TRANSMITTA L of OMAH A LEA D SITE 

SOIL REMEDIATIO N FIL E FOLDER 

SAID #: 2.2^1 1 Date: /lA/g7 

Address: ^7/ / D^^T ^ ArJc 

Reinediation Contractor: Coastal Environmental Group Year: 2007 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

D 

n 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

»i 

D 

D 

D 

Photographs 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description ofareas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

D 

D 

D 

ym­
- -^il Pewcy Afc. 

Final Report Property Check List (Please place with each file) 

Hard Copy Information 

[Q Property Check List 

^ Site Working Drawing Map 

3. EPA originals Map 

tZ2 Douglas County Assessor's Map 

IsJ Property Contact Sheet 

Agreement 

iD Access AgreeiTient 

i^j Restoration Agreement 

Miscellaneous Documents 

ttj Final Map from the Field 

./^/A 2. Change Orders 

f^XRF Data 

|\j/A; 4. Any emails or PO correspondences 

Property Completion 

\ 1. Executive Summary 

\ 2. AS BUILT 

^ Property Completion Agreement 

{\)H 4. Any buyout info or reimbursement info 

(\1 i P^ 5. Check or money order copies 

^ EPA Property Close Out Form 

[ZlAttached Begin Video 

Electronic Documentation 

Drawings 

Uj EPA original 

^ Working Drawing 

ti l AS Built.vso 

137 AS Built.jpg 

Photos 

"^Begin Photos 

'^uring/Excavation Photos 

v^ d Photos 

V30-Day Sod Photos 

\ Scanned Documents 

Final Documents 

\ Executive Summary 

Videos 

\Begin Video 

""^y Movie 
Property Access Checklist 

Property ID: "^ V ^ \ \ D WORKSTARTED ON: / / 

D WORKCOMPELTED ON: / / Property Address: Q- ^ ^ *l::^£..oe y KVw 

Renter: 0>vncr: '^^^^ ^ S^-A^rtW< ^ 

Address: \ J Phone: 

'^^o [ ^]y^cL ^ *2.v Fax: 

Cell/Pager: 

Phone Additional Information: : Z^^^^ ^ T ^ | ~ t^^ l b^ J 

Fax: 

Ccll/Pager: 

o^ Notification Letter Sent: By: 

HT Access Agreement Signed: 0$7 b I d l By: t iim^ZS^ ^ AU^W, 

WRestoratio • ^ n Agrccnicnt Signed: (0'^/ tt / f^H ^LE 3 Q=PSJ v--^-^ ,/a\^— V ' 

I I Topsoil Sampling (ifapplicable) By: ^ 

I I Disposal Sampling (ifapplicable) By: 

I I Garden Sampling (ifapplicable) By: 

Q^Utilitv Cle arance Called: "o l{l lO^\ By: ^^im^<>j/''^:^'io D 7" 

Q^ Vidco/Photos (Before) Onib^ l U 10 1 By : ck^ \ <LLVO^<' ^ ' -pe ^ e r 

Wy Vidco/Photos (During) On:^l£^l02 By: 0(2 r^ 

H^idco/Photos (After) on:SiiyLiy^ •Ryllfcvi 

W^Vidco/Photos (30-Day) On: ~71 ^ / oT By: 

o^ Property Completion Agreement Signed: ^ I (?^l ^ 7 By: 

I I Final Report Issued: By: 

Air IVIonitoring (as applicable) 

n Community \0\ Crew On: / / By: 

Results: 

n Community \7\ Crew On: / / By: 

Results: 

r~] Community \0] Crew On: / / By: 

Results: 

Omaha Lead Site 
Property Classification: 1200 • » 

