TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

^wr SAID #: ^ ^ '^'^ 0

 Date: 

Address: Kp h LfW ^ ^ < 

Remediation Contractor: Coastal Environmental Group_ Year: _2010ARRA_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ Video of property (DVD) 

^ Executive Summary 

^ 

EPA-provided property sketch 

Signed Access Agreement for subject property 

cH- Signed Access Agreement(s) for adjacent property 

0 Restoration Agreement 

0 Settlement doctmients (i.e., for damage or to replace plants, etc.) 

-&y Confirmation data 

0 Photographs Wc tpCpo/A'^AK\ -V b^^An< ^ X ^v^ 

s j As-built sketch 

£/ Satisfactory restoration signed by Property Owner 

0 Property close-out check list signed by EPA 

-fi— Description of areas not meeting ROD cleanup criteria 

U Utility clearances 

« / Property infi5Hnation from Douglas County Assessor's Office 

30218451 

HMii 

Superfund 
Property Access Checklist 

Property m: ^^^Q ^ D WORK STARTED ON: 

Property Address: D WORK COMPELTED ON: ;fiSF 

Owner; ;g=')|^=i;;:jr':5g:rn^M>»'^ '^*'°^^'' 

Address: 

Phone: 

Fax: 

Cell/Pager: 

Phone: ia<i Additional Information: 

Fax: 

CeU/Pager:3(^j^^^CS,g,^^^^^ 

n Notification Letter Sent: / / By: 

/ ^ Access Agreement Signed: l_/J3/l O By: 

J 7\ Restoration Agreement Signed: 0 \ / <5/\0 By: 

• Topsoil Sampling (if applicable) 1 1 By: 

Q Disposal Sampling (if applicable) 1 1 By: 

G Garden Sampling (if applicable) 1 1 By: 

S Utility Clearance Called: OS/63> /VO ^y=0"5A«;/io U3a.^dv^ 

[Q^-Video/Photos (Before) On: 41/22/-ID By: 0(^^<^'-'^ 

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

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

• Video/Photos (30-Day) On: / / By: 

Q Property Completion Agreement Siened:

 / / By: 

n Final Report Issued:

 / / By: 

• Community • Crew On: / / By: 

On: ./ / By: 

Results: 

• Community [Zl Crew 

Omaha Lead Site 
Douglas County Accotmt In tendon Page 1 of2 

Douglas County, Nebraska Property Record - R0917210000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - Vie w OH Ma p Information is valid as of 2009-10-15 Treasurer's Tax Report 

New Feature -•••- • Auto Sales Search 

Owner 

SCOTT ROBERT L 

ETAL 

4214 CLIFTON DR 

OMAHA NE 68134-0000 

Property Informatio n 

Key Number: 1721 0000 09 

Account Type: Residential 

Parcel Number: 0917210000 

Parcel Address: 

Legal Description: 

1504 GRANT ST 

OMAHA NE 68110-0000 

DARR PLACE LOT 28 BLOCK 0 40 X 96.2 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$2,100.00 

$2,100.00 

$2,100.00 

$2,100.00 

$2,100.00 

$2,100.00 

Improvement 

$6,600.00 

$6,600.00 

$6,300.00 

$6,300.00 

$6,300.00 

$11,400.00 

Total 

$8,700.00 

$8,700.00 

$8,400.00 

$8,400.00 

$8,400.00 

$13,500.00 

Sales Informatio n 

Sales Date: 2000-08-01 

Deed Type: 

Price: 

Grantor: 

$3,000.00 

Book: 2162 Page: 424 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres 

0.08 

SF 

3840.0 

Units 

1.0 

Depth 

96.0 

Width 

40.0 

Vacant 

No 

Improvemen t Informatio n 

http://douglasne.mapping-onHne.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 10/21/2009 
Douglas County Account Tnfifc|wtion Page 2 of2 

% 

Building 1 

JH 1504 Grant S« ^ ^ 

.^^fe^^Bi^^^a^b . -^W^^^ ^ <» 

L ^f^ ' '•'•'" SB ftrtfl v '-''^t^j^^^ji 

^^^^ ^ Si flllf • • MMMn • * • 

• ' k ^ -'•' i H Hosiery UMk 

-'. .'W'fdH 

1 CLICK TO ENLARGE IMAGE | CLICJ<_TQ_ENLARGEJMAGE 

Square Footage: 1234.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Fair 

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

HVAC: Forced Air Rooms: 6.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Hip Stories: 1.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1902 0% 1902 107 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 876.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch End Solid Wall 144.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 10/21/2009 
m Page 1 of2 

"> 

^i^7ot> 

Create Another Ticket ) Back to Irth Internet ) Send Email ] 

YOUR TICKET NUMBER IS 2496447. 


