TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 

Zlt'p^ Date: iHi II

Address: l[\^

 tmt j 9<

Remediation Contractor; Coastal Environmental Group Year: 2010ARRA 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

1/ Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement{s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

V 

Photographs [^ i:>yA(V^i\(M ^ {rf^Pil^CH^ \ ^<^^ 

As-built sketch 

Satisfactory restoration signed by Property Owner 

z 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

1 / Utility clearances 

cu/' Propertviftformation from Douglas County Assessor's Office 

fy 

gnature 

30218225 

Superfund 
^v 

Property Access Checklist 

Property ID: 5 p (^ 3 

Property Address: ; j | ^ 9'lYiin A S^ _ 

n

D

 WORK STARTED

 WORKCOMPELTED

 ON:

 ON:

 /

 /

 / 

/ 

Owner: V^-^-^^ ^ L.)Om/)0^ ^ 

Address: 

Phone: L^^^ ^ f^Qfj ^ 

Renter: 

Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

Fax: 

Cell/Pager: 

D Notification Letter Sent: 1 1 

J ^ Access Agreement Signed: C? / / liQ_ 

[ ^ Restoration Agreement Signed: c9v/0^ / VO 

D Topsoil Sampling (if applicable) / / 

D Disposal Sampling (if applicable) / / 

n Garden Sampling (if applicable) / / 

Q UtiUty Clearance CaUed: oU/o 5 l\0 

E ^ Video/Photos (Before) On: ^ r l I to 

D Video/Photos (During) On: / / 

D Video/Photos (After) On: / / 

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

f 

ffl) Property Completion Agreement Signed: y_/222^ ^ 

\^ Final Report Issued: / / 

Air Monitoring (as appUcable) 

• conununity QCrew On: / / 

Results: 

• Community |ZI Crew On: / 7 By: 

Results: 

• Community Q Crew On: / / By: 

Results: 

By: 

By: 

By: 

By: 

By: 

By: 

By:

By: 

By :

By: 

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Omaha Lead Site 
Douglas County Account Infojiution Page 1 of2 )J||^C 

# 

Douglas County, Nebraska Property Record - R1528480000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VJOW Oi l Ma p Information is valid as of 2009-11-19 Treasurer's Tax Report 

New Feature ^ •• ^ Auto Sales Search 

Owner 

WOMMOCK VIVIAN A 

2119 EMMET ST 

OMAHA NE 68110-0000 

Property Informatio n 

Key Number: 2848 0000 15 

Account Type: Residential 

Parcel Number: 1528480000 

Parcel Address: 2119 EMMET ST 

OMAHA NE 68110-0000 

Legal Description: KOUNTZE PLACE LOT 6 BLOCK 29 50 X 124 

Value Informatio n 

Land Improvement Total 

2009 $4,800.00 $47,600.00 $52,400.00 

2008 $4,800.00 $47,600.00 $52,400.00 

2007 $4,800.00 $42,400.00 $47,200.00 

2006 $4,800.00 $42,400.00 $47,200.00 

2005 $4,800.00 $42,400.00 $47,200.00 

2004 $4,800.00 $21,300.00 $26,100.00 

Sales Informatio n 

Sales Dato: 2006-06-29 

Deed Type: QC Book: 2006 Paga: 079520 

Price: $0.00 

Grantor: Wommocl< Vivian 

Grantee: Wommack Vivian 

Valid/Invalid: Invalid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.14 6200.0 1.0 124.0 50.0 No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 11/25/2009 
\ 

Douglas County Account Infq««^io QM^ K n Page 2 of2 

# 

Building 1 

2119 Emmet 

10 tr tii tr' 

Second FKm .r— ^ (MOsgl k 

\ 91S0tl|« . F^tr 

2 1/2 Story Unfin BM-rtfcW-it - -

CLICK TO ENLARGE IMAGE 

Square Footage: 1796.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: | Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 10.0 

Exterior: Frame Aluminum Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 — i 1 

Roof Type: Hip Stories: i 2.5 

Floorcover: Allowance Foundation: ! Bloci< 

Sprinkler Square Footage: I 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1907 0 0% 1907 103 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 740.0 

Fixture Base Fixtures 1.0 

Fixture Batli Full 1.0 

Porchi End Solid Wall 192.0 

Porch Slab Roof Ceiling 48.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 11/25/2009 
Page 1 of2 

"> 

ll Create Another Ticket 1 [ : Back to Irth Internet .] I Send Email %] 

• YOUR TICKET NUMBER IS 2457556. 

