TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID Date: i ^ u *iuH 

Address: ^"I^ifi I ^ f 

Remediation Contractor: Coastal Environmental Group_ Year: 20 tftSOIL REMEDIATION 

PROPERTY nL E FOLDER DOCUMENTS 

Video ofproperty (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

-G- Confinnation data 

Photographs JU ^f{1\( ^ \ ^CPo/ftTWn -y ^ ^ f |^<»'> 

/ As-built sketch 

x 30217571 i Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA i Win 

Superfund 

Description ofareas not meeting ROD cleanup criteriL 

Utility clearances 

Property information from Douglas County Assessor's Office 

CJ 

D 

• 
Property Access Checklist 

Property ID: 

um=L D WORK STARTED ON: __/__ / 

Propert D WORKCOMPELTED ON; / / y Address; 7 7 ^ ^ / ^-j r 

Owne Renten r M/^iA^LUCA S OttTl ^ 

Address: Phone: 

Fax: 

Cell/Pagen 

Additit»al Information: 

Phone: SoLj'-qd^qs 

Fax: 

Cell/Pagen 

D Nodfication Letter Sent: / / By: 

^ Access Agreement 

Signed: i^/13/Q Q By: 

J ^ Restoration Agreement Signed: id/13-/(23 By: 

D Topsoil Sampling (if applicable) /

 / By: 

D Disposal Samplhig (if applicable) /

 / By: 

D Garden Sampling (if applicable) /

 / By: 

|H1 Utility Qcarance 

Called: ^/^A22 . ^y-lole3p9 ^ Video/Photos (Before) On:Jl/

 3/J2i^ By: /4iUDX 

0 Viileo/Pbotos (Dnring) On: / / By: 

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

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

' ^ Property Completion Agreement Siened: II J\l-IO ^ By: 

t ] FinalReport Issued: / / By: 

Air Monitorine (as aoDlicable) 

n Community OCrcw ] On: / / By: 

Results: 

D Commnnity QCrew On: / / By: 

Resohs: 

D Community QCrcw On: / / . By: 

Results: 

Omaha Lead Site 
Dpuglas County Account InfoisM|ion Page 1 of3 i^Hgc 

Douglas County, Nebraska Property Record - R0417900001 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VlOW OH Ma p Infonmation is valid as of 2009-10-15 Treasurer's Tax Report 

New Feature •*'*' * Auto Sales Search 

Owner 

ORTIZ LUCAS 

2206 1 ST 

OMAHA NE 68107-0000 

Property Informatio n 

Key Number: 1790 0001 04 

Account Type: Residential 

Parcel Number: 0417900001 

Parcel Address: 

Legal Description: 

2206 1 ST 

OMAHA NE 68107-0000 

SOUTH OMAHA CITY LOTS LOT 8 BLOCK 134 W 60 FT 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$4,500.00 

$4,500.00 

$4,500.00 

$4,500.00 

$4,500.00 

$4,500.00 

/mprovemenf 

$75,500.00 

$75,500.00 

$75,500.00 

$75,500.00 

$43,200.00 

$43,200.00 

Total 

$80,000.00 

$80,000.00 

$80,000.00 

$80,000.00 

$47,700.00 

$47,700.00 

Sales Informatio n 

Sales Date: 2004-06-11 

Deed Type: WD Book: 2004 Page: 078037 

Price: $85,950.00 

Grantor: NEBRASKA-IOWA PROP LC 

Grantee: LUCAS ORTIZ 

Valid/lnvalid: Valid 

Exclusion Reason: 

Sales Date: 2004-03-04 

Deed Type: TRD Book: 2004 Page: 036918 

Price: $45,001.00 

Grantor: Eric Lindquist 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 10/17/2009 
Dpuglas ,r|^1 ( County Account Inforj^ion Page 2 of 3 

Grantee: ; N E-1 A Properties 

Valid/Invalid: Valid 

Exclusion Reason: 

_L 

Sales Date: 1991-10-14 

Deed Type: Book: 1912 Page: 528 

Price: $37,750.00 

Grantor: 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.06 3000.0 1.0 50.0 60.0 No 

Improvemen t Informatio n 

Building 1 

1 1,-2 Story Fin 2206 I St 

EttiSlMfWM 13! » » 

a t SNfr Woof Ct^iio 

8snnB«>!» TIHIICQ):, 

CLICK TO ENLARGE IMAGE 

Square Footage: 1152.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: ; Average 

Unit Type: Condition: Very Good 

Built As: 1 1/2 Story Fin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Gable Stories: 1.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 10/17/2009 
Douglas Cotmty Account Infori^o rji^ic n Page 3 of3 

Year Built 

1908 

Detail Type 

Add On 

Appliance 

Basement 

Fixture 

Fixture 

Garage 

Porch 

Porch 

User 

Year 

Remodeled 

0 

Percent 

Remodeled 

0% 

Detail Description 

Fence Wood 

Allowance 

Bsmnt Block 8 ft 

Base Fixtures 

Bath Full 

Detached 

End Solid Wall 

Slab Roof Ceil 

See Notes 

Adjusted Year Physical Age Built 

1908 101 

Units 

1.0 

1.0 

704.0 

1.0 

1.0 

180.0 

132.0 

120.0 

1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 10/17/2009 
Page 1 of2 

"> 

Greate Another Ticket, Back to Irth Internet ^^ Send Ernair.J 

• YOUR TICKET NUMBER IS 2402260. 


Original Call Date: 11/07/09

Work to Begin Date: 11/12/09

 Time: 12:12 pm 

 Time: 7:15 am 

Op: ELIZABETH18790 

State: NE 

Address: 2206 

County: DOUGLAS 

Street: I ST 

Place: OMAHA 

Twp:

Twp:

 14N Rng: 13E

 Rng:

 Sect-Qtr: 03-NW 

 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 OF CORNER PROPERTY 


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: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


ALTS72 

QLNNEIF 

ATTNEBRl CXCATV LEVELS MUD02 OMAHACOF 0PPDGPR6 

Service Area Contact Phone Number Utility Type 

ALT872 WINDSTREAM COMMUNICATION NA 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

ATTNEBRl ATT/T 

Day: 80024136249 

Alt: 

Emerg: 80024136249 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

AU: 4029340469 

Emerg: 4029329757 

LEVELS LEVEL3 COMMUNICATIONS, LLC NA 

Day: 8773668344 

Alt: 

Emerg: 8773668344 

http://vmw.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11/7/2009 
Page 2 of2 

MUD02 METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

AU: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICH/TRAFFIC

Day: 4024447197 

 AU: 4024445161 

Emerg: 4024445160 

OPPDGPR6 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

AU: 4062071494 

Emerg: 8887289343 

QLNNEIF QWEST LOCAL NETWORK NA 

Day: 4067289343 

AU: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 11/7/2009 
OLS#: 11134 As-Built Drawing Date Excavated: 11/10/09 

Date USEPA Sinned Off: 11/30/09 

COASTA L Omaha Lead Superfund Site Area Sodden: 135 so ft INvmONNIMTA L CROUP , IN C 

11134 

Exterior Paint North Am>w Omaha Lead Site 

Q Good Site Sketch • Poor 

Sampling Address: 2206 I ST QT Not paint \ 

Sample Lead Sample Samples Collected Number LAB Concentration Collected Firm: fOA F'SypQ 

RYASCPXA-11134 F1 2 3 H ppm D Date: TX^'O l 

RYBSCPXA-11134 F2 HH A ppmM Time: ^•.OOp.Or^, 

RYCSCPXA-11134 Bl CaJp ppm n

D Samples Analyzed RYDOOrXA 11134 B» ~ ppm 

RDZSCPXA-11134 DZ D ) 5fl H pom XRF Unit: GSHO Book: 2/ 3 

RGZSCPXA-11134 GZ I M 2 ppm D Date: fi -/ ^ -b t 

RTZSOPXA 11134 9A ppm D Time: D jar n Staff: Numtier of Samples = | ^ | | Q | JDikL 

Legend: Fl = 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, fadng properly 

Legend 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with 

Sod 

Area replaced with 

Rock/Mulch *^ 

w- Area left bare 

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

11134 

U {ofl ^ 

\ i \\^ix\o^ 

Omaii Exterior Painl Noriri Arrow a Lead Site 

Sit • Good e Sketch 

• Poor 

Sampling Address: 2206 I ST [2[ Not paint 

Lead Sample Samples Collected Sample Number LAB Concentration Collected Firm: fOf i ^'g./pVl ^ 

RYASCPXA-im 4 F1_ 

2 3 H ppm D Date; TM^'O ^ 

f?YBSCPXA-11134 "1=2 

D Time: H"-OC> p. m • 

RYCSCPXA-11134 Bl ppm D Samples Analyzed RYDCiCPKA 11134 -S& ppm n 

RDZ^CPXA-11134 bz ISBiL ppm n XRF Unit: CoSHO Book: 2/ 3 

RGZSCPXA-11134 GZ 31 ppm Date: fj-l H -O S . 

D 

npzccpxA 11104—F>a ppm D D 

Time Ar 

Numbe Staff JDikL r of Samples = | 5 ] [ Q ] 

Legend: Fl = 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 
11134 

U {oIn 

\i \\l\x\o^ 

Sampling Address: 2206 I ST 

Sample Number 

RYASCPXA-11134 Fl 

#YBSCPXA-11134 F2 

RYGSCPXA-11134 Bl 

nYDOGr'XA-11134 B^ 

RDZSCPXA-11134 DZ 

RGZSCPXA-11134 GZ 

nrZSGP W 11104 P * 

Omaha Lead Site 

Site Si(etcii 

Lead 

Concentration 

Sample 

Collected LAB 

ppm a' D 

ppmM D 

ppm n 

ppm D 

ppm n 

ppm D 

ppm D 

Number of Samples = [ 5 | | CS \ 

Exterior Paint North Arrow 

• Good 

• Poor 

[3 ^ Not paint \ 

Samples Collected 

Firm: fO A VQ>}^X\ 

Date: T\H'0 ^ 

Time: H'-O ^ p.m . 

Samples Analyzed 

XRF Unit: CoSHO Book: 2/ 3 

Date: _ fi-/^-os

Time: _ jat 

Staff: 

JQiisL 

Legend: Fl = 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 

Rev 2008 Created: O.^-May-OK 
11134 

Omah Exterior Paint North Arrow a Lead Site 

Site • Good Sketch • Poor 

Sampling Addrass: 22061 ST QfNot paint 1

Sample Number Lead 

Concentration 

Sample 

Coiiected LAB 

Firm: 

Samples Collected 

RYASCPXA-11134 Fl ppm sf D Date: 

RYBSCPXA-11134 F2 ppmM D Time: 

RYCSCPXA-11134

RVDOOPXAIIigM

 81 

 B» 

ppm 

ppm D 

D 

D Samples Analyzed 

RDZSCPXA-11134

RGZSCPXA-11134

nPgCOPWV 11104

 DZ 

 GZ 

 PA 

ppm 

ppm 

ppm D 

D 

D 

D 

XRF Unit: CSH O Book:

Dato: fJ-ltj'& S 

Tjme: A<» 

 2/ 3 

Numt>er of Samples = | ^ I | Q | Staff: POSUJ 

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 (iom the street, fadng propeily 

:^05'ti'4'Zda8 

_j»< i ^ A^ V ^ - s ^ •••:---V!- ­

w^ 

H

iOI C: 

iP! 

y ^ a .n 

fe\ :(p(o # 

'^ 

\ 

lT*)i^ i-^ ^ 

Rev 2008

^

 Oened : O3-M<y.0« 

= 

-Jf tc 

X^ 

^.n 

. k

234 

1^^ 

. n\ .:F^.. 

F2­ I 

044701.01.2.^ 
..•x^*«*"'«. 

