TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

yox 

i n iff SAID #: 

Date: 

Address: lu ^ LiftflM^M' Wt 

Remediation Contractor: Coastal Environmental Group_ Year: 200i 

^ 

SOIL REMEDIATION 

PROPERTY HLE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreenient(s) for adjacent property 

A Restoration Agreement 

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

Confirmation data 

Photographs i k ti?C^iyiVv^ 

As-built sketch 

A 

Satisfactory restoration signed by Property Owner 

A 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

PropertjnHironnation from Douglas County Assessors Office 

y^iio 

Date 

Superfund 
Property Access Checklist 

ProptrTj- ID: iSSDl 

• WORKST/VRTtD ON: 

D WORK COMPELTED ON: Propem Addr.»: 22.D H Lft\rmnr e AsJP. 

Oxvncr Rente r : '^tpVyCXv-a "TKomjQ' b 

Address: Phone: 

Scimje, 

PaxCell/Pager: 

Phone: ^^ ^ -n«=,O q AdditiofiSil Inlnrmnlion: 

F « v 

Ccll/Pager 

• Norification letter Sent: / / By: 

2 J ACCCM AfTcemcBi Signed: ;L/22/ ^ 

*>•= Brya/7 

(5 ' Restoration Agreement Signed: i/22-/ffl . 

^y hr\iAjLn 

O Topsoil Ssmpling (if applicuble) / / By: 

D Disposal Sampliog (if applicable) / / By: 

Q Gnrdcn Sampling (if apr)licable) / / By: 

n Utility Clearance Called: / / By: 

[0 ' Video/Phofos (Before) 

On:i/22/. ^ ^yCAL\(xy\^ 

D Video/Photos (During) On: / / B.>: 

n Video/Photos (After) On: / / By: 

D Video/Photos (30-Day) On: / / By: 

D Property Compielion Aj;reemen( Sir*cd: / / By: 

D Final Report Issued: / / By: 

Air Monitoring {•ix applicable) 

D Community Q Crew On: / / By: 

Results: 

D Community Q Crew On: / / By: 

Results: 

1 Q CommuniM O Cr\:» On: / Bv: 

r, 1.. . 

Omaha Lead Srte 
Property ID # 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

•^f)'^n\ 

X2_nM La^rmox-e Av 

Date: Time: Action: 

Date: Time: Action: 

Dale: Time: Action: 

Transmit lo EPA D Other Action: D 
Douglas County Account Infonj^Bb )n||Bk)n r Page 1 of2 

Douglas County, Nebraska Property Record - R l 133240000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - Vle W O n Ma p Infomiation is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature • • - • ^ Auto Sales Search 

Owner 

THOMAS RICHARD 

2204 LARIMORE AVE 

OMAHA NE 68110-0000 

Property Informatio n 

Key Numtier: 3324 0000 11 

Account Type: Residential 

Parcel Number: 1133240000 

Parcel Address: 2204 LARIMORE AV 

OMAHA NE 68110-0000 

Legal Description: FORDS SARATOGA LOT 14 BLOCK 0 E 1 FT LT 1 & ALL 44 X 135 

Value Informatio n 

Land Improvement Total 

2009 $2,500.00 $51,000.00 $53,500.00 

2008 $2,500.00 $51,000.00 $53,500.00 

2007 $2,500.00 $51,000.00 $53,500.00 

2006 $2,500.00 $51,000.00 $53,500.00 

2005 $2,500.00 $6,300.00 $8,800.00 

2004 $2,500.00 $5,700.00 $8,200.00 

L^nd Informatio n 

Acres SF Units Depth Width Vacant 

0.13 5940.0 1.0 135.0 44.0 No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoiintinfo.jsp?accoiintno=Rl 13... 7/7/2009 
Douglas County Account Info: irijAbr Page 2 of2 

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CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1835.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Fair 

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

HVAC: Central Air to Air Rooms: 9.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1900 0% 1900 109 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 1235.0 

Fixture Base Fixtures 1.0 

Fixture Batii Full 1.0 

Porch Slab Roof Ceil 48.0 

Porch Slab Roof Ceil 24.0 

Porch Slab w/Steps 9.0 

User Attic Full Finish 600.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R113... 7/7/2009 
Page 1 of2 

"> 

Create Another Ticket ] [ Back to Irth Internet ] Send Email 

• YOUR TICKET NUMBER IS 2332232. 

