CONTRAC T# EP-R7-06-0 4 AS W Associate s Inc . Omah a Lea d Sit e Remediation , Omaha , N E EP A 

### AS WAssociate s In cCertificatio n fo rPropertyCloseou t

BVI D 2184 2 PropertyAddres s 90 6 S 38 t h Stree t Fiel d Wor k Starte d 27-Oct-0 6 Fiel d Wor k Complete d SO-Nov-0 6 

### Summary : Th e excavatio n wa s performe d i n complianc e wit h th e work plan s an d specifications . Th e B 1 quadran t wa s excavate d t o a dept h o f1 2 inch . Th e B 2 quadran t wa s excavate d t o a dept h o f6 inch . Th e dri p zon e wa s excavate d t o a dept h o f 1 2 inch . Verificatio n sample s confirme d tha t th e cleanu p standard s wer e met . Verificatio n sample s wer e take n fro m botto m o fexcavation . Th e sit e wa s backfille d wit h material s whic h meet s contrac t specifications . Th e backfil l wa s compacte d t o acceptabl e standards . So d placement s an d sit e restoration s wer e conducte d i n complianc e wit h wor k plan s an d specifications . Analytica l dat a provide d i s pos t excavatio n a t th e botto m o fth e excavatio n fo rconfirmatio n purposes . 4026178 0 Comments : SUPERFUN D RECORD S None . Ja n Prawdzi k AS WProjec t Manage r

Nam e Titl e 

### Dat e Signature

### CONTRAC T# EP-R7-06-0 4 AS W Associate s Inc . Omah a Lea d Sit e Remediation , Omaha , N E 

### Analytica l Resul t Summar y OL S ID : 2184 2 Propert y Address : 90 6 S 38 th

### Stree t Sampl e I D XR FResult s 

### Avg . (ppm ) La b Result s 

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### 2I842-DE-B2-0 6 3 1 6 ±49. 6 N A 

### 21842-DE-DZ-1 2 131.3±38. 6 N A 

### 21842-DE-B1-1 2 22 4 ±68. 7 N A

Ja n Prawdzi k AS WProjec t Manage r

Nam e Titl e 

### bat e Sicfrfatur e

Sampl e Designatio n OLSIO-DE-Location-d d OLSI D i s aparticula r residentia l propert y I D fro mwhic hth e sampl e i s collected . D E= Durin g an dPos t Excavatio n Locatio no f th e sampl e a s follows : F l = Fron t Yar d(I " Quadrant ) B l =Bac k Yar d(1 MQuadrant ) F 2 = Fron t Yar d(2 n dQuadrant ) B 2 = Fron t Yar d(2 n dQuadrant ) D Z= Dri p Zon e P Z= Pla y Zon e G A= Garde n E A= Easemen t d ddescribe s th e dept hfro mwhic hth e sampl e wa s collected . N A= No t Applicabl e

# &EP A Remediation/Excavatio nContrac t (ASW ) EP APropert y Clos e Ou t For m $ t Property# : £ PropertyAddress : 1 0 ( > Date/Time : Owner' s Name : A ? rc Quad s Excavated : 

# w Contracto rGrou p Excavatio n Genera l Ye s N o 1 .I fnecessary , wer e th e correct quadrant(s ) excavate d an d restored ? / 2 .

I f necessary , wer e th e correct areas o f dri p zon e excavate d an d restored ? 

# s Gradin g So d an d Vegetatio nVe s N o 1 . Does th e gradin g aroun d th e perimete ro fth e hous e i n excavate d area s generall yslop e awa y fro m th e house ? i / 2 .Ha s so d bee n lai d i n al l area s tha t wer e excavated ? / 3 .

Doe s th e so d appea rt o b e generall yhealth yan d growing ? (Onl yevaluat e i finspecte d a t a 3 0 daytim e period ) 

# y 4 .Ar e sodde d area s generall yfir m an d evenl ygraded ? 

# « / 5 .Ar e th e joint s betwee n th e so d strip s generall ytight ? (Onl yevaluat e i finspecte d a t a 3 0 da y tim e period ) 

# s 6 .Wa s th e propert ygrade d suc h tha t wate rwil l no t poo l o n th e property? 

# / 7 .Wa s damag e t o landscapin g o rplan t material s avoided ? 

# / Gates , Fence s an d Retainin g Wall s Ye s N o 1 .D o gate s ope n an d clos e freely ? (I f applicable ) i / 2 .

Wer e al l gate s o rfence s take n dow n durin g restoratio n activitie s reinstalled ? (I fapplicable ) S 3 .

Wa s damag e l o gate s o rfence s avoided ? (I fapplicable ) / 4 .Wa s damag e t o retainin g wall s avoided ? (I f applicable ) y Foundation , Sidin g an d Gutter s Ye s N o 1 .Wa s damag e t o th e sidin g o rtri m avoided ? S 2 .

Wa s damag e t o th e foundatio n avoided ? 

# s 3 .

Wa s damag e t o window s avoided ? 

## i / 4 .

Wa s damag e t o window s o rdoo rscreen s avoided ? 

# I / 5 .

Wa s damag e t o downspout s o rdownspou t extension s avoided ? 

# i / Sidewalk s an d Driveway s (Concrete ) Ye s N o 1 .Was damag e to drivewa ysurface s avoided ? / 2 . Wa s damag e t o walkwa ysurface s avoided ? i /

### Owner s comments :

Inspectio nnotes :

Remova l an drestoratio nactivate s complet e includin g th e 30-day so dwarranty : EPARepresentativ e .^L, -£4^- . Date : si 

### Contrac t No : E P - R 7 - 0 6 - 0 4 •*•*'•• ) Propert yCloseou t Agreemen t 

### ® Omah a Lea d Superfun d Sit e OLSI D Propert y Addres s /"*i / C T " ? O ^ ~\* { J i " r~ ) __ j ._._ j y \v < • / 

### Propert y Owne r / I s th e Residen t th e Owne r j S Ye s D N o ^>ftC,tA. S 

### Complianc e Statement : U.S . Environmenta l Protectio nAgenc y (EPA ) o r it s authorize drepresentatives , (o r it s contractors) , t o ente r an dconduc t environmenta l restoratio nservice s fo r th e Omah aLea dSite . You r cooperatio ni ngivin g EPA/AS Wpermissio nt o acces s you r propert y durin g th e removal/restoratio n phas e i s sincerel y appreciated . Thi s documen t certifie s tha t al l wor k performe da t thi s property wa s complete di naccordanc e wit hth e contac t specification s an dEP Arequirements . I f

yo u hav e question s o r nee dadditiona l informatio npleas e contac t th e EP APubli c Informatio nCenter s a t (402 ) 731-304 5 o r (402 ) 991-958 3 o r th e EP AOffic e o f Externa l Program s a t 1-800-223-0425 . Additiona l Comment s b y EP Aand/o r ASW :

CONTRACTO RCERTIFICATIO N Ja nPrawdzi k AS WProjec t Manage r Nam e Titl e Dat e Signatur e 

## Propert y Owne r Sectio n Thi s agreemen t document s th e completio no f remedial/restoratio neffort s a t th e propert y t o m y satisfactio n { S Iagre e tha t restoratio ni s complete dat my propert y D ID o No t Agree : Comments :

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Owne r Signature : AS WAssociate s Inc . Prin t & Sig n

# 2184 2 Omah a Lea d Sit e Owne rName : JA N ERI C PUSC H 

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