TRANSMITTAL OF OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 25823 DATE: 1/15 

ADDRESS: 2826 CHARLES ST 

REMEDIATION CONTRAaOR: PRUDENT TECHNOLOGIES. INC. YEAR: 201^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

d PRE AND POST VIDEO OF PORPERTY (DVD) 

[ / EXECUTIVE SUMMARY 

{3 EPA-PROVIDED PROPERTY SKETCH 

[Z SIGNED ACCESS AGREEMENT FOR SUBJECT PROPERTY 

D SIGNED ACCESS AGREEMENT(S) FOR ADJACENT PROPERTY 

{^''^RESTORATION AGREEMENT 

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

Q^'^CONFIRMATION DATA 

B PHOTOGRAPHS 

Ca^S-BUILT SKETCH 

0 ^ SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

•^PROPERTY CLOSE-OUT CHECK LIST SIGNED BY EPA 

D DESCRIPTION OF AREAS NOT MEETING ROD CLEANUP CRITERIA 

^UJ\UV f CLEARANCES 

\ y PROPERTY INFORMATION FROM DOUGLAS COUNTY ASSESSOR'S OFFICE 

D 

n 

A«>SL Zhjn 

SIGNATURE DATE 

30217602 

Superfund 
PROPERTY SUMMARY 

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

Property Address: 2826 CHARLES ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encountered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Other Relevant Information: weak foundation 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 175 PPM @ 2"; B2 = 240 PPM @ 3"; NO EASEMENT 

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-excavationagreementdetails(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. 

TECHNOLOCIES. INC. 
Find Record Remediation Query Lead Remaining Query ! Property Damage Query 

Backfill: 

Sample Area: 25823 - 2826 CHARLES ST 

Owner: 

D Owner Occupied 

Owner Name: 

JCTTY OF OMAHA 

Owner Addressl: 

!c/0"aTYFINANCE" 

Owner Address2: 

J1819 FARNAM ST 

City: State: Zip Code: 

JOMAHA INT J68183-

Owner Phone Alternate Phone: 

1(402) 441^150 

Contract: 

Qjntractor: fPRUDENT2010_S 

Contract Option JOPTION 2 

User Provided Owner Information 

Owner Name: 

f ' 

Owner Address: 

City: state: Zip Code: 

r 1 •••' ! 

Owner Phone: Altemate Phone: 

r .1 

Assessment: 

Qualifying Group |400 

Assessment Max XRF Value 493 ^ 

Resident: 

Resident Name: 

jLOT 

Property Address: 

U826 CHARLES ST 

Zip Code: 

168131-

Resident Phone 

r 
JSMMMl 

TTECHNOLOGIES, INC. 

Property #: 2-'?^' ^ ^ 

Date/Time: 

Quads Excavated: ^ (16> 2_ 

EPA Property Close Out 

Property Address: "Z ^2^^Wl^ > 

Owner's Name: C^"'^ 4^ Oty^''^ 

Contractor Group: Prudent Technologies, Inc., 

Excavation Genera) Yes No 

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

2. If necessary, were the correct areas of dnp zone excavated and restored? / 

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? / 

3. 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? y 

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

time penod) y 

6. Was the property graded such tliat water will not pool on the property? / 

7 Was damage lo landscaping or plant materials avoided? y 

Gates, Fences and Retaining WaUs Yes No 

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

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

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 tesx 

1 Was damage to tl^e siding or trim avoided? 

Was damage to tlie foundation avoided? r 

Was damage to windows avoided? 

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

5. Was damage lo downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) 

Ycs/ No 

I. Was damage lo diiveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? y
Owners comments: 

Inspection notes: 

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

EPA Representative Qc^M^ Date: n\is\m 
TTlNOI.OUIES. INC 

AS - BUILT DRAWING 

OI.SS 25823 

Date Kxcavated: 10/07/2010 

I SEPASigncd-OITOalc: OMAHA LEAD SUPERFUND SITE 

Name: L i +"v^ o 4 CVnaii?! Omaha Lead Site Date: North Arrow V 

Address "Z-'t^^'J,: OI.N^/t^ s S / Site Sketch Time: 

Phone: 

t 

,Mc^ 

Team Iv , |i i> »i-S//te> .n v l'y'Uc.JSN\U # ^t>f t ^ XRF Code S ^ SS'f h 

Sample Number Lead Concentration Confirmation Sample 

/ ; Yes D No 0 ^ ppm 

ppm /-, Yes D No B ^ 

ppm /% Yes • No Q> ' a Vy9 »S8a3 j n ppm ^^Ye s n No C r 

ppm Yes D No O 

ppm Yes C) No Q 

ppm Yes D No • 

•.f::: » I •*>! 1 1 ^ 

| - r-." •5'3 /4i'/<^'it»-<Stjj 

• " ^ xM.. im... 

1 ^ . 