Original Call Date: 

Work to Begin Date: 

8/03/09

8/05/09

 Time: 12:29 pm 

 Time: 1:00 pm 

Op: ELIZABETH18790 

State: NE 

Address: 2204 

County: DOUGLAS 

Street: LARIMORE AVE 

Place: OMAHA 

Twp: 15N Rng: 13E 

Twp: Rng: 

Legal Given: C 

Sect-Qtr: 03-NW,04-NE 

Sect-Qtr: 

Type of Work: LEAD REMEDIATION 

Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 

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

: UNSURE ABOUT 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 

Involves Tunneling or Horizontal Boring : N 

Front: Y Rear: 

Explosives: N 

CXCATV MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 

Service Area Contact Phone Number Utiiity Type 

CXCATV COX COMMUNICATIONS, INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emerg: 4029329757 

MAGELLAN

Day: 9185747098 

 MAGELLAN MIDSTREAM PARTNERS LP DEBORAH Alt: 

Emerg: 9185747098 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irihintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/3/2009 
m Page 2 of2 m 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/3/2009 
^ As-Built Drawing d | 

COASTA L Omaha Lead Superfund Site 

35501 

Omaha Lead Site 

Site Sketch 

Owner Name: RICHARD THOMAS 

Address: 2204 LARIMORE Ay _ 

Phone: H 9<?(-^73 5 w." 

Sample Number Lead Sample LAB Concentration Collected 

RYASCPXA-35501 F1 ppm D g4?^ RYBSCPXA-35501 F2' M ' ppm \3A D 

RYCSCPXA-35501 B1 ppm D

3 S ^ RYDSCPXA-35501 82 ppm B ^ n 

RDZSCPXA-35501 DZ -2-7. U/r, ppm n

RGZSCPXA-35501 GZ ppm D 

RPZSCPXA-35501 PZ ppm D zoa Lab RPZSCPLA-35501 Number of Samples = / Result 215 ppm 

OLS#: 35501 

Date Excavated:8/11/09 

Exterior Paint North Arrow 

n Good 

p^-^oo r I 

I I Not paint 

^ample s Collected 

Firm . , 

Date: O ^ - L ^ • C^J-^, 

Time: ?Zy^d Qr^ 

Samples Analyzed 

XRF Unit: /OS" ? Book: I3 Z 

Date: /<g - / 3 -aS ~ 

Time: P/yi 

Staff: A A 

Omaha Lead Site V/flatnf \ox 

Legend 

Concre'te Dri p Zone Excaval^ed Quadrants Excavated 

Area replace d

Sod

 wit h 

' ' 

Area replaced with 

Rock/Mulch Area left bare 

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


46130 
35501 

Owne Omaha Lead Site r Name: RICHARD TH0MAS _ 

Address Site Sketch : 2204 LARIMORE AV 

Phone: H:991-^^3 5 W: 

Sampl Lead Sample e Number LAB Concentration Collected 

RYASCPXA-35501 F1 ppm D 

RYBSCPXA-35501 F2 " M ' 167 ppm \2A D 

RYCSCPXA-35501 B1 ppm D 

RYDSCPXA-35501 82 ppm n RDZSCPXA-35501 DZ ppm D RGZSCPXA-35501 GZ iia ppm D RPZSCPXA-35501 PZ ppm D 

Lab RPZSCPLA-35501 Number of Samples = : /

Result 215 ppm 

Exterior Paint North Arrow 

• Good 

0-^o r ( 

Q Not paint 

^amples Collected 

Firm: 

Date: 

Time: pA-\ 

Samples Analyzed 

XRF Unit: 105 1 Book: /? Z 

Date: _ 

Time: P/Y] 

Staff: AA 

Omaha Lead Site <mm\y 46130 \f(yLuy \o\ 
Owne Omaha Lead Site r Name: RICHARD THOK/IAS 

