CONTRACT # W912DQ-04-D-0017, T.O. DK03 

Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE US Army Corps 

of Engineers 

ECC Certification for Property Closeout 

BVID 27714 Property Address 43 16 Grant St 

Field Work Started 08/26/2006 Field Work Completed 09/01/2006 

Summary: 

• The excavation was performed in compliance with the work plans and specifications. 

• Fl excavation depth varied from 2 to 4 inches below ground surface. 

• F2 excavation depth varied from 2 to 4 inches below ground surface. 

• Bl excavation depth varied from 2 to 4 inches below ground surface. 

• Drip Zone excavation depth varied from 12 to 14 inches below ground surface. 

• Verification samples confirmed that cleanup standards were met. 

• The site was backfilled with material which meets the contract specifications. 

• The backfill was compacted to acceptable standards. 

• Sod placement and site restoration were conducted in compliance with the specifications and 

work plans. 

Comments: None. 

5 \Cv\p tAxVW ECC Project Manager k)'1~<)<r 

Name Title Date 

Jeff Hubbard USAGE Con Rep 

Name Title Date 

40286055 

Pill 

Superfund 
Name: Ol-WlleS, L\(i hoesT Omaha Lead Site Date: | \ Z^ North Arrow 

Address ^_ : Ll^lto G>t2AHT'*'' Site Sketch Time: ?:^l 

Phone: — k/A — 

( V&A 4S2> - ^/o ~}£~~ 

Omaha Lead Site 46130 
page 1 of. 

??/ v 

Omaha Lead Site 

Omaha. NE 

U.S Residential Yard Soils . Environmental Protection Agency Region VII 

Environmental Restoration 

Services 

PROPERTY ACCESS (to be completed by property owner) 

ne al i-£00-222-Oi:i 

U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USAGE). Omaha 

District to conduct environmental restoration services for the Omaha Lead Site. USAGE Omaha is working with 

Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration 

services. Your cooperation is requested in giving EPA/USACE/ECC permission to access your property during the 

removal/restoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­

7003 or the Office of External Programs, at 1-800-223-0425. 

Property Access Granted By 

(Please Print Name) 

(Date) 

NOTE: Granting permission DOES NOT necessarily imply your property will be remediated at this time. 

PROPERTY INFORMATION 

(fo be completed by resident and.-'or property owner • Please Print) 

Resident Name: \Q oowner LJ renter 

Residence Address: M ^ I [0 Cl rrvn4" 

(CITY) (STATE) (ZIP) 

'roperty Owned By. r-^ 

Owners mailing address: >^ 

Owner's telephone number - Home: 75~ Work: 

Age of Home? /D& years How long have you lived here? years 

Has the exteior been painted or covered with siding since 1978? Yes LJ No 

Has the interior been painted or covered since 1 978? Yes LJ No 

Total number of occupants: ft**. * / - 5"3- ~ -£-6 - / 7 - List Ages: 

~ "• --

List ages of occupants under 6 years old who play in the yard for 5 or more hours per week: ->2. /o_ - / / 

Comments: 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS 

he activities to be implemented by EPA under this agreement are pursuant to Section 104 of CERCLA, 42 U S.C 9604. EPA's right of access to 

he property for in Section 104(e) of CERCLA, 42 U.S.C. 9604 (e), which provides entry for, "determining the need for response, or choosing or 

aking any response action undet this title, oc otherwise enforcing the provisions of this title." 

Access Attempts: 

First: Second: : Third: : 
Contract No. W912DQ-04-D-0017, Task Order DK01

 

Omaha Lead Site, Omaha, NE 

Property Closeout Agreement 

BVTD Property Address a')'?/1

/ Hi fb r^wtProperty Owner Is the Owner the Resident? D Yes D No GfiM M\JTH 

Compliance Statement: 

U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers 

(USACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site, 

USACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead 

contaminated soil and provide subsequent restoration services. 

Your cooperation in giving EPA/USACE/ECC permission to access your property during the 

removal/restoration phase is sincerely appreciated. This document certifies that all work performed at 

this property was completed in accordance with the contract specifications and EPA requirements. 

If you have questions or need additional information please contact Don Bahnke, EPA Project Manager, 

at (913) 551-7003 or the Office of External Programs at 1-800-223-0425. 

Additional Comments by USACE and/or ECC: 

CONTRACTOR CERTIFICATION 

Prashant Khanna or ECC Project Manager 

Charles "Skip"Milton 

Name 

1

Title Date 

 • | -

Signature \ . 

