TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID #: 

X lun 

Date: 'in h 

Address: Kl'A (^Woh *^t 

Remediation Contractor: Coastal Environmental Group_ Year: 2010ARRA 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

Signed Access Agreement for subject property 

Signed Access Agreement(s) for adjacent property 

Restoration Agreement 

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

Confirmation data 

y 

Photographs f k hf^O^^. ^ ^ V^ ^jl^-fl ^ J^ ^O ^ 

As-built sketch 

Satisfactory restoration signed by Property Owner 

Property close-out check list signed by EPA 

Description ofareas not meeting ROD cleanup criteria 

Utility clearances 

Property infonnation from Douglas County Assessor's Office 

30218523 i 

Superfund 
vv 

Property Access Checklist 

Property ID: .Vh?.-] n WORK STARTED ON: / / 

Property Address: ^ n WORKCOMPELTED ON; / / 

Poinii'v) Parn^h ^'""'"'To^^^ ^I'CPr 

Address: Phone ^Ol-^'^l h o Cf ;),/| \'but' Mar-iin Ave Fax: 

Cell/Pager: 

^"""^^ Additional Information:  u^v'^^^.O 

Fax: 

Cell/Pager: 

n Notification Letter Sent: / / By: 

' ^ Access Agreement Signed: 2 ^ ^//6 ^ By: 

/jll' Signed:^ 2 3 llC) By: ^ Restoration Agreement 

D Topsoil Sampling (if applicable) 1 1 By: 

D Disposal Sampling (if applicable) 1 1 By: 

D Garden Sampling (if applicable) 1 1 By: 

^\W A 0U/iV«o c\.t,^it.A OH/iM«cJ , Q : utility Clearance CaUed:CJ!>/a^ l\Q 

• ^ Video/Photos (Before) On:^f^l]g _ By: 

n Video/Photos (During) On: / / By: 

n Video/Photos (After) On: / / By: 

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

n Property Completion Agreement Siened: / / By: 

D FinalReport Issued: / / By: 

Air Monitoring (as applicable) 

• Conunuiiity D Crew On: / / By: . 1 

1 Results: 

D Community QCrew On: / / By: 

Results: 

n Community QCrew On: / / By: 

Results: 

Omaha Lead Site 
Douglas County Account I ti|K|j^on Page 1 of3 

Douglas County, Nebraska Property Record - R l 134780000 

Print Report 

NEW Feature - Parcel Dimensions avaiiabie @ scaie 0-50 fi west of 52nd St - VlO W O n Ma p Information is valid as of 2009-12-15 Treasurer's Tax Report 

New Feature ^ - • ^ Auto Sales Search 

Owner 

PARRISH DANNY 

ETAL 

15112 MARTIN AVE 

OMAHA NE 68116-0000 

Property Informatio n 

Key Number: 3478 0000 11. 

Account Type: Residential 

Parcel Number: 1134780000 

Parcel Address: 2574 ELLISON AV 

OMAHA NE 68111-0000 

Legal Description: FORT VIEW ADD LOT 7 BLOCK 0 50 X 133.7 

Value Informatio n 

Land Improvement Total 

2009 

2008 

2007 

2006 

2005 

2004 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$2,600.00 

$29,900.00 

$29,900.00 

$23,100.00 

$23,100.00 

$23,100.00 

$10,200.00 

$32,500.00 

$32,500.00 

$25,700.00 

$25,700.00 

$25,700.00 

$12,800.00 

Sales Informatio n 

Sales Date: 2006-12-01 

Oeecf Type: GCM Book: 2007 Pago; 014657 

Price: $0.00 

Grantor: PARRISH DANNY ETAL 

Grantoe: PARRISH DANNY ETAL 

Valid/Invalid: Invalid 

Exclusion Reason: Multiple Parcel Sale 

Sales Date: 2006-10-20 

Deed Type: WDM SooAr: 2006 Page: 121720 

Price: $36,000.00 

Grantor: Bayer Helen G Estate of 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 12/31/2009 
f\ rW - • I 

