TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: U^{}{, Date: 

Address: \lAfh ^ tlf> ^ ^T 

Remediation Contractor: Coastal Environmental Group_ Year: 200 _200l : ^ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

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.) 

Confirmation data 

Photographs Q<^ATUv^

As-built sketch 

 | . f (^ "(^ic^^lVimg^ 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

I l^jtP 
Property Access Checklfst 

Propertym; ^(^OjQ ^ 

O WORK STARTED

Property Add. ^ 12(0 ^ 5 ZJT ^ 3j ­ D WORKCOMPELTBD

fynyiirrfr 

Owner: M^f)Renten ^ i ^ Win\c\\rs 

Address: Ptione: ^Q7 • ?S?)M 

UMMO am u 5^\0) Fto 

Cell/Pagen 

Phono Additional Infomuition: : M02..S/f),?,ft-^1 

Fax: 

Cen/Pager: 

D Notification Letter Sent: / / By: 

Qa Access Agrcenient Signed: 9_/^/Ca B r 

j ^ Restoration Agreonait SigBed:^/^03. By: 

D Tbpsoil SampUng (if applicable) / / By: 

O Disposal Sanqilfaig (if applicable) / / By: 

D Garden Sampling (ffappKcabie) / / By: 

1 ^ ^tili^aearance Called: i/2a/J29 By: lohjiQ

\l2f Video/PtiotDS (Bdbre) OB:j£./_5_/j2St By:<3,io^rt^i.," 

O Video/Pbotos (Daring) On: / / By: 

D VideoOtiotos (Alter) Om / / By: 

O Videomiotas (30-Day) O K / / By: 

" ^ Praperty Compledoa Agreement Signed: X^i^/ ^ By: 

D Rnal Report Issued: / / By: 

Air Monitoring (as applicable 

DCommnnl^ DCrcw On: / / By: 

Resalts: 

[_] Commnnity LJ Creir O K / / By: 

Resnits: 

D Commnnity DCrew H On: / / Br-

ResnttK 

 ON: 

 ON: 

ue^i: 

 2e\Uol1« 

Omaba Lead Site 

1 
• • 

bouglas County Account I [•^ra||ion Page 1 of3 

Douglas County, Nebraska Property Record - R2218320000 

Print Report 

NEW Feature - Parcel Dimensions available (S) scaie 0-50 ft west of 52nd St - VlO W O n Ma p Information is valid as of 2009-9-15 Treasurer's Tax Report 

New Feature -•-•• • Auto Sales Search 

Owner 

J H PROPERTIES LLC 

11440 S 146 ST #101 

OMAHA NE 68138-0000 

Property Informatio n 

Key Number: 1832 0000 22 

Account Type: Residential 

Parcel Number: 2218320000 

Parcel Address: 1203 S 27 ST 

OMAHA NE 68105-0000 

Legal Description: SHULLS 2ND ADD LOT 10 BLOCK 8 N 40.67 W 21 FT LT 9 & N 40.67 FT 

Value Informatio n 

Land Improvement Total 

2009 

2008 

2007 

2006 

2005 

2004 

$3,500.00 

$3,500.00 

$3,500.00 

$3,500.00 

$3,500.00 

$3,500.00 

$37,200.00 

$37,200.00 

$37,200.00 

$38,300.00 

$38,300.00 

$38,300.00 

$40,700.00 

$40,700.00 

$40,700.00 

$41,800.00 

$41,800.00 

$41,800.00 

Saies Informatio n 

Sales Date: 2004-01-30 

Deed Type: WD Book: 2004 Page: 017929 

Price: $0.00 

Grantor: John M Higgins etal 

Grantee: J H Properties 

Valld/lnvalld: Invalid 

Exclusion Reason: 

Sales Date: 2002-05-07 

Deed Type: SWD Booilr: 2212 Page: 119 

Price: $40,000.00 

Grantor: 

http://douglasne.mapping-online.com/DouglasCoNe/static/accoimtinfo.jsp?accoimtno=R22... 9/17/2009 
• • 

bouglas County Account I [j^srnMtion Page 2 of3 

Grantee: 

