CONTRACT # W912DQ-04-D-0017, T.O. DK03 

Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE US Army Corps 

of Engineers 

ECC Certification for Property Closeout 

BVID 28449 Property Address 1612 Willis Ave 

Field Work Started 09/29/2006 Field Work Completed 10/02/2006 

Summary: 

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

• Fl excavation depth varied from 4 to 6 inches below ground surface. 

• B2 excavation depth varied from 4 to 6 inches below ground surface. 

• 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. 

• Sod placement and site restoration were conducted in compliance with the specifications and 

work plans. 

Comments: 

None. 

ECC Project Manager II ~2* 

Name Title Date 

Jeff Hubbard USAGE Con Rep 

Name Title Date 

40286536 

Illlllllllllllllill 

Superfund 
page 1 of 

2, * V V 7 

Omaha Lead Site 

Omaha, NE 

U.S Residential Yard Soils . Environmental Protection Agency Region VII 

Environmental Restoration 

Services 

PROPERTY ACCESS (to be completed by property owner) 

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

District to conduct environmental restoration services for the Omaha Lead Site. USAGE 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/USACE/ECC 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 External Programs, at 1-800-223-0425. 

Property Access Granted By 

(Please Print Name) 

[P^perty" Owner Signature) (Date) 

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

PROPERTY INFORMATION 

(to be completed by resident and/or property owner • Please Print) 

Resident Name: LJ owner LJ renter 

Residence Address: 

(CITY) (STATE) (ZIP) 

Property Owned By: 

Owners mailing address: ° ^ <v 

Owner's telephone number ­ Home: / O^ ~ /o *-? Work: 

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

Has the exteior been painted or covered with siding since 1978? D Yes D No 

Has the interior been painted or covered since 1978? D Yes D No 

Total number of occupants: List Ages: 

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

omments: 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS 

The activities to be implemented by EPA under this agreement are pursuant to Section 104 of CERCLA, 42 U.S.C. 9604 EPA's right ot 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: 

First: Second:: Third: : 
pg-_ot.

 

List of Existing Conditions 

Property Address: /£/ Z. WA> ?^c-­ DVD ID # 

Owner: ~/% t^//i»o Date: #-U-'£ BVID# 

Ref: 

Photo 

# 

Description 

Owner Signature ECC 

Print & Sign Print_&_Si """ 
CONTRACT # W912DQ-04-D-0017, T.O. DK03

 

Environmental Chemical Corporation 

Omaha US Army Corps Lead Remediation, Omaha, NE of Engineers 

Analytical Results Summary 

BVID #28449 

1612 Willis Ave 

Sample 

Type 

DE 

DE 

PX 

Quadrant 

B2 

F1 

EA-S 

Depth 

6 

6 

0 

Date Collected 

9/29/2006 

9/29/2006 

9/29/2006 

XRF Results 

(ppm) (avg.) 

67 

14 

60 | 

Lab Results 

ppm (avg.) 

NA 

NA 

NA 

1 I 

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

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

PX = Pre-Excavation XRF sample 

PE = Pre-Excavation laboratory sample 

DE = During and Post Excavation 

Quadrant describes the sampling location (with sequential sample number tor 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 
25 06 01:38p
 U.S.EPfl REUlUN /
 

28449
 

Exterior Paint North Airow Owne a Lead Site r Name: TIMOTHY S WILSON JR Omah, 

Sit Q GoocJ e ' Sketch Address: 1612 WILLIS AV fj Poor 

Phone: K- 70(^^2^ W: Q Notpainl 4

Sample Number 

RYASCPXA-28449

RYBSCPXA-28449

 F1 

 F2 

Lead

Concentration

£?%>5 ppm

/ 2 £> ppm 

 Sample 

 Collected 

r^f 

LAB 

D 

D 

Firm:

Date:

Time:

Samples Collected 

 Fjyt MJ~/Tt> 

 &­ [*t 

 "? : 3O 

-^ 

RYCSCPXA-28449

RYDSCPXA-28449

 B1 

 B2 

/ fa & ppm 

43<0 Dom 

D & 

D Samples Analyzed 

l7nTTr^pri>n'A ^c***^ r\~7 ... Ppm D D XRFUnit: ' /<?37 Book: /Z9 

r7P"~TPonvA ^^-^din r*~? — ppm D a Datp1

 *7 ­• / Z. - o J 

~ Lab RYCSCPLA-28449 ' .— ppm D a Tims: ^ST] 

Result 160 ppm 

.JJ L/J Staff: £ /4 

Omaha Lead Site 46130 

SEP 25,200 6 01:23F 913 551 8"717 page 2 

1 
Contract No. W912DQ-04-D-0017, Task Order DK01

 

Omaha Lead Site, Omaha, NE 

Property Closeout Agreement 

BVU>

 AMI Property Address jfplA. MLLfS 

Property Owner TIM W/t^A/ Is the Owner the Resident? D Yes [4-No 

Compliance Statement: 

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. 

