TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SA1D« Dale­ ^ hs 

Address: \^^° \ ^'* H Ijf 

Remediation Conlractor: Coastal En\'ironmenta) Group Year: JOIOARRA 

SOIL REMEDIATION 

PROPERTV FILE FOLDER DOCUMENTS 

l/ Video of property (DVD) 

{/ Executive Summary 

Y EPA-provided property sketch 

y Signed Access Agreement foi subject propeny 

Signed Access Agreement(s) for adjacenl property 

Y Restoralion Agreemcnl 

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

Confinnation data 

Pholographs W V^^^^TVO^^ ^ (r^(^0 ^ ^ ^^-^7 

y As-built sketch 

Satisfactory restoralion signed by Property Owner 

(/ Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

y Utility clearances 

d Propert>Uflfonnation from Douglas County Assessor's Office 

-^AP/// 

Ignature Date' 

30237392 

Superfund 
^v 9 / 

Property Access Checklist 

PropertylD: ^SS9 ^ D WORK STARTED ON: / / 

D WORK COMPELTED ON: / / PropertyAddress: j(Q0< Y /^iki L *2ff ^ 

Owner: ^ 7U7U^JZY Z 

Address: 

Zpf^^y^^Jl-^ 

Phone:^^^/ / q ^ 

Fax: 

Cell/Pager: 

l~l Notification Letter 

ccess Agreement aqv. 54 :estoration Agreement 

•

Q

r~l

[ 3

^ D

n

n

O

D

 TTopsoi . l SampUng (if applicable) 

 Disposal Sampling (if applicable) 

 Garden Sampling (if applicable) 

 Utility Clearance 

Video/Photos (Before) 

 Video/Photos (During) 

 Video/Photos (After) 

 Video/Photos (30-Day) 

 Property Completion Agreement 

 Final Report 

Air Monitoring (as appUcable) 

• Conununity • Crew On:

Results: 

• Community • Crew On:

Results: 

• Community • Crew On:

Results: 

Renter: 

Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

Sent: / / By: 

Signed: ls2l7^lCO By= \j>u*­

Signed:/^/^^ZZ ^

/ / 

/ / 

/ / 

CaUed: W / fe / A O 

Ou:/d>lZf^l / ^ 

On: 

On: 

On: 

Signed:

Issued: 

/ / 

/ / 

/ / 

/ / 

/ / 

/ / 

/ / 

/ / 

By: 

By: 

Omaha Lead Site 

 By:

By: 

By: 

By: 

 y^.^ c 

"yBy: 

By: 

By: 

By: 

By: 

By: 

 \\l\ n

AAi ^ 

 Uo W^A. t 

1 

1 
Douglas Coimty Accoimt In pn 

Page 1 of2 

Douglas County, Nebraska Property Record - R1601330000 

Print Reoort 

View Interactive GiS Mao Information is valid as of 2010-8-30 Treasurer's Tax Reoort 

New Feature ^ -4 ^ Subdivision Sales Search 

Owner 

BRUNKEN S 

ETAL 

2503 N 16 ST #8 

OMAHA NE 68110-0000 

Property Informatio n 

Key Number: 0133 0000 16 

Account Type: Multiple Res 

Parcel Number: 

1601330000 

Parcel Address: 1609 LAKE ST 

OMAHA NE 68110-0000 

Legal Description: LAKE ADD LOT 1 BLOCK 6 W 66.33 FT 52.66 X 66.33 

Value Informatio n 

Land improvement Totai 

2010 $400.00 $0.00 $400.00 

2009 $400.00 $0.00 $400.00 

2008 $400.00 $0.00 $400.00 

2007 $400.00 $0.00 $400.00 

2006 $400.00 $0.00 $400.00 

2005 $400.00 $0.00 $400.00 

Show All Transactions 

Land Informatio n 

Acres SF 

Units Depth Width Vacant 

0.07 3432.0 0.0 52.0 66.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R160... 9/3/2010 
Page 1 of 1 

.Create Another Ticket 1 „;.;.,;BackitO;lrtbJntemet . 1 .Send^jnaH^] 

• YOUR TICKET NUMBER IS 2637693. 

Original Call Date: 11/08/10 Time: 5:45 pm Op: ELIZABETH18790 


Work to Begin Date: 11/10/10 Time: 6:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1609 Street: LAKE ST 


Twp: 15N Rng: 13E Sect-Qtr: 10-SE-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-TRAFFlC,SEWER RICH/TRAFFIC Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK ELM LOCATING Ah: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11/8/2010 
«i As-Built Drawing ^ 

C OASTA L maha Lead Superfund Site 

OLS#: 28S78 

Date Excavated: 11/11/2010 

Date USEPA Sianed Off: 

Area Sodden: 510 sa ft 

Omaha Lead Site Owner Name: S BRUNKEN TURNER 

Site Sketch Address: 1609 LAKE ST

Phone: H^ 

Sample Numt>er 

RYASCPXA-28578

RYBSCPXA-28578

RYCSCPXA-28578

RYDSCPXA-28578

RDZSCPXA-28578

RGZSCPXA 28578

RPZOCPXA 28S7B

:EN 

/ilic 

Omaha I.ead Site 

Concre'te 

 F1 

 F2 

 Bl 

 82 

 DZ 

 t3Z 

 PZ 

^ED 

?004 

Are a replace d wit h 

Sod 

Contract #: EP-R7-07-05


 _ 

W: 

Lead Sample LAB Concentration Collected 

ppm D 

s 

ppm D 

ppm UK D 

ppm \ 3 ^ D 

ppm D D 

ppm D D 

.ppm D D 

Numtjer of Samples = | 7^ 

55. 

^ \ . 

/yo'^cA 

10-4 

<y 

I. /.t^c; .-ST. 

Legend 

Drip Zone Excavated 


Area replaced with 


Rock/Mulch 


m 

28578 

Exterior Paint North Arrow 

• Good 

• Poor 

• Not paint 

Samples Collected 

Fim.:f-OA. OK\|^r V 

Date: C^^jC^ S 

Time: i lO-m 

Samples Analyzed 

XRF Unit: '?^ 1 \ _ Book: b D 

82 = 44 PPM @ 4" 

iW 

EA=131 PPM@1" 461.W 

Quadrants Excavated 


Area left bare 


 Coastal Environmental Group Inc. 

28578 

Omaha Lead Site 46130 
28578 

Omaiia Lead Site Owner Name:S BRUNKEN TURNER 

Site SIcetcli Address: 1609 LAKE ST 

Phone: H: W: 

Sample Nunnber Lead 

Concentratio antra n l 

Sample 

Collected LAB 

RYASCPXA-28578

RYBSCPXA-28578

RYCSCPXA-28578

RYDSCPXA-28578

 Fl 

 F2 

 Bl 

 82 

myi5Y 

ppm 

ppm 

ppm 

ppm 

D 

D 

D 

D 

RDZSCPXA-28578 DZ ppm D D 

RGZSCPXA 28578 t3Z ppm D D 

RPZ3CPXA-28§?8 PZ ppm n D 

Number of Samples = { / \ 

Exterior Paint Nortti Arrow 

• Good 

• Poor 

Q Not paint 

Samples Collected 

Fimi: ^O K 0 K\ ^Z ^ 

Date: Cy&[C3\ M 

Time: 1^'^ ^ ' 

Samples Analyzed 

XRF Unit: f{ I \ Book: b D 

Date:___iSjp4 

Time: f^t^^ 

Staff: 0 ^ 

Omaha Lead Site 46130 
28578 

Omaha Lead Site Exterior Paint Noftti Arrow Owner Name: S BRUNKEN TURNER 

Site SIcetcli • Good Address: 1609 LAKE ST • Poor Phone: H: W: 

Q Not paint 

Sample Numt>er Lead Sample Samples Collected LAB Concentration Collected Firm: "CV}^ (>VZ^\( y S 

RYASCPXA-28578 Fl D Date: 

RYBSCPXA-28578 F2 n Time:Ijn2E_: 

RYCSCPXA-28578 Bl n Samples Analyzed RYDSCPXA-28578 B2 D 

RDZSCPXA-28578 DZ U n XRF Unit: iK \ \ Book: 'V o 

RG7SCPXA 28578 XSL D n Date: ^ A - Q ^ 

fyZOCPXA 20078 PZ D n Time: ^T ^ 

Staff: Number of Samples = jd t ± 

iEN' ^ED 

^irc ": ^OIK 

55. U"io 

C^l ; 

.^ \ 

/fr»V He. 

