PROPERTY SUMMARY

 

| Date: 08/23/2007 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06 | Month of: August 

| Property Address: 4124 N 28 St 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: None 

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

A.3 Unique Findings: 

A.4 Other Relevant Information: 

CONFIRMATION SAMPLING DATA/RESULTS: 

El - 134 @ Scrape 

Fl-133@6" F2- 174 @ 10" 

Dl-314@10" 

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. 

„ 40284355 

Super-fund 

TECHNOLOGIES, INC, 
--

Total QuadranTCquare Footage to be Excavated = 434 

Property Classification: 800 Total Drip Zone Linear Footage to be Excavated = 144 I 1 

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Legend North Arrow Omaha Lead Site 

'oncrete Lii-'-'a.-.:! *- Omaha, Nebraska 

IZZ Ejccavated Area ^^- z Property Number 

listing Structure OLS- 33830 Scale 

ence Property Address 1 1nch = 20 feet or 1 grid = 5 x 5 ft 4124 N 28 ST 

[*£>$) F'ermanent Landscaping 

CQuadrant Boundary Post Excavation Co icentration s (ppm) 

Street Boundary F1 a 5 \S5/ ? ^ H%3 L B2 Play Are \ -JSJii.^ — HydroGeoLoi ic. Inc F2 D2 Easeme it

 O i"ree/Shrub XrW B1 Garden Othe sr

 

Description of post excavation areas: F1. front yard left-hand quadrant: F2 front yard right-hand quadrant: 61, backyard left-hand quadrant; B2. backyard right-hand quadrant: 

DZ, drip zone (1-3 foot area of soil around the foundation of the house). 

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Total Quadrant-Square Footage to be Excavated = 434 

£fgperty Classification: 800 Total Drio Zone Linear Footaae to be Excavated = 144 I 1 i !

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North Arrow Omaha Lead Site

 

$K$j\ Concrete Omaha, Nebraska

 

t^y^ Excavated Area ^^*

z 

Property Number 

! I Existing Structure OLS- 33830

 Scale

 

•—«— » Fence Property Address

 1 1nch = 20 feet or 1 grid = 5x5 ft 4124 N 28 ST bQty Permanent Landscaping 

— — — Quadrant Boundary o^"S. Post Excavation Cono antration s (ppm) 

Street Boundary HG L F1 B2 Play Are a 1^1T 1 HydroGeoLog ic, Inc F2 DZ Easemer t 

O Tree/Shrub V«x B1 Garden Othe r 

Description of pent excavation areas: F1. front yard ten-hand quadrant; F2, front yard rtgM-hand quadrant 81, backyant left-hand quadrant; Si. backyanl right-hand quadrant; 

OZ, drip zone (1-3 foot area of sod around the foundation of the house). 
J3830

 

Owner Name: EDWARD PATE 

Ad d ress: 41_24_N_28_ST 

Phone: H: 402-453-6899 

Sample Number 

RYASCPXA-33830 F1 

RYBSCPXA-33830 F2 

RYCSCPXA-33830 B1 

RYDSCPXA-33830 B2 

RDZSCPXA-33830 DZ. 

ENTERED 

Omaha Lead Site 

Site Sketch 

W: 

Lead 

Concentration 

Sample 

Collected LAB 

\ ppm D 

ppm 

ppm 

D 

_2i PPm 

PPm 

ppm 

Number of Samples = ! 

H3" 

\A> 

•\ 

Exterior Paint North Arrow 

Good 

Not paint 

Samples Collected 

Firm: 

Date: 

Time: 

Samples Analyzed 

XRFUnit: ^ \\ Book: ]$ 

Date: ,-M-f t 

Time: 

Staff: 

*<• 

Omaha Lead Site 46130 
tVv ••••• '°-/^ Agreem JPto allow access to

 

Omaha Lead // jj$& \ the property in order to conduct 

Site Remedial \ v???*/'

 ;;- environmental sampling and to

 

Action Vvfovfctafr ^ remove lead-contaminated soil 

Prudent Technologies, Lie. (Prudent) is under contract with the U. S. Environmental Protection Agency 

(EPA) to dean up lead-contaminated sous at a number ofprppertieslocflted in Omaha, Nebraska, 

including theproperty located at "M-| 3i \ UV c-£L S^~ . . Ihe EPArequests 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 perform activities related to the 

cleanup including soil sampling, removal of lead-contaminated soil, and restoration of the referenced 

property. After obtaining the owner's signature on this form, Prudent Technologies, Inc. will contact the 

property owner (and residents) within the next few weeks to coordinate performance the work. 

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

Administrative Clerk for the Omaha Lead Site cleanup, Ms. Cyndie Hinds 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) 991-958X(nortfa Omaha office). 

Property Access Granted Bv:y EL 

Property Owner Signature: X 

PROPERTY INFORMATION 

(To becompleted byresident and/or property owner- please print) 

RESIDENT NAME: V a<- fu.-f- Oner r~71ter 

1

RESIDENT ADDRESS: S&=? Ul,2,M t\] o* ^(- fcK 

IF RENTAL. PROPERTY OWNED BY: C d tO>Cure! PcL&(? 

