PROPERTY SUMMARY

 

Date: 09/27/2007 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: September 

Property Address; 5011 S 18 St 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: None 

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

A.3 Unique Findings: 

A.4 Other Relevant Information: 

CONFIRMATION SAMPLING DATA/RESULTS: 

F2 - 94 @ 6" 

Easement 95 @ 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) BV1D 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. 

Superfund 

TECHNOLOGIES, INC. 
Name: PeAv J TLis h/><.*- Omaha Lead Site 

Address: $61) 6 / ft & Site Sketch 

Phone: (oil 

Team BVID # 

Sample Number Lead Concentration 

ppm 

ppm 

ppm 

ppm 7/ ppm 

ppm 

ppm 

Lab RGZSCPLA-48509 

Result e?.3:ppm

 

*­

lo\ 

(6 

Date:CR North Arrow 

Time: <*L: 

XRF Code 

: PM 

: I32 

Confirmation Sample 

f Yes a 

f^ Yes CD 

6' Yes ^ 

82 Yes 

D 

Yes U 

'I 

No 

No 

No 

No 

No 

-Ncr 

No a 

... 

StP 

--^— ' 

Omaha Lead Site i. . 46130 

3, P' 


—

 Name: re.A*s~ J TiAS ///?€rAddress: 5 6 li 5 / fr .?Y 

Phone: 67^-^373 

Team Ic /TT'-J-fe^. BVID#

Sample Number 

^ v/i^/" ^V A — U Q C^\Ck » K.7f\*y\*'rS*!f*t *^pTy\j \ 

« A2fB^£^XA- Q9>GQ°( ^Pw ^^^-^* ^5 ^^ ,^\ ^ i_j £t ^^xs ^^

 *> ^V T mrt^ '^^ ^^r* T f(« ^^ »-f ^J 

1^^ ^ ^^ ^^f ^0 ^^^4 ^ *• Q ^C/^ ^l 

5 &£-Z5£/*XA - 4 /JSto^ 

fi ' 

Lab RG2 :SCPLA -48509 

Result 67.: 

Omaha Lead Site 

Site Sketch 

 ^^S O9 

Lead Concentrat ion 

Dpm /2T^ spm 2.6 ^

c. ispm 23 spm 7/ 1)pm — jpm — f)pm 

K/ .__S/-_-_ ___x x *X \- * y >

 

^c^i /^f ct^ V <:. i... i i .. 

Date: Cft Cf3-CC t— 

North Arrow 

Time: J.1 /L5 A^ 

A,5T JWV 

^ff: LA P«ite.'/* 

XRFCode //237 ^ffoK 132 

Confirmation Sample 

f ' Yes Q

 f t Yes CD

 6 ' Yes CD

 g* Yes ^x

 g2. Yes CB"^ ^V« B

• Yes D 

I 

IINT 

SEP 

* 

 No t2^. 

 No G3^*^ 

 NO O^T 

 No ^ 

 No D Mr. 'PI 

Ne-..rn 

C»T3 &1CJ ID 

13 2 I0S 

^

-....._..•? 

ji 't

......_.r 

. 

«^ 

J 

<?i i*f?

f

 p|f 

. /J7/ ^ : 

1 f 

— -j- -4 -

— 

T ! 

,6 >U ,-j 

1 j 

fI! r^ 

I7\ 4j !/27 H ^

"i^t ! 

i ^ — i- L-J 

j 

=: /(i 

D f Q 

Omaha Lead Site 46130 
M... ,-.-• *\,,f Agreeme o allow access to 

Omaha Lead ^

 :

 .-/ ^% '•_ the propefff in order to conduct 

Site Remedial :; V?ffv 5 environmental sampling and to 

v.,-»9ww»w*/• remove lead-contaminated soil 

Prudent Technologies, Inc. (Prudent) is under contract wim me U. S. Environmental Protection Agency 

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

MtrinAtguM property legated at £O II £ I & <S f . The EPA requests your 

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

By signing this form, the property owner grants permission to Prudent to peifumi activities related to the 

cleanup ttiflniing soil mnpline, removal of lead-contaminated soil, and restoration of fee referenced 

rty. After obtemmg the uwnei s signature on mis ronn, nudent Technologies, Inc. will contact me 

rty owner (and residents) within me next few weeks to coordinate performance me work. 

If yon have any questions about me soil cleanup planned for your property, please contact Prudent's 

Administrative Clerk for fhe Omaha Lead Site cleanup, Ms. Cyndie Binds 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 (aortn Omaha office) 

Property Access Granted By:. 