Douglas County Account I n|Ujj]^i( Page 2 of3 tion 

Grantee: : parrish Danny etal 

Valid/Invalid: invalid 

Exclusion Reason: Multiple Parcel Sale 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.15 6650.0 1.0 133.0 50.0 No 

Improvemen t Informatio n 

Building 1 

2574 ELLISON AV 

MO 

rmf-vy 9K>0 tg t 

;6nci5ic*i)»i»i ,_ ; 

1 llOOsqn '" I 

RANCH 

CLICK TO ENLARGE IMAGE 

Square Footage: 960.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Fair 

Unit Type: Condition: Fair 

Built As: Ranch Condo Square Footage: 0.0 

HVAC: Forced Air Rooms: 5.0 

Exterior: Frame Vinyl Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Shingle Bedrooms: 2.0 

Roof Type: Hip Stories: 1.0 

Floorcover: Allowance Foundation: Block 

Sprinlder Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1907 0 0% 1907 101 

Detail Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 960.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 12/31/2009 
Douglas County Account I i^uij^o n Page 3 of3 

Garage Detached 216.0 

Porch EncI Solid Wall 165.0 

Porch EncI Solid Wall 120.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl... 12/31/2009 
Page 1 of2 

"> 

L- •_p.r!!^te^0pt^j^[ T^'PJSQt . ] ^. Back to Irth jntemet _] SendErnail | 

• YOUR TICKET NUMBER IS 2460790. 

Original Call Date: 4/12/10 Time: 1:46 pm Op: ELIZABETH18790 


Work to Begin Date: 4/14/10 Time: 2:15 pm 


State: NE County: DOUGLAS Place: OMAHA 


Address: 2574 Street: ELLISON AVE 


Twp: 16N Rng: 13E Sect-Qtr: 33-SE 


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 


: UNStJRE IF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


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


Work Being Done For: COASTAL 


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


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MAGELLAN METRO MUDOl OMAHACOF OPPDGPR5 QLNNEIC 


Service Area Contact Phone Number 

Utmty 

Type 

CXCATV COX COMMUNICATIONS, INC HEIDI 

Day: 4029340469 

Alt: 4029340469 

Emerg: 4029329757 

X

MAGELLA * A /-CT T A XT MAGELLAN MIDSTREAM PARTNERS r»i:Dr,i> A U N . „ DEBORAH 

Day: 9185747098 

Alt: 

Emerg: 9185747098 

METRO METRO COMM. COLLEGE CHRIS 

Day: 4024572307 

Alt: 4026727033 

Emerg: 4024572313 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY 

Day: 4025047823 

Alt: 

Emerg: 4025047970 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.., 4/12/2010 
Page 2 of2 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RICHJTRAFFIC

Day:

 Alt:

 4024447197 

 4024445161 

Emerg: 4024445160 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT ELM 

LOCATING 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

QLNNEIC QWEST LOCAL NETWORK ELM 

LOCATING 

Day: 4067289343 

Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 4/12/2010 
^ As-Built Drawing ^ 

COASTA L Omaha Lead Superfund Srte 

OLS#: 37627 

Date Excavated: 4/16/2010 

Date USEPA Siqned Off: 9/10/2010 

Area Sodden: 2590 sa ft 

Nanne: firlrc R.\.'i>r Oinaha Lead Site Date: North Arrow iAddress: I-TIV 't/f.xj, ^< Site Sketch Time: 

Phone: y^T-VIS^ / r 1 

0 }nc ete Wall 

F2 = 72 PPM @ 6" 

Omaha Lead Site 46130 

Legend 

Concrete Drip Zone Excavated 

Quadrants Excavated 

Area replaced with Area replaced with 

Sod Rock/Mulc Area lef t bare h 

Contrac t #: EP-R7-07-05 Coastal Environmental Group Inc. 
® 

( .VPCA r V V. 0^ \ . /»M 

Name: /i^A*i K,yo/- Omaha Lead Site Date: [o-Z\i'o-i. Nortli Arrow 

Addrei5s: 7.r7</ ^/Afi«, /fcJt Site Sketch Time: !-«'"!' 

Phone: U^~m.<^ l 

Omaha Lead Site 46130 
Name: //vZ-t, R.^/^^ Omaha Lead Site Date: North Arrow ^ 

Address: 1s~?^ 'f//,scc A^t Site Sketch Time: 

Phone: Uf^-^Z'^ I r 1 

^\\ho ^ A-^g 

Omaha Lead Site 46130 
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Name: Mi ^ Hy^^ 

Address: 7.r7 V */Ac »

Phone: WST-^-ZST/ 

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Omah a Lea d Site 

SKe Skete h 

Date:

Time:

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NoithArrow 

Team %aUr/Mt^>^i4M (yAe<yt

Sample Numt>er 

 BVID# 3762 7 

Lead Concentration 

XRF Code 22SQL 

Confirmation Sample 

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Omaha Lead Site 46130 
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COASTA I INVIItONMIItTAl 

C « 0 11 r . IN C 

Consent for Access To Property 

RIGHT OF ENTRY TO PREI^ISES 

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: baVtime Phone: 

rVlAAv^ Pflrns l 

Address of Property 

covered by this i^n q Eiii^f\ a\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 

wori( 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 perfomned, the Grantor will have an 

opportunity to review and approve the planned soli removai, and restoration work 

before it begins. Once the work is finished, the Grantor will be asked to review the worit 

and confimi 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. 

ENVIRONI>4ENTAL 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 ali reasonable times 

and with prior notice, for the sole purpose of performing the worit. This access shall 

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

agrees to: 

Page 1 of 2 
f 

^^^*o... . 

V^^^^^^ y COASTAL 

"** PUC ^ C 1 O U * IH C 

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

piles, dog houses, etc; 

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

to save; 

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

necessary subsequent to an initial watering period by EPA; 

c 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. 

c Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the worit 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 

VI grant access to my properties D I do not grant access to my properties 

^-^-/ ^ 

Date Signature Date 

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

Page 2 of2 
C O A S T A L • MVIRONMI M T A L O 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 piupose of assuring that restoration 

activities are completed to the satisfaction of the property owner and the United States Enviromnental 

Protection Agency (EPA). 

PropertylD: "J/Wi^ ^ 

Property Address: 2.5r-i q f.lhV^/N Q.\r. 

Owner: J 2Q ^(\rr\^ 

Phone: m 

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 retum of these items is the Owner's responsibility. 

Item: 

JQwC^ 

Item: 

Kem: 

Item: 

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

Kem: 

k^v- . S^l( PU ^ 

Kem: ' / 

Item: 

Kem: 

Page lof 3 
C O A S T A L 

Items to Be Removed By Contractor During Remediation and Replaced 

Kem: 

Kem: 

Kem: 

Kem: 

I 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 to issue a plant 

voucher to the property 

owner. 

Easement Area, to be 

excavated 

Landscape Inventory 

Quantity Unit Conditionrrype/Species 

Quadrants 

Each 

Each 

MU Each 

Each 

Square Feet 

$ 

Each 

Page 2 of. 
COASTA L 

AddKional Comments / Instructions: 

The city of Omaha ordinances may prohibK 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 underiying 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 cKy of Omaha's Planning Department at (402) 444-5150. 

[^ Please check this box if you understand the infomiation outlined above. 

D 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. 

I agree O I do not agree 

h..rH.... y ^^2M0 famM^ a-^^O 

Owner's Signature y Date Contractor's Signature Date 

Page 3 of 
i 4 

BVID# 3n(,zn 

XRF PROPERTY SAIWIPLE SHEET 

Date Address 5r-ii-fO Project Omaha Lead ARRA Sample time 

XRF ID# TWm sample length ' 

Shot# Reading Sample area Shot# 

S2i^ ^Ip ±1 0 2%. ^?-?- ^ / ^ /' Depth M3^ 

^ ^ ^ 5d. t\ { _2f£. 

