TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 7" ] \ 'R 7_ Date: ]!-' V ' 0"^ 

Address: ZM?)' ^ Y)^t)nO\ n 

Remediation Contractor: Coastal Environmental Group Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

y 

Video of property (DVD) 403148 5 

y Executive Summary 1 1 1 I II

EPA-provide Superfund d 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.) 

y 

Confirmation data 

Photographs '^C^-D:fnrn)nh.(?a^ Ct\xA.cJltsd SO-cLui S6dj fifl M ^c d 

As-built sketch 

Satisfactory restoration signed by Property Owner 

y Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

D Utility clearances 

Property information from Douglas County Assessor's Office 

y 

y 

D' 

%>j^\l\ 

\M^\Jfy Signature Date 
Property Access Checklist 

ropertyID:^^|g2 . 

Property Address: ^ l\2,^^ \ ^.^^^. ^ 

G

D

 WORK STARTED 

 WORK COMPELTED 

ON: 

ON: 

_/

/

 / 

/ 

Address: 

Phone:^^2-2K9/^ 

Fax: 

Phone: 

Fa.\: 

Cell/Pager: 

Additional Information: 

Travel^ a\DrD Notification Letter Sent: / / 

,, 0 Access Agreement Signed: 5^/^/( ^ 

^^Restoration Agreement Signed: 3 /S^-^/OS 

CU Topsoil Sampling (if applicable) / / 

CD Disposal Sampling (if applicable) / / 

EH Garden Sampling (if applicable) / / 

Q^tilit y Clearance Called: ^ 1 11 1 O t 

J ^ Video/Photos (Before) On: U lULlM 

n VidcH)/Photos (During) On: / / 

n Video/Photos (After) On: / / 

n Video/Photos (30-Day) On: / / 

CD Property Completion Agreement Signed: / / 

n Final Report Issued: / / 

Air Monitoring (as applicable > 

n Community Q Crew On: / / By:

Results: 

cn Community CU Crew On:_ / / Bv: 

Rcsuhs: 

cn Community Q Crew On: / / By: 

Results: 

By: 

By: 

By: 

By: 

By: 

By: 

By:pr. ^// .

By: {\{fi^^ 

Bv: 

By: 

By: 

By: 

By: 

 ^2< ^ ^rarl 

1 

• 

Omaha Lead Site 
CONTACT FORM 

Property ID # 3 ~~l I Z ^ 

Property 

Address: yj^ yyy 

Initial Contact: DateiS'H"^ Time: |Sl^''>p>vs Action:pK?n< - r-toug-^fek^ina^W 

Second Contact: Date: Time: Action: 

Final Contact: Date: Time: Action: 

Final Action: 

Transmit to EPA D Other Action: n 

Comment: j 

Owner 

Comment (s): 

Site *£-\l ' ^^l^'^ ^Ou>yiy ovtr -Wia pKo>^e^ U^-^CAVC^^ 

Coordinator 

1 Comment (s): 

1 1 

1 
Douglas County Account Information Page 1 of 1 ^jma 

Dougla s County , Nebrask a Propert y Recor d - R194527000 0 

Print Report 

Parcel Dimensions available @ scale 0-50 ft west of 144 St - Vie W OP Ma p Information is valid as of 2008-4-17 Treasurer's Tax Report 

New Feature -•-•- • Auto Sales Search 

Owne r 

MORELLO BERNARD J 

11413 HICKORY RD 

OMAHA NE 68144-0000 

Propert y Informatio n 

Key Number: 4527 0000 19 

Account Type: Residential 

Parcel Number: 1945270000 

Parcel Address: 2433 BLONDO ST 

OMAHA NE 68111-0000 

Legal Description: PARKERS ADD LOT 6 BLOCK 6 E 30 N 72 FT 

Valu e Informatio n 

Land Improvement Total 

2007 $100.00 $0.00 $100.00 

2006 $100.00 $0.00 $100.00 

2005 $100.00 $0.00 $100.00 

2004 $100.00 $0.00 $100.00 

2003 $100.00 $0.00 $100.00 

2002 $0.00 $0.00 $0.00 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.04 2160.0 0.0 72.0 30.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R194... 5/7/2008 
Print Preview Page 1 of 1 

