TRANSMITTAL of OMAH A LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 9W^ ^ Date: Qf^rp/^ Q 

Address: .^D' ^ 1})(X)0( \e" ^ ^ \ 

Remediation Contractor: Coastal Environmental Group_ Year: _2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

ei Video of property (DVD) 

y Executive Summary 

E / EPA-provided property sketch 

[T Signed Access Agreement for subject property 

1^ jf^ Signed Access Agreement(s) for adjacent property 

B ^ Restoration Agreement 

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

y Confirmation data 

y Photographs prc-o/z-'/iJ^Aoyi ^ OC^^flJQTUHX^ |trvi{goe l 

<0 As-built sketch 

y Satisfactory restoration signed by Property Owner 

y ^ Property close-out check list signed by EPA 

AlJ ^ Description of areas not meeting ROD cleanup criteria 

S/^ Utility clearances 

M Property information from Douglas County Assessor's Office 

• \ <r0 4031815£ 

^ C^UA ^ igilllljllllll 

Signatu Irn e ' iJate 
Property Access Checklist 

Property ID: ^^^yj^^^j^^ ^ q 

Property Addre»: 6^0 ^ CJ^; . K^L ^ ^"b , 

D

D

 WORK STARTED

 WORK COMPELTED

 ON:

 ON:

 /

 /

 /_ 

 /_ 

Ownci" i

• l-ope - Address: 

1^^ \ Renter 

Phone: 

FiLv: 

Phone: ^c ^

Fjx: 

Cell/Pager. 

 -f^\t ^ 

Cell/Pager: 

Additional In1'onn»tion: 

D

^

15

D

CD

Q

EI

lEf

0

D

D

D

D

 Notification Letter 

 Acce&s Agreement 

 Restoration Agreement 

 Topsoil Sampling (if applicable) 

 Disposal Sampling (if applicable) 

 Garden Sampling (if applicable) 

 Utility Clearance 

 Video/Photos (Before) 

 Video/Photos (During) 

 Video/Photos (After) 

 Video/Photos (30-Day) 

 Property Completion Agreement 

 F'"*) Report 

Sent: / / 

Signed: 11 / lU' /Dpj 

Signed: il / Up / 0 5 

/ / 

/ / 

/ / 

Called: \\ / H / ipF^) 

On:4|/i2t/il<fc 

On: / / 

On: / / 

On: / / 

Signed: / / 

Issued: / / 

By: 

B>= VJ\rri^c^ S 

By= \0\roVc^ S 

By: 

By: 

By: 

B>= U [1^10 6 

By--fti.fV, 

By: 

By: 

By: 

By: 

By: 

Air Monitorine (as upplicabie) 

n Community • Crew 

Results: 

On: / / By: 1 

n Community

Results: 

O Crew On: / / By: 

• Community

ResulU: 

O Cruw On: / / By: 

Omaha Lead Stte 
Douglas County Account Infonnation 

Page 1 of 1 rmaiK 

Douglas County, Nebraska Property Record - R2029650000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 90th St - Vie w O n Ma p Information is valid as of 2008-11-5 Treasurer's Tax Report 

New Feature -»->- • Auto Sales Search 

Owner 

LOPEZ RAUL 

3220 HAMILTON ST 

OMAHA NE 68131-0000 

Property Informatio n 

Key Number: 2965 OOOO 20 

Account Type: Residential 

Parcel Number: 2029650000 

Parce - l Address: 

3207 CHARLES ST 

OMAHA NE 68131-0000 

Legal Description: PROSPECT PLACE LOT 2 BLOCK H E 36.2 W 37.2 N 95 FT 

Value Informatio n 

Land Improvement Total 

2008 $400.00 $0.00 $400.00 

2007 $400.00 $0.00 $400.00 

2006 $400.00 $0.00 $400.00 

2005 $400.00 $0.00 $400.00 

2004 $400.00 $0.00 $400.00 

2003 $400.00 $0.00 $400.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.08 3485.0 0.0 0.0 0.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2... 11 /14/2008 
• 

