?'."'- •'""' L r •'*•• --- ^ 

TRANSMITTAL of OMAH A LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID#: 5'^V?>9 Date: /<0V3~OB 

Address: 3aa9 > EmfyJ^ T S T 

Remediation Contractor: Coastal Environmental Group_ Year: _2008_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

JZI Video ofproperty (DVD) 

JET Executive Summary 

S""^ EPA-provided property sketch 

&^ Signed Access Agreement for subject property / 

P^fflj/]^ Signed Access Agreement(s) for adjacent property/j//'^ 

-^^r^ Restoration Agreement / 

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

_-0''^ Confirmation data . , 

Vf Photographs pr£-X)^/iJ/lJlj^O 6}(if^IJmmi^ ZO-A^aj ^ -jlA^t SOcL 

As-built sketch 

-0 Satisfactory restoration signed by Property Owner 

•B— Property close-out check list signed by EPA \imm,n«!^mlm^,9.S.. 

Hf ^ 1 Description of areas not meeting ROD cleanup criteria 

Superfund 

S"'^ Utility clearances ' 

S""'^ Property information from Douglas County Assessor's Office 

0 1^ ^ 

Date 

(f/zF^f 
m 

Property Access Checklist 

Property ID: ^'^L j ^ ^ 

n WORK STARTED ON: / / 

n WORKCOMPELTED ON:^ / / Property Address: y^'^ % l^tT) ^ 6 f • 

0>vner: ^jlj^] ^ U^flArxX A RenfeiT 

Address: F FTTr F Phone: 

Fa.x:Vv '>1l VZ-^-t 

Cell/Pager: 

Phone: 30 3 ­ ^// ^ ­ ^(g4 / Additional Int'orination: 

Fax:353-3n| ­ 1^ ^ 

Cell/Pa"er. 

0 Notification Letter Sent: / / 1 

12 Access Agreement Signed:5^ /\' \ /C)% B.v: A-M-f'C^ 

Ml Restoration Agreement Signed.-^ /l'h/C>^ ^y- A-iWr.'o^ . 1 1 Top.soil Sampling (if applicable) 1 1 By: 

0 Disposal Sampling (if a|)plicable) 1 1 B.v: 

1 1 Garden Sampling (if applicable) 1 1 By: 

D Utility Clearance Called: (o 1 ^6lC!% «>=^6/^Tri/5 /J=^V 

D Video/Photos (Before) On: / / By: 

n Video/Photos (During) On: / / By: 

D Video/Photos (After) On: / / -. By: 

D Video/Photos (30-Day) On: / / By: 

[U Pro|)erty Completion Agreement Signed: / / By: 

0 Final Report I.s.sued: / / By: 

. 

Air Monitoring (as applicable ) 

II n Comniiinity LJ Crew On:_ / / By: 

Results: j 

LJ Community LLJ Cre« On:_ / / Bv: 

Results: 

LU Community LI! Crew On:_ / / By: 

Results: 

Omaha Lead Site 
Property ID # 

Property 

Address: 

Initial Contact:

Second Contact:

Final Contact:

Final Action: 

j Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

CONTACT FORM 

5"«^3^ 

^Q3_FrfvrA^ ' 

 Date: -S/ya/feyTime: ^ pj^ Action; ^evd Ay 

 Date: Time: Action 

 Date: Time: Action! 

Transmit to EPA D Other ./Action: D 

• 

^Ulot Op ahead l^!haa 

• 

I . j 
f • • # 

FACSIMILE TRANSMITTAL SHEET 

^''fMMiS CHRpwoAA FROM ^do^ "fc^o'cK 

COMP.WV: D.\TE: ^ / J 

0)iist<J i'nvinmmcnni] (iroup O/ l^/O^ 

F.\X yiTMlM.R totM , KC). Ot- P%GES INCH l->l\c; COVER 

D tJRGENT D FOR REVIEW |3)PLEASE COMMENT D PLE.\SE P.W D PLE.XSE RECYCLE 

NOrreS/COMMENT? 

