TRANSMITTAL of OMAH A LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: l^^H ^ Date: l2--5i-n ^ 

Address: ^8b O lA3r\ah^ ' ^ ^ 

Remediation Contractor: Coastal Environmental Group_ Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

H / Executive Summary 

0 EPA-provided property sketch 

V Signed Access Agreement for subject property 

f?||T Signed Access Agreement(s) for adjacent property 

^ Restoration Agreement 

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

^ Confirmation data . 

1/ Photographs T^fe^'t)C(iaA)(m (>n Gjc/yiJa:^L>/l soA ^ r\t ^ 'Sod 

y As-built sketch 

S Satisfactory restoration signed by Property Owner 

M Property close-out check list signed by EPA 

|¥|n Description of areas not meeting ROD cleanup criteria 

H Utility clearances 

^ Property information from Douglas County Assessor's Office 

D 

>eO(lft( OJ^ £)/R<;;/^O(0i 

Signature 0ate 
Property Access Checklist 

ProportylD:]^^ ^ 

Property Address: J^^ ^ UlnVl^l ^ S-J 

n

D

 WORK STARTED

 WORK COIVIPELTED

 ON:

 ON:

 /

 /

 /_ 

/_ 

^"•"^^'WohA T

Address: ^^^ ^ 

 ^(^hnfiu\< ^ Renter:

Phone: 

j 

Fax: 

Ph«"^"^55C.-13c ^ 

Fax: 

Cell/Pager: 

Additional lut'ormation: 

Cell/Pager: 

O

y

1—. 

I/]

nil

 Notitlcation Letter 

 Access Agreement 

 Restoration Agreement 

 Tojisoil Sam|)ling (if applicable) 

Sent: / / 

Signed: _^/J5_/£2g: 

Signed: _£_/j5./_ ^ 

/ / 

1 '^ 

B.v: M M 

By: MM 

By: 1 

O

O

0 *

n

n

D

n

O

 Dispo.sal Sampling (if applicable) 

 Garden Sampling (if applicable) 

 Utility Clearance 

 Video/Photos (Before) 

 Video/Photos (During) 

 Video/Photos (After) 

 Video/Photos (3()-Day) 

 Property Completion Agreement 

/ / 

/ / 

Called: A/ik/n S 

On: / / 

On: / / 

On: / / 

On: / / 

Signed: / / 

By: 

By: 

^y-^io-oT. By:

By:

B y :

By:

By: 

1 

j 

1 

 II 

1 

n Final Repoit Issued: / / By: 

Air IVIonitoring (as ap[)lical)le) 

1 1 Community CD Crew 

Results: 

On: / / By: j 

1 1 Community

Results:

 LJ Crov On:_ / / Bv: 

1 

1 1 Community

Re.sults:

 CH Crew On: / / B.v: 

I 

Omaha Lead Site 
CONTACT FORM 

Property ID # IS^^^S 

Property 

Address: S^loOy^cia^Wi Sf 

Initial Contact:

Second Contact:

Final Contact:

Final Action:

 Date; 

Date: 

Date: 

Transmit to EP 

Time: 

Time: 

Time: 

>AA •• 

Aclion: 

Action: 

Action: 

Other Action: Q 

, JcMn„6 ^ 

Comment U " : 

Owner 

Comment (s): 

Site i 

Coordinator 

Comment (s): 
Douglas County Account InfoMaation Page 1 of2 

Douglas County, Nebraska Property Record - R1215750000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 90tti St - Vle W O n Ma p Information is valid as of 2008-7-14 Treasurer's Tax Report 

New Feature -•-•- • Auto Sales Search 

Owner 

YESHNOWSKI JOHN 

ETAL 

3860 WRIGHT ST 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number: 1575 0000 12 

Account Type: Residential 

Parcel Number: 1215750000 

Parcel Address: 3860 WRIGHT ST 

OMAHA NE 68105-0000 

Legal Description: GRANT PLACE LOT 36 BLOCK 4 50 X 124 

Value Informatio n 

Land Improvement Total 

2008 $14,000.00 $80,600.00 $94,600.00 

2007 $14,000.00 $80,600.00 $94,600.00 

2006 $14,000.00 $76,000.00 $90,000.00 

2005 $14,000.00 $76,000.00 $90,000.00 

2004 $6,400.00 $84,800.00 $91,200.00 

2003 $6,400.00 $84,800.00 $91,200.00 

Sales Informatio n 

Sales Date: 2005-05-31 

Deed Type: WD Book: 2005 Page: 065688 

Price: $90,000.00 

Grantor: Milo A Karnik etal 

Grantee: John T Yeshnowsl<i etal 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

 7/3 A/. 

