TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 1A\\^ D3,e: ^ \^ 

Address: 'l^l ^ iMlAlMl t, ( 

Remediation Contractor: Coastal Environmenta) Group Year: _20]0ARRA 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

1/ Video of property (DVD) 

(/ Executive Summary 

l7 EPA-provided property sketch 

1/ Signed Access Agreement for subject properly 

•^ Signed Access Agreement(s) for adjacent properly 

.1/ Restoration Agreement 

Settlement documents (i.e., for damage or to replace plants, etc.) 

Confirmation data 

7 Photographs ffr ^CA(\jfr((a^ ^ ^QwfiZHo^ ^ ^ 

As-built sketch 

Satisfactory restoration signed by Property Owner 

/ Property close-out check list signed by EPA 

^iy Description ofareas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

A\iSl h 

"Signature ~ Datt 

30237427 

•ii 

Superfund 
Property Access Checklist 

rPropcrtylD: ^^^^..^ D WORK STARTED ON: _/ /_ 

I D.........,.^., i .l.t..^..... [Propcnv Address^ ^^^^ ^^^ ^ .^ D WORK COMPELTED ON: / / 

Owner: CtV> _oi OAWV ^ 

Renter: 

Address: Phone: 

Fax: 

Ccll/Pagei-: 

Phone; HD1..H<<^ . vy^HCL. Additioniil Information: 1 

Fax: 

Ccll/Pager: 

• Notification Letter Sent: Bv: 1 

r^ Access Agreement Signed: VH / .vt / vo ^y­ v.oic 

S-Restoration Agreement Signed: \o /. By: J^Ji- ^ 

! O Topsoil Sampling (if applicable) By: 

Q Disposal Sampling (if applicable) Bv: 

Q Garden Sampling (if applicable) By: 

[^ Utility Clearance Called: m / ^ / \ « B v I **»/» " *' • — -

[^ Video/Photos (Before) On: w / tvL / v> 

D Video/Photos (During) On: / / Bv: 

• Video/Photos (After) On: By; 

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

Q Property Comjiletion Agreement Signed: / / By: 

D FinaJ Report I.iisued: / / By: 

D Community

Results: 

Q Crew On: / / _ E: 

D Community

Results: 

D Crew ] On: / / Bv: 

cn Comrounit>

Results: 

O Crc« On: / / 

Omaha Lead Site 
Douglas County Account In: l^i^ion Page 1 of2 

Douglas County, Nebraska Property Record

Information is valid as of 2010-8-30 

Owner 

CITY OF OMAHA 

C/O PLANNING DEPARTMENT 

1819 FARNAM ST #1111 

OMAHA NE 68183-0000 

Property Informatio n 

­ R0920340000 

New Feature ^ ^ ^

Print Reoort 

View Interactive GIS IMao 

Treasurer's Tax Reoort 

 Subdivision Sales Searcli 

Key Number: 

Account Type: 

Parcel Numlier: 

Parcel Address: 

Legal Description: 

Value Informatio n 

Land 

2010 

2009 

2008 

2007 

2006 

2005 

2034 OOOO 09 

Ex Government 

0920340000 

2219 MIAMI ST 

OMAHA NE 68110-0000 

DENISES ADD LOT 6 BLOCK 1 50 X 122 

$0.00 

$0.00 

$0.00 

$500.00 

$500.00 

$500.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$0.00 

$0.00 

$0.00 

$500.00 

$500.00 

$500.00 

Show All Transactions 

Land Informatio n 

Acres SF 

0.14 6100.0 

Units Deptii Widtii Vacant 

0.0 122.0 50.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R092... 9/3/2010 
Douglas County Account In|^|ution Page 2 of2 l ^ i 

CO cn 

Binney St Binney St Binney Sf 

Locust St 

J L 

Locust St 

_Maple St 

CO 

Corty St 

'Z: 

M Wiami SI 

5 

S3 

f 

MapteSt 

Miami SI 

CD 

I 

I. QiioS l 

^

<S 

 Maple St 

Corby St 

Miami Sl 

Lake St 

z 

Ohio St ~­ ^ 

 tli 

•Zi 

r„ 

OhioSt 

Lake St 

U) 

z 

g 

» 

Lake St 

ErsluneSt St John 

Ame Church 

Willis Ave • Willis Ave 2? 

WIWSAv 

Grant St 

•f i bi ; i 

Map data 62010 Google 

http://douglasne.mapping-onIine.com/DouglasCoNe/static/accountinfo.jsp?accountno=R092... 9/3/2010 
Page 1 of 1 

"> 

Create Another Ticket ] [ Back to Irth Intemet ] Send Email 

• YOUR TICKET NUMBER IS 2627870. 

