TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: Sl-jn^ ^ Date: ^Jf-yjllQ^?^ 

Address: ^^ ^ / N _^^-^ t 

Remediation Contractor: PQtDn>PN-f li-^M . 'X^'<^-y ^^^- °^cD^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

\y Video of property (DVD) 

y Executive Summary 

{y EPA-provided property sketch 

y 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.) 

y Confirmation data 

y Photographs 

y As-built sketch 

\ / Satisfactory restoration signed by Property Owner 

ffl' Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

H' Utility clearances 

y Property information from Douglas County Assessor's Office 

D 

D 

D 

^ii/» njLy 3/2y/a^ 

Signatup^ Date 

40311340 

iillillil 

Superfund 
PROPERTY SLIMMARY 

Date: 09/15/2008 | Omaha Lead Site Remedial Action Contract # EP-R7-07-06/0004 | Month of: Aug/Sept 

Property Address: 4331 N 42 ST 

A. EXECUTIVE SUMMARY 

A.l Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

,A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl=166 PPM @ 7"; DZ=88 PPM @ 12"; EA=57 PPM @ 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 sketchi) 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 tile, if available, or obtained include: 

i) Pre-e.\cavation agreement details (if any are made with the property owner) 

ii) Property Status Form signed by property owner 

iii) E.vcavation digital video in MPEG, WMV (Windows Media Video) or SWF (Flash Player) format and/or 

photographs 

iv) Signed fonn verifying satisfactory restoration 

v) Description of areas not meeting Interim ROD cleanup criteria. 

TECHNOLOCIES, INC. 
Find Record 

Backfill: 

Sample Area: 34099 - 4331 N 38 ST 

Owner: 

n Owner Occupied 

Owner Name: 

JWAGNER RONNETTE M 

Owner Addressl: 

1 

Owner AddressZ: 

)4331 N 38 ST 

City: State: Zip Code: 

[OMAHA |NE |68111 

Owner Phone: Alternate Phone: 

|(402) 451-2516 I (402) 457-8545 

Clean Up Query Lead Remaining Query i

Resident: 

Resident Name: 

[WAGNER RONNETTE M 

Property Address: 

|4331 N 38 ST 

Zip Code: 

J68111 

Resident Phone 

 Property Damage Query Close 

Contract: 

Contractor: 

1 

Group: 

1 

Assessment: 

Qualifying Group 

j PRIORITY 

Assessment XRF Date: 

1 

Assessment Max XRF Value: 

1 437.18 
^ R ^ 

EPA Property Close Out 

Property #: 3^0'?'? Property Address: 4-^' '^ ^8 ^>" 

Date/Time: ^J8j09 Owner's Name: fi, Uipoet 

Quads Excavated: Bt-,^ ^ Contractor Group Prudent Technologies 

Excavation General Yes No 

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

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

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? y 

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 a 30 

day time period) y 

4. Are sodded areas generally firm and evenly graded? y 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) y 

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

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

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

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

Foundation, Siding and Gutters Yes No 

1. Was damage to the siding or trim avoided? y 

2. Was damage to the foundation avoided? y 

3. Was damage to wmdows avoided? y 

4. Was damage to windows or door screens avoided? . y 

5. Was damage to downspouts or downspout extensions avoided? 

l y 

Sidewallts and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? y 

2. Was damage to walkway surfaces avoided? 

Ly> 
Owners comments: 

Inspection notes: 

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

EPA Representative fL.:A^ Date: 9/9/op 
&EPA 

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

Property ID: 3 (^ ^ Oj 

Property Address: L,^^. , ^ , o ,^ K, c^;. 

Owner: 

Phone: ^ \ ?> ­ 1 ^ ( C7 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

W.1^--^ D "2_ % 

Ik f I agree restoration is completed, except as noted above. 

