TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID-: 3^Jp9 ^ Dale: ih^i 

Address: ^if V \\ K" ^ h < 

Remediation Conlriiclor: Coastal EnN'ironnicnfa) Group Year: _20]0ARRA 

SOILREMEDIATJON 

PROPERTV FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

y EPA-provided properly sketch 

y Signed Access Agreement for subject properly 

Signed Access Agreement(s) for adjacent properly 

y Restoration Agreement 

Seltlemenl documenls (i.e., for damage or lo replace plants, etc.) 

Confinnation data 

y Photographs i K ^T^^^ll^t^ ^ V^(»rW » ^ f^^ 

y As-buill sketch 

y Satisfactory restoration signed by Property Owner 

y Property close-oul check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

1/ Utility clearances 

Property information from Douglas County Assessor's Office 

30218857 

wm 

Superfund 
Property Access Checklist 

Property ID: a.'=Vt£.°V 

J''^il^''!i!l^:!!!L _^to>s_ja.. o^,..J^._^, 

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 WORK STARTED

 WORKCOMPELTED

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_/

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 /_ 

/ 

Owner: 

Address: 

_L\V>5 oS O vrxvVix Renter: 

Phone: 

Fiix: 

Ptjonc • Wo. .

Fax: 

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Ccll/Pager: 

Additional liiformatinn: 

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 Notification Letter 

 Access Agreement 

 Restoration Agreement 

 Topsoil Sampling (if applicable) 

 Disposal Sampling (if applicable) 

 Garden Sampling (if applicable) 

Sent: / / 

Signed: SUL > -^h^/ -u^i. 

Signed: JLIJ. / _iH / iu_ 

Bv: 

By: 

By: 

By: 

Bv: 

By: 

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 Utility Clearance 

 Video/Photos (Before) 

 Video/Photos (During) 

 Video/Photos (After) 

 Video/Photos (30-Day) 

 Property Completion Agreement 

Called: v^ / /N 

On: J ^ / VA_ / \o 

On: / / 

On: / / 

On: / / 

Signed: / / 

By- \v/«.v/ic

By: V>^V<-V«L 

By: 

By: 

Bv: 

By: 

 \^tvNctv, 

D Final Report Lisued: / / By: 

[D Community

Results: 

d Crew On: / / By: 

Q Communitj'

Results: 

O Crov On: / / By: 

Results: 

• Community D Crc« On: / ' By: 

Omaha Lead Site 
Douglas County Account Inteaatio teaai n 

Page 1 of2 

Douglas County, Nebraska Property Record - R1743770000 

Print Report. 

View Interactive GIS Mao Information is valid as of 2010-8-30 Treasurer's Tax Reoort 

New Feature ^ ^ ^ Subdivision Sales Search 

Owner 

CITY OF OMAHA 

C/0 CITY FINANCE 

1819 FARNAM ST 

OMAHA NE 68183-0000 

Property Informatio n 

Key Number: 4377 0000 17 

Account Type: Ex Government 

Parcel Number: 1743770000 

Parcel Address: 

2635 N 15 ST 

OMAHA NE 68110-0000 

Legal Description: MILLARD & CALDWELL'S ADD LOT 5 BLOCK 0 S 40 W 160 FT 40 X 160 

Value Informatio n 

Land Improvement Total 

2010 $0.00 $0.00 $0.00 

2009 $0.00 $0.00 $0.00 

2008 $400.00 $0.00 $400.00 

2007 $400.00 $0.00 $400.00 

2006 $400.00 $0.00 $400.00 

2005 $400.00 $0.00 $400.00 

Show All Transactions 

Land Informatio n 

Acres SF Units Deptti Widtti Vacant 

0.14 6400.0 0.0 160.0 40.0 Yes 

http://douglasne.mapping-online.coni/DouglasCoNe/static/accountinfo.jsp?accountno=Rl 74... 9/3/2010 
Douglas County Account InfiBmatio jmaaa n Page 2 of2 

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Google VMorAve Map data'IBQOlO Google 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R174... 9/3/2010 
Page 1 of2 

(i. Create Another Ticket TI L ^tecktoJrth.Intemet 1 L.ggrtd^gjaL:^! 

• YOUR TICKET NUMBER IS 2632038. 

