TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: ^ ^^^ U Date: /2/^/ >ooS 

Address: 'h m S /Life^ .SA 

Remediation Contractor: /^,.py^. h ^tJ>, ^,<f^A,^^ ^JIV... Year: 2^o f 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

n Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

V Confirmation data 

Photographs 

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 infonnation from Douglas County Assessor's Office 

D 

40309557 

D 

D Superfund 

-.9am JLkf OUK 

Signatuq^ 
PROPERTY SUMMARY 

Date: 12/20/2008 Omaha Lead Site Remedial Action Contract # EP-R7-07-06/0004 Montii of: Nov/Dec. 

Property Addreas! 3718 PARKER ST 

A. EXECUTIVE SUMMARY 

A.1 Issues Encowitered: NONE 

A.2 Issues Resolved: NONE 

A.3 Unique Findings: NONE 

A.4 Odier Relevant Infonnation: NONE 

CONFIRMATION SAMPLING DATA/RESULTS: 

Bl = 351 PPM @ 7"; B2 = 179 PPM @ 11"; EA = 109 PPM @ SCRAPE. 

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 chp/photographs 

4) Post-Excavation digital video chp/photographs 

5) Documentation - Completed Close-out Checklist 

6) As-Built sketch ­

i) Shall includefinal lead levels v) Legend 

ii) Contamination left behind areas vi) Contractor identification 

hi) 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) 

u) Property Status Form signed by property owner 

hi) Excavation digital video m MPEG, WMV (Wmdows 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. 
Find Record Clean Up Query Lead Remaining Query I Property Damage Query 

Bacicfill: 

Sample Area: 89996 ­ 3718 PARKER ST 

Owner: Resident: Contract: 

n Owner Occupied 

Owner Name: 

CTTY OF OMAHA 

Owner Addressl: 

C/0 OTY FINANCE 

Owner AddressZ: 

1819 FARNAM ST 

City: 

OMAHA 

Owner Phone: 

(402) 444-5180 

Zip Code: 

|68183 

Altiernate Phone: 

|(402) 444-6140 

Resident Name: 

Property Address: 

3718 PARKER ST 

Zip Code: 

168111 

Resident Phone 

r 

Contractor: 

PRUDENT2008_S 

Group: 

Assessment: 

Qualifying Group 

|800" 

Assessment XRF Date: 

Assessment Max XRF Value: 

I 808' 
TECHNOLOGIES» INC &EPA 

EPA Property Close Out 

Property #: g-'^l'Jfc Property Address: il' ^ foi/^/i -

Date/Time: Owner's Name: 

Quads Excavated: 1^' / ^ i^ Contractor Group Prudent Technologies 

Excavation General Yes No 

1. Ifnecessary, were the correct qiiadrant(s) excavated and restored? / 

2. If necessary, were the correct areas of drip 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? 

y 

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 fmn and evenly graded? / 

5. Are the joints between the sod strips generally tight? (Only evaluate if mspected at a 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? y 

Gates, Fences and Retaining Walk 

Yes No 

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

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

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

4. Was damage to retaining walls avoided? (IfappUcable) / 

Foundation, Siding and Gutters 

Yes No 

1. Was damage to the siding or trim avoided? 

/ 

2. Was damage to the foundation avoided? / 

3. Was damage to windows avoided? / 

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

S. Was damage to downspouts or downspout extensions avoided? / 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? 

/ 

2. Was damage to waUcway surfaces avoided? 

y 
Owners comments: 

Inspection notes: 

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

EPA Representative Ga^ j^. ^ Date: ///ja/o» 

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

J . The EPA requests your permission to allow Prudent to perform a soil cleanup at this 

property to remove lead-contaminated soil. By signing this form, ttie property owner grants permission to Prudent to perform 

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

If you have any questions about the soil cleanup plaimed for your property, please contact Prudent Administrative Clerk for the 

Omaha Lead Site cleanup. Ms. Deborah Johnson -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: <1 /»^ S \/jAy/i £ C "' ^ T^layiH^" ^ 

f ' ^ease P?(nt Name) 

Property Owner Signature: 

(S^tuic) (Date) 

PROPERTY INFORMATION 

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

RESIDENT NAME: Owner Renter 

RESIDENT ADDRESS: 

KJ>^ 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS; 

81- Ji4r n^g> M^G«'iV 

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

-i 1 : 

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 INSTRUCTIONS: (I.E. DOGS, ENTRY GATES, ETCJ 

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's right of access to the property is provided for in Section 104(e) of 

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

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

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax:. (402) 504-1005 Fax:(210)579-6577 
>iiS -vBUILT ©RAWING X y.| 

OMAHA LIAD,ISUyEELEpyp,SfIIli ;^ OLS#: 89996 

Date Excavated: 10/16/2008 

USEPA SIpted-OffDate: 

89996 

Exterior Pant 

Q Good 

Omaha L^ad Sit* 

6ita Sketch n Poor 

Samplina Addrasa: 3718 PARKER 3T [gf Not paint } 

Sample Numt)er Lead Sample Samples Collected LAB Concentration Collected Firm: FDA Fg->gVt/ 

RYA8CPXA-S990e Fl 1.61 —ppm D Date: 10 - */-=o£ T 

RYBSCPXA-A9996 F2 _£a_pp m a Time: 2:oopi^ RYCSCPXA-B9g06 Bl _f±2iL-PPni a Samples Analyzed RYOSCPXA-809e6 B2 0O & own n 

RBasePMiMSSM BZ- pcm XRFUnM: Book:

i ~ D (^^Hl . /9 3

nozoopwh Bopoo—e» D __n__PPm n Date: \p-\7.'O l

RPZOOPXA-OOOOft • M D

D D Time: ^ L

Mumber o( Samples • Staff: MSW .Qj 

Legend: F1 - Front Left, F2 = Front Right, Bl == Back Left, B2 - Back Right OZ " Drip Zone, GZ « Ganlen, PZ > Play 

Al <)U(ilranK « • M wMid komttMUnM. fkcng pnpeity 

e £|^TBREb 

ocro d^di; i4Tf 8^d 

t>\ ez 

© 

Bl=3SlPPM(a7'* I 

3718 r*«r* 

6 

e>. 

.Fl. f t 

/r/. ' \ % 

f^Ai^.sT ; Htx i !.•««€* oCtSKlT II IS:I j 

^^•:*r.v;''<fc"3 I'.lf..^'.'** fc>^.«>iir) 

EA = 109 PPM®SCRAPE 

CONTRAa «: EP - R7-07-06 / 0004 PRUDENT TECHNOLOGIES, INC. 
ENVIRONMENTAL & 

CONSTRUCTION 

TECHNOLOGIES, mC. SERVICES 

Property Status Form 

Address: ^Hg - *fo.r\c ^ «S*t- Date: 

Phone: BVID: 

Plant & Permanent Landscaping To Remain In Place 

Item# 

Description and Location 

On Map 

Pre-Existing Condition of Structures 

Does your Basement have a history of leaking? Yes — No 

Item# Description & Location 

On Map 

Property Owner^ ^ ,4^C>J^ A Prudent Employee 

Signature: ^ - > / Signature: 

8080 Ward Parkway, Suite 405 250514724'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Om«na, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 

Fax: (816) 363-3707 

Phone: (402)504-1004 

Fax: (402)504-1005 

Phone: (210)822-9588 

Fax:(210)579-6577 
•V I 

sampling Address: 3718 PARKER ST_ 

Lead Sample Number Concentration 

RYASCPXA.8M96 Fl 

RYBSCPXA-8p996 F2 

RYCSCPXA^ )996 Bl 

RYDSCPXA-8)996 B2 

RDZoopxA'Owee—B» 

