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 28712 Property Address 2517 Ohio St 

Field Work Started 9/7/2007 Field Work Completed 9/7/2007 

Summary: 

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

• B1 excavation depth was 12 inches below ground surfaces. 

• B2 excavation depth was 12 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. 

• Sod placement and site restoration were conducted in compliance with the specifications and 

work plans. 

Comments: None 

~;J-H D-J"'...J ECCQCM /IJ!I7/rp T 

Name Title Date 

Jeff Hubbard USACE Con Rep W-~s-07 JiJJ~ Name Title Date Signature 
Omaha Exterior Paint North Arrow Owner Name: Lead Site JAMES X PIER~~ _ o Good Site Sketch Address: 2517 OHIO ST o Poor 

Phone: H: 402-455-2468 W: -~_ ••:_£ 

11111111111111111111111111111111111 28712
 

Team R. WeJJOn OLs_----I-,6-'<lJAq....I..- XRF Code_.......;3'----<-LJ-'-q~_
 

Quadrant
 

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B 1_---'-/":-2..",7/~-_ B2_~f2::c--rl _ 

DZ 

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Lead Concentration 

ZQ:, ppm '*

3ljS ppm* 

110 ppm 

22fJ ppm 

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_____--'ppm 

_____-'ppm 

ppm 

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LogBook

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046141.0123 
------------

Page 1 of _ 

Z ~41·7....

Omaha Lead Site 

Omaha, NE 

U.S. Environmental Protection Agency Region VII 

Residential Yard Soils 

Environmental Restoration 

Services 

1'!{OI'f.R J Y .\("C"l:I..,I.., 11,) be Ctlll1pklCd b~ I'll)PlTl~ (1IIIll'l) 

1',1I,lllTlhll l'~t:l 1·\)1111.1l"P:II)"I\wr '·.I\lll· IJ:lI11l';1I J-~'\fI(l-22~-(I-L>

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 perfonn certain environmental response 

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

Property Access Granted By ,\i'J/h ftC; {(C6rlCJ£, 

(Please Print Name) 

~, ~~ -0, 

(Date) 

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

I'ROl'un) I\FOR\\·\ IICY\ 

(1\1 b,' ClllllpklCd b~ IC~ldl'lll ;lllt! (11 PIl)Pl'lt~ ()\\l1cr-l'k,l~C l'lllll) 

Resident Name: _~~&1~-=- _ Owner o Renter 

Residence Address: d0'I, ~C .:s-r: 

(CITY) (STATE) (ZIP) 

Property owned by: S '" S x. Rae.. ",c.... 
 

Owners mailing address: <9-8bb LASTJ-1:4J p ~C"'..-'
 

Owner's telephone number-Home: ~'2- J7:l1{ Work:
 

Age of Home? _.:::L:::.......;o;;:;...-....;'-'-- years How long have you lived here? years 

Has the exterior been painted or covered with siding since 1978 DYES o NO 

Has the interior been painted or covered since 1978? DYES o NO 

Total number ofoccupants: _ List Ages: _ 

List ages ofoccupants 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 Seclion 104 ofCERCLA. 42 U.s.c. 9604. EPA's right of access to the 

property for in Section 100(e) ofCERCLA, 42 U.S.c. 9604 (e), which provides entry for, "delennining lite need for response, or choosing or taking 

any response action under this title, or otherwise enforcing lhe provisions of lhis title." 

Access Attempts:
 

First: Second: Third: _
 
pg._of_ 

List of Existing Conditions 

Property Address: ':l~11 r~Q~--r DVD ID #::Ji5JJu 

Description 

l/~ <-if" 

L~k~~O~

Ref: 

Photo 

# 

Date: ~-d3-~I BVID# g87/&
 

.J.. 

Owner ;- ~::; . r' rJ.t; ( -- Signa.... re..../. JM X 1I «.. L::Ecc 

Print &Sign 1." ()Jv> Print &Sign rCl~ - ) 

____...L....­ ..:.... r_"__ ...... ~"'---'_.;;......~ .......(...;;;-.o'__~_~.....;;..-.___::Ic,L:~~~~~~-­
Contract No. W912DQ-04-D-0017, Task Order DI(OI
 

Omaha Lead Site, Omaha, NE
 

Pronerty Closeout Aereement
 

BVID ..1g~ /~ Property Address I ~6~/'7 O/flO ::Sf

Property Owner Is the Owner the Resident? DYes ~fl'Mf-S. PJetct 

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 EPA/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. 

If you have questions or need additional information please contact Don Bahnke, EPA Project Manager, 

at (913) 551-7003 or the Office ofExternal Programs at 1-800-223-0425. 

Additional Comments hy USACE and/or ECC: 

CONTRACTOR CERTIFICATION
 

EeC Project Manager
 

Name Titlt' Date Signature 

.. 

PROPERTY OWNER SECTION 

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

satisfaction.
 

- .~agree that restoration is completed at my property, except as noted
 

Comments (if applicahle):
 

/1 1\ 

IXVIlA1Alh c{;.y~e.Q y 1..1- -.).,~ -tJ 'J 

Pr~ Owner's Signitn..el Datt

y - . 
Property Owner Satisfaction Survey Form 

Omaha Lead Superfund Site 

Perfonnance-Based Contracting (PBC) Pilot Project 

Remediation Contractor: ---"-"'''-'''''''"'''''''---------------

Property Identifier Number: _ 

Property BVID Number: r.lg' ~/J.---

Property Address: ~Sj? oiflO sr 

Property Owner's Name: :ra-M~es~____Ie"__L..IU...... r &~C~£--------­

(above information to be filled out by remediation contractor prior to delivery of fonn to Property Owner) 

*********************.*****••••**.*****•••••••••••••••*••••••••••••••••••••••* 

Instructions to Property Owner: 

1bis form is provided to you as a means oftlying 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 (USACE) are very interested in your opinion regarding the work perfonned 

by our contractors. 1bis 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 form 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" 

]-2 "very poor" 

Property Owner's Satisfaction Rating regarding Contractor's Work 

10 

9 

8 

7 

6 

5 

4 

3 

2 

1 

Property Owner's Signature: 
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 #28712 

2517 Ohio St 

Quadrant Sample 

Type 

DE I 81 

DE I 82 

DE I EA-N 

I 

1 

I 

I~pth I Date Collected XRF Results 

(ppm) (avg.) 

12 I 9/7/2007 110 

12 I 9/7/2 ""6 

0 I 9/7/2 177 

I 

I 

I 

SAi\IPLEIDSAMPLE 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 

B1or B2 .. 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 
ECCOWNER CHANGE REGlUEST. FORM 

PROPERTY ADDRESS 5 0 [1- t'lo~3 9 J' ~S~- :2;7 3 

OWNER NAME tOr ~. ~~

CHANGES REQUESTED: /) 

j7ltii l qrowd/ !Jt:I5e 1-f 0l'o<je 

/ 'Truck ~Q

OWNER SIGNATURE 6~ l 

ACTION TAKEN: 

fit)£.' jJ eueflt€. re az ",e,>~.t

SUPERVISOR INITIAL-Jl..!!L