Average ^SZ^> / j Average 

Shot# Reading Sample area Shot# 

^ b iolp -/- )2 P ^ i^ 

SB\ n ± ,h Depth M L 

^ 3 . ?^t ,^ 6" . leo^ 

/

Average TQ^^ iO" Average

. Shot# Reading Sample area Shot# 

Depth 

Average Average 

RETEST AREAS 

Shot# Reading Sample area Shot# 

Depth 

Average Average 

Signature/ fhnm 

Print< Titf^lnd'UxO/lMl^pJ) 

'2.^nH ^///SOi^ A\i&. am/pm 

30 sec 

Reading Sample area 

?^^ /^ 

?^^/ ^ Depth 

dy^^y^ i2: 

2iM / 

Reading Sample area 

^ ^ ^ :^ ^ ,^^iL. ^b\ ^ ^ Depth 

^ C ^ ^ £1. 

1/ r^'bOb 2y ^ 

Reading Sample area 

Depth 

Reading Sample area 

Depth 
Thermo 

SCIENTIFI C 

Tfiermo Fistier Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 603 

Mode SOIL 

Time 2010-05-11 17:05 

Duration 90.33 

Sequence Final 

Flags 

AVERAGE ^;;-Ava:o£fiQQ3tQ2i: 

ADDRESS 2574 Ellison ave 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 7.816 

Zr 393.287 ± 14.747 

Sr 176.186 ± 9.017 

U < LOD 14.620 

Rb 70.355 6.590 

Til 16^692, -8.892­

-207146——^ 

je " < LOD 5.820 

As 108.694 ± 20.259 

Hg < LOD 12.563 

Zn 226.212 ± 25.234 

W < LOD 85.970 

Cu 32.152 ± 20.699 

Nl 

Co 

Fe 

Mn 

< LOD 

< LOD 

18183.799 

550.734 

± 

± 

74.987 

179.669 

387.278 

98.275 

Supervised sr.^yiMMy 
Thermo 

SCIENTIFI C 

Tiiermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 600 

Mode SOIL 

Time 2010-05-11 17:04 

Duration 30.12 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 7.739 

Zr 375.813 ± 14.421 

Sr 173.748 ± 8.925 

U < LOD : 14.125 

Rb 67.053 ± 6.406 

Th 19.308 ± 9.058 

Pb 231.901 ± 20.173 

Se < LOD ; 6.041 

As 108.656 ± 20.249 

Hg < LOD : 12.826 

Zn 233.719 ± 25.573 

w < LOD 88.744 

Cu < LOD 30.756 

Ni < LOD 75.599 

Co 188.417 ± 120.505 

Fe 17888.510 ± 382.745 

Mn 515.310 ± 95.905 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 601 

Mode SOIL 

Time 2010-05-11 17:04 

Duration 30.10 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 7.786 

Zr 398.814 ± 14.911 

Sr 174.818 ± 9.041 

U < LOD \ 14.481 

Rb 74.837 ± 6.759 

Th < LOD \ 12.999 

Pb 231.333 ± 20.344 

Se < LOD \ 6.088 

As 109.472 ± 20.452 

Hg < LOD : 12.314 

Zn 223.897 ± 25.187 

w < LOD J 82.954 

Cu 34.511 ± 21.086 

Nl < LOD \ 76.736 

Co < LOD \ 180.051 

Fe 18486.014 ± 392.956 

Mn 646.090 ± 104.694 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 602 

Mode SOIL 

Time 2010-05-11 17:05 

Duration 30.11 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT EA 

DEPTH 1" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD .; 7.923 

Zr 405.234 ± 14.909 

Sr 179.992 ± 9.085 

U < LOD I 15.254 

Rb 69.175 ± 6.605 

Th 18.095 ' ± 8.951 

Pb 226.395 ± 19.920 

Se < LOD J 5.332 

As 107.953 ± 20.075 

Hg < LOD : 12.549 

Zn 221.019 ± 24.943 

W < LOD : 86.212 

Cu 31.622 ± 20.508 

Ni < LOD * 72.627 

Co < LOD : 178.199 

Fe 18176.875 ± 386.133 

Mn 490.802 ± 94.225 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 599 

Mode SOIL 

Time 2010-05-11 17:02 

Duration 90.32 

Sequence Final 

Flags 

AVERAGE ^^vpfjSEssa-^ 

ADDRESS yz^4'E\\\son ave 

QUADRANT DZ 

DEPTH 13" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 


Mo < LOD 8.249 

Zr 511.001 ± 16.615 

Sr 162.815 ± 8.791 

U < LOD 15.044 

Rb 70.829 ± 6.704 

Th 14.399 ± 7.446 

,753­

jle" < LOD 5.484 

As 69.816 ± 13.715 

Hg < LOD 12.603 

Zn 92.010 ± 17.966 

W < LOD 88.459 

Cu < LOD 31.168 

Ni < LOD 75.937 

Co < LOD 194.533 

Fe 20598.354 ± 417.062 

Mn 576.943 101.983 

Supervised By 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 596 

Mode SOIL 

Time 2010-05-11 17:01 

Duration 30.11 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT DZ 

DEPTH 13" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD [ 8.122 

Zr 514.202 ± 16.629 

Sr 163.416 ± 8.791 

U < LOD 15.069 • 

Rb 73.427 ± 6.788 

Th 13.318 ± 7.362 

Pb 74.474 ± 12.514 

Se < LOD 5.573 

As 59.804 ± 13.355 

Hg < LOD : 11.810 

Zn 99.438 ± 18.232 

w < LOD : 82.553 

Cu 35.115 ± 21.191 

Ni < LOD 76.926 

Co < LOD ; 192.891 

Fe 20242.393 ± 412.775 

Mn 615.125 ± 103.484 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 597 

Mode SOIL 

Time 2010-05-11 17:02 

Duration 30.11 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT DZ 

DEPTH 13" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.352 

Zr 509.385 ± 16.582 

Sr 158.857 ± 8.690 

U < LOD 15.136 

Rb 71.158 ± 6.726 

Th 15.729 rb 7.588 

Pb 74.658 ± 12.468 

Se < LOD 5.032 

As 73.722 ± 13.946 

Hg < LOD 12.716 

Zn 87.199 i 17.625 

w < LOD 88.424 

Cu < LOD 30.704 

Ni < LOD 76.183 

Co < LOD 196.222 

Fe 20679.424 ± 417.823 

Mn 563.556 ^ 101.358 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 598 

Mode SOIL 

Time 2010-05-11 17:02 

Duration 30.10 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT DZ 

DEPTH 13" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.274 

Zr 509.415 ± 16.634 

Sr 166.171 ± 8.891 

U < LOD 14.926 

Rb 67.902 ± 6.599 

Th 14.151 ± 7.389 

Pb 69.124 ± 12.177 

Se < LOD 5.845 

As 75.922 ± 13.844 

Hg < LOD 13.281 

Zn 89.391 ± 18.041 

w < LOD 94.399 

Cu < LOD 31.015 

Ni < LOD 74.701 

Co < LOD 194.485 

Fe 20873.244 ± 420.588 

Mn 552.148 ± 101.108 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 583 

Mode SOIL 

Time 2010-05-11 16:51 

Duration 90.66 

Sequence Final 

Flags 

AVERAGE 

ADDRESS j74 Ellison ave 

QUADRANT F2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.279 

Zr 510.920 ± 16.605 

Sr 160.468 ± 8.737 

U < LOD ; 15.609 

Rb 76.599 d: 6.965 

Th 

Se 

;

^J.DD

"71. Qiin / i.yt u 

< LOD 

^ 

j_J—'. — 

^ 

- 10.524u__, 

5.814 

As < LOD 16.793 

Hg < LOD 12.259 

Zn 81.817 ± 17.156 

w < LOD : 85.972 

Cu 35.520 ± 21.249 

Ni < LOD : 75.386 

Co < LOD ; 187.531 

Fe 19843.023 ± 409.841 

Mn 756.711 ± 112.987 

Cr < LOD 677.432 

V < LOD 1195.903 

Ti < LOD 5258.264 

Sc < LOD 490.885 

Ca < LOD 9130.324 

K < LOD ]L8311.129 

S <mD 483.661 

Supervised By:L-^AJLX Mflyi 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 580 