Total Qua^^BSquare Footage to be Excavated = 1958 

Total HBPlone Linear Footage to be Excavated = 0 

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 ' .  Dewey Avenue 

Legend 

\';:::/\ Concrete 

NorthArrow Omaha Lead Site 

Omaha, Nebraska 

7 A

r 1

L J 

m 

— 

o 

 Excavated Area 

^ .._.. .. _. ._ txisiing ^iruciure 

Permanent Landscaping 

Fence 

Quadrant Boundary 

Tre e/Sh rub 

ai y 

N 

Scale 

1 Inch = 20 feet or 1 grid = 5 x 5 ft 

•O VHCL 

V f -

Fl

F2 

B1 

Property Number 

OLS-22811 

Property Address 

2711 DEWEY AVE 

Post Excavation Concentrations 

 B2 PlayArea 

[ 

Gard en _ - Ease 

C 

ment 

Dther 

(ppm) 

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

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

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner City 

Owner 

State 

Owner Zip 

Sec-TwnRng 

2101940000 

MIDLAND 

MANAGEMENT 

INC 

2711 DEWEY AV 

OMAHA 

68105 

C/O RODNEY S 

SEDERSTROM 

3828 DODGE ST 

OMAHA 

NE 

68131 

21-15-13 

Owner 

Address 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Old 

Assessor 

Site 

New 

Assessor 

Site 

CIO RODNEY S SEDERSTROM 

REDICKS-J 1-SUB 

1 

4 

El/ 2 

26X123.5 

http://webarc.co.douglas.ne.us/dcassessor/details.asp? 

PARCELNB=2101940000 

http://webarc.co.douglas.ne.us:8080/RealWare1/details.do? 

id=R2101940000 

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 = 171 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 4/25/2007 
f 

Property ID # 

Property 

Address: 

Initial Contact:

Second Contact:

Final Contact:

Final Action:

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

_7 J/o Q oST^-

CONTACT FORM 

7^^^ 

/g^U ^'Lyy ^ A.v.2 ^ 

 Date: -fj g /07 Time: pfeWS Action: L'L^V m . I ' l^s.s/^-<:^ 

 Date: Time: Action: 

 Date: Time: Action: 

 Transmit to EPA D Other Action: D 

n,: .^l-ft,-\,i> yv. 1_KV.C 

7/i( /o ; 

^et ^f ^^^ '^^­

/ \ y 
£ \ 

Consent For Access To Property 

RIGHT OF ENTRY TO PRFMLSHS 

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

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

enter and perform certain environmental response activities upon the following described 

premises: 

Owner's Name: •^."^L.^VA ^ y\^\r\A\i^F '

Daytime Phone: 

Address: S'l-l\ \>^.r^f-^ A..t 

Address: 

Addresses of 

Properties covered by 

this Agreement: 

Address: 

Address: 

^YZ ? lOoijiAt f r I 

Address: 

PlfRPOSF ('>F RF.SPONSF ACTIVITII-.S 

The EP.A is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of arsenic and/or lead and may pose a health hazard The soil 

will be removed and the excavated area(s) vvill be replaced with clean materials and 

restored This vvork is being performed under the Omaha Lead Site Superfund Site 

remediation program. 

An EPA representative will contact the Grantor in-person to discuss the work to be 

performed, the Grantor will have an opportunity to review and approve the planned soil 

removal, and restoration work before it begins. Once the work is finished, the Grantor 

will be asked to review the work and confirm that it is complete and meets with the 

Grantor's approval. Upon completion, the Grantor will receive written documentation 

from EPA that the property' has been remediated. 

ENVIRONMENTAL RESPONSE ACTION.S 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times and 

with prior notice, for the sole purpose of performing the work. This access shall remain 

in effect until the work has been satisfactorily completed. The Grantor also agrees to: 

«Property_ID» Page 1 of 2 
•

 Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

• Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

• Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

• Abide by health and safety guidance provided by EPA; 

• Ifthe property is rented, assist EPA in obtaining tenant approval for access to the 

property to perform the work if EPA is unable to obtain such access; and 

• Allow videotaping and/or photography of the property including exterior and 

interior areas ofbuildings. 

AGRFEMT-:NT NOT To INTF:RFL:RF 

The Grantor agrees not to interfere or tamper with any ofthe 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 a manner. 

Should you have any questions about this program, please contact 

I grant access to my properties 

I I 1 do not grant access to my properties 

Signature 

LJ I would like to be present during any sampling that is required. 

