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 23139 Property Address 112 N 31 51 Ave 

Field Work Started 10/10/2007 Field Work Completed 10/20/2007 

Summary: 

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

• Fl excavation depth was 6 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 

D).·..; of.;; N ..' {)::J- ECCOCM 

Name Title Date 

Jeff Hubbard USACE Con Rep ii-I ~-01

Name Title Date 

"'" 
--

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-/-­

23139 

Omaq~ l.__ ad Site Owner Name:RfCHARO H SlOSBURG R 

Address,: Site Sketch 1 2 N31 AV --


Phone: Ii; W'
 

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page 1 of_
 

Omaha lead Site 

Omaha, NE 

Residential Yard Soils
 

Environmental Restoration
 

Services
 

U.S. Environmental Protection Agency Region VII 

• PROPERTY ACCESS (to be completed by property owner) 

~~,~",::.~'t.~'..J·C·'.. 2·· ... ". ~,..., 'oJ .. s .~r" ... :- :~.=_

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

District to conduct environmental restoration senrices 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 EPA/USACEJECC 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 External Programs. at 1-800-223-0425. 

Properly Access Granted By 

(Please Prinl Name) 

Downer o renter 

(STATE) (ZIP) 

Resident Name:--Y8cANT LOT 

Residence Addres~: 11eJ.. N eX' !tV 

Property Owned By: giClifrfU'> SLt68iJt6: T~ c)sr 

Owners mailing address: / (JO if0 /(§G'tJJ(!..f C if( eLf S ()IT€ 11"~~ OMn/t4 

Owner's telephone number - Home: S 7/- I) roo Work: ----------~I

ge of Home? ______years How long have you lived here? ____years 

Has the exteior been painted or cover:ed 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:--------------------fI1 

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 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 

aki any response action under this IiUe. Of othelWise enforcing the provisions of this title." 

Access Attempts:
 

First: Second: : Third: : _
 

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

Environmental Chemical Corporation ., 

.ECC.

Omaha Lead Remediation, Omaha, NE us Army Corps 

of Engineers 

Analytical Results Summary 

OLS # 23139 

112 N 31st Ave 

Sample 

Type I Quadrant II Depth I Date Collected 

I DE II F1 II 6 I 10/12/2007 

I 

I 

DE 

DE 

I EA-E 

I 82 Ute 

0 

0 

10/12/2007 

10/12/20007 

I 

I 

I I I 

XRF Results 

(ppm) (avg.) 

68 I 

168 I 

I 66

I 

II 

II 

SAMPLE 10-

SAMPLE ID is a particular residential property ID from which Ihe sample is collected. 

The sample 'Ype identifier (with sequential sample number for that location) as follows; 

PX '"' Pre-Excavation XRF sample 

DE = During and Post Excavation 

Quadrant describes Ihe 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 
Contract No. W912DQ-04-D-0017, Task Order DKOI
 

Omaha Lead Site, Omaha, NE
 

Property Closeout Agreement 

BVID 23 \,:>q Property Address I\\?- tJ 3 \ AN'­

Property Owner »~'! S\1)S ~j Is the Owner the Resident? ~~ \N;;1 

Compliance Statement: 

U.S. Environmental Protection Agency (EPA) has contracted the U.S. Anny 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 EPA1USACEIECC 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 ofExternal Programs at 1-800-223-0425. 

Additional Comments by USACE and/or ECC: J.o c..k I\f\o,.,,~ "1 'C .L- .QS-I-tA-k.. f~ "i\l-.1J£e.- -h, $(!.., 

(rl) W\Nj~. Sc....e.. ~O'-b ~+~uJ~J Cl+(~+

<6 -\-i 'rJ\~ . '(.eb ~Qt\ 0< lAJ\' \\ V\ 0+- S LS\A . 

CONTRACTOR CERTIFICATION
 

~0Jv\~ 5v..t?~~ECC Project Manager
 S\~> l O<? ,f.~

Name Title Date Signature

PROPERTY OWNER SECTION 

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

satisfaction.
 

• I 

N--...,. "'". lI\ JQ 

I agree that restoration is completed at m.y-property, except as noted 

Comments (if applicable): 

US b:=...~a.I.f lA tk~ \)rvp..-: ...·t'1 0Ui "'H.'..... AC.Ji.. (f;)~~C\ D \5+,..,C,", IS s\~l\J"~ a/v 

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\.A.J G ) ? <,c v,ol ~.J ~~ Ecc 

() // .JCJU OMClhq 

///r/ J b-' u c t1..I" 

Property Owner's Signature 

f)'~"'rl;; 7 /().5~/

Date