COASTA t IHytRONn f KTAI 

r. • o u p IN C '•»< fHO -

Consent for Axcess To Property 

RIGHT OF EISITRY 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: 

Daytime Phone: 

Address of Property 

covered by this >-r. •>7^^ y Agreement: 

PURPOSE OF RESPOJMSE 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 Environniental 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 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 
<,^-y 

8 

COASTA L tHVIKONH^KTA l 

CROU P IH C 

« Remove obstructions including boats, trailers, vehicles, playscape Items, wood 

piles, dog houses, etc; 

c 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; 

« 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 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 grsnt access to my properties 

z' 

'Signature Date ^ \ ' Signature Date 

Q i would like to be present during any sampling that is required. 

Page 2 of 2 
a 

1 

RESTORATION CHANGE ORDER 

OMAHA LEAD 

Property ID # l\\^ ^ 

Property Address l-SlJc>lj2 " p 1^4"-

Owner Name WL^u/vu^^s-. 0\Lf,i?-

Date I 1 - lQ-"0 ^ 

Cominents 

i^><^-'^<^ lij^4 UKJCI—t^yro ^ ficLiflia £J—C M f-^tTz-a/O- f jftW^\ J p'^.b/:^ CiLiC^ ini^—^:k^—IJCk^ e b.'^^XL^ f ^) ^ 

Owner Signature////6 P/ A 0/?^.yP . 

Contractor Signatiirej 
COASTA L 

C • O U r • »• C 

Restoratiion 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 of the property owner and the United States Environmental 

Protection Agency (EPA). 

7r/3^ 

Property Address: -TO^CXP - C ST.:. 

o^"-' .y„^4r- - UAC ^ Pi^r?^ 

Phooe: 6^f ^f r 

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 cenoval. stora.qe, disposal, and/or return of these itoms is the Owner's responeibiiity. 

ftem: 

A^ < , 

Item: / 

Item: 

Item: 

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

Item: 

/-)-Kn_ x \ 5^ -^/ / /T^ . ^ k y i^L ^ 

Item: / 

item: 

Item: 

Page 1 of, 
COASTA L 

c k (• u . I fc I 

Items to Be Removed By Conti^ctpr During Remediation and^Replaced^ 

Item: 

S^iL "f^ ^ , 07 ^ 

Item: 

"y^ ^ ' ^^J ^ 

Item: 

Item: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, pz- Quadrants that wilt be excavated, that 

is covered with grass. 

Number of trees > 2 inch Each 

trunlc diameter 7_

Number of trees <= 2 inch Each n^ trimlc diameter 

Number of Sprinlder 

Zones. Control Valves, 

M Each / Timers

Aii.ith i

, Heads

l sl>i'tcl

, etc

i o

. 

l ilitf 

V

'•pr'rklci l;;y'.iLii 

Number of and size of 

each garden/ flower lied Each 

area. Square Feet 

Alliich il skclrh ol rcliilivi.­

<i/cs mid lociiiioiis 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Voir l!ir ^Hl^ic will ni 

liSi'C IU it;u( .1 piBlii 

XOIKSU'.- 1(1 lhe i;rci))crl\ 

int ner. 

Easement Area, to be Each excavated 

Page 2 of. 
f 

1 i 

C O A S 1 A t. 

! Additional Comments / Instructions: 

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 do not agree 

' Owner's Signature Date tI (, Contractor'sSignatur Contractor's Sienature ifate

Page 3 of _ 
# 

BVID# I(f34 

XRF PROPERTY SAMPLE SHEET 


Date n-i o -09 Address ZIO h -1 . <^-

Project Omaha Lead ARRA Sample time am/pm 

XRFID# -h^OZJ^ sample length 30 sec 

Shot# Reading Sample area Shot# Reading Sample area 

GO 31*7 tz t pe 23/ -zm^ izo f^ 

C7I -S2.6^Z£> Depth -2-52. -Z-'S - / ^ Depth 

GZ ^H2> ^^ ^ ly -^33 Z.Zi t 1 <^ t" 

