TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: HHl^' ^ Date: l^/(p// 0 

Address: Q^O A MM & .St 

Remediation Contractor: Coastal Environmental Group_

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

y Video of property (DVD) 

y Executive Summary 

y EPA-provided property sketch 

j y Signed Access Agreement for subject property 

y ^ Signed Access Agreement(s) for adjacent property 

^ Restoration Agreement 

 Year: _2010ARRA_ 

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

y Confirmation data 

y Photographs 

^ As-built sketch 

j y Satisfactory restoration signed by Property Owner 

/A Property close-out check list signed by EPA 

# Description ofareas not meeting ROD cleanup criteria 

^ Utility clearances 

j2^ Property information from Douglas Coimty Assessor's Office 

D 

D 

D 

30218074 ilill 

Superfund 
• • 

Property Access Checklist 

Property IP= ' ^ ^ { Q [j 

PropertyAddress: ^q^ ^ f^j ^p ^ S ^ 

D

D

 WORK STARTED

 WORKCOMPELTED

 ON:

 ON:

 . /

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 / 

/ 

o^°«••=c^or^r9yl AJGiJbSnn 

Address: ' 

Phone:/^Q ^ ^5- / ^^7 7 

Fax: 

Cell/Pager: 

Renter: 

Phone: 

Fax: 

Ccll/Pager: 

Additional Information: 

• Notification Letter 

{Sf Access Agreement 

^ Restoration Agreement 

Q Topsoil Sampling (if applicable) 

Q Disposal Sampling (If applicable) 

D Garden Sampling (if applicable) 

[S UtiUty Clearance 

( 3 Video/Photos (Before) 

D Video/Photos (During) 

n Video/Photos (After) 

n Video/Photos (30-Day) 

0 Property Completion Agreement 

D Final Report 

Sent: / / 

Signed:/ 1/J 1/O 

Signed: T / 2^^l f^ 

1 1 

1 1 

1 1 

Called: oe> /03> AO 

On: y lZfl/ 0 

On: / / 

On: / / 

On: / / 

Signed: / / 

Issued: / / 

By: 

By: 

By: AJ l c y 

By: 

By: 

By: 

®y* Ofe/^-1-/(0

By:/y/c£ .

By: 

By: 

By: 

By: 

By:

 U3-i.«Jg 

T 

1 

Air Monitoring (as applicable) 

n Conununity D Crew 

Results: 

On: / / By: 1 

• Community

Results: 

 Q Crew On: / / By: 1 

• Community

Results: 

 [I] Crew On: / / By: 

Omaha Lead Site 
Douglas Coimty Accoimt Infoimatio i^t i n Page 1 of2 

• 

Douglas County, Nebraska Property Record - R1602110000 

Print Report 

NEW Feature - Parcel Dimensions avaiiable @ scaie 0-50 ft west of 52nd St - ViO W O n Ma p Information is valid as of 2009-10-15 Treasurer's Tax Report 

New Feature ••"•- • Auto Sales Search 

Owner 

NEWSOME JOSEPH P 

ETAL 

2902 N 48 ST 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number: 0211 0000 16 

Account Type: Residential 

Parcel Number: 1602110000 

Parcel Address: 

Legal Description: 

2902 N 48 ST 

OMAHA NE 68104-0000 

LAKE JAMES PARK LOT 12 BLOCK D 50 X 140 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$7,200.00 

$7,200.00 

$7,200.00 

$7,200.00 

$7,200.00 

$7,200.00 

Improvement 

$62,000.00 

$62,000.00 

$62,000.00 

$62,000.00 

$33,300.00 

$33,300.00 

Total 

$69,200.00 

$69,200.00 

$69,200.00 

$69,200.00 

$40,500.00 

$40,500.00 

Land Informatio n 

Acres 

0.16 

SF 

7000.0 

Units 

1.0 

Depth 

50.0 

Width 

140.0 

Vacant 

No 

Improvemen t Informatio n 

Buiiding 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 10/23/2009 
Douglas County Account Infoijj^tion Page 2 of2 ijll^ti 

1 1/2StofyUnfm 

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tlMOCLICK TO ENLARGE IMAGE 

Square Footage: 1084.0 Percent Complete: ; 100.0% 

Perimeter 0.0 Quality: ' Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 5.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Slate Bedrooms: 2.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year 

year Built Physical Age Remodeled Remodeled Built 

1923 0% 1923 86 

Detail Type Detail Description Units 

Add On Unfinished Attic W/floor 952.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 1260.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Basement Single 1.0 

Porch End Solid Wall 

108.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 10/23/2009 
Page 1 of 1 

"> 

Create Another Ticket Back to Irth Intemet 

Send Email ][ 

YOUR TICKET NUMBER IS 2510362. 

Original Call Date: 6/03/10 Time: 1:40 pm Op: ELIZABETH18790 


Work to Begin Date: 6/07/10 Time: 2:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2902 Street: N 48TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 07-NE-SE,08-NW-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 0PPDGPR5 QLNNEIC 


Service Area Contact 

Plione 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 CITV OF OMAHA-TRAFFICSEWER RICH/TRAFFIC Alt: 4024445161 


Emerg: 4024445160 


Day: 4067289343 


OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 


Emerg: 8887289343 


Day: 4067289343 

QLNNElC QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://vmw.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 6/3/2010 
A As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

OLS#: 74194 

Date Excavated: 6/9/2010 

Date USEPA Siqned Off: 7/27/2010 

Area Sodden: 830 sq ft

Omaha Lead Site 

Site Sketch 

Samplin g Address : 2902 N 48 ST 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

RYASCPXA-74194 Fl ppm 

RYBSCPXA-74194 F2 ppm D 

RYCSCPXA-74194 B1 Cn05 ppm D 

RYDSCPXA-74194 B2 ppm D 

RDZSCPXA-74194 DZ I I 07 ppm D 

RGZCCPXA 74104 6 2 ppm D D 

riPZOOPXA 74t04 Pg - ppm D D 

,Lab RYASCPU-74194 Number of Samples = [ ^ \j ^ _• Result 154 ppm = = =

 i,. 74194 

Extefior Paint 

• Poor 

[~1 No* paint 

Samples Collected 

Fimn 

Date: 

Time 

XRF Unit: 

Date: 

Time 

Staff: 

//'g'-O X 

/Z.Yi?,/' ^ 

Samples Analyzed 

ChSHO Book; ?7H 

12-11 O R 

r m 

m£to Front Right. B1 Back Left. 8 2 Back Right DZ Drip Zone, GZ = Garden. PZ = Pla: 

AH quadrants are as viewed from the street, fadng property 

OEC d 9 z m 

B2 = 244 PPfi/l la 4" 

7?*T i^Wi¥^tf^P»i*WiP r W3 

V /I/ Va. ^^ 

DZ = 773PPM@13" 

Legend 


Concxete Drip Zone Excavated Quadrants Excavated 


4,^^ 
 Area replaced with [ Area replaced with 


Area left bare 
 S od '• ' Rock/Mulch 


Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 

/ / 7<|^i .^ ^ 

l/n 

I A 

^c 

ii ecsc V ^ Uo\ 

Omaha Lead Site 

Site Sketch 

Exierior Paint 

[Q^ood 

• Poor 

74194 

Sampling Address: 2902 N 48 ST Q Nol paint 

Sample Number Lead 

Concenlralion 

Sample 

Collecled LAB 

Firm 

Samples Collecled 

F-DA rPE^ Arr 

RYASCPXA-74194

RYBSCPXA-74194

 F1 

 F2 l l ^ 

ppm 

ppm y D 

Date 

Time 

//-f-'=>i 

/?.:'/ o j^ ^ 

RYCSCPXA-74194

RYDSCPXA-74194

 Bl 

 B2 

(pOfi 

HQ5 

ppm 

ppm 

D 

D Samples Analyzed 

ROZSCPXA-74194 DZ I IQ I ppm D XRF Unit: CaSHO Book: ?7-i ^ 

noZCCPXA 74104 S2 ppm D D Date: I Z • U • gg > 

nPZCCPXA 74104 P2- ppm D D Time: rr»-v 

.Lab RYASCPLA-74194 

: ResuK 

Number of Samples = | S \ \ 1 Staff: PlSW) 

154 ppm FronI Right, B1 = Back Lefl, B2 = Back Right DZ - Drip Zone, GZ = Garden, PZ = Pla' 