Page 2 of 2 

Kprooertv ID: 
s ^ 

Restoration Agreement 

The purpose of this agreement is to pro\ ide a mutual agreement as to conditions of property prior to 

remediation aclivilies. This will also serve as decontamination for the purpose of assuring that 

restoration aclivities are completed to the satisfaction of the property ouner and the L'nited States 

Environmental Protection Agency (EPA). 

PropertylD: ^ ^ ^ j , 

Property Address: ^^^ ^ ^^^^ ^ /X^ ^ 

yi ' ^\-o-^ ^ /MA/\A C -O-K t_u^j ' Cf*. ^n{^}>n> ^ J)P hs.<-/CS4-<:cr>-i^ <t^ 

Phone: S s \ - ^l^ O ^ 

On the attached diagram(5) indicate area(s) to excavated and depth of excavation, location of all kno\sn 

utilities, subsurface features, surface structures and landscaping features, access locatioii(s) to be used bv 

contractor, and the direction of Nonh. Indicate distances, depths, material types, etc. hidicate digital photc^s 

hv referencing the photo-log number v^ith an arrow indicating direction of \ iew. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

The removal, storage, disposal, and/or return of thesa items is the Owrer's .'sspcrsibirty. 
((^ > 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: / 

Item: 7 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

- y/ « / 

Item: \ \ / 

Item: / 

Item: / 

Item: 7 

Page 2 of t ^ 
Items To Be Removed By Contractor During Remediation And Replace 

(Use additional sheets as necessary) 

y

3^ 

Paqe 3 of % ^ 
• ^ 

Item 

Pre-existing property area 

that is covered uith iirass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees inch 

trunk dianieter 

Number of Sprinkler 

Zones. Control VaKes. 

Timers. Heads, etc. 

Attach a skeich of the 

sprinkler la\Dut. 

Number of and size of 

each garden' flower bed 

area. 

Anach a sketch of relative 

sizes and locations. 

1 

Landscape Inventory 

(Use additional sheets as necessary) 

Quantity Unit Condition/Type/Species 

Square feet 

Each 

Each 

Each 

Each 

Square Feet 

Page 4 of '^ 1 ­
Item Quantity Unit Condition/Type/Species 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this value

used to issue

voucher to the

owner. 

 will be 

a plant 

 property 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. Each 

Include a sketch of were 

each plant will be placed 

b\ the contractor. 

.Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

area(s) to be replaced \\ith 

crass sod. 

SF 

Area of Cit\ or Countv' 

propertN to be landscaped 

per their requiremenis. SF 

Include

area (s) 

a sketch of the 

Page 5 ofi 
Additional Comments / Instructions: 

\yy7- C24<'^^{y>^^i>^ ^y) ^y-ri^ jg^r-eyayT^ ^:id^<yy^^-^ ^ " ^ - ^ 

fSyy ^ T^^-t^T^ ^ .:^07^/::f.u^ y^.^ ^ y ^^^^^- ^ ^ ^ y^0y^<-^^ ^ ^ 

iy>^/u 

• Check the box if Owner does not want CEG to document intenor foundation walls and possible 

pre-existing damage. By checking this box CEG is not responsible for any damage done to the 

intenor of house, including foundation cracks or fissures. 

I asree I I I do not agree D i s I I I do not agree agree 

Page 6 of _5: ichor's Signature 
Additional Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

(\(yy^ 

^ 

-<:= ^ •V

fapi^/^5 

Page ^ of 1 
N Total] ^ ^ Square Footage to be Excavated = 1958 

Property Classification: 1200 1r WK...^ Tone Linear Footage to be Excavated = 0

: 1 i 1 i 1 1 1 i i l i i 

11 1 jkoWaitd Stree t i 1 

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1 \ \ \ \ Dew€ iy Avenue 

i 1 

1 Legend 1 NorthArrow 1 Omaha Lead Site 1 

Omaha, Nel)raska 1 ^-:-^ Concrete

 | 

7 A Excavated Area t Property Number 

OLS-22811 

P I txisting wrucnire r Scale

Pennanent Landscaping 

Property Address 1 11nch = 20 feet or 1 grid = 5 x 5 ft 2711 DEWEY AVE Fence r 

— Quadrant Boundary Post Excavation Concentrations (ppm)