Original Call Date: 5/18/10 Time: 5:08 pm Op: ELIZABETH18790 

Work to Begin Date: 5/20/10 Time: 5:45 pm 

State: NE Coxinty: DOUGLAS Place: OMAHA 

Address: 1504 Street: GRANT ST 

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

Twp: Rng: Sect-Qtr: 

Legal Given: C 

Type of Work: LEAD REMEDIATION 


Location of Work: LOCATE ENTIRE PROPERTY, ALL EASEMENTS AND TO THE PEDESTAL 


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


: UNSURE IF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: COASTAL 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELLAN MCINEB MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 

Service Area Contact Phone Number 

UtiUty 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MAGELLAN MAGELLAN MIDSTREAM 

PARTNERS LP DEBORAH 

Day: 9185747098 

Alt: 

Emerg: 9185747098 

MCINEB MCI NO CAT I PER 

MEMO 

Day: 8002893427 

Alt: 

Emerg: 8002893427 

MUDOl METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 5/18/2010 
Page 2 of2 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICH/TRAFFIC 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

QLNNE1C QWEST LOCAL NETWORK ELM LOCATING 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 5/18/2010 
SI As-Built Drawing ^ 

COASTA L maha Lead Superfund Site ENVmONHENTAL CROUP . IN C 

OLS#: 28208 

Date Excavated: 5/19/2010 

Date USEPA Signed Off: 7/28/2010 

Area Sodden: 2415 SO ft 28208 

Omah Extenof Paint a Lead Site 

Sit [ 3 Good e Sketch 

• Poor 

Sampling Address: 1504 GRANT ST Q Not paint 

Lead Sample Samples Collected 

Concentration Collected 

Sample Numtjer 1 AR 

Firm; . 

RYASCPXA-28208 F1 n Date: . 'J-LB-OB ^ 

RYBSCPXA-28208 F2 'iOSi ppm Time: . In-.V^ f^> 

RYCSCPXA-28208 B1 

\i n 

.521. ppm ^ D Samples Analyzed RYDSCPXA-28208 B2 ppm t3r n 

RDZSCPXA-28208 DZ I-^5 ft . ppm [ / D XRF Uni 

nOZGCPXA-gOZOe 62­ . ppm D D Date:. f n - ll-OP . 

nrzocpxA-gogoo—P2- ppm D D Time: _ PM 

Staff: . /-KU/ Number of Samples = | ^ | | Q | 

Legend: F1 = Front Lefl. F2 = Front Right. 81 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden. PZ = Play 

All quadrants are as viewed from the street, facing property 

Rev2U(W.*A ( rcatcd: H-Mar-<18 

Legen d 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with Area replaced with 

Area lef t bare Sod Rock/Mulch 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group In c 
#

01 6^ 'L 

28208 

Omaha Erterior Paint Lead Site 

Site 0 Good Sketch 

• Poor 

Sampling Address: 1504 GRANT ST Q Not paint 

Sample Number Lead Sample Samples Collected LAB Concentration Collected Firm n)A Pfc.P ^ 

V,ByASCPXA-i8206 Fl ppm D Date: '^-l.g-OB 

RYBSCPXA-28208 F2 *10 & ppm 

i D Time: fc•.^'? f ^ 

RYCSCPXA-28206 81 ppm D 

Samples Analyzed 

RYDSCPXA-28208 B2 M3£i H' , ppm D 

RD2SCPXA-26208 DZ 1 5 5 8 ppm [ / D XRF Unit: (of^ b Book: 20 l 

RGZGCPXA-g0200 82" ~ ppm D D Date: Co- iZ-QP , 

nPZGCPXA-gOgOO P?- ~ ppm D D Time: IJ± 

Staff: Number of Samples • nsv/ 

Legend: Fl = Front Left. F2 = Front Right. B1 = Back Left, 82 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing properly 