Site Sketch Addrass : 2204 LARIMORp AV 

Phone:HL99l-<??35 w 

Sample Lead Sample Number LAB Concentration Collected 

RYASCPXA-35501 Fl ^ ppm D 

RYBSCPXA-35501 F2 ' M ' ffe7 ppm D 

RYCSCPXA-35501 B1 ppm D 

RYDSCPXA-35501 82 575" ppm D 

RDZSCPXA-35501 DZ ppm isar D -2-21^1^ RGZSCPXA-35601 GZ ppm D

RPZSCPXA-3550 1 1 f\ 1 PZ ppm D zoa Ub RP2SCPLA-35501 Number of Samples = /

Result 215 ppm 

35501 

Exterior Paint NorthArrow 

• Good 

0''^oor ( 

Q Not paint 

Samples Collected 

Firm 

Date: 

Time: i^'y^c> p/A 

Samples Analyzed 

XRF Unit: /05 1 Book: I3 Z 

Date: / a - / 3 'OS ' 

Time: PAY I 

Staff: L A 

_ Omaha Lead Site 46130 \/flCanf \o \ 
COASTA L ENVIHONHENTAL 

CROUP . INC . 

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: 

1S3'0^oH 

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, 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 
S' o 

\ COASTA L 

'•> '—.A # INVIRONHfNTA L 

CROUP . IN C 

• 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 (402) 991-1199 

" ^ grant access to my properties 

D I do not grant access to my properties 

Signature 

Date 

G I would like to be present during any sampling that is required. 

Page 2 of 2 
C > * S T A I 

Ro^toratfopi. 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 ED: ^r ^<yO 

^pert y Address: 7_/2Lc>M La^rivw^rg. 

t K wL,VN,c-.,rd, T \ts Qifv^ft 

\ Phone; G, ^ ^ CfyO^\ 

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. 

Stems to be Removed by the Owner before StaK. of Remediation: 

'\ \Ki .c-r.ovc.i: giof5r6, C'i£;obfc.i, fciio/ot iEt.;i:'i o.' tlit-Hfe iifciria i!- \.x\^ Uwusi f ipSf.x'tttii^.iiiiy.' 

r Kem: 

M \ ^mt>y {{jtM<h 

\ Kem: 

Kem: 

- r" Kem: 

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

Item: 

4flAU i\AmKb Uff iV^Hj, 

Item 

Item: 

Pagel ^AL 
C -) >* S T M L 

[terns_to Be Removed Ey Contractor During Remediation znd Repjzced 

Kem: 

^9y? ijlY (/h 

Kem: ^'\i f^ r c-^ r F* 

11 Kem: . . 

\ Item: 

Landscape Inventory 

Item Quantity' Unit Condction/Type/Species 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Quadrants 

HiAiC\A 

Number of trees > 2 inch 

trunk diameter 

% Each 

Number of trees <= 2 inch 

trunk diameter 

ny Each 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Auach r. sketch ut Uu-

>rti.il,lc i l;;<iui; 

A Each 

Number of and size of 

each garden/ flower bed 

area. 

Alliicli w ski'icli ol rfliUiM' 

biZiT- nnd Icrjiiioni. 

\ Each 

Square Feet 

yi\jt kh(h^ 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

"c;: ' !';;•. ' , ll' • . J. \y­

:'£•'( ' .( • '>''. : ••: ,i'.-'.\i -

SA S 

u A r 11 . 

Easement Area, to be 

excavated Each V "fTC i^^^n^iM ^ 

1 

Page 2 of. 
»" A, S 1 /• L 

r AddKional Conrtments / Instructions: 

QI Check the box "rf Owner does not want CEG to document interior foundation walls and possible 

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

interior of house, including foundation cracks or fissures. 