C0NTAC7 FORM 

Propeny ID ^ ^Q^.^^\:^ 

ProperTy 

Address: 3ao n C.V-Nc^\j2,s>SL 

Initial Contaci, Dale. Time Action: 

Second ConLact Date:_ Time Action: 

Final Coniact: Dale. Time Action; 

Final Action: Tran.smit lo EPA D Olher .Action: D 

Commenl 

0^vner 

C(5mment (s): 

...j Site 

Coordinator 

Commenl (sj; 
Page 1 of2 

• 

"> 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2176545. 

Original Call Date: 11/17/08 Time: 10:46 am Op: ELIZABETH18790 

Work to Begin Date: 11/19/08 Time: 11:15 am 

State: NE County: DOUGLAS Place: OMAHA 

Address: 32 07 Street: CHARLES ST 

Twp: 15N Rng: 13E Sect-Qtr: 16-NW 

Twp: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: Omaha Lead 


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


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


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 LEVEL3 MCLEODNE MUDOl OMAHACOF OPPDGPRS QLNNEIC 


Service Area Contact Phone Nuniber 

Utility 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVELS LEVELS COMMUNICATIONS, LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MCLEODNE MCLEODUSA NO NEED TO CALL OUT 

EMERGENCY 

Day: 8002891901 

Alt: 

Emerg: 8002891901 

MUDOl METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 11/17/2008 
~'-^iai;r*^."T' 

Page 2 of2 

• 

CITY OF OMAHA- OMAHACOF RON TRAFFICSEWER 

OMAHA PUBLIC POWER OPPDGPRS NA DISTRICT 

QLNNEIC QWEST LOCAL NETWORK NA 


Day: 4024447197 


Alt: 4024445161 


Emerg: 4024445160 


Day: 4067289343 


Alt: 8887289343 


Emerg: 4067289343 


Day: 4067289343 


Alt: 


Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 11/17/2008 
D Remote ID: R page of t 

To: COASTAL ENVIRONMENTAL SERVICE Attn: ELIZABETH 

Voice: 8776624210 Pax: 8776624211 

Re: Response to Dig Request 

This is an Important Message from Level 3 Communications (formerly known as 


Broadwing) replying to your request to locate our underground facilities in the 


area described on the One Call Center ticket. 


Ticket: 2176545 


County: DOUGLAS Place: OMAHA 


Address: 3207 CHARLES ST 


LEVBL3: 


Level 3 Conmunications has determined our facilities are clear of the dig site 


described by your One Call Center ticket. Level 3 Communications will not 


have to locate any underground utilities at this dig site. If you have any 


questions, please contact Level 3 Comntunications at 1-800-441-0223. 


If you have any questions, please contact Level 3's Asset Management Team at 


1-800-441-0223. 

As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

Name; ^«v l LofSCZ. 

Phone: •«J?3-*?5"& 

Team g j //*>t j^ s o 

Sample Number 

gV<lg-g.^)CA-Zg5*)q 

F-^{t>S Cf>)tA- •ZS5'=\ '\ 

Dat(» 

Omaha Lead Site 

Site Sketch 

BVID # -3 <-. f •> 7 

Lead Concentration 

^ ^ ^ ppm /7g> ppm 

ppm g^2 ­ ppm 

ppm 

ppm 

ppm 

25^? ? 

Date: North Arrow 

Time: l<3 ,1, 

XRF Code 10 3 7 Bao K = '3 2 

Confimiation Sample 

f l Yes t=l No ^ 

ra Yes D No a > 

/}/ Yes n No 5 ^ 

to-Yes t n No ^ 

"Ye a n -Nu ElYoo P 

• Yoo • •N6 LJ13 07 

Omaha Lead Site 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with 

Sod 

Area replaced with 

Rock/Mulch Area left bare 

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


46130 
# % ZSSff 

Name:

Address:

Phone:

 ^«v | LofiCfZ. 

3 •a©-' c'*f*M£.^t *?' 

 ^T>3-i^fff t 

Omaha Lead Site 

Site SIcetch 

Date:

Time:

 ^/^?/^ r

 (<} • re. 

. North Arrow V 

Team d /jr*x >/a KI BVID#^.^~:r?7 XRF Code /<g37 ^<?gK = /3 2 

Sample Number Lead Concentration Confirmation Sample 

f t Yes tn No ( ^ 

fa Yes t=l No O ^ [gV^gg.^>4A-Zg5^q 6f Yes n No ^ P-YDgg>/>XA-^g5't^ 62. Yes CD No 13^ 

Omaha Lead Site 46130 
# 25^?? 

Name: ^ev l Lojae, ^ 

Address: 3 •»©-» e /t^M/.£-f * ^ 

Phone: *!35-^?5'5 " 

Team ^s/j**t j^sKt 

Sample Number 

^'Hhscp%f< - zg-ry? 

gVB^^:pXA-2Lsgq q 

p.YDg^/>M-Zg5q'^ 

Omalia Lead Site 

Site Sicetch 

BVID # J <- ^ "y 7 

Lead Concentration 

ppm 173 ppm ^ g ^ 

ppm 5^2­ ppm 

ppm 

ppm 

ppm 

Date: North Arrow 

Time: 

\ 

XRF Code I0 3 7 BooX-' 132. 

Confirmation Sample 

f Yes n No ^ -

fa Yes n 

&/ Yes n 

62-Yes C] 

-W6 LJ13 07 

Omaha Lead Site 46130 
J"-*' < # 

COASTA L ENVIRONHENTA l 

GROUP , t N C 

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: 

Owner's Name: ^^^^ ^ [^/^ ^ ^^ , Daytime Plione: U^^ (^ ^ ^//' ^ 

Address of Property 

covered by this ^iQ^ Cm^^ V 

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 \N\\\ 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, will 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 

work 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 
"'«T7! 

m • • *#

%"****•;•' COASTAL ^ , ^fi ^ €NVmONMENT*L 

C II O U P , INC . 

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

piles, dog houses, etc; 

• 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 watering period by EPA; 

• 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 perform 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 work activities, or with any 

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

actions 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 (712) 352-0188 

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

Date Signature Date 

Q I would like to be present during any sampling that is required. 
COASTA L 

o II o u r IN C 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of the 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 ID: ±X$f9 

Property Address: J XO j C h o-f^e^.5 T 

Owner: X A t// /^ i 

Phone: rr ? r-//J 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of ail known 

utilities, subsurface features, syrface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

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

Item: 

./[y^ ^ef_ 

item: 

Item: 

item: 

item: 

Item: 

Item: 

Item: 

Page 1of it 
^^fe 

COASTA L (••VINCNntMTA L O ft O W r . IN C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

iincjl ,0a 140 l^fy^ hck'^nd -0 

Item: ' 0 ' / 

Item: y 

Item: / 

Item: / 

Item: 0 

Item: / 

Item: 

" / 

Item: / 

Item: / 

Item: 

Item: 

item: 

Kem: • 

item: 

Page 2 o\ X 
C O A S T A L • NVlftONnSMTAL C • O U r IN C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

/ O 1 g('^^-^ \ r ^ 

Item: 

^oj (?/'-Ci-P! -^ X 

Item: 

/ 

Item: / 

Item: / 

Item: / 

Item: / 

Item: 

/ 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item: 

/ 

Item: 

/ 

/ 

Page 3 of 6. 
COASTA L ENvinONHKNTA L C fl O U P . t N c 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Landscape Inventory 

(Use additional sheets as necessary) 

Quantity Unit Condition/Type/Species 

Square feet 

•-

Each 

^ 

i Each 

0 Each 

Each 

Square Feet 

^ 

Page 4of^ ^ 
COASTA L % N VHtONHkNTAl c N o u r IN C 

Item Quantity Urilt Condition/Type/Species 

Agreed upon value of 

plant materials not to be 

renlaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

^ 

$ 

. , : 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant will be placed 

by the contractor. 

