TRANSMITTA L of OMAH A LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID #: 3>'^?>4n Date: 

Address: ?^^9>^ U- ^^^ ^ ^ 

Remediation Contractor: Envrionmental Restoration, LLC_ Year: _2010_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

N Video of property (DVD) _'lS3efore DAfter D Basement ^ /i P mS/m^^uf^ 

L \ Executive Summary (Final Report) 

^ ^ EPA-provided property sketch 

a» Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

13- Restoration Agreement 

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

^S^ Confirmation data 

D Photographs jSLBefore DCrew Photos D Diu^ing Excavation D Sod 

^ 30-day Sod D 

X ^ As-buih sketch 

"Sv Completion Agreement signed by Property Owner 

l3v Property close-out check list signed by EPA 

D Description of areas not meeting ROD cleanup criteria 

^ Utility clearances 

\ ] Property information from Douglas County Assessor's Office 

S Property access checklist i' 

•v Contact Log ! 

D i 

Envirorunental Restoration Signature Date 

/i'ZZ,-/f -44EP^ A COR signature ~ X Date 
Omaha Lead Site—EP-R7-09-05 

I ^s^ y 8 Environmental Restoration, LLC 

www.ei11c.com 

: ^ 

EXECUTIVE SUMMARY: 

33347 - 3923 N 25 ST 

No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
ENVIRONMENTA 

RESTORATION 

PROPERTY CHANGE ORDER 

OMAHA LEAD 

Property ID # ^3J^ 7 

Property Address :^?^3 A/- PS'i^sUOwner Name S-^^^ks lUlf 

Date S'-fS-Zo 

Comments 

Owner of said property request that E.R. remove 

concrete sidewalk that's in the excavation area to 

access the B-1 quad instead of getting on the 

driveway. E.R. will not replace any concrete that was 

removed and is not responsible for any drainage 

issues due to removal of sidewalk. 

Owner Signature 

Contractor Signature 
-EPA 

EPA Property Close Out Form 

Omaha Lead Site 

Property #:_JWY^ _ Property Address: ^9>2> Ni- 9>5' f>T 

Date/Time: Owner's Name: S-h^JiT^-Vj t^ U 

Quads Excavated: fel Contractor Group : Environmental Restoration (ER) 

Excavation General Yes No 

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

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

Grading Sod and Vegetation Yes No 

1. Does the grading around the perimeter of the house in excavated areas generally slope away from the i / 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 30-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 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 Yes No 

Do gates open and close freely? (if applicable) 

2. Were all gates or fences taken down during restoration activities re-installed? (if applicable) i i ^ 3. Was damage to gates or fences avoided? (if applicable) 

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

Foundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? • " 

2. Was damage to the foundation avoided? k ^ 

3. Was damage to windows avoided? t ^ 

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

5. Was damage to downspouts or downspout extensions avoided? ^ 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? l ^ 

Was damage to walkway surfaces avoided? V Q ^n,,^<X A St«L.AaJ(L L CP^^^^P A ^y 

Mv g^y qgi^ci -^rXAk^ (^\c^^ A 

Inspection notes: 

O^&itt,\or Sdc l 

Remedial and restoration activitie ajitivities complet complete includin including 3(0-day sod warranty:

EPA Representativ tativeK^/^y^;;^:^^^^/-^ e , ^X.:?!^ Date: ZP 
Page I of2 

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

• YOUR TICKET NUMBER IS 255958 ^ 

Original Call Date: 


Work to Begin Date; 


State: NE 


Address: 3923 

Twp: 15N Rng: 13E 

Twp: Rng: 

Legal Given: C 


8/04/10 

8/06/lCf 

Time: 

Time: 

6 

7 

56 

15 

am 

am 1 

Op: TRACY24186 

County: DC 

Street: N 

)UGLAS 

25TH Sl 

Place: OMAHA 

Sect-Qtr 

Sect-Qtr 

04-SE 

Type of Work: Excavating the entire property 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)451-1069 

m SAID #33347 / 

Company ENVIRONMENTAL RESTORATION 

Contact Name TRACY BRISTOW 

Alt. Contact 

Work Being Done For: EPA 


Depth of Excavation: 12" Corner Lot: 


