TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

A ^ H jit SAID #: Date: 

Address: ll?, 1 \^ '^ ^ ^ y 

Remediation Contractor: Coastal Environmental Group Year: 2010ARRA 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

0/ EPA-provided property sketch 

Signed Access Agreement for subject property 

JS- Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

~& Confirmation data 

A Photographs W - b]0^irV ^ Y bo<^/nV n ^ S^^ 

A. As-built sketch 

A Satisfactory restoration signed by Property Owner 

A Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

/ Utility clearances 

Property infgnnation from Douglas County Assessor's Office 

30217520 

IUI 

Superfund 
^v 

Property Access Checklist 

PropertylD: f^(J{Cl^q 

Property Address: |72 7 Kl W

Address: 

Phone: 5)5 . qcQ ^ 

Fax: 

Cell/Pager: 

D Notification Letter 

yCi Access Agreement 

ro Restoration Agreement 

D TopsoU SampUng (if appUcable) 

D Disposal SampUng (if appUcable) 

Q Garden Sampling (if appUcable) 

- ^ UtUity Clearance 

j ^ Video/Photos (Before) 

D Video/Photos (During) 

D Video/Photos (After) 

D Video/Photos (30.Day) 

Q Property Completion Agreement 

D Final Report 

Air Monitoring (as appUcable) 

QCommimity QCrew On:_ 

Results: 

• Conununity O Crew On:. 

Results: 

Q Community QCrew On:. 

Results: 

n WORK STARTED ON: / / 

 S f n WORKCOMPELTED ON: / / 

Renter: 

Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

Sent: / / By: 

Signed: 2 113.'ID. By: 

Signed: I ll^lJ O By: 

1 1 By: 

1 I By: 

1 1 By: 

CaUed:OH / i-r AO By= cnUfyo 

On: 'A 1 Ji l 10 

^r-iiJ-AJy c/Ac^AJv 

On: / / By: 

On: / / By: 

On: / / By: 

Si£ned: / / By: 

Issued: / / By: 

/ / By: 1 

/ / By: . 1 

/ / 1 

Omaha Lead Site 
Douglas County Account Infora^ion Page 1 of4 

Douglas County, Nebraska Property Record - R2409790000 

Print Report 

NEW Feature - Parcel Dimensions available Id) scale 0-50 ft west of 52nd St - Vle W OH Ma p Information is valid as of 2009-12-15 . Treasurer's Tax Report 

New Feature •* ^ •* Auto Sales Search 

Owner 

REGAN KEVIN M 

ETAL 

1727 N 54 ST 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number: 0979 OOOO 24 

Account Type: Residential 

Parcel Number: 2409790000 

Parcel Address: 1727 N 54 ST 

OMAHA NE 68104-0000 

Legal Description: WASHINGTON HILL LOT 6 BLOCK 2 N 63.5 W 136 FT 63.5 X 136 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$13,700.00 

$13,700.00 

$13,700.00 

$13,700.00 

$13,700.00 

$13,700.00 

Improvement 

$224,700.00 

$224,700.00 

$224,700.00 

$169,800.00 

$169,800.00 

$169,800.00 

Total 

$238,400.00 

$238,400.00 

$238,400.00 

$183,500.00 

$183,500.00 

$183,500.00 

Sales Informatio n 

Sales Date: 2008-10-17 

Deed Type: 

Price: 

Grantor: 

Grantee: 

Vatld/lnvalld: 

WD 

$250,000.00 

Genoble Brett Joseph E

Regan Kevin M Etal 

Valid 

SooAr: 

tal 

2008 Page: 104141 

Exclusion Reason: 

Sales Date: 2006-09-01 

Deed Type: 

Price: 

Grantor: 

WD 

$247,500.00 

Sawyer Travis R etal 

Booiir: 2006 Page: 105131 

1 

http://douglasne.mapping-online.eom/DouglasCoNe/static/accountinfo.j sp?accovmtno=R2... 12/31 /2009 
Douglas County Account Infonaation Page 2 of4 

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

Sales Date: 

Deed Type: 

Price: 

Grantor: 

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

Sales Date: 

Deed Type: 

Price: 

Grantor: 

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

Sales Date: 

