TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATIO N FILE FOLDER 

SAID#: .^4 n Date: ^\QQ>llf\ 

Address: l^-^JjA lOi ^" ^ S f 

Remediation Contractor: Coastal Environmental Group_ Year: _2008_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

^ m Video of property (DVD) ^"""^^ \J(ULaJr [el 

B ^ Executive Summary 

B ^ EPA-provided property sketch 40314780 

H ^ Signed Access Agreement for subject property |||||| |||||||||||||||||||i| ||||||| 

MIL. Superfund 

tpV Signed Access Agreement(s) for adjacent property 

B^ Restoration Agreement 

|6^n Settlement documents (i.e., for damage or to replace plants, etc.) 

5K Confirmation data 

B^ Photographs pre. - 6 ^/Jc;i l OA QJCC^sJoJl^Q^^ yli^aA Sdc i 

c / As-built sketch 

S/ Satisfactory restoration signed by Property Owner 

H^ Property close-out check list signed by EPA 

|^l\ Description of areas not meeting ROD cleanup criteria 

W Utility clearances 

^ Property information from Douglas County Assessor's Office 

r I^QorL a.cULg-s<: nAeJcJi^-r 

^ (1^/2/ ^ i^ m 

D 
m 

Property Access Checklist 

Property ID: 3§m \ n WORK STARTED ON: / / 1 

Property Address: M ^i^ q ^ 2M ^ 3 n WORKCOIMPELTED ON: / / 

Ownci Renter: 

Address: Phone: 

Fa.\: 

Cell/Pager: 

'''"""(303)^i(o-4(D^l 

Fax: 

Additional Information: 

Cell/Pa,er^ge^^>) 31-1-\1X ? 

1 O Notification Letter Sent: / / By: 

Q * Access Agreement Signed: ^/JO/ ^ By-fr 

Q ' Restoration Aj^reement Signed: ^/i^/OS ' B.v^eC 1 

n Top.soil Samplini; (if applicable) / / By: 

O Disposal Sampling (if applicable) / / By: 

1 1 Garden Sampling (if a|)|)licable) / / By: 

' ^ Ltilitv Clearance Called: _g_/10/C ^ ^y(\'n'0% 

JZ^ Video/Photos (Before) On:_l//5_/ 6^ B>- i^trvdifls 

n Video/Photo.s (During) On: / / By: 

|" D Video/Photos (After) On: / / By: 

D Video/Photos (30-Day) On: / / By: 

nn Property Completion Agreement Signed: / / By: 

cn Final Report I.s.sued: / / By: 

Air Monitoring (as applicable ) 

• Community • Crew On: / / By: 1 

Results: I 

1 n Community O Crew On: / / By: _ 1 

Results: 

1 cn Community Cll'Crew On: / / By: 

Results: 

Omaha Lead Site 
CONTACT FORM 

Property ID # 

Property 

Address: 

Initial Contact: 

Second Contact: 

Final Contact: 

Final Action: 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 

.^5Hl\ 

4lliM U a^ 34 

Date: Time: Action: 

Date: Time: Action: 

Date: Time: Action: 

Transmit to EPA D Other Action: D 
VS, FAX 

TO Chapman Mittis L FROM: Elizabeth Caceres 

FAX: (303) 371-1228 FAX: 877 662 4211 Toll Free 

PHONE: (303) 916-4641 PHONE: (402) 504-2194 

SUBJECT: Access and Restoration Agreements DATE: September 9, 2008 

COMMENTS: 

Please complete, sign, date and fax back to our toll Free Fax 877-662-4211. 

