# I CONTRAC T #W912DQ-04-D-0017 , T.O . DK0 4 Environmenta l Chemica l Corporatio n Omah a Lea d Remediation , Omaha , N E
EC C Certificatio n fo r

Propert y Closeou t <>i< M u s Arm y Corp s o f Engineer s

OLSI D Fiel dWor k

Starte d 0072 1

8/20/200 7 Propert y Addres s

Fiel dWor k

Complete d 2612N15'^S t 8/30/200 7 Summary : • Th e excavatio n was performe di n complianc e with th e wor k plan s an dspecifications . • F l excavatio n depth was 6 inche s belo w groun dsurfaces . • F 2 excavatio n depth wa s 4 inche s belo w groun dsurfaces . • B 2 excavatio n depth was 5 inche s belo w groun dsurfaces . • Dri p zon e excavatio n depth wa s 5 inche s belo w groim dsurfaces . • Easemen t

Eas t excavatio n depth was 0 inche s belo w groimdsurfaces . • Verificatio n sample s confinne dtha t cleanu p standard s wer e met . • Th e sit e wa s backfille dwith materia l whic h meet s th e contrac t specifications . • Th e backfil l wa s compacte dt o acceptabl e standards . • So dplacemen t

an dsit e restoratio n wer e conducte di n complianc e wit h th e specification s an d wor k plans . Comments:Non e

Nam e Jef f Hubbar d Nam e EC C OC M

Titl e USAC E Co n Re p Titl e Dat e Dat e Signatur e

3004774 8 

# iil i Superfun d

## 72 1

Owne rName : &L^iJCjH: . C bfJMi S Address : 261 2 N 1 5 S

T ^

Omah a Lea d Sit e Sit e Sketc h Phone : H : W : ExteriorPain t • Goo d • Poo r n No t pain t Nort h Arro w 

# A

TeamC . Chi(g( 5 OLS F D AS56>ci4i+<- 5 XR F Cod e ^7^ ^ Quadran t F l ^ tlr^c h F 2 H inc h B l Lea dConcentratio n 2 5 ? jjpt n 

# m . B 2 S ihc K _pp m _pp m D Z ^,>icl » ^( a pp m Ife ? pp

m if> 0 pp m jjp m JJp m j p m Legend:Y A = vara^iNc; , lu - .«.-\— „ - Dat e 

## <Z/2l/o 7 Lo g Boo k

ly

K£NN£ L

Re v 4 046141.012 3U.S . Environmenta l Protectio n Agenc y Regio n VII Pag e 1 o f Omah aLea dSit e Omaha , N E 

# n^ i

Residentia l Yar dSoil s Environmenta l Restoratio n Service s
Granto r (th e property owner) , consent s t o an dauthorize s th e Unite dSate s Environmenta l Protectio n Agenc y (USEPA) o r it s authorize drepresentative s (o r it s contractors) , th e Grantee , t o ente r an dperformcertai n environmenta l respons e activitie s upo n th e followin g describe dpremises . Fo r furthe r informatio n pleas e contac t EPA a t 1-800-223-0425 .

(Propert y Owne r

Signature ) Propert y Acces s Grante dB y

'^^^ ^ (Pleas e Prin t Name ) Propert y Owne r

Signature ) (Date ) NOTE : Grantin g permissio n DOE S NO T necessaril y impl y you r propert y wil l b e remediate da t thi s time .
Residen t Name : ^L/^Naf^ ^ bAVt S Residenc e Address : c 3 (<?/c 3 / / /S ' S7 ~ lD/<Jwner D Rente r