Original Call Date: 4/08/10 Time: 10:14 am Op: ELIZABETH18790 

Work to Begin Date: 4/12/10 Time: 10:45 am 

State: NE County: DOUGLAS Place: OMAHA 

Address: 2119 Street: EMMET ST 

Twp: 15N Rng: 13E Sect-Qtr: 10-NW 

Twp: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: LEAD REMEDIATION 


Location of Work: LOCATE ENTIRE PROPERTY, ALL EASEMENTS AND TO THE PEDESTAL 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNSURE IF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: COASTAL 


Depth of Excavation: 4 FT Comer Lot: N Front: Y Rear: Y 


Involves Tiinneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number 

UtiUty 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

X* A /-CT T A XT MAGELLAN MIDSTREAM PARTNERS T^TM^ „ . MAGELLAN . „ DEBORAH „ 

Day: 9185747098 

Alt: 

Emerg: 9185747098 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICH/TRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/8/2010 
Page 2 of2 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM 

LOCATING 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM 

LOCATING 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irtliintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/8/2010 
31263 

As-Built Drawing 

C OASTA L Omaha Lead Superfund Site 

OLS#:31263 

Date Excavated: 4/12/2010 

Date USEPA Signed Off: 4/27/2010 

Area Sodden: 3006 sa ft 

Omaha Exterior Paint Lead Site Owner Name: yiVlAN A WOMMOCK 

Site Sketch • Good

Address: 2119 EMMET ST • Poor 

Phone: H: W; g^o ; l paint 

Sample Number Lead 

Concerrtralion 

Sample 

Collected LAB Sample Collect^ 

Firm: fr)F<^­

es Collected 

RYASCPXA-31263 Fl n Date: 

RYBSCPXA-31263 F2 n Time: 

RYCSCPXA-31263 

RYDSCPXA-31263 

B l 

B2 n n 4 ppm 

n 

D Samples Analyzed 

RDZSCPXA-31263 0 2 ppm D XRF Unit: % ^3 ^ Book: M 

noiiocr)(A-oigo9 -esr ppm D D Date: \ ­ \ ? ) - 0 

nPgCCPXA 31263 ppm D D Time: Ai^g" 

Number of Samples = ^ p 

M^-yM-iMMM:.^^.,. ;> .k _ EA = 228 PPM@ 1" y.....f,anenii^.M. . "TT i 

Omaha Lead Site 46130 

Legen d 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with Area replaced with 

Sod ^ ' Rock/Mulch Area lef t bare 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
«li 

31263 

rWr^ r vv^ o ^ K-a 

Omaha Lead Site 46130 
iii^X>^'i-&^VS£i!ri&iii~lif-yi\:iiS^^^ 

31263 

Omaha Exterior Paint North Arrow Lead Site r Owner Name: VIVIAN A WOMMOCK 

Sit • Good e Sketch! • Poor 

0^o t paint 

Ottiaha Lead Site 46130 
:•.^7h?'*J'.V^^-V"C-^;fV^^^-^:-u^>>>•V•^•^-•••.S-if^^.^^HO^.^^;<^ 

31263 

Omaha Lead Site Exterior Paint htorlhAiTow Ovmer Name: VIVIAN A WOMMOCK 

Site Sketch • Good

Address: 2119 EMMET ST • Poor 

Phone: H: W: 

jQ'^ t paint i' 

