TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: _3j^trL_.. Date: ^jH /(' 

Address: 

Remediation Contractor: Coastal Environmental Group Year: 2010ARRA 

SOIL REMEDIATION 

PROPERTV FILE FOLDER DOCUMENTS 

\/ Video of property (DVD) 

W Executive Summary 

1/ EPA-provided property sketch 

U Signed Access Agreement for subject property 

y Signed Access Agreement(s) for adjacent property 

llZ Restoraiion Agreement 

-T' Settlement documents (i.e., for damage or to replace plants, etc.) 

—- Confirmation data 

t / Photographs f k iVAw^fTcM -f- 6o^^n< ^ ^ ^ ^ 

!(j/ As-built sketch 

y Satisfactory restoration signed by Property Owner 

: / Property close-out check list signed by EPA 

Description of areas not meeting ROD cleanup criteria 

[0 Utility clearances 

/ Property information from Douglas County Assessor's Office 

signature 

30237370 Hill 

Superfund 
Property Access Checklist 

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Propert Property ID: :^^^, ^ 

Propert Property Address: 3«iV^ _ H ^Itt..,.^-.-.—., 

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 Access Agreement 

Restoration Agreement 

Topsoil Sampiing (if applicable) 

Disposal Sampling (if applicable) 

Garden Sampling (if applicable) 

Utility Clearance 

Video/Photos (Before) 

Video/Pbotos (During) 

Video/Photos (After) 

Video/Photos (30-Day) 

Property Completion Agreement 

FinaJ Report 

Signed: ^o . / i^ / , « 

Signed: v.? / > / »o 

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/ / 

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Called: W / v\ / 10 

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Air Monitoring (as applicable) 

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Omaha Lead Site 
Douglas County Account Ij^nnatio iT^pas n 

Page 1 of3 

Douglas County, Nebraska Property Record - R0701440000 

Print Report. 

View Interactive GIS Mao Information is valid as of 2010-10-12 Treasurer's Tax Reoort 

New Feature ^ T» T» Subdivision Sales Search 

Owner 

SANDERS WILLIS 

ETAL 

0/0 SANDRA OAMAOHO UC 

3911 N18ST 

OMAHA NE 68110-0000 

Property Informatio n 

Key Number: 0144 0000 07 

Account Type: Residential 

Parcel Number: 0701440000 

Parcel Address: 

3913 N 18 ST 

OMAHA NE 68110-0000 

Legal Description: BOULEVARD PARK ADD LOT 14 BLOCK 8 N 10 FT LOT 13 & S 30 FT LOT 14 40 

X 125 

Value Informatio n 

Land Improvement Total 

2010 $7,000.00 $13,200.00 $20,200.00 

2009 $7,000.00 $13,200.00 $20,200.00 

2008 $7,000.00 $15,800.00 $22,800.00 

2007 $7,000.00 $15,800.00 $22,800.00 

2006 $7,000.00 $15,800.00 $22,800.00 

2005 $7,000.00 $14,000.00 $21,000.00 

Show All Transactions 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.11 5000.0 1.0 125.0 40.0 No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 10/15/2010 
Douglas County Account Mfcrmation Page 2 of 3 

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CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE 

Square Footage: 1440.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Poor 

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

HVAC: Forced Air Rooms: 8.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 2.0 

Roof Cover: Composition Shingle Bedrooms: 4.0 

Roof Type: Hip Stories: 2.5 

Floorcover: Allowance Foundation: Block 

Sprinkler Square Footage: 0.0 

year Bu/7t Year 

Remodeled 

Percent 

Remodeled 

Adjusted Year 

Built Physical Age 

1912 0 0% 1912 97 

Detail Type Detail Description Units 

Add On Unfinished Attic W/floor 672.0 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 724.0 

Fixture Additional Fixtures 1.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 2.0 

Garage Detached 228.0 

Porch Cvrd Wood Deck 112.0 

Porch End Screen 20.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 10/15/2010 
Douglas County Account I n^jbmation Page 3 of 3 

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Map dafta @2010 Google 

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.com/DouglasCoNe/static/accountinfo.jsp?accountno=RO... 10/15/2010 
Page 1 of 1 

"> 

[ Create Another Ticket |[ Back to Irth intemet ] Send Email 

• YOUR TICKET NUMBER IS 2616751. 

Original Call Date: 10/13/10 Time: 5:56 pm Op: ELIZABETH18790 


Work to Begin Date: 10/15/10 Time: 6:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 3913 Street: N 18TH ST 


Twp: 15N Rng: 13E Sect-Qtr: 03-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: (877)662-4211 


: UNSURE IF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: COASTAL 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

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

Emerg: 4024445160 

Day: 4067289343 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 


QLNNEIC QWEST LOCAL NETWORK ELM LOCATING Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULT... 10/13/2010 
^ As-Built Drawing J) 

C OASTA L Omaha Lead Superfund Site ENVIKONHENTAL GROUP . IN C 

OLS#:33613 

Date Excavated: 10/20/2010 

Date USEPA Sianed Off: 11/2/2010 

Area Sodden: 1530 sa ft 

Name: f'f d ^.«^ > Omaha Lead Site Date: NorniAimw 

Address; J f// / ^ /? " 57*. Site Sketcli Time: 

Phone: "Ic 2 - V5"-; - /'/7 v —=7 

Team ^ j ^V BV1D# XRF Code SS O / rw±. Sample Number Lead Concentration Confirmation Sample 

/?YA SCPXA - J3C/.6 Z 3 ^ t/ 4 ppm ^•'Yes n No 1 ^ f?vai.'iC/=>XA •33C/.5 

ppm /^Zyes • No 23 /^YC^'iCPXA - A3C/3 ppm / J / Yes tD No H f?YD SCPXA - 33QI3 ppm ;^ lYes n No 13 

/^nZLSCPXA - 33(i,/3 to-'-'iJSS*^ JA/ ppm ;^zYes a No j 2 

ppm Yes a No • 

ppm Yes a No n 

/y-^ y. Omaha Lead Site 4M30 

Legen d 

Concrete Drip Zone Excavated Quadrants Excavated 

Area replaced

Sod 

 with Area replaced with 

Rock/Mulch Area lef t bare 

Contrac t #: EP-R7-07-05 Coasta l Environmenta l Group Inc . 
^ C\fr. JLk. \oAs ' 

Name: k/'i/lj i^f^y^ / Omaha Lead Site Date: _CZl^y ^ North Arrow —i 

Address: 3^/7 4^. Z?'^ 5 / Site Sketcti Time: //:>'. ^^^ 

Phone: ^^'2 - ^Si-Jjli j -=7 

Team ^/ ^ BVID# 3'U/J^ XRF Code SS O J 

Sample Number Lead Concentration Confirmation Sample 

/^YA SCPXA ' 33C/.=i pye% a No C3' 

j^vayjCPX A '33C/»> ^2-Yes n No ^ 7^3 i ^ PP^ ^YCyiQPKA - i^JC/>g / ? / Yes • No 12 /RYDSCPXA ' 33G/3 Z-Yes LJ No 0 /?DZ.3CPXA - dsa^S 7Yes n No ;zf 

ppm Yes • No a 

ppm Yes • No • 

Omaha Lead Site 46130 
Name: ^/A J S^^^'^^ Omaha Lead Site Date: iyiC/^ Z North Arrow 

Address: 3^/7 ^ /d ^ 5/. Site Sketch Time: A?y ^ 

Phone: v^-2 - ^tf6-3il H 

Team z^^ ly BVID# ru/y XRF Code S^ O / 

Sample Number Lead Concentration Confirmation Sample 

«9 O < / * f. l PYA SCPXA - :33gA6 Z3ZLJM. ^^Ye s n No ^ /^Vl^.'iCPXA •33Q/3 - m .-m . ^ 1 ^^Ye s a No ^ PYC,<iC.PXA' 336./S No 13 -u6-^^5rv J ppf" /7^ Yes • Z?YDSCPXA - 53Q/3 v-si£s=i tI2L ppm Dfl>f/-S2SC i_ZL ppm Z-Yes 1=1 No Q; zenzscpXA - 53^/3 'i/33 ¥ -^5/ ppm ZYes n No ; a i Yes • No n 

Yes • No • 

Omaha Lead Site 
Name: li/'i/Kj i><,<y^/ 

Address: 3^/7 .^Z^* ^ ^^ 

Phone: ^(g>2 ' '^5^6-3il H 

Z^^ Uy Team 

Sample Number 

/^YA SCPX A ' 33CI A 

J^Ya^SQPX A '33G/ 3 

ZiYC.'iOPyCA ' 6a^J 3 

^YQ^FX A • 33QI3 

/?nZ.SCPX A ' 53<i>/3 

—\ 

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Omaha Lead Site

Site Sketch

BV1D# ?J^/> 

Lead Concentration 

CittP' ' f l ppm 

J3<t fl<M. t/4 £ PP'" c,n>nJmS3- LZL ppm 

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Date: CyzC,^^^ North Arrow 

Time: A ? ' )e> 

XRF Code SS O J 

Confinnation Sample 

P ^ Yes CD No [^r 

^2_Yes a No ^ 

^ / Yes Q No 13 

^ Z-Yes C] No 5 

A ^Yes • No JZ^ 

"^ Yes • No a 

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/dl ^ 9-/. Omaha Lead Site 46130 
( (., f 

C-()|ii:(-ii i U-< / r t •-.-.i ^ 11 ' i('|)C- i l y 

I^IGHI OF EM7RY10 PREMISES 

Gientoi (the property ownei) conseiil^ tc ci:6 authiorizes tlie United Slate?, 

Fnvironmental Protection Agency (FT/\) c\ its outliorized representstives, collectively 

tfie Grantee, to entei snd perform certoin eiu'ironinental lesponse activities: upori the 

following described premises: 

Ownei's K'ame: Sc^^^^c C-xc c Wo ''''''''"' '^'°"" '^^') ~'(^ ^ 

Address of Ptoperty 

covered by this Z\(^ y s-y V ('S' Agreement: 

PuRPOsE Of RESPONSE AcTivniES 

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) vv'ill be 

excavated to remove contaminated soil. The removed contaminated soil w\\\ be 

replaced v^ith clean materials and the area w/ill 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, vv'ill contact 

the Grantor in-person to discuss the vyork 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 vi'ith the Grantor's approval Upon 

completion, the Grantor will receive written documentation from EPA that the property 

has been remediated 

ElSlVIRONMENTAL RESPONSE ACTIOixiS 

By signing this Access Agreement, the Grantor is orantino the EPA, its employees, 

contractors snd subcontractors the right to enter [he properly, at all reasonable times 

and witti prior notice, for the sole purpose of performing the work This access shall 

remain in effect until the work has been satisfactorily completed Ihe Grantoi also 

agrees to 

Page 1 of ? 
C C A. S W . i 

i ». \ 1*0* -

Remove cUosiructioni­ nic'v.iriinp bor.ls-. iiDileis, \'c-.hicicj-:. i';if.ysca[)(-- wcn^y. woov' 

piles, ooo finuse?. etc;. 

' Remove flov,'ef hplbs: oi j.jiants lhal ilu- Gicnloi oi the Giantoi's u-:[,r:nl rwc.)' vi'ish 

to save; 

Water and maintain leplacernenl vegetation, including fertilizer appiicriiori, as: 

necessary' subsequent tc an initial watering period by EPA, 

' Abide by tieallh and safety guidance piovided by ITI^A. 

' If the property is rented, assist EPA in obtaining (enaiil h\i\)icvc^ foi access lo 

the property to perform the work 

Allow videotaping and/or photograptiing of the properly. 

AGREEMENT l>JOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the work activities, oi v/ith any 

of the work done, or with the equipment used on his properly, 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 aliovv' 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 

" ^ grant access lo my properties O I do not grant access to my properties 

m\ \o 

Date Sipneture Date 

O I WOJIC' ifkt to bt pietcHt oufii.jj any ircmplrnt; ilii l ii- letu'iitc!. 

•••' • : A I 
COASTA L 

ENVIRONMENTA L 

GROUP , INC . 

ADJACENT PROPERTY ACCESS REQUEST 

WORKING PROPERTY ADDRESS .S ^ i 1^ AJ W J' _^» 0 -•S.^bvx. 

ADJACENT PROPERTY ADDRESS S^ 1 \ L) yy~^ 

OWNER NAME t.C'^c 

ACCESS REQUESTED: 

VVi(rrvNi'5S7oA A-Ci CjO^e. uy~y { 

ifT^Ci C 

OWNER SIGNATURE Mjc7(M'l i, jft^ Ca'/^l^^^CioQ 

FOREMAN SIGNATURE 

SUPERVISOR INITIAL z^ 

SUPERVISOR INITIAL A l^ . 
COASTA L 

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 '^••-^iy\\ 

Property Address: "X^^"^ u (9-^ 

Owner: -^Nf»r<; Zaf^G<y 

Phone: 

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 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 return of these items is the Owner's responsibility. 

Items to be Rj^moved by the Contractor During Remediation and Not Replaced 

Item: 

yy^y 

'

//^yz^ 

y

4y-V > ^ 'i^:f%y^ 

Item: / 

Item: 

Item: 

Page 1 of. 
« ^ ^ 

COASTA L IMVIROMMINTA L 

GROUP . IN C 

Items to Be Removed By Contractor During Remediation and Replaced 

Item: 

So) 

Item: 

s y 

Item: 

Item: 

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. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this value will be 

used (u issue a plant 

voucher lo the property 

owner. 

Easement Area, to be 

excavated 

Landscape Inventory 

Quantity 

\§^o^ 

y f 

^ 

y 

\ 

Unit 

Quadrants 

Each 

Each 

Each 

Each 

Square Feet 

$ 

Each 

Condition/Type/Species 

^^fZ -

V^A^-^*^ yy z 

Page 2 of 
COASTA L ENVIRONMENTAl . 

CROUP . IN C 

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 parldng 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. 

r~l Please check this box if you understand the information outlined above. 

h < /'Vjcr-K^ Q z) ti e rixA.^ 

Z\ 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. 

n I do not agree agree 

^ ( ^^^^ ^ 

Owner' ners Signatur Signaturee Date Contractor's Signature Date

Page 3 of. 
BVID# 33(^1^ 

XRF PROPERTY SAMPLE SHEET 


Date (7^1 2^-2- / 21011 Address. '^'^l' ^ M . 1 ^ S-t-. 

Omaha Lead ARRA Sample time am/pm 

XRF ID# sample length 30 sec 

Shot # Reading Sample area Shot# Reading Sample area 

V^M ll o I l^ \)Z 

\4 r \^ 3 i^ ^1 Depth Depth 

H u l-ho t\q, ^^ ' 

Average \ (^ 4 AA l >/ Average 

Shot# 

\4 ^ 

\H^ 

\^(P 

Reading 

nn ^- ^ 

vg-^ ^ v?^ 

i?^ :^ n 

Sample area 

eA 

Depth 

I" 

Shot# Reading Sample area 

Depth 

Average h 3 i \9 . l^ Average 

Shot# Reading Sample area Sh0t# ; . Reading .' Sample area 

\<^ t m t v<g V?>\ 

\^3 U^ i-H Depth Depth 

^^H \VZ -Z\i ^ U>' ' 

Average \} ^ ^ \ n ^ Average 

RETEST AREAS 

Shot# Reading Sample area Shot# Reading Sample area 

Average Z/ 

^ ­

-

y 

1 

/ 

Depth 

Average 

Depth 

Signature / ^ ^ 

P,in, 'UUZ

— 

 /Wl^) 
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 

XRF TECH 

MISC 

NOTE 

Supervised By; 

Certificate of Verification 

147 

SOIL 

2011-02-22 17:07 

91.01 

Final 

Avg of 144-146 

3913 N 18 ST 

DZ 

8" 

C.PADILLA 

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 

XRFTECH 

MISC 

NOTE 

ppm 

Pb 170.173 

Supervised By: 

Certificate of Verification 

144 

SOIL 

2011-02-22 17:06 

30.57 

Final 

33613 

3913 N 18 ST 

DZ 

8" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 18.319 
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 193.610 

Supervised By: 

Certificate of Verification 

145 

SOIL 

2011-02-22 17:07 

30.23 

Final 

33613 

3913 N 18 ST 

DZ 

8" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 21.413 
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 130.011

Supervised By: 

Certificate of Verification 

146 

SOIL 

2011-02-22 17:07 

30.21 

Final 

33613 

3913 N 18 ST 

DZ 

8" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 18.223 
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 

XRF TECH 

MISC 

NOTE 

Supervised By: 

Certificate of Verification 

151 

SOIL 

2011-02-22 17:10 

91.34 

Final 

Avg of 148-150 

3913 N 18 ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-39022 

Reading No 148 

Mode SOIL 

Time 2011-02-22 17:09 

Duration 30.25 

Sequence Final 

Flags 

BVID 33613 

ADDRESS 3913 N 18 ST 

QUADRANT EA 

DEPHT 1" 

XRF TECH C.PADILLA 

MISC CONFIRMATION 

NOTE CLEAR 

ppm ± Error 

Pb 177.293 ± 20.495 

Supervised By: 
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 182.637 

Supervised By: 

Certificate of Verification 

149 

SOIL 

2011-02-22 17:09 

30.52 

Final 

33613 

3913 N 18 ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 18.542 
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 159.275 

Supervised By: 

Certificate of Verification 

150 

SOIL 

2011-02-22 17:10 

30.57 

Final 

33613 

3913 N 18 ST 

EA 

1" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 17.604 
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 

XRF TECH 

MISC 

NOTE 

Pb 

Supervised By: 

Certificate of Verification 

155 

SOIL 

2011-02-22 17:13 

90.97 

Final 

Avg of 152-154 

3913 N 18 ST 

Bl 

6" 

C.PADILLA 

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 

XRFTECH 

MISC 

NOTE 

ppm 

Pb 123.604 

Supervised By: 

Certificate of Verification 

152 

SOIL 

2011-02-22 17:11 

30.18 

Final 

33613 

3913 N 18 ST 

Bl 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 18.244 
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 113.863 

Supervised By: 

Certificate of Verification 

153 

SOIL 

2011-02-22 17:12 

30.24 

Final 

33613 

3913 N 18 ST 

Bl 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 17.629 
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 122.784 

Supervised By: 

Certificate of Verification 

154 

SOIL 

2011-02-22 17:13 

30.55 

Final 

33613 

3913 N 18 ST 

Bl 

6" 

C.PADILLA 

CONFIRMATION 

CLEAR 

± Error 

± 16.014 
" l Omaha Lead Site—Fixed Price EP-R7-07-05 

\ •

o

 ^o*

 Coastal Environmental Group Inc. 

 www.coastalhazmat.com • 

%Pno-(t^" COASTA L ENVIRONMENTA L 

CROUP , INC . 

EXECUTIVE SUMMARY: 

BVID #33613-(3913 N 18 ST) 

X No Issues or Concerns Q Issues/Concerns 

Detail Explanation: 

-DAN GARVEY WALKED THE PROPERTY ON 11/2/2010 
F.PA Fropcrtv' Close Out Form 

Proprrt} «: "».-bC» ij i _ _ f r opt rt) Addro.v. -^3.^3 ^ »^J—_li»-At— 

Uale-ainif: Ownrr's Nsint­ ;-%r^^^' v -C'^r^^i^g:^' ' 

QllBd^ F.i.ca\st«-d­ Cnnlrsctor CJniup 

F]ir«va<lon Gtnfmi _ _ . . , '* »^ . ^" 

If ncrc'^'^ar^. wt-rc the correci (juadranKs) tutavalcd and tcMortri'' »' 

If nrccsia"^', v^ere Ihe correrl areas ol dnp 7onc cxcavalcd Hnd rtsioied" y 

(irariJDg Sod and Vr^ttUlioc _ 

I Docs the grading around ihe perimeter ofthe houst in exrsvairn ar(n< yrncralK ';KI|K t\'.-^\ y from ibc house? _ 

? Has sod been laid in all areas lhal were excavated'' y^­

Doc's ihc sod appear lo be peneraily heallhy and growing'' (Only evaluaie i' m^pirtid ai s Mi y ^ \ 

day lime ptriod) _ 

"1 .'Vre sodded areas generally firm and evenly graded'' / ' "- Are the joinu; between The sod smp;: generally tight'' (Onlv evaluate if inF.pccicd at a ~n dav 

tjjne period) _ . .^ , 

fc Was the property graded such thai water w ill nol pool cn I'K nroptnv' / 

_^ _ . ^ ^ 

7 Was damige lo landscaping or plant niaierialt avoided" Z 

(iBles, rupees and Rtlainlng Walls _ ^ '•* 

Do gates open and close freely'' (If applicahlc) / 

Were all gates 01 fences laken down during restoration acti\'ihe5 reinstalled'' (II arDlicat:l( i y 

Was damage lo gates or fences avoided'' (If applicable, y 

J Was damige to retaining walls avoided'' (If applicable) y' 

k oupdaiion, Siding and GuMers 

Was damage to the siding or trim avoided'' y 

\^'ai damage in the foundation avoided'' ^ 

Was damage Ic w indows avoided " y 

Was demage to windows or door screens avordtd'' , / ; 

WH". damage lo downspouts or downspout txien'ior's a\ oidcd ' y; 

SidfViiilkj and DrivcMay.s (toDcreleJ^ "i c- ^( 

I Was damage 10 drivfuay surfacrs a\(Hried ,' •^ 

1 

W'as da-nagr to l^alliv^a) surfaces avoided'' Z ' 
OM ner< comrrienls: 

' ? nsnfctifi n notes: 

Kenir'N'iil aiid itsuuaiiuii ,ii, liv^iU'.'- ^ tMupleic incUiding 'Jif .•'(t-day sod vvaria;i'^ 

IP A RffMCscniaiivf 9o^ ^ Dale; njij/ o 
Properly Completion Agreemeni 

! 'li^ n^i {•Liiii II' il(i( Miiifiii^ lilt I ('iriplcl ifni ol I ( iMcdi;- • i t 11 v i ir'- pf- lOi incd :ir, ii"i) i'., (ipf.i :\ N'^ y s ).• •OA.' t. 

wil l df:-.i)jn;Hl( lli.'il i ijiii sjlisfK.:^ \^\\}\ (he- (CSKH iilKUi of 'ii\' |.iippeil\ .'-rin (li^( iici iicm-. ,iic. -n ipicsi ,oii,< 

ri,Mv\- 01 .il r.r\ lino .n ihf fiiluK (vif[)l lliost IKTI S l'i,ttC hfliH'.. if ai'A 

J^,^p.^Kll)_^^^ ^ _. _ . .. . i 

Pnnpc^ v Address ^^^ ^ ^ ^ ^ ^ ^ J 

Ov%nfi o J ^ , ! 

Phoiu . _ i 

._._,. .•:ve.'?K...?vT>S-r-.!S.'i:^'\.. ,.. _ ^. . ..' 

Restoratio n Items in Question. 

Additiona l Comments : 

^V . I I ;ij^r ri I cMci at ifif n c omfilt It rl. r > tc ji l m ruili i 

1 I I rill nnl ;ii;i(r iiMm^tirji i i^ i (iiii)iif U i1 

n»/K i 's Sipn3li n <• !)«(( ( iirid ;tc((i; ',< .SipiiHIii) ( f);t(c