F1 B2 PlayArea Street Boundary j •J:.>v-T-.-._^-.;-: , ;.-lt 1 \ \^sA- i — - F2 )Z _ 1fasernent 1 ^ 

: 

Gard< Description of post excavation areas: F1. front yard left-hand quadrant; F2. front yard right-tiand quadrant; B1, t)ackyarct left-hand quadrant: B2, backyard nght-hand quadrant; 

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

o Tree/Shirub V 

Bl 5 n _ C)ther 
MP PROPERTY CLEARANCE WORKSHEET 

^^' - ^ 

Date 

Project 

XRF ID 

Shot # 

24U 

a4^ 

Aliquot 

1 

2 

3 

4 

5 

Aliquot 

1 

2 

3 

4 

5 

Aliquot 

1 

2 

3 

4 

S 

05j^lm 

Omaha Lead — Fixed Price 

ZZSli 

Z7(l T>^OL;CV^ h/r, 

Reading Sample Area 

Pass/Fail ? 

Composite 

(Dried & 

Sieved) 

Analytic 

al Spilt 

Sent? 

Lab 

Numbe 

r 

Analytical 

Results 

[ 

1 

Pass/Fail ? 

Composite 

(Dried & 

Sieved) 

Analytic 

al Spilt 

Sent? 

Lab 

Numbe 

r 

Analytical 

Results 

Pass/Fail ? 

Composite 

(Dried & 

Sieved) 

Analytic 

al Spilt 

Sent? 

Lab 

Numbe 

r 

Analytical 

Results 

Reading 

es 7f.^\ 

Sample Area 

I n Situ 

Reading 

0 

21 

i n 

on 

bO 

Sample Area 

I n Situ 

Reading 

1Z( 

77 A 

IQI 

lun 

159 

Sample Area 

I n Situ 

Reading 

0107-51 

Sample Area 

tV 

'r2.i 

Property ID 

Property 

Address 

Measuremen 

t 

Count/Time 

Field Shots 

Shot # 

B^ 17-1 L|" 

Composite Readings 

(Bag) 

,^/. 

+/- 0 ppm \p +/- 0 ppm 

^ • ^ 

+/- 0 ppm 

Y>\ 12-(t 

Composite Readings 

(Bag) 

+/- 0 ppm ^^M 1 +/- 0 ppm 

)Q<B +/- 0 ppm 

XRF Corrected Value - > 

(use calibration chart or add 

20<>/o to value) 

Composite Readings 

(Bag) 

+/- 0 ppm 

+/- 0 ppm 

+/- 0 ppm 

Composite 

Average 

(Bag) 

S5 

lOZ 

n 

Composite 

Average 

(Bag) 

;?5 

277 

Composite 

Average 

(Bag) 

Confidential 6/5/2007 

Page 1 of 2 

1 
Sample Area Pass/Fail ? 

Aliquot 

1 

I n Situ 

Reading Composite Readings 

(Bag) 

Composite 

Average 

(Bag) 

Composite 

(Dried & 

Sieved) 

Analytic 

al Spilt 

Sent? 

Lab 

Numbe 

r 

Analytical 

Results 

2 +/- 0 ppm 

3 +/- 0 ppm 

4 +/- 0 ppm 

XRF Corrected Value - > 

5 (use calibration chart or add 

2 0 % to value) 

Pass/Fail ? 

Aliquot 

1 

I n Situ 

Reading Composite Readings 

(Bag) 

Composite 

Average 

(Bag) 

Composite 

(Dried & 

Sieved) 

Analytic 

al Spilt 

Sent? 