Average -331 - ^-8 

Average -z^i ' n 

Shot# Reading Sample area Shot# Reading Sample area 

CG-

2'?^ t^c ^ ( A 

(oh 

-znn t2 ^ Depth Depth 

h -Z6^tcz-G (" i 

Average 

^i^^^'-zC Average 

Shot# Reading Sample area Shot# Reading Sample area 

Depth 

Depth 

Average 

Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

^ ^ 

Average Average 

Signature 

Print ^VI^^H K ^Ar6y<, 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 63 

Mode SOIL 

Time 2010-02-16 18:10 

Duration 90.75 

Sequence Final 

Flags 

AVERAGE rAv g of bU-b2 / 

ADDRESS 2206 I St. 

QUADRANT DZ 

DEPHT 13 

XRF TECH O. BARAJAS 

MISC 1 

NOTE 1 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 316.843 

Supervised By: 

Certificate of Verification 

60 

SOIL 

2010-02-16 18:05 

30.25 

Final 

11134 

2206 I St. 

DZ 

13 

O. BARAJAS 

1 

1 

± Error 

± 27.805 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 61 

Mode SOIL 

Time 2010-02-16 18:06 

Duration 30.23 

Sequence Final 

Flags 

BVID 11134 

ADDRESS 2206 I St. 

QUADRANT DZ 

DEPHT 13 

XRF TECH O. BARAJAS 

MISC 1 

NOTE 1 

ppm Error 

Pb 327.704 ± 28.195 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpiice 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 348.122 

Supervised By: 

Certificate of Verification 

62 

SOIL 

2010-02-16 18:10 

30.27 

Final 

11134 

2206 I St. 

DZ 

13 

O. BARAJAS 

1 

1 

± Error 

db 28.886 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 68 

Mode SOIL 

Time 2010-02-16 18:25 

Duration 90.78 

Sequence Final 

Flags 

AVERAGE V.Ayg_of65^67J 

ADDRESS 2206 I St. 

QUADRANT EM 

DEPHT 1 

XRF TECH 0. BARAJAS 

MISC 1 

NOTE 1 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 274.691 

Supervised By: 

Certificate of Verification 

65 

SOIL 

2010-02-16 18:24 

30.29 

Final 

11134 

2206 I St. 

EM 

1 

O. BARAJAS 

1 

1 

± Error 

± 26.061 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 276.529 

Supervised By: 

Certificate of Verification 

66 

SOIL 

2010-02-16 18:24 

30.30 

Final 

11134 

2206 I St. 

EM 

1 

O. BARAJAS 

1 

1 

± Error 

± 26.059 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 282.996 

Supervised By: 

Certificate of Verification 

67 

SOIL 

2010-02-16 18:25 

30.19 

Final 

11134 

2206 I St. 

EM 

1 

O. BARAJAS 

1 

1 

± Error 

± 26.364 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 234 

Mode SOIL 

Time 2009-11-10 12:01 

Duration 92.16 

Sequence Final 

Flags 

AVERAGE QjSgjPf-231-?-ti 

ADDRESS 2206 I st 

QUADRANT F2 

DEPHT 6" 

XRF TECH R. VENTRY 

MISC clearence 

NOTE ngnc 

ppm ± Error 

Pb ± Jis: 

Supervised -r.^MjUtl 
• • • • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 248.026 

Supervised By: 

Certificate of Verification 

231 

SOIL 

2009-11-10 12:00 

30.57 

Final 

11134 

2206 I st 

F2 

6" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 20.648 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 215.032 

Supervised By: 

Certificate of Verification 

232 

SOIL 

2009-11-10 12:00 

30.66 

Final 

11134 

2206 I st 

F2 

6" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 19.309 
# • 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 231.547 

Supervised By: 

Certificate of Verification 

233 

SOIL 

2009-11-10 12:01 

30.93 

Final 

11134 

2206 I st 

F2 

6" 

R. VENTRY 

clearence 

ngnc 

± Error 

± 19.774 
/lA. \ Omaha Lead Site—Fixed Price EP-R7-07-05 

I ^^^ ^ I Coastal Environmental Group Inc. 

