TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: _351k^_ _ Date: A'xfi H . ^QU 

Address: MC^ ^ KJ M6> " ^ 

Remediation Contractor: Coastal Environmental Group_ Year: _2010ARRA_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

!J Video ofproperty (DVD) 

D Executive Summary 

D EPA-provided property sketch 

0 Signed Access Agreement for subject property • 

U Signed Access Agreement(s) for adjacent property 

D Restoration Agreement 

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

D Confirmation data 

D Photographs 

D As-built sketch 

D Satisfactory restoration signed by Property Owner 

D Property close-out check list signed by EPA 

n Descriptionofareasnot meeting ROD cleanup criteria 

D Utility clearances 

• Property information from Douglas County Assessor's Office 

D 

D ^ '_ 

D 

30217696 

INHIi 

Superfund 
vv 

Property Access Checklist 

Property ID: 3^ 1 U ^ 

Property Address; HQ;^^: ^ M^ S 5 T 

n

n

 WORK STARTED

 WORK COMPELTED

 ON: __/__/_ 

 ON: __/__/_ 

Owner: /^A Irrtl

Address:

Same 

Phone: q,<^S'- Fax: 

ftuft^ 

* 

 ROCL^ 

Renter: 

Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

Cell/Pager: 

n Notification Letter 

Kl Access Agreement 

[jS^Kestoration Agreement 

D TopsoU Sampling (if applicable) 

Q Disposal Sampling (if applicable) 

D Garden Sampling (if applicable) 

S Utility Clearance 

IZl Video/Photos (Before) 

D Video/Photos (During) 

n Video/Photos (After) 

D Video/Photos (30-Day) 

Sent: / / 

Signed: (2_//ci//Q 

Siened: 3 / ^ I l O 

I I 

1 I 

1 I 

CaUed:0H/3m/\0 

On: 7 lU_ll O 

On: / / 

On: / / 

On: / / 

By: 

By: 

By: OcmV/o 

By: 

By: 

By: 

By=OH^/io UJtrrlvj 

By:/yVc/ < 

By: 

By: 

By: 

Q Property Completion Agreement Siened: / / By: 

n Final Report Issued: / / By: 

Air Monitorine (as applicable) 

CD Community D Crew 

Results: 

On: / / By: " I 

O Community

Results: 

D Crew On: / / By: 1 

Q Community

Results: 

D Crew On: / / By: 

Omaha Lead Site 
DtSuglas County Account Info: Page 1 of2 

Douglas CountY/ Nebraska Property Record - R I 129100000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VIe W OH Ma p Information is valid as of 2009-11 -19 Treasurer's Tax Report 

New Feature ••"•" • Auto Sales Search 

Owner 

BYERS TIMOTHY W 

ETAL 

4023 N 45 ST 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number: 2910 0000 11 

Account Type: Residential 

Parcel Number: 1129100000 

Parcel Address: 4023 N 45 ST 

OMAHA NE 68104-0000 

Legal Description: FONTENELLE PARK LOT 267 BLOCK 0 1/2 VAC ALLEY ADJ & 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$4,200.00 

$4,200.00 

$4,200.00 

$4,200.00 

$4,200.00 

$4,200.00 

Improvement 

$55,300.00 

$55,300.00 

$55,300.00 

$55,300.00 

$25,600.00 

$23,200.00 

Total 

$59,500.00 

$59,500.00 

$59,500.00 

$59,500.00 

$29,800.00 

$27,400.00 

Land Informatio n 

Acres 

0.1 

SF 

4680.0 

Units 

1.0 

Depth 

117.0 

Width 

40.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 11/24/2009 
<• Douglas County Account Info: na^^ n Page 2 of2 

•023 M « ST 

itm^ 1 * • • 

L. -^ 

F»it floor '*• Mr 1001.0 s<). a 

J

h • or 

ibtt I * 

Bstrrt Btoct 8 ft ino s« ^ «e 

1 ^(2 STORY 

CLICK TO ENLARGE IMAGE 

Square Footage: 1369.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Fioorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1922 1922 87 

Detail Type Detail Description Units 

Add On Fence Chain Link 1.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 816.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch End Screen 160.0 

User Attic 1/2 Finish 163.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 11/24/2009 
• • 

"> 

Page 1 of 1 

i[ SendEmajr ] 

YOUR TICKET NUMBER IS 2496418. 


