TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: Z^ipQl . Date: 'Z\\<^\tP) 

Address: 7_^^ ^ AAa^U^ . 

Remediation Contractor: _Coastal Environmental Group_ Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video ofproperty (DVD) 

5} / Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

5K Restoration Agreement 

Settlement documents (i.e., for damage or to replace plants, etc.) 

Confirmation data 

w Photographs ^<L-ofC/LxArHSCK ejLCjCu)ca\!S<K^ So-c^cu^, \t ^ ^^ ^ 

D As-built sketch 

Satisfactory restoration signed by Property Owner 40316442 

Property close-out check list signed by EPA Superfund 

m Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

D 

^h"^^^^ Signature 

diJ^^^^^ ^/M/O^ 
(i^ 

Property Access Checklist 

[Property ID: ^U|(^; ^ 

Property .4ddres.s: ;^^^L J (YVxf) ^<jf . 

D

n

 WORK STARTED 

 WORKCOMPELTED 

ON: 

ON: / / 

Owner: ^y^Y^ Q "l^^^ K 

Address:^^ ^ P^y^ ^ B/, j 

Rentcr:__^/ ^ 

r.1. ^^^Il^'-JSa, 

Phone: 

Fa.v: 

Phone:

Fax: 

 MOa-Sim-UH^ / 

Cell/Pagcr: 

Additional [nformation: 

Cell/Pager: 

O Notification Letter 

I5( Access Agreement 

1^ Restoration Agreement 

CH Topsoil Sampling (if applicable) 

1 1 Disposal Sam|)ling (if applicable) 

1 1 Garden Sampling (ifapplicable) 

Sent: / / 

Signed: S " / IM /<^% 

Signed:'^/!' / /CS^ 

/ / 

/ / 

/ / 

By: 

B.v: i\-hjdkicM\ 

B.v: ^ . W-r/cA 

By: 

By: 

By: 

0

^

n

I n

 Utility Clearance . 

 Video/Photos (Before) 

 Video/Photos (During) 

 Video/Photos (After) 

Called: ^ / ^ lO ^ 

On: S /IM/Bl 

On: / / 

On: / / 

By:(,/^l V^Vl'C^' 

B.v: (irooon , "t^^o dr\ 

By: 

By: 

1 n Video/Photos (30-Day) On: / / By: 

[M

n

 Property Comj)letion Agreement 

 Filial Re|)or< 

Signed: / / / 9-/0 ^ 

Issued: / / 

B.v:'B^,;^ 

By: 

Air Monitoring (as ap()licablc 

HD Community CH Crew 

) 

Results:

On:__/ _ / B.v: 1 

1 

CH Community

Results: 

 CH Crew On:__/_ _ / By: 

1 CH Community

Results:

 CH Crew On:_ _/ _ / By: 

1 

Omaha Lead Site 
# » 

CONTACT FORM 

Property ID # 9.%13 

Property 

Address: QMUhpkSt. Initial Contact: Date ___^^_ :S)l3JDi T_ Time . : U c>*v^ Action: (i^ov Mi ff\Qj<!^C\»^Q. 

Second Contact: Date:£/[M/{^ Time:<^ ^'^m Action: Si (AH ^ 

Final Contact: Date: Time: Action: 

Final Action: Transmit to EPA D Other Action: D 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

i 
Douglas County Accojuklnformatio o\m^x n Page 1 of 3 

Dougla s County , Nebrask a Propert y Recor d - R092081000 0 

Print Report 

Parcel Dimensions available @ scale 0-50 ft west of 144 St - Yie w PITI Ma p Information is valid as of 2008-4-17 Treasurer's Tax Report 

