## CONTRAC T# W912DQ-04-D-0017 , T.O . DK0 3 Environmenta l Chemica l Corporatio n Omah a Lea d Remediation , Omaha , N E U S Arm yCorp s o f Engineer s 

## EC C Certificatio nfo r Propert y Closeou t BVI D 2844 9 

## Propert y Addres s 161 2 Willi s Av e Fiel dWor k Starte d 09/29/200 6 

## Fiel dWor k Complete d 10/02/200 6 Summary : •Th e excavatio nwa s performe di ncomplianc e wit hth e wor k plan s an dspecifications . •F l excavatio ndept hvarie dfro m4 t o 6 inche s belo w groun dsurface . •B 2 excavatio ndept hvarie dfro m4 t o 6 inche s belo w groun dsurface . • Verificatio nsample s confirme dtha t cleanu p standard s wer e met . •Th e sit e wa s backfille dwit hmateria l whic hmeet s th e contrac t specifications . •Th e backfil l wa s compacte dt o acceptabl e standards . •So dplacemen t an dsit e restoratio nwer e conducte di ncomplianc e wit hth e specification s an d wor k plans .

Comments : None . EC C Projec t Manage r I I~2 * Nam e Titl e Dat e Jeff Hubbar d USAG ECo nRe p Nam e Titl e Dat e

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## pag e 1 o f 

# 2 , * V V 7 Omah a Lea d Sit e Omaha , N E Residentia l Yar d Soil s 

### U.S . Environmenta l Protectio n Agenc yRegio n VI I Environmenta l Restoratio n Service s 

### PROPERT YACCES S (t o b e complete d b ypropert yowner ) U.S . Environmenta l Protectio n Agenc y(EPA ) ha s contracte d th e U.S . Arm yCorp s o f Engineers (USAGE) , Omah a District t o conduc t environmenta l restoratio n service s fo rth e Omah a Lea d Site . USAG E Omah a i s workin g wit h Environmenta l Chemica l Corporatio n (ECC ) t o remov e lea d contaminate d soi l an d provid e subsequen t restoratio n services . You rcooperatio n i s requeste d i n givin g EPA/USACE/EC C permissio n t o acces s you rpropert ydurin g th e removal/restoratio n phase . Fo rfurthe rinformatio n pleas e contact Do n Bahnke , EP AProjec t Manage ra t (913 ) 551 ­ 700 3 o rth e Offic e o f Externa l Programs , a t 1-800-223-0425 . Propert yAcces s Grante d By (Pleas e Prin t Name ) [P^perty " Owne rSignature ) (Date ) NOTE : Grantin g permissio n DOE S NO T necessaril yimpl yyou rpropert ywil l b e remediate d a t thi s time . PROPERT YINFORMATIO N (t o b e complete d b yresiden t and/o rpropert yowne r• Pleas e Print) Residen t Name : L J owne r L J rente r Residenc e Address : (CITY ) (STATE ) (ZIP ) Propert yOwne d By : Owner s mailin g address : ° ^ 

# < v Owner' s telephon e numbe r­ Home : / O ^ ~ / o *- ? Work : Ag e o f Home ? • year s Ho wlon g hav e yo u live d here ? year s Ha s th e exteio rbee n painte d o rcovere d wit h sidin g since 1978 ? D Ye s D N o Ha s th e interio rbee n painte d o rcovere d sinc e 1978 ? D Ye s D N o Tota l numbe ro f occupants : Lis t Ages : Lis t age s o f occupant s unde r6 year s ol d wh o pla yi n th e yar d fo r5 o rmor e hours pe rweek :

omments : AUTHORIT YFO R ENVIRONMENTA L RESPONS E ACTION S Th e activitie s t o b e implemente d b yEP Aunde rthi s agreemen t ar e pursuan t t o Sectio n 10 4 o f CERCLA , 4 2 U.S.C . 9604 EPA' s righ t o t acces s t o h e propert yfo ri n Sectio n 104(e ) o f CERCLA . 4 2 U.S.C . 9604 (e) . whic h provide s entr yfor . "determinin g th e nee d fo rresponse , o rchoosin g o r akin g an yrespons e actio n unde rthi s title , o rotherwis e enforcin g th e provision s o f thi s title " Acces s Attempts : First : Second: : Third : :

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### CONTRAC T # W912DQ-04-D-0017 , T.O . DK0 3 Environmenta l Chemica l Corporatio n U S Arm yCorp s 

### Omah a Lea d Remediation , Omaha , N E o f Engineer s 

# Analytica l Result s Summar y BVI D #2844 9 161 2 Willi s Av e Sample

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### 67 1 4 6 0 | La b Result s pp m(avg. ) 

