CONTRACT # EP-R7-06-04 

ASW Associates Inc. 

Omaha Lead Site Remediation, Omaha, NE 

EPA 

ASW Associates Inc Certification for Property Closeout 

BVID 21987 Property Address 2912 Mason Street 

Field Work Started 12-Jun-06 Field Work Completed 29-Jul-06 

Summary: 

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

The F1 quadrant was excavated to a depth of 12 inch. 

The F2 quadrant was excavated to a depth of 6 inch. 

The B1 quadrant was excavated to a depth of 12 inch. 

The B2 quadrant was excavated to a depth of 12 inch. 

The drip zone was excavated to a depth of 18 inch. 

Verification samples confirmed that the cleanup standards were met.

 

The site was backfilled with materials which meets contract specifications.

 

The backfill was compacted to acceptable standards. 

Sod placements and site restorations were conducted in compliance with work plans and 

specifications. 

• Analytical data provided is post excavation at the bottom of the excavation for confirmation 

purposes 

Comments: 

None. 

Jan Prawdzik ASW Project Manager .tfde ^—/g)y 

Name Title Date ^-^ SidKature ^ 

40262006
 

SUPERFUND RECORDS
 
CONTRACT n EP-R7-06-04 

ASW Associates Inc. 

Omaha Lead Site Remediation, Omaha, NE 

EPA 

Analytical Result Summary 

OLS ID: 21987 

Property Address: 2912 Mason Street 

XRF Results Lab 

Sample ID Avg. Results

 

(ppm) (ppm)

 

21987-DE-F1-12 165.6 ±52 NA 

21987-DE-F2-06 205.3 ± 52.3 NA 

21987-DE-B1-12 346 ± 60 432 

21987-DE-B2-12 119,6 ±47 NA 

21987-DE-DZ-18 341 ± 109 526 

Jan Prawdzik ASW Project Manager 

Name Title Date Signatured 

Sample Designation 

OLSID-DE-Lowrlon-dd 

OLS1D is a particular residential property ID from which the sample is collected. 

DE = During and Post Excavation 

Location of the sample as follows;

 

Fl = Front Yard (I" Quadrant) 

B1 = Back Yard (1* Quadrant) 

F2 - Front Yard (2** Quadrant) 

B2 = Front Yard (2" Quadrant) 

DZ = Drip Zone 

PZ = Play Zone 

GA» Garden 

EA = Easement 

dd describes the depth from which the sample was collected. 

NA = Not Appl icablc 
&EPA

 

Property #: 

Date/Time: 

Quads Excavat 

Remediation/Excavation Contract (ASW) 

EPA Property Close Out Form 

Property Address: /V)»QOlO (5t. 

Owner's Name: g. Contractoe.Group 

Excavation General ^ 1 / / Yes No 

•"' 1 . If necessary, were the correct quadrant(s) excavated and restored? u­ 2. If necessary, were the correct areas of drip zone excavated and restored? ,»- LGrading Sod and Vegetation Yes No 

i. Does the grading around the perimeter of the house in excavated areas generally slope away ( from the house? 

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

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 ** 

day time period) u/ 

£^>* '" 4. Are sodded areas generally firm and evenly graded? 

5. Are the joints between the sod strips general ly^teb£fl(Only evaluate if inspected at a 30 day |l\1r 

time period) &d CtCeM /^-/^^WZtfl C to^ \j /

6. Was the property graded such that water will not pool on the property? \/ 

7. Was damage to landscaping or plant materials avoided? \_^ s

Gates, Fences and Retaining Walls /) Q i t*tM>/{^^ Yes No 

7 1. Do gates open and close freely? (If applicable) ^ / 

2. Were all ptes or fences taken down during restoration activities reinstalled? Of applicable) 

3. Was damage to gates or fences avoided? (If applicable) 

4. Was damage to retaining walls avoided? (If applicable) 

Foundation, Siding and Gutters Yes No 

1 . Was damage to the siding or trim avoided? U ^

­ 2. Was damage to the foundation avoided? L^ ^ 

L- 3. Was damage to windows avoided? *r~ 

4. Was damage to windows or door screens avoided? \^­^ 

5. Was damage to downspouts or downspout extensions avoided? yLX 

Sidewalks and Driveways (Concrete) Yes No 

1 . Was damage to driveway surfaces avoided? U/ 

2. Was damage to walkway surfaces avoided? ^/ 
Owners comments: 

Inspection notes: 

Gap* ' 

OF 

t., 

Removal and restoration activates complete including the 30-day sod warranty: 

EPA Representative *£U j^L- Date: 
g Contract No: EP - R7 - 06 - 04 

Property Closeout Agreement (y&| Omaha Lead Superfund Site 

OLSID Property Address 

toil *««. ^ 

Property Owner Is the Resident the Owner D Yes D No 

«JOH*) «Sfi^Oi5T> 1 

Compliance Statement: 

U.S. Environmental Protection Agency (EPA) or its authorized representatives, (or its contractors), to enter 

and conduct environmental restoration services for the Omaha Lead Site. 

Your cooperation in giving EPA/ASW 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 contact specifications and EPA requirements. 

If you have questions or need additional information please contact the EPA Public Information Centers at 

(402) 73 1-3045 or (402) 991-9583 or the EPA Office of External Programs at 1-800-223-0425. 

Additional Comments by EPA and/or ASW: 

CONTRACTOR CERTIFICATION 

Jan Prawdzik ASW Project Manager 

Name Title Date Signature 

Property Owner Section 

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

P. I agree that restoration is completed at my property 

D I Do Not Agree: Comments: 

(\ —X » VI R A 

(^Ti ^^ ^vJLJ.^i. I) Property Owner's Signature Date 0-lfa/0t> 

' 1 

J^^cXMi^Tfe^ 

(JEPA. Representative Signature Date

 07 '/Olfa 
Page 1 of 

Omaha Lead Site 

Omaha, NE 

U.S. Environmental Protection Agency Region VII 

Residential Yard Soils 

Environmental Restoration 

Services 

Grantor (the property owner), consents to and authorizes the United Sates Environmental Protection Agency (USEPA) 

or its authorized representatives (or its contractors), the Grantee, to enter and perform certain environmental response 

activities upon the following described premises. For farther information please contact EPA at 1-800-223-0425. 

Property Access Granted By 

(Please Print Name) 

5*- ii 

(PropffryfUwner Signature) (Date) 

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

Resident Name: D Renter 

Residence Address: 1 1 ST. (CITY) (STATE) (ZIP) 

Property owned by: 

Owners mailing address: 

Owner's telephone number—Home: j ( O "" f Work: 

Age of Home? fO years How long have you lived here? years 

Has the exterior been painted or covered with siding since 1978 D NO 

Has the interior been painted or covered since 1978? D NO 

^3> 

Total number of occupants: .~y List Ages: 

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

Comments: 

AUTHORITY FOR ENV1ORNMENTAL RESPONSE ACTIONS 

The activities to be implemented by EPA under this agreement are pursuant to Section ! 04 of CERCLA, 42 U.S.C. 9604 EPA's right of access to the 

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 taking any response action under this title, or otherwise enforcing the provisions of this title." 

Access Attempt^; 

First: Second: Third: 
List of existing Conditions pg-

Property Address: 2-^)0-

Owner: Date: ^ "//^j> OLS#: *Z ]

 

Description: 

Owner Signature: ASW Associates Inc. 

Print & Sign Print 
21987

 

Omaha Exterior Paint Owne Lead Site r Name: JOHN E SKARDSKL 

Sit Good e Sketch Addrax; 2912 MASON ST [JJ'foor 

Phone: H: 402-333-2928 W: 402-731-6136 Not paint 

Sample Number Lead 

Concentration 

Sample 

Collect) 

Samples Collected 

RYASCPXA-21987 

RYBSCPXA-21987 

RYCSCPXA-21987 

RYDSCPXA-21987 Samples Analyzed 

RDZSCPXA-21987 

Number of Samples = ; 

ENTERED 

Omaha Lead Site 46130