PROPERTY SUMMARY

 

Date; 08/28/2007 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: August 

Property Address; 1609 Grace St 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: None 

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

A.3 Unique Findings: 

A.4 Other Relevant Information 

CONFIRMATION SAMPLING DATA/RESULTS: 

Fl-299@8" F2- 213 @ 8" 

Bl - 243 @ 8" 

Easement 253 @ 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. 

CHNOLOCIES, INC. 
27124 

13 Lead Site Exterior Paint North Arrow — • Owner Name: CITY pF^OMAHA Ol

 ^ 

e Sketch Q Good 

Address: 1609 GRACJEJJ * "' D Poor ^ 

Phone: H: w. QJ^Not paint 

Sampl Lead Sample . .„ Samples Collected e Number 

Concentration Collected Firm: Pf &>/ ^ 

RYASCPXA-27124 F1 L \ j DDm jn [^r Date' b'fi'i'O^ 

RYBSCPXA-27124 F2 J5^2> DDm GT D Time: }\''A6 &**

 

RYCSCPXA-27124 B1 Xfl Ci'l Dom E^ D

 Samples Analyze* j RYDSCPXA-27124 B2 P VA X oom G^ D 

D D XRF Unit: H \ \ Bood 

pom D D j^A- Date: \J • ^ £ • 

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Omaha Lead Site 46130 

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27124

 

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 ;ha Leatl Site Exterior Paint North Arrow • Owner Name: CITY OF OMAHA fj Good . Address: 1609 GRACE ST , ite Sketch D Poor ^ 

Phone: H. w fjg^Not paint 

Lead Sample Samples Collected Sample Number AR

 

Concentration Collected pirm: ff Cf>( ^ 

RYASCPXA-27124 F1 ~\~~\ *D ppm JT).^ [3^ Date: (f-O^-OH 

RYBSCPXA-27124 F2 DDm S^S ^ D Time: HIM A&

 

RYCSCPXA-27124 B1 Vo 0 1 ppm Fv^ n . —

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Omaha Lead Site 46130 
^

<V1" "-v^ Agreemer^) Allow Access To 

Omaha Lead / ,$%, \ Property To Conduct Easement 

Site Remedial * v?!?y j* Sampling and Cleanup 

Action \r i^ 

Under Contract EP-R7-07-06, the U. S. Environmental Protection Agency (EPA) has Contracted Prudent 

Technologies, lac. (Prudent), to cleanup lead contamination on various residential properties including 

your property. You can help with this activity by giving permission to conduct easement sampling and 

conduct cleanup on your property. If you sign tins form, Prudent will return in a few weeks and perform 

the work. We will coordinate sampling and cleanup with you prior to commencement 

If you have any questions about the proposed work, please contact Dan Garvey, EPA's Project Officer for 

our Omaha Lead Site Contract Mr. Garvey can be reached at (402) 731-0788 

I t? I7o/ Property Access Granted By: ^J^ »**^ /\ ' / M2

-*-*-

Property Owner Signature: ^^— /C - / ^^ 7//^ A>7 

S/ (Signature) fDnt») 

PROPERTY INFORMATION 

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

RESIDENTNAHE: V M. C_-£l>—J| | p (r~ QDwner Qenter 

RESIDENT ADDRESS: 

IF RENTAL. PROPERTY OWNED BY. 

OWNER'S HAILING ADDRESS; 

OWNER'STELEPHONE NUMBER-HOME: ( ) WORK: J ) 

AGE OF HOHE7. YEARS. HOW LONG HAVE YO LIVED HERE? YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERDED WITH SIDMG SMCE1978? ^YES NO 

HAS THE INTERIOR BEEN PAINTED OR COVERED SINCE 19787 YES NO 

NUMBER OF OCCUPANTS UNDER C YEARS OLD: NUMBER OF OCCUPANTS 6 YEARS OLD AND OLDER 

NUMBER OF CHILDRENT UNDER 6 YEARS OLD WHO PLAY IN THE YARD FOR 5 HOURS OR MORE PER WEEK: 

COMMENTS OR SPECIAL INSTRUCTIONS: (IE. DOGS. ENTRY GATES. ETC.) 