# oM^m , ^ e (CITY ) (STATE ) (ZIP ) c. . Property owne dby : ^J^M ^ Owner s mailin g address : Owner' s telephon e number—Home : .^y ^ 'O^S o Work : Ag e o f Home ? year s Ho w lon g hav e yo u live dhere ? year s Ha s th e exterio r

bee n painte do r

covere dwit

h sidin g sinc e 197 8 Ha s th e interio r

bee n painte do r

coveredsinc e 1978 ? Tota l numbe r

o f occupants : Lis t Ages : D YE S

D YE S D N O

D N O
Lis t age s o f occupant s unde r

6 year s ol dwh o play i

n th e yar dfo

r 5 o r mor e hour s pe r

week : Comments : AUTHORIT Y FO RENVIORNMENTA L RESPONS E ACTION S Th e activitie s t o b e implemente db y EPA unde r thi s agreemen t

ar e pursuan t

t o Sectio n 10

4 o f CERCLA , 4 2 U.S.C . 9604 . EPA' s righ t o f acces s t o th e propert y for

i n Sectio n 104(e ) o f

CERCLA , 4 2 U.S.C . 960 4 (e) , whic h provide s entry for , "determinin g th e nee dfo r response , o r

choosin g o r

takin g any respons e actio n unde r thi s title , o r

otherwis e enforcin g th e provision s o f thi s title. " Acces s Attempts : First : Second : Third :

### pg-_of _ 

## Lis t o f Existin g Condition s Propert y Address : 0.(^1 ^ N L S S T DV D I D # Owner : RLRUc.iH ; bi^Mis . Date : ?-/Q-Of ) BVID # ^^ 1 Ref : Phot o # 

### Descriptio n / \ /^/ L Gf^oOt^t s I S - m ^ f ei\cc.A\//i-rE b 

### : i \ P^oPEf^r' Y Uji/ £ / M ejk^ K£/ob s B T 

### TEL^Pncjo e I^OL F 

### i s Rf.M6Y f -b O JOiT T fifiPLf^Cf aLCTttt< : LAJ P 

### P6L f 

### H \ Rf.Dno)/P''b o S^cn-Rf.PLA<if'fii ^ PL/^tor ^ /st^/iOB< : ET C

Owne rSignatur e EC C //^?i/t - Prin t & Sig n D.:„ * o.^:— / ^ {£>/^->sy-is -

### Contrac t No . W912DQ-04-D-0017 , Tas k Orde r DKOl Omah aLea dSite , Omaha , N E Propert y Closeou t

Agreemen t BVID 

## !2M
Propert y Addres s 

### ^GJ ^ N I ^ S Propert y Owne r 

### (^LM^cSf.hA^/l ^ I s th e Owne r th e Resident ? D-^ s 

### D N o Complianc e Statement : U.S . Environmenta

l Protectio n Agenc

y (EPA ) ha s contracte dth e U.S . Arm y Corp s o f Engineer s (USACE) , Omah

aDistric t t o conduct

environmenta

l restoratio n service s fo

r th e OmahaLea

dSite . USAC E Omahai s working wit

h Enviroimienta

l Chemica l Corporatio n (ECC ) t o remove lea d contaminatedsoi

l an dprovid e subsequen

t restoratio n services . You r cooperation i

n givin g EPA/USACE/EC C permissio n t o acces s you r propert y durin g th e removal/restoratio n phas e i s sincerel y appreciated . Thi s documen t certifie s tha

t al l wor k performe da t thi s propert

y wa s completedi

n accordanc e wit

h th e contrac t

specification s an

dEP A requirements . If yo u hav e question s or

nee dadditiona

l information pleas e contac t Do n Bahnke , EP

A Project Manager , a t (913 ) 551-700 3 or

th e Offic e o f Extema l Program s a

t 1-800-223-0425 . Additiona l Comment s b y USAC E and/o r ECC :

CONTRACTO RCERTIFICATIO N Prashan t -Khann aor Charle s "Slcip"Miltoa- , EC C Project Manage r Name Titl e 

### Dat e . 

### PROPERT Y OWNE RSECTIO N Thi s agreemen

t document s th e completion o f remedial/restoratio n eflfort

s a t th e propert

y t o m y satisfaction . h i I agree tha

t restoration i s completeda

t m y property , except

a s noted Comment s (if

applicable) :