Original Call Date: 11/02/10

Work to Begin Date: 11/04/10

 Time: 9:40 am 

 Time: 10:15 am 

Op: ELIZABETH18790 

State: NE 

Address: 2635 

County: DOUGLAS 

Street: N 15TH ST 

Place: OMAHA 

Twp: 15N

Twp:

 Rng: 13E

 Rng:

 Sect-Qtr: 10-SE 

 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 : C07VSTAL 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 Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MCINEB MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number 

Utility 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MCINEB MCI NO CALLPER 

MEMO 

Day: 8002893427 

Alt: 

Emerg: 8002893427 

MUDOl METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICH/TRAFFIC 

Day:

Alt:

 4024447197 

 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11/2/2010 
Page 2 of2 

0PPDGPR5 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/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11 /2/2010 
29609 

As-Built Drawing ^ 

COASTA

EHVIROMMCNTA

L 

L Omaha Lead Superfund Site e N O U P . IH C 

OLS#: 29609 

Date Excavated: 11/15/2010 

Date USEPA Signed Off: 12/2/2( 

Area Sodden: 6885 so ft 

Omali Exterior Paint Owne a Lead Site r Name: CHRISTOPHER BOGACZ • Good Site Sketch Address: 2635N15ST • Poor Ptione: H: W: [ J Not paint 

Lead Sample „ Samples Collected Sample Number Concenlration Collected Firm: FtA: HTJ-Ruj 

RYASCPXA-29609 F1 i>SD ppm Q^ D Date: ^'ZT^-S T 

RYBSCPXA-29609 F2 g^ p ppm Ef n Time: 12 4 S 

RYCSCPXA-29609 B1 dCe^ ppm 0 ' • 

Samples Analyzed RYDSCPXA-29609 B2 S T y ppm [?f • 

RDZOCrXA-ZOOOO -B2 - ppm • • 

XRF Unit lO'i T Book: /2 ? 

nC2SCPXA 20600 -G2 - ppm n D Date: a-3<-OS' 

-Pi - ppm • • Time: /=V»t 

Staff: i A Number of Samples = i • ^ ! ' "~ 

Legend: Fl = Front Left, F2 = Front Right, 81 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden. PZ = Play 

All quadrants are as viewed from ttie stieet. facing property 

AU6.2.3 5S85..'. 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with 

Sod ' ' 

Area replaced with 

Rock/Mulch Area left bare 

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

% 

29609 

CV-e i^r Vv \H K 

Exterior Paint North Arrow Owne Onnaha Lead Site r Name: CHRISTOPHER BOGACZ Q Good Site Sketch Address: 2635 N 15 ST • Poor 

Phone: H W: Q Nol paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

 Ft A Mzr/7?u 3 

RYASCPXA-29609

RYBSCPXA-29609

 Fl 

 F2 

^S P ppm 

SS^pp m 

D 

D 

Date: _^Z2--S ^ 

Time: 12 2Z 

RYCSCPXA-29609

RYDSCPXA-29609

 B1 

 B2 

6^ 9

g 7 6

 ppm 

 ppm \ ^ 

D 

D Samples Analyzed 

RDZOCPXA-20600 B2- " ppm D D XRF Unit: 103 7 Book IZ*) 

RGZ6GPXA 29600

Rf>gCCr.Y.A 20600

 62 -

 P2­

ppm 

ppm 

D 

D 

D 

a 

Date:

Time: 

_ A'31-OS ' 

r^ 

Number of Samples = -If Staff: JA. 

Legend: F1 = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from fhe street, facing property 

ENtEEKB 

^ 5 . 

(tl y^ '• <fV '• y y 

v; yt\ y^fzA 
29609 

Omah Exterior Paint North Arrow Owne a Lead Site r Name: CHRISTOPHER BOGACZ 

Site • Good Sketch Address: 2635 N 15 ST • Poor 

Phone: H: W: 

[~I Nol paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

 J^bA HJ'/'RL d 

RYASCPXA-296G9 Fl 6 S o ppm D Date: ^'ZZ-S ^ 

RYBSCPXA-29609 F2 gg ^ ppm D Time: 12 4 s 

RYCSCPXA-29609

RYDSCPXA-29609

 81 

 82 

6^ ^

5 7 i»

 ppm 

 ppm 

D 

D Samples Analyzed 

RDZOC^XJ^^20G00 B*­ ppm D D XRF Unit: 103 7 Book: /2 ? 

RGZCCrXA aOSOQ

RPZCCrXA 30600

 6i r 

 P2­

ppm 

ppm 

a 

D a

• 

Date:

Time: 

_ a-gz-os" 

P^yi 

Number of Samples = j ­ ^ Staff: AA. 