Lab 

Numbe 

r 

Analytical 

Results 

2 +/- 0 ppm 

3 +/- 0 ppm 

4 +/- 0 ppm 

XRF Corrected Value ~ > 

5 (use calibration chart or add 

20°/o to value) 

XRF Technician's 

USE ADDITIONAL SHEETS IF 

NEEDED 

Signiture /n\ .irO 

Confidential 6/5/2007 Page 2 of 2 
XRF DAILY CALIBRATION WORKSHEET 

Date A5 30 O^ 

Project Omaha Lead — Fixed Price 

XRF ID 0107-51 

Measurement Count/Time 30 sec 

Calibration Verification Checks 

Readinq Blank Low Med 

True Value 0.0 ppm 18.9 ppm 1162.0 ppm 

120% 22.7 ppm 1394.4 ppm 

80% 15.1 ppm 929.6 ppm 

ir^ 

linn 

Precision Measurements 

Average 

Within +/- 20% of True Value to Pass Calibration Check 

Precision Measurement Check 

Replicate Blank Low Med 

1 q» 

2 ^000 

3 mo 

4 ^?o 

5 QfSO 

6 m 

7 230 

Mean Concentration 

Standard Deviation 

Relative Standard Deviation 

Relative Standard Deviation 

Less than 20% 

Confidence Interval @ .95 #VALUE! 

Method Detection Limit #VALUE! 

Average Confidence Intervj #VALUE! 

High 

5532.0 ppm 

6638.4 ppm 

4425.6 ppm 

^S4in 

'TS'^IDC^ 

High 

^W) 

^m 

541(0 

.^160 

f ) W 

S2i)0 

553D 

#VALUE! 

V

m ~' ~ ,^ i * ^^tPBoi«^

Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

 wwwxoastalhazmat.com 

 COASTA L ENVIRONMENTA L 

C n 0 U P , INC . 

EXECUTIVE SUMMARY: 

22811—2711 DEWEY ST 

X No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

Total Ouadrant Square Footage to be Excavated = 1958 

Property Clasafication 1200 Total Drip Zone Linear Footage to be Excavated = 0 

Oata^tonal aostencamaborateai Ft front yard lett hand auadrarl F2 front yard nghl-nand Quadrant B1 bachyafd left-hand quadrant B? backyard iiciht-hand qu.id^ 

DZ, dnp £onc (1 3 toot area at soM around tne foundibon of the tiouse) 

Legend 

Area not Excavated l///i Dripzone Excavated QQ<yi Quadrants Excavated 

Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc . 
^ P A 

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 ofthe 

subject property, and that no items are in question, now, or at any time in the future, excluding any 

remaining sod warranty (30 days total) except those items listed below, if any. 

Property ID: 

Property Address: ^7// Cy(J/fjJfj\/l. 

Owner: 

Phone: 

Restoration Items in Question: 

y^-uy/c.. -^ y jyT ^ 

Item: 

Item: i 

Item: 

Item: 1 

Item: 1 1 

Required corrections to complete the property: 

S^ l agree restoration Is completeci, except as noted above. 

CH I do not agree restoration is completed 

4)ate y 
aEPA • 

EPA Property Close Out Form 

Property #: ^9-By Property Address: ^^TZ/i^^^^^^t ^ 

Date/Time: Owner's Name: /Inf.Ul/'UJ .S/'/UfS-i'rDry) 

Quads Excavated: Contracto [lUD y r Group 

Excavation General Yes No 

\. If necessary, were the correct quadrant(s) excavated and restored? d y 

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

Grading Sod and Vecetation Yes No 

1. Does the grading around the perimeter ofthe house in excavated areas generally slope away y from the house? 

2 i y . 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 t y 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? 

7. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls 

1. Do gates open and close freely? (Ifapplicable) 

2. Were all gates or fences taken down during restoration activities reinstalled? 

3. Was damage to gates or fences avoided? (Ifapplicable) 

4. Was damage to retaining walls avoided? (Ifapplicable) 

Foundation, Siding and Gutters 

1. Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 

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) 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

< ^ 

" ^ 

PA 

Yes No 

(If applicable)//.• 

fik 

fJk 

VA 

/A 

IJ^ 

Yes No 

tJJ^ 

^J^ 

^/A 

Yes

y 

 No 
Owners comments: 

Inspection notes: 

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

EPA Representatiye-'7^I^^fc;(f\l:^^;fe>tX^ Date: / - /JZ -Q 7