TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SA1D#: "^{ylO-} Date: 

Address: 7.<"7: ^ Z^cryoZ ^-J-i 

Remediation Contractor: _Envrionmental Restoration, LLC_ Year: 2009 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

;Z ^ Video of property (DVD) _a^for e DAfter JS-Basement • 

y0 Executive Summary (Final Report) 

jy ^ EPA-provided property sketch 

jy ^ Signed Access Agreement for subject property 

D Signed Access Agreement(s) for adjacent property 

y ^ Restoration Agreement 

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

y y Confinnation data 

X]^ Photographs [ZI Before DCrew Photos^ During Excavation [?f Sod 

X30-day Sod D . . 

Z As-built sketch 

p f Completion Agreement signed by Property Owner 

y f Property close-out check list signed by EPA 

D Description ofareas not meeting ROD cleanup criteria 

•^fj^l"^ Utility clearances 

J Z Property information from Douglas County Assessor's Office 

-0 Property access checklist 

J S Contact Log 

30260451 

D 

Superfund 

Environmental Restoration Signature Date 

i EP A COR sienature / Date 
Omaha Lead Site—EP-R7-09-G5 

Environmental Restoration, LLC 

vrtvw.crllc.com •^^. v*--

r:xECUTivR .SUMMARY : 

36701 - 2572 Fort ST 

No Issues or Concerns Q ] lssuc:s/C()iiccnKS 

)e(;iil l-.xplnnation: 

o^yy 6uy,^ ^^ ^^j ;.^ b^Zcj(A{^ 
-EPA 

EPA Property Close Out Form 

Omaha Lead Site OU#2 

Property #: bt^iol Property Address: ^5"J?S„-Efi;i.__'?t: 

Date/Time: Owner's Name: -t^-^le^ r>n\-tAI. 

Quads Excavated: ffil f3i j') 2 Contractor Group : Environmental Restoration (ER) 

Excavatiort General Yes No 

I. Ifnecessary, were the correct quadrant(s) excavated and restored? / 

2. Ifnecessary, were the correct areas ofdrip zone excavated and restored? 3y 

Grading Sod and Vegetation Yes No 

1. Does the grading around the perimeter ofthe house in excavated areas generally slope away from the y 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 ifinspected at 30-day time 

period). 

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

5. Are thejoints between the sod strips generally tight? (Only evaluate ifinspected at 30-day time period). 

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

7. Was damage to landscaping or plant materials avoided? y 

Gates, Fences and Retaining Walls Yes No 

Do gates open and close freely? (if applicable) 

2. Were all gates or fences taken down during restoration activities le-installed? (ifapplicahle) 

T ^ 3. Was damage to gates or fences avoided? (ifapplicahle) 

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

Foundation, Siding and Gutters Yes No 

1. Was damage to siding or trim avoided? y 

2. Was damage to the foundation avoided? y 

3. Was damage to windows avoided? f 

4. Was damage to window screens or door screens avoided? y 

5. Was damage to downspouts or downspout extensions avoided? i / 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Inspection notes: 

r«^ue,sic<L -^iuJc -\\ y u>{/irif3 e'K- ^oii " iGwoe,eT> 

Remedial and restoration activities complete including 30-day sod warranty: 

EPA Representative 33umi,.yMM6<Js^cr^ Date: 3IZL{IO 
Contact Information Log 

SAID# 3(^?<3Z 

I Owner's Name: ^5^?/- ^ _g^/ ^ U | Daytime Phone: Q ^ y ^ LJ^^ l , \ 

Property Address: d^S^ X f^-r Z ,iyA 

Attempt to contact Date/time Name 

^ZWCKif^ '^•^ V>i>'^V- //f^f i6:^jr "^^ ­

/^z/- ^ 03:^0 '^A ' 

. , ... / 

^^^^ ///f ^'^p^ kb j3yZ 

' 
Propetty Access Checklist 

SAID: Z)^~]^ i 

D WORK STARTED ON; / / 

n WORKCOMPELTED ON: / / PrcpertyAddress: 2Z ^ 1 0 /^^ ^ ( ^ 

^ 

|VL Access Agreement 

^ Restoration Agreement 

L 3 Video Property Before 

L 3 Digital Photos Before 

\ I Video Property After 

Signed •-ALZZLi^ 

Signed: // I ) f I 

On -.iLll^l. 

On -.JLl/ZL' 

On / / 

^r-K/y 

^y-^z^ 

By: /I D 

»y= ^/ ^ 

By: 

• Digital Photos After On / By: 

\ I Property Completion Agreement Signed: / By: 

I I Final Report Signed: /_ By: 

Additional Video or Digital Photo's Taken: 

n Video n Digital Photo On :

Reason: 

/ / 1 

D Video

Reason: 

n Digital Photo On : I I By: I 

n Video

Reason:

 n Digital Photo On : / / By: 1 

1 

n Video

Reason:

 D Digital Photo On : / / By: 

j 

Omaha Lead Project Work Plan 

Page 1 of 19 
 I 

Consent for Access to Property SA1D# ?ZJlOJ 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner), consents to and authorizes the United States Enviromnental 

Protection Agency (USEPA) or its authorized representatives, collectively the Grantee to enter 

and perfonn certain environmental response activities upon the following described premises.: 

I Owner's Name: 0:^1^/C (Z'r^ If V | Daytime Phone: HS'']-^S~~yO!>

Address: 2^-]: ^ Z-^rZ S3: 

Address: 

Addresses of Properties 

covered by this Address: 

Agreement: Address: 

Address: 

PURPOSE OF INVESTIGATION 

The purpose of the remedial activities is to remove all soils at the property which are 

contaminated with hazardous substances, in particular lead at concentrations greater than.or equal 

to 400 parts per million (ppm). 

REMEDIAL ACTIONS 

The environmental response actions to be perfomied on said property may include the following 

activities: 

a. Taking photographs and/or video of the property before, during, and after rernedial 

activities; 

b. Locating equipment and machinery on-site in preparation for and in the course ofthe 

environmental response; 

c. Plarming and implementing the removal action on or near Grantor's property. 

d. Obtaining samples from Grantor's property; 

.AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of lhe activities or work done, or the 

equipment used to perform the activities, or to undertake any actions regarding the use of said 

property which would tend to endanger the health or welfare ofthe Grantees or the environment, 

or to allow others to use the property in such 

v\ I grant access to my properties Q I do not grant access to my properties 

i . • -y f •' J 

ZZ Z3Z<-3 y>^^^A3ti Z - jZ-y3 ^ 

Signature Date Signature Date 
Additional Comments / Instructions: 

• Check this box if owner does not want E.R. to enter the residents to document interior 

foundation walls and possibie preexisting damage. By checking this box E.R. is not responsible 

for any damage done to the interior of house, including foundation cracks or fissures. 

F l I agree [H I do not agree D I agree I I'll do not agree 

iZ 

' . / •'Z 

Owner's Signature / / Date OontractorY Signbtu-Ik ^ ^""^^Daf^ /

 7 
Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of property prior to 

contractor 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). 

SAID: 3^7^ / 

PrcpertyAddress: ^57: 2 /PJ/ / 6 Z 

Owner: ^si>jc r'^^k'y 

^vt^nt.: ^r^-i-HrriS-^, 

On the attached diagram(s) indicate area(s) to be excavated and depth of excavation, location ofall 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 Contractor and not replaced: 

Item: 

OUntf l^ill 113.6 ^Z. 3y-el(/c:-A 1 

c^A a/y^a 

Item: J 

Item: 

kll 3>h 

Item: 

Item: 

Item: 

Item: 

Page 1 of 2 
Additional Comments / Instructions: 

lyf I agree [Zl I do not agree D I agree I do not agree 

fyy^Jr^yr//-jo-^>y 

Owner's Signature J ; Date 

Attachments 

Page 2 of 2 
Property Completion Agreement 

This agreement documents the completion of remedial activities perfonned on my property. My 

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

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

SAID: 3[^-lO / 

PrcpertyAddress: '^j:^^^ . f^rf ^ -

I Owner : B.<^/^ F^WljjZ 

e'bone 

Restoration Items In Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

I agree restoration is completed, except as noted 

I I do not agree restoration is completed o not agree restoration is completed 

ffllI agree restoration is completed, except as noted c/ag 

Owner' CJ ri„* s Signature C/ Bate Contractor's Signature Date 

I
Douglas County Account Intc^i^Pli 

Dougla s County , Nebrask a Propert y Record - R220258000 0 

! Print Report 

l„f,^,•.«-•;^ i,. ,,-i- j „ „ „ f onn n n o i NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VJeW On Ma p 