'%% 

10-4 

\ 

\ \t 

^ :?fOmaha Lead Site 46130 
COASlA l IHVItONHIKlJLl 

c a 0 u r I h c 

CoiTsanl for Aoc&ss To Property 

RIGHT OF ENTRY TO PREMISES 

Gfantot (the property owner) consents to antd authorizes the United States 

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

the Grantee, to enter and perform certain environmental response activities 

following described premises: 

Daytime Phone: 

y^^-3Vzy-yy?^ 

Address of Property 

covered by this {CO'i Lc^& / V 

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 heaith 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 K 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 
..-^•^^'""e . 

COASlA l 

y IKVIHOhKfKTA l 

C ft O I) ' IK C 

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 foi 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 

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

/ ^ -P^f- Date ^ ^/(Signature Date 

Q i would like tc be present during any sampling thst is required. 

Page 2 of 2 
COA S T A L • N VI n O H n I N T A L o a o u p . IN C 

Restoration Agreement 

The purpose ofthis 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: 2 - g' 5 " J ^ 

PropertyAddress: // • A\ La.j^<^ s f 

7^ Owner: 7 < ^ 

Phone: ^ H r /I <f 1 ~ 

On the attached diagram(s) indicate aFea(s) to excavate, surface stmctures and landscaping features and 

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

Photographically and Videographically docimient 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 retum of these Items Is the Owner's responsibility. 

Item: 

AfG Tfe^ 

Item: 

Kem: 

ttem: 

Items t< 3 be Removed by the Contractor During Remediation and Not Replaced 

ttem: 

A y ^ 

ttem: 

ttem: 

Item: 

Page l o f ^ 
COA S

O • O U P ,

 T A L 

 IN C 

Items to Be Removed By Contractor During Remediation and Replaced 

1 ttem: 

y o ; j 

ttem: 

5 0 h 

ttem: 

Item: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, Quadrants that will be excavated, that { ? ^ 

is covered with grass. 

Number of trees > 2 inch Each 

trunk diameter 

Number of trees <= 2 inch Each 

trunk diameter 

Ntmiber of Sprinkler 

Zones, Control Valves, Each Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Niunber of and size of 

each garden/ flower bed Each 

area. Square Feet 

Attach a sketch of relative 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Easement Area, to be 

excavated /"P ai^y 

Each 

i/hofnq /ye-^ c// r J 

Page 2 of 3 
A' 

COASTA L 

a It o l i p , INC . 

Addttional Comments / Instructions: 

The city of Omaha ordinances may prohibtt 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 wtthstanding 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. 

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

J 

G 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. 

Qj^re e O I do not agree 

jY. 7S.^>.^^ ^ 7Z^ - ^ f ­ Owner's Signature Date Contractor's Signature Date 

Page 3 of. 
BV!D# Z85^ 8 

XRF PROPERTY SAMPLE SHEET 

Date 1-13 - Z^Oll 

Project Omaha Lead ARRA 

XRF ID# 3^c?il2_ 

Shot# Reading Sample area 

4 S /56 t / ^ £ A 

46 iz(, t n Depth 

4 ^ III t 16 / " 

Average /3I t tq­ Y 

Shot# Reading Sample area 

5 4 ^ i ID 6^ . 

