

Emerg: 4025047946 

Day: 4024447197 

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

Emerg: 4024445160 

Day: 4067289343 

hrtp://www.dhon.org/irtruntemet/DHO^moticeCreation/MessageText.asp?ret=<RESULTS... 9/10/2007 
Page 2 of 2 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Alt: 

Emerg: 8887289343 

QLNNE 1C QWEST LOCAL NETWORK NA

Day:

 Alt: 

 4067289343 

Emerg: 8887289343 

http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/10/2007 
Find Record dean Up Query Lead Remaining Query I Property Damage Query Close 

U Owner Occupied 

Owner Name: 

IMALY JAMES R 

Owner Addressl 

Owner Address2 

14505 N 156 ST 

IBENNINGTON 

Owner Phone: 

(402) 238-2065 

State: Zip Code 

NE (68007 

Alternate Phone: 

J (402) 708-3309 

Resident Name: 

JVACANT LOT 

Property Address: 

(4222 PATRICK AV 

Zip Code: 

J68111 

Resident Phone 

|PRUDENT2007 

Group: 

Qualifying Group 

|800 

Assessment XRF Date: 

Assessment Max XRF Value 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SOLUTIONS 

August 24, 2007 

Mr. James Maly 

14505 N 156 Street 

BenningtonNE 68007 

RE: 140 N 37 Street, 4222 Patrick Av 

BVID# 23242, 27203 

Dear Sir: 

Thank you for participating in the soil clean up project being implemented by the U.S. 

Environmental Protection Agency (EPA) for the Omaha Lead Site. This clean-up project is being 

completed at no cost to the homeowners. 

In allowing the remediation of your property at 140 N 37 Street and 4222 Patrick Ave you will 

have achieved a lead safe environment from the exposure of lead in the soil for your family or the 

families of your tenant, if the property listed above is a rental property. 

We are asking you to sign the enclosed document stating that: by my signature on the enclosed 

agreement form. I hereby give permission to employees and/or authorized representatives of 

Prudent Technologies, Inc. (Prudent), contracted by the United States Environmental Protection 

Agency (EPA) under Contract EP-R7-07-06, to enter and have access to my property for the 

purpose of sampling and taking appropriate response actions which are necessary to implement 

the clean up of lead contamination in the soil. Such actions will include: (1) Preparation for and 

the excavation of contaminated soil from my property; (2) Backfill excavated areas with 

approved clean soil; (3) Restore grass and other vegetation or structures as close as possible to 

their pre-excavation state. 

Please sign the form where indicated and return in the pre-addressed stamped envelope, keeping 

the pink copy for your records or please contact me at the phone number listed below, and I will 

be happy to meet with you at your convenience to discuss any property issues. 

Also, please remember that the above property will be listed in the EPA's database as well as 

your county assessor's office of clean properties upon completion. 

Should you have any questions, please do not hesitate to contact our office at 2505 N 24th St, 

Suite 308, Omaha, NE 68110 or 402-504-1004. 

Thank you again for your prompt attention in this matter. 

Sincerely, 

Cyndie Hinds 

Prudent Technologies, Inc. 

Omaha Lead Site Administrative Clerk Team Member 

Enclosures 

8080 Ward Parkway, Suite 405 2505 N. 24TM Street, Suite 219 8918 Tesoro Drive, Suite 109 

Kansas City, MO 64114 Omaha, Nebraska San Antonio, TX 78217 

Phone:(816)363-3703 Phone: (402) 504-1004 (210) 822-9588 

Fax: (816) 363-3707 Fax:(402)504-1005 Fax:(210)579-6577