### N A N A N A
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tha t location ) a s follows : F l o r F 2 = Fron t Yar dOn e o r Fron t Yar dTw o B Io r B 2 = Bac k Yar dOn e o r Bac k Yar dTw o D Z= Dri p Zon e G A= Garde n P A= Pla y Are a E A= Easemen t Dept hdescribe s th e dept hfro mwhic hth e sampl e wa s collected , pp m= part s pe r millio n

### 2 5 0 6 01:38 p U.S.EPf l REUlU N/ 

# 2844 9 Exterio rPain t Nort h Airo w 

### a Lea d Sit e Owne rName : TIMOTH YS WILSO N J R Omah , Q Gooc J 

### Sit e ' Sketc h Address : 161 2 WILLI S A V fj Poo r

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## Contrac t No . W912DQ-04-D-0017 , Tas k Orde r DK0 1 Omah aLeadSite , Omaha , N E Propert y Closeou t Agreemen t BVU > 

# AM I Propert y Addres s jfplA . MLLf S Propert y Owne r 

# TI M W/t^A / I s th e Owne r th e Resident ? D Ye s [4-N o Complianc e Statement : U.S . Environmenta l Protectio nAgenc y (EPA ) ha s contracte dth e U.S . Arm y Corp s o f Engineer s (USACE) , Omah aDistric t t o conduc t environmenta l restoratio nservice s fo r th e Omah aLea dSite . USAG EOmah ai s workin g wit hEnvironmenta l Chemica l Corporatio n(ECC ) t o remov e lea d contaminate dsoi l an dprovid e subsequen t restoratio nservices . You r cooperatio ni ngivin g EPA/USACE/EC C permissio nt o acces s you r propert y durin g th e removal/restoratio nphas e i s sincerel y appreciated . Thi s documen t certifie s tha t al l wor k performe da t thi s propert y wa s complete di naccordanc e wit hth e contrac t specification s an dEP Arequirements . I f

yo u hav e question s o r nee dadditiona l informatio npleas e contac t Do nBahnke , EP AProjec t Manager , a t

(913 ) 551-700 3 o r th e Offic e o f Externa l Program s a t 1-800-223-0425 . Additiona l Comment s b y USAC Eand/o r ECC :

CONTRACTO RCERTIFICATIO N 

## Prashan t Khann ao r EC C Projec t Manage r Charle s "Skip"Milto n Nam e Dat e Signature . . 

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# TM M 1M-0G , AX>r M PROPERT Y OWNE RSECTIO N Thi s agreemen t document s th e completio no f remedial/restoratio neffort s a t th e propert y t o m y satisfaction . 1/

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## Propert y Owner' s Name : T ! W\ (abov e informatio nt o b e fille dou t b y remediatio ncontracto r prio r t o deliver y o f for mt o Property Owner ) 

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## Thi s for mi s provide dt o yo u a s amean s o f tryin g t o captur e you r leve l o f satisfactio n withth e work o f th e above-identifie dRemediatio nContractor , a s applicabl e t o th e soi l cleanu p actio na t you r property . Th e U.S . Environmenta l Protectio nAgenc y (EPA ) an dth e U.S . Army Corp s o f Engineer s (USAGE ) ar e ver y intereste di nyou r opinio nregardin g th e wor k performe d b y ou r contractors . Thi s for mi s intende dt o provid e a neas y mean s fo r yo u t o expres s you r opinio nabou t th e wor k performe do nyou r property . Pleas e indicat e you r leve l o f satisfactio nwithth e Contractor' s work b y selectin g a numerica l ratin g (rangin g fro m1 t o 10 ) usin g th e followin g ratin g scale , the npleas e sig n& dat e th e for man dretur ni t t o USAG Ei nth e attache dself-addresse d& stampe denvelope . (Additiona l comment s ma y als o b e provide di nth e spac e provided , a t th e optio no f th e propert y owner. ) 9-1 0 "excellent " 7- 8 "very good " 5- 6 "acceptable " 3- 4 "poor " 1- 2 "very poor " Propert y Owner' s Satisfactio n Ratin g regardin g Contractor' s Wor k 

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# 2844 9 Nortr i Arro w rOwne rName : TIMOTHY S W.LSO N J R °TM h a Lea d Sit e Exterio rPain t Gooc l

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# Propert yChec k List s Q C Locatio n ^C - * C . l/ V 5 V . I \ i ' ^> 

# BVI D ?* C **j t-J Q 

# Date s < \ & e u OVifc u JO-J-O O 

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Q C Note s 

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### sample s AS-Buil t ma p correcte d shot s mappe d concret e mappe d tree s marke d LI P marked/note d nam e dat e easemen t mappe d windo wwell s mappe d a cmappe d Lo g boo k u p t o dat e 

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# Backfil l chec k lis t reconstructio n ma p positiv e drainag e fro m hous e N O lo wspot s N O Rak e Gap s law n eve n soi l compacte d sidewal k 1 " cut s smoot h transitio n fro m walk s are a fre e o f debri s fence s repaire d damag e t o property ? damag e lis t 

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