CONTRACT # EP-R7-06-04

ASW Associates Inc.

Omaha Lead Site Remediation, Omaha, NE

EPA

ASW Associates Inc Certification for Property Cioseout

BVID

Field Work Started

15642

19-Jun-06

Property Address

Field Work Completed

2709 South 30th Street

11-Jul-06

Summary:

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

The F1 quadrant was excavated to a depth of 6 inch.

The B1 quadrant was excavated to a depth of 12 inch.

Verification samples confirmed that the cleanup standards were met.

The site was backfilled with materials which meets contract specifications.

The backfill was compacted to acceptable standards.

Sod placements and site restorations were conducted in compliance with work plans and

specifications.

Analytical data provided is post excavation at the bottom of the excavation for confirmation

purposes

Comments:

None.

Jan Prawdzik

Name

ASW Project Manager

Title Signature

40261967

SUPERFUND RECORDS
CONTRACT # EP-R7-06-04

ASW Associates Inc.

Omaha Lead Site Remediation, Omaha, NE

EPA

Analytical Result Summary

OLS ID: 15642

Property Address: 2709 South 30th Street

Sample ID

15642-DE-B1-12

15642-DE-F1-06

XRF Results

Avg.

(ppm)

190 ±54.6

57.5 ± 42

Lab

Results

(ppm)

NA

NA

Jan Prawdzik

Name

ASW Project Manager

Title

Simple Deilgnation

OLSID-DE-Locarlon-dd

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

DE » During and Post Excavation

Location of the sample as follows;

FI = Front Yard (1* Quadrant)

Bl = Back Yard (1« Quadrant)

F2 - Front Yard (2- Quadrant)

B2 « Front Yard (2" Quadrant)

DZ = Drip Zone

PZ = Play Zone

GA • Garden

EA = Easement

- dd describes the depth from which the sample was collected.

NA = Not Applicable
£EPA

Remediation/Excavation Contract (ASW)

EPA Property Close Out Form

Property #:

Quads Excavated:

Property Address:

Owner's Name:

30

Contractor Group /4$U/

Excavation General Yes >o

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

2. If necessary, were the correct areas of drip zone excavated and restored?

^

LS

/

Grading Sod and Vegetation Yes No

1.

2.

3.

4.

5.

6.

7.

Does the grading around the perimeter of the house in excavated areas generally slope away

from the house?

Has sod been laid in all areas that were excavated?

Does the sod appear to be generally healthy and growing? (Only evaluate if inspected aLa 30

day time period) 5t>fiil C0*\fMtN aM $+/&

f t T

Are sodded areas generally firm and evenly graded?

Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day

time period)

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

Was damage to landscaping or plant materials avoided?

C^

(-«

• 1

t — •

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'

/

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Gates, Fences and Retaining Walls frp/offpitnf *f

1. Do gates open and close freely? (If applicable) y^ HtffjS*

So***. $ecl M*.V Yes No

r-tj 4*»'/l k/4''t or\ "TT*7Cx

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2. Were all gates or fences taken down during restoration activities reinstalled? (If applicable)

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

4. Was damage to retaining walls avoided? (If applicable) ^

ft

^

Foundation, Siding and Gutters Yes No

1 . Was damage to the siding or trim avoided?

2. Was damage to the foundation avoided? *

3. Was damage to windows avoided?

4. Was damage to windows or door screens avoided?

5. Was damage to downspouts or downspout extensions avoided?

L/

L*

i/

is

\s

^

^

^

s»

\s

Sidewalks and Driveways (Concrete) Yes JVo

1 . Was damage to driveway surfaces avoided?

2. Was damage to walkway surfaces avoided?

^

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/

/
Owners comments:

V --V*

Inspection notes:

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

EPA Representative /\JgK, / \cJmJ*- Date:_
Contract No: EP - R7 - 06 - 04

Property Closeout Agreement

Omaha Lead Superfund Site

OLSID

Property Owner

*»•/*, »v

Property Address

7 7*1 f W

Is the Resfdent the Owner 0/Yes D No

Compliance Statement: £/

U.S. Environmental Protection Agency (EPA) or its authorized representatives, (or its contractors), to enter

and conduct environmental restoration services for the Omaha Lead Site.

Your cooperation in giving EPA/ASW 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 contact specifications and EPA requirements.

If you have questions or need additional information please contact the EPA Public Information Centers at

(402) 73 1-3045 or (402) 991-9583 or the EPA Office of External Programs at 1-800-223-0425.

Additional Comments by EPA and/or ASW:

Jan Prawdzlk

Name

CONTRACTOR CERTIFICATION

ASW Project Manager

Title Date

Property Owner Section

Signature

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

Of I agree that restoration is completed at my property

D I Do Not Agree: Comments:

^ Property Owner's Signature

JyW^lfl T\ff~1k±,)

EPA Representative Signature

Date

1-13 -0f c

Date
Page 1 of.

U.S. Environmental Protection Agency Region VII

Omaha Lead Site

Omaha, NE

Residential Yard Soils

Environmental Restoration

Services

Grantor (the property owner), consents to and authorizes the United Sates Environmental Protection Agency (USEPA)

or its authorized representatives (or its contractors), the Grantee, to enter and perform certain environmental response

activities upon the following described premises. For further information please contact EPA at 1-800-223-0425.

c

Property Access Granted By ~_

(Please Print Name)

(Prop rty Owner Signature) ( (Date)

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

Resident Name: fi Co

Residence Address: 2 £Q <? S 3 O

D Owner

Of*\ AM A

D Renter

Property owned by:

Owners mailing address:

(CITY) (STATE) (ZIP)

5 AJ£ <£&lO $""

Owner's telephone number—Home:r4tiQ- \Lfl^ ~,

7

Work(j^& )3/9 ~

Age of Home?

Has the exterior been painted or covered with siding since 1978

years How long have you lived here? _

P"YES

. years

Has the interior been painted or covered since 1978?

y List Ages:

B'YES

'V ^>

D NO

Q NO

Total number of occupants:

' — f ' y -7

List ages of occupants under 6 years old who play in the yard for 5 or more hours per week: / "» _5

Comments:

AUTHORITY FOR ENVIQRNMENTAL RESPONSE ACTIONS

Thewtivitiei to be implemented by EPA under thii •freement ire punuwit to Section 104 of CERCLA. 42 U.S.C. 9604. EPA'i right ofacoeu to the

property for in Section 104(e) of CERCLA, 42 U.S.C. 9604 (e), which provides entry for, "determining the need for raponie, or choosing or taking

any response action under this title, or otherwise enforcing the provisions of this tide."

Access Attempts:

First: Second: Third:
List of existing Conditions pg. _ of

Property Address: 27<3<? g

Owner: Date: OLS #

Description:

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Owner Signature:

Print «& Sign

ASW Associates Inc.

Print & Sigri^
15642

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Omaha Lead Site 46130