CONTRACT # W912DQ-04-D-0017, T.O. DK02 

Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE US Army Corps 

of Engineers 

ECC Certification for Property Closcout 

BVID 25799 Property Address 1514 N 40 St. 

Field Work Started 06/12/06 Field Work Completed 06/14/06 

Summary: 

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

• Fl excavation depth varied from 4 to 6 inches below ground surface. 

• F2 excavation depth varied from 4 to 6 inches below ground surface. 

• 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.. 

HUVA ECC Project Manager I'lQ-Qis yW v 

Name Title Date 

USAGE Con Rep 

Name Title Date 
AsAutt Qtembla f — 

d North Arrow Omaha Site Exterior Paint Lea Owner Name: "Daniel tL /"SU/lOl^r 

Sit ch n Good e Sket Address: /5W A/ *& lcfii_

 Phone: H: T3¥ -£Q35

 PJ Not paint 

Lead Samples Collected Sample Number

 Sample ,

Concentration Collected LAt 

Firm: /"YD/A — ED //CW 

^ 73 ppm EK' D Date: 6-^-06" 

2579 PPm B^ D Time: ^.'2 5" 

>pm D D Samples Analyzed f» i Uov^i /\^\~ xz j (iLs^y Ofc •

 >pm Q^ D rj r^^c*^ OV A r^7 ppm D D XRF Unit: /O37 Book: // 9 

2.^5 c pm S^ D Date: - *7-(o-O£~ t?[3*7^f*QYA n^~r DDm D D

 Time: /^/TJ 

itaff: Zx^ Number of Samples= /jtI.egend: F1 = Front Left, F2 = Front Right, B1 = Back Left. B2 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

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page 1 of. 

Omaha Lead Site 

Omaha. NE 

U.S. Environmental Protection Agency Region VII Residential Yard Soils 

Environmental Restoration 

Services 

PROPERTY ACCESS (to be completed by property owner) 

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

District to conduct environmental restoration services for the Omaha Lead Site. USAGE Omaha is working with 

Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration 

services. Your cooperation is requested in giving EPA/USACE/ECC permission to access your property during the 

removal/restoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­

7003 or the Office of External Programs, at 1-800-223-0425. 

Property Access Granted By CT 

(Please Print Name) 

;Profc€rty£>wneV Signature) (Date) 

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

PROPERTY INFORMATION 

(to be completed by resident and-'or property owner - Please Print) 

Resident Name D owner renter 

Residence Address: X_5/ 7 A/O. (CITY) (STATE) (ZIP) 

Property Owned C <Lft/2A 

Owners mailing address:_ 

Owner's telephone number - Home: 

-S 

-7^y 

-fWork: 

Age of Home? ^£?C? years How long have you lived here? years 

Has the exteior been painted or covered with siding since 1978? Ii3 Yes D No 

Has the interior been painted or covered since 1978? L_j Yes D No 

Total number of occupants: List Ages: 

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

Comments: 

AUTHORITY FOR ENVIRONMENTAL 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 

he 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 

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

Access Attempts: 

First: Second: Third: : 
£ "SBBd 06/L9 \rlL ZOb V90 :

I T VOOZ'Z Z Nflf 

OUN 21,2006 09:23A 4029321461 

Property Owner Satisfaction Survey Form 

Omaha Lead Superfund Site 

Performance-Based Contracting (PBC) Pilot Project 

Remediation Contractor: 

Property Identifier Number: 

Property BVID Number: 

Property Address: _ 

Property Owner's Name: 

(above mformnlion lo be fitted oul by remediation contractor prior to delivery of form to Property Owner) *»«+*»»+,»*,*»****»**#**+**»*»*»»***+«*»+»***•***++******•******»***»*****+*** 

Instructions to Property Owner: 

This form is provided lo you as a means of trying lo 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 (USAGE) are very interested in your opinion regarding the work 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 lo 10) using the following rating scale, then please sign & date 

the form 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 

M) 5 

7 2 

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

Property Owner's Signature: Date: 

90 
CONTRACT # W912DQ-04-D-0017, T.O. DK02

 

Environmental Chemical Corporation 

Omaha US Army Corps Lead Remediation, Omaha, NE of Engineers 

Analytical Results Summary 

BVID #25799 

1514 N 40th St. 

Sample 

Type 

Quadrant Depth 

Date Collected XRF Results 

(ppm) (avg.) 

