### CONTRACT # 

### W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE US Army Corps of Engineers


### ECC Certification for Property Closeout
OLSID 25283 

### Property Address 1120 N 20 th 

### St 

### Field Work Started 9/6/2007 

### Field Work Completed 9/8/2007 

### Summary: 

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

# • F1 excavation depth was 13 inches below ground surfaces. 

# • F2 excavation depth was 13 inches below ground surfaces. 

# • B1 excavation depth was 13 inches below ground surfaces. 

# • B2 excavation depth was 13 inches below ground surfaces. 

# • Verification samples confirmed that cleanup standards were met. 

# • The site was backfilled with material which meets the contract specifications. 

# • The backfill was compacted to acceptable standards. 

# • Site restoration was conducted in compliance with the specifications and work plans.



### Comments: None 

# ..s 0-1+ I).IIV N 

### ECCQCM Name Title Jeff Hubbard USACE Con Rep 

### II ature 

# ajVM4 Name Title Date

# 25283 Omaha lead 

## srte Site Sketch

Team**~/q** 

### LOK:**OLS_~R1.~%f=~** 

### XRF Code 

## Z7 

# Z5 Quadrant FI 

# J£Y F2 

# IX!**:~ ~/~**  DZ.
_ 

### Lead Concentration

# ~~: c£W ppm 

# ¥Zf' ppm

_ -1ppm

_____ -1ppm

_____ -'ppm

_____ -'ppm

## Datf;6-~7 LogBook

ppm

,

.... .. .. .. 

## . - ".: .. 

## . .. 

## . .. : .. .. .. . 

## . .. .. 

## ...... . .

.. .. :**:~** .. • I ;­ ';.
. 

# . .


# .. '.:
..... ! 

# ENTER'ED:

.. .. ..



# .. ':
... ,.; ...**S'~P"l'7fz~fB';**



# .

..... - ...... :. .. I
.... ':.
.. r ........ t ..... 

## . .

' •• ... :.. f
.. : : •• I I • I •



## .... : - - 

# .

. 

# . I'.:'
__**-.:"_.'.~.** 

## __ ..**~.".**

, 

### ....**~.-** 

## ...**,,~** 

## .. - ....**~.-**



### : : ::ffl?-(:



## . ,. , ..... "
.. '
.... , ,\. Ztl."
.. __ "., \" • _ .. !. '"
_ .. 

## · . ..... a, .... 

## · .

• .. • : .......... : .......... : ........ : ....... I ... : I • I -I , : '
..**~~, ~-**  , 

### ...

, 

## .

• .4 , ..**~;** _ : ;; _ .. 

## : ..... ,**:~** 

## . - 

### .... :

- 

### ..... - : ..



## .....**~.-,_** ... : ....... _--;. 

## ..... ...**~.** . , ,

.......... .. 

## . .

.. . .. .. 

## . .. 

# . ,



# . . 

### ......... 

## . "
Omaroa Lead Sile 46JJOPage 1 of
_

### SZ3~ Omaha Lead Site Omaha, NE U.S. Environmental Protection Agency Region 

### vn Residential Yard Soils Environmental Restoration Services**!'I~(** JI'I· J{ 1'1 .\("(."1:<.;"; (1,\ be**lOl1lpkl~'d b~**  !'I'upel**t~** (hI l1eJ)**1',II,II"~Tlhll l"t~l**  '·lll·lll.!**t:~p;Jliollllll** (,l\lll 1 1;11 11 l' ;11**I-S()!J-223-I)~2'** Grantor (the property owner), consents to and authorizes the United Sates Environmental Protection Agency (USEPA) or its authorized representatives (or its contractors), the Grantee, to enter and perfonn certain environmental response activities upon the following described premises. For further**info~on** please contact A at/I-800.223-0425. Property Access Granted By 

# II 

# I () () 

# I (? 

# f) (P/e"lrSe Print Name) (Date) NOTE: Granting permission DOES NOT necessarily imply your property will be remediated at this time. 1'J{OI'I;1{ 1'1 1\1 ()J{\l·\TIO\ (Ill he lUl1lpkll'd**h~ le~llkllt**  ,llld 01 fllllpl'l**[~** OIl Ill'I-!'k,bt: 1'111ll) Resident Name:**_~L:=a.a...L<--I\~** _ 

### p" Owner 

## o Renter

Age of Home? years How long have you lived here? years Has the exterior been painted or covered with siding since 1978 DYES 