Original Call Date: 10/27/10 Titne: 2:28 pm Op: ELIZABETH18790 


Work to Begin Date: 10/29/10 Time: 3:00 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2219 Street: MIAMI ST 


Twp: 15N Rng: 13E Sect-Qtr: 09-SE,10-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: LEAD REMEDIATION 


Location of Work: LOCATE ENTIRE PROPERTY, ALL EASEMENTS AND TO THE PEDESTAL 


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


: UNSURE IF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: COASTAL 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF OPPDGPRS 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-TRAFFICSEWER RICH/TRAFFIC Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://vmw.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/27/2010 
'^ As-Built Drawing 

COASTA L • NVIRONMtNTAL e K O U P. IN C 

Omaha Lead Superfund Site 

OLS#: 29117 

Date Excavated: 11/2/2010 

Date USEPA Siqned Off: 12/2/2010 

Area Sodden: 2219 sq ft 29117 

Omaha Exterior Paini Nofth Arrow Owne Lead Site r Name: JAMES DAVIS^ • Good Site Sketch Addiess: ^1 9 MMU ST QPoo r 

Phone: H 

Q Nol paint i

Lead Sample Samples Collected Sample Numtier LAB Concentration Collected Finn: fOPi C(. filA 

RYASCPXA 29117 F1 (i>X.\ ppm D Date: i 

6BI0(^ 

RYBSCPXA-29117 

F2 131 ppm D Time: 17---^ f> ^ 

RYCSCPXA-29117 

81 6)(pO ppm or Samples Analyzed RYDSCPXA-29117 

B2 i^ _ ppm D 

RDZSCPXA-29117— ppm XRF Unit IOO I

 Book: \^<=i 

RGZSCPXA 20117 G2- ppm D D 

D Date: 9-. - l l - D G 

-«- ppm D 

D Time: A m 

SResul

.Lab RYCSCPLA-2911

t 

7 D Staff: //lic J 765 ppm 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 are as viewed from the street, facing property 

Legen d 

Concrete Drip Zone Excava-ted Quadrants Excavated 

Area replaced with Area replaced with p ^ 

Area lef t bare Sod Rock/Mulch ^ ^ 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
n 29117 % 

P&* r 

^^ vo/ sa. Exterior Paint North Arrow 

Owne Omaha Lead Site r Name: JAMES DAVIS • Good Site Sketch Address: 2219 MIAMI ST QPoor 

W: Phone \ : n Q Not paint 

Sample Numt)er Lead 

Concentration 

Sample 

Collected LAB 

Firm 

Samples Collected 

RYASCPXA.29117 F l iaZZL^ ppm Bl D Date: 

RYBSCPXA-29117 F2 UL ppm D Time 

RYCSCPXA-29117

RYDSCPXA-29117

 81 

 B2 

o(^0 

m. ppm 

ppm D Samples Analyzed 

ppm D a XRF Unit loo n Book: \/i, ^ 

RGZSCPXA 20117 G^­ ppm D n Date 9>-.-ll ' /)G> 

. Lab RYCSCPLA-29117 ^ ^ ppm D D Time: ATL 

SResult 765ppm Number of Samples L Staff: T^ijy 

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

All quadrants are as viewed from the street, facing property 
29117 

Omah Exterior Paint North Arrow 

Owne a Lead Site r Name: JAMES DAVIS • Good Site Sketch Address: 2219 MIAMI ST n Poor 

Phone: H; W: Qg Not paint i

Sample Numtier Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

 ft>9\ CC, /^ M 

RYASCPXA-29117 Fl JtZLL ppm dl D Date: 6J3)0(^7 

RYBSCPXA-29117 F2 131 ppm D Time: ]77? ^ p w 

RYCSCPXA-29117

RYDSCPXA-29117

 Bl 

 B2 

LUO 

i^ 

ppm 

ppm D Samples Analyzed 

RDZOCrXA-29117 B ^ ppm D a XRF Unit IOO I Book: \/„Oi 

RGZSCPXA 20117— 

„Lab RYCSCPLA-29117 

ppm 

ppm 

D 

D 

D 

n 

Date:

Time:

 8 ' // " <P^ 

 A m 

^Result 765 ppm Numl)er of Samples = Lj Staff: Z'I^L J 

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

All quadrants are as viewed from the street, facing property 

046141.0123 
29117 

Omah Exterior Paint NorthAnow Owne a Lead Site r Name: JAMES DAVIS • Good Site Sketch Address: 2219 MIAMI ST QPoor 

