% 

TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: .'SZ^M ^ Date: \n\7JLo[Cf\ 

Address: 317 A M 1 4 'M 

Remediation Contractor: Coastal Environmental Group_ Year: 2008 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

S - ^ Video of property (DVD) 

tK^ Executive Siunmary 

Sr EPA-provided property sketch 

Sy^ Signed Access Agreement for subject property 

vll^ Signed Access Agreement(s) for adjacent property 

SY"^ Restoration Agreement 

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

[iU-^ Confirmation data 

B ^ Photographs [h'tfCf^tCV^ , 

0 ^ As-built sketch 

Q— Satisfactory restoration signed by Property Owner 

B-^" Property close-out check list signed by EPA 

^ Description ofareas not meeting ROD cleanup criteria 

B ^ Utility clearances 

SU^ Property information from Douglas Coimty Assessor's Office 

• . 

D 

Mam

Ignatur laturee Date Sign: 

30054532 

Superfund 
# # 

Property Access Checklist 

Propct^lD: 3 ^ f^U ^ 

Property Addre.: <^>-p^ a KS 7 U 1 ^ 

D

D

 WORK STARTED

 WORK COMPELTED

 ON. 

 ON: 

_/

/

 /_ 

/ 

Owner: ^p^^^^ )

Address: 

 ly^l^K S Rcnier 

Phone: 

Phone: 

F«x: 

Ccll/Pager. 

PJLV: 

Cell/Pager: 

Additional Inlnrmntion-. 

D NotiriCiilion Letter 

j S^ Acceu Afrccmcnl 

JS^ Restonitioo Agreemeni 

O Topsoil Sampling (if applicuble) 

O DitposiU Sampling (rf upplicable) 

Q Garden Sampling (if applicable) 

D Uiilily Clearance 

^S [ Video/Photos (Before) 

O Villeo/Photos (During) 

D Video/Pholo* (After) 

D Viileo/Photos (30-Djiy) 

• Property Complelion Agrcemeni 

1 D Finnl Report 

Sent: / / 

Signed: t^// ^ l( P 

Signed:to /L ^ /PP\ 

1 1 

1 1 

1 1 

Called: / / 

On:j(^/25/i2 ^ 

On: /' / 

On: / / 

On: / / 

Signed: / / 

Issued: / / 

By: 

»J=Ell7/*i^4VN 

By= Rirnhe^^/V 

By: 

By: 

By: 

By: 

8y-^vxa\fv 

By: 0 

By: 

By; 

By: 

By: 

Air Monilorint! {»s iipplicabie) 

D Community D Crew 

Results: 

On: / / By: 

D Comrounit?'

Rc«ulis: 

• Crew On: / / By: 

O Communiri

ResulU: 

D Crc>v On: / / By: 

Omaha Lead Site 
g» 

CONTACT FORM 

Property ID # Z l UM ^ 

Property 

Address: -M7 4 N 7M ^^ 

Initial Contact: Date: Time:_ Action: 

Second Contact: Date: Time: Action: 

Final Contact: Date: Time; Action: 

Final Action: Transmit to EPA D Other Action: D 

Comment: 

Owner 

Comment (s): 

Site f o t^^'^ -^ko^^^ i,e.^ fu\'ei^5> 

Coordinator 

Comment (s): 
Douglas Coimty Account mation Page 1 of2 

Douglas County, Nebraska Property Record - R1715590000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - VleVtf O n Ma p Information is valid as of 2009-5-12 Treasurer's Tax Report 

New Feature ••->- • Auto Sales Search 

Owner 

THOMAS DEBORAH K 

3724 N 24 ST 

OMAHA NE 68110-0000 

Property Informatio n 

Key Number: 1559 0000 17 

Account Type: Residential 

Parcel Number: 1715590000 

Parcel Address: 3724 N 24 ST 

OMAHA NE 68110-0000 

Legal Description: MARYSVILLE ADD LOT N 44 E 100 FT 44 X 100 

Value Informatio n 

Land Improvement Total 

2009 

2008 

2007 

2006 

2005 

2004 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

$2,200.00 

$60,000.00 

$60,000.00 

$60,000.00 

$60,000.00 

$17,900.00 

$16,200.00 

$62,200.00 

$62,200.00 

$62,200.00 

$62,200.00 

$20,100.00 

$18,400.00 

L^nd Informatio n 

Acres 

0.1 

SF 

4400.0 

Units 

1.0 

Depth 

100.0 

Wdth 

44.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R171... 6/7/2009 
Douglas County Account fl^Vation Page 2 of2 

