TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID «:JC0f^ 

Address: W^ k\ H(^ "!< 

Date: i Mi \(? 

Remediation Contractor: Coastal Environmental Group Year; 20i Oft 

SOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

fef 

5/ 

Video of property (DVD) 

Executive Siunmaiy 

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.) 

Confinnation data 

t/ 

d

J 

Photographs i U (^'^AV M 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out dieck list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property information from Douglas County Assessor's Office 

D 

U 

n 

Date ignature 
# • « • 

Property Access Checklist 

Proper, LP: f;^05?i ^ 

Propcnv Address: X l i Q N H* ^ 5 ^ 

D

n

 WORK STAJITED

 WORK COMPELTED

 ON:

 ON:

 /

 /

 /_ 

 /_ 

oxvnci: Y^csV^v ^

Addr.»: 5^V7Vfi> 

 ^>rSYY\3v n Renter 

Phone: 

P«L\: 

Phone: C:^59p^qf ^ 

F«x: 

Cell/Pager 

Cell/Pager: 

Additional IntnrmHtion: 

CD Notification L/Cttcr 

wAcceu Agreement 

QZ' ReslontioD Agreement 

C] Topsoil Sampling (if appllcuble) 

Q DispoiiU Sanapling (if ^applicable) 

Q Gnrdcn Sampling (if applicable) 

B " Utility Clearance 

5 ^ Video/Photos (Before) 

• Video/Photos (During) 

D Video/Pholoi (After) 

D Viileo/Photos (30-Diiy) 

W^ Property Complelion Agreement 

D final Report 

Sent: Bv: 

Signed: "7 I iQ I €f\ By#--l^i Q 

Signed: JZ./iQ (22- By: ^fyan 

By: 

/ / By: 

/ / By: 

Called:7 l" ^ l^ \ 

on-X'^Q-'^ 

On: / / Bv: 

On: By: 

OP : / / 58S : 

By: 

Signed By: 

Issued: / / By: 

yOia 

ZI 

Air Monitorine (-AS jpplicable^ 

D Community Q Crew 

RuuJts: 

On: / / By: 

C! Community'

Resulls: 

D Crew On: / / By: 

O Communiri

ResulU: 

D Crew On: / / By: 

Omaha Lead Site 
• • • • 

CONTACT FORM 

Property ID # 5^f)(-)&0 

Property 

Address: Z-12D tsi M^ JSi 

Initial Contact: Date: Y-^^Time : 2,:|0 

Second Contact: Date: Time: 

Final Contact: Date: Time: 

Final Action: Transmit to EPA D 

Comment: 

Owner P& /W hloMi It n

Comment (s): 

Site 

Coordinator 

Comment (s): 

Action: ' 

Action: 

Other Action: D 

 cMo ^ a^f/e 
• • 

Douglas County Account I g^mM^on Page 1 of2 

Douglas County, Nebraska Property Record - R2416560000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - Vie w OH Ma p Infomiation is valid as of 2009-6-16 Treasurer's Tax Report 

New Feature -•-»- • Auto Sales Search 

Owner 

FORSMAN ROBERT A 

ETAL 

2720 N 48 ST 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number: 1656 0000 24 

Account Type: Residential 

Parcel Number: 2416560000 

Parcel Address: 2720 N 48 ST 

OMAHA NE 68104-0000 

Legal Description: WEARNE PARK LOT 6 BLOCK 1 40 X 106.4 

Value Informatio n 

Land Improvement Total 

2009 $5,400.00 $67,200.00 $72,600.00 

2008 $5,400.00 $67,200.00 $72,600.00 

2007 $5,400.00 $67,200.00 $72,600.00 

2006 $5,400.00 $67,200.00 $72,600.00 

2005 $5,400.00 $27,200.00 $32,600.00 

2004 $5,400.00 $27,200.00 $32,600.00 

Sales Informatio n 

Sales Date: 1993-06-06 

Deed Type: Book: 1957 Page: 168 

Price: $29,500.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.09 4240.0 1.0 106.0 40.0 No 

Improvemen t Informatio n 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R241... 7/7/2009 
• • 

