TRANSMITTAL of OMAH A LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID #: 2^31 6 Date: Z\2.0\C<] 

Address: 74Z ^ felODClO St " 

Remediation Contractor: Coastal Environmental Group_

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

y Video of property (DVD) 

s y Executive Summary

\ y EPA-provided property sketch

s y Signed Access Agreement for subject property 

(^h Signed Access Agreement(s) for adjacent property 

\ y Restoration Agreement 

 Year: _2008_ 

40315436 

I I I III 

"^ und 

f4|i\ Settlement documents (i.e., for damage or to replace plants, etc.) 

y Confirmation data 

y Photographs ^i_-{LXf^n.ln^/Wx ^.jCC/Jukoa, ^d j ^A^U Sod 

0 As-built sketch 

sy Satisfactory restoration signed by Property Owner 

y Property close-out check list signed by EPA 

|ipV Description of areas not meeting ROD cleanup criteria 

y Utility clearances 

y Property information from Douglas County Assessor's Office 

„y y t ^{ n 

y <^jSviltL6f-prvrv 

D 

L^.my}^7) ^lonip^ 

Signature Signature ' Date 

^7i^^C£^ ^7y 
m 

Property Access Checklist 

Property ID: iS^^Xe; 

Property Address: r^^^ ^ 9AfVY\(^ <5\ 

n

n

 WORK STARTED

 WORKCOMPELTED

 ON:

 ON:

 /

 /

 / 

/ 

O""'^'^ NArsVrrr . \rAvY5)trv^S 

Address: 

Phone: 342,-25^2. 0 

Fax: 

Cell/Pasjer: 

Renter: 

Phone: 

Fa.\: 

Cell/Pager: 

Additional Information: 

1 1 Notification Letter 

l y Access Agreement 

\ y Restoration Agreement 

n Topsoil Sampling (ifapplicable) 

1 1 Disposal Sampling (if applicable) 

n Garden Sampling (if applicable) 

I l y Utility Clearance 

D Video/Photos (Before) 

n Video/Photos (Durinj;) 

1 D Video/Photos (After) 

n Video/Photos (3()-Day) 

• Pro|)erty Completion Agreement 

1 1 Final Report 

Sent: / / 

Signed: JL/.23/Qg 

Signed: J8_/23/ofi. 

/ / 

/ / 

/ / 

Called: ft / 28 /0% 

On: / / 

On: / / 

On: / / 

On: / / 

Signed: / / 

l.s.sued: / / 

By: 

By.^Q 

By: ^^^ 

By: 

By: 

By: 

B.v: 0^-2 08 

By: 

By: 

By: -. 

By: 

By:

By: 

j 

Air Monitoring (as applicable 

1 Communit} HH CrcM 

) 

Results: 

On: / / Bv: 

LJ Conununity

Results:

 EH Cre« On: / / B y: I 

j 

n Community

Results: 

• Crew On: / / B,: 

Omaha Lead Site 

I 
CONTACT FORM 

Property ID # 9?3\5 ' 

Property 

Address: a M,^?) ?)\Ohd0 T^i 

Initial Contact: Date: Time: Action: 

Second Contact: Date: Time: Action: 

Final Contact: Date: Time: Action; 

Final Action: Transmit to EPA D Other Action: D 

3Ma-a^r^o 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 
.Douglas County Account Information Page 1 of 1 

Dougla s County , Nebrask a Propert y Recor d - R194442000 0 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 90th St - Vje W OH Ma p Information is valid as of 2008-6-19 Treasurer's Tax Report 

New Feature -•->- > Auto Sales Search 

Owne r 

MOBECO INDUSTRIES 

11413 HICKORY RD 

OMAHA NE 68144-0000 

Propert y Informatio n 

Key Number: 4442 0000 19 

Account Type: Residential 

Parcel Number: 1944420000 

Parcel Address: 2428 BLONDO ST 

OMAHA NE 68111-0000 

Legal Description: PARKERS ADD LOT 5 BLOCK 1 W 1/2 30 X 140.87 

Valu e Informatio n 

Land Improvement Total 

2008 $200.00 $0.00 $200.00 

2007 $200.00 $0.00 $200.00 

2006 $200.00 $0.00 $200.00 

2005 $200.00 $0.00 $200.00 

2004 $200.00 $0.00 $200.00 

2003 $200.00 $0.00 $200.00 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.09 4230.0 0.0 141.0 30.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R19... 7/17/2008 
Page 1 of2 

Create Another Ticket Back to Irth Internet Send Email 

• YOUR TICKET NUMBER IS 2119034. 

Original Call Date: 8/28/08 Time: 12:16 pm Op: ELIZABETH187 90 


Work to Begin Date: 9/02/08 Time: 12:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2428 Street: BLONDO ST 


Twp: 15N Rng: 13E Sect-Qtr: 09-SE,10-SW,15-NW,16-NE 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remidiation 


Location of Work: LOCATE ENTIRE PROPERTY ALL THE WAY TO THE STREE. 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: VACANT LOT. 


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: coastal 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVELS MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 8773668344 

LEVEL3 LEVELS COMMUNICATIONS, LLC NA Alt: 

Emerg: 8773668344 

Day: 9185747098 


MAGELLAN MAGELLAN MIDSTREAM PARTNERS LP TONYA Alt: 

Emerg: 9185747098 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047946 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/28/2008 
Page 2 of2 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 8887289343 

Emerg: 4067289343 

Day: 4067289343 

QLNNE 1C QWEST LOCAL NETWORK NA Alt: 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/28/2008 
As-Built Drawing ^ r 

COASTA L Omaha Lead Superfund Site INVIRONHINTAL 

G II O U P . IN C 

27315 

Omah Exterior Paint North Arrow a Lead Site • Good Samplin g AddrMs : 2428 BLONDO ST Site Sketch 

Q Poor 

Phone : H (402)342-2820 ALT: [^No t paint f

Sampl e Number Lead Sample LAB Samples Collected 

Concentration Collected Firm: m \ ^ 0 • Pe> 

RYASCPXA-2731 5 F l 12/3 p p m D Date: 7 - 1 2 - 6 ^ 

RYBSCPXA-2731 5 F2 p p m Time: ID 'OO o-r^ 

RYCSCPXA-2731 5 B l p p m n 

Samples Analyzed RYDSCPXA-2731 5 B2 p p m I EZl 

RDZOCPXA-2731 5 B Z p p m D XRF Unit: 6>5H2 Book: 1 8 H 

RGZGOrXA-2731 5 G * p p m n n Date n /?- Q ^ 7 

Lab RYCSCPLA-2731 5 p p m D Tim e An I Result 803 pp m D n Staff: Number of Samples - KSW i 

Legend: F l = Front Left, F2 = Front Rigtit, B l = Back Left. B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are a& yiSMMd from the street, facing property 

OLS#: 27?1 i 

Date Excava ted .<: )/13/08 

Date USEPA Sigr ledG 

ff: 11/21/08 

Area Soddet 

2 sqft 

81 = 265 PPM 6" 

F1 = 83 PPM 6" 

TT^-t-.- ^^:^ 

" ^ 

Re\S Cicaud 6/li'2007 10 47 « 

Legend 

Concret e Drip Zone Excavated Quadrants Excavated 

Area replaced with Are a replace d wit h ^ ^ , -^ ,. 

Sod ' « T./W 1 V. ^ H Are a lef t bar e 

Rock/Mulch ^ ^ 

Contrac t #: EP-R7-07-05 Coastal Environmental Group Inc 
% 27315 

Omah Exterior Paint North Arrow a Lead Site 

Q Good Sampling Address: 2428 BLONDO^ Site Sketch • Poor 

Phone: » (402)342-2820 ALT [j3^Not paint 

Lead Sample Samples Collected Sample Number LAB Concentration Collected Firm 

RYASCPXA-27315 Fl 12J3 ppm D Date 7 - iZ' t 7 

RYBSCPXA-27315 F2 5 5 H ppm Time 

RYCSCPXA-27315 Bl ft^q ppm 0f 

Samples Analyzed RYDSCPXA-27315 82 ftqg ppm i n 

RDZGCPXA 27315 DZ ppm XRF Unit (D5H2 . Book JB H D D 

nGZ0CPXA-2731S GZ ppm D D Date H-^d l 

^Lab ppm RYCSCPLA-27315 Time D D itL s Result 803ppm Staff 

Number of Samples = y MsW 

% Legend F1 = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as vievwd from the street, facing property 

