TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: P?/yy Date: M-\-\V 

Address: /JoV OU s / 

Remediation Contractor: Envrionmental Restoration, LLC_ Year: _2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

j / Video of property (DVD) _^Before DAfter D Basement D 

J^ Executive Summary (Final Report) 

] ^ EPA-provided property sketch 

B ^ Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

0 ^ Restoration Agreement 

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

\2/ Confirmation data 

\^ Photographs ^Befor e DCrew Photos l/During Excavation D Sod 

[/30-day Sod D 

J^T As-built sketch 

J?C Completion Agreement signed by Property Owner 

yQ Property close-out check list signed by EPA 

D Description ofareas not meeting ROD cleanup criteria 

>0 Utility clearances 

J,a Property information from Douglas County Assessor's Office 

^ Property access checklist (pine* V~eot>r\) 

~ ' 30261897 Contact Log 

A ^ X/ard^-h /g/ - '""""""sujerfund 

' Environmental Restoration Signature Date 

EPA COR signature T^ ^ Date 
EPA 

EPA Property Close Out Form 

Omaha Lead Site OU#2 

Property #; cg?M? PropertyAddress: /foV aki o J'-J-. 

Date/Time: Owner's Name: Ac.*- \jJ-<S<^i/^i^ 

Quads Excavated: F1,BI,S^ Contractor Group : Environmental Restoration (ER) 

Excavation General Yes No 

1. Ifnecessary, were the correct quadrant(s) excavated and restored? i 7 

2. Ifnecessary, were the correct areas ofdrip zone excavated and restored? w 

Grading Sod and Vegetation Yes No 

w^ house? 

2. Has sod been laid in all areastiiat were excavated? -^ 

3. Does the sod appear to be generally healthy and growing? (Only evaluate ifinspected at 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 ifinspected at 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? •y 

Gates, Fences and Retaining Walls Yes No 

1. Do gates.open and close freely? (ifapplicable) ^K 

2- Were all gates or fences taken dovm during restoration activities re-installed? (ifapplicable) fJi 

3- Was damage to gates or fences avoided? (ifapplicable) y y 

4. Was damage to retaining walls avoided? (ifapplicable) A/A 

Foundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? 

2. Was damage to the foundation avoided? ^Jar/fA lofe 

3- Was damage to windows avoided? 

# ­ 4. Was damage to window screens 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? t / 

Inspection notes: 

Remedial and restoration activities complete including 30-day sod warranty: 

EPA RepresentativerT^/^^ ^ ^f^- ^ ^Az ^ " Date: 3/3//Jo/ / 
i >t£L \ Omaha Lead Site—EP-R7-09-05 

l^mfa r ' EnvironnoentaJ Restoration. LLC 

V ^ '••t*w»1t'' www.cr1lc.com 

EXECUTIVE SUMMARY: 

29199 1904 OHIO ST 

No Issues or Concerns [^ Issues/Concerns 
"> 

[ Create Another Ticket ] [ Back to Irth Intemet ] :[ Send Email 

YOUR TICKET NUMBER IS 2671017. 

Original Call Date: 2/14/11 Time: 8:52 am Op: ADAM24186 


Work to Begin Date: 2/16/11 Time: 9:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1904 Street: OHIO ST 


Twp: 15N Rng: 13E Sect-Qtr: 10-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead soil removal 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)451-1069 


: 29199 


Company : ENVIRONMENTAL RESTORATION 


Contact Name: ADAM Phone: (402)451-1314 


Alt. Contact: Phone: (636)288-9616 


Work Being Done For: epa 


Depth of Excavation: 24in Corner Lot: N Front: N Rear: N 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Nuinber Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY MUD Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITYOFOMAHA-TRAFFICSEWER RICH/TRAFFIC Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNE 1C QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 2/14/2011 
Contact information Log 

SA\D#J±133. 

Owner^sName: ^( ^ U^a>1>> hfifi& PUOE: I Daytime Phone: qQl'S^ ^ 

PropertyAddress: (g^ ^ C^VitCi <TX^' 

Attempt to contact Date/time Name 

i2'8-iO JTA4J:<W^ Q(^. ,2'<i>iC > JTA 

• ' ­
Property Final Report 

1 SAID: 2^1^* ^ 

1 Property Address:/<5J^^^ ^^^ Q ^ ^ 

n

D

 WORK STARTED 

 WORK COMPEL lED 

ON:

ON:

 /

 /

 / 

/ 

^^^^^'•kt^ Kjf^-z^Q. 7/^M^s

Address: 

Phone: LjOl--3^i . ^^Z'-\ 

Fax: 

Cell/Pager: 

 P/ta^- Renter: 

Phone: 

Fax: 

Celi/Pager: 

Additional Information: 

H

0

S

H

•

D

1 ^

D

 Access Agreement 

 Restoration Agreement 

 Video Property Before 

 Digital Photos Before 

 Video Property After 

 Digital Photos After 

 Property Completion Agreement 

 Final Report 

Signed: l « / *^ /I * 

Signed: (z, /*^ /J o 

On : IZ / *=^ /1 0 

On : 12. / "=1 / 16 

On :_/_/ _ 

On : / / 

Signed: 3 1-^Z 1 /f 

Signed: / / 

By::f.A. 