OWNER'S HAILING ADDRESS; U) }^_ f\] Iljg Sfr Qy ^ <5>Uxx K>« C f I/' 

OWNERS TELEPHONE NUMBER -HOME: i l\t\h & "^ ~ H ^ £IwQRK: ( } _ 

AGE OF HOME?: \ 5t) YEARS. HOW LONG HAVE YOU LIVED HERE? \ 0 YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? YES 

NUMBER OFOCCUPANTS UNDER 7 YEARS OLD: T) NUMBER OFOCCUPANTS 7 YEARS OLD AND OLDER |_ 

NUMBER OF CHILDREN UNDER 7 YEARS OLDWHO PLAY IN THE YARD FOR S HOURS OR MORE PER WEEK: Q 

o 

COMMENTS OR SPECIAL INSTRUCTIONS: fl.E. DOGS. ENTRY GATES. ETC.) A O fi JL,? r*\LJ<*>WV > A 

v lla ff dA nn \\P $* s. R e C * 09 o> U«» /«tt VJ 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: The activities to be implemented by EPA under this 

agre€mffltarepiffsaartttcS^DTil04csfCERCLA,42U.S.C. 9<504. EPA' srigstcf access to theprqssty is 

provided for in Section i04(e)of CERCLA,42U.5. C$60S(e),whidi provides entry for "determining the need for 

response, or choosing or taking anyresponse actionunderthis title, or otherwiseenforcingthe provisions of the 

title." 
SEPA

 

EPA Property Close Out 

Property #: 3383O Property Address: y/5y ^ S9^ s^ef/-

Date/Time: fiua.Si Owner's Name: £e>t^nt,0 &, /< 

Quads Excavated: , Contractor Group Prudent Technologies 

Excavation General

 Yes No 

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

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

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 time period) i^ 

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? tS 

7. Was damage to landscaping or plant materials avoided? trGates, Fences and Retaining Walls

 Yes No 

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

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 Yes No 

1. Was damage to the siding or trim avoided? i/ 

2. Was damage to the foundation avoided? 

L/ 

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: 

EPA Representative ,&,„. ,>g^ Date: 

— — 
Total Quadi

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Legend North Arrow Omaha Lead Site 

ck>ncrete Omaha, Nebraska 

£2 E xcavated Area Property Number 

[ | Ejusting Structure OLS- 33830 Scale 

ence Property Address 1 Inch = 20 feet or 1 grid = 5 x 5 ft 4124 N 28 ST 

S F'ermanent Landscaping 3

Ciuadrarrt Boundary Post Excavation Cono sntration! 5 (ppm) 

Street Boundary s^rV? v HGL F1 B2 Play Are a \ -i-^J/V Jf TM HyrlmGpnl ngir, Inr F2 DZ Easemer t

O ifree/Shrub ^"w

" B1 Garden Othe r 

Description or post excavation areas: F1. front yard ten-Hand quadrant; F2, front yard right-hand quadrant; B1. backyard lefUnnd quadrant; B2, backyard right-hand quadrant 

DZ. drip zone (1-3 foot area of sol around the foundation of the house). 
r N.I W^ac KM I Quadra^p^uar dra^P^u e Footage to be Excavated =434 

Property Classification: •80800 0' ' 1— Total Drip Zone Linear Footage to be Excavated = 144

il Concrete 

Omaha Lead Site 

Omaha, Nebraska 

23 ExcavatedArea Property Number 

a Existing Structure Scale OLS- 33830 

•—•—•

[*£xyi

 Fence 

Permanent Landscaping 

1 Inch =20 feet or 1 grid = 5x5f t PropertyAddress 

4124N28ST 

— Quadrant Boundary 

Street Boundary HGfL 

HynroGenl.rtgir, Inr 

F1. 

F2 

Post Excavation Concentrations (ppm) 

82 Play Area 

DZ Easement 

O Tree/Shrub B1 Garden Other 

Descrtplon of post excavation areas: F1, front yard left-hand quadrant F2, front yard right-hand quadrant; B1.backyard left-hand quadrant B2,backyard right-hand quadrant 

DZ. dn>zone (1-3 toot area of sot around the foundation of the house). 
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: 2» -2g> ^ ft 

Property Address: JL//^}tJ t / s\ (TV^— ^.~T~ N< s-46 O/-

Owner: /^ST// ;/>irs/ ffifrr/~i*> 

Phone: x ?<%^ £-/ 5?%~7 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

agree restoration is completed, except as noted above, 

do not agree restoration is completed 

Owner's Signature Date 
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Sample Area: 33830 - 4124 N 28 ST 

Owner: 

D Owner Occupied 

Owner Name: 

IPATE EDWARD 

Owner Address 1: 

Owner AddressZ: 

(4112 N 28 ST 

City: State: Zip Code: 

OMAHA |NE |68111 

Owner Phone: Alternate Phone: 

|(402) 453-6899 | 

Resident: 

Resident Name: 

PATE MICHAEL 

Property Address: 

4124 N 28 ST 

Zip Code: 

J68111 

Resident Phone 

] 

Contract: 

Contractor: 

JPRUDENT2007 

Group: 

i 

Assessment: 

Qualifying Group 

J800 

Assessment XRF Date: 

1 

Assessment Max XRF Value: 

| 890.7 
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