Deed Type: 

Price: 

Grantor: 

Grantee: 

Valid/Invalid: 

Exclusion Reason: 

Sales Date: 

Deed Type: 

Price: 

Grantor: 

Grantee: 

Valld/lnvalld: 

Exclusion Reason: 

Sales Date: 

Deed Type: 

Genoble Brett J etal 

Valid 

2005-07-29 

WD Book: 2005 Page: 093291 

$239,750.00 

Jeffrey Metzner etal 

Travis R Sawyer etal 

Valid 

2002-05-15 

WD Book: 2211 Page: 441 

$195,000.00 

Valid 

1999-02-20 

D Book: 2119 Page: 742 

$180,000.00 

Valid 

1996-11-21 

D Book: 2050 Page: 326 

$139,500.00 

Valid 

1995-04-23 

D Book: 2003 Page: 297 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2... 12/31/2009 
Douglas County Account Infoia^io trjl^i c n Page 3 of4 

Price: $118,500.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.19 8704.0 1.0 136.0 64.0 No 

Improvemen t Informatio n 

Building 1 

Verified 

MSOFP 

2(r 121 ittsiaevai 

t j c 

firtftx r 

_1Z!L. 

TWO STORY 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1994.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Masonry Common Brick Units: 1.0 

Interior: Drywall Baths: 3.5 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Hip Stories: 2.0 

Floorcover: Allowance Foundation: Block 

Sprinl^ier Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1938 1938 

71 

Detail Type Detail Description Units 

Add On Fence Chain Link 1.0 

Appliance Allowance 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R2... 12/31/2009 
DQuglas County Account Infoi|jB||ion Page 4 of4 

Appliance 

Basement 

Basement 

Fixture 

Fixture 

Fixture 

Garage 

Porch 

Porch 

Fireplace Masonry 

Bsmnt Block 8 ft 

Finished 

Base Fixtures 

Bath Full 

Bath Half 

Attached 

End Screen 

Slab Roof Ceiling 

1.0 

1069.0 

445.0 

1.0 

3.0 

1.0 

240.0 

96.0 

96.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accountno=R2... 12/31/2009 
Page 1 of 1 

BVID - 64«>3^ 

Create Another Ticket Back to Irth Intemet I [Sen d Email ] ][ 

• YOUR TICKET NUMBER IS 2475444. 

Original Call Date: 4/26/10 Time: 3:29 pm Op: ELIZABETH18790 


Work to Begin Date: 4/28/10 Time: 4:00 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1727 Street: N 54TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 18-NW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: LEAD REMEDIATION 


Location of Work: LOCATE ENTIRE PROPERTY, ALL EASEMENTS AND TO THE PEDESTAL 


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


: UNSURE IF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: COASTAL 


Depth of Excavation: 4 FT • Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Nuniber Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 


OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RICH/TRAFFIC Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 


QLNNEIC QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 


http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/26/2010 
84939 

As-Built Drawing A 

COASTA L Omaha Lead Superfund Site ENVIKOHMEMTAL G • O W P. IM C 

OLS#: 84939 

Date Excavated: 4/30/2010 

Date USEPA Signed Off:5/19/2010 

Area Sodden: 645 so ft 

Omaha Lead Site Exterior Paint 

Site Sketch • Good 

n Poor Sampling Address: 1727 N 54 ST (3 Not paint 

Sample Nurnber Lead Sample Samples Collected LAB Concentration Collecl^ Firm: 

RYASCPXA-84939 Fl I I Q ppm D Date: h 'S-e"! 

RYBSCPXA-84939 F2 UHZ . ppm 

i D Time: II-.50 A M 

RYCSCPXA-84939 B1 Z3 0 ppm D Samples Analyzed RYDSCPXA-84939 B2 22. 9 ppm D 

RDZSCPXA-84939 DZ ? L° l ppm D XRF Unil : loftfe^ Book: ZHU 

RCZ6CPXA 84030 -62 — ppm D Date: -^ -10 Cfil 

oV nriiocPXA'04000—P2 113 ppm D Time: Arv, 

Staff:. m^l^ Number of Samples = | Ig \ \ Q 

Legend: Fl = Front Left, F2 = Front Right, B1 = Back Left. 82 = Back Right DZ = Drip Zone, G2 = Garden. PZ = Pla; AH quadrants are as viewed fronn the street, facing propefty 

