TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID .J/mi Date: 41 

Address: Wo<\ \\ 9> ^ ^ ( 

Remediation Contractor: Coastal Environmental Group_ 

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/ 

1/ 

-3­

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a/ 

4 

SOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

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

Confimiation data 

Photographs t;/^(^t\ni M ^ fa b<<W<Vf\<M 

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 Office 

<7 

Year; 200 

\ 

40333882 

Superfund 

1 •i'l \[ f 

signature )ate 
• • • • 

Property Access Checklist 

 ON: __/__/_ 

ON:__/__/_ 

'^•tym: U-^ft/^U 

Property Address: y^^i St. 

Owncn ''Bi\iOirc\0'^(kS(\\f'Pt^ 

Address 

Fax; 

Cfeli/Pager: 

G^ Notification L^ter 

UCJ Access AgKCincnt 

1^ RestoratiottAgreeaBait 

D TopsoO Sampling (if applicable} 

O Disposal Sampling fif applicable) 

D Garden SampUng (ifapplicdile) 

^ Utility Clearance 

a Video/Fliotos (Before) 

a Videomiotos (Daring) 

a Video/Photos (After) 

D Video/Photos (30-Day) 

" ^ Property Completion Agreemeat 

D Final Report 

Air Monitorine (as appCcabie 

Lj Conunnnity |_J Crew On:

Results: 

DCommnnity DCrevr | On:

RcsnHs: 

Sent:^/2./Q 9 

Signed: |Q_/^/Q Q 

Signed: i£L/(iL/ ^ 

/ / 

/ / 

/ / 

Called: \Q./2_/C H 

On: / / 

On: / / 

On: / / 

On: / / 

Signed:///X/fiS . 

Issued: / / 

/ / |By: 

/ / By: 

n Conunnnity • Crew | ^ On: / / By: 

Results: 

Omaha Lead Stte 

n WORK STARTED

D WORKCOMPELTED

Raiten 

Phoae: 

Fax: 

Cell/Piigen 

Additional fafformatiaa: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 0|Q0^ 

By: 

Ily: 

By: 

By. 

By: 

By: 
• • 

Douglas County Account b^rm^on Page 1 of3 

Douglas County, Nebraska Property Record - R0821130002 

Print Report 

NEW Feature - Parcel Dimensions avaiiabie @ scaie 0-50 ft west of 52nd St - Vle W OH Ma p Information is valid as of 2009-9-29 Treasurer's Tax Report 

New Feature ^ - • ^ Auto Sales Search 

Owner 

VASQUEZ EDUARDO J 

1709 N 50 ST 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number: 2113 0002 08 

Account Type: Residential 

Parcel Number: 0821130002 

Parcel Address: 1709 N 50 ST 

OMAHA NE 68104-0000 

Legal Description: CLOVERDALE LOT 15 BLOCK 5 N 50 FT LOTS 13-14- & 50X152.1 

Value Informatio n 

Land Improvement Total 

2009 $6,200.00 $161,500.00 $167,700.00 

2008 $6,200.00 $161,500.00 $167,700.00 

2007 $6,200.00 $161,500.00 $167,700.00 

2006 $6,200.00 $134,500.00 $140,700.00 

2005 $6,200.00 $134,500.00 $140,700.00 

2004 $6,200.00 $134,500.00 $140,700.00 

Sales Informatio n 

Sales Date: 2006-08-31 

Deed Type: WD Book: 2006 Page: 103357 

Price: $173,000.00 

Grantor: Glaser Hollis F 

Grantee: Vasquez Eduardo J 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 1994-10-21 

Deed Type: Book: 1992 Page: 507 

Price: $95,500.00 

Grantor: 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R08... 10/1/2009 
• • 

Douglas County Account IIj^rm^io j n Page 2 of 3 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.17 7600.0 1.0 152.0 50.0 No 

Improvemen t Informatio n 

Building 1 

1709 N5 0 

ijri 

(D —mr­

' 1 3 

4M.DSq.n. FimFloiir 

10 1333 n Sq n 

j)U twm kur 

"Ljoo__a!i­

^i? r 

1 1Q Story Fin 

iOO Sq ft WH F n fisrrt turt »ic i- ''rt L> 

CLICK TO ENLARGEJMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1806.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Masonry Common Brick Units: 1.0 

Interior: Diywali Baths: j 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: i Block 

Sprinkler Square Footage: I 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1938 0% 1938 71 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 

1.0 

Basement Bsmnt Block 8 ft 1346.0 

Basement Minimal Finish 800.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R08... 10/1/2009 
• • 

Douglas County Accoimt I|^n||^ion Page 3 of3 

Fixture 

Fixture 

Fixture 

Garage 

Porch 

Porch 

User 

Additional Fixtures 

Base Fixtures 

Bath Full 

Basement Single 

End Solid Wall 

Slab w/Steps 

Attic Full Finish 

1.0 

1.0 

1.0 

1.0 

196.0 

40.0 

484.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R08... 10/1/2009 
Page 1 of 1 

"> 

[:^^ p!?g*Q.AnotherTicket^ ^J [^_ .BadUo IrthJntemeK ^ J ' II.:-?^? j_il!#.::.J 

• YOUR TICKET NUMBER IS 2388335. 

Original Call Date: 10/17/09 Time: 1:43 pm Op: ELIZABETH18790 


Work to Begin Date: 10/21/09 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1709 Street: N 50TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 18-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)662-421 0 

Work Being Done For: Coastal 

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

Involves Tunneling or Horizontal Boring : N Explosives: N 

CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 

Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RlCHn-RAFFlC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

0PPDGPR5 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=<RESULT... 10/17/2009 
OLS#: 63864 

As-Buil Date Excavated: 10/26/09 t Drawing Date USEPA Signed Off: 10/24/09 

COASTA L Area Sodden: 303 sa ft ENVIKONHENTAL Omaha Lead Superfund Site G n O U P , IN C 

63864 

Omaha Lead Site Exterior Paint NorthArrow 

Site Sketch n Good 

n,Poor 

Samolina Address: 1709 N 50 ST ipf Not paint 

Sampl Lead Sample Samples Collected e Number 

i 

LAB Concentration Collected Firm _£E^_I2SJ_AI I 

RYASCPXA-63864 F l J 4 3 ppm D Date: S"—/-Q? 

RYBSCPXA-63864 F2 -732. ppm a Time: ID'HO a m 

RYCSCPXA-63864 8 1 S 9 ppm n 

Samples Analyzed 

RYDSCPXA-63864 B2 F i l ppm 

RDZSCPXA-63864 D Z *<ZI p p m • 

XRF Unit: lORC^-Z Book: 2.1K'i 

nozocpxA-63e64—ez- ppm u Date: _ 

— ppm u • Time: _ Lab RYDSCPLA-63864 

Staff: • Result e „ o ^<v ^ Number of Samples = | f5 

60.6 ppm _L 

Legend: F1 = Front Lett. ^'Z = Front Right. B1 = Back Left. B2 = Back Right DZ = Drip Zone, G Z = Garden, P 2 = Pla; 

All ICKtfdrants are as viewed from the street, facing property • • j t XT C ' ^ 1 >*-

Legen d 

Concrete Dri p Zone Excavate d Quadrants Excavate d 

Area replaced with 

Sod 

Are a replace d wit h 

Rook/Mulch Are a lef t bar e 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
LL lO/.^^ 

63864 

Omaha Lead Site Exterior Paint North Arrow 

Site Sketch Q Good 

•^Poor 

Sampling Address: 1709 N 50 ST lyj Not paint 

Sampl Lead Sample 

Samples Collected e Number 

I 

LAB Concentration Colieclpd Firm f^A P/?•A^T 

RYASCPXA-63864 Fl ppm D Date 

RYBSCPXA-63864 F2 ppm D Time 

RYCSCPXA-63864 Bl ppm 

D Samples Analyzed RYDSCPXA-63864 B2 

57 ppm 2r 

RDZSCPXA-63864 DZ H2.I ppm I D XRF Unit: JOBit2. Book: 235 . RGZGCPXA-63864 GZ- ppm D D Date; _ 

nz. ppm D Time: 

Lab RYDSCPLA-63864 n Staff: •Result on e 

M^V^ Number of Samples • I 60.6 ppm 

Legend: F1 = Front Lett, \-^ Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ Pla^ 

All qqadrant^ 

Rtn' :oi i« 1144701 111.23 
LL' 10/ 7.\ 63864 

Omah Exterior Paint Nortti Arrow a Lead Site • Good Site Sketch •^Poor 

Sampling Address: 1709 N 50 ST 10 Not paint 

Sample Lead Sample Samples Collected Number 

i 

LAB Concentration Collected Fimi: fPA DE-ArJ 

RYASCPXA-63864 F1 ppm D Date: 5'-j-^ ? 

