TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: ,^qS O Date: q/ j 3./.c^ 

Address: ^^ R Florfn^^ g y\\] d 

Remediation Contractor: Coastal Environmental Group Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

y Executive Summary 

y EPA-provided property sketch 

m 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

y Restoration Agreement 

40315428 

Superfund 

1 

Settlement documents (i.e., for damage or to replace plants, etc.) 

Confirmation data 

Photographs •^e-I.^riMl^lSil ^ LjCC/J^iaridnI (fAgJ So d 

/ As-built sketch 

y Satisfactory restoration signed by Property Owner 

y Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

7 Property information from Douglas County Assessor's Office 

y "iVf)^:>^L> flxu^s d\eJ4a f 

y CjbynA- J^rA 

D 

taC^^Uh^ ^//^/g|^^ 

Signature 

y-fd^U ^ w/m 
% 

Property Access Checklist 

Property ID: 3'^^<^ ^ • WORK STARTED ON: / /_ 

n WORKCOMPELTED ON: / / Property Address:Q^^ I :^ Flr^/rir , 

Renter: 

Address: Phone: 

Fax: 

Cell/Pilfer: 

Phone: Additional Information: 

Fax: 

Cell/Paocn /^/d-^^q ^ 

Owner:-^^^^^ ^ "DenV^^ ^ 

O Notification Letter Sent: / / By: 

^ Access A<»recment Sijined: / / By: 

\yC Restoration Agreement Signed: / / By: 

[U Topsoil Sampling (if applicable) / / By: 

r~l Dispo.sai Samplin» (if applicable) / / By: 

1 1 Garden Sainplin» (if ap|)licahle) / / By: 1 

0 ' Utility Clearance Called: ^/^/£2 1 ^y-Qc. ^ • 3 1 

0 Video/Photos (Before) Oxi:yi_l^lQS_ By:^C 

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

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

n Video/Photos (3«-Day) On: / / By: 1 

LU Pro|)crty Completion Agreement Signed: / / By: 

1 

1 1 Final Repoit Issued:

 / / By: 1 

Air IVlonitoi ing (as ap|)lical)le) 

1 1 Community [H Crew On: / / By; 1 

Results: 

CD Community 0 Crew On: / / B y : . II 

Results: 

1 1 Coininunity O Crew On: / / 

1 

Results: 

Omaha Lead Site 
Page 1 of2 

Create Another Ticket Back to Irth Internet Send Email ly-'m 

YOUR TICKET NUMBER IS 2093379. 

Original Call Date: 7/29/08 Time: 10:22 am Op: ELIZABETH18790 


Work to Begin Date: 7/31/08 Time: 10:45 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3817 Street: FLORENCE BLVD 


Twp: 15N Rng: 13E Sect-Qtr: 03-SW .*.>»•'• 

Tv\;p: Rng: Sect-Qtr: '"'//' ...i.,.,. 

Legal Given: C ""**'* 

Type of Work: lead remidiation 


Location of Work: LOCATE ENTIRE PROPERTY ALL THE WAY TO THE STREET. 


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


: UNSURE OF CORNER LOT. y. 

Company : COASTAL ENVIRONiyiENTAL SERVICE 


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


Work Being Done For: coastal 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 


CXCATV COX COMMUNICATIONS, INC HEIDI Ah: 4029340469 


Emerg: 4029329757 


Day: 9185747098 


MAGELLAN MAGELLAN MIDSTREAM PARTNERS LP TONYA Alt: 


Emerg: 9185747098 


Day: 4025047823 


MUDOl METROPOLITAN UTILITIES DISTRICT EDWINA Alt: 

Emerg: 4025047946 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RON Ah: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/29/2008 
Page 2 of2 

Day: 4067289343 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 8887289343 

Emerg: 4067289343 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK NA Ah: 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/29/2008 
Douglas County Account Infiannation Page 1 of2 iTcmia 

Dougla s County , Nebrask a Propert y Recor d - R151253000 0 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 90th St - Vie w O n Ma p Infomiation is valid as of 2008-6-19 Treasurer's Tax Report 