0 Each 

i: 

Agreed upon area of 

property to be replaced 

widi grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. 

SF 

-' 

Area of City or County 

property to be landscaped 

per their requirements. 

Include a sketch of the 

area (s) 

£r SF 

' 

Easement Area, to be 

excavated 

SJO ^ SF 

Pages of / ) 
C O A S T A I. ttMWAKOUMCHTAL 

««iewr . IM C 

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

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

interior of house, including foundation cracks or fissures. 

|^Iagr« e O I do not agree 

M l _ . S>(MSLVI>^ 

/ner's S^at m Date Contractor's Signature Date 

Page 6 of. ..u...i.v----» ' 
Date 

Project 

XRFID# 

Shot# 

-"^B q

f^pg O

eS&q 1

c " ^ ^

Average

Shot# 

f ^ ^ ""i

^ 1 DCs 

fS\C> ^ 

Average

Shot# 

Average 

Shot# 

Average 

lab sample # 

XRF PROPERTY SAMPLE SHEET 

VO^\o,-n R 

Omaha lead FP 2nd year opllon 

Reading Sample area 

 :^^\•'^^-r^• ^ 

 3y\.^^^..^c\ ^ PJ •o^^ ^ 

 0Cf^.(^C^tl-7.^U Depth 

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Reading Sample area 

, D.^h.-ia'ri^.'aa 

onM ,3-^- ao-'AV &I 

3«fl.MRt;3o.& D Depth 

O'^'i.Si t^i?-^ ^ i^J 

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Reading Sample area 

Depth 

Address 

Sample time 

sample length 

Shot# 

i^?q M 

.SoB ^ 

j^Qi ^ 

^ O ^ !i 

Average

Shot# 

-.1 DM 

r^^O'S' 

S\DU? 

51 D-? 

Average

Shot* 

Average 

Reading 

RETEST AREAS 

Sample area Shot# 

Depth 

Lab result Sample area 

Average 

XRF Avg, 

BVID #c£^B 3 

^on , Ov^rv^yo^SV -

I<U'M,L P am/pm 

30 sec 

Reading Sample area 

q,?..qtst,i.8q 

^(.-DU^8.t?> F) 

i^-?.^l i ^^.-)^ Depth 

ID6.Sio^\g>.Sy5' [ ^ 

 SCo-H^ t n 36 ^ 

Reading Sample area 

/TT7( £ t W^-^u e.3 i ^ ^ ^a"- n.o u 

C:^\.(D<.;t i\.v-I Depth 

i:VA.36.t: m.s o 1-5 

 lau..i-Vr3i: 1 ^ . I 1 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Signature F^COitMji/^ 

Print ^\P,^bQ^ l Cj\PllJfn; ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 291.554 

Supervised By: 

Certificate of Verification 

5089 

SOIL 

2008-12-10 14:46 

30.63 

Final 

25599 

3207 Charles 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 20.237 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Tinne 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 279.892 

Supervised By: 

Certificate of Verification 

5090 

SOIL 

2008-12-10 14:47 

30.36 

Final 

25599 

3207 Charles 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 20.134 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 5091 

Mode SOIL 

Time 2008-12-10 14:47 

Duration 30.49 

Sequence Final 

Flags 

BVID # 25599 

ADDRESS 3207 Charles 

QUAD/ZONE easement 

INSPECTOR Ventry 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 205.596 ± 17.262 

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 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 186.163 

Supervised By: 

Certificate of Verification 

5092 

SOIL 

2008-12-10 14:48 

30.48 

Final 

25599 

3207 Charles 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 16.532 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By: 

Certificate of Verification 

5093 

SOIL 

2008-12-10 14:48 

121.96 

Final 

«Avg of 5089-5092 

3207 Charles , 

l^easemen^; « 

Ventry 

| 1 

CLEARANCE 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 43.947 

Supervised By: 