Cor 70 ^ 90pp>r4^ ^+ 3,^^ ^ ^^ ^ . p/^ ^ 

t^-eweiA; 
Douglas County Account Information Page 1 of2 

Dougla s County , Nebrask a Propert y Recor d - R054296000 1 

Print Report 

Parcel Dimensions available @ scale 0-50 ft west of 144 St - Vie w OH Ma p Information is valid as of 2008-4-17 Treasurer's Tax Report 

New Feature -•-•- • Auto Sales Search 

Owne r 

CHAPMAN Mini s L 

21453 E 54 PL > 

DENVER CO 80249-0000 

Propert y Informatio n 

Key Number: 4296 0001 05 

Account Type: Residential 

Parcel Number: 0542960001 

Parcel Address: 3228 EMMET ST 

OMAHA NE 68111-0000 

Legal Description: BEDFORD PLACE LOT 14 BLOCK 8 W 10 FT 

Valu e Informatio n 

2007 

2006 

2005 

2004 

2003 

2002 

Land 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

$0.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

$0.00 

Sales Informatio n 

Sales Date: 2006-11-15 

Deed Type: QC Book: 1 2007 Page: 1 048599 

Price: $1.00 

Grantor: COLORADO CLASSIC PROPERTIES INC 

Grantee: CHAPMAN MITTIS L 

Valid/lnvalid: Invalid 

Exclusion Reason: 

Sales Date: 2001-04-11 

Deed Type: SHD Book: 2003 Page: 171642 

Price: $974.00 

Grantor: SHERIFF 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R054... 5/8/2008 
Douglas County Account Information Page 2 of 2 ;^i t 

• # 

[ • Grantee: COLORADO CLASSIC PROPERTIES 

Valid/lnvalid: Invalid 

Exclusion Reason: Sale by Govt Agency 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.02 1280.0 0.0 128.0 10.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R054... 5/8/2008 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site INVIRONMENTAL 

G R O U r , INC . 

58439 

Omaha Exterior Paint North Arrow Lead Site 

Sampling AddrM*: 3228 EjyiMET ST Site SItetch 

• Good 

|~| Poor PhOlM: H: (303)916-4641 ALT: (303)418-4227 [ 7 | Not paint f 

Sample Numlser Lead Sample 

Samples Collected LAB 9- Concentration Collected Firm: FpA FB-1>0 

RYASCPXA-58439 Fl ^ q / q ppm D Date: Hi ?'0? 

nYBSCPXA-58430 F2 " ppm D Time: pm RYCSCPXA-58439 BI I S 3 G ppm D Samples Analyzed nYDSCPXA-56430 B^ ~ ppm D D 

RDZ6CPXA-S8430 Ba- " • ppm n D XRF Unit: 6,^H 1 Book; /g V 

RGZSCPXA 68430 62 ' " - ppm n n Date A - M cn 

nPZOCrXA-50430 PS- " ppm D Time AtL 

Staff Number of Samples = 2 . 

/tbWL. 

Legend: F l = Front Left, F2 = Front Rigtit. BI = Back Left, B2 = Back Rigtit DZ = Drip Zone, GZ = Garden, PZ = Play 

Ail quadrants are as v'cyp|l jnyn the street, facing property 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with 

Sod 

Area replaced with 

Rock/Mulch Area lef t bar e 

Contrac t #: EP-R7-07-05 Coasta l Environmental Group Inc. 
v^Wn^i U:> ock 

58439 

Omaha Exterior Paint North Arrow Load Site 

Sampling • Good Addrww: 3228 EMMET ST Site Sketch • Poor 

Phone: ^ (303)916-4641 ALT (303)418-4227 

0 Not paint f

Sample Number 

RYASCPXA-58439

RYB6GPXA-68430

RYCSCPXA-5&439

nYDGCPXA-58436

 F1 

R 

 B1 

 B2-

Lead 

Concentration 

Hqi q ppm 

" ppm 

I 5 3 O ppm 

~ ppm 

Sample 

Collected 

D 

lAB 

D 

D 

D 

D 

Firm: 

