TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: ^ 9 'yX^ . Date: /0~/3'6 S 

Address: <^9.l?. FAg^R£MC ^ iMVd . 

Remediation Contractor: Coastal Environmental Group_ Year: _2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

xecutive Summary ^ 

J > ^ 

EPA-provided property sketch ^ 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property ,'<t//W' 

Restoration Agreemei^-Jr 

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

Confirmation data . 

Photographs hri^^{LUA.)/irio<\^ Cji^ieko^^ 8d-^AU.i %'d£ul^\^t^^^ ^ 

\ -er As-built sketch 

Satisfactory restoration signed by Property Owne^^ 

40316443 

Property close-out check list signed by EPA^'"TM"" 

Tw Description ofareas not meeting ROD cleanup criteria Superfund ' 

Utility clearances •VUti/^HT*" 

Property information from Douglas County Assessor's Office 

y y 

y^ ti 

t£^ kUi ^ to<>LrajJr r\ty<rv< 

l^/tf 

Date 

duJ^i^-^l^ZUft^iiX^ 

(p/z^M 
Property Access Checklist 

1 Property ID: ^C^* ^. ^ 3 n WORK STARTED ON: / / 

Property Addrc.s.s: n WORKCOMPELTED ON: / / 

Owner: )<.(^^VK.4^ P)\CK i r Renter: 

Address:^Ly^^^^^^ ^ ^ Phone: 

Fax: 

Cell/Pager 

Phone: ^S^'^l^Q Additional Information: 

. Fax: 

Cell/Pa»cr: fa<0 ' f ^f^ ^ 

¥ Notification Letter Sent: 5^/1/0/ ^ B.v:]AWr)'ok 

I I Access Agreement Signed: / / Bv: 

I I Restoration Agreement Signed: / / By: 

I I Top.soil Sampling (if ap|)licablc) Bv: 

n Disposal Sampling (if applicable) Bv: 

CH Garden Sampling (if applicahle) Bv: 

^ Utility Clearance CA\\iii\:(a_IJ^IC^ ^y-tc ims\i\ \^cL2^^ w Video/Photos (Before) On-.Sl-^J^^ By: [L^ 

n Video/Photos (During) On: Bv: 

^ Video/Photos (After) 0n:0^/^/ ^ Bv 

^ 

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

B Property Coin|)letion Agreement Signed?^6 /oil/C I By: 4 i 

I I Final Report Issued: Bv: 

Air Monitoring (as applicable ) 

j CH Community CH Crov On: / / By: 

Results: [1 

1 CH Community CH Crew On: / / B,v: 

Results: j 

CH Community CH Crew On: / / By: 1 

Results: j 

Omaha Lead Site 
CONTACT FORM 

Property ID U 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

A^1^3 

2%I3 Flnc^r^Hd 

Date: Time: Action: 

Date: Time: Action: 

Date; Time: Action: 

Transmit to EPA D Other Action: D 

ci^rke-S 
Douglas County Account Infhrmation Page 1 of 1 t^jma 

Dougla s County , Nebrask a Propert y Recor d - R174522000 0 

Print Report 

Parcel Dimensions available @ scale 0-50 ft west of 144 St • Vie w Ofl Ma p Information is valid as of 2008-5-19 Treasurer's Tax Report 

New Feature -•-•- > Auto Sales Search 

Owne r 

BLAIR KENNETH 

ETAL 

5405 JAYNES ST 

OIVIAHANE 68104-0000 

Propert y Informatio n 

Key Number: 4522 0000 17 

Account Type: Residential 

Parcel Number: 1745220000 

Parcel Address: 2813 FLORENCE BD 

OIVIAHANE 68110-0000 

Legal Description: MILLARD & CALDWELL'S ADD LOT 39 BLOCK 0 N 50 W 139.5 FT & E 75 W 139.5 

