TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 1y(^M < Date: '^\'?\\< ^ 

Address: lll l Wl\ i P ^ "^^ 

Remediation Contractor: _CoastaI Environmental Group_ Year: _2OO0 

SOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

IM Signed Access Agreement for subject property 

'B Signed Access Agreeraent(s) for adjacent property 

0 Restoration Agreement 

-B- Settlement dociunents (i.e., for damage or to replace plants, etc.) 

-Gr Confinnation data 

Q / Photographs ^ H b.^^^W»'\r^?^ 

y As-built sketch 

^ Satisfactory restoration signed by Property Owner 

/ Property close-out check list signed by EPA 

-B" Description of areas not meeting ROD cleanup criteria 

U Utility clearances 

!D/ Property information from Douglas County Assessor's Office 

a . __ . 

D 

n 

^• I'h I u -t=^ Date 

30055270 

Superfund 
• • 

Property Access Checklist 

Propert, ID: TJ^^dHf ^ 

n WORK STARTED ON: _/ /_ 

D WORK COMPELTED ON: / / Propcm Address: n )7 - Mll)-hry/9 w 

o^^'"^'" \jY\rlin Rim(^.l Renter. 

Address: Phone: 

'"• ^amjL, FJL\: 

Cell/Pager: 

Additional InformKtion: 

Phone: 20- S - P)H n 

¥t\: 

Cell/Pager. 

D Norification Letter Sent: / / By: 

IX/ Access Agrccmcdf Signed: Jl/4i/ ^ 

By=^0:ie^\yiO 

(Q^ RestonttiOD Agreement Siened: 1 1 \[ l(A By= r^rvaio 

O 7 Topsoil Sampling (if applicublc) 1 1 

By: 

D DisposAi Samplins (W applicable) 1 1 By: 

D Gnrdcn Smnpling (if applicable) 1 1 By: 

D Utility CIcflrtncc Called: / / By: 

Video/Photos (Before) On: / / By: 

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

D Video/Photoj (After) On: / / By: 

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

/• \ "^^Pyopert y Complelion Agreement Signcd/T i/y-tf^^ By: 

d l Final Report Issued: / / By: 

Air Monitorine (as upplicAble) 

D Community D Crew On: / / By: 

Results: 

D ComrounitA' D Crew On: / / By: 

Results: 

• Community D Crew On: / 1 By: 

Results: 

Omaha Lead Stte 
Property ID # 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

# 

CONTACT FORM 

7.ko7.US 

nn . M^i^AVN/ PfV 

Date: Time: Action: 

Date: Time: Action: 

Date: Time: Action: 

Transmit to EPA D Other Action: D 
Douglas Coimty Account InfornMiio •rnMiic n Page 1 of3 

Douglas County, Nebraska Property Record - R2146550000 

Print Report 

NEW Feature - Parcel Dimensions availabie @ scaie 0-50 ft west of 52nd St - Vievtf OH Ma p Information is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature -•••- • Auto Sales Search 

Owner 

RIMEL LINDA L 

1712 MILITARY AVE 

OMAHA NE 68111-0000 

Property Informatio n 

Key Number: 4655 OOOO 21 

Account Type: Residential 

Parcel Number: 2146550000 

Parcel Address: 1712 MILITARY AV 

OMAHA NE 68111-0000 

Legal Description: SAUNDERS & HIMEBAUGHS ADD LOT 21 BLOCK B 50 X 159.7 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land Improvement 

$7,000.00 $72,300.00 

$7,000.00 $72,300.00 

$7,000.00 $72,300.00 

$7,000.00 $72,300.00 

$7,000.00 $32,100.00 

$7,000.00 $32,100.00 

Total 

$79,300.00 

$79,300.00 

$79,300.00 

$79,300.00 

$39,100.00 

$39,100.00 

Sales Informatio n 

Sales Date: 2003-02-25 

Deed Type: 

Price: 

WD 

$72,900.00 

Book: 2237 Page: 510 

Grantor: GREGORY A COLLINS ETAL 

Grantee: LINDA L RIMEL 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 1997-01-11 

Deed Type: Book: 2055 Page: 319 

Price: $33,500.00 

Grantor: 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R214... 7/7/2009 
Douglas County Account Inforn|||ion Page 2 of 3 rnmip 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth 