M) iVX 

PROPERTY OWNER SECTION 

This agreement documents the completion of remedial/restoration efforts at the property to my 

satisfaction. 

L3 I agree that restoration is completed at my property, except as noted 

Comments (if applicable): 

Property Owner's Signature Date 
Property Owner Satisfaction Survey Form 

Omaha Lead Superfimd Site 

Performance-Based Contracting (PBC) Pilot Project 

Remediation Contractor: 

Property Identifier Number: 

Property BVID Number: 

Property Address: */JV£ 

Property Owner's Name: 

(above information to be Filled out by remediation contractor prior to delivery of form to Property Owner) 

Instructions to Property Owner; 

This form is provided to you as a means of trying to capture your level of satisfaction 

with the work of the above-identified Remediation Contractor, as applicable to the soil cleanup 

action at your property. The U.S. Environmental Protection Agency (EPA) and the U.S. Army 

Corps of Engineers (USAGE) are very interested in your opinion regarding the work performed 

by our contractors. This form is intended to provide an easy means for you to express your 

opinion about the work performed on your property. 

Please indicate your level of satisfaction with the Contractor's work by selecting a 

numerical rating (ranging from 1 to 10) using the following rating scale, then please sign & date 

the form and return it to USAGE in the attached self-addressed & stamped envelope. (Additional 

comments may also be provided in the space provided, at the option of the property owner.) 

9-10 "excellent" 

"very good" 

5-6 "acceptable" 

3-4 "poor" 

1 -2 "very poor" 

Property Owner's Satisfaction Rating regarding Contractor's Work 

10 5 

9 4 

8 3 

7 2 

6 1 

Additional Comments from Property Owner (optional; continue on back of pace if needed) 

/ / / r/t S — II _^ 

Property Owner's Signature: -V^ //fl/*- /l/b/Sp} Date: / /"" £)" f] 6 -r\ / >r~t~ * t V_X 
CONTRACT # W912DQ-04-D-0017, T.O. DK03

 

Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE US Army Corps 

of Engineers 

Sample 

Type 

DE 

DE 

DE 

DE 

PX 

Analytical Results Summary 

BVID #27714 

4316 Grant St 

Quadran XRF Results t Depth Date Collected (ppm) (avg.) 

B1 4 8/26/2006 213

 

DZ 14 8/26/2006 79 

F1 4 8/26/2006 164 

F2 4 8/25/2006 81

 

EA-S 0 8/25/2006 53

 

Lab Results 

ppm (avg.) 

NA 

NA 

NA 

NA 

NA 

BVIDBVID is a particular residential property ID from which the sample is collected. 

The sample type identifier (with sequential sample number for thai location) as follows; 

PX = Pre-Excavation XRF sample 

PE = Pre-Excavation laboratory sample 

DE = During and Post Excavation 

Quadrant describes the sampling location (with sequential sample number for that location) as follows; 

Fl or F2 = Front Yard One or Front Yard Two 

BI or B2 = Back Yard One or Back Yard Two 

DZ = Drip Zone 

GA = Garden 

PA = Play Area 

EA = Easement 

Depth describes the depth from which the sample was collected, 

ppm = parts per million 

pg._of _

 

List of Existing Conditions 

Property Address: Girn^V SV. DVD ID # 

Owner: Date: BVID# 

Ref: 

Photo Description 

# 

02.-

P\ f6>.>r V-W- -P ar 

Owner Signature ECC 

Print & Sign Print &JSian > -' 
page 1 of. 

2-77 

Omaha Lead Site /&^^\

Omaha, NE ft O 'A 

U Residential Yard Soils ^^y £/

 us

- Environmental Protection Agency Region VII 

Environmental Restoration v^^*^** V 'V. r**S^

N^PRQ^X Services

 

( PROPERTY ACCESS (fo be completed by property owner)

 

Para recibir esta fcr.-na en espartoi 'por favor Name al 1-600-223-0425 

U.S. Environmental Protection Agency (EPA) has contracted the U.S. Army Corps of Engineers (USAGE), Omaha 

District to conduct environmental restoration services for the Omaha Lead Site. USAGE Omaha is working with 

Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration

 

services. Your cooperation is requested in giving EPA/USACE/ECC permission to access your property during the 

removal/restoration phase. For further information please contact Don Bahnke, EPA Project Manager at (913) 551­

7003 or the Office of External Programs, at 1-800-223-0425.

 

~>:''3 •••-• . . 1 ' 

Property Access Granted By . 'o •%i< .'v . ^ /^ ' <•-•

T

 ^­

(Please Print Name) 

//' /?.-/) I ; j ?- •' 'X / ,fa*-' 'fr A-7-..iX-' y 2/*2> 

(PropertV.-Ownef^Signature)/' (Date) 

( 

NOTE: Granting permission DOES NOT necessarily imply your property will be remediated at this time. 