## x ^ S^^ci^^^f . 

### Owner' s Signatur e Dat e

## Propert y Owne r Satisfactio n Surve y For m Omah aLea dSuperfim dSit e Performance-Base dContractin g (PBC ) Pilo t Projec t Remediatio n Contractor : f^C^C ^ Propert y Identifie r

Number : Propert y BVI D Number : 7^ 1 Propert y Address : ^^/A
- / / IS ' .S T Propert y Owner' s Name : 3LAK)Cyttf . Xi/it/J S (abov e informatio n to b e filledou t by remediatio n contracto r

prio r t o deliver y o f for mt o Propert

y Owner) Instruction s t o Propert y Owner : Thi s for mi s provide dto yo u a s amean s o f tryin g t o captur

e you r level o f satisfactio n wit h th e wor k ofth e above-identifie dRemediatio n Contractor , a s applicabl e t o th e soi l cleanup actio n a t your property . Th e U.S . Environmenta l Protectio n Agency (EPA ) an dth e U.S . Arm

y Corp s o f Engineer s (USACE ) ar

e vei y intereste din you r

opinio n regardin g th e woik performe d b y ou r contractors . Thi s for

mi s intende dt o provid e a

n eas y mean s fo

r yo u t o expres s you r opinio n about

th e wor k performedo n you r

property . Pleas e indicate you r

level o f satisfactio n wit

h th e Contractor' s wor

k b y selectin g a numerica l ratin g (rangin g fro

m1 t o 10) usin g th e following ratin g scale , the n pleas e sig n & date th e for mandretu mit

t o USACE in th e attache dself-addresse d& stampe denvelope . (Additiona l comment s ma

y als o b e provide di

n th e spac e provided , a

t th e optio n of

di e propert

y owner. ) "excellen£ ^ —?= 8 vei

y goou 5- 6 "acceptable " 3- 4 "poor " 1- 2 "ver y poor " Prooert y Owner' s Satisfacti c 1 0 9 8 7 6 ^ ^ ^ »

n Ratin e reeardin e Contractor' s 5 4 3 2 1 Wor k

Additiona l Comment s fro mPropert y Owne r (optional ; continu e o n bac k o f nae e i f needed )

Propert y Owner' s Signature : X^^^<> g ^- ^ /I^>^te :CONTRAC T # W912DQ-04-D-0017 , T.O . DK0 4 Environmenta l Chemica l Corporatio n Omah a Lea d Remediation , Omaha , N E u s Arm y Corp s o f Engineer s 

### Analytica l Result s Summar v OL S #0072 1 261 2 N 15* " S t Quadran t D E D E D E D E D E Sampl e Typ e F 1 F 2 B 2 D Z EA-E Dept

h 6 4 5 5 0 Date Collecte d 8/21/200 7 8/21/200 7 8/21/200 7 8/21/200 7 8/21/200 7 XRFResult s

(ppm ) (avg. ) 25 8 17 5 9 6 16 7 10 0

SAMPL E ID
SAMPL E I D i s aparticular residentia l property I

D fromwhic h th e sampl e i s collected . Th e sampl e typ e identifie r (wit h sequentia l sampl e numbe r for tha t location ) a s follows ; PX = Pre-Excavatio n XRFsampl e D E = Durin g an dPos t

Excavatio n Quadran t describe s th e samplin g locatio n (with sequentia l sampl e numbe r fo r tha t location ) a s follows ; F l o r F 2 = Fron t YardOn e o r

Fron t Yar dTw o B I o r B 2 = Bac k

Yar dOn e o r Bac k Yar dTw o DZ = Dri p Zon e G A = Garde n PA = Play Are a E A = Easemen t Depth describe s th e dept h fromwhic h th e sampl e wa s collected . pp m= part s pe r

millio n