TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: ^^IH< Date: 

1^ In )t 

Address: inln ^ \A\\^\^ i Hi \ 'HHW 

Remediation Contractor: Coastal Environmental Group_ Year: _2010ARRA_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

IT Signed Access Agreement(s) for adjacent property 

/ Restoration Agreement 

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

- ^ Confirmation data 

V Photographs m ­ h^O^^rn ^ y ^(AVMW ^ V 'V/ l^lAi^ ^ 

1 / As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

Utility clearances 

Property information fi'om Douglas County Assessor's Office 

)ate 

Superfund 
^\ 

Property Access Checklist 

Property ID: ^^ 0 IM S n WORK STARTED ON: __/__/_ 

Property Address: ^Q ^ ^ ^^ ^ [^ ^ ^ D WORK COMPELTED ON: / / 

Owner: p^j^j.^,; ^ Rj^-k r . Renter: 

Address: Phone: 

Fax: 

5ame 

Cell/Pager: 

Phone: Additional Information: 

Fax: 

Cell/Pagen^C^^^, <^3Ul<: 

D Notification Letter Sent: / / By: 

S^ Access Agreement Signed: 2. liUllO. By: 

^ Restoration Agreement Signed: Z. / ^^ li O By: 

Q Topsoil Sampling (if applicable) 1 1 By: 

Q Disposal Sampling (if appUcable) 1 1 By: 

n Garden Sampling (if applicable) I I By: 

^ Utmty Clearance CaUedO'!> ASO l\ 0 »y=CM/r;':iAi^ U)f«^.. Uf ^ 

n Video/Photos (Before) On:^l< 3 l<S>C5iO By: ^ 

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

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

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

• Property Completion Agreement Signed: / / By: 

n Final Report Issued: / / By: 

Air Monitoring (as applicable) 

Q Community QCrew On: / / By: 

Results: 

• Community O Crew On: / / By: 1 

Results: 1 

• Conmiunity • Crew On: / / By: 

Results: 

Omaha Lead Site 
•^Douglas County Account InfQ||^tio Qjll^c n Page 1 of2 

Douglas County, Nebraska Property Record - R1750540002 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - ViO W O n Ma p Information is valid as of 2009-12-15 Treasurer's Tax Report 

New Feature •• ^ - • Aiito Sales Search 

Owner 

EASTER PATRICIA L 

6703 MINNE LUSA BLVD 

OMAHA NE 68112-0000 

Property Informatio n 

Key Number: 5054 0002 17 

Account Type: Residential 

Parcel Number: 1750540002 

Piarcel Address: 6703 MINNE LUSA BD 

OMAHA NE 68112-0000 

Legal Description: MINNE LUSA LOT 14 BLOCK 11 LOTS 13 & 14 MINNIE LUSA ADD BLK 11 

Value Informatio n 

Land Improvement Total 

2009 $8,900.00 $83,100.00 $92,000.00 

2008 $8,900.00 $83,100.00 $92,000.00 

2007 $8,900.00 $83,900.00 $92,800.00 

2006 $8,900.00 $83,900.00 $92,800.00 

2005 $8,900.00 $83,900.00 $92,800.00 

2004 $8,900.00 $67,800.00 $76,700.00 

Sales Informatio n 

Sales Date: 2004-07-24 

Dieeef Type: WD Book: 2004 Page: 129040 

Price: $100,000.00 

Grantor: Mario T White etal 

Grantee: Patricia L Easter 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.0 0.0 1.0 120.0 105.0 No 

Improvemen t Informatio n 

http://douglasne.mapping-onlihe.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 12/31/2009 
-Douglas County Account Infqs|wtio ttaj^l i n Page 2 of2 0 

Building 1 

6703 Mime Lusa Blvd 

2 5lory 

U!^^ 

it 

jffifif% ^,\ 

"WS^T' 

CLICK TO ENLARGE IMAGE 

Square Footage: i 1711.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition Average : 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 6.0 

Exterior: ; Masonry Common Bricl< Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 2.0 

Floorcover: ; Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1925 0 0% 1925 84 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Appliance Fireplace Masonry 1.0 

Basement Bsmnt Blocl< 8 ft 768.0 

Fixture Additional Fixtures 1.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 361.0 

Porch Slab Roof Ceiling 70.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 12/31/2009 
Page 1 of2 

"> 

[ Create Artothei^Tjcket^ | ^ _BgckJo^lrth jptemet .] ; I ^end Email ] 

YOUR TICKET NUMBER IS 2458435. 

