CONTRACT # EP-R7-06-04

 

ASW Associates Inc. 

Omaha Lead Site Remediation, Omaha, NE 

EPA 

ASW Associates Inc Certification for Property Closeout 

BVID 46733 Property Address 5809 South 20th

 Street 

Field Work Started 17-JUI-06 Field Work Completed 5-Aug-06 

Summary: 

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

The F1 quadrant was excavated to a depth of 6 inch. 

The F2 quadrant was excavated to a depth of 12 inch. The drip zone was excavated to a depth of 6 inch.

 

Verification samples confirmed that the cleanup standards were met. The site was backfilled with materials which meets contract specifications.

 

The backfill was compacted to acceptable standards. Sod placements and site restorations were conducted in compliance with work plans and

 

specifications. 

Analytical data provided is post excavation at the bottom of the excavation for confirmation

 

purposes 

Comments: 

None. 

S'tC^oAJtaJ^Ar: 

Jan Prawdzlk ASW Project Manager 

Name Title Sfgnature 

40262016 

SUPERFUND RECORDS 
CONTRACT # EP-R7-06-04 

ASW Associates Inc. 

Omaha Lead Site Remediation, Omaha, NE 

EPA 

Analytical Result Summary 

OLS ID: 46733 

Property Address: 5809 South 20th

 Street 

XRF Results Lab 

Sample ID Avg. Results 

(ppm) (ppm) 

46733-DE-F1-06 89.7*55.6 NA 

46733-DE-DZ-06 117.6 ±58 MA 

46733-DE-F2-12 176 ±65.3 215 

46733-DE-UC-12 296.6 ± 67 NA 

Ja

Nam

n Prawdzi

e 

k ASW Projec

Title 

t Manager 

Datb ^r^ C—-s Sitanaturfe Signature ^

r

Sample Dciign*tlon 

OLSro-DE-Loc«tion-dd 

OLSID is s particular residential property ID from which the sample is collected. 

DE = During and Post Excavation 

Location of the sample as follows; 

Fl = Front Yard (I" Quadrant) 

Bl «= Back Yard (1* Quadrant) 

F2 » Front Yard (2"1 Quadrant) 

B2 - Front Yard (2"" Quadrant) 

DZ = Drip Zone 

PZ = Play Zone 

GA = Garden 

EA = Easement 

dd describes the depth from which the sample was collected. 

NA= Not Applicable 
SEPA

 

Remediation/Excavation Contract (ASW) 

EPA Property Close Out Form 

Property #: 

Date/Time: 

Quads Excavated: 

Property Address: 

Owner's Name: 

Contractor Group 

Excavation General 

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

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

Grading Sod and Vegetation

5 20 

Ves No 

( . ^f 

^ ( 

 Yes No 

1 . Does the grading around the perimeter of the house in excavated areas generally slope away L. -^ from the house? 

•^ 2.

 Has sod been laid in all areas that were excavated? L-" 

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 firm and evenly graded? *r 

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? U s

^ 

7. Was damage to landscaping or plant materials avoided? \ *• ^ 

Gates, Fences and Retaining Walls Yes No 

1. Do gates open and close freely? (If applicable) v\ f A^~^5 

2. Were all gates or fences taken down during restoration activities reinstalled? (If applicable) (~ */ 

3. Was damage to gates or fences avoided? (If applicable) ^ 

< — 4. Was damage to retaining walls avoided? (If applicable)

 u. ^ 

Foundation, Siding and Gutters Yes No 

1. Was damage to the siding or trim avoided? ( 

2. Was damage to the foundation avoided? (

s 

^ 3. Was damage to windows avoided?

 U 

4. Was damage to windows or door screens avoided? \^ ^­

5. Was damage to downspouts or downspout extensions avoided? U/ 

Sidewalks and Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? x/ 

/

s 

2. Was damage to walkway surfaces avoided? 

« — 
Owners comments: 

Inspection notes: 

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

EPA Representative J*^JP\_ 1(^/1^^-^ Date: 
8 Contract No: EP - R7 - 06 - 04 

Property Closeout Agreement (ySzj Omaha Lead Superfund Site 

OLSID Property Address 

rw s. i<- Property Owner Is the Resident the Owner a Yes GKNo 

i/A <•} e $44 £* 'i t ffa 

Compliance Statement: 

U.S. Environmental Protection Agency (EPA) or its authorized representatives, (or its contractors), to enter 

and conduct environmental restoration services for the Omaha Lead Site. 