 I I do not agree restoration is completed 

Sp^^/^i :; 

/Owner's Signature Date 

I
^^^* ' EUMN .•^ .VV. rt i.-' 

• * *»»' 

Pmdent TecfanclogieE, Inc. (PiaiasS) isundtT contrsctwiflithe U. 5. Eimiomnental Protection Agaicy(^A) to cleanip l»adccntiiTBiniitftd »3 s at anurabei of piop»iti»slocat»dmOmaha,Nebiadca, mcludingthe proper^ located at 

H l\ 3 I N J yZ, k \K ?CI— • The EPA requests your peiaunaon to allonr Pmdent to perfona aioil cleamq) atftds 

proper ei^to t remove i lea^-contammated soil. By dgDmgtisfonii, the propeity ovraer grants permisB on to Pmdent to peifona 

activities related to the cleamqi includug soil gnnplii^ removal of lead-contaninated soil, and restoration ofthe referenced property. 

If you have any quedions about the soil cleanup planned for your propeity, please contact Pmdent's Adninidrattve Clerk for the 

OmahaLeadSite cleanup. Ms. Shannon Holt-at f4021) 504-1004. General questions about &e Omaha Lead Site cleazsq) canbe 

direcUdto the EPA Public InfonnationCentersat(;402) 731-3)45 (^outhOmala office) or (402) 591-9583 (NorthOmaha office). 

PropertyAccessGrantedBy: /[l O j/- ? l^ . / / /Tf-^ ^ >^ <^> ­

l ^ (Please PiinttJ ame) 

Q. \-' 3yD~ ^ Propeity Owner Signatuie: ^^^^ * (Signat^e) •^^'^ ^ < ' - ^ ^^ ^ 

PROPERTir INFORUATION 

(To be coB^IelBd by nadenland/orprspeitjr otriur - pbostprintj 

RESIDENT NAB8E ^rf>A9l^ , ^y^PlQ ^fci T Renter 

& 

RESIDENT ADDRESS: 

,^^^^ Liqo,, to 3>sV^ S>l- V)ysK.2A^ Me, ^^ N | 

IF RENTAL. PROPERTY OWNED BY: 

OWNER'S HAILING ADDRESS: 

7\^7:,V.^ k$P Cs^Ci I 

OWNER'STELEPHONE NUMBER-HOUE: J L WORK: 

J 1 

AGE OF H0UE7: Wi YEARS. HOW LONG HAVE YOU LIVED HERE? YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 13787 YES HO 

NUUBER OF OCCUPANTS UNDER 7 YEARS OLD: NUMBER OF OCCUPANTS? YEARS OLD AND OLDER 

NUMBER OF CHILOREN UNDER 7 YEARS OLD WHO PLAY m THE YARD FOR 5 HOURS OR MORE PER WEEK: 

COMMENTS OR SPECIAL INSTRUCTIONS: (I.E. DOGS. ENTRY GATES. ETC.) 

AUTHORITY FORENVIRONMENTAL RESPONSE ACTIONS^ The activities to be implemented by EPA under this agreement 

are cursuantto Section 104 ofCERCLA42 U.SJC.9604 . EPA'S n ^ of access to the propeity IS provided for in Sectionl04(e) of 

CERCLA, 42 U £ C 9fi05(e), wfaich provides eitfiy for "deteiminii^ the need for rei^onse, or chooong or taking any req>onEe action 

under this title, or otherwise enforcii^the proviaons ofthe title." 

8(no Wffd Pskw^ , Suite 40S 2S05 N. 24" Street. Suite 308 4242 H«]lcal Drive. Surte42S0 

Kaia s Crt;. MO C4114 Omaha. Nebraaka68110 Sai Antonio. TX 78223 

Phono: (81G) 363-3703 

Fax: ^1S) 3C3-3707 

Phone: (402)504-1004 

Fax: (402)504-1005 

Phone: (210)822.3588 

Fax: (210)573^77 
fli * • » * r I. • X 

• t » » - » r J \ 

I , . w ..* *•-• V.', vv\w«V- /»• 

Prudent T»chnalo(^eE, Inc. (PmdeoQ isunder contract wi& th» U. S. Environmental Protection Agoacy I^A) to clean tq) l»sdcontamiaAed soilEat anumber of propertieslocatedin Omaha,)! ebradca, includii^lhe property locattd at 

M':^ "^ I N J "^JtHl \X- . The EPA requests your permission to allow Ptudent ta peifona a soil cleanup at Ans 

propM)y\o remove Uad-cculamiajted soU. By agong Ans foim. the propeity owner giants permisaon to Pmdent to pufoim 

activjtiesTelat«d to the cleamip n'''"'*"g soil sampling removal of lead-cantaminated soil, aod restoration ofthe referenced proper^. 

