CONTRACT # EP-R7-06-04

ASW Associates Inc.

Omaha Lead Site Remediation, Omaha, NE

EPA

ASW Associates Inc Certification for Property Closeout

BVID

Field Work Started

20204

21-Jun-06

Property Address

Field Work Completed

11 13 William Street

18-Jul-06

Summary:

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

The F1 quadrant was excavated to a depth of 12 inch.

The F2 quadrant was excavated to a depth of 12 inch.

The B1 quadrant was excavated to a depth of 12 inch.

The B2 quadrant was excavated to a depth of 12 inch.

The drip zone was excavated to a depth of 12 inch.

Verification samples confirmed that the cleanup standards were met.

The site was backfilled with materials which meets contract specifications.

The backfill was compacted to acceptable standards.

Sod placements and site restorations were conducted in compliance with work plans and

specifications.

Analytical data provided is post excavation at the bottom of the excavation for confirmation

purposes

Comments:

None.

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Jan Prawdzik

Name

ASW Project Manager

Title 'Da't 'e dfgnature

40261973

SUPERFUND RECORDS
CONTRACT # EP-R7-06-04

ASW Associates Inc.

Omaha Lead Site Remediation, Omaha, NE

EPA

Analytical Result Summary

OLS ID: 20204

Property Address: 1113 William Street

Sample ID

20204-DE-B1-12

20204-DE-B2-I2

20204-DE-F1-12

20204-DE-F2-12

20204-DE-DZ-12

XRF Results

Avg.

(ppm)

320.3 ±57.3

223 ± 56.6

510 ±72.6

204 ± 55

311 ±59.3

Lab Results

(ppm)

321

NA

NA

NA

NA

Jan Prawdzik

Name

ASW Project Manager

Title 'Date

Simple Deilgnatton

OLSlD-DE-Location-dd

OLSID is a particular residential property ID from which the sample is collected.

DE ~ During and Post Excavation

Location of the sample as follows;

Fl = Front Yard (1* Quadrant)

Bl = Back Yard (I" Quadrant)

F2 - Front Yard (2*1 Quadrant)

B2 •= Front Yard (2* Quadrant)

DZ = Drip Zone

PZ = Play Zone

GA = Garden

EA = Easement

dd describes the depth from which the sample was collected.

NA =• Not Applicable
&EPA

Property #:.

Date/Time: "

Quads Excavated:'

Remediation/Excavation Contract (ASW)

EPA Property Close Out Form

Property Address: /t(3

Owner's Name:

Contractor Group

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?

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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?

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 firm and evenly graded?

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected 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?

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Gates, Fences and Retaining Walls Yes No

1 . Do gates open and close freely? (If applicable) fa^fH '

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

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

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

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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?

5. Was damage to downspouts or downspout extensions avoided?

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Sidewalks and Driveways (Concrete) Yes No

1 . Was damage to driveway surfaces avoided?

2. Was damage to walkway surfaces avoided?

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Owners comments:

: T •» <•.-*

Inspection notes:

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

T^ / EPA Representative C/flV\ L.
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Contract No: EP - R7 - 06 - 04

Property Closeout Agreement

Omaha Lead Superfund Site ®

OLSID

Property Owner .

f-p£Ace Beii^e/j

Property Address

1113 CAf/trfm&t

Is the Resident the Owner D Yes B No

Compliance Statement:

U.S. Environmental Protection Agency (EPA) or its authorized representatives, (or its contractors), to enter

and conduct environmental restoration services for the Omaha Lead Site.

Your cooperation in giving EPA/ASW 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 contact specifications and EPA requirements.

If you have questions or need additional information please contact the EPA Public Information Centers at

(402) 731-3045 or (402) 991-9583 or the EPA Office of External Programs at 1-800-223-0425.

Additional Comments by EPA and/or ASW:

CONTRACTOR CERTIFICATION

Jan Prawdzik ASW Project Manager

Name Title Date

Property Owner Section

Signature

This agreement documents the completion of remedial/restoration efforts at the property to my satisfaction

{& I agree that restoration is completed at my property

D I Do Not Agree: Comments:

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 , x; A

Property Owner's Signature

1 1/4 - / •

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(I EPA Representative Signature

07/ZO /Ob

' Date

07/2LD/0 (o

Date
May 19 06 04:09p Horace Bethea

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402-292-332B

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402-292-33^0

4029321161

List of existing Conditions pg. . _ of'_

Property Address: /// ^

Owner H^r^r ^ fotjAVxe/y . Date: ^jl^/OL OLS #

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ASw Associates Inc.

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402 292 3328
20204

Own«r Name: HORACE BETHEA

Addr«M: 1 1 13 WILLIAM ST

PhOfW H. 402-292-0146

Omaha Lead Site

Site Sketch

W: 402-292-0146

Exterior Paint

O^Good

^0 Poor

[3 Not paint

Sample Number

RYASCPXA-20204 F1

RYBSCPXA-20204 F2

RYCSCPXA-20204 B1

RYDSCPXA-20204 82

RDZSCPXA-20204 DZ

RGZSCPXA-20204 GZ

Lead Sample

Concentration Collected

7 3 / pom \f>y

i'T'UZf DDm ^fy

5 5V oom I* f

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Number of Samples * | 5"

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LAB

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Samples Collected

Firm: ff\K> BH/SW

Date: <>//6?/c>^

Time: \.2-(a

Samples Analyzed

XRFUnit: ^/Z_Book: ^"2-

Date: 7/-

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ENTERED

Omaha Lead Site 46130