Sod 

(j/^\\it. Li i/d y 1^0% S$0 'ii,'\iH 
28208 

Eirterior Paint North Arrow Omaha Lead Site 

[3 Good 

^ofef-t- soon 

Site SIcetch 

• Poor 

Sampling Address: 1504 GRANT ST Q Not paint 

Sample Numtier Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

 P\)ft Pfc.Pfe 

RYASCPXA-28208 Fl D Date: <;-2,R 0 6 

RYBSCPXA-28208 F2 HO Q ppm D Time: fe.!*^ f^^ 

RYCSCPXA-28208

RYDSCPXA-28208

 B1 

 B2 

,5^73

S^f i

 ppm 

 ppm 

n 

n Samples Analyzed 

RDZSCPXA-28208 DZ \539> ppm n XRF Unit: d'^ i b Boolt: 20 l 

RGZSCPXA-20200 B t ~ ppm D D Date: G ­ IZ-Q ^ 

RPZOCPXA-gOgOO PS­ .ppm D D Time: P M 

Number of Samples = | ^ \ [ Q | Staff: MSV / 

Legend: F1 = Front Left. F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, fadng property 
# 

28208 

Omah a Lead Site Dterior Paint North Airow 

Site Sketch [3 Good 

• Poor 

Sampling Address: 1504 GRANT ST Q Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB Samples Collected 

Firm: _£!HKJSliSh. RYASCPXA-2a208 F1 _fil5_PP m D Date: ^-lR-o 6 

RYBSCPXA-28208 F2 *iO& PPn> D Time: tt'.l.*? f<*< 

RYCSCPXA-2820e

RYDSCPXA-26208

RDZSCPXA-26208

nozooPXA-eogoo

•RPZGOPXA-e0200

 B1 

 82 

 DZ 

 o a 

 F»2­

.£"73

^ff i

1556

~

~"

 ppm 

 ppm 

 Dom 

 ppm 

 ppm 

D 

D 

D 

D 

D 

D 

Samples Analyzed 

XRF Unit: 6)5H/> Book:

Date: (o-/^-g 6 

Time: P^? 

 20 7 

Number of Samples = | y | | Q | Staff: MSU / 

Legend: Fl = Front Left, F2 s Front F^ht, B1 = Back Left, B2 = Back Right DZ = Drip Zone, 6Z = Garden, PZ * Play 

All quadrants are as viewad from the streat, (adng property 

•' JUN 0 9 2006 

v=—« "5?" 

573 : > :5:^e 

E>i....;.j....:...B!Zi, 

TT 

•l^o l Gm»*t *+ 

^ . 

.te?..ii$5-a. 

tGi 

• f t ­

-olA-UK. 

;. GflAHV.st 

Rcv2008.)/> C:n!aKit l.t-Mar.Ofl 0447UI 
,•^^**»«'-''<r 

COASTA l 

EHVtltONHIhTAt 

C R 0 U f . 1 N C 

Consent for Access To Pr-operty 

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: "TJSt^^^ 

Owner's Name: Daytime Phone: 

Address of Property /^^^^C^^^AT T ' ^ { 

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 wori( is finished, the Grantor will be asked to review the wori( 

and confirm that it is complete and meets with the Grantor's approval. Upon 

completion, the Grantor vtnll 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 worit has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
• •" - - , * 

COASTA L tHVIROHHtHTAL 

C M O U P IN C 

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

piles, dog houses, etc; 

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

to save; 

e 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. 

ft 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 

Qi^ran grant D i do not grant access to my properties t access to my properties 

/Scd^^/^y^ 

Signatur W> e Date Signature Date 

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

Page 2 of 2 
COASTA L BNVinOMHIHTAI . G • O U P . INC . 

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). 

Property ID: '^'S't^ ^ 

Property Address: /^(5 ^ fy/t4jJ'T~ 

Owner: f^^^rj ' 5cJ'r r 

Phone: ^ ^ . ^ ^Ij-Q 

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 of the property and the basement if 

necessary. 

