### CONTRAC T# W912DQ-04-D-0017 , T.O . DK0 3 Environmenta l Chemica l Corporatio n Omah a Lea d Remediation , Omaha , N E U S Arm yCorp s o f Engineer s 

### EC C Certificatio nfo r Propert y Closeou t BVI D 3004 7 Propert y Addres s 1 8 1 2 Locus t S i Fiel dWor k Starte d 07/17/200 6 Fiel dWor k Complete d 07/28/200 6 Summary : •Th e excavatio nwa s performe di n complianc e wit hth e wor k plan s an dspecifications . •F l excavatio ndept h varie dfro m2 t o 4 inche s belo w groun dsurface . • Dri p Zon e excavatio ndept hvarie d fro m1 2 t o 1 4 inche s belo w groun dsurface . •Verificatio nsample s confirme dtha t cleanu p standard s wer e met . •Th e sit e wa s backfille dwit hmateria l whic hmeet s th e contrac t specifications . •Th e backfil l wa s compacte dt o acceptabl e standards . •So dplacemen t an dsit e restoratio n wer e conducte di ncomplianc e wit hth e specification s an d wor k plans .

Comments : None . Ski p Milto n EC C Projec t Manage r Nam e Titl e Dat e JeffHubbar d USAG E Co n Re p 

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# Asft//// T •• ff f i Name : |*le.l\A a fjer&S.e-k - Omah a Lea d Sit e Date : D^ - • \ o * - 0 3 Nort h Arro w- Address : V 3 \3 . Lon^y - fi V Sit e Sketc h Time : V^' , iZOp m Phone : ^ / A

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## pag e 1 of . Omah a Lea d Sit e Omaha . N E Residentia l Yar d Soil s 

### U.S . Environmenta l Protectio n AgencyRegio n VI I Environmenta l Restoratio n Service s 

### PROPERT Y ACCES S (t o Jb e complete d b yproperl yowner ) U.S . Environmenta l Protectio n Agenc y(EPA ) ha s contracte d th e U.S . Arm yCorp s o f Engineer s (USAGE) , Omah a Distric t t o conduc t environmenta l restoratio n service s fo rth e Omah a Lea d Site . USAG E Omah a i s workin g wit h Environmenta l Chemica l Corporatio n (EGG ) t o remov e lea d contaminate d soi l an d provid e subsequen t restoratio n services . You rcooperatio n i s requeste d i n givin g EPA/USACE/EC C permissio n t o acces s you rpropertydurin g th e removal/restoratio n phase . Fo rfurthe rinformatio n pleas e contact Do n Bahnke , EP AProjec t Manage rat (913 ) 551 ­ 700 3 o rth e Offic e o f Externa l Programs , a t 1-800-223-0425 . Propert yAcces s Grante d By 

### * L\V 

### -M O (Pleas e Prin t Name ) 

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## r - - \Date ) \/ n [PropertyOwne rSignature ) " NOTE : Grantin g permissio n DOE S NO T necessaril yimpl yyou rpropert ywil l b e remediate d a t thi s time . PROPERT YINFORMATIO N (t o b e complete d b yresiden t and'o rpropert yowne r• Pleas e Print) Residen t Name : y , yC^_C>_\ j j -\--L- L J owne r rente r Residenc e Address : $ 

### I D C 

### U.S\
- M l Ull l (CITY ) (STATE ) (ZIP ) PropertyOwne d By : Owner s mailin g address : f^C s Owner' s telephon e numbe r- Home . {< - Work : 3Ci l - Ag e o f Home ? &Li_i l year s Ho wlon g hav e yo u live d heje ? year s Ha s th e exteio rbee n painte d o rcovere d wit h sidin g since 1978 ? e s D N o Ha s th e interio rbee n painte d o rcovere d since 1978 ? Ye s D N o Tota l numbe ro f occupants: _ Lis t Ages : 1 Lis t age s o f occupant s unde r6 year s ol d wh o playi n th e yar d fo r5 o rmor e hours pe rweek : Comments : AUTHORITY FO R ENVIRONMENTA L RESPONS E ACTION S Th e activitie s t o b e implemente d b yEP Aunde rthi s agreemen t are pursuan t t o Sectio n 10 4 o f CERCLA , 4 2 U.S.C . 9604 . EPA' s righ t o f acces s t o :h e propert yfo ri n Sectio n 104(e ) o f CERCLA , 4 2 U.S.C . 9604 (e) , whic h provide s entr yfor , "determinin g th e nee d fo rresponse , o rchoosin g o r akin g an yrespons e actio n unde rthi s title , o rotherwis e enforcin g th e provision s o f thi s title. " Acces s Attempts : First : Second: : Third : :

### Contrac t No . W912DQ-04-D-0017 , Tas k Orde r DK0 1 Omah aLea dSite , Omaha , N E Propert y Closeou t Agreemen t 

# BVID Propert y Addres s 

### 1# > V ? 5^l i WO
- 5^54
- Propert y Owne r I s th e Owne r th e Resident ? D Ye s WN o 

# W\£-Vv>iG^ . [,«-s<«t y Complianc e Statement : U.S . Environmenta l Protectio n Agenc y (EPA ) ha s contracte dth e U.S . Arm y Corp s o f Engineer s (USAGE) , Omah aDistric t t o conduc t environmenta l restoratio n service s fo r th e Omah aLeadSite . USAG EOmah ai s workin g wit hEnvironmenta l Chemica l Corporatio n (ECC ) t o remov e lea d contaminate dsoi l an dprovid e subsequen t restoratio n services . You r cooperatio n i n givin g EPA/USACE/EC C permissio n t o acces s you r property durin g th e removal/restoratio n phas e i s sincerel y appreciated . Thi s documen t certifie s tha t al l work performe dat thi s propert y wa s complete di n accordanc e wit hth e contrac t specification s an dEP A requirements . I f

yo u hav e question s o r nee dadditiona l informatio npleas e contac t Do n Bahnke , EP A Projec t Manager , at