Involves Tunneling or Horizontal Boring : 


ALT872 CXCATV MUDOl OMAHACOF 


Service Area 

ALT872 WINDSTREAM COMMUNICATION 

CXCATV COX COMMUNICATIONS, INC 

MUDOl METROPOLITAN UTILITIES DISTRICT

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER 

Phone: (402)451-1314 


Phone: (314)504-4874 


N Front: Y Rear: 


N Explosives: N 


0PPDGPR5


Contact 

ELM LOCATING

HEIDI 

 SANDY 

RICH/TRAFFIC

 QLNNEIC 


Phone Number Utility Type 

Day: 4067289343 

 Ah: 4062071494 

Emerg: 8887289343 

Day: 4029340469 


Alt: 4029340469 


Emerg: 4029329757 


Day: 4025047823 


Ah: 


Emerg: 4025047970 

Day: 4024447197 


 Ah: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/4/2010 
Page 2 of2 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT

Day:

 ELM LOCATING Ah:

 4067289343 

 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK

Day: 4067289343 

 ELM LOCATING Ah: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/4/2010 
Contact InformatBon Log 

SAID#J33^?^ 

Owner's Name: SfrtrvU-r

Property Address: ^'\Z Z

 Uw U 

 M . i.S^^ ' 

Daytime Phone: V62,^ Tb'f­ //V o 

Attempt to contact Date/time 

ujivf^orxi CP ^t>*^^ 

Name 

/\.ct- Prt:6.1^ 

t-i)-)o '^'>^ A2>­

' 
Property Access Checklist 

SAID: J33V ? 

n WORK STARTED 

n WORKCOMPELTED 

Property Address: •aog^ Aj ^S"** •<"/• 

Owner: ^y^^[^ ^ \]^\ l 

Renter: 

Address: Phone: 

Fax: 

Cell/Pager: 

Additional Information: Phone: Vd<: \ To l - 1WO 

Fax: 

Cell/Pager: 

S^Access Agreement 

Signed: V / ZZ/ tO By: ZicJr^ fktiCl. 

iSl Restoration Agreement Signed: / / By: 

Q ^ Video Property Before On : V / 2Zrit> By: "V* ^ JL i^£6^je 

H^Digital Photos Before On '. H 1 ze. 1 lo By: 

<^.'.X fk6iU 

r~l Video Property After On : / / By: 

n Digital Photos After On : / / By: 

pQ Property Completion Agreement Signed: iS^/t^f/ to By: ^-0 

n Final Report Signed:

 / ./ IlL 

Additional Video or Digital Photo's Taken: 

D Video n Digital Photo On : / / By:

 1 

Reason: 

D Video D Digital Photo On / / By: 

Reason: 

D Video n Digital Photo On 

By: 

Reason: 

n Video n Digital Photo On / / By: 

Reason: 

Omaha Lead Project Work Plan Pagel of 19 
Consent for Access to Property SAiD# J3JV ? 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owmer), 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,: 

PURPOSE OF INVESTIGATION 

The purpose of the remedial activities is to remove all soils at the property which are 

contaminated with hazardous substances, in particular lead at concentrations greater than or equal 

to 400 parts per million (ppm). 

REMEDL^L 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 

envirormiental response; 

c. Planning and implementing the removal action on or near Grantor's property. 

d. Obtaining samplesfi-om Grantor's property; 

A.GREEMENT 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 of the Grantees or the environment, 

or to allow others to use the property in such 

Sl^r grant access to ray properties n I do not grant access to my properties 

^JLAydlJ <^^^-/^ 

Signature Date Signature Date 
Additional Comments / Instructions: 

Aa^t . c4hv ^ 4>vq-n: 

^c^ b / ^L;>\ACC 

0^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. 

Q^Ia; gree n I do not agree QT^ LJ I do not agree agree 

^JJV^ ^At/ C VZ^/s<?r 0 

Date Contractor's Signature riate ' 
Restoration Agreement 

The purpose of this agreement 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: 333C/ 7 

Property Address: 0 0 ^ « >• Zsr ^^' 

^""^^ ,^4^nl^v lA^W 

Phone: y^^N^ ^< ; . ^^^ ^ 

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 tlie direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log nimiber with an arrow indicating direction of view. 

Items to be removed by Contractor and not replaced: 

Page 1 of 2 
Additional Comments / Instructions: 

iCtlS/'Acc A:^ 

bz 

Q^! CH I do not agree I 11 agree n I do not agree agree 

Ldj / ^/-j;^-/^ fcrlV ^t'jt/^ tAcJt ^o/O 

Date Contractor's Signature 'Date' 

Attachments 

Page 2 of 2 
Property Completion Agreement 

This agreement documents the completion of remedial activities performed on my property. My 

signature will designat d( siffnatee that TI a amm satiant satisfieud VYH witUh LU thWe n^aiuianu restoratioun uiofm^y piupvuj property, and that no items are in

^•.— I.. 4.4.1 :* i;«4-„ j :J ^ question, —4 now, or at. an —y jjj^g jj^ ^j^g future, except those items listed below u^ i , if any

SAID: 3337? -

Property Address: J^^ S AJ. '^S' .5/--

Owner: ^ 4 (^^ y^/ ; 

Phone: ^^^\ ^ -^^g - / /c/p 

Restoration Items in Question: 

Item: 

item: 

item: 

Item: 

Item: 

Item: 

Additional Comments: 

J 

ISCIj agree restoration is completed, except as noted |\ | I agree restoration is completed, except as noted 

I I f do not agree restoration is completed I I I do not agree restoration is completed 

Owner's SignaMre'/ Date Contractor's Signature Date 
Douglas County Account Intbrmation Page 1 of2 

Douglas County, Nebraska Property Record - R1840440000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - Vle W O n Ma p Infonnation is valid as of 2009-12-31 Treasurer's Tax Report 

New Feature ->"->-+ Auto Sales Search 

Owner 

HALL JESSIE R 

ETAL 

3923 N 25 ST 

OMAHA NE 68111-0000 

Property Informatio n 

Key Number: 4044 0000 18 

Account Type: Residential 

Parcel Number: 1840440000 

Parcel Address: 

Legal Description: 

3923 N 25 ST 

OMAHA NE 68111-0000 

NORRIS SUB DIV LOT 6 BLOCK 0 42 X 100 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

Improvement 

$15,500.00 

$15,500.00 

$15,500.00 

$15,500.00 

$6,800.00 

$6,200.00 

Total 

$17,700.00 

$17,700.00 

$17,700.00 

$17,700.00 

$9,000.00 

$8,400.00 

Land Informatio n 

Acres 

0.09 

SF 

4200.0 

Units 

1.0 

Depth 

100.0 

Width 

42.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp ?accountno=Rl 8... 1/18/2010 
Douglas County Account Intormation f age 4^ ot 2 

}d23No 2Sll<» 

H i t 

\ tIZ am v Fb>^i«<l 

CLICK CLICK TO ENLARGE IMAGE TO ENLARGE IMAGE 

Square Footage: 1248.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Poor 

Built As: 1 1/2 Story Fin Condo Square Footage: 0.0 

HVAC: Forced Air Rooms: 7.0 

Exterior: Frame Siding Units: 1.0 

Interior: Plaster Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1910 0% 1910 100 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 856.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch Cvrd Wood Deck 153.0 

User Attic Full Finish 392.0 

User Source # 2.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp ?accountno=Rl 8... 1/18/2010 
ENVIRONMENTAL AS-BUILT DRAWING . 

