### C ONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE US Anny Corps of Engineers
ECC Certification for Property Closeout
OLSID 31808 Property Address 3512 N 26 th St Field Work Started 9 / 1 112007 Field Work Completed 9 / 1212007 Summary: 

## • The excavation was performed in compliance with the w ork plans and specifications
. 

## • F 1 excavation depth wa s 5 inches below ground surfaces
. 

## • F2 excavation depth was 5 inches bel ow ground surfaces. 

## • B I excavation depth was 5 inches below ground surfaces. 

# • B2 ex cavation depth was 5 inches below ground surfaces. 

# • Drip zone garage excavation depth was 13 inches below ground surfaces
. 

## • Verification samples confirmed that cleanup standards were met. 

# • The site was backfilled with material which meets the contract specifications. 

# • The backfill was compacted to acceptable standards. 

# • Site restoration was conducted in compliance with the specifications and work plans.

Comments: Per owners ' re quest: seed onl y 

# ,£ "H b .;.v"l ECCQCM

## II)**'/~** , Name Title Date

# :J leffHubbard USACE Co n Rell i{J 

### ·J.S-LI Name Title Date Sign 'ile

## 3 f 

## BOB North ArrCIrN Exterior Paint Omaha Lead Site Owner Name: (I) iTCH ELL- 

## 781"'-' 

# is. 

# o Good Site Sketch Address: .3S{';:J. N ':<0 

### ST 

## n Poor

Phone: H: 4Q')· Q6'7;)... W : .:tS'D- bUP

### OLS**_~F.!:::.?1-'.!W~** ___ XRF Code 

### £775 Lead Concentration 

### S.e ppm



### 1/5 ppm 

### It?'i ppm LogBook 

### 165 ppm

__ ::---r--JPpm

### ~**_--,U~¥~_--,ppm _~5.",-,'O~_--,ppm** 

_____--'ppm ppm Legeno:**~1** "**~ront** Len ,**~2** " !-ront Ri ght, B1 "Back left, B2" Back Right DZ" Drip Zone, GZ" Garden, PZ" Play All Quadrants are as viewed from the street, facing property 

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### CONTRACT 

### # W912DQ-04-D-0017, T.O. DK04 Environmental Chemical Corporation Omaha Lead Remediation, Omaha, NE US Army Corps of Engineers 

### Analytical Results Summary OLS#31808 3512 N 26 th 

### St Quadrant Sample Depth Date Collected XRF Results Type (ppm) (avg.) 

### DE F1 5 9/11/2007 

### DE DE DE DE DE 52 115 103 165 50

SAMPLEIDSAMP LE 10 is a particular residentiaJ property ID from which the sample is collected
. The sample type identifier (with sequential sample number for that location) as follows ; PX

- Pre-Excavation XRF sample DE
... Duri ng and Post Excavation Quadrant descri bes the sampling location (with sequential sample number for that location) as follows; Fl or F2 = Front Yard One or Front Yard Two Bt or 82 - Back Yard One or Back Yard Two DZ • Drip Zone GA

- Oarden PA - Play Area EA = Easement Depth describes the depth from which the sample was collected. ppm = parts per millionPage 1 of

_____ 

## "'3J SOb Omaha Lead Site Omaha, NE U.S. Envirorunental Protection Agency Region VII Residential Yard Soils Environmental Restoration Services PRC)]>[ I{ I) \l ( I SS (tl1 be Ullllpk'lLd b) PlllPl'I!\ 0\\ 11l'1 ) 1\11 d I <...l**il~ll** ("-..1.1 1,11111.1 L"ll,111(lI IWI 1.\\ llt I lell II 1.-' .11**1-8r)()-~~~-()-L~""** Grantor (the property owner), consents to and authorizes the United Sates Envirorunental Protection Agency (USEPA) or its authorized representatives (or its contractors), the Grantee, to enter and perform certain envirorunental response activities upon the following described premises. For further information please contact EPA at 1-800-223-0425
. Property Access Granted By ·'Yp:'TCMJf" (.k 

### ,0 A- V 

### I l> (Please Print Name) (Date) NOTE: Granting permission DOES NOT necessarily imply yourproperty will be remediated at this time. [,RO!'I RI,)**I~I()R\I\IIO,** (Iu bL' cUlllpkkd b) lL'''llillll .llld III pi lllJL'1t) O\\JlLJ Pk'.ht.' PI lilt) Resident Name:

________________ DOwner 

## o Renter Residence Address: 

## '3 S 1'2.. 11_ 

### d- (5 s-;­ (CITY) (STATE) (ZIP) Property owned by: 

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### OAl/.!:. 

# > Owners mailing address: 

# P. 0 eN:> '( 

## 3 

## 4 LA I 

## J Owner's telephone number

- Home: 

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### b'io'1«, Work:

___________ Age of Home? 

### -'L"-l.OLT-'--

______ years How long have you lived here?

_____ years Has the exterior been painted or covered with siding since 1978 DYES L?l NO Has the interior been painted or covered since 1978? DYES**~NO** Total number ofoccupants:

_______ List Ages:

________________ List ages of occupants under 6 years old who play in the yard for 5 or more hours per week:

_______ Comments:

____________________________________ AUTHORITY FOR ENVIORNMENTAL RESPONSE ACTIONS The activities to be implemented by EPA Wider this agreement are pursuant to Section 104 ofCERCLA, 42 US c. 9604 . EPA's right of access to the property for in Section I04(e} ofCERCLA, 42 U. S.C
. %04 (e), which provides entry for , "determining the need for response, or choosing or taking any response action under this title, or otherwise enforcing the provisions of this title ," Access Attempts: First:
___________ Second:

________ Third:

_________

# , pg._of_ 

# List of Existing Conditions Property Address: 

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### SignContract No. W912DQ-04-D-0017, Task Order DKOI Omaha Lead Site, Omaha, NE Property Closeout Agreement 

### BVID 

## :) JitJ8' Property Address 

# I JSIJ. N**~"sr** Is the Owner the Resident? DYes

### ~o Property Owner 

### /Yl (rNI'P 

### i L 

### 1\ 11-111**~** Compliance Statement: U.S. Environmental Protection Agency (EPA) has contracted the U.S. Anny Corps ofEngineers (USACE), Omaha District to conduct environmental restoration services for the Omaha Lead Site. USACE Omaha is working with Environmental Chemical Corporation (ECC) to remove lead contaminated soil and provide subsequent restoration services. Your cooperation in giving EP A/USACElECC permission to access your property during the removal/restoration phase is sincerely appreciated. This document certifies that all work performed at this property was completed in accordance with the contract specifications and EPA requirements. If you have questions or need additional information please contact Don Bahnke, EPA Project Manager, at (9\3) 551-7003 or the Office ofExtemal Programs at 1-800-223-0425
. Additional Comments by USACE andlor ECC:

CONTRACTOR CERTIFICATION Prashant Khanna or Charles "Skip"Milton ECC Project Manager Name Title Date Signature 

### PROPERTY OWNER SECTION This agreement documents the completion ofremedial/restoration efforts at the property to my satisfaction.

## ~I agree that restoration is completed at my property, except as noted Comments (if applicable): 

# xiV J:tIujj 

# tJ {Ii

# I~**IO·~,2r-?J7** Property Owner's Signature' Date

## Property Owner Satisfaction Survey Form Omaha Lead Superfund Site Perfonnance-Based Contracting (PBC) Pilot Project Remediation Contractor:

### _-,£",,-~CC::::lo.

## ________________ Property Identifier Number:

________ Property BVID Number:
_ 

## 3,L/LJ8''''-'''tJ'-'?'--

___ ......... Property Address: 

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### _________ Property Owner's Name: 

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### LL DI!IJI S­ (above infonnation to be filled out by remediation contractor prior to delivery of fonn to Property Owner) *.*******************************************************.******************** Instructions to Property Owner: This form is provided to you as a means of trying to capture your level of satisfaction with the work of the above-identified Remediation Contractor, as applicable to the soil cleanup action at your property. The U.S. Environmental Protection Agency (EPA) and the U.S. Army Corps of Engineers (USACE) are very interested in your opinion regarding the work performed by our contractors. This form is intended to provide an easy means for you to express your opinion about the work performed on your property. Please indicate your level of satisfaction with the Contractor's work by selecting a numerical rating (ranging from 1 to 10) using the following rating scale, then please sign & date the form and retum it to USACE in the attached self-addressed & stamped envelope. (Additional comments may also be provided in the space provided, at the option of the property owner.)

# ~ "excellent" 

### W"very good"

5-6 "acceptable" 3-4 "poor" 1-2 "very poor" Property Owner's Satisfaction Rating regarding Contractor's Work 10 5 9 4 g 3 7 2 6 1 Additional Comments from Property Owner (optional; continue on back of page if needed)

Property Owner's Signature:

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# ¢**~** Date: