CONTRAC T # EP-R7-06-0 4 

### AS W Associate s Inc . Omah a Lead Site Remediation , Omaha , N E EPA 

### AS W Associate s In c Certificatio n fo rPropert y Closeou t BVI D 4673 3 Propert y Addres s 

### 580 9 Sout h 20 t h 

### Street Fiel d Wor k Starte d 17-JUI-0 6 

### Fiel d Wor k Complete d 5-Aug-0 6 

### Summary : Th e excavatio n wa s performe d i n compliance wit h th e wor k plan s an d specifications . Th e F 1 quadrant wa s excavate d to a dept h of 6 inch . Th e F 2 quadran t wa s excavate d t o a dept h o f 1 2 inch . Th e dri p zon e wa s excavate d t o a dept h o f 6 inch . Verificatio n sample s confirme d tha t th e cleanu p standard s were met . Th e sit e wa s backfille d wit h material s whic h meet s contrac t specifications . Th e backfil l wa s compacte d t o acceptabl e standards . So d placement s an d site restoration s were conducte d i n complianc e wit h wor k plan s an d specifications . Analytica l dat a provide d is post excavatio n at th e botto m o f th e excavatio n fo rconfirmatio n purpose s Comments : None . S'tC^oAJtaJ^Ar :

Ja n Prawdzl k AS W Projec t Manage r Nam e Titl e Sfgnature

4026201 6 SUPERFUN D RECORD SCONTRAC T # EP-R7-06-04 

### AS W Associate s Inc . Omah a Lea d Sit e Remediation , Omaha , N E EP A 

### Analytica l Resul t Summar y OL S ID : 4673 3 Property Address : 580 9 South 20 t h

### Stree t XRFResult s Lab 

### Sampl e I D Avg . 

### Result s (ppm ) (ppm ) 46733-DE-F1-0 6 

### 89.7*55. 6 N A 46733-DE-DZ-0 6 

### 117. 6 ±5 8 M A 

### 46733-DE-F2-1 2 17 6 ±65. 3 21 5 46733-DE-UC-1 2 

### 296. 6 ± 6 7 N A



### Ja n Prawdzi k AS W Project Manage r 

# ^r^ r Dat b Sitanaturfe ^ 

### Nam e Titl e C—- s 

### Signatur e Sampl e Dciign*tlo n OLSro-DE-Loc«tion-d d OLSI D i s s particular residentia l property I D fro mwhic hth e sampl e i s collected . D E= Durin g an dPost Excavatio n Location o f the sample a s follows ; F l = Fron t Yard(I " Quadrant ) B l « = Bac k Yar d(1 * Quadrant ) F 2 » Fron t Yard(2" 1 Quadrant ) B 2 - Fron t Yard(2" " Quadrant ) D Z= Dri p Zon e PZ= Pla y Zon e GA = Garde n E A = Easemen t d ddescribe s th e depthfro mwhic hth e sampl e wa s collected . NA = No t Applicabl e

# SEP A Remediation/Excavatio n Contrac t (ASW ) EP A Propert y Clos e Ou t For m Propert y # : Date/Time : Quad s Excavated : Propert y Address : Owner' s Name : Contracto r Grou p Excavatio n Genera l } . I f necessary , wer e th e correc t quadrant(s ) excavate dan drestored ? 2 . If necessary , wer e the correct area s o f dri p zone excavatedan drestored ? Gradin g So dan dVegetatio n 

### 5 2 0

Ve s N o ( . ^f 

### ^ ( Ye s N o 1 .

Doe s th e gradin g aroun dth e perimete r o f th e hous e i n excavate darea s generall y slop e awa y 

### L . - ^ fro mth e house ? 

### •^ 2 .Ha s so dbeen lai di n al l area s tha t wer e excavated ? 

## L- " 3 .Doe s th e so dappea r t o b e generall y health y an dgrowing ? (Onl y evaluat e i f inspecte da t a3 0 day tim e period ) 4 .Ar e sodde darea s generall y fir man devenl y graded ? * r 5 .Ar e th e joint s betwee n th e so dstrip s generall y tight ? (Onl y evaluat e i f inspecte da t a3 0 da y 