Legend: Fl = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden. PZ = Play 

All quadrants are as viewed from the street, facing property 
Owne Omaha Lead Site r Name: CHRISTOPHER BOGACZ 

Address: 2635 N 15 ST Site Sketch 

Phone: H:

Sample Number 

RYASCPXA-29609

RyBSCPXA-29609

RYCSCPXAr29609

RYDSCPXA-29609

RDgOGPXiV2Q009

 F1 

 F2 

 81 

 82 

 B£> 

nozcGPXA aosoo—G2­

—RPZSCPXA aoeoo—pg­

 W: 

Lead Sample 

Concientration CollectBd 

6 5 0 ppm 

£Sa_PPm 

C»£»^ oom 

S 7 (fi ppm % 

ppm D 

ppm D 

ppm D 

Number of Samples = j y^ 

LAB 

n 

D 

D 

D 

Exterior Paint 

• Good 

• Poor 

Q Not paint 

29609 

NorthArrow 

Samples Collected 

Firm: F^tA M^T/T^U ) 

Date:

Time 

D XRF Unit 

Date: a 

Time: 

a Staff: 

 y-22.-5 ^ 

Samples Analyzed 

/g3 7 Book: _iZ± 

^.gZ-OS " 

J^2L 

AA 

Leigend: F1 = Front Left, F2 = Front Right, Bl = Back Left, 82 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the stie^, facing property 

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RIGHT OF ENTRY TO PREMISES 

Granto! (the property' owner) consents to and authorizes the United States 

Environmental Protection Agency (F-.PA) ot its authorized representatives, collectively 

the Grantee, to enter snd perform certain environmental response activities upori the 

following described premises: 

Ownef's Name; Daytime Phone; 

^VV' y^vg 

Address of Property 

covered by this 

Agreement; 

2^5^ V/5 5r 

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 wWh 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 properly, al 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 
c c A s I ;• I 

'. ^ Y t ^ 0 •- <•. h • Ii i 

' Remove obstiuctions incljciing boats, tiaileis, vc-.hicles., playscape-- iic-'nr, wood 

piles, dog houses, etc: 

< flemove fiov,'ei bulbs oi pianis that the Grantoi cf the Giafitoi's tc-!"icnt niriy w

to save; 

ish 

Water and maintain leplacernenl vegetation, including lerliiizer spplicrtion, as 

necessary' subsequent to sn initial watering period by EPA, 

< Abide by health and safety guidance provided by EPA, 

If the property' is rented, assist EPA in obtaining tenant sppioN'al foi

the property to perform the work. 

 access to 

I Allow videotaping and/or photographing of the properly. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interlere or tamper with any of the work activities, oi with any 

of the work done, or with the equipment used on his properly, 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 

•0^1 grant access to my properties • I do nol grant access to my properties 

Signature' 1 / Date Signature Dale 

• I wouid fikf. to be nreseiti ouriiij^ any sEmplInc that is (eqi'iied. 

Paoe 2 of 2 
Restoration Agreement 

Ttie 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). 

PropertylD: (-] H^jycOCXP 

Property Address: ^^5 5 ^ jc^ ^-j ­

0>vner: CfT^ ^ ^ Q^^^+fi. 

Phone: 4L/t| ^^-^ ^ 

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 before Start of Remediation: 

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

'^7V ^ 

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

I Item: " ^ '^ 

Page 1 of. 
COASTA L CNVIHOHMt N TA L 

c N o u r , ) M c 

Items to Be Removed By Contractor During Remediation and Replaced 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, Quadrants that will be excavated, that 

is covered with grass. 

Numbe i r of trees > 2 inch /r Each ­

trunk diameter 

Number of trees <= 2 inch Each ^ 

trunk diameter 

Number of Sprinkler 

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

Attach a sketch of the 

i.prinlvler layout. 

Number of and size of 

each garden/ flower bed Each 

area. Square Feet 

Attach a sketch ot'ielati\e 

sizes and localians. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this xiiluc «ili he 

used (0 issue n plant 

^()ucller 10 the propcrl> 

o>\ ncr. 

Easement Area, to be Each 

excavated Cl/v\Ay f-fyJ*"^^ /U&i^lA^ 

Page 2 of 
C O A S T if, L CNVIKONHI N TA L 

CROUP , INC . 

Additional Comments / Instructions: 

The city of Omaha ordinances may prohibit 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 underlying 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 replacing 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 withstanding 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 city of Omaha's Planning Department at (402) 444-5150. 

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

n 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. 