V"^^j ? www.coastalhazmat.com 

XPROT*^ COASTA L 

INVIIONNINTA S I lO U r, IN C 

EXECUTIVE SUMMARY: 

BVID #11134-(22061 ST) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 

-COASTAL TO REPLACE THE GRASS ON FRONT YARD WHERE FLOWERS WERE BEFORE. 

(COMPLETED 11/20/09) 
^ ^ EPA # 

laal r ^ EPA Property Close Out Form 

Propeny #: \^ ) 3.^ „ Property Address: 

Datc/Tlroc: Owner's Name:. ^ 

Quads Excavattd; f^ Z-, f) fP ^ 

Contractor Group 

Eicavation General 

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

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

Grading Sod and Vegetation 

I. t>oes the gnuling around the perimeter ofthe house in excavated areas generally slope away 

from the Iiouse? 

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 Tirm and evenly graded? 

S. 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>'' 

7. Was damage to landscaping or plant materials avoided? 

Gates, Fences and Reuining Walls 

1. Do gates open and close freely? (Ifapplicable) 

2. Were all gates or fences taken down during restoration activiiies reinstalled? (If applicable) 

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

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

Foundation, Siding and Gnllers 

I. Was damage to the siding or trim avoided? 

2. Was damage lo the foundation avoided? 

3. Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided? 

Sidewalks and Drh'cways (Concrete) 

1. Was damage to driveway surfaces avoided? 

2. Was damage to walkway surfaces avoided? 

Yes No 

, y 

Yes No 

y 

y_ 

y 

y 

y 

Ves No 

• 

y 

y 

1 ^ 

Yes No 

y 

y 

y 

y 

y 

Yes No 

y 

i ^ 
4^__ ^ Ort'ners comments: 

Inspection notes: 

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

EPA Representaiive B ^ JL^ Date: /yfe ^ 
Property Completion Agreement 

I his agreemenl documents lhe completion of remedial acliviues perloimed on my pioperly IVIy signature 

will designale ihai 1 am satisfied with (he restoraiion of my properly, and that no items are in queslions. 

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

PI operty fD: \{ \ 2^LJ 

Property Address: 12JOU > JX T SV L 

Phone: [HQZ^ C^^^ ^ ^^^C ^ 

Restoration items in Question: 

Item: 

Item: ^ 

I •• • I • • L L 

Item: 

item: 

Item: 

Item: 

Additional Comments: 

r^l I iiurcc I tstoralion i.t complcled, cxccpl as noted 

[_J I rto nol »\iTtc restomtion jj completed 

Owner's Sicnutmr Date ^^^GtrtTtiactor's Signature Dale 
© • 

Propertv Owner Satisfaction Survey 

Omaha Lead Superfund Sit NOV 2 3 2009 

2008 

Humediation Contractor: Coastal Environmental Group ^IIPFRFUN D DlVlSIOt ^ 

Property Identifier Number: \tt^ M Q U T L111 u 

Property Address: ?^QU/ C "SW 

Property Owner's Name: ' M Qr i A / Lor^fJ ^ Or-V-)! ^ 

(above Informaiion to be filled out by remediation contractor prior to delivery of form lo 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 reniediation contractor, as applicable to the soil cleanup action at your 

property. The U.S. Environmental Protection Agency (EPA) is very interested in your opinion regarding 

the worit performed by its contractors. This form is intended to provide an easy means for you to 

express your opinion about the woric performed on your property. 

Please indicate your level of satisfaction with the contractor's worl< by selecting a numerical 

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

return it to the USEPA in the attached self-addressed & stamped envelope, (additional comments may 

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

9-10 "excellent" 

7-8 "very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Property Owner's Satisfaction Rating Regarding Contractor's Work 

10 5 

(J) ^ 

fi 3 

7 2 

6 1 

Additional Comments from Property Owner (optional: continue to back of paee if neededl 

Property Owner's Signature: > A ^ J^/ ? //9 - f) /rV^JZ . Date: U/l^/rJ \