N22.7S 123.25 & E 15 W 64.5 N 21.20 S 123.25 FT 

Valu e Informatio n 

2008 

2007 

2006 

2005 

2004 

2003 

Land 

$600.00 

$600.00 

$600.00 

$600.00 

$600.00 

$600.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$600.00 

$600.00 

$600.00 

$600.00 

$600.00 

$600.00 

Sales Informatio n 

Sales Date: 2002-09-30 

Deed Type: QC Book: 2003 Page: 240750 

Price: $600.00 

Grantor: ROBERT PERRY 

Grantee: KENNETH BLAIR ETAL 

Valid/Invalid: Invalid 

Exclusion Reason: Land Sale 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.19 8395.0 0.0 115.0 73.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl 7... 6/11/2008 
U

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_D_ _Rfflnote_ ID:_ R .l>age of 

TiclceOrigi:i

Wcric ::

State:: 

Addre 3 

Twp: I 

Twp: 

Legal 

Type z-

Locat l 

Remark 

Ccrtipai:"! 

Contac; 

Alt . C 

Worlc ,:! 

Depth 

Involv 

CXCATV 

 CD: 2045131 

 L Cal l Date : 

; Begin Date : 

IE 


2813 


Rng: 13E 


tog: 


Lven: N 


County: DOUGLAS 


Street: FLORENCE BLVD 


Sect-Qtr: 10-SW 


Sect-Qtr: 


Work: LEAD REMEDIATION 


U Of Work: LOCATE ENTIRE PROPERTY 


: COASTAL EKVIRONMENTAL SERVICE 


Kame: ELIZABETH 


titact: MARCOS CR RON BROWN 


l.r.g Done For: THE EPA 


li" Excavation: 4FT Corner Lot: H
 ^ Tunneling or Horizontal Boring : N


MAGELLAN MODOl OMAHACOF 


6/02/08 Time: 1: 36 pnn Op: LJS 

6/04/08 Time: 2:00 pm 

Place: OMAHA 


Phone: (402)991-1199 


 Front: Y Rear: 


 Explosives: N 


0PPDGPR5 QLNNEIC 

As-Built Drawing 

C

ENVIRONMINTA

 OASTAL L Omaha Lead Superfund Site c n o u r . IN C 

29753 

Omah Exterior Paint North Arrow a Lead Site 

Sampllna Addre««: 28i3FLORENCE^BD Site Sketch • Good 

• Poor Phone: H (402)245-1132 ALT: [ ^ Not paint 

Lead Sample Samples Collected 

Concentration Collected LAB 

Firm: A^ w Ui^/lf : 

RYASCPXA-29753 F1 /g / ppm D Date: "''^il - x''ot 

RYBSCPXA-29753 F2 ^g- V ppm ^ Time: Z.y > Pi ^ 

RYCSCPXA-29753 B1 /iq g ppm D Samples Analyzed 

Sample Number 

RYDSCPXA-29753 B2 2Tfl ppm & D 

RD2SCPXA-29753 DZ ppm 33^^ Q' XRF Unit: CS'^ Z Book: \9>t 

nogocnxA-gQ753—ez- ppm n D D Date: ^/OS'/Q- ? 

ppm Lab RYBSCPLA-29753 D Time: n j^t L 

5 Result 249 ppm Staff: Number of Samples = ^ ^^W 

Legend: F l = Front Left, F2 = Front Right, B1 = Back Left, 82 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

Legend 

Concret Drip Zone Excavated Quadrants Excavated 
 e 

Area replaced with Area replaced with 


Area left bare 
 Sod Roclc/Mulch 


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

I 

^ M 

^ 29753 

Sampling Address: 2813 FLORENCE BD

Phone: H:^iBapi6 .1133 ALT: Keky\<dA.

