TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #:_yM: 

Address: L^ H HIMP K hi t 

Date: ^ V? \ 0 

Remediation Contractor: Coastal Environmental Group_ Year: 2001 

\ 

SOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

a/ 

•tr 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Coniirmation data 

1/ 

Photographs (>^6Al/^n»>^ ^ \i ^ W>[\/l^yH 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Ofiice 

30055440 

Superfund 
Property Access Checklist 

PropcrTj LD LfQnL j Q 

Q WORK STARTED ON: 

D WORK COMPELTED ON: Propcnv AUdr^^s 2. 1 n N/P l OpCH-Atg ^ 

Renter 

Address: Phone: 

3115 5(U?sr 

FiL\: 

Cell/Pager: 

Additionul Irdormiition: 

Ccll/Pager. 

12S NotinciJtion letter 

Scn,:ftL/3-Q By: 3 

^2l Access AgrcemcDl Signed: ^/CL/jQ 9 

B> = DA\ * \\r.\AA^ 

J ^ Reslordtioo Agreement Signed: ^/Ll _ / 0C ^ B> "DA U U/VV\»V 

O Topsoil Ssmpling (if applicuble) / / By: 

Q DispoiiU Sampling (K applicable) / / By: 

Q Gnrdcn Sampliog (if applicable) / / By: 

0 ^ Utility Clearance Called: _2:/^/D" ^ ^y 2iz\oi^ ^ 

[P'*^ideo/Photos (Before) Of^::jC'J^' ^ B>^r>N^v\n • Video/Photos (During) Go: / / Bv: 

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

D Viiieo/Photos 130-Dtxy) Oo: / / By. 

O Property Complelion Agreemenl Signed: / / By: 

D final Rcpon Issued:

 / / By: 

Air Monitorint; (AA applicable) 

D Communrty CD Crew O / / By: 

Ri^uJts: 

U ComrounitA' Q Crc« OD: / / By. 

Results: 

LJ Communiri Q Crv»v O n : / / Bv: 

Refuiti: 

Omaha Lead Srte 
Douglas County Account Info: rtd^u)n Page 1 of3 

Douglas County, Nebraska Property Record - R1753090000 

Print Report 

NEW Feature - Parcel Dimensions avaiiable ffl scale 0-50 ft west of 52nd St - Vle W OH Ma p Information is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature -» • • ^ Auto Sales Search 

Owner 

REAL PROPERTY HOLDINGS LLC 

OKOMAHA REAL ESTATE CO 

3715 8 16 ST 

OMAHA NE 68107-0000 

Property Informatio n 

Key Number: 5309 0000 17 

Account Type: Residential 

Parcel Number: 1753090000 

Parcel Address: 2717 NEWPORT AV 

OMAHA NE 68112-0000 

Legal Description: MINNE LUSA LOT 26 BLOCK 24 44 X 120 

Value Informatio n 

Land Improvement Total 

2009 $5,900.00 $26,900.00 $32,800.00 

2008 $5,900.00 $26,900.00 $32,800.00 

2007 $5,900.00 $33,300.00 $39,200.00 

2006 $5,900.00 $33,300.00 $39,200.00 

2005 $5,900.00 $33,300.00 $39,200.00 

2004 $5,900.00 $32,400.00 $38,300.00 

Sales Informatio n 

Sales Date: 2008-12-30 

Deed Type: TRD Sooilr; 2008 Page: 121876 

Price: $0.00 

Grantor: PETERSON TREVTR 

Grantee: REAL PROPERTY HOLDINGS LLC 

Valld/lnvalld: Invalid 

Exclusion Reason: 

Sales Date: 1997-10-23 

Deed Type: D Sooilr; 2075 Page: 292 

Price: $29,000.00 

Grantor: 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R175... 7/7/2009 
Douglas County Account Inforn|*k) >rn|Mk>n r Page 2 of 3

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.12 5280.0 1.0 120.0 44.0 No 

