## CONTRACT 

## #**W912DQ~04~D·0017,** 

## T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE US Army Corps of Engineers


## ECC Certification for Property Closeout

OLSID 29245 

## Property Address 2519 Corby St 

## Field Work Started 9/24/2007 

## Field Work Completed 9/26/2007 

## Summary: 

# • The excavation was perfonned in compliance with the work plans and specifications. 

# • F1 excavation depth was 13 inches below ground surfaces. 

# • F2 excavation depth was 13 inches below ground surfaces. 

# • B1 excavation depth was 13 inches below ground surfaces. 

# • B2 excavation depth was 13 inches below ground surfaces. 

# • Verification samples confirmed that cleanup standards were met. 

# • The site was backfilled with material which meets the contract specifications. 

# • The backfill was compacted to acceptable standards. 

# • Sod placement and site restoration were conducted in compliance with the specifications and work plans.



## Comments: None

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## cdtbvrJ~ ECCOCM 

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# , Name Title , 

### Date Jeff Hubbard USACE Con Rep 

# JD-lS-cl Name Title Date

# 29245 exterior Paillt North**A~row** 

### Owner Name: MARLA MWYNN 

## Omaha lead SUe Site Sketch Addftlss:2519 CORBY ST



### Phone:_H_= 

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# 1.3" F2 

# 13"7:",,--­ 

# ttl**~~:** Bl 

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# if1iIA .ECC:. 

## CONTRACT 

## # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE 

# m

us Army Corps

of Engineers 

# ..,.

Analytical Results Summary OLS#29245 2519 Corby

XRF Results Date Collected (ppm) (avg.) 

# I DE 

# II F1 

# II 13 

### 11'=9===/2==2/==20==07===11======:"3=9 

### ==11 

# I DE 

# I 81 

# II F2 

# II 13 

# I 9/22/2007 761 

# I DE 13 

### 9/22/2007 719 DE 13 

### 9/22/2007 756 DE

### =O~=ll==9=/2=2=/2= 216

SAMPLEIDSAMPLE ID is a particular residential property ID from which the sample is collected. The sample type identifier (with sequential sample number for that location) as follows; PX 

### = Pre-Excavation XR.F sample DE = During and Post Excavation Quadrant describes the sampling location (with sequentIal sample number for that location) as follows; FI or F2 

### = Front Yard One or Front Yard Two Bl or B2

- Back Yard One or Back Yard Two DZ = Drip Zone OA-Oarden PA Play Area EA
.. Easement Depth describes the depth from which the sample was collected ppm" parts per millionOmaha Lead Site Omaha, NE Residential Yard Soils Environmental Restoration Services 

### U.S. Environmental Protection Agency Region VII 

# • PROPERTY ACCESS (to be completed by property owner)**::-:l'(~ '·:,:.~'r** **E~:u** '':;'l'::**~n ..::s;(~·~:.**  :;0' 'i:vc' '...: r**~.;:. ~·c::**  :.:....:**:.~:.** . U.S. Environmental Protection Agency (EPA) has contraded the U.S. Army Corps of Engineers (USACE), Omaha

. District to conduct environmental restoration services for 

### the Omaha Lead Site. USACE Omaha is wof1cing with

Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation is requested in giving EPAlUSACElECC permission to access your property during the

, removal/restoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913)**551~**

. 7003 or the Office of External Programs, at 1-800-223-0425. 