Omaha Lead Site 

 Site Sketch 

 Ijhj r 

Exterior Paint 

• Good 

• Poor 

0^^ Not paint 

North Arrow 

Sample Number 

RYASCPXA-29753 

RYBSCPXA-29753 

RYCSCPXA-29753 

RYDSCPXA-29753 

RDZSCPXA-29753 

ROZGCrXA-20753 

ppm D 

M. ,Lab RYBSCPL^-29753 

Time; 

2 Result 249ppm 

Staff: Number of Samples I ^sw 

Legend: F1 = 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 

ENTERED 

9 ' •

,0 t/j. \ i iUL 2 J Z007: 

" 1 

ZlB : 

62 , 

^ 

^ X^ t 

b~L^S3'^ 

/<f/.... . 

n 7.e,x^ fu xLthice

 9,i\ ID :.. 

Lead Sample Samples Collected LAB Concentration 

Collected Firm: 

Fl J.dL ppm D Date: o -^^; i - r'^o > 

F2 25-y ppm Time: l- p P<^ 

Bl /i^s ppm u D 

Samples Analyzed B2 278 

ppm D 

D ppm D XRF Unit: LS^ Z Book: f ^ Z .^5± 

-GZ-

ppm u D Date: 9/OS'/<b7 

D 

, 

Rev 5 Created inflQ(i l 11 06 15 04(.M1.0I23 

V ?oo7 WW a»i WOT Kw w " aoer K»7 JOOJ ? :.'XPT;(»7»OI ju)'x»»JW'!W'M)'i»'M;3WTj«)jjacJMtrxw'xc'>»»J3OTino-MijT»ar rt»iroo'»i-x«';t»~KC'x*^^ Tn- • 
29753 \ 

Exterior Paint North Arrow ^ Omaha Lead Site 

Sampling Q Good Address: 2813 FLORENCE BD Site Sketch 

Q Poor 

Phone: n: l<oa)^<i 4<oa ALT: _ ^^^ji-o/A /j^ > |2| Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Fimi 

Samples Collected 

/^4w ^rlif : 

RYASCPXA-29753 Fl J S / ppm D Date 

RYBSCPXA-29753 

RYCSCPXA-29753 

RYDSCPXA-29753 

F2 

81 

82 

7^ V

ZTf i

 ppm 

 ppm 

D 

D 

Time 1-ppi^ 

Samptes Analyzed 

RDZSCPXA-29753 DZ 33 9 ppm D XRF Unit: LS^ Z Book ^ ^ 

ROEGCPXA 20753 -GZLab RYBSCPLA-29753 

SResuH 249 ppm 

•" ppm 

ppm 

Number of Samples =

D 

D 

^ 

D 

D 

/ 

Date

Time: 

Staff 

 9/0^/0 7 

M. ^^w 

Legenjl F1 = Front Left, F2 = Front Right. B1 = Back Left, 82 = Back Right DZ = Drip Zone, GZ = Garden. PZ = Play 

A l quadrants are as vievved fcom the streel. facing property 
29753 

Omaha Lead Site 

Sampling Address: 2813 FLORENCE BD Site Sketch 

Phone: ^- (402)24S4132 ALT: 

Sample Number 

RYASCPXA-29753

RYBSCPXA-29753

RYCSCPXA-29753

RYDSCPXA-29753

RDZSCPXA-29753

nOZOCPXA 20753

Lab RYBSCPLA-29753 "

8 Result 249 ppm 

Lead Sample 

Concentration Collected 

 Fl 

 F2 2 ^ ^ 

 B1 /T^ 8

 82 2Tf t

 DZ 3 3 9

 GZ­ "

ppm 

ppm 

 ppm 

 ppm 

 ppm 

 ppm D

 ppm D

Number of Samples = ^ 

LAB 

D 

[21 

D 

D 

D 

D 

D 

J 

Exterior Paint North Arrow 

Q Good 

• Poor 

[2''^Not paint 

Samples Collected 

Firm 

Date 

Time 

Samples Analyzed 

XRF Unit: loS*¥Z Book; l£ ^ 

Date; 9/Q£Ve>7 

Time; M. Staff; ^sW 

Legend; F l = 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 

ENTERED 

f ^ - . . ,1.. . y ... i ^ •TV' JlUL 2 3 2007: 

/7'je zie 

1 h\ 62 M O - • • 

) 

1 

1 

4 

Fa 

D^'^s*? 