Mode SOIL 

Time 2010-05-11 16:50 

Duration 30.12 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT F2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.354 

Zr 516.977 ± 16.671 

Sr 161.496 i 8.747 

U < LOD 15.153 

Rb 79.496 ± 7.007 

Th 12.157 i 7.203 

Pb 65.851 ± 11.982 

Se < LOD 5.965 

As 17.148 ± 10.956 

Hg < LOD 11.742 

Zn 85.695 ± 17.328 

w < LOD 84.132 

Cu < LOD 30.753 

Ni < LOD 74.594 

Co < LOD 187.509 

Fe 20153.357 ± 412.399 

Mn 788.991 ± 114.556 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 581 

Mode SOIL 

Time 2010-05-11 16:51 

Duration 30.11 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT F2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm 

Mo < LOD 

Zr 505.038 

Sr 159.573 

U < LOD 

Rb 76.412 

Th < LOD 

Pb 78.198 

Se < LOD 

As < LOD 

Hg < LOD 

Zn 71.361 

w < LOD . Cu < LOD 

Ni < LOD 

Co < LOD 

Fe 19809.330 

Mn 727.820 

Supervised By: 

Error 

8.303 

± 16.551 

± 8.736 

15.400 

± 6.941 

10.616 

± 12.800 

5.750 

17.114 

13.057 

± 16.443 

86.735 

31.036 

77.595 

189.040 

i 410.262 

± 111.346 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 582 

Mode SOIL 

Time 2010-05-11 16:51 

Duration 30.43 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT F2 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.179 

Zr 510.745 ± 16.594 

Sr 160.335 ± 8.727 

U < LOD 16.273 

Rb 73.890 ± 6.945 

Th < LOD 10.300 

Pb 71.770 i 12.324 

Se < LOD 5.727 

As < LOD 16.830 

Hg < LOD 11.977 

Zn 88.396 ± 17.697 

W < LOD 87.051 

Cu 53.717 ± 22.554 

Ni < LOD 73.970 

Co < LOD 186.042 

Fe 19566.383 i 406.863 

Mn 753.321 ± 113.060 

Cr < LOD 484.780 

V < LOD 1000.678 

Ti < LOD 4403.040 

Sc < LOD 507.722 

Ca < LOD 9973.794 

K < LOD 15822.035 

S < LOD 444.470 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 579 

Mode SOIL 

Time 2010-05-11 16:49 

Duration 90.66 

Sequence Final 

Flags 

AVERAGE CAvf-of-57i52aII~;;;;;~7 

ADDRESS 2574 Ellison ave 

QUADRANT Fl 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.278 

Zr 503.680 16.630 

Sr 156.020 8.691 

U < LOD 14.781 

Rb 70.445 6.705 

Th 13.316 7.166 

r Pb :49.S31~ 10.820;? 

—se—­ ^TJD D 5.623 

As 114.804 14.680 

Hg < LOD 12.674 

Zn 80.128 17.218 

w < LOD 87.874 

Cu < LOD 31.205 

Ni < LOD 76.540 

Co < LOD 192.575 

Fe 20370.033 ± 418.215 

Mn 482.905 ± 96.519 

Cr < LOD 401.189 

V < LOD 676.961 

Ti < LOD 3060.017 

Sc < LOD 258.450 

Ca < LOD 4900.919 

K 16974.494 ± 7952.307 

S < LOD 2912.115 

SupervisedBy:( M /! ( u(/Of\ 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 576 

Mode SOIL 

Time 2010-05-11 16:47 

Duration 30.11 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT Fl 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD : 8.161 

Zr 502.668 ± 16.516 

Sr 156.372 ± 8.642 

U < LOD : 15.280 

Rb 69.474 ± 6.696 

Th 14.066 ± 7.156 

Pb 45.668 ± 10.482 

Se < LOD 5.802 

As 118.879 ± 14.595 

Hg < LOD 12.118 

Zn 76.818 ± 16.859 

w < LOD 88.798 

Cu 33.299 ± 21.479 

Ni 120.893 ± 54.555 

Co < LOD I 190.216 

Fe 20455.328 ± 416.499 

Mn 481.785 ± 95.817 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 577 

Mode SOIL 

Time 2010-05-11 16:48 

Duration 30.12 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT Fl 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.325 

Zr 501.800 ± 16.613 

Sr 156.295 ± 8.706 

U < LOD 14.413 

Rb 73.271 ± 6.772 

Th < LOD ; 10.327 

Pb 51.010 ± 10.914 

Se < LOD I 5.739 

As 118.853 ± 14.909 

Hg < LOD J 13.163 

Zn 72.575 ± 16.828 

w < LOD : 91.311 

Cu < LOD : 29.994 

Ni < LOD : 73.393 

Co < LOD : 193.906 

Fe 20265.273 ± 417.559 

Mn 469.816 ± 95.794 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 578 

Mode SOIL 

Time 2010-05-11 16:49 

Duration 30.43 

Sequence Final 

Flags 

BVID 37627 

ADDRESS 2574 Ellison ave 

QUADRANT Fl 

DEPTH 6" 

TYPE CONFIRMATION 

INSPECTOR N. LOPEZ 

ppm Error 

Mo < LOD 8.348 

Zr 506.572 i 16.761 

Sr 155.392 ± 8.724 

U < LOD 14.650 

Rb 68.589 ± 6.648 

Th 15.698 ± 7.456 

Pb 51.915 ± 11.064 

Se < LOD 5.328 

As 106.679 ± 14.537 

Hg < LOD 12.742 

Zn 90.989 i 17.966 

w < LOD 83.513 

Cu < LOD 31.403 

Ni < LOD 74.394 

Co < LOD 193.604 

Fe 20389.500 i 420.588 

Mn 497.116 ± 97.946 

Cr < LOD 773.758 

V < LOD 1293.515 

Ti < LOD 5685.875 

Sc < LOD 482.466 

Ca < LOD 8708.589 

K < LOD 19555.676 

S < LOD 503.256 

Supervised By: 
1^ KA; \ Omaha Lead Site—Fixed Price EP-R7-07-05 

o ^^^T L I Coastal Environmental Group Inc. 

V~^^!j f www.coastalhazmat.com 

^"ipmy ^ COASTA L 

[NVIIOHHINTAl c • 0 u r, r N c 

EXECUTIVE SUMMARY: 

BVID #37627-(2574 ELLISON AVE) 

No Issues or Concerns [^ Issues/Concerns 

Detail Explanation: ] 

-DON BAHNKE WALKED THE PROPERTY ON 9/10/2010 
SEPA 

EPA Property Close Out Form 

Propert Property Addmr / . ; •• n ^ ,>^Tll y #:3!Zjfc2: 2 

Date/Time: ZZZ: ^ OwTe?. N,«e; .^B>r^tlV. Vg-'^^fe^ 

Quad '

 Contractor Group ' ' s Excavated: 

Yes No Eicavation General 

1. If necessBiy, were the coirect quadrant(s) excavated and restored? y r 

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

6 - ^ 

Gradin Yes

 Clo g Sod and Vegetation 

1. Does the grading around the perimeier ofthe house in excavated areas generally slope away yy from Ihe house?

 . 

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

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

4. Are sodded areas generally flrm and evenly graded? c y ^ 

5. Are the joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day 

time period) __^ . 

