•ii

 • • 

TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 14511 Date: 7//5A/Aq 

Address: .__2D2 2 5 ^."^ H" 

Remediation Contractor: Coastal Environmenta l Grou p Year; 200*^ 

SOIL REMEDIATIO N 

PROPERT Y HL E FOLDER DOCUMENT S 

. / Video ofproperty (DVD) 

• ^

 Executive Summary 

V EPA-provided property sketch 

^2f Signed Access Agreement for subject property 

f ^ Signed Access Agreement(s) for adjacent property 

yT Restoration Agreement 

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

sf Confirmation data 

i /' Photographs ^U-t^^Cfi(i/{kW2l^ -^ fe<^WAtl^ ^ ')<7 l^jyv, 

^ As-built sketch 

V^ Satisfactory restoration signed by Property Owner 

Ty Property close-out check list signed by EPA 

t^L Description ofareas not meeting ROD cleanup criteria 

f/ Utility clearances 

sT Property infonnation from Douglas County Assessor's Office 

[ I 

n 

n 

&W0UU- Signature "

30054509 

 T ^ 

 Date 

Superfund 
i'EttProperty Access Checklist 

Property ID: |H'5\" 7 D WORK STARTED ON: 

Property Addiess: "^Tf] H ^ "^"^ ^ L D WORK COIVIPELTED ON: 

1 Owner: f^^^^ fia\\f\^ r 

1 Address: 3cjnl ^ 

Phone: 5^1-^02 5 

Fax: 

1 Ccll/Pascr: 

O Notification Letter 

S J Access Agreement 

1 "SS Restoration Agreement 

CD Top.soil Sampling (if a|)plicablc) 

Q Disposal Sampling (if applicable) 

EH Garden Sampling (if applicable) 

M Utility Clearance 

1 5 7 Video/Photos (Before) 

n Video/Photos (During) 

n Video/Photos (After) 

D Video/Photo.s (30-Day) 

n Property Completion Agrcemeni 

n Filial Report 

Renter: | 

Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

Sent: / / Bv: 

Signed: |J2_/X'- ^ B.v: t. e 

Signed: j2_/X/ ± B.:6.C 

/ / By: 

/ / By: 

/ / By: 

Called: i£_/Jl/ ^ By: e c 

On:ic_/_[D/ C\ ^y-l\lltk/^n(xr\ 

On: / / Bv: 

On: / / By: 

On: / / By. 

Signed: / / Bv: 

Issued: / / By. 

Air Monitoring (as ai)plicable 

CH Community Q Crew 

) 

Results: 

On: / / B>: J 

CH Community

Results: 

 [H Ciov On: / / By: 

CD Communit>

Results: 

 CH Crc^v On: / / B>: 

Omaha Lead Site 
Property ID U 

Property 

Address: 

Initial Contact:

Second Contact:

Final Contact:

Final Action:

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

43i\ l 

^v^-il 5 ?.a 5^ 

 Date: Time: Action: 

 Date: Time: Action: 

 Date: Time: Action: 

 Transmit to EFA D Other Action: D 

hp^*<<: 
R^j^nt Request for Action Form (fll^) 

MK^ 

Project Name: Project No. 

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

Project Location: Property ID 

Omaha, NE 14317 

Home Owner's Tammy Bahner Name: 

Property Address: 3072 S 33 St 

Phone Number: 

Date & Time 

402.291.4000 Request 6/30/2009 

Received: 

Documented by: ELIZABETH CACERES

 | 

Issue: 

Tammy called because the power at her residence is out. PO thinks a power line may have been damaged 

during remediation. PIC provided PO with Contractor phone number and told PO that information would be 

forwarded. 

Coastal contracted a licensed electrician to replace an underground conduit that extended firom the garage to 

the house. The conduit wasn't identified by line locate and we damaged it while excavation the property. 

The electricians responded to the call the same day 6/30/2009 and schedules repairs with the homeowners for 

Thursday and completed the repairs on Friday the thinj. This call has been completed. 