Kf.v 5 Cicdlcd 6,'I2,-:0(I7 li)4?.)<) %\/)\^y/<7 4r a>:«r jo^rwuir. n-<x> :m' »•.«.-?»• >vi «• • .w j * .^ M.. 

iyidJbM^ y 
A 

27315 

Omah Exterior Paint Nortti Arrow a Lead Site 

Sampling Address: 2428 BLONDO ST Site Sketch 

Q Good 

Q Poor 

Phone: H (402)342-2820 ALT: [Q^Not paint r

Sampl Lead Sample 

Samples Collected e Number 

Concentration Collected LAB 

Firm: TO V0 • {/£> 

RYASCPXA-27315 Fl 1213 ppm D Date: 7 - [Z- b7 

RYBSCPXA-27315 F2 5 5 ^ ppm Time: JD'CO c^i^ 

RYCSCPXA-27315 B1 fl^q ppm 

n 

Samples Analyzed RYDSCPXA-27315 B2 

^°\(^ ppm I D

RDZGCrXA-27315 BZ ppm 

XRF Unit: 0>5H2. Book: l& H n RGZOGPXA-27315 GZ 

ppm n Date D fi-^dl 

Lab RYCSCPLA-27315 ppm D Time M. 

SResult 803 ppm 

Staff: Number of Samples = D D 

%.y MsW . Legend: F1 = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are asyiewad from the street, facing property 

ENTERED 

JUL 2 7 2007 

Rrk'5 Crealed 6/12'2007 10 47 4<> $IO]A^<7 C,\ 

046141 0123 

aiTM«rsy)>)noi wi-xr'»i/Mi'3«i f .ofrwniMn'/'W'JN"- n*.. .«.• jw , ,: «triD--yoi j^i/^..'I<W5(»ii J )• w vei'xei3mt nt:i n.ni . juu .ao jodXTT*.' «*>i .v 

W M M 
27315 

Omah Exterior Paint North Arrow a Lead Site 

Sampling • Good Address: 2428 BLONDO ST Site Sketch • Poor 

Phone: H; (402)342-2820 ALT: [Q^Not paint r

Sample Number Lead Sample Samples Collected LAB Concentration Collected Firm: Fm t^'Pi^ RYASCPXA-27315 Fl 1213 ppm D Date: 7 - IZ- 67 RYBSCPXA-27315 F2 ppm D 

Time: ID :0D o~t^ 

RYCSCPXA-27315 B1 fl^q ppm QI 

Samples Analyzed 

RYDSCPXA-27315 B2 A^ g ppm n 

RDZGCPXA 27315 BZ ppm D n XRF Unit: ^5H7 . Book: J& H 

RCZOCPXA 27315 GZ ppm D D Date /? Q • ^ 7 

Lab RYCSCPLA-27315 ppm D D Time: M. ^Result 803 ppm Staff: Number of Samples • y. 7 M.SW 

Legend: Fl = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as vieMMd from the street, facing property 

."CIXT' ssm.Ti ITTM-lTk • ... . 

81 6^5 JUL 2 7 2007 

U. 

2*^2^ BIw do IT. 

.... ^...1 

. JZ/3 S5H 

... . P i . f^ 

1 

U>AL/i " 

Blon4o7-h 

Crealed: 6/12/2007 10 47 49 

r jwioof J*: 1 '• /a>' XK^MCixo' :i u-I»?2W.«i;!W3«',ln'Wfjowwr.'j .'Rr'3WW"»f W'xr i«,rMnj 

Re^5 046141 0123 
<7^> * m COASTA L \ f NVIKONMlNTA l 

^ c ^ - ^ C > 0 U P . 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: \ i ^ ^ _^ 

Daytime Phone:^^^ ^ ^^ ^ ^ ^^^ ^ owner's Name: ^bhc O ^doS^.t ^ 

Address of Property 

covered by this Oirvh<^^B Ionian 

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 written 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 
v 

V^4^a^* ^ COASTAL ^ V <P

 CNVmOHHENTHl 

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

piles, dog houses, etc; 

• 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. 

