TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 36076 DATE: 12/15/2010 

ADDRESS: 2115 BROWNE ST 

REMEDIATION CONTRACTOR: PRUDENT TECHNOLOGIES. INC. YEAR: 2010 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

6 PRE AND POST VIDEO OF PORPERTY (DVD) 

EXECUTIVE SUMMARY 

EPA-PROVIDED PROPERTY SKETCH 

SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

n SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

RESTORATION AGREEMENT 

a SETTLEMENT DOCUMENTS (I.E., FOR DAMAGE OR TO REPLACE PLANTS, ETC.) 

A CONFIRMATION DATA 

b PHOTOGRAPHS 

AS-BUILT SKETCH 

SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

A PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

UTILITY CLEARANCES 

c4 PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

D 

<b^ ^ ,\isW 

SIGNATURE DATE 

30218590 

IIHI 

Superfund 
Find Record 

Baclcfill: 

Remediation Query i Lead Remaining Query j Property Damage Query 

Sample Area: 36076 ­ 2115 BROWNE ST 

Owner: User Provided Owner Information Resident: 

D Owner Occupied 

Owner Name: 

jCTTY OF OMAHA 

Owner Addressl: 

ja O QTY RNANCE 

Owner AddressZ: 

J1819 FARNAM ST 

City: 

JOMAHA 

Owner Phone 

1 

State: ZipCode: 

(NE" " |68I¥3-

Alternate Phone: 

'i 

Owner Name: 

Owner Address: 

r~~— 

City: 

I 

Owner Phone: 

State: Zip Code: 

r 

Alternate Phone: 

Resident Name: 

JBJORGAARD DENNIS 

Property Address: 

|2115 BROWNE ST 

Zip Code: 

J68110-

Resldent Phone 

Contract: Assessment: 

Contractor: PRUDEfiTZOlO S Qualifying Group J400/CHiLb 

Contract Option jOPTION 2 Assessment Max XRF Value j 649.39 
PROPERTY SUMMARY 

Date: 12/15/2010 Omaha Lead Site Reinedial Action Contract # EP-R7-07-06 TO#l Month of: December 

Property Address; 2115 BROWNE ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

B2 = 54 PPM @ 4"; EA = 63 PPM @ SCRAPE (~1") 

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) Property Status Form signed by property owner 

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

photographs 

iv) Signed form verifying satisfactory restoration 

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

TECHNOLOGIES, INC. 
TECHNOLCXJIES, INC. 

Property #: 3 ^ C>TQ? 

Date/Time: 

Quads Excavated: ^"2— 

EPA Property Close Out 

Property Address.: ZI^"^ SrooS ir^^SrH 

Owner's Name: C i<+<>v> o«!rOrvuJ(Wfl{ 

Contractor Group: Pnident Technologies, Inc., 

Excavation General Yes No 

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

y 

2. If necessiiry. 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 y from the house? 

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

1 Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day lime period) ' y 

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

5. Arc 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 tliat water will not pool on the propert)'' 

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

Gates, Fences and Retaining Wails Yes No 

1. Do gates open and close freely? (If appUcable) 

/ 

2. Were all gales or fences taken down during restoration activities reinstalled? (Ifapplicable) / 

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

4. Was damage lo retaining walls avoided? (Ifapplicable) y 

Foundation, Siding and Gutters Yes No 

1 Was damage to the siding or trim avoided? y 

2. Was damage (o the foundalion avoided? y 

Was damage lo windows avoided? y 

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

Was damage to downspouts or downspout extensions avoided? / 

Sidewalks and Priveways (Concrete) 

Yes v-No 

Wa Tf s damage to diivcwav surfaces avoided'^ 

2. Was damage lo walkway surfaces avoided? 
Ovners coinments: 

Inspection notes: 

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

EPA Representative ^ ^ •^n^ ^Date: ,iUi\io 
ra CHNOLOGIES. INC. 

AS - BUILT DRAWING 

OLS # 36076 

Date Excavated: 10/20/2010 OMAHA LEAD SUPERFUND SITE I SEPA Signed-Off Date: 

Oinaha Lead Site Data. <\m\^ ^ Nortti Arrow 

Address: ^ " Site Sketch Time: A ol ^ 

Phone: 

Team j^M L BVID# ^iaOlC y XRF Code ^^^ VSample Number Lead Concentration Confirmation Sample 

/S^^i 9 

ppm OVes CD No 5 ^ 0>^i/ ¥ +ZYes • No ^ 

ppm ftiYes d No raf. 

ppm DiYes n No ^• ­

ppm OT.Yes n No ^ 

ppm Yes a No n 

ppm Yes • No • 

ppm 

.ji ­

/« 

—-y^i— - ^ 

U2 = S4 PPM a 4' 

-; 1 4 f ^9^n '' 

£7£ k/£>^A^ ^ 

.i a\^ 

^ ^ . %V ..'.%;. - }­

K ^'^'?t$ 3 

..q^ K \ . . ^ 

\ 

- s ^ 

• -pl ­ ~rr 

pr­

; p ^ f\ ^^'T. \i^4.t/e 

I Vi- U.»t.' ^^ U J 'Y f\ t2i<B^u7Mi|f: 

'^(^VV/ ^ ij _ 

EA = 63 PPM a SC RAPE (~1") 

Omaha Lead Site 46130 

CONTRACT #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
SEPA 

Property Completion Agreement 

This agreement documents the compietion of removal activities performed on the below listed property. 

The property owner's signature indicates that the property owner is satisfied with the restoration of the 

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: [^^0^6 

Property Address: ;2nr /3/\QUA/£- Sr/jf-^-y 

Owner: ^v/U ,; T L/^-vY^l^ 

Phone: ^ ^oj^(^W- HJi V/-

Restoration items in Question: 

Item: 

item: 

Item: 

Item: 

item: 

item: 

Required corrections to complete the property: 

L ^ I agree restoration is completed. 