Acres SF Units Depth Width Vacant 

0.14 6200.0 1.0 124.0 50.0 No 

Improvemen t Information 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12...
Pouglas County Account Infc^^tio w n Page 2 of2 

Building 1 

Verified to IT 7^T 

OMt.OatiCm'n^^ntttt 

.atud rwu 

W)r?F 

»D 

»4fi koiir :4an> loovr 

1 1/2 STORY FINISHED 

CLICK TO ENLARGE IMAGE 

Square Footage: 1292.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: 1 1/2 Story Fin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1924 0% 1924 83 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 912.0 

Basement Outside Entrance 1.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

308.0 

Porch Slab Roof Ceil 

Garage Detached 

160.0 

20.0 

User Attic Full Finish 

Porch Slab Roof Ceil 

380.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12... 7/31/2008 
Page 1 of 1 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2108732. 

Original Call Date: 8/16/08 Time: 1:06 pm Op: ELIZABETH18790 


Work to Begin Date: 8/20/08 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3860 Street: WRIGHT ST 


Twp: 15N Rng: 13E Sect-Qtr: 29-SE,32-NE 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remidiation 


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


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


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 MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 


CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 


Emerg: 4029329757 


Day: 4025047823 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047946 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

0PPDGPR6 OMAHA PUBLIC POWER DISTRICT NA Alt: 8887289343 

Emerg: 4067289343 

Day: 4067289343 

QLNNEIF QWEST LOCAL NETWORK NA Alt: 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/16/2008 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

Name: .'^'li I t }u,t.ii k 

Address: '^i(,tD LU'ff^jf- S-f 

Phone HcZ - ^•^o'-(jri9 ^ 

Omaha Lead Site 

Site Sketch 

Date: f^-/<'^o'? 

Time: /2 2.9 t 

Team Vxilf,- jWiti.'V^^

Sample Number 

 /Ml>4)Qy\D # A'CVV^ 

Lead Concentration 

XRF Code y^^c ^ 

Confimiation SampI' 

Lab RD2SCPLA-15548" 

rZ-G:> -tiy z 

fyy6±^^ 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

P! Yes CD 

r^Yes d 

g ' Yes • 

^^Yes 5 ^ 

rzYes Ca^ 

Yes Q 

Yes • 

No ^ 

No 5 ^ 

No g ^ 

No ^ 

No ^ 

No • 

No • 

Result 2400 ppm m 

] OLS#:15§4S 

i DateiExo£rviated:8ii26/20q8 

Dpfe USpXstghed (pff:9/g/200H 

-Z^^^^^StidcJed 1224 sq flj ^ 1- '.—.\ \ _.4.. 

Legen d 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with

Sod ' '

 Area replaced with 

 Rock/Mulch ' ' Area lef t bare 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group In c 
aha Lead Site Date; ^-/.^-o" ? North Arrow —i 

Address- 3iS-ry UJ^j^i/' ^ t Site Slietch Time: rZ'Z.9 

Phone: ^CZ ^ Sr^^d ^^^9 ^ 

\ 

Team Iftg/ k jl^fCir^w^ fM(^^M\ Q # K<r^g ' XRF Code ^^gg ^ 

Sample Numt>er Lead Concentration Confirmation Sample 

gyAgggm-ZS'^ nves n No 2 ^ 

rZYes n No f ^ 

^S,i Ye.^s. O— No cC >—' NO ^- V 

^Ye s ° • . No " ^ 

ppm rJZYes S ^ No O 

ppm Yes O No Q 

ppm Yes • No • Lab RDZSCPLA-15548 

Result 2400 ppm 

H -r V i^^^t 
Name: .-^7/ /<i • kat^uk. ' ^ 0(n aha Lead Site Date: f^-/^-^" ? North Arrow —i 