By:5:ABy: n.fl 

By: cm 

By:

By: 

By:-;? ^ 

By: 

 N/A 

EXECUTIVE SUMMARY 

Omaha Lead Project Work Plan Page 1 of 19 
Consent for Access to Property SAID#^'9/"?^ 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner), consents to and authorizes the United States Environmental 

Protection Agency (USEPA) or its authorized representatives, collectively the Grantee to enter 

and perform certain enviromnental response activities upon the following described premises: 

Owner's Name: y}^^ \]Jg(jDTK7- Daytime Phone: ^ -3^/-'^^ ^ 

Address: ^^^^ ^ ^ l^oH w a ^r" 

Address: 

Addresses of Properties 

Address: covered by this 

Agreement: 

Address: 

Address: 

PURPOSE OF INVESTIGATION 

The purpose of the remedial activities is to remove all soils at the property which are 

contaminated with hazardous substances, in particular lead at concentrations greater than or equal 

to 400 parts per million (ppm). 

REMEDIAL ACTIONS 

The enviroimiental response actions to be performed on said property may include the following 

activities: 

a. Taking photographs and/or video of the property before, during, and after remedial 

activities; 

b. Locating equipment and machinery on-site in preparation for and in the course of the 

environmental response; 

c. Planning and implementing the removal action on or near Grantor's property. 

d. Obtaining samples from Grantor's property; 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the activities or work done, or the 

equipment used to perform the activities, or to undertake any actions regarding the use of said 

property which would tend to endanger the health or welfare ofthe Grantees or the environment, 

or to allow others to use the property in such 

I grant access to my properties 

n I do not grant access to my properties ^ 

Ai.d). -Pl 'MS. >a.-q-iD 

Signature Date Signature 

Date 
Additional Comments / Instructions: 

Pe r A Ho^^^ o*^ THt" PdoPsJt-r/ 

HCChec h k this box if owner does not want E.R. to enter the residents to document interior 

foundation walls and possible preexisting damage. By checking this box E.R. is not responsible 

for any damage done to the interior of house, including foundation cracks or fissures. 

A Q I agree d l I do not agree J^^^ agree CH I do not agree 

Owner's Signature Date Contractor'sSignature Date 
Restoration Agreement 

The purpose of this agreenient is to provide a mutual agreement as to conditions of property prior to 

contractor activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction of the property ovraer and the United States Environmental 

Protection Agency (EPA). 

SAW: 2,011 q ^ 

PropertyAddress: (t^QC/ QHCO SVOwner: ^ ^ K^^g^r ^ rOn the attached diagram(s) indicate area(s) to be excavated and depth of excavation, location of all known 

utilities, subsurface features, surface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items to be removed by Contractor and not replaced: 

Page 1 of 2 
Additional Comments / Instructions: 

'ikRJiCe L^rrH ^t > 

_Qj[ agree O I do not agree ^^PTl agree Q I do not agree 

f]);>i ^ Aifo in~^-in -p-Q ^^^AAJtt^ ^-2X-2DVl 

Owner' Owner'ss Signatur Signature Date Contractor' Contractor's Signature Date 

Attachment 

^ 

Page 2 of 2 
Property Completion Agreement 

This agreement documents the completion of remedial activities performed on my property. My 

signature will designate that I am satisfied with the restoration of my property, and that no items are in 

question, now, or at any time in the fiiture, except those items listed below, ifany. 

SMD-.l^t^ ^ 

Property Address: ^e^ ^ QfjC p <^7 ^ 

Owner: ke: {^f^u^rA^r 

Phone: c/^T-- 2lH l 

Restoration Items in Question: 

Item: 

Item: 

Item: 

item: 

Item: 

Item: 

Additional Comments: 

^\ | I agree restoration is completed, except as noted 1/11 agree restoration is completed, except as noted 

I 1 1 do not agree restoration is completed I I I do not agree restoration is completed 

VM/U, &1 'JurO ,^-ai-/l '- p q S..-:tt», 2,-2S-Zoi\ 

Owner's Signature Date Contractors Signature Date 
rree reopie i^earcn | wmierages -rngsr-rmnWhitePages 

Find People | Find a Business 

James A Price Is tliis you? Edit 

m 

2611 Florence Blvd 

Omaha, NE 68110-2110 

(402) 341-5884 

Job: Ace Welding Repairing. President 

Know me? Ask me to update my listing 

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Listing date: Nov. 2009 

Name popularity and name meaning for first name James and last name Price. 