Proposed Action • Issue not previously • Follow-up Required X No Further Action 

Is as Follows: Identified; Investigation 

Necessary 

• Additional comments: 
Douglas Covmty Accoi >U|^i^Kni{ ation Page 1 of2 

• # 

Douglas County, Nebraska Property Record - R1942920000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - Vlevtf OH Ma p Information is valid as of 2009-5-12 Treasurer's Tax Report 

New Feature -•••" • Auto Sales Search 

Owne r 

BAHNER BRIAN T 

ETAL 

3072 8 33 ST 

OMAHA NE 68105-0000 

Property Informatio n 

Key Numtier: 4292 OOOO 19 

Account Type: Residential 

Parcel Numlter: 1942920000 

Parcel Address: 

Legal Description: 

3072 S 33 ST 

OMAHA NE 68105-0000 

PARKVALE LOT 6 BLOCK 8 41 X 130 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$5,900.00 

$5,900.00 

$5,900.00 

$5,900.00 

$5,900.00 

$5,900.00 

Improvement 

$80,300.00 

$80,300.00 

$80,300.00 

$67,800.00 

$67,800.00 

$67,800.00 

Total 

$86,200.00 

$86,200.00 

$86,200.00 

$73,700.00 

$73,700.00 

$73,700.00 

Sales Informatio n 

Sales Date: 

Deed Type: 

Price: 

Grantor: 

1997-05-14 

$69,950.00 

Book: 2065 Page: 373 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres 

0.12 

SF 

5330.0 

Units 

1.0 

Depth 

130.0 

Width 

41.0 

Vacant 

No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R194... 6/6/2009 
Douglas County Acco i^l^n^n i ation Page 2 of2 

Building 1 

Rr*t Floor "l»eona Floor"' 

633.0 sq. f l 464.0 sqft 

«ir 

I M \ 16 P 

11/2 STORY FINISHED 

CLICK TO ENLARGE IMAGE 

Square Footage: 1097.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 5.0 

Exterior: Frame Stucco Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 2.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Blocl< 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1918 0% 1918 90 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 624.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 228.0 

Porch Encl Solid Wall 160.0 

User 1/2 Stucco & 1/2 Shingle 1.0 

User Attic Full Finish 464.0 

User Shed - NV 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R194... 6/6/2009 
0 Page 1 of 1 

"> 

Create Another Ticket Back to Irth Intemet , Send, Email 

• YOUR TICKET NUMBER IS 2293379. 

Original Call Date: 6/12/09 Time: 3:08 pm Op: ELIZABETH18790 


Work to Begin Date: G/lG/09 Time: 3:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3072 Street: S 33RD ST 


Twp: 15N Rng: 13E Sect-Qtr: 33-NW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remediation 


Location of Work: LOCATE 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 Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 


CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 


Emerg: 4029329757 


Day: 4025047823 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RON Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

0PPDGPR6 OMAHA PUBLIC POWER DISTRICT NA Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIF QWEST LOCAL NETWORK NA Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 6/12/2009 
http://www.dhoaaatirthintemet/DHONNoticeCreation/MessageText. LM& t .

Create Another Ticket Back to lith Intemet Send Email 

• YOUR TICKET NUMBER IS  2300156. 

Original Call Date: 6/22/09 Time: 12:44 pm Op: ELIZABETH187 90 


Work to Begin Date: 6/24/09 Time: 1:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3072 Street: S 33RD ST 


Twp: 15N Rng: 13E Sect-Qtr: 33-NW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: Leam Remediation 


Location of Work: INCLUDE ALL EASEMENT. 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 Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number 

Utility 

lype 

CXCATV COX COMMUNICATIONS, INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emerg: 4029329757 

MUD02 METROPOLITAN UTILITIES 

DISTRICT 

Day: 4025047823 

SAND Y Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

0PPDGPR6 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNE 1F QWEST LOCAL NETWORK NA Alt: 4062071494 

lof 2 6/22/2009 12:44 PM 
htq)://www.dhoaQ«ju1hintemet/DHONNoticeCreation/MessageText... 