ENTERED 

Legend 

Conorete Drip Zone Excava-ted Quadrants Excavated 

Area replaced

Sod 

 with Area replaced with 

Rook/Mulch ' ' Area left bare 

Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 

If^/'/^/U C/fl/^A/M>. (/7f^^^^/^<'''? ^'yyA^^ ^ 'Ai'^A'<^ ^i^"^' ­

' ^ 

Ua^^ 

(l\ e.c\y LL . OH /i^ 84939 

Omaha Lead Site Exterior Pair.l 

Site Sketch • Good 

n Poor 

Sampling Address: 1727 u s< ST [g Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Finm 

Samples Collected 

PPA Pg AT 

RYASCPXA-84939

RYBSCPXA-Wese

RYCSCPXA-84939

RYDSCPXA-84939

RDZSCPXA-84939

 F1 

 F2 

 B1 

 B2 

 DZ 

li q

UiTL

23C>

2.Z B

3 tt' ^

 ppm 

 ppm 

 ppm 

 ppm 

 ppm 

f D 

D 

D 

n 

Date 

Time 

^-5-tf 1 

II ­• ^ ^ AA>I 

Samples Analyzed 

XRF Unit; _liiai,'Z_ Book: 2H f« 

nCZCCPXA 8«030 6 2 — Ppm n Date: 1-10 oq ,y nPZOCPXA-04000 PZ 111. ppm D Time: A^ 

Numtier of Samples = | c \ D \ Q | Staff: /vi^Lo 

Legend: F1 ~ Front Left. F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = P(a: 

All quadrants are as viewed from the sireet, facing property 

ENTERED 
84939 

Omaha Lead Site Exterior Paint North Arrow 

Site Sketch • Good 

nPoo r 

Sampling Address: 1727 N 54 ST ( 2 Not paint 

Sample Number 

RYASCPXA-84939 Fl 

Lead 

Concentration 

_LL3_ ppm 

Sample 

Collected LAB 

n 

Firm 

Date 

Samples Collected 

fPA Pg-AJ 

h-S-e^ 

RYBSCPXA-84939

RYCSCPXA-84939

RYDSCPXA-84939

RDZSCPXA-84939

 F2 

 B1 

 B2 

 DZ 

loH^ 

23 0

2.ZS

•? lt° l

ppm 

 ppm 

 ppm 

 ppm i D 

D 

n 

n 

Time ir-^OAAA 

Samples Analyzed 

XRF Unit: Ift^t. ^ Book: iMC 

RCZ6CPXA 8<030 G2 — ppm n Date: 7 - (0 • o° l 

oV f>PZCiOPXA-04009 P i IZ 3 ppm n Time f\r^ 

Number of Samples = | fc [ | Q Staff /^<,l ^ 

Legend: Fl = Front Left, F2 = Front Right. B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Pla; 

AH quadrants are as viewedfrom the street, facing property 

ENTERED 

Rev :oi.iS rroalJd- 'td-Nw-MS L.'N..54.S-T..-

.r 

 t. ^ 

^-e v^" 

y o
84939 

Omah Exterior Paint North An'ow a Lead Site • Good Site Sketch 

n^Poor 

Sampling Address: 1727 N 54 ST Q Not paint 

Sample Numtwr 

RYASCPXA-84939

RYBSCPXA-84939

RYCSCPXA-84939

RYOSCPXA-84939

RDZSCPXA-84939

nCZSCPXA 84030

J l nrZOGPXA 04030

Lead Sample Samples Collected 

i

i 

LAB Concentration Collected Flmi: f m PfiA T 

 Fl ppm D Date: h 'S-fi*^ 

ppm F2 D Time: // •' 5g> AAA 

 Bl 23d> Dom D 

Samples Analyzed B2 Z2.8 pom D 

 DZ •? &>Q pom D XRF Unit: Ihfit.?. Book: ZMfo 

 6Z — ppm D Date: "7 • >0 -a/ ^ 

 PZ 1 1 ^ pom D Time: ^r** 

Numbe Staff: nsu? r of Samples = | Q \ \ Q | 

Legend: Fl = Front Left, F2 = Front Right, B1 = Back Left, B2 » Back Right DZ » Drip Zone, GZ = Garden, PZ = Pla; 

AO qua(feants ara as vieiwed from the street, fadng property ^^a^^f^^a^aJk^i^^^^^ y r % l^3 ENTERED 

iUM t 

zz.e •): 

) < S) .6 

pea: 

OBHO 

oe­

^ ^ 

VP.^.'.^.^T.. 