Certificate of Verification 

5094 

SOIL 

2008-12-10 14:49 

31.16 

Final 

25599 * 

3207 Charles 

Fl 

Ventry 

13 

CLEARANCE 

± Error 

± 7.890 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 46.242 

Supervised By: 

Certificate of Verification 

5095 

SOIL 

2008-12-10 14:50 

30.86 

Final 

25599 

3207 Charles 

Fl 

Ventry 

13 

CLEARANCE 

± Error 

± 8.128 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 147.310 

Supervised By: 

Certificate of Verification 

5096 

SOIL 

2008-12-10 14:51 

30.83 

Final 

25599 

3207 Charles 

Fl 

Ventry 

13 

CLEARANCE 

± Error 

± 15.779 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 108.202 

Supervised By: 

Certificate of Verification 

5097 

SOIL 

2008-12-10 14:51 

30.33 

Final 

25599 

3207 Charles 

Fl 

Ventry 

13 

CLEARANCE • 

± Error 

± 13.246 
-^YT-^ 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 5098 

Mode SOIL 

Time 2008-12-10 14:51 

Duration 123.18 

Sequence Final 

Flags 

AVERAGE |Avg of 5094-5097 

ADDRESS 3207 Charles 

QUAD/ZONE 

INSPECTOR 

DEPTH 

Ventry 

ii3 

SAMPLE TYPE CLEARANCE 

NOTE 

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 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 230.737 

Supervised By: 

Certificate of Verification 

5099 

SOIL 

2008-12-10 14:52 

30.13 

Final 

25599 

3207 Charles 

Bl 

Ventry 

13 

CLEARANCE 

± Error 

± 18.876 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 274.336 

Supervised By: 

Certificate of Verification 

5100 

SOIL 

2008-12-10 14:53 

30.40 

Final 

25599 

3207 Charles 

Bl 

Ventry 

13 

CLEARANCE 

± Error 

± 20.412 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 286.479 

Supervised By: 

Certificate of Verification 

5101 

SOIL 

2008-12-10 14:54 

31.20 

Final 

25599 

3207 Charles 

61 

Ventry 

13 

CLEARANCE 

± Error 

± 20.498 
• : ^ , , , ^ l * 1 • = . " — 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 295.308 

Supervised By: 

Certificate of Verification 

5102 

SOIL 

2008-12-10 14:54 

37.51 

Final 

25599 

3207 Charles 

Bl 

Ventry 

13 

CLEARANCE 

± Error 

± 20.806 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 5103 

Mode - SOIL 

Time 2008-12-10 14:54 

Duration 129.24 

Sequence Final 

Flags 

AVERAGE I^Avg of 5099-5102 

ADDRESS 3207 Charles 

QUAD/ZONE iB l 

INSPECTOR Ventry 

DEPTH |1 3 

SAMPLE TYPE CLEARANCE 

NOTE 

Supervised By: 
'•W' 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 177.762 

Supervised By: 

Certificate of Verification 

5104 

SOIL 

2008-12-10 14:56 

30.49 

Final 

25599 

3207 Charles 

B2 

Ventry 

13 

CLEARANCE 

± Error 

± 16.361 
• ^^F'.^ ^ 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 5105 

Mode SOIL 

Time 2008-12-10 14:57 

Duration 30.54 

Sequence Final 

Flags 

BVID # 25599 

ADDRESS 3207 Charles 

QUAD/ZONE B2 

INSPECTOR Ventry 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb ± 195.915 17.063 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 5106 

Mode SOIL 

Time 2008-12-10 14:58 

Duration 30.14 

Sequence Final 

Flags 

BVID # 25599 

ADDRESS 3207 Charles 

QUAD/ZONE B2 

INSPECTOR Ventry 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 69.685 ± 11.160 