Original Call Date: 5/18/10 Time: 5:01 pm Op: ELIZABETH18790 

Work to Begin Date: 5/20/10 Time: 5:30 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 4 023 Street: N 45TH ST 

Twp: 15N Rng: 13E Sect-Qtr: 05-SW 

Twp: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: LEAD REMEDIATION 


Location of Work: LOCATE ENTIRE PROPERTY, ALL EASEMENTS AND TO THE PEDESTAL 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNSURE IF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: COASTAL 


Depth of Excavation: 4 FT Corner Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICH/TRAFFIC Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 


QLNNElC QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 5/18/2010 
"> 

Page 1 of 1 

Create Another Ticket Backto Irth Internet i [. Send Email ] 3E 

• YOUR TICKET NUMBER IS 2474022. 

Original Call Date: 4/24/10 Time: 3:29 pm Op: ELIZABETH18790 


Work to Begin Date: 4/28/10 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 4023 Street: N 45TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 05-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: LEAD REMEDIATION 


Location of Work: LOCATE ENTIRE PROPERTY, ALL EASEMENTS AND TO THE PEDESTAL 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNSURE IF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: COASTAL 


Depth of Excavation: 4 FT Corner Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

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 


OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 


Day: 4067289343 


QLNNEIC QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/24/2010 
As-Built Drawing 

COASTAL Omaha Lead Superfund Site CMVIRONMENTAL C • O U P . IN C 

OLS#: 33168 

Date Excavated: 5/17/2010 

Date USEPA Signed Off: 6/24/2010 

Area Sodden: 1539 sa ft 

r Name: ///>i^// y >i3^^,rS Omaha Lead Site Date: NoithAmiw 

Address: V^9^ ^ A" V.5 ^ -T?' Stte Sketch Time: IF ^^j / 

Team /lc>..^y P^^K^ h^OjJ^ BviDt Sy/C^f ^ XRF Code \%0L^ 

Sample Number Lead Concentration Confinnation Sample 

P-YAScPxA-~?3ifef 

ppm 

r/Yes n No ^ R.VfiSCPxA~?7l^ 7 

ppm 

ft?Yes n No/5 

;S/Yes • RyDScfxA-3?ir^ 7 

ppm No -ej 

ppm 

9?Yes CD No- ^ RDZ5cPyA~3H/> g 

ppm pares CD No 12 

ppm 

Yes CD No CD 

ppm Yes a No • 

EA=110PPM 

ysfqi^+j^Ti^ 

Omaha Lead Site 

4<130 

Legend 

Concre'te m Drip Zone Excavated Quadrants Excavated 

Area replaced with WT% Area replaced with 

Area left bare 
 Sod 

Rock/Mulch 

Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 

CApo.r iA . OM/9f > 

Name: /(/y\j»H' y ^y^^ 5 Omaha Lead Site Date: North Arrow —i 

Address: '%?;i. ^ /[/ V^ ^ >"/ Site Sketch Time: mr 

Phone:Vi32Vrv5~- ^ ^ 9 3* i 

Team /^2c>,vv^//^t.^ A W . BVID # SS/^ f XRF Code 11^ OQSample Number 

Lead Concentration Confirmation Sample 

, ^ « .• iWAScPxA-?3tfe f 

ppm r/Yes ° 

No - ^ ^^F ppm NoJ ^ 

ppm :9/Yes n 

No /Q lR.yn^cfxA'3?i6 7 17.3 1 -2-3" 

ppm ^TYes ^ No 'E? 

ppm P2i"es CD No ^ 

ppm Yes n No • 

ppm Yes • No D 

y 

i/< I 1 1 ^ \ y i i I -^^ 

3h 

Omaha Lead Site 

<>(£) Ho S 46130 
• • 

late ijx^jo j North Arrow —i 

Address"~^A3 / /< ^ ^' • - " Site Sketch ime: 5.3<£> 

Name: /lry\y^^\ / ^v/<^S Omaha Lead Site Date: :

Time; 2IE^^^ Phone:V()^VXg-- ^ <^ 9 J* -^i 

If^fiO 

Team /2a.^v^//^W ^ Ad^ . BVID # IS/^ f XRF Code /?^o ^ 

Sample Number Lead Concentration Confirmation Sample 

f^YAScPxA-?3ifc^ 

R.VftSCPxA--?3l^ ?