Douglas County-Omaha, NE 

Parcel ID 

Owner 

Name 

Property 

Address 

City 

Zip 

Owner 

Address 

Owner 

Address 2 

Owner 

City 

Owner 

State 

Owner 

Zip 

1945270000 

MORELLO 

BERNARD J 

2433 

BLONDO ST 

OMAHA 

68111 

11413 

HICKORY 

RD 

OMAHA 

NE 

68144 

Sec-TwnRng 

Addition 

Block 

Lot 

Legal 1 

Legal 2 

Legal 3 

Legal 4 

Treasurer 

Website 

Link 

Assessor 

Website 

Link 

16-15-13 

PARKERS ADD 

6 

6 

E 30 N 72 FT 

http://webapps.dotcomm.org:8080/TreasTax/faces/pages/taxinfo.jsp? 

parc=1945270000 

http://douglasne.mappingonline.com/DouglasCoNe/static/accountinfo.jsp? 

accountno=R1945270000 

Disclaimer: Map and parcel data are believed to be accurate, but accuracy is not Map Scale guaranteed. This is not a legal document and should not be substituted for a title search, 1 inch = 72 feet appraisal, survey, or for zoning verification. 

http://www.dogis.org/dogis alias/dogis/printPreview.aspx?PrintOptData=Douglas County-... 6/21/2008 
( ^ As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

27182 

Omaha Exterior Paint Lead SHs 

Sampling Address: 2433 BLONDO ST Site Sketch • Good 

• Poor Phone: H (402)234-2820 ALT i 0 ^ Not paint 

Sample Number Lead Sample Samples Collected 

Concentration Collected LAB Firm: f M Fl^^e 

RYASCPXA-27182 F1 ppm Ef D Date: -?- jZ-C y 

RYBSCPXA-27182 F2 3 QI ppm D Time: !Ci'• ¥i> Q A^ 

RYCSCPXA-27182 B1 J±3± ppm D Samples Analyzed RYDSCPXA-27182 B2 2 07 ppm D 

RDZQCPXA-g7102 D* ppm D D XRF Unit: (f,5H2 Book /^ V 

RGgGCPXA 27162 G3- ppm D D Date ft-/6-07 

RPZOCPXA-27102 P2 ppm D D Time: 2 ^ Staff Number of Samples = ^ t^^w 

Legend: Fl = Front Left. F2 = Front Rigtit, 81 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

6LS#:2718 2 

Date Excavated:6/21/2008 

Date USEPA Signed Off:9/9/2008 

Area Sodded 1800 sq ft 

ENTERED 

JUL 2 1 m i 

B1 = 166 PPM @ 12 

Fl = 369 PPM @ 12 

Rev 5 Crejicd Tif.^wn 11 06 15 

Legen d 

Concret e Dri p Zone Excavate d Quadrants Excavate d 

Area replaced with Are a replace d wit h 

Are a lef t bar e Sod ' ' Rock/Mulch 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
27182 

Omah Exterior Paint North Arrow a Lead Site 

Sampling Address: 2433 BLONDO ST Site Sl(etch • Good 

• Poor Phone: H (402)aS-2820 ALT^^I ^ 

[yf Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm 

Samples Collected 

RYASCPXA-27182 Fl ^$12, ppm D Date ^-12-07 

RYBSCPXA-27182 F2 .3RL ppm 0 / D Time 

RYCSCPXA-27182

RYDSCPXA-27182

RDZGCPXA 27102

RGZGCnXA-27182

RPZOCrXA-27102

 Bl 

 82 

 DZ 

 GZ­

 PZ 

^±31. 2 o 7 

ppm 

ppm 

ppm 

ppm 

ppm 

D 

D 

D 

D 

n 

D 

D 

Samples Analyzed 

XRF Unit; /p5V2 Book: /ffV 

Date 

Time 

RI6-0 1 

2l± 

Number ot Samples • 

Staff: t^5\l 

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

All quadrants are as viewed from the street, facing property 

ENTERED 

; . lu i .0 7 9no7 . 1. i. 1 tw«» Jo 

-

•.OC>A;. 

lu9Bs>^ 

H 5 9 ^01 

Bl ^ BZ 

I.H35 .. si­

\ 

n n 

Z8T2 3Bi 

\ 

B/o^^C'^-f-. ' 