### Property Access Granted 

### By 

# :JJ)o7 (Date) NOTE 

### G f 

# . 

# . DOES NOT 

### ./ 

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# . ,. rt 'f! b 

### d' t 

### d tlh' f PROPERTY INFORMATION (to be completed by reSIdent and or property owner· Please PrInt) Resident Name: 

# LoT (]...".;yner 

# o renter Residence Address: 

# :;s/f COR&Y 

# St: (}/VtILLMt 

## IlJI£ (CITY) (STATE) (ZIP) Property Owned By: 

# rnAPLn W'IAJAJ Owners mailing address: 

# W Ifl{ 

# REf}/) Sf 

# O/)t,!HM 

# Ali: I 

# kflSJ. Owner's telephone number - Home: 

# IP:51- 'f(;,S? Work: !Age of Home?

______ years How long have you lived here?

_____ years Has the exteior been painted or**cove~ed** with siding since 1978? DYes 

# o No Has the interior been painted or covered since 1978? DYes 

# o No iTotal number of occupants:.
_ list Ages: 

## ---------------------11 Ust ages of occupants under 6 years old who play in the yard for 5 or more hours per week:

_ Comments: AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS The activities to be implemented by EPA under this agreement are pursuant to Section 104 of CERCLA, 42 U.S.C. 9604. EPA's right of access to he property for in section 104(e) of CERCLA, 42 U.S.C. 9604 (e). which provides entry for. "determining the need for response, or choosing or aking any response action under this tille. or otherwise enforcing the provisions of this title." Access Attempts: First: Second: : Third: : _

### pg._of_ 

# List of Existing Conditions Property Address: 

# d519 OJ)(b'l 

# st DVD ID 

# # 

# dC1 g 4 S- Owner: Date: 

# 9 JLP I 

# D'1 BVID#.Q9 

# d 

# '-I-s

Ref: Photo # 

## Description

Owner Signature ECC Print 

# & Sign Print & 

## Sign

## Contract No. W912DQ-04-D-0017, Task Order DKOI Omaha Lead Site, Omaha, NE Pronerlv Closeout Agreement BVID 

# r!). 

# 9 J- If 

# S Property Address 

# 1**~/CJ** 

## C-ORJ? If Sf 

## Property Owner 

# rn Yi 

# R Lr:+ it) 

# '1 AJ 

## A.J Is the Owner the Resident? DYes**.~(J** 

## Compliance Statement: U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is, working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EP A/USACEIECe 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 contract specifications and EPA requirements. If you have questions or need additional information please contact Don Bahnke, EPA Project Manager, at (913) 551-7003 or the Office of External Programs at 1-800-223-0425. Additional Comments by 

## USACE and/or ECC:

CONTRACTOR CERTIFICATION Eee Project Manager Name Title Date Signature 

# PROPERTY OWNER SECTION This agreement docu ments the completion of remedial/restoration efforts at the property to my satisfaction
. 

# .W Tagree that restoration is completed at my property, except as noted Comments (if applicable):

---J



## . 

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## Pro;I'" OJ 

## 'Uwner's Signature 

# (/ Date 

# /d-OS-- tJ ')

# Property Owner Satisfaction Sunrey Form Omaha Lead Superfund Site Perfonnance-Based Contracting (PBC) Pilot Project
Remediation Contractor: 

## _--&.oEo:-:::L=:- 

## '""C

_ Property Identifier Number:
_ Property BVID Number:**_......:l;=...l~~..:...-** _ 

## Property Address: 

# >:j&l CafR 

# r ,a r Property Owner's Name: 

# meeL4 wrAL.1? (above infonnation to be filled out by remediation contractor prior to delivery of fonn to Property Owner) 

## ***** ••••••• * ••••••• ** ••••••••••••••••••••• * ••• ** •••••••••••••••••••••• *.**.** Instnlctions to Property Owner: 

## This fonn is provided to you as a means of trying to capture your level of satisfaction with the work of the above-identified Remediation Contractor, as applicable to the soil cleanup action at your property. The U.S. Environmental Protection Agency (EPA) and the U.S. Army 

## Corps of Engineers (USACE) are very interested in your opinion regarding the work performed by our contractors. This form is intended to provide an easy means for you to express your opinion about the work performed on your property. Please indicate your level of satisfaction with the Contractor's work by selecting a numerical rating (ranging from 1 to 10) using the following rating scale, then please sign & 

## date the form and return it to USACE in the attached self-addressed & 

## stamped envelope. (Additional comments may also be 

## provided in the space provided, at the option of the property owner.) 9-10 "excellent" 7 -8 "very good" 5-6 "acceptable" 3-4 "poor" 1-2 "very poor" Property Owner's Satisfaction Rating regarding Contractor's Work 10 

### 5 9 

### 4 8 

### 3 7 2 6 1 

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

Date:

_ Property Owner's Signature: