# 

TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SA1D#: ^^V^ \ Date: w iM 

Address: Kp-^l OUlO ^J^ 

Remediation Contractor: _Coastal Environmental Group Year: 2010ARRA 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCIIMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

-& Signed Access Agreement(s) for adjacent property 

Bf Restoration Agreement 

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

-&' Confirmation data 

Z Photographs m ^CMPT^Q^ ^ tfC^^ViO^ ^ 9(<^ 

ef As-built sketch 

1/ 

Satisfactory restoration signed by Property Owner 

z Property close-out check list signed by EPA 

-or- Description ofareas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

Signature Date 

30261017 

11 

Superfund 
i^JProperty Access Checklist 

Property ID: ')j\()C \ | 

D WORK STARTED ON: / /_ 

D WORKCOMPELTED ON: / / Property Addrcs. 1(^(^9, C^i; ^ .^ t 

Owner:-\>U)^(Y^P^5Y^ ^ ^ Rcnter 

Address: Phonc: 

F;LV: 

Ccll/Pagcr: 

Phone: 1^01 ' 4^$ " ' 1^2, 4 2- Additional Information: 

Fax: 

Ccll/Pager: 

• NotiTication Letter Sent: 7 / By: 

LS Access Agreement Signed: J^/^/l D By: 

^ Restoration Agreement Siened: I D / ^> 1 lfi By: 

O Topsoil Sampling (if applicable) / / By: 

O Disposal Sampiing (if applicable) / / By: 

II] Garden Sampling (if applicable) / / By: 

D Utility Clearance Called: / / By: 

D Video/Photos (Before) On: / / By: 

• Video/Photos (During) On: / / By: 

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

D Video/Photos (30-Day) On: / / By: 

O Property Completion Agreement Signed: / / By: 

D Final Report Lssued: / / By: .y 

Air Monitoring (as applicable) 

• Community Q Crew On: / / 1 

Rcsuits: 

n ComiDunit}' D Crew On: / / By: 

Results: 

n Community d Crew On: / / By: 

Results: 

Omaha Lead Site 
Douglas Coimty Accoimt Ii^jtamation Page 1 of2 t^Mma 

% 

Douglas County, Nebraska Property Record - R0210170000 

Print Report 

View Interactive GIS Mao Information is valid as of 2010-8-30 Treasurer's Tax Report 

New Feature -» -> ^ Subdivision Sales Search 

Owner 

THOMPSON D L 

1682 WHITMORE ST 

OMAHA NE 68112-0000 

Property Informatio n 

Key Number: 1017 0000 02 

Account Type: Residential 

Parcel Number: 0210170000 

Parcel Address: 1503 OHIO ST 

OMAHA NE 68110-0000 

Legal Description: LANDS SEC-TWN-RGE 10-15-13 W 58 FT SUB LT 7 TAX LT 8 & E 58 W 388 FT 

TAXLT9 

Value Informatio n 

2010 

2009 

2008 

2007 

2006 

2005 

Land 

$500.00 

$500.00 

$500.00 

$500.00 

$500.00 

$500.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$500.00 

$500.00 

$500.00 

$500.00 

$500.00 

$500.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.21 9280.0 0.0 160.0 58.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R021... 9/3/2010 
Douglas County Account Information Page 2 of2 

L'' 

google Map data fiCQ1 CLGoogiB, 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R021... 9/3/2010 
3/31/2011 www.dhon.org/lrthintemet/DHONNotic..l 

Create Another Ticket Back ^Wtl h Intemet t Send Email 

• YOUR TICKET NUMBER IS 2700066. 

Original Call Date: 3/31/11 Time: 1:18 pm Op: ALFONSO18790 


Work to Begin Date: 4/04/11 Time: 1:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1503 Street: OHIO 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: (402)934-2811 


: PLEASE INCLUDE ALL EASEMENTS 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ALFONSO Phone: (402)934-2837 


Work Being Done For: Coastal 


Depth of Excavation: 4ft Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MCINEB MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Utility Service Area Contact Phone Nuniber Type 

Day: 4029340469 


CXCATV COX COMMUNICATIONS, INC HEIDI AH: 4029340469 

Emerg: 4029329757 


Day: 8002893427 


NO CALL PER MCINEB MCI Alt: 

MEMO 

Emerg: 8002893427 


Day: 4025047823 


METROPOLITAN UTILITIES MUDOl SANDY MUD Ah: DISTRICT 

Emerg: 4025047970 

Day: 4024447197 

CITY OF OMAHA- OMAHACOF RICH/TRAFFIC Alt: 4024445161 

TRAFFICSEWER 

Emerg: 4024445160 

dhon.org/irthlnternet/.../MessageText.as... 1/2 
3/31/2011 www.dhon.org/irthinternet/DHONNotic..^^ t Day: 4067289343 

: POWER „ OPPDGPR5 °'^TM''°'TM ^ ELM LOCATING M: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

dhon.org/irthinternet/.../MessageText.as... 2/2 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site ENVIRONNENTAL e II O U P . IN C 

OLS#: 29091 

Date Excavated: 4/5/2011 

Date USEPA Sianed Off: 4/19/2011 

Area Sodden: 3094 sa ft ^9<?9/ 

Name: PMAM J Thennjis^ n 

Address: ISO^ Ohi'o'Sf : 

Phone: ^SS^721 Z 

Omaha Lead SHe 

Site Sketch 

/oer'

Date: rdXTCi X 

Time; /fc.'irAn 

 pa .oT 

NorthAirow 

i 

Si^fi : {~A T3<i+e: l-T-oS" TimeryUi 

Team 9 E /<^T 4 b d BVID* ^9o9 1 XRF Code 103 7 BooK: / z.9 

Sample Numtier Lead Concentration Confirmation Sample 

ie.tAScfi)LA -zioqi 

eiBsc/xA- 210'^ I 

gibs<v»XA-zqo°>i 

3? 2. 

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737 

ppm 

ppm 

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f f Yes D

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52_Yes D

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Omaha Lead Site 46130

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced

Sod 

 with Area replaced with 

Rock/Mulch ' ' Area left bare 

Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 


 I 
i \k HA .^9^)9/ \ 

r Name: DaA/ta Tkor*^iaSe>/i 

Address: 1^0 ^ oht'o^St . 

Phone: 4SS-72*i a ^ ) 

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% % P-'^o 9/ 

JName: D«/*^a Tkorv<^S&n Omaha Lead Site Date: t P X' ^ d X North A[row [ 

Address: IS0 ^ ohi'o*S± . 

Phone: 4 55-7 2 *< 2 

Site Sketch

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.V' y Omaha Lead Site 46130 
^9(5 9/ 

Name: T>«/i^a X^iorvufiS&A Omaha Lead Site Date: tf i XT - tiS " North Alrow 

Address: ISa ^ Oht'o'Sf-. Sita Sketch Time: lt3l*=iDAM 

Phone: 4SS-72M 2 

tsidT ^'.fsrir i

S-f<%^>' £-A I><*+e: '?-7-«S' 71*ne:A/t 

Team P ^ f^T-l bQ. BV1D# ^0 9 \ XRF Code 103 7 BoehCi I z.<i 

Sample Number Lead Concentration Confirmation Sampte 

RVAgd/>>LA-.a«?oqi 3?a ppm f^i Yes ° No ^ ^ 

2SBSC^je.A- 2.<\0^\ ^AS. ppm /=2 Yes a No O ' G?.?> 

ppm A ' Yes D No © ^ gib<c/»XA-2.qgo>i 1 ^ 1 ppm A2,Yes ° No ^2 ^ 

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Omaha Lead Site 46130 
COASTA l ENVItOMntMIA t 

c i 0 u r . IH 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: 

Ov)(fiei;^s/Name: Daytime Phone: 

<!Z^ - y- ^zi/f} 

Address of Property 

covered by this / 3 OZ? o l io j' T Agreement; 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that coritains 

elevated concentrations of lead and may pose a health hazard. The area(s) w/ill be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean rnaterials and the area will be restored to Itis original condition. This 

work is being performed under the Omaha Lead Superfund Site rennediation program. 

A representative of Coastal Environnriental Group, contracted by USEPA, v^ll contact 

the Grantor in-person to discuss the work to be performed, the Grantor vyill have an 

opjjortunity to review and approve the planned soil remoyal, and restoriation 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 v^th the Grantor's approval. Upon 

completion, the Grantor will receive vvritteh 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 beeh satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
COASTA l 

c ti a u r IM C 

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

piles, dog houses, etc; 

c 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; 

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. 

c. Allow videotaping and/or photographing of the property. 