New Feature ->-•- • Auto Sales Search 

Owne r 

NEAL ROSE 

3817 FLORENCE BLVD 

OMAHA NE 68110-0000 

Propert y Informatio n 

Key Number: 1253 0000 15 

Account Type: Residential 

Parcel Number: 1512530000 

Parcel Address: 

Legal Description: 

3817 FLORENCE BD 

OMAHA NE 68110-0000 

KIRKWOOD ADD LOT 4 BLOCK 4 W 1/2 50 X 70 

Valu e Informatio n 

2008 

2007 

2006 

2005 

2004 

2003 

Land 

$1,900.00 

$1,900.00 

$1,900.00 

$1,900.00 

$1,900.00 

$1,900.00 

Improvement 

$36,400.00 

$36,400.00 

$36,400.00 

$5,700.00 

$5,200.00 

$5,200.00 

Total 

$38,300.00 

$38,300.00 

$38,300.00 

$7,600.00 

$7,100.00 

$7,100.00 

Lan d Informatio n 

Acres 

0.08 

SF 

3500.0 

Units 

1.0 

Depth 

70.0 

Width 

50.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R15... 7/17/2008 
Douglas County Account Infonnation Page 2 of 2 

Second Floor .leiTaissewcEBD 470.0 sq. «. 

"3T .—(^ l i e 

Fira floor 

S8I0«D.«. ,„ 

» WET f <i i 

11/2 STORY FIN 

esmtiBfc:.-j.kfi 

'< 3 9ei Cl u) t i W tin 

U*f 

{sir IDEO 11 I I 

;...»? . J 

CLICK CLICK TO ENLARQE ii^fl/^QE TO ENLARGE IMAGE 

Square Footage; 1351.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition; Fair 

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

HVAC: Forced Air Rooms: 7.0 

Exterior; Frame Stucco Units; 1.0 

Interior; Drywall Baths; 1.0 

Roof Cover; Composition Shingle Bedrooms: 3.0 

Roof Type; Gable Stories; 1.5 

Floorcover; Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1905 0% 1905 103 

Deta/7 Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 881.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Porch Slab Roof Ceil 160.0 

User Attic Full Finish 470.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno==R15... 7/17/2008 
CONTACT FORM 

Property ID # 

Property 

Address: :'^f(l'} f}ore7)re Rv/d 

Initial Contact: Date: Time: Action: 

Second Contact: Date: Time: Action: 

Final Contact: Date: Time: Action: 

Final Action: Transmit to EPA D Other Action: D 

1 vi>^v/\ I r^^^ _ 2 ^ \ ^ • 1 II ^ ^W^ ! 1 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

Name: A^^ A ^— Omaha Lead Site Date: ^V!^?/ ^ North Arrow 

Address: J^/ 7 y=y^aSttf^ ^ ^i>y> Site Sketch Time: /a...5-^ 

Phone: <^ V o ?> cl^/'^-^ST r - « ^ 

77 7~/ T^^yy/ 

XRF Code •SB'OI Team -24c/A7?^//9'// / BVID # 3 ZO'yy , 

Sample Number Lead Concentration Confirmation Sample 

5V mo t a V y/Ye s n 'ST >=^Yes n QS^L ^^ ^ / ^ oom -^/Ye s 1=1 YPSCLPyA r3^ ^ 

YID-^S(LPX(:\ A'37^W 

DDm 

289 PPM @ 6" 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with Area replaced with 


Area left bare 
 Sod ' ' Rock/Mulch 


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

J ^n-iosy all hoiTlO. f^j > j . 

r­ Name: yU^ A (~ 

Address; ?y/ 7 ^•=y>as^t^& iff'i^i) 

Phone: ^>y^7> <y^y^~y>siy 

Omaha Lead Site 

Site Sketch 

Date:

Time:

 <yyz yAi ^ 

 .y^^yC-^^ 

North Arrow 

77 T/

Team Z^/^/STyn/^/S// /

 TysTTj _ BVID# . 3 Z< f < y XRF Code 5B0 \ 

Lead Concentration Confirmation Sample 

m o ^ ^"7 pp^ 

^5 ^ ppm 

/^/Ye s n 

^^7 Yes n 

^•/Yes n 

^Z.Yes •=! 