New Feature ->-•- • Auto Sales Search 

Owne r 

ISAM SHEHU 

POBO X 11066 

OMAHA NE 68111-0000 

Propert y Informatio n 

Key Number: 2081 0000 09 

Account Type: Residential 

Parcel Number: 0920810000 

Parcel Address: 2224 MAPLE ST 

OMAHA NE 68110-0000 

Legal Description: DENISES ADD LOT 7 BLOCK 3 50 X 122 

Valu e Informatio n 

Land Improvement Total 

2007 $4,800.00 $22,200.00 $27,000.00 

2006 $4,800.00 $22,200.00 $27,000.00 

2005 $4,800.00 $22,200.00 $27,000.00 

2004 $4,800.00 $3,800.00 $8,600.00 

2003 $4,800.00 $3,800.00 $8,600.00 

2002 $0.00 $0.00 $0.00 

Sales Informatio n 

Sales Date: 2007-07-12 

Deed Type: Q C M Book: 2007 Page: 081489 

Price: $0.00 

Grantor: CARING NETWORK INC 

Grantee: ISAH SHEHU 

Valid/lnvalid: Invalid 

Exclusion Reason: Multiple Parcel Sale 

Sales Date: 2005-10-05 

Deed Type: WD Book: 2005 Page: 138041 

Price: $18,500.00 

Grantor: Estate of Claybem W moore 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R092... 5/8/2008 J 
Douglas County Accou«ynformatio 01U|^I n Page 2 of3 

\ 

Grantee: Caring Network Inc 

Valid/lnvalid: Valid 

Exclusion Reason: 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6100.0 1.0 122.0 50.0 No 

Improvemen t Informatio n 

Building 1 

2224 Maple 

.» 

0 "• 

«• 

""^,^ . Mtf 

'.tvnxi 

ICIOOSQFI 

ma MT •x<r\ 

n n 

M r '*' 

"i ttttrr ;" 2 1/2 Stofy Unfin 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1778.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Worn Out 

Built As: 2 1/2 Story Unfin Condo Square Footage: 0.0 

HVAC: Forced Air Rooms: 7.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 2.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1900 0 0% 1900 108 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 782.0 

Basement Minimal Finish 675.0 

Fixture Base Fixtures 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R092... 5/8/2008 
Douglas County Accotjiynformatio ot^l^T n Page 3 of3 

Fixture Bath Full 1.0 

Garage Detached 480.0 

Porch End Solid Wall 168.0 

http://douglasne.mapping-onhne.com/DouglasCoNe/static/accountinfo.jsp?accountno=R092... 5/8/2008 
As-Built Drawing 

COAST A L Omaha Lead Superfund Site CNVIRONMENTAL 

OROUP , INC f 

29692 

Extenor Paint North Arrow Omaha Lead Site 

Sampling AddrMs: 2224 MAPLE :sT Site Sketch • Good 

[a^Poor Phon«: H (402)208-6491 ALT • Not paint 1

Sample Lead Sample 

Samples Collected Number LAB Concentration Cotlected Firm /»!)^ KJ\li( 

RYASCPXA-29692 Fl 6 V . ppm [7] 

D Date 01-i^-?u67 

RYBSCPXA-29692 F2 /4^ ^ . ppm ^ D Time: Zcor ^ 

RYCSCPXA-29692 B1 156 

. ppm g f 

D Samples Analyzed RYDSCPXA-29692 B2 ir)Z°iZ . ppm 0 D

RDZSCPXA-29692 DZ ^^Q l . ppm 0 D XRF Unit ia5h Z Book /fiV 

. ppm n D Date ^/A^/0 7 — . ppm n D Time P M 

Staff: M-iu/ Number of Samples = $ O 

Legend: Fl = Front Left. F2 = Front Right. Bl = Back Left. B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed trom the street, facing property 

ENTERED 

JUL 2 3 2B07 

RcvS Cieacd fc'2S'2007 13 2913 

Legend 


Concrete Drip Zone Excavated Quadrzmts Excavated 


Area replaced with Area replaced wi1:h -^ ^ , ..,, ^ 

Sod ' Roclc/Mulch ^ ^« * ^« " ^» " 

