TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: ^>H1 ^ Date: ll jl o ((^^ 

Address: t4^ ^ \ \ H< m . 

Remediation Contractor: Coastal Environmental Group_ Year: ^Si69r' 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

0 Signed Access Agreement for subject property 

vtflft' Signed Access Agreement(s) for adjacent property 

iZl Restoration Agreement 

-a • Settlement documents (i.e., for damage or to replace plants, etc.) 

"CT Confinnation data 

0 Photographs 

• / As-built sketch 

Q' Satisfactory restoration signed by Property Owner 

Ef Property close-out check list signed by EPA 

0 Description of areas not meeting ROD cleanup criteria 

0 Utility clearances 

0 Property information from Douglas County Assessor's Office 

D 

D 

30054021 

in 

Superfund 
• % 

Property Access Checkllsl 

IPropcrDlD l^-^^^! ^ 

1 PropertV Addre*. ; Li; y \ | U*=^ti ^ /X\Ji£ 

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 WORK STAJITED

 WORK COMPELTED

 ON­

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1®^''"'=' Kfiv^A^h

AdJrcts: 

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PhonePhone. moc7)

1 F»\­ ^ 

Cell/Pager. 

 ^S3-9m q 

FiL\: 

Cell/Pager: 

Additioniil (nlnrmxtion: 

1 D Nutiricaiion Letter 

\s ^ Acceu AercerncDl 

^ Resiorvtioo Agreement 

1 O Toptoil Sampling (if ipplicubic) 

1 O DisposAl Simpllng (if applicable) 

D Ciirdcn Sdoipliog (if applicable) 

D Uliliiy Clearance 

JST Video/Photos (Before) 

D Video/Phoios (During) 

D VIdeo/Phoios (After) 

D Viileo/Photoi (30-Djiy) 

D Property Complelion A|;recmcni 

D Fin*! Report 

1 Sent­ / / 

Signed:U_/Zk/C23 

Signed: j;^/it£/( ^ 

1 ' ' 

/ / 

/ / 

Called: / / 

On:j£_l2^/^ 

On: / / 

On: / / 1 

On: / / 

Signed: / / ] 

By:

By: 

By: 

By: 

By:

By: 

By: 

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By:

By: 

By: 

By: 

Issued: / / By. 

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1 

1 

1 

1 

iKiT Monilorinii { a upplicable) 

D Community D Crew |

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D Comrounit?'

Results: 

D Crew Or­ / / By: 

ID Communin

ResulljO Crv« On. / / I j 

Omaha Lead Site 
I 

CONTACT FORM 

Property ID U (/^^M^ Q 

Property 

Address: 1,M-)M rs^ M'Sqy 

Initial Contact: Dale: Time: 

Second Contact: Date; Time: 

Final Contact: Dale: Time: 

Final Action: Transmit to EPA D 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

* 

Action: 

Aciion: 

Aciion; 

Other Action; D 
^ Douglas County Account Ioj[Bpiatio ojjBpia n Page 1 of2 

• 

Douglas County, Nebraska Property Record - R0811360000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-SO ft west of 52nd St - Vie w OH Ma p Information is valid as of 2009-5-12 Treasurer's Tax Repoit 

New Feature -•-•- » Auto Sales Search 

Owner 

ANDERSON KENNETH L 

ETAL 

2424 N 45 AVE 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number: 1136 0000 08 

Account Type: Residential 

Parcel Number: 0811360000 

Parcel Address: 

Legal Description: 

2424 N 45 AV 

OMAHA NE 68104-0000 

CLAIRIVtONT LOT 14 BLOCK 3 50 X 125 

Value Informatio n 

2009 

2008 

2007 

2006 

2005 

2004 

Land 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

$6,400.00 

Improvement 

$55,600.00 

$55,600.00 

$55,600.00 

$55,600.00 

$53,400.00 

$48,500.00 

Total 

$62,000.00 

$62,000.00 

$62,000.00 

$62,000.00 

$59,800.00 

$54,900.00 

Land Informatio n 

Acres 

0.14 

SF 

6250.0 

Units 

1.0 

Depth 

125.0 

Width 

50.0 

Vacant 

No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DougIasCoNe/static/accountinfo.jsp?accountno=R081... 6/7/2009 
^ Douglas County Account IijjMmatio dnm s n Page 2 of2 t 

MMNISAV 

"IP MB 

FIntFtoor SaoondFtoor «82.0Bq.«. <720<q I IOO I 

z r 2G 

1 1/2 STORY UNFIN 

BMfllBIKllll l 

«n.(iq.a. 

CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1354.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: 2 1/2 Story Unfin Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 6.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywali Baths: 1.0 

Roof Cover: Composition Shiingle Bedrooms: 3.0 

Roof Type: Hip Stories: 2.0 

Floorcover: Allowance Foundation: Btocl< 

Sprinkler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1914 0% 1914 95 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Blocl< 8 ft 672.0 

Fixture Base Fixtures 1.0 

Fixture Batti Full 1.0 

Garage Detaclied 576.0 

Porcti Stab Roof Ceil 192.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R081... 6/7/2009 
Page 1 of 1 

• » • 

"> 

[ Create Another Ticket ]} Back to Irtti Internet | Send Email | 

YOUR TICKET NUMBER IS 2326026. 

Original Call Date: 7/24/09 Time: 5:48 pm Op: ELIZABETH18790 


Work to Begin Date: 7/28/09 Time: 6:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2424 Street: N 4STH AVE 


Twp: 15N Rng: 13E Sect-Qtr: 08-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Wor)c: lead remediation 


Location of Wor)c: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


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


: UNSURE OF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: coastal 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

CXCATV COX COMMUNICATIONS. INC HEIDI

Day: 4029340469 

 Alt: 4029340469 

Emerg: 4029329757 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY

Day: 4025047823 

 Alt: 

Emerg: 4025047970 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON

Day: 4024447197 

 Alt: 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK NA

Day: 4067289343 

 Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/24/2009 
As-Built Drawing^ 

COAST A L Omaha Lead Superfund Site 

Omatia Lead Site 

Site Sketch 

Samplin g Address : 2424 N 45 AV 

Sampl e Number 

RYASCPXA-6349 9 

RYBSCPXA-6349 9 

RVOOOPXA 63400 

RYDSCPXA-6349 9 

RDZSCPXA-6349 9 

ROZOOPXA S3400 

WPZ6GPXA 63400 

Lab RYASCPLA-6349 9 

^Result 14 1 pp m 

:'re^tl*d i'i .Vug-.x 

Lead Sample LAB Concentralion Collected 

F1 / 2.°t ppm 

F2 1 /'n Q p pm n 

-B+ p pm n 

B2 BOI p pm n 

DZ 3filG , p pm n 

-sa- p pm n n 

- P Z — ppm D D 

Number of Samples : IJ 

63499 

Exterior Paint Nort h Arro w 

• Good 

Q^Poo r 

I I Not paint 

Samples Collecled 

Firm: PE TMC . Pf i T-^ 

Oate ^/^/c^ 

Tim e If.POKf ^ 

X R F Unit:

Date:

Time 

Staff 

Samples Analyzed 

 ^Q5*^ Q Book: 2 . ]° \ 

 fi -l€ ­ DB 

anMrsu. y 

Front Right. B l = Back Left. 8 2 = Back Right DZ = Drip Zone. GZ = Garden, PZ = Pla> 

A l l quadrant s ar e as viewe d fro m the strp.:>r, racing property Bl = 228 PPM @ 4" 

X^ •-«. 'f-: ^-4'.'.,»--• • 

SEP Z ci,'.;\S'-

OLS#: 63499 

Date Excavated:7/31/09 

Date USEPA Signed Off: 3/11/09 

Area Sodden: 696 sc ft 

DZ = 91 PPM @ 12" 

EA=193PPM @ 1" 

[S-^5 Av 'vuTii i f)i :.» 

Legend 

Concrete Drip Zone Excavated [ii-'i Quadrants Excavated 

Area replaced

Sod 

 with Area replaced with 

Rock/Mulch Area left bar e 

Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc , 
53499 

Omah Exterior Paint North Arrow a Lead Site 

Sit • Good e Sketch 

Q/Poor 

Sampling Address: 2424 N 45 AV Q] Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB Samples Collected 

Firm: ?EIML . P R X ^ 

RYASCPXA-63499 Fl I 2 °l ppm Date 1Nlof>> 

RYBSCPXA-63499 F2 / /"n 9 ppm D Time ir.DbKM 

RYCSCPXA-63400

RYDSCPXA-63499

 B4 

B2 801 

ppm 

ppm 

D 

D Samples Analyzed 

RDZSCPXA-63499 02 

RGZCGrXA-63400 G2­

Rr'Z6CPXA-63400 P2 

Lab RYASCPLA-63499 

141 ppm _ ! Result 

ppm 

ppm 

ppm 

Numtier of Samples • 

D 

D 

D 

D 

D 

1 

XRF Unit: ^^5^ 0 Book: 21 ^ 

Date 

Time 

Staff 

^-le-n ^ 

in . K-su; 