Phone: ^^; W: Q Not paint i

Sample Numt>er Lead Sample Samples Collected LAB Concentration Collected Fim): fb h CC. fi/A 

RYASCPXA-29117 F1 6>'L\ oom D Date: fll3/0Cg 

RYBSCPXA-29117 F2 /3 / Dom D Time: \?.\ ^ pyvi 

RYCSCPXA-29117 81 CoCO pom 

Samples Analyzed RYDSCPXA-29117 82 i a

RDgQCPXA'29117 B2­ ppm a XRF Unit IOOI Book: \6f l 

ROZSGPXA 20117 62- ppm D D Date: 9. ' l l - />G 

_PPm D D Time: A m „Lab RYCSCPLA-29117 "^ ^ D 8Result 765ppm Staff: /nic J Numl>er of Samples = | Lj 

Legend: Fl = Front Left, F2 = Front Right, Bi = Back Left, 82 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

* .

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C;()iij;c-;ii\ i c /•,(:{.:o.i:i- 'u> !"i(i|)eiiy 

RIGHT OF ENTRY TO PREMISES 

Grsntoi (the pjopert^' ov/nei) conseiil^. to end authoiizes the United States 

Fnviionmental Protection Agency (FPA) oi its suthorized representatives, collectively 

the Granlee, to entei and perform certain enviioniTiental lesponse activities upori the 

following described premises. 

9?iu-^ 

Ov/nei's K'ame: ZZl k ^A C^/VYCvtyj^ Da^'lime Phone: 'V W - Wjl ^k " 

Address of Property 

covered by this ^'^1" ! 7n,ar^', S-^cc-/- Agreement: 

PuRPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soli samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard The area(s) vvill be 

excavated to remove contaminated soil. The removed contaminated soil v/ill 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 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 v/ith 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 leasonable times 

and with prior notice, for the sole purpose of performing the worf-x This access shall 

remain in effect until the work has been satisfactorily completed lhe Grantor also 

agrees to: 

Page 1 of ? 

. 1/ 1 

 >• ( 
C C A. S 'i / 

I. ^ V I * 0 »• •-. h • T i 

C fc C I ' ' . »• 

I Remove olisliuction? incljriing boats, iiaileis, \'(-.hiclGP, jMrys-CHpe iK'Tir, woor' 

piles, doo houses, etc; 

' [Remove flov.'ei bulbs oi piaiils, thai ihe Grantoi oi the Giariini's u-iic-nt niriy wish 

to save; 

Water and meintain leplacernent vegetation, including ferliii?.er RpplicFiion, as 

necessary' subsequent to eri initial Vv'atering period by EPA; 

< Abide by healtii and safety guidance piovided by EPA, 

If the property is rented, assist EPA in obtaining tenant sp|.)io\'8l foi access lo 

the property to perform the work 

•. Allow videotaping and/or photographing of the properly. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tampei with any of the work activities, oi 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 

M l grant access to my properties • I do not grant access to my properties 

Date Signature Date 

• I wouid fike. to bt. nfeseiii ouiirsjj any tsmplinc fhct is? lepuired, 

Pace 2 of 2 
COAST S L fNVl'NONM r NTA L 

c n o V p . IN C 

Restoration Agreement 

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). 

Property ID: ^ ^// 7 

PropertyAddress: ^g^ ^ ^^^ . ^^^ ^ 

Owner: <^A o<F Z7/yyQ^lyh 

Phone: Vv^/-Vpv/ 

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, material 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: 

The removal, storage, disposal, and/or return of these items is the Owner's responsibility. 

Iter ns to be Removed by the Contractor During Remediation and Not Replaced 

item: 

Item: 

Item: 

Item: 

Page 1 of 3 
COASTA L 

ENVIRONM I NTA L 

C P O U P , IN C 

Items to Be Removed By Contractor During Remediation and Replaced 

Item 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, VA;^\ Quadrants that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch Each 

trunk diameter r^ 

Number of trees <= 2 inch Each 

trunk diameter r^ 

Number of Sprinkler 

Zones, Control Valves, Each Timers

Attach a

, Heads

 sketc

, etc

h o

. 

f tiie 

0

sprinkler layoul. 

Number of and size of 

each garden/ flower bed Each 

area. Square Feet 

•XIKKTI U skelch of rehitise Y 

-.izes and iiicaiions. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

^Otc this Miliif "ill be 

'iscri Hi Ivsiie il plant 

MUicluT Id tlu' propirix 

i>\\ lur . 