RYBSCPXA-63864 F2 -. 53Z 

ppm D Time: lO'-H0 ary\ 

RYCSCPXA-63864 B1 ppm 

D Samples Analyzed RYDSCPXA-63864 B2 5 1 ppm 

RDZSCPXA-63864 DZ HZI ppm n XRF Unit: loQC*1 Book: 2^ 5 

nGZOCPXA-63864 —G2- ppm D D Date S'HCPI 

mr-iTor^DVA ft' ppm D n Time . Lab RYDSCPLA-63864 !zn. • Result Staff: ^<w^ 60.6 ppm Number of Samples = | ^ ± 

Legend: F1 = Front Lett. Yi = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Pla; 

All qi^drants^e as viewed from ttie street, facing pro| 

Re\'2iii''l! rrenled i»i-Nov U47ril 111 23 
63864 

Omah Exterior Paint North Arraw a Lead Site 

Sit • Good e Sketch 

n^Poor 

Sampling Addraas: 1709 N 50 ST Q Not paint 

Sample Nuint)er 

RYASCPXA-63864 Fl 

RYBSCPXA-63864 F2 

RYCSCPXA-63864 Bl 

RYDSCPXA-63864 B2 

RDZSCPXA-e38e4 DZ 

RQZOGPXA-63864 62-

Lab RYDSCP1A^3864 

•"»"" " 60.6ppm 

Legend: Fl = Front Len, i-;i = 

ENTERED 

Lead Sample Samples Collected LAB Concentration Collected Fimi: FPA Pg.AvT 

ppm D Date: G'-l-Ql 

.^32L ppm D 

Time: tfWtf/r/ w 

8 ^ pom D Samples Analyzed __5L3 ppm Ef 

J1*L I PP*n D XRF Un»: 

J£a&2 . Book: 235 . 

— ppm D Date:_ 

"" ppm D Time:_ 

"im- Staff: Numlwr of Samples •» ^"5 I I / I n^W 

Front Right. Bl = Back Left, B2 = Back RIgtrt DZ = Drip Zone. GZ = Garden, PZ - Pla; 

RevMiS Cnrnd: «6-Ni>v-08 
> — ** 

COASTA I INVtRONKIRTA I 

C R 0 11 r . IN 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 

following described premises: 

Owner's Name: tCAUQ^Td O Daytime Phone: 

Address of Property 

covered by this noq N 50 st 

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 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 vmtten 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 
8 

COASTA L tNTINONHIKT&L 

t R 0 U r IN C 

€ Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

c 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. 

s 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 

X' grant access to my properties 

D I do not grant access to my properties 

Signature Signature Date 

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

Page 2 of 2 
;:t^ 

COASTA L 

C n o U r • M f 

Restoratioia Agreement 

The purpose ofthis agreement is to provide a mutual agreemem as to conditions ofthe property prior to 

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

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

PropertylD. (^5ft;7 7 

Property Address: n^ g ^ J ^ ^ ^ f 

^rri£duaidi:L_AZD.s%iiex 

Zi°°" "^^o-lMT^ 

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 Start of Remediation: 

The renoval. storage, disposal, and/or return of these Itoms is the Owner's responEibility. 

(Xv\a tSfWjdl p\aA\^ ^ \ne fYk\jedi 

Item: 

Item: 

Item: 

Items to be Removed by the Contractor During Remediation and Not Replaced 

Item: 

^v^u iSfrmil p/i 1^^ W Dehiort 

hem: 

Kem: 

Item: 

Page Iof 3 
" % . tCZM COASTA L 

Items to Be Removed By Contractor During Remediation and Replaced 

Item: 

Ksm: 

^ T ^ pg- ^ ^ ^ 

Kem: 

L_J^j\c:itt!r : 

Item Quantity 

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, 

Tnners, Heads, etc. 

