TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 32250 DATE: 12/15/2010 

ADDRESS: 256 9 PRATT ST 

REMEDIATION CONTRAaOR: PRUDENTTECHNOLOGIES. INC. YEAR: 2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS y 

m PRE AND POST VIDEO OF PORPERTY (DVD) ^^.^\'N(\ ^-"'i^e o .^ 

m EXECUTIVE SUMMARY 

of EPA-PROVIDED PROPERTY SKETCH 

m SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

• RESTORATION AGREEMENT 

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

Da CONFIRMATION DATA 

PHOTOGRAPHS 

d AS-BUILT SKETCH 

13 SATISFAaORY RESTORATION SIGNED BY PROPERTY OWNER 

13 PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

El UTILITY CLEARANCES 

m PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

D 

SIGNATURE DATE 

30218371 

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Zip Code: 

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PROPERTY SUMMARY 

Date: 12/15/2010 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 TO#l Montli of: December 

Property Address; 2569 PRATT ST 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: AREA NOT EXCAVATED: Fl/LS (i^XWr^'^ie^ = 146 PPM @ 

SCRAPE CSx'xss' ^ 

CONFIRMATION SAMPLING DATA/RESULTS: 

Fl = 77 PPM @ 2"; EA = 68 PPM @ SCRAPE (~1") 

ATTACHMENTS 

1) Property slcetch 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 of areas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES. INC. 
TECHNOLOGIfiS, INC. 

EPA Property CSose Out 

Property #: 3,2,2-^ C) Property Address: Z^^ ^ (TOL^TV ^ 

Date/Time: Owner's Name: i \ \}ccht^ O e A^J A 

Quads Excavated: f-\ Contractor Group; PrucJeint Technologie.s, Bmc, 

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? 

/ 

y 

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 lime period) 

4. Are sodded areas generally firm and evenly graded? / " 

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

lime penod) 

6. Was the property graded such tlnat water will not pool on the property? / 

7. Was diiniage to landscaping or plant materials avoided? y 

Gates, Fences and Retaining WaH» Yes No 

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

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

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

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

Foundation, Siding and Gutters Yes No 

I. Was damage lo the siding or trim avoided? A 

2 Was damage to the foundation avoided? y y 

.3. Was dainage lo windows avoided? y 

4. Was damage to windows or door screens avoided? 

/ 

5. Was damage to downspouts or dowiispout extensions avoided? / 

Sidewalks and Driveways (Concrete) Yes No 

Was damage to diivewav surfaces avoided? y 

Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

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

EPA Representative Q<^ ^ ^Date: t'U''l"> 
IRI l 

CHNOLOGIES. INC. 

AS - BUILT DRAWING 

OLS # 32250 

Date Excavated: 10/28/2010 OMAHA LEAD SUPERFUND SITE I'SEPA Signcd-OIT Date: 

32250 

Omaha Lead SKe Exterior Paint Modh Arrow Owner Name: PETER T^RAYSON 

Site Sketch • Good Address: 2569 PRATT ST 

Phone: H: w. • Poor \ 

Q Not pain* 

SampHe Number Lead 

Concentration 

Sample 

Collected LAB Fim,:

Samples Coileaed 

 rPP>/ FJ^lS G 

RYASCPXA-32250 Fl ppm D Date: fc/Z/O^ 

RYBSCPXA-32250 

RYCSCPXA-32250 

RYDSCPXA-32250 

RDZSCPXA-32250 

RGZSCPXA-32250 

RPZSCPXA-32250 

F2 

B1 

B2 

DZ 

GZ 

PZ 

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ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

Number of Samples =

can 

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Samples Analyzed 

XRF Unit: 

Date: _ 

Time: 

Staff: 

^IL Book: 

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ENTERED 

JUN 0 2 2004" 

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AREA NOT EXCAV.\TED: Fl/LS

(3'X25') = 146 PPM (g SCRAPE

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 Fl =77 PPM (£2" 

Omaha Lead Site 

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EA = 68 PPM « S( RAPE (I" ) 46130 

CONTRACT #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
Pr©pefty Completion Agreemeot 

This agreement documents the completion ot removal activities perfonned on tiie below Jisied propeiTy. 

The property owner's signature indicates that the property oM'ner 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 totai) except those items listed below, if any. 

Property ' ^ 2- 2-S^ 

Property Address" 'XS^' K ?y ^ S T OWVa.V^TUV l 

Own !!L\_:VW.XNA. ^ e J^^CN^ 

Phone: (V^OT) >OR-^H( ) 

Restoratiom Il4ems imi Qyestiomi: 

Required corrections to compielte th® property" 

liriTagree restoration is completed, except as noted above. 

L J I do not agree restoration is completed 

f-T—i"T"ir-f ' I "^ftrf^^a i • • I —• =^-4..J •^•"•""•^f"! J • iiimTiiMiMi^aii^ji m ifc iJw T >W^|B I m !• i i i^^ j n a^ip • ! 

Jwneir's SigBaKure mw 
Piiidcm Technologies. Inc (Prudenl) is under eontraci, with ihe U. S. Environmental Protection Agenev (EPA) to I'leai) uji le-iclcontaminated soils at .T numbev ofproperties located in Omalia^ Nebraslta, including the property located at 

Tlie KPA. 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 

.laivities related lo the cleanup including soil sampling, removal of Iead-contaminaled soil, and restoration of tbe referenced property 

Ifyou have any questions about the soil cleanup planned for your propeny, please contaa Prudent south office for the Omaha Lead 

Site cleanup-at ('102) 733-1188. General que.stions about the Omaha Lead Site cleanup can be directed to the EPA Public Information 

Cenlers at (402) 731 -.?045 (South Omaha office) or (402) 991-9583 (North Omaha office). 

Property .A.ccess (jranied By 

^ fPlease Print Name1 ' 

Property Owner h'ignatiir lCLr2A--y) (Date") 

RESIDENT MAME: Owner Renter 

RE-SIDENT ADDRESS: -_ . ^ f^y i yr^ A . » , ^ 

^q 

!F RENTAL. PROPERTY OVrfWED BY: 

OWNE /VNER' R S MAILING ADDRESS; „ . x- \ fl • O i 

ER'S TELEPHONE NUMBER - HOftfiE: _ L WORK: 

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

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

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

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY IN THE YARD FOR 5 HOURS OR MORE PER WEEK: 

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

..UlTHORITY FOR E?-IVlRONMENTAL RESPONSE ACTIONS, The activities to be implemented by F.PA under this agreement 

are pui^suaitrio Section 104 ofCERCLA, 42 U S.C. 9604. EPA's nght ofaccess to the property is provided for in Section 104(e) of 

CERCLA. 42 11.H C 9f>()5(e), which provides entry for "detei-miningthe need for response, or choosing or taking any icspunse aoliou 

under tins title, or otherwise enforcing the provisions cf the title." 

g080 Ward Pamwav. ^.'..im. • •rfiji) :•.. '.i) .S' •c'.'*?. i'/u;i.t)cai 'Lirivfi, ;5uii!t 421Jtt 

Kansas Citv. MO 64 n.-:!. .^vin Antonio, TX /(J'iiS 

Phone: (816) 363-5703 '^tion-y |210)[l2i!.S8eil 

•-9%: ;81S; 363-S70-' i-'fi f <4n;i ^ ••::;).•;!<!!:: 
KijDm £:Nvu;<:>rv.Mif;iv!.i.i.,,si 

rOMSTRUCTiO^^ 

TECHNOLOGIES, INC. 

Property Status Form 

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TECHNOLOGIES, INC, 

iiNVlKOi^iVIENTALA 

CONSTRUCTIOI^I 

S£KV5CKr> 

Address: 

Property Status Form 

Date: 

Phone: BVlDr 

Property Ow Prudent Employee 

Signature; Signature: 

3"S() Wiird Pai^wsV, Suiin *0t tvGOfl y -ft! Si •v/'i?. ivifif.))C£l Drivo, biitto 4:i£0 

• i.ansiis City, iVlO (541 VJ 

Phone; (3161 :J65-370.T rr-y 'V'^i^T 

Omana, istebrasK-i oS 107 

PhoMft: (407.i 7;i;;-!i3S c-...,. 1 .iis'^^-r'j-T -;<*o-*< 

Sari Anionic, 'i"X 73iiil) 

Phone: (210) 022.9fi8« 

K.>v* i'Hrt\ c"/o iicT-r 
32250 

Omaha Exterior Paint North Arrow Lead Site Owner Name: PETER T GRAYSON _ Site Sketch • Good Address: 2569 PRATT ST 

Phone: H: W: • Poor 4 • Not paint 

Sample Number 

RYASCPXA-32250

RYBSCPXA-32250

RYCSCPXA-32250

RYDSCPXA-32250

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Lead Sample Samples Collected 

Concentration Collected LAB Fimi: t^^P^/ TL^\SC T 

 F1 i3i_PPm Q' D Date: (^}Z/0 ^ 

 F2 i33_PPm 1 [3- D Time: /7'^ Q 

 B1 iSUpp m D Samples Analyzed 82 lA. ppm ny D 

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Omaha Lead Site 46130 
46.2

3X 124 

A Printed

: Nov 22, 2010 

www.dcgis.org/dogis 
Page 1 of 1 

"> 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2622427. 

Original Call Date: 10/20/10 Time: 5:25 pm Op: SIVA18967 


Work to Begin Date: 10/22/10 Time: 6:00 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2569 Street: PRATT ST 


Twp: 15N Rng: 13E Sect-Qtr: 04-SE,09-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 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Pbone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Ait: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICH/TRAFFIC

Day:

 Alt:

 4024447197 

 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/20/2010 
ENVIRONMENTAL 

ENGINEERmC AND 

TEeHMOUkSSS CONSTRUCTION , INC. 

SOLUTIONS 

SITE SAFETY HAZARD ANALYSIS 

Address; Sr?li?1 J?fa M -^ ^ 

Crew: hkhAi^ 

Item 

Overliead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leecli 

Field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees 

Structures 

Driveway 

Sprinkler System 

other 

Crew Foreman 

Condition 

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Excavation Date: / ^ '— 

Backfill Date: ^J^zA^jA . 

Hazards Corrective Action 

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Site Safety Office 

Date: 

8080 VMaRfBarloMy, Suite 4(B seoosiost 4242 Medical Drive, Suite 7250 

Kansas Gi{^, MO 84114 Omaha San Antonio, TX 78229 , Nebiaska 68107 Ptione: 1816) 363-3703 Phone: (21t)) 822-i9588 Phone: (402)733-1188 Fax: |8t6) 363-3707 Fax:(210)679-6577 I^DC (402)733-1883