Emerg: 8887289343 

2 of 2 6/22/2009 12:44 PM 
OLS#: 14317 

As-Buil Date Excavated:6/30/09 t Drawing Date USEPA Signed Off: 7/28/09 

C OASTA L Omaha Area Sodden: 721 sq ft INVIRONHKNTAL Lead Superfund Site O fl O U F . IN C 

14317 

Omaha Lead Site Exterior Pairrt Owner Name: BRIAN T BAHNER 

Site Sketch • Good 

• Poor 

0 Not pairrt 

Omaha Lead Site 46130 

Legen d 

Concrete Drip Zone Excavated 

Quadrants Excavated 

Area replaced with Area replaced with 

Sod Rock/Mulch Area left bare 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
14317 

Omaha Lead Site >^CV^6F^ 4613(1 
14317 

Omaha Lead Site Exterior Paint North Arrow r Owner Name: BRIAN T BAHNER 

Site Sketch • Good 

• Poor 

0 Not paint 

Omalia Lead Site '^^ojm 46130 
Owiwr Nam*: BRIAN T BAHNER 

AddfMs : 3072S33ST 

Phon*: H: 

Sample Numt>er 

RYASCPXA-14317 Fl 

RYBSCPXA-14317 F2 

RYCSCPXA-14317 B1 

RYDSCPXA-14317 B2 

RDZSCPXA-14317 DZ 

fiOZ00PKA-1-M17 0 2 

RP2SCPXA-14317 PZ 

Omaha Lead Site 

Site Sketch 

w 

Lead 

Concentration 

Sample 

Collected LAB 

D 

/^ ^ ppm D 

/ VjP ppm D 

'rv7 pom D 

73 / .ppm D 

ppm D 

l^lt y oom D 

14317 

Exteitor Paint North Arrow 

• Good 

n Poor 

gJ Not paint 

Samples Collected 

Firm: PJ»t> ^ DA \ t ^ tVN 

Date: QT - \S-O M 

Time: 'S' . VO 

Samples Analyzed 

XRF Unit: BJ'^ ^ Book: j^ f 

Date: ^./V-^?y -

Time: f^T ^ 

Number of Samples = I j ^ Staff: JZSZfZ. 

TOJg? s^s: 

IK- ^ 

r2) 7^a 

/ 3 

£7Z 

fov... 

72./. 

o * 

gp ^ 

t^7 

S^:r/f>^ 

T ^ 

^ 

ENTERED 

JUL 1 9 i£U«*: 

..<?, 

J 

Siks. <>>' 

. ^ 7 

^ ' 

753-1 

StfU^oo*"^ •yv\ ie^xnia.. 

'^'h ^ <i*-

Omaha [jcad Site 46130 
^^''^:>* 

COASTA L INVIHeNflfNTAl ^««. ^ • • O W P , tN 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 

follovi/ing described premises: 

Daytime Phone: 

l>olt 6 •b-^"'' ^-t 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 vi/ill 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 v^rk 

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 rrotice, 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: 

l o f 2 
• • 

COASTA L 

iMvitonnniiAi s I 0 u r. I *i 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 v^lch 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 

p/ggran i t access to my properties 

D I do not grant access to my properties 

C-'i'O^l 

Signature Date Signature 

Date 

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

COASTA L 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This wili also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction of the propert>' owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: WTT 

Property Address: "^tyi-^y '^h^ ^ ^ 1 

Owner; hU ^ f7(W^ ^ 

Phone: 

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

utilities, subsur^e features, surface 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 retum of these items Is the Owmer's responsibility. 

Item: 

Item: ( J ' 

-—. 