If you liav» any quedions about the sdl cleans planned for your ptoperty, please contact Pmdeul's AdainidraHv* Clerk for the OmahaLeadSite cleann). Ms. Shannon Holt-at (402) 504-1004. General quedions about Aie Omaha Lead Site cleantq> canbe direcud to &e EPA Public InformationCenters at(402) 731-3045 (^outfa Om ^ office) or (402) 991-9583 (^ otthOmaha office). 

Property AccessGranted By: ' ^ '/T tO / ^ <=> 7/ ~ / T r" ^ ^ •*•? i^/ ­

/ (Please PiintNam^ 

Proper^ Owner Si^iatue: Q.\- TLo^' i 

'-^/(Sigaature) ^ y ^ ' - - iPaU) 

./*' PROPjgRTY MFORMATION 

(T* b« ctaapbtoi by zeslsDtaiid/trpTDf ortjr •vw r - f bas»f iwt ) 

RESIDENT NAKE:^^/vPt^>. UVg ^ f~l \c\ IB r Owner Renter 

RESIDENT ADDRESS: o " ^ 

sT •<^ H ^:^>:>,^ 10 3sV ^ Sj i Qii.L2ii:.^„_Ue_^§(I | 

IF RENTAL. PROPERTY OWNED BY: 

b 

OWHER'S MAILING ADDRESS; 

-M2^2U L^ 3.Slk__SL 

-y\. ^K.'^-.K \c^ 

OWNER'STELEPHONE NUMBER-HOME: J _ WORK W ^ ^ J \ 

AGE OF HOME?: Md YEARS. HOW LONG HAVE YOU LIVED HERE? YEARS. 

HAS THE EXTERIOR BEEN PAINTED OR COVERED Wmt SDING SINCE 19787 i YES NO 

NUHBER OF OCCUPANTS UNDER 7 YEARS OLD: HUMBER OF OCCUPANTS? YEARS OLD AHD OLDER 

NUMBER OF CHILOREN UNDER 7 YEARS OLD WHO PLAY M TTIE YARD FOR S HOURS OR HORE PER WEEK: 

J s 

CDHHEHT5 OR SPECIAL INSTRUCTIONS: (I.E. DOGS, ENTRY GATES. ETC.) 

< ^ 

y - ^ y / 

AUTHORITYTOREMyiKigfNNailTi^SSSPONSE.ACTIONS: Th* activities to be implemerted by EPA under this agreement 

atvpursuant to Section 104 ^CWCLk,'tfohC.9€^l EPA'Eii^«f acGesttoth»propeTtyisprovidedfcrisSeclionl04(e) of 

CERCLA, 42 US.C 9605(e), which provides ervrfoindeteiiiiiniiQtne'tifedfbr'tesponn actioa under tUs title, or otheiwise eoForcingthepioviatm ofthe tUe.' 

8080 Want Paitway, Suite 405 

Kaheap City, MO 64114 

Phone: (816) 363-3703 

FflX:(31£)3C3^707 

ZSOS N. z^T Street, Suite 308 

Omani^, Nebraeka 68110 

Phtfne: (402)504-1004 

'"Fax: (402)504-1005 

4242 HedicM Drtvei Surte42S0 

Sai Antonio. TX 78223 

Phone: piO) 822-9588 

Fax: (210)579-6577 

.Ty" 

• y ^ 
iRijn & AS - BUILT DRAWING 

OMAHA LEAD SUPERFUND SITE 

OLS#: 34009 

Date Excavated: 7/12/2008 

Date USEPA Signed-OfT: 

