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 20th 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).IIVN ECCQCM 

Name Title
 

Jeff Hubbard USACE Con Rep II
 

ature 

Name Title Date ajVM4
25283
 

Omaha lead srte
 

Site Sketch
 

Team ~/q LOK: OLS_~R1.~%f=~ XRF Code Z7Z5 

Quadrant 

FI J£Y 

F2 IX! 

:~ ~/~ DZ. _ 

Lead Concentration 

~~: c£W ppm

¥Zf' ppm 

_ -1ppm 

_____-1ppm 

_____-'ppm 

_____-'ppm 

Datf;6-~7

LogBook 

ppm 

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Omaroa Lead Sile 46JJO 
Page 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 11;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 ofoccupants: _ 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 oftrying to capture your level ofsatisfaction 

with the work ofthe 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 ofEngineers (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 

.ECC. 

Omaha 

Environmental 

Lead Remediation, 

Chemical Corporation 

Omaha, NE us 

m

Army Corps 

of Engineers 

Analytical Results Summary 

OLS # 25283 

1120 N 20th St 

Quadrant Sample XRF Results I~p'b I Date Collected 

Type (ppm) (avg.) 

DE I F1 II 13 II 9/5/2007 I 220 

I DE I I F2 9/5/2007 II 13 490 

DE 9/5/2007 I 81 I 13 554 

DE I 82 9/5/2007 479 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