• 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 (712) 352-0188 

I grant access to my properties D I do not grant access to my properties 

y77ly(/y777ky77yyy/Ms\/^^ 7" y 

Signature 7^ Date/ / Signature Date 

IZI I would like to be present during any sampling that is required. 
COASTA L 

Restoration Agreement 

The purpose ofthis agreement is to provide a mutual agreement as lo conditions ofthe propert\' prior to 

remediation activities. This vviii 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: Q^^j ^ 

Property Address: g^^^ ^ B/onnlz ) ^ • 

Owner: m^QP f .C.<,AAi)^/e- 6 

Phone: t^zn-S^5L-^^Q 

On the attached diagram(s) indicate area(s) to excavated and depth of e.\ca\ation. location of all known 

utilities, subsurface features, surface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material tvpes, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

The removal, storage, disposal, and.'or return of these items is the Owners responsibility. 

Page 1 of. 
COASTA L 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

Item:

^ 

X

/ - ^ V 

, 

Item: \ 

Item: 

Item: 

\ 

Item:

\ 

\ 

Item: \ 

i 

Item: 

Item:

\ 

\ 

Item: 

Item: 

Item: 

Item: 

• \ 

^-­ ^ 

\ 

\ 

\ 

/ 

Item: ' 1 

Item: 

Page 2 of. 
COASTA L 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

1 

Item: 

Item: 

Item: 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

^ ^ _---^ ^ 

y 

7 

\ 

\ 

\ 

\ ^ 

\ 

\ 

\.^ 

\ 

) 

—— 

Page 3 of 
wt 

COASTA L 

Landscape Inventory 

(Use additional sheets as necessary) 

Item 

Pre-exisling property area, 

that will be excavaied, thai 

is covered with grass. 

Quantity Unit 

Square feet 

Condition/Type/Species 

O<oc^vccf<^ ^yy- c ryo^T ^ 

Number of trees > 2 inch 

irunk diameter % . Each 

jj 

Number of trees '-= 2 inch 

trunk diameter ~y Each 

\ 

Number y Sprinkler 

Zones. Control Valves. 

Timers. Heads, eic. 

Aiuich a skeich uf ihe 

;.pii:ikle:- k;\ OUT. 

Lr-> 

Each 

\ 

Number of and size of 

each garden/ flower bed 

area. 

•'•.;.;ii.]: ;; >KCiC!'i v i ......ul'.C 

-l;'e^ Z\n.}. localion-.. 

- ^ Each 

Square Feet 

Page 4 of 
m^ 

COASTA L 

Item 

Agreed upon value of 

plant materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

>ouctier to the propert) 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include n sketch c\^ were 

eiich plant uill be pbced 

b_\ ihe coniracioi. 

Agreed upon area of 

propertv to be replaced 

w iih grass sod. 

''icii:dc u skeu:ll >>; ihc 

.iiea(s) U' he ;epl.iccJ '•'-•li'i 

.Area ofCity or Count) 

propertv to be landscaped 

periheir requirements. 

Easement Area, to be 

excavated 

Quantity 

^ 

Unit 

*0 

Condltion/Type/Species 

^ k Each 

-

^(oyyj SF 

^ 

y ^ 

SF 

SF 

Page 5 of 
^ KJo^y \c7r. • Check the box If Owner does not want CEG to document interior foundation walls and possible 

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

interior of house, including foundation cracks or fissures. 