_ ^ • 1 •• >•>; m>wiw •'»"T"^y«^i^^fi7T^"y;^ K 

Fl 

P«\£ 

) 1 ^ 

fl 

iWAM; 

Rev AXIS Cr«iKnl: (i6-Nw-08 / . ^N^ssi.sx 044701.01.2} 
* *-

COASTA l 

[NVIIONHCRU I 

c « 0 II r IN C 

Consent fcf 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: 9^9bl 

{ li^f^( ^ 

Owner's Name: Daytime Phone: ^ «-v , * ^ (j*^c : 

Address of Property ni l KJ 'SV?/ 

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, v^rill 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 conflmi that it is complete and meets with the Grantor's approval. Upon 

completion, the Grantor v«ll receive v»n-itten 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 
..*^"''"'f . 

COASTA L 

CNVmOHHIKTAL 

< l PRO * 

i t o V t I It Q 

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

piles, dog houses, etc; 

e 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. 

6 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 (402) 991-1199 

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

Signature 

Date 

G I would like to be present during any sampling that is required. 

Page 2 of 2 
COA S T A L 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of the property 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). 

PropertylD; O^f ^5*7 " 

Property Address: |~7/'' 7 Kj ^3-r 

Owner: AK- ^^A^y j 

Phone •2J tr . o^c^7- ^ ^SSQ^4 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access location(s) to be used by the contractors, hidicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

Items to be Removed by the Owner before Start of Remediation: 

The removai, storage, disposal, and/or retum ofthese items is the Owner's responsibiiity. 

Hem: 

/4KV fi^yi-^^ ^ o W^-^fc. lu^ r 

Hem: 

Kem: 

Kem: 

items to t>e Removed by the Contractor During Remediation and Not Replaced 

Kem: . 

^ (c^vv'h' f e p ^ l^^fl'tiAlJ 

Kem: ^ " 

Kem: 

Kem: 

Pagel -a 
COA S T A L 

O • O U P . INC . 

Items to Be Removed B L Contractor During Remediation and Reolaced 

Kem: 

Kem: i 

item: 

Kem: 

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. 

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. 

Easement Area, to be 

excavated 

y 

^A 

Landscape Inventory 

Quantity Unit ConditionH'ype/Species 

y Quadrants 

yA Each 

z F,ach 

A Fach 

y Each 

Square Feet 

Ay $ 

^0^ ^ Each 

Page 2 of ^ 
COA S T A L • MVIHOMHBHTAL a ft O U P , INC . 

Additional Comments / instructions: 

The city of Omaha ordinances may prohibK you from using dirt or gravei areas on your property 

as driveways or vehicle parking areas. The Environmentai Protection Agency (EPA) may be 

removing and replacing soli underiying a gravel or dirt area on your property that you may be 

using as a driveway or vehicle parking area, if this Is the case, you should understand that this 

removing and replacing of soil does not mean that any Illegal driveway or parking area on your 

property is made legal. To the contrary, you may be cited by the city if you use a gravei or dirt area 

as a driveway or parking area, not wKhstanding any removai or replacement of soil by the EPA. 

If you have any question about legality of a certain driveway or parking area, you may contact 

the cKy of Omaha's Planning Department at <402) 444-5150. 

e^^ lease check this box if you understand the information outlined above. 

