### CONTRAC T # W912DQ-04-D-0017 , T.O . DK0 2 Environmenta l Chemica l Corporatio n Omah a Lea d Remediation , Omaha , N E U S Arm yCorp s o f Engineer s 

### EC C Certificatio nfo r Propert y Closeou t BVI D 3088 0 Propert y Addres s 340 4 N . 44 I h

### Av e Fiel dWor k Starte d 07/07/200 6 Fiel dWor k Complete d07/07/200 6 Summary : •Th e excavatio nwa s performe di n complianc e wit hth e wor k plan s an dspecifications . •F 2 excavatio n dept h varie dfro m4 t o 5 inche s belo w groun dsurface . •B l excavatio n dept h varie dfro m4 t o 6 inche s belo w groun dsurface . •Verificatio n sample s confirme dtha t cleanu p standard s wer e met . •Th e sit e wa s backfille dwit hmateria l whic hmeet s th e contrac t specifications . •Th e backfil l wa s compacte dl o acceptabl e standards . •So dplacemen t an dsit e restoratio n wer e conducte di ncomplianc e wit hth e specification s an d wor k plans .

Comments : Pe r owner' s reques t flowe r be dwa s left leve l 37 6 ppm . Ski p Milto n EC C Projec t Manage r Nam e Titl e Dat e Signatur e Jeff Hubbar d USAG ECo n Re p Nam e Titl e Dat eOmah a Lea d Sit e Sit e Sketc h

Lea d Concentratio n pp m

Omah aLea dSit e 4613 0

### pag e 1 of . Omah a Lea d Sit e Omaha , N E Residentia l Yar d Soil s U.S . Environmenta l Protectio n Agenc yRegio n VI I Environmenta l Restoratio n Service s PROPERT Y ACCES S (t o b e complete d b ypropertyowner ) U.S . Environmenta l Protectio n Agency(EPA ) ha s contracte d th e U.S . Arm yCorp s o f Engineers (USAGE) , Omah a District t o conduc t environmenta l restoratio n service s fo rth e Omah a Lea d Site . USAG E Omah a i s workin g wit h Environmenta l Chemica l Corporatio n (ECC ) t o remov e lea d contaminate d soi l an d provid e subsequen t restoratio n services . You rcooperatio n i s requeste d i n givin g EPA/USACE/EC C permissio n t o acces s you rpropert ydurin g th e removal/restoratio n phase . Fo rfurthe rinformatio n pleas e contac t Do n Bahnke , EP AProject Manage ra t (913 ) 551 ­ 700 3 o rth e Offic e o f Externa l Programs , a t 1-800-223-0425 . Propert yAcces s Grante d By 

# r'- w 0 A

# tits * / / (Pleas e Prin t Name ) (PrApertVOvttie rSignatur? ) (Date ) ! / NOTE : Grantin g permissio n DOE S NO T necessaril yimpl yyou rpropert ywil l b e remediate d a t thi s time . PROPERT YINFORMATIO N (t o b e complete d b yresiden t and/o rproperl yowne r• Pleas e Print ) j L J rente r Residen t Name : 0ow r owne r Residenc e Address : (CITY ? (STATE ) (ZIP ) PropertyOwne d By : Owners mailin g addres s Owner' s telephon e numbe r Ag e o f Home ? Ho wlon g hav e yo u live d here ? , 3 year s Ha s th e exteio rbee n painte d o rcovere d wit h sidin g sinc e 1978 ? Ha s th e interio rbee n painte d o rcovere d since 1978 ? Tota l numbe ro f occupants: _ Lis t Ages : Lis t age s o f occupant s unde r6 year s ol d wh o pla yi n th e yar d fo r5 o rmor e hours pe rweek :

omments . AUTHORIT YFO R ENVIRONMENTA L RESPONS E ACTION S Th e activitie s t o b e implemente d b yEP Aunde rthi s agreemen t ar e pursuan t t o Sectio n 10 4 o f CERCLA , 4 2 U.S.C . 9604 . EPA' s righ t o f acces s t o h e propert yfo ri n Sectio n 104(e ) o f CERCLA , 4 2 U.S.C . 9604 (e) , whic h provide s entr yfor . "determinin g th e nee d fo rresponse , o rchoosin g o r akin g an yrespons e actio n unde rthi s title , o rotherwis e enforcin g th e provision s o f thi s title. " Acces s Attempts : First : Second : Third : :