Sample Number 

RYASCPXA-31283 F1 

Lead 

Concentratio icentrationn 

ppm 

Samples Collected 

Flm,: mf.!^-A.l/ M 

Dale: J^ i 

RYBSCPXA-31263 F2 ppm Time: ^i'(( y 

RYCSCPXA-31263 Bl 

RYDSCPXA-31263 B2 ppm 

Samples Analyzed 

RDZSCPXA-31263 DZ 3. ^ ppm XRF Unit: _3i \ ^ Book: i H 

RonoopxA-01200—eg­ ppm Date: _ 

nPggCPXA 01B03 PZ ppm 

Number of Samples = i

=^ ^ 

^ | 

Time:_ 

Staff: 

>

f^ e 

y 4 

JAN a k 2005 y 

y 

A 5 P ^ B.l 

•70v^ 

y 

y 

y 

>2 i:i3i5 

'»^—J * ^ 

y­

^IHEmm^fSj 

•yP Ik . 

;?tfi>w^//^ 

lEmmkS. OlKiaha Lead Site 46130 
^^..tosr.,^ 

COASTA I ENVIRONHIKTAl 

c I o tl r . I h c 

Consent for Access 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 

following described premises: <p 

Owner's Name: Daytime Phone: UzZZ^^ JO Q ^ 7 

Address of Property t/7? y^^^i-^TT"^/ 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 
,AtO»f4lv. 

%^^^4r^ ^ COASTA L 

' I PBO"- C « O U r I X C 

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

piles, dog houses, etc; 

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

to save; 

c Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

e Abide by health and safety guidance provided by EPA; 

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

the property to perform the work. 

c Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the wortc 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 (402) 991-1199 

(^ I grant access to my properties D I do not grant access to my properties 

Signaturi SianaturlBB Dat Datee Signature Date 

D I would like to t)e present during any sampling that is required. 

Page 2 of 2 
C O A S T A L 

O K O U P . INC . 

Restoration Agreement 

The purpose of this 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 ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: 5/;^3 

Property Address: ^^ ^ ^/^^yT^X ^ 

Owner; y/zyyAAy '(^(rpA^An^cjc-

Phone 

^a 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access location(s) to be used by the contractors. Indicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

Items to be Removed by the Owner befbre Start of Remediation: 

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

Kem: 

VJ>1PY1 ^ 

Kem: 

Kem: 

Kem: 

Items to be Removed by the Contractor During Remediation and Not Replaced 

Item: 

_^2iiii;2sil__-—L^s^iS2akj Kem: 

Item: 

Kem: 

Pagel of_32­
C O A S T A L • MVmOMMIMTAI . o n e u p . INC . 

Items to Be Removed By Contractor During Remediation and Replaced 

item: 

'^^il ^ SPO 

Kem: 

IVvir;^ , 1 ^ fewtow^ 

Kem: 

Kem: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, Quadrants that will be excavated, that h\M 

is covered with grass. 

Number of trees > 2 inch Each 

trunk diameter 1 

Nimiber of trees <= 2 inch Each 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, Each Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed Each 

area. Square Feet 

Attach a sketch of relative 

sizes and locations. 

Agreed upon value ofplant 

materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Easement Area, to be Each excavated ^ u 51 

Page 2 of. 
C O A S T A L 

a • o u p . INC . 

Additional Comments / Instructions: 

The city of Omaha ordinances may prohibK you from using dirt or gravel areas on your property 

as driveways or vehicle parking areas. The Environmental Protection Agency (EPA) may be 

removing and replacing soil underiying a gravel or dirt area on your property that you may be 

using as a driveway or vehicle parking area. If this is the case, you should understand that this 

removing and repiacing of soil does not mean that any illegal driveway or parking area on your 

property is made legal. To the contrary, you may be cited by the city if you use a gravel or dirt area 

as a driveway or parking area, not wKhstanding any removal or replacement of soil by the EPA 

If you have any question about legality of a certain driveway or parking area, you may contact 

the cKy of Omaha's Planning Department at (402) 444-5150. 

Please check this box if you understand the information outlined above. 

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

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

interior of house, including foundation cracks or fissures. 