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Douglas County, Nebraska Property Record - R2030640000 

Print Reoort 

View Interactive GIS Mao Information is valid as of 2010-8-16 Treasurer's Tax Reoort 

New Feature -•-•- > Subdivision Sales Search 

Owner 

ACE WELDING AND REPAIRING INC 

C/O JAMES PRICE 

2611 FLORENCE BLVD 

OMAHA NE 68110-0000 

Property Informatio n 

Key Number. 3064 OOOO 20 

Account Type: Residential 

Parcel Number: 2030640000 

Parcel Address: 1904 OHIO ST 

OMAHA NE 68110-0000 

Legal Description: PRUYNES SUB DIV S 1/2 LOT 34 LOT 2 BLOCK 0 30 X 80 

Value Informatio n 

2010 

2009 

2008 

2007 

2006 

2005 

Land 

$300.00 

$300.00 

$300.00 

$300.00 

$300.00 

$300.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$300.00 

$300.00 

$300.00 

$300.00 

$300.00 

$300.00 

Sales Informatio n 

Sales Date: 

Deed Type: 

Price: 

Grantor: 

1997-02-12 

DM 

$70,000.00 

Book: 2054 Page: 047 

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

Valid 

Land Informatio n 

Acres 

0.05 

SF 

2400.0 

Units 

0.0 

Depth 

80.0 

Width 

30.0 

Vacant 

Yes 

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ENVIRONMENTAL AS-BUILT DRAV\/ING 

OMAHA LEAD SUPERFUND SIT » 

RESTORATION 

29199 

Exterior Paint North Arrow 

Owne Omaha Lead Site r Name: ACE WELDING & REPAIRING • Good Site Sketch Address: 1904 OHIO ST • Poor 

Phone: H: W: [Zp-1^ot paint 1

Sample Number Lead 

Concentration 

Sample 

Collected LAB Samples Collected 

Firm: ASUJAA I I> ^ 

RYASCPXA-2919 9 Fl 5' 3 5 ppm D Date: 7-/ V "O-fe 

RYBSCPXA-29199 F2 Q l ppm n Time: /O : 3 0 

RYCSCPXA-29199

RYDSCPXA-2919 9

 Bl 

 82 

511 .

Le I 8

 ppm 

 ppm 

n 

n Samples Analyzed 

ppm n n XRF Unit: \CS3~\ Book: IS' ^ 

RGZSCPXA 29189-­ GZ ppm n n Date: 'd ­ \-o ^ 

-RP2SePXA-2&499 PZ ppm D n Time: A «^— 

Number of Samples = ^ Staff: Wi.\iJ> 

Legend: F1 = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

ENTERED 

• ^^vtut)­

LES£tiQ 

Qtiadrant excavatad Dflp Zone Excavated Contamination Left Behind 

. « u . C O D-r AA n e cr*«..:v*^^»%»«.«^«*«4MI ^yr...^^.^-.^'.^...f. i i o 
29199 

Omah Exterior Paint North Arrow a Lead Site Owner Name: ACE WELDING & REPAIRING • Good Site Sketch Address: 1904 OHIO ST Q] Poor 

Phone: H: W: g^o t paint 

Sampl Lead Sample Samples Collected e Number LAB Concentration Collected Firm: ASU/AA I I>M^ 

RYASCPXA-29199 Fl ^ 3 5 _pp m D Date: 7-/ V "c ^ 

RYBSCPXA-29199 F2 _pp m D Time: /O : 3 0 _ai RYCSCPXA-29199 

RYDSCPXA-29199 

81 

82 

612 .

