TRANSMITTA L of OMAH A LEA D SITE 

SOIL REMEDIATIO N FIL E FOLDER 

SAID#: 33087 Date: 

Address: 2554 Spaulding St 

Remediation Contractor: Environmental Restoration, LLC_ Year: _2011 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

yy ^ Video of property (DVD) y^&K ^ DAfter D Basement D 

y y Executive Summary (Final Report) 

EPA-provided property sketch 

Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

y y Restoration Agreement 

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

y y Confirmation data 

Photographs jyi^for e DCrew Photo^^B^uring Excavation D Sod 

^,a^-da y Sod D 

As-built sketch 

>0^ Completion Agreement signed by Property Owner 

y ^ Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria. Contamination left behind 

Utility clearances 

Property information from Douglas County Assessor's Office 

Property access checklist 

j y Contact Log i,,,,, SJSJJ,?i 

D 

ErivironmentSTRpstor^tlon Signature Date 

EPA COR sienatur signature y Date 
EPA 

EPA Property Close Out Form 

Omaha Lead Site 

Property #: 33087 Property Address: 2554 Spaulding St 

Date/Time: Owner's Name: Candice Franks 

Quads Excavated: Bl Contractor Group: Environmental Restoration (ER) 

Excavation General \f(UL6A^ it^f Yes No 

1. If necessary, were the correct quadraiit(s) excavated and restored? y 

2. If necessary, were the correct areas ofdrip zone excavated and restored? 

Grading Sod and Vegetation Yes No 

y house? 

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

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

period). 

4. Are sodded areas generally firm and evenly graded? i ^ 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at 30-day time period). 

6. Was the property graded such that water will not pool on the property? l y 

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

Gates, Fences and Retaining Walls Yes No 

1. Do gates open and close freely? (if applicable) AJA 

2. Were all gates or fences taken down during restoration activities re-installed? (if applicable) **"*^ ^ ^ y y 

3. Was damage to gates or fences avoided? (if applicable) y 

4. Was damage to retaining walls avoided? (if apphcable) A;AFoundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? 

2. Was damage to the foundation avoided? ^fitc.i\^ \6V 

3. Was damage to windows avoided? yLJ4 

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? 1^ ­

2. Was damage to walkway surfaces avoided? y 

inspection notes: . / 

coder W ^^^^^rty Sdd 

Remedial and restoration activities complete including 30-day sod warranty: icsiuiitiiuu aciiviucs cuuipicic lUCIUUIUg ^v 

Date: / ^ Z //-/ 
^^^"X OMAHA LEAD SITE — EP-R7-09-05 

ENVIRONMENTAL RESTORATION, LLC 

WWW.ERLLC.COM 

'^4 no^^ 

EXECUTIVE SUMMARY: 

33087 2554 Spaulding St 

NO ISSUES OR CONCERNS ISSUES/CONCERNS 

DETAIL EXPLANATION: 
IRTH One Call Page 1 of 1 

• th ) 

Home Ticket 

Ticket Creation 

Create Another Ticket Go to Home Page 

• YOUR TICKET NUMBER IS 2903015. 

Original Call Date: 11/16/11 Time: 8:04 am 


Work to Begin Date: 11/18/11 Time: 8:15 am 


State: NE County: DOUGLAS 

Address: 2554 Street: SPAULDING ST 

Twp: 15N Rng: 13E Sect-Qtr: 04-SE 

Twp: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: LEAD REMOVAL 


Location of Work: LOCATE ENTIRE PROPERTY. 


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


: 33087 


Company : ENVIRONMENTAL RESTORATION 


Contact Name: TIM SUTTON 


Alt. Contact: CELL 


Work Being Done For: EPA 


Depth of Excavation: 24 INCHES Corner Lot: N 


Involves Tunneling or Horizontal Boring : N 


MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Service Area Name Contact Code 

MUDOl METROPOLITAN UTILITIES 

DISTRICT 

SANDY MUDOl 

OMAHACOF CITY OF OMAHA- RICH/TRAFFIC 

/->M AUf t 

Diggers Hotlin» 