^7Ye s a 

"Yes a 

Yes • 

No 

No 

No 

No 

No ta -

No • 

No • 

^>:'#~4?/....i 

y>r9y¥ ^ ^-

Omaha Lead Site 46130 
Name: y^^ 4 i - . Omaha Lead Site 

Address: jy/ 7 yy>.iZetf^e. ^iT p Site Sketch 

Phone: ^^o:? > <^7^~7>Siy 

Team 2/ ^ h 757^0/^ 7^// / BVID # 3 Z f y y 

Sample Number Lead Concentration 

g7[MQ£>L )35V 

ppm 

n^^DzadpyA S97FW ppm //y)^!^ ^ ppm 

ppm 

ppm 

Date: -^/^j/b^ " North Arrow —i 

Time: y<^yc y 

i ^ 7 

XRF Code 55-Qf 

Confirmation Sample 

/^Ye s ° 

y<ZYes n 

^/Ye s n 

^^lYes C: 

^zYes "^^ 

Yes n 

Yes • 

PUUH ^ \L^V^ 

Omaha Lead Site 46130 
Name X^rim"* ^ T t4^oy^V>^^A "JR. Omaha Lead Site Date:oQ- iS-0 3 North Arrow 

Address: .3 ft \ W .'^•^aoXo ^ S t Site Sketch Time: "S'.MS^f n 

Phone: l^/ft t 

Team XRFCodjfrl'SO^ <^i.c.^jQ^\5,VYm^H ^ BV1D#JM2L1S _ 

Sample Number Lead Concentration Confinnation Sample 

g^J^^cJ(^-3g3>9S> ^,Yes tn No S] ppm 

ppm QYes tD No 53 

o Yes O No IS ppm 

No sa ppm 1 o2or±:5 ¥ ppm oiXes n No S

Yes n No cn ppm 

ppm Yes • No n

^o^<^l^^ SV 

Omaha Lead Site 46130 
M) ( # 

COASTA L fNVIROHnlNTA t 

r • o u p . I M f 

Consent For Access To Property 

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: 

Owner's Name Daytime Phone: ( V<52 ) U *^"" ^ ^ t 7 QAM-7^ D^nX^no; 

Address of Property 

covered by this 

Agreement: 3^) 7 ^loY-^nC ^ ^\vJ r 

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 wt)rk 

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 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 
< # 

COASTA L f NVIIONM f NTk l 

c • o u ' ' <• r 

• 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 vwuld 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 

J^i I grant access to my properties 

O I do not grant access to my properties 

Signature Date Signature 

Date 

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

The purpose ofthis agreement is to provide a mutual agreement as to conditions ofthe propert>' prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

PropertylD: y%J ) 

Property Address: 1^^]-] ^^ . 

Owner: ^fx)U |^^|<^|i i ^ 

Phone: ^ n <f|vj p<in 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of all known 

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

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

by referencing the photo-log number with an arro\^ 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 Owners responsibility. 

Item: ^ 

/ / n 1 1 < flit 9^ //i/i/y - " ^ 

Item: y ^ 

Item: / ^ 

^y 

Item: y 

Item; y 

Item: -^ 

Item: y 

Item: 

Page i o f [// 
COASTA L 

Items To Be Removed By Contractor Durinq Remediation And Not Reoiaced 

(Use additional sheets as necessary) 

Item: . 

Item: r 

y u ?mi /ibo 10 '1ft 

Item: _______^ 

'1 *• . ^l - " r ' • / 

Item: / 

Item: / 

y 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item; 

Item: 

Page 2 of F 
^^^^^~ 

COASTA L 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

4l?IL 7 ^ h ^-H 

Item: 

Item:

^\ ) \yi h -f- p t Y v^^ ^ 

/ 

Item: / 

Item: / 

y 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item; / 

Item; / 

Item: / 

Item: / 

Item: 

Page 3 of c 
C O A S "I A L 

Landscape Inventory 

(Use additionai sheets as necessary) 

Item Quantity Unit Condltion/Type/Species 

Pre-existing property area, 

that wil l be excavated, thai 

is covered with grass. 

