# 

TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 2cy^??) 

Date: i/:^ 

Address: //^^ ^ H/^pl< 

Remediation Contractor: Coastal Environinentai Group_ Year: _2010ARRA_ 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video ofproperty (DVD) 

<y^ Executive Summary 

EPA-provided property sketch 

y Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

<2y Restoration Agreement 

•^'J?!^ Settlement documents (i.e., for damage or to replace plants, etc.) 

vS" Confirmation data 

^y^ Photographs \U t>^o>wproo^ X (:^<%(^cn^ y ^0\r 

iR"^ As-built sketch 

'O y Satisfactory restoration signed by Property Owner 

''^ y Property close-out check list signed by EPA 

-^S^ Description of areas not meeting ROD cleanup criteria 

^ y Utility clearances 

B^ ' Property information from Douglas County Assessor's Office 

D 

D 

D 

y 

Date 

30261021 

Superfund 
It 

Properfy Access Checklist 

Property ID: ZP\9)f>2> 

Property Address \,^Q ^ f\A6U? l e ^t -

D

D

 WORK STARTED 

 WORKCOMPELTED 

ON:

ON:

 /

 /

 ; 

/ 

^^^•^ .\\XX\(k QM}c(\m\{\(\S> 

Address: 0 

Phoac: ^O^'Zn - ^^^ ^ 

Fax: 

Cell/Pagen 

Renter 

Phone: 

Fai; 

Cell/Pagen 

Additional Information: 

D

^

^

O

D

G

D

D

n

n

n

D

•

 Notification Letter 

 Access Agreement 

 Restoration Agreement 

 Topsoil Sampling (if applicable) 

 Disposal Sampling (if applicable) 

 Garden Sampling (if applicable}* 

 Utility Clearance 

 Video/Photos (Before) 

 Video/Photos (During) 

 Video/Photos (After) 

 Video/Photos (30-Day) 

 Property Completion Agreement 

 Final Report 

Sent: / / 

Sizncd: 3 /1$ / ll 

Signed: 3 /l ^ 1 \ \ 

1 1 

1 1 

1 1 

Called: / / 

On: / / 

On: / / 

On: / / 

On: / / 

Si^ed: . / / 

Issued: / / 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: 

By: . . J 

Air Monitorine (as anplicable 

n Community QCrcw 

Results: 

On: / / 1 

D Conununity

Results: 

d Crew On: / / By: 1 

nn Community

Results: 

D Crew On: / / By: 

Omaha Lead Site 
Douglas County Account Infonnatio Tqama n 

Page 1 of2 l 

Douglas County, Nebraska Property Record - R1744670000 

Print Reoort 

View Interactive GIS Mao Information is valid as of 2010-8-30 Treasurer's Tax Reoort 

New Feature r* • ^ r* Subdivision Sales Search 

Owner 

CUMMINGS JULIA 

1607 LOCUST ST 

OMAHA NE 68110-0000 

Property Informatio n 

Key Number: 4467 0000 17 

Account Type: Residential 

Parcel Number: 

1744670000 

Parcel Address: 

1608 MAPLE ST 

OMAHA NE 68110-0000 

Legal Description: MILLARD & CALDWELL'S ADD LOT 21 BLOCK 0 W 30 E 150 N 71.625 FT 30 X 

71.625 

Vaiue Informatio n 

2010 

2009 

2008 

2007 

2006 

2005 

Land 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

Improvement 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

Total 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

$200.00 

Show All Transactions 

Land Informatio n 

Acres SF Units Depth Width Vacant 

O.OA 2130.0 0.0 71.0 30.0 Yes 

http://douglasne.mapping-online.com/DouglasCoNe/static/acco\mtinfo.jsp?accoiintno=R17... 9/15/2010 
Douglas County Account Infiamation Page 2 of2 ^jmai 

Spencej St Spencet S( 

IS} 

5 

5? 

• z WiftS) WrrtSt 

2 

zr S > 

CO CO 

ir*ey St Birsney St Biiiney SJ 

i cust St Locust St Locust St 

^ Maple SJ g 

Maple"s ml r 

CorbV St Conby'a 2 

3 

> Miami Sl Miami Sl 

Oji o -*"""' ^ Ofiw St 5*110 SI St 

Ohio St 2 N '4:1 Rt Z 

o Cady Ave 

I abra Cr 

The above map is powered by Google, and is intended to provide a general idea of a property's location. If 

you require a more exact property location, you may use the Interactive GIS Maps that are maintained by our 

office. 

http://douglasne.mapping-online.eom/DouglasCoNe/static/accountinfo.jsp?accountno=R 17... 9/15/2010 
4/5/2011 www.dhon.org/irthinternet/DHONNotic 

Create Another Ticket Back r^Wl h Intemet 

• E * Send Email 

• YOUR TICKET NUMBER IS 2703945. 