6 34 i °i Depth 

> 

Average 

SZ i

44 

 \[ 

10 

^ " 7 

Shot# Reading Sample area 

Depth 

Average 

Address 

Sample time 

sample length 

Shot# 

Average 

Shot# 

Average 

Shot# 

AvBTage 

RETEST AREAS 

Shot# Reading Sample area Shot# 

^^^-^ y 7 y 

Depth 

Average Average 

Signature 

Print f(K(y MiftT^^ 

/6o 9 Z^iA'/^ f^T 

am/pm 

30 sec 

Reading Sample area 

Depth • 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 
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 

ppm 

Pb 131.447 

Supervised By: 

Certificate of Verification 

48 

SOIL 

2011-01-13 13:51 

90.88 

Final 

Avg of 45-47 

1609 LAKE ST 

EA 

1" 

C.PADILU 

CONFIRMATION 

CLEAR 

Error 

17.460 
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 156.011 

Supervised By: 

Certificate of Verification 

45 

SOIL 

2011-01-13 13:50 

30.48 

Final 

28578 

1609 LAKE ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 17.663 
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 126.635 

Supervised By: 

Certificate of Verification 

46 

SOIL 

2011-01-13 13:51 

30.20 

Final 

28578 

1609 LAKE ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 17.768 
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 111.695 

Supervised By: 

Certificate of Verification 

47 

SOIL 

2011-01-13 13:51 

30.20 

Final 

28578 

1609 LAKE ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 16.947 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 8 

Mode SOIL 

Time 2011-01-13 19:36 

Duration 92.60 

Sequence Final 

Flags 

AVERAGE Avg of 5-7 

ADDRESS 1609 LAKE ST 

QUADRANT B2 

DEPHT 4" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo < LOD ; 7.584 

Zr 429.496 ± 14.605 

Sr 141.421 ± 7.834 

U < LOD : 13.526 

Rb 63.319 ± 6.042 

Th 12.933 ± 6.753 

Pb 44.973 ± 10.521 

Se < LOD 4.774 

As < LOD 14.455 

Hg < LOD 10.954 

Zn 86.438 ± 16.100 

w < LOD 75.682 • 

Cu < LOD \ ^ . ^^8.98 5 

Ni < LOD / 68.927 7\ Co < LOD .y ; A/ 164.679 

Fe 16161.419 X ± / 348.236 

Mn 596.916^ 103.757 

yyy^^A^. 7

y^ Supervised By: V ^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 5 

Mode SOIL 

Time 2011-01-13 19:34 

Duration 30.52 

Sequence Final 

Flags 

BVID 28578 

ADDRESS 1609 LAKE ST 

QUADRANT B2 

DEPHT 4" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR — • • — 

ppm ± Error 

Mo < LOD 7.446 

Zr 412.287 ± 14.387 

Sr 135.722 ± 7.715 

U < LOD 12.680 

Rb 63.046 ± 5.956 

Th 14.976 ± 6.985 

Pb 47.788 ± 10.801 

Se < LOD 4.830 

As < LOD 14.615 

Hg < LOD 11.152 

Zn 89.368 ± 16.268 

w < LOD 71.937 

Cu < LOD 29.370 

Ni < LOD 67.062 

Co < LOD 166.359 

Fe 15971.008 i 347.412 

Mn 668.722 ± 108.663 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 6 

Mode SOIL 

Time 2011-01-13 19:36 

Duration 31.21 

Sequence Final 

Flags 

BVID 28578 

ADDRESS 1609 LAKE ST 

QUADRANT B2 

DEPHT 4" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm Error 

Mo < LOD 7.636 

Zr 421.148 ± 14.364 

Sr 137.347 ± 7.666 

U < LOD 13.819 

Rb 61.144 ± 5.966 

Th 11.714 ± 6.476 

Pb 34.809 ± 9.700 

Se < LOD 5.025 

As 14.361 ± 9.092 

Hg < LOD 10.709 

Zn 84.436 ± 15.992 

w < LOD 80.323 

Cu < LOD 29.096 

Ni < LOD 68.870 

Co < LOD 159.726 

Fe 15867.708 ± 342.463 

Mn 495.894 ± 96.610 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

7 

SOIL 

2011-01-13 19:36 

30.87 

Final 

28578 

1609 LAKE ST 

B2 

4" 