'OMAHA LEAD SUPERFUND SITE( 

RESTORATION 

IIIII II IIIII! 33347 

Omah Exterior Paint North Arrow Owne a Lead Site r Name : JESSIE R HALL 

Sit • Good e Sketch Address : 3923 N 25 ST • Poor Phone : H 4»o2-451-483l w [y f Not paint 

Sat-nple Number Lead Sample Samples Collected LAB Concentration Collected Firm: 

RYASCPXA-33347 Fl 2,11 . f ppm 0" n Date: 

RYBSCPXA-33347 F2 1 12. ppm Q' D Time: 

RYCSCPXA-33347 Bl 4 Z 3 ppm 0 ' n Samples Analyzed RYDSCPXA-33347 82 Z 5 3 ppm \3r n RDZSCPXA-33347 DZ \HH n ppm cr n XRF Unit: 90 ^ Book: // S 

ppm n a Date: ^••z y ' ^q , 

RPiracrxA 33347 py — ppm n a Time: AM 

Staff: MS\^' Number of Samples -

Legend: Fl = Front Left. F2 = Front Right, Bl = Back Left, B2 = Back Right DZ •-

All quadrants are as viewed from the street, facin 

Drip Zone. GZ = Garden. PZ = Play 

EJ^TIEED 

SAID # 33347 

DATE EXCAVATED 8-13-10 

DATE EPA SIGNED OFF 8-25-10 

AREA SODDED 1160 SQ FT 

Quadrant axcavatad ^^^^ H Drip Zona EKcavatad Cofttatwlnittoo Laft Bahind 

/«»»»«..4.« M. C O D T A o n e 
l>y 

liilllillllMii 33347 ^ .Tc-s-iW \^^^' noi-lWO 

Omah Exterior Paint 

North Arrow Owne a Lead Site r Name: JESSIE R HALL • Good Site Sketch Address:3923 NJ5ST • Poor 

p"hone: H. 402-451-4831 W: 

[ ^ Not paint 

Sanrtple Lead Sample 

Samples Collected Number LAB Concentration Collected Firm: 

RYASCPXA-33347 F1 7-.i(.f ppm D I3ate: Os - l^.- 6£2 

RYBSCPXA-33347 F2 ni^ 

ppm D

Time: _J±jJ±o_^itCi 

RYCSCPXA-33347 B1 ppm 

D Samples Analyzed RYDSCPXA-33347 B2 Z63 ppm D 

ROZSCPXA-33347 DZ H -4 ppm D XRF Unit: 9Q ^ Book; // g 

%fii-3^347 G^ ppm n D 

Date: _ ^•zy ' aL ^ 

f—~~P? 

ppm n D 

Time: m. Staff: Number of Samples '• 

m^j 

Legend: Fl = Front Left, F2 = Front Right, Bl = Back Left, 82 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facin — "^ 

A£rt 

^iA<;u:ialk

pl^f 

 IS 

A H OVO^ ^ ^ 

a}c}r\ ^ r 

^\brx^-46^f^-^^ 

toyil t^*^pS 

v.o 

•^JX\' 

9:0 ­? - ^^•i^if"''^' d'Ori-p-ji^J^^---

A, 

J,n^uD<x\/ 

lllb ^ 

key 

0.(6141.013.1 \i. .%.^ . . .ST. 
llll nil! 111! 1 II 33347 

Exterior Paint North Arrow Owner Name: JESSIE RHALi^ Omaha Lead Site • Good 

Address: 3923 N 25 ST S'*® Sketc h • Poor 

Phone: H: 402-451-4831 W: 

0 ^ Not paint 

Sample Number Lead Sample Samples Collected LAB Concentration Collected Firm: p:t:>A j f<^\C N 

RYASCPXA-33347 Fl 0" ppm D Date: OS- !^ -6f e 

RYBSCPXA-33347 F2 ppm 12Z. 0' D Time: M'- Mo pu^ 

RYCSCPXA-33347 Bl iilX ppm 0^ D 

Samples Analyzed 

RYDSCPXA-33347 82 Z53 ppm 0 ' D 

RDZSCPXA-33347 DZ Q- IHH O ppm D XRF Unit: 9Q2 . Book: // 8 

-ReZ&ePXA-33347 GZ ppm a D Date: ^•T J ' 0( ^ 

RPZ3e-p)0^--'99»t?—p?: ppm D Time: AM 

Staff; Number of Samples • 

n 

m.j 

Legend; Fl = 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, facin ' —^ ' 

