CONTRACT n EP-R7-06-04 

ASW Associates Inc. 

Omaha Lead Site Remediation, Omaha, NE 

EPA 

ASW Associates Inc Certification for Property Closeout 

BVID 20727 Property Address 1213 South 27th

 Street 

Field Work Started 22-May-06 Field Work Completed 8-Jun-06 

Summary: 

The excavation was performed in compliance with the work plans and specifications. 

The F2 quadrant was excavated to a depth of 12 inch. 

The drip zone was excavated to a depth of 6 inch. 

Verification samples confirmed that the cleanup standards were met.

 

The site was backfilled with materials which meets contract specifications. 

The backfill was compacted to acceptable standards. 

Sod placements and site restorations were conducted in compliance with work plans and 

specifications. Analytical data provided is post excavation at the bottom of the excavation for confirmation

 

purposes 

Comments: 

The play zone was excavated to a depth of 12 inch. 

Punch List Fence was put back in place as per the requirement of property owner 

jan Prawdzik ASW Project Manager 

Name Title 

40260712 

SUPERFUND RECORDS 
CONTRACT # EP-R7-06-04 

ASW Associates Inc. 

Omaha Lead Site Remediation, Omaha, NE 

EPA 

Analytical Result Summary 

OLS ID: 20727 

Property Address: 1213 South 27th

 Street 

XRF Results Lab Results Sample ID Avg. (ppm) (ppm) 

20727-DE-F2-12 124 ±86 NA 

20727-DE-DZ-06 474 ± 84 NA 

20727-DE-DZ-06 443 ±97 NA 

20727-DE-F2-12 255 ±40 NA 

20727-DE-PZ-12 298 ± 36 NA 

Jan Prawdzik ASW Project Manager

 

Name Title

 

Sample Deaifiiatkra 

OLSm-DE-Locatton-dd 

OLSID is a particular residential property ID from which the sample is collected. 

DE - During and Post Excavation 

Location of the sample as follows;

 

Fl - Front Yard (I* Quadrant) 

Bl - Back Yard (1* Quadrant) 

F2 - Front Yard (2- Quadrant) 

B2 - Front Yard (2" Quadrant) 

DZ- Drip Zone 

PZ "PlayZone

QA«Oarden 

EA - Easement 

dd describes the depth from which the sample was collected. 

- NA-Not Applicable 
&ER& 

Remediation/Excavation Contract (ASW) 

EPA Property Close Out Form 

Property #: Property Address: 

Date/Time: Owner's Name: 

Quads Excavated:' 'f-J\ J>Z -f Contractor Group 

Excavation Genera! 

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

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

Grading Sod and Vegetation 

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? 

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

day tune 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 damage to landscaping or plant materials avoided? 

Gates, Fences and Retaining Walls 

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? (If applicable) 

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

Foundation, Siding and Gutters 

1. Was damage to die 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) 

1 . Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

Yes No 

If 

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Yes No 

>/ 

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Yes No 

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Yes No 

/ 

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Owners comments: 

Inspection notes: 

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

EPA Representative &* j&, Date: 
s Contract No: EP - R7 - 06 - 04 

Property Closeout Agreement W|) Omaha Lead Superfund Site 

OLsra Property Address 

I2\ 3 S.lTfSl 

Property Owner 

^t<2A&V-'

^Tski Is the Resident the Owner .49­ Yes D No 

Compliance Statement: 

U.S. Environmental Protection Agency (EPA) or its authorized representatives, (or its contractors), to enter 

and conduct environmental restoration services for the Omaha Lead Site. 

Your cooperation in giving EPA/ASW permission to access your property during the removal/restoration 

phase is sincerely appreciated. This document certifies that all work performed at this property was 

completed in accordance with the contact specifications and EPA requirements. 

If you have questions or need additional information please contact the EPA Public Information Centers at 

(402) 731-3045 or(402) 991-9583 or the EPA Office of External Programs at 1-800-223-0425. 

Additional Comments by EPA and/or ASW: 

CONTRACTOR CERTIFICATION 

Jan Prawdzik ASW Project Manager 

Name Title Date Signature 

Property Owner Section 

This agreement documents the completion of remedial/restoration efforts at the property to my satisfaction 

x I agree that restoration is completed at my property 

D I Do Not Agree: Comments: 

Property Owner's Signature Date 

Representative Signatur ign e Date 
Page 1 of_ 

Omaha Lead Site 

Omaha, NE 

U.S. Environmental Protection Agency Region Vll 

Residential Yard Soils 

Environmental Restoration 

Services 

Grantor (the property owner), consents to and authorizes the United Sates Environmental Protection Agency (USEPA) 

or its authorized representatives (or its contractors), the Grantee, to enter and perform certain environmental response 

activities upon the following described premises. For further information please contact EPA at I -800-223-0425. 

Property Access Granted By 

(PropertyVwner Signature) 

NOTE: Granting permission DOES NOT necessarily imply your property will be remediated at this time. 

Resident Name: 

Residence Address: 12* J3 £. (CITY) (STATE) (ZIP) 

Property owned by: /" 

Owners mailing address: 

Owner's telephone number— Home: ) V^ 742.Q Work: 

Age of Home? / Q LJ_ years How long have you lived here? .years 

Has the exterior been painted or covered with siding since 1978 OKyES D NO 

Has the interior been painted or covered since 1 978? D^YES D NO 

Total number of occupants: _ ±_ List Ages: ? / / , f , ° j i f •-/ ^ 

List ages of occupants under 6 years old who play in the yard for 5 or more hours per week: /C, / 

Comments: 

AUTHORITY FOR ENV1ORNMENTAL RESPONSE ACTIONS 

Theactivitia to be implemented by EPA under this agreement are pursuant to Section 104 of CERCLA. 42 U S.C. %04 EPA's right of access to the property for in Section |04(e) of CERCLA, 42 U.S.C. 9604 (e), which provides entry for, "determining the need for response, or choosing or taking any response action under this title, or otherwise enforcing the provisions of this title " 

Access Attempts: 

First: Second: Third:

 
List of existing Conditions pg. of 

Property Address: /£/; 5, 2 7 ** 

Owner: f^vr-ei //&^ Date: <y~2/-o6 OLS ft:I £>7 

Description: 

C 

Owner Signature: ASW Associates Inc. 

Print & Sign Print & Sign 
Omaha Lead Stte 

Site Sketch 

Omaha Lead Site 46130