PROPERTY INFORMATION

(fo be completed by resident and/or properly owner • Please Print) 

Resident Name: O r< /* / £• /I /< 7A l^J owner LJ renter 

Residence Address: '-\ ^ } 1 p Cn rr\nT ^>4 . 0 01 w Vl C\ ML

 

(CITY) (STATE) (ZIP)

 

Property Owned By: (—*, -=i ft \j E^ . ) 77 ji' A 

Owners mailing address: / 'b / £=> f/-~-/^t /^T -J^T . 

Owner's telephone number - Home: ^/'-l 'V^3~ *~/ $ 75 Work: 

Age of Home? //.'x^ years How long have you lived here? / o years

 

Has the exteior been painted or covered with siding since 1978? LJ" Yes D No 

Has the interior been painted or covered since 1978? I_J Yes D No 

Total number of occupants: r «.*•'/ .s List Ages: j? V r ;." ^) - .2 o -..g.^ - / 7 2./J./3. . i -

List ages of occupants under 6 years old who play in the yard for 5 or more hours per week: ~T ' 'x - / 'a. 

Comments: 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS 

The activities to be implemented by EPA under this agreement are pursuant to Section 104 of CERCLA. 42 U.S.C. 9604. EPA's right of access to 

(fie property for in Section 104(e) of CERCLA, 42 U.S.C. 9604 (e), which provides entry for . "determining the need for response, or choosing or 

taking any response action under this title, or otherwise enforcing the provisions of this title." 

Access Attempts: 

First: Second: : Third: : 

 1 
Property Check Lists- ;

QC 

Location miL C^AKtf 

BVID 2T%q 

Dates ftf 26 [CO 4iv£^ 

Excavation check list 

have easement map 

have site map 

homeowner agreement 

line locator 

access log 

decon.station 

tape barricade ' 

garden hose 

reconstruction map for buildback 

fences 

sod areas 

mulch 

gravel 

notes 

name and date 

QC Notes 

XRF check list 

have easemet map (1) 

have site map (3) . . ' • 

easements sample 

F1 . • samples 

F2 samples 

B1 samples 

B2 samples 

DZ samples 

AS-Built 

map corrected 

shots mapped 

concrete mapped 

trees marked 

LIP marked/noted 

name 

date . 

easement mapped 

window wells mapped 

ac mapped • 

Log book up to date ' 

Backfill check list 

reconstruction map 

positive drainage from house 

NO low spots 

NO Rake Gaps 

lawn even 

soil compacted ' 

sidewalk 1" cuts . ' 

smooth transition from walks 

area free of debris 

fences repaired 

damage to property? 

damage list 

punchlist filed 
'Name: ( \^t^^&L\ci^y2ST Omaha Lead Site Date: J (hslfis North Arrow 

Address: (_&\(a fefiAHT "^ Site Sketch Time: |3:iz_ 

Phone: — K(A-— t 

( 4{&\ ^£& - t/o"?S 

Omaha Lead Site 46130 
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Name: O^^Asde&LvnlK^esT 

Address: UStto &t2AM-~r ^ 

Phone: — KJA. — 

( 4^ 4£>2> ­ (-/o'^S 

Omaha Lead Site 

Site Sketch 

Date:

Time:

 ] { | IS fTjS 

|3:(Z_ 

North Arrow 

t 

BVID# XRFCode 

Sample Number Lead Concentration Confirmation Sample 

- Z77/ V 

- 277/V 

. f»X A ­ 277/V 

— 277/ V 

ppm 

ppm 

ppm 

ppm 

ppm 

f ' t< 

UZYes

Yes

Yes

yes

Yes

Yes

Yes

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0 

D 

0 

D 

a 

d 

No 

MO 

No 

No 

No 

NO

No 

a 

^Z. 

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4316 Grant St/50x120 

http://webarc.co.douglas.ne.us/servlet/com.esri.esrimap.Esrimap?ServiceName=TestAerial... 8/29/2006 
Hello, my name is David Barajas. I work for ASW a contractor through the EPA doing 

lead soil removal 

In Order to remove the lead contaminated soil from your yard we need your permission 

This project is a superfund site, funded by the EPA and this is at no expense to the owner, 

soil, and sod will be replaced. 

If you are not the owner, please inform your landlord of this attempt so that we are able 

to acquire permission. 

Please call me at41LJ JUl USS: M0£- 7.15" ­