/tf/ 

t* 

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, 

Rev 5 Created: 7«/2007 11:06.15 046141.0123 

OT xm jooT 3ap> aoi j«u> WT nor MC'MO'BD' jao'jom KOI x»r jao' V)7 xtrryx' xtr )mT iv r ne ' XLT-jsn ni' ' XET M A HD' lae- TOOI xai x»y j m JODT 3K'xo r xt a TVE'jtar jeo: xai itcTi ,> HJPT 3BP- Xg,' n ' Mt? Wl> »>.• SO ' M) ' JBO* WDJ « P XC7 1 
.^v^tOSM 

COASTA L ENVIRONMENTA L 

CROUP , INC . 

H^K3 

Consent For Acces s 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: 

Owner's Name: ^^»^/\.fcfK 151, \a.\r Daytime Phone: Lit) 9v- 45^'^" ^ 13 ^ 

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) 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 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 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 
*lt D STAf^ m 

COASTA L ENVIRONMENTA L 

GROUP , INC . 

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

piles, dog houses, etc; 

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; 

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 ofthe property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any ofthe 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 (877) 234-6270. 

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

S-zr-^r 

sigirature ' "*" Date^ ' ' ^ Signaturee O^^ <^<<C^ Date 

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

Page 2 of 2 
Mr. Blair, 

My name is Adam Detrich with Coastal Environmental Services. I spoke with 

you briefly over the phone about your property at 2813 Florence Blvd. Our Have been 

scheduled to excavate your property, backfill, and sod it. They would like to begin the 

work around the second week of June, but we need to get your paperwork processed soon 

to make this happen. It doesn't cost anything; the EPA pays for all of it. If you have any 

questions feel free to call. 

Office 402-991-1199 

Cell 402-504-0981 

Thank you, 

Adam Detrich 

Site Coordinator 
COASTA L 

Restoration 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 ID: ^^ ^ S 3 

Property Address: ^<g [ ^ ^loCiy^OL Qiit^cl 

Owner: Y>iy\^<S\ I3|(\ir 

Phone: V^Q-X' i\S'^ ^ M l3 2 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of all known 

utilities, subsurface features, surface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

by referencing the photo-log number with an arrow indicating direction of view. 

Items To Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

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

Item: 

UDVV^ 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Pagei of ^ 

1 
C O A S T A 'L ENV'.ROtMMEI M TA L 

G R A U P , IN C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

MbY\^ 

Item: 

Item: 

Item: 

Item: 

Item: 

item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 2 of ^ 
COASTA L ENVIRONMENTA L 

C R C» U P . INC . 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

klo^^ 

Item: 

Item: 

item: 

Item: 

Item: 

Item: 

Item: 

Item: 

item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Pages Of ^ 
C O A S T A .L 

Landscape Inventory 

(Use additional sheets as necessary) 

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. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Quantity 

6>,fa 

- & . 

-a. 

- ^ 

^ 

Unit 

Square feet 

Condition/Type/Species 

Each 

1 

Each 

Each 

' 

Each 

Square Feet 

Page 4 of. fo 

1 
COASTAt . 

Item Quantity Unit Condition/Type/Species 

Agreed upon value of 

Diant materials not to be 

renlaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

^ $ 0 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant wiil be placed 

by the contractor. 

• a Each 

V 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. 

SF 

Area of City or County 

property to be landscaped 

per their requirements. ^ SF 

Include

area (s) 

a sketch of the 

Easement Area, to be 

excavated SF 

Page 5 of. 
C O A S TAt . • MVlfeOMHCMTAt. c • e u p . INC . 