Date 

Time 

Samples Collected 

fpA FB-te ^ 

Fo 

?'0 J 

ptn 

Samples Analyzed 

RDZGCPXA-56430

RGgSCPXiA §8<3b

 B2­

 62> 

~

" "

 ppm 

 ppm 

n 

D 

D 

D 

XRF Unit:

Date Pi

 65'/ 2

 - H O f 

 Book l£ ± 

nPgOCPXA-SCHDO PiE­ — ppm D D Time AJ U 

Number of Samples = 2 . Staf( /Vit / 

Legend: F1 = Front Left, F2 = Front Right. BI = Back Left, 82 = Back Right DZ = Drip Zone. GZ = Garden PZ = Play 

All quadrants are as viewed Irwi the street facmg property 

ENTERED 

JUl 2 7 2007 

.VO:V^'^' p.^.O • : Sf. 

\ ^F ^ 

Fmrncf S-j-. 

Rev 5 Oaic t 7 |1..NI,17 lOSRlK • tf.lli al.'. 
58439 

Omah Exterior Paint North Arrow a Lead Site 

Sampling Address: 3228 EMMET ST Site Sketch • Good 

• Poor Phone: H: (303)916-4641 ALT: (303)418-4227 

[7] Not paint f

Sample Number Lead Sample Samples Collected 

Concentration Collected Firm: fPA FB- CS 

RyASCPXA-58439 Fl MO/ q ^ ppm D Date: Fo 

^'Q- ? 

RYBGCPXA 58430 R " ppm D Time: H'fo pm 

RYCSCPXA-58439 81 I 5 3 O ppm D 

Samples Analyzed 

RYDCCPXA-50439 B2- •~ ppm n 

RDZGCPXA 50430 B2- ~ ppm n D XRF Unit: 6,5'^7 Book: fSH 

RCZSCPXA 68"ISO GZ" " " ppm D D Date: ft • IH O l 

nPZOCPXA-G043Q • " ppm D D Time A/L 

Staff: M^W~ Number of Samples = 2. 

Legend: Fl = Front Left, F2 = Front Right, 81 - Back Left, 82 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed frmn the street, facing property 

ENTERED 

JUL , 2 7 2007 

\ ^ 

.lA^.hok.. OFO^ ^ 

1 T ^ / 

.^e;^... 

f?/ ^ 

^ • •' -^ H 

• Immc ^ S\ : •'

Rev 5 Created 7,1 .V2007 10 58:05 0461410123 

nixr»»o> joof aD«Picr'ano7MOi jwf *»• ino' UTiijno? jwi' jmi WOT JCBI joo*» I'awTtxrTaiT luoixij'm^i'ir n»'i w nor mo'imr iinr xu'7»7 » i nir^cnr xat x 
58439 

Omah Exterior Paint North Arrow a Lead Site 

Sampling Address: 3228 EMMET ST Site Sketch • Good 

• Poor 

Phone: » (303)916-4641 ALT: (303)418-4227 [7| Not paint f

Sample Numtier Lead 

Concentration 

Sample 

Collected LAB 

Firm 

Samples Collected 

FPA FB-1>^ 

RYASCPXA-68439 

nYDCCPXA-58430 

RYCSCPXA-58439

RYDGCPXA-50430

Fl 

 81 

 B2-

M q f q

"

I 5 3 0

~

 ppm 

 ppm 

 ppm 

 ppm D 

D 

D 

D 

D 

Date 

Time 

^ 

^ 

?-o? 

pm 

Samples Analyzed 

RDZCGPXA-S8430 B3­ " " ppm D D XRF Unit: 6>fiH7 Book: /B H 

RGZSCPXA 681130 Q ^ • ^ ppm D D Date ft -IHa-J 

RPZOCPXA-G0439 P2­ " " ppm D D Time AI L 

Number of Samples = 2 . Staff M^\JLegend: Fl = Front Left, F2 = Front Right, 81 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed frMn the street, facing property 

. ENTERED 

JUL 2 7 2 007 

.. ./53P ... 

...n 

5^5y«wtf 

: Sf. 

• i •• 

Fi'M^ .. 

fl 

• 

• 

: f/»»i«pf X-f: j 

Rev5 Created. 7/1.V20O7 10.58:05 046141.0123 

WZO'3aa'3M<7Wir3tr-j)Ii'xn'JOnr n-'iro' nr'Toe^ xo' jotitccJvo7 joi'3 BT XOt ta " JBP^ JOOI MO: KBT 3 W JOO' !WJT «PT MB? Juu' m r SB ! JWU 300^ »J 7 3UC> WOT W) " JOtT- 3 W W T JOOT MP) 3607 JpDI S W MO: 3I»» » W 3(177 3B0' JOr* XO-" :m ' - W W l 3«i7 3 
p . 2 

m m 13 08 10:30 a 

# 

COASTA L 

\ »««<* efl 4 u r . INC . 

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: 

f^iWi'S (Fh\^fY\a^ 

Owner's Name: Daytime Phone: 'hOl'-^H^ - Ij^q f 

Address of Property 

covered by this 0(Y\oJhc\ UC , 6i;iH 

Agreement: 

PURPOSE OF RESPONSE AcnvmEs 

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, tlie 

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, 

contractons 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: 
May 13 08 lOsaOa

 P3 

COASTA L 

Ci<«l>tl»i(iWTai 

r. H n ir ^ , IMC. 

• 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 perfonm 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. ­

'" , I 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (877) 234-6270. 

I grant access to my properties

 O I <io not grant access to nny properties 

nature / Date Signature Oaie 

D I would like to be present during any sampling that is required. 
n a a 13 08 10:31si P--^ 

COASTA L 

Restoration Agreement 

The purpose of this 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 satisfiiction of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID:^4^L | 3<?\ 

Property Address: 2,^^- ^ C^YMJ T <}t 

Owner; K^j^/. g CH^pmfi ^ 

Phone; 3>&3-g^/^-H^^ / 

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

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

contractor, and the direction of Nonh. Indicate distances, depths, material t>pes. etc. Indicate digital photos 

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

Itenrts To Be Removed By Owner Befors Start Of Remediation: 

(Use additional sheets as necessary) 

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

Item; 

hlon-c IW 

hem: 

Item: 

Item: 

Hem: 

Item: 

item: 

item: 

Page 1 of. 

'J^i^ 
p.5 ia^i 13 09 10:31a 

C O A 5 T A V 

« • r\ w • . 1 •* ^ 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: TI 01 ^ ^C y 

Hem: 

Item: 

Item: 

Hem: 

Item: 

Item: 

Item: 

Item: 

Hem: 

Item: 

Item: 

Hem: 

Item: 

Item: 

Page 2 of. 
\ S

 13 08 lQ:3l a P 

6 

COASTA L 

Items To Be Removed By Contractor During Remediation An d Replaced 

(Use additional sheets as necessary) 

Item: 

Uone. /ku 

Hem: 

item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 3 of 
P-7 rla%) 13 08 10:31 a 

COASTA L 

<: » i» u > t •• e 

Landscape Inventory 

(Use additional sheets as necessary) 

Item Quantity Unit Condition/Type/Species 

Pre-c>cisiing property area, 

thai wil l be excavated, that 

i? covered with grass. 

n,6i 

Square feet 

Number o f iTtcs >

trunk diameter 

 2 inch 

- ^ 

Each 

NuiTihcr of trees < "

trunk diameter 

 2 inch -A Each 

Number of Sprinkler 

Zones. Control Valves. 

Timers. Heads, etc. 

•Anail; A iketdi of tne 

spi'^dklcr lav out. 

U Each 

-

Number of and size of 

each garden." flower bed 

area. 

.•\;i:iw:: 'i vhCici'i vl' .•.•.•;i;i>,: ^ 

Each 

Square Feei 

Page 4 of 
1a» 13 08 10:31 a p . 9 

Item 

Agreed upon value of 

plant materials not to be 

replaced bv contractor. 

