TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: ^^0^ 3 

Date: .$?)^e>/o q 

Address: ^yDl ^ MiOJm i 3 f 

Remediation Contractor: Coastal Environmental Group_ Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

y 

Executiv 40314797 e Summary 

EPA-provided property sketch Superfund 

y^ 

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.) 

y 

Confirmation data 

Photographs ^C^-^irjij)aMjS(\ ^ H XCuJaitCA^ jfaru j ^ 0 <L 

As-built sketch 

^ 

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 

y Property information from Douglas County Assessor's Office 

y 

Xivr-nvu i . 

D 

Signature 

y£iM^.j^a>uusUt 
Property Access Checklist 

PropcrtjlD: <:9^^0^ 3 

D WORK STARTED ON: / / 1 

D WORK COMPELTED ON: / / Property Address: 2,0\ ^ V\ \ r^..V^v ^.t . > 

Owner Renter L L ^.,<4~s) q\o- CxC 

~ ^> r-r^i-\( •. ^^^ O

Address: " ^ Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

Fax: 

Phone: A'i:>\ - \^i(J2X:> 

Cell/Pager. 

D Notification Letter 

Sent: / / 1 By: 

13 Accesii Agreement Sipricd: U / ft /Of=^ By: i^( -, ^,r>->^cJ«V , 

E Restoration Agreement Siencd: \l / 6 /Dg , 

By: f-\\.:]^.)r^o'kV- ^ 

0 Topsoil Sampling (if applicable) / / By: 

D Disposal Sampling (if applicable) / / By: 

G Garden Sampling (if applicable) / / By: 

0 Utility Clearance Called: V \ / '^W C;& By: Ull?.ln b 

S Video/Photos (Before) On:JJ_/l^/Cl ^ By: e-rio^V) 

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

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

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

d Property Completion Agreement Signed: / / By: 1 

D Final Report Issued: / / By: 

Air Monitoring (as applicable) 

n Community Q Crew On: / / By: 1 

Results: 1 

n Community CU Crew OD: / / By: 1 

Results: 

0 Community O Crew On: ' / 

1 

Results: 

Omaha Lead Site 
Propeny ID #

Property 

Address: 

Initial Contaci: 

Second Contact: 

Final Conlacl: 

Final Action: 

Commeni: 

Owner 

Commeni (s); 

Site 

Coordinator 

Comment (s! 

CONTACT FORM 

_2^Q13 _ 

^Dia Mii^mt 'y 

Dale: Time: Action: 

Date: Time: Aclion: 

Dale: Time: Aclion; 

Tran.smit lo EPA D Other Action; D 
Douglas County Account Infcaaation Page 1 of2 ^a||al 

Douglas County, Nebraska Property Record - R1915870000 

Print Report 

NEW Feature - Parcel Dimensions available & scale 0-50 ft west of 90th St - ViOW OH Ma p Information is valid as of 2008-9-4 Treasurer's Tax Report 

New Feature -•-•- • Auto Sales Search 

Owner 

ZUNIGA FRANCISCO J 

3014 MIAMI ST 

OMAHA NE 68111-0000 

Property Informatio n 

Key Number: 1587 0000 19 

Account Type: Residential 

Parcel Number: 1915870000 

Parcel Address: 3014 MIAMI ST 

OMAHA NE 68111-0000 

Legal Description: OMAHA VIEW LOT 7 BLOCK 3 50 X 120 

Value Informatio n 

Land improvement Total 

2008 $2,500.00 $30,200.00 $32,700.00 

2007 $2,500.00 $30,200.00 $32,700.00 

2006 $2,500.00 $30,200.00 $32,700.00 

2005 $2,500.00 $30,200.00 $32,700.00 

2004 $500.00 $2,500.00 $3,000.00 

2003 $500.00 $2,500.00 $3,000.00 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.13 6000.0 1.0 120.0 50.0 No 

Impro vemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R19... 11/4/2008 
Douglas County Account Infoanation Page 2 of2 ^B|a t 

3014 Miami 

anti [ 

tj r 

limes* n n r 101) 

SwaM FMr 

lUU 

wo 

TUI M P 

• %S 

1 1/2 Story Rn 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1452.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Poor 

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

HVAC: Forced Air Rooms: 8.0 

Exterior: Frame Siding 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 Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1885 0% 1885 123 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 1046.0 

Basement Outside Entrance 2.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 525.0 

Porch End Screen 212.0 

User Attic Full Finish 406.0 

User See notes 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R19... 11/4/2008 
Page 1 of 1 

"> 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2172060. 