### Contrac t No . W912DQ-04-D-0017 , Tas k Orde r DK0 1 Omah aLea dSite , Omaha , N E Propert y Closeou t Agreemen t BVI D Propert y Addres s Propert y Owne r I s th e Owne r th e Resident ? 

### Ye s D N o Complianc e Statement : U.S . Environmenta l Protectio n Agenc y (EPA ) ha s contracte dth e U.S . Arm y Corp s o f Engineer s (USAGE) , Omah aDistric t t o conduc t environmenta l restoratio n service s fo r th e Omah aLea dSite . USAG EOmah ai s workin g wit hEnvironmenta l Chemica l Corporatio n (ECC ) t o remov e lea d contaminate dsoi l an dprovid e subsequen t restoratio n services . You r cooperatio n i n givin g EPA/USACE/EC C permissio n t o acces s you r propert y durin g th e removal/restoratio n phas e i s sincerel y appreciated . Thi s documen t certifie s tha t al l work performe da t thi s propert y wa s complete di n accordanc e wit hth e contrac t specification s an dEP A requirements . I f

yo u hav e question s o r nee dadditiona l informatio n pleas e contac t Do n Bahnke , EP A Projec t Manager , a t

(913 ) 551-700 3 o r th e Offic e o f Externa l Program s a t 1-800-223-0425 . Additiona l Comment s b y USAC E and/o r ECC :

CONTRACTO RCERTIFICATIO N Prashan t Khann ao r EC C Projec t Manage r Charle s "Skip"Milto n Nam e . Titl C 

### Dat e ~ A 

# SVOAH;\L \ PiM 7-CS-6J 6 

# s 

# ^Ti l- K PROPERT Y OWNE RSECTIO N Thi s agreemen t document s th e completio n o f remedial/restoratio n effort s a t th e propert y t o m y satisfaction . l_ l I agre e tha t restoratio n i s complete da t m y property , excep t a s note d Comment s (i f applicable) :



## 1?t f V ^ V 7TV M ,L W 

## 61 — 

## ll- ~ 

## 0 / * PropertyOwner' s ^ignitur e 

### Date " " "

## Propert y Owne r Satisfactio n Surve y Form Omah aLeadSuperfiin dSite Performance-Base dContractin g (PBC ) Pilo t Projec t Remediatio n Contractor : Propert y Identifie r Number : Propert y BVI D Number : J O Propert y Address : Property Owner' s Name : (abov e informatio n t o b e fille dou t b y remediatio n contracto r prio r t o deliver y o f formt o Propert y Owner ) 

### Instruction s to Propert y Owner ; Thi s for mi s provide dt o yo u a s amean s o f tryin g t o captur e you r leve l o f satisfactio n withth e work o f th e above-identifie dRemediatio n Contractor , a s applicabl e t o th e soi l cleanu p actio na t you r property . Th e U.S . Environmenta l Protectio nAgenc y (EPA ) an dth e U.S . Arm y Corp s o f Engineer s (USAGE ) ar e very intereste di n you r opinio n regardin g th e wor k performe d b y ou r contractors . Thi s for mi s intende dt o provid e an eas y mean s fo r yo u t o expres s you r opinio nabou t th e wor k performe do n you r property . Pleas e indicat e you r leve l o f satisfactio nwithth e Contractor' s wor k b y selectin g a numerica l ratin g (rangin g fro m1 t o 10 ) usin g th e followin g ratin g scale , the npleas e sig n & dat e th e for man dretur ni t t o USAG Ei nth e attache dself-addresse d& stampe denvelope . (Additiona l comment s may als o b e provide di n th e spac e provided , at th e optio n o f th e property owner. ) 9-1 0 "excellent " 7- 8 "very good " 5- 6 "acceptable " 3- 4 "poor " 1 - 2 "very poor " Propert y Owner' s Satisfactio n Ratin g regardin g Contractor' s Wor k 1 0 L /