Your cooperation in giving EPA/ASW 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 hi accordance with the contact specifications and EPA requirements. 

If you have questions or need additional information please contact the EPA Public Information Centers at 

(402) 731-3045 or (402) 991-9583 or the EPA Office of External Programs at 1-800-223-0425. 

Additional Comments by EPA and/or ASW: 

CONTRACTOR CERTIFICATION 

Jan Prawdzik ASW Project Manager 

Name Title Date Signature 

Property Owner Section 

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

tialal gree that restoration is completed at my property 

D I Do Not Agree: Comments: 

Propejrty Owner's Signature Date 

EPA rpresentative Signature Date 
lite

 

Page 1 of_ t 

Omaha Lead Site 

Omaha, NE 

U.S. Environmental Protection Agency Region VII 

Residential Yard Soils 

Environmental Restoration 

Services 

Grantor (the property owner), consents to and authorizes the United Sates Environmental Protection Agency (USEPA) 

or its authorized representatives (or its contractors), the Grantee, to enter and perform certain environmental response 

activities upon the following described premises. For further information please contact EPA at 1-800-223-0425. 

Property Access Granted By 

(Please Print Name) 

Property Owner Signature) / | / | (Date) 

NOTE: Granting permission DOES NOTnecessarily imply your property will be remediated at this time. 

Resident Name: 

Residence Address: O OP / S 2LQ 

(CITY) (STATE) (ZIP) 

Property owned by: \/Mt&&A

Owners mailing address: •

 (\0^^ 

ii 

 It 

Owner's telephone number—Home: Work: 

Age of Home? 1 C/ CP ""} years How long have you lived heraT years 

Has the exterior been painted or covered with siding since 1978 W YES*'' D NO 

Has the interior been painted or covered since

Total number of occupants: O

1978? 

List Ages: 

D NO 

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

Comments: 

AUTHORITY FOR ENVIORNMENTAL RESPONSE ACTIONS 

The activities to be implemented by EPA under this agreement ore pursuant to Section 104 of CERCLA, 42 U S.C. %04 F.PA's right of access to the 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 taking any response Action under this title, or otherwise enforcing the provisions of this title." 

Access Attempts: 

First: Second: Third: 
List of existing Conditions 

Property Address: 

Owner: Date: OLSID #

 

Description: 

ASW Assooiates Inc 

Print & SigrT' 

^—/ 
46733

 

Omah Exterior Paint North Arrow 

Owne a Lead Site r Name: VANESSA .GONZALEZ [] Good 

Address Site Sketch : 5809 S 20 ST 

PbonvH^ll-OLOZ w: 

Sample Number 

RYASCPXA-46733

RYBSCPXA-46733

RYCSCPXA-46733

RYDSCPXA-46733

RDZSCPXA-46733

RGZSCPXA-46733

nPZSCPXA 16733

 F1 

 F2 

 B1 

 82 

 DZ 

 GZ 

 P2-* 

Lead 

Concentration 

477 ijpm 

£340 Dom 

-Z.fi c)pm 

299 i>pm 

37/6 t>pm 

2-fa \ com

Dom 

Number of Samples = L (3 \ 9 

n Poor 

Q^Not paint 

Sample Samples Collected LAB Collected Firm: F&A M<T/1?W 

a Date: lO'l'JS1

'' LT a Time: *?•' 3o & a £Samples Analyzed a 

a XRF Unit 1037 Book: /33 

 Ff a Date: J/-7-05T 

a n TIme: /&#} 

<>taff £A 

\.egend: F1 = Front Left, F2 = Front Right. B1 = Back Left, 82 = Back Right DZ = Drip Zone, GZ = <Sarden, PZ=PlE >y All quadrants are as vtevwd from the street, facing property 

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