Improvemen t Informatio n 

Building 1 

2Tt7 Newport Ave 

11/2 Slory Untm 

iii2ir 

1*TfS,'ir 

^•Msr •^TcTrV 

CLICK TO ENLARGE IMAGE 

Square Footage: 704.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: ! Fair 

Built As: 1 1/2 Story Unfin Condo Square Footage: i 0.0 

HVAC: Forced Air Rooms: 4.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1923 0% 1923 85 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 704.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R175... 7/7/2009 
Douglas County Accotmt Infongi^n Page 3 of3 >ngi|u)r 

Garage Detached 280.0 

Porch EncI Solid Wall 176.0 

http://douglasne.mapping-online.coin/DouglasCoNe/static/accountinfo.jsp?accoimtno=R175... 7/7/2009 
Property ID #

Property 

Address:

Initial Contact:

Second Contact:

Final Contact:

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

• 

CONTACT FORM 

 HDDMCb 

 7n\ 1 M-e.w:>^C^r^ AV^ 

 Date:_^_[_2f^ Time: \2-.c5 Action: (jjl /g^A v^^jfis-,^ 

 Date: Time: Action: 

 Date; Time: Action: 

Transmit to EPA D Other Action: D 

Ofi^^C^ 
Page 1 of2 

Create Another^Tlcket^ ] Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2347161. 

Original Call Date: 

Work to Begin Date: 

8/23/09 

8/26/09 

Time: 

Time: 

2:40 pm 

7:15 am 

Op: ELIZABETH18790 

State: NE 

Address: 2717 

County: DOUGLAS 

Street: NEWPORT AVE 

Place: OMAHA 

Twp: 16N Rng: 13E Sect-Qtr: 33-NE 

Twp: Rng: Sect-Qtr: 

Legal Given: C 

Type of Work: Lead Remediation 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


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


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: Coastal 


Depth of Excavation: 4ft Comer Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELLAN METRO MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 9185747098 

MAGELLAN MAGELLAN MIDSTREAM PARTNERS LP DEBORAH Alt: 

Emerg: 9185747098 

Day: 4024572307 

METRO METRO COMM. COLLEGE CHRIS Alt: 4026727033 

Emerg: 4024572313 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/23/2009 
Page 2 of2 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 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... 8/23/2009 
OLS#: 40040 

Date Excavated:8/29/09 

Date USEPA Signed Off: 9/11/09 

As-Built Drawing 

C OASTA L Omaha Lead Superfund Site Area Sodden: 2124 sq ft 

Name: (pAi^t r S BSi ' f y Omaha Lead Stte Date: ^//^/' K North Arrow 

Address: •^7^' ? AX^f^/-/9x^ * Stte Sketcti Time: /'/'/^A<C ^ 

Phone: ^<i/'0' ' f 

Tpam //KA J JM. IC^ ­^ T?/Ri ­e BVID # 44)/ 3 Vd ) XRF Code ^9 7 

Sample Number Lead Concentration Confimiation Sample 

1

4

5

6

7

 gVAs^if 

 RYDScPx A ­ ^^^oo^o 

C-pfc5-cfxA- t*-r>o<4.o 

 RDZSCPXA-^Ootf D 

 Lab RYDSCPLA-40040-

Result 

V^>i£ ^

—-jXi i j

^ ^ 1 1?- ^

 ppm 

 ppm 

 ppm 

ppm 

Yes

Yes

Yes

Yes

Yes

Yes

Yes

 CD'­ '

 CD f X

 CD 5\

 I5^3JL

 CD P

 CDOZ

 •

 No 13- ^ 

 No ^ 

 No 123 

 No O . 

 No Ca^ 

 No £3 ^ 

 No CD 

Oinaha Lead Site 46130 

Legend 

Concret e Drxp Zone Excavated Quadrants Excavated 

Area replaced with 
 Area replaced with 

Sod ' ' Rock/Mulch ^ *=** l«f ^ ^^'^ ^ 

Contrac t #: EP-R7-07-05 Coasta l Environmental Group Inc . 
^i l ^fi>^h£ . 