Note (his value will be 

used to issue a plant 

>oucher to the property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sl<eTch nf weru^ 

each plant will he placed 

b\ Ihe contractcr. 

Agreed upon area of 

propcn>- to be replaced 

with gra.^s jod. 

•irsais! 10 be reiMac'ccI v\ iih 

.Area of City or Count>' 

property- to he landscaped 

per their requirements. 

Ixiin k :; ••'•cwi- v>;' ;f-.­

niva.s! 

Easement Area, lo be 

e.vcavatcd 

Quantity Unit Condition/Type/Species ] 

j 

/^ ^ 

^ 

^0 

-e. Each 

(il,fi 

I ^'^ 

tohoi^ profiJii'hf j 

•€i 

SF 

[ 

.1 

SF 

Paoe 5 of 
p . 9 

1«|N« 13 0 8 10:3S « 

COASTA t 

Additional Comments / InstructifMis: 

a Check the box if Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By ched^ing this box CEG is not responsible for any damage done to the 

interior of house, including foundation cracks cr fissures. 

Xi afree Q I do not agree 

^'ihi^ ^y . 4^ ^ 

Coetractor's Signature 

Page 6 of. 
' F-iTK-^iTr: 

BVID# ^?^^1 

XRF PROPERTY SAMPLE SHEET 


'•^•'^- -"i»ff'-i^:"r-CTf 

Date IW^ Address ^rVh tMM^f VT 1 

Project Omaha lead FP 2nd year option Sample time ^'\\Ki% ^n?/pm 

XRF ID# sample length 30 sec 1 

Shot# Reading Sample area Shot# Reading Sample area 

g ^ H.%^ . ^r>< 11^.% ^ IM--^ 

IJL <.l% t II. tg fl M %.C2^ o-T' $ 

m_ M-tfU lu-K Depth Depth 

s: 'I'^-^qtlMt ^ Flk^-r, -b.v o o 

Average %\n'i \\S Average (?0 ' ^ ( -^ ]l - ^ 1 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot # Reading Sample area Shot # Reading Sample area 

Depth Depth 

Average ..»i!' Average 

RETEST AREAS 

Shot# Reading Sample area Shot # Reading Sample area 

Depth Depth 

^ ­ ^ 

Average Average 

1 lab sample # Lab result Sample area XRF Avg. 

Signature 

Print Ufd-C^ Pf'^n?^^ 
-T-'sr; wrrr 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By 

Certificate of Verification 

431 

SOIL 

2008-07-05 09:10 

129.79 

Final 

Avg of 427-430 

3228 EMMET ST 

Fl 

MATEUS 

6 

CLEARANCE 
-^v^',':-"'' 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 427 

Mode SOIL 

Time 2008-07-05 09:08 

Duration 37.45 

Sequence Final 

Flags 

BVID # 58439 

ADDRESS 3228 EMMET ST 

QUAD/ZONE Fl 

INSPECTOR MATEUS 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 42.953 ± 9.050 

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 75.188 

Supervised By: 

Certificate of Verification 

428 

SOIL 

2008-07-05 09:09 

30.60 

Final 

58439 

3228 EMMET ST 

Fl 

MATEUS 

6 

CLEARANCE 

± 

± 11.298 

• '%• • 
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 167.564 

Supervised By: 

Certificate of Verification 

429 

SOIL 

2008-07-05 09:10 

31.04 

Final i. 

58439 

3228 EMMET ST 

Fl 

MATEUS 

6 

CLEARANCE 

± Error 

± 16.158 
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 Pi'PE 

NOTE 

ppm 

Pb 70.597 

Supervised By: 

Certificate of Verification 

430 

SOIL 

2008-07-05 09:10 

30.70 

Final 

58439 

3228 EMMET ST 

Fl 

MATEUS 

6 

CLEARANCE 

± Error 

± 11.122 

A - v 
-.i^, ' 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 436 

Mode SOIL 

Time 2008-07-05 09:16 

Duration 123.31 

Sequence Final 

Flags 

AVERAGE Avg of 432-435 

ADDRESS 3228 EMMET ST 

QUAD/ZONE BI 

INSPECTOR MATEUS 

DEPTH 6 

SAMPLE TYPE CLEARANCE : 