Q I do not agree 

i^TkTer'yyyym'y^ yy y 

Contractor's Signature Date 

Page 6 of. 
Date 

Project 

XRFID# 

Shot# 

SScso 

.•^«o \ 

:^9,o ^ 

5?y ^ 

Average

Shot# 

^Svc ­

3S.\ 

3&VQ 

38v 5 

Average

Shot# 

3B3 0 

3 8 a ^ 

383 a 

5^^^ 

Average

Shot# 

Average 

lab sample # 

BVID# cO"7?^i S 

XRF PROPERTY SAMPLE SHEET 

^- \^-o& Address ^^a ^ V^\C'^>-A A O ^ ^ • 

Omaha lead FP 2nd year option Sample time am/pm 

e,3yy \ sample length 30 sec 

Reading Sample area Shot# Reading Sample area 

aau -r^o''- \(\.^S^ 3&0 S \oa . n ' i^.o;^ Bl •&a cJia-^u,*^ av-A^\ aSoCp 106 S^'li t ^.'VD 

.^66.0'.*-.:3 V. ft! Depth 380 T loH.ti-b t \-^.^: i Depth 

cSlQ. Qy.3i\.3'C U? hP.0Z 108.-ssr I'A.n U' 

 <;3^S -^ i 1 /^ \ • 0"7 Average \(n^:, , \<\ t \ ^ b S 

Reading Sample area Shot# Reading Sample area 

^-i k^, t: \\.-m dBi S m7. 3i5 - \u-it.<! 

'^u.To i \S.3-3- f^ 3S\u> ^ir^iH-UHt \'b...3T T^S 

&H, S6-t^ \a.'o^ Depth .-S^iT 1^3- 31-" t-i6.6 i Depth 

77. 7U i \a.\'b u .^B\fe 13A -a.3.1 )S-\'v (^ 

 83.^\.g, ^ \Q. -^ O Average i ^ M .c/zu^^ \' ^ .y ^ 

Reading Sample area Shot# Reading Sample area 

i)vo-JB t i&.iH 

33^.33 - \'^--2.a ,^-"^ ^ 

dii)o.ST i \8.UU Depth Depth 

\ ,9u3.6Hln'» ^ 

 c^Vl.^ U t \S .^ p Average 

RETEST AREAS 

Reading Sample area Shot# Reading Sample area 

' ^ 

Depth ^ y / Depth 

y y 

Average 

Lab result Sample area XRF Avg. 

Signature^ 

P„n.' Ui>:H^ Mmr^s 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By 

Certificate of Verification 

3804 

SOIL 

2008-09-13 20:30 

121.86 

Final 

Avg of 3800-3803 

^42 8 Blonde st 

.fBl 

. LOPEZ 

fe 

CLEARANCE f 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 226.802 

Supervised By: 

Certificate of Verification 

3800 

SOIL 

2008-09-13 20:28 

30.24 

Final 

27315 

2428 Blondo st 

Bl 

LOPEZ 

6 

CLEARANCE 

± Error 

± 19.719 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE PI'PE 

NOTE 

ppm 

Pb 274.563 

Supervised By: 

Certificate of Verification 

3801 

SOIL 

2008-09-13 20:29 

30.56 

Final 

27315 

2428 Blondo st 

Bl 

LOPEZ 

6 

CLEARANCE 

± Error 

± 21.439 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 288.014 

Supervised By: 

Certificate of Verification 

3802 

SOIL 

2008-09-13 20:29 

30.51 

Final 

27315 

2428 Blondo st 

Bl 

LOPEZ 

6 

CLEARANCE 

± Error 

± 21.872 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE PI'PE 

NOTE 

ppm 

Pb 272.247 

Supervised By: 

Certificate of Verification 

3803 

SOIL 

2008-09-13 20:30 

30.55 

Final 

27315 

2428 Blondo st 

Bl 

LOPEZ 

6 

CLEARANCE 

± Error 

± 21.252 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3809 

Mode SOIL 

Time 2008-09-13 20:33 

Duration 121.41 

Sequence Final 

Flags 

AVERAGE Avg of 3805-3808 , 

ADDRESS 2428 Blondo st 

QUAD/ZONE B2 

INSPECTOR JjQPEZ 

DEPTH 

SAMPLE PVPE CLEARANCE| 

NOTE 

Pb 

Supervised By 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 102.172 

Supervised By: 

