TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: 'clolSy Date: 9//^/n ^ 

Address: M^l^ [')nr\eYh^CfYi k\\e 

Remediation Contractor: Coastal Environmental Group_ Year: _2008_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

y Video ofproperty (DVD) 

y Executive Summary 

\ y EPA-provided property sketch 

[r Signed Access Agreement for subject property 

fyjf\ Signed Access Agreement(s) for adjacent property 

y Restoration Agreement 

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

5K Confirmation data 

Q / Photographs TiT^- p ^nJoi x OA i> ^ /U)QMOa^ '^oA^ {^AJiisd d 

0 As-built sketch 

M Satisfactory restoration signed by Property Owner 

y Property close-out check list signed by EPA 

W^ Description ofareas not meeting ROD cleanup criteria 

5/ Utility clearances 

^ Property information from Douglas County Assessor's Office 

40316480 

y iiiiiiiii • Superfund 

^-^ Signature Date 
f \ 

Property Access Checklist 

Property ID: (^^J^^ . 

Property Address: q^/ Q |;^^^^, ^ n, 

n

n

 WORK STARTED

 WORK COIVIPELTED

 ON:

 ON:

 /

 /

 /_ 

/_ 

Owner ^'"TF^omq^ /^nphier 

Address: 

Phone:(qp-^>^ ^^j-^^^ ^ 

Fax: 

Cell/Pager: 

Renter: 

Phone: 

Fax: 

Cell/Pager: 

Additional Information: 

O Notification Letter 

Q^ Access Agreement 

0 ^ Restoration Agreement 

1 1 Topsoil Sampling (if applicable) 

O Disposal Sampling (if applicable) 

O Garden Sampling (if applicable) 

n utility Clearance 

0 ^ Vidco/Photos (Before) 

n Video/Photos (During) 

D Video/Photos (After) 

n Video/Photos (30-Day) 

n Property Completion Agreement 

CH Final Report 

Sent: / / 

Signed: _g_/it/ ^ 

Signed: _S_/(i_/ ^ 

/ / 

/ / 

/ / 

Called: J? /ll . / Ofi 

On: B/2Z)/i30 

On: / / 

On: / / 

On: / / 

Signed: / / 

Issued: / / 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

ft-\'^'C€> 

WM.-CC 

By: 

By: 

By: 

By: 

By: 

Air IVIonitoring ( 

1 1 Community 

as applicable 

D Crew 

Results: 

On: / / 1 

1 1 Community D

Results: 

 Crew On: / / B,: 

1 1 Community 

Results: 

D Crew On: / / By: 

Omaha Lead Site 
CONTACT FORM 

Property ID # {^(o'}'iio 

Property 

Address: M^iq vi/^rifKKimdmpInitial Conlact: Date:_ Time: Action: 

Second Contact: Date: Time: Action: 

Final Contact: Date: Time: Action: 

Final Action: Transmit to EPA D Olher Action: D 

|\ln \n\frv^-e\ \nfO 

Comment: 

Owner 

Comment (s); 

Site 

Coordinator 

Comment (s): 
Douglas County Account Informatio tifianna n Page 1 of2 

Dougla s County , Nebrask a Propert y Recor d - R095360000 0 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 90th St - Vie w O n Ma p Information is valid as of 2008-6-19 Treasurer's Tax Report 

New Feature - • ^ - • Auto Sales Search 

Owne r 

LANPHIER THOMAS M 

4819 UNDERWOOD AVE 

OMAHA NE 68132-0000 

Propert y Informatio n 

Key Number: 5360 0000 09 

Account Type: Residential 

Parcel Number: 0953600000 

Parcel Address: 

Legal Description: 

4819 UNDERWOOD AV 

OMAHA NE 68132-0000 

DUNDEE PLACE LOT 10 BLOCK 122 E 35 FT 35 X 128 

Valu e Informatio n 

2008 

2007 

2006 

2005 

2004 

2003 

Land 

$10,100.00 

$10,100.00 

$10,100.00 

$11,200.00 

$11,200.00 

$11,200.00 

Improvement 

$131,400.00 

$130,000.00 

$130,000.00 

$109,500.00 

$109,500.00 

$109,500.00 

Total 

$141,500.00 

$140,100.00 

$140,100.00 

$120,700.00 

$120,700.00 

$120,700.00 

Sales Informatio n 

Sales Date: 2008-03-25 

Deed Type: 