/ 

G 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 l agree 

A> ' 

G I do not agree 

^.m^^j? ^ 

" ^ ontractor's Signature Date 

Pages tnjL 
XRF PROPERTY SAMPLE SHEET 


Date ^USpK Address 

Project Omaha Lead ARRA Sample time 

XRF ID# sample length 

Shot# Reading Sample area Shot# 

501 Ff 

soz \jilt \\ Depth 

^y^ SA^ v\ 

Average VM ^ V L Average 

Shot# Reading Sample area Shot# 

Depth 

Average Average 

Shot# Reading Sample area Shot# 

Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# 

Depth 

^./-^ ^ ^ 

Average ./ / Average 

Signature ^. / ^ - - ^ -

Print UkyO) Ur(^ ^ 

BVID#_OJ5J3J 

/9-^9-^3vs-r 

am/pm 

30 sec 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpil<e 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 504 

Mode SOIL 

Time 2010-05-18 13:16 

Duration 90.64 

Sequence Final 

Flags 

AVERAGE ' Avg of 501-503 

ADDRESS 1727 N 54 st 

QUADRANT F2 

DEPTH 4 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.167 

Zr 492.743 ± 16.266 

Sr 149.849 ± 8.428 

U < LOD 14.860 

Rb 76.631 ± 6.868 

Th 15.778 ± 7.455 

Pb 60.603 ± 11.513 

Se < LOD 5.298 

As 18.126 ± 10.673 

Hq < LOD 12.379 

Zn 92.839 ± 17.892 

W < LOD • ...--" ' 85.449 

Cu 36.633 21.117 

NI < LOD . ,„--' ' /74.087 

Co < LOP ; / 198.212 

Fe 

Mn 

21304.385 

611.692 

± y '

422.751 

 103.905 

Supervised By: \ , y/ ^ T _ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 501 

Mode SOIL 

Time 2010-05-18 13:14 

Duration 30.11 

Sequence Final 

Flags 

BVID 84939 

ADDRESS 1727 N 54 st 

QUADRANT F2 

DEPTH 4 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD J 8.258 

Zr 494.172 ± 16.404 

Sr 154.817 ± 8.605 

U < LOD 15.105 

Rb 77.721 ± 6.968 

Th 17.473 ± 7.673 

Pb 61.148 ± 11.648 

Se < LOD I 5.614 

As 18.846 ± 10.811 

Hg < LOD : 12.247 

Zn 84.518 ± 17.547 

W < LOD : 89.656 

Cu 35.854 ± 21.218 

NI < LOD 72.853 

Co < LOD \ 199.567 

Fe 21447.826 ± 426.670 

Mn 579.914 ± 102.359 

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 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

ppm 

Mo < LOD 

Zr 480.439 

Sr 152.260 

U < LOD 

Rb 78.568 

Th 15.220 

Pb 61.315 

Se < LOD 

As 18.569 

Hg < LOD 

Zn 97.439 

W < LOD 

Cu 48.508 

NI < LOD 

Co 199.119 

Fe 21040.781 

Mn 640.874 

Cr < LOD 

V < LOD 

Tl 3612.505 

Sc < LOD 

Ca < LOD 

K 12274.251 

s < LOD 

Supervised By: 

Certificate of Verification 

502 

SOIL 

2010-05-18 13:15 

30.42 

Final 

84939 

1727 N 54 st 

F2 

4 

CONFIRMATION 

N. LOPEZ 

Error 

J 8.092 

± 16.018 

± 8.458 

: 14.488 

± 6.863 

± 7.381 

± 11.488 

4.875 

± 10.683 

12.574 

± 17.987 

80.265 

± 21.908 

76.023 

± 131.027 

± 418.185 

± 104.636 

: 456.700 

: 851.328 

± 1997.988 

: 163.097 

: 5337.903 

± 7026.706 

256.016 '• 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 503 

Mode SOIL 

Time 2010-05-18 13:16 

Duration 30.11 

Sequence Final 

Flags 

BVID 84939 

ADDRESS 1727 N 54 st 

QUADRANT F2 

DEPTH 4 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.153 

Zr 503.619 ± 16.376 

Sr 142.470 ± 8.221 

U < LOD 14.986 

Rb 73.603 ± 6.774 

Th 14.642 ± 7.311 

Pb 59.345 ± 11.403 

Se < LOD 5.404 

As 16.962 ± 10.524 

Hg < LOD 12.316 

Zn 96.561 ± 18.142 

W < LOD 86.426 

Cu < LOD 30.338 

Ni < LOD 73.385 

Co < LOD 198.529 

Fe 21424.551 ± 423.399 

Mn 614.288 ± 104.721 

Supervised By: 
^^•^to»'•<^-. 

