PROPERTY SUMMARY

 

| Date: 10/30/2007 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: October 

| Property Address: 1516 N 28 St 

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: 

Fl-244@6" 

El - 90 @ 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, 
25923

 

Oma Exterior Paint North Arrow Owne f ia Lead Site r Name: BERNICE JOHNS TR Q Good 

Address Sil je Sketch : 1 516 N 28 ST Q Poor

 

Phone: H: 402-346-3387 W: (jj'Not paint 

Sampl Lead Sample ..Q Samples Collected e Number Concentration Collected

 

RYASCPXA-25923 F1 840 ppm FT (I Date: i //vAtf

 

RYBSCPXA-25923 F2 ^•?rir? PPm D' D Time: 3 ; 3 *-

RYCSCPXA-25923 B1 /77 r. )pm Q^ D

 

£Samples Analyze d RYDSCPXA-25923 B2 ?t ?>& i>pm 0 D 

RDZ6CPXA 36023 B2- - c>pm D D >CR F Unit: In 3 7 Ron k: /35 |H^

pO7*»f*py A 05053 Gu? ' ^ t>pm D D C)ate- sO -2.ta-ol 

RPZSCPXA 35033 P2- ~ f>pm D D

 Time: ^}s*J 

e>taff: L4( Number of Sa mples = 

.egend: F1 = Front Left, F2 = Front Right, 81 - Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

• i *T& f .NT ER1 jiU 

SEP 2 7 2 85 

TtC! jj.^. V-^V^^K. t-T^— 

1 f\ 

V

si 

. i 

f •^t

 /77 330 

i to. 

f

f

4KWI ». •-•~» 

t

i

^ 

8VO 3?>*> 

f 

> 

J 

I V 

*^"9< 

1 \\ * S* Tj~^ 

cv4(

 h> a.2^ 046141 0123 
/5/£ N.

 
25923

 

Oma Exterior Paint North Arrow h ia Lead Site Owner Name: BE ERNICE JOHNS TR Q Good Sit £ Sketch Address: 15 16 N 28 ST Q Poor 

Phone: H: 402-346-3387 W: Qlf'Not paint 

Lead Sample . .„ Samples Collected Sample Number 

Concentration Collected

 

RYASCPXA-25923 F1 &HO i>pm CK D Date: i//rd>f

 

RYBSCPXA-25923 F2 ?!<?•.? Ppm cy n Time: 3 : 3 «r

 

RYCSCPXA-25923 B1 /77 i>pm o^ n

 c

Samples Analyze d RYDSCPXA-25923 82 <53£? c>pm 0 D

 

RDZ6CPXA 26023 92 — r. >pm a n > In S "7 Ron

 (R F Unit: fc <33 

>pm ^M n D C)ateRP3SCPXA 36033 PZ- ~ fipm D D Time: AW ,. ..-— , , , ; , . c>taff: £-4 Number of Samples = j T j i — i 

.egend: F1 = Front Left, F2 = Front Right, 81 = Back Left, 82 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, fadng property 

-

* :NT 

SEP 

ER] 

27 2 

SD 

05 

V^-wx^v rS^U­ ^Y^­

\ <s 

\ 

^ 

^

5 «••••* 

/77 

& 

^m *• 

aw 

4 

[ 

— > 

i 

3 

& 

-4 

?2 

33 

-f 

^ I*

h 

4 J . -

Rev 4> 

. 1, 

•"A 

, 

* ^ 

, ^ ../y. 

•*>* 

±*tf 046141.0123 
V1

V Agreement to allow access to •**V' '' L< gdi ,« 3 the property in order to conduct 

<I environmental sampling and to 

remove l@ad-con£ammatod soil 

iss, lac. (Pfasdeffii) is imdesr cositrect wj$a (fee U. S. EkvkomaeiHlai Psrotedioia Ageacy 

(EPA) to deass up lesd-costezmaatGd soils at a mmber of properties located im Omaha, Nebraska, 

at I *5 I G t\1 ^ <Z Si- The EPA requests your 

allow Pnzderat to pEsrfomx a soil deaaimp at S&sss property to remove lesd-cosatsmraated soil. 

By si fiJsis from, tfiie graperty owiafiff girsaata pezsmssiaffl to I*radleEst to p<sz?ww aciivitias sralated to iSie 

soil samplimg, refflsoval oiPiesd-cosstassaafflated soil, ssxd resteatSsoa of the refesrenced 

Aifieir obtaimog tiae OTOaesr's sigsaatoe oa tLis ftw&ia, Pmdesst TecEsamlogies, Sssc. wll coaiact-tSj 

owaef (ead ?esideste) TratSfflai t&e aext few weeks to coordinate pesrforsuaHce tiie work. 

If you have aaiy tpas^oais aboiut &e soil deamsg jsisaiaed WMT ycua- p?op&rty, f lease contact PimtJesifs 

A&mflastsratsve desk fosr the Omaha Lead Site deaorop, Ms. Cyadie Hrasls at (402) 504-1004. Geme^al 

quastjoas about iSie Osjaalsa Lead Site deaiaajgs caa be dHfrected to Sfiie EPA Public iafofimatioffl Cessfears at 

(402) 731-3045 (soutii OmaSia ofSce) off (402) 991-9583 (siorth Qwsnhs ofSce). 

Property Access Grafted By. V .Tjl^l 

(PUns» Print Name) 

ftopexty Oroieir Sigiaatee: 

(Dato) 

PROPERTY 

Kmsr -

Qenter 

IF REHTOL. PROPERTY OWWED BY: k DU. 

