TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID**: 2^2^14)1 Date: hl5-/J . 

Address: \^L b U\AN\ \ S4 -

Remediation Contractor: Coastal Environmental Group^ Year: ^_Q) 2. 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

WM Video of property (DVD) 

V Executive Summary 

1^ EPA-provided property sketch 

L%/ Signed Access Agreement for subject property 

ly/A Signed Access Agreenient(5) for adjacent property 

Ir Restoration Agreement 

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

V Confirmation data 

</ Photographs ff i fi^<aw(riiQf\^ ^yrruterhoifv SqQ 

^ As-built sketch 

V Satisfactory restoration signed by Property Owner 

V Property close-out check list signed by EPA 

fiji^ Description of areas not meeting ROD cleanup criteria 

i/ Utility clearances 

H Property information from Douglas County Assessor's OfYice 

5<^x<y -N^ 

Date 

30261702 

• i 

Superfund 
Properly Access Checklist 

PropertylD: Zf\l^j,' \ 

n V/OBK STARTED ON: / / 

D WORK COMPELTED ON:_ / /

PropertyAddress: ((pj^,?, INACa^ i ^-^ 

Q^'"' Renter ^ FrgLAvq\n Warfcr 

Address: 

Phone: I^QZ^ZQ^^^ ^ \Wyy^^ L6tr\e Fax: 

Celi/Pager 

Additional Information: 

pho^c^ceiS-HCz-H^or 

fh^PM.^ Fax: fets-^99--i?^^.r 

^ 

Cell/Pager U)t^-'g)0 ^ - ^ftQC^ 

D Notification Letter 1 Sent: / / By: 

1^ Access Agreement Signed: 4 /ii_/V | By: 

(21 Restoration Agreement Signed: _/Q/ H 1 li _ By: V^i^VlPu^ 

1 n Topsoil Sampling (if applicable) 1 1 By: U 

D Disposal Sampling (if applicable) 1 1 By: 

D Garden Sampling (if applicable)* 1 1 By: 

Q^ Utility Clearance Called: J^'OMJ^ By: jl^U^/iy^-6»LrfT^w 

By:' -^i — a Video/Photos (Before) On: / / 

D Video/Pbotos (During) On: / / By: 

n Video/Photos (After) On: / / By: 

D Video/Photos (30-Day) On: / / By:

D Property Completion Agreement Signed: . / / By: 

D Final Report Issued: / / By: 

Air Monitorine (as applicable) 

D Community D Crew On: / / By: 

Results: 

O Community • Crew On: / / By: 

i Results: 

r~l Community D Crew On: / / By: 

Results: 

Omaha Lead Site 

 1 
Douglas County Account Info^ ~<ation Page 1 of2 

Douglas County, Nebraska Property Record ­ R2544880000 

Information is valid as of 2010-8-30 

New Feature -»-•- »

Prmt Report. 

View interactive GiS Mao 

Treasurer's Tax Report 

 Subdivision Sales Search 

Owner 

HARPER FRANKLIN E 

1070 HARSH LANE 

CASTALIAN SPRING TN 37031-0000 

Property Informatio n 

Key Number: 4488 0000 25 

Account Type: 

Parcel Number 

Parcel Address: 

Legal Description: 

Residential 

2544880000 

1823 MIAMI ST 

OMAHA NE 68110-0000 

WRIGHT PLACE LOT 14 BLOCK 0 30 X 68 5/8 FT 

Value Informatio n 

2010 

2009 

2008 

2007 

2006 

2005 

Land 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.04 2070.0 0.0 69.0 30.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R254... 9/3/2010 
Douglas County Account Information 

Page 2 of2 u 

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3 

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CO Cady Ave 9 

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Si John 

i SheiwoodAve 5! 

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Willis Ave • Willis Ave WjWsAve 

ERtD EV 

WHi»Auc rjgl r c Map datajiCOl 0 Google 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R254... 9/3/2010 
IRTH One Call Page 1 of 1 

Dig9«rE Hotlin* 

Of u±h Nebraska 

Home Ticket 

Ticket Creation Logout 

Create Another Ticket Go to Home Page Send Email I—a 


! 1 

• YOUR TICKET NUMBER IS 2883766. 

Original Call Date: 10/22/11 Time: 1:36 pm Op: WENDY187 90 


Work to Begin Date: 10/26/11 Time: 7:00 am 


State: NE County: DOUGLAS Place: OMAHA 

Address: 1823 Street : Ml/y^I ST 

Twp: 15N Rng: 13E Sect-Qtr: 10-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: LEAD REMEDIATION 


Location of Work: INCLUDING EASEMENT AND UP TO PEDESTAL 


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


: EMAIL ALL CLEARS TO: WLARA@COASTALGRP.NET 


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: WENDY LARA Phone: (402)991-1199 


Alt. Contact: JOSE CARDENAS Phone: (402)504-0981 


Work Being Done For: COASTAL 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


COXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area utility Service Area Name Contact Phone Numbers Code Type 

COXCATV Li 
 COX COMMUNICATIONS ELMCOX ELMCOX Day: (406)728 - 9343 

INC Alt: (406) 327 - 2936 

Emerg: (888) 728 - 9343 

MUDOl METROPOLITAN UTILITIES SANDY MUDOl Day: (402) 504 - 7823 

DISTRICT Emerg: (402) 504 - 7970 

OMAHACOF CITY OF OMAHA- RICH/TRAFFIC Day: (402) 444 - 7197 

TRAFFICSEWER OMAHA Alt: (402) 444 - 5161 

r: —«-« . /Ar\'i \ AA A ac n 

http://www.dhon.org/IRTHOneCall/Ticket/TicketCreation.aspx?ViewTicketID=871109 10/22/2011 
Wendy Lara Q ^ 71(^7^ 

From:

Sent:

To:

Subject:

 agt_comm@irth.com 

 Sunday, October 23, 2011 6:57 AM 

 Wendy Lara 

 Response to Dig Request 

To: COASTAL ENVIRONMENTAL SERVICE Attn: WENDY LARA 

Voice: 4029911199 Fax: 8776624211 

Re: Response to Dig Request 

This is an important message fr'om Omaha Public Works replying to your request to locate our 


underground facilities in an area described on the one call center ticket. 


Ticket: 2883766 


County: DOUGLAS Place: Omaha 


Address: 1823 MIAMI ST 


OMAHACOF (Sewer): 


City of Omaha Sewer- No Conflict per info on the one call ticket 


OMAHACOF (Traffic): 


The City of Omaha Traffic Engineering Division has determined our facility is 


not in conflict with the dig site provided by the one call center. 


If you have any additional questions please contact Omaha Public Works. 


This message was generated by an automated system. Please do not reply to this email. 


11 

Wendy Lara g^g^-iFrom: I RTH. Net@qwest.com 

Sent: Monday, October 24, 2011 12:12 PM 

To: Wendy Lara 

Subject: Message from Qwest 

To: COASTAL ENVIRONMENTAL SERVICE Attn: WENDY LARA 


Voice: 4029911199 Fax: 8776624211 


Re: Message from Qwest 


Message from Qwest 


Ticket: 2883766 


County: DOUGLAS Place: Omaha 


Address: 1823 MIAMI ST 


QLNNEIC: 


The described dig area of your locate request has been marked. Qwest 


Communications Local Network facilities are present in the dig area, If you 


have any questions^ please call Qwest at 1-800-283-4237. 


Message from Qwest 


This message was generated by an automated system. Please do not reply to this email. 

As-Built Drawing 

OLS:29267 

DATE EXCAVATED:10/29/11 

^ . COASTAL DATE USEPA SIGNED 0FF:1imi1 

EnvironmentarGroup AREA SODDED: 800 , Omaha Lead Superfund Site 

Inc. ;^qa\.7 

Name: f,f^y,klil^ /Ju,/i,r 

Address: /^ 3 ^/.^y.' 5/-

Phone: 

Omaha Lead Site 

Site Sketch 

Date:

Time:

 S"-/'/'^' / 

 r-i / 

North Arro w 1-

Team -g/^//^^^ ^ /^/"J S "> BVID # Z^Zfe T XRF Code So^ 

Sample Number 

^^^ ^ ^ ^ I 

i2iy<i.'Sy: ^y^/^T 

g.Yi7^:=>f^A- 'z.^i^.^c^y 

Lead Concentration 

z^=S— PP'" 

Vy^ ppm 

f — ppm 

ppm 

ppm 

ppm 

Confirmation Sample 

*'Yes a 

'Yes a 

-Yes a 

Yes tn 

Yes Q 

Yes CD 

No ET 

No IS" 

No ra;;^ 

No [ ^ 

No CD 

No CD 

No • 

B1 =209ppm@ 13" 

IT

JZ3±

_^yiiy\ 1 

i 

* 

;Sic^e 2 y y : i:i4. 

¥ 

_^A.\

t '• ?^7. I ' 

"d FT 

3^<^^ 

r 

:a7<& 

T 

i ] ^ zz^. 

%^\ 

11 -t

^iC\pi^'^J>^ 

T" 

j£ j 

-vn wrevrr -df--­-

Cms 

CONCRETE 

d Site 

DRIP ZONE EXCAVATED QUADRANTS EXCAVATED 

46130 

AREA REPLACED WITH SOD AREA REPLACED WITH 

ROCK/MULCH 

AREA LEFT BARE 

CONTRACT #: EP-R7-09-06 COASTAL ENVIRONMENTAL GROUP, INC. 
-^^ /^l^ulli a^av,7 

Name:

Phone: 

 firtyktih jJutpt f Omaha LMd Site

Site Sketch

 Date:

 Time:

 Sr-/'/-c^'/ 

n i 

North Arrow

iL 

—i 

le^m&/k7L.^ f^fi'^ BVID# g?26 T XRF Code 80^7 

Sample Numt>er Lead Concentration Confirmation Sample 

gyft^FyA-^^2-^7 f7_G> 

'z.crj 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

^'Yes

-f'Yes

'"Yes

e^Yes

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Yes

 a 

a 

a 

n 

 t ^ 

• 

• 

No ^ 

No ^ 

No Q ^ 

No ET 

No C^ 

No a 

No • 

wmr"-

Omaha Lead Site 46130 
o % a^a\r7 

Name: f,foy,kl,h l-LrnjrAddress: K m Mi-'^»'V 5/--

Phone: 

- Omaha Lead Site 

Site Sketch 

Date:

Time:

 r-/</-^ ^ 

 t-t j 

North Arrow

>/

 \ 

1 

TeamMr//^>-^^ f^fi' ^ BVID# 1^(6 7 XRF Code g o ? 

Sample Number Lead Concentration Confinnation Sample 

Q^C^py/K ­ 7J7^j/y7 

3t^3 

2-7 

-go'Y 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

*'Yes

-ffYes

*'Ye s

*^Ye s

Yes

Yes

Yes

 n 

a 

a 

n 

 CD 

• 

• 

No [ ^ 

No l^ " 

No Q ^ 

No ET 

No n 

No • 

No • 

\—i— ^ 

'•A wnnr • i -

Omaha Lead Site 46130 
3^3LV.7 

Name: f^ou,Ll,h tLtp» f Omaha lAad Site Date: ST/t/'O i North Arrow 

Address: m i ^//-^J ' S/-- Stte Sketch Time: f-Z / 

Phone: 

TeamMf//L. ^ f^fi" ^ BVID# Z^QT f XRF Code go'? 

Sample Number Lead Concentration Confirmation Sample 

l^SiASCl 

- 2.?^^/ 

ew^f?x^ ­ Z'^g>7 

^4 ^ 

27' 

-go^y 

ppm 

ppm 

ppm 

ppm 

*<Yes

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0^Yes

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n 

a 

n 

No

No

No

No

 ^ 

 13' 

 Q ^ 

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ppm Yes CD No a 

ppm 

ppm 

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• 

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 a 

• 

32 

^ k ^ 'iA^t>r ^f'lnA 

r$ ^ .^2. 

^i i< S^ 

# f

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r 

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jsk. u^*^ 

^\'­ iifll £ ^ ./ ^ 

i£: 

7^ jzrmr df-.-

Omaha Lead Site 46130 
0^^^^ 

^6? ^ V 

COASTA l tttVIROHnlllM l 

« KOt l r. IN C 

Consent for Access To Pfoperty 

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: 

/^/iX/^//;yWz*'ir/ ^ 

Owner's Name: Daytime Phone: ^^^^^.^^^^^ ^ 

Address of Property 

covered by this 

Agreement: IP^l^ H>wt S r 

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 perfonmed, 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 confinn 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 IkVllOHHIKTAl 

C t O U r IR C 

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

piles, dog houses, etc; 

c Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

c Water and maintain replacement vegetation, including fertilizer application, as 

necessary' subsequent to an initial watering period by EPA; 

c 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. 

o 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 

[V3^rgran « t access to my properties

 D ' do not grant access to my properties 

^// . Signature Date 

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

Page 2 of 2 
v.\ 

COA S T A L 

C • O U P . IN C 

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: Q^q ^ (^Ty 

Property Address: \9277^ VA-^ftYT.; S: ^ 

Owner • V^^.r^V W JC^ -

Plione: 

U\'=..-^'^;:)..VA-v o U\<^ . y^r^u., ^ftO U 

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. Indicate 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 return of these items is the Owner's responsibility. 

