TRANSMITTAL of OMAIIA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: Z1^^}\ Date: ^/iB 110 

Address: ^FS/^f C^S?. S^ 

Remediation Contractor: _Coastal Environmental Group_ Year: _2009_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

V

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HI

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 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 

 As-built sketch 

 Satisfactory restoration signed by Property Owner 

 Property close-out check list signed by EPA 

 Description ofareas not meeting ROD cleanup criteria 

 Utility clearances 

 Property information fi-om Douglas County Assessor's Office 

^ ^ ^ 

D 

D " 

Signature ~A~~~~~~ ~~ ..........A. Date 

30217550 

Superifund 
«

^ 

Property Access Checklist 

PropertylD: 23,fS l 1 

Property Address: 2,0^ 1 CA^' ^ f^. 

n

D

 WORK STARTED 

WORK COMPEL IED 

ON:

ON:

 /

 /

 / 

/ 

Address: ' : 

bAMe 

Phone: ^f^^^(^^ Z

Fax: 

(J 

Ipq ^ qq/( ^ 

Renter: 

Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

Cell/Pager: 

n Notification Letter 

Sf Access Agreement 

X Restoration Agreement 

Q Topsoil Sampling (if applicable) 

Q Disposal Sampling (if appUcable) 

n Garden Sampling (if applicable) 

^ Utility Clearance 

Q Video/Photos (Before) 

n Video/Photos (During) 

n Video/Photos (After) 

n Video/Photos (30-Day) 

>Q^ Property Completion Agreement 

n Final Report 

Sent: / / 

Signed: 11 / 5 /O Q 

Siened: ll 1 3 iCf^ 

1 1 

I I 

1 I 

CaUed: JL/U>-/i] 9 

On-.Jll:_SinPt 

On: / / 

On: / / 

On: / / 

Signed: ^/^/fi ^ 

Issued: / / 

By: 

By: 

By: 

By: 

By: 

By: 

By: \ 10 

By^/f/x 

V ^ 

\l 

By: 

By: 

By: 

By: 

By: 

n Community

Results: 

Q Crew On: / / By: 

n Community

Results: 

Q Crew On: / / By: 1 

1 • Community Q

Results: 

Crew On: / / By: 1 

. 

Omaha Lead Site 
*Douglas County Account InforiMjip TVtUtT n Page 1 of3 

Douglas County, Nebraska Property Record - R1304790000 

Print Report 

NEW Feature - Parcel Dimensions available (8) scale 0-50 ft west of 52nd St - VlOW OH Ma p Information is valid as of 2009-10-15 Treasurer's Tax Report 

New Feature •*'*' * Auto Sales Search 

Owner 

CARTWRIGHT CAROLYN M 

3561 CASS ST 

OMAHA NE 68131-0000 

Property Informatio n 

Key Number: 0479 0000 13 

Account Type: Residential 

Parcel Number: 1304790000 

Parcel Address: 3561 CASS ST 

OMAHA NE 68131-0000 

Legal Description: HAWTHORNE ADD LOT 2 BLOCK 5 W 50 FT LTS 1 & 50 X 100 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$5,700.00 

$5,700.00 

$5,700.00 

$5,700.00 

$5,700.00 

$5,700.00 

Improvement 

$92,000.00 

$92,000.00 

$92,000.00 

$92,000.00 

$92,000.00 

$75,400.00 

Total 

$97,700.00 

$97,700.00 

$97,700.00 

$97,700.00 

$97,700.00 

$81,100.00 

Sales Informatio n 

Sales Date: 2004-07-15 

Deed Type: 

Price: 

Grantor: 

WD 

$99,500.00 

Maverick Resources 

Book: 2004 Page: 096738 

Grantee: 

Valld/lnvalld: 

Carolyn M Cartwright 

Valid 

Exclusion Reason: 

Sales Date: 2003-09-04 

Deed Type: 

Price: 

Grantor: 

