TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: ^^N ^ Date: •2^'^2y\cf] 

Address: lf^3 2 U \ ^ ^ t 

Remediation Contractor: _CoastaI Environmental Group_ Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

B^ Video of property (DVD) 

40314746 

Q^ Executive Summary 

Q^ EPA-provided property sketch Superfund 

Iv/ Signed Access Agreement for subject property 

M h Signed Access Agreement(s) for adjacent property 

Q / Restoration Agreement 

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

B^ Confirmation data ^ 

[^ Photographs pr^-^j>yg^^c^ ^ QJiOj^okm^ So-cU^ scA j^njJ sc^ 

'•a As-built sketch 

B^ Satisfactory restoration signed by Property Owner 

B^ Property close-out check list signed by EPA 

Nljil Description of areas not meeting ROD cleanup criteria 

SK^ Utility clearances 

CB^ Property information from Douglas County Assessor's Office 

D 

Signature Date 
m^ 

Property Access Checklist 

Piopeity ID: 'Jif/LfCj 

Propc-ty Address: ^^^g ^ f j /^^' ^ 5 / 

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D

 WORK STARTED

 WORK COMPELTED

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Renter: 

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Phone:

Fax: 

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Cell/Paser:

Additional Information: 

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Cell/Paser: 

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 Notification Letter 

Access Agreement 

Sent:

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By: 

By: 

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rj? Restoration Ajjreenient Signed: 1 / ) O ? By: 

[U Topsoil Sainplinj; (if applicable) / / By: 

1 1 Disposal Sam|)ling (if a|)plical)le) / / By: 

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 Garden Sampling (if applicable) 

Utility Clearance 

Video/Photos (Before) 

Video/Photos (During) 

Video/HPhotos (After) 

Video/Photos (30-Day) 

Property Completion Agreement 

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Called: "^

On: 1 /

On: /

On: /

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Signed:

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n Fiual Report I.s.sued: / / By: 

Air Monitoring (as applicable 

1 1 Community CH Crew 

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Results: 

On: / / By: 1 

1 1 Community

Results:

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Results: 1 

Omaha Lead Site 
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Page 1 of2 

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Create Another Ticket Back to Irth Internet Send Email L 

YOUR TICKET NUMBER IS 2078211. 

Original Call Date: 7/09/08 Time: 5:47 pm Op: ELIZABETH18790 


Work to Begin Date: 7/11/08 Time: 6:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2532 Street: N 18TH ST 


Twp: 15N Rng: 13E Sect-Qtr: IQ-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: Lead Remidiation 


Location of Work: ENTIRE PROPERTY ALL THE WAY TO THE STREET. 


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


: 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 MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 


CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 


Emerg: 4029329757 


Day: 9185747098 


MAGELLAN MAGELLAN MIDSTREAM PARTNERS LP TONYA Alt: 

Emerg: 9185747098 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT EDWINA Alt: 

Emerg: 4025047946 

Day: 4024447197 

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

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/9/2008 i 
Page 2 of2 

Day: 4067289343 


OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 8887289343 


Emerg: 4067289343 


Day: 4067289343 


QLNNEIC QWEST LOCAL NETWORK NA Alt: 


Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/9/2008 
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Douglas County Account Informatio nfcrr n Page 1 of2 

Dougla s County , Nebrask a Propert y Recor d - R160052000 0 

Print Report 

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

New Feature -»-•- • Auto Sales Search 

Owne r 

CITY OF OMAHA 

PLANNING DEPT 

1819 FARNAM ST #1111 

OMAHA NE 68183-0000 

Propert y Informatio n 

Key Number: 0052 0000 16 

Account Type: Ex Government 

Parcel Number: 1600520000 

Parcel Address: 2532 N 18 ST 

OMAHA NE 68110-0000 

Legal Description: LAKE ADD LOT 2 BLOCK 1 S 1/2 30.5 X 144 

Valu e Informatio n 

Land Improvement Total 

2008 so.oo $0.00 $0.00 

2007 $0.00 $0.00 $0.00 

2006 $0.00 $0.00 $0.00 

2005 $0.00 $0.00 $0.00 1 

2004 $400.00 $0.00 $400.00 

2003 $400.00 $0.00 $400.00 

Sales Informatio n 

Sales Date: 2005-09-16 

Deed Type: SWD Book: 2005 Page: 157628 

Price: $0.00 

Grantor: LAND REUTILIZATION COMMISSION 

Grantee: CITY OF OMAHA 

Valid/Invalid: Invalid 

Exclusion Reason: Sale by Govt Agency 

Sales Date: 1998-11-18 

Deed Type: SHD Book: 2005 Page: 157627 

Price: $0.00 

Grantor: DOUGLAS COUNTY SHERIFF 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R160... 7/2/2008 
Douglas County Account Information Page 2 of 2 