All quadrants are as viewed rrom Itie street, tadng property 
# # 

Sampling Address: 2902 N 48 ST 

Sample Number 

RYASCPXA-74194 Fl 

RYBSCPXA-74194 F2 

RYCSCPXA-74194 Bl 

RYDSCPXA-74194 B2 

RDZSCPXA-74194 DZ 

RGZSCPXA 74104 

RrZOOPXA-74104 Pil 

Lab RYASCPLA-74194

Omah a Lea d Site 

Site Sketc h 

Lead Sample LAB Concentration Collected 

I *? ^ oom y ppm n 

/pO S ppm n 

HO.'J ppm D 

I I 0 1 ppm n 

.ppm D n , ppm D D 

 Number of Samples = [ ^ |~i~ | 

74194 

Exterior Paint 

ip^oo d 

• Poor 

[ J Not paint 

Samples Collected 

Firm: /rp A "T^^ A'T 

Date: //-f-OS 

Time: /?.: fO .g/n 

Samples Analyzed 

XRF Unit: (aSHCt Book: 2ZH _ 

Date: _ \2-l l •O'b 

Time: _ 

Staff: pn^iQ =' Result 154 ppm Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ • Pla< 

All quadrants are as vievwd from tti* street, facing property 
€» 

74194 

Omaha Lead Site Exterior Paint North Arrow 

Site Sketch [H^oo d 

• Poor 

Sampling Ad«lro8«:2902N48ST Q Not paint 

Sample Number Lead Sample Samples Collected 

Concentration Collected LAB 

Firm: rPA "TffjA-T 

RYASCPXA-74104 F l of Date: ff'^-o x 

RYBSCPXA-74194 F2 I I 5 ppm 

D Time: /2.iY0iP/n 

RYCSCPXA-74ie4 B l ^z£2_PPm D Samples Analyzed RYDSCPXA-74104 B2 *i05 ppm D 

RDZSCPXA-74194 DZ I I Q l ppm D XRF Unit: CtiSH O Book: ^"^ H 

nO2CCPXA7<10< 62 " ppm D D Date: 12 - If Of ^ 

nPZOOPKA 74104 Pg "• ppm • D 

Time: Pr n 

,Lab RYASCPU-74194 Staff: _ClSk i Nuinber of Samples « | 5 \ \ J . I 

.3 Result 154 pp m Front Right, B l = Back Left, B2 - Back Rigtit DZ = Drip Zone, GZ = Ganlen, PZ = Pla; 

All quadrants are M vifltNBd framtfw Gtnet, tadno inpefly 

OEC d 9 2008 

0\ .oio.!r. 

^31^ : 

f.\ 

)5H 

^ 

^ 

DZr.\m 

2%t vi/8 

if 

n 

. # 

^(6 

WS 

^ 

(''rejtcd 2)-SqvJA ^ V ^ st^ 
COASTA I IhVltOHMf KIAI PBO' * c I o tl r . IH C 

Consent for Access To Property' 

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: - ^ y .^^ 

Owner's Name: Daytime Phone: ^ ^ ^,,^ ^ —» 

Address of Property 

covered by this 

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) wili be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored tb 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, vtrill contact 

the Grantor iri-person to discuss the work to be perfomned, 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 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 ali 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 
7^ — ** 

COASTA L tNVmOhHtKTl l ^^CP^O ^ C R O U r IMC. 

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; 

< Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

t 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. 

t 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 

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

y/'i y -<<* ^ - • 

Signature Date 

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

Page 2 of 2 
^c > -

COASTA L 

C n O U ** • H € 

RestoratioFi Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions ofthe properly 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: ~~jqi'r>C( 

PropertyAddress: <} J^O ^ / U C| <t "S ^ 

Owner: ^\G<,qo U V YeO^S^nM L 

Phone: MS 7") 

On the attached diagram(s} indicate aiiea(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 

necessaiy. 

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

The removal, storaqe, disposal, arid/or return of these itoms is the Ownerls responsibility. 

Item: 

C A^ ^ ' ' P^ 

'a y['(j h k 3</(rc^(^ 

Kem: .^ 1/ 

Item: 

Item: 

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

Rem: j 

Item: 

Item: 

Page 1of -^ 
ifV-T 'Hv,. 