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

^^^^ ^ o Coastal Environmentai Group Inc. 

\^^^^ ^ www.coa8talha2mat.com 

''^tno^^ COASTAL 

HTIIONNIIITAl SIO U r, i n C 

EXECUTIVE SUMMARY: 

BVID #84939-(1727 N 54 ST) 

No Issues or Concerns \ ^ Issues/Concerns 

Detail Explanation: 

DAN GARVEY WALKED THE PROPERTY ON 5/19/10 
SMIi EPA 

EPA Property Close Out Form 

Property #:_Sii33 a 

Datc/Tlmc: 

Quads Excavated: 

Contractor Group 

ExcavatioB General 

1. If necessaiy, were the correct quadrant(s) excavated and restored? 

2. If necessaty, were the correct areas of drip zone excavated and restored? 

Grading Sod and Vegrtation 

I. Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from tlie house? , 

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

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

day time period) 

4. Are sodded areas generally firm and evenly graded? 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) 

6. Was the property graded such that water will not pool on the property? 

7. Was danuge to landscaping or plant materials avoided? 

Gates, Fences and Retainins Walb 

1. Do gates open and close freely? (If applicable) 

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

3. Was damage to gates or fences avoided? (I f applicable) 

4. Was damage to retaining walls avoided? (If applicable) 

FouDdathta, Siding and Gatlers 

1. Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) 

I. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

/ 

A 

Yes No 

/ 

.X 

A 

A 

A 

A 

• ^ 

Yes No 

y 

A 

1 / 

y 

Yes No 

y 

y 

y 

y 

ty" 

Yes No 

y 

y 
Owners comments: 

Inspection notes: 

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

EPA Representative ^^« ^ Date: $1^^^^'° 
Property Completion Agreement 

Ihis agreemenl docuinenls lhe coniplclion of remedial aclivilies perfbimcd on my properly My signature 

will designate thai I am satisfied with the resloralion of my properly, and Ihal no items are in questions, 

now, or al any lime in the future, except ihose ilems listed below, ifany 

Property fD: ^t j ^ 3 Q 

Property Address: (1)2. 1 A i S H 5-V-

Phone: '^{^''^0^^ ^ '^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

JA l I Dgrcc rcxroralion 15 compleled, eiccpl at noferi 

[_| I flo npt-Mrcc resloration is completed 

9,cnrPiim '^hzJM c4 

Conli arioi's Signature Dale 
IZH3] 

Property Owner Assessment of Perform 

American Recovery and Reinvestment Act (A 

Omaha Lead Superfund Site , -, ^nin 

2009/2010 ^^'^^ ^ ' ^^^^ 

Remediation Contractor: Coastal Environ mental Group - EP-RT-wU^ E"'* ^ ^ D DIvlblu N 

Property Identifier Number: Q*-\^'^ ^ "" 

Property Address: l"l? n S\ f ^ f^' 

Property Owner's Name;-7T^i^ t j ^eo p Y\ 

Instructions to the Property Owner: 

This form serves to record the Property Owner's assessment of perfoimance (Incentive 1 

- Quality Assurance Surveillance Flan) involving the listed remediation contractor, as applicahle 

to the Omaha Lead Site. This form documents the timeliness of punch list resolution, business 

relations, complaint resolution and the overall quality of work. If need be, the Property Owner 

may utilize this form to record problems and/or issues not specifically tied to an assigned 

address, for example, business relations that generally don't follow the guidelines set forth in the 

Performance Work Statement, 

The Property Owner will indicate his/her assessment of performance with the contractor's 

work by checking a numerical rating on the table below using the numerical definitions ftom 

the rating scale below, then sign & date the form. 

9-10 "excellent" 

7-8 "very good" 

5-6 "acceptable' 

3-4 "poor" 

1-2 "very poor" 

Property Owner's Assessment of Performance Regarding the Contractor's Work 

10 

9 / 4 

8 ^ 3 

7 2 

6 1 

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

Property Owner Signature