D 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 [j| I do not agree 

^ 

: C^ e S-'/^-cjr 

/ i^ner's Signature Date Contractor's Signature Date 

Page 6 of ip 
BVID # 2 9 7^ 3 

XRF PROPERTY SAMPLE SHEET 


Date \ D ' \3-^0 ^ Address 'x^\'^ r^iactvi^ aivi 

Project Omaha lead FP 2nd year option Sample time -S^O ^/p m 

XRF ID# li\V-lb n VUeMstei ( sample length 30 sec 

Shot# 

73 ^ 

12}L 

IXL 

IT^lk 

Average

Reading 

'7&1 ­ ^"^-f 

1^3 i AO-3 

\s^-)± :^^ a 

Sample area 

& / 

Depth 

 131 . ^ ^ 0, 0 

Shot # 

Average 

Reading Sample area 

Depth 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot # Reading 

RETEST AREAS 

Sample area Shot# Reading Sample area 

Depth Depth 

Average 

, lab sample # 

l2^1<-5"!bl'Gl 

Lab result 

M'^c m 

Sample area 

M 

XRF Avg. 

\^^X''M 

Average 

Signature_ 

Print 

.^ ^ 

A • b-g/o^^tn 
Report Number: ^I^ A ll/llcllAffiS t A ^^^^ Reported: 

08-168-2314 ^i^UmmmmSmmSl^ y 06/16/08 

Account:

p^li'i fi

Page: 1 of 1 ^^,, ^ ^

 m. T ^ • • 1 m m ® ^1 ^ Laboratories, Inc. ^ , ., , , ^^^^ Received: °f';T ,^ 

 Date Sampled: " 13611 B Street • Omaha, Nebraska 68144-3693 • (402) 334-7770 • FAX (402) 334-9121 • www.midwestlabsuginio/og 

COASTAL ENVIRONMENTAL GROUP LEAD ANALYSIS 

MARCOS MATEUS 

2411 MARTHA ST 

OMAHA NE 68105 

Analysis As Detection Analyst Verifier 

Performed Received Units Limit Method Date Date 

U b number: 1434685 Sample ID: 29753-1B-61208-QC 

Lead (total) 179 mg/kg 5 EPA 6010 rrd/06-i6 bab/oe-ie 

For qiierstions cojai;&ct C^/ O 

Sue Ann Seitz 

Client Service Representative 

sueann@midwestlabs.com (402)829-9892 

The Cfisultfs) issued on this report only.reflect the analyst of tlie 5amp|e(s) submitted. For applicable test paramaters, Midvyest Laboratories is in compliance with NELAC requirements. Our Imports and letters are for'tlie exclusive and confidential use of our clients anamay not be reproduced in whole or in part, nor may any reference be made 

to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization. 
^[<^ Lali@rat®rieSj, Inc;: 

13611 B Street« Omaha, Nebraska 68144-3693 •= (402) 334-7770 ° FAX (402) 334-9121 »www.midwestlabs.com 

ACCOUNTNUMBER CHAIN OF CUSTODY RECORD: Yes No 

PURCHASEORDERNUMBER. 

REPORT&BILLTO IDENTIFICATION COPYTO j 

CoaLs\cx\ tr\Vtrt)AmeWTl>c\ 

ilHll M..-Vk<x i \ 

ZIP ZIP 

PHONE ( ) P^om^^lDCtX-HlW 

Chain-of-Custody will have a signature upon receipt but no subsequent signatures ^^"^ 02/02 

Distribution: Original accompanies shipment; copy to Coordinator Field Files 

•Matrix Code: SO - Soil. WA - Water. SL - Sludge, OT - Other Our report zw Isttsrs sre for the excljsVe end ccnfidsntiet 4!ss c? cy ciisivis tni ni£y rict i-e. reprodi-ced >'•; whole oi i:: peri, .^o{- n'ley E:.)' rererencc be rr.ECt 

'o t.'^ie wck, the rsEjits. or tne co-ripFny li'i an)- so'veriising, risws refajss, or othe.' pfbiic snr.eyncerrssnts withe;."' cbteiniriC CJ? VVX wrjiien ei!thori?.c:tlor. 
Thermo 