Name:

Phnn«­

ftn^S H->

 AlnO - aSX '

 Jc^ft^A^ 

 1- 5 V U 

Omaha LMd Site 

Stte Sketch 

Date:

Time;

 OT--U-0- b 

 t,'. Otsp^ ^ 

Nor* Am w 

Taam Ty^r-.t f< \CU<fc>^VU. BVID# -XMoAC^ XRF Code __£!^|^I_ 

Sample Number Lead Cotv»ntratfcin 

•2.\G±r ppm 

ppm 

Confirmation Sample 

fiYes ° 

-fni'ea a 

BiYes CD 

Yes a 

Yes • 

No 3 

—Ro~a -

No SB 

No 13 

No ( ^ 

No • 

No • 

(U 

NO f-ZOmahaLeadSite 46130 

CONTRACT #: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC. 
TIRUDEN' rECHNOLOGIES, INC. 

Property Status Form M^-^^ Address: Date: 

Phone: ^^^ , 5 | ^ <; BVID: 3'H o «=(^ 

Plants & Permanent Landscaping 

Item# 

On Map Description and Location 

f 

P2­

Pre-Existing Condition of Structures 

v ^ Does your Basement have a history of leaking? Yes No --

Item# Description & Location 

On Map 

\ 

^^yyy:p ^ 

Property Owner 

Signature: 

t y nPrudent Empl 

Signature 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraslta 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 
Name: Cni\ e V ^ VJQ-c.r,rr Omaha Lead Site Date: O ^ - U ^Ols North Arrow 

Address: <^?^•7.\ Kl-^sV^S.^ - Site SIcetch Time: t,'- D d p t^-. 

Phone: ^n^ - QS\ ­ 0.-5\U ^ 

Team ^^r..^^ft \cU<eAVL ^ BVID# '?.MOC\C^ XRF Code ^^c^ r 

Sample Number Lead Concentration Confirmation Sample 

No t3 (L^ •Ro~aOtYes n No K! 

^"^^^^^pp m %Yes a No ca 

f^vWf^ii/ i ppm 

No ISI 

ppm Yes n No a 

ppm Yes • JNo • 

Omaha Lead Site 46130 
Print http://us.mgl.maiLyahoo.coni/dc/launch? .rand=5crhjd8p^linoe 

• 

From: Langum, Steve M. (LangumSM@bv.com) 

To: Garvey.Daniel(^epamail.epa.gov; naga yalavarti 

Date: Thursday, June 26,2008 1:57:49 PM 

Cc: smudumala@prudentweb.com; Feild.Robert@epamail.epa.gov 

Subject: RE: BVID 34099, Address:4331 N 38th st. Prudent property list - 1st 100,2008 

Dan, drip zone composite sample result = 542ppm. 

Original Message 

From: Garvey.Daniel@epamail.epa.gov 

[mai Ito :Garvey.Daniel(a),epamail.epa.govl 

Sent: Wednesday, June 25,2008 4:58 PM 

To: naga yalavarti; Langum, Steve M. 

Cc: smudumala(a),prudentweb.com; Feild.Robert@epamail.epa.gov 

Subject: Re: BVID 34099, Address:4331 N 38th st. Prudent property list ­

1st 100,2008 

Steve - Can you please take a look at your records for 4331 N 38th 

Street and possibly sample the drip zone. Please let us know the 

outcome of your review. 

Thanks, 

Dan Garvey 

816-807-8802 (cell) 

naga yalavarti 

<naga_yala@yahoo 

.com> To 

Daniel Garvey/R7/USEPA/US@EPA 

06/25/2008 11:51 cc 

AM smudumala@prudentweb.com 

Subject 

Re: BVID 34099, Address:4331 N 

38th St. Prudent property list 

-1st 100,2008 

1 of 2 6/26/2008 2:32 PM 
Print http://us.mgl .mail.yahoo.com/dc/launch?.rand=5crhjd8palmoe 

Dan: 

The property sketch for the above referenced property has INVALID DRIP 

ZONE READING written for the drip zone sample (Sample Id 

#RDZSCPXA-34099). 