AGREEMENT NOT To INTERFERE 

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

of the wbri< done, or with the equipment used on his property, or to undertake any 

actions regiarding the use bf said property which would tend to endariger 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 

Environrttefital Group, at (402) 991-1199 

^ I grant access to my properties G t do not grant access to my properties 

Signature Signature Date 

D I wotild like to be present during any isampltng that is required. 

Page 2 of 2 
COASTA L CMVinOMHCMTAL CROUP , IMC . 

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 puipose of assuring that restoration 

activities are completed to the satisfaction of the property owner and the United States Enviroiunental 

Protection Agency (EPA). 

Property ID: 29^? / 

Property Address: / y~0 j , o- sr zyk) Owner: . Tko-T/^ a f a l/J P c^-r\ I^C\ 

Phone: 

V ^ 7ZV2. 

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 ofthe property and the basement if 

necessary. 

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

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

Item: 

/_y 0 -^ ^ 

Item: 

Item: 

Item: 

Page 1 of. 3 
C O A S T A L CMVinONMB N T A L 

C • O U P . IMC . 

Items to Be Removed By Contractor During Remediation and Replaced 

Item: 

5 ^ \ \ 

Item: 

S ^ i

Item: 

Item: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, ^I,f3 ^ Quadrants that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 7t Each 

trunk diameter 

Number of trees <= 2 inch y Each 

tmnk diameter 

Number of Sprinkler 

Zones, Control Valves, Each Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Nimiber of and size of 

each garden/ flower bed Each 

area. Square Feet 

Attach a sketch of relative 

sizes and locations. 

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 IP Each if^^ciu^ ^^A'^ ^ "Y 

Page 2 of. 3 
COASTA L • MVI ROMnaMTAl . C • O U P . INC . 

Additional Comments / Instructions: 

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

cis driveways or vehicle parking 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 parking 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 of Omaha's Planning Department at (402) 444-5150. 

O Please check this box if you understand the information outlined above. 

• 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. 

"S I agree nn I do not agree 

'^/y\ /J/IIS ^v-^yy ^ 

Owi Date Contractor's Signature Date 

Page 3 of C^ 
BVID# -^ 

XRF PROPERTY SAMPLE SHEET 


Date 

Project 

XRF ID# 

Shot# 

ZO 

^ \ 

t t ^ 

Average 

Shot# 

\U 

\n 

\ ^ 

Average

Shot# 

Average 

Shot# 

Average 

Signature_ 

Print

H-n-2^\ \ 

Omaha Lead ARRA 

ZtJD^' ^ 

Reading 

\'hoiu 

\1{t ^ ^ 

{0^^^ - \ ^ 

H") X n 

Reading 

2,^^-1 ^H 

^^'n t ^n 

1)^11: u 

 6^2^"^ LV 

Reading 

Reading 

^-^^ y 

y y 

y i 

 %fP ^ Mfrn^s 

Sample area 

tz 

Depth 

^30 

Sample area 

^V 

Depth 

W 

Sample area 

Depth 

Address \'~,a^ c w V c 

Sample time am/pm 

sample length 30 sec 

Shot# Reading Sample area 

Depth 

Average 

Shot# Reading Sample area 

Depth 

Average 

Shot# Reading Sample area 

Depth 

Average 

RETEST AREAS 

Sample area Shot# Reading Sample area 

Depth Depth 

Average 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 23 

Mode SOIL 

Time 2011-04-07 21 :20 

Duration 90.85 

Sequence Final 

Flags 

AVERAGE Avg of 20-22 

ADDRESS 1503 OHIO 

QUADRANT B2 

DEPHT 13" 

XRF TECH M. MATEUS 

MISC CLEARANCE 

NOTE CLEAR 

ppm Error 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

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 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 415.072 

Sr 156.876 

U < LOD 

Rb 71.008 

Th 16.990 

Pb 150.797 

Se < LOD 

As 27.963 

Hg < LOD 

Zn 258.383 

W < LOD 

Cu 38.611 

Ni < LOD 

Co < LOD 

Fe 18422.002 

Mn 761.960 

Supervised By: 