Item: ^^3 

Item: .^ ^ ' 

Item: ., ' 

Item: -

Item: /-' 

Item: 

Paget of. 
COASTA L 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

" Item: 

l\ha "iihmA (1/ ^ boL/y^J 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Kem: 

Item: 

Item: 

item: 

Item: 

Item: 

Item: 

Page 2 of. 
# • 

C p A S T A L CMVlMOMMIMTAl c n o u r IN C 

Items To Be Removed By Contractor During Remediation An d Replaced 

(Use additional sheets as necessary) 

Item: 

<o\l ' fa>n^ 

Item: 

.W &?- fmf m l>-^ 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

item: 

Item: 

Item: 

Item: 

Item: 

Page 3 of. 
1 ^ 

COASTA L t N vlHONMtM f A L 

GROUP . IH 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 

\ 

Each 

\ 

Each iff 

Each 

Square Feet 

\ 

Page 4 of. 
COASTA L • MVIJIONr«AMTAL OHOU P *N e 

Item 

N 

Agreed upon value of 

Diant materials not to be 

renlaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

\ 

Quantity Uriit 

$ 

Condition/Type/Species 

Agreed upon list of pla ^ 

materials that will be^ 

replaced by connector. Be 

very specific and detailed. Each 

Include a siietch of were 

each plant will be placed 

by the contractor. 

\ 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

arca(s) to be replaced with 

grass sod. 

SF 

Area of City or County 

proper^ to be landscaped 

per dieir requirements. \ SF 

Include

area(s) 

a sketch of the 

/ 

Easement Area, to be 

excavated SF 

RjxAxyv^ ^CMf e 

Page 5 of. 
• • 

; OAST A L. MVlkOMMCHTAi , « • tf F . IM C 

Additional Comments / Instnictfons: 

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

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

interior of house, induding foundation cracks or fissures. 

EOragr age e O I do not agree 

1 

Owner's S%;nature Date doi^ctor*8 Signatare Date 

PageSof 
BviD# iM5n 

XRF PROPERTY SAMPLE SHEET 


Date Ln Address ' m- m '6bn a ^?> ^V 

Project Omaha lead FP 2nd year opilcn Sample time am/gig ^^TT^ XRF1D# ?i?.r)«^ sample length 30 sec 

Shot# Reading Sample area Shot# Reading Sample area 

_kSD_ mn.2f»t i*s.^p U>^ ^ f»>\.r^tw.Mt » .^r**.^"^ SsM. iaiL*iu±J5Jd2^ t/>3U> °H.81 t IT.-'Sl IiL 

InSl. m n^± j ^ .fi^ Depth t»q.q5j:ii.i<» Depth 

j£Ji2L \^Z\ ± 1^.1% "Tz Ja S: ^q g i Il.l? , 

Average \'h\l>.l<^ t \5.'! ^ Average qii,.l U J H .L. 

Shot# Reading Sample area Shot# Reading Sample area 

M^ Jfi3k- I^.T±l*i.S-^ 

tXT.^?.llM.1.'? J2L 

u>q"i 

IIL33­ lll.qitl?t,'A7 

mt,*\\\nf^ 

Depth 

j£z 

Depth 

Average 12 1 ^ 4 ± I H • 2^ ^ Average 

[ Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot # Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

lab sample # Lab result Sample area XRF Avg. 

Signature tpCAJ^noA 

Print rJi7c.hP-Ho CjQlPe^f 5> 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 684 

Mode SOIL 

Time 2009-06-30 14:13 

Duration 121.74 

Sequence Final 

Flags 

AVERAGE ^^oL650=683-7 

ADDRESS 3072 s 33 st 

QUAD/ZONE easement 

INSPECTOR nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb ± 05735617 

Supervised By: Cf^jJ^orULfy­
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 680 

Mode SOIL 

Time 2009-06-30 14:10 

Duration 30.48 

Sequence Final 

Flags 

BVID # 14317 

ADDRESS 3072 s 33 st 

QUAD/ZONE easement 

INSPECTOR nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 140.250 ± 15.301 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 681 