Aii.nth 11 sketcii Dl il>e V\o •.rf'i^kitT ii;v'iiii 

Number of and size of 

each garden/ flower bed 

area. 

All;\tli il skclcli 1)1 ri-!;ilivi' \ 

>i/fS.niid loc;iiiiiM> 

Agreed upon value of plant 

materials not to be 

replaced by contractor. 

VOU' ll'-i' NMIIIC ^\ilt h i 

v:snL' 10 ib'.ui .! 'ilan; \ \ oiiclic; 1*1 llie liropc i i\ • 

u^^ ner. 

Easement Area, to be 

excavated 

Landscape Inventory 

Unit Condition/Type/Species 

Quadrants 

Each 

Each 

Each 

Each 

Square Feet 

S 

PevNi^iao, ?iU3\)\te Each 

Page 2 . > 
COASTA L 

! Additional Comments / Instructions: 

Q Check the box ff Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By checking this t)ox CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

Q I do not agree 

Owner's Signature Date Jtractor's Signature l)ate 

Page 3 of 
. 6SS6(/ BVID 

XRF PROPERTY SAMPLE SHEET 


Date Address /7to^ /t/ SD s rProject Omaha lead FP 2nd year opilon Sample time am/pm 

XRF ID# T.ZiO?^ sample length 30 sec 

Shot# Reading Sample area Shol# Reading Sample area 

d : ^ 1 E5 m^ Depth :a Depth

1 J^ /g»^

fys'/

^sr2^_ f;^ i^ /fT Tz: S5^ V:^ / ^ J^±. 

Average /3(f f/^

Average ^SZ - / ^ 

Shol# Reading Sample area Shot# Reading Sample area 

^ 3 T FZ­ •''^y-o /^\ ^ 19- j^SdL m± Deoth Depth iir 

2U2=- 7kt^ ^

1:1. iIz: 

Average / J P "I ^ /f l 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 

Print rjby heihOflrgre^;. 
^ #

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Ceitificate of Verification 

XL3t-32075 

Reading No 553 

Mode SOIL 

Time 2009-10-24 09:01 

Duration 120.00 

Sequence Final 

Flags 

AVERAGE r^Avg orSt9=552rs 

LOCATION 1709 iTSDrst—^ 

INSPECTOR VENTRY 

COR l em 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm Error 

pPB" -1387277- J7.805 

Cd <rTOvr 19.516 

Ag < LOD 14.019 

7.518 

U < LOD 19.969 

Rb 46.212 ± 6.076 

Th < LOD 14.309 

Se < LOD 5.796 

As < LOD 22.452 

Hg < LOD 12.310 

Zn 87.817 18.423 

W < LOD 73.290 

Cu < LOD 28.985 

Nl < LOD 67.621 

Co < LOD 147.597 

Fe 12566.446 ± 355.323 

Mn 298.045 ± 87.223 

Cr < LOD 131.749 

< LOD 290.837 

Tl < LOD 705.251 

Sc < LOD 91.176 

Ca < LOD 1378.872 

K < LOD 1562.642 

S, < LOD 1305.450 

Sr 93.278 

Supervised By: 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32075 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

SAMPLE 

LOCATION 

INSPECTOR 

COR 1 

COR 2 

MISC 

NOTE 

User Login 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Nl 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

Certificate of Verification 

549 

SOIL 

2009-10-24 08:59 

30.00 

Final 

63864 

1709 n 50 st 

VENTRY 

em 

1 

clearence 

epa gun 

EPA 

ppm ± Error 

147.450 ± 18.700 

< LOD 19.562 

< LOD 14.207 

98.933 ± 7.856 

< LOD 21.867 

41.601 ± 6.133 

< LOD 13.540 

< LOD 6.335 

< LOD 24.357 

< LOD 12.659 

101.155 19.758 

< LOD 71.930 

< LOD 29.481 

< LOD 66.327 

< LOD 149.626 

12560.879 ± 362.202 

331.976 db 92.214 

< LOD 251.743 

< LOD 370.088 

< LOD 859.189 

< LOD 40.684 

< LOD 1596.592 

< LOD 1233.496 

< LOD 1257.773 

Supervised By: 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 550 

Mode SOIL 

Time 2009-10-24 09:00 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 63864 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR l em 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm ± Error 