Certificate of Verification 

20 

SOIL 

2011-04-07 21:19 

30.51 

Final 

29091 

1503 OHIO 

B2 

13" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

\ 7.633 

± 14.816 

± 8.435 

14.187 

± 6.504 

± 8.296 

± 17.005 

6.117 

± 15.488 

11.244 

± 26.081 

: 78.192 

± 21.105 

: 71.367 

182.850 

± 380.781 

± 117.265 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 465.382 

Sr 158.028 

U < LOD 

Rb 72.579 

Th < LOD 

Pb 171.847 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 195.993 

w < LOD 

Cu 55.883 

Ni < LOD 

Co < LOD 

Fe 19361.486 

Mn 529.993 

Supervised By: 

Certificate of Verification 

21 

SOIL 

2011-04-07 21 20 

30.17 

Final 

29091 

1503 OHIO 

B2 

13" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

: 7.990 

± 16.121 

± 8.779 

: 15.751 

± 6.905 

: 12.546 

± 18.548 

: 5.868 

: 24.038 

12.589 

± 24.059 

: 85.303 

± 23.648 

: 78.042 

: 194.739 

± 404.254 

± 107.398 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 405.515 

Sr 159.095 

U < LOD 

Rb 67.591 

Th < LOD 

Pb 125.672 

Se < LOD 

As 31.486 

Hq < LOD 

Zn 210.795 

w < LOD 

Cu < LOD 

Ni < LOD 

Co < LOD 

Fe 17224.836 

Mn 573.407 

Supervised By: 

Certificate of Verification 

22 

SOIL 

2011-04-07 21:20 

30.17 

Final 

29091 

1503 OHIO 

B2 

13" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

7.894 

± 14.941 

± 8.644 

14.785 

± 6.541 

1 11.602 

± 15.984 

5.886 

± 14.883 

\ 12.104 

± 24.514 

90.142 

: 30.119 

72.052 

180.417 

± 375.099 

± 106.900 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Certificate of Verification 

19 

SOIL 

2011-04-07 21:17 

91.22 

Final 

f Avg of 16-18 

1503 OHIO 

Bl 

13" 

M. MATEUS 

CLEARANCE 

Mn 660.606/ - ^ 115.773 y 

Supervised By: y ^y L 

Fe •nmi.i°n y ± 

CLEAR 

ppm 

< LOD 

421.425 ± 

160.671 

± 

< LOD 

67.859 ± 

< LOD 

^82.334 

± 

< LOD 

< LOD 

< LOD 

475.760 

± 

< LOD 

58.105 ± 

< LOD ^ : ' < LOD ,y : 

Error 

7.941 

15.310 

8.763 

14.483 

6.566 

14.613 

26.208 

6.104 

34.637 

12.896 

35.599 

88.498 

.,^--^51 5 

76.495 

/ 203.148 

-'•" 427.069 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 421.468 

Sr 154.670 

U < LOD 

Rb 72.248 

Th 15.613 

Pb 326.575 

Se < LOD 

As 52.603 

Hg < LOD 

Zn 454.234 

W < LOD 

Cu 53.303 

Ni < LOD 

Co < LOD 

Fe 23800.350 

Mn 648.141 

Supervised By: 

Certificate of Verification 

16 

SOIL 

2011-04-07 21 16 

30.52 

Final 

29091 

1503 OHIO 

Bl 

13" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

* 8.073 

± 15.300 

± 8.604 

14.793 

± 6.748 

± 9.818 

± 24.444 

: 6.507 

± 22.269 

: 12.950 

± 34.788 

1 86.405 

± 23.161 

76.995 

: 210.873 

± 442.990 

± 115.683 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Mo < LOD 

Zr 450.494 

Sr 165.938 

U < LOD 

Rb 63.435 

Th 15.878 

Pb 429.144 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 472.582 

w < LOD 

Cu 66.448 

Ni < LOD 

Co < LOD 

Fe 21609.621 

Mn 746.134 

Supervised By: 

Certificate of Verification 

17 

SOIL 

2011-04-07 21:16 

30.52 

Final 

29091 

1503 OHIO 

Bl 

13" 

M. MATEUS 

CLEARANCE 

CLEAR 

Error 

7.916 

± 15.832 

± 8.923 

: 13.786 

± 6.356 

± 10.573 

± 27.791 

6.394 

36.098 

13.469 

± 35.711 

] 94.926 

± 24.304 

77.420 

: 203.024 

± 423.769 

± 121.472 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 18 

Mode SOIL 

Time 2011-04-07 21:17 

Duration 30.18 

Sequence Final 

Flags 

BVID 29091 

ADDRESS 1503 OHIO 

QUADRANT Bl 

DEPHT 13" 