Original Call Date: 4/08/10 Time: 6:31 pm Op: ELIZABETH18790 


Work to Begin Date: 4/13/10 Time: 7:15 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 6703 Street: MINNE LUSA BLVD 


Twp: 16N Rng: 13E Sect-Qtr: 33-NE 


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 Comer Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELLAN METRO MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number 

Utility 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

X* A /-CT T A XT MAGELLAN MIDSTREAM PARTNERS MAGELLAN ^ p j^^^r^T, A U DEBORAH 

Day: 9185747098 

Alt: 

Emerg: 9185747098 

METRO METRO COMM. COLLEGE CHRIS 

Day: 4024572307 

Alt: 4026727033 

Emerg: 4024572313 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/8/2010 
Page 2 of2 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RICHATRAFFIC

Day:

 Alt:

 4024447197 

 4024445161 

Emerg: 4024445160 

0PPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM 

LOCATING 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM 

LOCATING 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/8/2010 
^ As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

OLS#: 40145 

Date Excavated: 4/13/2010 

Date USEPA Signed Off: 6/24/2010 

Area Sodden: 1456 sa ft 

loss 

Omah Extenor Paint NotthAnow 1 a Lead S te 

Sit • Good e Sketcti n Poor 

Samplina Address: 67oi MINNE LUSA BD 0 Not paint 

Sampl Lead Sample Samples Collected 1 e Number LAB Conce ntratio n Collected Firm: FCA DB-A T 

RYASCPXA-401H5 F1 7 0 .ppm ^ D Date: h-3-0 ^ 

RYBSCPXA.40 1H5 F2 7 5 ppm ^ Time: 11: So A M 

RYCSCPXA-40m5 B1 .ppm m, n 1^1 Samples Analyzed 1 RYDSCPXA-40 IHi B2 .ppm M D 1 1 ^ 

RDZSCPXA-40l^i DZ .ppm 13 D XRF Unit: 109(o2. Book: 2 H 1 

.ppm n D Date: (B-7.O, . O^t n i 7 .ppm D D Time: ?r*-. D 

Numtte Staff: MSW r of Samples = | 5 1 ol 

Legend: Fl = Front LefL F2 = Front Right, 81 = Back Left. 82 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Pla' At! quadrants are as viewed rt) ^ ••^e st^ee* racing p^ope^ 

Legend 

Concrete Dri p Zone Excavatied Quadrants Excavate d 

Area replaced with 

Sod 

Area replace d wit h 

Rock/hfulch Area lef t bar e 

Contrac t #: EP-R7-07-05 Coastal Environmental Group Inc . 
a* 

Hons 

Omaha Lead Site Exterior Paint North Arrow 

Site Sketch • Good 

© • Poor 

Sampling Address: 67o3_MlNNE LUSA BD 0 Not paint 

Sample Number Lead Sample Samples Collected 

I

I 

LAB Concentration Coiiected Fimi: FPA PE> A T 

RYASCPXA-40iHi F1 I d ppm n Date: jj-S-O^ 

RYBSCPXA-40 \^<. F2 7 5 ppm D Time: 11 • So A/ ^ 

RYCSCPXA-40m5 B1 ppm n 

Samples Analyzed RYDSCPXA-40 IHi B2 ppm D 

RDZSCPXA-401 ^c. DZ ^ 5 ^ ppm D XRF Unit: lOfib l Book: 2 H ) 

RQZOCPXA-40179 S i ppm D D Date 4* • 2 ^ • g>^ 

nPZ6CPXA-40170 P2- ppm D D Time i:=a_ Staff: Number of Samples = | ^ \ \ Q t^^w 

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

All quadrants are as viewed from the street, facing property 

fclMMiMHE Ll6^. Bi -z 

70. .15.i 

e 

.F.j. fz. 

i iJkAei i:«>-Nov-rif! 