6. Was the property graded such that water will not pool on the property? y 

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

Gates, Feaces and Retaining Walb Yes No 

I. Do gates open and close freely? (If applicable) y 

2. Were all gates or fences taken down during restoration activities reinstalled? (If applicable) C / " 

3. Was damage to gates or Fences avoided? (Ifappiicable) y 

4. Was danuge to retaining walls avoided? (Ifappiicable) 

Foundation, Sidiag and GnMcrs 

Yes No 

I. Was damage lo the siding or trim avoided? 

t y ^ 

2. Was damage to the foundation avoided? y 

3. Was damage to windows avoided? 

4. Was damage to windows or door screens avoided? ~Z?^ 

S. Was damage to downspouts or downspoul extensions avoided? y ' 

Sidewalks nnd Driveways (Concrete) Yes No 

1. Was damage to driveway surfaces avoided? t y 

2. Was damage to walkway surfaces avoided? y 
Owners comments: 

Inspection notes: 

Removal and resloration aclivales eomplete including the 30-day sod warranty 

EPA Representative j ) ^ /C.j£j - Date:y//6^o/ ^ 
Property Completion Agreement 

I hii agreemenl documenls Ihe complclion ol remedial aciiviiies perlbimed on my properly My signalure 

will designate ihal I am satisfied with the restoralion of my properly, and Ihal no ilems are in questions, 

now, or ai any nme in the ftjlure, except (hose ilems listed below, if any 

Property ID: 3^^^ ^ 

Property Adddrcssy2^Z^r[ d ress y^'/^riL Ui ^C\' J ( t ( f goy> c , (jyjf? ^ 

Owner: P^^^y^ w '^^.<\^ ' 

Phone: qg^ ) ^^^c^f ) 

Restoration Items in Question: 

Item: 

Item: 

Item: 

' Hem: 

Item: 

Item: 

Additional Comments: 

J^ l ayrcc I cstoralion i% completed, rxccpl as noieil 

I J I rio not a^rec resloration is completed 

^ 

Owner's Sijpnanne IJat VJkXKc '^ Con Condarior' d arlor'ss Sienatur Sicnalurec Dale
Property Owner Assessment of Performance Form 

American Recovery and Reinvestment Act (ARRA) 

Omaha Lead Superfund Site 

2009/2010 

RECEIVED 

Remediation Contractor: Coastal Environmental Group - EP-R7-09-06 -«.- . ^ «-.-

Property Identifier Number: ^ 1 G 'ZJl UUI 10 ^UlU 

Property Address Address: ^^Z-^ '^LS^L^j eUr^^pjr lzll'/^CLr^\ f\)(^: MV€. _ SUPERFUND DIVISION

Property Owner's Name; "Dr>.rm^ \^(^ "^^ ' '^'^ 

Instructions to the Propertv Owner; 

This form serves to record the Property Owner's assessment of performance (Incentive 1 

- Quality Assurance Surveillance Plan) involving the listed remediation contractor, as applicable 

to the Omaha Lead Site. This form documents the timeliness of punch list resolution, business 

relations, complaint resolution and the overall quality of work. If need be, the Property Owner 

may utilize this form to record problems and/or issues not specifically tied to an assigned 

address, for example, business relations that generally don't follow the guidelines set forth in the 

Performance Work Statement. 

The Property Owner will indicate his/her assessment df performance with the contractor's 

work by checking a numerical rating on the table below using the nmnerical definitions iix)m 

the rating scale below, then sign & date the form. i 

"excellent" 

7-8 'Very good" 

5-6 "acceptable" 

3-4 "poor" 

1-2 "very poor" 

Propertv Owner's Assessment of Performance Regarding the Contractor's Work 

10 ^^ ^ 5 

9 4 

8 3 

7 2 

6 1 

Propertv Owner Additional Comments from (optional; continue on back page if needed) 

Property Owner Signature: ^^^ ^ ^'^i?-^g^'^^> ^ Date; O^ / ^ / O 
".*.*J . 

mote ID: R page of 

rCei-mite ^k Pest dTontz-ol Inc . 

1-433 0 Oortv y Strec:* : ­ Omab a ^ I>4E : 68 1 « 4 

C402 > T33-1.78 4 

I^OCr^^mOIS I OX>' WO.KC C PJ£BCf OK^4[J£r » 

2S7- 4 igrj.-rgtrT<r A.'VE: . 

L,NB * ea t 1 1 

4 —1 2—20- I O i>i*icrE 

irsivoic^i c -ix»'i">%.a-i 

^I X 

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