AUTHORITY FOR ENVIQRHMEMTAL RESPONSE ACTIONS 

The activities to be implements by EPA under this agreement are pursuant to Section 104 of CERCLE. 42 U. S.C. 

9604. EPA' a riefr of access to the propaty is provided for in Section 104<e) of CERCLE, 42 U.S. C 9605(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 title." 
£EPA 

EPA Property Close Out 

Property #: ^ Property Address: /£o?

 

Date/Time: Owner's Name: £, A OF O/w/»A,-»

 

Quads Excavated: Contractor Group Prudent Technologies

 

Excavation General Yes No 

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

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? i/ 

2. Has sod been laid in all areas that were excavated? i/ 

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

day time period) i/ 

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

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? y 

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) i/ 

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? V 

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? / 

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

Inspection notes: 

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

EP A Representative -,J ~ _ Date: IT 
27124

 

Owner Name: CjTV^J^OMAHA 

Address: 1609 GRACE SJ 

Phone: H: 

Sample Number 

RYASCPXA-27124

RYBSCPXA-27124

RYCSCPXA-27124

RYDSCPXA-27124

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cxieno North Arrow ha r Kaint Lead Site 

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Sample Samples Collected 

Collected Firm: Pf C^>/ U(^ 

Date: ft'O^'O^ 

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=^x Staff: OA/^^ LL. . .. ~ir. 

Omaha Lead Site 46130 
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27124 

O Exterior Paint North A/row i ha Lead Site r Owner Name: CITY OF OMAHA fj Good . .i te Sketch Address: 1609 GRACE ST 

D Poor ^ Phone: H: w QJ^fiot paint 

Sample Lead

Samples Collected Number Sample ^g

 

Concentration Collected Firm: Pf Cfl{ I^CLRYASCPXA-27124 F1 89ft ~%3r%> DDm fTj'" ftj^ Date: (?~OH'@H

 

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Lead Site 46130 
SEBV

 

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 hems listed below, if any. 

Property ID: 

Property Address 

Owner: M 

Phone: 

Restoration Items in Question: 

Item: 

Jtem; 

item: 

Item: 

Item: 

item: 

Required corrections to complete the property: 

agree restoration is completed, except as noted above. 

Lj I do not agree restoration is completed 

J 

Owner'* / 'Date 

L 
Print Preview rage i ui 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

2228920000 

CITY OF 

OMAHA 

1609 GRACE 

ST 

OMAHA 

68110 

C/O CITY 

FINANCE 

1819FARNAM 

ST 

OMAHA 

NE 

68183 

Sec-Twn-Rng 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal4 

Assessor 

Website Link 

15-15-13 

C/O CITY FINANCE 

SMITHS-EV-ADD 

15 

1 

W 33 E 129.4 FT 

33X66 

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

accountno=R2228920000 

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 = 20 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 7/16/2007 
Print Preview Page 1 ol 1 

Douglas County-Omaha, NE 

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Farce/ /D 2228930000 Sec-Twn-Rng 15-15-13 

Owner CITY OF Owner

 C/O CITY FINANCE Wame OMAHA Address

 

Property 1845 N 17 ST Addition SMITHS -E V- ADD Address

 

City OMAHA Block 15

 

Zip 68110 Lot 1

 

Owner C/O CITY Legal 1 N 33 W 54.6 FT Address FINANCE

 

Owner 1819 FARNAM Legal 2 / ^X 54.6\ Address 2 ST

 

Owner City OMAHA Legal 3 

Owner NE Legal 4 State

 

http://douglasne. mapping-

Assessor Owner Zip 68183 online. com/DouglasCoNe/static/accountinfo.jsp? Website Link accountno=R2228930000 

Disclaimer Map and parcel data are belie ived to be accurate, but accuracy is not . . Q . oHmilrl nr\t hd ft iKftiti itct.fi fr\r «^ tlHfj. oj!inr^K Map OCdl6 guaranteed. This is not a legal document and should not oe suDstituted tor a title search, , . .; AA f . 

appraisal, survey, or fc »r zoning verification. 1 inch = 11 feet 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 7/20/2007 
Print Preview Page 1 of 1 

Douglas County-Omaha, NE 

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 = 12 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 7/16/2007 
Sec-Twn-Rng 

Owner Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal3 

Legal 4 

Assessor 

Website Link 

Page 1 ot 1 

Douglas 

County-

Omaha, 

NE 

Map 

Scale 

1 inch = 

10 feet 

•^•^^•^^•^^^^•^^••••••••••••••a! 