Original Call Date: 11/09/08 Time: 4:28 pm Op: ELIZABETH18790 


Work to Begin Date: 11/13/08 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3 014 Street: MIAMI ST 


Twp: 15N Rng: 13E Sect-Qtr: 09-SE-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remidiation 


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


: STREET. 


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


Company : COASTAL 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 MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 


CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 


Emerg: 4029329757 


Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 


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


,;, Emerg: 4024445160 


Day: 4067289343 


OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 8887289343 


Emerg: 4067289343 


Day: 4067289343 


QLNNEIC QWEST LOCAL NETWORK WA ' AM 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11 /9/2008 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site ENVIRONMENTA L 

GROUP . INC . 

Name: f \ fxt\c l^t e T j^y^ ' "'C^-c, Omaha Lead Site Date: OS^ W ­ 0 3 North Arrow 

Address:' -.^ovq ^-^TrM^M sV ^ Site Sketch Time: ^=5'. DDp^/ ^ T 

Team 0^no\A\ ^ ?SUYIL&VL^ BV1D# gZyQOg^?^ XRF Code ITOLf 

Sample Number Lead Concentration Confirmation Sample 

K.YAS<OPyA ­ 7<f6n 

RVSScPyA. 

R.YPSCf'XA-'2-qb'g3 

P-Dg-SCrxA ­ •2'<ic'i'i 

RPiiCFx A -i.^ot Z 

IS i IT-S 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

p i Yes tu 

<^^Yes n 

<6i Yes n 

BJ-Yes n 

i^-Z-Yes n 

V Yes a 

Yes • 

(S; 

4\U \^\i •}•-l>•l^•^^.•.!.•.•.•.•.•.•.•.•.•.ir'^7?Tr'!^"^-" i" " 

OLS#: 29083 ; 

Date'Excavatt!!U:"t1f1i8/08^" 

datd USEPA Signed Off: 

Area.Soddedf225asiaftOmaha Lead Site 46130 

Legend 

Concrete Dri p Zone Excavate d ^^t>| Quadrants Excavate d 

Area replaced with Are a replace d wit h 

Are a lef t bar e Sod Rock/Muloh 

Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc . 
a f(9 g^3 

Omaha Lead Site Date: pg- U -6 3 North Arrow —i 

Address: •^C>\gt vv^Tfxt^ 1 ftV^ Site Sketch Time: f^-. Dppry \ 

Phone: ^r^g ^ L,1CL^ LCL9,t^ T 

Team XRF Code iTOL f P ^ no \ A \ ^sVxV^H ^ BVID # P^^0?>? ^ 

::^-rir­ ^ I Stfei^<^j^j':!''^j-j^&ut3a^ ^ 

^ 

Omaha Lead Site 46130 
Name: f VccrvcA^to T yyjr^'^Cy<^ Omaha Lead Site Date: dS- U -6 3 North Arrow 

Address: •.?>C>\^ ^Trvr^Ci aV-

- O Site SIcetch Time: ^•. Dpprv v 

Phone: ^f^g ^ U l CL^ LCL9.0 

iZS T 

Team O ^ t^o\ A \ ^Uv^H^ . BVID# A^Q?.? , XRF Code \70MSample Number Lead Concentration Confirmation Sample 

ppm 9^1 Yes O g.VPSCP><:A- -x^ot l C^Yes a ppm 

<!»)» Yes 1=] ppm R.YPScPXA-iqo'? 3 

ppm 0t-Yes O

P.D2-5CPXA - •2^<?0'gT 

ppm Jp^e s 1=1 

ppm -V Yes n

ppm Yes •

s T '^fx^^A^ \ '^!' '^} pygTa^ufetQjtid^ 

* 

Omaha Lead Site 46130 
Name: f ^cxJ^\c^^Ce> ' ^ yyjrK<y,^ yCK Omaha Lead Site 

Address: ac>\q Site Sketch 

Phone: ^r^fl iL.nSL^ iLg,Rt> 

Team OJ ( no \ A\ ^ 9^UrftAVU>. BVID # AAO^? ^ 

Sample Number Lead Concentration 

RYAS^PyA - -2^0%-% 1^? J It., ppm RYBSCPXA- aqpt ^ ^ 0 

ppm a.YCScPxA-'^D'Zl 

ppm RYPScPxA-'Z-qo'2 isi i-z:s 3 ppm P.D2:5CPXA - ^-<?ot'? ppm RPiE5C/xA -'•L^D'^3 ppm 

ppm 

Date: Og'- U -0 3 North Arrow 

Time: _SlQfi.fUv \ T 

XRF Code l?0 ^ 

Confirmation Sample 

^ . Yes ^ 

(?t^Yes CD 

( i t Yes • 

0»-Yes ^ 

i^Z-Yes l=l 

A^ Yes n 

Yes • 

Omaha Lead Site 46130 
fitfaciiv 

^ 

COASTA L 

(NVIiONHtNTtt 

CROUP . IH C 

Consent For Access To Property 

RIGHT OF ENTRY TO PREMISES 

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

Environmentai Protection Agency (EPA) or its authorized representatives, collectively 

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

following described premises: 

T 

Owner's Name: Daytime Phone: 

Address of Property 

covered by this 

Agreement: \fy\] y

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 worl< is being performed under the Omaha Lead Superfund Site remediation 

program. 

A representative of Coastal Environmental Group, contracted by USEPA, vwll 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 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 

c a 0 u p . IM 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 NOTTO 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 

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

Signatur Qirvnaf-iirea

 Dat a Date Signature

 Date 

O I would like to be present during any sampling that is required. 
COASTA L 

C • O U P IN C 

Restoration Agreement 

The purpose ofthis 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 propert\' owner and the United States Environmenlal 

Protection Agency (EPA). 

Property ID: ^C\Q^ 3 

PropartyAddres.: Q^t>\L\U\CWV>V 

Owner: 7-Am^c\a 1^Yr>y\c\<yn 

Phone: ^-s\-^^^Q 

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 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. 

= VD *oesa\\£«Accl 

X\v\u <i^Y^rYtU v\Gj{\\S\e^\ W>H,nd: ^ 

Item 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Pagel of ( Q 
^ ^ ^ 

COASTA L 

e « O V r . • K C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

r\^u ^\^a\\ p[CK\(\\?. \e ^ V:^h\od 

Item: 3 

^f\m\ rtrbri.^ 

Item 

Kem: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 2 ofJjL_ 
( ^ 

COASTA L «NV•1lo^•n••«T* L C M O U » I N C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

S6N\ Vft 

Item: 

Item: 

item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Kem: 

Item: 

Item: 

Item: 

Item: 

Pages of ( ^ 
-• ^ -• - » 

COASTA L CM'VlRONntMTA L 

C * O U r . t M C 

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/Specles 

Square feet • • ' . ,. i • 

?fi 

• 

. ** , , 

Each 

Each 

^ 

1 

t> Each 

Each 

Square Feet 

^ 

Page 4 of (/? 
COASTA L 

c K o u r I M e 

Item 

Agreed upon value of 

olant materials not to be 

renlaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to 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 Uriit Condition/Type/Species 

^ 

$ 

1, 

t l Each 

v<\ SF 

SF 

SF 

• 

^kx^m "^^^"i 

Page 5 of ( j> 
C O A S T A L •MV»«OMM<MTAL 

I Additional Comments / Instructions: ', 

y i y ^j> 

D 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. 

Qjllagree Q I do not agree 

Owoer's Sigoature Contractor'ss Signatur Sknataree Date 

Page 6 of I V 
BVID#^C^nf^? . 