Cicaled 7,'9/'20()7 11 06 15 
27182 

Omah Exterior Paint North Arrow a Lead Site • Good Sampling Address: 2433 BLONDO ST Site SIcetch • Poor 

Phone: ^ (402)aS-2820^LTt^^ ^ 

(vf Not paint 

Sample Number 

RYASCPXA-27182 Fl 

Lead 

Concentration 

2g7Z ppm 

Sample 

Collected 

Ef 

LAB 

D 

Firm 

Date 

Samples Collected 

F M ?e>'pe> 

RYBSCPXA-27182 F2 .3M. ppm n Time 

RYCSCPXA-27182

RYDSCPXA-27182

 B1 

 B2 

±L33. 2 07 

ppm 

ppm 

D 

n Samples Analyzed 

RDZOC^Xl^ 27102 B i ppm n D XRF Unit: f^5H l Book: 1BJ!L 

RGZOCPXA-27182 -GZ­ ppm D n Date: f^ J6-0 1 

RPZOCPXA-27102 PZ ppm D Time: P/^ 

Number of Samples: o Staff: f^ W 

Legend: 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 

ENTERED ,.. . mi . .0. 7 5n07 

Jo L L 1 LUU f 

.. .

/ 

. Bl 

.10 1 

u 

1 y35tymc{o 

 .j[. . ... 

1 ^ ' n 1 

\ I • M Ui . ' . . . 

Bh y\d tSf. 

Rev 5 Crealed 7,-9/2007 11 06 I 5 

y ]<»' »DT no ) X w joai a»i xir x rgK'KO'jai' MO' xfi> xoJ jan K I'iira ATiiXB'xo V Ton' ia>- xar jaii xxn M^ : 
27182 

Omaha Lead Site 

SamDiina Address: 2433 BLONDO ST Site Sketch 

Phone: H; (402)234-2820 ALT: 

Sample Number 

RYASCPXA-27182

RYBSCPXA-27182

RYCSCPXA-27182

RYDSCPXA-27182

ROZOCPXA 27102

ROZOCPXA 27162

RPZOCPXA-27102

Lead Sample LAB Concentration Collected 

 Fl 2S7 Z ppm D 

 F2 3 8 / ppm D 

 Bl W5^ ppm D 

 B2 2o7 ppm 0 D 

 9 ^ ppm D D 

 SZ- ppm D D 

 PZ ppm D D 

Number of Samples = ^ 

Exterior Paint North Arrow 

• Good 

n Poor 

0 ^ Not paint r

Samples Collected 

Firm: F M F^'l>0 

Date: J-- /2-07 

Time: It) • ^5 ~ <:i, A^ 

Samples Analyzed 

XRF Unit: f^6H2 Book: //^Y 

Date: f^yj-o i 

Time: 2l± 

Staff: M<^w 

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

All quadrants are as viewed from ttie street, facing property 

ENTERED , : . . . iUl. 0 7 9007 . L J Luvr Jo \

y 

/ 

.45^ 207 

' u c ^\ ' / 

I.H35 t\mdo 

1 ;^f. 

•s < ^ 

/ 

F/ ^ jt ^ F2 

2812 38/ 

\ 

> > 

' 

.BimdoSh ; 

Rev 5 Ciealed 7/V/20O7 110615 046141 0123 

0* XD* n r im' m! m ' XK' HO' i i: 50C1 XC' w wi ' w r Tptt- TMT ice' nr' loc' im ' rr f joc' 3 T 300' XV nr> KO' lasn n B'»r7 jxc-,'w aofiTxv'nooc'roD r jacxorxcixwac'm^'iecTnrxc i x 
COASTA L INVmOHnf NT«t 

C i O U » IMC 

^^nf^^ 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: Bernar d iWoC-cMci Daytime Phone: (4o3. - 3>MSl - 7.%'^ 0 

Address of Property 

covered by this 

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 
COASTA L FNVinONMEN'r& l 

C • O Li » ' l» C 

• 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 

grant access to my properties 

D I do not grant access to my properties 

0.^^ ^/7-0- i 

Signature Date 

Q I would like to be present during any sampling that is required. 
COASTA L ENVIRO~=e-4TA L 

C R o I. P I I N r. 