Valid/Invalid: 

Valid 

Exclusion Reason: 

Sales Date: ' 2001-12-05 

Deed Type: TRD Book: 2199 Page: 462 

Price: $51,480.00 

Grantor: 

Grantee: 

Valid/Invalid: Invalid 

Exclusion Reason: Foreclosure 

Sales Date: 1996-06-18 

Deed Type: D Book: 2035 Page: \ 657 

Price: $35,000.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.07 3198.0 1.0 78.0 41.0 No 

Improvemen t Informatio n 

Building 1 

jMS" 

«^ •" la Z7'^ 

Second Floor 616 0sq.n. put Floor j^a 

772.0 sq ft 

tDd CO 

^tZJ ' 

2 STOP ?Y 

CLICK TO ENLARGE IMAGE £LICK TO ENLARGE IMAGE 

Square Footage: 1388.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22... 9/17/2009 
• • 

bouglas Cotmty Accoimt I[i^rm||io ; n Page 3 of 3 

Condition: 

Condo Square Footage: 

Rooms: 

Units: 

Baths: 

Bedrooms: 

Stories: 

Foundation: 

Sprinkler Square Footage: 

Adjusted Year Physical Age Built 

Fair 

0.0 

8.0 

1.0 

1.0 

3.0 

2.0 

Block 

0.0 

Unit Type: 

Built As: 

HVAC: 

Exterior: 

Interior: 

Roof Cover: 

Roof Type: 

Floorcover: 

YearBuiit 

2 Story 

Central Air to Air 

Frame Stucco 

Plaster 

Composition Roll 

Gambrel 

Allowance 

Year Percent 

Remodeled Remodeled 

1902 0 0% 1902 107 

Units 

1.0 

706.0 

1.0 

1.0 

1.0 

240.0 

210.0 

1.0 

Detail Type 

Appliance 

Basement 

Fixture 

Fixture 

Fixture 

Garage 

Porch 

User 

Detail Description 

Allowance 

Bsmnt Block 8 ft 

Additional Fixtures 

Base Fixtures 

Bath Full 

Detached 

Open Slab 

New Roof 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R22... 9/17/2009 
Page 1 of2 

"> 

Create Another Ticket Back to Irth Internet Send Email ) 

• YOUR TICKET NUMBER IS 2387337. 

Original Call Date: 10/15/09 Time: 1:44 pm Op: ELIZABETH18790 


Work to Begin Date: 10/19/09 Time: 2:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1203 Street: S 27TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 28-NE 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: LEAD REMEDIATION 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


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


: UNSURE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: COASTAL 


Depth of Excavation: 4 FT Comer Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV LEVEL3 MUD02 OMAHACOF 0PPDGPR6 QLNNEIF 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVEL3 LEVELS COMMUNICATIONS, LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICH/TRAFFIC

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/15/2009 
Page 2 of2 

0PPDGPR6 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIF QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/15/2009 
OLS#: 20906 

As-Buil DateExcavated:10/17/09 t Drawing Date USEPA Signed Off: 11/10/09 

COASTA L Omaha Area Sodden: 1233 sa ft Lead Superfund Site 

20906 

Omaha Lead Site Exterior Paint Norlti^Tow Owner Name: JOHN M HIGGINS 

Address: 1203 S 27 ST 

Phone: H: 402-431-9290 W: 402-289-4316 

Site Sketch • Good 

• Poor 

Q^ t paint 

Sample Numt)er Lead 

Concentration 

Sample 

Collected LAB 

Firm: _ 

Samples Collected 

^'Juy ~ 7~y'/' 

RYASCPXA-20906 F1 .5 ^ / ppm D Date:. ^/i/<^ Y 

RYBSCPXA-20906 F2 "^ 1 ^ ppm D Time: . //s- ^ 

BV'OOCPXA-20900

RYDSCPXA-20906

 B4 

 B2 3^ ^

ppm 

 ppm 

D 

D Samples Analyzed 

RDZSCPXA-20906 DZ o>'^^P ppm D XRF Uni t: e/-Z - Book: ^-2 -

RGZSCPXA-20906 GZ ppm D D Date:. 