Mode SOIL 

Time 2009-06-30 14:10 

Duration 30.21 

Sequence Final 

Flags 

BVID # 14317 

ADDRESS 3072 s 33 st 

QUAD/ZONE easement 

INSPECTOR nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 134.459 ± 15.367 

Supervised By: 
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 142.090 

Supervised By: 

Certificate of Verification 

682 

SOIL 

2009-06-30 14:12 

30.55 

Final 

14317 

3072 s 33 st 

easement 

nicolas 

1 

CLEARANCE 

± Error 

± 15.575 
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 130.210 

Supervised By: 

Certificate of Verification 

683 

SOIL 

2009-06-30 14:13 

30.50 

Final 

14317 

3072 s 33 st 

easement 

nicolas 

1 

CLEARANCE 

± Error 

± 15.180 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 689 

Mode SOIL 

Time 2009-06-30 15:30 

Duration 120.74 

Sequence Final 

Flags 

AVERAGE GAvg of 685-688 

ADDRESS 3D7Z~s33-st 

QUAD/ZONE B2 

INSPECTOR nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

± Error ppm 

Pb [96.25^ ± 

Supervised By: CfiQAJ^n/lO^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 685 

Mode SOIL 

Time 2009-06-30 15:28 

Duration 30.20 

Sequence Final 

Flags 

BVID # 14317 

ADDRESS 3072 s 33 st 

QUAD/ZONE B2 

INSPECTOR nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 131.052 ± 14.455 

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 94.819 

Supervised By: 

Certificate of Verification 

686 

SOIL 

2009-06-30 15:29 

30.19 

Final 

14317 

3072 s 33 st 

B2 

nicolas 

6 

CLEARANCE 

± Error 

± 12.514 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 687 

Mode SOIL 

Time 2009-06-30 15:29 

Duration 30.18 

Sequence Final 

Flags 

BVID # 14317 

ADDRESS 3072 s 33 st 

QUAD/ZONE B2 

INSPECTOR nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 69.954 ± 11.186 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 688 

Mode SOIL 

Time 2009-06-30 15:30 

Duration 30.17 

Sequence Final 

Flags 

BVID # 14317 

ADDRESS 3072 s 33 st 

QUAD/ZONE B2 

INSPECTOR nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 89.195 ± 12.227 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 699 

Mode SOIL 

Time 2009-06-30 15:51 

Duration 121.00 

Sequence Final 

Flags 

AVERAGE rAvgof695=69S? 

ADDRESS ^trr2rs~33-sf^ 

QUAD/ZONE DZ 

INSPECTOR nicolas 

DEPTH 13 

SAMPLE TYPE RETEST 

NOTE 

ppm Error 

Pb rl273 ^ rpr26§/ 

Supervised By: VflOft>OJ7ff^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 695 

Mode SOIL 

Time 2009-06-30 15:49 

Duration 30.19 

Sequence Final 

Flags 

BVID # 14317 

ADDRESS 3072 s 33 st 

QUAD/ZONE DZ 

INSPECTOR nicolas 

DEPTH 13 

SAMPLE TYPE RETEST 

NOTE 

ppm ± Error 

Pb 138.698 ± 14.825 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 696 

Mode SOIL 

Time 2009-06-30 15:50 

Duration 30.20 

Sequence Final 

Flags 

BVID # 14317 

ADDRESS 3072 s 33 st 

QUAD/ZONE DZ 

INSPECTOR nicolas 

DEPTH 13 

SAMPLE TYPE RETEST 

NOTE 

ppm Error 

Pb 122.326 ± 14.246 

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 111.924 

Supervised By: 

Certificate of Verification 

697 

SOIL 

2009-06-30 15:50 

30.11 

Final 

14317 

3072 s 33 st 

DZ 

nicolas 

13 

RETEST 

± Error 

± 13.417 
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 136.410 

Supervised By: 

Certificate of Verification 

698 

SOIL 

2009-06-30 15:51 

30.50 

Final 

14317 

3072 s 33 st 

DZ 

nicolas 

13 

RETEST 

± Error 

± 14.587 
/ Jfk^ \ Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmentai Group Inc. 