Grantee: LAND REUTILIZATION COMMISSION 

Valid/Invalid: Invalid 

Exclusion Reason: Sale by Govt Agency 

Land Informatio n 

Acres SF Units Deptfi Width Vacant 

0.1 4464.0 0.0 144.0 31.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R160... 7/2/2008 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

Omah a Lead Site 

Site Sketc h 

Sampling Address: 2532 N 18 sr 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

RYASCPXA-74149 Fl 211 ppm D 

RYBSCPXA-74149 F2 ppm D 

RYCSCPXA-74149 B1 ppm D 

RYDSCPXA-74149 B2 ppm S' 

RDgOCPXA-74ia9 -BZ ppm n D 

RCgCCPX/ii 74140 ppm D D 

gLab RYDSCPLA-74149 ppm D D

"Result 373 ppm Number of Samples = 4 \ 

Legend Fl = Front Left. F2 = Front Rigfit. 81 = Back Left. B2 = Back Right 

All quadrants are as viewed from ttie street, facing 

OLS#-74149 

Date Excavated:7/14/2008 m j 

Date USEPA Signed Off:9/1 

Area Sodded 91 ^ sq 

4149 

Exterior Paint 

• GoocJ 

n^Poor 

[ 3 Not paint 

Samples Collected 

Firm rpf t BliiLlL _ 

Date: °^W!^ lo> 

Time: \:\ \ ff^ 

Samples Analyzed 

XRF Unil: fgS^- f Book: J^J _ 

Date: /O-ZT-O ? 

Time _£ d 

Staff M5H / 

DZ = Drip Zone, GZ = Garden, PZ = Play 

property 

<'rf««l 9;4.2>lii7n 15 14 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with Area replaced with Area left bar e 

Sod Rock/Mulch 

Contrac t #: EP-R7-07-05 Coasta l Environmental Group Inc. 
i 

74149 

Omah Exterior Paint Nortti An'ow a Lead Site 

C'^y ^OMO U Site Sketch • Good 

• Poor 

Sampling Address: 2532 N 18 ST pyf Niot paint 

Sample Number Lead Sample Samples Collected 

I 

LAB Concentration Collected 

i 

Firm 

RYASCPXA-74149 Fl 2M- ppm D Date 

RYBSCPXA-74149 F2 ^22L. ppm D Time 

RYCSCPXA-74149 Bl \i3 3 ppm D 

Samples Analyzed

RYDSCPXA-74149 B2 ppm 0' 

WDZOCrXA-74149 DZ ppm 

D XRF Unit: roSH ? Book: }*=i3 

nCZ6CPXA741<0 G3 ppm D Date: •

ppm D Time 'i^Lab RYDSCPLA-74149 in. 8 Result Staff 373 ppm Number of Samples = ] 4 / M5H/ 

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

All quadrants are as viewed from the street, facing property 

ENTERED 

OCTO 2 201 

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N l8 ^^ Rev irrcaod, 9':4,:I:H;7II:I5. U 

I- X*- : * - IIP" .-('•• .u " ^t - .•«'. " 

0123 
74149 

PrKy A./" A 1 Omaha Lead Site 

^^\ y Oir Uma M . Site Sketch 

Sannpling Address: 2532 N 18 ST 

Sample Number Lead Sample LAB Concentration Collected 

RYASCPXA-74149 Fl ppm n 7.11 RYBSCPXA-74149 F2 ppm n 

RYCSCPXA-74149 Bl ppm n

\IS 3 

RYDSCPXA-74149 B2 ppm i a'

