TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAE) #: '^^^IZ- Date: fl\\6~ 

Address: TJ l 2S : "B^ifVUii^ fVyf, 

Remediation Contractor: 9A)1(UJPA ^TM l \ ^ Year: ^ M O 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

d Executive Summary 

EPA-provided property sketch 

d Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

Ql Restoration Agreement 

D Settlement documents (i.e., for damage or to replace plants, etc.) 

ID Confirmation data 

1 Photographs 

As-built sketch 

Satisfectory restoration signed by Property Owner 

Property close-out check list signed by EPA 

a Description of areas not meeting ROD cleaniq) criteria 

Utility clearances 

'j Property information from Douglas County Assessor's Office 

D 

D 

D 

isignature ' Date 

30217975 

liiin 

Superfund 
Find Record Remediation Query I Lead Remaining Query I Property Damage Query 

Backfill: 

Sampie Area: 39822 ­ 2725 BAUMAN AV 

Owner: Resident: Contract: 

n Owner Ocoipled 

Owner Name: 

|HOWARD ERIC 

Owner Addressl: 

Resident Name: 

[JOHNSON YVONNE R 

Property Address: 

|2725 BAUMAN AV 

Contractor: 

|PRUDENT2009_S 

Contract Option 

jOPnON 2 

Owner Address2: 

|2725 BAUMAN AVE 

City: 

(OMAHA 

State:

|NE

 Zip Code: 

 |68112 

Zip Code: 

|68112 

Resident Phone 

I — " 

Assessment: 

Qualifying Group 

|400 " 

Owner Phone: Altemate Phone: 

1 Assessment Max XRF Value: 

r 513.6 
PROPERTY SUMMARY 

Date; QjHS/lOlO | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l | Month of: M O V 

Property Address; 2725 BAUMAN AVE 

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: 

F2 = 127 PPM @ 13"; DZ = 32 PPM @ 12"; B2 = 226 PPM @ 12"; EA = 186 PPM @ SCRAPE (~1") 

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) 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 verifying satisfactory restoration 

v) Description ofareas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES, INC. 
:$^SZe TECHNOLOGIBS. INC. 

EPA Property Close Out 

Property #: S ^ ^2 . 1^ Property Address: 2- 7 2.S t^to/i^vft^ A/ 

Date/Time: Owner's Name: U-evv^SC Uo^'W.'^d^ 

Quads Excavated: C7^ rf^ Contractor Group: Prudent Technologies, Inc., 

Excavation General Yes 

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? / 

Grading Sod and Vegetation Yes 

I. Does tlie grading around the perimeter of the house in excavated areas generally slope away 

from the house? y 

2. Has sod been laid in all areas diat were excavated? 7 

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

day time period) 7 

4. Are sodded areas generally firni and evenly graded? 7 

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

time period) 7 

6. Was tlie property graded such tliat water will not pool on the property? 7 

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

Gates, Fences and Retaining Walls Yes 

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

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

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

4. Wasdamage to retaining walls avoided? (If applicable) / 

Foundation, Siding and Gutters Yes 

I. Was damage lo tlie siding or trim avoided? / 

2. Was damage to tlie foundation avoided? / 

3. Was damage lo windows avoided? / 

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

5. Was damage lo downspouts or downspout extensions avoided? 

7 

Sidewalks and Driveways (Concrete) Yes 

1. Was damage lo driveway surfaces avoided? 

/ 

2. Was damage to walkway surfaces avoided? 

i/ 

No 

No 

No 

No 

No 
^ 9 3-5 Sojurra h Ai/^L^ 

Owners comments: 

^ Inspection notes: f

tto* 

efiy ^ 

ty} 

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

EPA Representative Qo^J ^ Date: ij<i('* 
-sr^ 

Property Completion Agreement 

This agreement documents the completion of removal activities perfcjrmed on the below listed property. 

The propjerty owner's signature indicates that the property owner is latisfied with the restoration of the 

subject pjroperty, 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 ai y 

Propert: 'ID: 

Propert;'Address: 3. 7 ^ F Bcj^y f^ O^/i 417,^ ^ 

Owner: \i^x\^Q. VAax^XitrA 

Phone: 

Restoraton items in Question: 

Item: 

Kem: 

Kem: 

Item: 

Kem: 

Item: 

Required corrections to complete the property: 

36 restoration is completed. 

D I do lot agree restoration is completed at (noted deficiencies abbve) 

agr|3e 

(2 /2(Q 9 

Owner's Signature Date 
Prudent Technologies, Inc. (Prudent) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up leadatgd j^ils at a number orproperties located in Omaha, Nebraska, including the property located at 

JifttgiA fliJ£^ . The EPA requests your permission to allow Prudent to perform a soil cleanup at this 

property 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 samphng, removal of lead-contaminated soil, and restoration ofthe referenced property. 

If you have any questions about the soil cleanup plaimed for your property, please contact the Prudent Ofiice 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 al (402) 731-3045 (South Omaha office) or (402) 991-9583 (North Omaha office). 

Property Access Granted 1 

(Please Print Name)^v ^ 

Property Owner SigmOure: X \} ^ OTS^/ H J^L^^cOiMS ^ ^ \ ^ ( C ? 

~ ~ ' (Signature?-^ ^ (Date) 

PROPERTY INFORMATION 

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

RESIDENT NAME: (?£AIS^ My ^7)/lJy ^ (g ^ Renter 

RESIDENT ADDRESS: 

^l^ y UAt/MaT? Ho e 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 5^^ ^ 

^ nn - ^99'^ OWNER'S TELEPHONE NUMBER - HOME: S WORK: 

J 1 

AGE OF HOME?: ^ YEARS. HOW LONG HAVE YOU LIVED HERE? "^ YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? YES ^ NO 

\/w n 

0

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


3 

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

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETC.) 