-03. i l uo 

B f t SKond Roac 

'J Fnt Floor T»,0»« 

777<m . DO 

.1 tKHaa-mm 

2 STORY 

7!3 0l l 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1530.0 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: 8.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: ! Composition Shingle Bedrooms: 4.0 

Roof Type: Hip/Gable Stories: 2.0 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: ; 0.0 

year Built Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1905 0 0% 1905 104 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 753.0 

Basement Outside Entrance 1.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

Garage Detached 216.0 

Porch Encl Solid Wall 147.0 

User SOURCE 3 1.0 

http://douglasne.mapping-onIine.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl71... 6/7/2009 
Remote ID: R page of 

1 


;ox 3 44 8 


O K 74103 . 
 4-709 8 


4-746 6 

>n lowin g OneCsil 1 Agenc y di g ti clcets C3L 1 1 e d i n fc>y : -tor-: COASTA L ENVIRONMENTA L SERVIC E 


imber-: 8776624 2 H 


Numk>er: 8776624 2 1 0 


.te : 2 009/07/ 2 8 


ci : 593.933 

>e CLEA R o- f und e i- g r-oun d -Fsic i 1 i t i e s -For-: MAGELLA N RIRELIN E 

Ticke t Nunriber - E?cceiv£itoi " Contsic t D i g Addnes s 

232825 3 ELIZABET H 593.9 N 52N D S T 

232830 0 

232830 3 

ELIZABET H 

ELIZABET H 

3.480 SRENCE R S T 

2 1 2 4 MARL E S T 

« 

232830 4 ELIZABET H 3 7 2 4 N 2 4T H S T 

232830 9 ELIZABET H 2 57 0 WHITMOR E S T 

HoLv e sin y questions . plesLs e conteic t MsigellBi n OneCa.l l Bi t 93.8/ 5 74—709 8 

J 
Page 1 of2 

• # 

"> 

[ Create Another Ticket ] 1 Back to Irth Internet ] Send Email 

• YOUR TICKET NUMBER IS 2328304. 

Original Call Date: 7/28/09 Time: 4:26 pm Op: ELIZABETH18790 

Work to Begin Date: 7/30/09 Time: 5:00 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 3724 Street: N 24TH ST 

Twp: 15N Rng: 13E Sect-Qtr: 03-SW,04-SE,09-NE,10-NW 

Twp: Rng: Sect-Qtr: 

Legal Given: C 

Type of Work: lead remediation 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNStJRE OF CORNER LOT 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: Coastal 


Depth of Excavation: 4 ft. Corner Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


ALTS72 CXCATV MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

ALT872 WINDSTREAM COMMUNICATION NA 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MAGELLAN

Day: 9185747098 

 MAGELLAN MIDSTREAM PARTNERS LP DEBORAH Alt: 

Emerg: 9185747098 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY

Day: 4025047823 

 Alt: 

Emerg: 4025047970 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/28/2009 
Page 2 of2 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK NA 

Day: 4067289343 

Ah: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/28/2009 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

33Q ^ 

Omah Extepior Paint North Arrow a Lead Site Owner U»mo: DEBORA H K THCM ^ 

Site Sketch Address: a^^Q f N & ^ ST . • Poor 

Phone: HiC^OS.') 88^-0^0 0 

r~| Not paint 

Sample Number Lead Sample LAB Samples Collected 

Concentration Collected 

Firm: /=73K; gO> K W 

RYASCPXA-olSM S F l D Date: S / 2 S J ^5 ^ 

RYBSCPXA ,ga(;4 ^ F2 • 

Time: ?^^ 0 

RYCSCPXA ,3R64»6 B I • 

Samples Analyzed 

RYDSCPXA-otaiMtS B2 D 

RDZSCPXA-,5{8£i4^ DZ D XRF Unit 

ROJOCPXA 0 2 n D Oate 

D 

Time 

Staff: Numtier of Samples = / . 