RPZSCPXA-20906 PZ ppm D D Time;. /Vr 7 

Staff: XT'j^Tr? 

Legen d 

Concret e Drip Zone Excavated Quadrants Excavate d 

Are a replace d

Sod

 wit h

 —

 Are a replace d wit h 

 Rock/Mulch Are a lef t bar e 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
v-v i^f^ 20906 

Owner Name: JOHN M HIGGINS 

Address: 1203 S 27 ST 

Omaha Lead Site 

Site Sketch 

Exterior Paint 

• Good 

• Poor 

North Arrow 

Q^o t paint 

Samples Collected 

Firm; _ 

Date: _ 6/^/'^ y 

Time; _ //^5 

Samples Analyzed 

XRF Uni t: ^/ ^ Book: ^'^~ -

Date: _ 

Time; _ f^/7 V 

Staff; .C^Tl ^ 

. jna I^ead Site 461.Iin 

'0^v\;^t\'\ fOLg. Ll^ x 
20906 

Owner Name: JOHN M HIGGINS 

Address: 1203 S 27 ST 

Phone: H: 402-431-9290

Sample Number 

RYASCPXA-20906 F 

RYBSCPXA-20906 F2 

RycocrxA-20000—©4 

RYDSCPXA-20906 B2 

RDZSCPXA-20906 J77 

RGZSCPXA-20906 GZ 

RPZSCPXA-20906 PZ 

Omaha Lead Site 

Site Sl(etch 

 W: 402-289-4316 

Lead 

Concentration 

Sample 

Collected LAB 

ppm D 

ppm n 

ppm 

ppm 

ppm 

ppm 

ppm 

D 

D 

D 

D 

D 

D 

D 

Exterior Paint North Arrow 

• Good 

^ • Poor 

Q^o t paint 

Samples Collected 

Firm: _ 

Date: . s/5/<^ y 

Time: . //^ 5 

Samples Analyzed 

XRF Uni K: B/'Z , Book: 5':2 -

Date:. 

Time:. jF^^r y 

Staff: •C^^TT^ 

ina Lead \ 46130 'Bf\^^^|^ ^ iou u^^x 
20906 

Owner Name: JOHN M HIGGINS 

Address: 1203 S 27 ST 

Phone: H: 402-431-9290

Sample Number 

RYASCPXA-20906 F1 

RYBSCPXA-20906 F2 

ByooGDtA-zooeo B+ 

RYDSCPXA-20906 82 

RDZSCPXA-20906 DZ 

RGZSCPXA-20906 GZ 

RPZSCPXA-20906 PZ 

Omaha Lead Site 

Site SIcetcli 

 W: 402-289-4316 

Lead Sample LAB Concentration Collected 

^ ^ / ppm D 

^ / ^ ppm D 

_pp m D 

3 ^ ^ ppm a 

Cfi ^ ^ ppm n 

ppm D n 

ppm D 

Numt>er of Samples = 

Exterior Paint Nortti Arrow 

• Good 

• Poor 

Q^ t paint 

Samples Collected 

Firm:. 

Date:. s/^/<i ' y 

Time:. //^i 

Samples Analyzed 

XRF Uni t: ^/-Z . Book: ^"Z- ^ 

Date:. 

Time:. ^/7 ^ 

Staff:. 4P77t? 

ENTJBBED 

0 7 20114 

Oinaha Lead Site 46130 
• ^ 

f<^'-°"*'t. 

-fcriKMf. \l\ci^i- hui^^i^ (JA^ji-n^. COASTA l IHTIIONHIMIAl 

C I O tf P . IN C 

Consen t for Acces s To Propert y 

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 perfonn certain environmental response activities upon the 

following described premises: T? r\ 1 fyyr\\ 

Owner's Name '• ]0\ ^ \\\(.U\A 

Address of Property 

covered by this 

Agreement: 1203 3 Vi^ ^ 

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 dean materials and the area will be restored to its original condition. This 

wori( 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 confimi that it is complete and meets with the Grantor's approval. Upon 

completion, the Grantor virill 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, fbr the sole purpose of performing the work. This access shall 

remain in effect until the vrark has bisen satisfadority completed. The Grantor also 

agrees to: 

Page 1 of 2 
% 

COASTA L tfrvtaoNKIirTAt 

C R O D » > tr C 

< Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

c Remove fiovkrer 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; 

c 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 (402) 991-1199 

( ^

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

Signal 

Date '" Signature Date 

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

Page 2 of2 
C; -^^ 

COASTA L 

c « o u •- • kt r 

Restoration Agireement 

The purpose of this agreement is tc 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 satisftiction of the property owner and the United States Environmental 

Protection Agency (EPA). 

PropertylD: 2oQ0U > 

Property Addren: {r/^^rx,^ ^ 7^7 ^ ^ 

I Phone: 1)0 ? . ^iCT. 2^1 1 

„J 

On die attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

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

Photographically and VideographicaJly document the existing conditions ofthe property and the Ixisement if 

necessary. 

items to be Removed by the Owner before Start of Remediation: 

The renoval. stora.ge. disposal, and/or return ofthese Homs Is the Owner's responsibility. 

I Rem: 

Kem: £ 

Rem: 

Rem: 

Items to be Removed by the Contractor During Remediation and Wot Replaced 

Rem: 

ht^ 9M^A y\(vy\H lift k<l\.U 

Rem: 

Rem: 

Item: 

—~~ - — — ^ 

Page 1 of -^ 
Items to Be Removed By Contractor During Remediation gnd Replaced^ 

ttem: 

.v>ii- '• ^ .^J- Rem: 

S O D •• F, ,0 ^ 

Rem: 

Rem: 

Landscape Inventory 

1 Item 1 Quantity Unit I Condition/Type/Species 

Pre-existing propmy area, 'FI.I> 2 1 Quadrants diat will be excavated, diat 

is covered with grass. 

Number of trees > 2 inch I Each 

trunk diameter 

Number of trees <= 2 inch Each 

Zones, Conlrol Valves, Eadi Tfaners, Heads, ^ c 

1 Aliath ,T sketch ol lhe 

1 srr'fklcp lin'.uii 

Number of and size of 

each garden/ flower bed Eacfa 

area. Square Feet 

Atimli .1 skcich ol fi-iiinu' 

<i/<.'S and locaiiiviN 

1 

1 

Agreed upon value of plant 

materials not to be 

1 replaced bv contra(Mr. S Voir Ihi" AHldc \\ill ni 

uii'C 10 IS*, ut ,1 plun; 

^ \Qiici\i.'; 1(> llie i;rotici-i\ 

[ 0" ner. 

Easement Area, to be Each 

excavated N|e^ 

^ 0 

Page 2 -Ji 
C O A S 1 A L 

! AddRtonal Comments / Instructions: 

Q Check the box if Owner does not want CEG to document Jnterror foundation walls and possible 

pre-e)dsting damage. By dieckir^ this box CEG is not responsible for any danrtage done to the 

Interior of house, including foundation oracks or ftssures. 