Easement Area, to be Each 

excavated Uyjl cy^^^ 

Page 2 of _i . 
COAST/ " L 

Additional Comments / Instructions: 

The city of Omaha ordinances may prohibit you from using dirt or gravel areas on your property 

as driveways or vehicle parking areas. The Environmental Protection Agency (EPA) may be 

removing and replacing soil underlying a gravel or dirt area on your property that you may be 

using as a driveway or vehicle parking area. If this is the case, you should understand that this 

removing and replacing of soil does not mean that any illegal driveway or parking area on your 

property is made legal. To the contrary, you may be cited by the city if you use a gravel or dirt area 

as a driveway or parking area, not withstanding any removal or replacement of soil by the EPA. 

If you have any question about legality of a certain driveway or parking area, you may contact 

the city of Omaha's Planning Department at (402) 444-5150. 

' Please check this box If you understand the information outlined above. ^ 

H^hec k 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. 

^ 1 I agree n I do not agree 

7<7'//y-yd/o ^ 7 ^ a^iAS^ 

Owner's Si Contractor's Signature Date 

Page 3 of _3_ 
I

BVID# ZflK ^ 

XRF PROPERTY SAMPLE SHEET 


Date I - Z,0-LO(\ 

Project Omaha Lead ARRA 

XRF ID# 3^^^Z_ 

 Shot # Reading Sample area 

Z-il \80 i LO EA 

•'LIS 

no i n Depth 

z^n 163 t 1^ / " 

Average ni '- l^ 7 

Shot# Reading Sample area 

Z(S 113 i 18 F( 

ZI4 1511 n Depth 

^ ( 5 lis t 11 4-

Average /S" ^ t 18 / 

Shot# Reading Sample area 

ZO"^ M i 11 Rl 

7J0 (85 i H Depth 

Ui m i u r 

Average /1 4 i ZO / 

Address 2^/*=? io((jL.t>A^i S r 

Sample time am/pm 

sample length 30 sec 

Shot # Reading Sample area 

Depth 

Average 

Shot# Reading Sample area 

Depth 

Average 

Shot # Reading Sample area 

Depth 

Average 

Shot # Reading 

RETEST AREAS 

Sample area Shot# Reading Sample area 

Average 

1 /- / Depth 

Average 

Depth 

Signature 

Print 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

220 

SOIL 

2011-01-20 11:26 

90.72 

Final 

Avg of 217-219 

2219 MIAMI ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 
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 180.584 

Supervised By: 

Certificate of Verification 

217 

SOIL 

2011-01-20 11:24 

30.26 

Final 

29117 

2219 MIAMI ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 20.500 
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 170.602 

Supervised By: 

Certificate of Verification 

218 

SOIL 

2011-01-20 11:25 

30.26 

Final 

29117 

2219 MIAMI ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

± 19.572 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 163.295 

Supervised By: 

Certificate of Verification 

219 

SOIL 

2011-01-20 11:26 

30.20 

Final 

29117 

2219 MIAMI ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 19.276 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

216 

SOIL 

2011-01-20 11:23 

92.24 

Final 

Avg of 213-215 

2219 MIAMI ST 

Fl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 143.753 

Supervised By: 

Certificate of Verification 

213 

SOIL 

2011-01-20 11:21 

30.19 

Final 

29117 

2219 MIAMI ST 

Fl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

18.864 
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 157.902 

Supervised By: 

Certificate of Verification 

214 

SOIL 

2011-01-20 11:22 

30.18 

Final 

29117 

2219 MIAMI ST 

Fl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 19.957 
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 175.626 

Supervised By: 

Certificate of Verification 

215 

SOIL 

2011-01-20 11:23 

31.87 

Final 

29117 

2219 MIAMI ST 

Fl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 17.513 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

212 

SOIL 

2011-01-20 11:20 

91.01 

Final 

Avg of 209-211 

2219 MIAMI ST 

Bl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 
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 161.038 

Supervised By: 

Certificate of Verification 

209 

SOIL 

2011-01-20 11:19 

30.57 

Final 

29117 

2219 MIAMI ST 

Bl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 17.703 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 183.039 

Supervised By: 

Certificate of Verification 

210 

SOIL 

2011-01-20 11:20 

30.25 

Final 

29117 

2219 MIAMI ST 

Bl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

± 21.267 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 178.036 

Supervised By: 

Certificate of Verification 

211 

SOIL 

2011-01-20 11:20 

30.19 

Final 

29117 

2219 MIAMI ST 

Bl 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 21.645 
f^^^^J \ Omaha Lead Site—Fixed Price EP-R7-07-05 

S ^^^ ^ I Coastal Environmental Group Inc. 