XRF PROPERTY SAMPLE SHEET 


Date \y\c\-a& Address 3o\'- \ VA^\ CX.«KAA <Sfc ' 

Project Omaha lead FP 2nd year opllon Sample time \ \'. \ 8 am/pm 

XRFID# sample length 30 sec ,3aoB°^ 

Shot# Reading Sample area Shot# Reading Sample area 

3ie ^ t'-iA..3,cii m.i q 3 1 y ^ ISO •-i.Ri: 12. ,-iS 

31S ^ i^i.q^iim.B o .aS-Sii ^ iS.'oQ 9^ 3 ~1UC> „,.----"' • ^-76b .^«3.43td?3.en Depth c^-7u?l il'-A.cJu !: Vi, ,^, Depth 

5 !.->-? •,•^-^.a'ft = ^^.l- } CP .?.-7t ^ r^<„iMi:u.^- l \ 

Average ^(^ V . ?>R :^ in-o B Average 13 .^U. r !?> or^ 

Shot# Reading Sample area Shot# Reading Sample area 

! 

Depth Depth 

Average Average 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth --—1 Depth 

^ ^ ^ 

Average Average 

lab sample # Lab result Sample area XRF Avg. 

\(.\Mm 

Wl^i'l-) 

\0 ^ 

It 

tiW6*i6^< 

n 

111;.^t 

to]. 3? 

Signature. 

Print 'pf^d^ t^/vr^ 
A\ Wfi It 

13611 B Street • Omaha, Nebraska 68144-3693 ' (402) 334-7770 • FAX (402) 334-9121 • www.midwes1labs.corT) 

ACCOUNT NUMBER CHAIN OF CUSTODY RECORD: Yes No 

PURCHASEORDERNUMBER. 

REPORT&BILLTO IDENTIFICATION COPYTO 

Cla<»-s-VQ.\ C*<\\firt>rK€i\'\~^ 

ZIP 

PHONE ( ^^^KVl)CC2''iX\0 

9 ! 

•Matrix Codt: SO - Soil, WA - Wpler, SL - Sludge. OT - Oirier Oyr reportii c.'ic c.x'

 lerie.- refte.-ss sr sree fo tor: ns tie excl-js'v excbs'Vee iW zrv ccnllcientic i ccntlclentie!! ususss c ofcj cj-- ciitni ciiinvss t.'i t.'i?? K.V nia;>'nana?t !•• ri€ repraJi-ced 'r. whoie ci ir. pe.'^i, r^st ruty j.n)' rsferericc be meCt 

to ttie viO'F, th£ rEEJlis. or i'le corr;prr.>' h any tdveriisiriS: '!£*•reiscse,or ct'iE.- r.i.'bi;c cTi:,c'jrxerr:snf5 witr.cv a''t?irji.(' r-.'^ -••'••^' V'M^ - ;-rfh/.,r-.-»;..r 
Report Number: Date Reported: 

08-354-2038 •i^BVIidwest 12/19/08 

Account: Date Received: 

20666 V| 12/16/08 ^ Laboratories, IncI 

Page: 1 of 1 Date Sampled: 

13611 B Street • Omaha, Nebraska 68144-3693 • (402) 334-7770 • FAX (402) 334-9121 • www.midwestlabs;p2)rri5/08 

COASTAL ENVIRONMENTAL GROUP 

MARCOS MATEUS 

2411 MARTHA ST 

OMAHA NE 68105 

LEAD ANALYSIS 

3014 MIAMI ST 

PO/Project #: OLS-2008 

Analysis As Detection Analyst Verifier 

Performed Received Units Limit Method Date Date 

U b number: 1519172 Sample ID: QC-29083 EASEMENT 

Lead (total) 104 mg/kg 5 EPA 6010 rrd/12-18 bab/12-19 

Lab number: 1519173 Sample ID: PZ 

Lead (total) 176 mg/kg 5 EPA 6010 rrcl/12-18 bab/12-19 

dyyn^^^ 

'leather Ramig 

Client Service Representative^ 

heather@midwestlabs.com (402)829-9891 

NELAQ.regulrements. 

to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization, 
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 

3758 

SOIL 

2008-11-19 11:21 

122.37 

Final 

|Avg of 3754-3757 

3014 mlami "^ ^ 

|PZ 

jVentry 

16 

^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 142.392 

Supervised By: 