Information is valid as of 2009-11 -3 | Treasu.r^erlsjfax Repprt 

.. . 1 New Feature ->->•-* Auto Sales Search 

Owne r 

FINLEY ESSIE M — ETAL 

2572 FORT ST 

OMAHA NE 68111-0000 

Propert y Informatio n 

Key Number: 0258 OOOO 22 

Account Type: Residential 

Parcel Number: 2202580000 

Parcel Address: 2572 FORT ST 

OMAHA NE 68111-0000 

Legal Description: SEYMOURS ADD LOT 14 BLOCK 1 S 6 FT E 41 1/3 FT LT 15 & E 41 1/3 FT LTS 

138.41 1/3X110 

Valu e Informatio n 

j Land \ Improvement ] Total 

2009 $2,300.00 \ $18,300.00 $20,600.00 

2008 !~ $2,300.00 $18,300.00 i $20,600.00 

2007 $2,300.00 $19,500.00 $21,800.00 

2006 ; $2,300.00 : $19,500.00 $21,800.00 

2005 1 $2,300.00 $19,500.00 ] $21,800.00 

2004 1 $2,300.00 $12,100.00 $14,400.00 

Sales Informatio n 

Sales Date: 2007-02-08 

Deed Type: QC 1 Book: 1 2007 i Page: 015448 

Price: $0.00 

Grantor: FINLEY ESSIE M 

Grantee: FINLEY ESSIE M ETAL 

Valid/Invalid: Invalid 

Exclusion Reason: Family Sale 

Lan d Informatio n 

Acres j SF 1 Units j Depth \ Width Vacant 

0.1 i 4510. 0 i 1.0 "TlO O '•• 1 41.0 " "• " • ' No 

Improvemen t Informatio n 

1 • •• • 

_^-"« rn,qnnina-onllne.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22... ll/9/2( 
Douglas County Account Info' 

Building 1 

!.wi'iniAiii.iiiiJimu, _ _^., 

"CLICK TOEN LARGEMAG E 

Square Footage: 1482.0 

Perimeter 0.0 

Unit Type: 

Built As: 1 1/2 Story Fin 

HVAC: Forced Air 

Exterior: Frame Siding 

Interior: Dryv\/all 

Roof Cover: Composition Shingle 

Roof Type: Gable 

Floorcover: • Allowance 

Year Built Year 

Remodeled 

Percent 

Remodeled 

1912 0% 

Detail Type Deta/7 Description 

Appliance Allowance 

Basement Bsmnt Block 8 ft 

Fixture Additional Fixtures 

Fixture Base Fixtures 

Fixture Bath Full 

Porch Slab Roof Ceiling 

•» I 'iKlfii -3^; 

Z M 

'W^rtf 

CLICK TO ENLARGE IMAGE 

Percent Complete: 100.0% 

Quality: Fair 

Condition: Poor 

Condo Square Footage: 0.0 

Rooms: 6.0 

Units: 1.0 

Baths: 1.0 

Bedrooms: 4.0 

Stories: 1.5 

Foundation: Block 

Sprinkler Square Footage: 0.0 

Adjusted Year Physical Age Built 

1912 97 

Units 

1.0 

912.0 

1.0 

1.0 

1.0 

144.0 

iflnniim-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22... 11/9/20 
Consent for Access to Property SAID# ZZZlO j 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner), consents to and authorizes the United States Environmental 

Protection Agency (USEPA) or its authorized representatives, collectively the Grantee to enter 

and perform certain environmental response activities upon the following described premises.: 

Owner's Name: ^ ^ ^/^ ^ ff' ^ j^y ^ Daytime Phone: 

Address: ^^l^ X Z-c^ 5Z 

Address: 

Addresses of Properties 

covered by this Address: 

Agreement: Address: 

Address: 

PURPOSE OF INVESTIGATION 

The purpose of the remedial activities is to remove all soils at the property which are 

contaminated with hazardous substances, in particular lead at concentrations greater than.or equal 

to 400 parts per million (ppm). 