0.18 7950.0 1.0 159.0 

Land Attributes 

Attribute 

Negative Influence 

Improvemen t Informatio n 

Building 1 

i.',rj.i.iin.T.i<.i.ir^Kw.i.iiinMAMaTi:a 

CLICK TO ENLARGE IMAGE 

Square Footage: 1477.0 

Perimeter 0.0 

Unit Type: 

Built As: 1 1/2 Story Fin 

HVAC: Central Air to Air 

Exterior: Frame Siding 

Interior: Drywall 

Roof Cover: Composition Shingle 

Roof Type: Gable 

Floorcover: Allowance 

Year Percent Year Built Remodeled Remodeled 

1900 0% 

Detail Type Detail Description 

Add On Fence Chain Link 

Width Vacant 

50.0 No 

Attribute Description 

Traffic 1 

IZ]i' 

•-ffir 

•Ta^-fl' 

CLICK TO ENLARGE IMAGE 

Percent Complete: 100.0% 

Quality: Average 

Condition: Average 

Condo Square Footage: \ 0.0 

Rooms: 7.0 

Units: 1.0 

Baths: 1.0 

Bedrooms: 3.0 

Stories: 1.5 

Foundation: Block 

Sprinkler Square Footage: 0.0 

Adjusted Year 

Built Physical Age 

1900 108 

Units 

1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R214... 7/7/2009 
Douglas County Accotmt Infornu|io Tiaibo n Page 3 of3 

Appliance 

Basement 

Fixture 

Fixture 

Porch 

Porch 

Allowance 

Bsmnt Block 8 ft 

Base Fixtures 

Bath Full 

Slab Roof Ceil 

Wood Deck 

1.0 

816.0 

1.0 

1.0 

144.0 

120.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R214... 7/7/2009 
Page 1 of 1 

1: - ::P'"ggte^notherJicket^ lL:_B8CJ<*oJjJhJr!Jg!ingJ_.::J Send Email j] 

YOUR TICKET NUMBER IS 2332211. 

Original Call Date: 

Work to Begin Date: 

8/03/09

8/05/09

 Time: 12:19 pm 

 Time: 1:00 pm 

Op: ELIZABETH18790 

State: NE 

Address: 1712 

County: DOUGLAS 

Street: MILITARY AVE 

Place: OMAHA 

Twp: 15N Rng: 13E 

Twp: Rng: 

Legal Given: C 

Sect-Qtr: 17-NW 

Sect-Qtr: 

Type of Work: LEAD REMEDIATION 

Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 

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

: UNSURE ABOUT CORNER LOT 

Company : COASTAL ENVIRONMENTAL SERVICE 

Contact Name: ELIZABETH Phone : (877)662-421 0 

Work Being Done For: COASTAL 

Depth of Excavation: 4 FT Corner Lot: N 

Involves Tunneling or Horizontal Boring : N 

Front :

Explosives :

CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 

Y

 N 

 Rear : 

Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY

Day: 4025047823 

 Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/3/2009 
26345 

As-Built Drawing ^ 

COASTA L Omaha Lead Superfund Site 

Omah a Exterior Paint North Arrow Owne Lea d Site r Name: LINDA L RIMEL 

Site Sketc h 

• Good Address : 1712 MiLrrARY AV • ,Foor Phone: H 402-933-1737 W: 402-697-5366 

|TJ Not paint 

Sampl Lead Sample Samples Collected e Number LAB Concentration Collected Firm 

RYASCPXA-26345 F l 57'2 , ppm 

n Date: ^-'S-^-^-g- RYBSCPXA-26345 F2 22* 3 ppm D Time: t • \ o 

RYCSCPXA-26345 B1 '2.(?0 ppm m/ n p»w 

Samples Analyzed RYDSCPXA-26345 B2 • -Z-lo ^ ppm D 

RDZSCPXA-26345 DZ 2ZZ S ppm n XRF Unit: /03 7 Book I 3 Z 

RQZ3CPXA-20340 S2 - ~ ppm n Date; / o -aS'-o ^ 

RPZSCPXA-26345 PZ & ^ ppm n Time: /^/rt 

Staff: J = ^ Number of Samples • 

Legend; F1 = Front Left, F2 Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, faang property OLS#: 26345 

Date Excavated:8/11/09 

[!)ate USEPA Signed Off: 10/6/09 

Legend 


Concrete m 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. 