? 

Ryr^scfxA-3?i67 

RDZ3cPyA-33i/> ? 

1X3 1-^3 PP"^ 

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 CD 

tn 

n 

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No • 

Omaha Lead Site 46130 
• • 

Omaha Lead SH* Date: NwthAnow - I 

StteSkatch Time>: : 3.3g > 

Phone:va;ji/3rg-- <? <g<? ? jk 

i;^ii/ 

Team /£x.^/i4t>7y^a^ ^ BVID # SS/^f ^ XRF Code. i?>0<^ 

Sample Number Lead Concentration Confirmation Sample 

pyAScPxA~3?it>? ppm f/Yes CD No ^ 

RVRS<:.PyA-T3l^ | ppm <^e8 CD 

RV£.<C ^ -211' ppm ^/Ye s CD No -ej gvrv^r,PxA-3ir?; ES 7 ppm 9*yes CD No>ei gr>z.-scfyA-33ife? ppm jaates CD No 0 

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Omaha Lead Site 46130 
y:?2*c::;'^ COASTAI 

Consent for Access To Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: "^-^ / / c y 

owner's Daytime Phone: Name: (^Hol^yJilZ S •^^)A-4S^>P 93 

Address of Property 

covered by this 

Agreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, v/ill contact 

the Grantor in-person to discuss the work to be performed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work 

before it begins. Once the work is finished, the Grantor will be asked to review the worit 

and confirm that it is complete and meets with the Grantor's approval. Upon 

completion, the Grantor will receive written documentation from EPA that the property 

has been remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of performing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
'•i 

COASTA L 

(IIVI«eilH(KT>t 

C « 0 U r IK C '*r y 

( Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

e Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

( Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial waterinjg period by EPA; 

t Abide by health and safety guidance provided by EPA; 

< If the property is rented, assist EPA in obtaining tenant approval for access to 

the property to perfonn the work. 

» Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the wortt activities, or with any 

of the work done, or with the equipment lised on his property, or to undertake any 

acftions 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 a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (402) 991 -1199 

iJ grant access to my properties D i do not grant access to my properties 

Signature Signature Date 

D i would like to be present during any sampling that is requiried. 

Page 2 of 2 
C OASTA L • NVinONMIMTA L O II O U » , INC . 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation 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). 

Property m: :^a,^af t 

Property'Address Address: L\Q2J? Ll(\Tf, > Nl M S S V

Owner: 

<!orfll ftjarsPhone: 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access location(s) to be used by the contractors. Indicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

Items to be Removred by the Owiler before Start of Remediation: 

The removal storage, disposal, and/or retum of these items is the Owner's responsibility. 

Hem: 

i4tU f^<JlA(.t h^\V^' 

Kem: 

?U^ ^ »\A^CW CiA^2^t(U^^ -

Hem: 

Kem: 

Items to be Removed by the Contractor During Remediation and Not Reolaced 

Hem: 

A^oi^i^ 

Kem: 

Kem: 

Kem: 

Page lof J 
C OA S T A L 

tNVinONMaNTAL o a o u p. INC . 

Items to Be Removed B L Contractor During Remediation and Reolaced 

Kem: 

Kem: 

Kem: 

Kem: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

tiiuik diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Nimiber of and si2e of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Easement Area, to be 

excavated 

Quantity 

t=jp,t>z. 

3 

? 

^i' 

A 

/ 

^ BS 

Landscape Inventory 

Unit ConditionH'ype/Species 

Quadrants 

Each 

Each 

Each 

Each 

Square Feet 

$ 

Each -f^wJ.^ y^^ -

Page 2 o,A 
C OAST A L • NVIMOMMBNTAL O a O U P , INC . 