Price: 

WD 

$0.00 

Boolt: 2008 Page: 029258 

Grantor: LANPHIER LAWRENCE A ETAL 

Grantee: LANPHIER THOMAS M 

Valid/Invalid: Invalid 

Exclusion Reason: Family Sale 

Lan d Informatio n 

Acres SF Units Depth Width Vacant 

0.1 4480.0 1.0 128.0 35.0 No 

Lan d Attribute s 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09... 7/17/2008 
Douglas County Account Information Page 2 of 2 

Attribute Attribute Description 

Negative Influence Traffic 1 

Improvemen t Informatio n 

Building 1 

481 9 Underv/ood A v '#S^ 160 ^ m io<r Q 101 

n 

B^H "aSSSTn?" 

MIT 

nnlPlM »j>ir Svconil Flow <aa »(T 

MejDs«.n. 744.0 3^. Fl. 

JUE. 

f7( ^^^1 lie 

^^^^ H !"f 

•--jn r ' 2 1/2 story eiima:ckan T44i]eg PL 

CUCKIQENLARgEiiyiyj^gE 

Square Footage: 1936.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

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

HVAC: Central Air to Air Rooms: 7.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.5 

Roof Cover: Composition Shingle Bedrooms: 3.0 

Roof Type: Hip Stories: 2.5 

Floorcover: Allowance Foundation: Block 

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 Block 8 ft 744.0 

Fixture Base Fixtures 

1.0 

Fixture Bath Full 

1.0 

Fixture Bath Half 1.0 

Garage Detached 360.0 

Porch End Screen 

58.0 

User Attic full finish 252.0 

User Needs paint 

1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R09... 7/17/2008 
Page 1 of2 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2105336. 

Original Call Date: 8/12/08 Time: 3:40 pm Op: ELIZABETH18790 


Work to Begin Date: 8/14/08 Time: 4:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 4819 Street: UNDERWOOD AVE 


Twp: 15N Rng: 13E Sect-Qtr: 17-SW,18-SE 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: lead remidiation 


Location of Work: LOCATE ENTIRE PROPERTY ALL THE WAY TO THE STREET. 


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


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 MCLEODNE MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility 

Type 

CXCATV COX COMMUNICATIONS, 

INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

MCLEODNE MCLEODUSA NO NEED TO CALL OUT 

EMERGENCY 

Day: 8002891901 

Alt: 

Emerg: 8002891901 

MUDOl METROPOLITAN UTILITIES 

DISTRICT EDWINA 

Day: 4025047823 

Alt: 

Emerg: 4025047946 

OMAHACOF CITY OF OMAHATRAFFICSEWER RON 

Day: 4024447197 

Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/12/2008 
Page 2 of2 

0PPDGPR5 OMAHA PUBLIC POWER 

DISTRICT NA 

Day: 4067289343 

Ah: 8887289343 

Emerg: 4067289343 

QLNNE 1C QWEST LOCAL NETWORK NA 

Day:

Alt: 

 4067289343 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 8/12/2008 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

66786 

Omaha Exterior Paint Lead Site 

Sit • Good e Sketch 

g] Poor 

Sampling Address: 4819 UNDERWOOD AV Q Nol paint 

Sample Number Lead Sample LAB Samples Collected 

Concentration Collected Firm 

RYASCPXA-66786 Fl ^di o ppm 

0 D Date 

RYBSCPXA-66786 F2 (ti'-i I ppm 

D Time RYCSCPXA-66786 B1 _fljEL5_PPm 

n Samples Analyzed 

RYDSCPXA-66786 B2 IIBO ppm 

RD2SCPXA-66786 D DZ 2*i(aU ppm D XRF Unit: CaSHl Book: 79 3 

RGZSCPXA-66786 GZ ~* Pom D Date: //%•?/>• 0 7 

RP2SCPXA-66786 

PZ ~ ppm D D 

D Time: /^/*f 

Staff: f*1^L/ Number of Samples = 5 " 

Legend: F1 = Front Left. F2 = Front Right. B1 = Back Lefl. 82 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play All quadrants ant as vwwed from ttie straet. facing property 

• dLS#:g62M 

Date Excavated :8/,28/2008 

Date USEPA Signed Off:1/27/200»-

Area Sodded 3563 sq f: 

6c [ 2:9 2G0? 

B2 = PPM117@6" 

B1 =PPM 167 @ 6" 

DZ=PPM117@12" 

F2 = PPM 38 @ 6" 

EA=PPM120@ r 

Cnnd <>ill3JU7«.l«:: 

Legen d 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced with 

Sod 

Area replaced with 

Rock/Mulch Area left bar e 

Contrac t # : EP-R7-07-05 Coasta l Environmenta l Group Inc . 
66786 

Omaha Exterior Paint Lead Site NorthArrow 

Site • Good Sketch 

g l Poor 

Sampling Address: 4819 UNDERWOOD AV r~| Not paint 

I 

Sampl Lead Sample Samples Collected e Number LAB Concentration Collected Firm A5y) /"toj/ZIM) RYASCPXA-66786 Fl D Date is 

RYBSCPXA-66786 lr ¥ SI D Time 

RYCSCPXA-66786 B1 El n Samples Analyzed RYDSCPXA-66786 82 0 

RDZSCPXA-66786 DZ D XRF Unit; CoSHZ Book: /9 3 

RGZSCPXA-66786 GZ D D Date /n-7/i0 7 

RPZSCPXA-66786 PZ D D Time D Ul. Staff: f^i\ J Number of Samples = ^ [ Q | N ^ 

Legend: Fl = Front Left, F2 = Front Right. B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

AH quadrants are as viewed from the slreet, facing property 

ENTEREP 
Omah a Lea d Site 

Site Sketc h 

Sampling Address: 4819 UNDERWOOD AV ^ i -

Sample Number 

RYASCPXA-66786 

RYBSCPXA-66786 

RYCSCPXA-66786 

RYDSCPXA-66786 

RDZSCPXA-66786 

RGZSCPXA-66786 

RPZSCPXA-66786 

Lead 

Concentration 

Sample 

Collected LAB 

\CiCD ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

ppm 

Number of Samples = ^ j Q 

66786 

Exterior Paint NorthArrow 

• Good 

g l Poor 

Q] Not paint 

Samples Collected 

A5IA3 ^UOJ/^H ) 

^ 3T AM 

Samples Analyzed 

XRF Unit: 65*^2 . Book: /9 3 

Date: m-7/iQ 7 

Time; m 

Staff; f\i\J 

Legend: F1 = Front Left, F2 = Front Right, Bl = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 

ENTERED 

OCT 2;9 2ua? f^ ~:i 

'•.fim 4(/t7;[oi/ni^ H ^ 

y-fiku: 

V-^X 

^ 

R c \ 5 r.-oalcd ft I:.;:.«)7 OS 06 : IUM4I ^\\2^ 

>» ' UU) ,>W) .ifW JM ' M*l jM t Kl f H,«(i .•*« ;o>'fi.1'»• J. 

WfrT^^Afeiif^ 

^»^'7blfl^t' 
f 

66786 

Omah Exterior Paint NorthArrow a Lead Site 

Sit • Good e Sketch 

g ] Poor 

Sampling Address: 4819 UNDERWOOD AV Q Not paint I 

I 

Sample Number 

RYASCPXA-66786 F1 

Lead 

Concentration 

366? ppm 

Sample 

Collected LAB 

D 

Firm; 

Date; 

Samples Collected 

A5io ry-jlhtA ) 

3'S" AM 

RYBSCPXA-66786 F2 CQH\ ppm SI D Time; iDJ^ik^ 

RYCSCPXA-66786

RYDSCPXA-66786

 B1 

 B2 

ppm 

ppm m 

D 

D Samples Analyzed 

RDZSCPXA-66786 DZ ppm D XRF Unit: G>SHZ Book; /9 3 

RGZSCPXA-66786 GZ ppm D D Date; ir^-iA - Q l 

RPZSCPXA-66786 PZ ppm D D Time; ? M 

Number of Samples = ^ [ Q | Staff; fli U 

Legend; Fl = Front Left, F2 • Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ • Garden, PZ = Play 

All quadrants are as viewed from the street, facing property 
w, • -5. COASTA L 

*^ , .r«C ^ ENVIRONMENTAL 

' t PKOI^ C « O 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: Daytime Phone: 

Address of Property 

covered by this 

Agreement: 

M?IA \lMe.Y\y.ntYi ^^jg 

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 
I 

V****^* " COASTA COASTALL 'J^ . _ _e C ENVIRONMENTA L 

GROUP . IN 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 ofthe 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 (712) 352-0188 

I grant access to my properties G I do not grant access to my properties 

^'/y^ ^ 

Signature Date 

nn I would like to be present during any sampling that is required. 
« ^ ^ 

COASTA L 

Restoration Agreement 

The purpose ofthis agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation acti\ities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction ofthe property owner and the United States Environmental 

Protection Agency (EPA). 

Properlj ID: U 1^^ 

Properl> Address: m\0^ [j\^yi:hJ^^V iMt 

Owner; 

W^^i uwttie^ 

Phone: "^ ^ ^^\-m^ 

On the attached diagram(s) indicate area(s) to excavated and depth of excavation, location of all known 

utilities, subsurface features, surface structures and landscaping features, access location(s) to be used by 

contractor, and the direction of North. Indicate distances, depths, material types, etc. Indicate digital photos 

b> referencing the photo-log number with an arrow indicating direction of view. 

Items TO Be Removed By Owner Before Start Of Remediation: 

(Use additional sheets as necessary) 

The removal, storage, disposal, and'or return cf these items is the Ov^ner s -esponsibility. 

Rem: C . /), yWlVfu. \W(v\1h ^ ^ 

Item: y ' 

Item: ^ y 

Item: / ^ 

Item: y 

Item: / ^ 

Item: y 

Item: 

Page 1 of (^ 
COASTA L 

Items TO Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

^f\i ^ fuvifz Uff y^^^ 110 

Item: 

Hem: 

Item: 

Kem: 

Item: 

item: 

Item: 

Item: 

Item; 

ttem: 

Item: 

Item: 

Item: 

Item: 

t 

Page 2 of. 
COASTA L 

C • O M • • M C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

4oiL ^ fy\l\ Y f>2. -v ^ ^ 

Item: 

\\\jy\>f t^2 e f\ 

Item: 

%>0y \^i : ^ H '^m c^m 

Item: 

^ ^ ^ ^•^ %i^ W ^ f ^ k^Fv ^\^^ 

Item: 

(^-. 1 - v 1 1 - '%-i' ^ 

h^]^ \^- y v\ Y vX ""y ^ 1 Item: y ^ 

ttem: 

/ 

Item: y 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Item: / 

Page 3 of 
COASTA L 

CMOUP . IN C 

Landscape Inventory 

(Use additional sheets as necessary) 

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 Sprinl<ler 

Zones. Control Valves, 

Timers. Heads, etc. 

Anach a sketch of the 

sprinkler lax out. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Quantity Unit Condition/Type/Species 

l^CU/^ Cih&^ Square feet 

y 

1 Each \ y 

y Each 

y Each 

Vi ^\ 

Each \ Square Feet 

Page 4of ^ 
P 

COASTA L 

Item Quantity Unit Condition/Type/Species 

.Agreed upon value of 

olant materials nol to be 

replaced bv contractor. ' 

Note this \alue v\ill be 

used to issue a plant 

voucher to the propert> 

owner. 

y s 

Agreed upon list of plant 

materials that ^\\\ be 

replaced by contractor. Be 

very specific and detailed. y Each 

Include a sketch of were 

each plant will be placed 

b\ the contractor. 

Agreed upon area of 

property to be replaced 

with grass sod. 

Include a sketch of the 

area(s) to be replaced with 

grass sod. H 

)yh 

SF 

Area of City or County 

property to be landscaped 

per their requirements. 

Include n «keicli v'f tl-.e 

area (s i 

SF &f1r7fci^^f 

Easement .^rea. to be 

excavated SF ^ U P\mA\A(!f\j 

Page 5 of G? 
C O A S T A 1. 

Additional Comments / Instnictions: 

_ '^yy\s}Mt ^ f« ^ fun^r^ i?5r h ^ ft^. Vwc% 

- - fUKt \o(Ay \% ^^y] x ^^^ ^"^ 

G Check the tx>x if Owner does not want CEG to document interior foundation walls arxl possible 

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

interior of house, including foundation cracks or fissures. 

Q I do Bot agree 

- 9 y - c"& 9fCkHisoh y\ y 

''Owner's Si^o^M ^ Date CoBoactor's Signatare Date 

PageSof. 
BVID# yyi^ijf

XRF PROPERTY SAMPLE SHEET 


Date 

Project 

XRFID# 

Shot# 

3Si: 

-^i-^ft^ 

-lmuk 

Average 

Shot* 

V ' K- ^ 

%1W W 

kk 

Average

Shot # 

ZllS 

HE

"i)?^ 

Average 

Shot# 

Average 

lab sample # 

i ^is -^V 

Omaha lead FP 2na year opllon 

^^^ n 

Reading

^-cqit H.^r 

iK q^i t iM>M) 

Pl-7\ - '^;K0 

wn y t y ^ 

Sample area 

hPficx^tfAf 

Depth 

]%. y t \H-^% 

Reading Sample area 

lO^.Ol t (1..v.f< 

iQ-qp ^ IVT^' M 

IK.OOi 1^-S1 Depth 

MMLjMI l'< 

1 1^ . 15 ^- \^-P | 

Reading Sample area 

l)g. 5] j : l^.i^n" 

Ul-?; . t i^-gi t^Z

H^-ot,i l>b^ Depth 

Ui.^ ^ t IV I ^ 

in.6< ^^ lyiu 

Address y\'i [j'M^iMUo'J^ 

Sample time )\-\ y /rrT)/pm 

sample length 30 sec ^ 

Shot# Reading Sample area 

Tn^ '>1MI PT 

Depth 

H 

Average "> i ^ 1 ^- ^-^ ^ 

Shot# Reading Sample area 

IK.O U lu.1 ^ 

^^. i r i. llJi. K 

3n< 1^(^. n t IL.ZL Depth 

LIU - ikH^ t M::^^ J y L 

Average W .V l ^ 1 U • (7 (p 

Shot# Reading Sample area 

Depth 

Average 

Reading 

RETEST AREAS 

Sample area Shot* Reading Sample area 

Depth 

Average 

y y 

yy 

Depth 

Lab result Sample area XRF Avg 

Signature 

Pnn," }hMy n f^ATfa-•? 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By: 

Certificate of Verification 

3139 

SOIL 

2008-08-28 11:14 

121.03 

Final 

|Av g of 3135-3138 

4819 Underwood ave 

teasemenl ^ 

*LOPEZ 

f l 

CLEARANCE 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3135 

Mode SOIL 

Time 2008-08-28 11:12 

Duration 30.08 

Sequence Final 

Flags 

BVID # 66786 

ADDRESS 4819 Underwood ave 

QUAD/ZONE easement 

INSPECTOR LOPEZ 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 126.905 ± 14.950 

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 115.942 

Supervised By: 

Certificate of Verification 

3136 

SOIL 

2008-08-28 11: 13 

30.28 

Final 

66786 

4819 Underwood ave 

easement 

LOPEZ 

1 

CLEARANCE 

± Error 

± 14.407 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3137 

Mode SOIL 

Time 2008-08-28 11:14 

Duration 30.34 

Sequence Final 

Flags 

BVID # 66786 

ADDRESS 4819 Underwood ave 

QUAD/ZONE easement 

INSPECTOR LOPEZ 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 121.751 ± 14.796 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3138 

Mode SOIL 

Time 2008-08-28 11:14 

Duration 30.33 

Sequence Final 

Flags 

BVID # 66786 

ADDRESS 4819 Underwood ave 

QUAD/ZONE easement 

INSPECTOR LOPEZ 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 117.991 ± 14.573 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3144 

Mode SOIL 

Time 2008-08-28 11: 18 

Duration 120.52 

Sequence Final 

Flags 

AVERAGE ^v g of 3140-3143 

ADDRESS 4819 Underwood ave 

QUAD/ZONE F2 

INSPECTOR LOPEZ 

DEPTH 6 

SAMPLE TYPE XLEARANCEf 

NOTE 

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 47.783 

Supervised By: 

Certificate of Verification 

3140 

SOIL 

2008-08-28 11:16 

30.24 

Final 

66786 

4819 Underwood ave 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 10.153 
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 39.877 

Supervised By: 

Certificate of Verification 

3141 

SOIL 

2008-08-28 11: 17 

30.07 

Final 

66786 

4819 Underwood ave 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 9.575 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3142 

Mode SOIL 

Time 2008-08-28 11:18 

Duration 30.18 

Sequence Final 

Flags 

BVID # 66786 

ADDRESS 4819 Underwood ave 

QUAD/ZONE F2 

INSPECTOR LOPEZ 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 30.077 ± 8.779 

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 35.341 

Supervised By: 

Certificate of Verification 

3143 

SOIL 

2008-08-28 11:18 

30.03 

Final 

66786 

4819 Underwood ave 

F2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 9.287 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

Supervised By 

Certificate of Verification 

3167 

SOIL 

2008-08-28 13:58 

121.68 

Final 

-i.Avg of 3163-3166 

4819 Underwood ave 

soz 

LOPEZ 

%2 ^ 

CLEARANCE 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3163 

Mode SOIL 

Time 2008-08-28 13:56 

Duration 30.33 

Sequence Final 

Flags 

BVID # 66786 

ADDRESS 4819 Underwood ave 

QUAD/ZONE DZ 

INSPECTOR LOPEZ 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 109.070 ± 13.450 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3164 

Mode SOIL 

Time 2008-08-28 13:56 

Duration 30.36 

Sequence Final 

Flags 

BVID # 66786 

ADDRESS 4819 Underwood ave 

QUAD/ZONE DZ 

INSPECTOR LOPEZ 

DEPTH 12 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 110.904 ± 13.790 

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 118.701 

Supervised By: 

Certificate of Verification 

3165 

SOIL 

2008-08-28 13:57 

30.38 

Final 

66786 

4819 Underwood ave 

DZ 

LOPEZ 

12 

CLEARANCE 

± Error 

± 13.896 
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 132.475 

Supervised By: 

Certificate of Verification 

3166 

SOIL 

2008-08-28 13:58 

30.61 

Final 

66786 

4819 Underwood ave 

DZ 

LOPEZ 

12 

CLEARANCE 

± Error 

± 14.923 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3177 

Mode SOIL 

Time 2008-08-28 14:09 

Duration 121.59 

Sequence Final 

Flags 

AVERAGE »Avg of 3173-3176 

ADDRESS 4819 Underwood ave 

QUAD/ZONE 

INSPECTOR LOPEZ 

DEPTH 16 

SAMPLE TYPE CLEARANCE 

NOTE 

Pb 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3173 

Mode SOIL 

Time 2008-08-28 14:07 

Duration 30.34 

Sequence Final 

Flags 

BVID # 66786 

ADDRESS 4819 Underwood ave 

QUAD/ZONE B l 

INSPECTOR LOPEZ 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 185.029 ± 16.730 

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 149.162 

Supervised By: 

Certificate of Verification 

3174 

SOIL 

2008-08-28 14:08 

30.42 

Final 

66786 

4819 Underwood ave 

Bl 

LOPEZ 

6 

CLEARANCE 

± Error 

± 15.236 
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 166.177 

Supervised By: 

Certificate of Verification 

3175 

SOIL 

2008-08-28 14:09 

30.41 

Final 

66786 

4819 Underwood ave 

Bl 

LOPEZ 

6 

CLEARANCE 

± Error 

16.223 
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 168.744 

Supervised By: 

Certificate of Verification 

3176 

SOIL 

2008-08-28 14:09 

30.42 

Final 

66786 

4819 Underwood ave 

Bl 

LOPEZ 

6 

CLEARANCE 

± Error 

± 16.067 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3188 

Mode SOIL 

Time 2008-08-28 14:24 

Duration 121.43 

Sequence Final 

Flags 

AVERAGE Avg of 3184-3187 

ADDRESS '4819 Underwood ave 

QUAD/ZONE 

INSPECTOR LOPEZ 

DEPTH 

SAMPLE TYPE CLEARANCE 

NOTE 

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 110.510 

Supervised By: 

Certificate of Verification 

3184 

SOIL 

2008-08-28 14:22 

30.35 

Final 

66786 

4819 Underwood ave 

B2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 13.479 
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 121.760 

Supervised By: 

Certificate of Verification 

3185 

SOIL 

2008-08-28 14:23 

30.05 

Final 

66786 

4819 Underwood ave 

B2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 14.017 
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 117.066 

Supervised By: 

Certificate of Verification 

3186 

SOIL 

2008-08-28 14:24 

30.31 

Final 

66786 

4819 Underwood ave 

B2 

LOPEZ 

6 

CLEARANCE 

± Error 

± 13.654 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3187 

Mode SOIL 

Time 2008-08-28 14:24 

Duration 30.72 

Sequence Final 

Flags 

BVID # 66786 

ADDRESS 4819 Underwood ave 

QUAD/ZONE B2 

INSPECTOR LOPEZ 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb at21-267 ± 13.911 

Supervised By: 
i,ML\

l^^^v ' I

\y^^ ^

 Omaha Lead Site—Fixed Price EP-R7-07-05 

 Coastal Environmental Group Inc. 

 www.coastalhazmat.com 

COASTA L ENViRONNCNTA L 

C II 0 U P . INC . 

EXECUTIVE SUMMARY: 

BVID # 66786 - (4819 UNDERWOOD AVE) 

^ No Issues or Concerns | ^ Issues/Concerns 

Detail Explanation: 

NO ISSUES PENDING. 
t ^^EPA 

EPA Propert>' Close Out Form 

Property P: UUiTBUs Property Addrew: 48 ^ ^ i ^rvC^Xjr-lX^C'yScl lA^j/C . 

Date/Tlroe: Owner's N«me:-^r.rr ^ 6^ s. y , ^Q\^\P.V -

Quads Excavated: ^ . ;^ \ ?^ 3 , \^ ^ Contracior Group (^pr. ^\f . 51 y f^ y r crrMy\x.\n.\c>4 , 

ExcavatioD General Ves No 

1. If necessa^'. ^crc the correct quadrant(s) excavated and resiored? y 

2 Ifnecessary, were the correct areas ofdrip zone excavated and restored? 7 

CradlDK Sod and Vecetation Yes No 

1 Does the grading around the perimeter ofthe house in excavaled areas generally slope away 

y from Ibe house? 

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

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

y day time period) 

4 Are sodded areas generally firm and evenly graded? y 

5 Are the joints t)etween the sod strips generally light? (Only evaluate ifinspected at a 30 day y lime period) 

6 Was the property graded such thai water will not pool on the property"' 

/ 

7 Was damage lo landscaping or plant materials avoided? / 

Gates. Fences and ReUiDlD£ Walls ^ es Nu 

1 Do gales open and close freely? (Ifapplicable) 

2. Were all gates or fences taken down during restoration activities reinstalled? (Ifapplicable) A\r •• ^i

3 Was damage to gates or fences avoided? (Ifapplicable) 

4 Was damage to retaining walls avoided? (Ifapplicable) 

Foundation, SidioK and Cullers Yes Nc 

1. Was damage lo the siding or trim avoided? y 

2 Was damage lo the foundation avoided? y 

3 Was damage lo windows avoided'' y 

4, Was damage to windows or door screens avoided? ^ 

5 Was damage to dowTispouts or downspoul exiensions avoided? ^ 

Sidewalks and Driveways (Concrete) Yes No 

1 Was damage to driveway surfaces avoided'' 

< / 

2. Was damage to wallcway surfaces avoided? i / 
# O »Ders comments: 

Inspection notes: 

L. 

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

EPA Representaiiv^.V^6^<^t.<^;^^:^^V:74^:^^ Dale: VZ^l/a? 
• t 

Property Completion Agreement 

This agreement documents the completion of remedial activities perlbrmecl on my properly. My signalure 

will designale lliat I am satLslied with the restoration of my property, and that n<i item.s iiie in qucstion.s, 

now. or at any time in the future, except those ilem.s li.sted below, ilany. 

Propc^ly^n>:^^^g(^ _ 

Property Address: C^g|C^ OndteroJDod t 

Owner: nrV^^ ^ ^^^^j^^^ ^ 

Restoration Items in Question: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Jc-L^ I agrct- resloralion i.v coni|ilclc<l, except us noted 

 I I ilo nol agree resCorHlion is complied 

^-yj^yy^^ yy i l(p Y 

Contractor's .Si^^natiire DalLI