Douglas County Account I i||ft||nM^on Page 2 of2 

Building 1 

1 1/2 Story Fin 2720 N 48 St 

= ?• L 

1; »H5i«i-i IS 

104 i4R 

(t.nrt*»M*fn 91?D9sF: 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1315.0 Percent Complete: ; 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: 1 1/2 Story Fin Condo Square Footage: < 0.0 

HVAC: Forced Air Rooms: 6.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1916 0% 1916 90 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 912.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 242.0 

Porch End Solid Wall 104.0 

Porch Wood Deck 100.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R241... 7/7/2009 
Page 1 of 1 

"> 

[ Create Another Ticket ][ " Back tolrth Internet | [ Send Email | 

YOUR TICKET NUMBER IS 2328271. 


Original Call Date: 7/28/09 Time: 4:03 pm Op: ELIZABETH18790 


Work to Begin Date: 7/30/09 Time: 4:45 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2720 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: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


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


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 Phone Niunber Utility Type 

CXCATV COX COMMUNICATIONS, INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY

Day:

 Alt: 

 4025047823 

EmeiB: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC.SEWER RON

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/28/2009 
As-Built Drawing ^ P 

COASTA L Omaha Lead Superfund Site 

85080 

Omah Exterior Paint North Arrow a Lead Site 

Sit | ~ | Goo d e Sketch 

[3^oo r 

Sannpling Address: 2720 N 4B ST I I Not paint 

Sample Number Lead Sample Samples Collected LJ^ B Concentration Collected Firm: Re TMT . O B T \ 

RYASCPXA-85080 F1 ppm D 

Date: \^2Mc & 

RYBSCPXA-85080 F2 i z t o ppm D Time: i:HSmA 

RYCSCPXA-85080 Bl Hl ^ ppm D Samples Analyzed -RYDOCrXA-05000 B2- ppm 

R DZSCPXA-85080 D2 H*^L, ppm n XRF Unit: jpSH O _ Book: Z-'Z.'-f 

ROgOCrXA-05000 S2- ppm D •

Date: n~'2J[jr- • C G 

RPZOCPXA-OGOeO P2 — ppm D • Time: 

_flcn_ Staff: Number of Samples -• r^c^ 

Legend: F1 = Front Left, F2 = Front Right Bl = Back Left. 82 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Pla> 

At! quadrants are as viewed from ttie street, facing property 

Legen d 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with 

Sod 

Area replaced with 

Rock/Mulch Area lef t bare 

Contract: #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
• * 

85080 

Omah Exterior Paint a Lead Site 

Sit • Good e Sketch 

Q^oo r 

Sampling Address: 2720 N 48 ST • Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB Samples Collected 

Firm: PEINC. Dft T \ 

RYASCPXA-85080 Fl ppm D Dale: \\llb\n^ 

R YBSCPXA-85080 F2 IZ/ O ppm D Time: J.- MS PtK 

RYCSCPXA-85080

-R YDOCrXA-05000

 Bl 

 B?­

ppm 

ppm a 

D 

D Samples Analyzed 

R DZSCPXA-85080 DZ 

R OgOCrXA-05000 S2-

RP'gocr'XA-osooo—Pi 

ppm 

ppm 

ppm 

n 

D 

Numberof Samples =|4 |

n 

D 

D 

 | ^ | 

XRF Unit: Cp5H(l_ Book:

Date: tl'2Jijr-Od 

Time firm 

Staff: rQ56>^ 

 ZZ ^ 

Legend' Fl = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right OZ = Drip Zone, GZ = Garden, PZ = Pla; All quadrants are as viewed from the street, facing property 

-r^- c d­
• • 

^ » 

85080 

Extenor Paint 

Site Sketch 

Omaha Lead Site 

• Good 

Q^oor 

Sampling Address: 2720 N 48 ST Q Not paint 

Sample Lead Sample Samples Collected Number LAB Concentration Collected Firm: P^Twr, Df t T \ 