USAGE 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 

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 of External Programs at 1-800-223-0425. 

Additional Comments by USACE and/or ECC: 

CONTRACTOR CERTIFICATION 

Prashant Khanna or ECC Project Manager 

Charles "Skip"Milton 

Name Date Signature. . 

,SV,:^ HjlLv TMM 1M-0G, AX> r M 

PROPERTY OWNER SECTION 

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

satisfaction. 

1/j I agree that restoration is completed at my property, except as noted 

Comments (if applicable): 

y_ /; 's Signature Date 
Property Owner Satisfaction Survey Form 

Omaha Lead Superfund Site 

Performance-Based Contracting (PBC) Pilot Project 

Remediation Contractor: 

Property Identifier Number: 

Property BVID Number: 

Property Address: l(ol!L 

Property Owner's Name: T! W\ 

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

Instructions to Property Owner: 

This form is provided to you as a means of trying to capture your level 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 (EPA) and the U.S. Army 

Corps of Engineers (USAGE) are very interested in your 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 1 to 10) using the following rating scale, then please sign & date 

the form and return it to USAGE 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 Contractor's Work 

10 

9 4 

X 3 

7 2 

6 1 

Additional Comments from Property Owner (optional; continue on back of page if needed) 

Property Owner's Signature: /// fr— //I/St^~s Date: 
Sep 25 06 01:38p U.S. EPR Ktliiun v 

28449 

Nortri Arrow r Owner Name: TIMOTHY S W.LSON JR °TMh

a Lead Site Exterior Paint Goocl _ Qkpfrh D

Address: 1612 WILLIS AV Olie OKeicn L-J .._..... — r~j poor \ r^KZto-UZJLZL-. _ __ D Notpainl 

Sample Number Lead Sample Samples Collected 

Concentration Collected Rrm: PKA- WJ-/T& 

RYASCPXA-28449 F1 (^.^^ DDm H/f PI p?t^' ^•-i'?-</ 

m RYBSCPXA-28449 F2 /?/5 c p d n Time: ^ '• '*>€> 

RYCSCPXA-28449 B1 //rf 5 C>pm Q [g' 

Samples Analyze d RYDSCPXA-28449 B2 t/30 cpm i2f n 

-ROgSCPXA-28449- Q£- "" C pm n n XRF Unit: /ft Z~J Rnn n: _/Z^_ Ffp-'Rp.pYA io>ii" /--? ^«»­

. " . c >pm D D Date: ^ -/ £-01 

— ._.. ppm n n Time: y£=»7 ' Lab RYCSCPLA-28449 '

 

Result 160ppm taff: Z. /4 Number of Sa r

AJ L/....I

 £ 

. (

- ~?;^ •*-«* ( j 

^ • . .• '"- ^ '"-

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I 

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/ "V / * WAUK 

K)lM-l< WrV 

Omaha Lead Site 46130 

SEP 25,2006 01:23P 913 551 8717 

page 2 
Sep 25 06 Ol:38p
 U.S. EPR
 

28449
 

Omaha Lead Site Exterior Paint North Arrow 

- Owner Name: TMOTHY_S WILSON_JR__ D Go0(J Site Sketch Address: 1612 WILLIS AV Q Poor 

Phone:

 H: TOJst -.fKaZJi.^ [3 Not paint 4

Sample Number Lead 

Concentration 

Sample

Collected Fjfm:

 Samples Collected 

 PM­ MJ/Tft 

RYASCPXA-28449 FA 6>£5 ppm F/f n Date­ 9­ ­ \<3 ­ "^ 

RYBSCPXA-28449 F2 IZ& ppm [vf n Time: H • ;^O 

RYCSCPXA-28449

RYDSCPXA-28449

 B1 

 B2 

I/* 2>

<J3Q

 c 

C 

pm

)p m

 D

 .O f

 & 

D Samples Analyzed 

-RDgQGPXA '20440 Q2~ — c pm D D XRF Unit: //7 •?"? Rnnl'TM­. .