COASTA L 

C k •< U I 

Kerns to Be Removed By Contractor During Remediation and Replaced 

Item: 

f^)] B/, 13^.0^ 

Item: 

<><=>^ OL O ^ . p ^ 

Kem: 

Kem: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, miW.lf - Quadrants ' 

; 

that will be excavated, that 

is covered wrth gtass. 

Number of trees > 2 inch Each 

trunk diameter P 

Number of trees <= 2 inch Each 

trunk diameter I 

Number of Sprinkler 

Zones, Control Valves, Each Timers

Attach ;

, Heads

i sketcl

, etc

i o

. 

l llie 0

».pr'pklci ijiv'.nii. 

Number of and size of 

each garden/ flower bed Each it>)Ly'f ^ I area. Square Feet 

Atuitli ;i slvt'irli ol rf!:itivc 

<i/i'S nnd loc;iii(iM> 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. S 

usix

vQiii-;ii.'

Vclf

'

 l!-,i

 1

r

0

 l(

 i5;ui

' NHlii

j ihe

. .

 Dmpcrl

c vvil

1 plan

l M

N 

l 

; y uvv ner. 

Easement Area, to be 

excavated ( 

Each Pend'iK^ ^ej^' h 

Page 2 oa 
% 

C O A S T A. L CNVIHOHKfNTt L 

c n o u P . I N c 

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 

j 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 removai 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. 

Q^ Please check this box if you understand the information outlined above. 

A 1^ ^J 

poll _f 

a r c A <=> 

plo.y-ic and lit \)j] 

^ ^A 2 7/^^ K P OTT ^ 

• 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. 

^ I agree 

Drfte / Contractor's Signature Date 

Page 3 of ( 
# # 

BVID# ?V/f y 

XRF PROPERTY SAMPLE SHEET 

Date ^f-t b 

Address .^o: k Ay "^tr w 

Project Omaha Lead ARRA Sample time am/pm 

XRF ID# ^^^:i^ sample length 30 sec 

Shot# Reading Sample area 

Shot# Readini Sample area 

^^r Hes±^ b l y ^ ^ ?^/ ^ 1- I^3L 

H(p(f ^^^^ r Depth ^ns- -^so£jyt Depth 

m^y 2^f: ^ H " M2± 

7^^^ ^ 7 3 ^ 

Average S^-^PzT Average yrhi^'^ 

Shot# Reading Sample area 

Shot# Reading Sample area 

TfTS- 1 ^ ^ ^ /bZ. ITS' 

^^^ ^ )(r d : ^ 

^»^i^^^ )?s-±. /gt Depth 1H ^ in r^^^i^^^;;^ NOt i /9- J-/ / 

Average «P^ ^ ^ ^ ^ Average / "D^L l I 7 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Signature fmtidib 

Print Tablet:'nee ffs 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 468 

Mode SOIL 

Time 2010-07-01 16:10 

Duration 91.91 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm Error 

Pb ZL~;Zh^~} 

Supervised sr.^gmiM 
• • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 465 

Mode SOIL 

Time 2010-07-01 16:08 

Duration 30.67 

Sequence Final 

Flags 

BVID 74194 

ADDRESS 2902 N 48 st 

QUADRANT Bl 

DEPHT 4" 

XRF TECH N. LOPEZ 

MISC confirmation 

NOTE none 

ppm ± Error 

Pb 404.784 28.032 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 377.960 

Supervised By: 

Certificate of Verification 

466 

SOIL 

2010-07-01 16:09 

30.62 

Final 

74194 

2902 N 48 st 

Bl 

4" 

N. LOPEZ 

confirmation 

none 

± Error 

± 27.247 
• • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blilerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 467 

Mode SOIL 

Time 2010-07-01 16:10 

Duration 30.62 

Sequence Final 

Flags 

BVID 74194 

ADDRESS 2902 N 48 st 

QUADRANT B l 

DEPHT 4" 

XRF TECH N. LOPEZ 

MISC confirmation 

NOTE none 

ppm ± Error 

Pb 382.830 ± 27.544 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blilerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 476 

Mode SOIL 

Time 2010-07-01 16:16 

Duration 92.10 

Sequence Final 

Flags 

AVERAGE sAyggSSaaSS^Sii^^-^--^ 

ADDRESS ^90 2 N 48 st 

QUADRANT B2 

DEPHT 4" 