Contract #: EP-R7-07-05 Coastal Environmental Group Inc 

29692 

^V^& W 'i^^ h Omaha Lead Site 

Samplfnq Address: 2224 MAPLE ST Sit e Sketc h 

Phone: H; (402)208-6491 ALT: 

Sample Number 

RYASCPXA-29692

RYBSCPXA-29692

RYCSCPXA-29692

RYDSCPXA-29692

RDZSCPXA-29692

RGZOGr)(A-2909g

RrZOCPXA-29G02

Lead Sample 

Concentration Collected 

 Fl AJL ppm 

 F2 y4 ^ ^ ppm 

 Bl 

1 5 6 ppm Ef 

 B2 /ftZ q 2. ppm 

 DZ ?^0 7 ppm 

ez - " " ppm n 

 PS- " " ppm n 

Number of Samples = ^ 

LAB 

D 

n 

D 

n 

Exterior Paint North Arrow 

• Good i H^Poor 

• Not paint 

Samples Collected 

Firm: 

Date: 01 >^-2 o f 

Time: 

D XRF Unit:

D Date:

D Time: 

Samples Analyzed 

 6>5*/Z Book 18 H 

 9jqfi/0 l 

2A. Staff: mw 

Legend: Fl = Front Left, F2 - Front Right, Bl = Bacl^ Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

• -t^ii,^^ 'S:'^U'.a. ..iUji 

ENTERED a JUL 2 3 2B07 y^p^^^: 

S^ACr.dr-c 

^ z fill 

)i/i.M -k 

f^^.Lt S^ 

Rev 5 Created. 6/28/2007 13:29 13 04<>I4I 0123 

D' xn: Md(ii< xv^ Ml* nvrjtw ner xnrn n loi'jDornO' JOt' vo'no'3 
# 29692 

Omaha Exterior Paint North Arrow Lead Site • Good Sampling Address: 2224 MAPLE ST Site Slcetch 

H^Poor 

Phone : H; (402)208-6491 ALT: [^ Not paint 1

Sample Number Lead Sample Samples Collected LAB Concentration Collected Firm: /^^-^ fJr/i-f 

RYASCPXA-29692 F1 A4_ ppm D

Date: 0-?->^-2obi 

RYBSCPXA-29692 F2 l(o^ ^ ppm D 

Time: Z'oo?r^ 

RYCSCPXA-29692 Bl 156 ppm Ef D 

Samples Analyzed 

RYDSCPXA-29692 B2 lt^Z.^2. ppm 

RDZSCPXA-29692 DZ n ??0-7 ppm XRF Unit: (D51 Z Book: l6 ^ 

RGZSCPXA-29G92 •—02­ D

ppm D Date: <^jqfi/01 

RrZOCPXA-20G02 PS- — D 

ppm D Time _Bn. D 

Numbe Staff: V\5VJ r of Samples = ^ 

Legend: Fl - Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing properly 

MLEY ENTERED -y -^ri^ ^ jUL 2 3 2t)07 

6 0 MC 

^ • d 

U. l^B ^.^Cr.d:<: f^ r 

ft» 

•S'Z 

D l . 

Ttr 6^' 

5­ xai W MACtC 

( 

DZ 35.01 = 

ox. 1 f 

L-t i ^ 

e 

'•'^M>r 

f^^.Lt i-r 

Rev 5 Crealed 6/28/2007 13 29 13 U4(>i4i o m 

] ' nor aM' 3D1' XT- KU' JW } >'vnrm> x c »)'2ca'n*' » ! nb'mn ^WXIOIXKT yn. n>, .MTM .apt mrm v w 
29692 

Exterio North Arrow Omaha r Paint Lead Site 

Samplin • Good g Address: 2224 MAPLE ST Site Sketch 

ca^poor Phone: H: (402)208-6491 ALT: 