RYASCPXA-85080 Fl ~l °\"\ ppm n Date: ll/za// ^ 

RYBSCPXA-85080 F2 12-1 0 ppm n Time: ;.'VSi m 

RYCSCPXA-85080 Bl _12^pp m D Samples Analyzed •RYDOCPXA-Q5000 B2- ~ ppm n 

R DZSCPXA-85080 DZ ^5Zc ppm a XRF Unit: (p5H 0 Book: ZZ y 

ROZOCnXA-05080 S3- ~ ppm D D Date: tt-2jj,-^-09 

R r^ZOCPXA-SSOBO P i " ppm D Time: n flm

Staff: Numbe < ^ ^ r of Samples = I 4 | | ^ [ 

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

All quadrants are as viewed from the street, facing property 
85080 

Omah Exterior Paint North Amw a Lead Site 

• Good Site Sketch 

|3^oor 

Sampling Address: 2720_N4BST_ • Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm:

Samples Collected 

feTur, DR T V 

RYASCPXA-85080 F1 ppm ^ D Date: li/yA/rtft 

RYBSCPXA-85080

RYCSCPXA-8S080

-RVDOOPXA-OSOOO

 F2 

 Bl 

 B2-

IZI O ppm 

ppm 

ppm 

\ g^ 

D, 

D 

D 

D 

Time: j-WSffM 

Samples Analyzed 

R DZSCPXA-85080 OZ ppm \3( D XRF Unit: (pSH O Book: ZZ y 

ROZOOPXA-05000 62- ppm U D Date: I l-20 r 0 0 

RPZOOPXA-OSOeO PZ ppm D D Time: flm 

Number of Samples" I L| | j Q [ Staff: rOSf. ^ 

Legend: Fl = Front Left, F2 =Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ =Plat 

All quadrants are as viewad tnm tha street, fadng pnpeity 

«fOV2 laooi 

» * y ?^ T 

Bi :^7<^ <3 

dftNL PfClC 

DZ- HSlk 

M. 

Fl 

1^1 

WALy. 

.N.MB.Sf. Re%':iJi|8 Ciejud: I7-S<pJ» 
9 

COASTA L ENVIRONHENTA L 

C K 0 U P , IN 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: 

ft. Owner' Daytime Phone: s Name: ^O^Hft-j p2>A5^/U>fA; 

II 

Address of Property 11X6 A) '\^^ ^ t covered by this 

I 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 perfonned, 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 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 
f 

- . / IU 

%< COASTA L ENVmOHHENTA L "^'V PROt*-^ CROUP . IH C 

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

piles, dog houses, etc; 

e 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; 

e 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. 

• 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 

\^ \ grant access to my properties G I do not grant access to my properties 

Date ^ Signature 

Date 

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

Page 2 of 2 
c » n s 

Ros^toratCQPi. Agreement 

The purpose ofthis agreement is to 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 satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

Property ED: g^g ^ 

Property Address: ^/ ^ J^ ^ ^ '^J' 

I Q^'''"- ^RE^ T f'^(L<,MAO 

Phone: 

= 

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, materia! types, etc. 

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

necessary. 

ItsifSS to be Removed by the Owner before StarC: of Remediatioiri: 

;.ii.5 .c-riovf.i: g'iotccfc, c-isojtifcl, fc:io/ot ;e(.:i.i c' ttifcf;^ iiin'i& if- ir\^. Uwhsi f ii:£f.c;i{:ii..!i:iy. 

Iteim: A 

'\^^<€^ w ?\As 

t Kem: ^ I 

Item: 

Item: 

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

item: , . ,|| 

Page 1 of 
C J »4 S T M L 

\i<sm& to Be Removed Ei^_Coint irsctor Durirv^ Remediation end Recsisced 

i l£em: 

Item: 

4.^4 

-F\ 

Kem: 

I 

I Item: 

i 

Item 

Pre-existing 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. 

Aliac h r. sketch ol tlic 

Number of and size of 

each garden/ flower bed 

area. 

Alliicli il ski'lcl' 111 rtliilivf 

siZi'f. and li'caiioiis 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

• 'c;.-. ' !'•:• . -,!(' • . i. l-i:. 