(2^2 ^ 

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's right ofaccess to the property is provided for in Section 104(e)of 

CERCLA, 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 ofthe title." 

one n \M-.WM O'.ri.i i ocn c KI •>;•'" ctro<kt Ciiit o 7n g A.'iA'y f.hai\\c-^\ nritfA QiiftA A9An 
FE«tM l«thN«KHNT<(S I J& 

TECHNOLOGIES, INC. SSRftVIO&S 

Property Status Form 

Address P7a r Bc^Tn^ f^U^ Date: : 

Phone: BVID: 

Item NO Plants & Permanent Landscaping To Remain In Place 

On Map Description & Location 

Pre-Existing Condition of Structures 

Does your Basement have a history of leaking? Yes No v 

Item NO Description & Location 

On Map 

Pt: 1 - Ctack^ a/\cl Uo^io7\ //i «5/>/ja// ^r^v^e 

f^ 3 -^ CrcLtkf I7\ C07lCret€. 

Property Owner Prudent Employee 

Si Signature: (/y ^ 

^S(S0jWtotflSai4nny,3uite-405 ;250S'N.>24'^tiEet,'SiJfte.'308 

(Omaha,rKebiaskat681i10 

t^^axaei (Stsir:3G3^3ZQ3 ^Ptione: ((402)^50441004 P?lii;iK­ l^H>):ScI:i;?fSS•­

FFax:;f816X363;3707 Fax: ff402)'504-ia05 Rar^ (KM»WTi'-iR^7'7V 
raiNOlXXilES. INC. 

AS - BUILT DRAWING 

OI.S#a9H22 

Dat« K\cavah-d: 11/10/2009 

t:SKP.\ Signcd-Ofn>ale: OMAHA LEAD SUPERFUND SITE 

r-\ Name; 7 ^r 

Address: _±_ 

1 Phone; 

7/ L7 OC •J • • 

7-

Omaha Lead Site 

Site Sketch 

Date;

Time;

 •?- jJ ­

 r'• .' 

 C3 North Arrow

1 

V 

Team Al /i.v'-Hif ("/-Q BVID #

Sample Number 

1 t^ H Ks> CP)C/^ ­ ;^? "O X. 

I y\r^i.viy\ky^ 

 }? ^A ^ 

Lead Concentration 

XRFCode^L^loMConfirmation SampI 

'^/Yes CD 

Yes Q 

>le 

6 

A,. v r/-<., 

TTTiTTiITj J7~ 

Omaha Lead Site i:A = 186 PPM a SrK.M'i: (1" ) 46130 

CONTRACT #: EP - R7-07-06 T0#1 PRUDENT TECHNOLOGIES, INC. 
• • 

7:} /,.. 

On»ha LtM Stct 46130 
25 BAUMAh. March 2007 DOUGLAS COUNTY ASSESS 

.1^ ' 
Print Preview Page 1 of2 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 

2 

Owner 

City 

Owner 

State 

Owner 

Zip 

Sec-TwnRng 

1753160000 

HOWARD 

ERIC 

2725 

BAUMAN AV 

OMAHA 

68112 

2725 

BAUMAN 

AVE 

OMAHA 

NE 

68112 

33-16-13 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Acres 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

MINNE LUSA 

25 

7 

44X120 

0.12 

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp? 

parc=1753160000 

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

accountno=R1753160000 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 9/2/2009 
i 

Page 1 of2 

"> 

iE 

. YOUR TICKET NUMBER IS 2398961. 

Original Call Date: 11/03/09 Time: 10:26 am Op: SIVA18967 


Work to Begin Date: 11/05/09 Time: 11:00 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2725 Street: BAUMAN AVE 


Twp: 16N Rng: 13E Sect-Qtr: 33-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: Y 


Involves Tunneling or Horizontal Boring N Explosives: N 


CXCATV MAGELLAN METRO MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number 

Utility 

Type 

CXCATV COX COMMUNICATIONS. INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

A

MAGELLA >f A r^cT T A XT N .. „ MAGELLAN MIDSTREAM PARTNERS T-,I:D/->D A U DEBORAH 

Day: 9185747098 

Alt: 

Emerg: 9185747098 

METRO METRO COMM. COLLEGE CHRIS 

Day: 4024572307 

Alt: 4026727033 

Emerg: 4024572313 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 
ENVIRONMENTAL & 

CONSTRUCTION 

SOLUTIONS TECHNOLOGIES, INC. 

QJ 

Site Safety Hazard Analysis 

Address: 771X5 <3/f^„^^, Ex. //-?--^^ 

Crew: ^j . (8^hY^ Th/ziPxM^-'/ 

Date : 'i / ^ • &^ 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic / Leech 

field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees /h^jk^s 

Structures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

f^O\(i\)\lA^d^ 

Condition 

9c:^5- ^ 

7\^n etJ 

) 

I 

A y ^ 

yyyf 

^», . 

A y ^ 

T-cijc 

^/f* ' 

7i\t/(­

yi^pUifru^ 

Corrective 

Hazards Action 

t>^^f/ij>^i> 

A**J }oc^-i~e 

1 

Jy^^.-/ /c^cuffd-^ 

u s e? y^/voo'C&ty 

Site Safety Officer 

8080 Ward Parkway, Sutte 405 2505 N. 24* Street, Suite 308 4242 Medical Drive, Suite 7250 Kansas City. MO 64114 Omaha, Webraska 68110 San Antonio, TX 78229 

Phone: (81Si 383-3703 Phone: (402)604-1004 Phone: (210) 622-9gRfl 

Fax: <81S1 363-3707 Fax : t'403» t.t\A.tittic