^ I agree Q I do. not agree 

Owner's Signature *^ Date ( ' Contractor's Signature Date 

PageSpf 
• • 

BVID# "bl^. b 

XRF PROPERTY SAMPLE SHEET 


Date "^^ryj-^:?^ Address -m^ysB^^^L 

Project Omaha Lead ARRA Sample time am/pm 

XRF ID# sample length 30 sec 

Shot# 

Mk 

^ 

u 

kl 

Average

Reading 

IMLLH. 

myi4 

]?ji­ if! 

f ^ ^ t / 

Sample area 

Depth 

^ ^ 

Shot# 

^ 

M 

Average

Reading 

?P>Q> £ 9-S33^6^s­

^^V^^^ " 

Sampl amplee are ai a

Depth 

5Z 

3-^ 6 C g^ y y 

Shot# 

3 

ii & 

Reading 

J^?y^iy ^ 

^^^t.f^ 

ViTfei (iW^/-. l-f 

Sample area 

/Vf7 

Depth 

/ / 

Average ^ ^ fc P7 > ' ^ 

Shot# 

Average 

Reading Sample area 

Depth 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot# Reading 

RETEST AREAS 

Sample area Shot# Reading Sample area 

Average 

^' Z Depth 

Average 

Depth 

Signature. 