Certificate of Verification 

3805 

SOIL 

2008-09-13 20:31 

30.32 

Final 

27315 

2428 Blondo st 

B2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 13.643 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 105.589 

Supervised By: 

Certificate of Verification 

3806 

SOIL 

2008-09-13 20:32 

30.52 

Final 

27315 

2428 Blondo st 

B2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 13.897 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 104.682 

Supervised By: 

Certificate of Verification 

3807 

SOIL 

2008-09-13 20:32 

30.23 

Final 

27315 

2428 Blondo st 

B2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 13.619 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 108.325 

Supervised By: 

Certificate of Verification 

3808 

SOIL 

2008-09-13 20:33 

30.34 

Final 

27315 

2428 Blondo st 

B2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 14.171 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Pb 

Supervised By: 

Certificate of Verification 

3814 

SOIL 

2008-09-13 20:39 

120.62 

Final 

Avg of 3810-3813 

2428 Blondo st "• 

i F l 

LOPEZ 

^6 

CLEARANCEi 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE PI'PE 

NOTE 

ppm 

Pb 75.845 

Supervised By: 

Certificate of Verification 

3810 

SOIL 

2008-09-13 20:34 

30.30 

Final 

27315 

2428 Blondo st 

Fl 

LOPEZ 

6 

CLEARANCE 

± Error 

± 11.737 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 96.701 

Supervised By: 

Certificate of Verification 

3811 

SOIL 

2008-09-13 20:36 

30.12 

Final 

27315 

2428 Blondo st 

Fl 

LOPEZ 

6 

CLEARANCE 

± Error 

± 13.223 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3812 

Mode SOIL 

Time 2008-09-13 20:37 

Duration 30.01 

Sequence Final 

Flags 

BVID # 27315 

ADDRESS 2428 Blondo st 

QUAD/ZONE Fl 

INSPECTOR LOPEZ 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 83.528 ± 12.514 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE P<PE 

NOTE 

ppm 

Pb 77.762 

Supervised By: 

Certificate of Verification 

3813 

SOIL 

2008-09-13 20:39 

30.19 

Final 

27315 

2428 Blondo st 

Fl 

LOPEZ 

6 

CLEARANCE 

± Error 

± 12.132 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By 

Certificate of Verification 

3819 

SOIL 

2008-09-13 20:46 

121.70 

Final 

fAvg of 3815-3818 

,2428 Blondo st 

IF2 

LOPEZ lit6 . 

CLEARANCE 'Hi f 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 147.375 

Supervised By: 

Certificate of Verification 

3815 

SOIL 

2008-09-13 20:43 

30.33 

Final 

27315 

2428 Blondo st 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 16.158 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE PI'PE 

NOTE 

ppm 

Pb 129.692 

Supervised By: 

Certificate of Verification 

3816 

SOIL 

2008-09-13 20:43 

30.28 

Final 

27315 

2428 Blondo st 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 15.269 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 132.360 

Supervised By: 

Certificate of Verification 

3817 

SOIL 

2008-09-13 20:44 

30.62 

Final 

27315 

2428 Blondo st 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 15.511 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 129.221 

Supervised By: 

Certificate of Verification 

3818 

SOIL 

2008-09-13 20:46 

30.47 

Final 

27315 

2428 Blondo st 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 15.192 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3824 

Mode SOIL 

Time 2008-09-13 20:55 

Duration 122.09 

Sequence Final 

Flags 

AVERAGE f Avg of 3820-3823 

ADDRESS 2428 Blondo st 

QUAD/ZONE easement 

INSPECTOR ' LOPEZ 

DEPTH 1 

SAMPLE TYPE CLEARANCE• 

NOTE 

Supervised By 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 210.279 

Supervised By: 

Certificate of Verification 

3820 

SOIL 

2008-09-13 20:53 

30.65 

Final 

27315 

2428 Blondo st 

easement 

LOPEZ 

1 

CLEARANCE 

± Error 

± 18.189 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 235.323 

Supervised By: 

