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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 28657 Property Address 2504N19St 

Field Work Started 09/25/2006 Field Work Completed 09/26/2006 

Summary: 

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

• F2 excavation depth varied frpmj4. to 6 inches below ground surface. 

• B2 excavation depth varied from 4 to 6 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: 

Concrete pad on original drawing 5-5-04 removed prior to clean up. XRF results for 147 ppm 

east pad and 1 9 ppm for west pad site. 

ECC 

Name Title Date 

JeffHubbard USAGE Con Rep 1/^Lltji 

Name Title Date ' Si 

40286384 

HI! HIM 

Superfund 
page 1 of. 

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) 

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) SSI-

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

Property Access Granted By 

(Please Print Name) 

•A 

(Property Owner Signature) 7 tT ~)(Date ) 

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

PROPERTY INFORMATION 

(to be completed by resident and.-or property owner - Please Print! 

Resident Name: C>t"» y o"i OmflnA owner LJ renter 

Residence Address: 

(CITY) (STATE) (ZIP)

 

Property Owned By c,4 y 

i ^ 

Owners mailing address: lc> I7 

Owner's telephone number - •itl-Sl%o(&K&) Work: 

•^ v-< 

Age of Home? /NO [Jyears How long have you lived here? >L years 

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

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

Total number of occupants: List Ages: 

List ages of occupants under 6 years old who play in the yard for 5 or more hours per week: 

xOmments: 

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 

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 under this title, or otherwise enforcing the provisions of this title.' 

Access Attempts: 

First: Of//8/0 Second: : Third: : 
Contract No. W912DQ-04-D-0017, Task Order DK01

 

Omaha Lead Site, Omaha, NE 

Property Closeout Agreement 

BVID Property Address ~z-o £, 5>~ ( ^ibf /O, IJ&SlProperty Owner 1 Is the Owner the Resident? D Yes )9-No ' OsnflnA 

Compliance Statement: 

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 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 USAGE and/or ECC: 

CONTRACTOR CERTIFICATION 

Prashant Khanna or ECC Project Manager 

Charles "Skip"Milton 

Name TitlC

 f\^ A Date Signature 1 . » ^>K;p *A\lU PM /2-/Z-<flr ,JY ly^ 

PROPERTY OWNER SECTION 

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

satisfaction. 

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

Comments (if applicable): 

£L U~f*~— /2-^ -Ob 

Property Owner's/Signature Date 
CONTRACT # W912DQ-04-D-0017, T.O. DK03 

Environmental Chemical Corporation 

Omaha Lead Remediation, Omaha, NE US Army Corps 

of Engineers 

Analytical Results Summary 

BVID #28657 

2504 N 19 St 

Sample 

Type 

Quadrant Depth Date Collected XRF Results 

(ppm) (avg.) 

Lab Results 

ppm (avg.) 

DE B2 6 9/25/2006 19 NA 

DE F2 6 9/25/2006 9 NA 

PX EA-E 0 9/25/2006 69 NA 

PX B1 0 12/12/2006 147 NA 

PX F1 0 12/12/2006 19 NA 

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

The sample type identifier (with sequential sample number for that 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; 

F1 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 
•«-—••• •*•••! 

North Arrow iha Lead Site Owner Name: £ii/v ^ £w lAx °m£ 

/ b ite Sketch Address: 2-^>Oc

/ A; !<? sl,

Phone: H:(£C^ r/8o CCh^^V

 

Sample Number 

RYAOCPXA 

RYBSCPXARYDSCPXA­

— R— 

F2 

B4-

B2 

Lead 

Concentration 

ppm 

~I72> ppm 

l&'2-'2— ppm 

Sample 

Collected

D 

D 

' • 

.LAB

D

D 

D 

n 

• 

• 

Firm:

DatpTime:

Samples Collected 

 /^/?5 

 5 '— *•) * f 

 A </ 7 

y/ 

Samples Analyzed 

R /"* ~~r e* /"• n v A 

— 92­ ppm 

ppm 

D 

D • •n 

XRF UnitDate:  R^ni^­

— PZ— - .­ ppm D n TimeNumber of Samples 

Staff: 

Omaha Lead Site 46130 
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: £50(-\ /O < ( ? 

Property Owner's Name: C * F ^/ &\ 

(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" 

7-8 "very good" 

5-6 "acceptable"7 

3-4 "poor" 

1-2 "very poor" 

Property Owner's Satisfaction Raring regarding Contractor's Work 

10 5 

9 4 

8 )s~ 3 

1 ' 2 

6 1 

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

Properly Owner's Signature: 
North Arrow iha Lead Site Owner Name: £iJ-ry <• f ' F)inn tna. Omz 

a ite Sketch Address: 2-5OL

l A; q sf,

Phone: ntyc?) ViA/'^'Sc) rc/-,,8/sf ) ' 

Lead Sample Samples Collected Sample' Number LAB Concentration Collected Firm: /*/£$ 

•RYAGCPXA — H— ppm Datp' S -~ *•> ~"><{ /

 

RYBSCPXA- F2 77<^ ppm D

 Time: A </ 7 

ovr"T^ r*Y A. &f pom D D Samples Analyzed RYDSCPXA- B2 /^^Z- ppm n 

Pn"7s r* P Y A — D2- ppm n n YRp I |njt- R^^UR/"* ~7 O i^> n V A •\3t-~- ppm n n Date: 

np-'^ppy A 

-B 

n n Time: 

Staff: Number of Samples 

Omaha Lead Site 46130 
North Arrow r ^ Omaha Lead Site Owner Name: ^SWv A>- 1 itonuvw. _. . 

Mdress -/ J> SI, S.te sketch : _^^O 

Phone: H(^Q X) M4<A-b VlSo C CK^s)

/ 

Lead Sample Samples Collected Sample Number LAB Concentration Collected Firm: /*7£5 

rwAocrxA R1— ppm n D Date- 'S-S-Crf 

RYBSCPXA- F2 77«£ ppm pf Time: A V 7 

RYCGCPXA- B4- DDm 1 1 D Samples Analyzed RYDSCPXA- B2 /^^Z- ppm [7f n 

9-7 _ 1 1 e— ppm | i n XRF Unit' RnnkR f~*~7c* r^ntv A o& pplll 1n 1 Date: 

P*7 nnn^ 1 1 2 ppm I | n Time' 

j

r , Staff: Number of Samples - i '2. j 

Omaha Lead Site 46130 
Map Output Page 1 of 1 

2504 N 19 St/62x90 

Legend 

;p;-:T. Hrjhlgtilad Ftjijlura IS.', TO 

| | Parcel 

,-,.,' Slrasl 

Blnck iinj While .Aorinls 

http://webarc.co.douglas.ne.us/servIet/com.esri.esrimap.Esrimap?ServiceName=TestAerial... 9/21/2006 
pg._ ot _ 

List of Existing Conditions 

Property Address: <^o*f /Q . l^^ S+~ DVD ID # 

Owner: C,4y of Om/iU Date: BVID# 

Ref: 

Photo Description 

# 

0 o£u^c£. i 

Owner Sinature ECC -

Print & Sign ' 
Property Check Lists QC

 

Location sson A/. /^' 

BVID 2^<^nDates 9/£S7o^. S^7^u 3-Mr-tfe. 

Excavation check list XRF check list Backfill check list 

have easement map have easemet map (1) reconstruction map 

have site map have site map (3) positive drainage from house 

home owner agreement easements sample NO low spots 

line locator F1 samples NO Rake Gaps 

access log F2 samples lawn even 

decon. station B1 samples soil compacted 

tape barricade B2 samples sidewalk 1" cuts 

garden hose DZ samples smooth transition from walks 

reconstruction map for buildback AS-Built area free of debris 

fences map corrected fences repaired 

sod areas shots mapped damage to property? 

mulch concrete mapped damage list 

gravel trees marked punchlist filed 

notes LIP marked/noted 

name and date name 

date 

easement mapped 

window wells mapped 

ac mapped 

Log book up to date 

QC Notes 
Map Output Page 1 of 1 

2504 N 19 St/62x90 

Legend 

d Fealute 

I I Part«l 

,v' Slreel 

Black, and While A a rials 

http://webarc.co.douglas.ne.us/servlet/com.esri.esrimap.Esrimap?ServiceName=TestAerial... 9/21/2006 
Omah North Arrow a Lead Site Owner Name: £Wy ^f fau lAx _ .. 

 Slte Sketch Address: Z5OC

/ rV l<? _a. Phone: H$5>J </V, V "5 

Lead Sample Samples Collected Sample Number LAB Concentration Collected Firm: /tff.5 

•RYAGCPXA P1 ppm n Date- 5^5~'<?y 

RYBSCPXA- F2 77<^ Dpm Time: 1: <f 7 

RYCGCPXA — B4- nnm 

Samples Analyzed RYDSCPXARDZ^PPXA 

B2 

-B2­

/£^Z­ ppm 

ppm D 

n 

n XRF Unit1

 Rook" 

RCZSCPXA 

PP-"-CPXA 

/TM»*7 

P7 

ppm n 

n TimeNumber of Samples

r 

­ | Zj' Staff: 

Omaha Lead Site 46130