I 

CONTRACT #W912DQ-04-D-0017, T.O. DK04 

Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE 

ECC Certification for Property Closeout 

<>i< M 

us Army Corps 

of Engineers 

OLSID 

Field Work Started 

00721 

8/20/2007 

Property Address 

Field Work Completed 

2612N15'^St 

8/30/2007 

Summary: 

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

• Fl excavation depth was 6 inches below ground surfaces. 

• F2 excavation depth was 4 inches below ground surfaces. 

• B2 excavation depth was 5 inches below ground surfaces. 

• Drip zone excavation depth was 5 inches below groimd surfaces. 

• Easement East excavation depth was 0 inches below groimd surfaces. 

• Verification samples confinned 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 

Name 

Jeff Hubbard 

Name 

ECC OCM 

Title 

USACE Con Rep 

Title 

Date 

Date Signature 

30047748 iili 

Superfund 
721 

Owner Name: &L^iJCjH:. C bfJMiS 

Address: 2612 N 15 ST 

^ Omaha Lead Site 

Site Sketch 

Phone: H: W: 

Exterior Paint 

• Good 

• Poor 

n Not paint 

North Arrow 

A 

Team C. Chi(g(5 OLS F D AS56>ci4i+<-5 XRF Code ^7^ ^ 

Quadrant 

Fl ^ tlr^ch 

F2 H inch 

Bl 

Lead Concentration 

2 5 ? jjptn 

m. 

B2 S ihcK 

_ppm 

_ppm 

DZ ^,>icl» 

^(a ppm 

Ife? ppm 

if>0 ppm 

jjpm 

JJpm 

j p m 

Legend:YA = vara^iNc;, lu - .«.-\—„ -

Date 

<Z/2l/o7 

Log Book 

ly 

K£NN£L 

Rev 4 

046141.0123 
U.S. Environmental Protection Agency Region VII 

Page 1 of 

Omaha Lead Site 

Omaha, NE 

n^i 

Residential Yard Soils 

Environmental Restoration 

Services 

Grantor (the property owner), consents to and authorizes the United Sates Environmental Protection Agency (USEPA) 

or its authorized representatives (or its contractors), the Grantee, to enter and perform certain environmental response 

activities upon the following described premises. For further information please contact EPA at 1-800-223-0425. 

(Property Owner Signature) 

Property Access Granted By 

'^^^ ^ 

(Please Print Name) 

Property Owner Signature) (Date) 

NOTE: Granting permission DOES NOT necessarily imply your property will be remediated at this time. 

Resident Name: ^L/^Naf^ ^ bAVt S 

Residence Address: c3 (<?/c3 / / /S ' S7 ~ 

lD/<Jwner D Renter 

oM^m, ^e 

(CITY) (STATE) (ZIP) c.. 

Property owned by: ^J^M ^ 

Owners mailing address: 

Owner's telephone number—Home: .^y ^ 'O^S o Work: 

Age of Home? years How long have you lived here? years 

Has the exterior been painted or covered with siding since 1978 

Has the interior been painted or covered since 1978? 

Total number of occupants: List Ages: 

D YES 

D YES 

D NO 

D NO 

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

Comments: 

AUTHORITY FOR ENVIORNMENTAL RESPONSE ACTIONS 

The 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 to the 

property 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 taking 

any response action under this title, or otherwise enforcing the provisions of this title." 

Access Attempts: 

First: Second: Third: 
pg-_of_ 

List of Existing Conditions 

Property Address: 0.(^1^ N LS S T DVD ID # 

Owner: RLRUc.iH; bi^Mis. Date: ?-/Q-Of) BVID# ^^ 1 

Ref: 

Photo 

# 

Description 

/\ /^/ L Gf^oOt^ts IS - m ^ f ei\cc.A\//i-rEb 

: i \ P^oPEf^r'Y Uji/£ /M ejk^K £/obs B T TEL^Pncjoe I^OLF 

i s Rf.M6Yf -b O JOiTT fifiPLf^Cf aLCTttt<: LAJ P P6L f 

H\ Rf.Dno)/P''bo S^cn-Rf.PLA<if'fii^ PL/^tor^ /st^/iOB<: ETC 

Owner Signature ECC //^?i/t -

Print & Sign D.:„* o.^:—/ ^ {£>/^->sy-is-
Contract No. W912DQ-04-D-0017, Task Order DKOl 

Omaha Lead Site, Omaha, NE 

Property Closeout Agreement 

BVID !2MProperty Address ^GJ ^ N I ^ S 

Property Owner (^LM^cSf.hA^/l^ Is the Owner the Resident? D-^ s D No 

Compliance Statement: 

U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers 

(USACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. 

USACE Omaha is working with Enviroimiental Chemical Corporation (ECC) to remove lead 

contaminated soil and provide subsequent restoration services. 

Your cooperation in giving EPA/USACE/ECC 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 of Extemal Programs at 1-800-223-0425. 

Additional Comments by USACE and/or ECC: 

CONTRACTOR CERTIFICATION 

Prashant -Khanna or 

Charles "Slcip"Miltoa-, 

ECC Project Manager 

Name Title Date . 

PROPERTY OWNER SECTION 

This agreement documents the completion of remedial/restoration eflforts at the property to my 

satisfaction. 

hi I agree that restoration is completed at my property, except as noted 

Comments (if applicable): 

x ^ S^^ci^^^f. 

Owner's Signature Date 
Property Owner Satisfaction Survey Form 

Omaha Lead Superfimd Site 

Performance-Based Contracting (PBC) Pilot Project 

Remediation Contractor: f^C^C^ 

Property Identifier Number: 

Property BVID Number: 7^1 

Property Address: ^^/A - / / IS ' .S T 

Property Owner's Name: 3LAK)Cyttf. Xi/it/JS 

(above information to be filled out by remediation contractor prior to delivery of form to Property Owner) 

Instructions to Property Owner: 

This form is provided to you as a means of trying 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 veiy interested in your opinion regarding the woik performed 

by our contractors. This form is intended to provide an easy means for you to express your 

opinion about the work performed 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 form 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 die property owner.) 

"excellen£ ^ 

—?=8 veiy goou 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Prooerty Owner's Satisfactic 

10 

9 

8 

7 

6 

^ ^ ^ 

»n Ratine reeardine Contractor's 

5 

4 

3 

2 

1 

Work 

Additional Comments from Property Owner (optional; continue on back of naee if needed) 

Property Owner's Signature: X^^^<> g ^- ^ /I^>^te : 
CONTRACT # W912DQ-04-D-0017, T.O. DK04 

Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE us Army Corps 

of Engineers 

Analytical Results Summarv 

OLS # 00721 

2612 N 15*" St 

Quadrant 

DE 

DE 

DE 

DE 

DE 

Sample 

Type 

F1 

F2 

B2 

DZ 

EA-E 

Depth 

6 

4 

5 

5 

0 

Date Collected 

8/21/2007 

8/21/2007 

8/21/2007 

8/21/2007 

8/21/2007 

XRF Results 

(ppm) (avg.) 

258 

175 

96 

167 

100 

SAMPLE IDSAMPLE ID is a particular residential property ID 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 

BI 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 million