ml 

Legend: F l = Front Left, F2 Front Right, B l = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

AH quadrants am as viewed from the street, taong propefty 

ENTEB13D 

2-5 tm% • 

OLS#:32642 

a/5/09 

F: 8/13/09 

Legen d 

Concrete Drip Zone Excavated gg j Quadrants Excavated 

Area replaced

Sod 

 with Area replaced with 

Rock/Mulch Area lef t bar e 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc , 
HL.Itto-*.^ 

(^V 77/4 330 ^ 

Omah Extejjor Paint North Arrow Owne a Lead Site r Name:^ 

Site Sketch 

Address: SPMM^^ Z • Poor Phone: H:M^18Bid:M£> Q Notpaint 

Sample Number Lead Sample 

Samples Collected LAB Concentration Collected Fimi: n> ^ eOi Kl*^ 

RYASCPXA-ol2(o4g F1 D Date: s/ZS^^ r 

RYBSCPXA-5!l8i£J4^ F2 

t D Time: <^'^0 

RYCSCPXA-3aS4*& B1 D 

Samples Analyzed RYDSCPXA-ol8(i4£ B2 

RD2SCPXA-,3Q54£ DZ D XRF Unit: 

RGZocpxA ez _ii__pp"i D Date: _ 

D m^-^ 

(jf. RPZSGPXA-3a54i& -B^- (OM ppm D D 

Time: _ 

Legend: Fl = Front Left, F2 = Front Right

Numbe

, 8

r o

1 =

f Sampte

 Back Left

s =

,

 I

 B

 ^

2 =

 i

 Back Righ

 ^—

t D

 ; 

Z = Dri

Staff

p Zone

. 

, GZ =

m

 Garden, PZ = Play 

All quadrants are as viewed from ttie street, facing propetty 

ENTERED; 

/ 

Rav 4' 

046141.0123 
C^37 77/4 

Omaha Lead Site 

Site Sketch Address: ,3?i2^J^^_^r , . 

Phone: H:X40B18a^'(D^00 

Sample Number Sample LAB Collected 

RYASCPXA-ot2|;o4g F1 _ppm D 

RYBSCPXA-5g64»S F2 Lg_ppm D 

RYCSCPXA-,3I8£P4^ BI ^J ^ ppm D 

RYDSCPXA-ol854^ B2 .P4; ? ppm D 

RDZSCPXA-,3g54;g DZ /(OCfl ^ ppm D 

RGgSCPXA fmZ ~ ppm D D 

(jd RPZSCPXA-,3aS4,^ £Z- ^ 9 ppm D 

Number of Samples ~ (^ "— ; 

3SG ^ 

Exterior Paint North Arrsw 

• Poor 

[~] (slot paint 

Samples Collected 

Firm: Fpt^ eO> i^ ^ 

Date: S/2 S J^ r 

Time: ?r5C> 

Samples Analyzed 

XRF Unit 

Date: _ (Ao-'OSrQ't 

Time: _ 

Staff: 

m 

Legend: Fl = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

An quadrants are as viewed from the street, facing property 

ENTERED 

MM .2-5-2095 

/ c 
QSGY^ 

Own«r Name 

Address: 

Phone: 

Sample Number 

RYASCPXA-aa54g Fi 

RYBSCPXA>3j8G4f& P2 

RYCSCPXA-,3II3;P4£ BI 

RYDSCPXA-^3Q(;4£ 62 

RDZSCP)(A-3g|Q4^ DZ 

nOgOCPXA- G2 

(jf. RnasopxA-<3»aSfi& -BZOmaha Lead Site 

Site Sketch 

Lead Sample 

Concentration Collected 

i.ppm 

J - , ppm D 

LAB 

D 

D 

D 

D 

D 

D 

D 

Number of Samples = [ A | j —* j 

North Amw 

[g^ood 

Extedor Paint 

• Poor 

Q Notpaint 

Samples Collected 

Firm: _£M_je2Ljf*iL 

Date: S/2S;g5 " 

Time: __2>LS Q 

Samples Analyzed 

XRF Unit: 

Date: _ 

Tlme:_ 

Staff. 