Lc I 8

 ppm 

 ppm 

[BT D 

D Samples Analyzed 

32 ppm u D XRF Unit: \OS \ Book: \S ^ 

RGZSCPXA-29499 GZ­ ppm a D Date: B ­ \-0(j g 

-RP£SePXA-2m99 PZ ppm n D Time: t\,fv^ 

Number of Samples = /^ Staff: n.<w> 

Legend: Fl = Front Left, F2 = Front Right, Bl = Back Left, 82 = Back Riglit DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

PKu\tV\-

Rev 4 046141 0123 
w\ 29199 

Exterior Paint North Ar ow 

Owne Omaha Lead Site r Name: ACE WELDING & REPAIRING Q Good Site Sketch Address: 1904 OHIO ST i • Poor 

Phone: H: W: l^-^ot paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

 ASUJ/A 7 J>/ ^ 

RYASCPXA-29199 

RYBSCPXA-29199 

RYCSCPXA-29199 

RYDSCPXA-29199 

F1 

F2 

Bl 

82 

fS-3 5 

_5a-

_ ppm 

_pp m 

512 . ppm 

LD I 8 ppm 

IT 

[ T 

n 

n 

n 

n 

Date:

Time:

 7-/ V "g-6 

 /O : 3 0 

Samples Analyzed 

-RDZ3CPXA-29199­ -BZ ppm n n XRF Unit: \CtT^ Book: j5<^ 

RGZSCPXA-2S.1.99.­ -GZ­ ppm n n Date: *B ­ VOL s 

•RP2S€PXA-29499­ -PZ ppm n n Time: AjQa _ 

Number of Samples = ^ Staff: Wi.\,.^ 

Legend: Fl = Front Left, F2 = Front Right, B1 = Back Left, 82 = Back Right DZ = Drip Zone, GZ Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

r 

ENTERED 

Rev 4 046141 0123 
c ENVIRONMENTAL XRF DATA ENTRY LOG 

RESTORATION 

sAiD# ^J\\^' ^ DATE -Z- \ Vto \ V \ 

PROPERTYADDRESS TIME 

\^0 ^ DrN\o •nr 

XRF S/N 

QUADRENT OR SAMPLE AREA 

DEPTH AVERAGE OF RESULTS SHOT#s 

redig 

D Fl 

D F2 

n 81 4 . X^T- t TX? -T9-V-l*&'-'i 

n 82 U•?^^ Vq -r^^--l'B- ^ 

n DZ 

n PZ 

n GZ 

n EZl • ^ Z?n t 7-^ . •T^°^-T=V2 . 

n F72 r 

n OTHER 

SAMPLER NAME "rvfiaCCL \ oi . if 
Thermo Fisher Scientific Thermo 900 Middlesex Tumpike 

Billertca, MA 01821 

SCIENTIFI C 

Index 1 irnc AVI.;K.\{:I-; AODKK.SS LSA.MI' I.I;AI{I:A<)I'I;KATO U DKI'II I NOI'K.S .SAID I'l l 

1 2011-02-16 10:31 Avg of789-79l 1904 Ohio st EZ jiinmy surface flnal clearance 237.20 ± 24.48 

2 2011-02-16 10:31 1904 Ohio st EZ jiminy surface final clearance 29199 241.25 ± 24.63 

3 2011-02-16 10:30 1904 Ohio st EZ jiminy surface final clearance 29199 242.84 ± 24,51 

4 2011-02-16 10:30 1904 Ohio st EZ jimmy surface final clearance 29199 227.51 ± 24.30 

5 2011-02-16 10:25 Avg of785-787 1904 Ohio st B2 jimmy final clearance 112.93 ± 18.57 

6 2011-02-16 10:25 1904 Ohio st B2 jimmy final clearance 29199 114.31 ± 18.65 

7 2011-02-16 10:24 1904 Ohio st B2 jimmy final clearance 29199 113.03 ± 18.50 

8 2011-02-16 10:24 1904 Ohio st D2 jimmy final clearance 29199 111.45 ± 18.55 

9 2011-02-16 10:22 Avg of 781-783 1904 Ohio st Bl jimmy final clearance 131.77 ± 19.92 

10 2011-02-16 10:22 1904 Ohio Sl Bl jimmy final cleaiBnce 29199 137.68 ± 20.35 

11 2011-02-16 10:22 1904 Ohio sl Bl jimmy final clearance 29199 124.14 ± 19.54 

12 2011-02-15 10:21 1904 Ohio st Bl jimmy final clearance 29199 133.49 ± 19.86 

13 2011-02-16 10:16 Avg of 777-779 1904 Ohio st Fl jinmiy final clearance 135.82 ± 20.18 

14 2011-02-16 10:16 1904 Ohio st Fl jimmy final clearance 29199 135.44 ± 20.24 

1} 2011-02-16 10:15 1904 Ohio st Fl jimmy final clearance 29199 136.41 ± 20.14 

16 2011-02-16 10:15 1904 Ohio st Fl jimmy final clearance 29199 135.61 ± 20.18 

Page 1 of I 02/16/11 10:12:34 
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