Pb 171.694 ± 19.388 

Cd < LOD 19.322 

Ag < LOD 13.899 

Sr 98.914 7.636 

U < LOD 20.515 

Rb 57.796 ± 6.582 

Th < LOD 14.710 

Se < LOD 5.235 

As < LOD 23.578 

Hg < LOD 11.753 

Zh 94.281 18.816 

W < LOD 75.220 

Cu < LOD 27.703 

Ni < LOD 70.389 

Co < LOD 153.242 

Fe 13778.697 ± 368.936 

Mn 300.077 87.141 

Cr < LOD 122.624 

V < LOD 305.331 

Ti < LOD 698.220 

Sc < LOD 107.285 

Ca < LOD 1082.741 

K < LOD 54.086 

S < LOD 824.999 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 551 

Mode SOIL 

Time 2009-10-24 09:01 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 63864 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR l em 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm Error 

Pb 136.418 ± 17.685 

Cd < LOD 19.418 

Ag < LOD 13.943 

Sr 105.810 ± 7.880 

U < LOD 19.486 

Rb 50.011 ± 6.177 

Th < LOD 14.337 

Se < LOD 5.905 

As < LOD 22.649 

Hg < LOD 12.269 

Zn 93.440 18.674 

W < LOD 69.027 

Cu < LOD 27.553 

Ni < LOD 63.744 

Co < LOD 153.013 

Fe 13862.582 ± 371.367 

Mn 330.109 ± 89.558 

Cr < LOD 48.833 

< LOD 476.889 

Tl < LOD 1195.183 

Sc < LOD 113.230 

Ca < LOD 1769.239 

K < LOD 2207.862 

S < LOD 1622.209 

Supervised By: 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 552 

Mode SOIL 

Time 2009-10-24 09:01 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 63864 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR 1 em 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm ± Error 

Pb 97.548 ± 15.446 

Cd < LOD 19.762 

Ag < LOD 14.028 

Sr 69.454 6.699 

U < LOD 18.009 

Rb 35.440 ± 5.413 

Th 17.788 ± 9.765 

Se < LOD 5.709 

As < LOD 19.222 

Hg < LOD 12.559 

Zn 62.392 ± 16.443 

W < LOD 76.982 

Cu 34.959 ± 20.801 

Ni < LOD 70.025 

Co < LOD 134.508 

Fe 10063.627 ± 318.785 

Mn 230.019 79.977 

Cr < LOD 103.797 

V < LOD 11.039 

Tl < LOD 68.413 

Sc < LOD 103.504 

Ca < LOD 1066.917 

K < LOD 2755.124 

S < LOD 1516.821 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 548 

Mode SOIL 

Time 2009-10-24 08:58 

Duration 120.00 

Sequence Final 

Flags 

/ERAS -Avq-ofl557547 ] 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR 1 dz 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

Error 

^LJ Cd < LOD 197779 

Ag < LOD 14.224 

Sr 106.309 ± 7.979 

U < LOD 20.904 

Rb 49.375 ± 6.319 

Th < LOD 12.404 

Se < LOD 5.619 

As < LOD 16.114 

Hg < LOD 12.510 

Zn 117.375 ± 20.635 

W < LOD 75.325 

Cu < LOD 29.871 

Nl < LOD 70.117 

Co < LOD 155.354 

Fe 13775.209 ± 374.212 

Mn 427.710 ± 98.888 

Cr < LOD 55.297 

V < LOD 222.647 

Ti < LOD 542.232 

Sc < LOD 34.680 

Ca < LOD 1366.170 

K < LOD 2157.560 

S < LOD 1418.931 

Supervised By: ( M ^ j m<yl^j2^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 544 

Mode SOIL 

Time 2009-10-24 08:56 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 63864 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR l dz 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm 

41.220 

< LOD 

< LOD 

106.782 

< LOD 

48.533 

< LOD 

< LOD 

< LOD 

< LOD 

79.813 

< LOD 

< LOD 

< LOD 

< LOD 

13803.873 

414.308 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

± 

± ' 