• n 

Square feet 

ftvif y^fi 

Number of trees

trunk diaineter 

 > 2 inch 

L

yQ Each 

\

\

 {\ 

^ 

Number of trees •'= 2 inch 

trunk diaineter \7 \ 

Fnrh 

y

a.

- ^ 

^

 u^iy 

f wt-, 

 \M?^ki^ 

Number of Sprinkler 

Zones. Control Valves. 

Timers. Heads, etc. 

-Auacli a sketcli \i\ ' inc 

i]iiii-ikler !a\ out. 

,-—\ 7 

y ^ 

Each 

Number of and size of 

each sarden. flower bed 

area. 

-•.:.j\.i , :'. ^.^cic! : ^'i ..; ,;::•, c 

-i;'e> :'.n..\ locations. 

i 

ry y 77 Each 

Square Feet 

Page 4 J 
m^ 

COASTA L 

Item 

Agreed upon value of 

plant materials not to be 

replaced bv contractor. 

Note this \alue will be 

used to issue a plant 

>oucher to the propert> 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of weie 

each plant w'\\\ be placed 

h\ the contracior. 

Agreed upon area of 

propertN to be replaced 

u ith grass sod. 

''iCll:de a vl-eU'li o'i illc 

.iieais) Ul he :epr.K'(.-j '.^'I'l 

Ll'-a-.s ^0d. 

.Area of Cir> or Counrs 

propertN to be landscaped 

per their requirements. 

•r'Li.alc . -r.t'i,-!! y :<\ 

Easement .Area, to be 

excavated 

Quantity 

^ 

Unit 

$ 

Condition/Type/Specles 

;3 

y Each 

H 

y SF \ \ l|VliyL% ^r\i^ 

SF \7k^{y^\AA< 

SF \ ^ U MTJXU, 

^ 

Page 5 of 
COASTA L 

c « o u r . ( M c. 

Additional Comments / Instructions: 

.- lf(7W H- V ^^ •-^'^\y7y-7:77/::, 

• 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. 

1X11 agree Q I do not agree 

I t \7{ 

Owner's Signature Date Coiuractor's Signature 

Page 6 of. 
BviD# y^< o 

XRF PROPERTY SAMPLE SHEET 


Date J y Address y ^ fi^Tyy Uvk' 

Project Omaha lead FP 2nd year opilon Sample time am//l yy ^ 

XRFID# sample length 30 sec y^yy\ 

Shot# Reading Sample area Shot# Reading Sample area IE is^%y\ i m i :ss ^^l-h^tl,V^l4 y V-i^ U(?M yy\ y-0-^' ^ \^-o 

yf^^c Depth WW ny y iM.i?s Depth 

m^ •yy^y yy ~WT yy'^'^^ \y \ yy^ 

Average Vi^yyi yy\ Average \w.y ^- \'^-% 

Shot# Reading Sample area Shot# Reading Sample area 

T , 

^ '%y\ i zy . TT 7y\ ^7M|.t<^tS. h 6A y\.y i zz-(j. y^<>'h ^v^.yy-h. K y/yy ^ Depth Depth ^UL lll- g ^ -2-1.^L %y y'X-ui zy.^n 

'Viy\ y\,-yyym ^ yy^ ^\y b J ^>.o(. 7 

Average %77^ ^ I'ly Average ^y.^^ J t 7^- ^ 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth ^.^-^— Depth J 

y 7 

Average Average 

lab sample # Lab result Sample area XRF Avg. 

