PROPERTY SUMMARY

 

Date: 11/15/2007 Omaha Lead Site Remedial Action Contract # EP-R7-07-06 Month of: November 

Property Address: 5804 N 29 St 

A. EXECUTIVE SUMMARY 

A.I Issues Encountered: Map error, sheet included in file. 

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: 

Fl - 110@6" 

El - 85 @ Scrape 

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. 

TECHNOLOGIES, INC. 


- -

3TSCI 

Exterior Paint North Arrow ?Omahc ) Lead Site Owner Name: Ca/QraC/O flnpert/G* fj Good Site Sketch Address: ttO*{ N £3* fit. fj Poor

 

Phone: H: w 3O.3 ~ H-/& ~ V22 7 g[ Not paint 

Sampl Lead Sample . _ Samples Collected e Number 

Concentration Collected Firm: Af^jol Ral &S~ 

IH "? ppm R' l~l Date: vft -2\- o C>

 

RYBSCPXA-375G/ F2 5" 5 ppm ET D Time: 10 .' "^o 3tv,

 

RYCSCPXA-J73C/ B1 T ^- Ppm

 

Samples Analyzed /S4" Ppm & D 

Ppm D D XRF Unit: /£?6*7 Book: I"?*? " "1 Vl r-, "~ ppm D D Date: /; ' " I 3 ~O Lt> ^ o/^/ ­ ~ ppm D D Time: ?t-^ 

^ i i - Staff: KVi'?^0 

Number of Samples — J 

Legend: F1 = 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 •^ •» fc* *.* k. A 

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Oct 12 07 09:0,
 Chapman
 720374E121 p.,
 

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&EPA

 

EPA Property Close Out 

Form 

Property #: _ Property Address: 

Date/Time: // Owner's Name: 

Quads Excavated: Contractor Group 3QO1 

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? 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? / •^

j. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 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 if inspected at a 30 day •" time period) 

6. Was the property' graded such that water will not pool on the property? S 

7. Was damage to landscaping or plant materials avoided? 

/ 

Gates, Fences and Retaining Walls Yes No 

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

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

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

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

Foundation, Siding and Gutters Yes No 

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

2. Was damage to the foundation avoided? S 

3. Was damage to windows avoided? S 

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

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: 

 nor

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LLFO *- <*< "'*'

ofM//3/C0-, 

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

EPA Representative fi^-JjL-_ Date: 
• 373CI 

\ Lead Site Exterior Paint North Arrow 

Owner Name: C.^l^r&clo /ftv*9/-//(29Omahi 

 CD Good Sketch Address: TAO4 N ?$' St.

 <e 

Phone: H w: 3Q3 - H-/& ~ f£.'i 7

 x • '

 [^ Not paint 

Sample Number

 Lead

 Sample Q Samples Collected 

Concentration Collected Firm: A<;ulRftl <*3~

 

RYASCPXA-.373C/ F1 ^\.0 -Mf I *? ppm R/ [~l Date: »a-2»-o t,

 

RYBSCPXA-375G/ F2 $$ opm H' D Time: |Q,'*^oaiv,

 DV^^o^DY A d ^^rt ^^ y R 1 *s X nr^m

 

Samples Analyzed RYDSCPXA-^^^/ B2 / 85^ PPm IZf D 

RDZSCPXA-gy^gg/ DZ ~* ppm D D ypp | Init1

 /X)/S*^ RnnU- 1*1 *? 

ROZ60PXA $ 73Gt CZ ~" ppm n n

 Date' l~L.'C%'OL0 rM-v-.n^nvr> /t_n^« , r>-» — D D

 Time: P/-^v 

Staff: |Oi'S't-~J 

Number of Samples = ^i i i ­ • i i 

Legend: F1 = 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 

-*- r->« >*-* 
Mov 10 07 09:55a Patrii Chapman 72037421! 2 

Mov 10 2007 10-.54RM Pf IENT TECHNOLOGIES 4CK.1SOJ 105 P • 

Property Completion Agreement 

This agreement documents the completion of removal activities perfonne.' ->n t' •'•-".• lr.- -J 

The property owner's signature indicates thai the property owner is satis • ..d • i 

subject property, and that no items are in question, now, or at any tin. ;;. ~ fu. -re, cxi.'. 

remaining warranty (90 days overall, 30 days on sod growth guarantee) except those items liste ! 

if any. 