Name: (pAJLr ^ P t I f y 

Address: ,jt 7/ "7 AJJMJAX^/-/^ -

Phone: ! ' '^^ ^ ' 

Team/4fLAJ M . k^ - P/h;-g BVID #

Sample Number 

^ Jgy«fc<cPyA- /(0<H»»- • .^ 

4 RYDSCPXA-•^o^ O 

5 t2.pg:5-CrxA-t<-DO<4.0 

7 Lab RYDSCPLA-40040 

Result .^ . ^ 

454 ppm 

Omaha Lead Site Date: ^V/f/ ^ North Arrow —i 

Site Sketch Time: /'/¥S~A*cS f 

 ^do^C ) XRF Code ?? ? 

Lead Concentration Confirmation Sample 

1^3 1^ ^ 

ppm 

Yes l^'' ' No Q- ^ 

Yes n /=;?, No ^ <iW.i m- ^ __ — Yes n g» No C^ 

Yes ^(^ X No 2 ^ 

Yes D p No S''^ 

Yes •^ 2 No B ^ 

Yes • No • 

.K 

Omaha Lead Site 

46130 
Name: frrlL' r PiUs J Oinaha Lead Site Date: <^/f/ ? North Arrow —i 

Address: A7) ^ Ak^pj^HSx ^ Site Sketch Time: f/¥5~A*:^ 

Phone: ^ f 

Team/4 ^ M K -f P/h;-? BV1D# ^do^C ^ XRF Code ^9 ? 

Sample Number Lead Concentration Confiimation Sample 

2 exsscFx A -• ff oo^Q 

1^3 1: g ^ „„ „ Yes

Yes

 n/- f

 n 1=5,

 No

 No

 t3 ^ 

 5 ^ 

4

5

6

 RYDSCPXA-^0^ 0 

 tLp^J-cfx A ­ ^00<»0 

•RD^SCPAA-^fO<> ' 

ppm 

ppm 

ppm 

Yes

Yes

Yes

Yes

 n 5»

 9^(iJL

 D p

 np ?

 No

 No

 No

 No

 [ ^ 

D 

 Ca^ 

 B ^ 

7 Lab RYDSCPLA-40040 ppm Yes • No • 

Result ,_>• 

454 ppm 

% 

% 

I

I

I 

i 

Omaha Lead Site 46130 
Name: Onwha Lead Site J: ^/» A North Arrow —i 

Address Site Sketch Time: j'/i^AtC i 

Phone: f 

Team^HiU MK4T>#h..e BVID* ^dn'/l i XRF Code .322 . 

Sample Numtwr Lead Concentration Confirmation Sample 

i2YAS£.ftcA ­ lU>oUo 

By<l<gfecA-*fOO<4.6 

B.D-fcSCPxA-tfO0<fD 

Lab RYDSCPLA-40040— 

741 tfc O 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

Yes

Yes

Yes

Yes

Yes

Yes

Yes

 CD/-/ No ^^ T 

 nf A No ^ 

 CDS* No ET 

 I^tcJi No O 

 O p No t3 ^ 

 CDPJ No B ^ 

• No CD 

454ppm 

5^Ea£ ic •<• > ajfe *^^i^^^^^^^ ^ ( ^ 

CiJ^'T" ^ ^ ±t-?­ 345t Sfi ^

:?(»u6^ 4 Br sr f^

-—fc— e Np 

I-lO i •-)*«*• 

I 

n«s«M& 

V»?»0 * 

( o (««i'* >*­

v ^­ ir *.^AH ; 

^7/7 Ai&uj^ u 

i 

f 

i0.4M/ 

P2 •2^1 t?1. 

'7^T31J^g p /=7 

4

u* 

^^34:;(«ss 

1» ^ *6 ^ 

/feu..y^U , l / M' 

Oinaha Lead Site 46130 
\ ^ ) COASTA. % ,< P INVI.ONMIXTA l 

'** PRO"** C « O U P ' w C 

Consen t fcr Acces s 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: Ll/->rNLl<*^ 

Owner's Name: Daytime Phone: ^02. - ^DZ-'^QQ' ^ 

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, will contact 

the Grantor in-person to discuss the viotk to be perfonned, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration worl( 

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 documentafion 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 ail reasonable times 

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

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

agrees to: 

Page 1 of 2 
|\W? "* \ / / CO A. STA I r, <P INVmOHHtKTAl 

*t o«0l*' CHOI/ ' ' " C 

< Remove obstructions including boats, trailers, vehicles, playscape Items, wood 

piles, dog houses, etc: 

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

to save; 

t 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 

EJ I grant access to my propertiM D I do not grant access to my properties 

Signature Date Signature Date 

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

Page 2 of 2 
COASTA L ENVIHONHENTA L h r C II O U F . ( N c

Consent for Access To 

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: 

T^obex-V-jQbn^a/^-)-

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 underthe 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 
„»'"J"». 

COASTA L \ - ENVIflONHENTAL 

CROUP . IN C 

€ 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; 

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

necessary subsequent to an initial watering period by EPA; 

e Abide by health and safety guidance provided by EPA; 

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

the property to perform the work. 

e 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 

W^£kJ r ^i^•$jo1 

Signature Date Signature Date 

Q I wouid like to be present during any sampling that is required. 

Page 2 of 2 
COASTA L 

R«stcratscn Agreement 

The purpose of this agreemenl is to provide a mutual agreement as to conditions ofthe properly 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 Environmenta) 

Protection Agency (EPA). 

j Property ID: L\Q^l4 0 

i Property Address: 2 1 H USNKiOOr ^ M t 

Owner: nKoMft^Uf l ^fea \ feS-hOlVe. 1 CQ ^i

IL""!'!. jyai^.a35L-n<^i__„_ . ..^ j 

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 Removed by the Owner before StarC of Remediation: .:• .v s s:o, t^s , c ;i •'Ji.k:, i- .0/0 S.L'i : o''.rSKfc'Ui'•o '- : " O-'-'i i F £:£•.;;. t. 

ttem: 

^r)\\ G)mall p\aAVs '^^ ^ 

Item: 

j Item: 

I 

I Item: 

Items to be Removed by the Contractor During Remediation and Not^piaced_ 

ptem: 

(XrA| 5mcx>U plar>\5 \e ^ behtir^ 

Item: 

Item: 

Item*. 

Page 1 of / 
COASTA L 

Items to Be Removed By Contractor During Remediation and Replaced 

hem: 

: 50il - e>\, V^ , t?l M^ fe , 

i Item: 

I Item: 1

I 

j 

f 

Item: 

Item 

Landscape Inventory 

Quantity Unit Conditionrrype/Species 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Quadrants 

Number of trees > 2 inch 

trunk diameter 

Each 

Number of trees <= 2 inch 

trunk diameter 

Each 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

^:.rrktc i r,'-^ .Mi. 

0 Each 

Number of and size of 

each garden/ flower bed 

area. 6 Each 

Square Feet 

- /I . •­ . c l J .•^•:.l.•••• ^ 

Agreed upon value of plant 

materials not to be 

replaced by contractor. 0 S 

; • 

Easement Area, to be Each 1 excavated N|es ri&5oi-te perdiA^ 

Page 2 o._22 
C OASTA L 

Additional Comments / Instructions: 

• Check the box ff 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. 

^ l 

Owner's Signature Date Contractor's Sisnaturr Date 

Page 3 o,- ^ 
Date 

Project 

XRFID# 

Shot# 

HtLZA. mm 

MM1.S 

MM2l^ 

Average

Shot # 

MM15-

MMHT 

^4lf t 

Average

Shot# 

m/^o 

HM?i\ 

m M 

44?.3 

Average

Shot# 

Average 

lab sample # 

BVID#400^iO_ 

XRF PROPERTY SAMPLE SHEET 

Address i^U^ioq ^1\ 1 Uf\A->v)nr\ Kyg' 

Omaha lead FP 2nd year opllon Sample time am/pm 

sample length 30 sec ^^Qyi 

Reading Sample area Shot# Readina Samplearea 

,MSJ* ^ ?l \Ql.uUiVv..9A MMfllo H8L ffl.W 6'HB 

\uA.n^\«>.^ \ Depth M Depth 

iA\.ni?3\u.cAf mt^ ^^.-wig.tji . 