AddKional Comments / Instructions: 

The city of Omaha ordinances may prohibK you from using dirt or gravel areas on your property 

as driveways or vehicle parking areas. The Environmental Protection Agency (EPA) may be 

removing and repiacing soii underlying a gravei or dirt area on your property that you may be 

using as a driveway or vehicle parking area. If this is the case, you should understand that this 

removing and repiacing of soil does not mean that any illegal driveway or parking area on your 

property is made legal. To the contrary, you may be cKed by the cKy if you use a gravei or dirt area 

as a driveway or parking area, not wKhstanding any removal or replacement of soil by the EPA 

If you have any question about legalKy of a certain driveway or parking area, you may contact 

the cKy of Omaha's Planning Department at (402) 444-5150. 

Q Please check this box if you understand the information outlined above. 

^ W\hYiKi^ W ^ J tee /^u ^ ) CL^^^MuS '^ l 

D Check the box if Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By checking th|s box CEG is not responsible for any damage done to the 

interiorjsf house, including foundation cracks or fissures. 

n I do not agree 

>f/M^) i^/9//y ^ CAf^oj^is^^u 3Ni ^ 

Owner's Signatuiy^ Date Contractor's Signature Date 

Page 3 of / 
• 

BVID# g3/6/ ^ 

XRF PROPERTY SAIVIPLE SHEET 

CfOl^^ / v '-cs~ ^^—" 

am/pm 

30 sec 

Reading Sample area 

Bl 

^•yz^-h- Depth 

^Stj-i^ 1±_ ^9^ ^ ^X{ p 

Reading Sample area 

/pyt N Sd=­ i/bt/y Depth 

//phi^ / r r^ 

 f/D ^J ^ 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Date 

Project 

XRF ID# 

Shot# 

m 

Hz^ 

f3 

Average

Shot# 

m­

<$o 

SX 

Average

Shot# 

Average 

Shot# 

Average 

h^-r^> 

Omaha Lead ARRA 

Reading 

l(oSl>/A 

ir/i^iE­ m t i« 

 /( p 7^/ ^ 

Reading 

^ ^ ^ / ^ 

/ ^ ^ \ ^ 

I'^TJ- (9­

/ ^ t J-11 ^ 

Reading 

Reading 

Sample area 

P^ 

Depth 

^ " 

Sample area 

tl^L 

Depth 

mi. 

Sample area 

Depth 

Address 

Sample time 

sample length 

Shot# 

HS-

Mk 

•dlL 

Average

Shot # 

"^3 

S: 

Average

Shot# 

Average 

RETEST AREAS 

Sample area Shot# 

Depth 

Average 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 44 

Mode SOIL 

Time 2010-06-05 10:25 

Duration 90.33 

Sequence Final 

Flags 

AVERAGE ^•L^^'^.'^^S^^W ^ 

ADDRESS 40^3 N 4b St 

QUADRANT Fl 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.157 

Zr 446.527 ± 15.893 

Sr 144.674 ± 8.461 

U < LOD : 14.750 

Rb 72.314 ± 6.819 

Th 14.032 ± 8.399 

(Pb/ 

Se 

166.796 

< LOD 

±, :. : ipM 5.951 

As 26.455 ± 16.116 

Hg < LOD : 13.087 

Zn 221.981 ± 25.822 

w 

Cu 

< LOD 

53.285 

: 

± 

90.428 

23.256 

Ni < LOD \ 79.433 

Co < LOD : 201.036 

Fe 21775.611 ± 435.878 

Mn 680.510>o ± 110.852 

Supervised By: C-K Ub Uid 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

w 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

452.041 

145.078 

< LOD 

70.655 

14.796 

165.207 

< LOD 

24.396 

< LOD 

237.719 

< LOD 

52.220 

< LOD 

< LOD 

21660.027 

803.126 

Supervised By: 

Certificate of Verification 

41 

SOIL 

2010-06-05 10:23 

30.11 

Final 

33168 

4023 N 45 st 

Fl 

6" 

