### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha , NE US Anny Corps of Eng i nee rs
ECC Certification for Property Closeout
OLSID 34371 Property Address 33 42 Ames Ave Field Work Started 

### 9 /

2012007 Field Work Completed 

### 9/20/2007 Summary: 

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

# • F2 excavation depth was 3 inches below ground surfaces. 

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

## • Drip zone excavation depth was 13 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. 

## • Sod placement and site restoration were conducted in compliance with the specifications and work plans.

Comments: None 

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Omaha Lead Si t e 4613 0

### CONTRACT 

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

### Analytical Results Summary OLS#34371 3342 Ames Ave
Quadrant Sample Type Depth Date Collected XRF Results (ppm) (avg.) 

# DE II F2 3 9/19/2007 74 

# DE II B2 5 9/19/2007 127 

# DE II 

# DZ I 13 

# I 9/19/2007 188 

# I DE II EA-H'SII 0 

# I 9/19/2007 91 

# I I I I

SAMPLE ID· SAMPLE ID is a part icular residentiaJ property ID from which the sample is collected
. The sample type identifier (with sequential sample number for that location) as follows; PX EI' 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 BI or 82 = 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 million

### page 1 

### of_ 

## S,/.sf)1 Omaha lead Site Omaha,NE Residential Yard Soils Environmental Restoration Services U.S. Environmental Protection Agency Region VII 

# • PROPERTY ACCESS (to be completed by property owner) ;:::3 a 'ec.tw es:a**fc'~'a** en es;:a;,o l ;=:or 'avor I Jr..,2 ;:;11-6::::;·223**~t.25** Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE), Omaha lin;
... ,,,, to conduct environmental restoration services for the Omaha lead Site. USACE Omaha is working with IIElnviror.m,enl:al Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration Your cooperation is requested in giving EPAIUSACElECC permission to aocess your property during the IIremelval/re,sto,ration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­ or the Office of External Programs, at 1-800-223-0425. Property**Ac,~e,.s-G:ratllted** By 

# s

IIResident Name: 

## SIJIJMM U9S0V /(!.H @--Owner 

# o renter IIReside,nce Address: 

## 33 

## '1..2 8ME.5 

### ltv
IIPrcmArtv Owned By:_-' S=..t8:.r...:.cf)!"'£.."'=-

_____________ ____ ____ II01Nn,ersmailing address: ----;---c:::-;.,-

_____________

## == ;-

_______ _ _ _ IIOwller's telephone

# numbe~~:.**_L. J{S,** **"'______ _=..!** **'_ -..LI_'9** **'__" ZL..!'8** **ht:'~:** jJ'::'

# '-2~~-"--=-="-- ___-I1

______ years

_____ years How long have you lived here? the exteior been painted or covered with siding since 1978? DYes 

# o No the interior been painted or covered since 1978? DYes 

# o No

number of occupants:

___ _ _ list ages of occupants under 6 years old who play in the yard for 5 or more hours per week:

_______

activities to be implemented by EPA under this agreement are pursuant to Section 104 of CERCLA, 42 U.S.C. 9604
. EPA's right of access Dro'DerIY for in Section 104(e) of CERCLA. 42 U
. S.C
. 9604 (e), which provides entry for, "determining the need for response, or choosing or action under this I
..
First:
__________ Second::
___________ Third::

___________pg._of_ 

# list of Existing Conditions Property Address: 33'1.id 

# &!Yle:$ 

# av DVD ID 

### #

_____ Owner: 

## SIll/DRO J.OSOV/CH Date: 

## r-/.J-CJ? BVID# JI-/3 

# 71

Ref: 

### Photo # 

### Description 

### /)

## N()#~

# ~~n#e(/) ECC

### ~ (,/.)-3c1IS Print&Si

# Pri~,**' i~./(j#~**  t7 

### /Contract No. W912DQ-04-D-0017, Task Order DKOI Omaha Lead Site, Omaha, NE Property Closeout Agreement DVID 

### Sl/3 PI Property Address 

# I ..?3¥0I. IfMt:S /ft/ Property Owner 

## SnAJ6ifl /..t1sme.Jf Is the Owner the Resident?

### ~es 

## 0 No Compliance Statement: U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps ofEngineers (USACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EPAlUSACElECC 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 Dahnke, 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 Charles "Skip"Milton ECC Project Manager Name Title Date Signature 

### PROPERTY OWNER SECTION This agreement documents the completion of remedial/restoration efforts at the property to my satisfaction. 

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


## /J r/7 

# X- 

# LA f**~A'd"L** I/-()?-o 

# '7 JifOperty Ownei's'Signature Date

## •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• Property Owner Satisfaction Survey Form Omaha 

### Lead Superfund Site Perfonnance-Dased Contractin& (PDC) Pilot Project Remediation Contractor:**_~.,.E,,",CC~~** 

# _______________ Property Identifier Number:

________ Pro)lerty DVID Number:

__

### :s..::::.....i'-3~'l'-'I'--_ Property Address: 

### _----"3"-''5==----<t-'''c1'''----'If.CLL:.M
...**t~St:._.L<,4wtl'___** 

### _________ Pro)lerty Owner's N_: 

## S**IJIID~d** 

### j, jfStN' {C 

### H (above information to be filled out by remediation COIl\I1lCtor prior to delivery of form to Property Owner) Instructions to Property Owner: This fonn is provided to you as a means oftrying to capture your level of satisfaction with the work ofthe 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 vel)' interested in your opinion regarding the work perfonned by our contractors. This 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 retum 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.) 10 "excellent" 7-8 "very good" 5-6 "acceptable" 3-4 "poor" 1-2 "very poor" Property Owner's Satisfaction Rating mardin!! Contractor's Work 10 5 9 4 8 3 7 2 6 1 Additional ComDlents from Property Owner (optional; continue on back of page If 

### needed)

Date:

_____