Item: 

^f>M^ 'Y"Co«^V<^ Vo V^o- -^^^v^oA 

Item: 

Item: 

Item: 

Items to be Removed by the Contractor During Remediation and Not Replaced 

Item: 

(^r>.^ T-An. •rsVe^ \o^ \ 

Item: 

Item: 

Item: 

Page 1 of 3 
VI 

COASTA L • NVinONnlNTA L CROUP . IN C 

Items to Be Removed By Contractor During Remediation and Replaced 

Item: 

<V^ \ \ "^ S ^ 

Item: 

Item: 

Item: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, Quadrants that will be excavated, that ^ \ 

is covered with grass. 

Number oftrees > 2 inch Each 

trunk diameter 

Number of trees <= 2 inch Each 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, Each Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed Each 

area. Square Feet 

Attach a sketch of relative 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced by contractor. $ Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Easement Area, to be Each 

excavated 

Page 2 of '^ 
VX 

COA S T A L 

O R O U P . IN C 

Additional Comments / Instructions: 

The city of Omaha ordinances may prohibit you from using dirt or gravel areas on your property 

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

removing and replacing soil underlying 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 gravel or dirt area 

as a driveway or parking area, not withstanding any removal 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 city of Omaha's Planning Department at (402) 444-5150. 

O Please check this box if you understand the information outlined above. 

• 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 do not agree 

vn/;^\ ^ 

Date Contr^tS»;^igSignatur i e Date 
FAX COVER SHEET 

COASTA OMAHA L 

Fax 

To: From: 

Franklin Harper Wendy Lara 

Fax No. 615.452.2167 Pages: 5 

Phone: 615.452.4305 615.804.9806 Date: 10/21/2011 

Re: 1823 Miami St cc: 

^Urgent ^Fo r Review nPlease Comment ^Please Reply nPlease Recycle 

• Comments: 

Enclosed you will find the paperwork necessary to start the lead remediation process. Please sign and 

retum the fomns provided to the address listed above. If you can, please fax the sheets back as soon as 

possible, since we are awaiting a response to start the lead remediation before the ground freezes. If you 

have any questions or concems, please feel free to call me at 402.991.1199. Thank you. 

Wendy Lara 

Site Coordination 

Coastal Environmental Group, Inc. 

—8(a), HUB Zone, MBE, DBE 

2411 Martha Street 

Omaha, NE 68105 

(402) 991-1199 ext. 3612 office 

(877)662-4211 fax 

(402)432-6947 cell 

w.lara@coastalgrp.net 

www.coastalgrp.net 

COASTAL Form 24 Revogio 
FAX COVER SHEET 

OMAHA 

CONFIDENTIALITY NOTICE: The information contained in this facsimile message and 

attachment(s) is intended for the sole confidential use of the designated recipient(s) and may 

contain confidential and privileged information otherwise protected by law. Any unauthorized 

review, dissemination, distribution or copying of this information is strictly prohibited. If you 

have received this communication in error, please notify us immediately via telephone and 

destroy all copies ofthe original message. 

ANY SITE — ANY SITUATION — EVERY TIME 

Certified MBE • DBE • 8(a) • HUB ZONE 

2411 Martha Street • Omaha, NE 68105 

877-662-4210 • Fax 877-662-4211 • www.coastalgrp.net 

COASTAL Form 24 Rev0910 
BVID# 2^^^ ^ 

XRF PROPERTY SAMPLE SHEET 

Date 1E£Z7L Address 

Project _ Omaha Lead ARRA Sample time 

XRF ID# K sample length 

Shot#"" _ Reading Sample area Shot# 

^ 2 

Depth 

.ll^l f3t 

.1.1... ..ZiytJjJ. 

_,yyc_ Average Average . Z^.Al72. 