Print 
Tiierm® 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 469 

Mode SOIL 

Time 2010-05^10 17:16 

Duration 90.34 

Sequence Final 

Flags 

AVERAGE ^Avg-of-466-468— 

ADDRESS I—2119 Emmet st-— 

QUADRANT Bl 

DEPTH 10 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.330 

Zr 471.368 ± 16.248 

Sr 172.755 ± 9.130 

U < LOD : 15.745 

Rb 71.480 ± 6.860 

Th 17.921 ± 8.788 

-178.830__ ±- 18.366 

Se < LOD 5.932 

As 25.610 ± 16.427 

Hg < LOD ; 13.046 

Zn 166.186 ± . 22.769 

W < LOD •^• ^ ' )0.493 

Cu 44.511 yy ± /22.26 0 

Ni < LOD / J / 77.665 

Co < LOD / '^ 215.675 : y Fe 25457.156 ' 467.396 '^y? Mn 668.87B 109J6S 

/ y ^ 

Supervised By: / 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 466 

Mode SOIL 

Time 2010-05-10 17:14 

Duration 30.11 

Sequence Final 

Flags 

BVID 31263 

ADDRESS 2119 Emmet st 

QUADRANT B l 

DEPTH 10 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.410 

Zr 472.979 ± 16.356 

Sr 171.077 ± 9.137 

U < LOD : 16.373 

Rb 70.751 ± 6.932 

Th 17.610 ± 8.728 

Pb 168.487 ± 17.985 

Se < LOD : 5.982 

As 27.661 ± 16.206 

Hg < LOD : 13.117 

Zn 171.288 ± 23.249 

W < LOD I 92.571 

Cu 61.113 ± 23.648 

Ni < LOD ; 77.072 

Co < LOD ; 209.962 

Fe 23705.480 ± 453.824 

Mn 633.447 ± 107.564 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 467 

Mode SOIL 

Time 2010-05-10 17:15 

Duration 30.11 

Sequence Final 

Flags 

BVID 31263 

ADDRESS 2119 Emmet st 

QUADRANT B l 

DEPTH 10 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.462 

Zr 464.827 ± 16.145 

Sr 173.969 ± 9.154 

U < LOD : 15.277 

Rb 74.356 ± 6.910 

Th 16.243 ± 8.756 

Pb 190.868 ± 18.862 

Se < LOD : 5.694 

As 30.227 ± 17.005 

Hg < LOD 13.466 

Zn 153.468 ± 22.183 

W < LOD : 95.507 

Cu 37.456 ± 21.779 

Ni < LOD : 78.628 

Co < LOD : 221.909 

Fe 26822.662 ± 479.712 

Mn 737.928 ± 114.366 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 468 

Mode SOIL 

Time 2010-05-10 17:16 

Duration 30.12 

Sequence Final 

Flags 

BVID 31263 

ADDRESS 2119 Emmet st 

QUADRANT B l 

DEPTH 10 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.117 

Zr 476.297 ± 16.241 

Sr 173.217 ± 9.098 

U < LOD : 15.586 

Rb 69.333 ± 6.738 

Th 19.908 ± 8.880 

Pb 177.134 ± 18.252 

Se < LOD 6.121 

As < LOD 24.103 

Hg < LOD 12.556 

Zn 173.803 ± 22.875 

W < LOD I 83.400 

Cu 34.963 ± 21.354 

Ni < LOD : 77.295 

Co < LOD : 215.153 

Fe 25843.324 ± 468.652 

Mn 635.262 ± 107.663 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 461 

Mode SOIL 

Time 2010-05-10 16:45 

Duration 90.32 

Sequence Final 

Flags 

AVERAGE fAvg of 458-460 

ADDRESS 2119 Emmet st 

QUADRANT B2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Erro r 

Mo < LOD : 8.294 

Zr 449.446 ± 16.294 

Sr 176.060 ± 9.412 

U < LOD \ 15.049 

Rb 71.056 ± 6.903 

Th 16.975 ± 10.149 

>-., Se-S . ,

336.161 

 ...-<rLOD ' 

• ±

""""' : 

, _ 25.103. 

6.504 

As 36.472 ± 22.243 

Hg < LOD • 13.660 

Zn 257.469 ± 28.146 

W < LOD : 100.723 

Cu 48.483 ±^.^ —) 23.489 

Ni < LOD ^.^^: / 80.442 

Co < LOD / • /^ 213.009 

Fe 

Mn 

24224.13/ 

608.926 y

yy ^ V ^ . 

465.861 

108.335 

' 

Supervised By: x 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 458 

Mode SOIL 

Time 2010-05-10 16:43 

Duration 30.11 

Sequence Final 

Flags 

BVID 31263 

ADDRESS 2119 Emmet st 

QUADRANT B2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

458.779 

182.754 

< LOD 

73.678 

23.044 

335.867 

< LOD 

50.377 

< LOD 

249.169 

< LOD 

54.862 

< LOD 

< LOD 

24815.256 

569.415 

Supervised By: 

I 

± 

± 

; 

± 

± 

± 

: • 

± 

J 

±/ 

: 

± 

: 

: 

± 

± 

Error 

8.405 

16.417 

9.548 

14.687 

6.945 

10.573 

25.086 

7.084 

22.564 

12.969 

27.600 

98.023 

23.837 

80.782 

215.210 

470.099 

105.614 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 459 

Mode SOIL 

Time 2010-05-10 16:44 

Duration 30.11 

Sequence Final 

Flags 

BVID 31263 

ADDRESS 2119 Emmet st 

QUADRANT B2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.143 

Zr 446.487 ± 16.025 

Sr 172.404 ± 9.203 

U < LOD : 15.574 

Rb 69.857 ± 6.841 

Th 17.594 ± 10.085 

Pb 338.790 ± 24.847 

Se < LOD 5.845 

As < LOD 32.474 

Hg < LOD 12.915 

Zn 240.125 ± 26.741 

W < LOD 89.718 

Cu 48.888 ± 22.832 

Ni < LOD ; 75.399 

Co < LOD : 211.508 

Fe 25085.678 ± 467.994 

Mn 665.509 ± 110.028 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 460 

Mode SOIL 

Time 2010-05-10 16:45 

Duration 30.10 

Sequence Final 

Flags 

BVID 31263 

ADDRESS 2119 Emmet st 

QUADRANT B2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

443.073 

173.022 

< LOD 

69.634 

< LOD 

333.825 

< LOD 

36.205 

< LOD 

283.112 

138.562 

41.700 

< LOD 

< LOD 

22771.453 

591.885 

Supervised By: 

: 

± 

± 

± 

± • 

± 

± 

± 

± 

: 

: 

± 

± 

Error 

8.334 

16.439 

9.486 

14.887 

6.922 

14.684 

25.375 

6.583 

22.514 

15.095 

30.096 

76.285 

23.799 

85.146 

212.310 

459.489 

109.365 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 457 

Mode SOIL 

Time 2010-05-10 16:42 

Duration 90.35 

Sequence Final 

Flags 

AVERAGE r—-Avg15r454-456 - -

ADDRESS ^-^2119 Emmet st 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.081 