Legend: Fl = Front Left. F2 = Front Right. Bl = Back Left, B2 = Back Right DZ <* Drip Zone. GZ = Garden, PZ « Play 

Alt quadrants ara as vtswed (rom the street, fbdng property 

ENTERED; 

MAY 2.5 .joss • 

st "—f 

:\)VWt\­

• ^ iW 

i.v:..;. 

'"t l •?p 

^ 

N-.^. 

? 

* iaJUX } I i7 

!=! 

isG3 

l l w 

lt«*4« t \ \ t t t... . . i . . . ..!.., . . t \ . . .. . V I , t 1 046141 ,0123 
M. V COASTAL h-., .^<fi^ ENVItONHENTAL 

••t PB01 * C II 0 U P , 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: yiMZOwner's Name: Daytime Phone: G£-^( 

O^llA i^ ^^^"^ Address of Property 

covered by this 

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 perfomned 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 perfomning the wori(. This access shall 

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

agrees to: 

Page 1 of 2 
ieos>;4. 

^ 

V**»*^ V COASTAL \ <JCP

 . ENVIKONHENTAL „

•' I PROl*- C 1 O U P . I N C. 

• 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 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 

^ 1 grant access to my properties D I do not grant access to my properties 

0/ 

Date ^ / Sigmnure Oate 

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

Page 2 of 2 
C O A S .T A L 

G K O U P 

Restoration 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 satisiaction of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property Address: " ^ J A AJ ^2^"^ ^ ' 

Owner: pg^gbig^i^ -Ji\XXtiltY^ Id 

On the attached diagrain(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 return of these items Is the Owner's responsibility. 

Item: 

^ y 9 ^ J I /^<^/<S 

Kem: 

Item: 

Item: 

items to be Remo )ved by the Contractor During Remediation and Not Replaced 

Item: 

A-^ / $^f^f/^0 

Item: / 

Item: 

Item: 

Pagel of. 
C O A sj r A L ^r»*'4'j MON».TNTAI . CROUP . IN C 

Items to Be Removed By Contractor During Remediation and Replaced 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Atiacii a sketch of the 

sprinkler lavout. 

Number of and size of 

each garden/ flower bed 

area. 

Anach a sketch of relative 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this \aluc will bt 

usetJ to issue a plant 

voucher to the property 

owner. 

Easement Area, to be 

excavated 

Quantity 

f \^ i^A 

^ 

y ^ 

H/< ^ 

Z^ 

i^i 

Landscape Inventory 

Unit 

Quadrants 

Each 

Each 

Each 

Each 

SquareFeet 

$ 

Condition/Type/Species 

rt^.^j ^e^'y^Ts 

Each 

Page 2 of. 
COASTA L 

^nou', < IN C 

Additional Comments / Instructions: 

V^ - ^ • 

• rtvs­ i^^D oUulcw ^<^ln^ G'^<>^^ 

vUulc/Vi ^ 

Sc?tU <i. Sot) . 

D Check the t)ox 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. 

BTagn Q I do not agree agree 

'Mi*y dCM>. Conmctor^s Signature Date 

Page 3 of. 
Date 

Project 

XRFID# 

Shot# 

.^aifa. lr\2r\ 

W2B 

1'\'L<\

Average

Shot# 

rvbiaJ2n2a. jaasL 

'2.-t?A

Average

Shot* 

Average 

Shot# 

Average 

lab sample # 

BVID#3j2-toy^, 

XRF PROPERTY SAMPLE SHEET 


ssa Address ?>-^m MXt4? ^ 

Omaha lead FP 2nd year option Sample time am/pm 

sample length 30 sec 

Reading Sample area Shot # Reading Samplearea 

^^Yf,A^•^ I Q 2,1 &\ 2teS.bKtl: 0 

^ \ t2>\ nifr^*9d^X'2x> ir\^' L ?^7.^f^-|» 1.-2. 

V^q>.r>tp-t \"t Depth ^teeLin i ? ^ Depth 

^l^i > 

 l-2.6.i.aTt2 o 0-^^*^ ll"\-V.-iqt to 

 QM^.^Arv ^ \ ^ Average '2.<k'3k>rniC'Z.! 

