### CONTRACT # 

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


### ECC Certification for Property Closeout

OLSID 29382 

### Property Address 2615 N 15 th 

### Ave 

### Field Work Started 9/20/2007 

### Field Work Completed 9/24/2007 

### Summary: 

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

# • B2 excavation depth was 12 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

ECCOCM

# 'Qho.~1- Title Date ll-).-{} 

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

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## 29382 Owner Name: STEVE J HUBER Address: 2615 N 15AV

Phone: H: 402-451-5153 

### Omaha lead Site Site Sketch w; 

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### If Exterior Paint 

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### XRF Code 

## 3J.H!b 

# . Quadrant Lead Concentration FI.
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## 2./if**ppm~** 

### F2.
_ t!175 ppJ1l>1i Bl
_ 0(70**pp~** 

### B2 

### 101**~~** ppm 

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## of_**:)q3'ir~** 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) D3ra**(ec.bl~** Es:a ·C'"11? en est=ancl cor**~avor** Ham.; al i·BOD·22J-':'42S 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 working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation is requested in giving EPNUSACElECC permission to access your property during the removal/restoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­

003 or the Office of Extemal Programs, at 1-800-223-0425. Property Access GrantedBy (Please Print Name)

I



### .......... ..... W
..... 

# o renter ! Resident 

### Name:---"S TL......>oo!;<..:II{_ 

### JV...:.....:;.,V
.... £-.L:e.o.....----\:l,---L----'O:::;..-:.T....,,)<--

## ~ner Residence

### Address:_=~:...I(p~1 

## S**---= N-=---'I-"s:~L...It** **<-.:V'--** 

### __ (STATE) (ZIP) Property Owned**By:._--==S=-T.L......>o£_V.=.....a..E--'II'-L-IotJ"-"~** _ 

### ....I:""'"-L.te.:...­
: Owners mailing address:

_

I Owner's telephone number - Home:

__**'i...L.:::S:::=....LI_----=:S:::...LI.:..5"'--='.s~** 

### __ geofHome?

______ years How long have you lived here?

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

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

# o No

otal 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 activities to be implemented by EPA under this agreement are pursuant 10 Section 104 ofCERCLA, 42 U.S.C. 9604. EPA's right of access to he property fOf in Section 104(e) of CERCLA, 42 U.S.C, 9604 (e), which provides entry for. "determining the need for response, or choosing Of aking any response action under this title, Of otherwise enforcing the provisions of this title." Access Attempts: First: Second: : Third: :

### pg._of_ 

# List of Existing Conditions Property Address:

# ~(P15**~.j~** A:...L...Y
_ 

## DVD ID 

## #

# ~93 

# gJ-
Owner: 

# diM. Date: 

# 8!31/()'] BVID#

## a938~

Ref: 

### Photo # 

### Description

Owner Signature ECC 

### Print & 

### Sign Print 

### & Sign

### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation 

# m ., .EI::I::. 

### Omaha Lead Remediation, Omaha, NE us Army Corps of Engineers 

## Analytical Results Summary OLS #29382 2615 N 15th 

## Ave
Quadrant Sample Date Collected 

# I

# ~pth I Type 9/21/2007 DE 82 12 

## I II 

# II I II II 

# I 

# I II 

# I II 

## I II 

## I II 

# I II 

# I XRF Results (ppm) (avg.) 236 

## I 

# I I 

# I 

# I 

# I I

SAMPLE IDSAMPLE ID 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-Excavation XRF sample DE During and Post Excavation Quadrant describes the sampling location (with sequential sample number for that location) as follows; F1 or F2 = Front Yard One or Front Yard Two 81 or 82 = 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

### Contract No. W912DQ-04-D-0017, Task Order 

### DKOI Omaha Lead Site, Omaha, NE Property Closeout Agreement BVID 

### Property Owner Property Address Is the Owner the Resident? DYes

### ~No 

### 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 (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EPA1USACElECC 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 orthe Office ofExtemal Programs at 1-800-223-0425. 

### Additional Comments by USACE and/or ECC:



# L.o+

CONTRACTOR CERTIFICATION Prashant Khanna or EeC Project Manager Charles "Ski "Milton 

### Name J Hel\

# ~~uV'"er PROPERTY OWNER SECTION This agreement documents the completion ofremedial/restoration efforts at the property to my sati sfaction.
I agree that restoration is completed at my property, except as noted 

### ents (ifapplicable):

Date

## Property Owner Satisfaction Survey Form Omaha Lead Superfund Site Performance-Based Contracting (PBC) Pilot Project
Remediation Contractor: 

# J_L_L.
_ Property Identifier Number:
_ Property BVID Number: 

### "2,

## 9_3_~-=--2- 

# _ Property Address: 

# ZLLIS AJ I

# '5 

# t 

# Ave VI ()

# e Property Owner's Name: 

# SfeveVl 

# Ii ube V'"' (above infonnation to be filled out by remediation contractor prior to delivery ofform 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. Anny Corps of Engineers (USACE) are very interested in your opinion regarding the work performed by our contractors. This fonn is intended to provide an easy means for you to express your opinion about the work perfonned 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 fonn 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 Contractor's Work 10 

### 5 9 

### 4 

### 8 3 7 2 6 I 

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

Date: Property Owner's Signature:·