Zr 475.716 ± 15.823 

Sr 172.454 ± 8.860 

U < LOD : 14.332 

Rb 65.033 , ± 6.332 

Th < LOD 12.510 

~Cr " Se— ­

— -•'n"7"00o 227.883. ' < Lbb '.•.•...•• ± :• 

: 

19.894 

5.867 

As < LOD ; 26.055 

Hg < LOD : 12.617 

Zn 174.744 ± 22.490 

W < LOD : 85.594, 

Cu 36.646 ± --'^0.692 ; 

Ni < LOD 73.480 

Co 

Fe 

< LOD 

19369.471 / y; 

± 

183^ 4 

396:468 

Mn 547.678 / ± /97.998 

Supervised By: ^

^y 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 454 

Mode SOIL 

Time 2010-05-10 16:41 

Duration 30.11 

Sequence Final 

Flags 

BVID 31263 

ADDRESS 2119 Emmet st 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm 

Mo < LOD 

Zr 485.527 

Sr 172.951 

U < LOD 

Rb 62.970 

Th < LOD 

Pb 238.991 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 174.976 

W < LOD 

Cu < LOD 

Ni < LOD 

Co < LOD 

Fe 19685.045 

Mn 483.964 

Supervised By: 

Error 

8.085 

± 16.011 

± 8.906 

14.642 

± 6.307 

12.140 

± 20.414 

6.202 

26.434 

12.940 

± 22.576 

86.262 

30.093 

75.562 

187.045 

± 400.953 

± 94.232 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 455 

Mode SOIL 

Time 2010-05-10 16:41 

Duration 30.12 

Sequence Final 

Flags 

BVID 31263 

ADDRESS 2119 Emmet st 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD J 8.120 

Zr 479.519 ± 15.909 

Sr 178.698 ± 9.021 

U < LOD : 14.273 

Rb 64.156 ± 6.298 

Th < LOD : 12.251 

Pb 225.421 ± 19.781 

Se < LOD : 5.406 

As < LOD * 26.062 

Hg < LOD : 12.359 

Zn 170.831 ± 22.235 

W < LOD I 82.623 

Cu 39.474 ± 20.875 

Ni < LOD : 72.454 

Co < LOD : 182.690 

Fe 19359.127 ± 396.902 

Mn 616.746 ± 102.105 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 456 

Mode SOIL 

Time 2010-05-10 16:42 

Duration 30.12 

Sequence Final 

Flags 

BVID 31263 

ADDRESS 2119 Emmet st 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.038 

Zr 462.102 ± 15.550 

Sr 165.714 ± 8.653 

U < LOD 14.082 

Rb 67.972 ± 6.392 

Th 17.570 ± 8.759 

Pb 219.238 ± 19.487 

Se < LOD 5.992 

As < LOD 25.670 

Hg < LOD 12.551 

Zn 178.425 ± 22.659 

W < LOD J 87.897 

Cu 44.373 ± 21.140 

Ni < LOD : 72.426 

Co < LOD : 180.837 

Fe 19064.238 ± 391.548 

Mn 542.325 ± 97.655 

Supervised By: 
/lAf \ Omaha Lead Site—Fixed Price EP-R7-07-05 

o ^^^ ^ ? Coastal Environmental Group Inc. ^^^ ^ 

v"^^i ? www.coastalhazmat.com '^^'^ 

^"tPBO^*^ COASTA L IM 

6 I O U r, IH C 

EXECUTIVE SUMMARY: 

BVID #31263-(2119 EMMET ST) 

No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
EPA Property Close Out Form 

; / 7 Property Address:: 2\\ ^ 9tU\W\ff ^ .-^ Property #: -^1^0^ 

DBteH'ifnc: dlXlig^K^ - Owner's N-me:.^)\\\nX ^ ,.\K}S\(r)rrr\CX) 

Quads ExcHvaled; Contractor Croup OnTPf^dZi 

TTJoZy): 

Excavation Yes No General 

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

2. If necessary, were the correct areas ofdrip rone excavated aod restored? ^ " 

Grading Sod and Vcicefatton Yes ^o 

Does the grading arovmd the perimeter ofthe house in excavaied areas generally slope away 

from the house? , 

y y 2.