-l^ ' \VAt ^ 

I t 

MlN.Ne.U;^A.EP, 

Q 

± ^ 

1144701.01.13 
^0\1 S 

Omah Exterior Paint North Arrow a Lead Site • Good Site Sketch 

n Poor 

Sampling Address: 67o^ MINNE LUSA BD 0 Not paint 

Sample Lead Sample Samples Collected Number LAB Concentration Collected Firm: FPA DBA J 

RYASCPXA-401HS Fl _ppm D Date: In-Z-O^ 

RYBSCPXA-40 IH3 F2 7 5 _ D Time: W-S o A/>^ ppm 

RYCSCPXA-40m3 81 iq 1 ppm D Samples Analyzed RYDSCPXA-40 IH5 B2 -7 l ^ _ ppm i n

RDZSCPXA-401 i^i DZ ^5 ^ ppm a XRF Unit: lOfib?. Book: Z H ) 

RQZOCnXA-40179 SS ppm D D Date: & • 2 ^ • g
 

F»PZeCPXA 40170 P2- — ppm D Time: ?r>^ n Staff: I^^W Number of Samples = | ^ [ | Q 

Legend: F1 = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Pla'. 

All quadrants are as viewed from fhe street, facing property 

• > 

.Fl fi 

s 0 

M^AtJ^ 

^ ::5& 

Re\-2TM:)8 Created: i:i6-No%- MIKNELW^ A RP, 1144701.01.23 
ions 

Omaha Lead Site Extenor Paint NoithAmw 

Site Sketcli • Good 

n Poor 

Sampling Address: 67<O^MINNE LUSA so ^ Not paint 

Sample Number Lead Sample Samples Collected 

I

t 

LAB Concentration Collected Firm: FDft DRA T 

RYASCPXA-40iHi Fl JJCL .ppm n Date: fc-g-O^ 

RYBSCPXA-40 IH5 F2 JLS- .ppm n Time: 11- gp A M 

RYCSCPXA-40l\S Bl AL ppm D

Samples Analyzed RYDSCPXA-40 l<i$ B2 ppm D 

RDZSCPXA-401 HS DZ .iSiL .ppm D XRF UnK: IDflLT. Book: 2M I 

rtOZOOPXA 40170 6£ ppm D D Date: &-20iO< ^ 

riPZOOPXA 40170 P2- ppm D D

Time: _aa_ Number of Samples «= | S I | Q | Staff: MSW

Legend: F1 = Front Left, F2 •• Front Right, Bl = Back Utt. B2 » Back Right DZ " Drip Zone, GZ - Garden, PZ - Pia; 

Ad QuftdrBfitsOT88 vtowBdfromttwstreet, todno property 

KevldtX Crated: 06-Kov48 
.•^^^ir^v* 

COASTA l fNVIIOHHIItTAI 

C B 0 tl r I h C 

Consent fcF Access To Propertj^ 

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: Daytime Phone: 

Address of Property 

covered by this ^7^ ^ y^m e ^^^S>^ BO 

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 perforrtiing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to: 

Page 1 of 2 
,•» — *». 

% 

V;rj*=fjr^'» COASTAL 

INriaONHIKTll '<tp„oit ^ c n o U r I K C 

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; 

c Abide by health and safety guidance provided by EPA; 

f If the property is rented, assist EPA in obtaining tenant approval for access to 

the property to perform the work. 

6 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 

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

sianatur ' Signaturee Dat Datee ' Signature Date

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

Page 2 of 2 
• • • 

COASTA L • MVIRONHa M T A L O • O U P . INC . 

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 docimientation 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: L| Q|\J^ ^ 

Property Address: ^y^- ^ ^/HMi £ Lu^ i 

Owner: >?^^^, ^ ^^^f^ ^ 

I Phone ^ ^ : ^^ . ^^ ^ /^^we^rg . 5 ^ e>¥^ ^ 

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, material types, etc. 

Photographically and Videographically document 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. 

Kem: 

XfDKi(r 

Kem: 

Kem: 

Kem: 

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

Kem: 

won ^ 

Kem: 

Kem: 

Kem: 

Page 1 of. 
C O A S T A L • MVIHONHINTA L O • e U P . INC . 

Items to Be Removed By Contractor During Remediation and Replaced 

Kem: 

^ o t L 1 Soo — ?2. Kem: * 

Kem: 

Kem: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, Quadrants that will be excavated, that 52. 

is covered with grass. 

Number of trees > 2 inch Each 

trunk diameter 3

Nimiber of trees <= 2 inch Each 

trunk diameter 

5 

Number of Sprinkler 

Zones, Control Valves, 

Each Timers, Heads, etc. ^A 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed Each 

area. 'T ^ 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 y-e.^s^ (i^'^^H excavated it-') Each 

Page 2 of. 7 
C OA S T A L • NVmONMaN TA L a a o u p , INC . 

