### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE US Army Corps of Engineers


### ECC Certification for Property Closeout

OLSID 25195 

### Property Address 2416 Indiana St 

### Field Work Started 10/5/2007 

### Field Work Completed 10/23/2007 

### Summary: 

## • The excavation was performed in compliance with the work plans and specifications. 

## • F2 excavation depth was 5 inches below ground surfaces. 

## • B1 excavation depth was 12 inches below ground surfaces. 

## • B2 excavation depth was 12 inches below ground surfaces. 

## • Verification samples confirmed that cleanup standards were met. 

## • The site was backfilled with material which meets the contract specifications. 

## • The backfill was compacted to acceptable standards. 

## • Site restoration was conducted in compliance with the specifications and work plans.



### Comments: None 

# Su:"", t, oJ. ECCQCM i\I'

# ~A~--- Name Title S ature Jeff Hubbard USACE Con Rep Name Title

### Team**_.:::::(.,~. ~G==-h~i** **~I d~S~_**  Quadrant Fl---:S=-nn--­ F2-- 

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## _ DZ,_----- Lead Concentration 

### 353 ppm 

# *" 284 ppm



## 5Cf ppm 

## B2 ppm _------<ppm _------"ppm _------<ppm

_____--'ppm ppm ....... Date 

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r- Name: Verl\l3**AK,~~** Omaha Lead Site Date:**4f//~h~­** North Arrow IAddress: q.. 

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# I I CONTRACT #**W912DQ~04-D-0017,** 

### T.O. DK04 Environmental Chemical Corporation 

# m .Eel:. 

# ,., Omaha Lead Remediation, Omaha, NE us Army Corps of Engineers 

### Analytical Results Summary OLS#25195 2416 Indiana St

Sample Type XRF Results Depth Date Collected (ppm) (avg.) 284

# ~~~6/2007 12 10/16/2007 59 12 10/16/2007 82 

### II II I II 

### II 

# I F2 81 82 

# I 

# I I I

SAMPLE 10- SAMPLE ID is a particular residential property lD from which the sample is collected. The sample type identifier (with sequential sample number for that location) as follows; PX
.. Pre-Excavation XRF sample DE During and Post Excavation Quadrant describes the sampling location (with sequential sample number for that location) as follows; Fl or F2 = Front Yard One or Front Yard Two Bl or B2 Back Yard One or Back Yard Two DZ • Drip Zone GA=Garden PA = Play Area EA = Easement Depth describes the depth from which the sample was collected. ppm = parts per millions**"~I'IA** 1 

### ",I ""::II" • ..... _­
omaha lead 

### Site Omaha. HE Residenliel ViW Soi1a U.S. Environmental Protection Agency Region VII ErMnunentat ReItofation S8Mces**----~--_.** -- -**-~-** ---- --­**-----...------.~-** -- --**-~----** 

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,S. Envirorvnenflt Protection Agency (EPA) has contracted !he U.S. Ann)' Corps of EngIneers (USACe). Om.,.

_ stItd to conducI environment8I rnIoration services for the Omaha Leed Site. USACE Omaha Is WOfking wfth

nvirgnment81 ChemiGal Corporation (eCC) to ntMOVe lead c:ontaminatad soli and provide subsequent restoration ·",w'ces. Your cooperation is requested In giving EPMJSACEJECC permission to access your property during the**~e8toration** phase. FOf further inlormalion please eontacl Don Behnke. EPA 

### Protect Menaget at (913) 551.

003 or the Offiee cf Extemal Progrems. at**t~223-0425.** fPli.e Print

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............... the ubIior been pelnted 01 CIO¥4nd with siding since 19781 the interiar been painted or since '918? 

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ist ages of occupants under 6 years old WOO play in the yard for 5 or more hours per weeII.: 

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_____ yelrs How long have you lived here? 

# AJ A

,...Jt'\ 0 Yes 

# o Yes

First 5ec;ond" Third::

_

### Contract No. W912DQ-04-D-0017, 

### Task Order DKOI 

### Omaha Lead Site, Omaha, NE Property Closeout Agreement DVID 

### d.::::>7 

## 'IS- Property Address 

# I :lJ.l/lo**~!J)b/1t1J1J** 

### Property Owner 

### Is the Owner the Resident? 

# o Yes 

## 0 No 

## V

£k>jJfr ftklJJIt Compliance Statement: 

### U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps ofEngineers (US ACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is working with Environmental Chemical Corporation (BCC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EP A1USACEIECC permission to access your property during the removal/restoration phase is sincerely appreciated. This document certifies that all work performed at this property was completed in accordance with the contract specifications and EPA requirements. If you have questions or need additional information please contact Don Bahnke, EPA Project Manager, at (913) 551-7003 or the Office ofExtemal Programs at 1-800-223-0425. Additional Comments by 

### USACE and/or ECC:

CONTRACTOR CERTIFICATION 

### Prashant Khanna or ECC Project Manager Charles "Skip"Milton Name Title Date Signature 

### PROPERTY OWNER SECTION This agreement documents the completion ofremedial/restoration efforts at the property to my sati sfaction. 

# w-I agree that restoration is completed at my property, except as noted Comments (if applicable):

A 

# ;;'?>0rJ 

# D7 Y 

# /itt., , 

### v'\./ 

### Propei'ty' Owner's Signature Date

## Property Owner Satisfaction Survey Form Omaha Lead Superfund Site Penonnance-Based Contracting (PBC) Pilot Project
Remediation Contractor:**_---J£~C:::;:C!:==--** 

### _ Property Identifier Number:

_ Property BVID Number:

### _~..;:..";,,...~---=--I**~'1_..s-** 

## _ Property Address: 

## :J LfI{z 

### J:/J1>11t1Jfl- 

## r Property Owner's Name:**_..u:L6-,-f.AR..LIJ.~'ltL-...L&.L..kQ",.LJ.IJJ~IJ~** 

### _ (above infonnation to be fined out by remediation contractor prior to delivery of fonn to Property Owner) 

## **** •••••• *••••••• ** ••••• 

## *••••••••• *•••••••••••• *••••• 

## *••••••••••••••••••••••• Instructions to Property Owner: lbis fonn is provided to you as a means ofUying to capture your level of satisfaction with the work of the above-identified Remediation Contractor, as applicable to the soil cleanup action at your property. The 

## u.s. Environmental Protection Agency (EPA) and the U.S. Army 

### Corps of Engineers (USACE) are very interested in your opinion regarding the work performed by our contractors. lbis fonn is intended to provide an easy 

### means for you to express your opinion about the work perfonned on your property. Please indicate your level of satisfaction with the Contractor's work by selecting a numerical rating (ranging from 1 to 10) using the following rating scale, then please sign & 

### date the fonn and return it to USACE in the attached self-addressed & 

### stamped envelope. (Additional comments may also be provided in the space provided, at the option of the property owner.) 9-10 "excellent" 7-8 "very good" 5-6 "acceptable" 3-4 "poor" 1-2 "very poor" 

### Property Owner's Satisfaction Rating regarding Contractor's Work 10 5 9 4 8 3 7 2 6 1 

### Additional Comments from Property Owner (optional; continue on back of page ifneeded)

Date: 

## ;2 

# 3 

# ,0615 O.y Property Owner's Signature: