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


District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is working wlh 


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


services. Your cooperation is requested in giving EPNUSACUECCpenisdion to access your property during the 


removallrestoration 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. 


Propem Access Granted By Y 

(Please Print Name) 

q-dl d7 

(Date) . 

I~esidentName: 7~dfllLK5 owner Menter 
A
Residence ~ddress: dsag STDL a? 


Properly Owned By: s. ck /T &/3-k~b
 L b 

Owners mailing address: 2 51% Bf;??d v - 5t . 4 Om4b, f 6Wl8

Owner's telephone number - Home: q4u A3305 )73b- 4g23work: 7~6- Ytld.8 

C ge of Home? years How long have you lived here? years Hasthe exteior been painted or covered with siding since 1978? 0 yes fl NO Has the interior been painted or covered since t 978? C1 Yes NO 

number of occupants: List 

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

[comments: 

AUTHORITY FOR ENVIRONMENTAL RESPONSEACTIONS The activities to be implementedby EPA under this agreement are pursuant to Section 104 of CERCIA. 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 lor ."determiningthe need lor response, or choosing oc 
taking any response actionunder this title,or otherwise enforcing the provisions of this litle.' 
 T 


Access Attempts: 

First: Second: : Third: : 
Ref: 

Photo Description 

# 

SEE '-fErC/&Fs * Wy- 3305- / L UCY) 
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 in giving EPA/USACE/ECC permission to access your property during the 

removalfrestoration 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) 55 1-7003 or the Office of External Programs at 1-800-223-0425. 

Additional Comments by USACE and/or ECC: 

.-... ..-a ... 

CONTRACTOR CERTIFICATION 

Prash JamesD.Garcia ECC Project anager &) Date wndent 1. ... 

PROPERTY OWNER SECTION 

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

satisfaction. 

Q/;agree that restoration is completed at my property, except as noted 

Comments (if applicable): 

A .. 

, 
Property~ddress: as&8' 1?@1572?~ STProperty Owner's Name: C~IFRMFJ~LA 

(above information to be filled out by remediation contractorprior to delivery ofform to Property Owner) 

.............................................................................. 


Inshuctions to Promrhr Owner: 

This form is provided to you as ameans of trying to capture your levd 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 @PA) and the U.S. Army 

Corps of Engineers (USACE)are very interested inyour 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 1to 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 of the property owner.) 

9-10 ccexcellent" 
7-8 "very good" 
5-6 "acceptable" 
3-4 "poor" 


1-2 "very poor" 


Pro~eFtvOwner's ~ati~on Ratine mardin% Contractor's Work 

I 

Additional Comments from Prouertv Owner (o~tionak contjnue on back of ~aueif needed) 

. . 

Property Owner's Signature: Date: 16-3i9 -09