OWNER'S C3AILC3G ADDRESS; 

OWMER'S TELEPHONE : f 3 g* : f ) 

YEARS. HOW L©HG HAVE YOU L8VEO HERE? YEARS. 

HAS THE EXTERKJR SEEfJ PAIMTEO ©R COVERE0 tfJOM SD3DG E3DJCE 1!S78? YES C3© 

HUdSER OF OCCURftMTS UMDER 7 YEARS OLD: _ MUOBER ©F ©CCUPAMTS7 YEARS ©LD AfJO OLDER 

HUQBER OF CMILDnEfJ UMDER 7 YEARS OLD WHO PLAY CJ THE YARD FOR 5 HOURS OK L1©RE PERWEEK: 

COCK3EMTS OR SPECIAL IMSTRUCTIOMS: (t.E. DOGS. EHTRY GATES. ETC.) 

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

agreement are pursuant tc Section 104 of CERCLA,42U.S.C. 9604. EPA' srigtt of access to the property is 

provided fcr in Section 104(e) of CERCLA, 42 U.S. C 9605(e), which provides entry for "determining the nead fcr 

respcnse, or choosing or taking any response action under this title, or otherwise enforcing the provisions of the 

title." 
•• 

&EPA 

EPA Property Close Out 

Property #: Property Address: IS'6 * 3*** 

Date/Time: Owner's Name: 0e***< -loit*9 

Quads Excavated: cf Contractor Group Prudent Technologies 

Excavation General Yes No 

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 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) /

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 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) S 

4. Was damage to retaining walls avoided? (If applicable) S 

Foundation, Siding and Gutters Yes No 

1. Was damage to the siding or trim avoided? S 

2. Was damage to the foundation avoided? i/ 

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) Yes No 

1. Was damage to driveway surfaces avoided? iS 

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 _ &**.&+_ Date: "7 
25923 

Exterior Paint North Arrow 

Owne Oi naha Lead Site r Name: BERNICE JOHNS TR Q Good Site Sketc »i Address: 1 516 N 28 ST n Poor

 

Phone:

 H: 402-345-3387 W:

 [2/

 Not paint 

Lead Sample Samples Collected Sample Number LAB Concentration Collected 

RYASCPXA-25923 F1 &HO DDm D Date: -»//r/6*~

 

RYBSCPXA-25923 F2 333 t)pm GK D Time: 3 J 3«-

RYCSCPXA-25923 B1 H7 i>pm D

 samples Analyze d RYDSCPXA-25923 B2 ?> 3o [>pm D 

RDZCCPXA 26023 B2- - [jpm D D )<R F Unit: />o 3 "7 Bon t: <3.S ^MB RGZSCPX/V25fl33 • G3 "~ t>pm D D Cate-

PPZSCPYA 35023 PZ ~ f)pm D D T me: /}S>1

 

i 77 i ; : Staff: ^/^ Number of Samples = | j ' i — ; 

I.egend: F1 = Front Left, F2 = Front Right, 81 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

Afl quadrants ere as viewed from the street, fadng property 

• 

j;NT ERI 3D 

:^b JQ^&e JL ^ii\o ^ SEP 272 C OS 

• 

v_- .

-^CJS 1-*" J 

( • j 

K i ^J /77 ^ 61 [ &* 4*««M> ~ *•) f~ -4

& 

W ?> 33 1 L

 

>

»\^® 

1 l

i[

Mptf Ife. 

4 ?lo? 

• 

: M. K i— « , G i! / ! 7

 %> jK? 

Rtv4 ../y. i '. 046HI.0123 a.2^ : : 
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 

2213440000 

JOHNS 

BERNICE 

1516N28ST 

OMAHA 

68111 

3112 

NICHOLAS ST 

OMAHA 

NE 

68131 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Assessor 

Website Link 

16-15-13 

SHINNS3RDADD 

Y 

2 

S 48 E 88 FT 

48X88 

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

accountno=R221 3440000 

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 = 18 feet appraisal, survey, or for zoning verification. 

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

subject property, and that no items are in question, now, or at any time in the future, excluding any 

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

Property ID: 2-. S ^ 2. ^ 

Property Address: I ^3 1 4> h-l x^ sv 

Owner: ^>e-rrv" Co ToV\ 

rDOD£! ^JG 2— *• *2 U ^ <^> r^^ g>f^1 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

LJ I agree restoration is completed, except as noted above. 

EH I do not agree restoration is completed 

/vlxdxLxv-tXxt-xC/' Vfy^Lx-ux? /& /

Owner's Signalure Date " 
Page 1 of 2 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 1864756. 

Original Call Date: 8/14/07 Time: 10:06 am Op: CYNDIE18967
 

Work to Begin Date: 8/16/07 Time: 10:30 am
 

State: NE County: DOUGLAS Place: OMAHA
 

Address: 1516 Street: N 28TH ST
 

Twp: 15N Rng: 13E Sect-Qtr: 16-NE
 

Twp: Rng: Sect-Qtr:
 

Legal Given: C
 

Type of Work: Soil Remediation - Lead - 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 LEVELS MUD01 OMAHACOF OPPDGPR5 QLNNE1C
 

Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344
 

LEVELS LEVEL3 COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 

Day: 4025047823 

MUD01 METROPOLITAN UTILITIES DISTRICT EDWINA Alt: 

Emerg: 4025047946 

Day: 4024447197 

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

Emerg: 4024445160 

Day: 4067289343 

http://www.dhon.org/irtrunternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/14/2007 
Page 2 of2 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Emerg: 8887289343 

QLNNE1C QWEST LOCAL NETWORK NA

Day:

 Alt: 

 4067289343 

Emerg: 8887289343 

http://www.dhon.org/irthinternet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/14/2007