 I ?Oi /&,-/. 

PvGZGGPKA SO < W G^~ ­ C>pm D D HalH' q _ / 2-<7j /^^^ 

'tab RYCSCPLA-28449 ' -" C pm n n Time: /=V^7 

Result 160 ppm Number of Sa mples = LJJ ;.../. 

";

j 

 Staff: <L /\ 

•1 ^ _/ »**• ^ ': '•• ••••':'' ^ • fis -^---i­ :n T"\ 

1C 

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a ^ 5(5 

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I 

n P"I. 

35. • \ I5% 

^ 

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Omaha Lead Sile 46130 

SEP 25,2006 01:23P 913 551 8717 

page 2 
i 

Map Output Page 1 of 1 

1612 Willis Ave/ 44 x 105.32 

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http://webarc.co.douglas.ne.us/servlet/com.esri.esrimap.Esrimap?ServiceName=TestAerial... 9/27/2006 
Sep 25 06 01:38p
 U.S.EPfl REGION 7
 313-5bl-O71V
 

28449
 

Omaha North A/row Lead Site Exterior Paint - Owner Name: TIMOTHY S WILSON JR 

D Goud Site Sketch Address: 1612 WILLIS AV W; fj Poor 

Phone: H: 706-^23 —\ (~| Not paint 

Lead Sample Samples Collected Sample Number 

Concentration Collected Firm: J^KA- WJyTfi

 

RYASCPXA-28449 F1 4?n%5 oom |"vf n Date: g>-|^—?

 

RYBSCPXA-28449 F2 I2& Ppm Ef, a Time: "? ' 3CJ

 

RYCSCPXA-28449 B1 / /r) 3 Dpm

 1 \a ff v a H' samples Analyze d RYDSCPX.A-28449 B2 T 3O Dpm nf a

 

--ROgSGPXA 28440 B£- ~ npm a D F Unit: XR / /I Z~) Rr^ri <; 12.^

 

•RGZSGPXA acmo 62- - ppm a a Clate <? — / ? -<7.S i—

 

- " Ppm a a T

' Lab RYCSCPLA-28449 me: ^fS>l

 

Result 160 ppm s taff: Z X

 Number of Sa mples - LaJ 17J

-.; ... . ; .. <i i^ - ^

 TM 

ff : ~ ^ 

1

/ •"'.'i 

\ 1 63^ HI 13O 

e\ \ ML 

IUI v i 

». 1— • • " -r • '— ' r i 1 rV 

FZ 

635 /38 

K 

f K 

ft
 

/ 

WAi^K 

': :Vv)jU-l< fiV 

Omaha Lead Sile. 

fe
 

SEP 25,2006 01:23P
 913 551 8717
 

page 2
 
Map Output Page 1 of 1 

1612 Willis Ave/44x105.32 

I I Faroe! 

A .••" Slreet 

Bldck and V.'liile Aorir 

http://webarc.co.douglas.ne.us/servletycom.esri.esrimap.Esrimap?ServiceName=TestAeria]... 9/27/2006 
Property Check Lists QC 

Location ^C- * C. l/V 5 V. I \ i' ^> 

BVID ?*C **j t-JQ 

Dates <\ & eu OVifcu JO-J-OO 

Excavation check list 

have easement map 

have site map 

home owner agreement 

line locator 

access log 

decon station 

tape barricade 

garden hose 

reconstruction map for buildback 

fences 

sod areas 

mulch 

gravel 

notes 

name and date 

QC Notes 

XRF check list 

have easemet map (1) 

have site map (3) 

easements sample 

F1 samples 

F2 samples 

B1 samples 

B2 samples 

DZ samples 

AS-Built 

map corrected 

shots mapped 

concrete mapped 

trees marked 

LIP marked/noted 

name 

date 

easement mapped 

window wells mapped 

ac mapped 

Log book up to date 

XUv.'s 

^t 

Backfill check list 

reconstruction map 

positive drainage from house 

NO low spots 

NO Rake Gaps 

lawn even 

soil compacted 

sidewalk 1" cuts 

smooth transition from walks 

area free of debris 

fences repaired 

damage to property? 

damage list 1)0 

punch list filed