CONFIRMATION 

N. LOPEZ 

Error 

: 8.218 

± 16.004 

± 8.489 

; 14.793 

± 6.767 

± 8.465 

± 17.856 

: 5.802 

± 16.003 

: 13.928 

± 26.698 

92.376 

± 23.246 

I 79.763 

: 201.844 

± 435.530 

± 118.422 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 42 

Mode SOIL 

Time 2010-06-05 10:24 

Duration 30.10 

Sequence Final 

Flags 

BVID 33168 

ADDRESS 4023 N 45 st 

QUADRANT Fl 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.116 

Zr 452.169 ± 15.987 

Sr 144.026 ± 8.451 

U < LOD 14.436 

Rb 73.394 ± 6.837 

Th < LOD 11.931 

Pb 170.688 ± 18.135 

Se < LOD 6.253 

As 24.748 ± 16.224 

Hg < LOD 12.036 

Zn 206.484 ± 24.998 

w < LOD 87.572 

Cu 56.525 ± 23.521 

Ni < LOD 79.911 

Co < LOD 203.263 

Fe 22046.582 ± 439.147 

Mn 624.899 ± 107.676 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

w 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

435.371 

144.917 

< LOD 

72.891 

18.945 

164.494 

< LOD 

30.221 

< LOD 

221.740 

< LOD 

51.109 

< LOD 

< LOD 

21620.227 

613.505 

Supervised By: 

Certificate of Verification 

43 

SOIL 

2010-06-05 10:25 

30.12 

Final 

33168 

4023 N 45 st 

Fl 

6" 

CONFIRMATION 

N. LOPEZ 

Error 

: 8.137 

± 15.688 

± 8.443 

; 15.022 

± 6.852 

± 8.777 

± 17.763 

: 5.797 

± 16.121 

: 13.296 

± 25.771 

* 91.338 

± 23.002 

* 78.625 

: 198.002 

± 432.956 

• ± 106.458 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

Mo 

Zr 

Sr 

U 

Rb 

Th 

CHSe : -.' 

As 

Hg 

Zn 

w 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

Supervised By: Of < % 

Certificate of Verification 

48 

SOIL 

2010-06-05 10:28 

90.65 

Final 

^mm^s^^ x ^02 3 N 45sr ^ 

Bl 

6" 

CONFIRMATION 

N. LOPEZ 

ppm 

< LOD 

476.577 

152.733 

< LOD 

73.756 

17.175 

3/3.64/ ,

< LOD 

< LOD 

< LOD 

225.434 

< LOD 

40.917 

< LOD 

< LOD 

22795.313 

677.904 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

± 

± 

± 

i 

i

:

± 

it. 

± 

± 

Error 

8.224 

16.254 

8.615 

15.359 

6.905 

lOJO? 

 T559k-^ 

6.260 

33.725 

13.454 

25.828 

91.436 

21.977 

76.929 

204.242 

441.942 

109.599 

237.005 

527.510 

2120.371 

171.215 

3837.755 

8049.603 

188.832 

VW/? 

v 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 45 

Mode SOIL 

Time 2010-06-05 10:26 

Duration 30.11 

Sequence Final 

Flags 

BVID 33168 

ADDRESS 4023 N 45 st 

QUADRANT Bl 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.343 

Zr 485.219 ± 16.374 

Sr 148.585 8.507 

U < LOD 15.189 

Rb 72.487 ± 6.840 

Th 22.323 ± 10.503 

Pb 364.455 25.506 

Se < LOD 6.182 

As 41.622 22.651 

Hg < LOD 13.529 

Zn 225.162 ± 25.752 

W < LOD 88.214 

Cu 43.546 dt 22.062 

Ni < LOD 75.141 

Co < LOD 204.974 

Fe 22832.750 ± 442.184 

Mn 678.081 109.698 

Supervised By: 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

w 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

475.800 

149.781 

< LOD 

75.377 

< LOD 

372.351 

< LOD 

< LOD 

< LOD 

217.141 

< LOD 

34.461 

< LOD 

< LOD 

22920.879 

644.268 

Supervised By: 

Certificate of Verification 

46 

SOIL 

2010-06-05 10:27 

30.12 

Final 

33168 

4023 N 45 st 

Bl 

6" 