C.PADILLA 

CONFIRMATION 

CLEAR 

Error 

7.670 

± 15.065 

± 8.122 

14.079 

± 6.202 

± 6.798 

± 11.061 

4.466 

15.111 

11.002 

± 16.039 

74.787 

28.490 

70.850 

167.952 

± 354.832 

± 105.999 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

Mo 

Zr 

Sr 

U 

Rb 

Th 

Pb 

Se 

As 

Hg 

Zn 

w 

Cu 

Ni 

Co 

Fe 

Mn 

ppm 

< LOD 

455.052 

151.194 

< LOD 

65.768 

12.109 

52.322 

< LOD 

< LOD 

< LOD 

85.509 

< LOD 

< LOD 

< LOD 

< LOD 

16645.541 

626.131 

Supervised By: 
.*^'^'-«. 

/ ^ Q ^^ Omaha Lead Site—Fixed Price EP-R7-07-05 

3 ^^^^ / I Coastal Environmental Group Inc. 

S^y^y^ www.coastalhaimat.com 

^4, y ^ ''"iP^a^ COASTA L EHVIIONHEHTAL 

C 1 0 U r, IN C 

EXECUTIVE SUMMARY: 

BVID #28578-(1609 LAKE ST) 

No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 
EPA Property Close Out Form 

Property #: i^^.7 ^ Property Addr«,: ^^fl-^^^-S^ " 

Daten-iine: ">f> ^ 1 Owner's Name:. fe(^ T7<yy*'^rSy^= 

Quads Excavated: Contraclor Group. 

- ^ 

Excavation Yes No General 

1. If necessaiy, were the correct quadtant(s) excavated and restored? / 

2. If necessary, were the con«ct areas ofdrip zone excavaled and restored? y 

Yes No 

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

Grading Sod and VegelatioB 

/ from the house? 

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

f 

/ 

3. Does the sod appear to be genetBlly healthy and growing? (Only evaluate if inspected at a 30 

day time period) 

4. Are sodded areas generally nrm and evenly graded? 

5, Ar

tim

e

e

 th

 period

e joint

) 

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

7

6. Was the propeny graded such that water will not pool on the property? 7 

r 

7. Was damtge to landscaping or plant ntaterials avoided? 7 

Gates, Fences and Reuining Walls 

Yes No 

I. Do gates open and close freely? (If applicable) 7 

2. Were all gates or fences taken down during restoration activities reinstalled? (if applicable) T 

3. Was damage to gates or fences avoided? (If applicable) 7" 

4. Was danuge to retaining walls avoided? (Ifapplicable) 7 

Foundation, SidioKand Gutters Ves No 

1. Was damage to the siding or trim avoided? ; 

2. Was damage to the foundation avoided? 

?. Was damage to windows avoided? 

A Was damage to windows or door screens avoided? 

5. Was damage to downspouts at downspoui extensions avoided? 

; 

J 

J 

J 

Sidewalks and Driveways (Concrete) 

1. Was damage to driveway surfaces avoided? 

Yes,

7 No 

2. Was damage to walkway surfaces avoided? y 
Ort'oers comments: 

In.spection notes: 

""> ' "^^'^" 

^ 

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

EPA Representative fiyi ja«^ Date: Sisl.'i­
Property Completion Agreement 

This agreement documents the completion ol remedial acliviiies perlbimed on my property My signature 

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

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

Property ID: ^5 - 7 ^ 

PropertyAddress: /j/ f ^ , /M^JJZ- -

Owner: ]^J^ T^yyUlAJ^^^.^ p T 

Phone: 'tlHg~-'lI ^ ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

\l7\ I agree iMtoralion w completed, mccpl as noted 

[_| I do not a|;r(C restoration is completed 

/^^.>v..t^, /^-xj^-A^yy c-y/y/y^ y/zy^. 

Owner's Signatine Date Conti arlor's Signature /6a(c I