L J I do not agree restoration is completed at (noted deficiencies above) 

'^-'//ji,<^„4(/-J'oio 

Owner's SIgl Date 
Pnidcnl Technologies, Inc. (Prudeni) is under contract with the U. S. Environmental Protection Agency (EPA) to clean up Icadconlaminated soils al a nutnber of properties located in Omalia. Nebraska, including the propeny located at 

J Ii r fnoi^yyf- >S^"«-' / The EPA requests your permission to allow Prudeni to perrorm a soil cleanup at this 

property to remove Icad^contaminated soil. By signing this fomi, llie property owner grants permission to Prudent to perform 

activities related to the cleanup including soil sampling, removal of lead-contaminated soil, and restoration ofthe referenced propeny. 

Ifyou have any questions about the soil cleanup planned for your property, please contact Prudeni south office .for the Omaha Lead 

Site cleanup-at (402) 733-t 188. General questions about the Omaha Lead Site cleanup can be directed to the EPA Public Information 

Centers at (402) 731-3045 (SoutJi Omaha office) or (402) 991-9583 (North Omaha office). 

Property Access Granted By: i^lHlAi ^ L.iyU(li y 

(Please Print Name) 

Property Owner Signature: ..JMHH ^ S-Qc-i-JuiO 

(Signature) (Date) 

PROPERTY INFORMATION 

(To bc completed by resideni and/or property owner ~ please print) 

RESIDENT NAME: Ovi^ner Renter 

RESIDENT ADDRESS lESS; : 

/vt^*- 3di 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

OWNER'S TELEPHONE NUMBER - HOME: J L WORK: 

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

HAS THE EXTERIOR BEEN PAINTED OR COVERED WITH SIDING SINCE 1978? YES NO 

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


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


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


AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS; The activities to be implemented by EPA under Ihis agreement 

are pursuant to Seclion 104 of CERCLA, 42 U.S.C. 9604. EPA's right of access to the propeny is provided for in Section 104(c) of 

CERCLA, 42 U.S. C 960S(e), which provides entry for "detennining the need for response, or choosing or taking any response aciion 

under this title, or otheru'ise enforcing the provisions of the title." 

8080 Ward Parkway, Suite 406 5600 S 10 St 4242 Medical Drive, Suite 4260 

Kansas City, MO 64114 Omaha, Nebraska 68107 San Antonio, TX 78229 

Phone:(816)363-3703 Phone: (402)733-1188 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)733-1883 Fax: (210) 579-6577 
ItpHAi^ 

Name: Dsinnb honopohcj Omaha Lead Site Date; 3M 02> North Arrow 

Site Sketch Time: 

: _iL2 j Address 

Phone: 

\ 

Team -ftl^^ BVID# T-laOKo XRFCode. 5-^^ / 

Sample Numtier Lead Concentration Confirmation Sample 

^^/ ^ f 5 Spm 

flYes

-P^Yes

WYes

BiYes

OlYes

Yes

Yes

 ° 

D 

n 

° 

 t^ 

n 

• 

No E ^ 

No 5 ^ 

No E T 

No E > 

No tS^ 

No CD 

No • 

Omaha Lead Site 46130 
Page 1 of 1

an 5 e-^M^o ^4-

SEPTEMBER 2008 - DOUGLAS COUNTY ASSESSO 

http://douglasne.mapping-online.com/assessdoc/Photos/03/R20049000000001.jpg 10/5/2010 
211

5 BROWNE ST: 53X108 

A Printed

: Dec 03, 2010 

www.dcgis.org/dogis 
Page 1 of 1 

"> 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2609460. 

Original Call Date: 10/05/10 Time: 4:33 pm Op: SIVA18 967 

Work to Begin Date: 10/07/10 Time: 5:00 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 2115 Street: BROWNE ST 

Twp: 15N Rng: 13E Sect-Qtr: 03-NW 

Twp: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: SOIL LEAD REMEDIATION PROJECT 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)733-1883 


: UNSURE CORNERS 


Company : PRUDENT TECHNOLOGIES 


Contact Name: SIVA JAMPAMA Phone: (402)733-1188 


Work Being Done For: EPA 


Depth of Excavation: 6 FT Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Nuinber Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICHATRAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNE 1C QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/5/2010 
ENVIRONMENTAL 

ENGINEERING AND 

CONSTRUCTION iscMNoui^BS, mc. SOLUTIONS 

SITE SAFETY HAZARD ANALYSIS 

Address: -3iijEJ2ir.r^i:N£-S ^ 

Crew: ^)^^!5v^ v 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining Walls 

Fences 

Trees 

Structures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

^^y^ 

Condition 

Cs:i6y>A 

bun^A 

\ 

< i y 

^/h 

A//A 

^c.- ^ 

V^r­

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'^0 6 rQjoaS 

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Excavation Date: /^^^^^^^ ^ 

Backfill Date: .^^Z^CLU ^ 

Hazards 

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Corrective Action 

*P\vvAJOci«N 

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Site Safety Office 

Date: 

._^-—<^.i.2 ^ 

8080 WHtf^eaftany. Suite 4<B seoosiost 4242 Medical Drive, Suite 72S0 

ICansas Cl|y;iia«4114 Omalia, Nabiasica 68107 San Antonio, TX ^229 

Rwne: (818) 36S47Q3 Phone: (402)733-1188 Phone: (2t0) 82Z-S688 

Fax: (8W)i363>'3707 Ptac (402)733^1883 Fax: (210)579-6577 

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