Thank You, 

Elizabeth Caceres 
Douglas County Account Information Page 1 of2 

Douglas County, Nebraska Property Record - R0204020000 

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 2008-9-4 Treasurer's Tax Report 

New Feature ->->-> Auto Sales Search 

Owner 

CHAPMAN MlTTlS L 

21453 E 54 PLZ 

DENVER CO 80249-0000 

Property Informatio n 

Key Number: 0402 0000 02 

Account Type: Residential 

Parcel Number: 0204020000 

Parcel Address: 4764 N 24 ST 

OMAHA NE 68110-0000 

Legal Description: LANDS SEC-TWN-RGE 04-15-13 S 1/2 SUB 2 & N 45 FT SUB 3 LT 11 67.5 X 132 

Value Informatio n 

2008 

2007 

2006 

2005 

2004 

2003 

Land 

$600.00 

$600.00 

$600.00 

$600.00 

$600.00 

$600.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$600.00 

$600.00 

$600.00 

$600.00 

$600.00 

$600.00 

Sales Informatio n 

Sales Date: 2006-11-15 

Deed Type: 

Price: 

QC 

$1.00 

Book: 2007 Page: 048606 

Grantor: Colorado Classic Properties 

Grantee: Chapman Mittis L 

Valid/Invalid: Invalid 

Exclusion Reason: 

Sales Date: 2001-04-11 

Deed Type: SHD Book: 2003 Page: 171705 

Price: $392.00 

Grantor: SHERIFF 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R020... 9/9/2008 
Douglas County Accoimt Information Page 2 of2 

Grantee: COLORADO CLASSIC PROPERTIES 

Valid/Invalid: Invalid 

Exclusion Reason: Sale by Govt Agency 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.2 8976.0 0.0 132.0 68.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R020... 9/9/2008 
Page 1 of2 

Create Another Ticket Back to Irth Internet Send Email 

YOUR TICKET NUMBER IS 2128551. 

Original Call Date: 9/10/08 Time: 5:04 pm Op: ELIZABETH18790 

Work to Begin Date: 9/12/08 Time: 5:30 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 4764 Street: N 24TH ST 

Twp: 15N Rng: 13E Sect-Qtr: 03-NW,04-NE 

Twp: Rng: Sect-Qtr: 

Legal Given: C 

Type of Work: lead remidiation 


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


: HOUSE. 


Remarks: 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 Comer Lot: N Front: Y Rear: Y 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELLAN MUDOl OMAHACOF 0PPDGPR5 QLNNEIC SPRNTPCS 


Service Area Contact Phone Number UtiUty Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 9185747098 

MAGELLAN MAGELLAN MIDSTREAM PARTNERS LP TONYA Alt: 

Emerg: 9185747098 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047946 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFIC,SEWER RON Alt: 4024445161 

Emerg: 4024445160 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/10/2008 
Page 2 of2 

Day: 4067289343 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 8887289343 

Emerg: 4067289343 

Day: 4067289343 

QLNNE 1C QWEST LOCAL NETWORK NA Alt: 

Emerg: 8887289343 

Day: 4025371800 

SPRNTPCS SPRINT SPECTRUM L P Alt: 4025371810 

Emerg: 8005210579 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 9/10/2008 
35411 

As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

Exterior Painl Nort^ Arrow 

Owne Omaha Lead Site r Name: COLORADO CLASSIC PROP 

Sit • Good e Sketch Address: 4764 N24ST • Poor Phone: H: W. 0 * Not paint 

Sample Lead Sample Samples Collected Number LAB Concentration Collected Firm: /^sw l p-si AJ " 

RYASCPXA-35411 F1 

J^i. ppm 0' D Date; ii - IS - og-. 

RYBSCPXA-35411 F2 I S ppm D 

Time: i n •.3>o Sr ^ 

RYCSCPXA-35411 Bl -Sl l ppm D 

Samples Analyzed 

RYDSCPXA-35411 82 ppm 

RDZSCPXA 3M11 Bir ±±5- ppm D n XRF Unit: /OCT? Book:/7 ^ 

nCZGCPXA 35411 S * ppm D D Date: /2 - / 2 - OCs 

nPZSCPXA 36411 P i ppm D D Time: Ar>^ D Staff: /^ii ^ Number of Samples = ^ 

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

All quadrants are as viewed from ttie street, facing property 

ENTERED OLS# 3S411 

Date Excavated: 9/14/08 

NOV 27^006 

Date USEPA Signed Off: 1/13/09 

Area Sodded 2275 sq ft 

Legend 

Concret e Dri p Zone Excavate d Quadrants Excavate d 

Area replaced with 

Sod ' ' 

Are a replace d wit h 

Are a lef t bar e Rock/Mulch 

Contrac t #: EP-R7-07-05 Coasta l Environmental Group Inc . 
35411 

X 

Exterior Paint North Arrow Owne Omaha Lead Site r Name: COLORADO CLASSIC PROP • Good Site Sketch Address: 4764 N 24 SI _ • Poor 

Phone: H W 

0 * Not paint -fr 

Sampl Lead Sample Samples Collected e Number LAB Concentration Collected Firm: /RSi-i l Ps l AT" 

RYASCPXA-35411 Fl Z i l ppm 0' ta Date: 11- is-ot ^ 

RYBSCPXA-35411 F2 J 8 ppm 0^ D Time: | 0 "So aTv^ 

RYCSCPXA-35411 B1 _S3_l____ppm [T D Samples Analyzed RYDSCPXA-35411 82 i H ^ ppm 

D 

RDZSCPXA aeon—D ^ ^ ppm u D XRF Unit Joe y Book: n-^ 

RGZCCPXA 35411 GZ ~ ppm D D Date J2 ' i2'OC s 

RPZOCPXA 35411 Pi. "~ ppm D D 

Time: Arr, 

Staff: Numbe f^-it ^ r of Samples = ; ^ 

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

All quadrants are as viewed from ttie street, facing property 

S, 

3rs^ Lsy^.^ps~ 

. _ 3 

I 
35411 

Omah Exterior Paint Nortli Arrow Owne a Lead Site r Name: COLORADO CLASSIC PROP 

Site • Good Sketch Address: 4764 N^24 ST • Poor 

Phone:» W: 0 * Not paint 

Sample Number Lead Sample Samples Collected LAB Concentration Collected Firm: /\s\ri \ ps i AJ~ 

RYASCPXA-35411 F1 

:2_L ppm 0' D Date: n - IS - O 4> 

RYBSCPXA-35411 F2 

JL8 ppm D Time: ;o :3>o QrrN 

RYCSCPXA-35411 Bl 

31 

ppm 

D Samples Analyzed RYDSCPXA-35411 B2 1 H 6 ppm D 

RDZSCPXA 36111 Q^ -~ ppm D D XRF Unit: J00~7 Book:/ 7 ^ 

RCZSCPXA 35411 GZ ~" ppm D D Date; /2-/ 2 ' OCD 

f^PZCCPXA 36411 PZ 

~ ppm D D 

Time: Anr, 

Staff: /^<u y Number of Samples = , ^ I j — 

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

All quadrants are as viewed from ttie street, facing property 

1 

X 

o O 

Rev 4 

•_i-.U.i^'^ 046141 0U3 .-..• ST_-_•.-_;-£3?t^|wl 
35411 

Omah Exterior Paint Nortti Arrow Owne a Lead Site r Name: COLORADO CLASSIC PROP 

Site • Good Sketch Address: 4764 N 24 ST • Poor 

Phone: Jj; W: 

0 * Not paint 

Sample Number Lead Sample Samples Collected LAB Concentration Collected Firm: As^n \ Q'~>\f\T 

RYASCPXA-35411 F1 "^ 1 ppm 0' D Date: ll - \S - QCr^ 

RYBSCPXA-35411 F2 J S ppm 0" D Time: ; o •.3>o ^TY^ 

RYCSCPXA-35411 Bl 831 ppm [T 

n Samples Analyzed 

RYDSCPXA-35411 B2 I M g ppm 

RDZSCPXA 36411 B£ D ~ ppm n XRF Unit: /AD"7 Book:/7 ^ 

RGZCCPXA 35411 -GZ D

• - ppm n D Date: 72-/ 2 ' t^6> 

RPZCCPXA 36411 -PZ " " ppm 

D Time: Arr-, 

n Staff: /t^<i ^ Number of Samples = : ^ 

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 

ENTEEED 

83 li.5. 

Bi^ 

NJ ZM 

-tr 

^ 

Ft F2. 

IXX .IB. 

-L. 

VJdlK^ 

Rev 4 .U. 2.4... ST. 0461410123 
^'^•**'> ' COASTAL ^'^l •-^It!'' HtVinONHlHTAl 

^*0^ C • O U p . 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: _ . . ,^11 

Owner's Name: Daytime Phone: 

CWxpwVUi^ KK^Mrvfs 

Address of Property 

covered by this 

Agreement: 

^-\M uan sv 

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 perfonned, 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 
D

 Remote ID; R page of 

COASTA L 

• 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 woiit. 

• 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 

Environmentai Group, at (712) 352-0188 

- ^

 j ^ I grant access to my properties • I do not grant access to my properties 

mM fy^ ^ 

Signature / Date Signature Date 

G I would like to be present during any sampling that is required. 
COASTA L 

a M o u r- < M c 

Restoration Agreement 

The purpose ofthis agreement is to provide a inutual 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:-O^UU 

Property Address: ^^(p^ ^ \ ^ Q^^Hi S^-

KKxWtS 

Phone:(^^Y<^\U^ 'AlnUV 

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 

by 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 of these items is the Owner's responsibility. 

Item: 

M^AiP. \mi{^<: D4hpru)iRe rvsh^/lw^ndhpy 

Item 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 1 of. 
< ^ ^ 

COASTA L f M VI«ONt«t MTA L O « O U P . IM C 

Items To Be Removed By Contractor During Remediation And Not Replaced 

(Use additional sheets as necessary) 

Item: 

l\f]ij ^mnnll fkyiH/debri s 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Kem: 

Page 2 of. 
( ^ 

C O A S T A L • MVtMONVttNTAL C « O U r IM C 

Items To Be Removed By Contractor During Remediation And Replaced 

(Use additional sheets as necessary) 

Item: 

ftl 

Item: 

U 

Item: 

Item: 

Kem: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Item: 

Page 3 of. 
-mCOASTA L 

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 Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketch of the 

sprinkler layout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relative 

sizes and locations. 

Quantity Unit Condition/Type/Species 

t)V Square feet 

V Each 

-. 

^\ ^ Each 

<5 Each 

^ Each 

Square Feet 

Page 4 of. 
COASTA L CNvmONHftNTAt c » o u r IM C 

Item 

Agreed upon value of 

plant materials not to be 

renlaced bv contractor. 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Agreed upon list of plant 

materials that will be 

replaced by contractor. Be 

very specific and detailed. 

Include a sketch of were 

each plant will be placed 

by 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. 

Area of City or County 

property to be landscaped 

per their requirements. 

Include a sketch of the 

aiea (s) 

Easement Area, to be 

excavated 

Quantity Uriit Condition/Type/Species 

$ 

4 

i Each 

<b\ SF 

To be dek.Y"VY\\r\ftl 

SF 

Vending too\Vs 

SF 

Page 5 of. 
D Remote ID: R page of 

; O A CT A K 

m * tt r . I M «. 

Addttional ComnMrrts / Instnictlotis: 

HjiF^ O Check the box if Owner does not warit CEG to document inieiior fiiurKlalion walls and possb 

pre-existing damage. By checkhg this box CEG is rxit responsitile for any damage done to tie 

interior of house, including fDundation cracks or fissures. 

. ^ ^ • I apree G I do Bot agree 

asL 

Owner's Signtture Date ContFutor's Sqrnaterc Date 

Page 6 Of 
BVID# Af:)Q U 

XRF PROPERTY SAMPLE SHEET 


Date ^-\a-o^ Address A-1^. ^ W->• cDUl^ S.V. 

Project Omaha lead FP 2na year option Sample time 6'-a. Q am/pm 

XRF ID# P^CPR sample length 30 sec 

Shot# 

j8iL o

y>r611

c^"> S

Average

Reading 

 :94^^^^^>?. ^ e ^ 

 o?,R,3fti:^A & Depth 

 tSftl-l-i^dto^M 

Sample area 

.^" ^ 

\ 

 ,^?>T . ^ftj i .Q^ . n Average 

Shot # Reading Sample area 

Depth 

Shot# Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average Average 

Shot# Reading Sample area Shot* Reading Sample area 

Depth Depth 

Average Average 

RETEST AREAS 

Shot# 

4iSza. QLU. 

^BIQ

3B-lg >

Reading 

^^.^L-CO-ft\ 

^f?l o5t-^^.-?f(, 

 ^^i-M\^>-^-^ 

fe^-..F>li35--vo 

Sample area 

•&1 

Depth 

la . 

Shot# Reading Sample area 

Depth 

Average X^\ 7^ t ^?^.^XG Average 

lab sample # Lab result Sample area XRF Avg. 

Signature. ?^A^M^ 

Print g.O»^^^tiQ^^ OAJ^WQA 
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 334.496 

Supervised By: 

Certificate of Verification 

3870 

SOIL 

2008-09-14 08:32 

30.55 

Final 

35411 

4764 N 24 st 

Bl 

lopez 

6 

RETEST 

± Error 

± 22.810 
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 PT'PE 

NOTE 

ppm 

Pb 361.034 

Supervised By: 

Certificate of Verification 

3871 

SOIL 

2008-09-14 08:33 

30.90 

Final 

35411 

4764 N 24 st 

Bl 

lopez 

6 

RETEST 

± Error 

± 23.759 
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 384.040 

Supervised By: 

Certificate of Verification 

3872 

SOIL 

2008-09-14 08:34 

30.37 

Final 

35411 

4764 N 24 st 

Bl 

lopez 

6 

RETEST 

± Error 

± 24.527 
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 rypE 

NOTE 

ppm 

Pb 325.812 

Supervised By: 

Certificate of Verification 

3873 

SOIL 

2008-09-14 08:34 

30.25 

Final 

35411 

4764 N 24 st 

Bl 

lopez 

6 

RETEST 

± Error 

± 22.718 
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 

Certificate of Verification 

3874 

SOIL 

2008-09-14 08:34 

122.07 

Final 

I Avg of 3870-3873 

4764 N 24 st 

lopez f6 

^RETESTJ 

ppm ± Error 

Pb 351.345 ± 23.453 

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 PT'PE 

NOTE 

ppm 

Pb 227.198 

Supervised By: 

Certificate of Verification 

3875 

SOIL 

2008-09-14 08:36 

30.61 

Final 

35411 

4764 N 24 st 

easement 

lopez 

1 

CLEARANCE 

± Error 

± 19.606 
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 245.861 

Supervised By: 

Certificate of Verification 

3876 

SOIL 

2008-09-14 08:37 

30.52 

Final 

35411 

4764 N 24 st 

easement 

lopez 

1 

CLEARANCE 

± Error 

± 20.346 
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 238.282 

Supervised By: 

Certificate of Verification 

3877 

SOIL 

2008-09-14 08:37 

30.61 

Final 

35411 

4764 N 24 st 

easement 

lopez 

1 

CLEARANCE 

± Error 

± 20.395 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 3878 

Mode SOIL 

Time 2008-09-14 08:38 

Duration 30.43 

Sequence Final 

Flags 

BVID # 35411 

ADDRESS 4764 N 24 st 

QUAD/ZONE easement 

INSPECTOR lopez 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 237.773 ± 20.335 

Supervised By: 
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 

Certificate of Verification 

3879 

SOIL 

2008-09-14 08:38 

122.17 

Final 

I Avg of 3875-3878 

4764 N 24 st ~ 

;/ easement^ 

lopez 

^ 1 

CLEARANCE 

ppm ± Error 

Pb 237.279 ± 20.171 

Supervised By: 
Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

www.coastalhazmat.com 

COASTA L ENVIRONMENTAL 

C R O U r , INC . 

EXECUTIVE SUMMARY: 

BVID # 35411 - (4764 N 24 ST) 

X No Issues or Concerns I I Issues/Concerns 

Detail Explanation: 

NO ISSUES PENDING. 
.^EPA 

EPA Propert> Close Out Form 

Prop«ny tt: r¥S A \ \ Property Address: 4~|(PA.\V- ^ ,^0^^^ . 

Dale/Tlroc: Owner's Name: OKf^^^A^lL,r^ _ KA..-H^ 

Quads Eicavatfd: "^ \ Contractor Group Oi2"~^-^^cx ^ 'g^QvArPTviMjtjrvtu^ 

Excavation General V l\C A U' X L o T ' Yes No 

1 If necessary, were the correcl quadram(s) excavated and reslored? 

^ 

2 If necessa-y, were the correct areas ofdrip zone excavated and restored'' 

# 

Grading Sod and Vcgctatiop Yes No 

I Does the grading arownd lh> [n liiiii irr of thi houic in excavated areas generally slope away 

v/ from tbe house? 

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

3. Does the sod appear to be generally healthy and growing'' (Only evaluate if inspected at a 30 u/^ day lime period) 

4 Are sodded areas generally firm and evenly graded? 

y 

5 Art the joints between the sod strips generally tight? (Only evaluate ifinspecied ai a 30 day < / 

time period) 

6 Was the property graded such that water will not pool on the propertv' 

c ^ 

7 Was damage to landscaping or plant materials avoided? 

c ^ 

Galet , Fences and RcUinlD£ Walls > es No 

1 Do gates open and close freely? (Ifapplicable) 

2 Were all gates or fences taken down during restoralion aciiviiies reinstalled? (If app icable) 

W L /l/A­ 3. Was dam«ge to gates or fences avoided? (Ifapplicable) 

4. Was damige lo relaming walls avoided? (Ifapplicable) 

Found • tlon, SidioK and Guller s Yes No 

1. Was damage to the siding or trim avoided? 

' 

2. Was damage lo the foundation avoided? 

[•DT 

</A 3 Was damage 10 windows avoided'' Mjti!,'^^ ^ 

4, Was damage to windows or door screens avoided^ 

/ 

5 Was damage lo downspouts or downspoul extensions avoided? 

/ 

Sidewalks and Driveways (Concrelt) Yes No 

Was damage lo driveway surfaces avoided'' 

2 Was damage to vAalkway surfaces avoided' 
O •ners commeots: 

Inspection notes: 

Removal and resloraiion activates complele including the 30-day sod warranty 

EPA Reoresentalive Dale: 
DRHttote IDiRpage 

Property Completion Agreement 

Diis agrconeiii dtwrnmems the compknion cifrcancdiiil activilies perlbnnecl on my properly My sigiKiiure 

will dcsignnie Ihat I «m iiaii«li«d wilh the re-Mofiiiion of my property, amt ilml ii(i items are in qucstidivi. 

HOW. nr Hi any linw in (lie (inure, excqjl ihose jlem.<i lisled beiow, if >tny. 

Piop«i-ty II); 3 5~Y7 / " '^ 

Owner: ZXWc^_ff *>\C**7 M^Jjt ' S— _ 

'•'""" pgjj^// nil 

^estoralloi) Kems In QuMtion: 

Item: 

Item 

Item: 

Item: 

Item 

Additional Commanls: 

J5 I afTK minr>(i«fl i> camplclcd, Clle^pt u IM(«I 

U I 'lo "'K •(!>••<• r<«H>riill»ii h csmplclrrf 

Owner's Sicnnliirc / Dnic Tunlriirtur'ii .Siuiiatiirr Oalc