Address: '^^(stD LLU M^|'S f Site SIcetch Time: iZ''Z 9 

Phone: V^^rZ-- S'^G'-^JJ^'J ^ t 

Team Pytilrf ///?r<n^w^ /M(^^y\ D # l^<^ ^ XRF Code .^^^ ^ 

Sample Numljer Lead Concentration Confirmation Sample 

ppm p»Yes ^ No 2 ^ 

ppm fZYes n No 5 ^ 

ppm g/Yes CD No 2 ^ 

ppm !52Yes 5 ^ No 13 

ppm No ^ 

ppm Yes n No a 

ppm Yes • No • 

Lab RDZSCPLA-15548 

Result 2400 ppm 

^^(A^l \ iofMi^, 
Name: .^^i U IUyn->ik Omaha Lead Site Date: fr-/^-^^"? North NrxQM 

Address: '^d O Lu<.f9^l- Sf Site Sketch Time: gZ-' ^ 

Phone: HcZ-^ 5^5-6//yOW T 

Team B^//rr /WsitnTtu^-^ /M{yf)BM\D # /TTV ^ 

XRF Code ^^g ^ 

Sample Number 

Lead Concentration Confirmation Sample 

f\ Yes I^ No 2 ^ ZSf ^"t^g ^ 

m fZYes n No 5 ^ A-i^g i 

g/Yes n No 2 ^ 

^Ye s ° / No CS 

raYes Q ^ No 1^ 

Yes n No n 

Yes • No • 

Lab RDZSCPLA-15548' 

Result 2400 ppm m 3 t 

^ ^ T T 

i_ 

Ii. 

irZiZ : L/?i \ 73'e^^'t ^< 

c 

t>­

'p^ 2i^sS\4z "rj^ r 

^ „ 

? 

0 

l-AM 

r 

>^ 

t 

I 11 

2^^ ^ i/^7i;?j^;r 

|i2_;p/i 

^/4) v 
,eo sr.,. 

mi COASTA L ^"'*X ^c^'*' ENVIRONMENTAL • ' i PPOl * C H O U ^ , IN 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: 

Owner's Name: Daytime Phone: 

Address of Property 

covered by this 

Agreement: 

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 
mi 

COASTA L EHVIROMMENTA l 

CROUP . 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 

I grant access to my properties 

D I do not grant access to my properties 

5 0^ 

ignature \ 1 Date Signature 

Date 

O I would like to be present during any sampling that is required. 
COASTA L 

Restoration Agreement 

Tiie purpose ofthis agreement is lo provide a mutual agreement as to conditions of tiie 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 propertv' owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: 

"W 

Property Address: %% C ' } '6^ V \hlhCA\k f ^ 

Owner: -J^y^ ?^^NloV»t^ | 

Plione: L/oL ^W'^jnc? 

On the attached diagrain(s) indicate area(s) to excavated and depth of excavation, location of all known 

utilities, subsurface featines, sgrface 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 Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

The removal, storage, disposal, and/or return of these items is the Owner's responsibility. 

Item: 

f\m y<^rmjl f)/rjnh ?n iii inty l \;k^ \b \:£t ^ 

Item: \ — 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 1 of. -A 
COASTA L FKivlNONriCMTA L c n O U P . ) M C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

Item: J • 

Item: 

Kem: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 2 .Sf 
• ^ 

COASTA L 

• ••VlROMMCWTA L C. H O U r IN C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

.^Ol h v H 

Item: 

f\ \' i>iy V f-h 

Item: 

iihr hkf- 1(^ ' Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

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, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Quantity 

h 

9 

ff 

y 

/y 

Unit 

Square feet 

Each 

Each 

Each 

Each 

Square Feet 

Condition/Type/Species 

\U { (AP^^? 

Page 4 of b 

i 
Item 

Agreed upon value of 

plant materials not to be 

replaced bv contractor. 

Note this \alue will be 

used to issue a plant 

voucher to the property 

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 will be placed 

by the contractor. 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. 

Area of City or County 

property to be landscaped 

per their requirements. 

Include a sketch of the 

aiea (s) 

Easement Area, to be 

excavated 

Quantity 

Jf 

^ 

H 

H^r4^ 

^jy 

Uriit 

$ 

Each 

SF 

SF 

SF 

Condition/Type/Species 

^ Page 5 of. 

i 
C O A S T A 1. • MVUKOCMCMTAL 

Additional Comments / Instructions: 

" % f \Mh> ^(Vfv? <*n G>c.-jt^,-f 

t^ \M 

^CMf^ f^ ^ 4(7v^ 

i^c^^imh^ 

n Check the box if Owner does not want CEG to document interiorfoundation 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. 

• I do not agree :agree 

\iriyfjdeA....A- fy t 

Owner's Signature Datr 7 •t^ODtractor's Signature 

Page 6 of. 
Date 

Project 

XRF ID# 

Shot# 

W^ 

vW\ 

Average

Shot# 

Average 

Shot# 

Average 

Shot# 

Average 

lab sample # 

BVID. '^y i 

XRF PROPERTY SAMPLE SHEET 

fkk Address Mo vjH^'y y 

Omaha lead FP 2nc) year option 

y ^ ^m. Sample time 

sample length 

lo?T 

30 sec 

(gny/pm 

Reading Sample area 

p« 

Depth "iflft q.n ^ ^ • ^ ^ ^ - ^ ^ I 4 ^ 

 ^ ^ > 1 t 1- ^ 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

RETEST AREAS 

Reading Sample area 

Depth 

Shot # Reading 

Kill 1-1^ 

J^ooJL. i ^<rt -].ti 

Sl2£lL - II t -/.^-^ 

%M ^o-iy i 1-^1 

Average |^1 ^ t

Shot# Reading 

Average 

Shot# Reading 

Average 

Shot# Reading 

Sample area 

f-z 

Depth 

.k: 

1-^ ^ 

Sample area 

Depth 

Sample area 

Depth 

Sample area 

_^ , Depth 

y-^y 

Average 

Lab result Sample area XRF Avg. 

Signature_ 

Print \-\k-i ^ M<VTtl/> 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3000 

Mode SOIL 

Time 2008-08-26 11:01 

Duration 121.80 

Sequence Final 

Flags 

AVERAGE *^Avg of 2996-2999 

ADDRESS 3860 Wright st 

QUAD/ZONE fD Z 

INSPECTOR ^PE Z 

DEPTH 

SAMPLE TYPE (CLEARANCE 

NOTE 

ppm Error 

Pb 39.376, 9.133 

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 Pr'PE 

NOTE 

ppm 

Pb 36.783 

Supervised By: 

Certificate of Verification 

2996 

SOIL 

2008-08-26 10:59 

30.59 

Final 

15548 

3860 Wright st 

DZ 

LOPEZ 

12 

CLEARANCE 

± Error 

± 8.887 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2997 

Mode SOIL 

Time 2008-08-26 11:00 

Duration 30.56 

Sequence Final 

Flags 

BVID # 15548 

ADDRESS 3860 Wright st 

QUAD/ZONE DZ 

INSPECTOR LOPEZ 

DEPTH 12 

SAMPLE PI'PE CLEARANCE 

NOTE 

ppm ± Error 

Pb 28.230 ± 8.269 

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 PCPE 

NOTE 

ppm 

Pb 49.201 

Supervised By: 

Certificate of Verification 

2998 

SOIL 

2008-08-26 11:01 

30.33 

Final 

15548 

3860 Wright st 

DZ 

LOPEZ 

12 

CLEARANCE 

± Error 

± 9.875 
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 Pr'PE 

NOTE 

ppm 

Pb 43.292 

Supervised By: 