AddKlonal Comments / Instructions: 

The city of Omaha ordinances may prohibK 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 cKed by the city If you use a gravel or dirt area 

as a driveway or parking area, not wKhstanding 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 cKy of Omaha's Planning Department at (402) 444-5150. 

Q^ease check this box If you understand the Information outlined above. 

•Jj- \^2 ^ v>u^ vi^n a Uf^^ ^ ST-w«^. 

^heck 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 pf<house, including foundation cracks or fissures. 

n I do not agree 

Owner's Signature Date ' Contractor's Sienature s Signature Date 

Page 3 of. 
BVID# WDlHS" 

XRF PROPERTY SAMPLE SHEET 

Date 

Project 

XRF ID# 

:^-//>'/o 

Omaha Lead ARRA 

'y^><^ 

Address 

Sample time 

sample length 

Shot # Reading Sample area 

s£ ^ 

Shot# 

5 ^ 

mr 

Id^i^/'r 

//•h t - / - ^ 

Depth 

7 ^ 

Average // g t / T Average

Shot# Reading Sample area Shot# 

Depth 

Average Average 

Shot# Reading Sample area Shot# 

Depth 

Average Average 

RETEST AREAS 

Shot# 

Average 

Signature 

m^ l^fri^^ 

f^^0 ^ /n<•r^r^^ Lu ^ P>M 

am/pm 

30 sec 

Reading Sampl >ampiee are a a

wr77 Depth 

V>^//:> 

^ ^ ^ / O 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 385 

Mode SOIL 

Time 2010-05-10 12:17 

Duration 90.34 

Sequence Final 

Flags 

AVERAGE -^Avq~Of 382T3O4 ADDRESS "^70 3 Minne lusa blvd 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 7.856 

Zr 419.105 ± 14.976 

Sr 163.561 ± 8.644 

U < LOD 14.684 

Rb 69.985 6.540 

Th 11.642 -7.459 

•118.391 It" "14.854 

< LOD 5.438 

As < LOD 19.657 

Hg < LOD 12.250 

Zn 147.784 20.958 

W < LOD 84.051 

Cu 30.956 20.368 

Ni < LO 75.082 

Co < 174.020 

Fe 1750 377.386 

Mn 4' 94.281 

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 

QUADRANT 

DEPTH 

TYPE 

INSPECTOR 

ppm 

Mo < LOD 

Zr 421.205 

Sr 165.515 

U < LOD 

Rb 69.295 

Th < LOD 

Pb 119.964 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 155.245 

W < LOD 

Cu 36.677 

Ni < LOD 

Co < LOD 

Fe 17687.799 

Mn 495.542 

Supervised By: 

Certificate of Verification 

382 

SOIL 

2010-05-10 12:16 

30.11 

Final 

40145 

'6703 Minne lusa blvd 

EA 

1" 

CONFIRMATION 

N. LOPEZ 

Error 

: 7.766 

± 14.988 

± 8.684 

• 15.050 

± 6.549 

: 10.688 

± 14.936 

I 5.575 

: 19.675 

• 11.556 

± 21.212 

J 78.471 

± 20.683 

I 74.107 

* 175.206 

± 378.956 

± 93.742 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 383 

Mode SOIL 

Time 2010-05-10 12:17 

Duration 30.11 

Sequence Final 

Flags 

BVID 40145 

ADDRESS 6703 Minne lusa blvd 

QUADRANT EA 

DEPTH 

TYPE r

CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 7.934 

Zr 418.363 ± 15.022 

Sr 165.885 ± 8.727 

U < LOD : 14.468 

Rb 69.384 ± 6.512 

Th 14.971 ± 7.808 

Pb 121.889 ± 15.087 

Se < LOD 5.456 

As < LOD 19.897 

Hg < LOD 12.875 

Zn 141.071 ± 20.787 

w 

Cu 

< LOD 

38.757 

: 

± 

88.425 

21.010 

Ni < LOD : 73.448 

Co < LOD : 175.120 

Fe 17869.055 ± 382.402 

Mn 502.700 ± 95.339 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 384 

Mode SOIL 

Time 2010-05-10 12:17 

Duration 30.12 

Sequence Final 

Flags 

BVID 40145 

ADDRESS 6703 Minne lusa blvd 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD I 7.868 

