CONTRACT # W912DQ-04-D-0017, T.O. DK02 

Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE US Army Corps 

of Engineers 

ECC Certification for Property Closeout 

BVID 30880 Property Address 3404 N. 44Ih Ave 

Field Work Started 07/07/2006 Field Work Completed 07/07/2006 

Summary: 

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

• F2 excavation depth varied from 4 to 5 inches below ground surface. 

• Bl excavation depth varied from 4 to 6 inches below ground surface. 

• Verification samples confirmed that cleanup standards were met. 

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

• The backfill was compacted lo acceptable standards. 

• Sod placement and site restoration were conducted in compliance with the specifications and 

work plans. 

Comments: 

Per owner's request flower bed was left level 376 ppm. 

Skip Milton ECC Project Manager 

Name Title Date Signature 

Jeff Hubbard USAGE Con Rep 

Name Title Date 
Omaha Lead Site 

Site Sketch 

Lead Concentration 

ppm 

Omaha Lead Site 46130 
page 1 of. 

Omaha Lead Site 

Omaha, NE 

U.S Residential Yard Soils . Environmental Protection Agency Region VII 

Environmental Restoration 

Services 

PROPERTY ACCESS (to be completed by property owner) 

U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USAGE), Omaha 

District to conduct environmental restoration services for the Omaha Lead Site. USAGE Omaha is working with 

Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration 

services. Your cooperation is requested in giving EPA/USACE/ECC 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 r'-w 0A tits* // 

(Please Print Name) 

(PrApertVOvttier Signatur?) (Date) 

!/ 

NOTE: Granting permission DOES NOT necessarily imply your property will be remediated at this time. 

PROPERTY INFORMATION 

(to be completed by resident and/or properly owner • Please Print) 

Resident Name: 0ow j owner r LJ renter 

Residence Address: 

(CITY? (STATE) (ZIP) 

Property Owned By: 

Owners mailing address 

Owner's telephone number 

Age of Home? How long have you lived here? , 3 years 

Has the exteior been painted or covered with siding since 1978? 

Has the interior been painted or covered since 1978? 

Total number of occupants:_ List Ages: 

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

omments. 

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 title, or otherwise enforcing the provisions of this title." 

Access Attempts: 

First: Second: Third: : 
Contract No. W912DQ-04-D-0017, Task Order DK01

 

Omaha Lead Site, Omaha, NE 

Property Closeout Agreement 

BVID Property Address 

Property Owner Is the Owner the Resident? Yes D No 

Compliance Statement: 

U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers 

(USAGE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. 

USAGE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead 

contaminated soil and provide subsequent restoration services. 

Your cooperation in giving EPA/USACE/ECC 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 

Prashant Khanna or ECC Project Manager 

Charles "Skip"Milton 

Name . TitlC Date ~ A SVOA H;\L\ PiM 7-CS-6J6 

s

^Ti l-K 

PROPERTY OWNER SECTION 

This agreement documents the completion of remedial/restoration efforts at the property to my 

satisfaction. 

l_l I agree that restoration is completed at my property, except as noted 

Comments (if applicable): 

1?tf V^ V 7TVM ,LW 61— ll-~ 0 /* 

Property Owner's ^igniture Date" " " 
Property Owner Satisfaction Survey Form 

Omaha Lead Superfiind Site 

Performance-Based Contracting (PBC) Pilot Project 

Remediation Contractor: 

Property Identifier Number: 

Property BVID Number: JO 

Property Address: 

Property Owner's Name: 

(above information to be filled out by remediation contractor prior to delivery of form to Property Owner) 

Instructions to Property Owner; 

This form 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 (USAGE) 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 USAGE 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 L/ 5 _ 

9 4 

8 3 

7 2 

6 1 

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

~~~T I 

Property Owner's Signature: //. /X^-V-U^£^ 0V\ /^/lAt-a/.t-v- Date: D 
CONTRACT # W912DQ-04-D-0017, T.O. DK02 

Environmental Chemical Corporation 

Omaha US Army Corps Lead Remediation, Omaha, NE of Engineers 

Analytical Results Summary 

BVID #30880 

3404 N 44 Ave 

Sample 

Type 

Quadrant Depth Date Collected XRF Results 

(ppm) (avg.) 

Lab Results 

ppm (avg.) 

DE B1 6 7/5/2006 79 NA 

DE F2 5 7/5/2006 320 NA 

PX EA-E 0 7/5/2006 107 NA 

PX EA-S 0 7/5/2006 164 NA 

BVIDBVID 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-Excavaiion XRF sample 

PE - Pre-Excavation laboratory sample 

DE = During and Post Excavation 

Quadrant describes the sampling location (with sequential sample number for that location) as follows; 

Fl or F2 = Front Yard One or Front Yard Two 

BI or B2 = Back Yard One or Back Yard Two 

DZ - Drip Zone 

GA = Garden 

PA = Play Area 

EA - Easement 

Depth describes the depth from which the sample was collected, 

ppm - parts per million 
Property Check Lists QC 

Location 

BVID 

Dates 

Excavation check list 

have easement map 

have site map 

home owner agreement 

line locator 

access log 

decon station 

tape barricade 

garden hose 

reconstruction map for buildback 

fences 

sod areas 

mulch 

gravel 

notes 

name and date 

^c. Cx: i^4r 

QC Notes 

XRF check list 

have easemet map (1) 

have site map (3) 

easements sample 

F1 samples 

F2 samples 

B1 samples 

62 samples 

DZ samples 

AS-Built 

map corrected 

shots mapped 

concrete mapped 

trees marked 

LIP marked/noted 

name 

date 

easement mapped 

window wells mapped 

ac mapped 

Log book up to date 

Backfill check list 

reconstruction map 

positive drainage from house 

NO low spots 

NO Rake Gaps 

lawn even 

soil compacted 

sidewalk 1"cuts 

smooth transition from walks 

area free of debris 

fences repaired 

damage to property? 

damage list 

punchlist filed •SfS 
Omaha Lead Site 
Omaha Lead Site 46130 
•Map Output Page 1 of 1 

» 3404 N. 44th Ave/BVID 30880 

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Black and While Ay rials 

http://webarc.co.douglas.ne.us/servlet/com.esri.esrimap.Esrimap?ServiceName=TestAerials... 6/9/2006 
Omaha Lead Site 46130