XRF TECH M. MATEUS 

MISC CLEARANCE 

NOTE CLEAR 

ppm Error 


Mo < LOD 7.834 

Zr 392.313 ± 14.799 

Sr 161.405 ± 8.762 

U < LOD 14.871 

Rb 67.894 ± 6.594 

Th < LOD 13.250 

Pb 391.283 ± 26.390 

Se < LOD 5.412 

As < LOD 34.410 

Hg < LOD 12.269 

Zn 500.463 ± 36.296 

W < LOD 84.163 

Cu 54.563 ± 23.081 

Nl < LOD 75.069 

Co < LOD 195.547 

Fe 20883.422 ± 414.448 

Mn 587.542 ± 110.166 

Supervised By: 

X 

i^QL'\ Omaha Lead Site—Fixed Price EP-R7-07-05 

o ^^^2 r ^ Coastal Environmental Group Inc. 

S^^^^Z^ www.coastalhazmat.com 

NpHoit ^ COASTA L EllfllOIINENTAl 

6 • O U P. IN C 

EXECUTIVE SUMMARY: 

BVID #29091-(1503 Ohio St) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 4/19/2011 
Property Completion Agreement 

This iiyiecmeni clocLimenis the LOinplchon ol remedi?! aciivmes pcMoimtdnn my properiy My sigiiaiurc 

uuill designalc ihai I am saiL^fied wilh lhe resloralion of my propeily. and ihai no uems are m quesnons. 

now, or al any lime m the fuiuir.. excepi ihose uems hsled below, ifany 

Propert)'ID ; i W ^ 

Propcrry. Address: f^P ) (j?)^ ^ ^ ^ 

Owne.-: ^J ^ ^^i^O ^ 

Phone: 

Restoration Items in Question: 

Additional Comments: 

^''fcXf) t-TrcTtc-rcMoralion w complcied, riccp l *% nnltrl 

[ I I rio nnl Ptji'fc rrjioratm n i.v coniplclcri 

X f>>Cry...r ^ 

Owner'."; Signafnrr Darr 
^ 

EPA Property Close Out Form 

Proptrty P ''^ ' ' Property Addrwr. >. ^ ^—.K^VT, . g/i "^ 

Dstt/Tlrae: 

Qusdi Excavatrd: Contrsftor Group

 , <Vir^ 

ExcavatioD y « No Gencnil 

1. If ncctssuy, wert the correct quadrani{i) excavated and restored? 

2. If necessary, were (he correci areai ofdrip zone excavated and restored? y 

Grading Sod acd VmcUtion 

Ves |Vo 

1. Does the grading arourd the perimeter ofthe house in excavaieri areas generally slope i^vxy 

frotn the house? 

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

3. Does Ihe sod appear to be generally healthy and growing? (Only evaluate if inspecifd ai a 30 / day lime period) 

4. AiT sodded areas g«i»eralty fum and evenly graded? 

r y 5 Art thejoints berween the sod strips generally tight? (Only evaluate if inspected at z 30 dsy 

i _ time period) 

-fy­ ) 6. Was tht property graded such Ihat waier will nol pool on lhe prnpertx'' 1 

j 7. Was dBiinige to landscaping or plant maieriais avoided? 

/ 

Gates. Fences «n<l ReUialPi! Walls ^n , .No 

r Do gates open and close freely? (If applicable) ZV^~ 

2. Were all gates or fences taken down during restoration activities reinjialied? (If app/icablf) 

3. Was damage to gates or fences avoided? (Ifapplicable) -zy 

4. Was damage to rcutning walls avoided? (Ifapplicable) 

u. 

Foupdation, Sidiat«nd Cullers Ves No 

Was damage to the siding or trim avoided? y 

7. Was damage to the foundation avoided? y 

.'. Was damage lo windows avoided? y 

6 Was damage to windows or door screens avoided'' 'y 

5. Was damage to downspouis or downspoul extensions avoided!' 

Sidevt-alks and Driveways (Coocrete) ^'rs No 

I 1. Was damage lo driveway surfaces avoided? 

2. Wa.s damage to walkway surfaces avoided'' '7 
OMpers romiH^ls: 

j fn.vpection notes: 

Removal a;id resloralion activates compJele including lhe 30-day .sod warrant' 

L-.PA Rcprescnuiiivt' 9<y» ^e ^ Date; ^|'''f'L