Of 

N«braska 

Logout 

A Send Email 

Op: TIM24186 


•A 

Place: OMAHA 


Phone: (402)451-1314 x2267 

Phone: (402)306-2347 Br 

Front: Rear: 

Explosives: 


Utility Phone Numbers Type 

Day: (402) 504 - 7823 

Emerg: (402) 504 - 7970 

Day: (402) 444 - 7197 

http://www.dhon.org/IRTHOneCall/Ticket/TicketCreation.aspx?ViewTicketID=895805 11/16/2011 
Contact Information Log 

SAID# ^3-63 7 

Owner's Name: Q «^./vo< / s i-r i/ \ ^ J" Daytime Phone: ^bj " S^ ^ S~ 

j Property Address: Pi'S' V Sfi^Ut'n ^ S f 

Attempt to contact Date/time Name 
Property Access Checklist 

SAID: 3 Jo ? 7 n WORK STARTED ON: / / 

Property D WORK COMPELTED ON:_ / / Address: J>55 / J>pa.wl<^i/^3 j / 

Owner: C'^^4y S p'rcA./^Ls Renter: 1 

Address: ^^^ ^ JV^M/MIA ^ -f/« Phone: 

Fax: 

Cell/Pager: 

Phone: "JOS­ SC^^S T Additional Information: 

^^^'Siyrr^Akj- V6 (g) Y«^o. cc ^ 

Cell/Pager: 

'Q] Access Agreement Siened: \\ / 11> / V f By:vt^ 

lyQ Restoration Agreement Signed: \ \ / ( S" / U By: ^ ^ 

P(|^ Video Property Before On :l » /fd»/ u By:fA 

B ' Digital Photos Before On :fi_/^/lA _ By:f= ^ 

n Video Property After On : / / By: 

n Digital Photos After On : / / By: 

I w Property Completion Agreement Signed: U /33/* ^ By:qi5 

D Final Report Signed: / / By: 

Additional Video or Digital Photo's Taken: 

] n Video D Digital Photo On : / / By: 

Reason: | 

D Video n Digital Photo On : / / By: 1 

Reason: | 

n Video n Digital Photo On : / / By: 

Reason: 

D Video n Digital Photo On : / / By: 

Reason: 
Consent for Access to Property SAID#3>?Z 

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 environmental response activities upon the following described premises: 

Owner's Name: C*'A<^i^ ProiA|^ Daytime Phone: r/o^ J ^6 S • S^^ 5 

Address: J55Y Sfp^ojJ'iai si 

Address: 

Addresses of Properties 

covered by this Address: 

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 environmental 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 of the Grantees or the environment, 

or to allow others to use the property in such 

[p^IJ grant access to my properties 

n I do not grant access to my properties 

Signature Date Signature Date 
C&^he 'Chci 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. 

• I agree n I do not agree ITTi agree n I do not agree 

UrtV-ib 

Owner's Signatlire Date Contractor*Ssignature Date 
Restoration Agreement 

The purpose of this agreement 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 owner and the United States Environmental 

Protection Agency (EPA). 

SAID: 33o^-7 

Property Address: y^^S Y S^^Uj/y ^ ^ f 

Owner: C<Ki^Jl) ^ ^nK/ykLs 

Phone: ^Y^ ) }>o^ • Si^<PS 

On 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: 

Item: 

/^j^fe- g ^ / <y<:ocvccfrLc7 gg<"^i '^'i'k So J 

Item: 

Item: 

Item: 

Item: 

Item 

Page 1 of 2 
I agree n I do not agree zTi agree n I do not agree 

H y/^'^S^-ti 

Owner'ss Signatur Signaturee Date 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 fiature, except those items listed below, if any. 