Q Not paint 1

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

 /Q^v^ Ki\IU 

RYASCPXA-29692 Fl ppm D Date: Ol-^^'lobi 

RYBSCPXA-29692

RYCSCPXA-29692

RYDSCPXA-29692

 F2 

 B1 

 B2 

156 

lCiL°lZ. 

ppm 

ppm 

ppm 

Ef 

D 

D 

D 

Time: Z-'U^TIVN 

Samples Analyzed 

RDZSCPXA-29692 DZ ?.?Q7 ppm D XRF Unit: G,5*iZ Book: i8 ^ 

ROZOGrXA-2909g 62- ppm D D Date: 9/Q.5/g7 

RrZ0CPXA-29G92 PS­ ppm D D Time: PM 

Number of Samples = ^ Staff nsw 

Legend: Fl = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

;ENTERED ^ * -...*' *!>' »>• V t " • 1 ' : jUL 2 i zuu' 

i 1 ' ^ r-i 

\ : 1 : . . ( ; \ .m... 1 10V\^ 

I , , . . t ; ' ( : ' : 

^ 

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Wat<: ^ 

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I|p53 

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Rev 5 CiKHed 6/28(7007 13:29; 13 046141 0123 

nr tas< wv r XU ' J 3' XD? TK' xor TBti -Mil XD' m r jae< IOBI VST X 
— * >

.*^^°1''^^.. 

COASTA L ENVIRONHENTA L 

CROUP , INC . 

Consent For Acces s To Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

follov\/ing described premises: 

Owner's Name: ^/l^A u ^XS^I ^ D^ytTM«Phone:l4|>)3^,3|^- (^Ljqj 

Address of Property 

covered by this 

Agreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Grantor in-person to discuss the work to be performed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work before 

it begins. Once the work is finished, the Grantor will be asked to review the work and 

confirm that it is complete and meets with the Grantor's approval. Upon completion, the 

Grantor will receive written documentation from EPA that the property has been 

remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of performing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
^s-^iO su . 

COASTA L ENVIHONMENTA L 

GROUP , INC . 

Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

Abide by health and safety guidance provided by EPA; 

If the property is rented, assist EPA in obtaining tenant approval for access to the 

property to perform the work. 

Allow videotaping and/or photographing ofthe property. 

AGREEMENT NOT TO INTERFERE --

The Grantor agrees not to interfere or tamper with any ofthe work activities, or with any 

of the work done, or with the equipment used on his property, or to undertake any 

actions regarding the use of said property which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (877) 234-6270. 

M i l grant access to my properties D I do not grant access to my properties 

C ^ r-/y-tf;f 

Signature Date ^ Signatun Date 

O I would like to be present during any sampling that is required. 

Page 2 of 2 
COASTA L 

C R O U 1 

Restoration Agreement 

The purpose ofthis agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: ^C^(^ ^ 2, 

Property Address: 3,-^-^t( (Y\rAplg. ^ . 

Owner: ^V^\^ ^ -^.^O M 

Phone: ^^g^_ ^Q ^ ^ ^^i^C^[ 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of all known 

utilities, subsurface features, surface structures and landscaping featureSi access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

The removal, storage, disposal, and/or return of these items is the Owner's responsibility. 

Item: 

Item: 

Item: 

Item: 

\^orr^^^- ^ ^ 

M-iU­ V^rwb-^ 

lOVvi-k. Vo<y\ 

r\ Vl 

\ r^ 

»/ \ 

orvi­ \) 

\^cy ^ 

h^ck 

ac i • 

ya(d 

y(AdItem: 

Item: 

Item: 

Item: 

* 

Page 1 of /_ 
COASTA L 

Items To Be Removed By Contractor During Remediation An d Not Replaced 

(Use additional sheets as necessary) 

'tem:(xV\ 9\cxM< ; , JlcU^O^TS , C oCi ^ ^/ \ Vi^Z. . 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 2 of Ij ^ 
COASTA L ENVIRONMENTA L 

CROUP , INC . 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

K\onj2_ Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Pages of ji . 
COASTA L ENVIRONMENTA L 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves," 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Landscape Inventory 

(Use additional sheets as necessary) 

Quantity Unit Condition/Type/Species 

F2, 85 

Square feet 

^Q^ Each 

1 

Each 

-

Each 

^ - ^ 

i 

^ Each 

Square Feet 

Page 4 of 6? 
COASTA L 

Item 

Agreed upon value of 

plant materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

include a sketch of were 

each plant will be placed 

by the contractor. 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. 

Area of City or County 

property to be landscaped 

per their requirements. 

Include a sketch of the 

area (s) 

Easement Area, to be 

excavated 

Quantity Unit Condition/Type/Species 

^ ^ 

S ^ 

i 

n^ Each 

•_ 

b2 SF 

X SF 

SF 

Page 5 of A. 
C O A S T A L • MVIMOMMCHTAL 

Additional Comments / Instructions: 

, ^ ^ O f D^OUA . ' 

D Check the box if Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By diecking this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

^ I O I do not agree agree 

'Mz^-(^^^ .rv^-^f 

Owner's Signature Date Contractor's Signatare Date 

PageSof Cfi 
Date 

Project 

XRFID# 

SM# 

-w 

ItiT W 

Average

SJiot# 

K^^ 

f3(? ^^1 

<in 

Average

Shot# 

Average 

Shot# 

Average 

lab sample # 

BVID # '^'^^^ t 

XRF PROPERTY SAMPLE SHEET 

"Zc^l Address "Z-^^l Vlrt^ut 4r 

Omaha IleaB d FP 2nd year opllon Sample time ]!.; i-Jf

 am/pm 

yiof>'^ sample length 30 sec 

Reading Sample area Shot# Reading Sample area 

\iy%t \L-u m Wjrli%-^'{ 

ipjiot ly^t. h 9^ )\vnt \V'!' 

^^•pi Depth LLL Depth :<->i ic,-u 

JJ, ^Ig iiki « t^.lP i 2S.1H W

 t^-'^ J \^. (,( Average /T/> . 1| ^ 

Reading Sample area Shot# Reading Sample area 

ni.O^ + lc7.n h JS5H ^H-on m.i<i bde^^f 1^'><7i il-14 1S< n(,.qn K.^<; t<(.'>Mt i(?.M Depth g-x;- \<f\.yit K-(in Depth 

-^H-H^t i^.«^4 (." ?^V1 151. <.i t m ^ I'' 

 {^t- ^ ^ ^ \o H^ Average K^ . <?1 j K- K 

Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average 

RETEST AREAS 

Reading Sample area Shot# Reading Sample area 

^^-7 

Depth Depth ^ y 

y y 

Average 

Lab result Sample area XRF Avg. 

Signature. 

Print \KkU<^ MlhlV^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 808 

Mode SOIL 

Time 2008-07-15 16:30 

Duration 120.71 

Sequence Final 

Flags 

AVERAGE ^Av g of 804-807 J 

ADDRESS 2224 maple st 

QUAD/ZONE 

INSPECTOR £1ATEUS 

DEPTH 

SAMPLE TYPE ICLEARANCE I 

NOTE 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 804 

Mode SOIL 

Time 2008-07-15 16:28 

Duration 30.13 

Sequence Final 

Flags 

BVID # 29692 

ADDRESS 2224 maple st 

QUAD/ZONE B2 

INSPECTOR MATEUS 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 183.983 ± 16.962 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 109.102 

Supervised By: 

Certificate of Verification 

805 

SOIL 

2008-07-15 16:29 

30.29 

Final 

29692 

2224 maple st 

B2 

MATEUS 

12 

CLEARANCE 

± Error 

± 13.964 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 450.237 

Supervised By: 