O I do not agree 

Ointractor' ntractor'ss Sign Signatur a e Date 

Page 3 of. 3 
BVIDtf ^)O^D(p 

XRF PROPERTY SAMPLE SHEET 

Date 

Project 

XRFID# 

Shot# 

A ^ ^ 

3-S ^ 

»^U 

^S9^ 

Average

Shol# 

^ / S 

^n 

H2.0 

W2-J 

Average 

Shot# 

Average 

Shot# 

Average 

lab sample # 

lO'Zo^O ^ 

Omaha lead FP 2nd year option 

Reading Sample area 

F/ 

wsus^ Depth 

iv-m If 2^ IZIS 

 Ite^-S d ^ «3g>.^^ 

Reading 

q«.*-n 

H I --IS 

•^i?.* iT 

^11 n 

/o/ '- n 

Reading 

Reading 

Lab resull 

Sample area 

P^ 

Depth 

ly 

Sample area 

Depth 

Address 

Sample time 

sample length 

Shol# 

232: 

"Zs ^ 

Average

Shot# 

Average 

Shot# 

Average 

RETEST AREAS 

Sample area Shot# 

Depth 

Average 

Sample area XRF Avg. 

Signature 

/^a> s 2 ^ s r am/pm 

30 sec 

Reading 

fiV.3Zil9SJ 

/k^liJ^Sb 

l&t.fiiJc.3S

/9V.^/3? /Y-Vg 

Sampie area 

^/f­ Depth 

1 

 IjQ.^' t /^ . g ^ 

Reading Sample area 

Depth 

Reading Sampie area 

Depth 

Reading Sample area 

—-- 7 

/ Depth 

y^y 

Print Mit^Cn 1/4 rr^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32075 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

LOCATION 

INSPECTOR 

COR 1 

COR 2 

MISC 

NOTE 

User Login 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

Supervised By: 

Certificate of Verification 

258 

SOIL 

2009-10-20 15:11 

120.00 

Final 

Avg of 254-257 

1203 s 27 st 

VENTRY 

f l 

13 

clearence 

epa gun 

EPA 

Error 

20.243 

20.991 

15.052 

8.734 

22.132 

6.699 

15.245 

6.246 

25.032 

13.529 

23.564 

80.004 

32.616 

78.628 

162.339 

391.966 

103.491 

141.233 

329.723 

53.326 

109.558 

1327.995 

2004.452 

1394.431 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 254 

Mode SOIL 

Time 2009-10-20 15:09 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 20906 

LOCATION 1203 s 27 st 

INSPECTOR VENTRY 

COR 1 fl 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm 

115.368 

< LOD 

< LOD 

119.565 

< LOD 

47.558 

< LOD 

< LOD 

< LOD 

< LOD 

104.874 

< LOD 

< LOD 

< LOD 

< LOD 

13852.471 

422.253 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

Supervised By: 

± 

± 

± 

± 

± 

± 

Error 

17.698 

21.090 

15.146 

8.940 

22.629 

6.687 

15.042 

5.831 

22.013 

13.669 

21.125 

77.584 

32.028 

76.483 

167.707 

400.001 

105.465 

122.986 

327.742 

801.917 

151.541 

1531.003 

1275.671 

1236.371 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 255 

Mode SOIL 

Time 2009-10-20 15: 10 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 20906 

LOCATION 1203 s 27 st 

INSPECTOR VENTRY 

COR 1 f l 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm 

294.097 

< LOD 

< LOD 

118.582 

< LOD 

49.675 

< LOD 

< LOD 

< LOD 

< LOD 

209.973 

< LOD 

< LOD 

< LOD 

< LOD 

14973.209 

342.736 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

Supervised By: 

± 

± 

± 

± 

± 

Error 

25.721 

20.702 

14.597 

8.544 

21.556 

6.511 

17.385 

6.249 

31.144 

13.893 

27.332 

84.836 

31.213 

77.103 

162.641 

398.230 

95.250 

124.487 

383.491 

933.783 

151.646 

1541.345 

2850.085 

1809.968 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 256 

Mode SOIL 

Time 2009-10-20 15:10 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 20906 

LOCATION 1203 s 27 st 

INSPECTOR VENTRY 

COR 1 fl 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm 

135.783 

< LOD 

< LOD 

111.105 

< LOD 

51.591 

< LOD 

< LOD 

< LOD 

< LOD 

162.562 

< LOD 

37.472 

< LOD 

< LOD 

12391.334 

482.526 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

Supervised By: 

± 

± 

± 

± 

± 

± 

± 

Error 

19.264 

21.479 

15.538 

8.812 

22.338 

6.926 

13.390 

6.751 

23.632 

14.152 

25.934 

87.560 

23.834 

82.982 

160.644 

385.235 

112.402 

117.640 

301.006 

531.252 

99.207 

839.449 

1684.490 

1104.427 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 257 

Mode SOIL 

Time 2009-10-20 15:11 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 20906 

LOCATION 1203 s 27 st 

INSPECTOR VENTRY 

COR 1 fl 

COR 2 13 

MISC clearence 

NOTE epa gun 

User Login EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm 

131.867 

< LOD 

< LOD 

117.813 

< LOD 

51.391 

< LOD 

< LOD 

< LOD 

< LOD 

98.707 

< LOD 

< LOD 

< LOD 

< LOD 

13529.228 

401.212 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

Supervised By: 

± 

± 

± 

± 

± 

Error 

18.287 

20.695 

14.928 

8.639 

22.007 

6.672 

15.163 

6.153 

23.338 

12.403 

19.865 

70.037 

31.472 

77.944 

158.366 

384.399 

100.849 

199.819 

306.653 

746.351 

35.837 

1400.183 

2207.562 

1426.957 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 253 

Mode SOIL 

Time 2009-10-20 15:07 

Duration 120.00 

Sequence Final 

Flags 

AVERAGE VAyg of 249-75?I 3 

LOCATION 1203 s 27 st 

INSPECTOR VENTRY 

COR l easement 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm Error 

I x u ^ " — Ig.Of J \

Cd < LOD 20.135 

Ag < LOD : 14.543 

Sr 119.605 ± 8.490 

U < LOD : 21.671 

Rb 49.518 ± 6.461 

Th < LOD 14.559 

Se < LOD 5.602 

As < LOD 24.968 

Hg < LOD 13.243 

Zn 163.187 ± 24.237 

W < LOD ; 78.723 

Cu 33.376 ± 21.182 

Ni < LOD : 72.502 

Co < LOD : 157.760 

Fe 13781.937 ± 379.231 

Mn 456.938 ± 103.050 

Cr < LOD 154.898 

V < LOD 210.991 

Ti < LOD ^ — 570.427 

Sc < LOD/ ^ '""'^ : y93.978 

Ca < LOD^'^ /1100.340 

K < LOD • y ^ 1630.052 

S </LOD 41660.629 

-£ 7 

Supervised By: / x 4 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 249 

Mode SOIL 

Time 2009-10-20 15:05 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 20906 

LOCATION 1203 s 27 st 

INSPECTOR VENTRY 

COR l easement 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm Error 

Pb 164.323 ± 19.837 

Cd < LOD 20.127 

Ag < LOD 14.777 

Sr 118.688 ± 8.601 

U < LOD 22.734 

Rb 53.018 ± 6.771 

Th < LOD 15.122 

Se < LOD 5.439 

As < LOD 24.098 

Hg < LOD 14.094 

Zn 172.457 ± 25.166 

W < LOD 80.557 

Cu < LOD 32.533 

Ni 84.078 ± 53.785 

Co < LOD 162.858 

Fe 14516.099 ± 395.019 

Mn 455.814 ± 105.112 

Cr < LOD 154.044 

V < LOD 194.303 

Ti < LOD 731.164 

Sc < LOD 100.360 

Ca < LOD 598.740 

K < LOD 1686.591 

S < LOD 162791.250 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32075 

Reading No 250 

Mode SOIL 

Time 2009-10-20 15:05 

Duration 30.00 

Sequence Final 

Flags 

SAMPLE 20906 

LOCATION 1203 s 27 st 

INSPECTOR VENTRY 

COR 1 easement 

COR 2 1 

MISC clearence 

NOTE epa gun 

User Login EPA 

ppm ± Error 

Pb 176.642 19.830 

Cd < LOD 19.694 

Ag < LOD 14.141 

Sr 118.120 ± 8.287 

U < LOD 20.222 

Rb 43.785 ± 6.008 

Th < LOD 14.323 

Se < LOD 5.953 

As < LOD 24.842 

Hg < LOD 12.494 

Zn 146.294 ± 22.860 

W < LOD 81.092 

Cu 58.772 ± 22.982 

Ni < LOD 72.682 

Co < LOD 155.927 

Fe 13432.585 ± 367.745 

Mn 428.228 ± 98.745 

Cr < LOD 203.833 

< LOD 305.146 

Ti < LOD 789.774 

Sc < LOD 107.092 

Ca < LOD 1084.704 

K < LOD 61.356 

S < LOD 885.922 

Supervised By: 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32075 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

SAMPLE 

LOCATION 

INSPECTOR 

COR 1 

COR 2 

MISC 

NOTE 

User Login 

Certificate of Verification 

251 

SOIL 

2009-10-20 15; 06 

30.00 

Final 

20906 

1203 s 27 st 

VENTRY 

easement 

1 

clearence 

epa gun 

EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm 

164.969 

< LOD 

< LOD 

110.480 

< LOD 

50.506 

< LOD 

< LOD 

< LOD 

< LOD 

167.258 

< LOD 

< LOD 

< LOD 

< LOD 

12983.194 

419.146 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

Supervised By: 

± 

± 

± 

± 

± 

± 

Error 

20.253 

21.126 

14.851 

8.500 

22.902 

6.774 

14.700 

6.111 

26.249 

13.852 

25.403 

85.258 

32.405 

74.510 

159.007 

380.805 

103.512 

112.927 

308.719 

403.302 

30.855 

1215.349 

2462.052 

1455.931 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32075 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

SAMPLE 

LOCATION 

INSPECTOR 

COR 1 

COR 2 

MISC 

NOTE 

User Login 

Certificate of Verification 

252 

SOIL 

2009-10-20 15:07 

30.00 

Final 

20906 

1203 s 27 st 

VENTRY 

easement 

1 

clearence 

epa gun 

EPA 

Pb 

Cd 

Ag 

Sr 

U 

Rb 

Th 

Se 

As 

Hg 

Zn 

W 

Cu 

Ni 

Co 

Fe 

Mn 

Cr 

Ti 

Sc 

Ca 

K 

S 

ppm 

174.811 

< LOD 

< LOD 

131.133 

< LOD 

50.760 

< LOD 

< LOD 

< LOD 

< LOD 

166.739 

< LOD 

< LOD 

< LOD 

< LOD 

14195.870 

524.562 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

< LOD 

Supervised By: 

± 

± 

± 

± 

± 

± 

Error 

19.452 

19.593 

14.401 

8.570 

20.827 

6.293 

14.093 

4.905 

24.685 

12.532 

23.519 

67.986 

27.682 

62.139 

153.250 

373.354 

104.829 

148.790 

35.796 

357.466 

137.605 

1502.569 

2310.210 

1509.408 

V 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 422 

Mode SOIL 

Time 2010-02-12 10:38 

Duration 120.75 

Sequence Final 

'i^^SSt^ _^|yg^oMl8^2r3] 

ADDRESS T2D3 ^ 27 St. 

QUADRANT DZ 

DEPHT 13 

XRF TECH O. BARAJAS 

MISC 1 

NOTE Red folder 

ppm ± Error 

Pb 100.977 ± 17.093 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 97.859 

Supervised By: 

Certificate of Verification 

418 

SOIL 

2010-02-12 10:36 

30.21 

Final 

20906 

1203 S 27 St. 

DZ 

13 

O. BARAJAS 

1 

Red folder 

± Error 

± 16.972 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 110.988 

Supervised By: 

Certificate of Verification 

419 

SOIL 

2010-02-12 10:37 

30.22 

Final 

20906 

1203 S 27 St. 

DZ 

13 

O. BARAJAS 

1 

Red folder 

± Error 

17.557 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 420 

Mode SOIL 

Time 2010-02-12 10:37 

Duration 30.14 

Sequence Final 

Flags 

BVID 20906 

ADDRESS 1203 S 27 St. 