0n I agree n I do not agree 

S^c. fM/t. J 

Contractor's Signature Date 

Page 3 of. 
BVIPg Z^6c 1 

XRF PROPERTY SAMPLE SHEET 

Date 

Project 

XRF iD# 

;-^4 ­ ZOH 

Omaha Lead ARRA 

7i°i07,t 

Address 

Sample time 

sample length 

Z3^ G AJ /.^

30 sec • 

 c r 

am/pm 

Shot# 

'^ t 

i 3 

14 

Reading 

m '• n 

13^ i 23 

/'^l/ i Zi 

Sample ares 

B A 

Depth 

/ " 

Shot# 

qg 

q*=i 

^ ^ 

Reading 

m i

3^^i

a64i

 z3 

 7.S 

 ^:?. 

Sample area 

5Z 

Depth 

6'-

Average ZJOO Zl y Average .^ ^ 2A. y 

Shot# Reading Sample area Shot# Reading Sample area 

5^ ZA^ i. ZA PL : \ \ 335 i Z^ n 

S^ 30i i Z,5 Depth -\6 3/5 > ZS Depth 

'\0 351 i Z-\ IT ^io 3^^i ;-.^ ^ " 

Average r^Z.:^ ^6 / Average 31<^ i^ 7.6 / 

Shot# Reading Sample area Shot# Reading Samplearea 

54 4Z.^ i Z.^ /^l 

%S 4 ^ ^ i 3D Depth Depth 

84 43^ t 5D /5" 

Average 455' ^ 2>0 y Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Samplearea 

^ - 7 Depth Depth 

y A 

Average Average 

Signature_ 

Print ^%i n ^'^^^' ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

95 

SOIL 

2011-01-24 11:56 

90.49 

Final 

Avg of 92-94 

2635 N 15 ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 174.468 

Supervised By: 

Certificate of Verification 

92 

SOIL 

2011-01-24 11:54 

30.19 

Final 

29609 

2635 N 15 ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 19.772 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 236.266 

Supervised By: 

Certificate of Verification 

93 

SOIL 

2011-01-24 11:55 

30.26 

Final 

29609 

2635 N 15 ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 23.163 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 191.666 

Supervised By: 

Certificate of Verification 

94 

SOIL 

2011-01-24 11:56 

30.04 

Final 

29609 

2635 N 15 ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

21.289 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

91 

SOIL 

2011-01-24 11:52 

90.76 

Final 

Avg of 88-90 

2635 N 15 ST 

F2 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 349.012 

Supervised By: 

Certificate of Verification 

88 

SOIL 

2011-01-24 11:50 

30.30 

Final 

29609 

2635 N 15 ST 

F2 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 27.125 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 301.166 

Supervised By: 

Certificate of Verification 

89 

SOIL 

2011-01-24 11:51 

30.23 

Final 

29609 

2635 N 15 ST 

F2 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 25.223 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 331.145 

Supervised By: 

Certificate of Verification 

90 

SOIL 

2011-01-24 11:52 

30.23 

Final 

29609 

2635 N 15 ST 

F2 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 27.057 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

87 

SOIL 

2011-01- 24 11:49 

90.90 

Final 

Avg of 84-86 

2635 N 15 ST 

Fl 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 420.170 

Supervised By: 

Certificate of Verification 

84 

SOIL 

2011-01-24 11:43 

30.31 

Final 

29609 

2635 N 15 ST 

Fl 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 29.367 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 447.787 

Supervised By: 

Certificate of Verification 

85 

SOIL 

2011-01-24 11:48 

30.31 

Final 

29609 

2635 N 15 ST 

Fl 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 30.572 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 439.167 

Supervised By: 

Certificate of Verification 

86 

SOIL 

2011-01-24 11:49 

30.28 

Final 

29609 

2635 N 15 ST 

Fl 

13" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 30.591 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

81 

SOIL 

2011-01-24 11:39 

91.20 

Final 

Avg of 78-80 

2635 N 15 ST 

B2 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 341.278 

Supervised By: 

Certificate of Verification 

78 

SOIL 

2011-01-24 11:37 

30.66 

Final 

29609 

2635 N 15 ST 

B2 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 23.999 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 378.820 

Supervised By: 

Certificate of Verification 

79 

SOIL 

2011-01-24 11:38 

30.27 

Final 

29609 

2635 N 15 ST 

B2 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 28.258 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 364.722 

Supervised By: 

Certificate of Verification 

80 

SOIL 

2011-01-24 11:39 

30.27 

Final 

29609 

2635 N 15 ST 

B2 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

27.417 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By 

Certificate of Verification 

77 

SOIL 

2011-01-24 11:36 

90.92 

Final 

Avg of 74-76 

2635 N 15 ST 

Bl 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 335.957 

Supervised By: 