Certificate of Verification 

3821 

SOIL 

2008-09-13 20:54 

30.43 

Final 

27315 

2428 Blondo st 

easement 

LOPEZ 

1 

CLEARANCE 

± Error 

± 19.324 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 220.569 

Supervised By: 

Certificate of Verification 

3822 

SOIL 

2008-09-13 20:54 

30.63 

Final 

27315 

2428 Blondo st 

easement 

LOPEZ 

1 

CLEARANCE 

± Error 

± 18.655 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 202.887 

Supervised By: 

Certificate of Verification 

3823 

SOIL 

2008-09- 13 20:55 

30.38 

Final 

27315 

2428 Blondo st 

easement 

LOPEZ 

1 

CLEARANCE 

± Error 

± 17.832 
Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 5S!»' ^ • .^ www.coastalhazmat.com 

^PBott"^"^" COASTA L ENVIRONHENTAL 

CROUP , INC . 

EXECUTIVE SUMMARY: 

BVID # 27315 - (2428 BLONDO ST) 

y 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 

NO ISSUES PENDING 
4

SiK. EPA 

EPA Property Close Out Form 

Property Property Addr«.- ^49? ^ fi\OYYlO.^ ff: ^^'^If T . . 

Quads Excavated: Fv . f ? ^y^ ^ ~ Contractor Group rnT^SM i >-.VAV\yr^nU>e,n-ttL\ 

Excavation Yes No General VAm/vlT LOT 

1. if ncccssuy, were the correct quadTant(s) excavated and restored? , y 

2. If necessary, were the con-ccl areas ofdrip zone excavated and restored? 

GradlDK Sod and Vecetation 

Yes No 

1. Docs the grading around the perimeier ofthe house in excavated areas generally slope away I 

from the house? 

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

3. 

Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 y day time period) 

4. 

Are sodded areas generally firm and evenly graded? 

5. 

Are the joints between the sod strips generally tight? (Only evaluate ifinspected at a 30 day 

time period) V' 

6. 

Was the property graded such that water will nol pool on the property? y 

7. 

Was damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls 

Yes No 

1. Do gates open and clo.se freely? (If applicable) ' 

2. Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) i 

^;\ 3.

 Was damage to gates or fences avoided? (Ifapplicable) 

4. Was damage to retaining walls avoided? (Ifapplicable) 1 

Foundation, SidioK and Gutters Yes No 

( I.

 Was dannage to the siding or trim avoided? 

2. Was damage to the foundation avoided? i 

3. Was damage to windows avoided? y 

 Was damage to windows or door screens avoided? 

5. Was damage lo downspouts or downspoul extensions avoided? \ 

Sidewalics and Driveways (Concrete) 

Ves No 

1. Was damage to driveway surfaces avoided? 

Vi\ 

2. Was damage to walkway surfaces avoided? 
O^'Dcrs comments: 

Inspection notes: 

Removal and restoration activates complete including the 30-day sod warranty: 

- — • -) y f . 

EPA Representative.y^7yy777^_y/^yK.^^y7^ Date: // /h. / / o Q^ 
Property Completion Agreement 

riiis agreemeni documenls. ihe complclion oi remedial activities perlbrmed nn my properly. My signalure 

Will designale thai I am satisfied with the restoration of my properly, and thai no items are m questions, 

now, or ai any lime in the future, except those items listed below, ifany 

Property ID ^ ^ 7 ? / 5 

Property Address: J_Z.;^ ^ (^ 7^ ^ ^ ^ st 

^/7!y 7^^7L&-^^y ^A^Tby^Ly Phone 31.|/^ JiyP>(9 

Restoration Items in Question 

Item; 

Item: 

Item: 

Item: 

Item: 

Item: 

y \ I ayrcc icstoralion is complcled, cxctp l as noleri 

[ I I fio nnl aj;icc restoralion Is completed 

'yAly{jfco ^^^^Lf ypyjt-7 

Owner' s Signalure ---—Oatc '^Conlracloi 's Signature 

ITOf ^JUyaAyy]n.^(yuih /t//s/oS' 

hale