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

## o NO Total number of occupants:
_ List Ages: List ages of occupants under 6 years old who play in the yard for 5 or more hours per week:
_ Comments:
_ AUTHORITY FOR ENVIORNMENTAL RESPONSE ACTIONS The activities to be implemented by EPA under this agreement are pursuant to Section 104 ofCERCLA, 42 U.S.C 9604. EPA's right of access to the property for in Section 104(e) ofCERCLA, 42 U.S.C. 9604 (e), which provides entry for, "determining the need for response, or choosing or taking any response action under this title, or otherwise enforcing the provisions of this title." Access Attempts: First: Second: Third:
_ (STATE) (ZIP) Residence Address: 

# Jl.ac..:O=--_-'-'**l..-"':"O~L..~~=-----**

Owner's telephone number-Home: --=--=---=

__ -6-::-Jo..c...."",_

# ----------

Print & 

### Sign 

# n pg._of_ 

# List of Existing Conditions Property Address: I /

## ~(J /h

## ~O**~~** 

## DVD 10 #**c2~** 

# J,-g3 Owner: Date: )$- 

## d 

# '1-0 J

Ref: Photo Description 

### #**~~l>** 

# - tI A C-4-.vT 

## LoT 

# - -

Owner Signature 

### ECC Print 

## & Sign

# Qq~S~c**QJe-8~**

## Property Owner Satisfaction Survey Form Omaha Lead Superfund Site**Perfonnanc~Based** 

### Contracting (PBC) Pilot Project
Remediation Contractor:**_--l£;....::....:C::...·~C=:....** 

### _ Property Identifier Number:
_ Property BVID Number:**_-=.,2;;;....s:---:=::,.1;;;..8';:....;;:;3~** 

### _ Property Address:**_-----'"/-'-/..;;..d....::;O.:_.._.LN~...¥d-.:_.._C>_cs;;;;......:...·r** 

### _ Property Owner's Name:**_...J.m~fte...c&uG12~-""R~o-=L;.=L:::-£:;.L;/2~<..il..StJ~JJ'--** 

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

## * ••••••• * •••• ******* •• *.****.** •••••••••••• **** •• * ••••••• * •• ** ••••••••••• ** •• * InstnJctions to Property Owner: 

### TItis fonn is provided to you as a means of trying to capture your level of satisfaction with the work of the above-identified Remediation Contractor, as applicable to the soil cleanup action at 

### your property. The U.S. Environmental Protection Agency (EPA) and the U.S. Anny 

### Corps of Engineers (USACE) are very interested in your opinion regarding the work perfonned by our contractors. TItis form is intended to provide an easy 

### means for you to express your opinion about the work perfonned on your property. Please indicate your level of satisfaction with the Contractor's work by 

### selecting a numerical rating (ranging from 1 

### to 10) 

### using the following rating scale, then please sign & 

### date the fonn and return it to USACE in the attached self-addressed & 

### stamped envelope. (Additional comments may also be provided in the space provided, at 

### the option of the property owner.) 9-10 

### "excellent" 1-8 "very good" 5-6 "acceptable" 3-4 "poor" 1-2 

### "very poor" Property Owner's Satisfaction Rating regarding Contractor's Work 10 5 9 4 8 

### 3 1 

### 2 6 1 

### Additional Comments from Property Owner (optional; continue on back of page ifneededl

### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation 

# m .ECC. 

### Omaha Lead Remediation, Omaha, NE us Army Corps of Engineers 

## Analytical Results Summary OLS # 

## 25283 1120 N 20 th 

## St

XRF Results Quadrant Sample 

# I**~p'b** I Date Collected (ppm) (avg.) Type DE 

# I F1 

### II 13 II 9/5/2007 

# I 220 I DE 

# I 9/5/2007 

# I F2 

## II 13 490 DE 9/5/2007 

# I 81 

# I 13 554 DE 9/5/2007 479 

# I 82 

# I 13 

# I 

# I I II 

# I 

# I I I 

# I I 

# I I I

SAMI>LE 11). SAMPLE ID is a particular residenlial property ID from which lhe sample IS collected. The sample type identifier (wllh sequential sample number for that location) as follows, PX = Pre-Excavation XRF sample DE = During and Post Exeavalion Quadrant describes Ihe sampling location (wilh.sequenltal smnple number for that location) as follows; 1'1 or F2 = Front Yard One or Front Yard Two BI or 132 = Dack Yard One or Back Yard Two DZ = Drip Zone GA = Garden PA = Play Area EA = Easement Deplh describes the deplh from which the sample was colleeled. ppm = parts per million