NOTE 

ppm ± 

Pb 68.211 ± 11.019 

Supervised By: 
'•iftl-TH-i 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 432 

Mode SOIL 

Time 2008-07-05 09:14 

Duration 30.66 

Sequence Final 

Flags 

BVID # 58439 

ADDRESS 3228 EMMET ST 

QUAD/ZONE BI 

INSPECTOR MATEUS 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 114.366 ± 14.382 

Supervised By: 
• m--' 

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 36.629 

Supervised By: 

Certificate of Verification 

433 

SOIL 

2008-07-05 09:15 

30.96 

Final 

58439 

3228 EMMET ST 

BI 

MATEUS 

6 

CLEARANCE v 

± 

± 8.739 

v^r 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 434 

Mode SOIL 

Time 2008-07-05 09:15 

Duration 30.42 

Sequence Final 

Flags 

BVID # 58439 

ADDRESS 3228 EMMET ST 

QUAD/ZONE BI 

INSPECTOR MATEUS 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 83.049 ± 12.068 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 435 

Mode SOIL 

Time 2008-07-05 09:16 

Duration 31.27 

Sequence Final 

Flags 

BVID # 58439 

ADDRESS 3228 EMMET ST 

QUAD/ZONE BI 

INSPECTOR MATEUS 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 38.801 ± 8.888 

Supervised By: 

**". 

'"V: 
Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

www.coastalhazmat.com 

COASTAL ENVKONHENTAl 

CROUP , INC . 

EXECUTIVE SUMMARY: 

BVID # 58439 - (3228 Emmet St.) 

X No Issues or Concerns I I Issues/Concerns 

Detail Explanation: 
SUfL EPA 

EPA Property Close Out Form 

Property #: IviT; ] Prnnertv Address -r-,—^r^ ^.../i . J . \—'- ^ 

Date/Time: 

Quads Excavated: ^ ] -{^ Pl Contractor Croup LOf^'yVPT^ 

Excavation General ^PiCAKT 

Yes No 

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

t y 

2. If necessary, were the correct areas of drip zone excavated and restored? 

y 

Grading Sod and Vecetation Ves No 

1 Does the grading around the perimeter of the house in excavated areas generally slope away y from the house? 

i y 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. Aje sodded areas generally firm and evenly graded? y 

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 propert},? y 

7 Was damage to landscaping or plant materials avoided? y 

Gates. Fences and Retaining Walls 

Ves No 

i Do gates open and close freely? (Ifapplicable) I 

Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) 

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

mio < ^

# ­

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

Foundation, Siding and Cullers \ Ces No 

/­ 1.

 Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? x)i^ ' ' 

3. Was damage to windows avoided? ^ ^ /J ^ 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? >r 

Sidewalks and Driveways (Concrete) 

Ves No 

1. Was damage to driveway surfaces avoided? 

^ ^ 

2. Was damage to walkway surfaces avoided? ^ ^ 
Owners comments: 

Inspection notes: 

(%JiMu- ffo oide^ / Monihr sad . r , 

Ski i^s hr^^ ar^s -^ F ar^ V/f^^W ts^ F d^i^ 

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

EPA Representativ Date: 7/3///)3 
D Remote ID; R page 

1 ^ 

Property Completion Agreement 

Tliis agreement dix:umcms the ctirnpietioii of remedial activilics porforinal on my property. My signjiliiri: 

wil! designale lliat I am satisfied with Hie resloralion of my properly, and thai mi items are in quuslmns. 

now, or at any lime in the tuiurc, exccpi tho.sc item.-? listed below, il'any. 

i'ropcrty ID: &f f LJ^G j 

Restoration Items in Question: 

Item: 

Itcrti 

Item; 

Kofn 

item 

Item 

Additional Comments: 

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L J ' rto niit SKfte tvstnrntmn ia ctmpletwt 

()wiirr's.Si|>nf)ilirc Date ftn»nicl(>r'.s .Si|;iuti Date