Lab Results 

ppm (avg.) 

PX EA-E 2 6/8/2006 87 NA 

DE F1 6 6/8/2006 38 NA 

DE F2 6 6/8/2006 53 NA 

BVIDBVID is a particular residential properly 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 

PE = Pre-Excavation laboratory1 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 

B1 or B2 = Back Yard One or Back Yard Two 

DZ = Drip Zone 

GA or GZ = Garden or Garage Zone 

PA = Play Area 

EA = Easement 

LlP=Left In Place Per Property Owner Request 

Depth describes the depth from which the sample was collected. 

ppm = parts per million 
06/L9 b£L ZQ\r gooz'z z Nnr 

page 3 4029321461 JTJN 21.2006 09-.25A 

Contract No. W912DQ-04-T>-OOI7, Task Order DKOl 

Omaha Lead Site, Omaha, NE 

Property Closcout Agreement 

BV1D Property Address 

Property Owner Fs the Owner the Resident? D Yes No 

^//r^/ O/f.^/1 

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 She. 

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

contaminated soil and provide subsequent restoration services. 

Your cooperation in giving EPA/USACE/ECC permission to access your properly 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 External Programs at 1-800-223-0425. 

Additional Comments by USACE and/or ECC: 

CONTRACTOR CERTIFICATION 

Prasltant Khanna or ECC Project Manager 

Charles "Skip"Milton 

Name Title Date Signature 

Ji 

PROPERTY OWNER SECTION 

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

V\ \ agree that restoration is completed at my property, except as noted 

Comments (if applicable): 

e

/l.:U 90 22 
Contract No. W912DQ-04-D-0017, Task Order DK01

 

Omaha Lead Site, Omaha, NE 

Property Closeout Agreement 

BVID Property Address 

Property Owner Is the Owner the Resident? D Yes No 

Compliance Statement: 

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

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

USAGE Omaha is working with Environmental 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 External 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 of remedial/restoration efforts at the property to my 

satisfaction. 

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

Comments (if applicable): 

Property Owner's Signature Date 
Property Owner Satisfaction Survey Form 

Omaha Lead Superfund Site 

Performance-Based Contracting (PBC) Pilot Project 

Remediation Contractor: 

Property Identifier Number: 

Property BVID Number: 

Property Address: _ 

Property Owner's Name: 

(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 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 (USAGE) are very interested in your opinion regarding the work 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 return it to USAGE 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 Raring reearding Contractor's Work 

10 5 

9 4 

8 3 

7 2 

6 1 

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

Property Owner's Signature: Date: 
e6ed 06^.9 VSO'T T 900Z'Z c Mm? 

page j. 4029321461 21,2006 09-.22A 

3322Pk*naySL 

Omtw. ME 68111 

Z-1514 (JWone) 

(tec) 

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'.'.Environmental 

Chemical Corp. 

X 

Dt»iU«nt DForR-wi-w O PI •to D ftocyc*?' 

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I'd 90 
402-734-6790 Jun 21 06 01:48p P.1 

page JUN 21,2006 09:22A 

33ZZPWnojrSt. 

Chemical Corp. 

Toe.
 

CC:
 

itt O
 

402 734 6790 page 1
 JUN 21,2006 01:36P
 
402-734-6790 p3 

Jun 21 06 01:48p 4fl29321461 JUN 21,2006 09:23A 40293214bl 

Property Owner Satisfaction Survey Form 

Omaha Lead Superfund Site 

Performance-Based Contracting (PBQ Pilot Project 

Remediation Contractor: 

Property Identifier Number: 

Property BV1D Number: 

Property Address: 

Property Owner's Name: 

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

*****«***»*******• •** ***********************+*************»**********»**** 

Instructions to Property Ovmer: 

This form is provided to you as a means of trying 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 (USAGE) are very interested in your opinion regarding the work 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 ) lo 10) using the following rating scale, then please sign & date 

the form 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" 