REMEDIAL ACTIONS 

The environmental response actions to be performed on said property may include the following 

activities: 

a. Taking photographs and/or video of the property before, during, and after remedial 

activities; 

b. Locating equipment and machinery on-site in preparation for and in the course ofthe 

environmental response; 

c. Planning and implementing the removal action on or near Grantor's property. 

d. Obtaining samples from Grantor's property; 

•AGREEMENT NOT T O INTERFERE 

The Grantor agrees not to interfere or tamper with any of the activities or work done, or the 

equipment used to perform the activities, or to undertake any actions regarding the use of said 

property which would tend to endanger the health or welfare ofthe Grantees or the enviromnent, 

or to allow others to use the property in such 

pn I grant access to my properties Q I do not grant access to my properties 

,/ 

C'T^- jyZ-<-3.^. ,;../ y\.-->-i. iA3ii y Z^y3^ 

Signature Date Signature Date 
Additional Comments / Instructions: 

• Check this box if owner does not want E.R. to enter the residents to document interior 

foundation walls and possible preexisting damage. By checking this box E.R. is not responsible 

for any damage done to the interior of house, including foundation cracks or fissures. 

[ 3 I agree Q I do not agree I 11 agree n I do not agree 

Zy... . _.f- ..., /

y i l±:-3)Z--y^ 

Owner's Signature /V Date Contractor's Signature Date 
Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of property prior to 

contractor 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). 

SA^P: 30Zb l 

Property Address: ^^7J 2 IZ)/ Z S ^ 

Owner: /%-gy ^ /^' ^ I f }/ . 

Phone: 

On the attached diE^ram(s) indicate area(s) to be excavated and depth of excavation, location ofall 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. 

Stems to be removed by Contractor and not replaced: 

Item: 

^<^J^€r l<^/// MS^ Z 3y-el(/<r^ '^^ Ci^'x ayycy 

Item: " • • • y 

Item: 

\Z\ y-b 

Item: 

Item: 

Item: 

Item: 

Page 1 of 2 
V^ I agree d I do not agree • I agree n I do not agree 

y Z3^n3y^ 

iJ\..-iy3~.Zr-ryCz^r /•/- •^ Z- yy 

Owner's Signature • y Date Contractor's Signature Date 

Attachments 

Page 2 of 2 
ENVIRONMENTAL AS-BUILT DRAWING 

*9 % wm^mf *%m 

pp<;Tr>DATir^w 

36701 

Omaha Lead Site Lxt«rior P*n1 r^Qh Ajrowv 

Sii v SKvtcl i 

SafTiplirs Ac)drc««: »7y FORT ST 

Q] Nott>.iint 

.^nmn<A Ntimtx^r Lead Sampl« LAB Sompo* Co<le<t<Mj 

Concenira'ton CoHecied F.rm: PET C-C. p.g . RYASCPXA-36r01 Fl ZI P ppm D Date 7 - M - 0J< 

RVBSCPXA 30701 Fa -ajL ppm Q^ Tirit«5 1 W : DA fc«-\ 

RYCSCP>A 36701 Bl D Samples Aruilyzed RYDSCP>A-3*701 B2 2.a'7 ppm GT D 

ROZSCPXA-36701 02 I&5. 5 ppm oar D XRF Urn 1 (a5^ 0 Book ^/? 

nOgBGPiiA 3870 < M ppm u U 

Date 7-2*y-ofc 

«Pe&CPXA-iKr^ Pt>rn D n 

[ in><5 /=»rr« 

Stofi n5v J LotJ RYBSCPLA-3«/^U1 Number of Samples » ^ ] [ [ 

.C Result 

307 ppm . « FiontR>gM, Bl ^ aicK Le«t. B2 ' Back Right CZ = Ofip 2o»w. GZ =• GafCfon, PZ =» Play 

• • __^^ ^ 

6 6 0 287 

JtIL 2 2 2001 

TM 6 1 DATE CXCAV/^TtD 12'5-0« 

DATE EPA SIGNED 0=F J-2&-10 

AREA SODDED 1237 SOFT 

< 

. ... . •-•••• ; : ; 

o £XL- .'Sirs' 

c 

2no 

0-Z r 

SCJEX K 

^31 \ 

EZ=299PPM@ r 

Mr.-*'"***' < 

?«*-»• S * 

LCfiEliP. 

Qirtdf anl oxcayatod Pf lp Zpno gxcava«i'd gontamlitatlon Loft Bctiind 

Contract*: EP-R7-09-05 

Environmental Restoration LLC 
Illllllillilliiilli 3670! 