TRD 

$80,100.00 

CAMILLE HAWK TR 

Book: 2003 Page: 232762 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 10/21/2009 
* Douglas County Account InforrMgipn Page 2 of 3 rrD|gu)r 

Grantee: MAVERICK RESOURCES LLC 

Valid/Invalid: 

Invalid 

Exclusion Reason: Foreclosure 

Sales Date: 1999-08-30 

Deed Type: Book: 2135 Page: \ 124 

Price: $99,500.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Sales Date: 1997-08-26 

Deed Type: Book: \ 2069 Page: 697 

i 

Price: $82,500.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Lan d Informatio n 

>^cres SF Units Depth Width Vacant 

0.11 5000.0 1.0 100.0 50.0 No 

Improvemen t Informatio n 

Building 1 

Two BsiTTt Wot* e n story resosq. 11 

3561 Cass St 

wrr ^ * 

Rrst noor 

w " 828 0«q It " " 7«BC<.!1 ft 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1596.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

http://douglasne.mapping-online.com/DougIasCoNe/static/accountinfo.jsp?accountno=Rl... 10/21/2009 
* Douglas County Account Infort^lip TV^t^t n Page 3 of3 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Frame Aluminum Units: 1.0 

Interior: Drywall Baths: 2.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 2.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1929 0 0% 1929 79 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 1.0 

Basement Bsmnt Block 8 ft 768.0 

Basement Finished 400.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 2.0 

Garage Detached 324.0 

Porch End Screen 144.0 

Porch Slab Roof Ceil 77.0 

Porch Slab Roof Ceil 60.0 

Porch Slab w/Steps 88.0 

Porch Wood Deck 150.0 

User Attic Full Finish 307.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accotmtno=Rl... 10/21/2009 
Page 1 of2 

"> 

Create Another T[cket_. J li_-- Back jp Ijrthjnternet^ |[ SendEnniail i) 

YOUR TICKET NUMBER IS 2401803. 


Original Call Date: 11/06/09 Time: 10:38 am Op: ELIZABETH18790 


Work to Begin Date: 11/10/09 Time: 11:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3561 Street: CASS ST 


Twp: 15N Rng: 13E Sect-Qtr: 16-SW,17-SE 


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 Mtrooi OMAHACOF OPPDGPRS QLNNEIC 


Service Area Contact Plione Number Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

LEVEL3 LEVEL3 COMMUNICATIONS, LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

MUDOl 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=<RESULTS... 11/6/2009 
Page 2 of2 

OPPDGPRS OMAHA PUBLIC POWER DISTRICT NA 

Day:

Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11/6/2009 
OLS#: 23811 9 As-Built Drawing ^ Date Excavated: 11/13/09 

Date USEPA Signed Off: 1/18/10 

COASTA L Omaha Lead Superfund Site Area Sodden: 1298 so ft 

23811 

Omaha Exterior Paint North Arrow Lead Site 

Site • Good Sketch 

• Poor Sampling Address: 3561 CASS ST \ [3^Not paint 

Sannpte Number Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

 Fr:>0i nR / \\-^ 

RYASCPXA-23811 F1 ppm D Date: '7-2\~0 ^ 

RYBSCPXA-23811 

RYCSCPXA-23811 

RYDSCPXA-23811 

F2 

B1 

B2 

22 1 ppm 

ppm 

ppm f D 

D 

D 

Time: ^A S p cn 

Samples Analyzed 

RDZSCPXA-23811 

nOZSCPXA 23811 

nPZSCPXA 23811 

DZ 

-GZ­ 7 8 6 1^/3 ppm 

ppm 

ppm 

D 

D 

D 

n 

XRF Unit: 65H Q Book: 2l 3 

Date: 6 Ml -O S 

Time: Pr.., 

^ Staff: mSU) Number of Samples = |

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

All quadrants ate as viewed frxxn the street, facing property 

Rc\-2l)UK iKUIeil D3-Ma>-(W 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced

Sod 

 with Area replaced with 

Rock/Mulch Area lef t bare 

Contract #: EP-R7-07-05 Coastal Environmental Group Inc, 
;>'U ! I 

2381 

Omali Exterior Paint a Lead Site • Good Site Sicetcli • Poor 

Sampling Address: 3561 CASS ST Q^Not paint 1 

Sampl Lead Sample Samples Collected e Number LAB Concenlration Collected Firm: Ft:>Pi D/;?/\i' b 

RYASCPXA-23811 Fl 22 1 

ppm D Date -l-7.\~09, 

RYBSCPXA-23611 FZ S H U ppm 

D Time '^\Sp m 

RYCSCPXA-23811 81 I ^ 2 ppm D 

Samples Analyzed 

RYDSCPXA-23811 82 7 88 , ppi^ f n

RDZSCPXA-23811 DZ -1AL3_ ppm D XRF Unit: G5H 0 Book: 2A2L. 

RGirCCPXA 23011 -GZ- ppm 

D n Date: 6 "l l -0 6 

RPZSCPXA 33811 -PZ- , ppm D n Time 

Staff Numtjer of Samples ^ msuj 0 

Legend: Fl = Front Left, F2 = Front Right, 81 = Back Left. B2 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Play 

AM quadrants are as viewed from the street, facing property 

)A<iok^ 

^^«^ 7 Af'C' 

RcvJIXlS Civ; 3^1 0 

Z. 
MH-tO :PM»^.) SCXKr^'a 

X)j9dojd Supe) 'jssjis am uioi) pawaiA se aie sjuejpenb nv 

^eid = Zd uapjBO = Z 3 auoz dug = ZQ m^iy >|oea = zg 'ija-) Moeg = [.g 'm6!y JUOJJ = 2 j 'ysT juoj j = i.d :pue69T 

I Q I I ^ I = sejdujes p JsqujnN 

aujj i D D ludd -?d- i i-eeg vxdoszdtj 

~ ~ go -11 - 8 SIBQ D D ludd 

usee vxdOszDiJ 

£i z -^ooa 0fT.S9 *•"" ='^^ D JZi uidd za i i.8C2-vxdOszaa 

uidd T7?r 

pazAjeuv sajdiuBs D zs n-8Cz-vxdOsaAy 

D i^dd I.S uses-yxdOSOAa 

uidd D Zd I- lecz-vxdosaAd 

Ludd n \t z td L i.8ez-vxdOsvAa 

pajoailoQ uO|)ej)u33uoo avT jaqixiofg sidiues papajjoo saiduieg ajduies pean 

lUjBd lON ^ IS SSVO I9S£ :ssejppv 6u||duJBS 

jood n 

poog qoje>|S ej!S • 

luied J0U8p(3 a)!S pea-| eqeui Q 

iT8ez 

# t n^, 
23811 

Omaha Extertor Paint NontiAmiw Lead Site 

Sits D Good Sketch • Poor 

Sampling Addrass: 3561 CASS ST Q^Not paint J 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

 /=&A r><R/ y s 

RYASCPXA-23811 Fl ppm D Date: ">~2\'0f t 

RYBSCPXA-23811 F2 S*ito ppm D Time: 3>.\S p cc\ 

RYCSCPXA-23811

RYDSCPXA-23811

RDZSCPXA-23811

 B1 

 B2 

 DZ 4 ^ 

ppm 

ppm 

ppm 

D 

D 

D 

Samples Analyzed 

XRF Unit: G5H 0 Book: 2l 3 

nOZCCPXA 23011

nPZSCPXA 23011

 62 -

 PSppm ppm 

D 

D 

D 

D 

Date: fiMI-Pg 

Time: P» , 

Numt)er of Samples = | ^ \ \ Q | Staff: rnsu > 

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

All quadrants are as viewad from Ihe stieet facing property 
COASTA l IHtrfRONnlttlAt 

c R o u r. IN C 

Consent for Access To Propsfly 

RIGHT OF ENTRY TO PREMISES 

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

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

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

following described premises: 

Owner's Name: Daytime Phone: 

(]jai\M^ ^ 3f ^ ' ffD l ' 7of f7/<. 