I -2 "very poor" 

Property Owner's Satisfaction Rating regarding Contractor's Work 

10 5 

9 4 

7 2 IUZZ 

f> I 

Additional Comments fi-om Property Owner (optional; continue on back of page if needed) 

Property Owner's Signature: _ Date: 

734 6790 page 3 

JUN 21,2006 01-.36P ~ 
402-734-6790 p.2 

Jun 21 06 01:48p page 3 4(329321461 JUN 21,2006 09:25A 

Contract No. W912DQ-04-D-0017, Task Order DKOI 

Omaha Lead Site, Omaha, NE 

Property Closeout Agreement 

BV1D Property Address 

Property Owner Is the Owner the Resident? D Yes 

Compliance Statement: 

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

(USAGE), 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 EPA/US ACE/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 External Programs al 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

" 1

A 

PROPERTY OWNER SECTION 

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

satisfaction. 

v \ agree that restoration is completed at my property, except as noled 

Comments <if applicable): 

page 2
 402 734 6790
 JUN 21,2006 01:36P
 
Property Check Lists QC 

Location <oM Hi <fc^ -sfBVID s^n^ 

i Dates 

Excavation check list 

have easement map 

have site map 

home owner agreement 

line locator 

access log 

decon station 

tape barricade 

garden hose 

reconstruction map for buildback 

fences 

sod areas 

mulch 

gravel 

notes 

name and date 

QC Notes 

XRF check list 

have easemet map (1 ) 

have site map (3) 

easements sample 

F1 samples 

F2 samples 

B1 samples 

B2 samples 

DZ samples 

AS-Built 

map corrected 

shots mapped 

concrete mapped 

trees marked 

LIP marked/noted 

name 

date 

easement mapped 

window wells mapped 

ac mapped 

Log book up to date 

Backfill check list 

reconstruction map 

positive drainage from house 

NO low spots 

NO Rake Gaps 

lawn even 

soil compacted 

sidewalk 1" cuts 

smooth transition from walks 

area free of debris 

fences repaired 

damage to property? 

damage list 

punchlist filed 

A/0 
Map Output Page 1 of 

1514 n 40 st. 

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Legend 

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Bldck and WiulB Aarials 

httD://webarc.co.douelas.ne.us/servlet/com.esri.esrimaD.EsriinaD?ServiceName=TestAerials... 6/3/2006 
Map Output Page 1 ofl 

1514 n 40 st. 

Legend 

. Hghkjhlad Ft'dlura 

| | Pa real 

/...-•' Slwal 

Black and White An nab 

httD://webarc.co.dou2las.ne.us/servlet/com.esri.esrimaD.EsrimaD?ServiceName=TestAerials... 6/3/2006 
£5733 

Omah Exterior Paint North Arrow a Lead Site Owner Name: Ddn/S/ (/ f'SUlUn^r fj Good Site Sketch Address: /5IH- AJ 10 M. 

Phone:

 H: T3¥~ 

pp^o^piv A r^^t 

[3 Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

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Phone: H: 73# -£O95TM _i £2 Not paint 

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Sample Number Lead

Concentration

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Firm:

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Exterior Paint North Arrow 

Owner Name: Z)<9/?/(5/ (J t^huU^er

 Omaha Lead Site 

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Phone:

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Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

 /•"OA — ^n/KW 

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Omah Exterior Paint North Arrow Owne a Lead Site r hJame: Daniel f/ fatilkn&r fj Good Site Sketch Adc lress:_^| '51+ M 4O fit. 

Phone:

 H 

Sample Number 

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Sample 

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^ 

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opm 

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Dom 

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All quadrants are as v ewed from the street, facing property 

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Sample Number Lead Sample g Samples Collected

 

Concentration Collected

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1.egend: F1 = Front Left, F2 = Front Right, BT = Back Left, B2 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Play 

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List of Existing Conditions 

Property Address: /5 /T &V / 70-^(V< DVD ID # 

Owner: ^^^< /y^/?&^ Date: S~3/-0^ BVID# 

Ref: 

Photo Description 

# 

Owner Signature ECC 

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