15-15-13 Disclaimer: 

Map and 

C/O CITY FINANCE parcel data 

are believed 

to be SMITHS -E V- ADD accurate, but 

accuracy is 

15 not 

1 guaranteed. 

This is not a 

N legal 33 W 54.6 FT 

document 

and should 

33 X 54.6 not be 

substituted 

for a title 

search, 

appraisal, 

http://douglasne. mapping- survey, or 

online. com/DouglasCoNe/static/accountinfo.jsp? for zoning 

accountno=R2228930000 verification. 

Print Preview 

^^^^ Parcel ID B

Owner 

Name 

Property 

Address 

\City 

•Zip 

Owner 

: Address 

Owner 

Address 2 

' Owner City 

Owner State 

Owner Zip 

^m^mmm. 2228930000 

CITY OF 

OMAHA 

1845N17ST 

OMAHA 

68110 

C/O CITY 

FINANCE 

181 9 FAR NAM 

ST 

OMAHA 

NE 

68183 

http://wvAv.dogis.org/dogis_aIias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 7/20/2007 
Page 1 oi 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 1845968. 

Original Call Date: 7/19/07 Time: 5:57 pm Op: CYNDIE10967
 

Work to Begin Date: 7/23/07 Time: 6:15 pm
 

State: NE County: DOUGLAS Place: OMAHA
 

Address: 1609 Street: GRACE ST
 

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

Twp: Rng: Sect-Qtr:
 

Legal Given: C
 

Type of Work: Soil Excavation
 

Location of Work: LOCATE ENTIRE PROPERTY
 

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

Company : PRUDENT

Contact Name: CYNDIE 

 TECHNOLOGIES 

Phone: (402)504­1004 

Work Being Done For: EPA 

Depth of Excavation: 13" Corner Lot: 

Involves Tunneling or Horizontal Boring : 

CXCATV LEVELS MAGELLAN MCI 

QLNNE1C 

N 

N 

MUD01 

Explo

Front: N

 N 

OMAHACOF

sives:

 Rear: 

 OPPDGPRb 

Utility Service Area Contact Phone Number Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757
 

Day: 8773668344 

LEVEL3 LEVEL3 COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 

Day: 9185747098
 

MAGELLAN MIDSTREAM MAGELLAN TONYA Alt: PARTNERS LP 

Emerg: 9185747098 

Day: 8002893427 

NO CALL PER MCI MCI Alt: MEMO 

Emerg: 8002893427 

http://www.dhon.org/irtm'ntemet/DHONNoticeCreationyMessageTexl.asp?ret=<RESULTS... 7/19/2007 
Find Record 

Sample Area: 27124 - 1609 GRACE ST 

Owner: 

dj Owner Occupied 

Owner Name: 

j CITY OF OMAHA 

Owner Addressl: 

1 |C/0 CITY FINANCE 

Owner Address2: 

|1819FARNAMST 

City: State: Zip Code: 

JOMAHA |NE J68183 

Owner Phone: Alternate Phone:

 

|(402) 441-5150 j(402) 444-5206 

Clean Up Query Lead Remaining Query

Resident: 

Resident Name: 

(VACANT LOT 

Property Address: 

1609 GRACE ST 

Zip Code: 

J68110 

Resident Phone 

| 

 Property Damage Query 

:

;

!

!

• 

Contract: 

Contractor: 

|PRUDENT2007 

Group: 

j 

-— — — 

Assessment: 

 Qualifying Group 

 jsoo 

 Assessment XRF Date: 

! 

Assessment Max XRF Value: 

| 877 
Page 2 of2 

METROPOLITAN UTILITIES MUDOI EDWINA DISTRICT 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

QLNNE1C 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://wvvw.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/19/2007