QUADRANT DZ 

DEPHT 13 

XRF TECH O. BARAJAS 

MISC 1 

NOTE Red folder 

ppm ± Error 

Pb 98.393 ± 17.053 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 96.667 

Supervised By: 

Certificate of Verification 

421 

SOIL 

2010-02-12 10:38 

30.18 

Final 

20906 

1203 S 27 St. 

DZ 

13 

O. BARAJAS 

1 

Red folder 

± Error 

± 16.789 
i\jf^\ Omaha Lead Site—Fixed Price EP-R7-07-05 

l^^^^^ f

^^^^5 ^

 Coastal Environmental Group Inc.

 www.coa8talhazmat.com 

M 

^ ^ 

^"iPBO^*"^ COASTA L 

ENfllONNIIITAl c • o u r, IH C 

EXECUTIVE SUMMARY: 

BVID #20906-(1203 S 27 ST) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 
4

/S ^ 

^ EPA 

EPA Property Close Out Form 

Property ff=^0^/)^,, Property Addresr. J^ ^ }fi/'\'' ^ 

Date/Tlroc: OwV.r'.N.me:.A3te^^^^= r 

Quads Excavated: \' \ .fs" ^ Contractor Group ( J^iOAy G^^tLp 

Excavatio Yes No n General 

\. If necessaiy, were the correct quadrant(s) excavated and restored? 

2. If necessaiy, were the correct areas ofdrip zone excavated and restored? ^ ^ 

Gradin Yes No g Sod and Vegetation 

1. Does the grading around the perimeier ofthe house in excavaled areas generally slope away 17 from the house?

 _^ 

2 L x " . Has sod been laid in ail areas that were excavated? 

3. Docs the sod appear to be generally healthy and growing? (Only evaluale if inspected at a 30 I/ " 

day time period) • 1?^ 

4. Are sodded areas generally Hrm and evenly graded? 

S. Are the joints Iwtween the sod strips generally tight? (Only evaluate if inspected at a 30 day \y time period) 

6. Was the property graded such that water will not pool on the propert>'? ^ ' 

7. Was damage to landscaping or plant materials avoided? 77^ 

Gates, Fencea and Retaining Wails 

V« No 

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

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

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

4. Was damage to retaining walls avoided? (Ifapplicable) 1>^ 

Foundation, Sidtng and GuHers 

Yes No 

I. Was damage to the siding or trim avoided? IX" 

2. Was damage to the foundation avoided? ~Z?^ 

3. Was damage to windows avoided? 

 Was damage to windows or door screens avoided? 

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

^ 

Sidewalks nnd Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? 'ZA 

2. Was damage to walkway surfaces avoided? ^ ' 
Ov*'ners comments: 

Inspection notes: 

Removal and resloration aclivales complete including the 30-day sod warranty: 

EPA Represenlalive <J(S^hJL ^ Dale: ]{m/0 ^ 
m 

Property Completion Agreement 

Tins agreement documenis the completion ol remedial acliviiies pcriormed on my property My signature 

will designate thai I am satisfied with the restoralion of my propeity. and thai no items are in questions, 

now, or al any lime in the future, except those ilems iisled below, ifany 

Property ID: 2<D^QU > 

Property Address: \20 ^ S 21'*'>^ S^ ^ 

Owner: ,\r^\r\<\ W\at^^^ \ 

Phone: LjQ^' . 5/ Q Z^^^T ) 

Restoration Items in Question: 

I Item: " 

Item; 

Item: 

Item: 

Item: 

Item: 

Additional Commenls: 

/oCLat^ c icKtarfllion it completed, except as noferi 

[_} I tio not »ifrec resforftfio/ is compleled 

. li/^/<^ £iMi ^ /f/Jo'1 

onti arlor's Signature