Reading Sample area Shot# Reading Sample area 

H-tM<tiq Ili'W \^z.qa» \M Et^ X ? l e;-\.nti\ o \t^.ifa{->; m ^im. tiii^.U^t W Depth 'z.t^?^ ^T^-X-T.ii \ s Depth 

 mu.tM t q -t1.-&-3>^ X-L XT, ^^4 ^ 

 ^*-\.\2.' t \ 0 Average \S^.» 0 " t H 

Reiading Sample area Shot# Reading Sample area 

Depth Depth 

Average 

RETEST AREAS 

Reading Sample area Shot* Reading Sample area 

Depth Depth 

Avenage 

Lab result Sample area XRF Avg. 

Signature 2CAe,tfA ^ 

Print&(ijyLhf#^ QMI^OVOTS 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2730 

Mode SOIL 

Time 2009-08-05 17:13 

Duration 121.26 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm ± Error 

Pb [249^702 ± 

<^ 

Supervised By: f(fAtiKU^ 
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 278.115 

Supervised By: 

Certificate of Verification 

2726 

SOIL 

2009-08-05 17:10 

30.27 

Final 

32642 

3724 N 24 st 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 20.342 
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 260.358 

Supervised By: 

Certificate of Verification 

2727 

SOIL 

2009-08-05 17:11 

30.37 

Final 

32642 

3724 N 24 St 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 20.107 
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 193.063 

Supervised By: 

Certificate of Verification 

2728 

SOIL 

2009-08-05 17:12 

30.29 

Final 

32642 

3724 N 24 st 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 17.259 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 267.271 

Supervised By: 

Certificate of Verification 

2729 

SOIL 

2009-08-05 17:13 

30.33 

Final 

32642 

3724 N 24 st 

Fl 

Nicolas 

6 

CLEARANCE 

± Error 

± 19.895 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2735 

Mode SOIL 

Time 2009-08-05 17:17 

Duration 123.01 

Sequence Final 

Flags 

AVERAGE 

ADDRESS 3724 N 24 St 

QUAD/ZONE Bl 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

± Error 

Pb ± 

Supervised By: t^nnJffC K 
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 265.676 

Supervised By: 

Certificate of Verification 

2731 

SOIL 

2009-08-05 17: 15 

30.69 

Final 

32642 

3724 N 24 st 

Bl 

Nicolas 

6 

CLEARANCE 

± Error 

± 19.998 
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 323.073 

Supervised By: 

Certificate of Verification 

2732 

SOIL 

2009-08-05 17:15 

30.99 

Final 

32642 

3724 N 24 st 

Bl 

Nicolas 

6 

CLEARANCE 

± Error 

± 21.918 
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 265.735 

Supervised By: 

Certificate of Verification 

2733 

SOIL 

2009-08-05 17:16 

30.70 

Final 

32642 

3724 N 24 st 

Bl 

Nicolas 

6 

CLEARANCE 

± Error 

± 20.063 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 277.790 

Supervised By: 

Certificate of Verification 

2734 

SOIL 

2009-08-05 17:17 

30.63 

Final 

32642 

3724 N 24 st 

Bl 

Nicolas 

6 

CLEARANCE 

± Error 

± 20.216 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2740 

Mode SOIL 

Time 2009-08-05 17:21 

Duration 122.18 

Sequence Final 

Flags 

AVERAGE ^%jOf27|6ig73 | 

ADDRESS 24 st 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 54!llE ± Oiil^ 

Supervised By: (VICOJ^IUZP ^ 
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 47.433 

Supervised By: 

Certificate of Verification 

2736 

SOIL 

2009-08-05 17:19 

30.88 

Final 

32642 

3724 N 24 St 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 9.398 
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 57.706 

Supervised By: 

Certificate of Verification 

2737 

SOIL 

2009-08-05 17:20 

30.55 

Final 

32642 

3724 N 24 St 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 10.363 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2738 

Mode SOIL 

Time 2009-08-05 17:20 

Duration 30.58 

Sequence Final 

Flags 

BVID # 32642 

ADDRESS 3724 N 24 st 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 66.478 ± 10.807 

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 44.843 

Supervised By: 

Certificate of Verification 

2739 

SOIL 

2009-08-05 17:21 

30.17 

Final 

32642 

3724 N 24 St 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 9.159 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerlca, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2745 

Mode SOIL 

Time 2009-08-05 17:24 

Duration 122.39 

Sequence Final 

Flags 

AVERAGE ^Ayg-Qf 2741^|gg 7 

ADDRESS 3724 N 24 St 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 

Supervised By: Z(^^^JtSiSSdi 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2741 

Mode SOIL 

Time 2009-08-05 17:22 

Duration 30.56 

Sequence Final 

Flags 

BVID # 32642 

ADDRESS 3724 N 24 st 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 132.944 ± 14.488 

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 118.679 

Supervised By: 

Certificate of Verification 

2742 

SOIL 

2009-08-05 17:23 

30.59 

Final 

32642 

3724 N 24 st 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 13.740 
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 213.730 

Supervised By: 

Certificate of Verification 

2743 

SOIL 

2009-08-05 17:24 

30.65 

Final 

32642 

3724 N 24 St 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 17.855 
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 77.832 

Supervised By: 

Certificate of Verification 

2744 

SOIL 

2009-08-05 17:24 

30.59 

Final 

32642 

3724 N 24 St 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 11.569 
i^^QL\ Omaha Lead Site—Fixed Price EP-R7-07-05 

3 ^^^L L I Coastal Environmental Group Inc. Ml ^ ^ 

Xpnorf^ ^ www.coastalhazmat.com 

COASTA L INVIIOHHINTAL 

G • O U P. IN C 

EXECUTIVE SUMMARY: 

BVID # 32642 - (3724 N 24 ST) 

^ No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 

Mulch was replaced on 8/15/2009 
St>i EPA 

EPA Property Close Out Form J7.:2.y A/z^.5-h 

Property tf: SZ0>H2^ . 

Property Addr 

Yes No Excavation General 

1. If necessaiy, vrere the correct quadiant(s) excavated and restored? ZVl 

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

Grading Sod and Vegetation 

Yes No 

1. Does the gniding around the perimeter ofthe house in excavated areas generally slope away 

2

3

.

. Doe

 Ha

from

s so

s

 th

 th

d

e

e

 bee

 house

 sod

n

 appea

 lai

? 

d in

r t

 al

o

l

 b

 area

e generall

s that wer

y health

e excavated

y and growing

? 

? (Only evaluate if inspected at a 30 17

w

' 

day time period) 

4. Are 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 property*] 

y-' 

7. Was danuge to landscaping or plant materials avoided? ^ - ^ 

Gates, Fcncea and Retaining Walb 

I. Do gates open and close freely? (Ifapplicable) ^

2. Were all gates or fences taken down duringrestoration activities reinstalled? (If applicable) 

3. Was damage to gates or fences avoided? (ifapplicable) 1?^. 4.

 Was damage to retaining walls avoided? (Ifapplicable) T7^ 

Foundation, Siding and GuHers 

Ves >/No 

I. Was damage to the siding or trim avoided? 

2. Was damage to the foundation avoided? y ' 

3. Was damage to windows avoided? 

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

5. Was damage to downspouts or downspoul extensions avoided? I/' 

Sidewalks and Driveways (Concrete) 

Yes No 

1. Was damage to driveway surfaces avoided? 1/ 

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

Inspection notes: 

Removal and resloration activates compleje incjuding the 30-day sod warranty: 

EPA Representative LJoK Uoni DaAnl-^ pme: ?f/3 M 
Property Completion Agreement 

This agrcemeni documenls. the completion oi remedial acliviiies perloimed on my properly My signature 

will designate lliai I am satisfied with the rc-stofalion ofmy properly, and Ihal no items are in queslion.s. 

now, or al any time m the future, excepl ihose items listed below, ifany 

Property fP: ^^(^^ 2 

Property Address: ^Y^C ^ ji) 2* ^ ^ \ 

Owner: PeW^AJ U 1 

Phone; |iitf<i.)(^^7-^s^g> 

Restoration Items in Question: 

Item: 

Ilem: 

Item: 

Item: 

Item: 

Item: 

Additional Comments uiiiuiia i v^vyiiiiiiisiiia. y 

t j I ngrcc i»ror«(to n n i< complcttd, cxccpl as noted 

[_J I rto nol »\irtc restoration tj complcleri 

Hate ^ieonlmrioi'sSigns^lHrc OAIC