Prop* rty ID: 

Property Addrea: A/.

 

Owner; 

Restoration ftems In Question: 

Hem: 

Item 

Kern: 

Item 

Required corrections to complete the property: 

Lj I do not agree restoration is completed 

7 

Date 
Mov 10 07 09:55a Patric Chapman 72O3742 

10 Z007 10:54RM •~ TECHNOLOGIES 4>;r?'.l 

'.VICES TECHNOLOGIES, INC 

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T<X From: 

Fax: (inci 

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Urgent O For Revfew D Pl««** Comment Q(PI«a»e V Y J Ptoase RIK: , . • 

rv 

HOBO want Parfcwiy, suta 40s 2SOS NL 34* Street Suto 218 8918 

Kansas City, MO 64114 Omaha, Nebraska 6»110 X7B:17 

Phone: (816) 3«W703 Phone: (402)504-1004 , ::<!-96tHJ 

Fax:<81S)3«M7[J7 Fix: (402)604-1005 :,-J-&£77 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

MAP ERROR REPORT FORM 

Property Address: 

B V1D Number: 3 7 ^ 6J 

Description of the Map Error: 

Date of the Report to EPA: (ftMethod of Reporting (Circle E-mail 

/"Met witTTEPA Other Method 

Description on how the error was resolved: 

f 

/?r­

.nature of the Reporting Staff Member 

8080 Ward Parkway, Suite 405 2505 N. 24lh

 Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 6411 4 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588

 

Fax:(816)363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
Print Preview Page 1 of 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

1015920000 

CHAPMAN 

MITTIS L 

5804 N 29 ST 

OMAHA 

68111 

21453 E 54 PL 

DENVER 

CO 

80249 

Sec-Twn-Rng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Assessor 

Website Link 

33-16-13 

ELLISTONE PARK PLACE 

0 

6 

N 38.5 S 77 W 136.25 

E 161 .25 FT 

38.5 X 136.25 

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

accountno=R1 01 5920000 

Disclaimer Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 54 feet appraisal, survey, or for zoning verification. 

— r- - J , 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData-Douglas Count... 10/10/2007 
Name: 

P 

Date: If 

No. Property Address Day Care 

AM Landscape 

X 

Others 

*f 
373CI 

<oaOmaha Leac (Site Exterior Paint North Arrow 

Ownerflame: (2o/9/"aOc? {rQp&rr Q Good Site Sket( :h Address: _$~<3OV N £S* fit. Q Poor 

I" Phone: H: w: ^Q3 - #/d ' V22 7 £jjj Not paint 

Sampl Lead Sample

 Samples Collected e Number 

Concentration Collected Firm: A<^)»i\ftll AtT 

RYASCPXA-375C/ F1 IH *\ pom F^ P) Date: ift - 21- o C> 

RYBSCPXA-373G/ F2 5"5 pom R' f] Time: iO,''%oaisi

 

RYCSCPXA-373C/ B1 ^~2~. Dpm 0* rj

 Samples Analyze J RYDSCPXA-.37\3C/ B2 IBS' Dpm [£| rj 

HU*1L'L' *"* I AA &f&Qf Lrc. npm D D XRF Unit: y«£>6*7 Bool *•'• n3 

UU«-C,U AA- ,3 j\J4t /' *-^ "" ppm D D Date: _£ L*/ ? *^ ^ 

nr^crxA-^r^./ r. pm D D

 Time: P/-^

 

Staff: /r»ft^> Number of Samples = *-\ \ { — 

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed frorMhe street, facing property 

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