XRF TECH N. LOPEZ 

MISC confirmation 

NOTE none 

Pb 22.200 

Supervised By -.^SMMim. 
• • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 251.709 

Supervised By: 

Certificate of Verification 

473 

SOIL 

2010-07-01 16:15 

30.60 

Final 

74194 

2902 N 48 st 

B2 

4" 

N. LOPEZ 

confirmation 

none 

± Error 

± 22.141 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blilerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 239.485 

Supervised By: 

Certificate of Verification 

474 

SOIL 

2010-07-01 16:15 

30.60 

Final 

74194 

2902 N 48 st 

B2 

4" 

N. LOPEZ 

confirmation 

none 

Error 

22.423 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blilerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 240.604 

Supervised By: 

Certificate of Verification 

475 

SOIL 

2010-07-01 16:16 

30.90 

Final 

74194 

2902 N 48 st 

B2 

4" 

N. LOPEZ 

confirmation 

none 

± Error 

± 22.035 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blilerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 480 

Mode SOIL 

Time 2010-07-01 16:19 

Duration 91.76 

Sequence Final 

Flags 

AVERAGE 

ADDRESS **^2902 N 48 st 

QUADRANT DZ 

DEPHT 13" 

XRF TECH N. LOPEZ 

MISC confirmation 

NOTE none 

ppm ± Error 

Pb 772.819** ^ ' ± 37.976 

Supervised By :_%£aai2a 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 477 

Mode SOIL 

Time 2010-07-01 16:18 

Duration 30.39 

Sequence Final 

Flags 

BVID 74194 

ADDRESS 2902 N 48 st 

QUADRANT DZ 

DEPHT 13" 

XRF TECH N. LOPEZ 

MISC confirmation 

NOTE none 

ppm Error 

Pb 750.775 ± 37.376 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blilerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 780.194 

Supervised By: 

Certificate of Verification 

478 

SOIL 

2010-07-01 16:19 

30.69 

Final 

74194 

2902 N 48 st 

DZ 

13" 

N. LOPEZ 

confirmation 

none 

± Error 

38.204 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Bilierica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 787.488 

Supervised By: 

Certificate of Verification 

479 

SOIL 

2010-07-01 16:19 

30.68 

Final 

74194 

2902 N 48 st 

DZ 

13" 

N. LOPEZ 

confirmation 

none 

Error 

38.348 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blilerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 488 

Mode SOIL 

Time 2010-07-01 16:29 

Duration 91.76 

Sequence Final 

Flags 

AVERAGE ^iii<Avg«bf'«485-48'7*'" 

ADDRESS 2902 N 48 st 

QUADRANT EA 

DEPHT 1" 

XRF TECH N. LOPEZ 

MISC confirmation 

NOTE none 

ppm ± Error 

Pb 133.329 ± 16.595 

Supen^sed B,: ^/ ) ^fjfflZ ) 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 124.903 

Supervised By: 

Certificate of Verification 

485 

SOIL 

2010-07-01 16:27 

30.54 

Final 

74194 

2902 N 48 st 

EA 

1" 

N. LOPEZ 

confirmation 

none 

± Error 

± 16.138 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Biilerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 134.679 

Supervised By: 

Certificate of Verification 

486 

SOIL 

2010-07-01 16:28 

30.66 

Final 

74194 

2902 N 48 st 

EA 

1" 

N. LOPEZ 

confirmation 

none 

± Error 

± 16.667 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blilerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 487 

Mode SOIL 

Time 2010-07-01 16:29 

Duration 30.56 

Sequence Final 

Flags 

BVID 74194 

ADDRESS 2902 N 48 st 

QUADRANT EA 

DEPHT 1" 

XRF TECH N. LOPEZ 

MISC confirmation 

NOTE none 

ppm Error 

Pb 140.406 ± 16.981 

Supervised By: 
^S'^ — ** 

iJOk^i Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

^ www.coastalhazmatcom 

'"tpno*"^ COASTAL 

A l 

G lO U P. I II C 

EXECUTIVE SUMMARY: 

BVID #74194-(2902 N 48 ST) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 7/27/10 
4

# s

EPA Property Close Out Form 

Property #: Property Address:* ^.»-Q C 

Date/Time: Owner's Name;. /fe- o^" ^ 

Quads Excavated: Contraclor Group _ 

Excavation CcBeml 

1. If neccssmy, were the conect quadi3nt(s) excavated and restored? 

2. If necessary, were the correci areas of drip zone excavaled and restored? 

Gradinc Sod and VcmlatloB 

Does the ending around the perimeter ofthe house in excBvaied areas generally slope away 

from tbe house? 

