TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: ^(-t^S'TO Date: ^-V-V V 

Address: 3 ^ ^^ ti-c c <f«f- "SV-, 

Remediation Contractor: Envrionmental Restoration, LLC_ Year: _2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ Video of property (DVD) JZ^efore DAfter D Basement D 

JZl Executive Summary (Final Report) 

EPA-provided property sketch 

J2A Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

2i Restoration Agreement 

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

CK Confirmation data 

JZl Photographs ^ j Before DCrew Photo^^0T)uring Excavation D Sod 

J^O-day Sod D 

^ As-built sketch 

jA^ Completion Agreement signed by Property Owner 

^ Property close-out check list signed by EPA 

D Description ofareas not meeting ROD cleanup criteria 

j A Utility clearances 

J2[ Property information from Douglas County Assessor's Office 

J Z Property access checklist tFuva I ^po^ ) 

30261901 

jA ^ Contact Log 

J ^ \JcLrQ/\-f /^ A Superfunc 

Envirotimental Restoration Signature Date 

EPA COR signature ~y ^ Date 
EPA 

EPA Property Close Out Form 

Omaha Lead Site OU#2 

Property #: ^t,sfs Property Address: 33a* I><a.for 

Date/Time: Owner's Name: Loij/s ^-f^ic j 

Quads Excavated: f?^,[H DP Contractor Group : Environmental Restoration (ER) 

Excavation General Yes No 

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

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

Grading Sod and Vegetation Yes No 

^ house? 

2. Has sod been laid in all areas that were excavated? 1 ^ 

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? .y ^ 

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? *y 

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

Gates, Fences and Retaining Walls Yes No 

1. Do gatesopen and close freely? (ifapplicable) 

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

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

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

Foundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? 

2. Was damage to the foundation avoided? \}[}^<UiM± I n 

3. Was damage to windows avoided? f^ 

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? m 

2. Was damage to walkway surfaces avoided? A^ 

Inspection notes: 

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

EPA Representative: ^^JAJ^J L AA/d^yW^^JLy ^ ' Date: ^-^/j . '^aA 
\ Omaha Lead Site—EP.R7-09-05 

t^H^tf ^ ' Environmental Restoration. Lt,C 

V ^ www.erllccom 

EXECUTIVE SUMMARY: 

26590 3320 DECATUR ST 

No Issues or Concerns Q] Issues/Concerns 
rage i ot z 

"> 

[ Create Another Ticket ] [ Back to Irth Internet ] Send Email 

YOUR TICKET NUMBER IS 2678075. 

Original Call Date: 3/03/11 Time: 7:50 am Op: ADAM24186 


Work to Begin Date: 3/07/11 Time: 8:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3320 Street: DECATUR ST 


Twp: 15N Rng: 13E Sect-Qtr: 16-NW 


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 


: 26590 


Company : ENVIRONMENTAL RESTORATION 

Contact Name: ADAM 

Alt. Contact: 

Phone:

Phone:

 (402)451-1314 

 (636)288-9616 

Work Being Done For: epa 

Depth of Excavation: 24in Corner Lot: 

Involves Tunneling or Horizontal Boring : 

CXCATV LEVEL3 MUDOl OMAHACOF 

N Front: N 

N Explosives: N 

0PPDGPR5 QLNNEIC 

Rear; 

Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVEL3 LEVEL3 COMMUNICATIONS, LLC NA Ah: 

Emerg: 8773668344 

Day; 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY MUD Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITYOFOMAHA-TRAFFICSEWER RICH/TRAFFIC Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 3/3/2011 
rage zoi z 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day:

 Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK

Day: 4067289343 

 ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://vvww.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 3/3/2011 
Contact Information Log SAID#^^'5'?o 

Owner's Name = Lo^is Kc,r.ks 

PropertyAddress: JfJJ^O ib^cft-ft^ r -T/ -

Attempt to contact Date/time Name 

5/^n^c^ /^r7-/ o ^ 
Property Final Report 

SAID: J)CfiS'?0 D WORK STARTED ON: l_ 

Property Address: J? ^ J o ^^^^^^ ^ j-f' n WORK COMPELTED ON: /_ 

Owner • C-aoi s ?<TK< 5 Renter: 