.'£•'( ' .( ' ':•' : r .: .l.V.li ' 

' Cli'.' i V •'-, '':' • \: . CH " , 

U .'. f' t l . 

Easement Area, to be 

excavated 

J 

f^ 

^ , 

51 

DZ 

»./^ ) 

V 

1 

1 

1 

Landscape inventory 

Quantity' Unit 

Quadrants 

Condclion/Type/Species 

|'£<i*y ^ 

P 

W 

Each 

Each 

Each 

^ 

Each 

Square Feet 

k $ 

\< > 

Each TW^>a ^ ^'C'=>^6 

Page 2 o, - ^ 
C »- A, S 1 /• L 

Additional Comments / instructionE: 

Q 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. 

S] I agree n I do not agree 

naturee ^ Date / Contractor's Date 

Page 3 of / 

'wner's Signatur - Contractcjf's Signatur Signature e
Date 

Project 

XRFID# 

Shot# 

2.-\»(^ 

'2-nn 

•av?; ^ m 

Average

Shot# 

2-^q ^ ^ ^ 

^^^ \ 

^^'bT . 

Average

Shot# 

jl^r ^ 

j25aa­ x ^ ^ 

^fts \ 

Average

Shot# 

Average 

lab sample # 

-sasjjQa. Omaha lead FP 2nd year option 

^rLrSjOj 

Reading Sample area 

^-l.?flti o 

Mfc.iJQt\ 0 e>l 

H^.i^q t IO Depth 

Z%.'b\ ± J, lp 

 46.36* ^ \f) 

Reading Sample area 

OPiA'^-i *» Irl 

Depth tflO.Cftj^iO 

to-a.-^gx^ 3_ 

 0*0»Dr\ Jc \ n 

Reading Sample area 

F-^­

4\..^1.-^ S Depth 

\a.^Qqi\g ; 

 C£>%."\'?>'^ \V 

Address 

Sample time 

sample length 

Shot# 

^•^OL 

aip^ jiAca. jQfi ^ 

Average

Shot# 

ZSiit3. 

ggtp H 

^f?^g ^ 

'^.^bt^CT) 

Average

Shot# 

Average 

Reading 

RETEST AREAS 

Sample area Shot* 

Depth 

L^b result Sampte area 

Average 

XRF Avg. 

BVID# Sg)D^& 

'in-L O U«48<5.A 

am/pm 

30 sec 

Reading Sample area 

\qg..'L'=^-vn 

2iS^.i/>(/>-tl'8 ep^ 

Depth ^cn^l'\•^\'i 

^\itn"i*\'s 

 "IXH^.V^J : \% 

Reading Sample area 

a.i-\it^-t\ ^ 

y>-?7.-t \7, v^ 

U>Qi^^'i= Depth ^ \ \ 

40.0^1^ . 13­

 ^^.H^J i \1 . 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

XRF PROPERTY SAMPLE SHEET 


Signature CC^f^iJ^tr s 

Print fixr^iro ^ rVlg>0?QA 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2720 

Mode SOIL 

Time 2009-08-05 15:12 

Duration 121.60 

Sequence Final 

Flags 

AVERAGE gAv.q.6f.i2r7.1.6.-2719l 

ADDRESS 2720 N 48 St 

QUAD/ZONE Bl 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE VfPE RETEST 

NOTE 

ppm ± 

Pb ± 

Supervised By :(^to£ 'JlJ^CA 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 57.392 

Supervised By: 

Certificate of Verification 

2716 

SOIL 

2009-08-05 15:10 

30.57 

Final 

85080 

2720 N 48 st 

Bl 

Nicolas 

6 

RETEST 

± Error 

± 10.382 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 46.492 

Supervised By: 

Certificate of Verification 

2717 

SOIL 

2009-08-05 15:11 

30.48 

Final 

85080 

2720 N 48 st 

Bl 

Nicolas 

6 

RETEST 

± Error 

9.691 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 48.994 

Supervised By: 

Certificate of Verification 

2718 

SOIL 

2009-08-05 15:11 

30.15 

Final 

85080 

2720 N 48 st 

Bl 

Nicolas 

6 

RETEST 

± Error 

± 10.125 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 28.531 

Supervised By: 