9I agre« n I do no* agree 

1-^iA . _£^£i£m&&z. Owner's Signature Contractor's Signature Date 

Page 3 of. 
BVID# S56o\ 

XRF PROPERTY SAMPLE SHEET 


Date 

Project 

XRFID# 

Shot# 

Vi\Ab 

1^\PKI> 

2^i>n 

1«»/«A 

Average

Shot# 

2^70 

loai tAni 

2<^1 ^ 

Average

Shot* 

VM^ 

292lc_ 7.^11 

^qnft 

Average

Shot# 

Average 

lab sample # 

?^jii/oq 

Omatia lead FP 2n{l year option 

9a.c>%Oi 

Reading 

\y\.3\-i\<,.is 

132.^ 1 W.35 

\0\^.V\ 4 15.1 

iq^. S ^\'\.%> 

Sample area 

^•2 

Depth 

% 

 \^q.l?> t \M.» ^ 

Reading

23l.ait|fl.iq 

?/}S-"y^^ P.MM f

iflZ-W^ Wtf.tg 

 Sample area 

Da 

Depth 

iqi^.U<bJ: vinl~ n 

 ?/)5 . i q j n.5 ^ 

Reading Sample area 

JAa..^WtlU.ftS232.(^5 G » ^ MS.'^I 

i2-).fl± i^.Q.«? Depth 

20M.\S-fcn.MI ^ 

 jftTfl ^ Urt.\. 3 

Address 

Sample time 

sample length 

Shot# 

2(?Art 

9<^?^\ 

Mft 2 

?qft ^ 

Average

Shot# 

Average 

Shot# 

Average 

Reading 

RETEST AREAS 

Sample area Shot# 

Depth 

Lab result 

Average 

Sample area XRF Avg. 

OALDlX Lnfimf\ye 

am/pm 

30 sec 

Reading 

l«U.»*.\a.u.<^ 

.«;^.^i i irt.?^ 

5A.\^ i q.«^i 

\a^ri[±\Q. m 

Sample area 

yDepth 

/ 

 S^.^Q t

Reading 

 \fiM? ^ 

Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Signature C^jftjgiU&iUS 

Print £,UijiLbg:^ Ca&ego5 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2965 

Mode SOIL 

Time 2009-08-11 14:19 

Duration 30.64 

Sequence Final 

Flags 

BVID # 35501 

ADDRESS 2204 Larymore ave 

QUAD/ZONE B2 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 169.305 ± 15.746 

Supervised By: L»t^QPSlC i 
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 132.540 

Supervised By: 

Certificate of Verification 

2966 

SOIL 

2009-08-11 14:20 

30.50 

Final 

35501 

2204 Larymore ave 

B2 

Nicolas 

8 

CLEARANCE 

± Error 

± 14.350 
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 106.286 

Supervised By: 

Certificate of Verification 

2967 

SOIL 

2009-08-11 14:21 

30.23 

Final 

35501 

2204 Larymore ave 

B2 

Nicolas 

8 

CLEARANCE 

± Error 

± 13.050 
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 148.796 

Supervised By: 

Certificate of Verification 

2968 

SOIL 

2009-08-11 14:21 

30.25 

Final 

35501 

2204 Larymore ave 

B2 

Nicolas 

8 

CLEARANCE 

± Error 

± 14.956 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2969 

Mode SOIL 

Time 2009-08-11 14:21 

Duration 121.62 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE B2 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 

Supervised By: A^/t^tj^lTjJ A 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2974 

Mode SOIL 

Time 2009-08-11 14:24 

Duration 121.76 

Sequence Final 

Flags 

AVERAGE 

ADDRESS -2204^t^ymore^ e 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb [_203jaiIiJ ± 

Supervised By F^r/sni?ox 
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 231.207 

Supervised By: 

Certificate of Verification 

2970 

SOIL 

2009-08-11 14:23 

30.59 

Final 

35501 

2204 Larymore ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 18.288 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2971 

Mode SOIL 

Time 2009-08-11 14:23 

Duration 30.27 

Sequence Final 

Flags 

BVID # 35501 

ADDRESS 2204 Larymore ave 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 205.333 ± 17.444 

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 182.597 

Supervised By: 

Certificate of Verification 

2972 

SOIL 

2009-08-11 14:24 

30.65 

Final 

35501 

2204 Larymore ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 16.550 
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 193.627 

Supervised By: 

Certificate of Verification 

2973 

SOIL 

2009-08-11 14:24 

30.25 

Final 

35501 

2204 Larymore ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 17.267 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2979 

Mode SOIL 

Time 2009-08-11 14:28 

Duration 121.86 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 2204 Larymore ave 

QUAD/ZONE GZ 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

± Error 

Pb ± 16.633 

ppm 

187.083 

Supervised By: A^A^WcA s 
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 184.337 

Supervised By: 

Certificate of Verification 

2975 

SOIL 

2009-08-11 14:26 

30.27 

Final 

35501 

2204 Larymore ave 

GZ 

Nicolas 

8 

CLEARANCE 

± Error 

± 16.847 
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 232.045 

Supervised By: 

Certificate of Verification 

2976 

SOIL 

2009-08-11 14:26 

30.67 

Final 

35501 

2204 Larymore ave 

GZ 

Nicolas 

8 

CLEARANCE 

± Error 

± 18.311 
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 127.797 

Supervised By: 

Certificate of Verification 

2977 

SOIL 

2009-08-11 14:27 

30.24 

Final 

35501 

2204 Larymore ave 

GZ 

Nicolas 

8 

CLEARANCE 

± Error 

13.951 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2978 

Mode SOIL 

Time 2009-08-11 14:28 

Duration 30.68 

Sequence Final 

Flags 

BVID # 35501 

ADDRESS 2204 Larymore ave 

QUAD/ZONE GZ 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 204.152 ± 17.424 

Supervised By: 

Certificate of Verification 

XL3t-32089 

Reading No 

MnHp 

2984 

«;nTi 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2981 

Mode SOIL 

Time 2009-08-11 14:30 

Duration 30.15 

Sequence Final 

Flags 

BVID # 35501 

ADDRESS 2204 Larymore ave 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 58.872 ± 10.354 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2982 

Mode SOIL 

Time 2009-08-11 14:30 

Duration 30.15 

Sequence Final 

Flags 

BVID # 35501 

ADDRESS 2204 Larymore ave 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 53.643 ± 9.908 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2983 

Mode SOIL 

Time 2009-08-11 14:31 

Duration 30.45 

Sequence Final 

Flags 

BVID # 35501 

ADDRESS 2204 Larymore ave 

QUAD/ZONE easemerit 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 62.713 ± 10.840 

Supervised By: 
p 

/AQL \

§ ^^^LI

^yZ A

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

 Coastal Envlronmental Group Inc. 

 www.coa8talhazmat.com COASTAL 

mVIIOIIHEIITAl a lour . IH C 

EXECUTIVE SUMMARY: 

BVID #35501-(2204 LARIMORE AVE) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 
0 

0 .1 EPA V 

EPA Property Close Out Form 

Property Property Addms:>^^gAimi5^ ^ 4: 3fc60A. „ Datc/Tlnic: Ow^y* Nam.: ^3Ap£f^<A,V(tf{^^ . ^> 

Quads Excavated: 'Y ^ (^l^ff, € Contractor Group /^nrtf^VvX 9 V\<\fGV\<neft01 

Yes No Excavation Geaeral 

1. If necessary, vtrere the correct quadrant(s) excavated and restored? 

2. if necessaiy, were the correct areas ofdrip zone excavated and restored? y 

Grading Sod and Vegetation 

Yes No 

I. Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from the house? __^ _ ZA 

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 A 

day tune period) \A 

4. Arc sodded areas generally firm and evenly graded? y 

S. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day IA' 

time period) ____ ^ 

6. Was the property graded such that water will nol pool on the propert>'? y 

7. Was danuge to landscaping or plant materials avoided? 

Gates, Fences aad Retaining Wails 

Yes > o 

1. Do gates open and close freely? (Ifappiicable) 

2. Were all gates or fences taken down during restoration activities reinstalled? (ifappiicable) Z ' 

3. Was damage to gates or fences avoided? (Ifappiicable) Z ' 

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

Foundation, Siding and Gutters 

I. Was damage lo the siding or trim avoided? W 

2. Was damage to the foundation avoided? 

Z^ 

A. 3.

 Was damage to windows avoided? y 

4 Was damage to windows or door screens avoided? -A 

5. Was damage to downspouts or downspoul extensions avoided? 

Z 

Sidewalks and Driveways (Concrete) 

Vcsy^ o 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 
Owners comments: 

Inspection notes: 

Removal and restoration aclivales complete including lhe 30-day sod warranty: 

EPA RepresentativeLJiT n n l)A,Ayt.lA Date: ^ 2(p 0 ^ 
Property Compietion Agreement 

This agreement documents the completion of remedial aclivmes perioimed on my properly My signaiure 

will designate ihai I am satisfied with the rcstoralion of my propeily. and ihai no iiems are in questions, 

now, or al any lime in the future, except Ihose ilems listed below, ifany 

Property ID: 3>^^ ^ | 

Property Address: Q20l- / L^^lVKO/ ^ 

0"»^'- t^Tt^Vvc^d 

Phone: ^a^:^,^<^ ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

I Hgrcc I'cxtoralion i% completed, rxccpi as noted 

[_| I do not a); rec rcsroration is completed 

Owner's Sicnamrr atrarior's Signature 
• 

Water Bill Settlement 

Property ID 35501 

Property Address 2204 LARIMORE AVE 

Tenant Richard Thomas 

I have received from the contractor, Coastal Environmental Group Inc. (Coastal), the sum of $ 48.51 for 

water usage required to maintain the sod. 

Check Number 1718 

Value of Check $48.51 

Made Out To Richard Thomas 

Description of Settlement 

To reimburse tenant for estimated water charges on their MUD monthly invoices. 

My signature below is acknowledgement of the receipt of the sum listed above, which I further 

acknowledge to be fair compensation and full payment for the above, and release Coastal 

Environmental Group Inc. from further obligations or liability. 

Owner* wner*ss Signatur Sienaturee Dat Date e Contractor'ss Signatur Sienaturee Date 

COASTAL ENVIRONMENTAL GROUP INC 

2411 MARTHA STREET 

OMAHA, NE 68105 

1718 

27-V1040003 

6247372904 

n 

VMhFi>gDBaili.NA. 

IWinikl wMllifiitflffniii 

FOR %m /IATAM l^m<ik 

i: 101*0000Ban E.21.737EIOI^H- oi7i a 
Account : 251208-1148281 

RICHARD E. THOMAS 

Senrice addreaa: 2204 LARIMORE AVE 

Call Sb^^.TTT/ If you smel l gas. 

No charge to check gas leaks. Have heating 

system checked every year by a qualified 

heating contractor. Keep chimneys and flues 

free of debris. 

600 ' 1 300 ­

liiil 

0 _ 

Oct Nov Dec Jan Fab Mar Apr May Jun Jul Aug Sep 

Your Gas Us« 

• Paal 12 Month* • PlB*l13-e« Months 

This Montti Last Year 

Billing units: 13 37 

Use per day: 0.4 1.2 

Average cost per day: $0.73 $1.68 

Numtier of days in billing cycle: 30 30 

Oct Nov Oac Jan Fab Mar Apr May Jun Jul Aug Sap 

Your Water Use 

Past 12 Months Past 13-24 MonUia 

Ttiis Montti L^st Year 

Billing units: 20 2 

Use per day: 0.7 0.1 

Average cost per day: $1.08 -$0.27 

Numlwrof days in l)illjng cycle: 30 30 

1723 Harney St • Omaha, NE 68102 • 402.554.6666 e-mail: customer_service@mudomaha.com • website; www.mudomaha.com 

Billing date Sep 24,2009 

Previous balance 

Payment received -Thank you 

Current charges 

New balance 

• Total due Oct 9, 2009 Your budget payment of $222.00 is due Oct 9,2009. Budget varianoea: 

Current =-$1542 4 Total = -$247.84 

METROPOLITAN UTILITIE S DISTRIC T 

XJNtQittri. Think Blue. 

$222.00 

222.00 CR 

222.00 

222.00 

$222.00 

Detaib of current charges: 

GAS RESIDENTIAL RATE A: Aug 19 to Sep 18 

Meter Number 320514 

Current read (actual): 671 - Previous read (estimate): 658 -^ 13 CCF 

Gas Use: 13 CCF x 1.022 (heat value) = 13.286 therma 

13 days 5.757 therms at 0.5283 < $3.04 

17 days 7.529 therms at 0.4632 < 3.48 

Service Ctiarge 12.00 

Gas Cost k $18.52 

Gas Infrastructure Replacement 30 0 

WATER RESIDENTIAL RATE W-1: Aug 19 to Sep 18 

Meter Numt)er 88336056 Size: 5/8 -inch 

Current read (actual): 1607 - Previous read (estimate): 1587 •= 20 CCF 

Water Use: 20.000 CCF or 14,960 gallons 

9.000 CCF at 0.9614 - $8.65 

11.000 CCF at 1.3451 - 14.80 

Service Ctiarge 4.86 

7> ->\ Water Cost > $28.31 

Water Infrastructure Replacement 2.00 

Budget Payment Plan Interest 0.07 CR 

City of Omaha Sewer 11.57 

Sales Tax 4.43 

• Current Charges $67.76 
Account : 251208-1148281 

RICHARD E. THOMAS 

Sen/ice address: 2204 LARIMORE AVE 

Call 811 t)efore you dig in your yard, build a 

fence, etc. Call at least hwo working days in 

advance. Utilities will mark gas, water, electric, 

cable and phone lines. No charge for this 

service. 

600 "1 1 

300­

0 _hiiiiilBJ 

Sep Od Nov Oec Jan Fab Mac Apr May Jun Jul Aug 

Your Gas Use 

• l>iBst12MaMlis B Past 13«4 Months 

Ttiis Month l^tYea r 

Billing units: 36 18 

Use per day: 1.2 0 6 

Average cost per day: $117 $1.26 

Numtier of days in billing cycle: 30 29 

Sep Oct Nov Dec Jan Feb Mai Api May Jun Jul Aug 

Your Water Use 

Past 12 Montlis B Pest 1»a4 Montlis 

Ttiis Montti Last Year 

Billing units: 11 3 

Use per day: 0.4 0.1 

Average cost per day: $0.64 $1.06 

Numt>er of days in tiilling cycle: 30 29 

1723 Harney St • Omaha, NE 68102 • 402.554.6666 

e-mail: customer_serviceemudomaha.com • website: www.mudomaha.com 

Billing date Aug 25, 2009 

Previous balance 

Payment received -Thank you 

Current charges 

New balance 

• Total due Sep 9,2009 

Your budget payment of $222.00 is due Sep 9,2009. Budget variances: 

Current ==-(15401 Total = (93.60 

METROPOLITAN 

UTILITIES DISTRIC T 

Live Green. T^OT* 5k . 

$222.00 

222.00 CR 

222.00 

222.00 

$222.00 

Details of cunent citarges: 

GAS RESIDENTIAL RATE A: Jul 20 to Aug 19 

Meter Number 320514 

Current read (estimate): 658 - Previous read (actual): 623 » 35 CCF 

Gas Use: 35 CCF x 1.015 (heat value) = 35.525 therms 

12 days 14.210 therms at 0.5286 ­ $7.51 

18 days 21.315 therms at 0.5283° 11.26 

Service ctiarge 12.0 0 

Gas Cost • $30.77 

Gas Infrastructure Replacement 3.00 

WATER RESIDENTIAL RATE W-1: Jul 20 to Aug 19 

Meter Number 88336056 Size: 5/8 -inch 

Current read (estimate): 1587 - Previous read (actual): 1576'° 11 CCF 

Water Use: 11 000 CCF or 8,228 gallons 

9.000 CCF at 0.9614 = $8.65 

2.000 CCF at 1.3451 - 2.69 

Sen/ice Charge 4.86 

Water Cost • $1620 

Water Infrastructure Replacement 2.00 yW-T- City of Omaha Sewer 11.57 

Sales Tax 4.45 

• Current Charges $67.99