SCIENTIFI C 

Thernno Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XLt 14644 

Reading No 126 

Mode SOIL 

Time 2008-06-12 09:51 

Duration 121.49 

Sequence Final 

Flags 

AVERAGE = Avg of 122-125 

LOCATION 

INSPECTOR detrich 

COR 1 

C0R2 

MISC 

NOTE 

ppm Error 

Sb < LOD 71.932 

Sn < LOD 66.830 

Cd < LOD 23.150 

Ag < LOD 12.216 

Rh < LOD 10.499 

Pd < LOD 4.623 

Sr 112.820 ± 9.154 

Rb 53.701 • 6.327 

Pb 137.792 19.995 1 

Au < LOD 16.743 

Pt < LOD 26.868 

As < LOD 24.561 

Re < LOD 60.871 

Zn 117.333 i 28.936 

Os < LOD 53.521 

Cu < LOD 34.661 

Ni < LOD 70.598 

Co < LOD ,249:302 

Fe 15960.432 - " 430^298 

Mn 450.838 ,^' ^ .109.535 

Cr < LOD y 118.353 

Ir < LQD y 59.358 

( 

Sup ervised By: y^ ''^^^ ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XLt 14644 

Reading No 122 

Mode SOIL 

Time 2008-06-12 09:49 

Duration 29.61 

Sequence Final 

Flags 

SAMPLE 29753 2813 florenc^y 

LOCATION bl 

INSPECTOR detrich 

COR 1 

COR 2 

MISC 

NOTE 

ppm Error 

Sb < LOD 72.679 

Sn < LOD 67.239 

Cd < LOD 23.585 

Ag < LOD 12.381 

Rh < LOD 10.954 

Pd < LOD 4.443 

Sr 111.722 i 9.167 

Rb , „• •« . 47.246 ± 6.031 

PE 154.111 21.238 

Au < LOD 17.639 

Pt < LOD 27.435 

As < LOD 25.851 

Re < LOD 62.557 

Zn 110.445 ± 28.634 

Os < LOD 54.834 

Cu < LOD 34.824 

Ni < LOD 74.481 

Co < LOD 252.250 

Fe 16062.364 ± 434.031 

Mn 477.883 ± 111.254 

Cr < LOD 98.878 

Ir 63.410 ± 42.192 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XLt 14644 

Reading No 123 

Mode SOIL 

Time 2008-06-12 09:49 

Duration 30.85 

Sequence Final 

Flags 

SAMPLE 29753 2813 florence 

LOCATION •b l 

INSPECTOR detrich 

COR 1 

COR 2 

MISC 

NOTE 

ppm Error 

Sb < LOD 69.690 

Sn < LOD 64.575 

Cd < LOD 22.082 

Ag < LOD 11.947 

Rh < LOD 9.885 

Pd < LOD 4.612 

Sr 114.900 ± 8.995 

Rb 51.391 ± 6.057 

Pb " ^53.04 4 .Aan^m^j ^ "•" ' 20.315 

Au < LOD 16.004 

Pt < LOD 23.745 

As < LOD 24.291 

Re < LOD 61.429 

Zn 106.969 ± 27.584 

Os < LOD 50.864 

Cu 38.261 ± 23,298 

Ni < LOD 69.058 

Co < LOD 239.967 

Fe 15519.640 ± 413.854 

Mn 392.417 ± 102.158 

Cr < LOD 119.216 

Ir < LOD 51.986 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XLt 14644 

Reading No 124 

Mode SOIL 

Time 2008-06-12 09:50 

Duration 30.22 

Sequence Final 

Flags 

I SAMPLE 29753 2813 florences 

LOCATION % b l 

INSPECTOR detrich 

COR 1 

COR 2 

MISC 

NOTE 

ppm Error 

Sb < LOD 69.882 

Sn < LOD 65.129 

Cd < LOD 22.861 

Ag < LOD 11.720 

Rh < LOD 9.598 

Pd < LOD 4.682 

Sr 98.015 :i 8.502 

Rb 59.571 if 6.517 

Pb ' 128.731 ~"~3 19.103 

Au < LOD 16.421 

Pt < LOD 26.402 

As < LOD 23.945 

Re < LOD 62.696 

Zn 123.558 ± 29.160 

Os < LOD 53.619 

Cu < LOD 31.362 

Ni < LOD 72.563 

Co 279.351 ± 166.492 

Fe 16099.938 ± 425.822 

Mn 518.907 ± 113.677 

Cr < LOD 123.235 

Ir < LOD 56.057 

Superv sed By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XLt 14644 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