Signature 

^i^^t Mrf^^^ Print 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2867 

Mode SOIL 

Time 2008-08-23 15:30 

Duration 120.95 

Sequence Final 

Flags 

AVERAGE Avg of 2863-2866 

ADDRESS 3817 Florence blvd 

QUAD/ZONE 

INSPECTOR "tOPEZ 

DEPTH 

SAMPLE TYPE CLEARANCE 

NOTE 

Supervised By 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 299.074 

Supervised By: 

Certificate of Verification 

2863 

SOIL 

2008-08-23 15:27 

30.23 

Final 

32950 

3817 Florence blvd 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 21.371 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 275.734 

Supervised By: 

Certificate of Verification 

2864 

SOIL 

2008-08-23 15:28 

30.25 

Final 

32950 

3817 Florence blvd 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 20.007 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 275.651 

Supervised By: 

Certificate of Verification 

2865 

SOIL 

2008-08-23 15:29 

30.23 

Final 

32950 

3817 Florence blvd 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 20.865 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 306.496 

Supervised By: 

Certificate of Verification 

2866 

SOIL 

2008-08-23 15:30 

30.24 

Final 

32950 

3817 Florence blvd 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 21.911 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2872 

Mode SOIL 

Time 2008-08-23 15:34 

Duration 120.50 

Sequence Final 

Flags 

AVERAGE jAv g of 2868-2871 

ADDRESS 3817 Florence blvd 

QUAD/ZONE flpz 

INSPECTOR 

DEPTH LOPEZ 

SAMPLE TYPE 

NOTE CLEARANCE 

Supervised By 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 231.063 

Supervised By: 

Certificate of Verification 

2868 

SOIL 

2008-08-23 15:31 

30.05 

Final 

32950 

3817 Florence blvd 

DZ 

LOPEZ 

13 

CLEARANCE 

± Error 

± 18.543 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 165.076 

Supervised By: 

Certificate of Verification 

2869 

SOIL 

2008-08-23 15:33 

30.03 

Final 

32950 

3817 Florence blvd 

DZ 

LOPEZ 

13 

CLEARANCE 

± Error 

± 16.017 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 123.158 

Supervised By: 

Certificate of Verification 

2870 

SOIL 

2008-08-23 15:34 

30.26 

Final 

32950 

3817 Florence blvd 

DZ 

LOPEZ 

13 

CLEARANCE 

± Error 

± 14.180 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 147.899 

Supervised By: 

Certificate of Verification 

2871 

SOIL 

2008-08-23 15:34 

30.16 

Final 

32950 

3817 Florence blvd 

DZ 

LOPEZ 

13 

CLEARANCE 

± Error 

± 15.188 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2878 

Mode SOIL 

Time 2008-08-23 15:39 

Duration 120.89 

Sequence Final 

Flags 

AVERAGE |Av g of 2874-2877 

ADDRESS 3817 Florence blvd 

QUAD/ZONE Fl 

INSPECTOR LOPEZ 

DEPTH 

SAMPLE TYPE CLEARANCE 

NOTE 

Supervised By 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 356.715 

Supervised By: 

Certificate of Verification 

2874 

SOIL 

2008-08-23 15:37 

30.08 

Final 

32950 

3817 Florence blvd 

F l 

LOPEZ 

4 

CLEARANCE 

± Error 

± 23.248 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 331.961 

Supervised By: 

Certificate of Verification 

2875 

SOIL 

2008-08-23 15:38 

30.31 

Final 

32950 

3817 Florence blvd 

Fl 

LOPEZ 

4 

CLEARANCE 

± Error 

± 22.637 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 311.555 

Supervised By: 

Certificate of Verification 

2876 

SOIL 

2008-08-23 15:38 

30.07 

Final 

32950 

3817 Florence blvd 

Fl 

LOPEZ 

4 

CLEARANCE 

± Error 

± 21.861 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2877 

Mode SOIL 

Time 2008-08-23 15:39 

Duration 30.43 

Sequence Final 

Flags 

BVID # 32950 

ADDRESS 3817 Florence blvd 

QUAD/ZONE Fl 

INSPECTOR LOPEZ 

DEPTH 4 

SAMPLE TYPE CLEARANCE 

NOTE 

Error 

Pb 296.334 ± 21.423 

Supervised By: 

ppm 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3655 

Mode SOIL 

Time 2008-09- 10 14:46 

Duration 122.14 

Sequence Final 

Flags 

AVERAGE §Av g of 3651-3654 

ADDRESS 3817 Florence blvd 

QUAD/ZONE •easeme % INSPECTOR lopez 

DEPTH 

SAMPLE TYPE CLEARANCE 

NOTE 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 341.655 

Supervised By: 