.Cone/­

•••••:d^'<j-: ­

•nnr; 

B).: 

113. 

b-n 

•> 

A 

•Oc\ b m 

^ -ft o»p>^ 

itrni 

.3^13.^3.5.ST 

•DZ. ;.i%'.^ , 

^ 

P2. 

ftvtit oar: P •hM^­

Iji.2—T 

V-UMLW!> W \^V^^ AAou/]b 

Rev 4 W-.2.-^, -sr 046141.012.3 
ENVIRONMENTAL XRF DATA ENTRY LOG 

RESTORATION 

SAlD#322i^a DATE 

PROPERTY ADDRESS TIME 

XRF S/N 

QUADRENT OR SAMPLE AREA 

DEPTH AVERAGE OF RESULTS 

redig 

D Fl 

D 

• 

F2 

Bl A. \\^^\ ^ 

a 82 

n DZ ^ \ \^t. Y\ 

a PZ 

n GZ 

D EZ1 Jk­ 27J~) ­ 2, ^ 

n EZ2 

a OTHER 

SAMPLER NAME <~-J>i.or>rrv.cA^ \3> 

C 

g \ lAW ^ 

-^1? o 

SHOT #s 

n-Z-\-lz.4 

-T-2ib--TZ.ft 

-I7g\. - -l-2>-2­
Thermo Fisher Scientific Thermo 900 Middlesex Turnpike 

Billerica, MA 01821 

SCIENTIFI C 

Index 1 imc WKUAI.i : VnDRKSS SA>M' l.i; ARI A pPI'.KArOR OKPi n NOU S SAID pi> 

1 2010-08-14 14:58 Avg of 729-731 3923 n 25 st EZ jimmy surface final clearance 219.86 ± 23.96 

2 2010-08-14 14:58 3923 n 25 st EZ jimmy surface final clearance 33347 219.19 ± 24.11 

3 2010-08-14 14:58 3923 n 25 st EZ jimmy surface final clearance 33347 216.33 ± 23.66 

4 2010-08-14 14:57 3923 n 25 st EZ jimmy surface final clearance 33347 224.08 ± 24.10 

5 2010-08-14 14:56 Avg of 725-727 3923 n 25 st DZ jimmy 8 final clearance 118.11 ± 19,10 

6 2010-08-14 14:56 3923 n 25 st DZ jimmy 8 final clearance 33347 131.45 ± 19.75 

7 2010-08-14 14:55 3923 n 25 st DZ jimmy 8 final clearance 33347 119.32 ± 19.25 

8 2010-08-14 14:55 3923 n 25 st DZ jimmy 8 final clearance 33347 103.57 ± 18.31 

9 2010-08-14 14:53 Avg of 721-723 3923 n 25 st Bl jimmy 4 final clearance 109.81 ± 18.79 

10 2010-08-14 14:53 3923 n 25 st Bl jimmy 4 final clearance 33347 114.98 ± 19.23 

11 2010-08-14 14:53 3923 n 25 st Bl jimmy 4 final clearance 33347 100.58 ± 18.12 

12 2010-08-14 14:52 3923 n 25 st Bl jimmy 4 final clearance 33347 113.86 ± 19.02 

Page 1 of 1 08/14/10 16:11:23 
3 s 

.

^.

- L r 

- -

­ r 1 r 1 

r 

1 r 

1 

^ 

•

1 

5: 60 3 

s I 1 I +1 +1 +1 

c5 > 

s 

0 --• 

<-> 

1 0 

r 

0 caX 

"So 1 

1

0 

i 

11 1 1 1 i, 1 1 1 1 i 1 1 1 1 ! 1, 1, 1 1. 1, 1