Shol# 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, J2A^2 ^ 

Print jOr*ytf,( ^^i^- ^ 

/ y2- i /^/'«//n/-' 

am/pm 

30 sec 

Reading Sample area 

2Sf ^ Sf2- ye>5» 

2.7^7 Depth z<7 

2^^^ 2/ / " 

2^ ^ j^^- ? 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Units 

Sigma Value 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 209.355 

Supervised By: 

Certificate of Verification 

21 

Soil 

2011-11-04 09:53 

94.79 

ppm 

2 

Final 

Avg of 18-20 

1823 MIAMI 

Bl 

13" 

PATLAN 

CONFORMATIONS 

CONFORMATIONS 

Error 

19.338 

.yyTLj­
u 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Units 

Sigma Value 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 208.893 

Supervised By: 

Certificate of Verification 

18 

Soil 

2011-11-04 09:52 

32.59 

ppm 

2 

Final 

29267 

1823 MIAMI 

Bl 

13" 

PATLAN 

CONFORMATIONS 

CONFORMATIONS 

± Error 

± 18.881 
SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Units 

Sigma Value 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 216.223 

Supervised By: 

Certificate of Verification 

19 

Soil 

2011-11-04 09:53 

30.55 

ppm 

2 

Final 

29267 

1823 MIAMI 

Bl 

13" 

PATLAN 

CONFORMATIONS 

CONFORMATIONS 

± Error 

± 19.981 
SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Units 

Sigma Value 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 202.950 

Supervised By: 

Certificate of Verification 

20 

Soil 

2011-11-04 09:53 

31.65 

ppm 

2 

Final 

29267 

1823 MIAMI 

Bl 

13" 

PATLAN 

CONFORMATIONS 

CONFORMATIONS 

± Error 

± 19.151 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Units 

Sigma Value 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 249.649 

Supervised By: 

Certificate of Verification 

25 

Soil 

2011-11-04 09:56 

90.72 

ppm 

2 

Final 

Avg of 22-24 

1823 MIAMI 

EA 

1" 

PATLAN 

EX-SITUS 

CONFORMATIONS 

Error 

23.761 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Units 

Sigma Value 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 231.121 

Supervised By: 

Certificate of Verification 

22 

Soil 

2011-11-04 09:55 

30.20 

ppm 

2 

Final 

29267 

1823 MIAMI 

EA 

1 " 

PATLAN 

EX-SITUS 

CONFORMATIONS 

± Error 

22.966 
SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Units 

Sigma Value 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 259.500 

Supervised By: 

Certificate of Verification 

23 

Soil 

2011-11-04 09:56 

30.20 

ppm 

2 

Final 

29267 

1823 MIAMI 

EA 

1" 

PATLAN 

EX-SITUS 

CONFORMATIONS 

± Error 

± 24.258 
SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Units 

Sigma Value 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 258.327 

Supervised By: 

Certificate of Verification 

24 

Soil 

2011-11-04 09:56 

30.32 

ppm 

2 

Final 

29267 

1823 MIAMI 

EA 

1" 

PATLAN 

EX-SITUS 

CONFORMATIONS 

± Error 

± 24.058 
/Ifi^' o

3 ^^^^ ^ I

^^^*~J( ?

^"" ^

 Omaha Lead Site—Fixed Price EP-R7-09-06 

 Coastal Environmental Group Inc.

 www.coastalhazmat.com

 ... 

 vJ 

 COASTAL 

EXECUTIVE SUMMARY: 

BVID #29267(1823 MIAMI ST) 

No Issues or Concerns Issues/Concerns 

Detail Explanation: 
11/02/2011 17:17 FAX 171258607.' Office Hex 0971 
 81003 

COASTAL 

Anperty Comidetion Agreement 

This apaeawnt documnts die oomplelion of remedial activities perfonned oo my pmp Tty My sisnature wili 

designate Aat I am sttiified with the Msunatidn of myppoperty, and that oo iteoui are ii qasitloa, ooweratioy 

date in die fntnxe, except those iieois lisied below, ifu y 

ftapotym: ao^^yTN 

PropertyAddress: VCKOLTS VA^^^- . S A 

Owner F«^^V\\.>v Nx. ^ 

Phone: UV<^-ftr>H 

RcstorotioD Items in Question: 

kem: 

Item: 

Itegn: 

hem: 

Bern: 

Additioaal Coauneats: 

Q^agI agrer e restoration in completed, except as noted 

LJ I do not agree restoration is completed 

M''l \\h/\\ 

Owner's Signature Date Date 

2d 90efr-39t^l.9 esudje}U3 jedJBH d/gigo i, i, eo '^ON 
lEPA 

EPA Property Close Out Form 

^^^t^n • r..^Hv AdHr^. Jm3_jm.^QiLii ProperlA' M: 

Dale/Tlroe: 

Quads Exca\«(ed: _^\ _ 

Conlraclor Group {JO(Ki-Tt\/\ 

Excavation General 

I. If Dfccssao', were ihc correct quadrant(s) excavated and restored? yz 

2. If nccessan,', were the correct areas ofdrip zone excavated and restored? y 

Grading Sod and VegeUtion Ves Ko 

Docs tlie grading aroiind l.he perimeter ofthe hou.<;e in excavated areas generally slope away 

3

2

.