Omaha Lead Site 

Site Sketch 

Samoiina Address: 2572 FORT ST 

Sample Number 

RYASCPXA-36701

RYBSCPXA-36701

RYCSCPXA-36701

RYDSCPXA-36701

RDZSCPXA-36701

nCZGOPXA. 36701

fiPZGCPXA-36701

 Fl 

 F2 

 Bl 

 82 

 DZ 

 G^ 

P2­

^Lab RYBSCPLA-36701 

'Result 

Lead Sample LAB Concentration Collected 

2 1 0 ppm D 

H 3 I ppm 

GUCO ppm D

2.Q"7 ppm f D 

Exterior Paint 

Q Good 

g ] Poor 

Q Not paint 

North Arrow 

M 1 

Samples Collected 

Firm: V t ^. C D-g . 

Date: 7 - l(- Qg 

Time: |(?!0r> ^V\ 

Samples Analyzed 

I ^6 S ppm n XRF Unit: CnSHO Book: 2/ ? 

~ ppm D D Date: 7-Z^-0e> 

- • ppm D D Time: r\rY^ 

Staff: C^iyi Number of Samples = | ^ \ \ \ | 

^3!333}. _ = Front Right, Bl = Back Leff, B2 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Play 

All quadranis are as viewed from the street, facing property 

-^ Y y—^ — 

z 

t 

6 ^ .j.2,87.;.. 

JUL 2 2 2008 

B ; 6^ 

)^3CZ^^z^ 35? ^ 

••^3^syZ^^'^­ c 

<R -< /<iP = ^Cx D7­

• vu:.. . 

j£>'^ciJ=^ .(3P4> 3 

r>z=..;i8^-r.. 

2S11 M 5i © 

>^/"5^^^ " 

yD^ 

2.70 

F-'-

ZEETE 

.-43! ^ 

T^orf 5 ^ Rev 2008.N Created: 26-rcb-08 0+< 701.01,2.1 
Iiillliilllliilli 36701 

Omaha Exterior Paint North Arrow Lead Site • Good Site Sketch 

Sampling Address: 2572 FORT ST [~] Not paint 1

Sample Lead Sample Samples Collected Number 

I 

LAB Concentration Collected Firm: p r (3'C. D-B. RYASCPXA-36701 Fl 2 7 O ppm n Date: 7- K-Og RYBSCPXA-36701 F2 "4 3 1 ppm Time: \0-C)<\ ^N \ 

RYCSCPXA-36701 Bl C>(DC:> ppm D Samples Analyzed RYDSCPXA-36701 B2 2 e 7 ppm n 

RDZSCPXA-36701 DZ I ^S S ppm a' D XRF Unit: Gi^HO Book: 2/ 5 

RGZSCPXA-36701 G2 - ppm D D Date; 1-ZH-O ^ 

RPZGCPXA-36701 P?- • " ppm D D Time: 

D 

/^rv^ 

Staff: Lab RYBSCP17V-36701 msu) Number of Samples • a

: Result 397ppm i-wuw . .« . _ = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ Play 

All quadrants are as viewedfrom the street, facing property 

- ^ 

y JiiL 2 2 2008 

6^.).2,87 

1^1 62. 

^ • 

^^i'f ? ^ •vu: 

R ^ /O F ^ O D7­

}£>'fpi.l - fp^ 3 

7 « . ^ f j 

9 

m. 

2-70 

F'. 

V-'AT 

r^rf ^-^ Re 044701 01 2.1 v 2008.N Created: 2fi-Feb-0S 
.'Il 36701 

Exterior Paint North Arrow Omaha Lead Site 

Site • Good Sketch i 

0 Poor 

Sampling Address: 2572 FORT ST • Not paint 

Sample Number 

RYASCPXA-36701

RYBSCPXA-36701

RYCSCPXA-36701

RYDSCPXA-36701

RDZSCPXA-36701

nCZSCPXA-36701

RPZsenxA-3c/oi

 F1 

 F2 

 B1 

 B2 

 DZ 

 SZ 

 p*h 

.Lab RYBSCPLA-36701 

.^Result 

Lead Sample Samples Collected 

Concentration Collected LAB Firm: VC t'(3. D-g. 2 7 0 ppm D Date: 7 - M- Q% 

^31 ppm Time: iQ.nr^ kv \ 

ppm i D

Samples Analyzed 2 0 7 ppm a sf 

ppm n XRF Unit: GiSH O Book: 2/ 5 s3 

ppm D Date: 7-2*J-0g ) D 

ppm Time: D a htrz. Staff: fn5U Number of Samples = | 3 | y

s3??^ . _ = 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 

i^ Y --¥• ^ 

I 

i.. . JUL 2 2 2008 

6^.1 Z87 

B 62­

4y 

DT­ 1

lSltft>r\5>ir s 

D% 

270 

F' 