Address: 3^0 5 P<^r)c-fr Phone: 

Fax: 

Cell/Pager: 

Phone: SS3'UU ^ Additional Information: 

Fax: 

Cell/Pager: 

IB Access Agreement Signed: ////7 / ' C> Byil^O 

[ y Restoration Agreement Signed: /^ / / 7 / ' o By= ^ 0 

^ \ Video Prbperty Before On -.IL/K/IQ By: J 6 

i ^ Digital Photos Before On :iL/l^/iII By: J 6 

n Video Property After On :_/_/ _ By: N/A 

[ D Digital Photos After On : / / By: 

L0Propert y Completion Agreement Signed:-^ iJj A 1 If By: ^ 

n FinalReport Signed: / / By: 

EXECUTIVE SUMIVIARY 

Omaha Lead Project Work Plan Page 1 of 19 
% 

Consent for Access to Property SAID# DO£JO 

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'sName: Loui s B<i/\I<S Daytime Phone: S S 3Of0> y 

Address: 3JPO OccJ^ r .r/- 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 v^dth 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 ofthe Grantees or the environment, 

or to allow others to use the property in such 

IS I grant access to my properties 

Q I do not grant access to my properties 

VAAIAA JB^^^^^/^ ^ 

Date ll-* f^^ 0 Signature 

Date 
Additional Comments / Instructions: 

gpAff+y LJO ^ 

• Check 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 11 agree n I do not agree [~11 agree n 1 do not agree 

Owner's Signature Date Contractor's Signature Date 
% 

Restoration Agreement 

The purpose of this agreetnent 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: ^QS7 0 

PropertyAddress: 3:^S>0 b<(<fh r M -

Owner: ^^^; ^ l^c^^ksr 

Phone: S^S-J'OfC^ 

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: 

2al^c^ u^(4K So J 

Kem: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 1 of 2 
% 

Additional Comments / Instructions: 

5 ^ I agree n I do not agree f/Tl agree CH I do not agree 

^/^iZ^L.,^»^ggy^}^^^^- ^ ^^i>uc^dbbw ^-2^-1C\ V 

Owner's Signature Date / I — /7 - / O 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 future, except those items listed below, ifany. 

SAID: J^OS? 0 

PropertyAddress: -p^^ p ^c«t4o r s 4 

Owner: <^qw.r "go^id-S 

Phone: XTj?- ^ C^^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Kem: 

Kem: 

AddKional Comments: 

I agree restoration is completed, except as noted jA\ \ agree restoration is completed, except as noted 

I I I do not agree restoration is completed LJ I do not agree restoration is completed 

ner's Signature 

SAy^^nMl-^.zi/:^..// 

Date Contractor's Signature "»• Date "
^.'''isSf'iJT'-;^" bree People Search | WhitePages Fage I ot Z 

WhitePages 

Find People | Find a Business 

Or search: 

• Last name only 

• I Metro area 

Lewis Banks Is this you? Edit 

3325 Parker St 

Omaha, NE 68111-4152 

(402) 553-6163 

Age: 65+ 

Mary J Banks, 

Household: Brigitte L Baskin, 

Cody Banks, 

Know me? Ask me to update my listing D 

Focresl &i«!«tl» St Lawn 

Patricli Cemetery Lindsay AW , Ave 

ffi««!6St etc 

Parktw St 

Xi&fj&ai SI 

Id - i 

0 } c Fr;)nl>iif> St I K 

% S«*af d SI 

© 2010 Microsoft Corporation © 2010 NAVTEQ © AND 

Name popularity and name meaning for first name Lewis and last name Banks. 

http://www.whitepages.com/search/FindPerson7firstname begins with=l&firstname=loui... 8/20/2010 
uouglas i.;ounty Account iniormation rage i oi z 