CONFIRMATION 

N. LOPEZ 

Error 

: 8.057 

± 16.114 

± 8.487 

• 14.876 

± 6.879 

: 13.789 

± 25.523 

I 5.677 

: 33.638 

: 13.469 

± 25.334 

: 93.694 

± 21.396 

: 78.018 

\ 204.268 

± 440.705 

± 107.389 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 47 

Mode SOIL 

Time 2010-06-05 10:28 

Duration 30.42 

Sequence Final 

Flags 

BVID 33168 

ADDRESS 4023 N 45 st 

QUADRANT B l 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.271 

Zr 468.712 i 16.273 

Sr 159.833 ± 8.850 

U < LOD 16.012 

Rb 73.403 ± 6.997 

Th 25.254 ± 10.909 

Pb 384.136 ± 26.358 

Se < LOD 6.922 

As < LOD 33.561 

Hg < LOD 13.363 

Zn 234.000 ± 26.399 

w 

Cu 

< LOD 

44.743 ± 

92.400 

22.472 

Ni < LOD 77.629 

Co < LOD 203.485 

Fe 22632.307 ± 442.938 

Mn 711.362 ± 111.711 

Cr < LOD 711.016 

v < LOD 1582.530 

Ti < LOD 6361.112 

Sc < LOD 513.645 

Ca < LOD 11513.265 

K < LOD 24148.809 

S < LOD 566.497 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 52 

Mode SOIL 

Time 2010-06-05 10:31 

Duration 90.33 

Sequence Final 

Flags 

AVERAGE 0m^^i£J 

ADDRESS ^02 3 N 45 st 

QUADRANT DZ 

DEPTH 13" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD ; 8.355 

Zr 455.508 ± 16.196 

Sr 161.252 ± 8.962 

U < LOD ; 15.506 

Rb 78.355 ± 7.148 

Th 13.119 ± 8.229 

my:- I48;u/y ~ ± ITrt m 

Se - < LOD b.U/9 

As < LOD 22.266 

Hg < LOD 13.512 

Zn 261.880 ± 28.069 

w < LOD : 97.579 

Cu 39.149 ± 22.511 

Ni < LOD 80.180 

Co < LOD • 209.902 

Fe 23590.814 ± 457.007 

Mn 838.757 ± 120.865 

Supervised By: (-C^i '.:Mi ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 49 

Mode SOIL 

Time 2010-06-05 10:29 

Duration 30.11 

Sequence Final 

Flags 

BVID 33168 

ADDRESS 4023 N 45 st 

QUADRANT DZ 

DEPTH 13" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD ; 8.295 

Zr 444.191 ± 15.944 

Sr 162.561 ± 8.960 

U < LOD : 14.657 

Rb 76.007 ± 6.956 

Th < LOD 10.905 

Pb 142.167 db 16.662 

Se < LOD : 5.803 

As < LOD : 21.920 

Hg < LOD ; 13.415 

Zn 266.362 ± ' 28.175 

w < LOD ; 97.442 

Cu 35.286 ± 22.079 

Ni < LOD : 78.769 

Co < LOD ; 209.656 

Fe 23678.639 ± 456.147 

Mn 856.735 ± 121.564 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

ppm 

Mo < LOD 

Zr 461.852 

Sr 154.601 

U < LOD 

Rb 78.423 

Th 22.251 

Pb 150.156 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 263.920 

w < LOD 

Cu 56.541 

Ni < LOD 

Co < LOD 

Fe 23213.969 

Mn 852.192 

Supervised By: 

Certificate of Verification 

50 

SOIL 

2010-06-05 10:30 

30.11 

Final 

33168 

4023 N 45 st 

DZ 

13" 