26345 

Exterior Paint North Arrow 

Owne Omaha Lead Site r Name: LINDA L RIMEL • Good Site Sketch Address: 1712 MILITARY AV npoo r 

Phone: H; 402-933-1737 W: 402-697-5366 [Tj Not paint 

Sample Number Lead Sample Samples Collected LAB Concentration Collected Firm: M£ S c M ,^n^< ^ 

RYASCPXA-26345 Fl syz , ppm D Date: ^~%'0 3 

RYBSCPXA-26345 F2 2^Z3 ppm D Time: i •• ^O p iw 

RYCSCPXA-26345 B1 2.(90 ppm D 

Samples Analyzed 

RYDSCPXA-26345 82 -Z-M ppm D 

RDZSCPXA-26345 DZ Zzzs_ ppm 1/ D XRF Unit: /d3 7 Book 13Z 

ROZOCrXA-20345 ppm D Date: 

RPZSCPXA-26345 PZ 

m. ppm D Time: p/n 

Staff: Number of Samples =\( p • AA. 

Legend: Fl = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrant^ are as viewed from the street, facing property 

Rev 4 046141 0123 
26345 

Omah Exterior Paint North Anew Owne a Lead Site r Name: LINDA L RIMEL 

Site D Good SIcetch Address: 1712 MILfTARY AV 

npoo r Phone: H: 402-933-1737 W: 402-697-5366 Qrto t paint 

Sample Nuinber Lead Sample Samples Collected LAB Concentration Collected Finn: 

RYASCPXA-26345 Fl 57 2 ppm D Date 

RYBSCPXA-26345 F2 2Z 3 Dpm Time: 

RYCSCPXA-26345 Bl 2^ ^ ppm w n

Samples Analyzed RYDSCPXA-2e345 B2 D 

RDZSCPXA-26345 DZ 222 5 ppm XRF Unit /037 Book: i3Z 

RQZ0CPXA'e0945 02 ppm D Date: /A-aS-'O^ 

RPZSCPXA-26345 PZ 8 9 ppm D i. Time: P/ft 

D 

D Staff: £.A 

Number of Samples = | ^ j 

Legend: Fl = Front Left. F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip 2:one, GZ = Garden, PZ = Play 

All quadraQ^ are as viewed from the street, facing property 

SEP 12 

Ilev4' O46I410IZ3 
^""^' o 

COASTA L INVIIONHINTAl 

e I 0 w p. INC 

Consent For Access To Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environnnental Protection Agency (EPA) or Its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

follov^^ng described premises: ^—>^ " ^ ^.A/C T 

z:2. Owner's Nai Daytime Phone: ^2-r//7 

Address of Property 

covered by this 1712- J4,ll U^l ;4\J. 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 vyrork 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 v^th 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: 
rf*^***. 

COASTA L INVIIONNrNTftl 

S I 0 U r , I l< 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. 

e 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 

I grant access to my properties 

D i do not grant access to my properties 

Signature 

Date 

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

COASTA L 

RestoralJsoni AgFeemsnt 

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

remediation activities. This 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 Addr^>i;;7 '' ^ ^3 ^ T ^ ' i{'^ ^ •H'W. 

Owner: 

Phoii ^^v^.^-.^^// 

On the attached diagram(s) indicate aFea(s) to excavate, surface structures and landscaping features and 

access Iocation(s) to be used by the contractors. Indicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

items to be Removed by the Owner before Starl^ of Remediation: 

The ramoval. stofEse. dl&nub£l, ano/or return of these Itoms Is tht'? Qyyners responsiiiviiitji 

Kem: 

Ar-f- IgyiT'^ -j-fo PC <-^l < - ^ l\y^ \ ^ ^ 

Item: 

1-Item: 

Item: 

Itgms to be Removed by ttte Contractor During Remediation and Not Replaced 

Item: 

77/ty pk^' h /e-// P^k/^dP 

Hem: 

Item: 

item: 

Page1 of y 
COASTA L 

Items to Be Removed By Contractor During Remediation and Replaced 

Item: 

>o 

Item: ^oA

Kem: 

Item: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

tmnk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Aliach ;) sketc h ot llif 

spi'rklc i li'.NCHi;. 

Number of and size of 

each garden/ flower bed 

area. 

An;vth a sk..'ich of n.--:nivL' 

sizes and locaiidiK. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

>'o'( i"!'.i' \ nUiQ v, iit riL 

iSc t io !^:u; r'. •)\t:v,; 

• cinli;.' - td iiii' i';:-'i|K;is 

OM I'^r. 