Has sod been laid in all areas that were excavated? 

Does the sod ^>pear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day time period) 

Are sodded areas genetally firm and evenly graded? 

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

time period) 

Was the property graded such that water will not pool on the prnpertV) 

Was damage to landscaping or plant materials avoided? 

Gates. Fences and Rctataio« Walb 

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

2. Were all gates or fences taken down during restoration activities reinsulied? (If applicable) 

3. Was damage to gates or fences avoided? (If applicable) 

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

Foundation, SidiORand Coders 

1. Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? 

3. Was damage to windows avoided? 

 Was damage to windows or door screens avoided? 

5, Was damage to downspouts or downspoul extensions avoided? 

Sidewalks and DrKeways (Concrete) 

I. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

y 

y 

Yes No 

y 

y 

y 

y 

y 

y 

J i 

Yes No 

/ 

y 

y 

/ 

Yes .No 

y 

y 

—1 

/ 

• 

/ ] 

Yes No 

T 
i # 

O^'oers comments: 

I 

[Inspection notes: 

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

EPA Representalive <ft», ^ Date: '^ij^'llyL 
/ # 

Property Completion Agreement 

/his agreemenl documenli the complclion of remedial aclivilies perroimed on my pioperty My signaluie 

will designate Ihal I am satisfied wilh Ihe restoralion of my properly, and lhat no items are in questions, 

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

Property JD: __2^A^6 ^ 

PropertyAddress: ^^ ^ ^ ^^S f 

Owner •^^• ^ J±hcl9rr^ 

Phoiie: Vr/-ff^?-?-

Restoration Items in Question: 

Item: 

A^iP-^r O o ^H-e-T r^iA 6 ^ 0>rh^ ^ A-t>oi/<L^ ^cxycxc, (z..^ 

ttem: A 0 ^ 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

jy i I agree restoralion is compleled, rxccpt as noted 

[ J I (io nol afjrec resloration 'n completed 

O^ci/ s Signatur/ Date' ' Cunti arior's Signnture Dale 
# 1^ 

Property Owner Assessment of Performance Form 

American Recovery and Reinvestment Act (ARRA) 

Omaha Lead Superfimd Site 

2009/2010 

Remediation Contractor; Coastal EnvirOTimental Group - EP-R7-09-06 

Property Identifier Number; '-^l^ ^ 

Property Address; '^ ^ ^ ^ ^ ^ ^ 

Property Owner's Name; "^jp^Mjg^ y[fiji!>9nfr^ 

Instructions to tlie Propertv Owner; 

This form serves to record the Property Owner's assessment of performance (Incentive 1 

- Quality Assurance Surveillance Plan) involving the listed remediation contractor, as applicable 

to the Omaha Lead Site. This foim documents the timeliness of pimch list resolution, business 

relations, complaint resolution and the overall quality of work. If need be, the Property Owner 

may utilize this form to record problems and/or issues not specifically tied to an assigned 

address, for example, business relations that generally don't follow the guidelines set forth in the 

Performance Work Statement. 

The Property Owner will indicate his/her assessment of performance with the contractor's 

work by cliecldng a numerical rating on the table below using the ntmierical definitions from 

the rating scale below, then sign & date the form. •nrrrrD-WTTDTx 

9-10 "excellent" JUL 2 ? 2010 

7-8 'Veiygood" JUL<i<i£Uiu 

5-6 "acceptable" SUPERFUND DIVISION 

3-4 "poor" 

1-2 "very poor" 

Propertv Owner's Assessment of Performance Regarding the Contractor's Work 

10 5 

9 _^^ _ 4 

7 2 

6 1 

Propertv Owner Additional Comments from (optional; continue on back page if needed) 

Property Owner Signature; .^^L-^^^ r A/>-^'-w— ^Date