Property Owner Signature: \^T^ \ U ^iin€r- 7 '07 ~07 

PROPI5RTYIWFORMATTON 

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

REStOEHTMA«: 

6 '1*6 

IF RENTAL. PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; jQlj O 

OWNER'S TELEPMOMEHUHBER-HOME: I \ WORK: J L 

AGE OF HOME?: //JU YEARS. HOW LONG HAVE YOU LIVED HERE? / 7 YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 19187 YES X "° 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: 0 NUMBER OF OCCUPANTS 7 YEARS OLD AND OLDER ]_ 

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY 0 THE YARD FOR 6 HOURS OR MORE PER WEEK: O 

ENTS OR S0ECIAL USTRUCTIONS^f. DOGS. ENTRY GATES. ETC ^ritfi ' ' 

r if\ K4 kjhal/^fli'f WlLsJ tf/A iLA/tJ - "^ If . ^ 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: Tteattwitiestobeiinplemaatfldby EPA unda- this 

^reementarepursuanttoS«lionl04ofCERCLA,42U.S.C. 9604. EPA' srigta of access to the property is P(°\C 

provided for in Section 104(e) of CERCLA, 42 U.S. C 9605(6), which i^wides entry for "detemining the need for I 

response, or choosing or taking any response acticn under this title, or otherwise enforcing the provifitans of the -^i -Ol 

tiU9." ' 
EPA Property Close Out Form

 

Property #: Property Address: SOI/ 

Date/Time: s, Owner's Name: Pat Fife 

Quads Excavated: Contractor Group 

Excavation General 

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

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 

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) 

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

Foundation, Siding and Gutters 

1 . Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 

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) 

1 . Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

S 

i/ 

 Yes No 

/ 

(/ 

i/ 

S 

s 

<s 

/ 

Yes No 

S 

«/ 

/ 

/ 

Yes No 

/ 

«• 

i/ 

s 

y 

Yes No 

•/ 

l/ 
t

 

Owners comments: 

Inspection notes: 

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

EPA Representative Q^, .jj^ Date: 
„ Total Quad; uare Footage to be Excavated = 923 

Propert Total Dri Linear Footage to be Excavated = 0 y Classification: 1200 

Concrete 

Excavated Area 

Existing Structure 

Fence 

Permanent Landscaping 

Quadrant Boundary 

Street Boundary 

Tree/Shrub 

wtp*" Q6 

South 18 Street 

North Arrow Omaha Lead Site 

Omaha, Nebraska 

Property Number 

OLS-48509 Scale 

Property Address 1 Inch = 20 feet or 1 grid = 5 x 5 ft 

5011S18ST 

Post Excavation Concentrations (ppm) HGL F1 B2 Ray Area 

F2 °\^ DZ Easement °l ^ 

B1 Garden Other 

Descriptor of post excavation areas' F1, front yard lad-hand quadrant: F2. front yam right-nand quadrant, 61 backyard left-hand quadrant: B2. backyard right-hand quadrant: 

DZ, drip zone (1-3foot area of sol around the foundation of the house). 
SEPA (OLOGIES, INC. 

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 sod warranty (90 days total) except those items listed below, if any. 

Property ID: tj ^-C"^ <^ 

Property Address: <^ / i ST- ( ^

 ST. Owner: ' ii/_^ F ,-\ ^^ ^

 

Phone: AVl 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

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

I I I do not agree restoration is completed 

-/) <n 

(J / 

Date 
<>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: /L| <g <^ Q 0[ 

G C

^

- Property Address: ==5 o \ \ \ *£. V <~\ b W fvk: (2=. ^i x 

Owner: \ ^ ~\Y^\\ € ^P V 

J x\ . Phone: /0/\o (? ^1 ^ - C _J ^^ *-^i 1 r 'V'W" gV \ 1 ~^ 1 I VN_J^^ e I ^n^fc - qntf-D 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

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

LH I do not agree restoration is completed 

Oder's Signature 
• • •

Total Quadr^M)uare Footage to be Excavated = 923 

Property Classification: 1200 Total DripiiBfe Linear Footage to be Excavated = 0 /\) C /Kf «. I„ » Total

 Quadr^fci (_A( * flNJOKfll DrijBI • i . " ! • <S : 

Legend

m&

y'/[

[ j

' X i

— — —

'".. >

 Co-***' 

Excavated Area 

Extsting Structure 

Fence 

Permanent Landscaping 

Quadrant Boundary 

Street Boundary 

Tree/Shrub 

North Arrow 

Scale 

1 Inch = 20 feet or 1grid = 5x5tt 

F1. 