Supervised By: 
•./!?- .•,-:'^«,—,?r:^ :' '"Tt'-'^^'tyi.j• ,.•:? • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 134.246 

Supervised By: 

Certificate of Verification 

5107 

SOIL 

2008-12-10 14:58 

30.87 

Final 

25599 

3207 Charles 

B2 

Ventry 

13 

CLEARANCE 

± Error 

± 14.503 
~ v "'^ Tvr-f ^K&Tv^ 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By: 

Certificate of Verification 

5108 

SOIL 

2008-12-10 14:58 

122.04 

Final 

^v g of 5104-510^^ 

3207 Charles 

182 

Ventry 

,13 

CLEARANCE 
t 

Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

% y www.coastalhazmat.com y COASTA L ENVmONHENTAL 

C K 0 U P, IN C 

EXECUTIVE SUMMARY: 

BVID # 25599 - (3207 CHARLES ST) 

No Issues or Concerns I I Issues/Concerns 

Detail Explanation: 

NO ISSUES PENDING. 
.-^EPA 

EPA Property Close Out Form 

Property «: ,^9S'6'^' ^ Property Addrns-.JS^ I OrVj^y^Ji- ^ "^ ' 

Dale/Time: Owner's N«mt:1?.,r.>„^JL^ 0U-.-p.<i ^ 

Quads Excavated: 0 \ g)\ "^ ^ Contractor Croup C>oc>-<vW^c' X.^^><-cSYM>^^-^'^rvte>^ 

Excavation CcDcral 

•JACMT U)'f' \ n No 

I. Ifnecessary, were the correct quadrant(s) excavated and restored? 

2 If necessary, were the correct areas of drip zone excavated and restored' A/A 

Grading Sod and VcscUtion Yes No 

1 Does the grading^twtid tht penmeier of Iht huube in excavdied aieai generally slope away 

from tbe house? 

0 

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 lime 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 

time period) 

y 

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

0 

7 Was damage to landscaping or plant materials avoided? 

1

0 

Gales, FcDces and ReLainins Walls 

Ves No 

1 Do gales open and close freely? (Ifapplicable) A / ^ 

2 Were all gates or fences taken down during restoration aciiviiies reinstalled? (Ifapplicable) l ^ 

3 Was dam»ge to gates or fences avoided? (Ifapplicable) 

L. ^ 

4 Was damige to retaining walls avoided? (Ifapplicable) /tM 

Foundation, Siding and Cullers 

Yes No 

1. Was damage to the siding or trim avoided? 

— .-' 

2 Was damage to the foundation avoided'^ 

vtM'' 

3 Was damage lo windows avoided? U^< 

A//^ 

4 Was damage to windows or door screens avoided'' 

5 Was damage to downspouts or downspoul extensions avoided? 

1 

Sidewalics and Drtvtways (Concrett) 

Yes No 

Was damage lo driveway surfaces avoided'' 0 

2. Was damage lo walkway surfaces avoided? 

l y 
O »Ders comments: 

Inspection notes: 

Removal and resloralion activates complele including the 30-day sod warranty 

C£^.^ce^ EPA Representative Dale: 
• • 

^ ( ^ 

Property Compfetlon Agreement 

Tliis agreement documents the complclion of remedial activities performai on iny properly. My signaiure 

will designale lliat ! am salislied willi the resloralion of my property, and thai no items are in questions, 

now, or at any time in the future, except those items listed below, if any. 

Property^lD^ ^JJff 

Property Address: -^ JJ Q J _ CK^ f (g, g s. -f 

Onnen ~'^^^/_ • /^^_ ^ ' J ^ _ 

Phone: 

Restoration items in Question: 

Item: 

Item: 

Item: 

Item: 

Kem: 

Item: 

Additional Comments: 

I agree resturafioiiivconiplotcd, except as noted 

I I I do nol agr^c rcsloratiob is compleied 

01.1 

hmm \ \alalloy O wnci^sVSi j> na I irt^c/^ 0irte Contractor's Si);nature Date