Zr 417.748 ± 14.916 

Sr 159.284 ± 8.521 

U < LOD : 14.534 

Rb 71.277 ± 6.560 

Th 12.054 ±' 7.443 

Pb 113.321 ± 14.539 

Se < LOD 5.283 

As < LOD 19.400 

Hg < LOD 12.319 

Zn 147.036 ± 20.875 

w < LOD 85.257 

Cu < LOD • 29.116 

Ni 104.621 ± 51.794 

Co < LOD J 171.734 

Fe 16948.691 ± 370.800 

Mn 498.549 ± 93.763 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 381 

Mode SOIL 

Time 2010-05-10 12:14 

Duration 90.65 

Sequence Final 

Flags 

AVERAGE ^^Avg75r378^E 

ADDRESS 6703 Minne lusa blvd 

QUADRANT B2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.102 

Zr 483.742 ± 16.062 

Sr 163.515 ± 8.725 

U < LOD ; 14.878 

Rb 71.256 ± 6.645 

Th 11.560 ± 6.824 

r-pb. Se 

- 45.554. 

< LOD : 

_: 10:316 

5.55r 

As 14.797 ± 9.549 

Hg < LOD : 12.675 

Zn 99.549 ± 18.228 

W < LOD 85.086 

Cu < LOD 30.418 

Ni < LOD 73.482 

Co < LOD 193.850 

Fe 20929.830 ± 416.364 

Mn 609.385 ± 103.149 

Cr < LOD 307.286 

V < LOD 653.915 

Ti < LOD ^^>­ — - 29rh.812 

Sc < LOD ^«-'^ : 195.054 

Ca 

K 

< \.o\y 22135.826 

: 

± y 

5«2.672 

9326.944 

S < LOD 306.811 

y^^^ y * 

Supervised By: y y ^ ^ r ­
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 378 

Mode SOIL 

Time 2010-05-10 12:12 

Duration 30.11 

Sequence Final 

Flags 

BVID 40145 

ADDRESS 6703 Minne lusa blvd 

QUADRANT 82 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.205 

Zr 500.214 ± 16.363 

Sr 160.432 ± 8.684 

U < LOD 14.788 

Rb 72.605 ± 6.709 

Th 13.751 ± 7.040 

Pb 41.206 ± 10.028 

Se < LOD 5.650 

As 19.649 ± 9.614 

Hg < LOD 12.830 

Zn 109.747 .± 19.085 

W < LOD 89.261 

Cu < LOD 30.789 

Ni < LOD 75.343 

Co < LOD 194.809 

Fe 21168.518 ± 420.542 

Mn 606.977 ± 103.726 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 379 

Mode SOIL 

Time 2010-05-10 12:13 

Duration 30.11 

Sequence Final 

Flags 

BVID 40145 

ADDRESS 6703 Minne lusa blvd 

QUADRANT B2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.022 

Zr 484.459 ± 16.027 

Sr 161.011 ± 8.644 

U < LOD 14.281 • 

Rb 67.071 ± 6.421 

Th 12.220 ± 6.881 

Pb 48.912 ± 10.577 

Se < LOD 5.429 

As < LOD 14.569 

Hg < LOD 12.078 

Zn 94.982 ± 17.649 

w < LOD ', 77.627 

Cu 31.434 ± 20.400 

Ni < LOD I 72.735 

Co < LOD I 191.144 

Fe 20759.705 ± 413.609 

Mn 546.062 ± 99.246 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 380 

Mode SOIL 

Time 2010-05-10 12:14 

Duration 30.43 

Sequence Final 

Flags 

BVID 40145 

ADDRESS 6703 Minne lusa blvd 

QUADRANT B2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD ; 8.079 

Zr 466.553 ± 15.795 

Sr 169.101 ± 8.846 

U < LOD : 15.565 

Rb 74.092 ± 6.804 

Th < LOD I 9.830 

Pb 46.544 ± 10.342 

Se < LOD 5.574 

As < LOD 13.981 

Hg < LOD 13.118 

Zn 93.918 ± 17.949 

W < LOD 88.369 

Cu < LOD 29.867 

Ni < LOD 72.369 

Co 215.066 ± 130.398 

Fe 20861.273 ± 414.941 

Mn 675.118 ± 106.474 

Cr < LOD 305.572 

V < LOD 773.266 

Ti < LOD 3067.662 

Sc < LOD 265.729 

Ca 10767.670 ± 4915.825 

K 18931.426 ± 8907.053 

S < LOD 330.691 

Supervised By: 
.'^*!1^^>. iysA.'\ Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^ ^ I Coastal Environmental Group Inc. vi 