F2 

B1 

£ V v HGL 

Omaha Lead Site 

Omaha. Nebraska 

Property Number 

OLS-48509 

Property Address 

5011 S 18 ST 

Post Excavation Concentrations (ppm) 

B2 Play Area 

DZ Easement 

Garden Other 

Dascripflon of post mcavadcn areas: F1. frcnt yard left-hand quadrant; F2. (rant yard rtght-hand quadrant B1, backyard ten-fund quadrant; B2, backyan) hgnMwnd quadrant 

DZ, drt> zene (1-3 toot area ot ed around the foundaton of the house). 
Print Preview Page 1 of 1 

t 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

0413840001 

TUSHNER 

PETER J 

5011 S18ST 

OMAHA 

68107 

5018S18ST 

OMAHA 

NE 

68107 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Assessor 

Website Link 

SOUTH OMAHA CITY LOTS 

106 

4 

S 27.7 FT LT 4 

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

accountno=R041 3840001 

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 = 80 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 6/21/2007 
Douglas County Page 1 of 1 

t 

Douglas County, Nebraska Property Record - R0413840001 

Information is valid as of 2007-5-9 Print Report 

Values not finalized until after Board of Equalization View on Map 

Owner 

TUSHNER PETER J 

5018S18ST 

OMAHA NE 68107-0000 

Property Information 

Key Number: j 13840001 04 

Account Type: \ Residential 

Parcel Number: \ 0413840001 

Parcel Address: ; 5011 S 18 ST 

OMAHA NE 681 07-0000 

Legal Description: \ SOUTH OMAHA CITY LOTS LOT 4 BLOCK 106 S 27.7 FT LT 4 

Value Information 

Land i Improvement ! Total . .1 . - .
 2007 

2006 

2005 

2004 

2003 

2002 

$1,000.00 

$1,000.00 

$1,000.00 

$1,000.00 

$1,000.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$1,000.00 

$1,000.00 

$1,000.00 

$1,000.00 

$1,000.00 

$0.00 

Sales Information 

Date '. Type Book Page Price 

Land Information 

Acres 

0.08 

I SF 

3640.0 

FF 

28.0 

Units 

0.0 

Depth 

130.0 

Width 

28.0 

Vacant 

Yes 

Land Attributes 

Attribute Attribute Description 

Improvement Information 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R04... 6/22/2007 
Page 1 of 2 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 1836198. 

Original Call Date: 7/09/07 Time: 3:21 pm Op: CYNDIE18967
 

Work to Begin Date: 7/11/07 Time: 3:45 pm
 

State: NE County: DOUGLAS Place: OMAHA
 

Address: 501.1 Street: S 18TH ST
 

Twp: 14N Rng: 13E Sect-Qtr: 03-SW
 

Twp: Rng: Sect-Qtr:
 

Legal Given: C
 

Type of Work: Lead Soil 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: 13" Corner Lot: N Front: N Rear:
 

Involves Tunneling or Horizontal Boring : N Explosives: N
 

CXCATV LEVEL3 MCI MCLEODNE MUD02 OMAHACOF OPPDGPR6
 

QLNNE1F
 

Service Area Contact Phone Number Utility 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVEL3 LEVEL3 COMMUNICATIONS, LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MCI MCI NO CALL PER 

MEMO 

Day: 8002893427 

Alt: 

Emerg: 8002893427 

MCLEODNE MCLEODUSA NA 

Day: 8002891901 

Alt: 

Emerg: 8002891901 

http://www.dhon.org/irthinternet7DHONNoticeCreation/MessageTexl.asp?ret-<RESULTS... 7/9/2007 
t Page 2 of 2 

METROPOLITAN UTILITIES MUD02 EDWINA DISTRICT 

OMAHACOF CITYOFOMAHA-TRAFFIC,SEWER RON 

OPPDGPR6 OMAHA PUBLIC POWER DISTRICT NA 

QLNNE1F QWEST LOCAL NETWORK NA 

Day: 4025047823 

Alt: 

Emerg: 4025047946
 

Day: 4024447197
 

Alt: 4024445161
 

Emerg: 4024445160
 

Day: 4067289343
 

Alt:
 

Emerg: 8887289343
 

Day: 4067289343
 

Alt:
 

Emerg: 8887289343 

http://www.dhon.org/irthinternet/DHOlMNoticeCreation/MessageText.asp?ret=<RESULTS... 7/9/2007 
! md Record

 Clean Up Query Lead Remaining Query Property Damage Query Close 

Sample Area: 48509 - 5011 S 18 ST 

Owner: Resident: Contract: 

i_j Owner Occupied Resident Name: j j Contractor: 

Owner Name: (VACANT LOT | • |PRUDENT2007 

ITUSHNER PETER Property Address: Group:

 

Owner Addressl: i [5011518 ST

 

; Zip Code: 

Assessment: Owner Address2:

 ! (68107

 

i 

J5018 S 18 ST i Resident Phone Qualifying Group

 

City: State: Zip Code: | (1200

 

JOMAHA INE ^68107 "

; Assessment XRF Date: 

Owner Phone: Alternate Phone: I \ 

i j Assessment Max XRF Value: