TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAiD#: 25349 DATE: 1/15 

ADDRESS: 2418 CALDWELL ST 

REMEDIATION CONTRACTOR: PRUDENTTECHNOLOGIES. INC. YEAR: 20lj) 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

K'­ nf PRE AND POST VIDEO OF PORPERTY (DVD) /v\.-&Si«<i P»ei'D<"«^ ^^^ ^ 

d EXECUTIVE SUMMARY 

m EPA-PROVIDED PROPERTY SKETCH 

U SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

[ / RESTORATION AGREEMENT 

n SETTLEMENT DOCUMENTS (I.E., FOR DAMAGE OR TO REPLACE PLANTS, ETC.) 

d CONFIRMATION DATA 

a PHOTOGRAPHS 

d AS-BUILT SKETCH 

m SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

Q PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

d UTILITY CLEARANCES 

m PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

^ ^ .lililiL 

SIGNATURE DATE 

30218377 

HHilHIil 

Superfund 
PROPERTY SUMMARY 

Date: /15/2010 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Month of: 

Property Address: 2418 CALDWELL ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A 3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Fl = 200 PPM @ 8"; B2 = 69 PPM @ 4"; 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 sketchi) 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 veriiying satisfactory restoration 

v) Description ofareas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES. INC. 
luMlWliWl :.i^.l^Rft TECHNCHJOGIKS, INC. >.^i- « 

EPA Property Close Owt 

Propertv-#: 2-5" 5^ ^ Property Address: 24' ^ /'^iJl^d l ^ ' 

Date/Time: Owner's Name: Mffb<S(30 Z^r^-

Quads Excavated: pf ^2 - Contractor Group: Prudent Technologies, fac, 

Excavation General Ye9 No 

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

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

Grading Sod and Vegetation Yes No 

1. Does the grading around the perimeter of the house in excavated areas generally slope away y from the house? 

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

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

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

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

time period) y

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

7. Was diiniage to landscaping or plant materials avoided? 

^ 

Gates, Fences and Retaining WaJSs Yes No 

!. Do gates open and close freely? (If applicable) y 

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

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

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

Foundation, Siding and Gutters Yes No 

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

2. Was damage to tlie foimdation avoided? y 

3. Was damagclo windows avoided? y 

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

5 Was damage to downspouts or downspout extensions avoided? y 

Sidewalks and Driveways (Concrete) Yes No 

I. Was damage to driveway surfaces avoided'^' y 

Was damage to walkway surfaces avoided? -y 
Owners comments: 

Inspection notes: 

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

EPA Representative Bt>^^^ Date: tt\i\\o 
IRH 

CHNOLOGIES. INC 

AS - BUILT DRAWING 

OLS # 25349 

Date Excavated: 10/21/2010 

rSEPA Signed-Off Date: OMAHA LEAD SUPERFUND SITE 

2^3^*? 

Name: /yltisc a XnAvtWit, i Omaha Lead Site Date; . North Anmr 

/Wdress: 3. V / » r./tci9 K,£U . S / Sfte Sketch Time: 

Phone; 

Team ff-t* ^ <.s A.f* ^ BVID# ^S'i^ f f XRF Code /g>g 7 gooj^ ' J3 Z 

Sampie Number Lead Concentration Confirmation Sample 

gY/»irg/>XA-gg3q? ^ 7 

ppm f ' Yes a No QJ^ :i5 i Fa Yes a gMCS^A>XA-^S3tJ<? ppm No cr 2,(2- ppm ^ / Yes • No Q ; ^^ ^ ppm /JaYes n No czr 

ppm YBb O NO D 

ppm -Yes • No CD 

ppm V6S n No • 

EJ 

Oinaha l^ad Site 46130 

CONTRACT #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
%EPA 

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 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: 

^Y^^ (jjyiy^^t:; 

Owner: 

Phone: 

Restoration Kerns in Question: 

Item: 

Item: 

Rem: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

L&Tagr agrei e restoration is completed. 

L J I do not agree restoration is completed at (noted deficiencies above) 

/Kdtaisyu^'y^<^ l\ /^3//Q 

Owner's Signature Date 

O^^fDj^O^^^ 
^>®V: 

Prudent Technologies, Inc. (Prudent) is under contract with the U. S. EnvironmentaJ Protection Agency (EPA) to clean up leadcontaminated soils at a,number of m£perties located in Omaha, Nebraska, including the property located at 

r 9 (t-l o (_c^({CO 0)j- Off The EPA requests your permission to allow Prudent to perform a soil cleanup at this 

properti' to remove lead-contaminated soiL By signing this form, the 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 contaa Prudent south office for the Omaha Lead 

Site cleanup-at (402) 733-1188. General questions about the Omaha Lead Site cleanup can be directed to the EPA Public Information 

Centers at (402) 731-3045 (South Omalta office) or (402) 991-9583 (North Omaha office). 

Property Access Granted By: ^^I/Z^ik/ID yvi/)i^^Lln f^o'^ py\OB^9 ZTAJO. T^^Q , 

(Please Print Name) 

Property Owner Signatui ')jiUt^/^jyUL^<^ ' /o/lljfd 

/ ^ (Signature) (Date) 

PROPERTY INFORMATION 

(To be completed by resident and/or property owner — please print) 

RESIDENT NAME: '^AjC/^AiT Ltl T Renter 

RESIDENT ADDRESS: 

'cZ¥i^ CALjQiy^s/j-^ sr. 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

OWNER'S TELEPHONE NUMBER - HOME: 1'°^ ) 3l2 - Z ^2- 0 WORK: 

J 1 

AGE OF HOME?: AJ/1 ^ YEARS. HOW LONG HAVE YOU LIVED HERE? /^ / Fl YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? YES NO A*/ A 

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

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY IN THE YARD FOR 5 HOURS OR MORE PER WEEK •yj/ ^ 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETC ., /^/A 

AllTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS; The activities to be implemented by EPA under this agreement 

are pursuant fo Section 104 of CERCLA, 42 U S.C. 9604. EPA's right of access to the property is provided for in Section 104(e) of 

CERCLA, 42 U.S. C 9605(e), which provides entiy for '"detemiining the need for .response, or choosing or taking any response action 

under tliis title, or otherwise enforcing the provisions ofthe title." 

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

Kansas City,'MO 64114 Omaha, Nebraska S8107 San Antonio, TX 78229 

Phone: f816) 363-3703 Phone: (402) 733-1188 Phone: (210)822-9588 

Fax: <816> 363-3707 Faie; (4021 733-1883 Fax:(210)579-6677 
' ^ 

^ 2^3^*? 

Name: /)1di>ef.n JT/i^^vifi-.e^ Omaha Lead Site Date: . North Arrow 

Address: a V / « <JUJ } SJ£ U ^ Site SIcetch Time: 

Phone: 

Team >»aiO <.s A^ ^ BVID# ^ S" 3 ^/ 5^ XRF Code l03 1 RooiLi \3 Z 

Sample Number 

Lead Concentration Confirmation Sampie 

ppm 

^ ' Yes CD No CB^ 

Fa Yes n No 5 ^ 

^/ Yes n No o ; 

"fc- ^ ppm /5a Yes C] No ^ 

-II ppm YOB P No D 

H ppm Y68 a NO a 

Z ppm 'Y6S • -Wo a 

w 

' i l l * r • 

! < ! i l l 

* I ' * 'II * 

Omaha Lead Site 

46130 
N 

li 2418 Caldwell St. 

A "WW^' Printed: Dec 08.2010 www. dcgis. org/dogis 
Page 1 of2 

"> 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2618627. 

Original Call Date: 10/15/10 Time: 4:02 pm Op: SIVA18967 


Work to Begin Date: 10/19/10 Time: 4:30 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2418 Street: CALDWELL ST 


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


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 


: 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 LEVEL3 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVEL3 LEVELS COMMUNICATIONS, LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICHATRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

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Page 2 of2 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT Alt: 4062071494 ELM LOCATING 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK

Day:

 ELM LOCATING Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/15/2010 
CONSTRUCTION .mc. SOLUTIONS 

SITE SAFfcTY HAZARD ANALYSIS 

Address: -MlSL. Cidi^nd J^ . Excavation Date: 

Crew: BackfiU Date: 

Item 

Overliead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees 

Structures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

Condition Hazards Corrective Action 

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Site Safety Office 

Date: 

M O VManfBariomy. Suto4(K SSOOSIOSt 4242 Medical Drive, Sufte 7260 

iGiir;Ma«4ii 4 Onridni, NitanMa 08107 San Antonio, I X 78229 

Plwiie: (403)733-1108 Phone: (2t0) 822-M88 

Fax: (40Z) 733-4883 Fax: (210) 679-6577 
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