.•431 

V At K 

fo^f s^ Rev 044701 01 :.! 2(K18.N Crc. ltd. 2f)-Fch-08 
ENVIRONMENTAL XRF DATA ENTRY LOG 

RESTORATION 

SAID# rJiiO I 

PROPERTYADDRESS 

2r7:i 3o'Z St 

QUADRENT OR SAMPLE AREA 

Fl 

^-^O^/ ^ P2 

81 

82 

DZ 

PZ 

GZ 

EZ1 

EZ2 

OTHER 

DEPTH 

•r 

lo " 

il " 

3 

DATE 

TIME 

AVERAGE OF RESULTS

(DI t / y 

ly_ij&_ 

31lS.jy] 

I 2^\ c 7\ c y 

/ 5 3 d 

 SHOT #s 

/i>/:i-/^/(^ 

z-Jil-/CSC 

/L>o ?^--/6/3-

SAMPLER NAME Hd^m. hlV' ^ 
Thermo Fisher Scienlific 

900 Middlesex Turnpike rhermo Billerica, MA 01821 

SCIENTIFI C 

Indci. . • Kciidin ^ )No lime SAID ADDItpSS SAMI'I.K AKKA OI'KUAIOU o m II NO 1 i;S A\ I'.RAGK I'h 

1 1609 2009-12-07 13:18 36701 2572 Fort Sl EZ AD.A.M surface final clearance 302.58 =c 26.97 

2 1610 2009-12-07 13:19 36701 2572 Fon St EZ .ADAM surface lina! clearance 299.51 i 26.82 

3 1611 2009-12-07 13:19 36701 2572 Fon SI EZ ADAM surface iinal clearance 296.03 ± 26.65 

•i 1612 2009-12-07 13:19 2572 Fon Si F,Z ADAM surface final clearance A '(:on609-161 •299..''-3 ± 26.81 

5 161.1 2009-12-07 13:23 36701 2572 Fon Si Bl ADAM 11) final clearance 61.3S ... 14.69 

6 1614 2009-12-07 13:24 36701 2572 Fort St Bl ADAM 10 final clearance 58.31 ± 14.43 

7 I6l.'i 2009-12-07 13:25 36701 2572 Fon Sl Bl ADAM 10 final clearance 62.93 ± 14.97 

8 1616 2009-12-07 13:25 2572 Fon St Bl ADAM 10 final clearance A •goflbl3-161 60.87 ± 14.70 

9 1627 2009-12-07 13:.14 36701 2572 Fon St DZ ADAM 13 final cleanmce 96.73 I 16 S9 

10 162S 2009-12-07 13:35 36701 2572 Fort St DZ ADAM 13 final clearance 96.48 ± 16.65 

11 1629 2009-12-07 13:35 36701 2572 Fon St DZ ADAM 13 final clearance 92.43 ± 14.78 

i : 1630 2009-12-07 13:35 2572 Fon St DZ ADAM 13 final clearance A •g of 1627-162 95.21 ± 16.10 

1.1 2053 2010-03-09 17:46 36701 2572 fon st F2 ADAM 3 final clearance 146.95 ± 20 45 

14 2054 2010-03-09 17:47 36701 2572 fonst F2 ADAM 3 final clearance 155.08 ± 20.89 

15 2055 2010-03-09 17:47 36701 2572 fon st F2 ADAM 3 final cieanincc 145 68 ± 20.42 

16 2056 2010-03-09 17:47 2572 fon SI F2 ADAM 3 final clearance A •gof2053-:05 149.24 ± 20.59 

Ptljit I of I 0.3/09/10 17:50:29 
'eadingNo Time SAID ADDRESS SAMPLE AREA OPERATOR DEPTH NOTES AVERAGE. r0i 0 ^Pb Pb Error 

1609 12/7/2009 13:18 36701 2572 Fort St EZ ADAM surface final clearance 302.58 26.97 

1610 12/7/2009 13:19 36701 2572 Fort St EZ ADAM surface final clearance 299.51 26.82 