Certificate of Verification 

806 

SOIL 

2008-07-15 16:29 

30.25 

Final 

29692 

2224 maple st 

B2 

MATEUS 

12 

CLEARANCE 

± Error 

± 26.010 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 202.693 

Supervised By: 

Certificate of Verification 

807 

SOIL 

2008-07-15 16:30 

30.04 

Final 

29692 

2224 maple st 

B2 

MATEUS 

12 

CLEARANCE 

± Error 

± 17.671 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 813 

Mode SOIL 

Time 2008-07-15 16:36 

Duration 139.77 

Sequence Final 

Flags 

AVERAGE jAvg of 809-812 

ADDRESS 2224 maple st 

QUAD/ZONE |DZ 

INSPECTOR MATEUS 

DEPTH Ml3 

SAMPLE TYPE K.CLEARANCEJP 

NOTE 

Supervised By: 
# 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 809 

Mode SOIL 

Time 2008-07-15 16:32 

Duration 30.27 

Sequence Final 

Flags 

BVID # 29692 

ADDRESS 2224 maple st 

QUAD/ZONE DZ 

INSPECTOR MATEUS 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 892.625 ± 36.097 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 113.823 

Supervised By: 

Certificate of Verification 

810 

SOIL 

2008-07-15 16:34 

49.11 

Final 

29692 

2224 maple st 

DZ 

MATEUS 

13 

CLEARANCE 

± Error 

± 14.131 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 175.702 

Supervised By: 

Certificate of Verification 

811 

SOIL 

2008-07-15 16:35 

30.20 

Final 

29692 

2224 maple st 

DZ 

MATEUS 

13 

CLEARANCE 

± Error 

± 16.601 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 386.701 

Supervised By: 

Certificate of Verification 

812 

SOIL 

2008-07-15 16:36 

30.19 

Final 

29692 

2224 maple st 

DZ 

MATEUS 

13 

CLEARANCE 

± Error 

± 23.746 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 833 

Mode SOIL 

Time 2008-07-16 12:32 

Duration 120.67 

Sequence Final 

Flags 

AVERAGE §Avg of 829-832 

ADDRESS —2224 maple st 

QUAD/ZONE •F 2 

INSPECTOR ATEUS 

DEPTH 

SAMPLE TYPE LCIeara nee 

NOTE 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 71.021 

Supervised By: 

Certificate of Verification 

829 

SOIL 

2008-07-16 12:30 

30.20 

Final 

29692 

2224 maple st 

F2 

MATEUS 

6 

Clearance 

± Error 

± 10.939 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 830 

Mode SOIL 

Time 2008-07-16 12:31 

Duration 30.18 

Sequence Final 

Flags 

BVID # 29692 

ADDRESS 2224 maple st 

QUAD/ZONE F2 

INSPECTOR MATEUS 

DEPTH 6 

SAMPLE TYPE Clearance 

NOTE 

ppm ± Error 

Pb 78.308 ± 11.748 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 64.349 

Supervised By: 

Certificate of Verification 

831 

SOIL 

2008-07-16 12:32 

30.17 

Final 

29692 

2224 maple st 

F2 

MATEUS 

6 

Clearance 

± Error 

± 10.694 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 34.440 

Supervised By: 

Certificate of Verification 

832 

SOIL 

2008-07-16 12:32 

30.12 

Final 

29692 

2224 maple st 

F2 

MATEUS 

6 

Clearance 

± Error 

± 8.547 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By: 

Certificate of Verification 

838 

SOIL 

2008-07-16 12:47 

120.75 

Final 

jAvg of 834-837_| 

2224 maple st 

feasement 

MATEUS 

'SURFACE 

CLEARANCE] 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 144.086 

Supervised By: 