.lAX. 3y. 151 = 175 IM'M a 2" H2 = 240 I'I'M a 3" 

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Omaha Lead Site 46130 

CONTRAa #: EP-S7-10-05 PRUDENT TECHNOLOGIES, INC. 
'^M ^ BOM 

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 of the 

subject pi'opcity, 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: 

Property Address: c^Ub ci.xu , y 

Owner: r'// | Y ^,X;../.J 

Phone: '- '(0)- '-/VV '(j^ij 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

0 I agree restoration is completed. 

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

' \ / ' • I'yf r ( ,•• / / . / • / u 

Owner's Signatu ;t \:y.y^- Date 

y 
Prudent Technologies, Inc. (Prudent) is under contract with Ihe U. S. Environmental Protection Agency (EPA) to clean up Icadconjj|ninated soils at a number of properties located in Omaha. Nebraska, including the property located at 

r<j>/- The EPA requests your permission to allow Prudent to pcrrorm a soil cleanup at this ^S2jt^ propcrtyl6 remove Icnd-contaminatcd soil. By signing this Torm, tjic properly owner grants permission to Prudent to perfonn 

activities related to Ihe cleanup including soil sampling, removal of lead-contaminated soil, and restoration ofthe rercrcnccd property. 

If you have any questions about the soil cleanup planned for your property, please contact Prudent south ofTice .for the Omaha Lead 

Site cleanup-at (402) 733-1188. General questions about the Omaha Lead Site cleanup can be directed to the EPA Public Infonnation 

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

Property Access Granted By: AV///^ ^ H'C-cU/Tn h 

I? (Please Print Name) 

Property Owner Signature: s'-i/^yyj/O 

(Signalun;) (Date) 

PROPERTY INFORMATION 

(To be completed by resident and/or properly owner -- please print) 

f^ESlDENT NAME: Owner Renter 

RESIDENT ADDRESS 'r\..A.^ Rt fiN^^i^ lOb ^«'I f2 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

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

KHO^\ ^NH ' ^(jf-iy 

AGE OF HOME?: YEARS. HOW LONQ 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 INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETC.) 

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

are pursuant to Section 104 of CERCLA, 42 U.S.C. 9604. EPA'sright of access to the property is provided for in Section 104(e) of 

CERCLA, 42 U.S. C 9ft05(c), which provides entry for "determining the need for response, or choosing or taking any response action 

under this title, or otherwise enforcing the provisions of the title." 

8080 Ward Parkway, Suite 405 SSOOSIOSt 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)822-0588 

Fax: (816) 363-3707 Fax: (402)733-1883 Fax:(210)679-6577 
Name: C t "^vi o n OtwattA Omaha Lead Site Date: North Arrow —i 

Address: -^^TJ ^ ^ a^^^ /^s S t SKe Sketch Time: 

Phone: t 

Team UJ .|1 i»viV/K>WA „ /S«/|WLBVID # 2,5& 23

Sample Numtier 

Lead Concentration 

-J2Z 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

 XRF Code ^ <?S ^ 

Confirmation Sample 

/ ; Yes D

Yes n 

,3/ Yes CJ 

&_Yes n 

Yes D 

Yes n 

Yes D 

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Omaha Lead Site 

46130 
i. 2826 Charles st. 

A T^^* " 

Printed: Dec 08. 2010 

www.dcgis.org/dogis 
Page 1 of2 

" > 

Create Another Ticket ) Back to Irth Intemet Send Email 

YOUR TICKET NUMBER IS 2609454. 

Original Call Date: 10/05/10 

Work to Begin Date: 10/07/10 

Time: 

Time: 

4:31 pm 

5:00 pm 

Op: SIVA18967 

State: NE 

Address: 2826' 

County: DOUGLA 

Street: CHARLES ST 

UGLAS S Place: OMAHA 

Twp: 15N Rng: 13E 

Twp: Rng: 

Legal Given: C 

Sect-Qtr: 16-NE 

Sect-Qtr: 

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 LEVEL3 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Pbone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVELS LEVELS COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 


OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICH/TRAFFIC Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/5/2010 
IBOHNOLOi^B, mc. CONSTRUCTION 

SOLUTIONS 

SITE SAFETY HAZARD ANALYSIS 

Address: 212J^ cUJ^ ^L Excavation Date: 

Crew: BackfiU Date: — 

Item 

Overhead Lines 

Gas Line 

Water Line 

Sewer Line 

Septic/Leech 

Field 

Propane/Butane 

Sidewalk 

Foundation 

Retaining WaUs 

Fences 

Trees 

Structures 

Driveway 

Sprinkler System 

Other 

Crew Foreman 

Condition Hazards Corrective Action 

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Site Safety Office 

Date: 

ten WvtfVortamy. Suite 405 isaoosiost 4242 fifedical Drive, Suits 7250 

(amasCi|ly;MO«4ll4 Owafaa. MttorjUka 00107 San Antonio, TX 78229 

ifianK (SK) Ses-STOS Plioiw: (4aZ)733-11tt Phone: (210) 822-«588 

:«K:f»tS)36»4707 Fax: (402)733^t8«3 Fax: (210)«r9-6577