Certificate of Verification 

2719 

SOIL 

2009-08-05 15:12 

30.40 

Final 

85080 

2720 N 48 st 

Bl 

Nicolas 

6 

RETEST 

± Error 

± 8.218 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2706 

Mode SOIL 

Time 2009-08-05 13:12 

Duration 121.41 

Sequence Final 

Flags 

AVERAGE 

ADDRESS *^^720 N^48 st ' 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb CJO^MI ? ± [MM3 

Supervised By: CJpCGi^Ji ^ H A 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 195.227 

Supervised By: 

Certificate of Verification 

2702 

SOIL 

2009-08-05 13:10 

30.51 

Final 

85080 

2720 N 48 st 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 17.190 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 209.659 

Supervised By: 

Certificate of Verification 

2703 

SOIL 

2009-08-05 13:11 

30.31 

Final 

85080 

2720 N 48 st 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 17.778 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 207.787 

Supervised By: 

Certificate of Verification 

2704 

SOIL 

2009-08-05 13:11 

30.27 

Final 

85080 

2720 N 48 st 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 17.725 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 212.468 

Supervised By: 

Certificate of Verification 

2705 

SOIL 

2009-08-05 13:12 

30.32 

Final 

85080 

2720 N 48 st 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 17.714 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2553 

Mode SOIL 

Time 2009-08-04 09:08 

Duration 121.04 

Sequence Final 

Flags 

AVERAGE rSvq of 2549-2552 

ADDRESS ^2 0 N 48 st 

QUAD/ZONE Fl 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

Error 

Pb ± f 10.228 / 

Supervised By: 

ppm 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2549 

Mode SOIL 

Time 2009-08-04 09:06 

Duration 30.54 

Sequence Final 

Flags 

BVID # 85080 

ADDRESS 2720 N 48 st 

QUAD/ZONE Fl 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 66.910 ± 10.979 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 29.931 

Supervised By: 

Certificate of Verification 

2550 

SOIL 

2009-08-04 09:07 

30.12 

Final 

85080 

2720 N 48 st 

Fl 

Nicolas 

8 

CLEARANCE 

± Error 

± 8.472 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2551 

Mode SOIL 

Time 2009-08-04 09:07 

Duration 30.21 

Sequence Final 

Flags 

BVID # 85080 

ADDRESS 2720 N 48 St 

QUAD/ZONE Fl 

INSPECTOR Nicolas 

DEPTH 8 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 60.053 ± 10.460 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 63.384 

Supervised By: 

Certificate of Verification 

2552 

SOIL 

2009-08-04 09:08 

30.17 

Final 

85080 

2720 N 48 st 

Fl 

Nicolas 

8 

CLEARANCE 

± Error 

± 11.001 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2567 

Mode SOIL 

Time 2009-08-04 10:59 

Duration 121.56 

Sequence Final 

Flags 

AVERAGE "Avg of 2563-256t 

ADDRESS 2720 N48 st 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

Error 

Pb 

Supervised By: QoO/l^ C PD A 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 217.160 

Supervised By: 

Certificate of Verification 

2563 

SOIL 

2009-08-04 10:57 

30.64 

Final 

85080 

2720 N48 st 

DZ 

Nicolas 

13 

CLEARANCE 

± Error 

± 18.476 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2564 

Mode SOIL 

Time 2009-08-04 10:58 

Duration 30.20 

Sequence Final 

Flags 

BVID # 85080 

ADDRESS 2720 N48 st 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 80.219 ± 11.712 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2565 

Mode SOIL 

Time 2009-08-04 10:59 

Duration 30.22 

Sequence Final 

Flags 

BVID # 85080 

ADDRESS 2720 N48 st 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 60.377 ± 10.620 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2566 

Mode SOIL 

Time 2009-08-04 10:59 

Duration 30.50 

Sequence Final 

Flags 

BVID # 85080 

ADDRESS 2720 N48 st 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 40.055 ± 9.044 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2582 