Front Rigtit, 81 = Back Lefl, B2 = Back Rigtit DZ = Drip Zone. GZ • Garden, PZ = Plai 

All quadrants are as viewed from ttie street, facing property 

:i»lll '"rciit d liJ-.NugOS 
f 

63499 

Omah Exterior Paint North Arrow a Lead Site • Good Site Sketch 

Q^Poor 

Sampling Address: 2424 N 45 AV Q] Not paint 

Sample Lead Sample Samples Collected Numl)er LAB Concentration Collected Firm: PE XM C P R T-^ 

RYASCPXA-63499 Fl I Z° l ppm 

Date: '?N/ojg> 

RYBSCPXA-63499 F2 / Cf> Q ppm n 

Time: ir.OhkrA 

RYCCCPXA 63400 B+ "" ppm n 

Samples Analyzed 

RYDSCPXA-63499 82 _fiOJ__ppm D 

RDZSCPXA-63499 DZ 3 8 i CP ppm 

D XRF Unit: ^JiSHO Book: 21 ^ 

ROg00rXA-&340Q 82- ~ ppm D n Date: ^-/g-O S 

RPZ6CPXA-63400 P£ ~ ppm D Time s: 

Lab RYASCPLA-63499 

Numbe

n Staff: K-Suj r of Samples = | Lj Result 141 ppm _ 1 

Front Right, Bl = Back Lefl, 82 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Pla; 

All quadrants are as viewed from ttie street, facing property 

ReviiKiS Craiwd: !0-.\ugJ)S 
63499 

Omaha Lead Site Exterior Paint (^lorth Arrow 

Site Sketch • Good 

Q/Poor 

Sampling Address: 2424 N 45 AV |~| Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB Samples Collected 

Firm: PE Inc. . ITR TJ> RYASCPXA-63499 F1 / 2 «=) o m Date: 'JNIc A 

RYBSCPXA-63499

RYOCOPXA-63409

RYDSCPXA-63499

RDZSCPXA-634»

RO200PXA-634B0

RPZBOPXA-63400

 F2 

B4­

82 

OZ 

SZPZ 

i^ q 

—

8o i 

38/6. 

— 

ppm 

DPm 

.ppm 

ppm 

.ppm 

ppm 

a" 

n 

D 

n 

n 

D 

D 

D 

Time: H-QOht^ 

Samples Analyzed 

XRF Unit: t)i5H0 Book: Zl3 -

Date: ^-/g-Q g 

Time: s: 

Lab RYASCPLA-63499 

: Result 141 ppm D Numt)er of Samples = | l \ \ \ j Staff: tn\J •• Front Rigtit, B1 = Back Left, 82 = Back Riglit DZ = Drip Zone, GZ = Garden, PZ = Plai 

All quadrants are as viewed from the street, facing propeity 

^ *• • • • 

6oM^­

m. "TF

SEP 

. -Z. 

o 

•tSEfffi 

7T 

: 132= 36/6 

VZ H 

F2 

| 2 ^ 

WALVC 

.N-.^5.Ay, Rev 2008 Ciewed, 19-Au6-i> 
* 1 " «'<> % 

COASTA L 

"1 PRO'*'' c I 0 u r IN C 

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: 

Owner's Name: K^»,*«,Hv ^•^cleft'^NOi 

Address of Property aMl H ^ l\c,^ A ^ 

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 performed 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 performing the work. This access shall 

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

agrees to: 

Page 1 of 2 
% 

/// • ^ ^ 

COASTA L 

C H O U r IN C " I PRO-"*'' 

9 Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

c Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

e Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

e Abide by health and safety guidance provided by EPA, 

c 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 

M4..grant access to my properties D I do not grant access to my properties 

/^....^:&^^^^A^— C - /^-^ 9 

Signature Date Signature Date 

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

Page 2 of 2 
^ 

COAST A 

iNvmoMnrMfl 

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 satisfaction of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: ^^ty^ ^ 

Property Address; 2M2 M <J MS"*^ >^tie. 