^^^^ ^ www.coa8talhazmat.com 

\p„e ^ COASTA L IHViaONNINTA l G IO U P, IN C 

EXECUTIVE SUMMARY: 

BVID # 14317-(3072 S 33 ST) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 

-SOD IS BROWN DUE TO PROPERTY OWNERS DOG (EVALUATE 30 DAY SOD PHOTOS) 
4

EPA 

EPA Property Close Out Form 

Property # Property Address;- ^fll/ - - ^ . ''^^^'' ' 

Datc/Tlmc Owner's Name: Ajfl P •• V^lQ-t^^ y • 

Quads Excavate avatedd: Sl^ ^X^'L; Contractor Group CjOoftbLl GtAttTMrltAy 

Excavatio Yes No n General 

i^" 1.

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

: ^ 

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

Grading Sod and Vegetation Yes No

1. Does the grading around the perimeter ofthe house in excavated areas generally slope away V" from tbe bouse? 

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

3. Does Ute sod appear to be generally healdi healdiy anandd Bftov»ing?XOnl ^^^ing?^0nlyy evaWlat eva^t ee ^

 if inspecte inspected^at^ d at aa 330

day time period) ^

P ^ ^ TJ^ h(^C- /^^ ^ hyjiK Jt/iL 

4. Are sodded areas generally nrm and evenly graded? ly^ ' 

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 thai water will nol pool on the property? i ^ 

7. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Rctoining Walb 

Yts No 

1. Do gates open and close freely? (If applicable) L ^ ^ 

Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) 1 ^ ' 

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

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

Foundation, Siding and Gutters Yes No 

I. Was damage to the siding or trim avoided? 1 / ^ 

2. Was damage to the foundation avoided? y 

3. Was damage lo windows avoided? TT-' 

Was damage to windows or door screens avoided? -y^ 

5. Was damage to dowrnspouts or downspoul extensions avoided? 1?^ 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage lo driveway surfaces avoided? lyc 

2. Was damage lo walkway surfaces avoided? 
m % 

Property Conf>pletlon Agreement 

This agrcemeni documenls Ihe compiclion ol remedial acliviiies perlbimed on my properly My signaluie 

will designate ihai J am salisfied with the restoration of my properly, and Ihal no items are in question.^, 

now. or al any lime in ihe futui-e, except ihose items listed below, ifany 

Property ID: ) Lj ^ ) ' j 

Property Address: •a/N'TO ^ !? ^ < + 

Q""^" ^lAtt. "bfthner. Phone: ^ 4 | , ^^y; ^ 

Restoration Items in Question: 

Item: 

Ilem: 

Item: 

t'w » 'wrm mtmmv tj 1 

Item: 

Item: 

Item: 

Additional Comments: 

l\ f I ngrcc restoration i< complcitd, rxccpl as noltrl 

[_J I flo nol ajjrec resiomtion is eompleled 

Owno'.«Sicnatnrr Date CJinti aclor's Signature Dale 
Water Bill Settlement 

Property E) 14317 

Property Address 3072 S. 33"" Street 

Tenant Mr. Brian Bahner 

Plione 402-341-8085 

I have received fix)m the contractor, Coastal Environmental Group Inc. (Coastal), the sum of $ 70.56 for 

water usage required to maintain the sod. 

Check Number 1789 

Value of Check $70.56 

Made Out To Brian Bahner 

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. 

n / • / 

2 ­ lylM ^ nU 

Owner's Signature Date "cdr infractor's Signature Date 

Page 1 of 1 
h 'iln Oilt m'i 3io •<.!.') \w #11-) n 

Accounts 129003-1173798 

BRIAN BAHNER 

Service addreaa: 3072 8 33RD 8T 

Call 811 before 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. 