SAID: 33Q@ 7 

Property Address: J^$S/^ . ^*t^/g/z^ q ,^ -

Owner: jfg^^,;^^l ^ k g 

Phone /^^) 3<^s-sces^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

\ y\ I agree restoration is completed, except as noted J^Tl agree restoration is completed, except as noted 

I I { do not agree restoration is completed I I I do not agree restoration is completed 

Owner's Signature Date Contractor's Signature Date 
a(l)^ftOQD0 0Q 

w 2554 Spaulding St .^fflM ^ 

A Printed: Nov 14,2011 

www.dcgis.org/dogis 

y.s^^-^ 
i 

uougias Lounty Account intormation rage i or i 

i Douglas County, Nebraska Property Record - R0204520000 

Print ReDort 

View Interactive GIS Mao Information is valid as of 2011-11-2 Treasurer's Tax ReDort 

New Feature ->->-> Subdivision Sales Search 

Owner 

FRANKS CANDIS Y 

2552 SPAULDING ST 

OMAHA NE 68111-0000 

Property Informatio n 

Key Number: 0452 0000 02 

Account Type: Residential 

Parcel Number: 0204520000 

Parcel Address: 2554 SPAULDING ST 

OMAHA NE 68111-0000 

Legal Description: LANDS SEC-TWN-RGE 04-15-13 -EX ST- SUB LT 2 LOT 29 - 40 X 125 

Value Informatio n 

Land Improvement Total 

2011 $400.00 $0.00 $400.00 

2010 $400.00 $0.00 $400.00 

2009 $400.00 $0.00 $400.00 

2008 $400.00 $0.00 $400.00 

2007 $400.00 $0.00 $400.00 

2006 $400.00 $0.00 $400.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.12 5400.0 0.0 135.0 40.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 11/14/2011 
• • 

ENVIRONMENTAL AS-BUILT DRAWING J***""'**, 

OMAH A LEAD * 

SUPERFUND SITE I 

RESTORATIO N Contracttt EP-R7-09-05 

330 S7 

Omah Exterior Paint North Arrow a Lead Site 

|~| Good Site Sketch i n Poor 

Samplin g Address : Z.S& ^ S.PALJUO\M<S » Si - fyKNo t paint 

Sampl e Numbe r Lead Sampl e Samples Collected l_AB Concentration Collected Fimn: F=^ j K1<=.W/t:i.t=> 

RYASCPXA-3.3«i>S"7 F1 3>Z T pp m D Date: c=>S>./ oS i /t^^* ^ 

nvBscpx A 33g>g T r a — pp m n • Time : c:>-2_ :-z. ^ pior i 

RYCSCPXA-3308- 7 B1 ^2 0 pp m Sample s Analyze d RYDSCPX A 3.30er 7 6 3 — pp m D • 

RDZSCPXA gyg>ca8T D^- — pp m D • X R F Unit: Book : 

RCZ6CP.XA. J3<QS 7 G Z — pp m D Date: 

• RPZSCPXA 3-3«De~7 PZ — pp m Time : 

Staff: E>«^V 

Number of Samples = 2L 

Legend: F l Front Left, F2 = Front Right, B l = Back Left, B2 = Bac k Right DZ = Drip Zone , G Z = Garden , PZ = Play 

All quadrants are as viewed from the street, facing property 

'iVK"ki:]^B:r> 

NOV 1 5 2011 

&AC K O P HOUSE: 

^2.se Z SFAULDJNS SfSAID » 33087 

DATE EXCAVATED 11-16-11 

DATE EPA SIGNED OFF 12-1-11 

AREA SODDED 2184 SQ FT 

LU 

> ^^4. 

WAUK . 

•A ^^i_i.gr­

«,pAUUDlNkS> Srt- RK'IWISD I f-rcMcd l6-\/.ay.0S (U<3141 1112? 

LEGEND 

Quadrant Excavated Drip Zone Excavated Lead Soil Remaining Easement Excavated 
^M^-'t 

330 67 

Omah Exterior Paint North Arrow a Lead Site • Good Site Sketch • Poor 

Sampling Address: Z-SS U S.PAU 1 J2iN< S Si - g^Not paint 

1 

Sampl Lea I Sample 

Samples Collected e Number LAB Concent ation Collected Firm: PS j M^w/tr. P 

RYASCPXA-330«T F1 3 ^ ppm 

n Date: <=>^oS/g=> ^ 

nYBSCPXA 33CS 7 r 2 _pp m D a Time: <=>Z[-^^r ^ 

RYCSCPXA-aSOST Bl ^2f 3 ppm 

n Samples Analyzed •RYDSCPXA 3.30g 7

 63 _pp m D D 

RDZGCPXA J'SOQT D^- _pp m D D XRF Unit: Book: 

RGZSCPXA J206 7 GZ _pp m D D Date: _ 

•RPZSCPXA 3308 1 Pg- _pp m D 

a Time: _

Staff: B4V Numbe r of Samples = i 2 . 