Restoration Agreement 

The purpose ofthis agreement is to provide a mutual agreement as to conditions of the propert\' prior to 

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

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

Protection Agency (EPA). 

Property ID: ^T j \%9 ^ 

Property Address: ^t{5 3 ftlon^O V . 

Owner: i^cfnoT d ^or^U o 

Phone: qj^g^ , 3^9^"21*^^ 0 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, 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 types, 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 Owner's responsibility. 

Item: 

H^V>€.. 

Item: 

item: 

Item: 

Item: 

Item: 

Item: 

• 

Item: 

Page 1 of. 
COASTA L 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

Wov)iL 

Item: 

Item: 

Item: 

Item: 

: 

Item: 

• 

Item: 

Item: 

Item: 

Item: 

Item: 

Item:

Item: 

Item: 

Item: 

Page 2 of. 

 1 
COASTA L 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

UDVVL 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 3 of. 
COASTA L 

Landscape Inventory 

(Use additional sheets as necessary) 

Item 

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, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Quantity 

Fi,e> i 

I 

- ^ s 

^ 

^5s 

Unit 

Square feet 

a 

-

Condition/Type/Species 

 \e--ti ha.1^ D-C prcpp-er-fy. 

Each 

--

Each 

Each 

Each 

Square Feet 

Page 4of. 
COASTA L 

Item Quantity Uiiit Condition/Type/Species 

Agreed upon value of 

plant materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

- ^ $ 0 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant will be placed 

by the contractor. 

A Each 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. , 

Ft,l3> i 

SF 

- &-X\ esi^cx^^ ^ Os<j>~ 

Area of City or County 

property to be landscaped 

per their requirements. SF 

1 1 

Include

area (s) 

a sketch of the 

Easement Area, to be 

excavated ^£jfJLXf\lUtCi SF 1 

Page 5 of. 
C O A S T A I. • N VMikO M M^ M T A L CaOUr . IM C 

<? 

Additionai Comments / Instructions: 

y -5c?fe ^^^ ee-'^+''^e^^ areA<>. 

Wf\uK 

c 3 

Q>ior^cU> S f 

n 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. 

n I agree n I do not agree 

Ce^ yyy-cr 

Owner's Signature Date Contractor's Signature Date 
• 

BVID# (97^62 

XRF PROPERTY SAMPLE SHEET 


Date yj:i\jtfi> Address 'M^\ NorvcU'^SF: 

Project Omaha lead FP 2nd year option 

Sample time ^ TB am, 

XRF ID# 'h'Xb^^ sample length 30 sec 

Shot# Reading Sample area Shot# Reading Sample area 

HE '?iV< i h e 3>4^ -t 33 n G/ 

Yi . 

-t i2> 1'5'i *. -x^ 

s<\l ± ^D Depth u<ru> i -hH Depth 1 S/2) ^ ^ y^n^ ± ^'h \j> 

Average \D^I ^ 3 3 Average ^5?/ ' t ^ U 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

^ ^la 3 N i: /t^ ^ 

\ ^ mbin k a^ r/ 1 

a. STSX^ ?/ 

3 3/ ^ a^v Depth 

TT^E Depth ^ ^g-^a i l l 

S -fc M 7 ^ 

^ i T 

Average 3^ ^ "^ ^ ^ Average ll ^ ~U<­

Date^/;?y<Q6 

Signature_ 

Print |flW^6 if^-Z^O^. 

lab sample # Lab result Sample area XRF Avg. 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 187 

Mode SOIL 

Time 2008-06-21 16:43 

Duration 122.11 

Sequence Final 

Flags 

AVERAGE f Avg of 183-186 * 

ADDRESS 2433 Blondo * 

QUAD/ZONE 

INSPECTOR MATTEUS 

DEPTH 6 

SAMPLE TYPE P CLEARANCE? 

NOTE 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 748.268 

Supervised By: 

Certificate of Verification 

182 

SOIL 

2008-06-21 16:39 

30.30 

Final 

27182 

2433 Blondo 

B2 

MATTEUS 

6 

CLEARANCE 

± Error 

± 34.525 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 665.194 

Supervised By: 

Certificate of Verification 

183 

SOIL 

2008-06-21 16:40 

30.40 

Final 

27182 

2433 Blondo 

62 

MATTEUS 

6 

CLEARANCE 

± Error 

± 32.630 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 591.264 

Supervised By: 

Certificate of Verification 

184 

SOIL 

2008-06-21 16:41 

30.65 

Final 

27182 

2433 Blondo 

B2 

MATTEUS 

6 

CLEARANCE 

± Error 

± 29.705 
• I 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 185 

Mode SOIL 

Time 2008-06-21 16:42 

Duration 30.67 

Sequence Final 

Flags 

BVID # 27182 

ADDRESS 2433 Blondo 

QUAD/ZONE B2 

INSPECTOR MATTEUS 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 813.820 ± 35.337 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 186 

Mode SOIL 

Time 2008-06-21 16:43 

Duration 30.39 

Sequence Final 

Flags 

BVID # s 27182 

ADDRESS 2433 Blondo 

QUAD/ZONE B2 

INSPECTOR MATTEUS 

DEPTH 1^:6 

SAMPLE TYPE CLEARANCE 

NOTE 

Supervised By 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 192 

Mode SOIL 

Time 2008-06-21 16:46 

Duration 122.90 

Sequence Final 

Flags 

AVERAGE Avg of 188-191? 

ADDRESS 2433 Blondo 

QUAD/ZONE Fl 

INSPECTOR MATTEUS 

DEPTH 6 

SAMPLE TYPE 'CLEARANCE 

NOTE 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 343.986 

Supervised By: 

Certificate of Verification 

188 

SOIL 

2008-06-21 16:44 

30.64 

Final 

27182 

2433 Blondo 

Fl 

MATTEUS 

6 

CLEARANCE 

± Error 

± 22.138 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 758.547 

Supervised By: 

Certificate of Verification 

189 

SOIL 

2008-06-21 16:45 

30.31 

Final 

27182 

2433 Blondo 

Fl 

MATTEUS 

6 

CLEARANCE 

± Error 

± 34.416 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 456.157 

Supervised By: 

Certificate of Verification 

190 

SOIL 

2008-06-21 16:46 

30.65 

Final 

27182 

2433 Blondo 

Fl 

MATTEUS 

6 

CLEARANCE 

± Error 

± 25.822 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 366.934 

Supervised By: 

Certificate of Verification 

191 

SOIL 

2008-06-21 16:46 

31.30 

Final 

27182 

2433 Blondo 

Fl 

MATTEUS 

6 

CLEARANCE 

± Error 

± 23.336 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, 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 

197 

SOIL 

2008-06-21 16:56 

122.21 

Final 

Avg of 193-196 

2433 Blondo 

Fl 

MATTEUS 

12 

RETEST 
^ 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 193 

Mode SOIL 

Time 2008-06-21 16:53 

Duration 30.63 

Sequence Final 

Flags 

BVID # 27182 

ADDRESS 2433 Blondo 

QUAD/ZONE Fl 

INSPECTOR MATEUS 

DEPTH 12 

SAMPLE TYPE RETEST 

NOTE 

ppm ± Error 

Pb 389.119 ± 23.892 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 323.855 

Supervised By: 

Certificate of Verification 

194 

SOIL 

2008-06-21 16:54 

30.30 

Final 

27182 

2433 Blondo 

Fl 

MATTEUS 

12 

RETEST 

± Error 

± 22.319 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 231.471 

Supervised By: 

Certificate of Verification 

195 

SOIL 

2008-06-21 16:55 

30.97 

Final 

27182 

2433 Blondo 

Fl 

MATTEUS 

12 

RETEST 

± Error 

± 18.507 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 532.313 

Supervised By: 

Certificate of Verification 

196 

SOIL 

2008-06-21 16:56 

30.31 

Final 

27182 

2433 Blondo 

Fl 

MATTEUS 

12 

RETEST 

± Error 

± 29.316 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 202 

Mode SOIL 

Time 2008-06-21 17:00 

Duration 123.77 

Sequence Final 

Flags 

AVERAGE Avg of 198-201 

ADDRESS 2433 Blondo - -

QUAD/ZONE 

INSPECTOR MATTEUS 

DEPTH 12 

SAMPLE TYPE RETEST I 

NOTE 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 214.200 

Supervised By: 

Certificate of Verification 

198 

SOIL 

2008-06-21 16:58 

30.65 

Final 

27182 

2433 Blondo 

Bl 

MATTEUS 

12 

RETEST 

± Error 

± 18.032 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 271.865 

Supervised By: 

Certificate of Verification 

199 

SOIL 

2008-06-21 16:59 

31.00 

Final 

27182 

2433 Blondo 

Bl 

MATTEUS 

12 

RETEST 

± Error 

± 20.696 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 200 

Mode SOIL 

Time 2008-06-21 16:59 

Duration 31.22 

Sequence Final 

Flags 

BVID # 27182 

ADDRESS 2433 Blondo 

QUAD/ZONE Bl 

INSPECTOR MATTEUS 

DEPTH 12 

SAMPLE TYPE RETEST 

NOTE 

ppm ± Error 

Pb 78.926 ± 11.778 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 98.413 

Supervised By: 

Certificate of Verification 

201 

SOIL 

2008-06-21 17:00 

30.90 

Final 

27182 

2433 Blondo 

Bl 

MATTEUS 

12 

RETEST 

± Error 

± 12.736 
?lfiL, \

i }^^ ^ I

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

 Coastal Environmental Group Inc. 

 www.CGastalha2mat.com 

 COASTA L ENVIKONMENTAL 

G n o u r. INC . 

EXECUTIVE SUMMARY: 

BVID # 27182 - (2433 BLONDO ST) 

~x\ No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 

NO ISSUES PENDING. 
^ -^^EPA 

EPA Property Close Out Form 

24^^ gjte^ 3^ Property tt: Z^l^ Z , , . Property Address: 

Date/Time: Owner' ^ ,____ s Name: /, ^ „ij[m£i=— 

Quads Excavated: 2'j &1 Contractor Group (jQOLS|<gd Pji^U\fftmvOfyVh^l 

Excavatio Yes No n General ^f\Cf{hf \ LPT ^ 

I. If necessary, were the correct quadrant(s) excavated and restored? 

2. If necessary, were the correct areas of drip zone excavated and restored? L ^ 

Grading Yes No Sod and Vegetation 

Does the grading around the perimeter ofthe house in excavated areas generally slope away A/A from the house? 

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

3. Does the sod appear to t>e generally healthy and growing? (Only evaluate if inspected at a .30 

y day time period) 

4. Are sodded areas generally firm and evenly graded? y 

5. Are the joints between the sod strips generally tight'' (Only evaluate if inspected at a 30 day "Scxn^-­

time period) W; ^ \>ee^^ rewo/tu A - (2-£^G I'-'lU '^-s^ 

6. Was the property graded such that water will not pool on the properT)' 

7 W£is damage to landscaping or plant materials avoided'^' 0h 

Gates, Fences and Retainine Walls \ es No 

1, Do gates open and close freely? (Ifapplicable) 

2, 

Were all gates or fences taken down during restoration activilies reinstalled? (Ifapplicable) — 

1 

/y>­ 3. 

Was damage to gates or fences avoided? (ifapplicable) 

4. 

Was damage to retaining walls avoided? (Ifapplicable) 4 

Foupdation, Siding and Gutters 

Yes .No 

1. 

Was damage to the siding or trim avoided? 

2. 

Was damage to the foundation avoided? 

l-rP*^^ J . 

Was damage to windows avoided? y^y 

A/A4. 

Was damage to windows or door screens avoided? 

5. 

Was damage lo downspouts or downspoul extensions avoided? 

i 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided'^ A/,t 

2. Was damage to walkway surfaces avoided? (vA 
'Owners comments: 

Inspection notes: 

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

EPA Representati^.r^'^J^X^^y^.^^^X ^ Date:__£/f^4 ^ 
Property Completion Agreement 

Tliis agreement documents the completion of remedial activities performed on my property. My signature 

will designate that I am satisfied with the restoration of my property, and that no items are in questions, 

now, or at any time in the future, except those items listed below, ifany. 

Property ID: j -t i (70 

Property Address: X H' ^ ^ C3\«^A o s-\ I 

0^"^'-= 6e.... y Mo.-^A(^ i 

Phone: J .,^ ^^ ^ ^ ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

T I I aiijrce restoration Is completed, except as noted 

 I I do not agreeTestoratlon is completed 

y ' ' Owner's SigniUm-c Date / Contractor's Signature Date 

./ 

I