Certificate of Verification 

74 

SOIL 

2011-01-24 11:35 

30.31 

Final 

29609 

2635 N 15 ST 

Bl 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 26.563 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 315.964 

Supervised By: 

Certificate of Verification 

75 

SOIL 

2011-01-24 11:36 

30.31 

Final 

29609 

2635 N 15 ST 

Bl 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 25.599 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 397.390 

Supervised By: 

Certificate of Verification 

76 

SOIL 

2011-01-24 11:36 

30.30 

Final 

29609 

2635 N 15 ST 

Bl 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 28.818 
\ Omaha Lead Site—Fixed Price EP-R7-07-05 

I

vr^^JJ ?

 Coastal Environmental Group Inc. www.coastalhazmat.com 

Xp„o,t«i*^ COASTA L ENVIIONMINTAL 

C HO U P, IN C 

EXECUTIVE SUMMARY: 

BVID #29609-(2635 N 15 ST) 

"xl No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
£

£ 

EPA Property Close Out Form 

Proptrty #: . _ 3?£^ 5 Property Addresr. — 

Date/Time: txl>-l*C 

Owner's Nsmt- r. , . 

Quad Confractor Group t FxcBvnlrd: Fl^F4,BlJJ'i Cccjr**-­

E;icavat)on General 

1 IfneccsSMy, were the correct quadranl(t) excavated and restored'' 

y

'4 

2 if nccessar)', were the correct areas of dnp /.one cxcavaied and restored'' y I 

Yes N(/ 

I I Does the grading around the perimeier ofthe hou.se in excavairri area? generally SIUJH awa\ I y ~ 

from the house? 

Has sod been laid in all areas thai %vere excavated? / 

Grfldlng Sod and VcgcUliop 

I i 

i Docs the sod appear ro be generally healthy and growing? (t)nly evaluate if msprriod ai a ?0 /

day time period) . . _ ­

y 4 Are sodded areas generally firm and evenly graded? 

V -I ­ 1 *> Are the joints between the sod strips generally tight? (Only evaluate if inspccicd at a ?n day 

lime period) _ _ y

r 

6 Was the property graded such thai water will tioi pool cm ihf propertv'' y 

7 Was damage to landscaping or plam materials avoided'' y 

Gates. Ftoces apd Retaining Walls T 

Do gates open and close freely? fif applitable) • / , , 

Were all gates oi fences taken down dunng restoralion atiiviiies reinstalled'.' (II apo/icahk i I ' I 

' Was damage to gales or fences avoided? (Ifapplicable) 

t Was damage to retaining wails avoided? (Ifapplicable) y\ 

J. 

f otipdation, SidJBK and GMtlers _ _ _ 

I Was damage to the siding or trim avoided? A' 

Y ' 

I 2 Was damage to the foundation avoided'' A ' "' Was damage lc windows avoided'' A 

<! W'B.S damage to windows or door screens avoided'' 

Wa"; damage io downspouts or downspoui ixiensions avoided' ! y 

Sidewalks and Driveways (Coocrtte) > es ^(• _ —! • 

I Was damage lo driveway surfaces avoided'' 

1. Was damage to walkway surfaces avoided'' 
OMPPP* comments: 

InsnfTtion notes: 

Removal and resioiatioii Hi.li\ale.s ciunpleie including ihe 30-day .sod wancinry 

l.-PA Rcprespniituvc _ B"^ ^ _ Oate; _ _ M^° 
' ^ 

Property Completion Agreement 

This a(!recmeni dcictnncni} (he i:(unplclion ol rrinediiil 8C(ivMi» pcrloiintd no my pioperty My signaiuie 

will desigiiaic ihal I am sslL^fied wtlh llie rctioralion of my properly, and Ihal no ncms are in quesiion.*^ 

iiov^. or al any inne in the fulure. cxcepi ihosc iiems listed below, rf any 

Property IP: XTCs O 2.~ _ ~ 

PropcreyAddmvQ-^-^; ^ 'fJ f^^ X 

^myHlLtS^. -cJ:—Oincih^A. 

Resloration Items In Queslion: 

Kem: 

llem: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

R^ I )i|:rcr i ntomllon i« compltKd, c>ct|il *> nMtd 

f j I do nol »iittt /rfipi'Diisn i» tonipltitd 

h I,./, /P 

C'ltnti arifli 't Signaliix Uair