## \ — tim e period ) s 6 .Wa s th e propert y grade dsuc h tha t wate r wil l no t poo l o n th e property ? 

### U ^ 7 .Wa s damag e t o landscapin g o r plan t material s avoided ? 

# \* • ^ Gates , Fence s an dRetainin g Wall s Ye s N o 1 .D o gate s ope n an dclos e freely ? (I f applicable ) v \f 

# A^~^ 5 2 .Wer e al l gate s o r fence s take n dow n durin g restoratio n activitie s reinstalled ? (I f applicable ) 

### ( ~ 

## * / 3 .Wa s damag e t o gate s o r fence s avoided ? (I f applicable ) 

### ^ <— 4 . Wa s damag e t o retainin g wall s avoided ? (I f applicable ) 

# u . ^ Foundation , Sidin g an dGutter s Ye s N o 1 .

Wa s damag e to th e sidin g o r tri mavoided ? 

# ( 2 .Wa s damag e t o th e foundatio n avoided ? 

# ( s ^ 3 . Wa s damag e t o window s avoided ? 

## U 4 . Wa s damag e t o window s o r doo r screen s avoided ? 

## \ ^ ^ ­ 5 . Wa s damag e t o downspout s o r downspou t extension s avoided ? 

# U 

# / Sidewalk s an dDriveway s (Concrete )Ye s N o 1 . Wa s damag e to drivewa y surface s avoided ? 

# x/ / s 2 .Wa s damag e t o walkwa y surface s avoided ? 

## « —

### Owner s comments :

Inspectio n notes :

Remova l an drestoratio n activate s complet e includin g th e 30-day so dwarrant y EP A Representativ e J*^JP\

_1(^/1^^- ^ Date :

# 8 Contract No : E P - R 7 - 0 6 - 0 4 Property Closeou t Agreemen t 

# (ySz j Omah a Lea d Superfun d Sit e 

## OLSI D Propert y Addres s 

# rw s . i< - Propert y Owner I s th e Residen t th e Owne r aYe s GKN o i/

A <• } e $44 £ * ' i t f



### f a Complianc e Statement : U.S . Environmental Protectio n Agenc y (EPA ) o r it s authorize drepresentatives , (o r it s contractors) , to enter an dconduc t environmental restoratio n service s fo r th e Omah aLea dSite . You r cooperatio n i n givin g EPA/AS W permissio n t o acces s you r propert y durin g th e removal/restoratio n phas e i s sincerely appreciated . Thi s document certifie s that al l wor k

performe da t thi s propert y wa s complete dh i accordanc e with th e contac t specification s an dEP A requirements . I f

yo u hav e question s o r nee dadditiona l informatio n pleas e contac t th e EP A Publi c Informatio n Center s at (402 ) 731-304 5 o r (402 ) 991-958 3 o r th e EPA Offic e o f Externa l Program s a t 1-800-223-0425 . Additiona l Comment s b y EP A and/o r ASW :

CONTRACTO RCERTIFICATIO N 

### Ja n Prawdzi k AS WProjec t Manage r Nam e Titl e Dat e Signatur e 

### Propert y Owne r Sectio n Thi s agreemen t document s th e completio n o f remedial/restoratio n effort s at th e property t o my satisfactio n 

### tia

l l 

### a

gre e tha t restoratio n i s complete da t my property D I D o No t Agree : Comments :

Propejrty Owner' s Signatur e Dat e EP A rpresentativ e Signatur e Dat e

# lit e Pag e 1 of _ 

# t Omah aLea dSit e Omaha , N E U.S . Environmenta l Protectio n Agenc y Regio n VI I Residentia l Yar dSoil s Environmenta lRestoratio n Service s Granto r (th e property owner) , consent s t o an dauthorize s th e Unite dSate s Environmenta l Protectio n Agenc y (USEPA ) o r

it s authorize drepresentative s (o r it s contractors) , th e Grantee , t o ente r an dperfor mcertai n environmenta l respons e activitie s upo n th e followin g describe dpremises . Fo r furthe r informatio n pleas e contac t EP A a t 1-800-223-0425 . Propert y Acces s Grante dB y (Pleas e Prin t Name ) Propert y Owne r Signature ) / | / |(Date ) NOTE :Grantin g permissio n DOE S NOTnecessaril y impl y you r propert y wil l b e remediate da t thi s time . Residen t Name : 

### Residenc e Address : O O P / S 2L Q (CITY ) (STATE ) (ZIP ) 

### Propert y owne dby : \/Mt&& A Owner s mailin g address : • 

### (\0^ ^ i i I t Owner' s telephon e number—Home : Work : Ag e o f Home ? 1 C / C P "" } year s Ho w lon g hav e yo u live dheraT year s Ha s th e exterio r bee n painte do r covere dwit hs i din g sinc e 197 8 W YES*' ' D N O 

### Ha s th e interio r bee n painte do r covere dsinc e



# O Tota l numbe r o f occupants : 

### 1978 ? Lis t Ages : 

### D N O Lis t age s o f occupant s unde r 6 year s ol dwh o pla y i n th e yar dfo r 5 o r mor e hour s pe r week : 

# o Comments : AUTHORIT Y FO RENVIORNMENTA L RESPONS E ACTION S Th e activitie s t o b e implemente db y EP A unde r thi s agreemen t or e pursuan t t o Sectio n10 4 o f CERCLA , 4 2 U S.C . %0 4 F.PA' s righ t o f

acces s t o th e property fo r i nSectio n104(e)o f CERCLA , 4 2 U.S.C . 9604 (e) , whic hprovide s entry for , "determinin g th e needfo r response , o r choosin g o r takin g an y respons e Actio nunde r thi s title , o r otherwis e enforcin g th e provision s o f thi s title. " Acces s Attempts : First : Second : Third :

# Lis t o f existin g Condition s Property Address : Owner : Date : OLSI D # Description :

AS W Assooiate s In c Prin t & SigrT ' ^— /

# 4673 3 Exterio rPain t Nort h Arro w 

## Omah a Lea d Sit e Owne rName : VANESSA .GONZALE Z [ ] Goo d 

## Site Sketc h Address : 580 9 S 2 0 S T



### P bonvH^ll-OLO Z w : Sampl e Numbe r RYASCPXA-4673 3 RYBSCPXA-4673 3 RYCSCPXA-46733 RYDSCPXA-4673 3 RDZSCPXA-4673 3 RGZSCPXA-4673 3 nPZSCPXA 16733 F 1 F 2 B 1 8 2 D Z G Z P2- * Lea d Concentratio n 

## 47 7 

## i jp m 

### £34 0 Do m



### -Z.f i c 

### )p m 

## 29 9 

## i >p m 

## 37/ 6 

## t >p m 

### 2-f a 

### \ co m Do m Numbe ro f Samples = L ( 3 \ 9 n Poo r Q^No t pain t Sampl e Sample s Collecte d LA B Collecte d Firm : F& A M<T/1? W 

# a Date : lO'l'JS 1 ' ' 

# L

T a Time : *?• ' 3 o 

# & a £ Samples Analyze d 

# a a XR F Uni t 1037 Book: /3 3 

### F f 

# a Date : J/-7-05 T 

# a n T 

### Ime : /&# } < >taf f £ A \ .egend : F 1 = Fron t Left , F 2 = Fron t Right . B 1 = Bac k Left , 8 2 = Back Righ t D Z = Dri p Zone , G Z = < Sarden , PZ=Pl E

## >y Al l quadrant s ar e as vtevw d fro m th e street , facin g propert y



## ££' —



# > r^ C 

### — WA L

## K• 

## A n .ev

## : • 

## co* c 

## « e 

# • iTE :

-* n 

# -il l i 

## i $2 * 

# & k

## 2 

# * n f 

# \s _ 1 

# *'. [ 

# t * t 

## ] 

# *', * 

# '• << $*<% . 

# < 

# . » ? s t , 3 DZ. = 

## 3 7 

# i < e » '

* 4 

### D * 4 

### &fy - 

# '// £ Y.S / 

### : 

# yt/V^'x . / 

# •

t 

# ffitfa'" /

/ £t f 

# / 

# / / />



# ^ • JLI N 

# TE 1 JCE D f 

# n CT.I I 20115 .

<* t 

### ^ X r ~ 

# *- u ^ /



### s 

# *£ > ^ 

# '/// , E : LCfW PNT£. O AOU =

### *



## : Z0\ ^



## : Re v4 04614 1 012 3