SAID#: 29121

TRANSMITTAL OF OIVIAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

 DATE: 1/15 

ADDRESS: 1411 OHIO ST 

REMEDIATION CONTRAaOR: PRUDENT TECHNOLOGIES. INC. YEAR: 20ll^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

d PRE AND POST VIDEO OF PORPERTY (DVD) 

d EXECUTIVE SUMMARY 

EPA-PROVIDED PROPERTY SKETCH 

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 

m PHOTOGRAPHS 

dl AS-BUILT SKETCH 

SATISFACTORY RESTORATION SIGNED BY PROPERTY OWNER 

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 

D 

D 

D 

SIGNATURE DATE 

30218306 

Superfund 
PROPERTY SUMMARY 

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

Property Address: 1411 OHIO 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: 

F2 = 93 PPM @ 8"; 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-excavationagreement 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. 

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TECHNOLOGIES, INC. 

Property #: 7 "^ ^ 2- \ 

Date/Time: 

Quads Excavated; F'Z-— 

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EPA Property Close Out 

Property Address; t*^^* ^^^0 9t~, 

Owner's Name: C~>-*^yi, oS^ OvwiW\ 

Contractor Group: Prurient Technologies, Inc., 

Excavation General Yes No 

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

2. If necessary, 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? / 

3. Does tlie sod appear to be generally healthy and growing? (Only evaluate if inspected al a 30 

day time period) y 

4. Are sodded areas generalh' fimi and evenly graded? y 

5, Arc the joints between the sod suips generally tight? (Only evaluate if inspected at a 30 day y time penod) 

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

7. Was dainage lo landscapmg or plant materials avoided? y 

Gates, Fences and Retaining Walls Yes No 

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

2Were 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 windows avoided? y 

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

5. Was damage to downspouts or downispout extensions avoided? y 

Sidewalks and Driveways (Concrete) Yes No 

Wns dniuaoe to drivewav surfaces avoided'^ y^ 

2 Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

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

EPA Representative Q^ ?9^ ^Date: /2|g/ro 
;CHNOUXJIES. INC. AS - BUILT DRAWING 

OLS #29121 

Date Excavated: 10/07/2010 OMAHA LEAD SUPERFUND SITE 

ISEPA Signed-OfT Date: 

29121 

Omaha Exterior Paint Lead Site 

Site • Good Sketcli 

• Poor Sampling Address: I4i i OHIO ST [3^ Not paint 

Sample Number Lead Sample Samples Collected LAB Concentration Collected Firm: FDA- FP, CS 

RYASCPXA-29121 Fl i I 3 pom n Date: RY8SCPXA-29121 F2 HS O ppm n Time: \Z:oO prvv 

RYCSCPXA-29121 Bl Jj . ppm D Samples Analyzed RYDSCPXA-29121 B2 _lJ9LL_ppm I D nozcorxA 20121—ea­ ~ ppm n XRF Unit: CfSHZ Book: /*?3 

nczccpxA eoi2i—©g "~ ppm D Date: lO-OS-c n •RPZocpxAaoiai—P2- ~ pp m D D 

D D Time AtL 

Staff: Number of Samples = L n^vi LO_l 

Legend: Fl = Front Left, F2 = Front Right, Bl = Back Lett, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play All quadrants are as viewed from the street, facing property 

ENTERED 

OCTO: 1231!? 

iii i mo 

F2 = 93 PPM (fl- 8" 

.113 HBQ 

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Rev S Couted. 9.^4,0)07 M 15:13 

NO EASEMENT 

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

1 
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 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: 

Property Address: j^^ ^ ^j^, ^ .C-Zz-c^-f 

Owner: ^fL^ y H^U -

Phone: G 6/ty^/'WP^ ^ 

Restoration Items In Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Required corrections to complete the property: 

^ - 1 agree restoration is completed. 

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

yyy/yyjy^ Qr-()cy:>oi() 

rner's Signature (_/ Date 
Prudent Technologies, Inc. (Prudent) Is under contracl with the U. S. Environmental Protection Agency (EPA) to clean up leadcontamintted soils at a number oT properties located in Omaha, Nebraska, including the propeity located at 

/V/ / Ohii''^ SH-f<.t'T~ The EPA requests your peimisslon to allow Prudent to perform a soil cleanup at this 

property to remove lead-contaminated soil. By signing this foim, the property owner grants permission to Prudent lo perform 

activities related to the cleanup including soil sampling, removal of lead-contaminated soil, and restoration of the referenced propcit)'. 

If you have any questions about Ihe soil cleanup planned for your propeity, please contact Prudent south oflice .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 biformation 

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

Property Access Granted By: /i^/////q i^y //« ^-U^/H h 

(Please Print Name) 

Property Owner Signature: ^yy / S(ki'PO/0 

(Signature) (Date) 

PROPERTY INFORMATION 

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

RESIDENT NAME: Owner Renter 

RESIDENT ADPRESS: . 

?0 9 ^ -4«/L 

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 6 HOURS OR MORE PER WEEK: 


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


AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS; The activilici lo be implemented by EPA under this agreement 

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

CERCLA, 42 U.S. C 9605(e), which provides entry for "detemiining 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 6600 S 10 St 4242 Medical Drive, Suite 4260 

Kansas City, MO 64114 Omaha, NebrasKa 68107 San Antonio, TX 78220 

Phone: (816) 363-3703 Phone: (402)733-1188 Phone: (210)822-9688 

Fax: (816) 363-3707 Fax: (402)733-1883 Fax: (210) 579-6577 
29121 

Omah Exterior Paint North Arrow a Lead Site • Good Site SIcetch 

n Poor f Sampling Address: 1411 OHIO ST QNo t paint 

Sample Number Lead Sampie Samples Collected 

Concentration Collected Firm; PDA- FR DR 

RYASCPXA-29121 Fl ppm D Date: H 3 RYBSCPXA-29121 F2 ppm D Time: \Z:OQ py \ 

RYCSCPXA-29121 Bl ppm D

1? Samples Analyzed 

RYDSCPXA-29121 82 ppm D 

nDzoopXA 20121—ae- D D

"" ppm XRF Unit: CfSHZ Book: f^ 3 

nozocpxA aoiai—e s ' " ppm D D Date. lO'O S -c n 

npzccpxA aoiai—PS - " ppm 

D Time: A M n Staff: n^V i Number of Samples = i t LQJ 

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 flom the street, fating property 

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1 OHIO ST: 45X107.25 

A <ii—ats.. Printed: Dec 10.2010 

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Page 1 of2 

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Create Another Ticket Back to Irth Intemet Send Email 

YOUR TICKET NUMBER IS 2609473. 

Original Call Date: 10/05/10 

Work to Begin Date: 10/07/10 

Time: 

Time: 

4:37 pm 

5:00 pm 

Op: SIVA18967 

State: NE

Address: 1411 

 County: UGLAS Place: OMAHA 

Twp: 15N Rng: 13E Sect-Qtr: 10-SE 


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 MCINEB MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number 

Utility 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MCINEB MCI NO CALL PER 

MEMO 

Day: 8002893427 

Alt: 

Emerg: 8002893427 

MUDOl METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RICH/TRAFFIC 

Day:

Alt:

 4024447197 

 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/5/2010 
Page 2 of2 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

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

ENVIRONMENTAL 

ENGINEERING AND 

CONSTRUCTION 

SOLUTIONS 

SITE SAF*:TY EtAZARD ANALYSIS 

Address: tkLiU!)!^ ^ Excavation Date:^^=^^—^ 

Crew: --S^V^T ; [n ^ Backfill Date: lCJL:zKjli P 

Item Condition Hazards Corrective Action 

Overhead Lines 

Sewer Line 

Septic/Leecli 

Field 

/ ^ ^ Propane/Bntane )ry>c-7 ^ ^ ^ Sidewalk 

^ gj^^f^ Foundation 

i''\^' " ^ Retaining Walls 7^'r?i 

Fences T ~^E^ i 

Trees 

^-'0 ^ Structures Sft, 

O- Driveway 

Sprinkler System 

Other 

Crew Foreman Site Safety Office 

Date: 

^jhe^jUa^x yy .^2: ^:i_j^z^ 

8080 VKaitf BarioBay. Sute 405 5600810 St 4242 Medical Drive, Suite 72S0 

Kansas Gtty. MO 64114 Omaha, Ncbnsfea 68107 San Antonio, TX 78229 

Phone: 1816) 363^703 Plione: (402)733-1188 Plione: (210)822-.9588 

Fax:(816)363-3707 l^x: {402)733'1883 Fax: (210)579-6577