 H L &! ^ VV..\2 Average 3l.l 1 J S.MM 

Reading Sample area Shot# Reading Sample area 

Ji-lic.cSlt^V.-J? Has 3?^.iflq^aq3 

A-7.-2ft± I2.<:i« 6) M3A ••yi.Lni\Q.\#^ 92: . '^.y.^ - \C\.TA Depth HMA2. Depth ^5stMM. W.M2»i|0.3^ lo MMQ ^ MEMUffiUn 

 l^.tpS ^ U.\S Average 5g.5l±\Q.-¥ ; 

Reading Sample area Shot# Reading Sample area 

ms.^o* iy.7A &2 \ n \<vi l\8ft 

Tft.-rtlW.V/S Depth Depth 

Ho-:%s * «^.oi u 

 <^'?.<^<^ J^ \9...^S Average 

RETEST AREAS 

Reading Sample area Shot # Reading Sahfiple area 

Depth Depth 

Average 

L^b result Samplearea XRF Avg. 

Signature P^?CjagjU?lA 

Print P^i^lQfeV h [)iO0i£ % 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4427 

Mode SOIL 

Time 2009-08-29 08:38 

Duration 122.59 

Sequence Final 

Flags 

AVERAGE (^Kvg of 442i-4426-j 

ADDRESS 27tTTTCWport-aveJ 

QUAD/ZONE easement 

INSPECTOR VENTRY 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb d^^Tsm-j ± ris.ios) 

Supervised By: ^^J^lCUl ^ 
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 162.213 

Supervised By: 

Certificate of Verification 

4423 

SOIL 

2009-08-29 08:36 

30.63 

Final 

40040 

2717 newport ave 

easement 

VENTRY 

1 

CLEARANCE 

± Error 

± 15.568 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 197.640 

Supervised By: 

Certificate of Verification 

4424 

SOIL 

2009-08-29 08:37 

30.67 

Final 

40040 

2717 newport ave 

easement 

VENTRY 

1 

CLEARANCE 

± Error 

± 16.893 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 160.171 

Supervised By: 

Certificate of Verification 

4425 

SOIL 

2009-08-29 08:37 

30.69 

Final 

40040 

2717 newport ave 

easement 

VENTRY 

1 

CLEARANCE 

± Error 

± 15.414 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 191.215 

Supervised By: 

Certificate of Verification 

4426 

SOIL 

2009-08-29 08:38 

30.60 

Final 

40040 

2717 newport ave 

easement 

VENTRY 

1 

CLEARANCE 

Error 

16.557 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4479 

Mode SOIL 

Time 2009-08-29 13:16 

Duration 122.51 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 1

(yg,6f 4475-447.8^ 

•^ 7 rJewport ave 

QUAD/ZONE Bl 

INSPECTOR VENTRY 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 73.651 11.154 

Supervised By: (^OOJtV^Q ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 76.071 

Supervised By: 

Certificate of Verification 

4475 

SOIL 

2009-08-29 13:14 

30.54 

Final 

40040 

2717 Newport ave 

Bl 

VENTRY 

6 

CLEARANCE 

± Error 

± 11.369 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 97.284 

Supervised By: 

Certificate of Verification 

4476 

SOIL 

2009-08-29 13:14 

30.88 

Final 

40040 

2717 Newport ave 

Bl 

VENTRY 

6 

CLEARANCE 

± Error 

± 12.563 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID# 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 56.816 

Supervised By: 

Certificate of Verification 

4477 

SOIL 

2009-08-29 13:15 

30.54 

Final 

40040 

2717 Newport ave 

Bl 

VENTRY 

6 

CLEARANCE 

± Error 

± 10.293 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4478 

Mode SOIL 

Time 2009-08-29 13:16 

Duration 30.55 

Sequence Final 

Flags 

BVID # 40040 

ADDRESS 2717 Newport ave 

QUAD/ZONE Bl 

INSPECTOR VENTRY 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 64.432 ± 10.393 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4484 

Mode SOIL 

Time 2009-08-29 13:19 

Duration 122.61 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 2717 Newport ave 

QUAD/ZONE B2 

INSPECTOR VENTRY 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb fT 97.894 y ± ^^350^7 

Supervised By: r^ i 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 145.304 

Supervised By: 

Certificate of Verification 

4480 

SOIL 

2009-08-29 13:17 

30.60 

Final 

40040 

2717 Newport ave 

B2 

VENTRY 

6 

CLEARANCE 

± Error 

± 14.778 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 127.150 

Supervised By: 

Certificate of Verification 

4481 

SOIL 

2009-08-29 13:17 

30.59 

Final 

40040 

2717 Newport ave 

B2 

VENTRY 

6 

CLEARANCE 

± Error 

13.877 
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 78.771 

Supervised By: 

Certificate of Verification 

4482 

SOIL 

2009-08-29 13:18 

30.55 

Final 

40040 

2717 Newport ave 

B2 

VENTRY 

6 

CLEARANCE 

± Error 

± 11.677 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4483 

Mode SOIL 

Time 2009-08-29 13:19 

Duration 30.87 

Sequence Final 

Flags 

BVID # 40040 

ADDRESS 2717 Newport ave 

QUAD/ZONE B2 

INSPECTOR VENTRY 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 40.351 ± 9.068 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4489 

Mode SOIL 

Time 2009-08-29 13:22 

Duration 122.88 

Sequence Final 

Flags 

AVERAGE /^Ayq, 0^4485-44881^ 

ADDRESS 2717 Newport ave 

QUAD/ZONE PZ 

INSPECTOR VENTRY 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 31 ± dfiiiSZij' 

Supervised By: CJ^Afjlypp/ } 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4485 

Mode SOIL 

Time 2009-08-29 13:20 

Duration 30.49 

Sequence Final 

Flags 

BVID # 40040 

ADDRESS 2717 Newport ave 

QUAD/ZONE PZ 

INSPECTOR VENTRY 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

Error 

Pb ± 9.217 

ppm 

41.579 

Supervised By: 
• 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 28.683 

Supervised By: 

Certificate of Verification 

4486 

SOIL 

2009-08-29 13:20 

30.43 

Final 

40040 

2717 Newport ave 

PZ 

VENTRY 

6 

CLEARANCE 

± Error 

± 8.476 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 22.584 

Supervised By: 

Certificate of Verification 

4487 

SOIL 

2009-08-29 13:21 

31.11 

Final 

40040 

2717 Newport ave 

PZ 

VENTRY 

6 

CLEARANCE 

± Error 

± 7.638 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 32.222 

Supervised By: 

Certificate of Verification 

4488 

SOIL 

2009-08-29 13:22 

30.85 

Final 

40040 

2717 Newport ave 

PZ 

VENTRY 

6 

CLEARANCE 

± Error 

8.422 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4494 

Mode SOIL 

Time 2009-08-29 13:25 

Duration 121.73 

Sequence Final 

Flags 

AVERAGE Avg of 4490-449J1 

ADDRESS 2717 NewpDrirave"^ 

QUAD/ZONE DZ 

INSPECTOR VENTRY 

DEPTH 10 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Supervised By: CgCMMdU ) 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 38.693 

Supervised By: 