Legend: F1 = Front Left, F2 = Front Right, 111 = Back Left, 82 = Back Right DZ = Drip Zone. GZ = Garden. PZ = Play 

All quae rants are as viewed from the street, facing property 

&ACK- OF: HOU^E. ^Z5$ Z SpAULDJN<S S+ 

Fl 

321:7 

LU 

> -^rf. 

^ . WALK 

>i •A w^mx : •>« . 

SPAUL.DJN<2 J S+ 

Rsv 20081)1. Creaed: 16-.Vlav-0S 

(4614! 012.1 
330ST 

Omah Exterior Paint North Arrow a Lead Site 

Sit • Good e Sketch i • Poor 

Samplina Address: ZSS a SpAUL D\H<^ & \ Q^Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm: 

Samples Collected 

RYASCPXA-330«7 Fl 32 T ppm B" n Date: >^oS/<o ^ 

•nYBOCPXA 336er r F 2 — ppm D n Time; c=>2.:-zg>pivi 

RYCSCPXA-33<38T B1 

RYDSCPXA 3300 7 B2 

42 Q

—

 ppm 

ppm 

B" 

D 

n 

a Samples Analyzed 

RDZSCPXA' iyaoO T DZ .j= ppm D n XRF Unit: Book: 

RCZSCPy^A 3206 7 GZ _ = ppm D D Date: _ 

-RPZSCPXA 33(067 PZ =. ppm D n Time:

Staff: 

_ 

B>4^V Number of Samples • 

Legend; Fl = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

> 1 jj^m':£["ij:ji^jED '. 

Z5 f 5 4 SPAULDING 

^ ^ NOVl 5 2011 

^ 

t 

f 

...BJ : 

4 : ^2iO ; : V 

\ f : : ^ 

BACK. O F HOUSE. . 

PZ5$ Z S-PAULD>JN<S ^ 

\ : _jy^'^'^ .r r 

. 

5f 

b * 

. . rra -rt.-T* 

O A W 

• c >>* 

* >

1 c :5^ > 

• y : 

* c > : LU : « . - " 1 - ­

-*« . • £ ) • 

: ^ : WALJK.... 

) 

/ , PI...": 

' ^t ^ N ^^ ^ v^AU-h ^ 

S f ^AUUDJNC^ ^S+ Rev 20(18 BL Created: 16-May-08 

'
0 ENVIRONMENTAL XRF DATA ENTRY LOG 

RESTORATION 

SAID# .330^7 DATE M \lfe\/( 

PROPERTY ADDRESS TIME 

^56 4 S^a,)lAtn.q ST 

XRF S/N P>^'^ SO 

QUADRENT OR SAMPLE AREA 

DEPTH AVERAGE OF RESULTS SHOT#s 

redig 

D F1 

D F2 

D Bl ^%?>-<P^ i [W-^^ 

D 82 

n DZ 

n PZ 

n GZ 

n 

n EZ1 W)et 

EZ2 

n OTHER 

SAMPLER NAME riimmu P 
Thermo Fisher Scientific "Vlnoi^iiiiiini 900 Middlesex Tumpilce 

Billerica, MA 01821 

SCIENTIFI C 

index lime AVKR.\€K ADDKhSS ISAMPLK ARKA OPERAIOR UKPTH NOTKS Hags SAID Pl> 

I 2011-11-16 15:00 Avg of 283-285 2554 spaulding stBl JIMMY 4 final clearance 188.77 ± 22.55 

2 2011-11-16 15:00 2554 spaulding stBl JIMMY 4 final clearance 33087 203.41 ± 23.22 

3 2011-11-16 14:59 2554 spaulding StBl JIMMY 4 final clearance 33087 189.43 ± 22.59 

4 2011-11-16 14:59 2554 spaulding StBl JIMMY 4 final clearance 33087 173.46 ± 21.85 

Page I of I 11/16/11 14:52:07 
'%A.v-y Ti ¥i­