Address of Property 

covered by this A%\ <^3 ^^- 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 

work 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 perfomied, 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 vmtten documentation from EPA that the property 

has been remediated. 

ENVIRONIVIENTAL 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 
_^,««rv,^ 

8 

COASTA l ' • •, / INVtflONHf KTAt 

'-< P,o^t^ C « O U P IH C 

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

piles, dog houses, etc; 

c Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

c 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. 

c 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 

^J^Tgrant 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. 

Page 2 of 2 
c > » S T :^ L 

C n D o r ( N c 

The purpose of this agreement is to provide a mutual agreement as to conditions of the 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). 

PropertylD: "ZA)^ ) 

I Property Address: ^'S^ f A^JlC5 ^ T . 

j Owner; (JAIltOLAh fi^yrL\Q ^ 

\ P*-^"" S^<^-\ ^0^ - r^(l - Vo ^ 9 9 I A, 

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

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

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

necessary. 

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

I fi3 ;c-r:ovc!. gtornce, 6ls>>c;s£l, eno/ot retcf.i or >he£e items is thg Uwnei .«: respcnsltiility. 

i Item: 

^ 

ttem: 7 

Item: 

ttem: 

Items to be Removed by the Contractor During Remediation and Not Replacjed 

Page l of. 
C _» •» S T M L 

C h Cl U ^ i n C 

Items to Be Removed By Contractor During Remediation ancf Repleced 

I ttem: 

\>>0 

ttem: 

f^oD ­

n ttem: 

ttem: 

Item 

F*re-«xisting 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. 

Atiach r. skeicli ui llie 

>rr'.ikloi 1;-Mur. 

Number of and size of 

each garden/ flower bed 

area. 

Aiuicli il skcicli 1)1 rel.TiiM' 

ii?.Ci aiiG lociiliiin^. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

••C.C i'.i\ : i;lll. ' '-.iii h-. 

•js-'C .c i^s'.ic r. y.nn' 

<ciK>:ti 1(1 I'lc r.ir.pt'i ;^ 

UA ntr . 

Easement Area, to be 

excavated 

 ft^ ?r^ VA. 

Quantity 

\ 

\ 

> ^ 

t 

A 

A 

/

/

/ 

M^ 

Landscape Inventory 

Unit 

Quadrants 

Each 

Each 

Condition/Type/Species 

Each 

Each 

Square Feet 

$ 

Each A^l^-^-y 

Page 2 of. 
•C r- ty.S t r L 

(I fl O U P . I »• c 

r Additional Comments / Instructions: 

7 l> ^ lOCXi^^ ^-^r.p>^ ^-u^-r. 

• 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. 

Q I do not agree 

"yt. 9.rVtr(H;hr) ii|&irt'^ 

Contractor's Signature Date 

Page 3 of. 
m 

2.3^'/ 
 BVID# 


XRF PROPERTY SAMPLE SHEET 


36CI Cx<s s-i-­ am/pm 

30 sec 

Reading Sample area 

m t n BJf^ 

luotr d Depth 

n i t z( 1" 

[ p " - 2S) 

Reading Sample area 

<L0P F2_ 

<LOP 

Depth 

<L0!7 R' ' 

^/LOP 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Date 

Project 

XRF ID# 

Shot# 

HHQ 

H H I 

yv5 

Average

Shot# 

^-to 

SS/ 

^9ZAverage 

Shot# 

Average 

Shot# 

Average 

//-tz.' oq 

Omaha Lead ARRA 

• ^ ^ 0 2.2. 

Reading 

lOH i l ^ 

qe t in 

^"^t if^ 

" " " •-P 

Reading 

3^^( 0 

^ / ^ /2. 