Items to be Removed by the Owner before Start of Remediation: 

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

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

Item: 

1 S^^^(l Rvuj vP-t fejL.J Item: 

item: 

Item: 

Pagel or3 
COASTA L INVmONMIHTA L a « O U P . INC . 

Items to Be Removed By Contractor During Remediation and Reolaced 

Item: 

e 3or) 

Kem: 

Item: 

Item: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Quadrants 

Number of trees > 2 inch 

trunk diameter ^ 

Each 

Number of trees <= 2 inch 

trunk diameter 

1 Each 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Nfw- Each 

Nimiber of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

X Each 

Square Feet 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

/ 

$ 

Easement Area, to be 

excavated l^b Each 

Page 2 of. 3 
C O A S T A L BNVIRONHI N T A L a n o u p . INC . 

Additional Comments / Instructions: 

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

as driveways or vehicle parldng 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 parlcing 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 pf Omaha's Planning Department at (402) 444-5150. 

Q^lease check this box if you understand the information outlined above. 

^ T»6, A^o^^A ftoSo vgc^sU, 

• 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. 

• I do not agree 

0(^/^~/ 0 

Owner's Signature Date Contractor's Signature Date 

Page 3 of. 
Date 

Project 

XRF ID# 

Shot# 

Ml. J^LIL 

IM. 

Average 

Shot# 

.ZS L 

IS2i. JSt-

Average

Average

Shot# 

Average 

Signature 

Print 

BVID#ZS'Z-g>^ 

XRF PROPERTY SAMPLE SHEET 

ji-i'f-fr? 

Address 

Omaha Lead ARRA 

Sample time 

Reading

i

•f^i- 1 ^ 

Wt 1^ sfit n 

m^i2i. 

-?)

n

' ^

 7 

Reading 

^ - A 

± A 

^ M 

^ j . / ^ 

Reading 

1^2^ -t M 

1 ^ t Ig^ 

Sampl mpiee area

Depth 

illL 

Sample area 

hi 

Depth 

/3V 

Samplearea 

Depth 

/ / 

sample length 30 sec 

/^"7l>y ^ 

Average

RETEST AREAS 

Reading Sample area Shot# 

^ 

->, Depth 

/

^ ^ ^ 

Average 

Reading 

s U ^ 

J: y ^ 

i : / 3 

/i>CiJ^/3 

Reading 

^rf^ ^ 

^^>i^-^^ ^ 

^^"^ ^ ^ l 

c?7v ^g^< y 

Reading 

-t ^^ 

mi ^^?? 

3^ ^ ^^" ^ 

Reading 

am/pm 

Sample area 

P 7 -

Depth 

ill 

Sample area 

£i2^ 

Depth 

i2f f 

Sapiple area

15r-

Depth 

15 

Sample area 

Depth 

Shot# 

MI 

mi

m. 

Average 

Shot# 

w. 

JkjL 

f ^ ^ 

Average

Shot# 

Wf 

n£L 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 (Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

TInne 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

149 

SOIL 

2010-06-19 10:27 

91.41 

Final 

Avg of 146-148 

1504 Grant st 

Fl 

13" 

N. LOPEZ 

confirmation 

none 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 65.290 

Supervised By: 

Certificate of Verification 

146 

SOIL 

2010-06-19 10:26 

30.49 

Final 

28208 

1504 Grant st 

Fl 

13" 

N. LOPEZ 

confirmation 

none 

± Error 

± 13.239 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpilce 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 68.636 

Supervised By: 

Certificate of Verification 

147 

SOIL 

2010-06-19 10:27 

30.54 

Final 

28208 

1504 Grant st 

Fl 

13" 

N. LOPEZ 

confirmation 

none 

± Error 

± 13.393 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 58.828 

Supervised By: 

Certificate of Verification 

148 

SOIL 

2010-06-19 10:27 

30.38 

Final 

28208 

1504 Grant st 

Fl 

13" 

N. LOPEZ 

confirmation 

none 

± Error 

12.801 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

159 

SOIL 

2010-06-19 10:34 

91.47 

Final 

Avg of 156-158 

1504 Grant st 

Bl 

13" 