CONFIRMATION 

N. LOPEZ 

Error 

: %.Tn 

± 16.248 

± 8.764 

: 15.407 

± 7.129 

± 9.028 

± 17.183 

5.797 

22.615 

13.768 

± 28.174 

: 99.644 

± 23.710 

: 79.712 

: 210.062 

± 452.169 

± 121.176 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 51 

Mode SOIL 

Time 2010-06-05 10:31 

Duration 30.11 

Sequence Final 

Flags 

BVID 33168 

ADDRESS 4023 N 45 st 

QUADRANT DZ 

DEPTH 13" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.494 

Zr 460.481 :t 16.396 

Sr 166.595 i 9.162 

U < LOD 16.455 

Rb 80.636 i 7.360 

Th 13.324 i 8.390 

Pb 151.915 i 17.488 

Se < LOD 6.638 

As < LOD 22.263 

Hg < LOD 13.354 

Zn 255.357 i 27.857 

w < LOD 95.652 

Cu < LOD 32.616 

Ni < LOD 82.061 

Co < LOD 209.988 

Fe 23879.836 ± 462.705 

Mn 807.343 ± 119.856 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 56 

Mode SOIL 

Time 2010-06-05 10:33 

Duration 90.34 

Sequence Final 

Flags 

AVERAGE l»V.ti»orft5,3a5E 

ADDRESS 4023 N 4Vst 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

Mo 

Zr 

Sr 

U 

Rb 

Th 

)e 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

252.214 

186.367 

< LOD 

57.695 

< LOD 

.,A'i0V045 

< LOD 

< LOD 

< LOD 

230.515 

< LOD 

36.701 

< LOD 

< LOD 

14021.805 

378.264 


Supervised By: 


± 


± 


± 


± 

± 

Error 


7.266 


11.847 


8.855 


13.633 


5.821 


10.208 


-137822--;) 


4:yui 


17.724 


11.184 


24.287 


79.735 


19.634 


68.630 


149.469 


326.087 


80.722 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 53 

Mode SOIL 

Time 2010-06-05 10:32 

Duration 30.12 

Sequence Final 

Flags 

BVID 33168 

ADDRESS 4023N45s t 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 7.252 

Zr 253.000 ± 11.866 

Sr 185.699 ± 8.852 

U < LOD 13.867 

Rb 61.261 ± 5.971 

Th < LOD 10.169 

Pb 105.176 ± 13.586 

Se < LOD 4.953 

As < LOD 17.463 

Hg < LOD 11.738 

Zn 249.197 ± 25.122 

w < LOD 79.116 

Cu < LOD 28.009 

Ni < LOD 69.472 

Co < LOD 147.568 

Fe 13909.616 ± 325.105 

Mn 438.777 i 85.391 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

w 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

254.263 

182.055 

< LOD 

55.878 

< LOD 

112.617 

< LOD 

< LOD 

< LOD 

218.618 

< LOD 

45.799 

< LOD 

< LOD 

14114.994 

328.796 

Supervised By: 

Certificate of Verification 

54 

SOIL 

2010-06-05 10:32 

30.11 

Final 

33168 

4023 N 45 st 

EA 

1" 

CONFIRMATION 

N. LOPEZ 

Error 

: 7.271 

± 11.889 

± 8.776 

: 13.163 

± 5.716 

I 9.987 

± 13.958 

', 4.937 

; 17.996 

: 11.689 

± 23.950 

85.630 

± 20.420 

; 69.021 

: 150.602 

± 327.843 

± 76.840 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

w 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

249.378 

191.347 

< LOD 

55.947 

11.069 

112.343 

< LOD 

< LOD 

< LOD 

223.730 

< LOD 

41.392 

< LOD 

< LOD 

14040.802 

367.217 

Supervised By: 

Certificate of Verification 

55 

SOIL 

2010-06-05 10:33 

30.11 

Final 

33168 

4023 N 45 st 

EA 

1" 

CONFIRMATION 

N. LOPEZ 

Error 

: 7.276 

± 11.785 

± 8.939 

: 13.868 

± 5.775 

± 6.979 

± 13.922 

4.813 

17.713 

10.124 

± 23.790 

: 74.460 

± 19.808 

: 67.397 

\ 150.237 

± 325.313 

± 79.936 
/^Q A Omaha Lead Site—Fixed Price EP-R7-07-05 

§ ^^^ ^ I Coastal Environmental Group Inc. 