5 S ^ 10 

3^ ^ // 

Reading 

Reading 

Sample area 

O ^ 

Depth 

/ 3 " 

Sample area 

"B^ 

Depth 

ir' 

Sample area 

Depth 

Signature, E^Mm 

Phn.gUMV^I).\V\(Vli>tj^fl.^ 

Address 

Sample time 

sample length 

Shot# 

HH2. 

H HZ 

H^'-l 

Average

Shot# 

^^t. 

^igT 

2.^S 

Average 

Shot# 

Average 

RETEST AREAS 

Sample area Shot# 

Depth 

Average 
• • • • 

Thernno 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 445 

Mode SOIL 

Time 2010-02-12 14:35 

Duration 91.03 

Sequence Final 

Flags 

AVERAGE Avg of 442-444 

ADDRESS 3561 Cass St. 

QUADRANT EM 

DEPHT 1 

XRF TECH O. BARAJAS 

MISC 1 

NOTE 1 

ppm ± Error 

Pb 166.533 ± 20.290 

Supervised By : ^Cm^^nob 
• • • • 

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 168.711 

Supervised By: 

Certificate of Verification 

442 

SOIL 

2010-02-12 14:33 

30.56 

Final 

23811 

3561 Cass St. 

EM 

1 

O. BARAJAS 

1 

1 

± Error 

± 18.897 
• • • • 

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 160.286 

Supervised By: 

Certificate of Verification 

443 

SOIL 

2010-02-12 14:34 

30.26 

Final 

23811 

3561 Cass St. 

EM 

1 

O. BARAJAS 

1 

1 

± Error 

± 20.752 
• • • • 

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 170.603 

Supervised By: 

Certificate of Verification 

444 

SOIL 

2010-02-12 14:35 

30.21 

Final 

23811 

3561 Cass St. 

EM 

1 

O. BARAJAS 

1 

1 

± Error 

± 21.222 
• • • • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 99.153 

Supervised By: 

Certificate of Verification 

449 

SOIL 

2010-02-12 14:51 

90.45 

Final 

Avg of 446-448 

3561 Cass St. 

DZ 

13 

O. BARAJAS 

1 

1 

± Error 

± 17.774 
• • • • 

Thermo 

S C I E N T I F I 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 103.688 

Supervised By: 

Certificate of Verification 

446 

SOIL 

2010-02-12 14:50 

30.18 

Final 

23811 

3561 Cass St. 

DZ 

13 

O. BARAJAS 

1 

1 

± Error 

18.117 
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 95.161 

Supervised By: 

Certificate of Verification 

447 

SOIL 

2010-02-12 14:51 

30.11 

Final 

23811 

3561 Cass St. 

DZ 

13 

O. BARAJAS 

1 

1 

± Error 

± 17.331 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 448 

Mode SOIL 

Time 2010-02-12 14:51 

Duration 30.16 

Sequence Final 

Flags 

BVID 23811 

ADDRESS 3561 Cass St. 

QUADRANT DZ 

DEPHT 13 

XRF TECH O. BARAJAS 

MISC 1 

NOTE 1 

ppm ± Error 

Pb 98.608 ± 17.875 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 893 

Mode SOIL 

Time 2009-11-19 12:36 

Duration 91.07 

Sequence Final 

Flags 

AVERAGE Avg of 890-892 

ADDRESS 3561 cass st 

QUADRANT B2 

DEPHT 13" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm Error 

Pb 39.141 11.328 

Supervised By •-^CfLClMIy 
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 37.410 

Supervised By: 

Certificate of Verification 

890 

SOIL 

2009-11-19 12:35 

30.48 

Final 

23811 

3561 cass st 

B2 

13" 

R. VENTRY 

clearence 

ngnc 

± Error 

db 10.711 
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 41.790 

Supervised By: 

Certificate of Verification 

891 

SOIL 

2009-11-19 12:36 

30.20 

Final 

23811 

3561 cass st 

B2 

13" 

R. VENTRY 

clearence 

ngnc 

db Error 

± 12.496 
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 38.221 

Supervised By: 

Certificate of Verification 

892 

SOIL 

2009-11- 19 12:36 

30.39 

Final 

23811 

3561 cass st 

B2 

13" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 10.777 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 889 

Mode SOIL 

Time 2009-11-19 12:34 

Duration 91.98 

Sequence Final 

Flags 

AVERAGE Avg of 886-888 

ADDRESS 3561 cass st 

QUADRANT F2 

DEPHT 13" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppnit Error 

Pb < LCD 12.169 

Supervised By ••^OCL^M ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 886 

Mode SOIL 

Time 2009-11-19 12:33 

Duration 30.87 

Sequence Final 

Flags 

BVID 23811 

ADDRESS 3561 cass st 

QUADRANT F2 

DEPHT 13" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm Error 

Pb < 12.575 LOD 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 887 

Mode SOIL 

Time 2009-11-19 12:34 

Duration 30.55 

Sequence Final 

Flags 

BVID 23811 

ADDRESS 3561 cass st 

QUADRANT F2 

DEPHT 13" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm Error 

Pb < LOD 12.208 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 888 

Mode SOIL 

Time 2009-11-19 12:34 

Duration 30.56 

Sequence Final 

Flags 

BVID 23811 

ADDRESS 3561 cass st 

QUADRANT F2 

DEPHT 13" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm Error 

Pb < LOD 11.725 

Supervised By: 
• • # • 

y^°J!*>. 

i^>SL\ Omaha Lead Site—Fixed Price EP-R7-07-05 

l^^^^ o Coastal Environmental Group Inc. ^"^g^ p 

\^^T ^ wfww.coastalhazmatcom "^^^^ 

^-itPHOi*^ COASTA L 

C 1 0 U p. IN C 

EXECUTIVE SUMMARY: 

BVID #23811-(3561 CASS ST) 

~x| No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
SEPA 

EPA Property Close Out Form 

Property #: ^3/) Property Address: 

Datc/Tlmc: . Owner's Name:. Ab-A^ 

Quads Excavattd: p7 ^ f)2 , \^ f Contractor Group 

Excavatton Gcaenil 

I, If necessaiy, u«re the correct quadrant(s) excavated and restored? 

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

Grading Sod and Vegetation 

I. Does the grading around the perimeter ofthe house in excavated areas generally slope away 

from the house? 

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

3. Does the iod 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. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) ^ 

6, Was the property graded such that water will not pool on the property"! 

7. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Reuining Walls 

1. Oo gates open and close freely? (If applicable) 

2. Were all pte s or fences taken down during restoration activities reinstalled? (If applicable) 

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

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

Foundation, Sidiogand Gutters 

1. 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? 

5. Was damage to downspouts or downspoul extensions avoided? 

Sidewalks and Driveways (Concrete) 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

^-T. 

Yes No 

/ 

A 

Yes No 

y 

y 

y 

y 

y 

y 

y 

Ves No 

y 

/ 

y 

y 

Yes No 

/ 

y 

A 

A 

y 

Yes No 

/ 

y 
Owners coniments: 

Inspection notes: 

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

EPA Representative ^'^ jjfj Date: >l>'l'* 
Property Completion Agreement 

This agreement documents the complclion of remediai adivities perloimed on my properly My signature 

will designate ihal I am satisfied wilh the resloralion ofmy propeily, and Ihal no ilems are in questions, 

now. or al any lime in the future, except Ihose ilems listed below, ifany 

PropertylD: 2<S?)\ \ 

Property Address: ^ ^ \j, \ CyK'SC ^ 

Owner: f ^mlU A CarHjO f iOjf,\-

Phone: 2>^<^^t^ ^ Z ^ ^

IQQ-'^^IU 

Restoration Items in Question: 

Itein: 

Item: 

Item: 

Item: 

Item: 

Item: 

Ktorallon i% completed, except as noleri 

l_l I rio not ii|;rec restoration is completer! 

Conti actor's Signature