(913 ) 551-700 3 o r th e Offic e o f Externa l Program s at 1-800-223-0425 . Additiona l Comment s b y USAC Eand/o r ECC :

CONTRACTO RCERTIFICATIO N Prashan t Khann ao r EC C Projec t Manage r 

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# / ,^^^L ~ Charle s "Skip"Milto n Nam e Titl e Dat e Signatur e 

## PROPERT Y OWNE RSECTIO N Thi s agreemen t document s th e completio n o f remedial/restoratio n effort s a t th e property t o m y satisfaction . IA ) I agre e tha t restoratio n i s complete dat my property , excep t a s note d Comment s (i f applicable) :

Proper t yOwner' s Signatur e Dat e

# Property Owne r Satisfactio n Surve y Form Omah aLea dSuperfim dSit e Performance-Base dContractin g (PBC ) Pilo t Projec t Remediatio n Contractor : Property Identifie r Number : Property BVI D Number : ~$QQ Property Address : l^ & f " ^ ^

—£ ? < ^ L < Property Owner' s Name : « V b ^ I ^ ( £" l (above infonnatio n t o b e fille dou t b y remediatio n contracto r prio r t o delivery o f for mt o Propert y Owner ) 

## Instruction s t o Property Owner : Thi s for mi s provide dt o yo u a s amean s o f tryin g t o capture you r leve l o f satisfactio n withth e work o f th e above-identifie dRemediatio nContractor , a s applicabl e to th e soi l cleanu p actio nat you r property . Th e U.S . Environmenta l Protectio nAgenc y (EPA ) an dth e U.S . Army Corp s o f Engineer s (USAGE ) are very intereste di nyou r opinio nregardin g th e wor k

performe d b y ou r contractors . Thi s for mi s intende dt o provid e aneasy mean s fo r yo u t o expres s you r opinio nabout th e wor k

performe do nyou r property . Pleas e indicat e you r leve l o f satisfactio nwithth e Contractor' s work b y selectin g a numerica l ratin g (ranging fro m1 t o 10 ) usin g th e followin g ratin g scale , the npleas e sig n& dat e the for mandretur nit to USAG Einthe attache dself-addresse d& stampe denvelope . (Additiona l comment s may als o b e provide di nth e spac e provided , at th e optio no f th e property owner. ) 9-1 0 "excellent " 1- 8 "very good " 5- 6 "acceptable " 3- 4 "poor " 1 - 2 "very poor " Property Owner' s Satisfactio nRatin g regardin g Contractor' s Work 1 0 5 9 * / 4 8 3 7 2 6 1 

## Additiona l Comment s fro mProperty Owner (optional ; continu e o n bac k o f pac e i f needed )

Propert y Owner' s Signature : Mu \ 

## Date : \Mu»4i O w^yyo ^

### CONTRAC T# W912DQ-04-D-0017 , T.O . DK0 3 Environmenta l Chemica l Corporatio n Omah a Lea d Remediation , Omaha , N E U S Arm yCorp s o f Engineer s 

## Analytica l Result s Summar y BVI D #3004 7 181 2 Locus t S t

Sampl e

Typ e Quadran t Dept h Dat e Collecte d XR F Result s (ppm ) (avg. ) La b Result s pp m (avg. ) D E D Z 1 4 7/11/200 6 10 1 N/ A D E F 1 4 7/11/200 6 2 6 N/ A P X EA- S 0 7/11/200 6 22 4 N/ A

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BVI D i s aparticula r residentia l propert y I D fro mwhic hth e sampl e i s collected .

-Th e sampl e typ e identifie r (wit hsequentia l sampl e numbe r fo r tha t location ) a s follows ; P X = Pre-Excavatio nXR Fsampl e P E= Pre-Excavatio nlaborator y sampl e D E= Durin g an dPos t Excavatio n

—Quadran t describe s th e samplin g locatio n(wit hsequentia l sampl e numbe r fo r tha t location ) a s follows ; F l o r F 2 = Fron t Yar dOn e o r Fron t Yar dTw o B 1 o r B 2 = Bac k Yar dOn e o r Bac k Yar dTw o D Z= Dri p Zon e I G A = Garde n P A = Pla y Are a E A = Easemen t Dept hdescribe s th e dept hfro mwhic hth e sampl e wa s collected .

- pp m = part s pe r millio n

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Excavatio n chec k lis t hav e easemen t ma p hav e sit e ma p hom e owne ragreemen t lin e locato r acces s lo g deco n statio n tap e barricad e garde n hos e reconstructio n ma p fo rbuildbac k fence s so d area s mulc h grave l note s nam e an d dat e

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## XR F chec k lis t hav e easeme t ma p (1 ) hav e sit e ma p (3 ) easements sampl e 

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## fif Backfil l chec k lis t reconstructio n ma p positiv e drainag e fro m hous e N O lowspot s N O Rak e Gap s lawrveve n soi l compacte d sidewal k Toil s smoot h transitio n fro m walk s are a fre e o f debri s fence s repaire d damag e t o property ? damag e list punchlis t file dvOmah a Lea d Sit e 4613 0Name : Mej \ AQ fjerf^J ^ Omah a Lea d Sit e Date : D 1 - \ Q - 0 3 Nort h Arro w Address: ^ \« a L Sit e Sketc h Time : VS.' , 3 . o pr-\ -ofi^V - 5V - Phone : AV ^ ' 

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