WQBBePXA 0 WOO OZ 

nPZOOPXA9>9Q6 PZ 

3± 

jn^ gQg 

Omaha Lead SKo 

€ite Skatch 

Sample 

I 

LAt Collected 

ppm D 

ppm a 

ppm n 

ppm n 

ppm D D 

ppm D 

ppm D a 

Numt>ero Samples: 

Exterior Paint 

• Good 

n Poor 

[ ^ Not paint 

Samples CoKtcted 

Firm: FO A Fig ^ikL 

Date: ID - H ­

i > i 

T.me: Z'Q O ^tei 

Samples Ana yzed 

XRF Unit: (mf^Hl . Dook: |^ S 

Date: 10-^-^ 2 

Time: Pfl 

Staff. MSW 

89996 

tarthAirow 

\ 

Legend: Fl « Froijt Left. F2 = Front Right. B1 - Back Left, B2 = Back Righ DZ» Drtp Zone. GZ = Ganfen. PZ^ Play 

Ali)UBdrart I areas viewed from the UteeLtair) property 

I ^ EJlTBRBb 

acToisai? 

\ 

I 

3718 f^«rter Sr 

6> 

I i FZ": 

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i. 

.j?Aiti<€^.s:n. Rw 5 Cnecd: tfM^U r 11:15:15 046141.0123 
Page 1 of 1 Print Preview 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner 

City 

Owner 

State 

Owner 

Zip 

1925720234 

CITY OF 

OMAHA 

3718 

PARKER ST 

OMAHA 

68111 

C/0 CITY 

FINANCE 

1819 

FARNAM ST 

OMAHA 

NE 

68183 

Sec-TwnRng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website 

Unk 

Assessor 

Website 

Unk 

17-15-13 

ORCHARD HILL REP NO 7* 

0 

2 

60X130 

http://webapps.dotcomm.org:8080/Trea8Tax/face8/pages/taxinfo.jsp? 

parx;=1925720234 

http://do uglasne. ma ppingonline.com/DouglasCoNe/statlc/accountinfb.jsp? 

accountno=R1925720234 

Disclaimer Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch a 80 fset appraisal, survey, or for zoning verification. 





Page 1 of2 

"> 

Create Another Ticl<et Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2149455. 

Original Call Date: 10/07/08

Work to Begin Date: 10/09/08

 Time: 11:50 am 

 Time: 12:15 pm 

Op: RAMITAl8967 

State: NE 

Address: 3718 

County: DOUGLAS 

Street: PARKER ST 

Place: OMAHA 

Twp: 15N Rng: 13E

Twp: Rng:

Legal Given: C 

 Sect-Qtr: 

 Sect-Qtr: 

17-NE 

Type of Work: lead remediation project for soil 

Location of Work: LOCATE ENTIRE PROPERTY 

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


: UNSURE CORNERS 


Company : PRUDENT TECHNOLOGIES 


Contact Name: RAMITA Phone: (402)733-1455 


Alt. Contact: 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 MCLEODNE MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Utility Service Area Contact Phone Number Type 

Day: 4029340469 


/-v/- A TM COX COMMUNICATIONS, HEIDI Alt: 4029340469 CXCATV ^ ^ 

Emerg: 4029329757 


Day: 8002891901 


NO NEED TO CALL OUT MCLEODNE MCLEODUSA Alt: EMERGENCY 

Emerg: 8002891901 

Day: 4025047823 


METROPOLITAN UTILITIES MUDOl SANDY Alt: DISTRICT 

Emerg: 4025047946 


Day: 4024447197 


CITY OF OMAHA- OMAHACOF RON Alt: 4024445161 TRAFFICSEWER 

Emerg: 4024445160 


http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/7/2008 
Page 2 of2 


Day: 4067289343 


Alt: 8887289343 
 0PPDGPR5 XSCT"^'^'''"'''^^^ NA 


Emerg: 4067289343 


Day: 4067289343 


QLNNEIC QWEST LOCAL NETWORK NA Alt: 


Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 10/7/2008