Easement Area, to be 

excavated 

fl-V ^ 

 Pl^pz. 

Quantity 

^ 

J 

y^ 

^ 

y 

Landscape Inventory 

Unit Condition/Type/Species 

Quadrants 0 

Each 

Each 

Each 

Each 

Square Feet 

S 

Each fj « ie^hrr-^^^^ 

Page! o,i 
':vk.. 

COASTA L 

t MWinOWMLNTA L 

anas*- - • •* c 

Additional Comments / instructions: 

^ i^A hc^yc /- ^ ^" ^ / 

\)^^crQ­ \-^cji p/^ 2Ay-, 

j£,X ccwjorV^o K) 

L. 

Q Check the box if Owner does not want CEG to document interior foundatran 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. 

n I do not agree 

( lii^iidA. CMZM- i/i\m 

Contracror's Signature Date 

Page 3 of ^ 
XRF PROPERTY SAMPLE SHEET 

BVID# 2/(0^45^ 

Date 

Project 

XRFID# 

1^1 w M 

Omaha lead F FP 2nd year option 

'^9f: ^ 

Address 

Sample time 

sample length 30 sec 

fvnipm 

Shot# Reading Sample area Shot# Reading Sample area 

?.opl^ ^h,prdn.\M s ^ ect ^ 

2Ml£ •^tp.OVtf-t'U.VjS - Depth Depth l^OEL o.S"^^-^^^^ 

9ft\ Qu i 70.11 2m&. T 

Average 3o0.7_U:t 2 0 •Q<^ Average 

Shot# Reading Sample area Shot# Reading Sample area 

2AZ5. l2qV^i.iq.MS 

12.S^^i\^'^Vi> n ia&u 

^q^^-i m-lu*.u.m Depth Depth 4S 7qft?> -ia.^iiU.ftr 

Average 107.1 S-± I2.QI Average 

Shot* Reading Sample area Shot# Reading Sample area 

7Q<^n ^A.o^\ini 

lOQX. eon3^ )1•^/'U' o^ 

z.qq7. U0.04i Depth Depth 

^<CT iL^^a. UnnUi:\Q.OH 1 ^ " 

Average n\.<^\: t W-T L Average 

Shot# Reading 

RETEST AREAS 

Sample area Shot# Reading Sample area 

Depth Depth 

Average 

lab sample # Lab result Sample area 

Average 

XRF Avg. 

Sionature ZlC^AjMl h 

Print ^JAykiP ^ Cnrecc^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2999 

Mode SOIL 

Time 2009-08-11 15:15 

Duration 121.18 

Sequence Final 

Flags 

AVERAGE rAvg-or299S=2998-n 

ADDRESS 1712 Mllltary-ave—' 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb r 300.'^24F> ± r^6:986~ ] 

Supervised By: QCiliiate^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 346.970 

Supervised By: 

Certificate of Verification 

2995 

SOIL 

2009-08-11 15:13 

30.27 

Final 

26345 

1712 Military ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 22.642 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 316.061 

Supervised By: 

Certificate of Verification 

2996 

SOIL 

2009-08-11 15:13 

30.33 

Final 

26345 

1712 Military ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 21.647 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 256.887 

Supervised By: 

Certificate of Verification 

2997 

SOIL 

2009-08-11 15:14 

30.29 

Final 

26345 

1712 Mllitar/ ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 19.386 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 281.042 

Supervised By: 

Certificate of Verification 

2998 

SOIL 

2009-08-11 15:15 

30.29 

Final 

26345 

1712 Military ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 20.269 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2989 

Mode SOIL 

Time 2009-08-11 15:07 

Duration 121.25 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 1712 Military ave 

QUAD/ZONE Fl 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb (^JoUsO? ± 

Supervised By: (^/h/'OP'Oj O 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 129.181 

Supervised By: 

Certificate of Verification 

2985 

SOIL 

2009-08-11 15:06 

30.23 

Final 

26345 

1712 Military ave 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 14.454 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 125.337 

Supervised By: 

Certificate of Verification 

2986 

SOIL 

2009-08-11 15:06 

30.24 

Final 

26345 

1712 Military ave 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 13.962 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 74.264 

Supervised By: 

Certificate of Verification 

2987 

SOIL 

2009-08-11 15:07 

30.18 

Final 

26345 

1712 Military ave 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 11.410 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 79.817 

Supervised By: 