Certificate of Verification 

4490 

SOIL 

2009-08-29 13:23 

30.51 

Final 

40040 

2717 Newport ave 

DZ 

VENTRY 

10 

CLEARANCE 

± Error 

± 8.926 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4491 

Mode SOIL 

Time 2009-08-29 13:23 

Duration 30.56 

Sequence Final 

Flags 

BVID # 40040 

ADDRESS 2717 Newport ave 

QUAD/ZONE DZ 

INSPECTOR VENTRY 

DEPTH 10 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 59.674 ± 10.613 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4492 

Mode SOIL 

Time 2009-08-29 13:24 

Duration 30.14 

Sequence Final 

Flags 

BVID # 40040 

ADDRESS 2717 Newport ave 

QUAD/ZONE DZ 

INSPECTOR VENTRY 

DEPTH 10 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 48.462 ± 9.750 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 4493 

Mode SOIL 

Time 2009-08-29 13:25 

Duration 30.52 

Sequence Final 

Flags 

BVID# 40040 

ADDRESS 2717 Newport ave 

QUAD/ZONE DZ 

INSPECTOR VENTRY 

DEPTH 10 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 87.442 ± 12.091 

Supervised By: 
^lA. ^ Omaha Lead Site—Fixed Price EP-R7-07-05 

.^^^^I Coastal Environmentai Group Inc. ^^s^ ^ 

^^^j ^ www.coastalhazmat.com ^^ ^ 

^"tpROrf ^ COASTA L mVltOIININTAl 

c •OU r, IH C 

EXECUTIVE SUMMARY: 

BVID #40040-(2717 NEWPORT AVE) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 
StK EPA 

EPA Property Close Out Form 

L|o(?q Property # Property Address: 

Date/TInc Owncr^w«.r's. Namee;.^^. : .4105M y j • .-i.^^—• :<• •• • ;

Quads Eicavated: Rl 4-fil- V fT. A- P^, Contractor Group LOtHiY ^ 

Excavatio Yes No n General 

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

2. If necessary, were the correct areas ofdrip zone excavated and restored? T ; ^ 

Gradin Yes No g Sod and Vegetation 

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

2. Has sod been laid in all areas that were excavated? i;^ 

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? y­ 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? u^ 

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

Gates, Fences and RctainlBg Walls 

Yes No 

1. Do gates open and close freely? (Ifapplicable) ^

/ ­

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

3. Was damage to gates or fences avoided? (Ifapplicable) -y' 

'— 

4. Was damage to retaining walls avoided? (Ifapplicable) 

(y 

Foundation, SidlnK and Gmters Yes No 

I. Was damage to the siding or trim avoided? i/' 

2. Was damage to the foiuidation avoided? 

7. Was damage to windows avoided? 

4. Was damage to windows or door saeens avoided? 

5. Was damage to downspouts or downspoul extensions avoided? 1 / 

Sidewalks and Driveways (Concrete) 

Vcs/ No 

1. Was damage to driveway surfaces avoided? 7\ 

2. Was damage to walkway surfaces avoided? 
Ovf'ners comments: 

Inspection notes: 

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

EPA Representative T)/r^I]J^L ^..^III 01 
_D_^ Remote, ID:_ Rjjajje of 

FroorCOASTAL ENVIBONNENTAL B77 662 4211 09/10/200m3:4 JWa 9 f365 P.003/003 

Property Completion Agreement 

rin^ agieemm documentt tbe ocanptelion of remedial activilies pertiDiinedon my property My s-.grnu»« 

•nil desis^ic tlw I am uiisfied wdh the ftatoralipn of my propsty. and ihai no iieim are in qbCtiioiK. 

•WW. or »i any iHne m the future, netfii thote iicms liued below, tf any 

»i<pcrtyH>:l4(Xy40 

r^ - C\a,^ ^nr^t^rx 

RmleraMen In 

T/A tlxJL 

I Mam 

AMWona) Command: 

©T«Br I aer< M tcMaraitonii comylclttf, fiw ^ u oalcif 

[ J I ••• nai acre* rtilnatMB 

'C%]Jl4^' LLC 

OwMT** ScBstwv AI^ C CwMiarlar* 

tm a

ariorl Senahm 

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