Douglas County, Nebraska Property Record - R1640040000 

Information is valid as of 2010-8-16 

New Feature ->->-> 

Print Reoort 

View Interactive GIS Mao 

Treasurer's Tax Report 

Subdivision Sales Search 

Owner 

BANKS LOUIS 

ETAL 

3325 PARKER ST 

OMAHA NE 68111-0000 

Property Informatio n 

Key Number 4004 OOOO 16 

Account Type: Residential 

Parcel Number. 1640040000 

Parcel Address: 

Legal Description: 

3320 DECATUR ST 

OMAHA NE 68111-0000 

LOWES ADD LOT 8 BLOCK G E 40 FT 40 X 127.5 

Value Informatio n 

2010 

2009 

2008 

2007 

2006 

2005 

Land 

$800.00 

$800.00 

$800.00 

$800.00 

$800.00 

$800.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$800.00 

$800.00 

$800.00 

$800.00 

$800.00 

$800.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.11 5080.0 0.0 127.0 40.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R16... 8/20/2010 
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http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=Rl 6... 8/20/2010 
ENVIRONMENTAL AS-BUILT DRAWING 

I OMAHA LEAD SUPERFUND SITB ^ 

RESTORATION 

26590 

Omah Exterior Paint North Arrow Owner Name: LOUIS BANKS a Lead Site

Sit • Good e Sketch Address: 3320 DECATUR ST • Poor 

Phone: ": 402-553-6163 Vt. rpJNot paint t 

Sampl Lead Sample Samples Collected e Number LAB Concentration Coiiected 

I 

Firm 

RYASCPXA-26590 F1 ppm n Date 

RYBSCPXA-26590 F2 

S7g ppm D Time 

RYCSCPXA-26590 B l ppm n 

Samples Analyzed

RYDSCPXA-26590 B2 ^Z-7 ppm D 

RDZ3CPXA>20Ci9G &S- ppm n XRF Unit: I O 3 1 Book: / 3 Z 

RG2SCPXA-26590 GZ ^ 0 2- ppm D Date D /^-/3-^-S' RPg8CPXA-20090 PS- ppm n .Time ^y n 

Staff:

Number of Samples •• D ^-A 

Legend: F l = Front Left, F2 Front Right, B l = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

ENTERED 

s;rP t 8 2895 

|.EfiEttC 

Quadrant axcavatad Drip Zona Excavated CotitawinaMon LaW Bahtnd H 

Zv^\a*m0^9*f0a0^*^m^^^\ 0^^*.^»^*>#%* « 11 ^ /^#^r«^^^« U. C O 0 7 AA AC 
liiiiiiiiiiiiiiiiii 26590 

Exterio North Arrow Omaha r Paint Owne Lead Site r Name: LOU'S BANKS 

Site Sketch • Good Add ress: 3320 DECATUR ST • Poor Phone: ^ 402-553-6153 W: 

[^''^Not paint f

Sample Number Lead Sampie Samples Collected LAB Concentration Collected Firm. //^t. ^ < i Ac**^ 

RYASCPXA-26590 F1 29 / ppm D 

Date: fA^'v/as' 

RYBSCPXA-26590 F2 512 . ppm 

D Time: 

RYCSCPXA-26590 Bl 

3(/? ^ ppm D Samples Analyzed RYDSCPXA-26590 82 iAZ I ppm i D

r!DZOOrXA-2G590 B2­ ppm D XRF Unit: I03 1 Book: 132. D RGZSCPXA-26590 GZ ^OZ . ppm D Date: // ? -/3-< 9 5 " [Zf RPZ3CPXA-20590 P*- ppm D .Time: /=>/>} D 

Staff: ^ A Number of Samples = S 

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 

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Rev 4. 0461410123 
26590 

Omah Exterior Paint North Arrow Owne a Lead Site r Name: LOUIS BANKS • Good Site Sketch Address: 3320 DECATUR ST • Poor 