Mode SOIL 

Time 2009-08-04 14:06 

Duration 121.89 

Sequence Final 

Flags 

AVERAGE ^mjfj^78-2S8 1 ] 

ADDRESS ^iON48s t 

QUAD/ZONE F2 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

± Error ppm 

Pb ± 

Supervised By : $?Che'X2S . ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 46.881 

Supervised By: 

Certificate of Verification 

2578 

SOIL 

2009-08-04 14:05 

30.47 

Final 

85080 

2720 N 48 st 

F2 

Nicolas 

6 

CLEARANCE 

± Error 

± 9.771 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2579 

Mode SOIL 

Time 2009-08-04 14:05 

Duration 30.58 

Sequence Final 

Flags 

BVID # 85080 

ADDRESS 2720 N 48 st 

QUAD/ZONE F2 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 60.737 ± 10.738 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 41.323 

Supervised By: 

Certificate of Verification 

2580 

SOIL 

2009-08-04 14:06 

30.55 

Final 

85080 

2720 N 48 st 

F2 

Nicolas 

6 

CLEARANCE 

± Error 

± 9.245 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2581 

Mode SOIL 

Time 2009-08-04 14:06 

Duration 30.29 

Sequence Final 

Flags 

BVID # 85080 

ADDRESS 2720 N 48 st 

QUAD/ZONE F2 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 125.994 ± 14.562 

Supervised By: 
# • • • 

Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

www.coa8talhazmat.com 

COASTAL 

ENVIIONHINTAL c ( 0 u r, IN C 

EXECUTIVE SUMMARY: 

BVID #85080-(2720 N 48 ST) 

No Issues or Concerns Issues/Concerns 

Detail Explanation: 

-COASTAL TO REPLACE THE CLOTHES LINE POLE . (COMPLETED 8/10/09) 
4

% 0% EPA 0 

EPA Property Close Out Form 

Property #: 'R,^K(2 i 

Datc/nme: 

Quad Contractor Group <^Of\5^ \ grtVl'TOOnnCni^ ' s Excavated: f\ , Tv? [<,•?. ^\y t 

Excavation Yes NO Geaenl 

1. if necessary, were the correct quadrant(s) excavated and restored? 

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

Grading Sod and Vegetatioa 

1. Does the grading around the perimeicr 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 sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

^ " day tune period) 

4. Arc sodded areas generally fum and evenly graded? l?^ 

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

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

7. Was damage to landscaping or plant materials avoided? I?" 

Gates, Fences and Retaining Walls ^ 

I. Do gates open and close freely? (If applicable) 

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

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

4. Was damage to retaining walls avoided? (If applicable) 

Foundation, Siding and Gutters Yes No 

I. Was damage to the siding or trim avoided? \y' 

2. Was damage to the foundation avoided? T7 

3. Was damage to windows avoided? 

 Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? iX 

Sidewalks and Driveways (Coocrelc) Vcs No 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? ^ 
« % Ovf'ners comments: 

Inspection notes: 

Removal and restoration activates compleje ijjjicluding the 30-day sod warranty: 

EPA Representative P(y M /Sr,// . Da.e: pjuld j 
Property Completion Agreement 

I'his agieemeni documenis the complelion of remedial aclivmes perl'oimcd nn my properly My signaiure 

will designate lliai I am satisfied with Ihe restoralion of my properly, and ihai no ilems are m questions, 

now, or al any lime m the fuluie, except those items listed below, if any 

Property rp: ^ ^Q^ Q 

Property Address: ^-^2/ j J 1 ^8S f 

Owner: ^g^^^ ^ /^>g^>^ ^ 

Pho..c: 55/ . ^^5 ^ 

Restoration Items in Question: 

Item: 

^cc ci }o /^OMCrt denser /j'n£- A/^ 1 1 kr

Item: f • / 

Item: 

Item: 

Item: 

Item: 

! 

|V] 1 ayrcc I fstorjilion i< complcird, fxccpi »s nnieri 

[ I I rto t>tt^ *(!iec rcKiorjition is romplelcft 

cr's Signiwiii' Signaffiufr Date J onti actor's Signatur fnaluree Dale