### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 

# r:P'S':'Il Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE us Army Corps of Engineers 

### ECC Certification for Property Closeout
OLSID 30575 

### Property Address 2201 Spencer St 

### Field Work Started 10/3/2007 

### Field Work Completed 10/3/2007 

### Summary: 

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

# • F I excavation depth was 5 inches below ground surfaces. 

# • F2 excavation depth was 5 inches below ground surfaces. 

# • B2 excavation depth was 5 inches below ground surfaces. 

# • Verification samples confirmed that cleanup standards were met. 

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

# • The backfill was compacted to acceptable standards. 

# • Site restoration was conducted in compliance with the specifications and work plans.



### Comments: None

### 5~ c-H j) .JfV:,J 

### ECCQCM 01 NO'J C ':}­ 

### Name Title Date JeffHubbard Name USACE Con Rep Title 

# Date III (:Xk) i

# 1 1II1111Wd100100 III flrl 30575 NOJthArrow**Exteri~r** Pai'l 

### Omaha lead Site Owner. ame: rAARLA M WY 

# o GOOd 

### Site Sketch**Addre$$~** 2201 SPENCER ST '" 

# o Poor Phone- H: lJoZ 

### c?r w: q{P'}(p @"Not paint Team 

### T;lRve Quadrant F1 ,..,..- _**F2._---'s~5.L_1I** _ B1
_ r;( 82 ·

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### C/f-,l{,6ffi-Of**OLS.---'--R.....Ji2~>,LJ'-L** 

### XRF Code**~77** 

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### Lead Concentration 

# .?rtI ppm-* 

### 37 ppm 

### €tr6 PPnW 

### ISO ppm

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### CONTRACT # 

### W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE US Army Corps of Engineers 

### Analytical Results Summary OLS # 

### 30575 2201 Spencer St
Sample Quadrant

Type



### DE 

## I F2 

# I DE II 82 

# I DE 

# I EA-N DE 

# I EA:Mr DE 

# I F1 

# I 

# I Depth

0 

## a 5 Date Collected XRF Results (ppm) (avg.) 

# H 9/28/2007 

### 37 9/28/2007 150 9/28/2007 

# I 209 

# I 9/28/2007 

# I 308 

# I 9/28/2007 

# I 217 

# I

SAMPLE ID IS a particular rcsidelllial property ID from which the sample IS collected. The sample type identllier (with sequential sample number for that localion) as follows; PX = Pre-Excavation XRfo sample DE = During and Post Excavation Quadrant describes the sampling location (with sequential sample numher for lhat locallon) as follows, FI or F2 =Front Yard One or Fronl Yard Two BI or 132 

### =Back Yard One or l3ack Yard Two DZ'" Drip Zone GA = Garden PA =Play Area EA =Easement Depth describes the depth from which lhe sample was collected ppm =pariS per million

## ----------- 

# ----------- ----------- page 1 

## of_**30S~S** Omaha lead Site Omaha, NE Residential Yard Soils U.S. Environmental Protection Agency Region VII Environmental Restoration Services 

# • PROPERTY ACCESS (to be completed by property owner) ;':.'

_ =- "**~.** : : - . '+: '''';:' •. _ _ _' • _ •**.-~** : ;.**~.** r.'- _..:..: :,,::'j U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USACE), Omaha District to conduct environmental restoration services for the Omaha lead Site. USACE Omaha is wort<ing with Environmental Chemical Corporation (ECG) 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

(Date) (Please Print Na PropertyAccess GrantedBy 003 or the Office of External Programs, at 1-800-223-0425.

geofHome?

______ years How long have you lived here?

_____ years Has the exteior been painted or**cove~ed** with siding since 1978? DYes 

# o No Has the interior been painted or covered since 1978? DYes 

## D No

olal number of occupants:, _ list Ages:

## '------------------11 List ages of occupants under 6 years old who play in the yard for 5 or more hours per week:,
_ Comments:

UTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS he aetlvibes 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 e 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 an response actIon under thIS title. or otherwise enforcing the provisions of this title," Access Attempts:' First: Second: : Third: :pg._of_ 

# List of Existing Conditions Property Address:**~l.,=.;~----:~f-Uo""-'--'L..-.:=~** _ 

## DVD 10 

## # 

# 3D575 Date: BVID#
............

# ~"'-'- .......__ Ref: 

### Photo #



### ECC 

### Print & 

### Sign Description

Owner Signature Print & 

### Sign

### Contract No.**W912DQ~04-D-0017,** 

### Task Order DKOI Omaha Lead Site, Omaha, NE Pronerty Closeout Agreement



### . Tagree that restoration is completed at my property, except as noted Comments (ifapplicable):**Proper~** 

### Owner's SCgntrhlre 

# U Datl" BVID Property Address 

# I :J..J-tJ , 

# s fJ€,1J C€ 

## It Property Owner 

### fh**L~** 

## vi l{

### AJ 

## AJ Is the Owner the Resident? 

# 0 Yes 

## IiJ-N'O Compliance Statement: 

### U.S. Environmental Protection Agency (EPA) has contracted the 

# u.s. Army Corps ofEngineers (USACE). Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is. working with Environmental Chemical Corporation (BCC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EPNUSACElECC 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. Ifyou have questions or need additional information please contact Don Bahnke, EPA Project Manager, at (913) 551-7003 or the Office ofExternal Programs at 1-800-223-0425. Additional Comments by 

### USACE and/or ECC:

CONTRACTOR CERTIFICATION 

### ECC Project Manager Signature Title Date Name 

## PROPERTY OWNER SECTION This agreement documents the completion ofremedial/restoration efforts at the property to my satisfaction.

# •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• Property Owner Satisfaction Sunrey Form Omaha Lead Superfund Site Perfonnance-Dased Contrading (PDC) Pilot Projed Remediation Contrador: --"1'--
....... """------------------ 

### Property Identifier Number: _ Property OVID 

### Number: IS 

## OS 

# '7..s: Property Address: 

## .blOt.:s eErA} k,Et:. 

### Property Owner's Name: 

## InMU'l W LIAJ A) (above infonnation to be filled out by remediation contractor prior to delivery offonn to Property Owner) 

### Instructions to Property Owner: 

### This fonn is provided to you as a means oftrying to capture your level ofsatisfaction with the work ofthe 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 ofEngineers (USACE) 

### are very interested in your opinion regarding the work perfonned 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 ofsatisfaction with the Contractor's work by selecting a numerical rating (ranging from I 

### to 10) using the following rating scale, then please sign & 

### date the form and return it to USACE in the attached self-addressed & 

### stamped envelope. (Additional comments may 

### also be 

### provided in the space provided, at the option ofthe 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 Contrador's Work 

### 10 9 

### 8 5 

### 4 3 7 2 6 1 

### Additional Comments from Property Owner (optional; continue on back ofpage ifneeded)

Property Owner's Signature: Date: 

## IJ.--OS-()?