Phone: H: 402-553-6163 W: 0^^Not paint f

Sample Number 

RYASCPXA-26590

RYBSCPXA-26590

RYCSCPXA-26590

RYDSCPXA-26590

RDZ3OPXA-20590

RGZSCPXA-26590

KPZ3CPXA-20590

 Fl 

 F2 

 Bl 

 82 

 B2­

 GZ 

 Pir 

Lead 

Concentration 

Z^ i ppm 

512 . ppm 

^4 ^ ppm 

tAZ l ppm 

ppm 

ppm 

ppm 

30 Z 

Sample 

Collected 

\A, 

K

K

d 

D 

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n 

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Samples Collected 

Firm: ^^t< J c iAc** ^ 

Date 

Time 

y/^«//^s -

Samples Analyzed 

XRF Unit: /<?5 7 Book:

Date: /Q-l'j-OS' 

.Time: ^/} 1 

 \3 Z 

Number of Samples •• Y'\ _ Staff: ^ A 

Legend: Fl = 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 

/i^^ r 

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5^X 

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27/ 572 

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Rev 4. 046141 0123 
ENVIRONMENTAL XRF DATA ENTRY LOG a 

RESTORATION 

SAID# 2i=5ClO DATE •5 \ "Xx W 

PROPERTY ADDRESS TfME 

^'2>ZO 'C><:^A »j<~ . S-r 

XRF S/N 3Sr73o 

QUADRENT OR SAMPLE AREA 

DEPTH AVERAGE OF RESULTS SHOT#s 

redig 

• F2 4 \«i ^ \ \ ^\tf^-Zie< > 

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n DZ 

n PZ 

n GZ 

a EZl - ^ <*-2-t V'^ 7r7M­ r-7-7 

n F7? 

n OTHER 

SAMPLER NAME 
Thermo Fisher Scientillc Thermo 900 Middlesex Tumpike 

Billerica, MA 01821 

SCIENTIFI C 

-VVKKACK ADDUKSS SAMI'l,K AUI.A OI'KUAI OU 

1 2011-03.09 09:38 Avgor274-276 3320 decaiur st EZ JIMMV surface linal clearance 

2 2011-03-09 09:38 3320 decatur st EZ JIMMY surfece Bnal clearance 

3 2011-03-09 09:38 3320 decatur st EZ JIMMY surface final clearance 

4 2011-03-09 09:37 3320 decatur st EZ JIMMY surface linal clearance 

5 2011-03-09 09:34 Avg of 270-272 3320 decatur st B2 JIMMY final clearance 

6 2011-03-09 09:34 3320 decatur st 02 JIMMY final clearance 

7 2011-03-09 09:34 3320 decatur st B2 JIMMY final clearance 

g 2011-03-09 09:33 3320 decatur st B2 JIMMY final clearance 

9 2011-03-09 09:32 Avg of 266-268 3320 decatur st Bl JIMMY final clearance 

10 2011-03-09 09:32 .1320 decatur st Bl JIMMY final clearance 

11 2011-03-09 09:31 3320 decaiur st Bl JIMMY final clearance 

12 2011-03-09 09:31 J320 decatur st Bl JIMMY final clearance 

13 2011-03-09 09:29 Avg of 262-264 3320 decaiur si F2 JIMMY final clearance 

14 2011-03-09 09:29 3320 decaiur st F2 JIMMY final clearance 

l.'i 2011-03-09 09:29 3320 decatur st F2 JIMMY final clearance 

16 2011-03-09 09:28 3320 decatur st F2 JIMMY final clearance 

61.91 ± 14.37 

26390 60.21 ± 14.34 

26590 65.38 ± 14.62 

26590 60.13 ± 14.13 

33.22 ± 12.85 

26590 36.09 ± 12.86 

26590 26.70 ± 12.20 

26590 42.86 ± 13.48 

20.23 ± 11.38 

26390 25.20 ± 11.72 

26590 24.22 ± 11.82 

26390 <LOD 1: 115.92 

<LOD 1: 116.26 

26590 <LOD 1: 15.56 

26590 24.12 ± 11.63 

26590 <LOD 1: 113.77 

Page 1 of 1 03/09/11 14:04:33 
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