TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 2.0|l4 - Date: :2/^/p^ 

Address: SCrPi PrfplgtP n ftvP. 

Remediation Contractor: Coastal Environmental Group_ Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

40314809 Executive Summary 

EPA-provided property sketch 

Superfund 

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 

Photographs pfy,-^r/-Jg>h_flrv^ S6cl^ \\(uJ< Sc4. 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

PfOpff^ CUre&s Qj{<LeU^ST 

doJrtlc f Jorr ^ 

D 

P<pCAje5L\? ^ Signature 

y^/^auJ^ ^ 
Property Access Checklist 

Property ID: Z<0^/4 

D WORK STARTED ON: _/ l_ 

Property D WORK COMPELTED ON: J I Address: ^Qn^ ^ %pl^,k) n ^ 

l^'*^"'- druQ.e. Address: |l| ^ ^ Th^mps-en 

5 ^^ ^-j " 

Renter 

Phone: 

Fa.\: 

Cell/Pager. 

Phonc: -1^ 4 . 15^- ^ Additional Information: 

Fax: 

Cell/Pager. 

n Notification Letter Sent: / / By: 

pn Accesii Agreement Siened: i P t ^ 1 f=> By:£C, 

1^ Restoration Agreement Signed: | () / ^ l 9 By: r C 

Q Topsoil Sampling (if applicable) 1 1 By: 

O Disposal Sampling (if applicable) 1 1 By: 

D Garden Sampling (if applicable) 1 1 By: 

Q [ Utility Clearance Called:^//a/-a i ^T.}0/I5J[?^ 

^ Video/Photos (Before) On:/? 1 / / IS ^ ny-M^/^^y^^ 

n Video/Photos (During) On: / / By: 

1 n Video/Photos (After) On: / / By: 

D Video/Photos (30-Day) On: / / By: 

n Property Completion Agreement Siened: / / By: 

D Final Report Issued: / / By: 

Air Monitoring (as applicable 

1 • Community • Crow 

> 

Results:

On: / / 1 

1 

EU Community' IH Crew 

Results: 

On: / / By: 

• Communit)' Q Crow 

Results: 

On: / / B, : 

Omaha Lead Site 
1 

CONTACT FORM 

Property ID tf -2taii 

Property 

Address: ^00'^ poppVf ?!ron hjt 

Initial Contact: Date Time: Action; 

Second Contact; Date Time: Action: 

Final Conlact: Date _____^ Time: Aclion: 

Final Action; Tran.smit to EPA D Other Action: D 

Comment: 

Owner 

1 Comment (s): 

She 

Coordinator 

Comment (s): 

1 
Douglas County Account Infq^tetio a ^ n Page 1 of2 t 

Douglas County, Nebraska Property Record - R1237440000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 90th St - Vle W O n Ma p Information is valid as of 2008-9-4 Treasurer's Tax Report 

New Feature -•-•- • Auto Sales Search 

Owner 

THOMPSEN BRUCE A 

ETAL 

1119S31 ST 

OMAHA NE 68105-0000 

Property Informatio n 

Key Number: 3744 0000 12 

Account Type: Residential 

Parcel Number: 1237440000 

Parcel Address: 3009 POPPLETON AV 

OMAHA NE 68105-0000 

Legal Description: HANSCOM PU\CE LOT 1 BLOCK 10 W 41.3 E 142 FT 41.3 X 50 

Value Informatio n 

2008 

2007 

2006 

2005 

2004 

2003 

Land 

$3,700.00 

$3,700.00 

$3,700.00 

$3,700.00 

$3,700.00 

$3,700.00 

Improvement 

$60,100.00 

$60,100.00 

$31,400.00 

$31,400.00 

$31,400.00 

$31,400.00 

Total 

$63,800.00 

$63,800.00 

$35,100.00 

$35,100.00 

$35,100.00 

$35,100.00 

Land Informatio n 

Acres 

0.04 

SF 

2050.0 

Units 

1.0 

Depth 

50.0 

Widtii 

41.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12... 10/7/2008 
iJouglas County Account Infc^^tion Page 2 of2 V' 

1 1/2 STORY FINISHED 

.„,.„Ujr ; ii r 

1 •»•» "f jp JMllBIi m 7!ff li t 

L.uJ TfttOiqt 33301 rr 

'i n t r zatr u v 

'H 

11 

21 ff 

CLICK TO ENLARGE IMAGE CUCKXaENLARGE IMAGE 

Square Footage: 1111.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gambrel Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year 

year Built Physical Age Remodeled Remodeled Built 

1890 0 0% 1890 117 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Appliance Fireplace Metal 1.0 

Basement Bsmnt Block 8 ft 693.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch Open Slab 256.0 

Porch Slab Roof Ceil 35.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R12... 10/7/2008 
Page 1 of2 

"> 

[ Create Another Ticket j [ Back to Irth Internet ] [ Send Email 

. YOUR TICKET NUMBER IS 2160984. 

Original Call Date: 10/23/08 Time: 9:05 pm Op: ELIZABETH18790 


Work to Begin Date: 10/28/08 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3 009 Street: POPPLETON AVE 


Twp: 15N Rng: 13E Sect-Qtr: 28-NE-NW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remediation 


Location of Work: LOCATE ENTIRE PROPERTY INCLUDING THE HOUSE ALL THE WAY TO 


: THE STREET. 


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


Company : COASTT^ ENVIRONMENTAL SERVICE 


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


Work Being Done For: coastal 


Depth of Excavation: 4ft Corner Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MCLEODNE MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


QWEST2 


Service Area Contact Phone Number UtiUty 

Type 

CXCATV 

COX COMMUNICATIONS, 

INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVELS 

LEVEL3 COMMUNICATIONS, 

LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MCLEODNE MCLEODUSA NO NEED TO CALL OUT 

EMERGENCY 

Day: 8002891901 

Alt: 

Emerg: 8002891901 

MUD02 METROPOLITAN UTILITIES 

DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047946 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/23/2008 
Page 2 of2 

CITY OF OMAHA- OMAHACOF RON TRAFFIC,SEWER 

OMAHA PUBLIC POWER 0PPDGPR6 NA DISTRICT 

QLNNEIF QWEST LOCAL NETWORK NA 

QWEST2 QWEST LONG DISTANCE SARA 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

Alt: 8887289343 

Emerg: 4067289343 

Day: 4067289343 

Alt: 

Emerg: 8887289343 

Day: 8002834237 

Alt: 3039921926 

Emerg: 8002834237 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/23/2008 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

Name; R.'vc t TK^Mp-,«A Omaha Lead Site Date: 9'^~&-Rj North Arrow ^ 

Address, 'i.cc^i f^pfi'-^'- y Site SIcetch Time: /d'/S-

Phone: 

Team /A I/tv', )J,( (/^C j BVID# 7jOHl i XRF Code 5-^ ^ 

Sample Numt>er Lead Concentration Confirmation Sample 

f?'//ffC/'x A - 2 o V^/• / /-/Yes n No 13 

/V,Yes CD No El 

eyves • No -El 

<S^Yes n No E! 

No 13 

ppm Yes • No CD 

Yes • No • G) 

Oli.S#: 20414 

Date Exdavated: 10/24/08 

XyatebSEPASTdheaOfniT/S/Og 

Area Sodded 22Z sqift 

^Opflt . ft>:n 

Omaha Lead Site 46130 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 


Area replaced with Area replaced with 

Sod ^— ^ Rook/Mulch ^ Area left bare 

Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 
Name: Ri' J C e i K*-^ ^yar^ Omaha Lead Site Date: 9-^' ^ North Arrow [• 

Address: ^<.c<^ f^pf^'^"\ Site SIcetch Time: (0HS . 

Phone: 

Team /A)/AJ,)Jje­ f>£ 7 BVID# ')jO^\' i XRF Code 5-^^^^ 

Sample Number Lead Concentration Confirmation Sample 

ppm 

ppm 

/5'Yes

;y,Yes

eyves

S^Yes

az^es

Yes

 °

 Q

 D

 1^

 tu

 D

 No ca 

 No E] 

 No -Q 

 Ho ^ 

 No 13 

 No Q 

No n 

^op^lt. fpn 

Omaha Lead Site 46130 
] Name: R^'yce T K».Aps<yv Omaha Lead Site Date: 9-^-^3 North Arrow

Address: o.cc'^ p^p/^*+^A Site SItetch Time: /f?V^ . 

Phone: 

^^1

V 

SS£>¥- Team A\/U},)ht- ifi El BVID#_2s2iid- XRF Code 

Sample Number Lead Concentration Confirmation Sample 

f?*/Afc/'x4 - a o V/ -f 

ppm /yves tu No ca

ppm /y^Yes Cl No S] 

ppm e/Yes • No -ED 7 3 t I S 

ppm &t>Yes n No ^ 

ppm -*2:/es n No S 

ppm Yes • No • 

ppm Yes D No • 

l^op^lt. fan 

Omaha Lead Site 46130 
COASTA L ENVMONHIMTA l 

CROUP . IN C 

Consent For Access To Propeity 

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: 

Own&f's Name: ^— - > Daytime Phone: 

Address of Property 

covered by this 30oj/^^/¥'^J^T^ TJ 

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 al! 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 
\^**** i

* >

 COASTAL **^ , 1*' ^

 CNVIIOHMFNTA I 

* ^ O t * C • 0 U f , t »« C 

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

piles, dog houses, etc; 

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

to save; 

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

necessary subsequent to an initial watering period by EPA; 

• Abide by health and safety guidance provided by EPA; 

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

the property to perform the work. 

• Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the work 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 (712) 352-0188 

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

>ignature j . Da(^ / Signature Date 

Q I would like to be present during any sampling that is required. 
Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of the property prior to 

remediation activities. Tliis 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). 

Property ID: ^ Q 

Property Address: J(9 ^ f /^^^ ^ ^-^ ^ ^ 

Owner 

Phone: 

ruc ^ TE 

7/^ ^^^"^ 

y^ ASt^ n -pOn the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of ail known 

utilities, subsurface features, syrface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

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

Item: 

Jjj_^ 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 1 of /C 
^ f ^ 

C O A S T A U r »H V I NONt^ C *«TA L 

C R O U «• , • N C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

Item: 

§rcJi^rc^^(J '3 S/^c^'l T>'ee-x oA • : 

Item: 

lo^c)^ oT nke. k<.iJi ^ - ^ 

/ 

Item: / 

Item: 

/ 

Item: 

/ 

/ 

Item: / 

Item: / 

Item: 

/ 

Item: 

/ 

Item: / 

Item: / 

Item: / 

Item: / 

Item: 

/ 

Page 2 of ^ 
i^ ^ 

COASTA L 

C M O U P > N C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

 3'y[ ^ / -I^ i - 5^ d

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 3 of ^ 
— •<•> • 

COASTA L 

c « o u )• I M <: 

Item 

• 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Landscape Inventory 

(Use additional sheets as necessary) 

Quantity Unit Condition/Type/Species 

. Square feet ^ 

1 

., •^ 

Each 

Each 

Each 

^ 

Each 

^ Square Feet 

Page 4 o^X1 
< ^ ^ 

C O A S T A L EMVlMOIsHkNIA l 

Item 

Agreed upon value of 

plant materials not to be 

renlaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher fo the property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant will be placed 

by the contractor. 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. 

Area of City or County 

property to be landscaped 

per their requirements. 

Include a sketch of the 

area (s) 

Easement Area, to be 

excavated 

Quantity Uiiit Condition/Type/Species 

^ 

r 

$ 

Each 

j "

y 

• 

r. SF 

^ SF 

i 

SF Y­ , -{^ 

Page 5 of ; 
C O A S T A IAdditional Comments / Instructions: 

 I? <)T^)f> CX.V V O ^ P^ ^ ^ ^ c\/\c <^ i a d

/lo^^CcJ ofl -Vli^-/^"^ ^ 

^> 

• 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 cradcs or fissures. 

n I do not agree agree 

Owner's Signature / Date Contractor's Stature Date 

Page 6 of. 
XRF PROPERTY SAMPLE SHEET 

Date k->-(Q-l- of t Address 

Project Omaha lead FP 2nd year option Sample lime 

XRF ID# .^^D8S sample length 

Shot# Reading Sample area Shot# 

OX30 4 

cSooS " 

r^an.^n T n.^ a 

iq'Uu \ t: U..r^,i 1^\ 

cQoo q 

cSov 0 

C3DDW •AuiX).U'i,i:Da.,-,A Depth c^{-i \ \ 

CSDO ^ ?,o^''^'^'^Qon o IJB ^s}^^?) 

Average o)G2^,;:)b t \q.^ M Average

Shot# Reading Sample area Shct# 

Depth 

Average Average 

Shot # Reading Sample area Shot# 

Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# 

Depth 

Average Average 

lab sample # Lab result Sample area XRF Avg. 

Signature 

BviD#0(:M\M 

.2,0ol Pof)vpl9\cy ^ A:V. 

am/pm 

30 sec 

Reading Sample area 

6U u'^ £- '^ .'D^ 

Ml.x\+ . ?i.-18 CCOajJOrvAX 

Sn.-otN^ o^-U'S Depth 

5 a .u\! : <\ . 5 3 \ 

 :^? . • M ^ t '^.^.' ^ 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

'7 

,'-' /Dept h 

/ ^ ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 204.565 

Supervised By: 

Certificate of Verification 

2004 

SOIL 

2008-10-27 09:07 

30.94 

Final 

20414 

3009 poppleton 

Bl 

Ventry 

6 

CLEARANCE 

± Error 

± 17.221 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2005 

Mode SOIL 

Time 2008-10-27 09:08 

Duration 31.32 

Sequence Final 

Flags 

BVID # 20414 

ADDRESS 3009 poppleton 

QUAD/ZONE Bl 

INSPECTOR Ventry 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 199.606 ± 16.812 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 362.653 

Supervised By: 

Certificate of Verification 

2006 

SOIL 

2008-10-27 09:08 

30.61 

Final 

20414 

3009 poppleton 

Bl 

Ventry 

6 

CLEARANCE 

± Error 

± 22.617 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 309.993 

Supervised By: 

Certificate of Verification 

2007 

SOIL 

2008-10-27 09:09 

30.34 

Final 

20414 

3009 poppleton 

Bl 

Ventry 

6 

CLEARANCE 

± Error 

± 20.702 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By 

Certificate of Verification 

2008 

SOIL 

2008-10-27 09:09 

123.21 

Final 

"ST 

U v g of 2004-2007 

-3009 poppleton 

i B l 

Ventry 

6 

^CLEARANCE 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 56.692 

Supervised By: 

Certificate of Verification 

2009 

SOIL 

2008-10-27 09:10 

30.91 

Final 

20414 

3009 poppleton 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 9.538 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 47.110 

Supervised By: 

Certificate of Verification 

2010 

SOIL 

2008-10-27 09:11 

30.55 

Final 

20414 

3009 poppleton 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 8.784 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2011 

Mode SOIL 

Time 2008-10-27 09:12 

Duration 30.56 

Sequence Final 

Flags J, 

BVID # 20414 

ADDRESS 3009 poppleton 

QUAD/ZONE easement 

INSPECTOR Ventry 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 57.588 ± 9.682 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 52.413 

Supervised By: 

Certificate of Verification 

2012 

SOIL 

2008-10-27 09:13 

31.23 

Final 

20414 

3009 poppleton 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 9.317 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2013 

Mode SOIL 

Time 2008-10-27 09:13 

Duration 123.25 

Sequence Final 

Flags 

AVERAGE I^Avg of 2009-2012 

ADDRESS 3009 poppleton 

QUAD/ZONE ^easement 

INSPECTOR Ventry 

DEPTH 

SAMPLE TYPE ^CLEARANCE 

NOTE 

Supervised By: 
X 

Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

\ www.coastalhazmat.com ^-BO^--^ * 

COASTAL ENVIItONHENTAL 

C It O U r, IN C 

EXECUTIVE SUMMARY: 

BVID # 20414 - (3009 POPPLETON AVE) 

No Issues or Concerns I I Issues/Concerns 

Detail Explanation: 
2

5>t EPA 

EPA Property Close Out Form 

Property #: c^O'-AV'-A Property Address: 30O ^ PcrfipJhrVr^VX.-Ary' 

Date/Time: Owner's Name: ?:>ri>oCJL "TVSnVY^pS^rN 

Quads Excavated: lj>\ Contractor Croup Q oOi^V-v-i 0 . 

Excavation General Yes No 

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

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

u ^ 

GradinK Sod and Vecetation 

Yes No 

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

from the house? 

{ ^ 

2. Has sod t>een laid in all areas that were excavated? c-^ 

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? . ^ 

5. Are the Joints t)etween the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) 

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

7. Was damage to landscaping or plant materials avoided? u ^ 

Gates, Fences and RcUininf; Walls 

Yes No 

1. Do gates open and close freely? (Ifapplicable) 

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

[ \l j(//r 3.

 Was damage to gates or fences avoided? (Ifapplicable) 

4. Was damage to retaining walls avoided? (Ifapplicable) 

Foundation, Siding and Gutters Yes No 

1. Was damage to the siding or trim avoided? ^ 

2. Was damage to the foundation avoided? 

ly ^ 

3. Was damage to windows avoided? 

1 ^ 

. ^ 4.

 Was damage to windows or door screens avoided? 

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

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? u ^ 

2, Was damage to walkway surfaces avoided? y 
O fliers comments: 

Inspection notes: 

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

EPA Representali^</^^fe^^;;^,^^<tJ4.^^ Date: ///<i/dJ^ 
Property Completion Agreement 

I'liis agreement documenis the completion of remedial activities performed on my property. My signature 

will designaie Ihat 1 am satisfied wilii tlie restoration of my property, and that no items are in qucstioii.s, 

now. nr al any time in the fulure, except those items listed below, ifany. 

piopcit^u): _^(9y; Y 

kyJC 

Owiici (J_r^c^_ TWoyt/A p ;e*\ 

Phone: li' i 15^3 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

1/^ I a{;rec re\lorafion is completed, except as iiolecl 

 I I Jo not agree rrsloration is completed 

^-^-^ ^ ^ -J/'^^ 

Owner's Si{» Date 

I