### 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 30225 Property Address 2871 Wirt St 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. 

## • B I excavation depth was 12 inches below ground surfaces. 

# • Verification samples confirmed that cleanup standards were rriet. 

## • The site was backfilled with material which meets the contract specification s. 

## • The backfill was compacted to acceptable standards. 

## • Sod placement and si te restoration were conducted in compliance with the specifications and work plans.

Comments: None


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### ,.;.1 ECCQCM Name Title Jeff Hubbard USACE Con Rep Name Title I{- / $ 

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# III**~lIl1m** 30225 Owner Name : FRANCIS E THOMA S ET Al Address: 2B71 WIRT ST

Phone: H ; 402·451-4466 VI; 

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## of_**j'O~S** 

### u.s. Environmental Protection Agency Region VII Omaha Lead Site Omaha,NE Residential Yard Soils Environmental Restoration Services PROPERTY ACCESS (to be completed by property owner)**~a:a** 'cC;.tH cs'", 'e'Ta en es;::a'101 t:Cl' :avo' nan t:; al .·50J 223-"::425 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 (ECG) 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 7003 or the Office of Extemal Programs, at 1-800-223-0425. Property Access Granted By (Please Print Name)



# . NOTE G t" 

# . , DOES NOT 1 . 

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- PROPERTY INFORMATION (to be completed by reSident and or property owner - Please Print) Resident Name:

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__ (CITY) (STATE) (ZIP) Property Owned By:
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______ _________ Owners mailing address: tf"flft2 (M/t1,fr 

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# r Owner's telephone number - Home: 

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### 4'f1p6 Work: ----------------------il**~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:.

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

_____________ Comments: It>.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 aking any response action under this title, or otherwise enforcing the provisions of this title: Access Attempts:

# 'lMJ**jJ~** First:
__________ Second: : _________ Third::**(P/~-** 

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# List of Existing Conditions Property Ad dress: _..I::cJ!i.!:J'c!......Ll'J

## 1_&!:::I.!""J.ca~d..;/--.£.A.;I~.,-- 

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_____ BVID# 

## S()Ms: Owner :

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# ~\**P~A~**Contract No. W912DQ-04-D-0017, Task Order DKOI Omaha Lead Site, Omaha, NE Property Closeout Agreement BVID 

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## TH o IYIft s. Is the Owner the Resident? DYes 

### ClJ...1«O 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. US ACE Omaha is .working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EPAlUSACEIECC 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:

CONTRACTOR CERTIFICATION ECC Project Manager Name Title Date Signature 

### PROPERTY OWNER SECTION This agreement documents the completion of remedial/restoration efforts at the property to my satisfaction. /' .CU/'l-agree that restoration is completed at my property, except as noted Comments (if applicable):


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## Property Owner Satisfaction Survey Form Omaha 

### Lead Superfund Site Performance-Based Contracting (PBC) Pilot Projed Remediation Contrador:

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_**.** ______________ Property Identifier Number:

________ Property BVID Number:

### --"**"-' ()** **J. J.** **=__ :...**  

### __ Property Address:

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________ (above infonnation to be filled out by remediation contractor prior to delivery of form to Property Owner) 

### •••••••••••• ** •• ** ••••••••••••• 

### **••••••••••••••••••••••••••••••••••••••••••••• Instructions to Property Owner: 

### Ibis fonn is provided to you as a means oftrying to capture your level of satisfaction 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 . Army 

### Corps of Engineers (USACE) are very interested in your opinion regarding the work perfonned by our contractors . Ibis 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 retum it to US ACE 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 " excellent " 7-8 "very good" 5-6 "acceptable" 3-4 " poor" 1-2 " very poor" Property Owner's Satisfaction Rating regarding Contrador's Work 

### 10 5 9 4 8 3 7 2 6 1 Additional Comments from Property Owner (optional; continue on back of page if needed)

# '**ld~~ ~** **~q~ ~** 

Property Owner's Signature:

# e~**-;, w**  Date: ..I

### CONTRACT 

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

### Omaha Lead Remediation, Omaha, NE of Engineers 

### Analytical Results Summary OLS #30225 2871 Wirt St
Sample

Type Quadrant Depth Date Collected XRF Results (ppm) (avg.) DE 81 12 10/11/2007 322 DE EA-N 0 10/11/2007 117

SAMPLE 10- SAMPLE 10 is a particular residential properly ID from which the sample IS collected. TIle sample lype Identifier (with sequential sample number for that location) as follows ; PX = Pre-Excavation XRF sample DE
- Dunng and POSI Excavation Quadrant**descnbt~:s** the samphng location (with sequenl1al sample number for that location) as follows : FI or F2 · Front YDrd One or Front Yard Two 131 or 02 - Oack Yard One or Back Yard Two DZ
- Drip Zone GA :::E Garden PA " Play Area EA .2!- Easement Depth desCribes the depth from which the sample was collected ppm = paris per million

# ECC OWNER CHANGE REQUEST . FORM
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OWNER SIGNATURE 

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SUPERVISOR INITIAL

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