 Has sod been laid in all areas that were excavated? 

.1. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day time period) 

4. Are sodded areas generally nrm and evenly graded? \y •

 J — --* ­

j 5 Are ihejoints between the sod strips generally tight? (Only evaluate if inspected at a 30 day : , ^ 

time period) j 

' 6. Was the property graded such that water will not pool on the propeny"' ^ ^ 

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

i X 

Gates. Fences and Retalnlpg Walls 

i. Do gates open and close freely? (Ifapplicable) ~iy'" 

2 Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable] 

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

A. Was damage 10 retaining walls avoided? (Ifapplicable) y\ 

Foundatton, SidJBRand Gatlers 

Yes .No 

I. Was damage to the siding or trim avoided? y ^ 

2. Was damage to the foundation avoided? 1

I 

.". Was damage to windows avoided? 

A Was damage to windows or door screens avoided? 

f, Was damage to downspouts or downspout extensions avoided? 

y\'~ 

Sidewafks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? i/ " 

2, Was damage to walkway surfaces avoided? 
G*M'riers comnienifs: 

Fn.spection notes: 

^,y24 ^ yU^^UTW-^ 

Removal and resloration s complele including e 30-day so warrany vai ana restoration activate activates complete incjuding ththe JU-day sodd warranty: 

EPA Rckpresentative /J< m l)fljLs4> ^ Date: y/$ ? IJ^/ V 
Property Completion Agreement 

llns agreemeni documenls Ihe complclion ot remedial acliviiies perloimed on my property My signature 

will designale ihal I am satisfied with the restoration of my properly, and thai no ileins are in questions, 

now, or al any lime in the future, except ihose ilems lisled below, ifany 

Property ID: 3,y^^^3 _ 

Property Addrcss:^!^ ^ ^^^^ \ ^ 

Q""^'-- l/|V/iVi^ H)r^ry\fvncJK2 

P''^"^- ^5i?>. ^gp ^ 

Restoration Items in Question: 

Item: 

Item: 

Item; 

Item: 

Item: 

Item: 

Additional Comments: 

PQ I Agree ccftoraiion it completed, rxccpl as noted 

[_j I do not ayrtc resiorntinn is completed 

Owner's Signatiirc Date Ciint Ccintiartoi' i artoi'ss Si Sicnalnr g c Dale
Oss) 

^010 

American Recovery and Reirwestment Act (ARJIA) Ul\^j^ >• 

Omaha Ltad Si^pef^.nd Site ^^^S/HA 

2009/2010 ^^^ 

Remedifiticn Contractor: CoitCt-l EnvironMeKtEJ Groun - EP'_R7;ji9-_06 

Prcpei-t>,' kdendfier NuBiber; '2t)^in^ 

Property Address: 7J) ^ f..rAvy\P^- f^. 

Property OwQer's Name: \jnh/OA }ir)>vo/yy^r-JC 

lmftructioa.5 to tbe Frcpertv Owner: 

This form serves to record the Property Ovmev's assessment of performance (Incentive 1 

- Quality Assurance Surveillance Plan) involving the listed remediation contractor, as applicable 

to the Omaha Lead Site. This form documents the timeliness of punch list resolution, business 

relations, complaint resolution and the overall quality of work. Ifneed be, the Property Owner 

may utilize this form to record problems and/or issues not specifically tied to an assigned 

address, for example, business relations that generally don't follow the guidelines set forth in the 

Performance Work Statement. 

The Property Owner will indicate his/her assessment of performance with the contractor's 

work by checking a autnerical rating on the Cable below using the numerical definitions firom 

the rating scale below, then sign & date the form. 

9-10 "excellent" 

7-8 "very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Owner's Assessmept of Performance Regarding the Contracror's Work 

10 _! _ 5 

9 4 

8 3 

7 2 

6 1 

Property Owner Additional Comments from foptJongl; continue on back PERC if needed) 

Property Owner Signature ^Ltz ^