Certificate of Verification 

3651 

SOIL 

2008-09-10 14:43 

30.66 

Final 

32950 

3817 Florence blvd 

easement 

lopez 

1 

CLEARANCE 

± Error 

± 23.813 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 323.255 

Supervised By: 

Certificate of Verification 

3652 

SOIL 

2008-09-10 14:44 

30.49 

Final 

32950 

3817 Florence blvd 

easement 

lopez 

1 

CLEARANCE 

± Error 

± 23.159 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 338.202 

Supervised By: 

Certificate of Verification 

3653 

SOIL 

2008-09-10 14:45 

30.53 

Final 

32950 

3817 Florence blvd 

easement 

lopez 

1 

CLEARANCE 

± Error 

± 23.674 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 316.435 

Supervised By: 

Certificate of Verification 

3654 

SOIL 

2008-09-10 14:46 

30.46 

Final 

32950 

3817 Florence blvd 

easement 

lopez 

1 

CLEARANCE 

± Error 

± 23.063 
^y^-"^ f 

Omaha Lead Site—Fixed Price EP-R7-07-05 M Coastal Environmental Group Inc. 

\ • J? www.coastalhazmat.com 

*^'>i.no-y COASTA L eNVmONMENTAL 

c It 0 u r. INC . 

EXECUTIVE SUMMARY: 

BVID # 32950 - (3817 FLORENCE BLVD) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 
sm. EPA 

EPA Property Close Out Form 

Property ff: .^.3^5 0 Property Addrew: S^il-fiOfetlC C f^\\ic l 

Date/Time: Owner's Name: Vj^fOff V(rr>Hn y 

Quads Excavated: F> . p j Q%/ Contractor Croup C/Vl,^i[rLt F)nM\rCSYltrY'/\irJ 

Excavation General 

Yes No 

1. If necessa^', were the correct quadrant(s) excavated and restored? y 

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

Grading Sod and Vegetation Yes No 

1. Does the grading around the perimeter ofthe house in excavated areas generally slope away ^ from the house? 

2. Has sod been laid in all areas that were excavated? 

y 

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

y day time period) 

4. Are sodded areas generally firm and evenly graded? • ^ 

5. Are the joints between 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? -

7. Was damage to landscaping or plant materials avoided? 

L. y 

Gates, Fences and Retaining Walls Yes No 

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

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

1 

3. Was damage to gates or fences avoided? (Ifapplicable) y­ 4. Was damage to retaining walls avoided? (Ifapplicable) 

Foundation, Siding and Gutters Ves No 

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

2. Was damage to the foundation avoided? l y 

3. Was damage to windows avoided? 

y 

4. Was damage to windows or door screens avoided? 

L ^ 

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

Sidewalks and Driveways (Concrete) Yes No 

I. Was damage to driveway surfaces avoided? j ^ 

2. Was damage to walkway surfaces avoided? 

y 

i 
O vners comments: 

Inspection notes: 

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

EPA Represent^tivr7^>^ ^ ^£^^,^^^^3 ^ Date: ^^ ^ 
% % 

Property Completion Agreement 

(his agreemeni documents the completion of remedial activities performed on my property. My signature 

Will designate that I am satisfied with the restoration of my properly, and Ihal no items are in questions, 

now, or al any time in the future, except those ilems listed below, ifany 

Propcrtj ID: -j^qsz , 

Propcrtj 1 Address: ~}S \ 7 Flo r€f\ce^ b U 

Owner: Bruc e O^nk i /i 5 

Phone; C / i oy?7 

Restoration Items in Question: 

Item 

Item: 

Item: 

Item: 

Item; 

I I I agree restoration is completed, except as noted 

I I I do not a(;rec restoration is conipletcd 

%\APU. t)cyik/^^ %-y^C> 0 g­ Owner's Signature Date Contractor's Signature Dace