Certificate of Verification 

2988 

SOIL 

2009-08-11 15:07 

30.60 

Final 

26345 

1712 Military ave 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 11.820 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2994 

Mode SOIL 

Time 2009-08-11 15:11 

Duration 121.41 

Sequence Final 

Flags 

AVERAGE CTYg-or299a-2g93J 

ADDRESS T:/l'2'r5iriH:aryave' 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

Error ppm ± 

Pb 

Supervised By 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2990 

Mode SOIL 

Time 2009-08-11 15:09 

Duration 30.57 

Sequence Final 

Flags 

BVID # 26345 

ADDRESS 1712 Military ave 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 80.094 ± 11.710 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 80.733 

Supervised By: 

Certificate of Verification 

2991 

SOIL 

2009-08-11 15:10 

30.19 

Final 

26345 

1712 Military ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 11.664 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2992 

Mode SOIL 

Time 2009-08-11 15:10 

Duration 30.17 

Sequence Final 

Flags 

BVID # 26345 

ADDRESS 1712 Military ave 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 60.038 ± 10.579 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2993 

Mode SOIL 

Time 2009-08-11 15:11 

Duration 30.48 

Sequence Final 

Flags 

BVID # 26345 

ADDRESS 1712 Military ave 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 66.755 ± 10.914 

Supervised By: 
4 

i^jQL;\ Omahaa Lea I .. d Site—Fixed Price EP-R7-07-0 . . . ._5 

8 ^^^ ^ °

S^y^y^

Coastal lEnvironmenta Environmentall Grou Groupp Inc ' .

www.coa8talhazmat.com 

>) ^ ^ 

^"tpRCfrtJ^ COASTA L mfllOMIIIIITAl 6 •our . IN C 

EXECUTIVE SUMMARY: 

BVID #26345-(1712 MILITARY AVE) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 

-COASTAL TO CHECK ON THE BRICK SIDEWALK NOTED BY THE PO AS SUNKEN BY 

TRUCKS. (COMPLETED 3/26/10) 

-DON BAHNKE WALKED THE PROPERTY 10/06/09 
«

SERA # 

EPA Property Close Out Form 

Property #: fff'^^^ . 

Date/Time: 

Quads Excavated; f^J j Q f 

Excavation Geaeml „

I. If necessuy, were the correct quadnint(s) excavated and restored? 

2. If necessary, were the conect areas ofdrip zone excavated and restored? y

Grading Sod and Vegetettoa 

Yes No 

I. Does tiie grading around the perimeter of the house in excavated areas generally slope away Uf fix)m tlie 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 

day time period) 

4. Are sodded areas generally firm and evenly graded? T:;^ 

5. Ar

tim

e

e

 di

 period

e joint

) 

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

6. Was the property graded such that water will not pool on (he propert>'' -y 

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

Gates, Fences aad Rettialag Walls 

Yes No 

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

\ y ' 

Were all gates or fences taken down during restoration acliviiies reinstalled? (Ifapplicable) t / " 

3. Was damage to gates or fences avoided? (Ifapplicable) 1/^ 

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

Foundation, Siding and Cutlers 

Ves No 

I. Was dainage lo the siding or trim avoided? y 

2. Was damage to the foundation avoided? y 

3. Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? -y 

5. Was damage to downspouts or downspoul extensions avoided? x>' ^ 

Sidewalks nnd Driveways (Concrete) 

Yes ^ 0 

1. Was damage to driveway surfaces avoided? ^ / 

2. Was damage to wallcway surfaces avoided? 

^ ' 
J Owners comments: # t 

iDspection notes: 

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

EPA Representative jJfl ^ IXKAJL - Date: 1({QI0 ^ 
# # 

Property Completion Agreement 

Ihis agreeincnl documenis the completion of remedial activilie.s perlbmied on my properly. My sigiuidire 

will designale that I am satisiied wilh the restoration oi'my pr()perty, and that no items are in questions, 

now; or at any time in the fulure, except those items listed below, ifany. 

PiopcrJyJ^): ^^^<^ ^ 

Property A,idres.s:"/^ ^ /^jj^^j^^^~A^ ^ 

Owner: U^^^_t^;^^ ( '^ 

Phone: 2p^_-_3.V/?;_ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

I agrco restornhon i.s completed, except as noted 

|_ | I do not acrec restoration is' completed 

tncr's Si(>nalurc Date rorrfriich)r's .Siijnatiire Date