O^"-^ K^An^tU AfsJicrion 

PhoDef^Q/^^^^3 - 9]t ^ ^/MOa)^ ^ 

On the attached diagram(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 Videographlcally 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. 

r\*^h^ ^«A~MjV pAe^'^^'S 

Item: 

Item: 

Hem: 

Hams to be Removed by the Contractor During Remediation and Not Replaced 

Item: 

4-* ^ f-^yfi^sIlCw^^y SiU^ ^ M ^ /i^^UC-ef 

ttem: 

Item: 

Item: 

Pagel of. 
4 

C O ASTBL L 

(MVtnaNM f r^B" ' 

Items to Be Removed By Contractor During Remediation and Replaced 

item: / 

pz 9 ^ V 

'^••4.A VbOttem: 

ttem: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

mink diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch ol the 

sprinkler lavoui. 

Number of and size of 

each garden/ flower bed 

area. 

Aiiach a sketch of relaiivc 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note tills Naliic will ht 

used lo issue H pluni 

\oiielier lo the propcrt> 

owner. 

Easement Area, to be 

excavated 

Quantity 

hi 

02 

0' 

0 

f 

^ 

^ 

v^ 

Landscape Inventory 

Unit 

Quadrants 

Each 

Each 

Each 

Each 

Square Feet 

$ 

Each 

Condition/Type/Species 

?e*.W U^u \\6 

Page 2 of. 
k-. 

C O A S -I AI ­

OI. o u II Addttional Comments / Instructions: 

\J\c\ ^^tJ^c^'^^v^ ISL/sVes m\rc>v^r 

C^W p o Z~ ^ ^o.v/1^ te^-fore- ej£<:avo+iov\ 

Q Check the box if Owner does not want GEG to document interior foundation walls and possible 

pre-existing damage. By checking this box GEG is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

H j agree Q I do not agree 

Owner' Owner'ss Signatur Signaturee Dat Datee Contrauor' Contrauor'ss Signatur Signaturee Date ' 

Page 3 of, 

Account: 240445-1 155340 

K L. ANDERSON b3L\W 

Service address: 2424 N 45TH AVE 

Call 554.7777 if you smell gas. 

No charge to check gas leaks. Have heating 

system checked every year by a qualified 

heating contractor. Keep chimneys and flues 

free of debris. 

Your Gas Use I 	 1.
 - R.112Yonth. . Rs113MYonths I
 I


I 	 I I 

Th~sMonth Last Year 

Bllllna units 16 18 

Use per day 05 0 6 

Average cost per day $0 76 $1 13 

Number of days in brlllngcycle 31 . 29 

1723 Harney St. Omaha, NE 68102 a 402 554 6666 

e-mall cuslomer~servoe@mudomahacorn website wmudomaha com 	 METROPOLITAN 

UTILITIES DISTRICT 

Live Green. Think Blut Billing date Sep 23,2009 


Previous balance $112.00 


Payment reoeived -Thank you 112.00 CR 


Current charges 112.00 


New balance 112.00 


b Total due Oct 8,2009 $1 12.00 

Your budget payment of S112.Wla due Oot 8.20W Budget varlancee. 


Current= -(50.36 Tots1 = -$I6577 


Detaik. of currentchalges 

GAS RESIDENTIAL RATE A: Aug 17 to Sep 17 

Meter Number 288559 


Current read (actual): 2633 - Previous read (actual): 2617 - 16 CCF 


Gas Use: 16 CCF x 1.021 (heat value) = 16.336 therms 


16 days 8.431 therms at 0.4632 = $3.91 


15days 7.905therms at 0.5283 - 4.18 


Sewice Charge 	 12.00 

Gas Cost b 	 $20.09 

Gas Inhastructure Replacement 	 3.00 

10 

0 
 osl Nw Deo Jan Feb Ma epl May Jun Jd Aw Ssp 

Your Water Use 

This Month Last Year 

Billma unlts: 14 15 

Use per day 

Average cost per day. 

Numberof days in Lilingcycle: 

0.5 

$0.79 

30 

0.5 

$0.83 

29 

WATER RESIDENTIAL RATE W-1: Aug 17 to Sep 16 

Meter Number 93160402 Size: 518 -inch 

Current read (actual): 1593 - Previous read (actual): 1579 - 14 CCF 

Water Use: 14.000 CCF or 10,472 gallons 

9.000 CCF at 0.9614 - $8.65 

5.000 CCF at 1.3451 = 6.73 

Servioe Charge 4.86 

Water Cost b $20.24 

Water Infrastructure Replacement 	 2.00 

Budget Payment Plan Interest 0.09 CR 

City of Omaha Sewer 1236 

Sales Tax 4.04 

) Current Charges $61.64 
Oate 

Project 

XRF[D# 

Shot# 

24D5 

2.H0U? 

2H0 1 

2^0^. 

Average

Shot# 

•2MZVg 

2MX"I 

7^11 

1H23L 

Average

Shot# 

Average 

Shot# 

Average 

lab sample # 

XRF PROPERTY SAMPLE SHEET 


7''?.1'D S 

Omaha lead FP 2nd year option 

JilKlK"^ 

Reading 

2iq./9tn?. ^ 

^H1 .^^ ):7D.^ 

Z6^.2r3-t^.i^? 

I^.MTln.M ^ 

 22n.^ H ±

Reading 

iD-a> nl\^Q i 

I'jl^ i II.T 

^i-t) t n.a'& 

/D2.^3:<!>.I3 

Sample area 

J ^ 

Depth 

 I?? .^ I 

Sample area 

D 2 

Depth 

12 

^ I 2 ^ J I7_ M ^ 

Reading Sample area 

Depth 

Address 

Sample time 

sample length 

Shot# 

2M1 0 

^Hl \ 

241 2 

ZMl ^ 

Average

Shot# 

Average 

Shot# 

Average 

RETEST AREAS 

Reading Sample area 

Depth 

Lab result Sample area XRF Avg. 

Shot# 

Average 

Signature_ 

BVID # i^'^nq ? 

?.H2q N L\f^ (xv-e 

H:> • T^T ?^pm 

30 sec 

Reading 

20S zs l n.MT. 

ZOM.JHtn.ia, 

1^0.Mi^.! n.1) 

n i ssiivo.-z?! 

Sampie area 

«p.»- ^ 

Depth 

1 

 H?) . \ t

Reading 

 H-I M 

Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Print iil;Q^ih)HntoOPr>^^ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2409 

Mode SOIL 

Time 2009-07-31 10:37 

Duration 122.38 

Sequence Final 

Flags ! AVERAGE Avg of 2405-2408] 

ADDRESS 2424 N 45 ave 

QUAD/ZONE B2 

INSPECTOR Nicolas 

DEPTH 4 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pfe f 227.815 ± 18.909 

Supervised By 2jp(l/!LJl^iJ{^ 
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 219.185 

Supervised By: 

Certificate of Verification 

2405 

SOIL 

2009-07-31 10:34 

30.62 

Final 

63499 

2424 N 45 ave 

82 

Nicolas 

4 

CLEARANCE 

± Error 

± 18.293 
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 247.853 

Supervised By: 

Certificate of Verification 

2406 

SOIL 

2009-07-31 10:35 

30.64 

Final 

63499 

2424 N 45 ave 

B2 

Nicolas 

4 

CLEARANCE 

± Error 

± 20.298 
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 253.800 

Supervised By: 

Certificate of Verification 

2407 

SOIL 

2009-07-31 10:36 

30.53 

Final 

63499 

2424 N 45 ave 

B2 

Nicolas 

4 

CLEARANCE 

± Error 

± 19.619 
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 190.422 

Supervised By: 

Certificate of Verification 

2408 

SOIL 

2009-07-31 10:37 

30.59 

Final 

63499 

2424 N 45 ave 

B2 

Nicolas 

4 

CLEARANCE 

± Error 

± 17.424 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2414 

Mode SOIL 

Time 2009-07-31 10:45 

Duration 121.03 

Sequence Final 

Flags 

AVERAGE Avg of 2410-2413' 

ADDRESS 2424 N 45 ave 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error •)«OV«»-""'!I»V 

Pt> 193.103 17.140 / 

Supervised By: ^M9.P.iiJ: ^ 
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 205.284 

Supervised By: 

Certificate of Verification 

2410 

SOIL 

2009-07-31 10:38 

30.32 

Final 

63499 

2424 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 17.422 
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 204.341 

Supervised By: 

Certificate of Verification 

2411 

SOIL 

2009-07-31 10:44 

30.30 

Final 

63499 

2424 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

17.733 
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 190.459 

Supervised By: 

Certificate of Verification 

2412 

SOIL 

2009-07-31 10:44 

30.22 

Final 

63499 

2424 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 17.114 
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 172.328 

Supervised By: 

Certificate of Verification 

2413 

SOIL 

2009-07-31 10:45 

30.19 

Final 

63499 

2424 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 16.290 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Readmg No 2430 

Mode SOIL 

Time 2009-07-31 14:08 

Duration 121.19 

Sequence Final 

Flags . 

AVERAGE Avg of 2426-2429 

ADDRESS 2424 N 45 ave 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 91.286 12.445 

Supervised By: ^C6I^^J{IQ/ \ 
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 103.167 

Supervised By: 

Certificate of Verification 

2426 

SOIL 

2009-07-31 14:06 

30.18 

Final 

63499 

2424 N 45 ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 13.070 
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 78.279 

Supervised By: 

Certificate of Verification 

2427 

SOIL 

2009-07-31 14:07 

30.57 

Final 

63499 

2424 N 45 ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 11.697 
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 81.495 

Supervised By: 

Certificate of Verification 

2428 

SOIL 

2009-07-31 14:07 

30.21 

Final 

63499 

2424 N 45 ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 11.880 
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 102.202 

Supervised By: 

Certificate of Verification 

2429 

SOIL 

2009-07-31 14:08 

30.23 

Final 

63499 

2424 N 45 ave 

DZ 

Nicolas 

12 

CLEARANCE 

± Error 

± 13.132 
X 

m 

/IfiL'-o Omaha Lead Site—Fixed Price EP-R7-07.05 

o J^^^ l I Coastal Environmental Group Inc. 

^^^^Tp * www.coastalhazmat.com 

VpRoit'' COASTA L INVIItONHtHTAL 

CROU P IN C 

EXECUTIVE SUMMARY: 

BVID # 63499 - (2424 N 45 AVE) 

No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 

• Property owner has concem about the sod and lack of watering. Coastal is to check it again in 

the Spring. 
^s^EPA 

EPA Property Close Out Form 

Property Addr«,:- 747 M SJ ^?>,fW^ ^ Property «:_k5!ia3 ^ 

Date/Time: 

Contractor Group f oaa^<i\ \ FnVinrfAgAT ^ J Quads Excavalfd: Y\\ j ^ 2 

EicavatioD Yes No General 

I Ifnecessary, were (he correct quadrant(s) excavated and restored? 

2 If necessary, were the conect areas of dnp ?.one excavated and restored'' 

Yes Nt) 

I Does the grading around the perimeter of ttie house in excavated areas generally slope away 

Grading Sod and Vegetation 

L / ' 

from tbe house? ^___ _ 

2. Has sod been laid in all areas that were excavated? 

3 Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

i ^ 

day time period) 

A C ^ " Are sodded areas generally fu^ and evenly graded? 

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 nol pool on the propeny'' cy 

7 Was damage to landscaping or plant materials avoided? 

Cates. Fences and Rctaiplnt Walb Ves No 

I Do gates open and close freely*' (If applicable) 

2 Were all gates or fences taken down dunng restoration activities reinstalled'' (Ifapplicablc) 

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

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

Foupdaiton, Siding and GuHert Yes No 

I. Was damage to the siding or trim avoided? 

2. Was damage to the foujidation avoided? 

3. Was damage to windows avoided'' 

4 Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspout extensions avoided'' 

Sidewalks and Driveways (Concrete) Ves No, 

I Was damage lo driveway surfaces avoided? 

2 Was damage to walkway surfaces avoided? ^ " ^ 
Ownen; comments: 

Inspection notes: 

Removal and resloration iiclivales complele including the 30-day sod vvananry: 

EPA Represenlaiive r^(y> l^Cr>,bal \ l Da,e: W^ ^ 
Property Completion Agreement 

I his a|iieemeni documenls. the complelion ot remedial acliviiies perloimcd on my pioperly My Mgnalme 

will designate ilial 1 am satisfied with the restoration of my property, and thai no ileitis are m questions 

now. or al any ume m lhe future, except those iiems listed below, if any 

Property tP: (^7^»^<^Ci 

Property Addre.ss: ^U ^ «-| jJ 4 ^ 4\/ ^ 

Owner: jf^^^^icW ^.J^u-^iy ^ 

Phono fHa:n-^^„3-:-.^iH4~ ( H^n^^3 > • SlM*^ 

Restoration Items in Question: 

Item: 

V' d Lock f Bc2A ) /u f-,.j^cj.- y/hi-ci. llem. 

/I/H/ 'L^:t y)^-^,^,'^^^ n '/Q^-'-^Q. ^ / A.rJ^ 

Item: .--r f -tItem. / i f J J 

Item: 

Item: 

j^-J-iyc c ic«rar«lion n completed, rtccpi xs nottrt 

[ I I rio nol *i;rrc rcslomtinn \\ compielcri 

Owner's Sicn;innr Dale Innu artni 's Signature