N. LOPEZ 

confirmation 

none 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 156 

Mode SOIL 

Time 2010-06-19 10:33 

Duration 30.50 

Sequence Final 

Flags 

BVID 28208 

ADDRESS 1504 Grant st 

QUADRANT Bl 

DEPHT 13" 

XRF TECH N. LOPEZ 

MISC confirmation 

NOTE none 

ppm ± Error 

Pb 80.600 ± 14.465 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 75.855 

Supervised By: 

Certificate of Verification 

157 

SOIL 

2010-06-19 10:34 

30.49 

Final 

28208 

1504 Grant st 

Bl 

13" 

N. LOPEZ 

confirmation 

none 

± Error 

± 14.141 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 79.128 

Supervised By: 

Certificate of Verification 

158 

SOIL 

2010-06-19 10:34 

30.48 

Final 

28208 

1504 Grant st 

Bl 

13" 

N. LOPEZ 

confirmation 

none 

± Error 

± 14.405 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

163 

SOIL 

2010-06­

91.31 

Final 

19 10:38 

Avg of 160-162 

1504 Grant st 

82 

10" 

N. LOPEZ 

confirmation 

none 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 202.384 

Supervised By: 

Certificate of Verification 

160 

SOIL 

2010-06-19 10:36 

30.17 

Final 

28208 

1504 Grant st 

B2 

10" 

N. LOPEZ 

confirmation 

none 

± Error 

± 22.874 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientiflc 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 232.099 

Supervised By: 

Certificate of Verification 

161 

SOIL 

2010-06-19 10:37 

30.57 

Final 

28208 

1504 Grant st 

B2 

10" 

N. LOPEZ 

confirmation 

none 

± Error 

21.503 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 223.208 

Supervised By: 

Certificate of Verification 

162 

SOIL 

2010-06-19 10:38 

30.57 

Final 

28208 

1504 Grant st 

B2 

10" 

N. LOPEZ 

confirmation 

none 

± Error 

± 21.090 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

167 

SOIL 

2010-06-19 10:40 

92.00 

Final 

Avg of 164-166 

1504 Grant st 

F2 

6" 

N. LOPEZ 

confirmation 

none 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 164 

Mode SOIL 

Time 2010-06-19 10:39 

Duration 30.58 

Sequence Final 

Flags 

BVID 28208 

ADDRESS 1504 Grant st 

QUADRANT F2 

DEPHT 6" 

XRF TECH N. LOPEZ 

MISC confirmation 

NOTE none 

ppm Error 

Pb 171.013 ± 18.780 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 172.076 

Supervised By: 

Certificate of Verification 

165 

SOIL 

2010-06-19 10:40 

30.56 

Final 

28208 

1504 Grant st 

F2 

6" 

N. LOPEZ 

confirmation 

none 

± Error 

± 18.962 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 157.948 

Supervised By: 

Certificate of Verification 

166 

SOIL 

2010-06-19 10:40 

30.86 

Final 

28208 

1504 Grant st 

F2 

6" 

N. LOPEZ 

confirmation 

none 

± Error 

± 18.172 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 171 

Mode SOIL 

Time 2010-06-19 10:43 

Duration 92.24 

Sequence Final 

Flags 

AVERAGE Avg of 168-170 

ADDRESS 1504 Grant st 

QUADRANT DZ 

DEPHT 13" 

XRF TECH N. LOPEZ 

MISC confirmation 

NOTE none 

ppm 

Pb 255.313^ 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 248.468 

Supervised By: 

Certificate of Verification 

168 

SOIL 

2010-06-19 10:42 

31.03 

Final 

28208 

1504 Grant st 

DZ 

13" 

N. LOPEZ 

confirmation 

none 

± Error 

± 21.913 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 251.516 

Supervised By: 

Certificate of Verification 

169 

SOIL 

2010-06-19 10:43 

30.63 

Final 

28208 

1504 Grant st 

DZ 

13" 

N. LOPEZ 

confirmation 

none 

± Error 

± 22.476 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 265.955 

Supervised By: 

Certificate of Verification 

170 

SOIL 

2010-06-19 10:43 

30.58 

Final 

28208 

1504 Grant st 

DZ 

13" 