Certificate of Verification 

3754 

SOIL 

2008-11-19 11:18 

30.61 

Final 

29083 

3014 miami 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 14.786 
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 141.993 

Supervised By: 

Certificate of Verification 

3755 

SOIL 

2008-11-19 11:19 

30.55 

Final 

29083 

3014 miami 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 14.797 
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 383.433 

Supervised By: 

Certificate of Verification 

3756 

SOIL 

2008-11-19 11:20 

30.41 

Final 

29083 

3014 miami 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 23.972 
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 137.684 

Supervised By: 

Certificate of Verification 

3757 

SOIL 

2008-11-19 11:21 

30.80 

Final 

29083 

3014 miami 

PZ 

Ventry 

6 

CLEARANCE 

± Error 

± 14.772 
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 

Pb 

Supervised By 

Certificate of Verification 

3763 

SOIL 

2008-11-19 11:24 

122.79 

Final 

_Avg of 3759-3762 

^3014 mlami 

feasement 

ventry 

* "l 

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 120.481 

Supervised By: 

Certificate of Verification 

3759 

SOIL 

2008-11-19 11:22 

30.54 

Final 

29083 

3014 mlami 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 13.452 
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 123.532 

Supervised By: 

Certificate of Verification 

3760 

SOIL 

2008-11-19 11:23 

30.92 

Final 

29083 

3014 mlami 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 13.524 
Thermo 

SCIENTIFI C 

Thermo Rsher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3761 

Mode SOIL 

Time 2008-11-19 11:23 

Duration 30.83 

Sequence Final 

Flags 

BVID # 29083 

ADDRESS 3014 mlami 

QUAD/ZONE easement 

INSPECTOR Ventry 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 114.264 ± 13.147 

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 95.142 

Supervised By: 

Certificate of Verification 

3762 

SOIL 

2008-11-19 11:24 

30.50 

Final 

29083 

3014 miami 

easement 

Ventry 

1 

CLEARANCE 

± Error 

± 11.868 
X 

y'^% 

%. • ^

^'^'-PHo-^^'' 'i-pfio- ^

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

Coastal Environmental Group Inc. 

 www.coastalhazmat.com 

EXECUTIVE SUMMARY: 

BVID # 29083 - (3014 MIAMI ST) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation 

 r/Mi ^ 

 COASTA L ENVIItONHENTAL 

CROUP . IN C 
s ^ EPA 

EPA Property Close Out Form 

Property *t: r9'^bB ^ Property Address: ^\' A ^-A\Oo^AI "^V , 

Date/Time: Owner's Name: "g^ . r^\ cxr. ^ ^rr v .\r\fA I %QJD 

Quads Excavaied: Vf c Contraclor Group (f,rxcgyWx.Q, "Fr^s^rrnoiMJuA^i^e. 

Excavation General Yes No 

1. If necessary, were the correct quadrant(s) excavaied and restored? I-'" 

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

Grading Sod and Vecetation Yes No 

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

^ from the house? 

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

3. Docs 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 Ajie the joints between the sod strips generally tight? (Only evaluate ifinspecied at a 30 day 

^ time period) 

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

7 Was damage to landscaping or plant materials avoided? ^ 

Gates, Fences and RcUininf; Walls Yes No 

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

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

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

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

FouDdatioD, SidioK and Gutters Yes No 

I. 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? i ^ 

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

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? - ^ 

2. Was damage to walkway surfaces avoided? u ^ 
O vners comments: 

Inspection notes: 

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

EPA Representative^..-7^^]^;;?l-w^^^^wW:z^ Date: /^//f/^i ^ 
''m 

Property Completion Agreement 

Tliis agreement documenis the complclion of remedial activilies performed on my property. My signaiure 

will designaie Ihat I am satisfied wiih the restoration of my property, and that no items are in questions, 

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

Prope^tyJD:^^^^ ^ 

Property Address: 3^^C ^ /^^ ^ / __^ ^ 

Owner: fy^^^}^^ ^ 2^.o ^ 

Phone: "^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

-TSTufjl agree restoration is completed, except as noted 

 I I do not agree resloration is completed 

«' Owner's SiKnaliire ll^|r XContractor's Signature ' Da^c 

I