350 1 

J ,- fcillili.,, 

Sep Od Nov Dae Jan Feb Mar Apr May Jun Jul Aug 

Your Gaa Uaa 

ftet 12 Montti* • Past 134* MonUM 

This Month Last Year 

Billing units: 8 7 

Use per day: 0.3 0.2 

Average cost per day: $0.65 $0.81 

Number of days in tsilling cycle: 30 31 

40 1 I 

Jltll-- - iL 

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

Your Water Uae 

• PMt 12 Months B Past 1344 Monttis 

This Month Last Year 

Billing units: 25 26 

Use per day: 0.8 0.9 

Average cost per day: $1.20 $1.30 

Number of days in billing cycle: 33 30 

Please retum this portion of the bill with payment. • Pleaaedo not ataple payment to bill. 

X e-mail: ou8tomer_9eivloe(^mudomaha.oom 

websita: www.mudomaha.oom 

METROPOLITAN UTILITIE S DISTRIC T 

1723HameySt • Omaha, NE 68102- 402.554.6666 

8850 0010 MU RP 07 08082009 YNNNNY 01 002821 

BRIAN BAHNER 

3072 8 33RD ST 

OMAHA NE 68105-3664 

>l>|l"l I'illll|l>l I"ll<l'll>ll»"|ll|'l Ill 

Givetothe Heat Aid Fund. Seewww.mudomaha.com. 

Monthly donation ~ Add: Q $2 D $3 D $5 Other $_ 

1723 Harney St • Omaha, NE 68102 • 402.554.6666 

e-mail: customer_service@mudomaha.com • website: www.mudomatia.com 

Billing date Aug 7,2009 

Previoua balance 

Payment reoeived -Thank you 

Current ohargea 

New balance 

• Total due Aug 25,2009 

Your budget payment of $138.00 it due Aug 25,2009 Budget varianoes: 

Currently-$67.44 Total ° -$51.50 

Details of ourrent oharges: 

METROPOLITAN 

UTILITIES DISTRIC T 

ImGieai . Think Blue. 

$138.00 

138.00 OR 

138.00 

138.00 

$138.00 

QAS RESIDENTIAL RATE A: Jul 1 to Jul 31 

Meter Number 268558 

Current read (aohiao: 7326 - Previous read (estimate): 7318 » 8 CCF 

Gas Use: 8 CCF x 1.024 (heat value) = 8.192 therms 

30 daya 8.192 therma at 0.5286 > $4.33 

Senrice Charge 12.00 

Gas Cost . • $16.33 

Gas Infrastmoture Replacement 3.00 

WATER RESIDENTIAL RATE W-1: Jul 1 to Aug 3 

Meter Number 35052315 Size: 5/8 -inch 

Cunent read (esuimte): 1728 - Previous read (estimate): 1703 •• 25 CCF 

Water Use: 25.000 CCF or 18,700 gallons 

9.000 CCF at 0.9614 « $8.65 

16.000 CCF at 1.3451 ­ 21.52 

Service Charge 4.86 

Water Cost • 

Water Infrastructure Replacement 

City of Omaha Sewer 

Sales Tax 

> Current Charges 

$35.03 

2.00 

9.59 

4.61 

$70.56 

0001290031173798000000138000 


Due on or before Aug 25: $138.00 

Your budget payment of $138.00 is due Aug 25. 

Amount Paid: 

METROPOLITAN UTILITIES DISTRICT 

PO BOX 3600 

OMAHA NE 68103-0600 

|„|.,„j,i|i..„i..,i,|iiiii|.||.,|i||i||,i...|l'liil"ii'n'l' 

Account: 129003-1173798 
'• f^^ r ««»e«^'i 

' (402)556-3600 ^ ^ 

4315 Cuming Street, Omaha, NE 6813t^M8 

After Bus. Hours Sunday & Holidays Call: 

; 7th & Seward ^ 36th & k 87th & Maple Bellevue Millard Springfield Chaico Valley Elkhorn Co. Bluffs ^"A^H'IDO I 