Original Call Date; 4/05/11 Time: 10:03 am Op: ALFONSO18790 


Work to Begin Date; 4/07/11 Time: 10:30 am 


State: NE County: DOUGLAS Place: OMAHA 


Address: 1608 Street: MAPLE ST 


Twp: 15N Rng: 13E Sect-Qtr: 10-NE-NW-SE-SW 


Twp: Rng: Sect-Qtr: 


Legal Given: C 


Type of Work: Lead Remediation 


Location of Work: LOCATE ENTIRE PROPERTY, ALL EASEMENTS AND TO THE PEDESTAL 


Remarks: FAX ALL CLEARS TO: (402)934-2811 


: PLEASE INCLUDE ALL EASEMENTS 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ALFONSO Phone: (402)934-2837 


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 


Utility Service Area Contact Phone Nuniber Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

METROPOLITAN UTILITIES MUDOl SANDY MUD Alt: DISTRICT 

Emerg: 4025047970 


Day: 4024447197 


CITY OF OMAHA- OMAHACOF RICH/TRAFFIC Alt: 4024445161 TRAFFICSEWER 

Emerg: 4024445160 

Day: 4067289343 


OMAHA PUBLIC POWER ELM 0PPDGPR5 Ah: 4062071494 DISTRICT LOCATING 

Emerg: 8887289343 


dhon.org/irthinternet/.../MessageText.as... 1/2 
4/5/2011

QLNNEIC

 ^^ ^ www.dhon.org/irthinternet/DHONNotic..^^^ 

M flV Day:

^ ^ FTM ^ ^ 

 QWEST LOCAL NETWORK T r^r> K^rr^^r^ Alt:

 4067289343 

 4062071494 

Emerg: 8887289343 

dhon.org/irthinternet/.../MessageText.as... 2/2 
29883 

I^P As-Built Drawing 

COASTA L Omaha Lead Superfund Site CNVinONHENTAL G K O U r . IN C 

OLS#:29883 

Date Excavated: 4/5/2011 

Date USEPA Sianed Off: 4/21/M 

Area Sodden: 2380 sa ft iH 

Omaha Exterior Paint Nonti Arxw Lead Site 

Site Sketch 

Owner Name: CLARA DANCER • Good Address: 1608 MAPLE ST 

Phone: H: w. • Poor r

[34^ot paint 

Lead Sample Samples Collected Sample Number LAB Concentration Collectejl Firm '^J • / V > 

RYASCPXA-29883 Ft ppm D Date: x / ? y^--- V 

RYBSCPXA-29883 F2 ppm D Time: y ^ . }6 

RYCSCPXA-29883 Bl ppm D Samples Analyzed RYDSCPXA-29883 B2 ppm D •WIgOCPXA 29000 ppm n D XRF Unit: ^ 1 \ BOORR.

RGZSCPXA 20883 ppm n D Date: 

D D \yyy^ R.PZSCPyft.298a3 ppm Time:f\K4 

Staff: I g r 

Omaha Lead Site r!'/'^ 

Legen d 

Concret e Dri p Zone Excavate d Quadrants Excavate d 

Are a replace d wit h Area replace d wit h 

Are a lef t bar e Sod Rock/Mulch 

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

 i 
--­ ' IL J III IIII III H 29883 

Owner Name: CLARA DANCER Omah a Lea d Site Exterior Paint North Arrow 

.cno .iAf^. c: CT Site Skctch • Good 

Address: 1608 MAPLE ST • Poor 

Phone: H: W: r Q^^ot paint 

Sample Number Lead Sample Samples Collected 

Concentration CollectejJ LAB 

Firm: •y^* ^ T^y^ j 

RYASCPXA-29883 Fl ^M p ppm D Date: y y/ ? y^'' ^ 

RYBSCPXA-29883 F2 I.^Ar ) ppm D Time: 

y o , } 6 

RYCSCPXA-29883 B1 1 "?! / S ppm 

D Samples Analyzed RYDSCPXA-29883 82 Ip \ ^ ppm 

f^DZGCPXA-29003­ ppm n D XRF Unit VA Boom 

RG^SCPX;^ 20883—GZ ppm D D Date: _ 

PP7QrpyA-9Qft«- ^ P7 D

ppm D Time: fi KJ \ D Staff: (."an: Number of Samples = Y ; 

jl/cih't^> '/h'f^^ 

ENTERED ' i-trfii'^i 

Allft 7 3 2005 

,L:^ / / / 

1^5 y^\% 

/ 

ufi^- i r l y iyen4 7 ("^ 

y /t •/<r 

v.. AS 

9^ 

r %y\^ 

f r^ 

5UQ i^u 

M— - ^ x^ \C- X- MZOmaha Lead Site n^f/ /«t 46130 
Omah

a Lead Site 46130 1^ Apl^ 5"< -4 ^3()M^ 
29883 

Omaha Exterior Paint Nortti AJTOW Owne Lead She r Name: CLAFtA DANCER 

Site Sketch • Good Address: 1608 MAPLE ST • Poor Phone: H: W: 

[34jot paint 

T

Sample Lead Sample 

Samples Collected Number LAB Concentration Collected Firni: ^-^' ^ T/^y^ J 

RYASCPXA-29883 F1 C^i-i n oom D Date: ?? y/ ? ^ ^ V 

RYBSCPXA-29883 F2 n.^l n ppm D Time: / o >'^^ 

RYCSCPXA-29883 B1 1 "?> / S ppm D Samples Analyzed RYDSCPXA-29883 82 .Q \ % Dom n 

RDZOCPXA 20003 oom D a XRF Unit: liLBoom 

rtGZSCPXA 20883—GZ pom D n Date: _ 

RP7srpYft.?g8m £Z . ppm 

D 

Time:fiJ^ 

Staff: 

D 

Number of Samples = ; 7 j c^ 

^ jt/cih'f l 'fb'f^^ 

ENTEiRED 

,,-nfdi^i 

Al 1/5 9 3 2005 

/3( ^ ^ 

Wh \s\\ 

r 

ufi*- i r h l/*<r^ r /o 

0e^ , j / i i/< 

f\ 

r^ 

5U0. 

13U 

V---X---V ' 7 ^ 

-9^ T^ r Omaha Lead Site 

TrV ^ 46130 
>*^^'!r"'. 

COASTA l EHVIItOMnlk1i. t 

Clou r I »( c 

Conse^nvfof Access^ To l^roperly 

RIGHT OF ENTRY TO PREMISES 

Grantot (the property' owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) oi its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

2yM:z^^siy--

Address of Property 

covered by this 'kog; (Y\Qp/^ c^f- 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 
I

t 

\y^^^^^'i COASTA L • .

 X " thyHOhKlKTJ H 

 DfiQlV C » 0 U P t V C 

t Remove obstructions including boats, Irailers, vehicles, playscape ilems, wood 

piles, dog houses, etc; 

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

to save; 

c Water and maintain leplacement vegetation, including feriilizer 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 foi access to 

the property/ to perform the work. 

I 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 

M I grant access to my properties Q ' do nol grant access to my properties 

OJZiiSli 

ate Signature Date 

Q I Vt'ouid (ike lo be preseni during any sampling that ts required. 

Paoe 2 of 2 
COASTA L KMViaOMHCNTA L 

C n O U P . INC . 

Restoration Agreement 

The purpose of this agreement is to provide a mutual agreement as to conditions of the 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: Z^^^ 3 

Property Address: y^^^ ^ A/l^ f l ^ ^ ^ 

Owner: 

Phone: 40-2.-z^n- i^^^o 

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, hidicate distances, depths, material types, etc. 

Photographically and Videographically 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 retum of these items is the Owner's responsibility. 

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

Item: 

jv[l?^/^ 

Item: 

Item: 

Item: 

Paget of / _ 
COASTA L EMVinONnlMTA L 

C « O U P . INC . 

Items to Be Removed By Contractor During Remediation and Replaced 

Item: 

lyi j y ^^iL f y ^^ y U y i^ - Item: 

Item: 

Item: 

Landscape Inventory 

Item Quantity Unit Condition/Type/Species 

Pre-existing property area, Quadrants that will be excavated, that Vv^y*^ iA\n,h 

is covered with grass. n^ 

Number of trees > 2 inch Each fkvwj tnmk diameter y 

Number of trees <= 2 inch y Each 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, Each Timers, Heads, etc. 

Attach a sketch of the / 

sprinkler layout. 

Number of and size of 

each garden/ flower bed Each 

area. y Square Feet 

Attach a sketch of relative 

sizes and locations. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

y $

y 

Note this value will be 

used to issue a plant 

voucher to the property 

owner. 

Easement Area, to be Each 

excavated jy 

Page 2 of. 
COASTA L IMVIROMHI M TA i. C It O U P . INC . 

Additional Comments / Instructions: 

The city of Omaha ordinances may prohibit you from using dirt or gravel areas on your property 

as driveways or vehicle parking areas. The Environmental Protection Agency (EPA) may be 

removing and replacing soil underlying a gravel or dirt area on your property that you may be 

using as a driveway or vehicle parking area. If this is the case, you should understand that this 

removing and replacing of soil does not mean that any illegal driveway or parking area on your 

property is made legal. To the contrary, you may be cited by the city if you use a gravel or dirt area 

as a driveway or parking area, not withstanding any removal or replacement of soil by the EPA. 

if you have any question about legality of a certain driveway or parking area, you may contact 

the city of Omaha's Planning Department at (402) 444-5150. 

O Please check this box if you understand the information outlined above. 

• Check the box if Owner does not want CEG to document interior foundation walls and possible 

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

interior of house, including foundation cracks or fissures. 

p ] I agree Q I do not agree 

Owner' ivner'ss Signatur Signaturee Date Contfactor's Signature

Pages y 
BV1D# ^'-1^ 8 "5 

XRF PROPERTY SAMPLE SHEET 

Date 

Project 

XRF ID# 

Shot# 

\ 

I 

^ 

Average

Shot# 

5 

{r> 

-n 

Average 

Shot# 

^ 

\D 

W 

Average 

Shot# 

Average 

Signature 

Print 

\\^C?.> rv\c._-^ve 

am/pm 

30 sec 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

Reading Sample area 

Depth 

-i'l ^ 2,cv\ 

Omaha Lead ARRA 

'^T^o'L^'Z/ 

Reading 

:^\c 1 z5 

b'%1 ^ ^ 

^•b b t ^ h 

•Dy> ~ y > 

Reading 

\b4i\ V 

\nX)^-VV 

\%^-ao 

v^c i V^ 

Reading 

3'\\ ^ xy 

if)y^x-^ 

^%y - 0^ 

'^yvt' 

Reading 

^ ^ 

y^ / 

Sample area 

ft 

Depth 

y 

Sample area 

O 

Depth 

i." 

Sample area 

^ • l 

Depth 

W' 

Address 

Sample time 

sample length 

Shot# 

Average 

Shot# 

Average 

Shot# 

Average 

RETEST AREAS 

Sample area Shot# 

Depth 

Average 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRFTECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

4 

SOIL 

2011-04-06 18:26 

91.46 

Final 

Avg of 1-3 

1608 Maple 

F2 

6" 

M. MATEUS 

Confirmation 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 310.141 

Supervised By: 

Certificate of Verification 

1 

SOIL 

2011-04-06 18:24 

30.33 

Final 

29883 

1608 Maple 

F2 

6" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 25.149 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 370.570 

Supervised By: 

Certificate of Verification 

2 

SOIL 

2011-04-06 18:26 

30.90 

Final 

29883 

1608 Maple 

F2 

6" 

M. MATEUS 

Confirmation 

CLEAR 

Error 

± 24.785 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 336.625 

Supervised By: 

Certificate of Verification 

3 

SOIL 

2011-04-06 18:26 

30.23 

Final 

29883 

1608 Maple 

F2 

6" 

M. MATEUS 

Confirmation 

CLEAR 

Error 

± 26.338 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRFTECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

8 

SOIL 

2011-04-06 18:30 

90.57 

Final 

Avg of 5-7 

1608 Maple 

Fl 

6" 

M. MATEUS 

Confirmation 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 104.710 

Supervised By: 

Certificate of Verification 

5 

SOIL 

2011-04-06 18:28 

30.21 

Final 

29883 

1608 Maple 

Fl 

6" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 16.577 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm

Pb 100.580

Supervised By: 

Certificate of Verification 

6 

SOIL 

2011-04-06 18:29 

30.24 

Final 

29883 

1608 Maple 

Fl 

6" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 16.603 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 155.489 

Supervised By: 

Certificate of Verification 

7 

SOIL 

2011-04-06 18:30 

30.12 

Final 

29883 

1608 Maple 

Fl 

6" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 20.203 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

AVERAGE 

ADDRESS 

QUADRANT 

DEPHT 

XRFTECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

12 

SOIL 

2011-04-06 18:33 

90.92 

Final 

Avg of 9-11 

1608 Maple 

B2 

6" 

M. MATEUS 

Confirmation 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 371.184 

Supervised By: 

Certificate of Verification 

9 

SOIL 

2011-04-06 18:32 

30.31 

Final 

29883 

1608 Maple 

B2 

6" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 27.910 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 396.986 

Supervised By: 

Certificate of Verification 

10 

SOIL 

2011-04-06 18:32 

30.32 

Final 

29883 

1608 Maple 

B2 

6" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 28.958 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-39022 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID 

ADDRESS 

QUADRANT 

DEPHT 

XRF TECH 

MISC 

NOTE 

ppm 

Pb 386.835 

Supervised By: 

Certificate of Verification 

11 

SOIL 

2011-04-06 18:33 

30.29 

Final 

29883 

1608 Maple 

B2 

6" 

M. MATEUS 

Confirmation 

CLEAR 

± Error 

± 29.870 
"" " " * Omaha Lead Site—Fixed Price EP-R7-07-05 

Coastal Environmental Group Inc. 

V "' -^^ www.coastalhazmat.com 

^Pfloi* ^ COASTA L ENVIRONHENTAL 

GROUP , IN C 

EXECUTIVE SUMMARY: 

BVID #29883-(1808 MAPLE ST) 

X No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 4/21/11 
L 

Property Completion Agreement 

This agreemenl documents the completion of remedial aciivmes perroimed on my property. My signature 

will designale thai I am satisfied with the rtsioralion ofmy properly, and thai no items are in questions, 

now, or at any lime in Ihe fuluie, excepi those ilems lisled below, ifany 

Property ID: 2^<^gg; ^ 

Property Address: \^,QC ^ \\f\C\jp \ & 9{- . 

o>v»«='-^ Oa.li(^ CuynynlAac 

Phone ^ : ^Q ^ ^ ^ ^ ^ ^^AZ ? 

Restoration Items in Question: 

Item: 

Ilem: 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

I /Q ) xfircc icstorgtion it completed, exccpl ai nnlcri 

[ I I rio not a^rec rcstornrinii is compielcd 

QLI - i^~l ( ^ m 

Owner's Signatnre 
PA 

EPA Propcrt>' Close Out Form 

\\oO'B fWXf jg ^-^ Property #: M^'d S . . Property Address:­

Datc/Tirae: 

Quads Excavaied: Contractor Croup COA^-t^^ l 

Excavation Ves >'o General 

I. If neccssao', ^'cre the correct quadrantfs) excavaied and resiored? 

y 

2. If necessary, were the correal areas ofdrip zone excavaied and restored? 

y 

Grading Sod aod VegcUtion Ves No 

Does the grading around the perimeier ofthe house in excavated areas generally slope away y from the house? 

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

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

4. .\rc sodded areas generally firm and evenly graded? / 

5. Are thejoints between the sod scrips generally tight? (Only evaluate ifinspected at a 30 day 

time period) 

6. Was the property graded such that waier will not pool on the property? y_ 

7. Was damage to landscaping or plant materials avoided? y 

Gales. Fences and RcUipJiit Walls Ves Nu 

Do gates open and close freely? (Ifapplicable) y 

2. Were all gaies or fences laken down during resloration acliviiies reinstalled? (Ifapplicable) y 

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

4. Was damage lo retaining walls avoided? (Ifapplicable) y

Foundation, Sidiagand Culler? Yes Ne 

1. Was damage lo thc sidi/ig or trim avoided? y 

2. Was damage lo the foundation avoided? / 

W'as damage to windows avoided? y 

4 Was damage to windows or door screens avoided? y 

5. Was damage lo downspouts or downspoul extensions avoided? / 

Sidt>valk5 and Driveways (Copcretc) Ves No 

Was damage lo driveway surfaces avoided'' / 

2. Was damage lo walkway surfaces avoided? 

T 
Owners comments: 

Inspection no<es: 

Remova! and restoration activates complete including the 30-day sod warranty: 

EPA Representative _ ^ Date: Hjti/fl