± 

± 

± 

± 

Error 

11.311 

19.821 

14.403 

8.008 

21.600 

6.358 

11.667 

5.775 

14.522 

11.605 

17.805 

72.074 

28.321 

71.639 

153.958 

375.352 

99.026 

19.291 

224.375 

592.785 

31.000 

1221.464 

3017.501 

1709.035 

Supervised By: 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 545 

Mode SOIL 

Time 2009-10-24 08:56 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 63864 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR 1 dz 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm ± Error 

Pb 46.151 ± 11.797 

Cd < LOD 19.729 

Ag < LOD 14.280 

Sr 109.345 ± 8.116 

U < LOD 20.783 

Rb 52.387 ± 6.459 

Th < LOD 12.971 

Se < LOD 5.655 

As < LOD 15.041 

Hg < LOD 12.874 

Zn 108.221 20.315 

W < LOD 76.548 

Cu < LOD 30.379 

Ni < LOD 67.238 

Co < LOD 162.984 

Fe 14697.056 ± 388.608 

Mn 438.073 ± 100.396 

Cr < LOD 114.151 

< LOD 44.887 

Ti < LOD 449.595 

Sc < LOD 26.703 

Ca < LOD 1056.197 

K < LOD 2130.901 

S < LOD 1282.212 

Supervised By: 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 546 

Mode SOIL 

Time 2009-10-24 08:57 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 63864 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR 1 dz 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm 

51.303 

< LOD 

< LOD 

100.573 

< LOD 

52.066 

< LOD 

< LOD 

< LOD 

< LOD 

97.328 

< LOD 

< LOD 

< LOD 

< LOD 

13479.838 

460.420 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

Supervised By: 

± 

± 

± 

± 

Error 

12.028 

19.944 

13.945 

7.723 

20.099 

6.324 

13.074 

5.518 

15.138 

12.830 

19.362 

81.381 

29.871 

72.815 

152.063 

366.927 

99.874 

39.912 

300.809 

628.625 

39.046 

1529.617 

1275.328 

1156.900 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 547 

Mode SOIL 

Time 2009-10-24 08:58 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 63864 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR 1 dz 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm 

93.755 

< LOD 

< LOD 

108.536 

< LOD 

44.515 

< LOD 

< LOD 

< LOD 

< LOD 

184.139 

< LOD 

32.084 

< LOD 

< LOD 

13120.070 

398.038 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

± 

± 

± 

± 

± 

± 

± 

± 

Error 

15.214 

19.623 

14.269 

8.069 

21.136 

6.134 

11.904 

5.530 

19.757 

12.731 

25.058 

71.299 

20.608 

68.773 

152.412 

365.960 

96.257 

47.834 

320.516 

497.922 

41.972 

1657.404 

2206.509 

1527.578 

Supervised By: 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 543 

Mode SOIL 

Time 2009-10-24 08:54 

Duration 120.00 

Sequence Final 

Flags 

AVERAGE 1 Ava of S39-542 • • ; 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR l f2 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm Error 

Pb nfi/wf i 1'• 17:582 • 1 Cd < LOD 197692 

Ag < LOD 14.024 

Sr 96.107 ± 7.b// 

U < LOD 20.551 

Rb 50.200 ± 6.279 

Th < LOD 13.421 

Se < LOD 5.565 

As 60.319 ± 16.901 

Hg < LOD 12.138 

Zn 129.617 • ± 21.321 

W < LOD 71.928 

Cu < LOD 29.661 

Ni < LOD 70.597 

Co < LOD 151.167 

Fe 13746.489 ± 369.528 

Mn 337.390 ± 90.754 

Cr < LOD 141.235 

< LOD 280.112 

Tl < LOD 656.655 

Sc < LOD 100.925 

Ca < LOD 785.311 

K < LOD 1889.552 

S < LOD 1153.450 

Supervised By/^pW . mOD 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 539 

Mode SOIL 

Time 2009-10-24 08:52 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 63864 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR 1 f2 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm 

