CONTRACT # EP-R7-06-04

 

ASW Associates Inc. 

Omaha Lead Site Remediation, Omaha, NE 

EPA 

ASW Associates Inc Certification for Property Closeout 

BVID 22002 Property Address 91 7 S 27th

 Street 

Field Work Started 9-Jun-06 Field Work Completed 5-Jul-06 

Summary: 

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

The B2 quadrant was excavated to a depth of 6 inch. 

The drip zone was excavated to a depth of 12 inch. 

Verification samples confirmed that the cleanup standards were met.

 

Verification samples were taken from bottom of excavation. 

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. 

40258558 

Comments: 

None. SUPERFUNI) RECORDS

 

Jan Prawdzik ASW Project Manager xs 

Name Title Stfjnature 
CONTRACT # EP-R7-06-04

 

ASW Associates Inc. 

Omaha Lead Site Remediation, Omaha, NE 

EPA 

Analytical Result Summary 

OLS ID: 22002 

th Property Address: 917 S 27"1

 Street 

Sample ID 

XRF Results 

Avg. 

(ppm) 

Lab Results 

(ppm) 

22002-DE-B2-06 155151.6 290 

2002-DE-DZ-I2 402.5 ± 67 NA 

Jan Prawdzik ASW Project Manager 

Name Title Date 

Sample Designation 

OLSID-DE-Location-dd 

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

DE = During and Post Excavation 

Location of the sample as follows; 

Fl = Front Yard (I" Quadrant) 

Bl = Back Yard (1° Quadrant) 

F2 = Front Yard (2nd Quadrant) 

B2 = Front Yard (2nd Quadrant) 

DZ = Drip Zone 

PZ = Play Zone 

GA = Garden 

EA = Easement 

dd describes the depth from which the sample was collected. 

NA = Not Applicable 
Remediation/Excavation Contract (ASW)

 

EPA Property Close Out Form 

Property #: • Property Address: i / 7 

Date/Time: Owner's Name: /*?,'( A e/lf 

Quads Excavated: Dz. Contractor Group 

Excavation General Yes No 

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

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

Grading Sod and Vegetation Yes No 

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

from the house? s

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 

day time period) </ 

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

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

time period) s 

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

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

Gates, Fences and Retaining Walls Yes No 

1. Do gates open and close freely? (If applicable) v/ 

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

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

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

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? y 

5. Was damage to downspouts or downspout extensions avoided? s 

Sidewalks and Driveways (Concrete) Yes No 

1 . Was damage to driveway surfaces avoided? / 

2. Was damage to walkway surfaces avoided? / 
Owners comments: 

Inspection notes: 

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

EPA Representative BQ^^-^ Date: 
Owners comments: 

>'.; '•; .'.:. ;> ••:• \* 

-f * •: * '.•-•• \ > '• V»« ? \' 

Inspection notes: 

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

EPA Representative &"" ^2 Date: / 
t» 1

 

Page 1 of 

(/'A/ / w ~ Omaha Lead Site 

bmahafNE 

U.S. Environmental Protection Agency Region VII 

Residential Yard Soils 

Environmental Restoration 

Services 

PROPERTY ACCESS do be completed In Pror. 

-223-042: 

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. 

Property Access Granted By , Hi-; iU..L.q k.ji.i / (A 

(Please Print Name) 

(Property Owner Signature) (Date) 

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

PROPERTY INFORMATION 

(to be completed b\ resident and'or nropenv owner—F 

Resident Name: D Owner D Renter 

Residence Address: h 2? S; 

(CITY) (STATE) (ZIP) 

Property owned by: 

Owners mailing address: 

Owner's telephone number—Home: 3$~0' 1^1 work: 

Age of Home? years How long have you lived here? years 

Has the exterior been painted or covered with siding since 1978 DlxYES D NO 

Has the interior been painted or covered since 1978? CVfES D NO 

Total number of occupants: ^ List Ages: 

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

Comments: 

AUTHORITY FOR ENVIORNMENTAL RESPONSE ACTIONS 

The 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 to the 

property for in Section I04(e) of CERCLA, 42 U.S.C. 9604 (e), which provides entry for, "determining the need for response, or choosing or taking 

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

Access Attempts: 

First: Second: Third:

 
§. 

Contract No: EP - R7 - 06 - 04 

Propert

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a

 Closeou

 Lead Superfun

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d Site 

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OLsro Property Address . Q I 7 ^. '")~7iM<i T/i «^ . c* / A| 

Property Owner Is the Resident the Owner 6f Yes D No 

I'T) \ t-A^ G 1 l<t- T\ O if-lo^ 

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: 

CONTRACTOR CERTIFICATION 

Jan Prawdzik ASW Project Manager 

Name Title Date Signature 

Property Owner Section 

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

SL I agree that restoration is completed at my property 

D I Do Not Agree: Comments: 

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Property Owner's Signature Date 

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[EFA RepresentativeS/gnature '

 f Date 
List of existing Conditions pg. J_ of jf

 

Property Address: 

Owner: Date: "5-MO-UN* OLS # 

Description: 

Owner Signature: ASW Associates Inc 

Print & Sign 
Omaha Lead Site 46130