Certificate of Verification 

2999 

SOIL 

2008-08-26 11:01 

30.32 

Final 

15548 

3860 Wright st 

DZ 

LOPEZ 

12 

CLEARANCE 

± Error 

± 9.502 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3005 

Mode SOIL 

Time 2008-08-26 11:05 

Duration 121.65 

Sequence Final 

Flags 

AVERAGE I Avg of 3001-3004 

ADDRESS 3860 Wright st 

QUAD/ZONE 

INSPECTOR LOPEZ 

DEPTH P|6 

SAMPLE TYPE CLEARANCE 

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 15.816 

Supervised By: 

Certificate of Verification 

3001 

SOIL 

2008-08-26 11:03 

30.10 

Final 

15548 

3860 Wright st 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 7.123 
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 PI'PE 

NOTE 

ppm 

Pb 16.355 

Supervised By: 

Certificate of Verification 

3002 

SOIL 

2008-08-26 11:04 

30.34 

Final 

15548 

3860 Wright st 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 7.094 
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 PI'PE 

NOTE 

ppm 

Pb 24.183 

Supervised By: 

Certificate of Verification 

3003 

SOIL 

2008-08-26 11:04 

30.60 

Final 

15548 

3860 Wright st 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 7.935 
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 20.235 

Supervised By: 

Certificate of Verification 

3004 

SOIL 

2008-08-26 11:05 

30.61 

Final 

15548 

3860 Wright st 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 7.452 
y^^l'"-^^ 

f^l^' o Omaha Lead Site—Fixed Price EP-R7-07-05 (fiS ^ 

l^^^v^ f Coastal Environmental Group Inc. \^^ ^ 

\^^^p * www.coastalhazmat.com 

"iPBo^*^ COASTA L ENVIItONHENTAL 

C R 0 U F , INCEXECUTIVE SUMMARY: 

BVID # 15548 - (3860 WRIGHT ST) 

I I No Issues or Concerns ^ Issues/Concerns 

Detail Explanation: 

IT APPEARS THAT PO HAS MOVED SOD FROM DZ AREAS TO WEST OF 

DRIVEWAY. 
^>t EPA 

EPA Property Close Out Form 

Property #: IS'5'M ^ Property Address: Sf/^c ) S/d^ClYj^ S 4 

Date/Time: Owner's Name: .V^hr-) N f.SU^fjoo.<^lr^" 

Quads Excavated: Ft F a S^j Contractor Group CrO/jf, ^ g,^l/'0n(0T<»n.4<M 

Excavation General 

Yes No 

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

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

Grading Sod and Vegetation 

Yes No 

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

from the house? L ^ 

2. Has sod been laid in all areas that were excavated? u ^ 

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

day time period) 

4. Are sodded areas generally fuin and evenly graded? t - ^ 

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 propertv? y 

7. Was damage to landscaping or plant materials avoided? 

1 ^ 

Gates, Fences and Retaining Walls 

Yes No 

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

ly ^ 

2. Were all gates or fences taken down during restoration activiiies reinstalled? (Ifapplicable) ty ^ 

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

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

Foundation, Siding and Gutters 

Yes No 

1. Was damage to the siding or trim avoided? 

Ly ^ 

2. Was damage to the foundation avoided? * ^ 

3. Was damage to windows avoided? i ^ 

4. Was damage to windows or door screens avoided? ^ 

5. Was damage to downspouts or downspout extensions avoided? l ^ 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? U 

^ 2.

 Was damage to walkway surfaces avoided? 
. O.Kners comments: 

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

EPA RepresentaW^;^^.^^;^,^ ^ Date: 9/9/yy 
Property Completion Agreement 

Ihis agreemenl documenis the completion of remedial activities peri'ormed on my property. My signature 

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

now, or at any time m the fuiure, except those items listed below, ifany. 

Property ID: i C~^ ^ ^ 

7.^erty~Address:" y^^ ^ \ ^ ^ j Cf/f T ^7 ^ 

Owner: \^\^ ^ J yg^^ ^ , ^ JK I 

Phone • rf 6 -y} M~ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

>f\J I agree restoration is completed, except as noled 

L I I do nol ayiec restoration is completed 

vwiit'r's SignaHir* Date C'tmtiaclor's Signature Dafe /