161.882 

< LOD 

< LOD 

103.870 

< LOD 

54.173 

< LOD 

< LOD 

53.003 

< LOD 

144.801 

< LOD 

< LOD 

< LOD 

< LOD 

14934.622 

384.072 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

Supervised By: 

± 

± 

± 

± 

± 

± 

± 

Error 

18.989 

19.768 

13.880 

7.826 

19.959 

6.401 

14.382 

5.461 

17.623 

11.814 

22.340 

71.679 

28.590 

68.137 

153.604 

385.498 

95.680 

157.076 

424.472 

718.518 

98.162 

600.108 

1685.829 

1051.559 

V 
# 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 542 

Mode SOIL 

Time 2009-10-24 08:54 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 63864 

LOCATION 1709 n 50 st 

INSPECTOR VENTRY 

COR 1 f2 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm ± Error 

Pb 126.330 17.426 

Cd < LOD 19.990 

Ag < LOD 14.171 

Sr 96.191 ± 7.718 

U < LOD 20.379 

Rb 44.584 ± 6.092 

Th < LOD 14.184 

Se < LOD 6.037 

As 79.676 ± 17.573 

Hg < LOD 12.348 

Zn 142.863 ± 22.433 

w < LOD 66.026 

Cu < LOD 31.050 

Ni < LOD 70.956 

Co < LOD 147.894 

Fe 12805.746 ± 363.168 

Mn 309.564 ± 89.250 

Cr < LOD 129.409 

V < LOD 353.279 

Ti < LOD 828.480 

Sc < LOD 101.578 

Ca < LOD 632.931 

K < LOD 1234.349 

S < LOD 835.997 

Supervised By: 
/1^. \ Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^ ^ ° Coastal Environmental Group Inc, 

S!~^j^ www.coastalhazmat.com 

<*tPBO^"^ COASTA L 

cto u r, I NC 

EXECUTIVE SUMMARY: 

BVID #63864-(1709 N 50 ST) 

No Issues or Concerns | | Issues/Concerns 

Detail Explanation: 
a^ EPA 

# 

EPA Property Close Out Form 

Prt»peny #: LP'?^ ^ Property Address:* - t 

Datc/Tlme: Owner's Nane: 

Quads Excavated: J ) ^ ^ 9^2 ^ Contractor Group 

Excavation GcnenI 

1. If necessaiy, were the correct quadtant(s) excavated and restored? 

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

Gradin Yes No g Sod and Vegetation 

1. Does the grading around the perimeter of the house in excavated areas generally slope away 

from the house? 

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

3. Docs the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 ^ - ^ day time period) 

4. Arc sodded areas generally Hrm and evenly graded? ^ " 

5. Arc the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day T7" time period) 

6. Was the property graded such that water will not pool on the property? 

p-^ 

7. Was danuge to landscaping or plant materials avoided? 

,^' ' 

Gates, Fences and Retaining Walls 

Yes No 

I. Do gates open and close fi-eely? (Ifapplicable) 

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

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

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

Foundation, Siding aad Gutters 

Yes No 

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

2. Was damage to the foundation avoided? ^ ^ 

3. Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspoui extensions avoided? ^ ' ^ 

Sidewalks and Driveways (Concrete) 

Vcs No 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? w 
Ov^'oers comments: 

Inspection notes: 

Removal and restoratioonn activate activatess complet completee includin includingg ththee 30-da 30-dayy sosodd warranty warranty:: 

EPA Representative Ucn^ KJJJ L Dale: Iff/j/of 
Property Completion Agreement 

ihii agreement documenls the complelion ol remedial acliviiies perloimed on my properly My signalure 

will designate Ihal I am satisfied with the resloration of my properly, and thai no ilems are in questions, 

now. or al any lime in the fiilui-e, excepl ihose ilems lisled below, ifany 

PropertylD: ^3a\j^L ( 

Property Address: Y^QO J ^ 3 ^ Q S T 

Owner: p^)^,f,^l n Na<V-^V^^7^ 

Phone: ^<;0..-^^-^< ^ 

Restoratiort Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

item: 

|V] I Ayrcr restoralion if completed, except as noted 

[_} I rfo not a(;rec rc$lor«tinn is compleled 

/iv ^2 ^ ^ (%i^ . iHf^ 

Date Contrartor's Signature Dale