RDZOCPXA-74149 BZ ppm n a RGZSCPXA 74140 92 ppm n n 

ppm n Lab RYDSCPLA-74149 n s Result 373 ppm Number of Samples : 

Exterior Paint North An'ow 

• Good 

• .Poor 

Q Not paint 

Samples Collected 

Firm: 

Date: 

Time: 

Samples Analyzed 

XRF Unit: fr,^H7 Book: /*?3 

Date: _ 

Time: in. Staff: /W5Vl/ 

Legend: F1 = Front Left, F2 = Front Rigtit, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ • GanJen, PZ = Play 

All quadrants are as viewed from the street, facing property 

f^\uy \ 

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V.WL ^ 

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z n 338 

FJ.. \ f l 

ENTE3RED 

OCTO 2 2007 

i 

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NlS.^^ i ^ l>c<nal: 9':4.';i:» |71I:I5;I 4 ILlAial 
--

74149 

Omah Exterior Paint North Arrow a Lead Site • Good Site Sketch 

D^Poor 

Sampling Address: 2532 N 18 ST rvf Nol paint 

Sample Number Lead Sample Samples Collected 

I 

LAB Concentration Collected Firm: 

RYASCPXA-74149 F1 

2J1. ppm D Date: 

RYBSCPXA-74149 F2 

33b ppm n Time: 

RYCSCPXA-74149 81 I/S 3 ppm 

D Samples Analyzed RYDSCPXA-74149 82 3 Z^ ppm H' 

RDZ3CPXA-74149 Df ppm 5 D XRF Unit: CaSIZ Book: J^J_ nCZSCPXA 74140 G2 ppm D D Date: _

ppm D D Time: "La b RYDSCPU-74149 un. 

'Result D Staff: MSn / 

373 ppm Number of Samples = H I 

Legend: Fl = Front Left, F2 = Front Right, 81 = Back Left, 82 = Back Right DZ = Drip Zone, GZ = GanJen, PZ = Play 

All quadrants are as viewed from the street, facing property 

ft\uy i ENTi 3RED 

OCTO 2 200 7 

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..H:I8^^ : Rev5 Created: 9:4.CiXI7 11:15.14 m614101Z3 
,f 

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COASTA L ENVtHOHHINTA L 

C I O U r . IM 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; 4^- "^ M IM *^ 

owner's Name: C^^] ^ ^ Qmo U Daytime Phone: t. f ^I f - ^ l ^ D 

dsiT. u. 1«-^^ Address of Property 

covered by this 

Agreement: i 

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 COASTA L CNVtRONMrNTAt . %^^- ^ 

C R O U F . IN 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 

4^9r' 

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

-7-/ ' ^ ^ 2 ^ 

7-/-^^ /I^C Date Signature 

Date 

Q I would like to be present during any sampling that is required. 
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 ov\ner and the United States Environmental 

Protection Agency (EPA). 

Property ID: ^l-j^lU ^ 

Property Address: 0^^2)3 . Ki., (^^5f. Owner: QJ^ ^ ^ QrmJ ^ 

Phone: ^1/)^-^W- S^J^h 

On the attached diagram(s) indicate area(s) to excavated and depth of e.xcavation. 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 t\pes, etc. Indicate digital photos 

by referencing the photo-log number uith an arrou 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. 

Item: 

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: 

Item: x 

Item: \ 

Item: \ 

Item: 

\ 

\ 

Item: 

\ 

Item: \ 

Item: \ 

Item: \ 

Item: \ 

Item: \ 

Item: \ 

Item: \ 

Item: \ 

Item: 

Page 2 of. 
m^ ^ 

COASTA L 

c • o o » ' N c 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: X 

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, eic. 

Aiiach a sketch ^-.l ihc 

sprinkle: !a.\ oui. 

Number of and size of 

each garden/ flower bed" 

area. 

'•.w.i^i. i. sKcicii v'l .c..i:i'.c 

'•ir'es :<.nJ. locaiions. 

Quantity 

61 

Unit 

Square feet 

Condition/Type/Species 

bacl< le^ a^rnijr' 

'-­ ^ Each 

- ^ Each 

~^ ^ Each 

i 

t 

Each 

Square Feel 

Page 4 of 
fip^ 

COASTA L 

Item 

Agreed upon value of 

plant materials not to be 

replaced bv contractor. 

Note this value nil l be 

used to issue a plant 

voucher to the propertv 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant wil l be placed 

1\\ ihe contraclor. 

Agreed upon area of 

propertN to be replaced 

vsith grass sod. 

':u'li:de L; sl-eicli o; ihc 

.treats;, ii.-. be :epijcca -.^ 'I'l 

Li'-.iss >od. 

.Area of City or Count) 

property to be landscaped 

per their requireinents. 

h'lLi.nlc .. -r.c'i.Ti 1.;' :!c 

.•,:c\, is ! 

Easement .Area, to be 

excavated 

Quantity Unit Condition/Type/Species 

^ ^ $ o 

^ ^ Each 

Bl S ^ ev<iAi/J'^2d ac^i^ 

SF 

-e k SF 

SF 

Page 5 of 
C O A S T A L • HVfliOMHKMTAI . C • O U r . t M C 

Vaoj^vdr U T 

[H Check the box if Owner does not want CEG to document interior foundation wails and possible 

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

interior of house, including foundation cracks or fissures. 

[^fagi Q I do not agree agree 

cLfd £±2^ 7-/-^ ^ 7-/-^^ 

Owner's Signature Date Contractor's Signature Date 

Page 6 of. 
BVID# 1W\ 

XRF PROPERTY SAMPLE SHEET 

Date l\\' ^ I^V Address ^sy- U l]SW ^t 

Project Omaha lead FP 2nd year option Sample time 1Z^•6. am/(?5> 

XRF ID# sample length 30 sec 

Shot# 

W 

^ E 

Average

Reading 

iv?--u'^y?\'\ 

'^y . Mlt 3-1-% 

TK.qtt 'b^\>i. 

Sample area 

»-«~l 

Depth 

 '^!?(^4fcj : % ^ y ] ^ 

Shot# 

Average 

Reading Sample area 

Depth 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

l|l M 

Shot# 

IVh 

_m 

3i ^ 

4 nx-}^ fp\ RETEST AREAS 

Reading 

J3<. -zn K.-]^ 

g|^|.^^f>X.(t^C 

:ii^_ut_zi^ 

Sample area 

U 

Depth 

Shot# Reading 

^..^--7 

^ / 

Sample area 

Depth 

Average \^<,\ •H \ J ^^- H Average 

lab sample # Lab result Sample area XRF Avg. 

Signature 

^„j;ti\p(^ MfrTt^^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 765 

Mode SOIL 

Time 2008-07-14 12:26 

Duration 121.49 

Sequence Final 

Flags 

AVERAGE jjAvg of 761-764 ' 1 

ADDRESS 2532 north 18th street 

QUAD/ZONE Bl 

INSPECTOR ^MATEUS 

DEPTH 

SAMPLE TYPE 

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 723.780 

Supervised By: 

Certificate of Verification 

761 

SOIL 

2008-07-14 12:24 

30.57 

Final 

74149 

2532 north 18th street 

81 

MATEUS 

6 

± Error 

± 33.143 
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 807.773 

Supervised By: 

Certificate of Verification 

762 

SOIL 

2008-07-14 12:25 

30.53 

Final 

74149 

2532 north 18th street 

Bl 

MATEUS 

6 

± Error 

± 34.767 
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 920.417 

Supervised By: 

Certificate of Verification 

763 

SOIL 

2008-07-14 12:25 

30.23 

Final 

74149 

2532 north 18th street 

Bl 

MATEUS 

6 

± Error 

± 37.459 
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 775.489 

Supervised By: 