1611 12/7/2009 13:19 36701 2572 Fort St EZ ADAM surface final clearance 296.03 26.66 

1612 12/7/2009 13:19 2572 Fort St EZ ADAM surface final clearance Avg of 1609-1611 299.38 26.81 

1613 12/7/2009 13:23 36701 2572 Fort St Bl ADAM 10 final clearance 61.38 14.69 

1614 12/7/2009 13:24 36701 2572 Fort St Bl ADAM 10 final clearance 58.31 14.43 

1615 12/7/2009 13:25 36701 2572 Fort St Bl ADAM 10 final clearance 62.93 14.97 

1616 12/7/2009 13:25 2572 Fort St Bl ADAM 10 final clearance Avg of 1613-1615 60.87 14.7 

1627 12/7/2009 13:34 36701 2572 Fort St DZ ADAM 13 final clearance 96.73 16.89 

1628 12/7/2009 13:35 36701 2572 Fort St DZ ADAM 13 final clearance 96.48 16.65 

• 1629 12/7/2009 13:35 36701 2572 Fort St DZ ADAM 13 final clearance 92.43 14.78 

1630 12/7/2009 13:35 2572 Fort St DZ ADAM 13 final clearance Avg of 1627-1629 95.21 16.1 

2053 3/9/2010 17:46 36701 2572 fort st F2 ADAM 3 final clearance 146.95 20.45 

2054 3/9/2010 17:47 36701 2572 fort st F2 ADAM 3 final clearance 155.08 20.89 

2055 3/9/2010 17:47 36701 2572 fort st F2 ADAM 3 final clearance 145.68 20.42 

2056 3/9/2010 17:47 2572 fort st F2 ADAM 3 final clearance Avg of 2053-2055 149.24 20.59 
Reading No rime Duration AVERAGE ADDRESS f f?«r* SAMPLE AREA OPERATOR DEPTH NOTES SAID Pb Pb Error 