Ramita informed me that there is sod and aflower bed to the east and 

west ofthe drip zone respectively. 

Please advise 

Naga 

Cell: 913-424-0854 

2 of 2 6/26/2008 2:32 PM 
Name: ftn^^ H^ ^°-^«i ^ 

Address: i~,'h^\ >^'^'&V^^ ^ 

Phone: -Mna-t^sv - a^\ U 

Team ry>r..si^ \ck^e^H ^

Sample Number 

jg-PggrPJO^-^^^g'yf 

Omaha Lead Site 

Site Si(etch 

 BviD#_2.vy2_aa. 

Lead Concentration 

^^^^^'pp m 

,* ^ jS^Sv?^PPm 

ftX ^lfL^ptr\ ppm 

Ppm 

Date: O^-U-^C b North Arrow 

Time: ti-Ot;>p^ ^ 

^tTc^r XRF Code 

Confirmation Sample 

^ 

OiYes n 

%Yes a 

O'r'es tn 

Yes a 

Yes • 

NO (^ZOmaha Lead Site 46130 
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 

1612980000 

WAGNER 

RONNbl Ib 

M 

4331 N 38 ST 

OMAHA 

68111 

4331 N 38 ST 

OIVIAHA 

NE 

68111 

Sec-TwnRng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

05-15-13 

LANCASTER PLACE 

2 

20 

40X133 

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp? 

parc=1612980000 

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

accountno=R1612980000 

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 = 44 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis_alias/dogis/printPreview.aspx?PrintOptData=Douglas%20County-Omah... 6/12/2008 

^ 3 3 j N ^x^^^ J 
R16129800000001.jp http://douglasnejnapping-online.com/assessdoc/Photos/01/R161298. g (JPEG Image, 640x480 pixels) 

7/2/2008 11:37 AM lofl 
^^/o ^ 

mi yli'W 

f!k\ift.V»XmS4lirX-w.' 

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!»i^. ! ;•;"•»•'-••?•>•• 5. • • 




file:///C-/Users/lord''^is%20my%20shepherd/Desktop/STREETS/4. i°^ i 

Create Another Ticket ,1 Back tolrth Intemet Send Email 

YOUR TICKET NUMBER IS « 2077048. 

Original Call Date: 7/08/08 Time: 9:47 pm Op: RAMITA18967 


Work to Begin Date: 7/11/08 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 4331 Street: N 38TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 05-NE-SE 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remidation 


Location of Work: ENTIRE PROPERTY LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (4 02)504-1005 


: UNSURE CORNER 


Company 

Contact Name 

Alt. Contact 

PRUDENT TECHNOLOGIES 

RAMITA Phone:

Phone:

 (402)504-1004 

 (402)452-9806 

Work Being Done For: EPA 

Depth of Excavation: 6ft Corner Lot: 

Involves Tunneling or Horizontal Boring : 

CXCATV METRO MUDOl OMAHACOF 

N Front: Y

N Explosives: N 

0PPDGPR5 QLNNEIC 

 Rear: 

Utility Service Area Contact Phone Number Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4024572307 

METRO METRO COMM. COLLEGE CHRIS Alt: 4026727033 

Emerg: 4024572313 

Day: 4025047823 

METROPOLITAN UTILITIES 

MUDOl EDWINA Alt: 

DISTRICT 

Emerg: 4025047946 

Day: 4024447197 


CITY OF OMAHA- OMAHACOF R ON Alt: 4024445161 

TRAFFIC.SEWER 

Emerg: 4024445160 

OMAHA PUBLIC POWER Day: 4067289343 

0PPDGPR5 NA DISTRICT 

1 of2 7/9/2008 1.18 PM 
tlle:///C:/Users/lord''^is%20my%20shepherd/Desktop/STREETS/4.. l"^! 
 . 

Alt: 8887289343 


Emerg: 4067289343 


Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK NA Alt: 

Emerg: 8887289343 

2 of 2 7/9/2008 1 • 18 PM