Certificate of Verification 

764 

SOIL 

2008-07-14 12:26 

30.16 

Final 

74149 

2532 north 18th street 

Bl 

MATEUS 

6 

± Error 

± 34.669 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 786 

Mode SOIL 

Time 2008-07-14 21:55 

Duration 122.15 

Sequence Final 

Flags 

AVERAGE fAv g of 782-785* 

ADDRESS 2532 N 18th ST 

QUAD/ZONE B l 

INSPECTOR " 1 MATEUS 

DEPTH • 13 

SAMPLE TYPE I RETEST 

NOTE "CLEARANC E @ 13 inches 

Supervised By 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 782 

Mode SOIL 

Time 2008-07-14 21:52 

Duration 30.92 

Sequence Final 

Flags 

BVID # 74149 

ADDRESS 2532 N 18th ST 

QUAD/ZONE Bl 

INSPECTOR MATEUS 

DEPTH 13 

SAMPLE TYPE RETEST 

NOTE CLEARANCE @ 13 inches 

ppm ± Error 

Pb 477.255 ± 26.637 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 783 

Mode SOIL 

Time 2008-07-14 21:52 

Duration 30.46 

Sequence Final 

Flags 

BVID # 74149 

ADDRESS 2532 N 18th ST 

QUAD/ZONE Bl 

INSPECTOR MATEUS 

DEPTH 13 

SAMPLE TYPE RETEST 

NOTE CLEARANCE @ 13 inches 

ppm Error 

Pb 435.284 ± 25.733 

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 981.751 

Supervised By: 

Certificate of Verification 

784 

SOIL 

2008-07-14 21:53 

30.41 

Final 

74149 

2532 N 18th ST 

Bl 

MATEUS 

13 

RETEST 

CLEARANCE @ 13 inches 

± Error 

± 38.651 
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 311.648 

Supervised By: 

Certificate of Verification 

785 

SOIL 

2008-07-14 21:55 

30.36 

Final 

74149 

2532 N 18th ST 

Bl 

MATEUS 

13 

RETEST 

CLEARANCE @ 13 inches 

± Error 

± 21.680 
Vltl* ST4f 

^ • -^ '^-i-pfui^"' ^

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

Coastal Environmental Group Inc. 

 www.coastalhazmat.com 

 COASTA L ENVIKONHENTA L 

GROUP , INC . 

EXECUTIVE SUMMARY: 

BVID # 74149 - (2532 N 18 ST) 

I I No Issues or Concerns [ ^ Issues/Concerns 

Detail Explanation: 

CONTINUE TO MONITOR SOD ESPECIALLY AREAS REPLACED. 

WILL REVISE IN SPRING OF 2009. 
^ ^ EPA 

EPA Property Close Out Form 

Property M: 3^\M ^ Property Address: -r^S^^^^-M- ^ ^ - -

Date/Time: OwVer's Name: £ \ W Cf^ QUrm ^ . 

Quads Excavated: ^ \ Contractor Group (W0Oi A 

Excavation General \f^^,AiKtr j_O T 

Yes No 

1. If necessary, were the correa quadrant(s) excavated and restored? y 

2 If necessary, were the correct areas of drip zone excavated and restored? fjA 

Grading Sod and Vegetation 

Yes No 

1. Does the grading around the perimeter of the house in excavated areas generally slope away 

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 

dav time period) 

4. 

Are sodded areas generally finn 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 properry graded such that water will not pool on the property? i / 

7. 

Was damage to landscaping or plant materials avoided? y 

Gates. FcDces and Retaining Walls 

Ves Nc 

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

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

3 ~P . Was damage to gates or fences avoided? (Ifapplicable) 

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

Foundation, SidiDK and Gutters 

Yes No 

1. Was damage lo the siding or trim avoided? 

1 (fi< 

2 Was damage to the foundation avoided? ^

^ iftflO 

l y v 

J. Was damage to windows avoided? 

/

T ^ 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? ik 

2. Was damage to walkway surfaces avoided? fli­
Owners, comments: 

Inspection notes: 

Removal and restoration activates complete including the 30-day sod warrant)': 

EPA Representalivfr^^^'^^^^^^^^^,^^ ^ Date: 9//0/p S 
Property Completion Agreement 

fills agreemenl documenis the completion of remedial activities performed on my property My signature 

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

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

Property ID: -jjj j l^Cj /[ im / / JJ ^

Property Address: ^Lj^^ ^ ~^^^S ^ 

Owner: 

.C.f^ o f O l'U\.a.h-0 L \ 

Phone: ^l^ i{. 5-/ ^D 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 1 

I a{i;rcc restoration is completed, excepi as noted 

I I Irio nol ai;rec restoration is completed 

f^-t^^ -<£:^w. 

Owner's Signatiiyp Date //Contractor's Signature Date