SAMPLE 

LOCATION 

INSPECTOR 

COR 1 

COR 2 

MISC 

NOTE 

ppm 

Sb < LOD 

Sn < LOD 

Cd < LOD 

Ag < LOD 

Rh < LOD 

Pd < LOD 

Sr 126.642 

Rb 56.595 

Pb 115.282 

Au < LOD 

Pt < LOD 

As < LOD 

Re < LOD 

Zn 128.358 

Os < LOD 

Cu 37.738 

Ni < LOD 

Co < LOD 

Fe 16159.790 

Mn 414.146 

Cr < LOD 

Ir 68.452 

Supervised By: 

Certificate of Verification 

125 

SOIL 

2008-06-12 09:51 

30.81 

Final 

129753 2813 florencel tbl 

detrich 

Error 

75.477 

70.376 

24.073 

12.815 

11.561 

4.755 

± 9.954 

± 6.703 

± 19.325 

16.907 

29.892 

24.158 

56.802 

± 30.365 

54.765 

± 25.007 

66.289 

257.254 

± 447.487 

± 111.052 

132.081 

± 44.069 
ixJlt^\ Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^V^ f Coastal Environmental Group Inc. 

^^^^<P * www.coastalhazmat.com 

'<t«,ott ^ COASTA L INVmONHINTAL 

e 11 0 u p. IN C 

EXECUTIVE SUMMARY: 

BVID # 29753 - (2813 Florence Blvd.) 

"xl No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 
S i ^ EPA 

EPA Property Close Out Form 

Propert MK-y 

Property Addre«: ^^( ^ HoHnU ; y #: 

Datcn-imc: 1 \ l Owner's Name: l^HI/'lf-fll l>ll>^ll^~ 

Quads Excavated: |^| Contractor Group CoP(',Vn[^ 

Excavatio \/AaArr LoV Yes No n General 

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

y 2.

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

Grading Sod and Vegetation 

Yes No 

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

y 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 time period) 

4. Are sodded areas generally firni 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 Retaining Walls 

Yes No 

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

2. Were all gates or fences taken dovm during restoration activities reinstalled? (ifapplicable) ^ t 

3. Wasdamage to gates or fences avoided? (Ifapplicable) A/J 

4. Wasdamagetoretaining walls avoided? (Ifapplicable) J/ ^ 

Foundation, Siding and Gutters 

Yes No 

I. Was damage to the siding or trim avoided? Mi 

2. Was damage to the foundation avoided? A: 

3. Was damage to windows avoided? JLMI 

4. Was damage to windows or door screens avoided? At 

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

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? A ^ 

2. Was damage to walkway surfaces avoided? 

y ^ 
Owners comments: 

Inspection notes: 

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

EPA '^^V^^^tx^\2X\}i^^7^^^^^J^ Date: 7//C>Aa 
Property Completion Agreement 

This agreement documents the complelion of remedial activities performed on my property. My signature 

will designate that I am satisfied with the restoration of my property, and that no items are in questions, 

now, or at any lime in the future, excepl those ilems listed below, ifany. 

Property ID: g9"7^ 3 

Property Address: ^^<^i3 " f\atV)C( ^ P^\/ J 

Owner: jCtfim k JMgl r 

Phone: Ll^^^Qi:^: i 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: ?; 

Item: 

Item: 

I

I agree restoration is completed, except as noted 

I 

 I I do not agree restoration is completed 

f (Tvviier's Signature Rate Contractor's Signature

atjQ, b-dj'OF; 

 Date