V*^^! ^ www.coastalhazmat.com ^ ^ 

^'•iPno^''^ COASTA L 

C 1 0 U P. IH C 

EXECUTIVE SUMMARY: 

BVID #40145-(6703 MINNE LUSA BLVD) 

No Issues or Concerns [~| Issues/Concerns 

Detail Explanation: 

DAN GARVEY WALKED THE PROPERTY ON 6/24/10 
SEPA • 

EPA Property Close Out Form 

Lno 3 ^^^.^t>X_iIS(K6\vci 

Property#: ^0/^5L . Property Address:* -

Date/Time: . Owner's Name:. ^ 

Quad Contractor Group s Excavated: 

Eicavatto Yes No n General 

I. If necessvy, were the coirect quadTant(s) excavated and restored? / 

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

Gradinc Sod and Veselation Yes No 

I. 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? y 

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 y day time period) 

4. Are sodded areas generally Hrm and evenly graded? / 

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

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

7. Was danuge to landscaping or plant materials avoided? y 

Gates, Fences aad Retainlag Walls Yes No 

1. Do gates open and close freely? (tfapplicable) y 

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

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

4. Was danuge lo retaining walls avoided? (Ifapplicable) y 

Fouodadon, SidlnKand Gutters Yes No 

t. Was damage to the siding or trim avoided? y 

2. Was damage to the foundation avoided? y 

3. Was damage to windows avoided? y 

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

5. Was damage to downspouts or downspoul extensions avoided? • 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage lo driveway surfaces avoided? / 

2. Was damage to walkway surfaces avoided? / 
Owner ^ s comments: 

Inspection notes: 

Removal and resloration aclivales complete including the 30-day sod warranty: 

EPA Representative jQ^3 ^ Date: g/sy/ic^ 
Property Completion Agreement 

This agreement documenls lhe completion ot remedial acliviues perloimed on my properly My signaluie 

will designate ihai I am salisfied with the restoraiion of my propeily. and Ihal no items are in queslions. 

now, or al any lime in the future, except Ihose ilems listed below, if any 

PropertylD: ^ 0 / <^ S" 

Proper (y Address: C.n03 (Y\,i.r.^. UJS(K felvH. 

Owncr 'i^rx\rc\'cAtK. ^c.^Vj2,r 

Phoiie: S"t2» '^^f,f^ 

Restoration Items in Question: 

Item: f^ ^ I^ hr/)ii3A fij O/tAc p^h^,%. - ^^m^Dipc 

Item: 

ivia.i I • uu 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

)S 1 8grcc I c.ftorolion K completed, except as nofeit 

do not a|;rec restoration is completed 

y^i ^ 

Owner's Signatiirr Date Conti arlor's Sicnnlnrc Dale 
• • 

Property Owner Assessment of Performance Form 

American Recovery and Reinvestment Act (ARRA) RECEIVFT I 

Omaha Lead Superfund Site 

2009/2010 JUN 28 2010 

Remediation Contractor: Coastal Environmental Group - EP-R7-09-ffP^^^^^^^^^^^^ DIVISION 

Property Identifier Number; ^ 0 / ^ ^ 

Property Address: lO 'H) g? , /^tC t^tl € 

Property Owner's Name: YOXkjCyjJ!*^ (^!^. 

Instructions to tlie Propertv Owner: 

This form serves to record the Property Owner's assessment of perfonnance (Incentive 1 

- Quality Assurance Siuvdllance Flan) involving the listed remediation contractor, as applicable 

to the Omaha Lead Site. This form documents the timeliness of punch list resolution, business 

relations, complaint resolution and the overall quality of work. If need be, the Property Owner 

may utilize this form to record problems and/or issues not specifically tied to an assigned 

address, for example, business relations that generally don't follow the guidelines set forth in the 

Pofbrmance Work Statement. 

The Property Owner will indicate his/her assessment of perfonnance with the contractor's 

work by checking a numerical rating on the table below using the ninnerical defuiitions fVom 

the rating scale below, then sign & date the form. 

9-10 "excellent" 

Q ^ 'Very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Propertv Owner^s Assessment of Performance Regarding the Contractor's Work 

10 5 

^ 

Propertv Owner Additional Comments from (optional; contJBue on back page if needed) 

Property Owner Signatu