5 _ 9 4 

### 8 3 7 2 6 1 

### Additiona l Comment s fro mPropert y Owne r (optional ; continu e o n bac k o f pag e i f needed )

~~~T I 

### Propert y Owner' s Signature : // . /X^-V-U^£ ^ 0V \/^/lAt-a/.t-v
- Date : D

### CONTRAC T # W912DQ-04-D-0017 , T.O . DK0 2 Environmenta l Chemica l Corporatio n U S Arm yCorp s 

### Omah a Lea d Remediation , Omaha , N E o f Engineer s 

## Analytica l Result s Summar y BVI D #3088 0 340 4 N 4 4 Av e
Sampl e

Typ e Quadran t Dept h Dat e Collecte d XR F Result s (ppm ) (avg. ) La b Result s pp m (avg. ) D E B 1 6 7/5/200 6 7 9 N A D E F 2 5 7/5/200 6 32 0 N A P X EA- E 0 7/5/200 6 10 7 N A P X EA- S 0 7/5/200 6 16 4 N A

BVID
BVI D i s aparticula r residentia l propert y I D fro mwhic hth e sampl e i s collected . Th e sampl e typ e identifie r (wit hsequentia l sampl e numbe r fo r tha t location ) a s follows ; P X = Pre-Excavaiio nXR Fsampl e P E- Pre-Excavatio nlaborator y sampl e D E= Durin g an dPos t Excavatio n Quadran t describe s th e samplin g locatio n(wit hsequentia l sampl e numbe r fo r tha t location ) a s follows ; F l o r F 2 = Fron t Yar dOn e o r Fron t Yar dTw o B I o r B 2 = Bac k Yar dOn e o r Bac k Yar dTw o D Z- Dri p Zon e G A = Garde n P A = Pla y Are a E A - Easemen t Dept hdescribe s th e dept hfro mwhic hth e sampl e wa s collected , pp m- part s pe r millio n

## Propert yChec k List s Q C Locatio n BVI D Date s Excavatio n chec k lis t hav e easemen t ma p hav e sit e ma p hom e owne ragreemen t lin e locato r acces s lo g deco n statio n tap e barricad e garde n hos e reconstructio n ma p fo rbuildbac k fence s so d area s mulc h grave l note s nam e an d dat e

^c . Cx : i^4 r Q C Note s 

## XR F chec k lis t hav e easeme t ma p (1 ) hav e sit e ma p (3 ) easement s sampl e F 1 sample s F2 sample s B 1 sample s 6 2 sample s D Z sample s AS-Buil t ma p correcte d shot s mappe d concret e mappe d tree s marke d LI P marked/note d nam e dat e easemen t mappe d windo wwell s mappe d a cmappe d Lo g boo k u p t o dat e 

## Backfil l chec k lis t reconstructio n ma p positiv e drainag e fro m hous e N O lo wspot s N O Rak e Gap s law n eve n soi l compacte d sidewal k 1"cut s smoot h transitio n fro m walk s are a fre e o f debri s fence s repaire d damag e t o property ? damag e lis t punchlis t file d •Sf SOmah aLea dSit eOmah aLea dSit e 4613 0

### • Ma p Outpu t Pag e 1 o f 1

» 340 4 N . 44t h Ave/BVI D 3088 0

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### http://webarc.co.douglas.ne.us/servlet/com.esri.esrimap.Esrimap?ServiceName=TestAerials .. . 6/9/200 6Omah aLea dSit e 4613 0