.

 Doe

 Ha

from

s so

s

 (h

 th

d

e

e

 bee

 so

 house

d

n

 appea

 lai

? 

d in

r t

 al

o b

l area

e generall

s that wer

y health

e excavated

y and growing

? 

? (Only evaluate if inspected at a 30 

7

day time period) 

4. Alt sodded areas generally TUTTI and evenly graded? y

L. 

5 Ar

lim

c

e

 th

 period

e joint

) 

s between the sod strips generally tight? (Only evaluate if inspected at a 30 day y

6. Was the propeny graded such that water will no! pool on the property? 

7 Was damage lo landscaping or plant materials avoided? 'Tyr~\ 

Gaiei, Fences and Rctaiping Walls 

V es No 

!. Do gates open and clo.se freely? (If applicable! 

"T 

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

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

A. Wais damage to retaining walls avoided? (Ifapplicable) T, 

Foupdation. .Siding and GuMer? Yes . .Nu 

Was damage to the siding or trim avoided? y 

Was damage tn the foundalion avoided? y 

Was damage to windows avoided? xy ^

 'A'as datnage to windowi or door Kreens avoided'-

H 

^- Was damage to Jowdspouis m duwri>pe)ui i-xieniion.s a\i)idcd!' 

Sidewaiki «nd Driveways (Coucrcic) \'i V >(.' 

' 1 Was damage 10 drivewey surfaces Hvoided' 

T 

Wai damage to v^ulkwas Mirfacei avoided'.' / 
Qwnen comments: 

inspection notes: 

9^^' 

Re,nov„, ^ d rou.a<,TM »U,v.>.s c,.TMple,e .ncl.ding ,h. M,-d.y sod w„m„..y: 

r-",,,i . 
11/02/2011 17:17 FAX 171236f 4 Office Hex 0071 81004 

Propel ^ Owner Attestncnt «S PerfornaBce Fo-m 

Aacricm Recovoy and Rdnvestment Act (ARRA) 

Qnaha Lead Si^aAind Site 

2011 

Remediatioa Conaactor: COASTAL Envnonmeptal Group - EP-SLl-09-06 

Property Identifier Number Qpy a Vy\ 

PropertyAddress: Vfe^^jk VJ.\».^ - T^^ 

Property Owner's Name: Ww^v\\ ^ U^^«y>^ 

(Akove infonmction w befilled outfay die icmediatiu conmctor prior to utUiaaiin by ih<; EPA COR) 

lartroetioBs to the PiwieiH Ower; 

This fbtmscnvs to ncoid the Pnipefty Owner's itsessment of perfb^I)lnc^!(IncentI l-Quaiity 

Assunnce Surveillaoce Plan) involving the listed remedialion cooiractor, as api iic»ble to the Omaha 

Lead Site. This form docuneais the timdiness of pnnch list resolotiaa, busineii leLrtions, complaiot 

resohitioa and die overall quality of woric. If need be, die Property Owner siay i tJliH this fonn to record 

problems and/or issues not specificaUy tied to an assigned eddiess,for example, bwiiess idatioiis that 

generally dont follow guidelines set forth in the Peifonnance Work Statement. 

The Property Owner will indicate his/her assessment of performance wi 'h tttr contractor's woric 

by chcckSng a umerical rating on tke tahk bckiw using tbe sumerical defini 'iocsfrom the raiting scale 

beloiw, the sign A datethe forok 

9-10 "exceUcBt*' 

7-8 •Veiygood" 

5 ^ "aeceptabfe*^ 

3-4 -poor 

1-2 "very poor" 

Pimmij Owaer'e Afseasmentof ^"fc'-iwacfe IfayrprJi^e the Contractor*s Work 

10 5 

9 _ ^ 4 

8 >^ ^ 3 

7 2 

6 1 

AdditioDai CoiPJweBts from EPA CORfentieial; cositittne oa back neee if n eedenH 

Property Owner Signature: yytd-*^ •f'Ci' Cp^i^l ^ Date: -/yL ?-^^/ 

» 

gd 90Efr-29^l.9 esudJeiuqjedJBH d/cioni.icnAOM