N. LOPEZ 

confirmation 

none 

± Error 

± 22.750 
i 

/^A^ % Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^^ ^ I Coastal Environmental Group Inc. ^\S^? ' 

\~^j ^ www.c0astalha2mat.com '^^ ^ 

Xp„ott ^ COASTAL *i e >o u p. IN C 

EXECUTIVE SUMMARY: 

BVID #28208-(1504 GRANT ST) 

No Issues or Concerns Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 7/28/10 
>^ ^_ 0% 4 Crn # 

EPA Property Close Out Form 

Proocm... ^S-ZO ^Property Addressi-M<; Addr^Z/T^ ^ Y—^—T V fr^^" ^ ^

Date/Tine: 

Owner's Name: )c!^X*^iX.^'i'xS 

Quads Excavated: 

Contractor Group CJDC S 

Eicavatlon General Yes No

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

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

Grading Sod and VegctotJon 

Yes No 

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 y day time period) 

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

5. Are thejoints between the sod strips generally tight? (Only evaluate if inspected at a 30 day y 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 aad Retaining Walls 

Ves No 

I. Do gates (9>en and close freely? (If applicable) / 

2. Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) / 

3. Was damage to gates or fences avoided? (I f applicable) / 

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

Foundation, Siding and Gutters 

Yes No 

I. Was damage to the siding or trim avoided? / 

2. Was damage to the foundation avoided? 

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) 

Yes No 

1. Was damage lo driveway stufaces avoided? 

2. Was damage to walkway surfaces avoided? J 
Ovf'Ders comments: 

Inspection notes: 

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

EPA Representative Date: 
# # 

Property Completion Agreement 

This agreemenl docuinenls Ihe complclion ol reinediai acliviiies perroimed on my pioperly My signature 

will designate ihai I am satisfied with the restoration of my properly, and thai no items are in queslions. 

now, or al any lime in the future, except ihose ilems listed below, if any 

PropcrrylD: '2^ % 2-0 % 

Property Address: /|--Q U ^l/?Xyv- r ^fj^ - Owner: ^^^^ ^ ^ ^ 

Phone: (^^^^^g O 

Restoration Items in Question: 

Item: 

Co^r^fi^ >?A^OJ4|£ IAJ^4. c-{^<^9C^ ^e-^^r^^ ho\ t^-<, i>:>r<.^n< 

Item: /^,^f f^xo.oH^'^­- :f^dv^ ^ v->i(l t>e cl'^eci'cci t-^'^- ^ 

Item: 

^o-V ^^s^ ^ b - ^ c;p 

Item: 

Item: 

Item: 

Additional Comments: 

nCl^l Agree I'CstorAlion is completed, except as noted 

[_} I lio not aurtc restoration ii completed 

6-\5-v'^^ 

Owner's iSignatiire Conti aclot' i 'ss Sicnalur SignaturceDale
Property Owner Assessment of Per&rmaEce Fonn^"'^ 

American Recovery and Reinvestment AtUiR^^^hjhji^ ^, , 

Omaha Lead Superftind Site ' '^^' i^/l//.^/ni 

2009/2010 

Remediatioii Contractor: Coastal Environmental Group - EP-R7-09-06 

Propert>' Identifier Number: 'Z.S'ZO^ 

Property Address: /g:o W G[ro\y\ \ S^-• 

Property' Owner's Name; fiojptg'.f^ fyc.rJJ^-

Instructions to the Property Owner: 

This form serves to record the Properly Owner's assessment of performance (Incentive 1 

- Quality Assurance Surveillance Plan) involving the listed remediation contractor, as applicable 

to the Omaha Lead Site. This form documents the timeliness of punch list resolution, business 

relations, complaint resolution and the overall quality of work. If need be, the Property Owner 

may utilize this form to record problems and/or issues not specifically tied to an assigned 

address, for example, business relations that generally don't follow the guidelines set forth in the 

Performance Work Statement. 

The Property Owner will indicate his/her assessment of performance with the contractor's 

work by checking a numerical rating on the table below using the numerical definitions from 

the rating scale below, then sign & date the form. 

9-10 "excellent" 

7-8 "very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Property Owner's Assessment of Performance Regarding the Contractor's Work 

10 5 

9 4 

8 ZX - 3 

7 2 

6 1 

Property Owner Additional Comiaents from (optional; continue on back page if needed) -. 

