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CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

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us Army Corps

of Engineers .EI:C:.



### ECC Certification for Property Closeout



### OLSID 30057 

### Property Address 1626 Locust St 

### Field Work Started 8/3/2007 

### Field Work Completed 8/17/2007 

### Summary: 

# • The excavation was performed in compliance with the work plans and specifications. 

# • F1 excavation depth was 8 inches below ground surfaces. 

# • F2 excavation depth was 8 inches below ground surfaces. 

# • Verification samples confirmed that cleanup standards were met. 

# • The site was backfilled with material which meets the contract specifications. 

# • The backfill was compacted to acceptable standards. 

# • Sad placement and site restoration were conducted in compliance with the specifications and work plans.



### Comments: None

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### Title Date Jeff Hubbard USACE Can Rep 

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'Omaha Lead Site 46130

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Omaha Lead Site Omaha, NE Residential Yard Soils U.S. Environmental Protection Agency Region VII Environmental Restoration Services PROPERTY ACCESS (to be completed by property owner) Para ree.:)I: Es:a**fc:~"a** en es;:a ...... ,J1 ;:;0: favor bJrne 31 1-600-223·(;425 U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation is requested in giving EPAlUSACElECC permission to access**yo~r** property during the removal/restoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­ 7003 or the Office of External Programs, at 1-800-223-0425. l 

# (' Property Access Granted 

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# .r ?... -()? (Dale) 

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• , 1 . t • NOTE G f DOES NOT rt '/1 be ed' t d lth' f**~_~** 

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### _ PROPERTY INFORMATION (to be completed by reSident and'or properly owner' Please Print) Resident Name: 

### Nl:hJ LI FE C IIf$cH OJ': 

### GO/)**~ner** 

# o renter Residence Address: 

## /Wfo I..OCVST 

# s..,­ (CITY) (STATE) (ZIP) Property Owned By:_--=S.**'f)u.",.<!.E'(~** .......... _ Owners mailing address:

__ Owner's telephone number
- Home: 

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## 'IS lJs..1':J. Work: 

## ------------i1

_____ years iAge of Home? 

## V flcf}rVT /-()r years How long have you lived here? Has the exteior been painted or covered with siding since 1978? DYes 

# o No Has the interior been painted or covered since 19787 DYes 

# o No Total number of occupants:

_ List Ages: 

### ---------------------il List ages of occupants under 6 years old who play in the yard for 5 or more hours per week:

_ Comments: AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS The activities to be implemented by EPA under this agreement are pursuant to Seclion 104 of CERCLA. 42 U.S.C. 9604. EPA's right of access to he property fOf' in Section 104(e) of CERCLA. 42 U.S.C. 9604 (e). which provides enlly for. "determining the need fOf' response, or choosing or aking any response action under this title, Of' olherwise enforcing lhe provisions of this title." Access Attempts: First Second: : Third: :
_

### pg._of_ 

# List of Existing Conditions Property Address: OVO 10 # 

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BVID# 

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Ref: 

### Photo # 

### Description

Owner Signature 

## ECC Print & 

### Sign Print & 

### Sign

### Contract No. W912DQ-04-D-0017, 

### Taste Order DKOI 

### Omaha Lead Site, Omaha, NE Pronertv Closeout Agreement
DVID Property Address 

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## 3Ct1,i7 t'J.-t;tO Property Owner Is the Owner the Resident? DYes 

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## If Compliance Statement: U.S. Environmental Protection Agency (EPA) has contracted the 

# u.s. Army Corps of Engineers (US ACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EP A/USACEIECC permission to access your property during the removal/restoration phase is sincerely appreciated. This document certifies that all work performed at this property was completed in accordance with the contract specifications and EPA requirements. If you have questions or need additional information please contact Don Bahnke, EPA Project Manager, at (913) 551-7003 or the Office of Ex tema 

### I Programs at 1-800-223-0425. Additional Comments by USACE and/or ECC:

CONTRACTOR CERTIFICATION Prashant Khanna or ECC Project Manager Charles "Skip"Milton Name Title Date Signature 

## PROPERTY OWNER SECTION This agreement documents the completion of remedial/restoration efforts at the property to my satisfaction

.

. ­ 

# .u;:l.-/ 

# r agree that restoration is completed at my property,' except as noted Comments (if applicable):

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# ~1A~ ,.**Pr~eriy** 

### Owner's Signature- Date /

## Property Owner Satisfaction Snnrey Form Omaha Lead Superfund Site Perfonnance-Based Contracting (PBC) Pilot Project
Remediation Contractor:**-~===----------------** 

### Property Identifier Number:

_ Property BVID Number: 

## 3 

## O"S 

# 'J Property Address: 

# &cJ bLoC uS T 

## S 

# r Property Owner's Name: 

## N{w LIFE 

## CHtJPC# of 

## G-tJ.b (above infonnation to be filled out by remediation contractor prior to delivery of form to Property Owner) 

## ••••••••••••••••••••••••••••••••••••••••••••••••••• ** ••••••••••••••••••••••••• Instructions to Property Owner: 

### This fonn is provided to you as a means of trying to capture your level of satisfaction with the work of the above-identified Remediation Contractor, as applicable to the soil cleanup action at your property. The U.S. Environmental Protection Agency (EPA) and the U.S. Anny 

### Corps of Engineers (USACE) are very interested in your opinion regarding the work perfonned by our contractors. This fonn is intended to provide an easy means for you to express your opinion about the work perfonned on your property. Please indicate your level of satisfaction with the Contractor's work by 

### selecting a numerical rating (ranging from 1 to 10) using the following rating scale, then please sign & 

### date the form and return it to USACE in the attached self-addressed & 

### stamped envelope. (Additional comments may also be 

### provided in the space provided, at 

### the option of the property owner.) 9-10 "excellent" 7-8 "very good" 5-6 "acceptable" 3-4 "poor" 1-2 "very poor" Property Owner's Satisfaction Rating regarding Contractor's Work 10 

### 9 

# / 5 4 8 

### 3 

### 7 2 

### 6 1 

### Additional Comments from Property Owner (optional; continue on back of page if needed)

Property Owner's Signature: 

# ;CCCu 2( ",) tUM Date: 

# II- 

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### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

# mJ

us Anny Corps

of Engineers .Et:t:. 

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Analytical Results Summary OLS # 

## 30057 1626 Locust St

XRF Results Quadrant Sample 

# I

# ~pth I Date Collected (ppm) (avg.) Type 

# : DE F2 8/3/2007 274 

# I 8 

# I 8/3/2007 DE F1 

### 8 96 

### 8/3/2007 

### PX EA-S 174 0 

# I II II 

# ,

SAMPLEIDSAMPLE ID is a particular residential property ID from which the sample is collected. The sample type identifier (with sequential sample number for that location) as follows; PX'" Pre-Excavation XRF sample DE '" During and Post Excavation Quadrant describes the sampling location (with sequential sample number for that location) as follows; FI or F2 '" front Yard One or Front Yard Two 81 or 82 '" Back Yard One or Back Yard Two DZ '" Drip Zone GA '" Garden PA'" Play Area EA '" Easement Depth describes the depth from which the sample was collected. ppm'" parts per million