^T^^^ ^ www.coastalhazmat.com 

^"Lno^" ^ COASTA L EHVItONHEHTAl 

c II 0 u r, IN O 

EXECUTIVE SUMMARY: 

BVID # 29117 - (2219 MIAMI ST) 

No Issues or Concerns Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 12/2/2010 
^ J ^

 j 

EPA Propert}' Close Out Form 

Proprrtj «: 3N\>^^ ^ Property Addrtiy. -^^^i^^—*V'"'T ' ^^ 

Uate/Tlme: . Owner's Nsiuf /:—CiAij--itt_5>»»«J<5a= 

Oiiadu F.xcBvstfd: _ _ ConlrBCtor Group 

Excavation Gtneral .'^»"?.^' ' 

' 1 If nfCfssarj. ^^rc the corrrct quadranKs) excavaled and restored'' 4 J

' 2 If nccessan,', were the correci areas ofdnp ;one excavaled nnd restored 7 I 

Yes Ni l 

1 Does the gnding around the pcrimeier ofthe house in excavairri area? generally ".IUJK i)»va\ 

Gfading Sod and Vrttctatiop 

/ ; from tbe house? 

2 Has sod been leid in all areas that were excavated? 

< Does the sod appear to be generally healthy and growing''(Only evaluaie ir in^prrirdai a ^0 j / " 

day titne period) ^ . • / \ 

4 Are sodded areas generally firm and evenly graded'' ' 

^ Are the joints between the sod strips generally tight'' (Only evaluate ir inspccied ai a .Tn da} / 

time period) _ __ ^ 1 

r " • • . . . . - -- ^ - I / f 

6 Was the propeny graded such that waier uil l nol pool on ihf prnpenv • j 

7 Was damage to landscaping or plant materials avoided'' j / 

Gates. Fence] and ReUinlnc Walls W-^ ^H 

Do gates open and clo.ie freely'' (If applitablc) 

1 / ! " 

r Were all gates oi fences taken down dunng restoralion aiiiviiies reinstalled'' (1) apo/icahlr i i/i-­ ^

 Was damage lo gates or fences avoided'' (Ifapplicable; i/i­ j 4 Was damage to retaining walls avoided? (Ifapplicable)

 j 

f oupdation pdation,, Sidin Sidingg anandd Cutler Cutlerss _ . _ _ _ _ yj / "^f 

I Was damage to the siding or trim avoided'' 

' ? Was damage tn the foundation avoided'' -y\

\ 7 Was damage tc wmdou-s avoided'' 

^ Was damage lo windows or door screens avoided'' P\. '

 Wa.^ damage lo downspouts nr downspout txiensions a^ oidcd' 

•Sjdj-w^lks^nd Driveways (Concrete) > cs ^^ 

I Was damage 10 driveway suHacrs as oided' I / ' 

?. Was damage lo walkwa)- surfaces avoided'' 

1 7 ' 
O^verr romm eniff^F H

|n.«;pf>ctinn note*;: 

Ren)0^•al and resimatiuiirtiilvalf..<^ tcinplcie incliiding iht .M)-day .sod wanaiU) 

l.-PA Kc[5respniaiivt' 0c zH Date: alt("> 
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€> 

Property Completion Agreement 

Ihii aiticctneni diicuinenif Ihe lomplclion ol iciriediiti acliviiies pcilonntdnn my pioperiy My .Mgnaimt 

will designate ihai I ant S8ii.<>fied wilh lhe re.<iioralion of my ptoperty Knd ihut no nrin.^ arc in que.^iions 

now, or al any lime in the fulutr. except ihose uems hsled bdow, ifany 

!!lPI!:!L!!L_2aAi-5_ Property Addreu. .^^ ^ ^^^^ . 

Owner: -Cyfc<^-. «fe. niK^itVtb 

Fhoiic : .,Vf^>U^„^3,Mfc .J 

Restoralion Ilems in Question. 

Hem: 

Hem: 

Item: 

Hem: 

Hem: 

item: 

Additionat Comments: 

L. 

^ n t tl|,>rcc ir<leralion i< complrKd, rtccpl ki nnitit 

[ J I (to nnl turt t rr»ipi'*linn in (ompkici l 

^X V> '70 

Owner's Sicnnime 0«ie Ciinitaiioi't Sign»iiiie Dale