Certificate of Verification 

834 

SOIL 

2008-07- 16 12:43 

30.28 

Final 

29692 

2224 maple st 

easement 

MATEUS 

SURFACE 

CLEARANCE 

± Error 

± 14.740 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 176.439 

Supervised By: 

Certificate of Verification 

835 

SOIL 

2008-07-16 12:45 

30.12 

Final 

29692 

2224 maple st 

easement 

MATEUS 

SURFACE 

CLEARANCE 

± Error 

± 15.950 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 161.320 

Supervised By: 

Certificate of Verification 

836 

SOIL 

2008-07-16 12:46 

30.27 

Final 

29692 

2224 maple st 

easement 

MATEUS 

SURFACE 

CLEARANCE 

± Error 

± 15.479 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 137.673 

Supervised By; 

Certificate of Verification 

837 

SOIL 

2008-07-16 12:47 

30.08 

Final 

29692 

2224 maple st 

easement 

MATEUS 

SURFACE 

CLEARANCE 

± Error 

± 14.451 
m Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

%u ' j ^ www.coastalhazmat.com ^-ttPRtfit?^ COASTA L [NVIRONHENTAL 

CROUP , INC . 

EXECUTIVE SUMMARY: 

BVID # 29692 - (2224 MAPLE ST) 

I I No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 

TRAFFIC WEAR ON FE SOD 
Property Completion Agreement 

This agieemeni documenis the completion of remedial activities performed on my properly. My signature 

will designale ihal I am salislied wilh the restoralion of my properly, and Ihal no items are in questions, 

now. nr al any lime in the fiiUire, excepl those ilems listed below, il'any. 

Propcr.>MI): ^^^9 ^ _ _ _ 

Propc., ty Address^^ ^ ^ Z^^^/ ^ . 5>^ , _ _ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

I 

"-^•xtj ^ ayrc f rrvtoiation i.<. completed, except av noted 

I I I do no\ agree lestorwtion is completed 

O ry 

Owner's ;^{jfna(nrc Dflfc "Tontracfor's .S'i;^iiatiir(' Date 
smL EPA 

EPA Property Close Out Form 

Property Addre«:-^^^^ ^ Mr^{>lf.^ - Property #: '::^'-\ LoS\ Q 

Date/Time: Owner's Name: ,i^\.\.iJ}'^ j . LXJ. f/'^V^j , , „a ^ . 

Quads Excavated: y^^ $>2> ^ \Nfc Contractor Group r.^riS.-^vC T ^ p v v rOTvAAXYlft^ 

Excavation Yes No General 

1. If necessary, were the correct quadrant(s) excavated and restored? X 

2. If necessary, v^fere the correct areas ofdrip zone excavated and restored? / 

Grading Sod and Vegetation 

Yes No 

I. Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from the house? L ^ 

2. Has sod been laid in all areas that were excavated? 

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 y day time period)

 _ ^ 

4. Are sodded areas generally firm and evenly graded? y 

5. Arc the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day y time period) 

6. Was the property graded such that water will not pool on the property-? 

7. Was damage to landscaping or plant materials avoided? y 

Gates, Fences and Rctaininf; Walls Yes No 

!. Do gates open and clo.se freely? (Ifapplicable) 

2. Were all gates or fences taken down during restoration activilies reinstalled? (Ifapplicable) J A 

3. Was damage to gates or fences avoided? (Ifapplicable) v ^ 

4. Was damage to retaining walls avoided? (Ifapplicable) 

Foundation, Siding and Gutlers Yes No 

1. Was damage to the siding or trim avoided? y 

2. Was damage to the foundation avoided? 

y 

3. Was damage lo windows avoided? ^ 

4, Was damage to windows or door screens avoided? 

y 

5. Was damage to downspouts or downspoul extensions avoided? 

^ 

Sidewalks and Driveways (Concrete) Yes No 

 Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? y 

1
Or^ners comments: 

Inspection notes: 

Removal and restoration activates complete including the 30-day sod warranty: 

Date: (I U^/o t