Property Owner Signature: _^^=qsV^. JTr^ ^^^^^Hy X Date: L — VS ^ — \V_) 
» Better Business Bureau 

« 11811 P Street 

^JJI ­ Omaha, NE 68137 

BBB ^ Tel: 402-391-7612 / 800-649-6814 Fax: 402-391-7535 Sla-twthTiial 

July 9, 2010 

Mr. Dave Henney 

Coastal Environmental Group, Inc. 

2411 Martha Street 

Omaha, NE 68105 

RE: Case # 300059511: Anita Lively 

Enclosed is a complaint from a consumer. This case is NOT being treated as a complaint, 

but we wanted to inform you of this communication. 

Your BBB is a non-profit organization dedicated to helping consumers and companies 

resolve disputes. We encourage you to respond to the consumer and try and resolve the 

issues presented in the complaint. 

The BBB Is not requesting a written response from you, however, if you choose you may 

send a letter addressing this complaint for our files. If you send a letter directly to your 

customer, please send BBB a copy of the response. 

Thank you for your prompt attention to this matter. 

Sincerely, 

Susan, Ext. 8527 

Dispute Resolution Specialist 

sdylla@bbbnebraska.org 
Better Business Bureau 

COMPLAINT ACTIVIPr' REPORT Case # 30005951 1 

Consumer InJFo: Lively, Anita Business Info: Coastal Environmental Group, Inc. 

1504 Grant St 2411 Martha Street 

Omaha, NE 68110-2511 Omaha, NE 68105 

402 880-6954 402 880-6954 877 662-4210 

Consumer's Original Complaint: 

The Epa had Coastal come out to remove lead from my property around May 20-23, 2010. During the removal process, they tore 

down one of my new gutters, broke my sidewalk and took down my fence. A guy came with a ladder and a saw and removed the 

damaged portion of the gutter and left. I have been in contact with Coastal (877-662-4210), The EPA (Dan-402-731-0788, for the 

last 1 1/2 months. Several people have been out, taken pictures, promised to fix things., then nothing., they took notes, I signed 3 

different forms regarding the damage and when they came out the last time, they had 1 piece of paper with the sidewalk written 

down and said that was all they had. They replaced the portion of gutter that they sawed out and put in new fence posts which are 

not even. When I asked the workers about my sidewalk, they told me they knew someone that would put a new top on it for $400 

and would replace it for $800. Everyone said they would fix everything, but noone has done anything to date. They also did not 

level the back yard. I told them all about that too., they said they would fix it too. Thank you, Anita Lively, Omaha NE 

Consumer's Desired Resolution: 

I want them to professionally fix what they broke and took down. 

BBB Processing 

07/06/2010 web BBB Case Received by BBB 

07/09/2010 NM BBB Case Determined to be INFO ONLY - Wait 

07/09/2010 Otto BBB Inform Consumer - Case Closed INFO ONLY 

07/09/2010 NM MAIL Inform Business of Case Closed INFO ONLY 
% % 

Water Bill Settlement 

Property ID 28208 

Property Address 1504 Grant St 

Tenant Anita Lively 

I have received from the contractor, Coastal Environmental Group Inc. (Coastal), the sum of $ 9.18 for 

water usage required to maintain the sod. 

Check Number 1966 

Value of Check $9.18 

Made Out To Anita Lively 

Description of Settlement 

To reimburse tenant for estimated water charges on their MUD monthly invoices. 

My signature below is acknowledgement of the receipt of the sum listed above, which I further 

acknowledge to be fair compensation and full payment for the above, and release Coastal 

Environmental Group Inc. from further obligations or liability. 

r^Signafttrc ^^^ . Date Contractor's Signature Date 

l ' •'^?^'^:^ •^!'^;^t/^' r^-:' 

COASTAL 1966 ENVIRONMENTAL GROUP INC. 2411 MARTHA STREET 27-V1040003 

OUAHA, NE 8S105 6247372SM bls^Uo 

DATE 

PA.Y 

ORDER 

IMnski 

FOR . iaiMSJ- .^:^i34^teuA •1101.0000Ban EiEi,7 37E^Oi,"' Oiq&E.