%y^^ ^ www.coa8talhazmat.com 

'^tPHOT*'^ COASTAL 

INVIIOIINIIITAl 6 10 U r, IMC 

EXECUTIVE SUMMARY: 

BVID #33168-(4023 N 45 ST) 

No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 

- DAN GARVEY WALKED THE PROPERTY ON 6/24/10 
$ ^ 

EPA Property Close Out Form 

Proptny#: 3 3 /^ ^ 

DBtc/Tlmc: 

Quads Excavated: 

Contractor Group 

Excavatio Yes No n Geaeral 

1. If necessaiy, were the correct quadi3nt(s) excavated and restored? 

^ 

2. If necessary, were the correct areas of drip zone excavaled and restored? 

y 

Yes No 

I Does the grading around the perimeter ofthe house iii excavaled areas generally slope away 

from the house? •. 

Grading Sod aad VcwtetioB 

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 y day tune 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 y time period) •

 __. . 

6. Was the property graded such that water will not pool on ihe propeny'' 

y 

r 7. Was damage to landscaping or plant materials avoided? y 

Gates, Fences and Retainlos Walls V « No 

1. Do gates open and cioiie finely? (Ifappiicable) y 

y 2. Were all gates or fences taken down during restoration activilies reinsulled? (If applicable) 

3. Was demtge to gates or fences avoided? (Ifappiicable) 

• 

4. Was damage to retaining walls avoided? (Ifappiicable) ^ 

Foundation, SidiBR aod Gutters Yea No 

1. Was damage to the siding or trim avoided? 

y 

2. Was damage to the foundation avoided? 

y 

?. Was damage to windows avoided? 

y 

4 Was damage to windows or door screens avoided? 

y 

5. Was damage lo downspouts or downspoul extensions avoided? y 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage lo driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

y 
Ort'oers comments: 

\ _, 

piinspection notes: 

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

EPA Representative jB^ Ay Date: fAvA) 
L 

Property Completion Agreement 

This agreement documenls the complclion ot remedial acliviiies perioimed on my property My signature 

will designate ihal I am satisfied with (lie restoration of my propeily. and thai no items are in questions, 

now, or at any lime in the future, except Ihose ilems lisled below, if any 

PropcifyfP: -^-Z,\Q,% 

Property Address: H^'Zl > M • ^ f j fj)- ­

Owncr^^r-Q| _ JZ,sJp^c 6 

Phone: 

H55'- ^0^-? ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

1 ^ I ii|;rcc restoralion is completed, except as noted 

[ I I rio not a(;rec restoratinn i» completed 

^ ^AV/^ 

Date .ontiac'ioi's Signature 
® / 

Property Owner Assessment of Performanc< 

American Recovery and Reinvestment Act (ARRAf 

Omaha Lead Superfund Site 

2009/2010 JUN 2 1 2010 

Remediation Contractor: Coastal Environmental Groun - EP-R7-09-0tf^UPERFUND DIV 1S10N 

Property Identifier Number: 3^lLuf t 

Property Address: ^<^^ 5 U Q ^ SJProperty Owner's Name; ('!^?r(OJ fti6»^ 

Instructions to the Propertv Owner: 

This form serves to record the Property Owner's assessment of perfonnance (Incentive 1 

- Quality Assurance Surveillance Plan) involving the listed remediation contractor, as applicable 

to the Omaha Lead Site. This form documents the timeliness of punch list resolution, business 

relations, complaint resolution and the overall quality of work. If need be, the Property Owner 

may utilize this form to record problems and/or issues not specifically tied to an assigned 

address, for example, business relations that generally don't follow the guidelines set forth in the 

Poformance Work Statement. 

The Property Owner will indicate his/her assessment of perfomiance with the contractor's 

work by checking a numerical rating on the table below using the numerical definitions firom 

the rating scale below, then sign & date the form. 

9-10 "exceUent" 

7-8 "very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Propertv Owner's Assessment of Performance Regarding the Contractor's Work 

10 y 5 

9 y 4 

8 3 

7 2 

6 1 

Propertv Owner Additional Comments from (optional; continue on back page if needed) 

Property Owner Signature: ( jJjLAyyyji^id y ^Date^•4y//J/^ : ^/^st/yO. .