### 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 27818 Property Address Field Work Started 10/3/2007 Field Work Completed Summary: 1625 Burdette St 10/3/2007


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

## • B 1 excavation depth was 3 inches below ground surfaces. 

## • Verification samples confinned 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 were conducted in compliance with the specifications and work plans.

Comments: .None 

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# r .**.-~** Name Title Date 

# JatUre Jeff Hubbard USACE Con Rep 

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## 27818 E xterio r Pai nt Omaha Lead Site Owner Nam e: MEARES SPYR I DON F 

# o Good Site Sketch Address : 1625 BURDETIE ST 

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## ----------------- ----------------- ----------------- page 1 

### of_ 

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# 0 Omaha lead Site Omaha. NE Residential Yard Soils 

### u.s. Environmental Protection Agency Region VII Envi ronmental Restorat ion Services 

# • PROPERTY ACCESS (to be completed by property owner) Para 'eo:; br t:;5'" le''''a e:l**eS;;2~01** ":0' 'avor iil"l'C. 31 " cOO 22:**~425** Environmental Protection Agency (EPA) has contracted the U.S. Anny Corps of Engineers (USACE). Omaha lin,
... ,,.. to conduct environmental restoration services for the Omaha lead Site. USACE Omaha is working with IIElnvirorlm,ental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration Your cooperation is requested in giving EPAIUSACElECC pennission to access your property during the Ilremc,vallre,stomt·ion phase. For further information please contact Don Bahnke. EPA Project Manager at (913) 551­ or the Office of External Programs. at 1-800-223-0425. Property Access Granted By (Pfease Print Name)

IIRE.sidlent Name:-< Nu/

..., A

'--
_ _ ___________ Downer 

# o renter IIResi,jence Address:
_ \ 

# ladS 

# Bu.aieJfeSt liP,roP,erty Owned By: Omaha Economic Development Corporati on Iln
.... n.,..mailing address: 2 221 North 24 Street IIOINn,or's telephone number - Home:

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1A

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_________ Work:**..1.:j~J2:.:!..2:~:!!!!.-----l1** the exteior been painted or covered with siding since 1978? the interior been painted or covered since 1978? DYes DYes 

# o No 

# o No number of occupants:_ Nw./" A

_ _ _ list Ages:'--"-''''''-

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

_______ is
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 for in Section 104(e) of CERCLA, 42 U
.S.C. 9604 (e), which provides entry for. "determining the need for response, or choosmg Of action under this ' ,or otherwise the of this title." ______ years How long have you lived here? .JNlI.,/uA !I-

__ years

First: Second: : Third: :pg._of_ 

## List of Existing Conditions Property Address: '\ 

# LP 

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# {-Y7 81 

# r Owner: 

# Q£**0eveJ~** 

# rwdJ- Date: 

# q/J4/D7 BVID# 

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Ref: 

### Photo #



### ECC 

### Print & 

### Sign Description

## ~()ne.

Owner Signature Print & 

### SignContract No. W912DQ-04-D-0017, Task Order DKOI Omaha Lead Site, Omaha, NE Property Closeout Agreement DVID 

## .;). '7 'if I g' Property Address 

# I / {pJ0**RiJ~l>tIr~** Property Owner 

## ()€D(' Is the Owner the Resident? DYes

### ~ 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. USACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EP A/USACEIECC 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. Ifyou have questions or need additional information please contact Don Bahnke, EPA Project Manager, at (913) 551-7003 or the Office ofExtemal Programs at 1-800-223-0425. Additional Comments by USACE and/or ECC:

CONTRACTOR CERTIFICATION 

### PWo

# JLjC't: Pro;'" mager Charle 

# /A . Name _ erintendent 

### I 

### , ......... ,- Date

# ~rr1A 

# v . fJ ';' 

# . PROPERTY OWNER SECTION This agreement documents the completion ofremedial/restoration efforts at the property to my satisfaction.

### ~ I agree that restoration is completed at my property, except as noted Comments (if applicable):**~** 

# )(/YJ

# ALJ!UJ/~Jh~ /0**-s(}~(}7** Property Owner's Signature V Date

## •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• Property Owner Satisfaction Survey Form Omaha Lead Superfund Site Performance-Based Contractine (PBq Pilot Project Remediation Contractor:

__... 

### ....... G"'-C C_·

_______________ Property Identifier Number:

________ Property BVID Number:**_--"~=..L?-"g'_LI** 

## .... 

# 8'

___ Property Address:

___**luki::<:4z::.s-~_.s.I&C..!oU~k'fl....!J)~€",__,__rrL...t:;€.,_____,.s_=..Lr** 

### _______ Property Owner's Name: 

### _--JOL"L..!e.:::..:!<J):l.C

_______________ (above information to be filled out by remediation conllactor prior to delivety of form to Property Owner) Instructions to Pronerty Owner: This fonn is provided to you as a means oftrying to capture your level ofsatisfaction 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 ofEngineers (US ACE) are very interested in your opinion regarding the work perfonned by our contractors. This 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 ofsatisfaction 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 return it to USACE in the attached self-addressed & stamped envelope. (Additional comments may also 

### be provided in the space provided, at the option ofthe property owner.) 9-10 " excellent" 7-8 " very good" 5-6 "acceptable" 3-4 "poor" 1-2 "very poor" Property Owner's Satisfaction Ratine regarding Contractor's Work 10 5 9 4 8 3 7 2 6 1 Additional Comments from Property Owner (optional; continue on back ofpagejfneeded)

### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE US Army Corps of Engineers 

### Analytical Results Summary OLS # 27818 1625 Burdette St Quadrant Sample Type Depth Date Collected XRF Results (ppm) (avg.) 

### DE 

## I B1 

## II 3 9/29/2007 64 

## I II I II I II I

SAMPLE [D. SAMPLE ID 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 DE = During and Post Excavation Quadrant describes the sampling location (with sequential sample number for that location) as follows : FI or F2 = Front Yard One or Front Yard Two BI or 82 = 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