556-3604 556-3606 556-3603 556-3607 •­ 556-3605' 253-2770 §56-3601 359-5923 556-3602 (712)322-7044"' 557-4891 

Ticket # Plant •Dite V Tlrhe TmcK Driver Dispatcher 

3369725 6 07/145/09' •iO:0 6 3344^ ^ ,*.L.^CKMAN .JEFFCustomer:

•4533 3 -COSTA

 V :• o 

 CONSTSUCTIONf 

RrojQct 0'. .Order # 

2011'A 

P07Job # 

Delivery address/instructions a ' • > if 

307 2 SOUTH 33RD ^VE f* 

1 7 0 ,'60 

COASTAL ENVIRONMENTAL QROUP INC. 1753 

2411 MARTHA STREET 

OMAHA 27-6/1040003 . NE 6810S 6247372904 ^//H/ ^ 

DATE 

PAYTO THE 

ORDER OF _ X>nmtn^A X?i^?­ ^JZU^Z 

•tXOn V\OMr(^A ?^Afejr>Hj S^Vrr^^\f)i 

imbhlgi>ainil.NA. 

mbmk a 

iwlihiUiiuiiii 

FOR i2S 

1:101.0000sai: & EU737 Eqoi,n-^01753 

MI.?^IHDM IJOAD' CHARGE HR.& SEKW .AVh'L.Xiii.' bUDioial ,:?. .6 0 

START TIME: Ju l .1.6 / 2jpb9 10:30:0(--> Tax ,14 . SS 

Total 

*4i.xWARNING: DO NOT ALLOW ANY SKIN OR BODY PART TO COME INTO CONTACT WITH WET, UNH(^ f Nftgjf^^RET^ . ^-'^STTT' ^ 

SKIN: First, second or third degree burns can result from wet unhardened concrete and/or dry cement powder contacting the skin. To prevent 

contact with the skin, wear high rubber boots, waterproof gloves, waterproof clothing and long-sleeved shirts. If the skin comes into contact with wet, 

unhardened concrete, promptly remove the concrete with a dry towel and then wash the area thoroughly with soap and water. If the skin comes into 

^^ contact with concrete juices through saturated shoes or clothing, remove immediately and rinse affec^d skin areas as directed above. If any skin 

^ redness or irritation persists, seek prompt medical attention. 

EYES: If any^concrete material gets into the eyes, rinse immediately with v/a ^ for 15 minutes and seek medical jattention. o ,i . 0 0 

I agree to Inform others wh»xnay t>e working with the wet, unhardened concrete of its hazards. -..-.-.' ^., ^,:. n 

All orders are for street curb delivery. The weigl\t of the truck could l^iise damage to the property if driv ^ beydfid tti&curb line. IF I INSTRUCT THE 

DRIVER TO GO BEYOND THE 6URB LINE, f ASSUME ALL RESl>(»4SIBILITY FOR ALL RESULTING OAM^E ^ AND AGREE TO INDEMNIFY 

> AND HOLD SELLER AND ITS AFFILIATES AND SUBSIDIARIES HARMLESS FROM ANY CLAIM FOR^UCH DAMAGES. 

The water/cement ratio affects the plastic and hardened properties of concrete. Seller will not accept responsibility for concrete if water is added at the 

jobsite. " . "."'" " , ' •< ' ' ' <" 

FAVOR DE VER EL LAPP REVERSCPP^RA LA VERSI6N EN ESPAftOL/ feleage a6e reverse s'jde for Spanish version.) 

I have read and understand Qje warnings above and I also understand and Print name: 

agree to the Additional Term? and Conditions stated-gp the reverse side of 

this ticket: (Must be signed tefore delivery truck will ttriload) Signature: 

I acknowledge receipt of the items set forth above in good condition and Signature/initials: 

,as described in type and quantity as set forth above:' 

AM AM 

2.0c 2.00 PM PM 

Ordered quantity Cumulative total Arrived on job site: Left job site: Water added (gallons):