1455 12/5/2009 18:08 30.58 2S11 fort st DZ MICHAEL 13 field clearance 

1454 12/5/2009 18:07 30.24 2572 fort st DZ MICHAEL 13 field clearance 

1453 12/5/2009 18:07 30.56 2572 fort st DZ MICHAEL 13 field clearance 

1451 12/5/2009 18:04 30.31 2572 fort st Bl MICHAEL 10 field clearance 

1450 12/5/2009 18:04 30.21 2572 fort st Bl MICHAEL 10 field clearance 

1449 12/5/2009 18:03 30.18 2572 fort st Bl MICHAEL 10 field clearance 

1419 12/5/2009 13:55 2.75 2572 fort st OTHER MICHAEL N/A spot test 

1418 12/5/2009 13:55 2.73 2572 fort st OTHER MICHAEL N/A spot test 

1417 12/5/2009 13:55 5.04 2572 fort st OTHER MICHAEL N/A spot test 

1416 12/5/2009 13:54 3.4 2572 fort st OTHER MICHAEL N/A spot test 

1415 12/5/2009 13:54 4.04 2572 fort st OTHER MICHAEL N/A spot test 

1414 12/5/2009 13:54 6.96 2572 fort st OTHER MICHAEL N/A spot test 

1413 12/5/2009 13:53 24.87 2572 fort st OTHER MICHAEL N/A spot test 

1412 12/5/2009 13:52 20.47 2572 fort st OTHER MICHAEL N/A spot test 

1411 12/5/2009 13:51 7.37 2572 fort st OTHER MICHAEL N/A spot test 

1410 12/5/2009 13:50 8.83 2572 fort st OTHER MICHAEL N/A spot test 

1409 12/5/2009 13:49 16.54 2572 fort st OTHER MICHAEL N/A spot test 

1408 12/5/2009 13:49 7.12 2572 fort st OTHER MICHAEL N/A spot test 

1393 12/5/2009 11:39 3.72 2572 fort st OTHER MICHAEL N/A spot test 

1392 12/5/2009 11:39 6.72 2572 fort st OTHER MICHAEL N/A spot test 

1391 12/5/2009 11:38 11.76 2572 fort st OTHER MICHAEL N/A spot test 

1390 12/5/2009 11:38 7.78 2572 fort st OTHER MICHAEL N/A spot test 

1389 12/5/2009 11:37 4.04 2572 fort st OTHER MICHAEL N/A spot test 

1388 12/5/2009 11:37 4.42 2572 fort st OTHER MICHAEL N/A spot test 

1387 12/5/2009 11:37 3.78 2572 fort st OTHER MICHAEL N/A spot test 

1386 12/5/2009 11:37 6.04 2572 fort st OTHER MICHAEL N/A spot test 

1385 12/5/2009 11:37 7.12 2572 fort st OTHER MICHAEL N/A spot test 

1384 12/5/2009 11:36 5.69 2572 fort st OTHER MICHAEL N/A spot test 

1383 12/5/2009 11:36 3.34 2572 fort st OTHER MICHAEL N/A spot test 

1382 12/5/2009 11:36 4.06 2572 fort st OTHER MICHAEL N/A spot test 

1381 12/5/2009 11:35 3.74 2572 fort st OTHER MICHAEL N/A spot test 

1380 12/5/2009 11:35 4.37 2572 fort st OTHER MICHAEL N/A spot test 

1379 12/5/2009 11:35 4.37 2572 fort st OTHER MICHAEL N/A spot test 

1378 12/5/2009 11:34 3.69 2572 fort st OTHER MICHAEL N/A spot test 

1377 12/5/2009 11:34 3.7 2572 fort st OTHER MICHAEL N/A spot test 

1376 12/5/2009 11:34 5.09 2572 fort st OTHER MICHAEL N/A spot test 

1375 12/5/2009 11:33 5.35 2572 fort st OTHER MICHAEL N/A spot test 

1374 12/5/2009 11:32 13.84 2572 fort st OTHER MICHAEL N/A spot test 

36701 122.03 14.39 

36701 99.7 15.21 

36701 100.82 13.08 

36701 145.57 17.57 

36701 111.99 15.61 

36701 91.67 14.85 

36701 <LOD 16.9 

36701 <LOD 176.99 

36701 <LOD 120.39 

36701 <LOD 152.87 

36701 <LOD 135.55 

36701 198.05 79.12 

36701 336.03 32.48 

36701 371.18 38.91 

36701 131.43 61.62 

36701 1026.68 122.41 

36701 466.86 52.27 

36701 434.41 115.12 

36701 <LOD 161.39 

36701 215.13 83.32 

36701 382.72 56.83 

36701 262.78 74.29 

36701 < LOD 124.74 

36701 431.9 209.29 

36701 934.54 331.16 

36701 238.82 106.82 

36701 909.39 153.25 

36701 224.54 122.63 

36701 <LOD 218.44 

36701 <LOD 271.91 

36701 <LOD 135.12 

36701 <LOD 16.67 

36701 <LOD 302.92 

36701 <LOD 230.3 

36701 < LOD 175.82 

36701 517.37 205.07 

36701 <LOD 204.61 

36701 519.92 59.07 
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• YOUR TICKET NUMBER IS 2412626. 

Original Call Date: 11/24/09

Work to Begin Date: 11/30/09

 Time: 12:53 pm 

 Time: 1:30 pm 

Op: .zi.DAM2 4186 

State: NE 

Address: J72 

County: DOUGLAS 

Street: FORT ST 

Place: OMAHA 

Twp: 15N

Twp: 16N

 Rng: 13E

 Rng: 13E

 Sect-Qtr: 04-NE 

 Sect-Qtr: 33-SE 

Legal Given: C 


Type of Work: Lead excavation 


Location of Work: LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (402)451-0880 


Company : ENVIRONMENTAL RESTORATION 


Contact Name: ADAM Phone: (402)4 51-1314 


Alt. Contact: Phone: (636)288-9616 


Work Being Done For: EPA 


Depth of E.vcavation: 24 Corner Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELL.AN METRO MUDOl OMAHACOF OPPDGPRS QLNNEIC 


Service Area Contact Phone Number 

Utility 

Type 

CXCATV co x COMMUNICATIONS, IMC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

K,*/-c.iAxi MAGELLAN MAGELLAN MIDSTREAM PARTNERS r^cor^oAL, DEBORAH 

Day: 9185747098 

Alt: 

Emerg: 9185747098 

METRO METRO COMM. COLLEGE CHRIS 

Day: 4024572307 

Alt: 4026727033 

Emerg: 4024572313 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

http:/Av'ww.dhon.org/irthinternet/DHON>JoticeCreation/MessageText.asp?ret=<RESULT... 11/24/2009